UHB controls its culture review, NHS executive secrecy and what value from the “TheValueCircle”?

By Dr Minh Alexander 29 May 2023

The painful spectacle of the NHS denial machine grinding on at University Hospitals Birmingham NHS Foundation Trust (UHB) continues to embarrass us all.

Instead of an effective and genuine response to staff and patient concerns about maladministration, under-resourcing and related safety matters, the upper echelons of the NHS are wasting thousands in public cash on reputation management. Literally, because the relevant commissioner, Birmingham and Solihull ICB has hired the well known professional reputation managers, Freshwater.

Part of the prestidigitation is the performative exercise of allowing UHB to control a culture review on itself. This is akin to the useless models of internal Freedom To Speak Up arrangements for NHS whistleblowing and internal NHS arrangements for conducting Fit and Proper Persons investigations under CQC Regulation 5.

UHB, through a panel chaired by Roger Kline, has appointed a private company called “TheValueCircle” to carry out the culture review. TheValueCircle was set up by a former employee of the Good Governance Institute, another private company, which has many links with UHB managers and former managers, including Jacqui Smith former UHB Chair.

Roger Kline   Roger Kline was previously a Co-director of the now defunct organisation Patients First.   I have written previously about Patients First.   Roger Kline has links with the organisation B-RAP and has done joint work with this organisation. B-RAP was until 10 January 2023 chaired by Karen Kneller, a UHB non executive director.   Naledi Kline is a trustee of B-RAP.     Roger Kline interacted with UHB prior to the announcement that he would chair a panel to select the organisation to conduct the UHB culture review.   A local media report confirmed in April that he had prior links with the trust:   “He confirmed he has prior links to UHB, having worked with some of the existing leadership in the past on a ‘fairness taskforce’ looking at staffing issues, but insisted he had ‘no interest’ in positioning the trust chiefs in a positive light if that was not what he found.”   It is remarkable that the UHB trust board, and ultimately NHS England where Kline was previously a director, even at this late stage, appear unconcerned about any appearance of potential conflict of interests.

TheValueCircle is notable in that one of its consultants is a CURRENT member of the NHS England board, Andrew Morris, as declared in the NHSE register of interests.

Several of its other consultants are former NHS trust directors, regulators and commissioners, some very recently stepped through the revolving door, such as Ian Hall who according to his LinkedIn entry was until June 2022 Regional Director of System Improvement, for NHS England Midlands.

This is the very NHS England region responsible for UHB and which is controlling the conduct of the UHB reviews behind the scenes, as revealed by PHSO correspondence, which is another topic for another day.

Unhealthy proximity, did I hear you say?

To understand TheValueCircle’s past work for the NHS, I looked for examples of other reviews and consultancy work. Strikingly, I found no past work product by TheValueCircle in the public domain. But I did find a comment on the company’s website about the fact that it did not produce much in the way of reports:

To find out more I requested, under FOIA, information from ten NHS bodies which appeared to have used TheValueCircle’s services in the past. They were mostly located in the West Midlands and North West regions. The results are provided below.

1) Walsall Healthcare NHS Trust

In an FOI response, Walsall reported it spent £119,232 on TheValueCircle for “Acute Partnership Development Support” and “Board Development Programme 2021/22”.

Astonishingly, the trust claimed that it held no data on which consultants from TheValueCircle carried out this work, any reports by TheValueCircle or whether NHS England had recommended the TheValueCircle.

This is the Walsall Healthcare FOI disclosure.

2) Sandwell and West Birmingham NHS Trust (and false claims)

This trust and Walsall Healthcare NHS Trust are both chaired by David Nicholson, the former CEO of NHS England who was forced to resign after the scandal of the MidStaffs Public Inquiry.

He is now a major influence again in the West Midlands region, where it all started, as the chair of multiple NHS trusts.

Although Sandwell and Birmingham NHS Trust board papers recorded that Nicholson commissioned a review by TheValueCircle as one of his first acts as trust chair in, the trust FOI department bizarrely claimed to me that the trust had NEVER hired TheValueCircle.

“We have never commissioned this company for any consultancy work, advice or any services.”

When I pointed out that this was incorrect and supplied the evidence to prove this, the trust FOI department simply ignored me. Alongside this, I actually wrote to Nicholson to ask him if he had prior experience of TheValueCircle. He responded via a message from his office confirming that a review report had been produced but with a new narrative that it was not he but his CEO who had commissioned the review. He denied that NHS England had recommended TheValueCircle.

“From: REDACTED

Subject: RE: The Value Circle

Date: 18 April 2023 at 16:51:45 BST

To: REDACTED

Dear Dr Alexander

Many thanks for your email below.

Sir David has confirmed that he has not used The Value Circle previously.  Sandwell and West Birmingham used them and I understand that they produced a good report which focussed heavily on the culture and behaviour elements of governance.  This was requested by Richard Beeken the CEO.  There is no connection with NHSE.

I hope the above is helpful.

Kind Regards

REDACTED”

Sandwell and West Birmingham did not respond properly to my FOI request until I complained to the ICO and I published my letter of complaint.

