NAO investigation of PCSE finds fault with both Capita and NHS England

NAO investigation of PCSE finds fault with both Capita and NHS England

May 17, 2018

Neither Capita nor NHS England fully understood the service levels and performance standards required to fulfil the Primary Care Support England (PCSE) role when the contract began, an investigation by the National Audit Office (NAO) has concluded.

The NAO report on NHS England’s management of the PCSE contract with Capita states that whilst NHS England felt pressured to make significant reductions in administrative running costs when tendering the contract, the subsequent failure to adequately deliver key functions by Capita put primary care providers and, potentially, patients at risk of serious harm.

For example, investigators found that only 41% of pharmacy market entry applications were processed within 70 days in November 2017 which, in one case, meant a pharmacist was unable to retire.

The NAO was investigating problems raised across the primary care sector, including by PSNC in a letter sent to NHS England in 2016 raising concerns about the pharmacy services provided by Capita.

The following reasons behind the service failures have been identified in the NAO report:

  • Capita underestimated the scale and nature of the task;
  • NHS England’s performance measures did not cover all the required service areas;
  • NHS England’s assessment of the contract focused on the financial savings target;
  • NHS England did not have the contractual mechanisms to intervene in some of Capita’s service changes; and
  • Basic principles about the contract are still not agreed, which limits NHS England’s ability to hold Capita to account.

PSNC fed into the NAO investigation, using evidence gathered from contractors and LPCs, and agrees with these findings.

The NAO report goes on to recommend the following actions for NHS England:

  1. Determine whether some of the current PCSE services should be taken in-house by NHS England;
  2. Agree with Capita performance indicators and targets;
  3. Prioritise the stabilisation of existing services when rescheduling transformation programmes;
  4. Secure user engagement in advance of service changes;
  5. Pilot significant transformation changes effectively;
  6. Create a joint risk register which would more thoroughly set out dependencies, mitigations, responsibilities and required actions; and
  7. Improve its management of the factors which influence the overall performance of PCSE, which are outside Capita’s control.

Read the NAO report

PSNC Director of Operations and Support, Gordon Hockey, said:

“The conclusions of the NAO will come as no surprise to the many community pharmacies and LPCs who have reported problems with PCSE services, provided through Capita. PSNC wrote to NHS England in July 2016 expressing its dismay at Capita’s services and seeking remedial action; at that point we had many reports of services operating at well below acceptable standards, and this is echoed by the NAO report. We are pleased our work to raise the matter and push for improvements has had some impact, with services generally improving since 2016, but we will continue to work closely with pharmacies, LPCs and Capita to ensure this continues – we must have confidence that PCSE is offering a consistently good service to pharmacies across the country.”


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