Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the performance of (a) NHS England, (b) NHS Improvement and (c) Greenwich Clinical Commissioning Group in the awarding of the contract to provide musculoskeletal services in Greenwich to Circle Holdings PLC; and if he will make a statement.
Answered by Philip Dunne
The procurement of local health services by means of competitive tendering is a matter for the local National Health Service.
NHS England has advised that it carried out an assessment of the procurement process that Greenwich Clinical Commissioning Group (CCG) followed for the contracting of musculoskeletal services and was satisfied the CCG had followed due process.
We are informed that NHS Improvement did not have a role in this procurement process as it was a local commissioning decision for Greenwich CCG.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what discussions he has had with Greenwich Clinical Commissioning Group, NHS, England, NHS Improvement and Lewisham and Greenwich Healthcare Trust as a result of that clinical commissioning group's decision to propose signing the contract to provide musculoskeletal services with Circle Holdings PLC; and if he will make a statement.
Answered by Philip Dunne
The provision of local health services is a matter for the local National Health Service.
There have been no discussions between Ministers at the Department with Greenwich Clinical Commissioning Group (CCG), NHS England, NHS Improvement and Lewisham and Greenwich Healthcare Trust as a result of the CCG's decision to propose signing the contract to provide musculoskeletal services with Circle Holdings PLC.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what advice NHS England gave to Greenwich Clinical Commissioning Group (CCG) in the contracting process for musculoskeletal services in Greenwich on (a) ensuring that the CCG followed the correct procedures, (b) ensuring that the CCG was quorate at the time that it decided to let the contract, (c) advising the CCG whether companies should be invited to bid and (d) ensuring that the CCG had carried out a full impact assessment on other NHS services; and if he will make a statement.
Answered by Philip Dunne
NHS England has a statutory responsibility to carry out an annual assessment of a clinical commissioning group’s (CCG) delivery of its statutory duties. In addition, it has an ongoing assurance and oversight role through which it checks whether CCGs are delivering improvements in care in the best interests of residents and in line with the principles in the NHS Constitution.
In respect of the contracting for musculoskeletal services (MSK) in Greenwich, NHS England has advised that it carried out an assessment of the procurement process that Greenwich CCG followed in order to secure a new provider of integrated MSK services. This assessment was designed to make sure that the CCG had followed an appropriate procurement process, that the scope of the procurement was clear, that the CCG was commissioning a service that met expected quality standards, that the CCG was managing any possible conflicts of interest, and that any statutory and accounting issues and risks were fully understood and mitigated.
We are advised that NHS England wrote to the CCG on 22 July 2016 to confirm that it was satisfied that the procurement had followed due process and identified the risk and implications for the existing provider.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 20 October 2016 to Question 48889, whether it is standard NHS procurement procedures to allow clinical commissioning groups (CCGs) to double count members who are present as delegated substitutes for members that were absent in order to achieve a quorum when voting to grant multi million pound contracts; on how many occasions CCGs have acted in such a manner; and if he will make a statement.
Answered by Philip Dunne
The Governing Body of Greenwich Clinical Commissioning Group (CCG) met on 29 June to consider the outcome of the assessment panels which had looked at the bids for the musculoskeletal services contract referred to in Question 48889. Three general practitioners present believed that they had conflicts of interest and therefore delegated their votes to other members of the Governing Body. The CCG assured NHS England that this delegation is in line with its Constitution and compliant with statutory guidance on management of conflicts of interest.
Information on how many times CCGs have acted in this way in order to manage potential conflicts of interest is not collected or held centrally.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, how his Department assesses the value for money of health service contracts that are tendered by clinical commissioning groups; and if he will make a statement.
Answered by Philip Dunne
Clinical commissioning groups (CCGs) should take all possible steps to ensure that they are buying the best services for patients from the best providers available. It remains for commissioners to decide how best to procure services in the interests of their patients while seeking best value for taxpayers.
In October 2016 the Department published guidance on the Public Contract Regulations 2015, which aims to support commissioners in complying with the Public Contract Regulations 2015.
The guidance can be found at the following address:
https://www.gov.uk/government/publications/public-contracts-regulations-2015-for-nhs-commissioners
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 17 October 2016 to Question 48022, how he monitors the performance of clinical commissioning groups and health service providers on their delivery of the Getting it right first time requirements; and if he will make a statement.
