Agenda item

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 60.

Contract with AT Medics

The Chair advised the Committee that he would be taking an additional item under any other urgent business in accordance with Standing Order 60. The item was in relation to the APMS contracts that were held by AT Medics. The item was considered urgent as it had been discussed at the Brent CCG meeting the previous week, resulting in considerable interest amongst residents and councillors.

Jo Ohlson (Accountable Officer, NWL CCG) explained that there were 2 APMS contracts in Brent held by AT Medics. An APMS contract had more detail and KPIs than other GP contracts. AT Medics had approached the CCG at the end of the previous year to seek consent for a change of control. As a result the control had moved to Operose which was a British based company dealing with healthcare. As Accountable Officers across London it was agreed this would be looked at collectively in relation to seeking legal advice and due diligence, including looking at their financial standing and other governance measures. A number of assurance were sought from AT Medics, who the contract remained with, and they concluded there would be no change to the services being provided or to the staff providing them throughout London. Assurance was also sought that the current directors would remain involved in the service, and although they would no longer be statutory directors they would be directors on Operose and involved in the management of the practices. Jo Ohlsen advised that if there were any changes in relation to service provision or concerns about services having changed as a result of the change in control that would be picked up by Fana Hussain (Assistant Director of Primary Care, CCG) and her team who would continue to manage those contracts.

The Chair thanked Joe Ohlson for providing the background information and invited members of the Committee to ask questions, with the following issues raised:

The Committee queried why the change was taking place if nothing would change regarding the services or financially. Jo Ohlson clarified that the APMS contract had not been given up but that there had been a change in the owner of AT Medics, therefore no TUPE indications applied. In relation to the reason behind the change, Jo Ohlson advised she had met with the Chief Executive of AT Medics across London and in their view there was a benefit in coming together with Operose for the skills they had around population health management. She confirmed it was a decision for AT Medics to make regarding who they wanted to work with and the CCGs job was to be assured they would continue to provide the services to the same standard as they were currently doing and hopefully improve them. She added that AT medics was rated good by the CQC and had gone into areas that were difficult to provide services and recruit to and been able to do that.

In relation to Operose’s financial standing, the Committee expressed concerns at their most recently submitted accounts records. Jo Ohlson advised that due diligence had been completed and they had been assured that they were fit to hold the contract and added that any concern in that regard would be followed up immediately. In relation to the CCGs ability to control the change of contract, the Committee were advised that the CCG were being sought their consent and there was no legal reason or basis in which they could have stopped the change in control as there had been no change to the service provided. The ability to consult or insist on consultation was limited also as there was no substantial change of service to patients and that would leave the CCG open to questioning every practice merger. Jo Ohlson assured the Committee that the CCG would continue to ensure the services patients had received would continue and monitor in the way they would monitor any other practices in Brent to ensure services were delivered.

The Committee raised concerns about data privacy with Operose. Jo Ohhlson explained that they had requested a cast iron guarantee there would be no sharing of data outside of the UK which they had received and if there was any transgression of that it would be picked up.

The Committee acknowledged that this was a difficult and unusual situation but felt that there was not enough time or information present to understand the issue in full. As a result, the Chair drew discussions to a close and invited the Committee to make recommendations, with the following RESOLVED:

i)                    To request that the CCG provide a written briefing note to the Chair in relation to the matter and to respond to questions as submitted by the Committee within that note. The Committee then delegates to the Chair to take a view as to whether the matter requires a further scrutiny of the matter following that briefing note.