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Monitor publishes report in to the commissioning of learning disability services in Cornwall

Cornwall and the Isles of Scilly Primary Care Trust failed to conduct transparent decision-making in its commissioning of learning disability services, according to a report by Monitor.

The health sector regulator also found that there was no decision made by the Trust to exclude the independent sector from providing specialist inpatient mental health and learning disability services.

St. Piran's Healthcare Ltd was the operator of Kryllas Manor, a 14 bed hospital in Falmouth, Cornwall, which provided services for adults with learning disabilities who required inpatient medical, psychiatric and nursing care. The facility closed in November 2010.

St. Piran's complained that Cornwall PCT breached the Principles and Rules of Co-operation and Competition by deciding not to commission specialist inpatient mental health and learning disability services from independent sector providers in Cornwall, and specifically from St. Piran's.

The Co-operation and Competition Panel (CCP), which is now part of Monitor, has found that:

  • Cornwall PCT did not decide against commissioning specialist inpatient mental health and learning disability services from independent sector providers.
  • Cornwall PCT made statements suggesting it had closed its mind to the possibility of commissioning services from Kryllas Manor. The main reason for Cornwall PCT's view was that it objected to the type of services provided at Kryllas Manor (inpatient services) as it was the PCT’s policy to avoid inpatient placements for individuals with learning disabilities.
  • Cornwall PCT failed to conduct a transparent decision-making process in relation to the placement of patients with a learning disability and mental health illness.

Monitor examined Cornwall PCT's decisions to refer patients to providers other than St. Piran’s and found no adverse effects on these patients resulting from Cornwall PCT's conduct.

Primary care trusts ceased to exist as a result of recent health reforms but this case will serve as guidance for Kernow Clinical Commissioning Group (which has replaced Cornwall PCT) and other CCGs to improve commissioning practices.

Catherine Davies, Executive Director of Cooperation and Competition at Monitor, said: "We have investigated this complaint fully and have found no adverse effect on patients. However the transparency of Cornwall PCT's commissioning decisions could have been better. This case should serve as guidance for commissioners as they seek to commission services that best meet the needs of patients."

Notes to Editors

  • Monitor is the sector regulator of NHS-funded health care services. Under the Health and Social Care Act 2012 its main duty is to protect and promote the interests of people who use health care services. Information about Monitor's new role can be found here.
  • A copy of Monitor’s report is available here.
  • This case was commenced by the Co-operation and Competition Panel (CCP) in October 2012. In April 2013, the CCP became Monitor's Cooperation and Competition Directorate. More information on Monitor's Cooperation and Competition Directorate can be found here.
  • As this case commenced before the reforms introduced by the Health and Social Care Act 2012, it has been considered under the Principles and Rules for Cooperation and Competition. In future, complaints concerning the conduct of commissioners will be considered by Monitor under the National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013.
  • Monitor is now on Twitter - follow us @MonitorUpdate


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