Loophole in APMS contracts threatens primary care stability, enquiry warns

Posted on June 28, 2012. Filed under: Closure | Tags: , |

GP Online | By Marina Soteriou, 27 June 2012

A serious loophole in APMS contracts allows GP practices to become a ‘commodity traded in the private market’, an enquiry into the closure of a London practice run by a private company has found.

Camden Council’s Health Scrutiny Panel of Enquiry report into the closure of the Camden Road Surgery in north London, due to be discussed at a council meeting tonight, is urging the NHS Commissioning Board (NCB) to take ‘prompt action’ to prevent a repeat of the incident.

The panel hit out at private companies involved in running the surgery for failing to provide evidence to the enquiry, and called for greater transparency on deals with private firms involved in running NHS services.

Private healthcare firm United Health won a five-year contract to run the Camden Road Surgery in 2008, but then transferred the contract to another provider, The Practice plc, in April 2011.

A year later, in April 2012, the surgery was shut down when its premises lease ran out, forcing its 4,700 patients to register elsewhere.

The report reads: ‘There appears to be a serious loophole in the national contract for alternative providers, which allowed United Health to transfer the contract.

‘The panel were of the view that this was a serious loophole. In our view, primary care by GPs should not be a commodity traded in the private market and prompt action should be taken by the NHS Commissioning Board, which will be responsible for commissioning primary care, to remedy this.’

Minimise use of locums
The panel said it would welcome further discussions with NHS North Central London and with the NCB on how contract specifications can best ensure continuity of care and to minimise the use of locums.

Its report reads: ‘Contracts should promote the long-term commitment to continuity of GP care, to counter the concerns expressed in evidence that large private providers have less commitment to a local population.’

The enquiry said it welcomed the prospect that from next April councils’ health and scrutiny committees will have enhanced power to require private health providers and GP practices to go before them.

It said: ‘A regrettable aspect of this enquiry was the failure of United Health or The Practice to provide any evidence whatsoever.

‘We welcome the decision of the Information Commissioner’s Office to order Camden PCT to disclose details of the contract with United Health, including the pricing, and believe further consideration needs to be given by the NHS Commissioning Board to the transparency of contractual arrangements as the market for alternative providers increases.

‘The Panel were concerned that there does not appear to be an open and transparent protocol for monitoring performance in primary care, which is understood by the public and public agencies.’

The report added: ‘In the absence of any evidence to the contrary we have no reason not to believe that the reason for United Health UK’s decision [to transfer the Camden Road contract to The Practice plc] was their desire to concentrate on providing services to the GP commissioner consortia being set up under the National Health and Social Care Act 2012.’

Spokespeople for the United Health UK and the Practice plc were unavailable to comment.

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UnitedHealth quits primary care and sells off surgeries to The Practice

Posted on April 20, 2011. Filed under: Uncategorized | Tags: , |

Pulse – UnitedHealth quits primary care and sells off surgeries to The Practice.

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PCT and UnitedHealth end deal

Posted on August 20, 2010. Filed under: Commissioner, News stories | Tags: |

HSJ |18 AUGUST, 2010 | BY STEVE FORD

NHS Northamptonshire has terminated its contract for commissioning support with UnitedHealth UK a year early.

The primary care trust signed a three year deal with UnitedHealth, under the framework for procuring external support for commissioners, in 2008.

The NHS landscape has changed significantly since the deal first began; PCT priorities have shifted

NHS Northamptonshire chief executive John Parkes said both sides had agreed to conclude the project in July, 12 months early.

He said: “The NHS landscape has changed significantly since the deal first began; PCT priorities have shifted.”

Mr Parkes noted the partnership had “notable successes”, including improvements in the use of data and pathways for patients with chronic disease.

He said: “UnitedHealth have had a significant impact in the organisation’s improvement as a first class commissioner and I’d look forward to working with them again.”

UnitedHealth used the Northamptonshire deal as a case study in its evidence to the Commons health committee inquiry on commissioning in January, setting out how the framework had enhanced NHS commissioning.

UnitedHealth’s submission said PCTs were “not always able to build critical mass to be world class commissioners” on an individual basis.

It stated: “To achieve the goals of improved quality and access while meeting important productivity and efficiency targets, successful commissioning with tested external organisations should be continued and expanded.”

NHS Northamptonshire improved moved up this year’s world class commissioning league table by five places.

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Private provision of NHS services under threat

Posted on December 2, 2009. Filed under: GP-led health centres, ISTC, News stories, Providers | Tags: , , , |

The Guardian | By Owen Bowcott | 2 December 2009

The government has reignited the political debate about private healthcare companies delivering NHS treatment.

Private companies could find they are not the preferred option for delivering NHS treatments. Photograph: Graham Turner

On a spotless hospital ward pensioners displaying fresh bandages were delighted their knees and hips had just been replaced by the NHS. The surgery had been as good as going private, they declared. Which was what, in fact, it was.

Their confusion was understandable. The sign at the door reads North East London NHS treatment centre. The unit may be based in the same complex as the local NHS King George hospital in Ilford, Essex, and free at the point of delivery, but it is an independent sector treatment centre (ISTC) – a commercial venture, with the surgery provided by private company Care UK.

