26/09/2013

DE00000805407

Dear Mr Walker,

Thank you for your request of 3 August 2013 under the Freedom of Information Act (2000).  Your exact request was:

“Under the FOI Act I wish to know what fees, licences or other costs were paid by Carillion plc, its subsidiaries or agents, in whatever form, for the privilege of running the Lister Surgicentre which was recently bought back by the NHS.”

Thank you also for your clarification of the request of 30 August 2013, which was as follows:

“In answer to your question, you can exclude salaries, ground rent for any period already expired (but including anything paid in advance and not used or refunded). The rest should be included in as much detail as possible within the statutory cost limit.”

The Department holds no information on amounts actually paid by Clinicenta or Carillion to the NHS.

The Department holds limited information on amounts contracted between the Trust and Clinicenta.

Financial Model

The financial model supplied by Clinicenta shows an estimated amount to be paid to the Trust. This is summarised below:

Sub-contracts

The Department holds copies of the contracts forming part of the overall scheme between Clinicenta and Carillion and other parties. Extracts from these contracts are shown below. These describe the services provided and associated costs for each activity. It should be noted that as these are extracts, any paragraph numbering of cross references should be ignored.

1. STAFF SERVICES AGREEMENT between East & North Hertfordshire NHS Trust and Clinicenta Limited dated 17 April 2009

Schedule 2 - The Charges

The Charges payable by the Provider to the Trust in respect of the Seconded Staff and the Agreed Periods shall be the aggregate of:

(a) the Chargeable Employment Costs directly applicable to the Seconded Staff (including any Locum staff and any staff provided to meet any Increased Staff Demand under clause 4.9 or 4.10) for Agreed Periods;

(b) the Administration Charge; and

(c) any Incentives that the Provider may direct the Trust and which the Trust has consented to pay to Seconded Staff in accordance with paragraph 5 of this Schedule 2.

Administration Charge means in each year of this Agreement, £200,000 increased on the first anniversary of the Commencement Date and each subsequent year by the same percentage as the percentage increase (if any) in the Index over the 12 month period since the previous anniversary (or in the case of the first anniversary, since the Commencement Date).

2. AGREEMENT FOR THE PROVISION OF SERVICES between EAST & NORTH HERTFORDSHIRE NHS TRUST and CLINICENTA LIMITED on 17 April 2009

Schedule 2 - Mandatory Services

Brief Services Description

(a) The Radiology, Network and Helpdesk Services include the provision by the Trust (or the procurement by the Trust) of the following radiology examinations:

(i) Plain Film;

(ii) Ultrasound;

(iii) Nuclear Medicine (excluding cardiac);

(iv) MRI (excluding cardiac);

(v) CT Scanning (excluding cardiac); and

(vi) Fluoroscopy (excluding cardiac).

Charges

Radiology Charges

(a) Clinicenta will pay Charges to the Trust for the provision of the Radiology

Services on a cost per test basis, as follows:

·         Magnetic Resonance Imaging Scan, one area, no contrast £147

·         Magnetic Resonance Imaging Scan, one area, post contrast only £190

·         Magnetic Resonance Imaging Scan, two - three areas, no contrast £220

·         Magnetic Resonance Imaging Scan, requiring extensive patient repositioning and/or more than one contrast agent £260

·         Computerised Tomography Scan, one area, no contrast £105

·         Computerised Tomography Scan, one area with post contrast only £120

·         Computerised Tomography Scan, one area, pre and post contrast £132

·         Computerised Tomography Scan, two areas without contrast £120

·         Computerised Tomography Scan, two areas with contrast £135

·         Computerised Tomography Scan, more than three areas £132

·         Dexa Scan £47

·         Contrast fluoroscopy Procedures less than 20 mins £140

·         Contrast fluoroscopy Procedures 20 - 40 minutes £200

·         Contrast fluoroscopy Procedures more than 40 minutes £260

·         Ultrasound Scan, non-imaging Procedures £66

·         Ultrasound Scan less than 20 minutes £43

·         Ultrasound Scan more than 20 minutes £90

·         Ultrasound Mobile Scan / Intraoperative Procedures

·         less than 20 minutes £61

·         Plain Film, one area £23

·         Plain Film, two - three areas £30

·         Plain Film, contrast Procedures without fluoroscopy £82

·         Plain Film, mobile / intraoperative Procedures, one area £60

·         Nuclear Medicine - Category 2 £144

·         Nuclear Medicine - Category 3 £287

The above Charges are index linked.

