PRIVATE firms have been paid a ‘shocking’ £2.3m to draw up controversial plans which will cut health and social care spending by more than £1bn in a part of London.
According to health leaders drawing up the North Central London STP (sustainability and transformation plan), six-figure sums were paid to eight different companies – including accountants Deloitte and management consultants McKinsey – for services stretching from ‘administrative support’ and ‘financial modelling’ to ‘communications support’.
A firm called Consultants Methods Advisory Ltd, which describes itself as ‘shaping public services for the digital age’, racked up the biggest costs, invoicing £617,850 for ‘programme management office and strategy support’. Doctors leaders described the figures as ‘appalling’.
BMA council chair Mark Porter said: ‘While hospitals fall into crisis, social care hits rock bottom and the Government blames hard-working GPs for its political choice to underfund the NHS, every penny of health service money becomes more desperately valuable and doctors will find it galling to see that so much vital resource has been handed to consultancy firms for their part in failing plans which, ultimately, may never come to fruition, while frontline staff struggle to provide safe patient care in a service increasingly becoming unfit for purpose.’
BMA News analysis last year revealed that the STP process – which has seen England divided into 44 ‘footprint’ areas, with each asked to produce a plan to integrate and transform local services – will need to cut some £26bn from their budgets by 2021. And in December an NHS Improvement board paper revealed that only projects which were ‘shovel ready’ would be likely to be funded – with capital resource too tight to pay for all the projects.
Dr Porter added: ‘NHS Improvement has admitted that it will pick and choose the parts of these vast, bewildering plans it can actually put into action and, as such, it leads me to question whether all of this money handed out to private companies will be completely wasted – yet another example of vital resource being frittered away in a health service devoid of direction and leadership and lurching from one unnecessary crisis to another.’
The North Central London STP – and its final iteration: a 68-page word document in PDF format – aims to combine ‘radical service transformation and incremental improvements’. It reveals that the area faces a funding shortfall of £1.2bn in 2020/21 if spending and funding levels continue as expected.
In the plan, health leaders admit to ‘not having all the answers’ and still expects its NHS organisations to be in the red by £75m in five years – even after all the cuts. Camden GP and local medical committee chair Farah Jameel said: ‘As a practising GP struggling to meet patient needs with ever tighter resources, the words that come to mind when presented with these financial figures are shocking, disgusting, appalling and ultimately not surprising.
‘The Government should be held accountable for allowing this inappropriate use of funds and be encouraged to focus attention on addressing the very real challenges affecting those who work in and rely on the NHS. We are in the midst of a winter crisis, the NHS has systematically been stripped of much needed resources, translating into services performing under extreme pressure and stress, in this context these monies would be much better spent on frontline services like A&Es and General Practice.
”I remain acutely aware of the Government’s agenda to transform and reconfigure services to better suit the needs of the population within the constraints of a shrinking financial envelope. With that in mind the absence of strong clinical input regarding service capacity and patient need in the planning process is frankly disappointing, especially given the large figures of taxpayers money involved.’ A new norm?
In total 17 different firms were paid for their involvement in putting together the STP.
McKinsey and Company were given £360,000 for ‘strategy assessment’ and ‘financial modelling’ particularly related to mental health services and initiatives. Deloitte LLP was given £257,336 for ‘finance and activity modelling’.
And recruitment specialists Hunter Healthcare Resourcing charged £282,518 for administrative support. Methods Advisory Ltd did not respond to BMA News’ request for comment. But a column on its website said: ‘We have worked in health and care for over 25 years, with all its incarnations and ambitions.
‘This gives us the ability to know what has worked (or not) before, alongside knowing what the potential… (to be) the “new normal” in health and care.’ The revelations come months after a letter was leaked to the BBC revealing the cost of external providers to an STP in Cheshire and Merseyside.
PricewaterhouseCoopers were paid £300,000 – less than a seventh of the total cost in North Central London – to help draw up the Cheshire and Merseyside STP, a plan which requires savings of £999m within five years.
Explaining the costs, Louise Shepherd, lead for the Cheshire and Merseyside STP, said: ‘This is to provide additional capacity and expertise to help and support our clinicians and managers design our future care models while still delivering a very challenging “day job”.’
NHS Improvement and the North Central STP lead have been contacted for comment.
The North Central London patch includes: Barnet, Enfield and Haringey Mental Health NHS Trust; Camden and Islington NHS Foundation Trust; Central and North West London NHS Foundation Trust; Central London Community Health Care NHS Trust; Great Ormond Street Hospital; Moorfields Eye Hospital; North Middlesex University Hospital NHS Trust; Royal Free London NHS Foundation Trust; Royal National Orthopaedic Hospital; Tavistock and Portman NHS Foundation Trust; University College London; and Whittington Hospital.
• GP surgeries in England will not be forced to extend opening hours, despite comments by prime minister Theresa May apparently blaming practices for the crisis in hospitals.
The Department of Health and NHS England have said that there will be no changes to surgeries’ existing contractual hours, following calls for clarification by the BMA. The association was one of a number of health organisations criticising the prime minister after she stated earlier on 13 January that GPs’ failure to extend their opening hours was putting pressure on emergency medicine departments.
May had further suggested that cuts to funding would be applied to surgeries that did not seek to widen opening hours. In a letter to GPs published on 23 January BMA GPs committee chair Chaand Nagpaul said that the prime minister’s comments had been an unacceptable slur against general practice.
He added that he had since sought confirmation that practices would not be forced to change their hours, and that ministers had a responsibility to engage seriously with doctors in finding solutions to the challenges facing the NHS. He said: ‘I was shocked and dismayed by media reports of the prime minister’s attacks on GPs for being a cause of the crisis in the NHS and hospital pressures – and of reports that GP practices would be required to open seven days a week or face funding cuts.
‘These reported comments made a little more than a week ago were unacceptable and a slur on the profession. GPC will not accept pushing GPs to work any longer or harder at a time when we manifestly don’t have the capacity and are unable to cope within our current hours. I have spoken to NHS England and the DH and, contrary to the headlines, there will be no obligation on individual GP practices to be open for seven days, or beyond their contractual hours. GPC will continue to fight for the survival of general practice and for the necessary investment for GPs to be able to do our jobs properly and provide safe, high-quality care to patients.’
The BMA, which wrote to May in the wake of her comments, was backed in its warning to Government not to scapegoat GPs by organisations such as the King’s Fund, Royal College of GPs and House of Commons health select committee chair Sarah Wollaston.
GPs from around England also voiced their anger and disappointment at May’s comments, with many suggesting that they showed the prime minister’s lack of understanding as to the extreme challenges faced by many practices.