back to article Capita cost-cutting on NHS England contract 'put patients at risk' – spending watchdog

A botched £330m seven-year NHS contract with Capita to outsource back-office support for 39,000 GPs, dentists and opticians was today savaged by the UK government's spending watchdog over its "potential to seriously harm patients". In 2015 Capita won the primary care support services contract to administer payments to GP …

  1. Chris G Silver badge

    "The Register asked Crapita to comment."

    So that's 162001 items of delayed correspondence!

    1. macjules Silver badge

      Or,

      .. Capita previously has taken on some contracts that contained too many unknowns. Our new strategy will ensure we focus on doing fewer things better and securing business that we know can be delivered well

      "fewer things better" = "we are losing business hand over foot" and "securing business that we know can be delivered well" = "our undisciplined goonsquads just lost us another Home Office contract to Mitie"

      When Capita finally gets flushed down the pan of bankrupt oblivion I shall indeed be celebrating. From what I hear that could be a lot sooner than I thought.

    2. Anonymous Coward
      Anonymous Coward

      What happens when...

      Capita see patients as a bunch of 'Jeremy Hunts', in the overall business model.

  2. Aladdin Sane Silver badge

    Sounds like a bad deal for all involved.

    1. Rich 11 Silver badge

      Except for the politician who approved it at the time and crowed to Parliament that it was yet another high point in the long and bright history of the private sector bringing innovation and resource-saving to the benighted public sector.

      I forget his name.

  3. }{amis}{ Silver badge
    FAIL

    Corporate Manslaughter

    This will be a fun chain of responsibility it looks like Capata has screwed up by the numbers, but at the same time, the NHS seems to have both failed to specify a viable contract and also failed to enforce the terms.

    Given that this has almost certainly resulted in unnecessary deaths and prolonged suffering due to delayed and or missed treatment, I hope the directors of both organisations get time preferably sharing a cell with "Uncle Buba"

    1. James Anderson

      Re: Corporate Manslaughter

      Trouble is the extra 'deaths' are a statistical guestimate.

      Yes almost certainly the number of deaths increased because of admin errors -- but you cannot say exactly which ones. You would need to prove Captita was responsible for a specific individuals death before a corporate manslaughter charge could be brought.

  4. Doctor Syntax Silver badge

    "It decided to outsource the service as it lacked the necessary skills to transform services through better use of IT, the NAO said."

    This is the central problem. Those are also the skills needed to supervise an outsourcing contract. A successful IT operation must start with a core team in-house with adequate knowledge to understand what the business or organisation needs and what's available to meet those needs. With that in place they can then make a sensible decision about whether to outsource or to develop in-house, bringing in external help on an as-needed basis.

    1. Jellied Eel Silver badge

      Scalpel, meet forcep

      Well said, and I was about to quote that bit :)

      I also suspect it's an untrue statement. The NHS was and is a mammoth beast and had a lot of IT staff. Including ones with responsibility for IT in their job titles and pay grades. So I'd be pretty certain that included some who had the skills and understood the operating environment.. But they presumably were ignored in favor of following the outsourcing craze, and the rest is expensive history.

      Meanwhile, the IT staff that were capable and competent have probably long jumped ship, so the NHS is even less likely to be able to bring this back in-house. And the senior staff responsible for this fiasco will no doubt be unaccountable.

      And as you say, this shouldn't be brain surgery. In-house core team to capture requirements, with representation from service users. Add a dab of futureology to cope with inevitable change every time there's a new Health Minister or government. Then break that into manageable work packages that may or may not include outsourcing aspects like FM/desktop support that's more generic, or contract systems development whilst in-house staff are also trained up to support it.

      Time and time again the NAO report the same problems with public sector outsourcing projects.

    2. Mr Gullible
      Pint

      No, No, No

      You don't need to know anything about the subject matter in order to manage a project, whether that's managing a new baby or managing a house-building project, it's all just management. It's fatal for a project manager to get bogged down in the boring details. Not knowing anything about the subject matter enables them to properly focus on the higher level aspects of "Managing the project"

      Anyway, just off for a beer after telling mine that two-line code change will take two weeks of exhaustive problem solving and testing.

    3. a_yank_lurker Silver badge

      @Doctor Syntax - Spot on. But many PHBs and MBAs (being redundant) only look at personnel as a cost not a resource. Having the resource internal to you makes it easier to shift them were needed. Also, internal personnel if they can talk to each other can share resources with each other more freely; they are both working for the same company.

