The shape of things to come? Virgin Care named as preferred bidder for Bath's community health care
The Bath and North East Somerset (BANES) Clinical Commissioning Group (CCG) has selected Virgin Care as the preferred bidder for its £700 million community health services contract. The contract is worth £69.2 million annually over seven years - with an option to extend by a further three years.
The contract covers 200 different services - from district nurses to the falls prevention team - currently provided by 60 different organisations.
The Virgin Care bid looks set to be approved by both BANES CCG and BANES Council during November - with a handover in April 2017. The CCG is selling this as bringing "more community care, closer to home."
Does this matter to Wiltshire's NHS provision? It probably matters quite a lot - BANES is part of the new area organisation for Sustainability and Transformation Plans that includes Wiltshire and is currently drawing up new plans for the delivery of NHS-funded sertvices across the STP area.
In addition, the Virgin Care offer looks very much like a version of an Accountable Care Organisation (sorry - that's an ACO) - one of the new ways of delivering services on the NHS' current reorganisation agenda. An ACO passes the responsibility for the detailed commissioning of health services from the CCG itself to a single commercial or NHS provider.
In this case the CCG will be contracting with a single organisation to commission and monitor those 200 community health services - that will in effect see Virgin Care acting as an ACO. A slimming down of CCG staff can be expected to follow the April handover to Virgin Care.
It is understood that Virgin Care will be able to sub-contract as many of the 200 services covered by the contract to other providers - commercial, NHS or charities - as it sees fit. This change could well result in months of uncertainty for the employees currently delivering the services.
In the CCG's announcement, the BANES Council cabinet member for Adult Social Care, Councillor Vic Pritchard, says people who were consulted on the contract "...asked us to join up services and information so that it’s easier for different professionals to work together to coordinate care. Virgin Care will enable this to happen by bringing people’s health and care records into one secure place.”
He adds: “We will also include a clause in the contract which requires any financial surplus made by the new prime provider to be reinvested into services in BANES.” This will parallel the Wiltshire deal for children's community care with Virgin Care which Baroness Scott has said has a clause stating that no profit will be made from the contract.
According to the Health Service Journal, Virgin Care was preferred over a consortium led by the Sirona Care and Health (a social enterprise group), in partnership with the Avon and Wiltshire Partnership Mental Health Trust, Bath's Royal United Hospital and a local group of GPs.
It was only six years ago that BANES council put Sirona in charge of its social and health care services - moving 1,700 members of staff into the social enterprise organisation. Sirona's website still says it is "In Partnership with Bath & North East Somerset Council". Sirona also have an active role in Swindon's health services.
Recently BANES CCG was given the headline rating of 'Requires Improvement' - as were several others of England's CCGs. This related mainly to the CCG's failure to meet NHS targets - notably for urgent and emergency care and access to elective care.