A ‘trusted’ not-for-profit company led by GPs is set to lose its out-of-hours (OOH) contract in Shropshire, after the local ICB revealed plans to award it to a private provider.
Shropdoc, which is a cooperative of over 200 GP members in Shropshire and Powys, has run OOH services in the area since 1996.
But at the end of last month, Shropshire, Telford and Wrekin (STW) ICB revealed its intention to award the new five-year OOH GP contract, worth over £32.5m, to the Wiltshire-based company Medvivo.
This prompted criticism from residents, with a petition opposing the decision reaching almost 13,000 signatures in just two weeks.
The petition, started by the campaign group Shropshire, Telford and Wrekin Defend our NHS, said signatories ‘oppose’ the plans from health bosses to replace Shropdoc with a private for-profit company ‘with no local knowledge at all’.
It also claimed that Medvivo won the contract on a ‘rock-bottom bid that will mean massive service cuts’. However, the ICB told Pulse that all bids are highly confidential, and that this claim is unfounded with no evidence base.
Shropshire, Telford and Wrekin Defend our NHS wrote to health secretary Wes Streeting last week to raise concerns about the ICB’s plans and the potential loss of Shropdoc.
The group’s chair Gill George wrote: ‘By definition, the GPs providing care through Shropdoc are already at the heart of our communities and our local health and care system through their regular primary care roles.
‘They know the patch. They know our communities. They have a detailed knowledge of the complex web of NHS, care and voluntary sector services that care for local people.’
Ms George told Pulse that she thinks the petition received a high number of signatories because ‘people know Shropdoc and trust Shropdoc’.
She said: ‘There are so many memories like “when my husband couldn’t breathe in the middle of the night Shropdoc came and they helped us” – it matters to people, they’ve been around 29 years and they’ve offered good quality services, with no fuss and no bother, and obviously not in pursuit of profit.’
After the ICB’s intention to award contract notice was published at the start of this month, a nine-day standstill period began. This means bidders can challenge the decision via ‘written representations’.
STW ICB confirmed that it has ‘received representation’ under the regulations which has ‘resulted in an extension of the standstill period’, and that the challenge must be considered by an ‘independent panel’. Pulse understands that Shropdoc, as the incumbent provider, has made such a challenge.
The contract notice covers out-of-hours GP services, GP cover for protected learning time, outbreak response, and ‘care coordination centre single point access’ for unplanned referral management.
It said: ‘The contract will be for a period of three years with the option to extend for up to a further 24-month period. NHS Standard Contract Terms and Conditions will apply.
‘The anticipated Contract go-live date is 01st July 2025. The approximate lifetime value including the available extension is £32,520,000.00.’
Shropshire Council’s health committee said that they are ‘acutely aware that there are concerns expressed’ by residents regarding the procurement process, in a statement last week.
Councillor Derek White said: ‘I’ve never seen so much public concern about any decision, because it seems that the only part of the system that is actually working is now being screwed up.’
In response to these concerns, STW ICB’s chief medical officer Dr Lorna Clarson recognised that removing the contract from Shropdoc was a ‘difficult thing to do’, but she argued that the competitive tender process was necessary as the ‘procurement regulations required [the ICB] to do that’.
She told the committee: ‘There was no option to further extend the contract. There was no legal option to directly award, we had to go to procurement. That’s what we’ve done. I am confident that we have run a clean, independent and unbiased process.’
Dr Clarson also sought to correct claims that the proposed contract award to Medvivo is cheaper than the current contract with Shropdoc.
‘The envelope around what we wanted to spend is unchanged, there is no saving against it, and that envelope has expanded quite considerably in the last few years following Covid and various other things – there is no saving to be made there,’ she said.
In an update to residents, the ICB said that the extension to the standstill period ‘does not signal a pause in the re-procurement process’.
It added: ‘From the very beginning, NHS Shropshire, Telford and Wrekin has been committed to delivering a high-quality, value-for-money out-of-hours service that meets the needs of our local communities.
‘The service specification remains unchanged, and the re-procurement is not a cost-cutting measure. It will continue to be a locally provided service, staffed by local clinicians, with face-to-face appointments forming a core element and remaining available at the out of hours bases and via home visits.
‘Commissioners are currently reviewing representation and will provide further guidance on next steps as soon as possible.’
The ICB did not respond to Pulse’s question about the value of the current contract with Shropdoc.
Shropdoc and Medvivo both said they are not able to comment on the process due to procurement regulations.
The ICB appears to be clearly stating that the cost is the same, irrespective which company is provider, so it must be that the new company promissed to provide a better service in some way.
Maybe we will see what improves?
Does TUPE apply to the staff? It would appear so.
The ICB have e carefully said that “the envelope around what we wanted to spend is unchanged” so maybe they had already decided to cut the funding for the service or add in extras without funding them. If true, this is another goal for the commercial for-profit sector: NHS Nil – Private enterprise 1. In the West Midlands Shropdoc is one of only two GP led NHS OOH providers left out of an original 9 or 10 GP co-ops.
Seen it before. The ICB will be trying to save a few pounds.
Their excuse will be that they chose the most cost efficient option. Give it awhile and the private provider will discover they cannot deliver at the price. They will want more money or the the service will decline.
The Co-op will have ceased to exist so the ICB will have no alternative except to pay up
AR spot on seen it so many times before
Yep AR will sadly be completely right
When common sense comes up against the opaque market mechanisms of ICB tenders, Stupidity and the private sector win again….
These OOH companies ceased to be true cooperatives years ago.
The biggest mistake was devaluing years of sweat equity built into the balance sheets (GP’s working below locum market rates) as most of them became Ltd Companies / CIC’s /Not for profit enterprises.
Because they had organisational and financial strength they started hoovering up contracts that would previously been doable by motivated GP practices.
CCGs / PCTs became far too cosy with them. In many cases GPs sat on boards of CCG and OOH simultaneously.
Local Enhanced Services became devalued and replaced by work dumping.