The mix of private and public healthcare providers within the NHS means that it is hard to disentangle one sector from another. Senior consultants at the ISTC have contracts to work in both the adjoining hospital and the treatment centre; other staff are on loan from the NHS. No private patients are treated. Soon, medical students will be training in Care UK’s facilities.

Blairite triumph

The health market has been presented as a triumph of Blairite politics, enabling internal competition to spur on progress towards improved standards, say its supporters. The health secretary, Andy Burnham, this autumn endorsed that settlement, though, in almost the same breath, he inadvertently helped to destabilise it. “With quality at its core … the NHS can finally move beyond the polarising debates of the last decade over private or public sector provision,” he told health thinktank the King’s Fund – before adding: “Where I stand in this debate … is that the NHS is our preferred provider.”

Labour’s pronouncements since then on patients’ rights, and what is known as the “private patient cap” – the percentage of private treatments that hospitals are permitted to carry out – have set political compasses spinning. While the private/public divide has not been a significant battleground between Labour and the Conservatives in recent years, competitive tendering processes and residual ideological suspicions are now reviving the dormant row.

Burnham’s promise that the NHS should be the “preferred provider” has been interpreted by the private sector as a snub, and by health unions as a signal of Brownite support for traditional Labour values.

Few are clear what “preferred provider” means. The Department of Health attempted unsuccessfully last week to explain by asserting that: “Where existing NHS services are delivering a good standard of care for patients, there is no need to look to the market.” It then qualified the position, explaining that: “Where [NHS] primary care trusts are commissioning new services, then we expect them to engage with a range of potential providers before deciding whether to issue an open tender. These decisions will be made locally, and we will not choose to exclude either NHS or private providers on grounds of ideology – quality and what is best for patients must always come first. This could well mean more private provision, not less.”

Mike Parish, chief executive of Care UK, initially dismissed Burnham’s phrase as merely a political “rebalancing act”. Since then he has become more anxious about its impact. “People have taken that original good intention and presented it as something much more substantive,” he says. “Across primary care trusts there are people who are enthusiasts in terms of reform and others who are uncomfortable with any concept of plurality. This [statement] could take things in a direction that was never intended. There’s a risk of a runaway horse. We are already seeing tenders being issued for the redesign of services with the invitation going exclusively to NHS providers only. It not only constrains the options for PCTs and patients, it’s also certainly anti-competitive. I don’t know if it’s even permissible.”

Parish estimates that 6% of all NHS work is currently carried out by private firms including Spire Healthcare and UnitedHealth UK. Care UK runs a further nine ISTCs, urgent care centres in Luton, and healthcare services in Brixton prison. The company is considering bidding for what would be the first privately run NHS district general hospital at Hinchingbrooke in Huntingdon. Parish fears the “preferred provider” publicity will blight his chances. He is proud of the firm’s very high patient satisfaction rates and its clinical record in the NHS of no cases of MRSA infections.

Landmark battle

Care UK has, however, just lost one landmark battle. Awarded the tender to provide a GP-led health centre by Camden PCT in north London, it had to abandon the contract last month when anti-privatisation campaigners won a judgment in the high court that forced the trust to go back and ask the public whether the area actually needs a GP-led health centre.

The government’s decision to review the private patient cap – while instructing Labour peers to vote down a proposal raising the minimum permissible level of private work to at least 1.5% of treatments in all NHS foundation trusts – has also helped to reignite the issue of private sector involvement in the NHS.

Sue Slipman, director of the NHS Foundation Trust Network, says trusts want to raise the cap, not in order to treat private patients but “because they want to go into joint ventures to bring in money to their hospitals and support expansion of NHS provisions”.

Burnham’s announcement that in future patients will be legally entitled to free private care if not treated by the NHS within 18 weeks has added a further twist to the debate. The British Medical Association is concerned that this will lead to more NHS work going to private providers, with destabilising effects on hard-pressed NHS services.

Back at the North East London treatment centre, the relieved patients were not perturbed about the origins of their free NHS surgery. Instead, they were looking forward to going home quickly.

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Serious concern over damaging effect of new 8-to-8 health centre in Oadby

Posted on November 12, 2009. Filed under: News stories, Providers | Tags: |

Politics.co.uk | 12 November 2009

The Oadby and Wigston Conservative Group has raised serious concerns over the effect of the new 8-8 Health Centre in Oadby on patients and existing GP surgeries. Already district nurses housed in the Oadby Clinic, which is to be converted to an 8-8 centre, have been told to vacate the premises before Christmas.

NHS Leicestershire County and Rutland voted to go ahead with the 8-8 centre on 5th November but the impact of the centre on local GPs and patients is worrying local Conservatives, with major concerns yet to be addressed.

The main concerns of Oadby and Wigston Conservative Group are:

District Nurses, presently housed in the clinic building, have been told they have to move within the next month, jeopardising the care and services they provide.

Concern whether the centre will bring additional funding or whether existing surgeries will have their funding reduced.

Where the new practice will draw its own registered patients from and the effect of losing patients on smaller practices.

