Tory donor Lord Ashcroft’s outsourcing firm lands £350m vaccination contract

Medacs Healthcare is part of a group whose largest shareholder is Michael Ashcroft – who has given millions to the Conservatives.

OpenDemocracy January 20 2021

A healthcare company ultimately controlled by leading Tory donor and former party chairman, Lord Ashcroft, has received a £350m contract as part of the government’s COVID-19 vaccination roll-out, openDemocracy has learned.

Last month the Department of Health and Social Care gave the lucrative contract to Medacs Healthcare plc. In recent weeks, the outsourcing company, which specialises in providing staff to the NHS, social care services and private healthcare providers, has been advertising for staff to work on the huge vaccination project.

Medacs is a subsidiary of Impellam Group, a FTSE-listed firm whose largest shareholder is Michael Ashcroft, the Belize-based Conservative peer who has donated millions to the party, including more than £175,000 in the past year.

The award of a major COVID contract to a firm with close ties to the Tories has sparked further questions about politically connected firms benefiting financially from the UK’s pandemic response.

Last year, a highly critical National Audit Office report found that companies with political links were directed to a “VIP lane” for government contracts where bids were ten times more likely to be successful.

Cronyism, incompetence and waste have been everyday features of this government’s approach to outsourcing

Shadow cabinet office minister Rachel Reeves told openDemocracy: “People are understandably furious seeing businesses owned and run by the friends and donors of the Tory Party being awarded huge multi-million-pound public contracts throughout this pandemic.

“Cronyism, incompetence and waste have been everyday features of this government’s approach to outsourcing and ministers show little willingness to learn lessons from the National Audit Office investigations.”

Outsourcing vaccination roll-out

Ashcroft is non-executive chairman of Impellam, and the largest shareholder in the publicly listed company, according to documents filed at Companies House.

Impellam describes itself as a “leading global talent acquisition and managed workforce solutions provider”. In 2019, the group’s accounts reported profits of £274.1m. Its healthcare division, Medacs Global Group – Medacs Healthcare is one of its brands – recorded revenues of £245.8m and a gross profit of £46.6m.

Medacs has previously worked with numerous councils across England but this appears to be the company’s first major COVID contract.

The public version of the contract between government and Medacs has been heavily redacted and does not include key sections – including the ‘contract charges’ and details of the services being provided – but it does confirm that Medacs will provide a “temporary workforce to support medical and clinical services in laboratories or to assist the national testing programme in response to Covid-19”.

The national testing programme is headed by Dido Harding. The Tory peer has defended the much-criticised Test and Trace scheme, which has seen private consultants paid £1,000 a day. It is estimated that Test and Trace will have cost the UK exchequer £23bn by March.

Medacs’ work appears to be part of the vaccination roll-out scheme. In December, Medacs released a statement saying that it was “delighted” to be working “in building a workforce for the National Vaccination Programme”.

However, in mid-December, Medacs was still recruiting staff to fulfil numerous important roles, including immunisers, nurses, GPs and paramedics as well as volunteers “from any background”.

In 2019 when a Care Quality Commission report on a homecare service run by Medacs was rated “inadequate”. The regulator found “that the care people received was not safe”.

A job advertisement for a ‘band 5 immuniser’ published on Medacs’ website called for staff to “deliver Covid-19 vaccination to all eligible citizens and assist with the overall delivery of the vaccination programme”.

Another ad required Medac staff to “travel to individual residences to deliver the vaccination to specific cohorts (such as housebound and shielding citizens) who are unable to undertake the vaccination in a vaccination centre”.

Medacs was criticised in 2019 when a Care Quality Commission report on a homecare service run by the firm was rated “inadequate”.

The regulator found “that the care people received was not safe. The majority of people’s care calls were not delivered at the time they were expected and people gave examples of where this had impacted significantly upon them and the safety of the care that they received.”

Furthermore the report noted that: “medicines records were not kept up to date and CQC identified instances where medicines records showed a potential overdose”.

At the time, Medacs said that the poor rating was down to a lack of staff after the firm won a series of contracts in quick succession. “These award successes were characterised by an unprecedented shortfall in staff transferring from the outgoing providers,” the director of the company’s Croydon care home said.

“We have invested in new staff and in additional training and support as a priority measure,” she added.