  5. Slef

    But the starting point is "private is good Public is bad" rather than What is actually needed and accept that sometimes companies put in unsustainably low bids just to get the contract and then try to cut staff costs (exept for the top managers) to a point where it is undeliverable and then who picks up the bill? think stagecoach and virgin in the railway setting or carillion!

  6. Wolfclaw Silver badge

    Capita high standards, three words that you cannot seriously ever put together in one sentence !

    Whereas Capita, underperforming, loss making, incompetent, useless and many more can !

    1. Evil Scot

      Has Nae.

  7. tip pc

    Why are they insistent on outsourcing

    "It decided to outsource the service as it lacked the necessary skills to transform services through better use of IT, the NAO said."

    Sounds like the initial system was run in house and NHS England has decided they are not an IT shop and that IT can be run via a contract with a third party.

    Why do they keep teaching this crap to those that end up making the decisions. Its time they realised that what ever it is they do, its built on IT and that the IT bits that need outsourcing are stuff like WAN's, Hardware etc. Config should all be in house, it's fine to buy COSH but ensure you have the people in-house that know how to configure it and have a vested interest in getting it right. Also pay them properly else they will go elsewhere just like anyone else in any other profession.

  8. Anonymous Coward
    Anonymous Coward

    Shocked...

    ...I am not.

    We have been saying for years how shit Crapita are. I've also been saying for years why outsourcing IT is mostly bad. It's the directors and execs wanting to make a name for themselves that cause this "Director blah blah saved the NHS £1million a year outsourcing". Then they ignore the fact it all goes wrong and costs more later down the line.

    Sussex Partnership Trust are one such trust. Had perfectly fine IT, then outsourced it to Crapita. They have been predictably shit (which they were warned they would be), now they regret it.

    Fucking irritating when they listening to bullshitting consultants rather than their own fucking staff.

    1. Anonymous Coward
      Anonymous Coward

      Re: Shocked...

      They listen to the Consultants because (a) they are paying the Consultants huge amounts of money and anything that costs so much *must* be good and (b) their own staff are obviously more concerned with keeping their own jobs than with getting the best for the business (which is another problem - it's a service - it SERVES. It's one of the - if not the - biggest drain on the nation's coffers - we shouldn't expect it to make a profit since that would mean we're giving it too much money).

      They seem to forget that, if the staff mess it all up then they lose their jobs too (and, unlike most management seem to have, the staff are unlikely to have golden parachutes or anything similar to help them).

  9. Anonymous Coward
    Anonymous Coward

    "to run existing services and also simultaneously to transform those services"

    That right there is most stupid thing I've ever read, which clown setting up this contract came up with that idea?

    How on earth can you transform something you don't know how to run? Transform it first then outsource if you really must.

    It's like there are people in government that want the NHS to fail so it can be shipped off wholesale to the private sector after which they can separate the cost from taxes to healthcare insurance.

    1. tip pc

      @AC

      It's like there are people in government that want the NHS to fail so it can be shipped off wholesale to the private sector after which they can separate the cost from taxes to healthcare insurance.

      You mean like National Insurance?

      https://en.wikipedia.org/wiki/National_Insurance

      National Insurance (NI) is a tax system in the United Kingdom paid by workers and employers for funding state benefits. Initially, it was a contributory form of insurance against illness and unemployment, and eventually provided retirement pensions and other benefits.[1] Citizens pay National Insurance contributions to become eligible for State Pension and other benefits. Anyone 16 years old and above are mandated to pay National Insurance provided the employee earns more than £162 a week or the individual is self-employed and makes a profit of £6,205 or more annually. It is necessary to obtain a National Insurance number before starting to pay contributions.

      while i don't know your circumstances, as a permie i paid over £5k in national Insurance last year in addition to also paying extra tax because my employer provides me private health care, in addition to me also paying into my private pension pot.

      Like it or not we already pay into a National Insurance that is meant to provide for ill health & unemployment. I won't be paying an extra insurance over what i am already paying for the same thing.

      1. Anonymous Coward
        Anonymous Coward

        I know, I meant move it from your wages to create an American system of healthcare,

        1. Aladdin Sane Silver badge

          Re: American system of healthcare

          Also known as "Fuck the poor".

      2. Richard 12 Silver badge

        NI is just an employment tax

        It all goes into the big pot.

        Also, NI payments don't even come close to covering the cost of pensions and the NHS.

        In 2016/17 total NI payments were £125 billion*.

        The NHS planned spending was £124 billion. (Actual will have been higher, budget was £120 bn)

        Pension spending was roughly £111 bn, out of a total welfare spending of £264 bn.