It is unclear what will happen to profit made by United Health Primary Care, an American company, and whether it is ploughed back into local healthcare or simply skimmed off by shareholders.

The existing site for the 8-8 centre is too small for the proposed services and it is unclear how expansion will be achieved without moving site again, further confusing and disrupting local healthcare.

The lack of consultation by the PCT with our local doctors and patients. There is little evidence of surveys and other consultations and the process used in the decision to site the centre in this location.

Conservatives are extremely disappointed at the lack of leadership shown by the Oadby and Wigston Borough Council in waiting so long to consult with residents and in their lack of support for their local GP surgeries. Furthermore, they are also highly displeased that many residents are only finding out about the new centre after it has been announced in the press.

A public meeting has been called for 15th December after pressure from Cllr. Colin Gore, Leader of the Conservative Group at Oadby and Wigston Borough Council.

Conservative Councillor Mrs. Jill Gore said

“No-one can argue with the concept, but one can query the effect on local surgeries. Negotiation is an integral part of any process, but I fear the most important groups of people – the residents and our local medical personnel have been excluded from this aspect and presented with a fait accompli.”

Local MP Edward Garnier, said

“The days when the public were kept in the dark about important changes to local NHS provision or planning matters are surely long over. We have a right to know in advance what is intended and how our taxes are to be spent. It should not have taken Conservative councillors and activists to get this all out in the open. The Council’s governing Liberal Democrat group should have been dealing with this some time ago – it now seems things have been set in place and there is little local people or GP practices and NHS employees can do about it.”

Graham Wilson, Vice Chairman of Oadby Conservative Group, added to these comments with concerns about the effect of the new centre on elderly and patients with chronic conditions:

“The relationship between a GP and a patient is of the utmost importance and one built on trust. Many Oadby and Wigston residents, especially the elderly and patients with long-term illnesses, will be worried whether their practice will be forced to close and they will have to visit a new and unfamiliar GP. This can only be stressful for the patient and is a shameful situation for the Borough to be in.”

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New Era for GP-led Healthcare as NHS Leicester City names preferred bidders in £15m investment

Posted on November 10, 2009. Filed under: GP-led health centres, Press/News Releases, Providers | Tags: , |

NHS Leicester City | News Release | 10 November 2009 (pdf)

Patients in Leicester will get a huge boost to their health care thanks to a £15million investment for new General Practitioner (GP) practices and a GP-led health centre.

This means two new GP practices and a new GP-led health centre are to open next year with a further practice planned for 2010. Additionally there will be new premises for an existing GP practice.

For the first time in Leicester, patients will be able to access GP or nurse-led healthcare, at a new walk-in centre, without needing to be registered at any practice.

The announcement of preferred bidders for new contracts heralds world-class primary care services for Leicester. This will mean more GPs and nurses serving the city, better access to local healthcare, longer opening hours, and more choice for local patients. The plans are set to benefit more than 15,000 Leicester patients by 2013, with local patients being able to choose from a wider range of doctors.

The contracts are for the management of clinical services run from the new GP-led health centre and the two new GP practices. Additionally, a full relocation package is being announced for an established local GP practice.

The process started with a rigorous six-month tendering process which received 46 initial expressions of interest from potential bidders. The evaluation process involved bidders providing detailed information with the short-listed giving interviews and hosting site visits. A panel of health and other professionals, including a GP and patient representative, worked on the assessment of the proposals.

The contracts for the brand new premises will be awarded, subject to final negotiations, to:

• Canon Street, an established Leicester City GP surgery

• UnitedHealth Primary Care, a national health and wellbeing primary services company

• SSAFA Community Interest Company (Soldiers, Sailors, Airmen and Families Association), an international charitable organisation providing health and social care services

In addition The Willows Practice will be relocating to Rowlatts Hill.

Leicester’s Canon Street Surgery, run by GP Dr Bhupendra Modi, is the successful bidder for the new Northfields GP practice in the north of the city. It will be housed in temporary accommodation on St Ives Road until the planned new premises are built. Canon Street will continue as a GP practice and both it and Northfields will be run by Dr Modi, who is also a clinical GP trainer. An estimated 6,000 additional patients will be able to register at Northfields.

UnitedHealth Primary Care will run the new city centre GP practice which will have the capacity to see a potential 6,000 patients. The practice will be at 29/31 Bowling Green Street. The company already runs two successful GP practices in Derby, Normanton Medical Centre which opened in 2006 and Vidya, which began seeing patients earlier this year. The company also has three GP practices in London.

SSAFA Community Interest Company will run a new GP-led health centre within the new Charnwood Health and Social Care Centre in the Charnwood area of the city. SSAFA CIC opened its first UK health centre in Luton in July this year but runs primary care practices all over the world. An estimated 3,500 patients will be able to register at this practice. The site will include a walk-in centre for unregistered patients – anyone will be able to see a nurse or GP here.

The organisations were all chosen for their ability to deliver world class health care to the people of Leicester. They were subject to extensive assessments on standards in quality of care, patient experience and value for money.

