CCGs can control and manage contracts - if they have a system
Sadly, I wasn’t at all surprised to read a report recently (in Pulse) saying that CCGs were not doing a great job in managing private contracts.
The article, based on research done by The Centre for Health and Public Interest, said that 12% of CCGs did not do site visits to inspect private contractors, and in fact 60% had no record of any visit at all. And only 16 of the 181 CCGs contacted said that they had the ability to impose financial penalties for non-delivery of outsourced services.
The scary stats continue: only 7 out of 15000 contracts (0.05%) had been terminated due to poor performance and only 134 contract query notices (0.9%) had been issued.
The conclusion arrived at by the researchers is very straightforward: the NHS is not equipped to manage these contracts and so outsourced companies are not necessarily doing the high quality and safe job that we need them to do.
As I said, this is not a surprise. Outsourcing and contract management is a specialised skill. Private companies, whose profits and so very existence depends on being excellent at negotiation and writing favourable contracts, employ the best people to do a first rate job. And the NHS is traditionally trusting and positive, expecting people to do the very best they can without being threatened if they don’t.
All the while the patients, and very possibly the tax payer, lose out.
What do we do? Well, we need to recognise where we do not have the skills to do a job, and get someone who does. We need to stop pretending that we can be good enough at everything and start focusing on getting people who have the skill set to do it properly. Some might say that we need to stop idolising the private sector! Others would conclude that this proves private companies should be kept out of the NHS but this is surely wrong: there are some excellent, innovative and totally customer focused companies out there, who add value and help to push up standards across the public sector.
We believe there must be a healthy middle ground. We can use the private sector and outsource contracts, but retain control and manage things better.
Supplier management is key. NHS organisations need to have a system that allows them to easily monitor the delivery of what was agreed and if necessary get involved in managing the performance more closely. This will allow for a better product improving the quality and of course saving money.
But a sustainable solution starts with an honest assessment. A review of what you do (if anything?) and whether it works will at least get us to the start line in a healthy position.
The NHS need to have the tools in place to find them, use them and ensure we are getting the best deal for the patient. It starts by accepting that managing contracts is perhaps one weakness and an area where outside help can really add value.