THERE was no breach of contract by a private partnership running GP surgeries that failed to pay doctors, staff, pension contributions and the taxman.
That’s what the chief operating officer of Gwent’s Aneurin Bevan University Health Board said as it was explained how the NHS body has taken back control of a practice in Brynmawr and will be putting in place enhanced monitoring of four of the seven other surgeries that remain with the partnership.
Leanne Watkins, speaking at the health board meeting at St Cadoc’s Hospital, addressed local councillors who’d raised concerns over the partnership run by doctors J Ahmed and J Allinson and supported by a private firm, eHarley Street.
Ms Watkins told the board meeting: “Technically, as hard as it is for you guys to believe, there is no breach of contract. It is really important for us to maintain good working relationships, had we got into a difficult legal situation we wouldn’t have been able to take action as quickly as we did.
“In Brynmawr they voluntarily resigned that contract.”
The Aneurin Bevan Board had previously directly managed Brynmawr and four other surgeries which the Ahmed/Allinson partnership took on since April last year. The partnership also runs three other surgeries in Gwent.
The board began “escalated monitoring” of the partnership at the end of October following complaints from doctors, staff, patients and local politicians.
Health board chief executive Nicola Prygodzicz said: “There were concerns around locums not being paid, issues with HMRC, pensions and suppliers not being paid.”
This week the partnership handed back the contract for Brynmawr and Ms Prygodzicz said four other surgeries, which are Aberbeeg in Abertillery, Bryntirion in Bargoed, Pontypool and Tredegar, will be subject to enhanced monitoring.
Ms Prygodcicz said those four are the surgeries the board “continues to be the most concerned about.”
She also confirmed an internal audit will be carried out into how the contracts were awarded.
She said: “We sought legal advice to understand the contractual position and have commissioned an internal audit to undertake a review of our contract award process which is a standard process.
“There are a lot of questions around the health board and due diligence and I thought it important we commission that internal audit for assurance and highlight any issues we should have picked up.”
As part of the health board’s monitoring it is visiting the surgeries but members were told there are no safety concerns.
But the chief executive said the board wants reassurances over management and payments that must be made.
“We will be working closely with them for continued assurance around payments that are outstanding to locums and suppliers and are concerned these are still an issue for them and also seeking further assurances around HMRC and pensions because we are being assured all that is now above board, there were some issues in transition, but we are told all that is now above board.
“But we have been picking up concern through individuals that they are concerned their personal accounts are not up to date and are trying to seek further assurance with the partnership around this particular issue.”
Board finance chief Rob Holcombe said financial support it has provided, which has included paying for additional GP sessions in Brynmawr in December, is available to all GP surgeries. He also said a lot of GPs surgeries across the UK are facing pressures.
He said failure to pay bills has created a “vicious circle” that has added to recruitment struggles if doctors think “they are not going to get paid” and the board wants the practice to get a “grip and control” of its finances.
Mr Holcombe added: “Where we are putting in additional support we are requesting, directing as much as we can, payments to locums that are outstanding, pension payments in particular that are outstanding, HMRC thought that is more of an issue for the company owners themselves, are prioritised payments made from the support we are giving to them.”
During the meeting it was explained when the health board managed the partnerships it had struggled to recruit permanent GPs and Ahmed/Allinson were awarded the contracts having put forward a plan to improve their “sustainability” by recruiting salaried GPs, and it was felt the partnership had “greater access to the GP market.”
The partnership’s model has relied on its “back office functions” being subcontracted to a private firm, eHarley Street.
Ms Prygodcicz said that model is more common in England, where the firm and partnership already operates, and talks will be held with the Welsh Government over different operating models for GP practices with questions over whether the traditional format of GPs managing their practices is sustainable.
The chief executive said she also wanted to address concerns over “back door privatisation” of the NHS and said GPs have always been private contractors since the establishment of the service.
The Ahmed/Allinson partnership acquired its first practice in Gwent when it took over Lliswery, Newport without the health board’s involvement and went through the normal local vetting and scrutiny process GPs need to comply with to practise.
It was awarded the Pontypool contract, under Aneruin Bevan’s vacant practice process, in October 2023, after it was handed back to the health board.
The Ahmed/Allinson partnership, supported by eHarley Street, also hold the contract for surgeries at Gelligaer and Blaenavon and Ms Prygodcicz said concerns about those surgeries, and Lliswery, aren’t out of line with any other practices.