NHS Leicester City has decided not to award a contract for the originally proposed planned new premises in Crown Hills. Instead The Willows Practice, currently situated on Coleman Road on the edge of the Rowlatts Hill estate will relocate to a development at the heart of the estate. These new premises will improve access for the people living in Rowlatts Hill estate and provide the opportunity for the practice to extend its range of services. Dr Mo Roshan, who leads The Willows, is a clinical GP trainer and has worked in Leicester since 1990. The practice currently serves 3,000 patients.

It is expected Charnwood Health and Social Care Centre will open its doors from the end of January next year. The new Northfields practice is set to open its doors from next May while United Health’s city centre practice will open at 29/31 Bowling Green Street from September 2009. The new Northfields practice will be housed in state-of-the-art temporary buildings until the permanent premises are completed.

NHS Leicester City’s chief executive Tim Rideout said: “This is a proud day for NHS Leicester City and a great day for local patients. It’s a sign of the importance that we attach to improving health and picking up signs of poor health at an early stage that we are committing £15 million to these great new primary care facilities.”

Leicestershire and Rutland Local Medical Committee chairman Dr Nick Simpson said: “The LMC welcomes this announcement. We are pleased that an existing local GP practice has been successful and that these new contracts will not all go to a single private sector company.

“We are also glad that NHS Leicester City has listened to feedback and responded by identifying an alternative solution to meeting the needs of residents in the Crown Hills area.

“We had initial concerns at the start of this process but we feel that today’s announcement is a good outcome for the patients and existing practices of the city.”

NHS Leicester City plans to launch another new GP practice elsewhere in Leicester in 2010.

Ends

For interviews, photo opportunities or further information, please contact Joanna Petersen on 0116 295 4123 or joanna.petersen@leicestercity.nhs.uk

Notes to editors

NHS Leicester City’s overall objective is to meet the health needs of the people of Leicester within the available resources. It is accountable for a budget of approximately £470 million, and serves a population of more than 340,000 people.

Within its remit, the Trust is responsible for engaging with the local population to improve health and well-being; commissioning a comprehensive range of high quality health services; directly providing health services where this is most appropriate, and ensuring that it gets best value for taxpayer’s money.

Clinical GP trainer: Trains registrars (new doctors) to make the transfer from being a hospital doctor to a community general practitioner.

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Company struggling to find site for new health centre

Posted on October 30, 2009. Filed under: Uncategorized | Tags: |

Leicester Mercury | NHS Leicester County & Ruthland | 30 October 2009

A private company brought in to run a new health centre in Leicestershire is struggling to find premises to open.

United Health Primary Care, which won the contract from NHS Leicestershire County and Rutland, was due to have the centre up and running by the end of the year.

But two planning applications to convert empty shops – one in Oadby and one in Wigston – have both been rejected by planners.

Now, bosses at the company, which is also due to open a GP practice in the city centre for NHS Leicester City, have asked for help in finding premises.

Once up and running, it will open from 8am-8pm, seven days a week, and anyone needing to see a GP can turn up without an appointment and does not have to be registered with the doctors.

There will also be a new GP practice within the centre to cater for a total of about 3,500 people once fully established.

But the plans have caused controversy with local residents and among GP practices.

Doctors are worried that a new practice will take patients from their surgeries and force them to close or cut back on services.

They say money would be better spent on helping to modernise and expand existing practices in the area.

But a spokesman for NHS Leicestershire County and Rutland said: “The development is part of a drive by the primary care trust to offer greater choice and convenience by providing a wider range of services for patients with a variety of needs and at times which are convenient to them.

“The Oadby and Wigston area was chosen as a preferred location because there are areas there that have higher than average levels of hospital admissions and there are fewer community health services currently available.

“We are now looking at other options regarding the exact location of the premises.”

The Leicestershire County Council’s health scrutiny committee has already backed a new health centre for the area.

Tony Sampson, director of external affairs for United Health Primary Care, said there is now a possibility of using premises already owned by NHS Leicestershire County and Rutland.

He is optimistic that the company will be able to open the new health centre and GP practice by the end of the year.

He said: “We would have liked to have been offering services before now but we hope to open as soon as possible.”

He said that plans for a new GP practice were still on track.

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PCT faces High Court over contract award

Posted on October 22, 2009. Filed under: GP-led health centres, News stories, Polyclinics | Tags: , , |

Pulse | By Gareth Iacobucci | 21 October 2009

A PCT is facing a High Court battle over its decision to award a GP-led health centre to private firm Care UK.

Residents have begun legal action against NHS Camden over an alleged lack of consultation on the centre.

Legal firm Leigh Day and Co has issued an application for Judicial Review on behalf of claimant Bob Austin, a former councillor backed by anti-privatisation campaigners.

The case centres on a consultation document recently issued by the trust about its GP services, which included information about plans for a GP-led health centre.

The consultation was not due to finish until October but the PCT announced on 31 July that Care UK had been selected to run the clinic.

Opponents of the new centre, which will be located close to Euston station, believe it could lead to the closure of local GP practices and are demanding a full consultation.

Candy Udwin, chair of the Camden Keep Our NHS Public campaign group, said: ‘The consultation has been a sham. The PCT has chosen the site, awarded the contract and started advertising for staff before the consultation has even closed.’

