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Is Capita too vital to fail?

Hard-wired GP

Luke Koupparis

Tuesday, 06 February 2018

AdobeStock_56998578_capita.jpgIt would seem that we are in an era where no company is too big to fail. I guess that is apart from the banks, who really were too big to fail and their collapse would have brought down capitalism in a big way. I mean companies like Carillion, who were the second largest construction company in the United Kingdom listed on the stock exchange. They entered into compulsory liquidation on the 15th January 2018. The knock-on effects were huge with many projects grinding to a halt causing financial losses to 30,000 suppliers and uncertainty for the 28,500 workers in the pension scheme.

So, what has construction got to do with providing healthcare? Well, my worry is the company Capita, another listed organisation who provide a number of professional services to the NHS.

In June 2015, they were awarded a lucrative contract lasting four years to become sole provider of administrative services including payment administration, management of medical records and eligibility lists of practitioners for GPs, opticians and dentists across the UK by NHS England. In September 2015, they established Primary Care Support England (PCSE) which replaced regional support services.

However, the service they have provided has been near shambolic. Since rolling out their services there have been ongoing problems, including missing patient records, lack of registrations, performers list problems and delays in practice payments, including those for GP trainees. In addition, a BMA survey found that 73% of GPs reported that the system of pension payments was in disarray.

In November 2017, the LMC voted at conference to have Capita stripped of their support service contract. Richard Vautrey was forced to write a letter in January 2018 to Simon Stephens outlining his concerns about their service and the fact that little has improved, despite repeated concerns raised. In his letter he appended a copy of the survey carried out and concluded that the BMA would be supporting practices and doctors to take legal action.

In a further twist to this story which very much mirrors what happened to Carillion, at the end of January Capita saw a 40% drop in its share price after it issued a profit warning. The potential for a large company like this to collapse became very real and both GPs and GP leaders became worried about the impact on patient care alongside their businesses should Capita completely fail. With the disbanding of local support services, the knowledge required to deliver these services no longer exists, so the potential consequences of failure would be colossal.

NHS England have now accepted that they will publish a review of patient harm that has occurred as a result of failures by Capita by the end of April and is planning an information campaign for GPs on how to handle incorrect correspondence. Capita have disputed that redirecting letters for patients not registered at the practice was not part of their contract and this was down to GPs.

This whole debacle shows that simply outsourcing back office services is seen as a quick win for efficiency by the Government, but the reality is that it can easily go badly wrong to the extent that the company could fail and file for bankruptcy. The private company can then simply walk away with responsibility for failure rarely attributed or acknowledged.

I do think that Capita are probably too vital for the NHS to fail, as there really is no plan B waiting in the wings to take on their key role. Let’s hope that the introduction of a new chief executive along with a root and branch analysis of failings will ensure that it really is too big to fail. If the share price is anything to go on they might have been taken off the critical list with a 6% boost.

Author's Image

Luke Koupparis

Luke is a general practitioner in the Bristol area with interests in men's health, child health, minor surgery, online education and medical information technology. He is the IT lead for Bristol clinical commissioning group, LMC representative and chair of the locality provider group. He also works as the medical editor to OnMedica helping to deliver high quality, peer reviewed information to the wider medical community. In his spare time he is a keen road cyclist and likes to ski with his children.
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