Following a Parliamentary question posed to Secretary of State for Health, Jeremy Hunt, in late March, NHS England commissioned a review into Liverpool CCG Remunerations.
The report is now live on Liverpool CCG’s website, albeit hidden behind smoke and mirrors. The self-awarding pay rises out of tax-payers’ money and officers’ dereliction of duty are now available for all to see.
While frontline staff are subject to a 1% cap on public sector pay rises, this organisation was handing themselves increases of between 15% and a staggering 81%.
Commenting on this major NHS report, Rosie Cooper MP said:
“I am pleased that NHS England have carried out this major report quite thoroughly, but already we are seeing Liverpool CCG attempting to bury it behind websites and computer software.
“The report is quite clear in its findings and recommendations that members of the Governing Body have failed in duty to the people of Liverpool to whom they are meant to serve. A lack of transparency, a cavalier attitude to contracting and most of all considering and voting to award themselves a huge pay rise out of tax-payers’ money is unacceptable.
“Everyone with knowledge of this situation is up in arms, the public, the GPs, voluntary and community sector, and rightly so. It is not sufficient for the Chair of the remuneration board to simply stand down, the Governing Body should resign and pay back the monies they’ve grabbed.”
Rosie Cooper MP has reacted with utter derision at the staggering incompetence of NHS Improvement in their handling of the Liverpool community health services contract, which has now seen them walk away from their original decision.
On 7 February 2017, NHS Improvement announced there would be a ‘temporary pause’ in the transfer of Liverpool community health services to the preferred bidder, Bridgewater Community Healthcare NHS Foundation Trust, after it became publicly known that the Trust received a ‘requires improvement’ rating in their Care Quality Commission inspection, despite NHS Improvement and Liverpool Clinical Commissioning Group being fully aware of this before they made their original decision.
Today (Thursday 30 March 2017) NHS Improvement have announced that the planned transfer of services to Bridgewater Community Healthcare will now not go ahead.
Instead, Alder Hey Children’s NHS Foundation Trust have been appointed to provide interim management with the hospital’s chief executive, Louise Shepherd, and chairman, David Henshaw, taking on those roles at Liverpool Community Health NHS Trust from 1 May 2017.
Alder Hey Hospital will be working in partnership with Aintree University Hospital NHS Foundation Trust and the Royal Liverpool and Broadgreen University Hospitals NHS Trust to deliver these community health services across the city. There has been no consultation by NHS Improvement with patients, staff, or other health partners or any open process being followed in changing their original decision and abandoning the original transaction process.
At the time of the “temporary pause” announcement, West Lancashire MP Rosie Cooper ‘cautiously welcomed’ the decision. Responding to the outcome of the NHS Improvement assurance review process, she said:
“NHS Improvement have today confirmed they were wrong to appoint Bridgewater Community Healthcare to run the Liverpool community health services contract in the first place.
“It is by NHS Improvement’s own hand that we now have the evidence that Bridgewater Community Healthcare were not up to the job of delivering this contract safely within the finance available and that NHS Improvement made the wrong decision.
“I think it also proves that NHS Improvement are not up to the job either.
“In the end I was right to be cautious about this pause and what it would mean for the patients and staff of Liverpool community health services.
“Health bosses appear to have pulled an Easter rabbit from the hat with this decision. So much for transparency, it seems that NHS management now just makes it up as it goes along. There appear to be no rules in this smash and grab raid!
“All that has happened is NHS Improvement have tried to rectify one horrendously bad decision only to make another equally bad decision.
“I have absolutely no confidence in NHS Improvement's ability to put patients’ interests first and last, when it comes to health services.
“Patients and staff of Liverpool Community Health NHS Trust need certainty, stability and assurances that the harm caused by past failings will not be repeated.
“During the pause neither NHS Improvement nor Liverpool Clinical Commissioning Group have addressed the significant underfunding of the Liverpool community health services contract.
“The current budget is £81.6 million; this is after the current executive team at Liverpool Community Health NHS Trust have already delivered £15 million in savings.
“After two years this contract figure will be reduced to £77 million, a further cut of £4.6 million, on top of which much more will be required to be done in the community for much less money. I understand that Liverpool CCG's Finance Director openly talks of a future financial gap of £13million on community services. This feels like the staff will be returning to the nightmare they thought they had escaped.