‘Politically connected companies’

Ashcroft has been one of the largest Conservative donors on record. In 2010, an Electoral Commission investigation cleared him of any wrongdoing after one of his companies, Bearwood Corporate Services, channelled more than £5m to the Tories.

Ashcroft, who famously fell out with the former Conservative prime minister David Cameron, re-emerged as a party donor in 2017, joining the Leader’s Group of top donors. Among his recent donations was £100,000 towards Shaun Bailey’s bid to become the next mayor of London.

The award of government contracts to firms with political connections has been a running issue in recent months, with billions given to companies with ties to the Conservatives. As openDemocracy reported, Boris Johnson’s government was accused of cronyism after a Tory councillor won a £156m COVID contract. Stroud councillor Steve Dechan ran a small, loss-making firm distributing medical devices.

In November, openDemocracy discovered that Lord Feldman, another former Tory chairman and a corporate lobbyist, had been secretly appointed as a COVID advisor. Feldman’s role prompted fresh concerns about privileged access given to Tory ‘friends and donors.

Commenting on the award to Medacs, the Good Law Project’s Jolyon Maugham said:

“The question many of us will have been wondering is: how will the government monetise the public health emergency that is the vaccine roll-out? The answer none of us will be surprised at is: with the help of, and so as financially to benefit, a large Conservative Party donor.”

The Department for Health and Social Care spokesperson said: “As part of our response to this unprecedented global pandemic, we rightly have drawn on the expertise of a number of organisations to support this important work.

“This includes when establishing the largest diagnostic network in British history, and a test and trace system used by tens of millions of people to reduce rates of Coronavirus. Proper due diligence is carried out on all government contracts.”

Medacs and Impellam have been approached for comment.

Updated: England’s 1,200 covid vaccination sites

​Health Service Journal January 12th 2021.​​

HSJ has mapped the more than 1,200 locations across England which have begun delivering the covid vaccination, according to NHS England. 

The map includes hospital hubs and primary-care run local vaccination centres, as well as the 17 mass vaccination centres and six pharmacy sites announced so far. These are based on data from NHS England.

Hospital hubs are marked in blue, mass centres in orange, pharmacies in yellow and local GP-led centres — which make up the vast majority — in green.

NHSE’ published data on the vaccine sites does not include their exact location, and for some we have had to approximate it. Some sites appear twice, both as mass vaccination centres and local vaccination centres, as they likely also have a GP-led service running from the location — in these cases we have plotted both. HSJ has contacted NHSE for clarity on these points.

According to NHSE, 96 per cent of the population is within 10 miles of a covid vaccination service. HSJ’s map includes an overlay of population density based on Office for National Statistics data — this can be viewed by accessing the map menu at the top left of the map and ticking the box for population density. 

More services will open in coming weeks and months, with around 1,000 local centres, and up to 40-50 mass centres, being planned.

There are reports from some local centres which have previously begun vaccinating people, that they have had their supply stopped, meaning they may not all still be providing vaccination. They will receive more supply in the future.

NHSE statistics also show that, as of 18 January, more than 4.1 million doses of covid vaccine have been given, including almost 3.7 million first doses. 

Earlier this month, Boris Johnson said the NHS would offer the vaccine to the top four priority groups — covering just over 12 million people in England — by mid-February. 

Key

Local GP centres: green

Hospital hubs: blue

Mass vaccination centres: orange

Pharmacies: yellow

For interactive map, go to HSJ​.

NHS England data; ONS data

Crowdjustice Update on What are the Government hiding about their response?

Crowdjustice  COVID-19: The ICU cover-up January 18th 2021

It’s unusual for one crowdjustice campaign to raise funds for another crowdjustice campaign, but this one is important and it ties into Exercise Cygnus. It’s time to tell you the story of Chris Day​ and the Government’s ICU cover-up.

Chris is currently treating very sick NHS patients as an A&E doctor in one of the UK’s busiest COVID-19 hospitals. He’s done the same job for about 5 years, mostly working late shifts to support his family after a Government agency deleted his career as a young ICU doctor. This agency reported directly to Jeremy Hunt, the Health Secretary.

The Government deleted his career after he raised patient safety concerns in a dangerously understaffed ICU department. This was all happening as Exercise Cygnus was playing out.