(b) Any other request for a Patient to be seen on Clinicenta's premises (mobile) will be charged for at £60 per request. This Charge will be index linked.

(c) Clinicenta will pay to the Trust a 50% uplift on the prices outlined above for

any tests which are carried out outside Trust Radiology Working Hours.

(d) Clinicenta will pay the Trust for radiographer attendance during Clinicenta's theatre sessions at Direct Staff Cost, plus a mark-up based on the Staff

Overheads Percentage applied to the Direct Staff Cost.

(e) Clinicenta will pay additional Charges for recovery of Historic Images from

storage should the Trust incur an additional cost for recovery.

(f) The Trust reserves the right to charge for the following, and Clinicenta will pay any such charges:

(i) all unavoidable costs incurred by the Trust as a result of an examination not taking place due to any of the reasons set out in paragraph 2.3(b)(viii). The unavoidable costs will be charged at a rate directly related to the loss of direct access income associated with the unused examination appointment. This income excludes the cost of contrast which is not included in the charge for direct access examinations; and

(ii) all unavoidable costs incurred by the Trust in the event that Clinicenta

cancels a theatre session in accordance with paragraph 2.4(f), in the event that the radiographers cannot be redeployed elsewhere within the Radiology Services. The unavoidable costs will be radiographer time charged at Direct Staff Cost, plus a mark-up based on the Staff Overheads Percentage applied to the Direct Staff Cost.

Network and Helpdesk Charges

(a) Clinicenta will pay Charges to the Trust for any new pagers which it provides at a rate of £350.00 per unit. This rate is index linked.

(b) The Trust shall not be entitled to charge Clinicenta for ongoing revenue charges or for use of pager system.

Blood Transfusion Services

Brief Services Description

The BT Service comprises the provision by the Trust (or the procurement by the Trust of provision elsewhere) of:

(a) testing in respect of Patient samples;

(b) pathology reports in respect of the testing of Patient samples;

(c) statutory mandatory training for Clinicenta's Staff in relation to blood

transfusion; and

(d) blood and blood products for transfusion.

Charges

4.1 Testing will be charged for in accordance with Schedule 3 {Non-Mandatory Services), Part 4 {Haematology Services) for the relevant test undertaken. Clinicenta will pay Charges to the Trust for cross-match testing at a rate of at £1.50 per test. This rate shall be indexed linked.

4.2 The provision of blood, blood products and coagulation factors will be charged to Clinicenta at cost plus a 10% handling charge.

4.3 Clinicenta shall not be charged for blood which has been kept and returned in accordance with this Schedule 2, Part 2 and is reusable as determined by the Trust.

4.4 Clinicenta will pay Charges to the Trust for training at an hourly rate of £25.00, and for each competency assessment at a rate of £12.50 per assessment. Both those rates shall be index linked. In addition, the Trust will charge Clinicenta a mark-up on the cost of such training, based on the Staff Overhead Percentage applied to the relevant hourly rate for the training.

Schedule 3 - Non-Mandatory Services

Part 1 - Histopathology Services

Brief Services Description

The Histopathology Services encompass the provision by the Trust (or the procurement by the Trust of the provision elsewhere) of a diagnostic histopathology service (including histopathology, diagnostic cytopathology and cervical cytopathology) to Clinicenta at the Facility.

Charges

Clinicenta will pay to the Trust Charges for testing (including advice in respect of the results of such testing) on a cost per test basis. The Charges per test are £22.00 for histology/histopathology per single slide examined and £24.00 per cytology test (excluding Cervical Screening Programme). Those Charges are index linked. Clinicenta will pay the Trust's costs for tests sent externally on a pass through basis.

