In parts of the UK, commissioners have outsourced community services to private providers in deals worth hundreds of millions of pounds, or plan to do so. Cambridgeshire and Peterborough CCG has invited bids for a deal worth up to £1.1bn to run services including community nursing, while Virgin bid successfully for a £500m deal to run community services in Suffolk last year.
But Western Cheshire CCG voted unanimously on 18 July not to put community services, including the district nursing and community therapy services, out to tender.
A report commissioned by the CCG to help inform their commissioning decisions recommended that the services should not be put out to tender. It warned of the ‘impact of uncertainty on staff’ and that further changes were likely to be required across the health and social care system after the 2015 general election.
CCG chairman Dr Huw Charles Jones said: ‘The CCG has closely examined the recommendations highlighted in this community services review report. We decided not to go out to tender primarily because we were assured that all local NHS organisations are committed to patient-focused integrated care. The development of community care is critical to the effectiveness of our local NHS, so how we do it is a big decision.’
Manchester LMC honorary secretary Dr John Hughes said CCGs should not fear legal challenges if they decide not to put services out to tender.
‘There has always been an issue in the NHS where commissioners feel like they have to put services out to tender so they don’t face legal challenges,’ he said.
‘The EU competition laws appear to be over-interpreted by CCGs and the PCTs before them. I think there is a duty on commissioners to seek the best quality and best value but that may not mean putting services out to tender.
‘The CCGs feel they have to go through the full tendering process and that can discriminate against smaller providers like GP practices.
‘I think the issue is that any process has to be transparent. It has to be open to challenge and they have to be able to justify why they have made that decision.’
This month the House of Commons public account committee warned that the NHS must be tougher on private providers. The scathing report into the management of the out-of-hours service in Cornwall said that the NHS needs to be much more 'commercially shrewd' in dealing with big contractors.