Executive Summary: It's quiet... too quiet

Silence isn’t golden in contract fiasco

When the news broke last week that one of the biggest contracts ever put out to tender by the NHS had collapsed just eight months after going live, the story shot straight to the top of hsj.co.uk’s most popular and most commented lists.

The amount of time, money and innovation involved in the £800m, five year contract to provide older people’s care for Cambridgeshire and Peterborough had attracted widespread interest.

And yet neither the commissioner, Cambridgeshire and Peterborough CCG, nor the provider, the Uniting Care Partnership, has proven willing and able to give an explanation for the rapid collapse. Their silence is “troubling”, says HSJ senior correspondent David Williams.

All that both sides have said is that the arrangement was not “financially sustainable”, and the contract has been handed back to the commissioners.

But, Williams writes, “the truth is that for a contract to be handed back this rapidly it can never have been financially sustainable, but neither party has attempted to explain why this was the case”.

He continues: “When a five year contract of this size and this importance to some of the most vulnerable people in society fails, it is not enough to shrug and walk away. The £1m-plus spent on setting this up – and the amount of senior NHS leadership time devoted to the tender – make this a matter of national public interest.”

At the very least, “a fuller explanation is owed to the 1,200 staff who were transferred to new employers because of this deal, after two years of uncertainty over the future of their jobs”.

The CQC still brandishes the stick

Yesterday the Care Quality Commission confirmed the appointment of Peter Wyman as its new chair – no great surprise after he was given the thumbs up by the Commons health committee last week.

One of the things in Mr Wyman’s in-tray when he starts the job in January will be the implementation of the regulator’s new “use of resources” ratings, which will be piloted from April.

The CQC is going to consult on the detail of its proposals in the new year, but HSJ has received an indication of the regulator’s current thinking about how the new regime will work.

According to Alex Baylis, the CQC’s head of acute sector policy, trusts found to be performing poorly on efficiency are unlikely to be put in special measures.

The CQC does not have authority to take action against providers for being inefficient, so it will have to work closely with NHS Improvement (which will have such powers) once it is up and running, to make the regime work.

However, a report by the CQC in October said it was looking at how to “incentivise” providers to pursue an outstanding efficiency rating, and what “sanctions” might follow an inadequate rating.

In other words, the use of a regulatory stick has not been ruled out yet.