Controversial care contract folds without warning

UnitingCare17:09 Thursday 3rd December 2015
BBC Radio Cambridgeshire

CHRIS MANN: It’s been revealed this afternoon that a consortium which was set up to look after community care in Cambridgeshire has ended, with all parties saying it’s no longer financially sustainable. The consortium was made up of Addenbrooke’s Hospital and the Cambridgeshire and Peterborough NHS Foundation Trust. The £800 million contract was the biggest outsourcing of the NHS care in its sixty year history, and yet eight months later it has apparently broken down. Only back in July, just three months into the contract, the Chief Executive of UnitingCare, Keith Spencer, told BBC Radio Cambridgeshire they’d made a promising start.
KEITH SPENCER: From 1st April we managed to transfer services safely, and 40 from the Community Services staff transferred to the Cambridgeshire and Peterborough NHS Foundation Trust. But we’ve also introduced two new services. So on 6th May we introduced OneCall, which is a 24/7 single point of contact co-ordination and source of advice, in the first instance for GPs. But we will be extending that to patients later in the year.
CHRIS MANN: So that was Keith Spencer speaking in July, the Chief Executive of UnitingCare. Then today came that news. Well earlier I spoke to Jo Rust. She’s the Regional Organiser of Unison, and she began by giving me her reaction to the news.
JO RUST: Well I’m totally shocked, because we were actually at a management meeting with senior managers in CPFT the mental health trust that oversees UnitingCare, and there was no inkling of it whatsoever there.
CHRIS MANN: When was the meeting?
JO RUST: Yesterday.
CHRIS MANN: And they didn’t say anything?
JO RUST: No. Nothing at all. We know that the Finance Director wasn’t there. He was at a meeting with the CCG, so it could well have been that was the reason for his absence.
CHRIS MANN: I think ordinary people will be baffled. Patients will be baffled at what’s going on here. Give us your interpretation.

JO RUST:  Well it was obvious from the start that the CCG needed to put all this, all their eggs in one basket so to speak, for financial reasons as well as to ensure the quality of care. And our concern at the time was that it cost an awful lot of money to go out to procurement, to commission the services. And how were they actually going to save the money there? And it’s evident that they can’t make the financial cost savings. And at an expense .. we’re already seeing mental health services that are being squeezed all the time. And it was just not going to be able to financially run.
CHRIS MANN: So has this been a complete waste of time and money?
JO RUST:  Well that’s our fear, yes. And the staff involved, the very staff that we rely on to provide a good service, are naturally going to feel very concerned about security, job security and the rest of it. They’ve just undergone a huge upheaval, being transferred from one NHS organisation to another. There’s been restructures while it’s going on. They’ve had changes to job descriptions and that type of thing. And now to face this uncertainty as well. And I do understand that both CPFT and the CCG, the Clinical Commissioning Group, are saying that the services will continue, they’re still needed. And so people should be reassured that their jobs aren’t going to be at risk. But at the same time of course they’re going to be fearful that that will be what actually happens.
CHRIS MANN: And there’s also the concern for patients who must be listening to this now, and their relatives and friends, wondering is our care going to continue.
JO RUST: Absolutely. The patients are always at the heart of the things that we do, and we look after the patients by making sure that the staff are cared for. Now of course you know that those staff are totally committed to their patient care. And those that came over from CCS, came over from an absolutely outstanding NHS organisation. And we know that the people within that organisation, CPFT, have pride to make this work. And as a trade union organiser I’ve been part along with the other trade unions in trying to make it work for them. But yes, the patients are naturally going to be concerned. I guess I would join the CCG and the other NHS organisations in trying to provide a degree of reassurance for them that these services aren’t suddenly going to disappear. So I think that for them they should be reassured that it’s business as usual. For the staff concerned obviously we make that same reassurance, but ..
CHRIS MANN: But for how long.
JO RUST: Yes I know. That’s the concern. And if it isn’t financially viable now, when will it be? How will it be?
CHRIS MANN: Today we’ve been told by the Cambridgeshire and Peterborough Clinical Commissioning Group they’re not putting anybody up for interview, because they say they’ve got to talk to staff first. But it leaves a great deal of uncertainty. Should they be more public about this? What’s your view? Why aren’t we getting the clear picture and explanation from them?
JO RUST: Well because there will be staff out there that haven’t yet been told. There has been an email. I’ve just come back in from being on the road, and there is an email there that has been sent out. But naturally the staff are going to want to hear from their managers first. I need to reassure them that if they’re trade union members they can go and speak to their trade union reps as well to get some reassurance.  And I do need to repeat it will be business as usual, because these services are vital to the health economy in the Cambridgeshire and Peterborough area. But of course there’s that degree of uncertainty.
CHRIS MANN: Is the commissioning system working?
JO RUST: Well, I don’t think I’m the person that should answer that necessarily. We never wanted this system in place in the first place. And it was ‘no more top-down re-organisation of the NHS’ and then what happened? A massive top-down re-organisation that cost billions of pounds to implement, money that should have been going directly into the services. So I’m not a fan in the first place.
CHRIS MANN: But I interviewed a former senior executive in the NHS quite recently, and he said that too much money was going on commissioning and administration, and more of that should go on the front line.  You wouldn’t disagree with that?
JO RUST:  No. That’s exactly what I have said, albeit in a different way. They spent billions of pounds changing a system that, you know, it might not have been perfect but it wasn’t as badly broken as it is now. And the commissioning services themselves, all they are there to do, the CCG, is to commission services. And that takes a massive amount of money. It cost well over £1 million to commission UnitingCare Partnership, to put it out to tender, to make sure public consultation was done. That was a waste of money.
CHRIS MANN: That’s Jo Rust of Unison.