Article by Duncan Cranmer published in Health Business May/June 2005
It is a well known fact that with over one million employees, the UK's NHS is the world's second largest employer after the Chinese People's Liberation Army. Whilst most people would not expect the Chinese government to outsource its domestic protection to a third party, those organisations able to provide quality and cost effective clinical services to the NHS stand to not only make a valuable social contribution, but generate significant revenues.
Outsourcing and the NHS
In the past the NHS has been reluctant to outsource its clinical care, but times are changing. The Government wants commissioners responsible for providing healthcare services to look more broadly for service provision going forward, specifically from private specialist providers. The NHS is warming to the benefits that a successful outsource to a partner like this can bring, like increased economies of scale and guaranteed cost savings, and has a £50 billion pound budget for health services.
Whether the Labour party wins a third term or not, this trend is set to accelerate. Labour looks set to turn up the volume of their healthcare access and reform agenda if elected and the Conservatives are making plain their own commitment to provision to the NHS from the outside.
Where it already works
For the last 12 months one of the most persistent issues in healthcare has been around the new GMS contract for GPs and specifically that section of the doctors' contract that has allowed them to opt out of being legally obliged to provide patient care 24 hours a day. Many of the GP co-operatives that were formed to allow GPs to honour their erstwhile legal obligation have disappeared, leaving a service shortfall in a critical area. By definition patients needing to see a doctor at night time or during the weekends are likely to be anxious and in pain and require immediate reassurance and care.
New models of best practice
Harmoni CPO, the brainchild of consulting and outsource provider WCI, combined with established co-op, Harmoni+, helping PCTs fill the void left in out-of-hours and provide care to patients when GP surgeries are closed. In its first months of operation this new primary care provider now services more than 5 per cent of the OOH market, equating to 2.7 million patients. With over 1,000 doctors working for Harmoni, the organisation is one of the largest employers of clinicians in the UK. As models of care and associated funding streams continue to rapidly evolve, care providers such as Harmoni with access to a vast pool of clinical skill are best positioned to explore new models of best practice and thus provide NHS commissioners with cost effective, high quality patient care.
Tried and Tested
WCI brought its expertise in process design and technology to bear. The delivery of out-of hours is dependent upon processes that are well integrated, clinically robust, and maximise the use of nurses and remote triage. Its experience in designing complex processes was very pertinent, and enabled the design of lean, efficient but high quality processes to support the robust technology that underpins the out-of-hours operation.
WCI had a tried and tested method of looking to strike the optimum balance between efficiency and compliance and the nurse triage model increased the per cent of calls that could be addressed, minimising the need for a follow-on call by a doctor.
Support
Harmoni CPO now supports people across the UK in the three regional clusters serving Hertfordshire, Buckinghamshire and London Borough of Wandsworth. Andrew Gardner, Chairman of the CPO Group says, "Harmoni CPO is the first company within the newly formed Clinical Process Outsourcing Group (The CPO Group). The CPO Group has been set up to meet the requirements of the Government for greater choice in the provision of clinical services whilst remaining committed to the basic tenet of the NHS that patients receive care for free service at the point of delivery."
New generation
The fusion of an consulting and outsource provider with a well-established co-op has created a new generation of primary care provider; a provider trusted by the NHS to the extent that it is prepared and happy to outsource its own clinical responsibilities to ask Harmoni CPO take care of its local patients.
There will be many other opportunities over the next few years, as the whole NHS landscape changes. These are exciting times for service providers to the NHS. There are great opportunities for The CPO Group, with its first venture, Harmoni CPO, creating a £10 million business within its first 6 months.