Dr Mark Atkinson, NHS Camden chief executive, said the trust would ‘rigorously defend’ itself against the accusations.

‘No legal case has yet been lodged at the High Court. If that happens, NHS Camden will rigorously defend Camden patients’ rights to expansion of local GP services.’

The PCT also found itself at the centre of controversy over an APMS tender in 2008, when it awarded three local GP practices to UnitedHealth, despite a rival GP bid being rated higher for planned service provision.
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PCT threatened with legal action over Darzi centre

Pulse | By Gareth Iacobucci | 5 August 2009

The Keep Our NHS Public campaign group are threatening NHS Camden with legal action over an alleged lack of consultation on a new GP-led health centre in north London.

The anti-privatisation campaigners, supported by local GPs and patients, are demanding that the PCT suspends its plans for a new Darzi centre near Euston station, pending a full local consultation.

Legal firm Leigh Day and Co have served the trust with a letter before action on behalf of a local pensioner, Willibald Davies, which claims the PCT have not consulted adequately on the procurement, and should immediately cease the process until a full local consultation has taken place.

Opponents to the new centre, which will be run by private firm Care UK, believe it could lead to the closure of local GP practices in the area.

The controversy centres on a consultation document recently issued by the trust about the future of Camden’s GP services, which included information about the GP-led health centre.

Although the consultation is not due to finish until October, the PCT announced on 31 July that Care UK had beaten local GPs to run the clinic.

Local campaigners have also threatened to organise a public boycott of any new clinic if their demands for a full consultation period are not met.

The latest battle is the second time in as many years the PCT has found itself at the centre of controversy over an APMS tender. In 2008, the trust was heavily criticised for awarding three local GP practices to US-giant United Health, despite local GPs being rated as offering substantially better services.

Camden was also one of two north London trusts which held secret talks with private providers including Virgin Healthcare about running the country’s first fully-fledged polyclinic before the public had been consulted.

Rob Larkman, NHS Camden Chief Executive, said: ‘Since 2007 NHS Camden has made clear our desire to increase access to GP services for the people of South Camden, one of the most deprived areas of the borough. By the end of 2009 a brand new health centre with a brand new GP practice will open offering local people world class health care, at times convenient for local residents.’

‘It is incorrect to suggest that we are presently subject to a Judicial Review. No case against NHS Camden has been lodged with the courts’.

Fears over privatisation plan for GP centre

Ham & High | Tan Parsons | 6 August 2009

CAMPAIGNERS are threatening legal action over NHS Camden’s decision to hand control of a health centre to a private company.

Last Friday (July 31) the group confirmed that the contract to run a new GP-led health centre in Hampstead Road would be awarded to Care UK, a company that in April this year was criticised in a BBC Panorama investigation into the quality of elderly homecare.

Campaigners were also furious that NHS Camden’s decision was announced more than two months ahead of the conclusion of their Primary and Urgent Care Strategy consultation on October 9.

Leigh Day and Co solicitors have now served NHS Camden with a letter before action on behalf of Camden pensioner, Willibald Davies, who has diabetes. The firm has insisted that NHS Camden should immediately halt the procurement process and the signing of any contract until full local consultation has taken place.

Chairwoman of Camden Keep Our NHS Public, Candy Udwin, said: “We are appalled by the idea that more private companies could get a toehold in Camden family doctors services.

“The fact there’s been no consultation makes it even more appalling. 

“People want to see a family doctor who knows them and their problems and who sees them every time they go to the doctors.”

The proposed development is one of the so called ‘GP-led health centres’ that was being promoted by Lord Darzi before he resigned last month as health minister.

NHS Camden’s decision to select Care UK as the preferred bidder follows the controversial appointment of private American firm United Health to run three local GP practices in the south of Camden.

However, patients spokesman Neil Woodnick, who is chairman of the Camden Local Involvement Network, said that a consultation would only delay the inevitable.

He said: “Even if there is a judicial review and NHS Camden was forced to hold a consultation, you have to remember a consultation isn’t a democratic process. 

“They could still award the contract to whoever they choose.

“At the moment figures show there is overall patient satisfaction at the surgeries run by United Health, so I’m not that worried about the prospect of another private care provider. 

“But obviously we will monitor the situation closely and see how it works out. We are more concerned about how confusing it is for people in Camden now. 

“How do they know whether to go to accident and emergency, an urgent care unit or the GP-led health centre?”

A spokeswoman for NHS Camden said that no case against the organisation had been lodged with the courts at the time the Ham&High went to press.

She said: “Since 2007 we have made clear our desire to increase access to GP services for the people of South Camden, one of the most deprived areas of the borough.

“By the end of 2009 a brand new health centre with a brand new GP practice will open, offering world class health care at times convenient for local residents.

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Top GP slams Camden NHS as ‘megalomaniac and misleading’

Posted on October 1, 2009. Filed under: GP-led health centres, News stories, Providers | Tags: , , |

Camden News | By Tom Foot | 1 October 2009

No evidence that for-profits surgeries policy is beneficial to patients, she says.

THE President of the Royal College of GPs has launched a stinging attack on Camden’s health chiefs for failing to listen to patients.