        In short, National Insurance contributions usually can't cover the cost of the NHS, let alone pensions as well.

        It's really paid for by general taxation and Government borrowing. Ring-fencing NI would actually reduce the budget!

        And yes, state pensions cost almost as much as the NHS. Welfare has by far the biggest budget.

        Source: www.ons.gov.uk

        * using 1bn = 1000 million. Sorry.

  10. Will Godfrey Silver badge
    Unhappy

    The changes that will actually be made

    {crickets}

  11. justAnITGuy

    Corporate Incompetence Rules The Day

    Incompetence in any other business or industry would be rewarded with a trip to the Job Centre whatever it is called in these more enlightened times of ours.

    Everything about this sorry tale is utterly predictable from the outset. As soon as you outsource anything you hand over your testicles to the outsource who, being an entirely different business to yours, has not got the beginning of a scooby what to do with them. And then the now critically damaged business wonders what possibly went wrong (hint: every-fucking-thing) and what they can do now (put pencils up nose and repeat "wibble" until it all goes away, perhaps?).

    Fundamentally, the chiefs are clueless, having learned how to be chiefs in a nice quiet and cosy echo chamber in some University somewhere. They've then entered at a Management/Director level having had zero experience of what is actually going on in the firm. If they'd start these "graduates" off as if Apprentices, give them a broom to sweep the shop floor, as it were, and grow in the business based on their own success and achievement, our modern day captains of industry may just become the leaders that they need to be, based on merit rather than any degree of entitlement.

  12. Anonymous Coward
    Anonymous Coward

    Anonymous cos of reasons

    I've had to deal with Capita in the past and while there are some excellent ex-Capita people that have been a pleasure to work with, a lot of the current staff are awful. Not awful in that they don't know stuff they should - we've all been dropped into positions where we've had to learn on the job - but in that they generally either seem not to care or are told not to care by their management.

    On one occasion we had a prolonged outage one one of their services and my employer raised hell with them, so they arranged a call to discuss the options and what they could do. The Brits introduced themselves, explained the problem and then handed over to their development lead to explain himself - a team leader from their offshore organisation. This was about the only time I've felt sorry for someone in an offshore organisation because while he was being turned inside out by our business owners for the shambolic service, his management were all on mute keeping schtum while he copped all the flak. Bastards.

    Awful company, awful culture.

    1. Anonymous Coward
      Anonymous Coward

      Re: Anonymous cos of reasons

      I worked for this company for a time, my experience was that they a had a few competent people who spent >90% of their time fixing the faults caused by the rest.

      Since the incompetent majority had retained their positions by toadying to the equally incompetent management then putting the competent forward to take flak was the norm. The hope being that since they knew what they were talking about then they could present the lies better and because a relationship of trust inevitably built up between the ones who could do the job and those that needed it doing.

      Unsurprisingly this resulted in the competent leaving, so I would say that the longer the contract has been running the worse the service until they are getting in contractors for the simplest things who they then blame their failures upon until it all falls over and they loose the contract. At which point they move the incompetents to any other contract they can fit them into and repeat.

      Given that Capita was only ever an investment group without technical understanding at the highest levels then what do you expect.

      1. AndyMulhearn

        Re: Anonymous cos of reasons

        I worked for this company for a time, my experience was that they a had a few competent people who spent >90% of their time fixing the faults caused by the rest.

        Yeah, saw that as well on another gig. Key technical people driven to illness or departure if they had any sense due to the stress of carrying everything for too long.

  13. StuntMisanthrope Bronze badge

    Juvenal v3.0 Kickback Editon

    The problem here is, you can only give the project to an organisation that has the existing balance sheet and liability cover to build in the almost certain cost of failure charge. Combine that with commercial expertise that is less than your average dope dealer and the lack of technical scope and real-world experience. I've had the youthful flush of foolishness, entering public service tender processes and wouldn't dream of wasting my time in the future. I'd embed within the organisation on agency terms but you have to know someone and have previous sector experience. #horsetranquiliserplease

  14. Jez53

    Hate for Capita

    Capita may not be perfect, but neither were the dumbass public sector sloths who used to do this work.

    Only way things will improve is if the public sector stops awarding jobs to the lowest price tender and start to police contract awards effectively.

    1. Mike Pellatt

      Re: Hate for Capita

      Only way things will improve is if the public sector .... starts to police contract awards effectively.

      But, as someone up there somewhere said, the set of skills needed to be effective on the client side of a contract of this nature, and the set of skills needed to effectively manage the job in-house have a pretty massive overlap.

