Capita under fire again over GP support contract – but NHS England praises “improvements”

By Tony Collins

Hundreds of trainee GPs have not received their salaries from Capita, which is under contract to pay them, reports The Guardian.

Some of the trainees have applied for emergency funds from The Cameron Fund, a charity for the prevention of hardship among GPs and their dependents.

Capita administers training grants for GPs under its wide-ranging £1bn contract with NHS England to provide primary care services.

In November 2016 the then Health minister Nicola Blackwood described failings on Capita’s GP support contract as “entirely unacceptable”. 

She said Capita had inadequately prepared for delivering a “complex transition”.

In response,  Capita said it adding the full-time equivalent of 500 extra staff on the contract.

But in February 2017, after continuing complaints,  the Health Secretary Jeremy Hunt said he would be prepared to end Capita’s contract if necessary.

Since then, though, NHS England has praised “improvements” in the contract, according to Pulse.

Yesterday The Guardian reported extracts from a letter the British Medical Association sent to NHS England on 30 October 2017.

It said some GP practices were “having to pay trainees out of already overstretched practice budgets, or trainees are going months without being paid if the practice cannot cover the shortfall”.

Capita confirmed it had outstanding payments to some trainee GPs but was unable to say how many it is responsible for paying, or how many it has not paid.

It said that it had not received all the information it needed to pay salaries from the relevant employers. A Capita spokesperson told The Guardian that the problems were an inevitable part of “a major transformation project to modernise a localised and unstandardised service”.

It added: “We have made significant investment to deliver improvements and these have been recognised by NHS England and demonstrated through improved service performance and improved customer satisfaction.”

The Cameron Fund’s treasurer Dr David Wrigley described the outsourcing of GP support services as a “botched privatisation”.

“NHS England has commissioned out what was a very efficient service run within the NHS, and now Capita runs this contract in what I’d call another botched privatisation.”

One trainee GP went unpaid two consecutive months.  At the end of October she posted on a private message board for GPs: “Anyone know of how I access hardship funds (quickly) to feed children/pay nursery/mortgage (quickly)?”

Her surgery gave her a loan last month to tide her over but did not have enough surplus funds to do the same thing again.

She said that in the last 24 hours partners have stepped forward and have all taken a pay cut to provide a loan “to get me through the month as they were worried about my family”.

An NHS England spokesperson said it was “holding Capita’s feet to the fire on needed improvements”.

It added: “In the meantime, the lead employer for Health Education England or the GP practice are responsible for paying their GP trainee salaries and are subsequently reimbursed for this. Backlogs are being prioritised by Capita.”

The BMA’s letter to the NHS chief executive Simon Stevens criticises Capita.

“We are disappointed at the lack of progress that has been made … These issues have been ongoing since NHS England commissioned Capita … and it is unacceptable that more progress has not been made to getting these resolved …

Wrigley wants the House of Commons’ public accounts committee to investigate the contract.

“NHS England have known about this for a while and the BMA has been putting constant pressure on, and it’s all promises that it’ll get better but it doesn’t.”

New systems for cervical screening and GP payments and pensions that are also contracted out to Capita are due to go live next July. The BMA has told NHS England that it has “no confidence” in Capita’s ability to deliver the services.

Comment

It’s possible to have some sympathy for Capita which has the daunting task of trying to standardize a wide range of systems for supporting disparate GP support services.

But, as Campiagn4Change has reported many times on Barnet Council’s Capita outsourcing contract, it can be difficult if not impossible to make huge savings in the cost of running services (£40m in the case of the GP support contract), deliver an IT-based transformation based on new investment and provide a healthy profit for the supplier’s shareholders while at the same time making internal efficiency savings.

Capita’s share price is relatively low and under continuing pressure but is holding up reasonably well given the company’s varied problems.

Still, we wonder whether the company can afford to put large sums into sorting out problems on the GP support contract, at Barnet Council and on other well-publicised contracts?

The MoD has ended a Capita contract early, the company faces litigation from the Co-op and its staff are staging nine days of strikes over pensions.

Who’s to blame?

If anyone is to blame in this NHS saga it is NHS England for not fully understanding the scale and complexity of the challenges when it outsourced to Capita.

The first rule of outsourcing is: Don’t outsource a problem.

Doctors warned NHS England against signing the contract. Under financial pressure to do so – it needed the promised savings  – NHS England’s public servants signed the deal.

Those public servants will not be held accountable for their decision. In which case, what’s to stop public and civil servants making the wrong decisions time and again?

Two further questions:

Is NHS England too close to Capita to see the faults?

Do public servants have a vested interest in not criticising their outsourcing suppliers, in case opprobrium falls on both parties? 

Thank you to Zara Pradyer for drawing my attention to the Guardian article.

Hundreds of trainee GPs facing hardship as outsourcing firm Capita fails to pay – The Guardian.