Dr Iona Heath, a partner at the Caversham Practice in Kentish Town, described NHS Camden as “megalomaniac” and branded its current consultation on the controversial GP-led health centre – a new super surgery planned for Euston – a “travesty”.

In her first article for the British Medical Journal since becoming the country’s GPs’ leader in June, Dr Heath said: “There has been no attempt to survey public opinion or the views of health professionals working in Camden in a way that could be considered statistically valid or defensible.”

Dr Heath is furious that NHS Camden has named private operators Care UK as its preferred bidder for the massive £20 million contract to run the health centre in Hampstead Road before the public had responded to the proposals.
She raised concerns over a recent trend in Camden of awarding major contracts to profit-making companies ahead of familiar local NHS practitioners.

Contracts to run three surgeries have been awarded to American health giant UnitedHealth and Camden’s specialist physiotherapy services will be run by the Northumberland-based firm Connect Physical Health

Camden’s community nursing service will also also be offered to private operators later this month.

Dr Heath said: “NHS Camden is the new name for Camden Primary Care Trust – a name that manages to be both misleading and megalomaniac. This most local outpost of the Department of Health seems ever more intent on awarding successive contracts to private for-profit companies despite mounting opposition from residents and health professionals and in the complete absence of evidence of benefit for patients.”

Dr Heath’s comments came as Camden’s branch of Keep Our NHS Public claimed a breakthrough in the Town Hall last Thursday.

The council’s health and scrutiny committee agreed to request further advice from Health Secretary Andy Burnham over NHS Camden’s efforts to seek the views of the public.

NHS Camden argues it does not need to consult patients on the GP-led health centre, which existing GP surgeries fear will take away their work. But a letter sent in March by then Health Secretary Ben Bradshaw to Liberal Democrat committee chairman Councillor John Bryant suggested the opposite.

If the minister confirms that consultation is required, the health scrutiny committee has the power to refer the whole process to the Secretary of State for a final decision.

Green councillor Alex Goodman said that NHS Camden should “in good faith” put all contract talks with private operators on pause until the Department of Health had decided it had acted properly.

Candy Udwin, chairman of Camden Keep Our NHS Public, added: “It’s good news for the campaign. At least it gives us a bit of breathing space.”

She said planned legal action against NHS Camden over the decision to hire Care UK has been suspended until the minister has given his verdict.

A NHS Camden spokesman said: “NHS Camden did not consult on the creation of the new GP practice at the GP-led health centre as this is a government directive that NHS Camden is obliged to follow. The additional services that will be housed in the centre are currently being consulted on.”

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Patients urged to boycott new private super surgery

Posted on August 27, 2009. Filed under: GP-led health centres, News stories | Tags: , |

Camden News Journal | By Tom Foot | 27 August 2009

Health campaigners warn of slippery slope to privatising NHS

ANTI-PRIVATISATION campaigners are calling on patients to boycott a new “super-surgery” in Euston.

Private company Care UK as been named the preferred bidder to run the GP-led health centre ahead of a consortium of south Camden doctors and without any consultation. 

NHS Camden, the borough’s Primary Care Trust, believes it does not have to consult on the centre, which is expected to open in Hampstead Road in December.

But lawyers disagree and are poised to launch a legal challenge that could stall the process and land NHS bosses up in the High Court.

Candy Udwin, chairwoman of Camden Keep Our NHS Public, said: “A privatised GP health centre is just the next step on the privatisation road that threatens the National Health Service as we know it. We are telling patients at nearby surgeries to boycott the health centre.”

The decision to give millions of pounds of NHS funding to a private company, ahead of a consortium of local doctors, mirrors the decision last April to award the American healthcare giant UnitedHealth contracts to run three south Camden surgeries.

Decisions on who runs what are made by NHS Camden board members and overseen by the official patients’ representative group, Camden Link.

Link chairman Neil Woodnick, who sat in on the committee that awarded United Health a contract, said: “We asked, specifically about the GP-led health centre, how much weighting there was on value for money. I was told 70 per cent was quality of the service, and 30 per cent was value for money. 

“The big thing about United Healthcare was that value for money seemed to come in later. It was said that the PCT moved the goalposts during the consultation. Value for money suddenly became an important thing – UH bid £25 less per patient than the GPs. 

“The fact is that these contracts are set up as legal contracts obliged to offer it to other firms. You cannot say we are not prepared to take any bids from the private sector – it’s illegal to do that. The whole thing is about outcome. 

“Are the patients satisfied? If you look at United Health practices, the numbers of patients has increased r oughly by 8 per cent. If they are not happy, patients will walk with their feet.”

Campaigners to sue as private firm wins contract for GP centre

London Evening Standard | By Anna Davis, Health Reporter | 20 August 2009

Campaigners are to sue the NHS after control of a new health centre was awarded to a private company.

Lawyers have written to Camden primary care trust warning they could start proceedings over the decision to award Care UK the contract for the GP-led centre in Hampstead Road.

They are demanding the scheme be postponed until the public has been properly consulted. The trust has angered residents by announcing Care UK had beaten local NHS GPs to the contract — before public consultation ends on 9 October.

