Tony O’Sullivan comments,
Lowdown readers may remember that the SE London Integrated Care System (‘Our Healthier South East London’ – OHSEL) has been overseeing the drawing up of a huge pathology network contract for South East London. The estimated value is a staggering £2.25 billion over 15 years (with a 5-year extension option). SE London Clinical Commissioning Group (SELCCG) has now given the green light to the private company SYNLAB.
Lewisham & Greenwich NHS Trust (LGT) chose to opt out of the contracting process, deterred by the size of the contract and the fact that local NHS partners appeared to favour a partnership with the private sector.
LGT is now working with Barts and the Homerton NHS trusts to provide a wholly NHS pathology network, aiming to maintain the link between the pathology service and their respective communities in north east and south east London, and NHS England/Improvement is not obstructing this path.
Part of LGT’s work has been ‘direct access’ pathology services for GPs, mental health and community services in the three boroughs of Lewisham, Greenwich and Bexley, over 45% of its pathology income. This service has been satisfactorily delivered for years, but will now come from SYNLAB after April 2021, an international private provider with no proven record of good service delivery in South East London.
Previous assurances (minuted at a Lewisham Council Healthier Communities Select Committee October 2019) that direct access pathology for borough health services would be subject to local borough-based commissioning have been ignored.
So this major commissioning decision for the OHSEL Integrated Care System (ICS), taken by the recently merged South East London CCG, has flouted previous commitments and in one swipe takes services worth £12.1m from Lewisham and Greenwich Trust.
In a related twist that smells of back room dealing, the two NHS foundation trusts Kings College Hospital and Guys and St Thomas’ (GSTT) bought out Serco’s share in their joint partnership company Viapath, which has been providing pathology services for those trusts and other contracts. Kings and GSTT now are described as in a joint partnership with SYNLAB to provide the pathology network contract – including the six-borough SE London direct access pathology service.
Many local campaigners will feel that between the ICS, the CCG and the two foundation trusts, Lewisham & Greenwich Trust’s pathology services have been stabbed in the back.
The trust will lose £12.1m income (at 2018/19 prices). Consequences for their pathology department in terms of loss of staff and service capacity will inevitably follow and undermine the ability to demonstrate ‘value for money’ for future years, 2022/23 onwards. The SELCCG deny any risk or impact on the SE London health system.
The CCG claims that the award for direct access pathology is only for 2021/22, but it is inconceivable that services will be re-provided by the new private contract only to be returned to the NHS so shortly after.
And SYNLAB certainly seem to be in it for the longer term with its CEO stating:
“I am delighted that SYNLAB has been chosen to transform and deliver pathology services in South East London”, and predicted that: “The collaboration will bring a raft of improvements for patients, with urgent and routine tests turned around more quickly“ and promised the NHS “substantial costs savings”
This all remains to be seen, but if this is the kind of undemocratic decision that can emerge through the new NHS structure of integrated care systems and merged CCGs, then other massive outsourcing deals over 10-15 could surely follow. Campaigners and NHS trusts should beware.
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