“The acute trusts, who are already running their own deficits, are going to take on an under-funded community service, together with Liverpool City Council’s efforts to add their cash-strapped social care services to the mix, while there also efforts to try to merge the Royal Liverpool and Aintree hospitals.
“This pause has not tackled a single one of the issues that could bring this crashing down. All they’ve done is changed the names of the players in their game.
“I have no trust or belief, on this performance, that NHS Improvement or Liverpool Clinical Commissioning Group are capable of resolving this mess.
“There needed to be a long-term solution. Instead we got the exact opposite.
“When I spoke to NHS Improvement they were unable to say how long Alder Hey hospital will be providing this interim arrangement.
“When I asked about the next steps in this process they had no answers. Why? They are still working them out was the response.
“Apparently there is going to be a Partnership Board set-up to oversee the long-term solution. Once again they had no answers as to who would be sitting on this board, except themselves. It is clear that once Alder Hey have taken children's services, community health services will be integrated and run by the merged acute trust.
“NHS Improvement and Liverpool Clinical Commissioning Group began the process to secure a new provider for community health services in the summer of 2015. Over 18 months on and we are still no closer to a meaningful solution and one that puts patients and staff first.
“Every day we hear about acute hospital trusts being under incredible financial pressures and their daily struggle to actually cope with the number of patients coming through their doors.
“NHS Improvement’s answer is to, at a stroke, without a proper plan, to add to these pressures by adding community health services to this unstable mix from a trust that between 2010 and 2014 was harming its patients and staff and is only now recovering.
“All we have from today’s announcement is the overwhelming certainty that NHS Improvement should be renamed NHS Incompetent.
“For the patients and staff of Liverpool community health services, all they can do now is hope and pray that at some undisclosed, indeterminate point in the future their needs and interests are put ahead of what is in the interests of health bosses in Liverpool and in London.”
Rosie Cooper MP called on Theresa May today (Wednesday 22 March 2017) to investigate pay increases of up to 80% at NHS Liverpool Clinical Commissioning Group (CCG) as they embark on funding cuts to frontline health services and NHS staff receive a below inflation 1% pay increase.
A freedom of information request to Liverpool CCG from Commons health select committee member, Rosie Cooper, revealed members of the governing body received bumper pay rises mainly in 2014/15.
Notable increases include a 15% increase for the chief officer from £135,000 – £140,000 (2013/14) rising to £155,000 - £160,000 (2014/15). She also received £1,500 in expenses in 2014/15.
At the same time the chief finance officer received an inflation-busting 16% salary increase, taking his pay from £125,000 -£130,000 rising by at least £20,000 to £145,000 - £150,000. In 2014/15 he also had £600 in expenses according to published accounts.
However, these rises don’t compare to the 50% increase for the CCG Chair with a whopping £50,000 pay rise from his £100,000 – £105,000 salary in 2013/14 rocketing to £150,000 - £155,000 the next year.
For his Deputy Chair, a 42.85% salary increase taking their salary from £70,000 - £75,000 to £100,000 plus one year later.
In light of this information MP Rosie Cooper called on the Prime Minister to investigate the lack of governance and accountability that allows clinical commissioning groups to pay this level of salary and to only have two non -executive directors instead of the usual five.
In response the Prime Minister confirmed that NHS England would now be investigating the remuneration of members of the governing body of Liverpool Clinical Commissioning Group.
Speaking after her challenge to Theresa May at Prime Minister’s Questions, Rosie Cooper MP said:
“The tremendous pressures on frontline NHS services to meet demand is not a secret.
“Whilst the CCG were handing out these scandalous pay rises to reward themselves, the CCG stood by and allowed grotesque failings to occur at Liverpool Community Health NHS Trust in which patients and staff were harmed by the culture of bullying and horrific management failures.
“The actions of Liverpool CCG reveal the extent to which, in this new health system, nobody is really holding CCG’s to account. They are a law unto themselves. It is clear in Liverpool they can do as they please and believe they do not answer to anyone.
“I believe there are serious questions that needed to be asked of, and answered by, the CCG in relation to the size of their pay increases, the number of people receiving these astronomical increases and how they justify the current salary levels especially at a time when community health services have seen £4.6 million cut from current funding, when frontline services are being cut and NHS staff are handed a 1% salary increase.
