East Suffolk and North Essex Foundation Trust seems determined to outsource nonclinical support services at Colchester Hospital, 12 years after boasting of the Colchester trust’s success at bringing them back in-house. 

But why they have chosen to do so, and why they have not considered any other options remains a mystery, since the Trust has conducted all of its discussions behind closed doors in private sessions of the Trust Board, and is refusing to publish the outline business case, claiming this is because of ‘commercial confidentiality’. 

The jobs of almost 300 NHS cleaners, catering and other support staff at Colchester are at stake. They were baffled to be told that a private meeting of the board had decided to “outsource” (privatise) their work. 

Management at Colchester had previously raised no concerns with staff representatives, published no negative reports on the quality of services, and made no effort to engage with staff or their unions. The trust is one of few with no financial problems, and so no need to slash spending to balance the books. 

Requests from the main union, UNISON, for sight of the business case setting out the argument for privatisation (which is normally provided by other trusts making similar proposals) were refused, which appears to be a cover for the lack of any coherent or credible case.  

However at the trust’s public board meeting on May 2 the story seemed to have changed. It was announced that outsourcing is an “option” being considered – implying that other options might now be included, and UNISON was assured they would, after all, be given information on why this controversial and unpopular policy had even been discussed. 

The proposal for privatisation is even more shocking because the trust is bucking a recent trend, in which a series of major London trusts including Imperial College Healthcare, Epsom & St Helier, Great Ormond Street Hospital, Barts, and North Middlesex Hospital have been ending their outsourced contracts and bringing staff back in house.  

Relatively few support service contracts have been outsourced since the early collapse of large-scale contracts in Leicester (2016) and Nottingham (2017). 

Indeed just 13 years ago Colchester hospital bosses themselves brought their services back in-house, arguing it was the best way to “gain greater direct control over … estates and facilities services.”  

Trust chiefs, proud of their decision, boasted to other health bosses and the wider public about the many advantages of delivering services in house and briefed local councillors on what a good decision this had turned out to be.  

In 2012 the Trust’s special projects director and associate director of estates wrote an extensive article for the Health Service Journal, explaining why they ended the outsourced contract, arguing that it: 

“gave the trust little control over how services were delivered and how they were aligned to support clinical care. This made it difficult for the trust to achieve added value and efficiency from the contract.” 

They went on to argue that as a result of “swimming against the tide” and bringing services in-house they were winning on every front, “close to achieving the cost savings we forecast,” and, more importantly, “from a patient perspective, we saw an overall improvement in our National Patient Safety Agency audit cleaning standards scores.” 

They have yet to offer any explanation of their recent, abrupt change of policy. 

Colchester and Ipswich hospitals merged into a single trust in 2018: the outsourced support services contract in Ipswich is nearing its end date.  

UNISON is still waiting to hear the trust explain why the end of that contract should not be taken as an opportunity to bring the 450 staff in Ipswich back in house on the same terms as their Colchester colleagues. The fight goes on. 

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