Two commissioning support units have not made it onto NHS England’s procurement framework – placing their long term future in doubt, HSJ has learned

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5.55pm BREAKING: Two commissioning support units have not made it onto NHS England’s procurement framework – placing their long term future in doubt, HSJ has learned.

North West CSU, which serves clinical commissioning groups in Cheshire, Merseyside and Greater Manchester, and Yorkshire and Humber CSU, were unsuccessful in their bids for accreditation to provide the full range of “end to end” support services.

Staff at the CSUs have been briefed on the issue today, HSJ understands.

The CSUs collectively serve 47 CCGs. In 2013-14 their combined turnover was £183m.

It means that the following CSU bids were successful:

  • North of England CSU;
  • South East CSU;
  • Greater East Midlands and Arden CSU;
  • Midlands and Lancashire CSU;
  • North East London CSU;
  • South CSU and South West CSU; and
  • Central Southern CSU.

Since bidding separately for accreditation onto the framework, Central Southern, South West and South CSUs have announced they will merge.

HSJ has not yet learned the outcome of any of the non NHS bids for the framework.

In August, HSJ reported that the following had been invited to tender:

  • Essex Council Council;
  • Surrey County Council;
  • Mouchel, BDO, Engine and Dr Foster Intelligence co-bidding as “MBED”;
  • Capita;
  • SSG Health; and
  • UnitedHealth UK (trading as Optum) and its supply chain partners including BT, KPMG, BDO, Healthskills, NHS Greater Manchester CSU, Hanover Media and CSC.

The procurement framework is being established by NHS England to ensure that CCGs had a choice of quality assured support services. CSUs have spent the past year preparing and refining their bids for the scheme. A year ago NHS England announced that CSUs that did not win accreditation had no viable future.

The impact for the two CSUs which were unsuccessful is unlikely to be immediate, as they hold CCG service level agreements which are in many cases likely to run until next summer.

It is currently unclear what the future prospects for the staff who work in them will be, and whether the CCGs they serve will have to procure an alternative provider or whether the transition will be managed by NHS England’s business development unit, which has managed CSUs until now.

5.40pm Clinical commissioning groups are considering swapping GPs with their neighbouring groups to safeguard against potential conflicts of interest in commissioning primary care.

CCGs have been invited to submit proposals to co-commission primary care, which is currently the responsibility of NHS England’s area teams. HSJ revealed this week that 77 groups are bidding for delegated responsibility, meaning they would be responsible for the performance management and budgets of their member GP practice

3.02pm The BBC reports that accident and emergency waiting times in England have improved to their best level since November, but targets are still being missed, according to official figures.

2.40pm The Independent reports that prescribing statins to more people could have the unintended effect of “widening social inequalities”, a new study has claimed.

The cholesterol-lowering drugs, which are set to be prescribed to millions more in the UK, have saved 50 per cent more lives among the richest people in the country than among the poorest, researchers from the University of Liverpool found.

2.33pm Local regulation of midwives should be scrapped according to a report by the King’s Fund which has found “no evidence” to justify its existence.

Midwives are currently regulated in a two tier process by local supervising authorities made up of senior midwifery staff which both regulate and support midwives. Midwives are also subject to the national Nursing and Midwifery Council code of conduct.

The review, commissioned by the NMC after concerns over failings of the supervisory system during poor maternity care at Morecambe Bay Foundation Trust, said midwives should have the same single tier regulation as nurses.

An independent inquiry into failures at the trust is due to report next month.

2.14pm Commissioners have voiced concern that their efforts to integrate services will be hampered by ‘enforced competition’ after Monitor released a report warning them against simply rolling over existing community services contracts.

1.46pm We’re aware there’s been some problems with our newsletter today. Please accept our apologies, we’re doing our best to fix it right now.

1.20pm Shadow care minister Liz Kendall has said “there will remain a role” for the private and voluntary sector in the NHS “where they can add extra capacity to the NHS or challenge to the system”.

Her remarks suggest difference in stance with Labour leader Ed Miliband and shadow health secretary Andy Burnham, who have both highly critical of what they claim is the privatisation of the health service under the coalition government.

Speaking to The House magazine, Ms Kendall said “I’ve always believed what matters is what works”.

She noted the positive role played by independent sector treatment centres  in reducing waiting times.

