LMC warning over hospital growth as GPs challenge tendering process

LMC fears 'empire building' hospitals are forcing out GP-led services, after a GP out-of-hours provider lost out in a tendering process it believes was unfair and illegal.

Dr George Rae: fear of 'vertical integration'
Dr George Rae: fear of 'vertical integration'

Northern Doctors Urgent Care (NDUC) filed a claim in the High Court against three CCGs in the north east of England following a tender process for an out-of-hours service.

Commissioners said they were ‘urgently considering’ the legal challenge, and defended the ‘thorough and robust’ procurement process.

NDUC, the incumbent provider, lost two of the three lots put out to tender, GP understands, retaining a North Tyneside contract when bidders were notified on 11 December.

Two separate bids were awarded contracts for Newcastle and Northumberland.

The successful bidders are believed to include a hospital foundation trust. A spokeswoman for Newcastle Upon Tyne Hospitals Foundation Trust said it was ‘not in a position to comment’ at this stage, and could not confirm whether it was involved.

A local GP leader said foundation trust involvement would raise fears of ‘vertical integration’ and ‘empire building’, although there is no suggestion any bidder has acted improperly.

In court documents seen by GP, NDUC claimed the decision to award the two lots taken by Newcastle Northern, Newcastle West, and Northumberland CCGs and the North of England commissioning support unit (CSU) was based on a process ‘conducted in breach of the Public Contract Regulations 2006 and/or the key principles derived from the Treaty for the European Union.’

NDUC claimed the CCGs ‘failed to conduct a proportionate, transparent and fair process for the tender’, and that their failure to use discretion and accept documents after a deadline affected the decision.

The claim asks the court to order the tender process be abandoned, or damages and costs be awarded.

In October, John Harrison, chief executive of NDUC's parent company, Vocare, warned GP out-of-hours providers they could be 'squeezed out' by expanding foundation trusts and the integration of urgent and emergency care.

Speaking to members of Urgent Health UK (UHUK), the umbrella organisation for social enterprise and GP-co-op providers, Mr Harrison said CCGs were commissioning integrated urgent care contracts, ‘gifted to hospital trusts’.

Local GPs are concerned over hospitals taking over primary care services, said Newcastle and North Tyneside LMC chief executive and GPC member Dr George Rae.

He said it appeared a hospital foundation trust was part of the winning bid in Newcastle. It was ‘incongruous’, he said, that multiple providers could be running the service across the region.

‘It raises an eyebrow,' he said, ‘but I do also say for the future delivery of the health service there has to be better coming together of primary and secondary care. What I do not want, and the concern I would have, is that there is empire building within secondary care, thinking this is the start of a vertical integration process; we would like to run, we would like to control and shape what is happening in primary care.’

A spokeswoman for the North of England CSU said: ‘The clinical commissioning groups in Newcastle, North Tyneside and Northumberland have been undertaking a procurement to appoint a provider for out-of-hours GP services for Newcastle, North Tyneside and Northumberland.

‘The procurement process has involved a thorough and robust assessment of bids (including both written and face-to-face evaluation) across a broad range of criteria and is fully compliant with the relevant procurement legislation.

‘The result being the bidder achieving the highest overall score being appointed as the "recommended bidder". The procurement process has ended and recommended bidders have been notified.

A spokesman for NDUC said: 'We hope to be able to issue a statement soon, but we have taken legal advice, so we have to listen to that.'

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