An interesting report from the Guardian last week on the wholesale outsourcing of palliative care in two health trusts to the voluntary sector:
Since 1 April the hospice has been run by Sue Ryder, after NHS Berkshire West primary care trust outsourced its entire specialist palliative care services to the charity. The move mirrors a similar development in Rotherham where earlier this year the NHS transferred specialist palliative services to the local hospice.
Although the voluntary sector provides much end-of-life care locally across the UK, this is the first time that it has been given responsibility for an area’s entire palliative services.
As such, end-of-life care is at the vanguard of the government’s “any qualified provider” policy. Last week, the health secretary, Andrew Lansley, announced that up to £1bn of NHS services would be opened to competition from voluntary organisations and the private sector.
For both Berkshire West and Rotherham, the drive to outsource palliative care comes from the Department of Health’s transforming community services programme, which in 2009 instructed primary care trusts to stop directly providing services. While some PCTs opted to transfer responsibility for palliative care to foundation trusts or community foundation trusts, Rotherham and Berkshire West outsourced to the voluntary sector.
I imagine there would have been an interesting reaction if a service was outsourced wholesale to the private sector, so I’d be interested to know people’s views on why outsourcing to the voluntary sector is seen as more favourable (assuming it’s not just me projecting such a view on to this)?
I’d also be interested in people’s views on the report that Sue Ryder will need to raise £2m a year in addition to the £2m it receives from Rotherham NHS – a match funding contribution of 100%.
Finally, it would also be interesting to see what sort of commissioning intentions informed this move, and whether and how these were translated into procurement processes. For example, could either NHS Berkshire West or Rotherham specify that the contract go to a provider in the voluntary sector? I don’t believe this is possible (especially for contracts of the size awarded), so the decision-making process behind these moves would be fascinating to see.