Cancer test blunder sees Capita scrutinised for NHS outsourcing role

19 November 2018 Consultancy.uk

Scandal-stricken professional services firm Capita has reportedly come under heavy fire for its mishandling of almost 50,000 letters relating to cancer screening information across England. The company, which has worked as an administrative support outsourcer for the NHS since 2015, failed to send the letters to patients, which included crucial information such as hundreds of abnormal results in their contents.

In reports first circulated by the Financial Times, The British Medical Association has written to the Chief Executive of NHS England to express its “extreme concern” that hundreds of women had not received vital information concerning cervical cancer screenings. The medical notes had not been sent, following a system error on the part of contractor Capita, which the Financial Times also suggested faces losing its NHS deal over the botched delivery.

In 2015, Capita first won a 7-to-10-year contract to supply administrative support to the NHS. The contract was said at the time to be worth as much as £1 billion, but has in fact seen Capita make a significant loss. Following a succession of complaints by GPs, the embattled firm – which has spent 2018 attempting to improve its prospects following a shock profit warning – was forced to invest £130 million to improve its service provision on the essential contract. The deal is supposed to see Capita supply GPs, opticians, pharmacists and dentists with a range of back-office services, including payments administration and the management of clinical records across England.Cancer test blunder sees Capita scrutinised for NHS outsourcing role

Earlier in the year, Capita also came under fire alongside fellow outsourcer Atos for the reported mishandling of as many as a third of the Personal Independence Payment (PIP) assessments they carried out. The firms received a raise for their efforts last year, raking in more than £250 million each for the controversial disability welfare checks, despite Parliament’s Work and Pensions Committee recently suggesting vulnerable people had been “pushed to the brink of destitution” by the contractors’ handling of the scheme.

In Essex, meanwhile, while Capita recently won a contract to boost NHS connectivity in the region, the firm was also forced to withdraw its sponsorship of this year’s Social Worker of the Year Awards after a nominee and a judge protested against its involvement. Capita carries out resourcing and recruitment functions for the East of England authority, and had been listed as the sponsor of the ‘Championing Social Work Values’ award category, in partnership with Essex council. The charity Social Workers Without Borders, which was shortlisted this year, and Nick Berbiers, who was on the judging panel, both declared they would boycott the event if this did not change, however.

Now, as the firm seemingly stumbles from one crisis to another, Capita has been lambasted for what NHS England labelled an “administrative failure”, which saw 48,500 letters to women telling them of cervical screening dates or containing test results go unsent. According to further reports in the British press, 4,000 of the letters included test results, while the remainder invited women for screening or reminded them of test dates. While NHS England said Capita had alerted it to the error and claimed there was “no current evidence that this incident has led to harm to the women involved”, between 150 and 200 are understood to have included details of abnormal results.

“At risk of serious harm”

The news will prompt further examinations of comments from the National Audit Office in May 2018, when the organisation warned that the NHS’ contract with Capita – viewed as dimly as a cost-cutting measure by some critics – had led to failures which put “patients at risk of serious harm.” The National Audit Office scrutinises public spending for Parliament. As well as the danger which the failures posed to patients, the body also noted the performance issues incurred by Capita had caused the NHS to spend more than £10 million to rectify them, while Capita had at that time had £5.3 million deducted by NHS England as penalties for poor performance.

The National Audit Office subsequently proposed that NHS England should consider taking back in-house part of the contract. Following this latest blunder, it is now understood that Capita is in talks with NHS England to return part of the work covering cervical cancer screening.

At the same time, in a bid to stop the rot, Capita has confirmed it is investigating the matter internally. Capita has appointed an independent audit team, led by PwC, to “review operational systems”. It also apologised to “both the NHS and to the women whose correspondence was delayed.”

Capita is not the only outsourcer to have faced a turbulent 2018 in Britain’s outsourcing industry, however. Elsewhere, major government contractor Carillion, which was one of the Ministry of Defence’s biggest outsourcers, famously collapsed in January, while concerns surrounding the future of embattled firm Interserve also look set to continue.

