The Department's Private Finance Unit is highly regarded by Trusts, but has a limited role
4.7 Trusts have the primary responsibility for managing contracts. The Department provides support to Trusts' contract managers through the Private Finance Unit. The Unit consists of 22 people with expertise in corporate finance and contract law. In 2008-09, the Unit spent £3.8 million. Of this, it estimates £111,000 was on activities relating directly to operational PFIs. The Unit also has responsibilities for scrutinising new projects and supporting other corporate finance projects across the NHS.
4.8 The Unit provides high quality and useful support to Trusts that ask for help or who choose to attend its meetings. It:
a Runs a quarterly PFI forum for contract managers. The forum's agendas focus on topics raised by Trusts or emerging issues identified by the Unit. Two-thirds of Trusts use the forum whilst 98 per cent of users (all except one) describe it as useful.
b Facilitates community-of-interest groups. These bring Trusts who share a contractor together to discuss common issues.
c Issues good practice guidance. For example, the Unit has issued guidance on variation protocols and value testing. Seventy-one per cent of Trusts were aware of such guidance, whilst 44 per cent felt that it focused on the right issues.
d Provides a professional mediation service. This is offered to Trusts who are in dispute with their providers. It has been used four times.
e Offers informal support. Trusts are encouraged to contact the Unit when they require advice on technical and legal issues, although they will not supplant the Trust's advisers.
4.9 Seventy-two per cent of Trusts believe that the amount of support the Department provides is sufficient. Our case studies generally viewed the Unit, and in particular the PFI forum, as a good source of professional advice. However, some Trust Chief Executives stated that, whilst they could call on the Unit for advice, the Unit is not proactive in engaging Trusts' senior management.
4.10 The Department aims for the NHS to extend its devolved delivery and accountability model in which Trusts have responsibility for managing PFI contracts with appropriate central control. As part of this, it aims for all Trusts to become Foundation Trusts by the end of 2013-14. Whilst the Unit provides support to all Trusts, it does not provide support to those Trusts that do not seek it. This approach has limitations:
a A lack of oversight. The Department cannot easily require Foundation Trusts to provide performance data, and has not made it mandatory for other Trusts to do so. It also does not use statutory returns to monitor the PFI portfolio. A lack of central data on the performance of the PFI portfolio restricts the Department's ability to assess its value for money and cannot provide information to Trusts on how their performance compares to others.
b Restricted lesson learning. Although the Department spreads good practice amongst Trusts that engage with it, it does not systematically set out to assess, collate and define good practice. Nor does it collate lessons learnt on key areas of risk such as dispute resolution or value testing.
c A lack of targeting. The Department cannot know whether Trusts which are not accessing support have unidentified performance issues. It is unable to target its resources to support Trusts most in need of help.
d Weakened commercial leverage. The Department has more commercial weight than any single Trust. But with more information on Trusts' projects the Department could use this leverage to update contracts on common issues, or facilitate performance and efficiency improvements.