NHS investigation: Trust ‘didn’t know’ of role played by doctor with conflict of interests

Bootham Park Hospital.
Bootham Park Hospital.
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A HEALTH trust was “surprised” to learn a doctor with a potential conflict of interest played a key role in deciding who won a £190m contract to provide mental health services in York and the surrounding area.

A formal letter of complaint sent by Leeds and York Partnership NHS Foundation Trust (LYPFT) to regulator Monitor says the trust had not been aware Dr Louise Barker was on the panel judging rival bids until after the decision was made in May when documentation surrounding the process was disclosed. Dr Barker’s partner works for Tees, Esk and Wear Valleys NHS Trust (TEWV) which was awarded the contract, currently held by LYPFT.

The letter, which calls for Monitor to use its powers to officially investigate the actions of Vale of York Clinical Commissioning Group (CCG), says LYPFT reviewed the breakdown of scores after narrowly losing the tender in what is known as the standstill period “and was concerned that its scores in a number of areas appeared to be unjustifiably low.”

It says that although the trust was aware that Dr Barker was the CCG’s lead on mental health and that her partner worked for TEWV “... we were surprised to learn… that Dr Barker was actually on the assessment panel itself.”

The personal relationship is acknowledged on Dr Barker’s formal register of interests with CCG, but the letter claims the CCG failed “to ensure that Dr Barker’s conflict of interest was registered in every meeting where the Procurement was discussed, and in failing to ensure that Dr Barker was not in a position to influence the outcome of the Procurement, it is the Trust’s contention that the CCG has failed to comply with both its statutory, and organisational, obligations in relation to the management of conflicts of interest.”

The LYPFT letter says: “As the CCG’s mental health lead, Dr Barker had an important role in planning the elements of the specification for the Procurement. Further, Dr Barker formed part of the evaluation panel for the majority of the qualitative aspects of the Procurement.

“Dr Barker’s scores for TEWV were, in most cases, substantially higher than other evaluators’ scores, and substantially higher than the scores awarded by Dr Barker to the Trust’s bid.

“The disclosed documents also demonstrated that Dr Barker was the only clinician with recent experience of the mental health services being procured on the evaluation panel. Not only would this lack of clinical expertise make it difficult for the other evaluators to assess the merit of bidders’ technical submission, it is also likely to have meant that Dr Barker was in a position of considerable influence at the evaluator consensus meetings at which the final scores were decided.

“The Trust makes no allegations regarding Dr Barker’s integrity... Dr Barker’s position of conflict could have led to an unintentional preference for TEWV’s bid, which impacted on the outcome.”

The letter to Monitor says the CCG rejected LYPFT’s concerns about the handling of the tender process and was told its failure to obtain the contract was “caused solely by the considerably higher price submitted by the Trust”.

The Yorkshire Post understands LYPT’s bid was around £195m for the five-year contract, around £5m above the target cost with the extra funding largely focussed on much needed improvements to services for inpatients at the rundown Bootham Park Hospital in York.

LYPT says the upheaval associated with a change of provider at a time when it is trying to manage service improvements for people with serious mental health problems “is very likely to put the safety and welfare of service users at risk.”

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