“There are now plans to merge Liverpool CCG with neighbouring South Sefton CCG and Southport and Formby CCG. Can you imagine the salaries they’d hand themselves from commissioning health services across three communities as well as the lack of proper governance in choosing the chief executive officer?
“All I am asking is for this situation to be reviewed and for there to be real public accountability.”
Following the announcement by Southport and Ormskirk Hospital NHS Trust of the outcome of executive disciplinary appeals, West Lancashire MP Rosie Cooper said:
"I am pleased this lengthy investigation into whistleblowing allegations made against senior executives has been concluded for the good of Southport and Ormskirk Hospital NHS Trust, its staff and the patients it serves.
"The priority for the hospital trust now is to find a talented chief executive with a passion for delivering the best quality healthcare for West Lancashire and who is capable of tackling head on the financial and organisational challenges the trust faces.
"I have written to the hospital trust requesting that they now take the opportunity to answer all the outstanding questions on this case.
“For a start, what are the accusations leading to disciplinary action and dismissals? Why was the process so lengthy? And what is the cost of the investigation and disciplinary action?
"As a taxpayer-funded service there are legitimate public interest concerns the trust has to satisfactorily address and I would encourage them to do so in as open and transparent a way as possible."
Responding to concerns over proposals for the 'downgrading' of accident and emergency services at Southport and Ormskirk NHS Hospital Trust, West Lancashire MP Rosie Cooper said:
“This information on proposals to downgrade local A&E services was published in November 2016. There is no new information from reports over recent days, merely it is a review of all STPs nationally.
“I raised my concerns in a parliamentary debate alongside Southport MP, John Pugh, back in November.
“The fundamental problem with Sustainability and Transformation Plans is from the beginning they were put together in secret. Local residents have been totally excluded from the decision-making processes.
“Still, NHS bosses have failed to adequately explain what they mean by ‘downgrading’. What this means in NHS management speak and what me and local residents understand it to mean can be completely different.
“Publishing this information without any explanation has led to anxiety and distress about the future of local health services. It also adds further pressure and begins to destabilise our local hospitals at a time when they are already under incredible pressure.
“This whole situation highlights the lack of accountability we now have within the NHS. Bosses seem to believe they can do as they please with taxpayer-funded services and don’t have to answer to anyone.
"I am obviously concerned about the future of the hospital and will be expressing my concerns when I meet with the chief executive of NHS Improvement in the coming weeks.
“I will always fight to protect local health services, which I have done in the past and continue to do as the people of West Lancashire should have access to a local hospital and local accident and emergency services."
West Lancashire MP Rosie Cooper has cautiously welcomed the announcement by NHS Improvement that there will be a temporary pause as they review the transaction process for transferring Liverpool community health services to Bridgewater Community Healthcare NHS Foundation Trust.
Responding to the announcement, MP Rosie Cooper said:
“I believe this pause is the right decision by NHS Improvement, especially in light of Bridgewater Community Healthcare’s Care Quality Commission inspection rating of 'requiring improvement' released yesterday (Monday 6 February 2017).
“Throughout this transaction process I have expressed my reservations about the capability and suitability of Bridgewater Community Healthcare in taking over these services.
“Having exposed the extensive management failures and bullying culture at Liverpool Community Health NHS Trust between 2010 and 2014, I am absolutely determined there is no repeat of the harm caused to patients and staff.
“An under-funded contract run by a trust with financial weaknesses, requiring improvement run by an inexperienced executive management team all feels very familiar when it comes to Liverpool community health services.
“I am cautious in welcoming this pause until I better understand its focus. Is it to review whether the current decision is actually in the best interests of patients and staff; ensuring the quality of care is right or is it to provide more time to ensure Liverpool Clinical Commissioning Group don’t lose face having appointed Bridgewater Community Healthcare as their preferred bidder in the first place despite all the warning signs?
“Members of staff who have seen their former poor, bullying organisation transformed for the benefit of patients and staff have contacted me saying they are terrified that they are now being moved against their will from the QE2 to the Titanic.
“It may be a good idea for NHS Improvement to consult Liverpool Community Health NHS Trust staff during this pause to get their views on the prospect of transferring to Bridgewater Community Healthcare.