In a separate move, trust bosses have awarded a contract to provide physiotherapy in Camden to the private firm Connect Physical Health Ltd.

Campaigners fear the new GP-led health centres, which must be set up in every primary care trust in the country under government reforms, will put profits before patient care.

Care UK already runs GP practices and walk-in centres in Dagenham and Stamford Hill, and the walk-in centre in Victoria. It also provides some services at Brixton prison.

Camden PCT allowed US firm United Health to run three GP surgeries last year. A spokeswoman for campaign group Keep Our NHS Public said: “As private companies have a legal obligation to their shareholders, in the financially stringent times ahead Camden patients will suffer as shareholder dividends are protected.”

Londonwide LMCs demands rethink over Darzi centre private contract

Pulse | By Steve Nowottny | 18 August 2009

GP leaders in London are demanding that NHS Camden rethink its decision to award the contract for a new GP-led health centre to private company Care UK.

They warned there is ‘no evidence’ that the PCT ‘has effectively or meaningfully consulted with the people of Camden’, and urged trust bosses to reconsider, claiming the centre is not the best use of resources or most effective way to provide care.

In an open letter to the PCT’s chair, Dr Paddy Glackin, medical director of Londonwide LMCs, said local GPs had concerns about the scoring system used to award the contract, as well as the extent of public consultation.

It comes as the Keep Our NHS Public campaign group mulls whether to press ahead with a legal challenge to the contract award.

The anti-privatisation campaigners, supported by local GPs and patients, sent a ‘letter before action’ to the PCT on behalf of a local pensioner earlier this month.

They have now received a response from the PCT and are discussing with solicitors whether to proceed with the challenge.

In the letter released today, Dr Glackin said: ‘We have seen no evidence that the PCT has effectively or meaningfully consulted with the people of Camden about whether they feel that opening a GP-led health centre would be the best and most effective manner of spending money to improve their care. We seriously doubt whether this is the best use of scarce NHS resources.’

‘Given the PCT’s repeated failure to consult adequately with the local community we call on the PCT board, its executive and non-executive directors, to reconsider its decision to award the contract at this time and to ensure that adequate meaningful consultation with the local community occurs in all future tendering processes.’

Dr Glackin added: ‘We have concerns about the scoring system used by the PCT, which gives no weighting to local knowledge or experience. We believe that organisations and individuals with a proven track record of providing high quality clinical services to the people of Camden should have had some recognition of that fact. ‘

And he also raised concerns about whether the new centre – near Euston and St Pancras stations – would be used more by commuters and walk-in patients than by local patients.

A spokesperson for NHS Camden said: ‘Unfortunately we have not yet officially received this letter from the LMC. However, if the contents are the same as the text sent to the newspaper, then we are very surprised at the LMC’s views.’

‘Throughout the tendering process for the GP led health centre, a representative from the LMC was involved, taking an active role in the decision-making process, and they raised no concerns with process or the final outcome.’

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Recession forces Chilvers McCrea to drop APMS contract

Posted on April 28, 2009. Filed under: News stories, Providers | Tags: , , , |

Pulse | By Gareth Iacobucci | 28 April 2009

A squeeze on bank lending is forcing private providers to ditch APMS contracts, Pulse can reveal.

Chilvers McCrea Healthcare, which manages over 30 practices across the UK, has been forced to terminate its contact to run an APMS practice in Essex because of the tough economic climate.

It is the latest in a series of private sector withdrawals from primary care which appear to pose a serious threat to the Government’s drive to ramp up competition.

The company’s decision to stop running the Pier Medical Centre in Southend, which includes two surgeries, comes just weeks after its chair, Dr Rory McCrea, warned GPs would find it increasingly difficult to make a profit on APMS contracts.

South East Essex PCT is now having to search for a new provider for the contract, which runs out in 2010.

Dr McCrea told Pulse: ‘Due to the current economic climate, it was not sustainable for Chilvers McCrea Healthcare to carry on the contract to manage the practice.

‘Chilvers McCrea, like many companies across all sectors, is debt funded and currently banks are going through a period of being nervous about lending.’

A spokesman for the PCT said: ‘ChilversMcCrea is continuing to deliver services until 2010. During this time we will secure a new provider through the procurement process to ensure there is a seamless transfer of services.’

The move comes after private firm Atos Healthcare recently pulled out of running an APMS practice in Berkshire due to the financial climate and low demand for services.

Both Atos and United Health also dropped out of the running for a tender in Sheffield prior to the award of the contract.

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NHS chiefs plan to speed up privatisation in primary care

Posted on April 17, 2009. Filed under: News stories, Providers | Tags: , , , , , |

Pulse | By Gareth Iacobucci | 9 March 2009

PCTs are set to dramatically ramp up efforts to entice the private sector into primary care after failing to meet Government targets to increase competition.

A series of detailed SHA assessments of PCTs commissioning skills found they had not gone far enough to open up the primary care market.

Reports carried out under the Government’s World Class Commissioning scheme show even trusts that have embraced APMS have failed to achieve above average scores, which is set to lead to a renewed drive to meet future targets.

The NHS Confederation said it expected many PCT-run surgeries to be farmed out to APMS, as trusts look to entice private providers to run GP services.