Part 2 - Biochemistry Services

Brief Services Description

The Biochemistry Services comprise the provision by the Trust (or the procurement

by the Trust of provision elsewhere) of:

(i)            biochemistry testing and pathology reporting; and

(ii)          immunology testing and pathology reporting; and

(iii)         clinical and non-clinical advice,

Charges

Clinicenta will pay Charges to the Trust for testing conducted by the Trust (including advice in respect of the results to such testing) on a cost per test basis. The Charges per test for Trust services are £2.00 per test. For immunology tests the Charges per test are £11.00 per test. Both those Charges are index linked. Clinicenta will pay the Trust's costs for tests sent externally on a pass through basis.

Part 3 - Microbiology Services

Brief Services Description

The Microbiology Services comprise the provision by the Trust (or the procurement

by the Trust of provision elsewhere) of a pathology service to Clinicenta at the

Facility which includes open access to the Trust's microbiology department repertoire

as set out in the Pathology User Guide.

Charges

Clinicenta will pay Charges to the Trust for testing (including advice in respect of the results to such testing) on a cost per test basis. The Charges for microbiology and virology testing are £13.00 per test. Such Charges are index linked. Clinicenta will pay the Trust's costs for tests sent externally on a pass through basis.

Part 4 - Haematology Services

Brief Services Description

The Haematology Services comprise of the provision by the Trust (or the procurement by the Trust of provision elsewhere) of:

(a) haematology testing in respect of Patient samples;

(b) Pathology Reports in respect of the haematology testing of Patient samples.

Charges

Clinicenta will pay Charges to the Trust for haematology testing conducted by the Trust (including advice in respect of the results produced by testing) on a cost per test basis. The Charges for Haematology Services are £4.00 per test excluding phlebotomy. The Charges for phlebotomy are £5.00 per Patient. Both those Charges are index linked. Clinicenta will pay the Trust's costs for tests sent externally on a pass through basis, plus any associated administration costs.

Part 5 - Pain Management Services

Brief Services Description

(a) The Pain Management Services broadly involve the provision during Working Hours only of pain management services to those Patients who have been clinically identified as requiring such care as described in further detail in

paragraph 2 below.

(b) Except for the provision of the Pain Management Training provided in accordance with paragraph 2.9 below, the Pain Management Services shall be made available for 60 hours during each Contract Month comprising:

(i) planned visits to the Step-Down Area and the In-Patient Ward; and

(ii) Ad Hoc Requests, quality control and Ad Hoc Training.

Charges

6.1 All time spent by Trust Staff performing Pain Management Services in respect of the Facility will be charged for at Direct Staff Cost, plus a mark up based on the Staff Overheads Percentage applied to the Direct Staff Cost.

6.2 Pain Management Training courses will be charged at a fixed fee per delegate, to be agreed at the time of the course.

Part 7 - Infection Prevention and Control Services

Brief Services Description

(a) The Infection Control Services comprise the provision of advice and related services to Clinicenta in relation to the prevention and control of infection and outbreaks of infection within the Facility, as described in more detail in paragraph 2 below. The Infection Control Services do not include any

requirement on the Trust, and the Trust is not responsible, for taking any steps to implement any advice given pursuant to these Infection Control Services, or to prevent the spread of any infection at the Facility, or for any failure of Clinicenta to implement the advice given.

(b) The Infection Control Services will only be provided during Working Hours.

Charges

5.1 All time spent by members of the Infection Control Team performing Infection Control Services in respect of the Facility will be paid for by Clinicenta at Direct Staff Cost, plus a mark up based on the Staff Overheads Percentage applied to the Direct Staff Cost.

5.2 Clinicenta will pay Charges to the Trust of £10,000 per Contract Year in respect of Infection Control Services provided by a Trust microbiologist (consultant grade). These charges will be paid in monthly instalments. The Charges will be subject to review every six (6) Contract Months and any changes agreed in writing between the parties. The Charges shall be index linked, unless the parties agree otherwise in writing.

5.3 The Trust shall not charge Clinicenta for any infection control training provided to Clinicenta's link nurses at the link nurse meetings they attend pursuant to paragraph 2.4 above.