The day after, a response finally arrived indicating that the trust spent £28,200.00 on TheValueCircle’s services for a “Governance Review”.

The trust refused to disclose which consultants from TheValueCircle did the work claiming it was exempt as personal data.

Despite paying for and owning the review report on behalf of the public, the trust claimed it needed TheValueCircle’s permission to disclose it to the public:

“The report was prepared solely for the use of Sandwell and West Birmingham Hospitals NHS Trust. There is a disclaimer that the details may be made available to specified external agencies, but otherwise the report should not be quoted or referred to in whole or in part without prior consent. No responsibility to any third party is accepted as the report has not been prepared and is not intended for any other purpose. We have requested permission from The Value Circle as to what can be shared. We will respond once they have confirmed.”

The trust denied that NHS England recommended TheValueCircle and stated: “…they were chosen through a competitive bidding tender process.”

This is the Sandwell and West Birmingham FOI disclosure.

3) Dudley Integrated Health and Care NHS Trust 

No response.

I will be complaining to the ICO.

UPDATE 20 JUNE 2023

After a complaint to the ICO, Dudley Integrated Health and Care NHS Trust revealed it has spent £468K on TheValueCircle’s services since 1 April 2021. But it refuses to disclose any reports by the same, on grounds of personal privacy (Section 40).

FOI response 20 June 2023 by Dudley Integrated Health and Care NHS Trust, spending on purchases from TheValueCircle

4) Gloucestershire Health and Care NHS Trust

This trust hired TheValueCircle to provide “training to our Board including a Well Led training session so that Board members would be further prepared for the then upcoming CQC inspection and also a Board Development programme.”

This cost £43,316.49 ex VAT.

The trust refused to disclose which consultants from TheValueCircle supplied the purchased services on grounds that disclosure would prejudice the conduct of public affairs. Really? Were the consultants current public servants?

The trust dubiously claimed that it could not disclose reports by TheValueCircle on grounds of commercial sensitivity.

It implied that NHS England had not recommended TheValueCircle:

“The Trust was made aware of TVC and other potential suppliers of Well Led reviews via a Trust Secretary network. TVC were appointed through a procurement exercise/tender by the Trust.”

This is the Gloucestershire Health and Care FOI disclosure.

I have asked for an internal review.

5) Shropshire Telford and Wrekin ICB (and false claims)

ICB records clearly showed that TheValueCircle was hired to work on transformation of musculoskeletal services:

“To help shape the future ambition for MSK services, ICS organisations jointly commissioned The Value Circle to undertake a review of the current MSK transformation programme and make recommendations on next steps. The initial feedback which remains in draft form is attached in Appendix 1.”

This is the the relevant section of Appendix 1.

However, the ICB claimed to me that it had never conducted any business with TheValueCircle.

This has been questioned and await a response.

6) Harrogate and District NHS Foundation Trust

No response.

I will be complaining to the ICO.

7) Liverpool University Hospitals NHS Foundation Trust

This trust spent £83,160.00 (inc VAT) by hiring TheValueCircle “work in partnership to develop a new risk management framework”.

The main man from TheValueCircle, David Cockayne, was the main consultant supplied, as is the case at UHB:

“David Cockayne, Chief Executive (The Value Circle LLP) was the senior sponsor supplied to co- ordinate the work undertaken with the Trust.”

Astonishingly, for £83,160.00 of public money spent, there is purportedly no tangible product to show for it:

“In accordance with Section 1 of the FOIA, we can confirm that the Trust does not record/collate the above information. We do not hold a final written report in order to answer Q4 of your request.”

The trust denied that NHS England recommended TheValueCircle in an interestingly worded reply:

“No external body recommended TheValueCircle to the Trust”.

8) East Lancashire Hospitals NHS Trust

This trust hired TheValueCircle to provide “Support to the development of the Provider Collaborative Strategy” and paid £193,065.90 inc VAT for this service.

The trust was reluctant to disclose which consultants from TheValueCircle provided the service, copies of their reports or whether NHS England had recommended TheValueCircle to the trust. It repeatedly gave the answer:

“The Trust does not hold this information centrally.”

This is the East Lancashire FOI disclosure.

I am requesting an internal review of this given reason for non-disclosure.

Until July 2021, the CEO of this trust was Kevin Mc Gee.

An apparent testimonial by Mr Mc Gee appears on TheValueCircle’s website:

I have asked Kevin McGee to kindly confirm that this comment was correctly attributed to him.

9) Blackpool Teaching Hospitals NHS Foundation Trust

This is another trust under Kevin McGee’s oversight as CEO.

The trust disclosed that it had hired TheValueCircle for the following jobs:

“From 19/20 the Trust commissioned 3 pieces of work:-

• a review of our Wholly Owned Subsidiary – Atlas
• a review of our Divisional Structure and consideration of a Tertiary Division
• a support piece of work for the Development of the Provider Collaborative for L&SC – this was commissioned by BTH but was for the entire PCB across Lancashire and South Cumbria.”

This all cost £350K.

David Cockayne was the main consultant for this project, as he is at UHB currently.

“David Cockayne, Chief Executive of Value Circle, was the lead contact for the projects, deploying various other consultants dependent upon the work.”

