InSourcing – a new variant of the NHS privatisation virus

  • NHS campaigners and members of the public! How about finding out from your Integrated Care System/Sustainability and Transformation Partnership whether they are planning to use “insourcing” businesses to make “effective use of residual elective capacity”, in order to clear the Covid-19-caused waiting lists backlog? And if so, what businesses they are proposing to subcontract to?
  • Insourcing is a new variant of the NHS privatisation virus – there’s an outline below of how this works and why it matters. Plus an example of questions to ask in order to get the desired information.
  • You can find your Integrated Care System/Sustainability and Transformation Partnership contact details via this NHSE webpage Please let us know how you get on.

What is insourcing? The recent start-up Totally Healthcare would have us believe it’s the good old private sector riding to the rescue to cut all those pesky long NHS waiting lists, of course

But when Totally Ltd bought Vocare four years ago (paying each of the 2 Vocare doctor owners a cool £4.7m each), the company’s chairman said that the NHS represents a massive market opportunity.

So insourcing is more likely a massive market opportunity for private companies and their shareholders

Last year Totally Ltd launched what they call their “insourcing” business, Totally Healthcare

Turns out “insourcing” means NHS hospitals pay Totally Healthcare to carry out medical services/procedures including diagnostics, day-case surgery and outpatients, IN THE NHS HOSPITALS using their NHS premises and equipment during downtime.

Totally Healthcare “insourcing” includes these specialisms:

  • endoscopy
  • ophthalmology
  • ear nose and throat (ENT)
  • orthopaedics
  • urology
  • plastics

They say this “insourcing” is so the NHS hospitals can reduce waiting lists.

WHY is NHS workforce planning so sh*t that there aren’t enough NHS hospital staff to make full use of NHS hospitals’ premises and equipment? And where do Totally Health staff come from if not from the NHS?

PLUS Totally Healthcare is on the approved suppliers list of NHS Shared Business Services for both England and Scotland. NHS Shared Business Services describes itself as

“the market leader in corporate services …[providing] services to around 40% of the NHS.”

and

“A trusted partner to the NHS [e]stablished by the Department of Health and Social Care (DHSC) in a unique partnership with digital experts Sopra Steria

NHS Shared Business Services provide their corporate services to every NHS commissioning organisation in England. That means they’ll be pushing their “insourcing” Totally Healthcare business to every Clinical Commissioning Group/Integrated Care System in the country.

It seems likely that “insourcing” businesses such as Totally Healthcare are going to clean up from the Covid-19-caused waiting lists backlog

This is from an HSJ article today about London NHSE telling London ICSs to prepare for 3rd surge of Covid-19 – and in meantime to reduce waiting lists as a priority:

“Under the elective recovery section, the [NHSE] presentation said ICSs should set out how their long waiter backlog — those waiting 52 weeks or more — will be “eliminated through the effective use of residual elective capacity”.

Subcontracting to insourcing companies for effective use of residual elective capacity

That’s the subject heading of the email that I just sent to the West Yorkshire and Harrogate Integrated Care System Director and Engagement person. I asked:

Q: Are WYH ICS and WYAAT planning to make effective use of residual elective capacity as key to eliminating the waiting list backlog of patients waiting more than 54 weeks?

They sidestepped that question. Instead they said that they have

“sought to…to continue to maximise [the system’s] capacity in all settings to treat non-COVID patients…and will continue to do so as we begin the recovery process.”

Which was not at all what I asked. The West Yorkshire and Harrogate Integrated Care System make a habit of evasive answers to public questions. Why?

Q: If so, will WYH ICS and WYAAT be, or are they, subcontracting to private “insourcing” companies? And what is the timeframe for these decisions?

“A: As part of our recovery planning we are exploring all opportunities for additional capacity from NHS hospitals, the Independent Sector, VCSE, community providers and primary care.”

 “All local acute hospitals are working hard to ensure all people in need of care receive this as soon as possible. In order to manage this in the most effective way, each will be looking at what they need to do to make this possible. Timelines and approaches may vary and change depending on what each hospital needs to do at a given time.

Again, this is an evasive answer. It avoids mentioning the use of residual elective capacity, and the insourcing question. Why is the West Yorkshire and Harrogate Integrated Care System unable or unwilling to give a straight answer to a straight question?

Q: If so, which insourcing companies will WYH ICS and WYAAT be, or are considering, subcontracting to for the purpose of elective recovery?

A: “We have no definite plans at present.”

Update

Finally, CK999 sent his written question to the West Yorkshire and Harrogate Integrated Care System Board meeting on June 1st 2021:

“Are West Yorkshire hospitals subcontracting to “insourcing” businesses such as Totally Ltd, in order to clear the Covid-19-caused waiting lists backlog? If so, which insourcing companies will WYH ICS and WYAAT be, or are, considering subcontracting to for the purpose of elective recovery?”

The response was:

“Individual trusts are responsible for determining any requirements for sub-contracting. The ICS is not responsible for the decisions that individual trusts make and does not hold this information.”

“Physical space remains a challenge. The West Yorkshire Association of Acute Trusts Elective Co-ordination Group is looking at mutual aid opportunities to utilise fallow weekend theatre space and reviewing different uses for facilities. Staffing remains a challenge due to some areas having high sickness and also difficulty with staffing additional lists at weekends. Staff recovery and mental health awareness are rightly high on Trust’s agendas.”

Why didn’t they tell us that right away, back in March 2021 when we first asked about insourcing and use of residual elective capacity?

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