      Add into that, as I keep banging on, you can transfer financial risk (at least in the short term) from the public sector to the private sector, but the risk of service failure will always fall to the public sector. Along with the concomitant costs....

  15. Anonymous Coward
    Anonymous Coward

    But - the private sector is wonderful. It generates profits for overseas tax dodgers in tax havens. The public sector is bad because it can't do that. Serfs know your place and don't challenge your lords and masters !

  16. RonWheeler

    would it have been

    Any better if done by the NHS's own staff and resources, assuming budget the same? Evidence?

    1. Rich 11 Silver badge

      Re: would it have been

      assuming budget the same

      This is where it all falls down, regardless of who attempts to do the job or how. Assuming a one-third cost saving is achievable is the underlying problem. You can see why NHS England jumped at the chance, given the financial pressure they've been put under by a government which doesn't give a flying fuck, but they shouldn't have done so.

  17. N2 Silver badge

    Capita high standards?

    Ye Gods, what are they smoking?

    High standards of complete cock ups, over budgets, late deliveries.

    1. Rich 11 Silver badge

      Re: Capita high standards?

      On the plus side, it'll sell a few more copies of Private Eye.

  18. Aging Hippy

    What's the fuss about?

    Only £330m - when Brexit is complete the NHS will have this much extra money to waste EVERY WEEK.

    Yes I am a cynical bastard but I prefer the word "realistic".

  19. Anonymous Coward
    Mushroom

    Warning capital letter abuse ahead!

    "It decided to outsource the service as it lacked the necessary skills to transform services through better use of IT, the NAO said."

    THEN TRAIN YOUR FUCKING STAFF INSTEAD OF PISSING THE MONEY ON OVERPAID CONSULTANTS WHO KNOW FUCK ALL ABOUT YOUR BUSINESS.

  20. Gordon Pryra

    Bit 2 faced of the Government here

    If someone undercuts the competition by millions, then they are not going to be providing a comparable service.

    How can the person who accepted the bribe, sorry, bid, claim they thought otherwise?

  21. BinkyTheMagicPaperclip Silver badge

    Crapita to fail next

    There's already been rumblings in Private Eye, and direct warnings in government that Carillion could happen again, and soon.

    Not that I feel optimistic about the alternative, they'll probably try and get Virgin to do it, after all Virgin don't have to carry the can for fucking up the east coast mainline now.

  22. Anonymous Coward
    Anonymous Coward

    Intelligent customer function

    This is not rocket science. An "intelligent customer" does not hand over the keys to the Kingdom to immoral shysters like Crapita. They need to be torn apart.

    I feel sorry for some good employees... But the management sharks should left to feed on each other till they disappear

    The "intelligent" customer understands the components and does not allow a single supplier to feed at the trough.

    The margin upon margin upon margin stacks within the bad ship Crapita, between business units, are astonishing... And worse, none of them has a clue about what any other one does. Same as most big SIs, just an order of magnitude bigger.

    For what it's worth, I will shortly be blowing the whistle, in public, on some unbelievable shit they put both the NHS and me through. Watch this space :-) and feel free to share and care your own experiences. Tear down the walls...

  23. doug_bostrom

    Where private sector provisioning of public services begins: unaligned objectives. The whole point of the private sector is to divert money from fulfilling the needs of consumers, what we call "profit."

    Capita's intended purpose is to make money first, provide services as an unfortunate side-effect of making money.

    So we're not really surprised by this, are we?

  24. W.S.Gosset Bronze badge
    Thumb Up

    Concise writing, at the NAO

    > it lacked the necessary skills to transform services through better use of IT, the NAO said.

    Magnificently, although written about the NHS, this sentence works as-is for Capita, too.

  25. Myself_27

    Con artists and thieves

    Capita are con artists!! They ‘improved’ the service (money grabbed) by moving the day-to-day work to the GP surgeries which are already over stretched.

    No harm to patients?!? how about a patient dying 18 months into a registration with new GP and we still had no records so we treated based on an old, forgetful persons account of medical history!! How about a patients referral delayed because we can’t obtain PMH as urgent notes request was processed by them sending an email to old surgery and then telling us that’s it our jobs done if you e not got in 5 days chase it up with surgery yourself. Verbal conversation- it’s not our job to chase up surgeries to send notes on; err yes yes it is!!! A main part of your job is to facilitate the safe transfer of medical records from old GP to new GP.

    And with 16 years of NHS service I think I know the procedure better than the call handler you’ve employed who doesnt understand the terminology or the meaning of unacknowledged.

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