Trusts pay £200k each to consultants to reduce care package costs

Two health trusts in Northern Ireland paid hundreds of thousands of pounds to a private consultancy firm to help them reduce care package costs.

Freedom of Information requests show the Northern Trust and South Eastern Trust each paid more than £200,000 to Liaison Care, which reviews high-cost cases.

Other trusts refused to reveal details of the contracts and the amount of public money paid to Liaison Care due to "commercial sensitivities".

BBC News NI can also reveal that Department of Health officials previously raised concerns about a potential lack of oversight of the company because it carried out its online assessments remotely.

They also highlighted a concern that those being assessed may have no comeback over complaints through Northern Ireland's regulatory system.

In March, England-based Liaison Care was ordered to stop operating in Northern Ireland by the Regulation and Quality Improvement Authority (RQIA), which inspects healthcare services and facilities.

The move followed concerns from relatives of some patients whose cases had been reviewed by Liaison Care.

The company had used a remote online method to carry out the assessments of 130 people receiving social care packages.

The BBC has learned that the order to stop operating has now been lifted after the RQIA concluded the healthcare group did not need to register with it.

The Northern Ireland Social Care Council (NISCC) - which regulates individual social workers - said no social workers or social care workers are employed by Liaison Care had registered with it.

The care packages of adults transferred from Muckamore Abbey Hospital were among those reviewed by Liaison Care.

Two families whose relatives were in Muckamore made complaints about the way assessments were carried out. The Belfast Health Trust apologised to both families involved.

In documents seen by the BBC, Department of Health officials said they had been "unaware of the detail" around Liaison Care's work in Northern Ireland and had asked the health trusts about the extent of their involvement with the company.

Officials also wrote to former Health Minister Mike Nesbitt, pointing out that assessing people remotely from England meant it was "possible that they sit completely outside NISCC's regulatory authority".

They said this potentially meant the NISCC "cannot hold them to NI's code of practice", "cannot investigate their conduct", "cannot apply fitness-to-practice sanctions" and service users "have no recourse through NI's regulatory system".

In a statement to the BBC, Liaison Care said it provided "person-centred recommendations" which helped trusts to "complete reviews more efficiently and make timely decisions about care needs".

"All reviews are undertaken by qualified professionals in line with due process and our triple-lock quality assurance standards, with all required registrations in place," said the company.

"We continue to work with RQIA, the trusts and NISCC to support a consistent approach to governance, engagement and professional registration in Northern Ireland."

The Department of Health said "any engagement with Liaison Care must operate within appropriate governance arrangements" and "must not diminish the statutory responsibilities of health and social care trusts for assessment, care planning and decision-making for service users".

"Trusts are currently working collaboratively to agree a standard operating procedure for any future engagement with the organisation."

Having paused their engagement with Liaison Care in March, the health trusts have restarted their engagement.

Through a Freedom of Information request, the BBC has learned that the deal struck between some health trusts and Liaison Care is that the company can make a profit of up to 33% of the amount it reduces the cost of a person's social care package by.

The BBC has learned the South Eastern Health Trust paid the firm £213,000, while the Northern Health Trust paid it £202,000.

The South Eastern Trust said its engagement with Liaison Care was limited to a previously agreed review of work and to consider future work, but insisted the company "does not have responsibility for clinical or operational decisions about individual service users".

The Northern Trust said families and carers would be involved in any reviews of social care packages, and all care and commissioning decisions remained under the trust's control.

The Western, Belfast and Southern trusts said while they had engaged with Liaison Care, they had not yet paid it any money.

The Belfast trust said it had "not reached a stage of implementing or agreeing outcomes" recommended by Liaison Care.