Commissioners have agreed to help an acute trust access more incentive funding through changing the way its accident and emergency performance is reported – despite the decision breaching procurement regulations.
Kernow Clinical Commissioning Group will amend its adult community services contract to allow Royal Cornwall Hospitals Trust to become the provider of Cornwall’s nine minor injuries units.
The units are currently run by Cornwall Partnership Foundation Trust, but transferring the responsibility to Royal Cornwall means its A&E performance will improve – boosting its chances of achieving its A&E trajectory and unlocking more money from the sustainability and transformation fund.
However, in its board papers the CCG said approving the request would be a breach of the Public Contracts Regulations 2015 because it would constitute a direct award of a contract.
The service has a proxy value of £6.3m, the board papers said. The request was submitted jointly by both trusts, and Royal Cornwall intends to subcontract the service back to Cornwall Partnership – meaning existing management arrangements will not change.
The CCG said in its papers there would be no impact on the service provided to patients.
A spokeswoman said the CCG sought legal advice over the request, and the papers show its finance committee believed a challenge from another provider was “unlikely”.
The spokeswoman said the contract amendment would provide “consistency in the reporting of activity against the national four hour standard”.
“Given the importance of these services and the joined-up approach that is being taken to deliver a clinically led integrated health and care system in Cornwall and the Isles of Scilly, the proposal was approved,” she added.
“At present the delivery of minor injury service is provided by Cornwall Partnership, while Royal Cornwall provides emergency care from Treliske Hospital, Truro, and a minor injury and urgent care service from West Cornwall Hospital, Penzance, under a separate contract.
“The activity and performance at Treliske and West Cornwall hospitals is reported differently than the other minor injury units and does not give a true reflection of our activity levels.
“It is not uncommon for two individual providers working in the same community to combine their emergency department and minor injury activity when reporting against the four hour standard and this variation brings Cornwall and the Isles of Scilly in line with other parts of the country.
“This change is not intended to have any impact on the quality of service or care, but Kernow CCG will continue to scrutinise this as part of its regular contract monitoring.
“It’s important to stress this contract variation should not be seen as the only way health and care services are working collaboratively to ensure people access high-quality care, when they need it.
She added: “Achieving this will help reduce pressure in other parts of our system – such as the emergency department – and ensure people get the care they need, when they need it.”
CCG statement and board papers
6 July 2017