On 20 January, Donald Trump became the 45th president of the United States. His inauguration resulted in a huge divide across the world. With such a reaction, it was hard to avoid any mention of the T word. So perfect timing for the UK government to quietly advertise the sale of an NHS contract worth £515m.
The National Framework Agreement for Health and Social Care Transport – Wave 5 contract is designed to recruit transport services to help ease mounting transport issues in the NHS. This includes public and private sector bodies.
The government discreetly advertised this contract on the same day as Trump’s inauguration. They valued the contract at “£515.0m”. This figure includes all payments to be made, or potentially to be made, under the five-year duration of the contract.
As the contract states, this is the fifth wave of recruitment for providers nationwide. The contract value takes into account all the providers they’ve sub-contracted on previous rounds.
The contract states:
NHS Shared Business Services Limited (NHS SBS) in partnership with Specialist Commissioning Support Service 365 Response are seeking to add Providers to the Framework Agreement for Health and Social Care Transport, for use by or on behalf of UK public sector bodies.
The overarching agreement is for 60 Months and will end in April 2019 with options to extend by 2 years. This current procurement is the fourth such ‘reopening’.
Previous rounds of the contract
In August 2014, the government announced round two and recruited multiple private transport providers. They included Banbury Private Ambulance Service Limited and MED-PTS Ambulance Services. More private transport companies were again recruited during round three. These included Alpha Care Ambulance Service and Cartello Ambulance.
But this “opportunity” has been advertised four times and is “currently unfulfilled“. NHS professionals familiar with similar processes told The Canary that this suggests previous providers have fallen short. The contract states:
For Providers who failed to meet the application criteria the first time of applying or for any new entrants to the market during the life of the Framework Agreement, the application process will be reopened at a minimum of 6 monthly intervals and advertised accordingly.
This is essentially a merry-go-round application process where contractors can keep reapplying. But the fact that this contract is failing to attract suitable candidates suggests innate problems in the system.
NHS transport issues and privatisation
Such innate problems are a result of sub-contracting inadequate private companies. But instead of investing in more NHS services, the government continues to outsource the service.
In April 2016, The Guardian reported that “hundreds of patients [in south east England] including people with cancer and kidney failure… missed important appointments for treatment”. This was because the privately-run transport service was so unreliable. Some elderly patients waited more than five hours for an ambulance and many patients were left stranded at hospital due to Coperforma’s shambolic service.
As a result, the South East Coast Ambulance Service (an NHS service) stepped in and took back control from Coperforma.
Some other NHS trusts tried to recall contracts from privately-owned services because things got so bad. In April 2016 and October 2016, both the East Midlands Ambulance Service and the Yorkshire Ambulance Service expressed their desire to see services run in-house following issues of cost and reliability.
Another major issue is one of regulation. While many private services claim to train their staff for emergency situations, some whistleblowers claim differently. The Private Ambulance Service in Essex claims that “all staff are trained to the relevant standards required”. But some staff told the BBC they only had an hour’s training to drive using blue emergency lights.
The new contract
The system is a shambles. Yet despite these constant problems, the government continues to outsource the service. Instead of investing in a regulated national service which benefits both patients and the NHS, it is allowing a for-profit business to capitalise on it.
This article was amended on 30 January at 5:20pm. The line “In April 2016 and October 2016, both the East Midlands Ambulance Service and the Yorkshire Ambulance Service expressed their desire to end the contracts on grounds of poor service and excessive costs.” was changed to: “In April 2016 and October 2016, both the East Midlands Ambulance Service and the Yorkshire Ambulance Service expressed their desire to see services run in-house following issues of cost and reliability.” This reflects the fact that actual contract decisions are taken by Clinical Commissioning Groups.
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Featured image via Flickr/Pete