“There is too much at stake to get this wrong again for the patients and staff involved in Liverpool community health services; commissioners cannot afford a repeat of their previous failures. I for one will be monitoring developments during this pause very carefully.”
Bridgewater Community Healthcare NHS Foundation Trust’s ‘Requires Improvement’ inspection rating from the Care Quality Commission (CQC) has prompted an angry response from West Lancashire MP Rosie Cooper given the report’s delayed publication and Bridgewater’s preferred bidder status for Liverpool community health services.
Rosie Cooper MP had brought to light the revelations about a bullying culture under the former management of Liverpool Community Health NHS Trust. A culture that resulted in patient and staff harm being caused, as detailed in the 'Capsticks Report' and which is currently the subject of an independent review by Dr Bill Kirkup, who led the inquiry into Morecambe Bay.
This led to NHS Improvement / Liverpool Clinical Commissioning Group (CCG) breaking up Liverpool Community Health NHS Trust with the individual contracts being put out to tender with Bridgewater Community Healthcare NHS Foundation Trust being one of the bidders.
Over a period of several months, MP Rosie Cooper has publicly raised financial and service quality concerns as to Bridgewater Community Healthcare’s suitability to take on Liverpool community health services in the circumstances of previous failures.
In July 2016 Rosie Cooper MP called on the Care Quality Commission to publish their inspection report into Bridgewater Community Healthcare ahead of any decision by Liverpool Clinical Commissioning Group and NHS Improvement on awarding the multi-million pound contract for Liverpool community health services.
In responding to the inspection reports publication, MP Rosie Cooper said:
“We now know why Bridgewater Community Healthcare tried to delay the publication of this report.
“In the key areas of safety, leadership and the effectiveness of patient care the Care Quality Commission finds that Bridgewater Community Healthcare is not delivering to the required standards and requires improvement.
“It is quite staggering that despite today's independent verdict on Bridgewater Community Healthcare, NHS Improvement and Liverpool CCG could even contemplate in the face of this evidence to hand Bridgewater Community Healthcare, a seriously underfunded contract to run Liverpool's community health services in July.
“NHS rules are clear, to take over other trusts and services you must have a 'good' CQC rating. If this were to go ahead, with Bridgewater Community Healthcare requiring improvement, it would show that Liverpool CCG and NHS Improvement are willing to breach their own rules, sacrifice quality and are abandoning their duty of care to patients, staff and Liverpool residents.
“I have called on the Secretary of State to review this sorry state of affairs and intervene to uphold NHS rules.
“If NHS Improvement and Liverpool CCG were attempting to restore confidence in Liverpool community health services in contracting a new provider following the previous failures they have abjectly fallen well short.
“Many aspects of this report echo dangerous practises with medicine management, staff shortages, and financial pressures- all similar to the root failures under the previous management at Liverpool Community Health NHS Trust, which were revealed in 2014.
“What this report tells us is Bridgewater Community Healthcare need to improve the services they have currently got. NHS commissioners then want to add extra community health services on top of services which have been poorly managed and underfunded and are only now back on the road to recovery.
“Then add to this mix the new alliance agreement, which will see social care services included in a new model of care with community health services provided by Bridgewater Community Healthcare, Liverpool City Council and Liverpool GP Provider Organisation.
“Publication of Bridgewater Community Healthcare inspection rating raises some very serious questions about the entire transaction process in Liverpool.
“What the Care Quality Commission’s report shows is that the decision by NHS Improvement and Liverpool CCG to give Bridgewater Community Healthcare the keys to NHS community services in Liverpool is patient safety comes a distant third to commissioner’s interest’s and financial savings.”
West Lancashire MP Rosie Cooper is incredulous about the further delays to the publication of Bridgewater Community Healthcare NHS Foundation Trust’s inspection report by the Care Quality Commission.
Seven months have passed since the inspection concluded. MP Rosie had been told publication of the report was imminent but even now that has been delayed for a further two weeks.
This most recent delay results from a request from Bridgewater’s chief executive who won’t be around for the next two weeks, which Rosie Cooper has described as “unbelievable”. She has previously pressed the CQC to issue Bridgewater’s inspection report ahead of the decision to award the contract for the £80 million Liverpool community health services contract because Bridgewater’s only previous inspection had been part of the CQC’s pilot inspection, not the more in-depth inspection regime they now use.
