The favourable version of outsourcing?

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.


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Man of letters & numbers; also occasionally of action. Husband to NTW. Dad of three. Friendly geek.

3 thoughts on “The favourable version of outsourcing?”

  1. I would also like to know what decisions are made when outsourcing. I thought we were supposed to be living in a society of choice and have a system that puts the person at the centre thus giving choice.

    If sole responsibility for a service is outsourced to the same private or voluntary organisation isnt that a Monopoly and in effect illegal? I’m no lawyer just an owner of a Domiciliary care agency who would like a fair crack at taking on work based on the service I provide. I believe we improve quality and get better value by generating healthy competion.

    As for your point about ‘another reaction if the service was outsourced to a private sector organisation’ I’m sure there would have been as the private sector is deemed more expensive therefore the voluntary sector won’t attract as much attention due to the nature of being voluntary and therefore percieved as cheap. The quality of service in care almost seems irrelevant these days and it seems only what is considered best value gets considered when outsourcing.

    Having said that I’m sure Sue Ryder and lots of voluntary organisations do an excellent job and long may that continue! All I ask is everyone is treated fairly and decisions are not made as money saving projects only.

  2. For me private vs voluntary sector outsourcing comes down to the nature of the sector. I don’t have as many problems with outsourcing to the voluntary sector because it is by definition not for profit. The service will centre around the best needs of the patient. With the private sector they are trying to make a profit from running the service and so the needs of the patient will be squeezed to try and maximise profit.

    1. “I don’t have as many problems with outsourcing to the voluntary sector because it is by definition not for profit.”

      For me this is the key point. The profit motive and the aims of care are often at odds and sometimes fundamentally divergent.

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