As Serco look set to win a further £300m contract to provide NHS test and trace, major concerns remain over Serco’s delivery, both for the NHS and other government departments, with some clinical contracts associated with cost-cutting measures, under-staffing and early escapes from unprofitable contracts
Test and trace system failings
In early 2020, the government introduced emergency procurement rules in an attempt to employ companies to carry out vital work with no delays. The rules meant no competitive tender and little transparency over the contracts. Serco was awarded a contract to recruit thousands of people to carry out contact tracing for the tracking and tracing operation vital for controlling the virus outbreak. In May 2020, it was found that Serco had already managed to share the email contact details of 300 new recruits for contact tracing. This incident is a matter for the Information Commissioner to investigate as a breach of data protection legislation.
By August 2020, many stories had emerged of how poorly the test and trace system run by Serco and the company Sitel has performed. One of the major criticisms is that although a big fanfare was made of the recruitment of 20,000 contact tracers when the system launched in May, many call-handlers have since come forward to say that they have had little work to do. Although, contact tracing is a specialist skill that needs tact to obtain sometimes sensitive information from sick individuals. The contact tracers recruited by Serco and Sitel had little or no experience and were given minimal training when hired on near-minimum wage.
It was revealed in August 2020 that just 56% of close contacts handled online or by call centres run by Serco and Sitel, a second private firm used, are being reached. In contrast, the local council’s contact tracers in the Blackburn with Darwen area managed to contact 90%, one of a growing number of councils now setting up their own systems, due to frustration with the centralised Serco/Sitel system.
Breast cancer helpline fiasco
In May 2018, Serco was criticised for the way it was running a breast cancer screening hotline. The hotline was set up by the government as a computer error meant 450,000 women between the ages of 68 and 71 did not receive letters inviting them for a final breast cancer screening. However, women contacting the hotline were being connected with call-handlers who had had only one hour’s training and are relying on a cheat sheet of symptoms. The call-handlers were employed by Serco at call centres based in Glasgow, Liverpool and Newcastle.
Staff at the call centres said they are “disgusted” at the way it is being operated and described scenes of chaos as call volumes rose from 5,000 to 10,000 in two days. The staff said the rush to set up the hotline led them to fear mistakes could be made in the handling of women’s cases as they were not medical professionals and had received so little training.
Suffolk Community Care
In March 2012 Serco was awarded a three-year £140 million contract to provide community health services for NHS Suffolk. Serco was to provide community and specialist nursing, the management and operation of community hospitals, speech and language therapy, specialist children’s services and equipment services. After winning this contact, Serco announced it was to cut 137 health jobs. At the time, Unison said it was “deeply worried” about the effect the staff cuts would have on the level of care. Tim Roberts, from Unison, said: “We warned at the time that the only way they would be able to deliver the contract would be by making drastic cuts and that’s exactly what they are now proposing.”
In January 2014, Suffolk County Council issued a report criticizing Serco’s service in the county; Serco was found not to be hitting three of their key performance indicators (KPI) in community health response times. By August 2014 Serco had determined that clinical care services was not a profitable business area and made the decision to withdraw from this market. Serco eventually handed over the community care contract in Suffolk to new providers in September 2015. A Serco spokesperson noted that the £140 million the company was paid for the contract was “not adequate” for the work required.
Braintree Hospital
This contract for Braintree Hospital began in 2011. By 2013 Serco had realized that it was not going to make a profit on the contract and was trying to leave. The company reported that the hospital contract had an operating loss of £2 million in 2013 and as there was little scope for increasing the profitability of the hospital, the company was no longer interested in the contract. Serco terminated the contract a year early in January 2014.
GSTS Pathology
In 2009 Serco formed GSTS Pathology a joint venture with Guy’s and St Thomas’ NHS Foundation Trust providing pathology services. The 50:50 joint venture was under a ten-year contract valued at around £250 million to Serco. King’s College Hospital Foundation Trust joined the venture in 2010. The company is now known as Viapath.
In August 2014 an investigation by The Independent and Corporate Watch found that Viapath had overcharged NHS hospitals by millions of pounds for the pathology service. Leaked documents indicated that three of its fifteen laboratories had overcharged by £283,561 in a three-month period, with its invoicing and billing systems deemed to be “unreliable” and containing “material inaccuracies”. It was that the overcharging could have amounted to £1m in 2012 alone. The service has also been criticised for cost cutting by not adequately replacing staff and introducing pay cuts, which have affected the quality of the laboratories’ output.
Cornwall out-of-hours contract
In April 2006 Serco was awarded a five-year contract to provide out-of-hours service in Cornwall and the Scilly Isles valued at £6.1 million. In 2011 the contract was renewed for a further five years valued at £6.4 million. Prior to 2006, the contract was run by a consortium of local GPs for £7.5 million; Serco’s bid was considerably cheaper and the consortium failed in its bid to gain the contract in 2011. However, the contract did not run smoothly and by 2013 Serco was trying to extricate itself from the contract. The company eventually left the contract in May 2015, almost eighteen months early. Following information received from whistleblowers and investigations by the Care Quality Commission (CQC) Serco’s OOH service in Cornwall is now known to have been badly managed and frequently understaffed, and was a contributory factor in the deaths of two children.
A major problem was the introduction of a new cost-saving NHS IT system to the out-of-hours service in 2011, enabling it to replace skilled clinicians with call-handlers without medical training who follow a computer-generated script to assess patients. The move triggered a fourfold increase in ambulance call-outs.