“It was the NHS – and the increased investment we put in the NHS – that delivered the vast majority of the reductions in the waits. But some challenge in the system was crucial to that,” she said.

She also stressed that NHS involve more than just involving the private sector.

“I think people do worry that there is a kind of ‘reform’ which is to just ‘put it out to the private sector’, when actually what you want is to reshape services locally and, I would argue, nationally too,” she said.

“Salami-slicing cuts and simply putting things out to tender isn’t what I call real reform.

“That isn’t to say that there isn’t an important role for the independent and private sectors. But real reform is more difficult than that.”

12.30pm Liverpool Community Health Trust has stopped delivering health services at a prison, following a Care Quality Commission inspection which found the trust was not meeting quality and safety standards.

The regulator carried out an unannounced inspection at the health suite of HM Prison Liverpool, in Walton, on 31 October and 1 November in response to concerns that standards were not being met.

The trust had already confirmed in November that it would not retender to run offender health services in future when the contract comes up again in June.

12.00pm Commenting on the Medical Innovation Bill, which is in its third reading in the House of Lords today, the Royal College of Psychiatrists president Professor Sir Simon Wessely said:“RCPsych understands and sympathises with the sentiment behind the Medical Innovation Bill, but regrettably cannot support it in its present form.

“We have significant concerns that the Bill in its current form is unnecessary, leaves the door open for irresponsible practice in the name of innovation (which could be detrimental to patients), and also fails to provide any mechanisms to promote good innovation for the benefit of patients.
“We note and respect the clear legal opinions of Sir Robert Francis QC as to why this Bill is unnecessary.  The current law of negligence does not prevent responsible innovation and never has. The Medical Protection Society, which has extensive experience of issues of clinical negligence and advising doctors on ethical and medico-legal matters, has clearly stated it is not aware that a fear of clinical negligence claims is preventing doctors from being innovative.
“The Bill’s current provisions about the need for doctors to obtain the views of potentially just one ‘appropriately qualified’ doctor and ‘taking account’ of their views before undertaking innovation treatment are worryingly vague, and provide an insufficient safeguard for protecting patients against an unjustifiable risk of harm.
“The Bill would also significantly inhibit genuine medical innovation. If innovation is to be of any real benefit it has to be a collective and not an individual activity. The lack of reference in the Bill to the need to record and disseminate knowledge about a new treatment or procedure practised by an individual clinician will result in a missed opportunity to bring about any potential wider public benefit from its provisions.

“Moreover, if individual clinicians feel that the Bill offers them the opportunity of by-passing the need for clinical trials on a regular basis, this could significantly undermine recruitment to and participation in proper clinical trials which are key to finding innovative new treatments. This would be detrimental to patients in the long term.”

11.53am The Guardian reports that the NHS will end up with a £65bn hole in its finances by 2030 unless ministers plug the gap or allow the quality or availability of care to slip, health economists have said.

Analysus by the Health Foundation identifies the sum as the extra amount of Treasury funding the NHS will need by then because it is unlikely to meet unrealistically optimistic productivity targets.

It says the NHS will need its budget to rise by 2.9 per cent a year above inflation each year between 2015-16 and 2030-31 if it is to maintain the standard of services and avoid having to ration access to treatment.

11.42am Responding to accident and emergency figures released this morning, shadow health secretary Andy Burnham said: “These figures show that hospitals all over England remain at their limits and are sailing dangerously close to the wind.

“The Tory A&E crisis shows no sign of easing and too many patients continue to suffer poor care. It is having a damaging effect on the care of thousands of patients right across the NHS, with far too many now suffering the distress of having even the most urgent operations cancelled at the last minute.

“David Cameron must personally explain the steps he will take to bring England’s A&Es back up to acceptable standards. He caused this crisis by making it harder to see a GP and taking social care support away from hundreds of thousands of people.

“The Prime Minister has failed to produce a plan to turn things around and his complacency cannot continue. The Government is gambling with patient safety and allowing far too many patients to be exposed to far too much risk – proof you can’t trust the Tories with the NHS.

“Without solutions to their own crisis, the Government should implement Labour’s five-point A&E plan without delay.

“They should match Labour’s commitment to give the NHS an extra £2.5bn each year to provide a long-term solution to this crisis and recruit the doctors and nurses it desperately needs.”

11.27am The Guardian reports that the NHS has disregarded tens of thousands of requests by patients to opt out of the health service’s system of sharing medical records.

