• Report into conflict of interest and bullying released after HSJ Freedom of Information Act request
  • Verita investigation finds catalogue of failings at Crawley CCG
  • Governing body tried to overrule whistleblower who said chair had breached conflict of interest rules

The governing body of a clinical commissioning group bullied their head of governance in an attempt to protect their chair, who had breached a conflict of interest rule, an investigation has found.

A review commissioned by NHS England into Crawley CCG, released after a Freedom of Information Act request by HSJ, makes wide-ranging criticisms of senior leaders.

An internal investigation by the CCG in 2017 found its chair Alan Kennedy had breached conflict of interest rules by advocating for a technology company that had paid his consultancy firm £35,000.

The report published this week, produced by the investigation firm Verita, found the CCG had attempted to rerun the investigation and that the chief clinical officer had bullied the head of governance.

The chief clinical officer, Amit Bhargava, previously a well-known GP leader, retired in July 2017 and chair Alan Kennedy resigned the same month.

The report said: “The response of the governing body to the allegations against Mr Kennedy was to try to protect their colleague. It would have been better if they had avoided discussion of the matter and allowed the proper processes to be followed. For the governing body to act inappropriately in this way amounted to bullying.”

It also stated: “While this was to some extent understandable, it was also inappropriate. A process was being followed and that did not include the governing body and they should have avoided intervening.”

It added: “Dr Bhargava’s response to [the internal] report appears to have been motivated by a desire to protect a valued colleague. It is evident from Dr Bhargava’s emails that he put emphasis on putting Mr Kennedy’s case forward, repeating the incorrect assumption that Mr Kennedy had not had an opportunity to put forward his case and pressing for [the] investigation to be re-done.

“In fact, Dr Bhargava should have been taking a position of strict neutrality, particularly as the second in command of the organisation which was dealing with problems relating to the most senior person. He completely failed to fulfil his responsibilities in this regard.

“It is also clear that Dr Bhargava acted inappropriately towards [the CCG’s conflict of interest guardian], most particularly in their meeting of 8 May where an independent witness describes him as hostile, angry and bullying.”

Breach of Nolan principles

The Verita report found that the pretext for the proposed second CCG-led investigation was that Mr Kennedy had said he had not had an opportunity to put his side of the case. The Verita report said this was “misleading”. HSJ has approached Mr Kennedy for comment.

Verita concluded Mr Kennedy had breached the Nolan principles on standards in public life, and said in its report: “The evidence is overwhelming that [his] business interests created a conflict of interest for him and that this conflict was not handled appropriately by either the CCG or [him].”

Mr Kennedy’s company Fusion Healthcare had been paid by Redwood Technologies Ltd. The Verita investigators said there was no suggestion of criticism of the latter firm.

The investigators quoted a GP and former member of the Crawley governing body as saying: “He took no end of people up to Redwood, kept on mentioning that in terms of the way in which other organisations, other areas have linked into that technology, something that could really get going, but he did say, ‘I can only go so far with this, everybody else has to take it and run with it, and do whatever with it, if that’s what they decide to do, but it’s a really good thing, I think, and certainly worth looking at.’”

Verita said the conflict of interest had continued for a long period of time and become “normalised”.

The investigators recommended that conflict of interest registers should provide details of the relationship being declared and that governing bodies should see the declaration “as the beginning of the management process for the conflict, rather than as an end in itself”.

The report said: “It may well have been, as several interviewees suggest, that Mr Kennedy was motivated by the best intentions to share his knowledge and enthusiasm for technological initiatives that were valuable to the NHS. Nevertheless, he was doing so while being a paid consultant to a particular supplier. This was inappropriate.”

The CCG would not confirm to HSJ how much it or Horsham CCG – with whom it shared a finance director – had paid Redwood. The report said the “payment terms were generous to Redwood. It seems to us unusual for a CCG to pay a monthly fee spread throughout the year in one go right at the beginning of the year”.

‘Substantially more expensive’

The report also singles out the former finance director, Barry Young, for criticism, saying he had failed to “respond appropriately” to the chair’s COI declaration.

It added: “The documentation is unclear but it would appear that the quotation from Redwood is substantially more expensive than the alternatives.”

It said there was “poor financial control”, “poor contracting practice” and “poor financial governance”, and added: “These failings would be disappointing in any organisation. When they relate to a supplier which has a financial relationship with the chair of the CCG, they give serious cause for concern.

“In our conversations with the chief finance officer, [he] has not demonstrated a grip on these issues. Despite being given advance warning has been unprepared and unable to explain the circumstances behind these issues, appeared to have given no consideration to how the issue of the wrong payment might be resolved (in cash or accounting terms), although told us that this has now been addressed. We found explanations confused and unclear.”

In a statement, the CCG said the organisation had “changed significantly at all levels in terms of its leadership arrangements” since the events of 2017.

The chair, accountable officer and finance director role are all now held by new appointees.

A spokesman said: “Crawley CCG has been working with neighbouring CCGs under a single management and operational structure for the last 18 months and this has enabled widespread improvements to its processes and procedures. The CCG had the legal directions for quality of leadership lifted by NHS England in November in recognition of the improvements that had been made.”

He added: “We are committed to being open and transparent.”

HSJ has asked Dr Bhargava for comment, and asked the CCG whether it could seek response from Mr Young.

Since the publication of HSJ’s story, we note that Verita has published a statement made by Redwood Technologies. It can be read here