Speaking about the most current delay to the eagerly anticipated inspection report, West Lancashire MP Rosie Cooper said:
“It is simply unbelievable that Bridgewater have been allowed to delay the publication of their CQC inspection report by a further two weeks, when people have been made to wait seven months already.
“Why are they waiting? Have they got something to hide?
“Bridgewater have lost some local contracts recently so if the report is critical then they may rightly fear that it will detrimentally affect the confidence of Liverpool residents that they are able to provide a ‘good service’.
“It is astonishing and, I think, telling that the chief executive doesn’t feel confident enough to allow his deputy or the medical director to take the lead, and reveals a lack of depth and experience in the management team at Bridgewater.
“It is worrying that an organisation set to take over running community health services in Liverpool doesn’t seem to have the management strength to cope with the increased demands.
“The time has come for Bridgewater Community Healthcare to answer some questions. Let’s start with what have they got to hide?”
West Lancashire MP Rosie Cooper, who exposed the far-reaching failures at Liverpool Community Health NHS Trust, is calling on the newly appointed provider, Bridgewater Community Healthcare NHS Foundation Trust, to come clean over plans for a health and social care joint venture.
MP Rosie has received information that Bridgewater Community Healthcare NHS Foundation Trust, Liverpool City Council and Liverpool GP Provider Organisation have plans to set-up a joint venture, pooling all budgets to provide all community health and social care from a single company.
MP Rosie, a member of the Commons Health Select Committee, has submitted a formal Freedom of Information request to each of the three organisations to establish the extent of any discussions.
She is also calling on the three organisations to issue an immediate confirmation or denial of these plans so patients and staff know where they stand.
Responding to this information, MP Rosie said:
“Deeply concerning to me are the rumours I’m hearing about the intention to set-up a new organisation. I understand it is the intention of Bridgewater Community Healthcare, the Liverpool GP Provider Organisation and Liverpool City Council to use Section 75 of the NHS Act 2006 to merge services into one organisation. This would bring together community health, social care and primary care.
“I would urge these three organisations to confirm or deny these plans immediately.
“If this is an option being discussed then Bridgewater Community Healthcare need to assure staff they will take on from Liverpool Community Health NHS Trust that they will retain their NHS terms and conditions indefinitely under any new organisation.
“The contract was let for approximately £5m less than it costs to run now. The interim administration has already cut the back office and managerial costs which means that future savings will come from staffing costs.
“These organisations also need to be clear that any future cost savings will not be done by cutting quality to patients or on the back of hard-working, committed and dedicated staff by cutting their pay and conditions.”
Responding to the announcement that Liverpool Clinical Commissioning Group have awarded the Liverpool community health services contract to Bridgewater Community Healthcare NHS Trust, West Lancashire MP Rosie Cooper said:
“Having closely followed this procurement process, this is a disappointing outcome.
“This outcome should be really worrying for the current staff at Liverpool Community Health NHS Trust who will transfer to the new provider; and for the residents of Liverpool using these services.
“The incompetent Liverpool CCG, who laughably won CCG of the year, strike again. These are the same commissioners who presided over the scandalous failures in Liverpool community health services up to 2014. Failures that led to patient and staff harm that are now subject to an independent clinical review.
“Sadly, Liverpool CCG don’t seem to have learnt any lessons from past failures. This decision, I believe, shows they continue down the same path as before.
“There are still so many unanswered questions about Bridgewater Community Healthcare. We still await the publication of their recent Care Quality Commission inspection report, which may yet raise further questions over their appointment.
“Deeply concerning to me are the rumours I’m hearing about the intention to set-up a new organisation. I understand it is the intention of Bridgewater Community Healthcare, the Liverpool GP Federation and Liverpool City Council to use Section 75 of the NHS Act 2006 to merge services into one organisation. This would bring together community health, social care and primary care.
“I would urge these three organisations to confirm or deny these plans immediately.
“If this is an option being discussed then Bridgewater Community Healthcare need to assure staff that they will retain their NHS terms and conditions under any new organisation.
“These organisations also need to be clear that any future cost savings will not be done by cutting quality to patients or on the back of hard-working, committed and dedicated staff by cutting staff pay.”