Withnell Health Centre future still uncertain after meeting

Dr Ann Robinson has run Withnell Health Centre for the past 11 years.  But when a partnership with another doctor at the surgery was dissolved at the end of 2021, the contract to provide GP services from the Railway Road facility had to be opened up to anybody who wanted to bid for it.

That process ended a year ago, with Dr. Robinson being told she had lost out to a conglomerate – much to the fury of many of her 5,500 patients, who formed a campaign group to keep her in post.

But the decision later unravelled after the Lancashire and South Cumbria Integrated Care Board (ICB) accepted tcentre users had not been properly consulted – leaving Dr. Robinson in place on an interim contract .

The ICB had been due to decide the arrangements for securing a permanent operator for the surgery – for up to the next 15 years – at a meeting of its primary care commissioning committee on Thursday.   

Members had been advised to launch a fresh round of bidding as part of a competitive tender for the contract – having received two expressions of interest in operating the facility.   It is not known whether the firm chosen last year – SSP Health – is among them.

But the Save Withnell Health Centre group had demanded NHS leaders instead make a so-called 'direct award' to Dr. Robinson – eliminating any potential competition.

That was an option the ICB had concluded was not available to it, but – just an hour before the meeting – it is understood the organisation received legal advice which prompted the contract award to be deferred for further consideration.

Later Dr. Robinson said while the move at least kept alive the hope she could still be handed the contract without having to go through another competitive bid, the delay was merely adding to the “stress and anxiety” felt by patients and staff.

She added: "People genuinely cannot understand why, when they have got the feedback they have from 2,500 patients [as part of a recent engagement process], that in the next breath, they have said they might have to go out to procurement again."

Craig Harris, ICB chief operating officer, said:  “We know this isn’t an ideal situation, but we’d like to reassure the local population we are still on track with the timeframes originally set. We remain committed to securing the best outcome for Withnell Health Centre and its patients within the legal guidance we are required and permitted to consider."

“We just have to reassure our patients and staff that we’ve just got to keep strong and trust that they will make the right decision – and so we fight on,” Dr. Robinson added.

Under the new NHS provider selection regime, which came into force at the start of the year, there are three routes by which organisations and individuals can be directly awarded health service contracts without competition.

Withnell Health Centre is ineligible for two of them, which apply only where the existing operator is the only one that can deliver the service in question or where patients have an unrestricted choice of providers.

The third option requires the existing provider to be satisfying its current contract and be judged by commissioners as being “ likely” to satisfy the new one “to a sufficient standard”. But it comes with a caveat that the new contract must not be worth “considerably” more than the deal it will replace – defined as it exceeding the existing arrangement both by £500,000 in cash terms and 25 per cent as a proportion of the total contract value.

Dr Robinson and her practice team argue that the proposed new contract for the Withnell facility would fall within those limits when compared to the arrangement that was dissolved in 2021.

But it is understood the ICB has been advised the benchmark for the comparison must be the current interim contract between Dr. Robinson and the NHS, which can run for a maximum of 30 months – and so is worth far less than the up-to-15-year deal now on offer.

Mr Harrjs added: “A decision on the approach to be taken in relation to the procurement option was due to be made [on Thursday] at our primary care commissioning committee meeting; however, the committee has agreed to defer a formal decision on the procurement route until further advice is sought.

 “The Provider Selection Regime, which is the national guidance we have to adhere to, was published on January 1 and we are one of the first ICBs in the country to apply this. During the meeting, a few points were raised by committee members that we need to seek legal clarity on before going forward.

 “We know this isn’t an ideal situation, but we’d like to reassure the local population we are still on track with the timeframes originally set. We remain committed to securing the best outcome for Withnell Health Centre and its patients within the legal guidance we are required and permitted to consider.