OUTSOURCING
an advantage there. But the fact is that we don’t really know who the competition is going to be. The private sector is really very good at coming in and making attractive of- fers and learning very quickly. Our issue is that these spun-out organisations are very dependent on the PCTs for their business. That’s a vulnerability for any organisation, to be dependent on one source for your work. There are pros and cons.”
One of the cons is the complex property ar- rangements in place, with the spin-outs of- ten working from the same NHS premises that staff were using when they were NHS employees. There are few ways round this, Clarke said.
“I can’t think of anything PCTs could do that could ease the complications. What they should be doing is making sure that they are going into this with their eyes open and monitoring what’s happening, so they know they retain some of the risk of owning the property.
“They need to be aware of what will hap- pen if the social enterprise moves out of the accommodation they’re in, meaning the PCT is left holding onto it, along with the responsibility for maintenance and upgrad-
ing and so on. I can’t think of a panacea for this, but you really do have to be very aware of what you’re entering into and the risks.”
Rocking the boat
It is fair to say that the NAO report ruf- fl ed a few feathers. Peter Holbrook, chief executive of the Social Enterprise Coali- tion (SEC), questioned the value of the study, saying: “We have to question why a value for money assessment was conducted when only four of the 47 Right to Request organisations had completed the process.
“It is very diffi cult to draw any accurate or fair conclusions based on the evi- dence. Research to assess value for money would have been much better carried out at a later date with a larger sample size.”
He said it was “naïve” to suggest social en- terprises might not deliver value for mon- ey, noting that as businesses, their survival depended upon it, and added that they are subject to the provisions of QIPP just as other parts of the health service are.”
The Department of Health itself was unu- sually blunt in its reaction to the report, saying the NAO had “failed to understand
the point of this initiative”, which “has de- livered clear benefi ts”, it said.
We asked Clarke to respond to those criti- cisms, and he said: “I wouldn’t have a re- sponse to their particular comments, but I will say on sample size that we were obvi- ously able to look only at the social enter- prises that have actually spun out already, and I think the report makes it clear that it’s early days. But the issues we’re raising aren’t at all dependent on sample size; they could affect anyone, so I don’t think that af- fects our conclusions or recommendations for the future.”
He and audit principal Emma Taylor also pointed out that, in line with the NAO’s customary practice, the Department of Health had seen earlier drafts of the report and approved the published ver- sion as factually ac- curate.
David Clarke FOR MORE INFORMATION
The full report and detailed recommendations are at
tinyurl.com/NAO- Right-To-Request
Steve Collier, from Environmental Waste Controls, explains how a pilot study at an NHS hospital prompted changes to Department of Health technical guidance enabling signifi cant environmental benefi ts and reduced fi nancial costs on NHS estates.
T
he NHS is the largest producer of clini- cal waste in the country, handling an
average of 250,000 tonnes of waste a year, at a cost of over £40m. The Government re- cently published its review of waste policy that set out ambitious targets to encourage waste prevention and re-use.
Until now, the technical guidelines restrict- ed healthcare managers in the way they both classifi ed and disposed of waste.
In line with the Government’s waste policy, the Department of Health published re- vised guidance (Technical memorandum 07-01: Safe management of healthcare waste) that enables health trusts to re- classify their waste and implement new processes that bring about improvements in waste handling and return signifi cant fi nancial savings.
The Royal College of Nursing has been at the forefront of a campaign to reclassify
54 | national health executive Jul/Aug 11
case study highlights a pilot scheme at one NHS foundation trust that resulted in an £88k year one saving as well as improve- ments in safe handling and environmental benefi ts.
waste and adopt new techniques in waste storage, carriage, treatment and disposal. The RCN estimates that for every 1% of waste reclassifi ed, a saving of £272,000 per annum can be achieved. If the ‘offen- sive’ waste is then compacted, the savings are greater.
In the Department of Health guidance, a
At present most NHS offensive waste is collected in wheeled bins and skips, lead- ing to storage and transport issues. The guidance allows for the reclassifi cation called for by the RCN and the introduc- tion of compacting within a sealed con- tainer as a disposal method reducing on-site storage and transport costs and providing carbon savings.
Steve Collier FOR MORE INFORMATION
Steve Collier T: 0845 456 2456 E:
steve.collier@
ewc.eu.com
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84