Yes, you understood correctly. Jeremy Hunt’s agency was effectively covering up evidence of understaffed ICU services,​ at the same time the Cygnus Reports were informing Jeremy Hunt that the UK’s ICU capacity was completely inadequate​for a likely future pandemic. Their conduct was so questionable that the Solicitors Regulation Authority was called to investigate the conduct of lawyers in the case.​

Chris Day is as brave as any whistleblower, but he has proven more resilient than most. He has fought multiple legal battles against the Government while working as a busy A&E doctor, won whistleblowing protection for 54000 doctors and their millions of patients, crowdfunded a landmark legal case for another doctor which changed Government policy on medical manslaughter, had his own case widely reported by major newspapers, and his case has been raised by senior MPs in Parliament.​

Dr Day has now won the right to turn the tables on the legal establishment by cross-examining the QC barristers who represented the Government in a landmark case which hopes to get to the truth of what happened when he raised safety concerns back in 2014. He’s preparing the case files himself, but he does need a funding boost to pay for a barrister to cross-examine the Government’s story of what happened.

We think this is a test case for the NHS, and we’d be incredibly grateful if you’d lend it your support.

You can find out more in our CygnusReports blog here: “Before Covid-19”​

You can support Chris Day’s case here: £700k to crush a junior doctor – don’t let them get away with it​

With your generous support, we can keep fighting – and we will. Thank you.

Firms accused of putting workers’ lives at risk by bending lockdown trading rules

As workplace infections soar, an Observer study reveals no company has been punished this year for breaching Covid safety laws.

Guardian January 16th 2021

• Staff pressured to go back to work in breach of Covid rules

Irresponsible firms are exploiting looser lockdown regulations to bring thousands of non-essential workers into sometimes busy workplaces, with little chance of enforcement action by the nation’s safety watchdog.

Analysis by the Observer shows that no enforcement notices have been served on companies by Health and Safety Executive (HSE) inspectors for Covid safety breaches since the country went into the latest lockdown, despite being contacted 2,945 times about workplace safety issues between 6 and 14 January. Overall, just 0.1% of the nearly 97,000 Covid safety cases dealt with by the agency during the pandemic appear to have resulted in an improvement or prohibition safety notice, with not a single company prosecuted for Covid-related breaches of safety laws.

This comes as the latest Public Health England surveillance data suggests workplace infections surged as people returned to work in January. The number of coronavirus outbreaks in workplaces rose by almost 70% in the first week of the national lockdown, with 175 Covid case clusters reported in English workplaces, not including care homes, hospitals and schools. New polling carried out by the TUC shows that fewer than half of workers are in workplaces with Covid-secure risk assessments.

In the past week, the government has focused attention on the failure of some people to stick to social distancing rules, from the release of a video of police approaching an individual in a parked car to an advert warning that “grabbing a coffee can kill”. But experts and unions have warned that unsafe workplaces may be playing a bigger role in fuelling the pandemic.

“If the government is upping enforcement, ministers should start with employers who break Covid safety rules,” said TUC general secretary Frances O’Grady. She called for big increases in resources for the HSE to stop rogue employers getting away with putting staff at risk.

Non-essential shops are supposed to be shut and most workers are expected to work from home to reduce the transmission of the virus, but unlike the first national lockdown all businesses are allowed to provide click and collect services in England. This contrasts with Scotland, where non-essential retailers were on Saturday banned from allowing customers to pick up goods ordered online.

Shop assistant Mike Richards, who works in a luxury fashion store in the centre of Birmingham, was furloughed during the first national lockdown in March but ordered to come into work last week to make sales calls alongside his colleagues under the guise of click and collect. “We got an email out of the blue saying, ‘You’ve got to get back into the store to sell.’ This is a luxury fashion brand – how can it be essential?”

Richards (not his real name) had to travel by train into work and was told to call clients who had previously bought luxury handbags. “There were eight of us in the store that day. We were masked up but there was hardly any socially distancing,” he said. “Every single facet of what we’re doing could be done in the comfort of our own homes. But we’re being forced to go in. It’s an irresponsible act, for the sake of a little bit of profit for a multibillion-pound company.”

He added that staff had been given letters in case they were stopped by the police on the way to work. “It says, ‘We are carrying out duties of click and collect and home deliveries.’ Nowhere does it say, ‘This person is in the store selling’, which is what we are actually doing.”

Professor Susan Michie, who sits on one of the government’s Sage subcommittees, said people were being needlessly driven into workplaces amid a raging pandemic, which has pushed the NHS to the brink in many parts of the country. “Every day I get contacted by distraught people who are being forced into workplaces, which they feel are completely unsafe. They are having to choose between the risk of serious illness or death and losing their job – not to mention the risk of spreading the virus on the way to and from work.”

She added that click and collect services were providing transmission routes for Covid. “They should all be shut down unless absolutely essential,” said Michie.

As well as clamping down on click and collect abuses, Scotland’s first minister, Nicola Sturgeon, also placed a legal obligation on employers to ensure people can work from home wherever possible. This contrasts with England, where businesses only have to facilitate working from home.

Administrator Sandra Jackson, who works for a small vehicle supplier in Essex, was ordered to come in last week, even though there has been an outbreak of coronavirus, with just over a third of the workforce testing positive in December and January.

“I worked from home for one day and then I got a message saying, ‘This isn’t working. We won’t allow you to work from home.’ I’m absolutely furious about it.”

Tradespeople in England are still allowed to carry out all types of work in people’s homes. Electrician Stuart Collins has been ordered to install smart meters in multiple homes every day. “If people had lost supply or if it was a new connection, I would have no issue whatsoever,” he said. “But exchanging existing meters for smart meters is not essential. All we are doing is assisting this virus to spread. They are putting financial gain ahead of people’s lives.”

Professor Stephen Reicher, who advises both the UK and Scottish government, called on UK ministers to follow Sturgeon’s lead. “People have got to have the right to work at home if they can,” he said. “These are not wild and woolly ideas. They’re happening in Scotland. They could be very easily done. But the UK government seems to want to keep its head in the sand.”

Michie said more businesses were being allowed trade in England and more workers were going into workplaces because the government’s lockdown rules were so broad that almost any businesses could claim to be essential. “The government has effectively handed responsibility to employers to say whether they are essential or not,” she said.

The HSE said it had scaled up its proactive work to check, support and advise businesses on public health guidance. It added that it had carried out more than 32,000 site visits during the pandemic. “Inspectors continue to be out and about, putting employers on the spot and checking that they are complying with health and safety law. Our role in contributing to the national response to reduce Covid-19 transmissions and support economic recovery has been widely recognised,” said a spokesperson.

A government spokesperson said: “The law is clear that people can only leave the home to work if they cannot reasonably work from home. We have worked with trade unions, businesses and medical experts to produce comprehensive Covid-secure guidance so that businesses permitted to remain open can do so in a way that is as safe as possible for workers and customers.”

National investigation launched after oxygen problems leave trust struggling to care for covid patients

• Health Service Journal January 15th 2021
• Healthcare Safety Investigation Branch starts new investigation
• Incident at acute trust triggers the review
• Trusts grappling with oxygen infrastructure problems

A national investigation has been launched into the robustness of hospital oxygen supply systems after the need to care for a rapildy increasing number of covid-19 cases caused problems which saw one trust struggling to treat critically ill patients.

The Healthcare Safety Investigation Branch today announced an investigation into the provision of piped oxygen gas supplies.

The move comes after HSJ revealed national NHS estates chiefs have warned of “very high demand” for oxygen across the health service. The problem is not one of supply, but rather the capacity to flow enough oxygen through hospitals’ pipes and infrastructure, as many NHS hospitals are old and require upgrading. 

All trusts have been told to involve gas engineers in their clinical decision-making as they open new covid-19 wards within their estate.

According to NHS England/Improvement data, as of 14 January, hospitals across England are treating 32,925 covid-19 patients, of which 3,351 – 10.2 per cent – are in mechanical ventilation beds.

HSIB’s investigation was triggered after an acute trust had to divert patients to different hospitals, and transfer patients between clinical environments, due to demands on its oxygen supply.

The trust – which HSIB has not named – had sufficient supplies of liquid oxygen available, but its piped system was unable to deliver the volume of oxygen gas required to meet all patient needs.

During its investigation, HSIB will examine the incident at the trust to “better understand issues highlighted about limitations in piped oxygen supply to hospitals”, according to its statement.

The watchdog will also look at the role of engineering specialists and medical gasses committees in piped oxygen supply across the NHS.

HSIB hopes this will help identify “any safety action or learning that can assist in mitigating the risk to piped oxygen supplies”, and highlight actions that can assist NHS organisations both during and after the pandemic.

In its statement, the watchdog said: “Covid-19 can cause severe inflammation of the lungs affecting a patient’s ability to breathe.

“As a result, an increased number of patients have required oxygen therapy within hospitals. Insufficient oxygen supply to seriously ill patients can have very severe consequences, including death.”

HSIB plans to release several interim reports before publishing its final report.

Earlier today, HSJ reported incidents of ambulances crews in the East of England working with less oxygen supplies due to shortages, while the Care Quality Commission is “monitoring” a hospital in Essex after it was forced to lower patients’ oxygen-intake due to capacity issues with the infrastructure.

GPs hit out at ‘grossly unfair’ plan to delay follow-up COVID-19 jabs

By Emma Bower on the 31 December 2020

GPOnline 31st December 2020

GPs have said plans to delay appointments for patients due to receive the second dose of the Pfizer/BioNTech COVID-19 vaccine in January are ‘grossly unfair’ and will be almost impossible to implement in the time available.

The BMA said rearranging appointments for tens of thousands of patients would cause ‘huge logistical problems’ for practices. It said existing appointments should be honoured and that it would support GPs if they decided to vaccinate those patients who were due to have a second jab next month.

The decision to delay appointments to 12 weeks after the first jab follows updated advice from the Joint Committee on Vaccinations and Immunisations (JCVI) that as many people as possible in at-risk groups should receive the first dose of the vaccine. As cases continue to surge across the country it is hoped that vaccinating greater numbers with one dose of either the Pfizer or Oxford/AstraZeneca jab will provide more people with short term protection against the virus.

The DHSC said on Wednesday that the decision would also extend to cover anyone with an appointment for a follow-up jab after 4 January. A letter from NHS England chief executive Sir Simon Stevens yesterday advised that appointments should be shifted to the week before the 12-week deadline ‘in most instances’, however it said that clinical discretion could be applied if needed.

Meanwhile, Pfizer released a statement on Wednesday saying that its vaccine was not intended to be taken 12 weeks apart. It said the vaccine’s safety and efficacy had not been evaluated on any dosing schedule other than 21 days between jabs. It added that ‘there are no data to demonstrate that protection after the first dose is sustained after 21 days’.

Impossible task

A primary care bulletin from NHS England on Wednesday acknowledged that moving appointments would ‘be a significant job for general practice at a busy time’ and it was looking at how it could support practices with the task.

A number of GPs on Twitter said that ‘at least’ appointments for next week should remain in place, with many saying it would be impossible to rearrange so many vaccinations at such short notice.

Oxford GP Dr Helen Salisbury invited health secretary Matt Hancock to come and help her practice with the task of rearranging appointments. She said her PCN would need to cancel and rebook 1,160 jabs, which would be around 193 hours work.

Professor Steve Cox, chair of the RCGP’s Mersey Faculty and a GP in St Helen’s, Merseyside, said on Twitter that his practice would not be rearranging second immunisations for over-90s because the ‘carer logistics were too great’.

One GP-led vaccination site in Kent said that it had secured agreement with its CCG to continue second vaccinations as planned next week.

The BMA said that scores of GPs had contacted it to say the decision to delay second doses for those already vaccinated would have a ‘detrimental impact’ on the wellbeing of their most vulnerable patients.

GPs on Twitter also raised concerns about the medico-legal implications of waiting for 12 weeks to administer the second dose, particularly given that patients had already consented to the second dose three weeks after the first and in light of Pfizer’s statement about how its vaccine should be used.

BMA GP committee chair Dr Richard Vautrey said: ‘It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments. Local leaders are telling us that is unprofessional and impractical to amend the appointments for thousands of frail elderly patients, particularly those booked and who have already made arrangements to have their second vaccination in the next two weeks.

‘The decision to ask GPs, at such short notice, to rebook patients for three months hence, will also cause huge logistical problems for almost all vaccination sites and practices. For example, to make contact with even just two thousand elderly or vulnerable patients will take a team of five staff at a practice about a week, and that’s simply untenable.

‘The government must see that it’s only right that existing bookings for the oldest and most vulnerable members of our society are honoured, and it must also as soon as possible publish a scientifically-validated justification for its new approach.’

On Wednesday NHS England confirmed that PCNs would now be paid after each dose of the vaccine is delivered, rather than after both have been administered, because the change to a 12-week gap between doses would ‘delay payment to an unreasonable extent’.