5.4 The Trust shall be entitled to charge Clinicenta for any additional infection control training which is organised for Clinicenta's Staff outside of the planned programme of link nurse meetings. The Trust will charge for such additional infection control training at a fixed price per person booked onto the relevant training course. The fixed price per person will be agreed between the parties at the time of Clinicenta booking the course. A cancellation charge will also be levied if Clinicenta cancels any delegate's attendance on the course with less than four (4) weeks' notice, or if a delegate does not attend the course when booked to do so.

Part 8 - Patient Record Services

Brief Services Description

The Patient Record Services comprise the provision of Patient Records on request in accordance with the Operational Policy.

Charges

5.1 Clinicenta shall pay to the Trust Charges of £2.84 per Patient Record provided by the Trust pursuant to the Patient Record Services. Such Charges shall be indexed linked.

5.2 The Trust shall be entitled to require Clinicenta to pay an additional charge for the recovery of Patient Records in long term/archive storage, should the Trust incur an additional charge for recovery over and above the charge outlined in paragraph 5.1above. The Trust will confirm the amount of the charge at the time.

Part 9 - Pharmacy Services

Brief Services Description

(a) The Pharmacy Services comprise, inter alia, the supply by the Trust to Clinicenta's Staff of Drugs from the Trust Pharmacy Department to meet the needs of Patients, including support to Clinicenta for medicines management

issues related to the care of Patients more specifically described below in paragraph 2.

(b) Clinicenta require from the Trust a supply of a range of pharmacy products to support routine elective inpatient and day surgery cases including diagnostics, pre-assessment, surgery and follow up and emergency drug boxes for resuscitation trolleys. Anaesthesia will include General Anaesthesia, Regional Anaesthesia, Local Anaesthesia and conscious sedation. Some Controlled Drugs will also be required.

(c) Clinicenta will purchase drugs and the range of pharmacy products outlined within this Schedule 3, Part 9 exclusively from the Trust.

Charges

Clinicenta will pay Charges to the Trust for:

(a) requested Drugs at cost plus a 10% handling charge, including externally sourced and supplied Pre-packs; and

(b) internally produced Pre-packs at cost, plus a £1.00 pre-packing fee per pack, plus a 10% handling charge. Such £1.00 fee shall be index linked.

Clinicenta will be charged for all Drugs purchased by the Trust at the request of Clinicenta whether or not Clinicenta uses these drugs. Refunds for any returned Drugs will be made in accordance with paragraph 2.17 above.

The time spent by Trust Staff performing Pharmacy Services within the Facility will be charged at Direct Staff Cost, plus a mark-up based on the Staff Overheads Percentage applied to the Direct Staff Cost.

Clinicenta will pay separate Charges for Advice provided outside Pharmacy Operational Hours. These Charges will be based on the Staff Overheads Percentage applied to the value of the total annual on call service. They will be paid as a standing charge on a monthly basis. Charges per call out will also be made for Trust Staffs attendance on site at Direct Staff Cost, plus a mark-up based on the Staff Overheads Percentage applied to the Direct Staff Cost.

Clinicenta will pay Charges to the Trust for provision of cytotoxic Drugs at cost plus a 10% handling charge and a £30.00 manufacturing charge per item requested. Such manufacturing charge shall be index linked.

If you have any queries about this email, please contact me. Please remember to quote the reference number above in any future communications.

If you are dissatisfied with the handling of your request, you have the right to ask for an internal review. Internal review requests should be submitted within two months of the date of receipt of the response to your original letter and should be addressed to:

Head of the Freedom of Information Team

Department of Health

Room 507

Richmond House

79 Whitehall

London

SW1A 2NS

Email: [email address]  

If you are not content with the outcome of your complaint, you may apply directly to the Information Commissioner (ICO) for a decision. Generally, the ICO cannot make a decision unless you have exhausted the complaints procedure provided by the Department. The ICO can be contacted at:

The Information Commissioner's Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Yours sincerely,

Jonathan Young

Freedom of Information Officer
Department of Health

[email address]