Dr Coral Jones, honorary secretary of City and Hackney BMA and a candidate in last month’s BMA Council elections, interrupted a dinner and policy discussion for CCG leaders in a private room of a riverside London restaurant earlier this year.
The London GP fears that meetings behind closed doors between NHS commissioners and private providers could create potential conflicts of interest.
The dinner interrupted by Dr Jones was organised by Impower, a private consultancy firm dedicated to ‘redesign’ and ‘reform’ of public services, and was addressed by NHS England’s commissioning strategy group director Michael Macdonnell.
Impower holds NHS contracts, including with Bromley CCG to develop an integration strategy for out-of-hospital care and has worked with Sandwell and West Birmingham CCG to develop an A&E attendance reduction strategy.
The dinner was organised by the firm's director Kieran Brett, a former Downing Street policy advisor to Tony Blair.
In an invitation sent to CCG leaders, Mr Brett said the dinner offered a chance to hear from Mr Macdonnell about the sustainability and transformation plans (STP) programme he leads. The programme aims to shape how local health systems will deliver NHS England’s Five Year Forward View strategy.
In a document called Bending the Curve, shared with commissioners at the dinner, Impower set out its plan for health service redesign to help CCGs meet their share of the £22bn savings required by the Five Year Forward View, including developing new contracts to facilitate new care models.
The report highlights the firm’s ‘extensive knowledge’ of Whitehall, No 10, the Treasury and DH and its strong, senior-level networks inside NHS England.
Impower confirmed to GPonline that it funded the hospitality for the CCG leaders present, none of whom are current clients of the firm.
Dr Jones said that commissioners were ‘wide open to lobbying from consultancy firms who promise to deliver the required savings and organisational transformations at the speed required’ as they seek to deliver targets in STP plans.
Conflict of interest rules
She said the Impower event was ‘hidden from public scrutiny or accountability’, and called on NHS England to toughen conflict of interest rules. ‘Stringent safeguards are indeed needed if the NHS is to be protected from corporate lobbying,’ she said.
NHS England’s board announced in March plans to tighten rules on conflicts of interest after an audit of primary care co-commissioning arrangements found inconsistencies and breaches of statutory guidance.
Under proposals being consulted on CCGs could be ordered to appoint conflict of interest guardians and publish more extensive registers of gifts and hospitality and wider registers of procurement decisions.
NHS England's own internal policy will be toughened to include more stringent safeguards on the role of lobbyists and commercial organisations.
Mr Brett told GPonline that contributing to the policy debate was a legitimate part of what consultancy firms do. ‘Unless people in the NHS are suggesting we should be stopped from doing that, which feels heavy handed to me,’ he said.
‘I can name lots and lots of companies with commercial arrangements that can still try and do something above and beyond the call of its commercial arrangements,' he said. ‘That seems quite a noble thing to me.'
Mr Brett said that while other consultancies may operate by using such events to pitch for business, that wasn’t how Impower operated. ‘If we wanted private commercial sales meetings with CCGs, we could do that. We'd just get them into a room, have dinner and pitch something to them. We could definitely do that. Lots of consultancies do that.’
Mr Brett added that he believed Dr Jones had ‘got the wrong end of the stick’ about the nature of the event.
The firm’s Bending the Curve strategy document was a pitch for CCG business, Mr Brett acknowledged, which was available at the dinner event for commissioners to take away. ‘It's all about helping the NHS to achieve sustainability through transformation,’ he said.
‘It's an attempt to empower patients and carers through education, support and care planning. Targeted at high risk, high cost patients using risk stratification. And about how you build multidisciplinary teams around patient and develop new relationships with the third sector to help support patients and free up NHS resources so they can be used to meet increasing future demand.’
An NHS England spokeswoman said: ‘As is common practice Michael [Macdonnell] was invited to attend this event as a speaker to discuss sustainability and transformation planning with other CCG leaders. He paid for his own dinner and expenses as per NHS policy, including our conflict of interest guidelines.’