Health

“A completely inappropriate balance of risk and reward”: Damning report identifies catalogue of failings that led to Health and Wellbeing Centre fiasco

By David Prior at

An independent report into the Altrincham Health and Wellbeing Centre fiasco has identified a catalogue of failings and bad management that led to a “completely inappropriate balance of risk and reward”.

The report, published this morning, was commissioned by the Greater Manchester Health and Social Care Partnership last summer when it became clear that the 88,000 sq ft building did not have any secured NHS tenants, at an ongoing cost to the Trafford CCG of over £51,000 a week.

Altrincham’s Health and Wellbeing Centre on Market Street

It paints a damning picture of a series of failures dating back to September 2014, when the idea for the centre was first conceived, and that it was a “poorly conceived programme with poor commercial outcomes for the CCG and should not have been progressed without fundamental questions being asked and resolved”.

The key findings from the 20-page report – which was undertaken by consultants EY and took evidence from 32 interviews with the CCG and external partners and over 100 documents – include:

  • The decision-making process in 2014/15 with respect to the construction and occupation of the Hub was badly flawed.
  • GP practices and other NHS services – including St John’s Surgery and Barrington Road Surgery in Altrincham – which were publicly earmarked to go in the centre had never actually contractually agreed to this.
  • There were, and continue to be, a number of close professional relationships between former CCG employees, a Council Officer and Citybranch, the developers.
  • The CCG would be liable for the cost of any relevant empty space until it was tenanted, and it had negotiated no benefit from any profit made on the development to offset risks or costs.
  • The site of the old Altrincham General Hospital was selected as the centre’s location without robust evaluation of other potential locations, or any challenge to the size of the development.
  • Management failed to recognise and address the risks inherent in the programme and the CCG’s Governing Body did not hold them effectively to account.

Extraordinarily, the report concludes that there was “little evidence of proactive efforts” to secure tenants for the centre.

It says: “Whilst a number of governance failures occurred during the approval of the scheme, these were compounded by poor management, in the period between February 2016 and March 2018, when there is little evidence of proactive efforts to secure tenants to mitigate the financial risk to the CCG.

The majority of the building is already kitted out with medical equipment

“Evidence to support decisions made throughout the project is limited. Ongoing challenge and risk management from the Governing Body was also limited, partly due to undefined governance processes and unclear schemes of delegation. This poor management and lack of governance meant that opportunities to partly mitigate the risks and impacts arising from the original deal were missed.”

It adds that it found no evidence that due diligence was performed on the developer, Citybranch, a point Citybranch disputed. It also highlighted the “number of close professional relationships” between individuals working for Trafford Council, the CCG and Citybranch.

The report adds: “The current situation was avoidable. Had appropriate challenge been provided in the early stages of the project and at many points thereafter, the CCG would have been saved from expending funds and resources on a programme that provided a completely inappropriate balance of risk and reward.”

The building has lain dormant since it was completed in September 2018

The report will make particularly difficult reading for those past members of Trafford CCG’s Governing Body who oversaw the conception and implementation – or lack of it – or the Health and Wellbeing Centre programme.

The Governing Body was chaired between 2015 and 2018 by Matt Colledge, the former Leader of Trafford Council.

Other senior personnel on the Governing Body included Chief Operating Officer Gina Lawrence, Chief Clinical Officer Dr Nigel Guest, Chief Finance Officer Joe Mcguigan, Clinical Director for Strategy and Policy Dr Michael Gregory, and Clinical Director for Quality Finance and Performance Dr Mark Jarvis.

Trafford Council’s Health and Wellbeing Board, meanwhile, was chaired during the period by former deputy leader Alex Williams, who has now left the council.

The report makes a series of recommendations in the way the CCG and NHS England deals with similar sized projects in the future.

Jon Rouse, chief officer of the Greater Manchester Health and Social Care Partnership, said that lessons had to be learnt

Jon Rouse, chief officer of the Greater Manchester Health and Social Care Partnership, said that lessons had to be learnt to ensure a similar situation “cannot happen again”.

“We must learn from what went wrong to make sure this is not happening anywhere else now, and cannot happen again,” he said.

“There have been changes to rules and procedures nationally in the NHS since the events of 2014 and 2015 which should prevent this in future and I’ve asked all NHS organisations in Greater Manchester to reflect on their decision making and ensure they are always acting fully in the public interest.

Inside the 88,000 sq ft Health and Wellbeing Centre

“There is no doubt that this is a serious situation. The Governing Body at the time failed to handle an avoidable situation – the report concludes they could, and should, have scrutinised this far more effectively.

“Trafford CCG is now under new and stable leadership at Board and executive level and has our full support as they seek to make the most of what I hope will become a real asset for Altrincham.”

The CCG has recommended that the centre is partially converted into office space to lessen the financial burden of the Market Street facility.

Rouse said that his team were now supporting the CCG and NHS Property Services to secure tenants “with a focus on local health and care services”, with progress so far described as “encouraging”.