One of the first widely reported major incidents that led to Serco coming under scrutiny was in June 2011 when a six year old boy died as a result of a burst appendix which was not accurately diagnosed. The father of the boy was asked to examine his son in the hospital car park by Serco’s call handlers and advised to visit the GP the next day. An inquest heard that the triage nurse did not ask enough questions and was subsequently put on six months close supervision.
Whistleblowers then reported on the frequent under-staffing of the service, alleging that more than once there had only been one GP available to cover the whole county from midnight until 8am. Investigations by the CGC eventually led to a highly critical report in July 2012. The report highlighted that the service had a shortage of “qualified, skilled and experienced staff to meet people’s needs”. Serco was also found to have falsified records to make the service appear faster and more efficient than it actually was.
The CQC’s damming report also noted that a quarter of staff had not completed mandatory training. Although Serco said all its GPs received formal clinical supervision, not all staff had received regular appraisals. Inspectors noted that “the provider did not have an effective system to assess and monitor the quality of service that people receive”. The report was highly critical of the number of staff on duty, stating that “there was a shortage of clinical staff at times”. The CQC inspectors found that on one particular weekend, some doctors were working double shifts which consisted of 13-hours through the night, and others were working 11-hour daytime shifts.
Although regulators reported that Serco’s service had improved following the CQC report, it did not improve sufficiently for one young boy. William Mead died of sepsis in September 2014 within 12 hours of the call to Serco’s 111 helpline. A report published in January 2016 found that there were four missed opportunities to save William’s life, including a call to the 111 helpline hours before his death and visits to out-of-hours GPs. The report said the “tickbox” system used by call handlers failed to include “sepsis red flags” despite the fact that it is one of commonest causes of death among children.
By 2013 Serco was seeking to get out of the contract in Cornwall. The company first tried to unsuccessfully sub-contract the work to Devon Doctors, the GP consortium that had failed to win the original bid. Then in December 2013 Serco announced that its contract to provide out-of-hours care in Cornwall would end 18 months early in May 2015. In June 2015 two GP provider companies, Cornwall Health and Kernow Health, took over the service. GP-led social enterprise Devon Doctors, which already runs the Devon out-of-hours services, is behind Cornwall Health, while Kernow Health is run by Cornish GPs as a community interest company.
Outside the NHS
Prisons and Detention Centres
In the UK, Serco had a major contract with the UK government for the electronic tagging of prisoners. However, following an audit of the contract, Serco was found to have charged for tagging of prisoners who did not exist, were dead or were still in jail. Serco was the subject of a criminal investigation by the Serious Fraud Office, which led to the cancellation of the privatisation of three prisons in Yorkshire, for which Serco was the lead bidder. Serco has subsequently paid back £68.5m to the government after it became known that it had overcharged on its contract for the remote tagging of offenders, with the scale of its overcharging being revealed as three times greater than it was initially estimated. Serco was fined £19.2 million and ordered to fork out £3.7 million in costs after they understated profits made from electronic monitoring contracts when they reported them to the Ministry of Justice.
The company was also criticised, following the death of Rafal Sochacki at Westminister magistrates’ court on 21 June 2017 (one of the hottest days for four decades). The man suffered a heart attack after he was held in a Serco custody van for 50 minutes with the engine turned off and inside a court cell where the air conditioning was broken meaning his cell was estimated to have reached 34-40 degrees. He was said to have experienced “excessive temperatures” both in the Serco van and the cell.
In 2014, Serco was being investigated by MPs after a secret internal report into alleged sexual abuse by a member of staff against a detainee at the Serco operated Yarl’s Wood detention centre came to light following a four-month legal battle for its publication between the company and The Guardian, which ended with the high court ruling for its disclosure. There is concern over the way that Serco handled the investigation into the allegations including the way it dealt with evidence from another member of staff and the assertions by management about the credibility of the alleged victim. In 2015, a dossier of a decade of complaints about sexual abuse and mistreatment at Yarl’s Wood was handed to MPs.
The decision to award Serco a further eight-year, £70m contract to run the Yarl’s Wood women’s detention centre has been heavily criticised by human rights groups, in light of the allegations of mistreatment by staff at the centre. It was awarded a new contract despite the fact that it is the subject of an investigation by the home affairs select committee into its running of Yarl’s Wood.
In light of these concerns, and others, relating to criminal justice contracts, The Howard League for Penal Reform has called on Serco to be barred from applying for new contracts until investigations into the controversies surrounding company have been completed.
Despite these concerns, the home office awarded Serco another contract worth £200 million in early 2020 to run two more immigration removal centre, Brook House and Tinsley House near Gatwick airport from May 2020 for eight years.
There was further controversy for Serco in February 2020, when a Nigerian woman told a court hearing that she was thrown to the floor “like a bag of cement” in an incident involving 11 Serco guards at Yarl’s wood.
Serco was also severely criticised for its mass eviction of asylum seekers in Glasgow 2019, although the courts ultimately deemed the move was lawful.
Serco has come under fire in Australia with regard to its business in prisons and detention centres. Serco staff have been criticised for their actions over the death of refugees following the sinking of a refugee boat off Christmas Island in 2010. There have also been inquests into suicides and beatings of detainees at other detention centres in Australia run by Serco.
Dear Reader,
If you like our content please support our campaigning journalism to protect health care for all.
Our goal is to inform people, hold our politicians to account and help to build change through evidence based ideas.
Everyone should have access to comprehensive healthcare, but our NHS needs support. You can help us to continue to counter bad policy, battle neglect of the NHS and correct dangerous mis-infomation.
Supporters of the NHS are crucial in sustaining our health service and with your help we will be able to engage more people in securing its future.
Please donate to help support our campaigning NHS research and journalism.
Comments are closed.