HSJ’s roundup of Thursday’s must read health policy stories
- Today’s must know: Swindells to join NHS England as national operations director
- Today’s talking point: Landmark £800m outcomes based contract collapses after eight months
- Today’s risk: Possible legal challenge over better care fund millions
An £800m mess
One of the biggest contracts ever tendered in the NHS has collapsed. The ambitious contract for older people’s services in Cambridge and Peterborough has been handed back to the clinical commissioning group after both purchaser and provider agreed it was not financially sustainable.
The £800m, five year deal only went live in April.
The provider consortium, UnitingCare, was a limited liability partnership co-owned by Cambridgeshire and Peterborough FT and Cambridge University Hospitals FT.
The deal was not only noteworthy for its sheer size. It was an early attempt to completely rethink how contracting operates in the NHS, using a capitated budget for a defined population and holding a single lead provider to account for patient outcomes, rather than paying for activity or episodes of care.
Its collapse raises questions about this outcomes based contracting approach, which is being adopted by many CCGs both for individual services such as musculoskeletal, and for broader based populations. But it will also be important to learn why the contract collapsed – did the CCG underestimate the cost of providing the service, or was UnitingCare’s bid unrealistic?
Finally, questions have again been asked about the involvement of the Strategic Projects Team, which advised Cambridgeshire and Peterborough CCG on this tender. The team has been involved in a number of controversial exercises including Hinchingbrooke, the friends and family test, and the abandoned George Eliot and Weston Area Health Trust procurements.
New era for New Labour
“We’re getting the band back together,” was Your Humble Servant’s take on Simon Stevens’ decision to hire Matthew Swindells, a fellow former health policy adviser of the Tony Blair era, as his director of commissioning operations and information. And HSJ editor Alastair McLellan has pointed out the remarkable parallels between their careers: both were NHS managers, Labour party advisers, then moved to the private sector and held senior roles with companies in the US. In Mr Swindells’ case, he will join NHS England in “late spring” next year from his current vice president role at the global IT firm Cerner.
He will also be reunited with Ian Dodge, another senior civil servant and adviser during the Blair period, who is now commissioning strategy director at the NHS quango mothership. This means the re-establishment of the “Swindells and Dodge partnership” – a title perfect for a parody firm of untrustworthy lawyers, if anyone wants it.
NHS England has also hired Pauline Philip, chief executive of Luton and Dunstable University Hospital Foundation Trust, as its national urgent and emergency care director, on a secondment basis.
Despite the better care fund being born to bring health and social care together, a potentially ugly dispute has broken out between Wiltshire Clinical Commissioning Group and Wiltshire Council over BCF payments.
The council claims it is owed £2.3m, but the CCG is withholding this payment “in line with national guidance”.
NHS England guidance on the BCF says a portion of the fund should be withheld under “payment for performance”, and will only be paid if targets attached to the fund are met. The council is not recognising this payment for performance criteria, the CCG said.
Separately the CCG’s auditors have looked at the use of the better care fund and found “no evidence” that another £2.3m set aside for adult social care had been used for this purpose.
Ominiously, the CCG has warned that the council could launch a legal challenge.