back to article Capita contract probed after thousands of clinical letters stuffed in a drawer somewhere

The UK's National Audit Office is investigating a backlog of 162,000 undelivered items of clinical correspondence on the watch of Capita's £700m Primary Care Services contract. NHS logo affixed to building NHS: Remember those patient records we didn't deliver? Well, we found another 162,000 READ MORE In September 2015, …

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  1. }{amis}{ Silver badge
    FAIL

    How? Why!!!

    How is this crap still happening you would of thought that anyone evolved in NHS paperwork would have made sure that they were not making the same mistakes after the last disaster!

    1. Simon Ward

      Re: How? Why!!!

      I suspect that brown envelopes stuffed with cash have a lot to do with it.

      I'm not cynical at all. Dearie me, no.

      1. HmmmYes Silver badge

        Re: How? Why!!!

        I dont.

        This smells more like idiots not being sacked in GPs and the NHS. Oh, and the people who wrote the Capita contract.

        1. macjules Silver badge

          Re: How? Why!!!

          Oh, and the people who wrote the Capita contract.

          Capita wrote the contract, under NAO Procurement Manual guidelines for Government Preferred Suppliers

          As they say, Oops ("Oh shit" if you are at NAO)

    2. Jon 37
      Facepalm

      Re: How? Why!!!

      If you outsource, you get what you ask for and pay for.

      No-one asked Capita to do anything with this paperwork, no-one paid Capita to do anything with this paperwork, so Capita didn't do anything with it.

      Doing something with this paperwork would have cost money, and by outsourcing you saved that money!

      This is outsourcing working as documented (but not as actually intended).

      1. Mycho Silver badge

        Re: How? Why!!!

        In fairness, Capita probably asked their contact several times what to do with the paperwork but the people who understood it had been downsized in order to outsource their jobs to Capita.

        The whole situation incubates these clusterfucks. Capita are part of the problem but not the root cause, the root cause is the outsourcing epidemic.

        1. Anonymous Coward
          Anonymous Coward

          Re: How? Why!!!

          The people who would have known what to do we’re all made redundant last year!

      2. Stuart 22

        Re: How? Why!!!

        "If you outsource, you get what [their better paid lawyers decided] you asked for and pay for."

        FTFY. And of course if the penalties are less than the cost of doing the job, why do it? If they really screw up then Chris Grayling may be their answer ... just sayin'

        1. FidotheFrightful
          Unhappy

          Re: How? Why!!!

          Need a penalty clause contract , so these incompetents pay for their mistakes. Ah but the taxpayers deep pockets will pay.!

      3. stu 4

        Re: How? Why!!!

        "No-one asked Capita to do anything with this paperwork, no-one paid Capita to do anything with this paperwork, so Capita didn't do anything with it.

        Doing something with this paperwork would have cost money, and by outsourcing you saved that money!"

        got it in a nutshell.

        similar situation with TCS at BA (building the quality ticketing system):

        - requirements ask for service that processes the scanned ticket giving you access to gate.

        - requirements don't have non functionals (like... max response time)

        - TCS spent 2 months building service that takes 120 seconds on average per scanned ticket.

        - Not one of the geniuses asks the question 'er... I know there's no sla.. but it's like for scanning tickets..maybe as part of being a supposed professional I should ask'

        - service delivered into NFT where we (me) finds for the first time it's useless and has to be thrown away.

        - you pays peanuts, etc...

        1. Anonymous Coward
          Anonymous Coward

          Re: How? Why!!!

          TCS spent 2 months building service that takes 120 seconds on average per scanned ticket.

          Let me guess, Javascript?

        2. HmmmYes Silver badge

          Re: How? Why!!!

          Yeah.

          Ive sat in meetings where very expensive managers talk to very exoensive lawyers and discuss escrow, main man risk, invasion by Nork, etc etc. And not one bither with detail of the product thats to be delivered.

          Some times you just have to take the rusk, it never goes away.

          Maybe comoanies need to be prototyping then, when thry are gphappy, contracting out for scale and performance?

          1. tfewster Silver badge
            Joke

            Re: How? Why!!!

            Upvoted for "co-moanies" - e.g. Customers, outsourced staff who aren't allowed to do what they know is needed, and re-moaning in-house staff who can't get the outsourcer to do the needful because "it's not in the contract".

