‘No one held accountable’ for Hinchingbrooke deal, says PAC report

The Commons public accounts committee today published a update report into Hinchingbrooke Healthcare Trust, following the announcement earlier this year by Circle, the firm managing the hospital, that it was withdrawing early from its 10 year contract.

The report described the franchise deal an “innovative experiment” but stressed concern that “none of those involved in the decisions has been properly held to account”. It said the Department of Health “did not put sufficient controls in place to monitor and learn from this innovation”.

Accountability and responsibility for the contact was “fragmented and dispersed across the health system”, the report added.  

Although the DH’s director of general finance Richard Douglas “accepted that he was ultimately accountable for approving the contract”, the report pointed out that “officials in the [East of England] Strategic Health Authority who developed the franchise arrangement have not been held to account”.

• Circle drops challenge to ‘inadequate’ Hinchingbrooke rating

Its former chief executive, Sir Neil Mckay, “received a generous redundancy package and has since taken up another role in the health service”.

The NHS Trust Develop Authority also came under fire for “not [overseeing] this high risk venture effectively”.

The trust itself “had unusual governance arrangements” and “neither Circle’s management nor the trust board accepted responsibility for holding the trust’s management to account”, the report said.

The Care Quality Commission had raised concerns about the Hinchingbrooke’s governance structure following its inspection of the trust, which it rated “inadequate” in January.  

The committee’s report criticised the CQC for not giving a “satisfactory explanation as to why the inspection rating was so out of line with previous assessments of the quality of care at the hospital”. The trust had been assessed as low risk by CQC’s own intelligent monitoring system prior to its inspection.

Cambridgeshire and Peterborough Clinical Commissioning Group had “limited resources” to monitor the trust’s performance, believing it to be “reasonably good” with “some areas of concern”.

The TDA also “monitored some aspects of care quality” and considered that “on the whole” the trust’s performance “did not indicate a particular problem”.

Among its recommendations, the MPs called for the DH and TDA to “ensure that strong governance and clear accountabilities are put in place for future novel or high risk ventures” with “strong and effective monitoring”.

It also said that at the start of the next parliament the DH should report back on lessons learnt from the franchise experiment “which will inform future protocols in dealing with private providers”.