Private provider’s takeover of urgent service sparks union opposition

King’s College Hospital Foundation Trust will transfer staff working at its urgent treatment centre at Denmark Hill, in southeast London, to Greenbrook Healthcare. The three-year, £10m contract will come under the new provision from 4 October.

The provider delivers NHS primary care services, including UTCs, walk-in centres and community services, across London and surrounding areas. It oversees nine UTCs, most of which are in London and includes one at the Princess Royal University Hospital in Bromley, which is also run by KCHFT.

However, in an internal letter to trust leaders last month, seen by HSJ, emergency nurse practitioners at the UTC criticised the takeover’s process and described the apparent lack of communication as “dumbfounding”.

The Royal College of Nursing and the trade union Unison have expressed concerns over the plans.

Addressed to KCHFT chief executive Professor Clive Kay, and chief nurse Professor Nicola Ranger, their joint letter claimed staff found out the news via text message. It said: “This has stirred up so [much] emotion within our team. Not sleeping, anxiety, tears, obviously very low morale at work and anger.”

The letter added: “This situation is particularly hard as it is not one we have asked for, or agreed to, and now feel it is affecting our health and wellbeing, particularly off the back of what has been the most challenging 18 months any of us have experienced in our careers.”

In response, senior managers apologised for how the news was sent out and acknowledged communication had been “limited” on the “wider process”. However, they insisted staff will remain a part of the hospital’s emergency department team.

The contract, which was in collaboration with the Hurley Group, expired in July 2020 but the procurement was suspended due to the pandemic. The “mixed model” UTC had GPs employed by the Hurley Group while emergency nurse practitioners were retained by KCHFT.

A tender for the provision was published in February this year before it was awarded to Greenbrook Healthcare.

Unison claimed there had not been a “proper consultation” on the plans. Jamie Brown, its head of health for London, said: “Staff employed in the unit don’t want to work for a private company, and many are leaving as a result.”

RCN London officer Charlotte Daus said they are supporting a number of its members who have raised “serious concerns” about the proposed changes, claiming neither KCHFT, nor Greenbrook Healthcare, have provided “sufficient information or a clear rationale” about why the decision has been taken.

She added: “Furthermore, Greenbrook Healthcare does not recognise trade unions. RCN London believes this will have a detrimental impact on nursing staff, but also erode years of constructive joint working between management and trade unions.”

The trust has said it is “consulting appropriately with staff and providing them with advice and support”.

KCHFT has previously reported problems with the UTC. In February 2019, its then chief operating officer Shelley Dolan told a board meeting: “The urgent care centre at Denmark Hill is not working at all optimally. This is a legal issue and we will be taking action. We have worked with them to try to improve the model. We are at a stage now where that needs to change.”

The trust’s latest board papers noted: “Poor performance in emergency nurse practitioner and GP queue, and continued deterioration in GP performance, with some sub-40 per cent performance days for GP patients.”

Greenbrook Healthcare is a wholly owned subsidiary of Totally Plc, which delivers planned, urgent and insourcing healthcare across the United Kingdom. It forms part of its urgent care division alongside Vocare Ltd, which was acquired in 2017.

KCHFT told HSJ that urgent care services at Denmark Hill will be “run in partnership” with Greenbrook Healthcare from early October. 

A statement added: “High-quality patient care remains our priority, and we will continue to support staff affected by the transfer. We are also actively addressing concerns raised by staff about how the process has been managed.”

Totally Plc chief executive Wendy Lawrence said: “We are looking forward to supporting KCHFT in this new partnership. Together with KCHFT, we are committed to delivering high-quality care for patients accessing urgent care services at the trust.

“We are also doing everything we can to support staff as part of this process.”

The Hurley Group told HSJ it will continue to provide the GPs working in the UTC until 30 September, adding they had also engaged with their team of GPs and “ensured they are fully aware of their rights” with regards to the TUPE process.