            The only happy people are 1) internal directors who got a bonus for cutting costs and 2) The outsorcerers. Apparently education Academy trusts have taken this to a whole new level. They take the money, then walk away from the contract if fulfilling the service would be too expensive.

            1. Anonymous Coward
              Anonymous Coward

              Re: How? Why!!!

              "education Academy trusts have taken this to a whole new level. They take the money, then walk away from the contract if fulfilling the service would be too expensive."

              Close - but you omitted the "distribute the money amongst the suppliers run by mates and relatives" stage.

              E.g. Lincolnshire 2012:

              http://www.telegraph.co.uk/education/educationnews/9232201/Academy-head-used-school-funds-for-luxury-flat-refurbishment-and-sex-games.html

              E.g. Birmingham (many years, Perry Beeches Academy Trust, this article from 2016)

              https://www.birminghammail.co.uk/news/midlands-news/calls-more-schools-oversight-wake-11803716

              E.g. Manchester 2014-16

              https://www.theguardian.com/education/2016/aug/16/academy-trust-chief-executive-collective-spirit-education

              Or akmost any month you choose since academies arrived, in the columns of Private Eye (sorry no links).

      4. Anonymous Coward
        Anonymous Coward

        Re: How? Why!!!

        Indeed. I hope Capita charged for the storage of this paperwork whilst the incompetent customer decided what to do.

      5. John Smith 19 Gold badge
        FAIL

        "In the absence of any agreed and contracted process for handling correspondence for "

        If you didn't ask for it (specifically, and in detail) you don't get it.

        Now I might think that "S**t's accumulating in our offices" would be a flag to contact someone in the DoH and ask them "What do you want done with it?"

        Did this happen?

        Maybe and the DoH asked "What's it going to cost?" or maybe they were told "We're not sure as the guy who deals with that stuff was let go two months ago."

        or maybe they didn't bother.

        Remember the Golden Rule of Outsourcing.

        "Everything the client forgets has to get done is another opportunity to charge for additional work. "

        1. Anonymous Coward
          Anonymous Coward

          Re: "In the absence of any agreed and contracted process for handling correspondence for "

          Need a penalty clause contract so Capita pay

          1. Anonymous Coward
            Anonymous Coward

            Re: "In the absence of any agreed and contracted process for handling correspondence for "

            "Need a penalty clause contract so Capita pay"

            No.

            Fine a company and nothing changes, the cost is passed on to their customers, employees, suppliers, etc. Nothing changes.

            Fine the individual managers that were responsible, and who should be (but frequently aren't) held accountable, and then there's a chance that behaviours will change.

            After all, the people in charge are clearly personally and individual responsible when things go right (that's why they have their personal and individual long term incentive plans etc, innit). So by the same logic they must surely also be responsible when things go wrong.

      6. the spectacularly refined chap

        Re: How? Why!!!

        No-one asked Capita to do anything with this paperwork, no-one paid Capita to do anything with this paperwork, so Capita didn't do anything with it.

        To be fair that isn't strictly true. I know this contract well, Capita are contractually not allowed to forward it to the intended recipient under NHS England Information Governance regulations. The change in procedure actually slightly predates Capita's involvement.

        The fault here is squarely with the sending practices, hospitals and other healthcare providers. If Capita are receiving thousands of clinical notes a month that is thousands of data breaches occuring every month in the wider NHS sending confidential data to the wrong destination.

        In this respect at least Capita are blameless. From my experience dealing with admin staff at care providers I can't say I'm surprised: many seem to have an inflated sense of their own importance and such niceties as following the correct procedure or obeying laws and regulations are entirely optional if you utter the words "clinical need".

      7. FidotheFrightful
        Unhappy

        Re: How? Why!!!

        Need a penalty clause contact so that these incompetents get clobbered. Ah but the deep pockets of the taxpayer will pay for these cock ups!

  2. m0rt Silver badge

    Sounds like some kind of national body, responsible for the health services to citizens is needed. That way everything can be subject to a centralized management process. That would also be able to handle funding that can be .... Oh wait....

  3. Gordon 10 Silver badge
    WTF?

    Some Sympathy here

    Heaven forbid but if I have read this right - if NHS England failed to communicate the correct address after Capita took over - then don't Capita share very little of the blame? Unless they were in charge of the comms as well of course then all bets are off.

