Decision to axe Edics was 'phenomenally difficult', says CCG chief officer

The man who pulled the plug on an award-winning healthcare service has defended the "phenomenally difficult" decision.

Miles Freeman, chief officer of Surrey Downs Clinical Commissioning Group (SDCCG), decided not to renew the contract of the Epsom Downs Integrated Care Services (Edics) in August.

Edics provided specialist NHS clinics in the community and has since gone into administration – to the upset and anger of thousands of its patients who were subsequently transferred to alternative providers such as Epsom Hospital.

Mr Freeman said he believes the situation was well-handled because both parties "put patients first".

In an exclusive interview with the Epsom Guardian, he said: "We were faced with a service which was demonstrably not providing value for money but which also a majority of our doctors were shareholders in.

"To take a decision like that so early in the life of the CCG was extremely difficult. I don’t see it as a knee-jerk reaction at all.

"It was a decision which had to be made and we worked extremely hard, and Edics deserve credit as well, because despite the issues and arguments we were having, we managed to continue services extremely well for patients."

Mediation between the parties has failed and should an adjudication also prove unsuccessful, the issue is likely to go to court.

At a meeting of its governing body held at the end of September, SDCCG said is stands to lose £2.5m in the dispute.

A SDCCG spokeswoman said the adjudication process is being led by an independent mediation organisation called CEDR and any timescales, which are unknown to the CCG, will be set by the company.

The CCG came under fresh criticism from Mike Sadler, a former non-executive director at Epsom and St Helier Hospital Trust, who called SDCCG “criminal cowboys” for its decision to axe Edics.

He said the Edics episode demonstrated that, despite the move to GP commissioning from Primary Care Trusts this year, "NHS bureaucrats" are still pulling the strings.

Responding to the claims, Mr Freeman, who has worked in NHS commissioning for 11 years, said: "Criminal cowboys? I don't have a criminal record and have never ridden a horse."

He said that Edics was a specific situation in which he had to take a decision on behalf of Surrey Downs' GPs because many of them had shares in Edics.

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Edics is now in administration and in adjudication talks with SDCCG

Mr Freeman said: "I’ve worked in PCTs and it feels extremely different in a CCG. Our clinicians are definitely in control and have overwhelming backed the decisions around Edics.

"The way the health reforms have been set up, they have created the role of the accountable officer.

"One of the things people were concerned about when you set up GP organisations was how you would deal with GPs' conflicts of interests and how GPs would make decisions around payments to other GPs.

"It's probably the only area where I felt that I, the managing arm of the CCG, needed to make a clear decision.

"That wasn’t just the management, it was the lay governance as well.

"The GPs all supported the decision. They were very clear they did not want to hinder any action which could be taken around Edics because of their own self-interest."

Mr Freeman said that in contrast, the CCG's decision to walk out on the Better Services Better Value (BSBV) review, earlier this month, was driven by the GPs.

He added: "It is easy to portray it as managers in control but then you see our GPs voting 75-25 against BSBV.

"The management and governing body of the CCG make a recommendation to the membership and say 'you make the decision and we will follow that decision' and I think that’s about GPs being in control.

"CCGs need professional managers, they need experience in contracting. It's support to enact clinical decisions."

Edics' creditors

A document sent by UHY Hacker Young LLP, administrators for Edics, to its creditors, seen by the Epsom Guardian, shows 95 creditors are owed money by Edics, at a total of £2.7million.

The companies owed the greatest sums include: