Capita cut out of screening support services

The services will be taken out of Capita’s ill-fated £330m Primary Care Support England contract later this year and moved in-house, NHS England chief executive Simon Stevens told the Parliamentary public accounts committee yesterday.

The NHSE boss said the health service had not been satisfied with the company’s performance on the work which forms part of the primary care back-office services contract it has held since 2015.

Mr Stevens told MPs: “Therefore, today I am announcing that we are bringing the cervical screening service back in-house, to the NHS from Capita, beginning June and then a phased transition through the rest of the year.”

A Capita spokeswoman said: “We support NHS England’s decision…and we will work together to ensure a seamless transition.”

The move follows a major national incident last November in which Capita revealed it had failed to send letters to women on time about their appointments for a screen or their results. About 47,000 women were affected and the company apologised for the error.

The system relies on the National Health Application and Infrastructure Services system, a suite of software made up of 83 databases. The local cervical screening programmes draw personal information from these databases to send invitations to women for their screen.

The NHS had intended to move away from NHAIS to a new database system in 2017 but put this plan on hold because it “did not have confidence… based on Capita’s ability to manage that transition safely,” Mr Stevens explained.

Therefore, “we have determined that we will take that in-house and together with NHS Digital will do that ourselves”, he added.

NHSE and NHS Digital will begin to move to a new system, the patient demographic service, through 2020.

The shift to PDS was meant to happen sooner so it could support long-awaited changes to how the screening tests are analysed.

At present, samples are examined under a microscope for abnormalities. By December this year, all samples are expected to be checked for the presence of the cancer-causing virus first, called primary HPV screening.

The chief executive of a leading cervical cancer charity wrote to health and social care secretary Matt Hancock last year to express serious safety concerns over the risks of moving to primary HPV screening while relying on the old IT system.

Yesterday’s announcement will reduce the number of systems involved in calling and recalling women for screening but the committee was told there will still be approximately 360 systems operated by NHS trusts around England, which manage women who the screening system determines require further tests and, potentially, treatment.

MPs questioned the wisdom of this ongoing complexity. Mr Stevens said “the key weakness” in the system was the reliance on the NHAIS system, which will be replaced. “There will still be… local systems that hospitals are using for the subsequent checks, but I don’t think that’s illegitimate,” he added.

Former national cancer director Sir Mike Richards also gave evidence to the PAC yesterday. He argued there was a case for saying “we need an end-to-end system” to replace the constellation of diagnostic and treatment systems run by local NHS bodies.

Sir Mike is currently leading a review of the national cancer screening programmes. It was commissioned in the wake of the revelation of Capita’s errors in handling patient letters in the cervical programme.

HSJ understands he will recommend a far-reaching overhaul of cancer IT screening programmes. This will feed into a strategic review of the national screening programmes being conducted by the Department of Health and Social Care, which will report after Sir Mike has concluded his own review.

A Capita spokeswoman said: “Returning administrative support of the cervical screening programme in England in-house is consistent with the approach in all other national screening programmes and will enable better integration across those programmes.

“We support NHS England’s decision as part of its broader review of screening services, and we will work together to ensure a seamless transition.”