The contract for Wiltshire’s community children’s health services has been awarded to Virgin Care. The announcement of this significant five year, £12.8 million contract follows a procurement process run jointly by Wiltshire Council, NHS England and the Wiltshire Clinical Commissioning Group (CCG).
Wiltshire’s community children’s health services for 110,000 nought-to-18 year-olds are currently provided by five organisations: Great Western Hospitals, Sirona Health and Care (a not for profit social enterprise established working in the south-west), Salisbury Hospital, the Royal United Hospital and Swindon Borough Council.
The fourteen elements of these services include health visitors, school nursing, school aged immunisation programmes, community paediatrics, speech and language therapy, the safeguarding of children service and health services for looked after children.
Some of these services are the sole responsibility of the Council – mostly those that come under the transfer of public health to local authorities. They are not funded from the Council’s own budget, but by money coming directly from central government.
Virgin Care’s contract – which is now subject to a ten day ‘standstill period’ – will start in April 2016. Staff working for the present providers will have statutory TUPE arrangements which protect employees’ rights when their organisation or service transfers to a new employer. TUPE was introduced in 2006, but the law was ‘modernised’ or ‘weakened’ (depending on whether you are management or staff) in 2014 with new regulations.
The Council’s share of the contract is £6,886,989. Of this £6,294,081 comes directly as part of the public health grant from central government. In addition £592,908 – for speech and language therapy and occupational therapy – is paid directly from the ring-fenced Dedicated Schools Grant from government.
Putting these diverse services out to tender as an ‘over-arching’ contract means there is less need for day-to-day management of services by Wiltshire Council and the CCG and that back-office administration and running costs for the services are paid from the ‘front line’ contract budget.
A report on this tender process put before Wiltshire Council Cabinet meeting on Tuesday (October 13) makes it clear how future financial pressures may impact on the Council’s parts of this contract: “In the event of any central government changes to grant funding allocations which impact on this budget there would be necessary in year negotiations with the provider to ensure that the services are provided within the available financial envelope, and no costs fall to the council/council tax.”
This means that in policy and financial terms the Council is acting as central government’s agent rather than as the provider of needed services. If the funding is cut, the services will be cut.
Other private health providers with contracts in Wiltshire include Medvivo which runs the out-of-hours GP service and the Single Point of Access with its related services such as Urgent Care at Home. In Wiltshire the contract for the NHS 111 free telephone service which replaced NHS Direct, was won by Harmoni, which is now owned by Care UK.
Virgin Care Ltd was founded in 2010 when Virgin bought a majority stake in Assura Medical. Its website features this mission statement: “Our aim is to make a real difference to people’s lives by offering services that: are free; are better than before; provide a great experience for everyone; and save the NHS and public money.”
Virgin Care is involved in primary care services, including GP services and walk-in centres. It is also has contracts for community-based NHS services. The company is ultimately controlled by Richard Branson and his family through a complex pattern of companies.
It is said that since 2010, Virgin Care has won NHS contracts valued at almost £1 billion – that could be an under estimate as contract values are not always released to the public. Certainly this Wiltshire deal is not among Virgin care’s biggest contracts.
In March Virgin Care won a £280 million contract as prime provider to run services for the frail and elderly in East Staffordshire. They have a contract with NHS Surrey to deliver community health services from 2012 to 2017 – that is worth £450 million.
The Wiltshire procurement process included workshops with children, carers and parents so that the three commissioning parties could understand how the services should be run. The announcement says: “The contract was awarded to Virgin Care following a robust procurement process which adhered to the necessary regulatory and policy requirements.”
On the CCG’s website the procurement process is explained: “Commissioners of NHS healthcare and local authority services must contract with the provider who is most capable of delivering the specified requirements, within the funds available.”
The tender was open to all providers, but Marlborough News Online understands that the Virgin Care bid was the only one to meet the required standards.
There are very useful answers to questions that may be raised by parents and carers about this change to their services on the CCG website – scroll down to the bottom of the page.
