HSJ’s round-up of the most important stories in health policy

PCS in ‘almighty mess’

NHS England’s decision to outsource a set of unglamorous but utterly critical primary care support functions last year is not currently looking like a wise one.

It’s (relatively) early days, in that Capita is only a few months into a seven year contract, but after a period of calm – before the company tried to change the service – it is clear that there are now systemic problems with PCS.

Two things have gone wrong. First, Capita do not seem to have been able to manage the movement of information around the system: routine tasks like moving paper records from one GP practice to another; supplying pharmacists with the right paperwork; and invoicing and payments seem to have broken down.

Second, Capita has clearly underestimated just how wrong things could go: its call centre has not been able to cope with the amount of order queries and complaints it has had to deal with. This leaves providers with two problems: the original one, and the time and effort they have to waste time chasing up the mistake.

Chaand Nagpaul of the BMA’s GP committee makes a useful observation to be considered in future outsourcing programmes: “The idea of outsourcing appears attractive in offering more for less, but that is based on a very simplistic view of how the NHS functions… The NHS functions on organisational memory, and you cannot just take a service over and run it better.”

Unwanted records

The number of patients waiting for an elective procedure could be as high as 3.7m, according to NHS England’s latest data – the highest level in nine years.

Official figures released on Thursday said the confirmed total was 3.5m but when trusts that were unable to report their waiting times data were factored in the total was higher than at any time since December 2007.

To add to the misery, the English NHS has also recorded its worst yearly results for four-hour waits in A&E since the target was introduced.

The data shows performance against the target that 95 per cent of patients should be treated within four hours dropped to 87.9 per cent in 2015-16.

Read waiting times expert Rob Findlay’s in-depth data analysis on hsj.co.uk for the story behind the numbers.