UK's National Health Service Pilot Program Procurement Pulled

The National Health Service in the UK decided to test a plan to provide a new program for health services delivery. It is not clear to me just what the program entails, but it appears to be some kind of doctor appointments/referral system. The system was to be installed in a variety of regional centres. You can read the story and decipher for yourself at Procurement breach throws 111 pilots into disarray.

Since this was a two year test run, someone (or ones) some where (or wheres) made the decision to simply award the test sites services ("pilots") without a competitive process. At the last minute, the roll-out was cancelled and awarded pilots were cancelled. As the article explains,

Contracts for pilots covering NHS Westminster, NHS Kensington and Chelsea, NHS Hammersmith and Fulham and NHS Hillingdon were pulled after NHS North West London admitted its decision to award contracts without any tender process could be open to legal challenge.

The move has raised fears that pilots elsewhere in the country, some of which have also been awarded rather than put out to tender, could also be open to challenge – a prospect which could throw the national deployment of 111 into disarray.

Pulse understands the move has triggered anger from local GPs who had invested time and resources in planning how to integrate with the 111 pilot.

The wider impact of the decision remains unclear, amid confusion over whether NHS trusts are required to put pilots out to tender. Contracts for the full rollout of NHS 111, some of which are expected to be worth as much as £100m, will need to undergo a full competitive tender process, but the Department of Health told Pulse there was no central guidance on whether pilots should be put out to tender, and it was considered a matter for ‘local commissioners, subject to their legal advice'.

Dr Richard Vautrey, GPC deputy chair, said: ‘GPs are right to be angry about this, but it also reflects the complexities of the 111 procurement agenda and the pressures PCT clusters and CCGs are under because of the very tight timescale set by DH.'

Dr Agnelo Fernandes, the RCGP's urgent care lead and chair of Croydon Healthcare Consortium in Croydon said: ‘They are pilots so they are not covered by the same rules as full procurement but CCGs need to cover themselves by doing some kind of limited procurement, even if it is a pilot for 111.'

This is an instructive article for two purposes (at least). First, it illustrates, again, the way procurements too often get trampled in the rushed implementation of some political bright idea. Time and again this leads to unhappy endings. We should learn from these examples to get it right the first time. It's all part of the planning principle.

Second, it raises the matter of remedies for broken procurement. Here the procurement was cancelled, as were awards already made. Not all regimes allow awards to be rescinded, which I consider a moral hazard because it means if you hurry fast enough you can get away with abusing the process. Guam law also allows contracts that have been awarded by a faulty procurement process to be cancelled, as does the US federal law.

Insofar as this article raised the notion that "pilot programs" should somehow be exempt from general procurement requirements, I consider that to be a bad idea. Guam law, for instance, requires any contract by the government to be governed by the procurement process. There is a very big advantage that accrues to an incumbent contractor, and if a contractor could gain that advantage without competition, it would give the contractor an even more unfair advantage.