It always seems to be the independents that take the hit when it comes to financial worry, and the case of Capita contracts is no exception.
It was back in June 2015 when outsourcing firm Capita agreed a huge £1bn contract with NHS England to deliver administrative support services for optics. The initial seven-to-10-year contract aimed to refresh and modernise services, and hopefully create much-needed savings for the NHS.
The deal was the latest in a run of NHS contract wins for Capita, as the health service increasingly sought to use the private sector in order to keep funds in check. Yet the contract has caused problems for practices up and down the country. Capita has come under fire due to late or incorrect General Ophthalmic Services (GOS) payments to practices, form order problems and customer service delays. Some practices have experienced payments being made to the wrong payees or sent to the wrong practices with patient information on them.
In July, Capita told Optician it was monitoring payment arrangements and would work with bodies including Locsu to improve the service.
In August, leaders of the Optical Confederation and Locsu sent a letter to NHS chief Simon Stevens demanding urgent action to bring payment services delivered by Capita ‘up to an acceptable standard’. The Association of Optometrists (AOP) even appointed a dedicated temporary resource to work in collaboration with Locsu to help resolve payment issues GOS contractors were facing with Primary Care Support England (PCSE), although the position has since been closed.
Karen Wheeler, the NHS England director responsible for overseeing the contract, provided assurances that Capita was being held to account for its unacceptable service levels and confirmed that financial penalties had been applied. But how has the mismanagement of contracts affected practices, in particular the independents where a steady and consistent cash flow is fundamental to the success of the business? The administrative issues have existed for a number of months, and it is becoming increasingly difficult for independents to carry the financial burden of missed payments.
Staffordshire optometrist and contact lens practitioner Brian Hitchin told Optician he had got into serious financial trouble as a result of the Capita takeover and subsequent missed payments. He has had to rely on funds from his pension and family members to keep the practice running.
‘The money is not in the bank so I can’t pay my bills, and it leaves me wondering, even when we do get the money, who’s going to pay the extra expenses such as bank and credit charges as a result of missed payments?
‘I had a patient who I have had to turn away as they needed equipment that I couldn’t afford to buy. I then had to suggest that patient goes somewhere else.’
Hitchin’s problems with Capita began in April following missed payments to the practice. This continued for the following months until September when Hitchin received paperwork containing details of payment for the previous two months, yet the information was inaccurate, he said.
Not everything has added up since Capita took over
‘I’ve been paid £300, which is too much for the list of patients on the files,’ said Hitchin. ‘They also contain four names on them which are not patients I have seen or patients I have claimed for. I may have seen them in the past but I haven’t claimed for those. It’s all a bit of a mess.
‘I’ve spent the whole day on the phone and I can’t help feel that we are letting the patients down. The last two weeks I have hardly done any work because I do not want to run up any more bills. I’ve only done contract work which I’m obliged to do and have a responsibility over.’
Hitchin, who wrote a letter to Optician in August demanding joint action in taking NHS England to court, is now planning to write a letter to the chairman of the Parliamentary Medical Committee and the General Financial Committee.
‘I have more or less stopped work because I am running the bills up and am unable to do it anymore. I’ve owned my practice for the past 50 years and the issue with Capita is one of the largest financial problems I have faced.’
Hitchin’s case is just one of many practices going without vital payments. Stalbridge based dispensing optician and practice manager Grace Haine is all too familiar with Hitchin’s problems.
She said: ‘We’re chasing the money we’re owed with little response to the emails we send. We have requested a breakdown and we are still waiting for that. You just can’t contact Capita or get through, by email you get a lot of “we’ll get back to you”.
‘We finally received a payment after three months. But that was only part of the payment, and it was sent with no information or summary attached to it.’
Haine had been warned by a friend about the Capita takeover and the problems some practices were having, and therefore extended the business overdraft to cover any extra costs.
‘At four years old we are a relatively new business so it has put extra stress on the company, so far we are owed £7,000,’ said Haine.
And it is not just the financial implications, but also time and energy spent trying to contact Capita that is putting extra pressure on practices.
‘I spend every Wednesday trying to get through to them [Capita], the practice totalled up a full week of work doing this since July,’ said Haine. ‘I know I can claim the money back but nothing matches up, it makes life much more complicated. You don’t know how you’re doing against last year, of course I can do it on a sales basis, but I don’t know for sure until all of my records match up.’
Kate Webb, director of Cranmers Opticians in Minehead noticed immediately when the contracts changed hands, even though Capita claimed not to acknowledge there was a problem.
She said: ‘It’s the same battle every month and has been going on for at least four months – it’s an administrative nightmare. It’s up to you to re-calculate how many contracts have been sent and when they were sent.’
But there is some progress being made for Cranmers, and there’s confidence that the administrative problems will be fixed. ‘In our area, I work with a chap from Capita who tries to do everything he can as soon as he can. He does everything in his power because he really understands. I have a really good relationship with him so I’m very grateful for that.’
Unfortunately, optometrists are not the only healthcare profession to suffer under the changes. GPs have decried Capita as a ‘shambles’ after experiencing a host of problems with patients’ medical records and suffering equipment shortages.
With Capita making headlines last week following a share fall of 28%, it seems administrative problems are just the tip of the iceberg for the firm. It was expected payments would stabilise at the end of October, with residual issues resolved by the end of the year. Only time will tell if this target will be met.