    Defending Capita - I feel dirty right now...

    1. Mycho Silver badge

      Re: Some Sympathy here

      Capita are the bloody arsehole of a system with all manner of bowel diseases.

      They're not the cause but it's not unrelated.

    2. Hollerithevo Silver badge

      Re: Some Sympathy here

      There's the issue of professionalism and coutresy. Someone at capita should have realised the seriousness of the problem and not stopped until they had an answer. You don't just shove this kind of stuff into a cupboard. Geez, it could have been their kid's medical records or their own, if the idea of strangers being injured didn't move them.

      1. Mark 85 Silver badge

        Re: Some Sympathy here

        It's the collision of two bureaucracies and that never ends well. Each assumes the other is dealing with an issue when neither aren't. Those employed by them, don't dare open their mouth to question anything. And so it goes...

      2. Ken Hagan Gold badge

        Re: Some Sympathy here

        "There's the issue of professionalism and coutresy. "

        Yes, if not also the general duty of care that all members of society are obliged to perform towards each other.

  4. HmmmYes Silver badge

    Capita dont come out of this looking good.

    But neither do the GPs and the NHS.

    And we pay these peple - Capita + NHS/GPs.

  5. Zog_but_not_the_first Silver badge
    Devil

    The devil you don't know?

    First Carillion, now Crapita. My sympathy is limited to the poor workers at the shitty end of these meltdowns but I'm wondering, "Why now?" Are there some US corporations waiting to pounce for the work as part of the Brexit avant garde?

    I know my suspicion gland is working overtime, but you know...

    1. Ken Hagan Gold badge

      Re: The devil you don't know?

      I think it is more likely that we're seeing how journalism works. There are always stories about bad stuff happening, but it your new story is "like the last one, but bigger" it is easier to persuade an editor to run with it. The result is that stories around a particular theme come along in groups, like the proverbial busses.

    2. Cpt Blue Bear

      Re: The devil you don't know?

      Maybe they are waiting to pounce, but its an effect rather than a cause - pure opportunism.

      What you are seeing is the effect of the same forces that got you Brexit manifest in a different way. There is no longer enough slack in the system to allow it to run properly. Its usually the product of management with an "efficiency" fixation pushing to do more with less until you pass some inflection point where it breaks down.

      My former boss likened it to a worn bicycle chain: you keep adjusting it until its overtight and fails catastrophically. He was a great source of colourful metaphors...

  6. This post has been deleted by its author

  7. Wolfclaw Silver badge

    Surely the common sense approach, yeh I know that is a bit of a tall order for the NHS, would be to have one central correspondence receiving center address that never changes, regardless of who is running the contract ????

    1. Lysenko Silver badge

      Surely the common sense approach, yeh I know that is a bit of a tall order for the NHS, would be to have one central correspondence receiving center address that never changes, regardless of who is running the contract ????

      Perhaps one of those new-fangled "P.O. Box" thingies?

  8. John 110

    Meanwhile in NHS Tayside...

    The Tory MSP for NE Scotland is complaining about £100,000 worth of uneaten food in Tayside hospitals, claiming it's " further evidence of the health board’s inefficiency"

    Oh - and it's not privatised...

    It kinda puts a bill for £6m for sorting out a cock-up into perspective, eh.

    1. Jason 24

      Re: Meanwhile in NHS Tayside...

      £100,000 per year, and they are well under the 10% waste limit at 7.6%.

      Given they are £5,600,000 in the hole I don't think this bit of waste (within limits) is much of an issue.

      Neither of the articles I can find have said how much is spent in total, nor provide any comparison against other trusts.

    2. Arthur the cat Silver badge

      Re: Meanwhile in NHS Tayside...

      The Tory MSP for NE Scotland is complaining about £100,000 worth of uneaten food in Tayside hospitals, claiming it's " further evidence of the health board’s inefficiency"

      Judging by my last stay in hospital, it's more likely it's evidence of the food's inedibility.

      1. Terry 6 Silver badge

        Re: Meanwhile in NHS Tayside...

        The celeb chef James Martin did a little TV series on hospital food a year or so back. And his main conclusion was pretty much that moving to supposedly cost-saving cook-chill outsourced catering and closing hospital kitchens just lead to intolerable waste and poor patient nutrition. Just another consequence of beancounters making decisions.

