Report On “Accounting For Public Money” Part 2

Barry French gives his candid thoughts and questions on matters from the West Lancashire CCG.

“I am not the smartest guy in the room and my IQ hovvers round lukewarm, but I have the ability to know when something is not right.

“When West Lancashire CCG announced the short intense support service [SISS] in September 2019 it said that VirginCare would see a maximum of 78 patients and each patient would be seen for a maximum of 3 days with 6 visits a day for the 3 days.

“When I worked out this cost it was not value for money [VFM] and when I saw the auditor inform the CCG that the SISS was not in their opinion VFM and raised a red flag on the SISS and they said there is a failure in budget and weakness planning on the SISS I thought the CCG would take notice.

“But what did they do next? They expanded the SISS with an extra £640k. I asked the CCG on a Freedom of Information in September 2020 “was the contract still the same”. No reply as of today so I take it they are going to see a maximum of 260 patients for a total of £1.63 million. I will now go on to show you the phase 1 and 2 costings.

“Phase1cost for this service £350,000k. For this amount they will see a maximum 0f 78 patients for 3 days with a maximum of 18 visits of the 3 days. If you divide 78 into 350,000k it works out at £4,487 per patient. The final contract costing for phase 1. It saw a total of 177 patients.

“VirginCare refund the CCG £77,233 for seeing more than double the contact patients for less? Poor budget and planning the auditor was spot on. When you work out the final costings it shows it is still not VFM. [I think the CCG or anyone would check the costings].

“If you take out the rebate from the contract sum of £350,000k less the rebate £77,233 the contract is now worth £272,767. New contract sum £272,767, divide by the new number of patients 177, it works out at £1,514 per patient or £513 per day or £285 per visit. Is this still VFM?

“I have asked VirginCare for details on the SISS. They said ask the CCG. The question I asked the CCG “How many patients were seen for 1 or 2 days or were they all seen for the full 3 days”? Their reply? No data.

“I asked how many were referred to hospital after the 3 days? No data.

Did a doctor sign off patients after the 3 days treatment? No data, but as we were informed who had referred them to the SISS. It does seem there is no due diligence which you then ask, is there any accountability?

“Phase2. The contract sum is £1.63 million to see a maximum of 260 patients and then it’s the same as phase1. But if you divide 260 into £1.63 million this works out at £6,300 per patient WOW! So when the auditor see this ,and after giving them a warning and informing them on their failure in budget responsibility and their weakness in planning, it seems the CCG take no notice and have expanded the SISS. Have they informed the auditor of this expansion?

“I have asked questions on all the above on FOI but have been informed they will replying in January 2021. It’s seems to me that VirginCare and the CCG will come up with more patients than the contract says but again, no data as to where they come from and perhaps a rebate? As phase 1?

“The SISS contract. I have asked for copy of the SISS contract, but no reply. It was first thought of in 2018 and after many workshop and telecom meetings where no minutes were taken, when I asked for copies of notes taken I was given notes on scraps that were hard to read. This contact ended up seeing more than double the numbers patient started in the plan, and a rebate for seeing double the amount of patients.

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“Confused? I am, so what were they talking about in the meeting that was written on the scrap paper? Is that why the auditor says “failure in budget responsibility and a weakness in planning”?

“That why I think I may have to ask another agency to come and ask questions on the SISS, as we were misled on phase 1and due to the silence on my FOI on phase2. I don’t wish to be misled again.

Mr French has written to the CCG “You don’t reply to concerns that you receive on enquiries, but on this email I do expect a response from your team”.

Persistence might pay off? The CCG might well say “Read our annual report and accounts”? And Mr French might reply “Been there, done that”. In which case we might be writing Part 3 quite soon.

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