To receive Questions from the Public, in accordance with the Council’s Constitution.
Minutes:
Five public questions were submitted by Caroline Bedale for the Commissioning Partnership Board to consider:
1. Payments to non-public sector for healthcare services
I understand that Greater Manchester Health & Social Care Partnership Board is promoting a public sector model for commissioning and provision of healthcare services. So why is Oldham commissioning so much healthcare services from non-public sector organisations, rather than from the NHS or other public sector? I assume the figures are similar for 2018/19.
2017/18: £50,397,000 is the expenditure on non-NHS / non-public sector providers. This is 18.2% of the total expenditure on healthcare services of £276,537,000.
This does not include expenditure to councils/other public sector/quasi public sector (Oldham £4,611,000, Oldham Community Leisure £57,000, Tameside £18,000) and other NHS £294,000. The total of these is £4,980,000.
2017/18 Total £50,397,000 £ ‘000
Private 28,255
Care homes/home care 13,406
GPs extras 4,341
Voluntary – large/UK 1,996
Voluntary – local 411
Hospice 1,030
Personal health budgets 292 unspecified recipients
GM population health 259 unspecified recipients or what this includes
Winter resilience 100 unspecified recipients or what this includes
Small providers/accruals 307 unspecified recipients or what this includes
Over ¾ of the expenditure, £38,405,000, is paid to 18 companies / organisations with over 1% share of the total each, and about ¼, £12,352,000 to the remaining 90 non-NHS providers, many of which are care homes/nursing homes/home care services.
£ ‘000
Pennine MSK 7,103 musculoskeletal services
BMI Healthcare Ltd 5,498 various acute services
Lancaster House Cons
Diagnostic & Surgical 5,320 ultrasound, urology, cardiology, continence, gynaecology
Lloyds Pharmacy 3,711 home care drugs
Care UK Clin Serv Ltd / In Health 2,071 IVF, gastrology, ENT (CATS)
Go to Doc 2,003 out of hours services
Priory Group Ltd 1,875 care home
Virgin Care Provider Services Ltd 1,756 dermatology services
CAS Behavioural Health Ltd
and Cygnet Healthcare Ltd – all part of Universal Health Services Inc
1,404 care home
Oaklands Hospital 1,318 various acute services
Chadderton Total Care Unit 1,225 care home
Dr Kershaws Hospice 1,003 hospice
DHP Care Ltd 819 care home
TOG* Mind 723 IAPTS (*Tameside, Oldham, Glossop)
Instream Partnership 693 care home
St Georges Nursing Home Ltd 674 care home
Turning Point 654 mental health services
Bridging the Gap 555 care home
38,405
I am particularly concerned about the over £7 million being paid to Pennine MSK, as it is a waste of public money to be paying a private company for healthcare services which the NHS could provide if they were commissioned to do so. I was referred to this company last year. As I do not wish to be assessed or treated by a private company rather than the NHS, I asked the booking system to refer me direct to the NHS – but they could not / would not do so. I had to go back to my GP and ask her to write a letter to the booking system specifically asking for me to be referred to the NHS. Eventually this was done, but it meant I had a delay of about 2 months between first going to the GP and being seen by an NHS consultant. I tried to check how much Pennine MSK pays its Directors and Officers and how much profit they make – but they do not declare this in their company information, as being a small company they are legally entitled to withhold this information. It cannot be right that a private company is making profit out of the NHS and furthermore that it is not transparent about how much that profit is or how much the Directors make out of it.
Also, there are large amounts being paid to BMI Healthcare and Oaklands Hospital – both private hospitals. Why is Oldham buying healthcare services from them rather than from the NHS?
Why is so much being paid to Lancaster House and to Care UK/InHealth, it would appear for diagnostic services, rather than the NHS providing these services?
2. Is there a Performance Report up to the end of December 2018, showing whether Oldham has met national targets (eg, for A&E waiting times, IAPT services, out of area bed placements – particularly for mental health.)
3. Is there a Finance Report up to the end of December 2018, showing budget and forecast figures?
4. Is there any report on mental health services in Oldham?
5. What will happen to community health services as Pennine Care does not wish to continue the contract to provide these services?
Mike Barker, Strategic Director of Commissioning/Chief Operating Officer responded to the questions as submitted:
1 Why is Oldham commissioning so much healthcare services from non-public sector organisations, rather than from the NHS or other public sector?
Response
The CCG has a wide range of contracts as outlined in the question. Where the CCG has conducted a tender process, NHS and private providers have been eligible to apply and to be awarded those contracts.
All of the contracts are NHS contracts on the standard NHS contract with NHS terms and conditions. Irrespective of the provider the prices that are paid are NHS prices.
2 I am particularly concerned about the over £7 million being paid to Pennine MSK, as it is a waste of public money to be paying a private company for healthcare services which the NHS could provide if they were commissioned to do so.
Response
Pennine MSK has an NHS contract held with the CCG for the provision of Muscular-Skeletal services for the population of Oldham. The service includes NHS staff who work with Pennine MSK and also with our core hospital services. This service has grown and developed in partnership with our NHS hospital and community services. I can seek to get information about MSK as outlined but I am not certain this is going to help.
3 There are large amounts being paid to BMI Healthcare and Oaklands Hospital – both private hospitals. Why is Oldham buying healthcare services from them rather than from the NHS?
As stated in the answer to question 1 above, the CCG has a wide range of contracts as outlined in the question. In the case of BMI and Oakland’s they principally provide planned (Elective) Care where patients are given a choice of where they would like to have their surgery undertaken. All of the contracts are NHS contracts on the standard NHS contract with NHS terms and conditions. Irrespective of the provider the prices that are paid are NHS prices.
Providers such as BMI healthcare and Oaklands have capacity and facilities to support the care and provision of that care for the population of Oldham.
4 Performance report, Finance report & mental health services
Our most recent performance and finance reports are available on our web site and can be provided. The CCG does not have a specific report on mental health services at present .A number of papers have been to our Governing body and commissioning partnership board which are both held in public. There have also been presentations to the Overview and scrutiny committee and Health and Well-being Board. Oldham Cares is committed to the development of mental health services and is pleased to have a number of transformation projects in this area.
5 What will happen to community health services as Pennine Care does not wish to continue to provide them?
The Oldham Cares team are working to ensure that there is a smooth and effective transition of community services. Our focus is on ensuring continuity of services for patients and also for the staff who deliver the services. Oldham Cares is working closely with its alliance of providers to ensure that this process is safe and effective and supports the needs of the population of Oldham.
RESOLVED – That the public questions and responses be noted.