        1. Boris the Cockroach Silver badge

          Re: Meanwhile in NHS Tayside...

          the local hospital here does cook-chill meals..........

          Bland and horrible is how I'd describe them (when actually edible)

          However Southampton has its own kitchens and does reasonable food..... but the catch is... the menu is the same everyday.. so by the time you've been there 5 days you've had everything on the menu......

          Anyway... back to capita ... oops forgot the r there

    3. boltar Silver badge

      Re: Meanwhile in NHS Tayside...

      "The Tory MSP for NE Scotland is complaining about £100,000 worth of uneaten food in Tayside hospitals"

      Someone should tell this clown that when people are very ill (which is usually the reason for a hospital stay as opposed to it being a w/e break) , they often tend not to be hungry and so if they are served a meal there's a good chance it will go to waste.

      Of course back in the day it would have been fed to the local farmers pigs so it wouldn't have mattered so much, but now with paranoid rules about foot and mouth and BSE you can't even do that so it just goes to landfill. Such a waste.

  9. JimmyPage Silver badge
    Flame

    Dead tree letters. In 2018

    was my first thought

    How come the entire Arab Spring was managed by Twitter in 2012 with a mobile and mainly anonymous population, and these clowns can't get letters letters FFS to a static address in the same unwar-torn country ????????

    There will be small "3rd world" countries looking at the UK wondering "and this is what we are supposed to aspire to ?"

    What on earth was I doing over 30 fucking years ago, diligently working on RFCs for email and email addressing ?????? I should have been taking Pitman instead.

  10. matjaggard

    Typo

    You have a typo in your headline. It's spelled "Crapita"

  11. Doctor Syntax Silver badge

    "Capita told us that, with hindsight, it believes it could have reported the backlog sooner,"

    Hindsight: the poor substitute for foresight.

    1. David Nash Silver badge

      it could have reported the backlog sooner

      Irrespective of their [lack of] contractual responsibilities, did nobody at Capita think, "hang on a minute, this could be important stuff, we better tell the NHS"

      1. Aladdin Sane Silver badge

        Re: did nobody at Capita think

        No they didn't, because Crapita give heartless bastards a bad reputation.

  12. Anonymous Coward
    Anonymous Coward

    not a problem limited to crapita

    this is a problem for outsourcing in general, in particular large multidimensional contracts where no one really knows the overall picture or the importance of individual processes. People that run the contract are disconnected from the reality of the jobs they have outsourced.

    The summary statement of "Clinical Correspondence" demonstrates this. Just a bod looking at medical looking notes and having no idea why they exist or what use they may be and adding a note to a list.

    I find this sort of situation alarmingly common...

    Also the "not obliged to, so didn't do it even though its bleeding obvious there is a problem" statement is alarmingly common for the bigger contracts. Probably the same causes.

    Overall the head-of gets a pat on the back for making everything cheaper (by missing out work that should be getting done) and the contractor gets a good rap for making it look cheaper.

    My experience is that the more disconnected the contract managers are from the processes and process consumers the more likely this effect is. Then only have to deliver the "appearance" of value.

    1. Terry 6 Silver badge

      Re: not a problem limited to crapita

      Yes

      Take a fairly complex set of interactions. Treat it a a mechanical one-dimensional operation. Define it in terms of just the visible formal processes. Employ some corporation of beancounters and lawyers to do the specified items listed. Move to a highly paid job in private industry before the poo hits the ventilation.

      1. Anonymous Coward
        Anonymous Coward

        Re: not a problem limited to crapita

        "Overall the head-of gets a pat on the back for making everything cheaper (by missing out work that should be getting done) and the contractor gets a good rap for making it look cheaper."

        ... and the experienced IT staff who do have business knowledge are sat on the sidelines and seen as troublemakers because of their distaste in outsourcing.

        Right up until "the poo hits the ventilation", and the contractor and "implementation team" have moved on and the business has realised it's not fit for purpose - then it's our problem (if we're still employed there).

  13. zaax

    The NHS messaging system is a mess. Other government departments have good working messaging handling systems why can't the NHS just copy them.

    1. tfewster Silver badge
      Thumb Up

      "Not Invented Here"

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