‘Considerable disquiet’ over lack of savings from £7m consultancy contract

Cornwall Partnership Foundation Trust contracted Newton Europe in 2019 to work on a health transformation project called Embrace Care, which aims to improve treatment of over-65s across the county. The programme was also expected to deliver cost savings.

It has been led by the trust on behalf of the county’s integrated care system, and has been disrupted and delayed by the pandemic.

In its audit report for 2020-21, the trust’s external auditor Deloitte said: “The Embrace project with Newton Europe… has caused considerable disquiet within the board and an acknowledgement exists that it has delivered no tangible savings.

“Although post covid-19 restrictions (sic), restarting the project may ultimately deliver financial savings, the current position is that the total spend of £7m is not considered to have provided value for money.”

The report, which is dated 6 September but was published this week alongside the trust’s annual report, earlier states the trust has “spent approximately £7m with Newton Europe”.

The trust said the programme was not fully implemented and is no longer running, but that “its ethos forms the basis of our approach to providing health and social care”.

The Embrace project was initially launched in the spring of 2019, with Newton Europe involved in working on the design and testing of the model. It was paused in late March 2020 due to the outbreak of the pandemic, before the implementation phase.

The project restarted again in September 2020, but the following month health chiefs decided not to proceed with implementation in the way that was originally planned, and it is understood Newton Europe left the programme at the end of October 2020. This meant the implementation of the new model of care was not progressed, and the expected savings were not achieved.

The consultancy spending is one of several incidents which has led the trust’s auditor to warn that CPFT is at “significant ongoing risk” of “not achieving value for money” within its governance, amid a string of board-level failures in the last 12 months.

According to past CPFT board reports, concerns were raised about the Embrace project by various directors over the last year.

In November 2020, non-executive director Nick Lewis “wanted an explanation around the Embrace project” after chief executive Phil Confue said the trust had committed to another £1m of spending to the project.

Rich Lake, the trust’s interim director of finance, told the same meeting that bringing in consultants was an “expensive way of operating and unfortunately de-skills our staff”.

In April 2021, the trust’s finance director Sally May told the board there was “little evidence of to support any financial benefits of the project”.

One senior source in the Cornish NHS told HSJ the programme “could and should” have delivered service and financial benefits, but it was “poorly led” by the ICS and “impacted by covid-19”.

HSJ has asked the trust and ICS what the overall spending on the programme has been. 

Newton Europe, which offers “operational improvement” to the NHS, did not wish to comment. But the company flagged several projects it has delivered, such as a similar scheme in Birmingham.

A spokeswoman for CPFT said: “The arrival of covid meant the recommendations could not be fully implemented, although closer partnership working has delivered significant benefits to our patients.”

What was the Embrace Care programme?

The Embrace Care programme aimed to reduce the number of over-65s needing hospital treatment by ensuring individual packages of home or community-based care are put in place to treat patients away from hospital. 

Since re-launching in September 2020, the programme tried to improve collaboration within the Cornwall ICS to make hospital discharges, home care commissioning, community intervention, and bed-based reablement more efficient. 

Governance problems at CPFT

HSJ has previously reported how NHS England intervened in the running of the trust, after a review identified multiple governance concerns and found “reasonable grounds” for further independent investigation of bullying by an unnamed senior manager at the trust.

Meanwhile, former CEO Mr Confue was among four executive directors who received “inappropriate” overtime payments during the early stages of the pandemic, for which the trust later apologised.

In January the trust appointed Caroline White as a new director of governance and agreed a set of improvement tasks with NHS England.

In CPFT’s annual report, auditors Deloitte said the trust had made progress in strengthening its governance, but it still had concerns.

The CPFT spokeswoman added: ”The governance improvement plan contained a small number of long-term actions that are now part of the objectives assigned to individual directors. All other actions in the plan have been implemented.”

• Article updated at 10.27pm on 12 October to clarify that the Embrace Care programme restarted in September 2020 instead of October 2020.