In a surprising move North Bristol NHS Trust (NBT) have announced that they are not bidding for the contract to continue providing their current Children’s Community Health Partnership (CCHP) services.
This could mean the privatisation of CCHP, which includes all community child health and child and adolescent mental health services (CAMHS) in Bristol and South Gloucestershire, including services like community paediatrics and school nursing.
NBT won a £150 million contract to run the CCHP services in April 2009, at the time the largest ever tendering process for clinical services in the UK. But are now relinquishing these services due to the “non-core nature of the service”, a “lack of management capacity” and “financial pressure”, according to a Bristol Clinical Commissioning Group (CCG) statement.
These changes add pressure to an already underfunded service facing increasing demands in Bristol. The city has a burgeoning child population, an estimated 27,600 vulnerable children and 15,000 children with mental health needs. Also one in four children in Bristol are growing up in poverty, according to the children’s charity Kids Company Bristol that has recently been forced to close.
This is in the national context of £85 million cuts to child mental health services in the past five years. In the last financial year £9.6 billion worth of NHS contracts were awarded through competition, the majority of which have consistently been won by private companies.
CCG announced last week that two providers have been shortlisted to run CCHP for a one-year interim period, until a provider for a further five year contract is awarded in September 2016. The winner of the interim contract will be well positioned to acquire the next contract.
Dr Charlotte Paterson, from campaign group Protect Our NHS, told the Cable: “the interim contract commissioning period is very tight […] we are concerned that service users – children, young people, parents and carers – have not been informed and consulted about this process and have not have the opportunity to influence the decisions being made by the CCG.”
Although CCG have yet to name these providers, a document seen by the Cable reveals that private health firms Virgin and Sirona sent a total of eight representatives to a CCHP procurement engagement event on 25 June – along with other public providers who may win the contract.
Speaking exclusively to The Bristol Cable a manager within CCHP, who wishes to remain anonymous, said: “we have grave concerns about what privatisation would mean for these services […] tax-payers money will go directly into the pockets of private companies rather than towards patient care.
“A fundamental problem with a privatised service is that a private provider has to make profit and therefore has to put less money into services than an NHS provider would. This makes private models of service provision fundamentally incompatible with health service delivery”, they added.
CCHP services might also be split up. The Riverside Adolescent Unit, an in-patient service for young people with severe mental health problems in Fishponds, is currently integrated within CCHP but is commissioned separately by NHS England. Riverside was just accredited as excellent by the Quality Network in Inpatient CAMHS, but it could be split off to a separate bidder.
Dr Paterson said it was essential the Riverside unit be managed by the same provider as CCHP: “Integration of services is essential for children’s community health and this was highlighted as a key principle by patients, carers, local groups and professionals when they were consulted by the CCG last year. Services need to be part of a connected network across community, voluntary, educational and social services for children and young people.
“We believe health service should be for people, not for profit. The track record of private companies taking over NHS services is alarming. For example, Circle Holdings pulled out of its contract to operate Hinchingbrooke Hospital in Cambridgeshire, after running up a £7.2 million deficit and failing a Care Quality Commission inspection.”
Changes to CCHP could also affect its over 800 staff. Mandy Robinson, a mental health nurse and UNISON representative, told the Cable: “I have supported members whose employer has moved from public to private provider and it has never been a positive move either for them or their service users. Staff find that within a few months the service changes. Terms and conditions are shifted, there is poor morale, skilled and dedicated staff leave and all of this impacts negatively on service users.”
A campaign has been launched with Protect Our NHS who are holding a demonstration, to present a 38 degrees petition calling on CCG to keep Bristol’s children’s services integrated and within the NHS, at 12.30pm on Wednesday 26 August meeting at the Bearpit and walking to CCG offices at South Plaza, Marlborough Street.
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Charlotte, a GP in Plymouth, signed the petition stating:
“our services have been privatised – now provided by VIRGINCARE! Staff have been downgraded, no longer get NHS pensions or terms and conditions of service and the service to patients is DREADFUL!”