The reports, many of which marked PCTs down from their self-assessments, offer detailed advice on how trusts can stimulate the market by next year’s assessment.

NHS Berkshire West was marked down on two of the three categories for stimulating the market, and advised to ‘encompass a wider range of services provider’.

NHS Suffolk, which scored level one, the lowest score, on all aspects of stimulating the market was advised to ‘continue building on its active approach to tendering’.

Even Camden PCT, which handed three practices to US healthcare giant UnitedHealth last year, was marked down to level one on all three categories for stimulating the market.

David Stout, director of the NHS Confederation’s PCT Network, said it was unsurprising to see PCTs struggling as the market was ‘very new for the NHS’.

He said: ‘[The indicator] is asking, “Are there concerns about quality, and are there alternative providers who could add something?”. If there are, how do you encourage them to participate?’

Mr Stout said while he didn’t necessarily envisage an immediate expansion of APMS, he did expect many PCT-run services and any new contracts to be tendered.

He said: ‘Where APMS will be used is where new services will be commissioned. From a competition point of view, you’d be hard pressed not to use APMS.’

But Dr Chaand Nagpaul, GPC negotiator with responsibility for commissioning, said the drive to increase competition had ‘nothing to do with improving healthcare’.

‘This highlights how PCTs can be diverted into pursuing meaningless political targets rather than supporting and developing existing GP practices.’

A Department of Health spokesperson said: ‘PCTs are expected to stimulate and shape the market including a number of providers from voluntary, NHS, private, local government sectors and others.’

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GP-led firms are the big APMS winners

Posted on April 17, 2009. Filed under: GP-led health centres, News stories | Tags: , , , , , , , |

Pulse | By Gareth Iacobucci | 18 November 2008

Companies led by GPs are the big winners in the Government’s rollout of APMS services and are dominating the bidding for services across the country, a new analysis reveals.

But a new breed of business-minded GPs are blurring the boundaries between general practice and the private sector and in some cases pitting GP against GP.

One GP-led company has now secured a contract to run services hundreds of miles from the practice at which it is based, yet local GPs are often struggling to win bids.

Academics from the Health Services Management Centre, based at the University of Birmingham, found that since 2004 113 tenders had been won by new market entrants, including a long list of new born GP companies.

GP-led firms have won ‘significantly more practices than either corporate providers or social enterprises’, it adds.

Well known companies such as United Health, Atos and Care UK make up just 9% of the total figure, with GP-led companies gaining 89% of contracts, and not for profit social enterprises the remaining 2%.

But the researchers admitted it was now increasingly difficult to distinguish between GPs and private providers.

Professor Chris Ham, professor of Health Policy and Management at the University Of Birmingham, who led the research, said ‘Quite a lot of the GP bidders have turned themselves into separate companies to bid for contracts, and quite a lot of the corporate bidders have strong GP involvement. The categories we’ve been using in the past are increasingly unhelpful.’

The rise of APMS has had another controversial twist, pitching local GPs against bidders often from far afield. Pulse revealed in September that many local GPs had failed to make it past even the initial stages of bidding for Darzi centres.

Professor Ham said the research had revealed widespread concern about the quality of local bids, which had been embarrassed by more professional bids by GPs turned entrepreneurs.

‘This had created a tension between needing to ensure the conditions for open and fair competition, but wanting to support and encourage local practices to bid.’

Local GPs have often found themselves outgunned. Last week, Kent-based GP group Malling Health was announced as preferred provider for a new Darzi practice in Weston-Super-Mare, North Somerset, nearly 200 miles away.

Dr Peter Maksimczyk, a GP in Weston-super-Mare, who lost out to the Malling Health bid said: ‘I can’t see how GPs from Kent can pick up the difficulties. Practice is different in towns like Weston. It’s very difficult to see this as anything other than a complete slap in the face.’

But Dr Thomas Reichelm, development lead for Malling Health, said: ‘We’re aware there might be some initial rejection but we’re fairly confident that by meeting people in person, we’ll be able to convince them we have no bad intentions.

‘We’ve already started the process of finding out the local sensitivities and what matters locally. It’s quite refreshing to bring a new outlook and perspective.

DEFINING ‘NEW’ PRIMARY CARE PROVIDERS

GP-led companies
Companies set by GPs for the purpose of bidding for general practice and other primary care contracts. Have access to NHS pension scheme. Key players: Chilvers McCrea (37 practices), SSP Health (11 practices), Aston healthcare (9 practices), Intrahealth (8 practices)

Corporate providers
Investor owned companies, usually operating for profit. Do not have access to the NHS pension scheme. Key players: United Health UK (5 practices), Care UK, (3 practices), Atos healthcare (2 practices).

Social enterprises
Not for profit organisations – often set by groups of healthcare professionals, which reinvest any profits back into the organisation. NHS staff still transferring into new social enterprises and delivering NHS care can stay in the NHS pension scheme. Current players: Central Nottinghamshire Clinical Services, (Nottingham) Willow Bank (Stoke)

Source: Health Services Management Centre – Choice and Competition in Primary Care: Much ado about nothing?

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