The takeover of a Bristol GP service by a private company has been abandoned at the last minute, the Cable can reveal.
Charlotte Keel Medical Practice, a GP surgery in Easton, is currently run by social enterprise BrisDoc.
The practice was due to be handed over by private provider One Medicare on 1 July after a lengthy tendering process.
But just a week before One Medicare was due to take over the service under an eight-year contract worth £23m, NHS bosses announced they were pulling the plug.
BrisDoc has run Charlotte Keel Medical Practice since 2018, when GPs resigned their contract due to reductions to funding.
The practice, which serves around 17,000 patients, was rated as ‘requires improvement’ by the Care Quality Commision (CQC) in 2019. Improvements were indeed made, leading to a rating of ‘good’ in 2020.
Now, BrisDoc will have to step back in and continue running the surgery at a week’s notice.
Private provider’s mixed record
A few months ago, it became public that the GP service would be taken over by a new provider. One Medicare is a private company based in Leeds that runs 10 NHS services across the UK (but none in Bristol), including GP practices, walk-in and urgent care centres.
One Medicare has some services rated as ‘good’ by the CQC, but its most recent inspections have resulted in ‘requires improvement’ judgments. In addition, the company has run services that were placed in special measures and had to be closed down.
According to the company’s most recent accounts to the year up to September 2021, its profit after tax was £1.08m, with £200,000 paid out in dividends to shareholders and the highest paid director taking a £159,000 salary.
GPs have always been independent contractors since the NHS began. But since 2004 further privatisation has crept in.
Back then, the New Labour government introduced Alternative Medical Provider Services contracts, making it easier for private companies or third-sector organisations to take over practices. Although large companies buying up chains of practices have made national headlines, privately run GP surgeries remain rare – about 3% of all practices.
This is in the context of general practice facing pressures due to difficulties in recruiting and retaining GPs, and because of increasingly complex workloads.
Since finding out about the Charlotte Keel Medical Practice takeover, Bristol NHS campaigners have been trying to get answers about what procedures were followed and whether patients were consulted.
On 9 June, just three weeks before the contract was going to change hands, Shane Devlin, the CEO of Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB), told campaigners that the decision to award the contract was made in March.
This came after the ICB published an invitation to tender for the eight-year contract with a potential two-year extension after having tested market interest earlier in the year. Bids for the contract were verified by the NHS South, Central and West Commissioning Support Unit and then evaluated by experts and moderation panels.
Question marks over decision to abandon
Devlin added that each bid was evaluated against quality, financial and social value criteria, and scored individually by evaluators. But he said he couldn’t provide more details on the strength of bids due to confidentiality. He did not disclose either that the new contract was about to be abandoned and the process started all over again.
A spokesperson for BNSSG ICB said: “We have made the decision to abandon the current procurement process for the provision of primary care medical services at Charlotte Keel Medical Practice.
“This means services will not be transferring to One Medicare and will for the time being remain with current provider BrisDoc. We would like to assure all patients at the practice that services will continue as usual.
“We will be undertaking a review and will then start a new procurement process for this practice in the near future.”
The Cable asked why the ICB had decided to go back to the drawing board at such a late stage, and what the timeline would be for finding a long-term provider, but it did not provide an answer.
Ron Mendel, from campaign group Protect Our NHS, welcomed the decision not to go ahead with awarding the contract to a private firm.
“We expect that the ICB will take every possible step to engage with the patients and especially the Patient Participation Group at Charlotte Keel practice in any future round of procurement for GP services,” Mendel told the Cable.
“We feel it is essential that in the assessment of any future bids to provide GP services that financial criteria are not prioritised at the expense of quality so that the patients at Charlotte Keel receive the primary care they need and deserve.”
A spokesperson for One Medicare said the ICB had made the decision “following robust due diligence completed in partnership with ourselves”.
“We would like to thank the ICB and all the staff at Charlotte Keel Medical Practice for all their efforts since the award,” they said. “Patients at the practice will be assured that the service will continue as usual.”
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