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How data insights helped Network Rail improve the South-East route

11 April 2019 Consultancy.uk

Amey Consulting has leveraged data insights to assist Network Rail with the improvement of its South-Eastern route. Using the Quartz tool, which monitors train movement, Network Rail will now be able to commit to data-enabled interventions to quickly improve underperforming train stations.

With rail services in the UK coming under strain from the demands of modern commuter life, while the infrastructure and service delivery of the nation’s railways has come in for sustained criticism in recent years, a period of regeneration is on the cards at last. Network Rail is the owner and infrastructure manager of most of the railway network in Great Britain, and has subsequently tapped the consulting industry on a regular basis to help find areas of improvement.

The group recently drafted in consultancy BearingPoint to conduct a thorough organisational evaluation and advise Network Rail (High Speed) on attaining a ‘fit for purpose’ organisational standard – for which the consultancy was nominated at the 2019 MCA Awards. Meanwhile, ArupArcadis and Aecom have been contracted to help Colas Rail and Babcock Rail implement a decade-long framework for Network Rail, aimed at supporting the delivery of the next generation of rail systems, with the contracts said to be worth as much as £5 billion

How data insights helped Network Rail improve the South-East route

As Network Rail further aims to improve its performance and customer service offering, another area it has sought help from the consulting sector for is its South-East route. The network of railways connects London with the southern parts of the country, as well as with Europe, making it the busiest in the country, with more than 500 million passenger journeys per year. This crucial expanse of rail was plagued with small minute delays, which were impacting millions of passengers every day, while reducing the efficiency and capacity of the overall network – something Amey Consulting was selected to help solve.

Amey Consulting soon determined that with the sub-threshold delays to services only lasting for 1 or 2 minutes, most were not the subject of detailed root cause analysis, and this made their corrections almost impossible – with dire consequences. Without addressing these delays, passenger satisfaction would fall, while the capacity and efficiency of the network would be reduced, stinging the income of Network Rail even before a host of delay-related fines would hit the company.

In order to help the client gain a better understanding of where, how, when and what these small delays occur, Amey Consulting looked to demonstrate the value of data-led consulting, with a significant reduction in delays within the first month of rolling out changes to key stations. The consultants embedded themselves in Network Rail’s team, helping them learn the key skills needed to support and apply data-driven solutions.

Agile transport

This involved the deployment of the Quartz tool. The system utilises to-the-second train movement data to present the performance of individual stations across the South-East route. It allows users to effortlessly understand station performance with a high level of detail, and use this information to identify losses caused by small-minute delays. The granular data allows for targeted actions to drive efficiency savings and performance improvements. More importantly, it allows users to understand the impact of small process changes on performance. 

Steve Dyke, an Executive Partner at Amey Consulting, said of the project, “We looked to identify the physical root cause on the infrastructure, building a case for change then managing that project implementation and tracking the benefit/value.  In doing so we are working to define a data performance improvement service to the operational and infrastructure owners.”

Just as important for the project as the technology, however, was teaching the Network Rail team how to leverage it after the consultants were gone. The Amey Consulting team worked to develop an agile working culture within Network Rail’s South-East division, helping staff to be confident in using data to improve the journeys of millions of people per year by attacking the problem from the ground up.

Dyke concluded, “This is less about the tools and about the approach to managing performance.  It meant using by-the-second analysis, data science, and then agile development to visualise and identify areas where improvements can be made.  We then worked with NR to change the way they approached the management of the infrastructure changes.  So rather than pass the information down the value chain, any of which could have been missed, we managed the change end-to-end.”

The project was so successful that Amey Consulting was also among those honoured at the recent MCA Awards. The firm scooped the Performance Improvement in the Public Sector prize for its work with Network Rail, at the 2019 ceremony in London.