Private provider Virgin Care is set to run adult social work services as part of a £700m deal to reshape social care and community health support in Bath and North East Somerset.
Local council chiefs and NHS commissioners have met fierce opposition from anti-privatisation campaigners and trade unions over their decision to make Richard Branson’s firm their preferred provider for the minimum seven-year contract.
Approval for the plans will be sought from councillors and the clinical commissioning group’s board at public meetings on Thursday. If they go through, Virgin Care will run three statutory services – adult social care, continuing healthcare and children’s community health – from April 2017.
The deal marks the first time a council’s core adult social work services will be directly delivered by a for-profit private firm, although the council said a clause in the contract will require any financial surplus to be reinvested in services.
Unlike in children’s services, there are no laws preventing councils from delegating statutory adult social work functions to profit-making providers.
A range of non-statutory services such as public health nursing, integrated re-ablement and speech and language therapy are also included in the contract. Virgin will have the option to sub-contract providers to take on some services while retaining overall responsibility as “prime provider”.
Rival bid
Bath’s adult social care services are currently run by Sirona Care, a not-for-profit social enterprise spun out of the council’s social services in 2011.
Virgin Care was selected over a rival bid from a consortium of local services led by Sirona Care. The council and NHS commissioners said the Virgin bid at least matched the consortium in every individual area, and there was a “significant” final difference in the total scores.
A Bath council spokesman told Community Care the authority expected the “vast majority” of frontline staff to continue in their current roles, although they “may be working for a different organisation”.
“Detailed arrangements will be agreed with Sirona and Virgin Care over the coming months but we can confirm that anyone transferring to another organisation under TUPE regulations will retain their existing terms and conditions, pay, and pension,” he added.
Hubs model
Health and local authority chiefs said the Virgin Care deal will deliver more joined up and preventative care by setting up locality hubs aligned with GP practices to ensure “seamless communication” with primary care.
But unions, social work leaders and staff affected have all raised concerns over the move.
Lewis Carson from Unison said the union’s members were opposed to a profit-making firm taking over services.
“We’re fighting to oppose the contract. We have concerns about what this means for staff conditions and service delivery.
“From past experience we know staff terms and conditions can be targeted for savings. Our members are passionate about the care they deliver and there are a lot of unanswered questions about what this will mean in terms of teams, workloads and day-to-day work. We’re extremely concerned.”
Concerns
One social worker likely to be in line for a transfer to Virgin Care under the contract, said the firm’s track record seemed to be in delivering health services, rather than social care.
“We’ve seen nothing which assures us of their knowledge of the Care Act, the Mental Capacity Act and, crucially, the safeguarding of the most vulnerable residents of Bath and North East Somerset.
“After the final decision is made there will be a very short time period to transfer staff and clear information on the future of the teams has been limited to say the least.
“It had only been five years since we moved from the council to Sirona and this proposal does not fill me with confidence about the value placed on statutory social work, its importance to local communities and the risk that more statutory services will be privatised.”
Ruth Allen, chief executive of the British Association of Social Workers, said the move was a warning sign that councils and NHS commissioners could try to “off-load” the difficult issue of integrating care at a time of rising demand and shrinking budgets.
She said a sustainable financial settlement for social care was needed, adding: “The private nature of adult social care, most often in people’s homes or residential care, and the fragmentation of provision through multiple agencies, are some of the reasons why adult care does not have the visibility and public and political drive needed to unlock the funding needed. This needs to change.
“I am also concerned about how social workers within these outsourced arrangements with Virgin Care will be supported and enabled to practice to meet statutory duties. I foresee many ethical and practical issues, as well as concerns about workforce rights being properly upheld.
“The fundamental issue with outsourcing to for-profit organisations is how can they provide sustainable value on public money and highest quality when they need to show dividend returns to shareholders? It’s a simple equation that rarely works out in the long term.
“There may be a clause suggesting profits will be reinvested in local services but the question is how long will that last and how will surpluses be defined?”
‘Co-ordinated care’
Council bosses and NHS chiefs said the decision to award the contract to Virgin Care followed a “two year period of engagement”
Dr Ian Orpen, a local GP and Clinical Chair of the CCG said: “We have listened carefully to what local people had to say and we have a very good understanding of the improvements they would like to see.
“Many people have difficulty finding their way around the health and care system to get the care they need. Virgin Care’s proposal means that services can be better co-ordinated and people will be supported to access all the services that can help them improve their health and wellbeing.”
Councillor Vic Pritchard, the council’s Cabinet Member for Adult Social Care and Health, said Virgin Care would help join up care by bringing people’s health and care records into one secure place.
A Virgin Care spokesperson said: “We have been providing community health and care services for a decade, working with a range of partners to look after more than a million people a year.
“The Council and CCG’s shared vision for Bath and North East Somerset is for people to ‘no longer need to distinguish between health and social care’. We are really pleased to have been selected to deliver that vision, and we’re looking forward to working with professionals and other organisations in the area.”