Capita outsourcing could have harmed patients

A new report by the National Audit Office (NAO) has found that patients could have been put at risk of serious harm after NHS services in England were outsourced.

NHS England’s management of the primary care support services contract with Capita cited how 87 women were wrongly told they were no longer part of the cervical screening programme after Capita started running back-office services in 2015, with services falling below acceptable standards. Furthermore, processing issues led to an estimated 1,000 GPs, dentists and opticians being delayed from working with patients and some of these practitioners lost earnings. Although no harm to patients had been recorded, the risk was highlighted.

Having agreed a seven-year £330 million deal with Capita in 2015 to deliver primary care support services aiming to reduce costs by 35 per cent. Transferred duties included sending out test results, moving patients' medical records, processing patient registrations and paying GP practices. Capita expected to make a loss of £64 million in the first two years of the contract, which it planned to recoup in later years. However, Capita was incentivised through the contract to close existing services to minimise its losses, but it proved more complicated than either party anticipated.

According to the report, Capita acknowledged that it made performance issues worse by continuing to close support offices in summer 2016 even though it was aware the customer service centre was struggling to meet demand at that time, with NHS England contractually unable to stop Capita's aggressive office closure programme, even though it was having a harmful impact on service delivery.  

Amyas Morse, the head of the NAO, said: “Neither NHS England nor Capita fully understood the complexity and variation of the services being outsourced. As a result, both parties misjudged the scale and nature of the risk in outsourcing these services. While NHS England has achieved financial savings and some services have now improved, value for money is about more than just cost reduction. It is deeply unsatisfactory that, two and a half years into the contract, NHS England and Capita have not yet reached the level of partnership working required to make a contract like this work effectively.”

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "The long list of failures made by Capita have been incredibly frustrating for GPs and our teams, and we are still dealing with the fallout - including a significant additional administrative burden - at a time when practices are already working under intense resource and workforce pressures.

"Some of these failings have led to trained healthcare professionals being unable to work in the NHS, at a time when general practice and the wider health service is crying out for people to deliver patient care. Other failures have involved mismanagement of tasks that might seem on the face of it to be low risk but can have serious consequences for our patients' safety if consistently completed inadequately. Moving forward, lessons must be learnt by the NHS, but also by companies bidding for NHS contracts who need to realise that by taking on this work, patient care and patient safety lies in their hands. Patient safety must always be the number one priority when awarding private companies contracts for any work in the health service."

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