"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan

Monday, 20 August 2012


Ali Parsa, the chief executive of Circle, has an annoying habit of repeating a statement without explaining the evidence behind the statement. This is a common PR technique: by repeating a statement people believe that it is true, and by not explaining the evidence, listeners (particularly journalists) deduce and extrapolate their own "evidence": it becomes true because journalists make it true.

Nations Healthcare was one of the first companies to be contracted to run an Independent Sector Treatment centre (ISTC) the New Labour government's mechanism to privatise some NHS services. The company was created in 2002 and has its origins in the US. Nations Healthcare was contracted to open its ISTC in Nottingham in December 2007, but it missed this deadline and the facility opened in July 2008, by this time Nations Healthcare had been taken over by Circle. Thus, the Nottingham NHS Treatment Centre should be regarded as always being a Circle facility because it was not opened until after Circle took over Nations.

The IPA management consultancy group have produced a case study of Circle (Sept 2011). In this they say:
"Circle has only been delivering services at the Midlands Centre for three years, Nottingham for two years, and Bath for less than a year, so data on long-term productivity trends is limited. However, evidence gathered by the company shows that in 2009, Nottingham had a 22 per cent productivity gain, and the Midlands centre had a 17 per cent productivity gain. Data is not yet available for Bath. 
At the Midlands Centre the employees have been engaged in a turnaround operation, after a period of low performance under the previous owner, which has set a clear direction."
This says that the two facilities (Nottingham and the Midlands Centre in Burton) had poor productivity in 2008 and in 2009 there were similar productivity gains (of about 20%). The study lays the blame for the poor productivity of the Midlands Centre on Nations Healthcare. However, 2009 is two years after Circle took over Nations (ie they had been running the facilities for 2008 and 2009) and in the case of the Nottingham ISTC, Nations had never run the facility, so the 22% productivity gain in 2009 was an improvement on the poor running of the centre by Circle in 2008. It seems quite a coincidence that Circle (who ran the Nottingham ISTC badly in 2008) would also take over another facility that was also run badly, and that both facilities improved by a similar amount in 2009. It would be reasonable to conclude that Circle ran both facilities badly in 2008.

Even though the "evidence" is provided by Circle (it would be more believable if they used an independent organisation), this is only one year of productivity gain. The website for the Nottingham NHS Treatment Centre says this:
"This was achieved at the same time as staff redesigned patient pathways to deliver average productivity gains of 18% each year since opening,"
This year is 2012 and the facility has been open for 4 years. Is what they are saying seriously possible? Is it possible to increase productivity by 18% every year for four years? If that is the case, a procedure carried out now would cost 45% what it cost in 2008. Or put it another way, for the same money they are performing 94% more procedures than they would in 2008. Is this possible, because if it is, they were either seriously under-performing in 2008, or Circle have found a magic productivity potion!

Much more likely is that this refers to just one year and the website has either not been updated, or it is deliberately trying to deceive us. Circle love to throw out "statistics" and if these are not challenged, however unbelievable they are, the "statistics" become true.

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