The trust refused to disclose any reports by TheValueCircle on grounds of commercial sensitivity.

Most incredibly, the trust also refused to disclose whether or not NHS England had recommended TheValueCircle on grounds of commercial sensitivity.

Shurely shome mistake?!, I hear you cry.

Surely no one at NHS England has a commercial interest in TheValueCircle getting lucrative NHS contracts?

This is the Blackpool FOI disclosure.

I am requesting an internal review of these claimed exemptions.

The last but possibly the most important example:

10) North East Ambulance Service NHS Foundation Trust

As the NEAS deaths cover up and coronial misreporting scandal swirls on, compounded by the appointment of Marianne Griffiths as an investigator despite her controversial history with whistleblowers, who is found in the mix but TheValueCircle.

I discovered that TheValueCircle had been hired from NEAS financial transparency data , which showed that the trust CEO had authorised a payment to the company in December 2022 for “external consultancy”.

In response to FOI questions, the trust disclosed that it had hired TheValueCircle to undertake a  “Well Led Independent Review” at a cost of £79,253 ex VAT and a  “Full review of Trusts Governance and Assurance Framework” at a cost of £127,660 ex VAT.

TheValueCircle consultants who did the work were Sue Hillyard, Maggie Boyd a former NHS Improvement director in the Midlands and East Region and David Cockayne.

With desperation, and despite the massive and obvious public interest arguments, the trust claimed that it would be prejudicial to the conduct of public affairs if the reports produced by TheValueCircle were shared:

“Frankness and candour are essential for good decision-making. We believe that disclosure would be likely to prevent future reviews taking place with an honesty and candour needed to ensure that corrections can be made to improve our services.

We are therefore unable to release this information and apply section 36(2)(b)(i)&(ii) and section 36(2)(c) exemptions. This exemption states that information is exempt information if, in the reasonable opinion of a qualified person, disclosure of the information under the legislation:

(b) would, or would be likely to, inhibit –
(i) the free and frank provision of advice, or
(ii) the free and frank exchange of views for the purposes of deliberation, or
(c) would otherwise prejudice, or would be likely otherwise to prejudice, the effective conduct of public affairs.

The documents requested and subsequently withheld contain the findings and opinions from external reviews that, if made public, would likely inhibit the future frankness and candour that we require to ensure our decisions are robust and informed.

In my reasonable opinion, this would likely damage the quality of advice and deliberation and lead to poorer decision making in the future. It would also inhibit the necessary frankness and candour of our staff if their discussions were made public.”

It is striking how the NHS will argue that night is day and vice versa when it suits.

When it is inconvenient, as at NEAS, embarrassing findings are hidden behind the wall of Section 36 exemption.

When it is less inconvenient, they may be published in full.

Here is an example of a fully public Well Led Review report on another NHS trust, of which Maggie Boyd was also a co-author:

Well Led review report on North West Anglia NHS Foundation Trust

NEAS also denied that NHS England recommended TheValueCircle:

“The Value Circle was not recommended by another body. Procurement exercise completed for Well Led Independent Review and further work on Governance and Assurance Framework required rapid completion post CQC inspection.”

This is the NEAS FOI disclosure.

Conclusion

So there you have it dear reader, UHB which has been severely criticised for secrecy and marking its own homework, allowing cover ups of patient safety and staff abuse, is being allowed to mark its own homework again using a private company about which there is studiously little transparency despite large amounts of hard public cash changing hands.

So far, even with three of ten trusts failing to respond to the FOI requests, over a million pounds were spent on TheValueCircle with nothing tangible in the public domain to show for it, even with a major scandal and many lives lost at North East Ambulance.

Why should highly paid NHS trust executives pay others with our money to do their jobs for them?

In times of austerity, when the lowest paid NHS frontline have to rely on foodbanks and 7.3 million patients wait for treatment, is not an obscene sight that money is frittered away in this fashion?

If these highly paid executives are incapable of doing their jobs, they should be shown the door. But oh, wait, there is still no sign of any implementation of the Kark review which the current Secretary of State himself commissioned but reportedly has stifled. He has not replied to a letter of 7 February 2023 asking him to reconsider his decision to reject Tom Kark’s recommendation of a disbarring mechanism. I have written once more:

LETTER TO STEVE BARCLAY SECRETARY OF STATE ABOUT DISBARRING UNFIT NHS MANAGERS 29 MAY 2023

NEUROLINGUISTIC PROGRAMMING AT THEVALUECIRCLE

As a little bonus feature, I should draw attention to the fact that one of TheValueCircle’s featured consultants Margaret McCabe is advertised as a NLP practitioner.

Her arrival was announced by David Cockayne himself.

NLP has been described as “pseudo-scientific”, “folk magic”, a “quasi-religion” and a New Age “psycho-religion”.

The current NHS National Freedom To Speak Up Guardian is master practitioner of NLP, not to mention a fire walk trainer. Nuff said.

Neuro-linguistic-programming: a critical review of NLP research and the application of NLP in coaching

Thirty-Five Years of Research on Neuro-Linguistic Programming. NLP Research Data Base. State of the Art or Pseudoscientific Decoration?

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