Answered by Philip Dunne
Getting it Right First Time (GIRFT) was a recommendation in Lord Carter’s report on Hospital Productivity published in February 2016. NHS Improvement is responsible for delivering the recommendations of that report. It is accountable to the Secretary of State for Health for the delivery of the overall programme and the Secretary of State regularly reviews progress. NHS Improvement has provided an update on its plans for delivering and monitoring performance in individual clinical commissioning groups and health service providers.
The orthopaedic GIRFT pilot was led by the programme lead Professor Tim Briggs. The GIRFT team mined nationally available data sources and produced a report for each provider of orthopaedics in England that included a consolidated view of all available data and metrics pertaining to each provider’s clinical and financial performance at a service line/individual specialty level. Professor Briggs then visited every trust in England to discuss their data in order to reflect on variation in clinical practice, management approach and variations in procurement. The reports benchmark providers nationally and explore how clinical evidence is considered and informs practice. This is a highly detailed approach facilitating an extensive understanding of the links between practice, outcome and cost drivers, which in turn enabled a series of recommendations to be developed benefitting quality of care and finances of both providers and commissioners. Following the provider level reports and visits, a national report and recommendations were produced. The Model Hospital will provide a platform for an ongoing series of dashboards to track performance against key performance metrics. The GIRFT team will be working closely with NHS England’s RightCare programme which is aimed at commissioners to align their work to achieve joint objectives.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, pursuant to the Answer of 17 October 2016 to Question 48024, what steps his Department is taking to monitor the costs to health service providers of tendering for contracts and the implications for paying for patient services; and if he will make a statement.
Answered by Philip Dunne
We do not collect information on which providers have been awarded contracts or the costs to providers of tendering for contracts, but commissioners are required to publish information on the contracts they award.
The NHS Procurement, Patient Choice and Competition (No2) Regulation 2013 to requires Monitor, now working with the NHS Trust Development Authority as NHS Improvement, to ensure that choice and competition operate in the best interests of patients, that procurement decisions by commissioners achieve the best results, and that all providers are treated fairly.
In making judgements on which services to commission, clinical commissioning groups should take all possible steps to ensure that they are buying the best services for patients from the best providers available. It remains for commissioners to decide how best to procure services in the interests of their patients while seeking best value for taxpayers.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what assessment he has made of the adequacy of patient involvement in the commissioning process for musculoskeletal services carried out by Greenwich Clinical Commissioning Group prior to the granting of that contract to Circle Holdings PLC; and if he will make a statement.
Answered by Philip Dunne
The procurement of local health services by means of competitive tendering is a matter for the local National Health Service.
We are advised by NHS England that Greenwich Clinical Commissioning Group (CCG) undertook the first of its engagement events on the proposed redesign of the musculoskeletal services pathway during November 2013. We understand that this initial engagement enabled the CCG to identify that the existing pathway was felt to be fragmented and complex for patients. In light of that, a new model was proposed in December 2013, and was shared with the public at workshops during 2014.
We are further advised by NHS England that the proposed pathway was outlined in the draft service specification, which was shared with the patient reference group (PRG) during February and March 2016. We understand that the specification was sent to PRG members to cascade to their patient participation groups and other groups of which they are members, such as the Pensioners’ Forum.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, whether he has received representations on whether Greenwich Clinical Commissioning Group was quorate at its meeting of 29 June 2016 when it awarded the contract for musculoskeletal services to Circle Holdings PLC; and if he will make a statement.
Answered by Philip Dunne
The procurement of local health services by means of competitive tendering is a matter for the local National Health Service.
The Department has not received any representations on the matter of whether Greenwich Clinical Commissioning Group (CCG) was quorate at its meeting of 29 June 2016 when it awarded the contract for musculoskeletal services to Circle Health.
We are informed by NHS England that the CCG follows standard NHS procurement procedures and these procedures were followed for this procurement.
Asked by: Clive Efford (Labour - Eltham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health, what discussions he has had with Greenwich Clinical Commissioning Group and Healthwatch Greenwich on patient involvement in the commissioning process prior to the granting of the contract to provide musculoskeletal services to Circle Holdings PLC; and if he will make a statement.
Answered by Philip Dunne
The provision of local health services is a matter for the local National Health Service.
There have been no meetings between Ministers at the Department and Greenwich Clinical Commissioning Group and Healthwatch Greenwich about patient involvement in the commissioning process prior to the granting of the contract to provide musculoskeletal services to Circle Holdings PLC.