Community Health Provision: The Cornish Debacle

Posted on: 10th October 2015

Community Health Provision: The Cornish Debacle can be traced back to Labour. It was Labour that decided that the PCT could not commission and provide services. This paved the way for Peninsula Community Health (PCH) being born and community health provision going out of the NHS.

My daughter was a community nurse in Penzance when the consequence of Labour policy came home to roost and she had a letter telling her that either she signed to agree to transfer from NHS to PCH or she was in effect resigning her position. As a young person, she was quite relaxed by it but I remember raging that it was awful that she would no longer be part of the NHS! She did not want to be unemployed so signed, as did her colleagues.

After a troubled start, credit where its due, the new management of PCH do seem to have taken the company forward in a public spirited way (well, if you overlook the Poltair consultation) BUT PCH cannot have debts, unlike the NHS, a story in the news now. PCH have been externally inspected and rated excellent and they are not willing to compromise with standards by agreeing to provide services for less money.

My worry is the risk that any new provider will not have adequate time or money to prepare and pick up our community health services when the current contract comes to an end on 31 March 2016. I have no idea whether Virgin or Serco or any other such company are in the running for the contract or whether a credible bid has been made from an NHS provider (my personal hope).

What I will share are the resolutions passed at a recent Health and Social Care Scrutiny committee. Now, whilst common sense would say that as a committee we should have had the Heads of Peninsula Community Health and Kernow Clinical Commissioning Group (KCCG), who are responsible for the contract, in the same room at the same time ‘rules’ did not allow that!

The resolutions passed at the recent meeting of the Scrutiny Committee give a clue to the worries of a cross party group of Cornwall Councillors. In respect of PCH the committee resolved that :-

  1. The contents of the report be noted with concern but the Committee are assured that the Board of Peninsular Community Health is committed to working with NHS Kernow on a smooth transition of service to a new provider in April 2016.
  1. The Committee seek assurance from NHS Kernow that any newly procured service will continue on a like for like basis and maintaining a high standard of care, for the patients of Cornwall and the Isles of Scilly, facilitates the integration of the health and social care system and that the timescales for procurement allow this to happen.
  1. A report detailing updates on the re-procurement and any resultant changes be provided by NHS Kernow at the next meeting of the Committee.
  1. Peninsular Community Health be congratulated on their performance over the length of their contract.

The separate resolutions, after considering the report and questioning the leader of the KCCG were:-

  1. The content of the report be noted and great concern be expressed at the proposed timescales for procurement, implementation and that there was the potential threat of reconfiguration of services rather than the expectation that the provision would be a ‘like for like’ contract.
  1. Ongoing reassurance be sought from NHS Kernow with further reports brought to Committee from the next meeting.

(Bold is my emphasis)

Sadly, as the next meeting of the Health and Social Care Scrutiny Committee is not until 25 November, that will only leave 4 months for the new arrangements to be put in place. Although PCH is willing to extend the contract to allow more time to seek an appropriate service provider, as Councillors we were not assured that KCCG is engaging in meaningful discussions for this to happen.

I had probably best end here as I am at risk of getting myself in trouble for disclosing information that was not given in a public session. That said, it is information that I’m sure there is public interest in so perhaps people would like to write to Kernow Clinical Commissioning Group at The Sedgemoor Centre, Priory Road, St Austell, Cornwall. PL25 5AS. I suggest people ask:

  1. What assurance they can provide that on 1st April 2016, when new contract is due to start, a suitable provider will be selected and operating to the current high standards which Cornwall patients deserve?
  2. Given uncertainties over future provision and the National shortage of nurses, how can they ensure that staff do not leave and that the vacant posts will become impossible to fill?