Commissioners Taken To Task

We reported last September that the Surrey County Council Adults and Health Select Committee (AHSC) had decided to set up a Task Group of councilors to look into concerns raised by Surrey Healthwatch, Surrey Coalition of Disabled People and the BHU Patients campaign about the lack of engagement of patients, GPs and other stakeholders in the commissioning of the contract for sexual health and HIV services in Surrey awarded to the single bidder, Central & North West London NHS Trust (CNWL). The Task Group was chaired by Cllr Sinead Mooney and had two other members, Cllr Nick Darby and Cllr John O’Reilly. They took evidence earlier in the year and submitted their report to the Health, Integration & Commissioning Select Committee (HICSC), the successor to the AHSC, at its meeting on 4 July 2018. The report can be found at the following link: https://mycouncil.surreycc.gov.uk/ieListDocuments.aspx?CId=713&MId=6815&Ver=4 We commend the Task Group for their report which, although written in restrained terms, is a comprehensive critique of the abject failures in process and procedure that, through lack of effective stakeholder and patient engagement, led to the hollowing out of sexual health and HIV services in Surrey. The report refers to guidance documents produced by the Department of Health and NHSE which were not followed to the extent required. We would contend that there were statutory obligations under the NHS Constitution, NHS Act, Local Government Act and Equality Act that were equally not met. The Task Group also highlight the failures in market engagement – inaccurate information provided in the tender submission documentation and lack of dialogue to ascertain why 22 expressions of interest resulted in just one bidder. The one third cut in the service budget was clearly a factor and at the very least there should have been some dialogue, not least with Ashford & St Peter’s Hospitals NHS Trust (ASPH) and Frimley Park as existing local service providers, to ascertain why they did not consider the contract to be viable. The Task Group makes a number of recommendations in its report – all of which were accepted and, indeed, some further tightened by the HICSC - to improve the engagement and communication process in future commissioning arrangements. Certainly we would expect these to be followed when the existing contract with CNWL comes up for renewal in 2019. The Task Group also note the difficulties experienced by patients in accessing the CNWL service – ironic given that we were pressing for a further delay in transferring the BHU contract to CNWL last September as they were clearly not ready. Those difficulties continue and we know that patients are choosing to go elsewhere rather than make the journey to Buryfields Clinic on the outskirts of Guildford or, even more worryingly, may have given up trying to access services altogether. The BHU Patients campaign is represented on the Woking Group set up at our instigation by the commissioners to monitor the “new” service. The Working Group is chaired by Professor Mark Britton, former Medical Director of Ashford & St Peter’s Hospitals NHS Foundation Trust, and meets roughly every two months with SCC, NHS England and CNWL managers. Along with Surrey Healthwatch, who collate patients’ experiences of the CNWL service, and the Surrey Coalition of the Disabled, we will continue to do our best through the Working Group to ensure that CNWL meets its obligations, limited though they are by the financial restraints on the contract, and to mitigate as far as possible the worst aspects of the new service model.