Officials have admitted that not sharing the data would affect the treatment patients received – such as cancer screening services, the paper writes.

Under guidelines released by the NHS last year, patients had been told they could, without affecting their care, “object to any information containing data that identifies you from leaving the secure environment…”

However, in a letter to MPs, the head of the Health and Social Care Information Centre, which collects patients data, admitted that “none of the objections registered by patients…have been enacted.”

11.15am Also in The Times, a 91 year old RAF veteran has been awarded £60,000 in damages after his council held him a dementia unit and charged him 17 months of fees.

While social workers have the power to place an elderly person in residential care to maintain their own safety if they believe they no longer have the necessary mental capacity to live independently, the Court of Protection ruled that Essex council had breached various safeguards.

11.11am Splits have emerged within the cabinet over plans to ban branding on cigarette packets, The Times reports.

Philip Hammond, the foreign secretary, suggested yesterday that he may not back the policy, warning it could lead to an increase in illicit cigarettes.

The ban could come into force in May next year after a free vote next month.

10.27am The Times reports that doctors will be drafted in to provide emergency cover for the ambulance service if anational pay strike goes ahead next week.

GPs and hospital staff have been asked to help if paramedics and ambulance technicians strike for 12 hours as planned on Thursday, as unions warned last night that they would not back down.

10.16am The chair of the Care Quality Commission has written a column in The Times defending the decision to rate Hinchingbrooke Healthcare Trust as “inadequate”.

Writing in the Thunderer column, David Prior said while he had hoped the CQC’s inspection would reveal “an outstanding institution providing care to the highest standards… what [inspectors] saw simply wasn’t good enough”.

He rejected claims made by the Daily Mail that the CQC judgments reflected an anti privatisation bias.

Mr Prior, who has previously been accused of “helping the Tories to pave the way for the privatisation of the NHS”, said “If we are attacked by both sides of the privatisation debate, we are probably doing something right”.

9.55am In case you missed it when the story broke yesterday, the government has raided a £240m NHS technology fund to bolster financial support for hospitals struggling with accident and emergency demand this winter, senior sources have told HSJ.

Senior health service figures said a large amount of the money originally earmarked to help pay for projects such as digital patient records had now been diverted into the £700m winter pressures fund.

9.52am Attendances to major A&Es continued to fall according to last week’s figures, with 244,546 patients turning up – the lowest number since January 2013.

However, providers managed to only slightly boost their performance against the four hour target, with 88.5 per cent of patients seen within the target compared to 84.3 per cent the previous week.

Emergency admissions were also down on previous weeks, with 73,104 patients admitted via major A&Es compared to 75,546 the previous week.

The number of patients waiting longer than four hours to be seen also dropped slightly – down from 39,705 the previous week to 28,620 in the latest figures.

9.35am The Financial Times reports that tobacco companies have said they would be prepared to sue the government if it forced them to remove branding from cigarette packaging.

Cigarettes could be sold in plain, unbranded packets in England as soon as May 2016 after the government said it would try to pass legislation before the general election this year.

The UK’s biggest seller of cigerettes, Imperial Tobacco, accused the government of electioneering and said it would “seriously consider” legal action when the final legislation is published.

9.30am Medical professionals who work for both the NHS and privately could face unexpected tax charges because of changes to pensions rules, according to chartered accountants Blick Rothenberg LLP.
Nimesh Shah, partner, said: “Thousands of medical professionals may be unaware of the new rules which came into effect on 6 April 2014 and they could be facing an unexpected bill.
“The first problem with the new rules is the reduction in the amount that a person can contribute annually to their pension. This is now capped at £40,000 and contributions in excess of this amount will no longer attract tax relief.
“Secondly, the amount a person can build up in their pension is also capped at £1.25 million and if they breach this limit, they could face a tax charge of 55% on the excess.”
Nimesh added: “The rules are particularly troublesome to medical professionals who are members of their own private pension and the NHS pension schemes. To test these new limits you have to combine private pension arrangements and the NHS pension scheme. The problem with the NHS pension scheme is that it is difficult to assess the contributions being made. Therefore, these limits can be unknowingly and quite easily breached.
“Medical professionals should be reviewing their pensions as soon as possible but not make any hasty decisions to leave the NHS scheme, as this can still provide valuable benefits despite the tax charges.”

7.00am Good morning and welcome to HSJ Live.