There was a ‘loss of organisational memory and delays in addressing known shortcomings’
The offices of Sirona Health & Care, in Yate, South Gloucestershire(Image: Google Maps)
Bristol’s main provider of health care in the home has breached the terms of its licence, after a collapse in leadership last year.
In a new report, NHS England said it has ‘reasonable grounds to suspect that’ Sirona Health & Care ‘has provided healthcare for the purposes of the NHS in breach of conditions of its licence’.
Sirona Health & Care is a community interest company set up and funded by the NHS and local councils to provide adult and children care in their homes across Bristol, North Somerset and South Gloucestershire.
It is the biggest provider of healthcare in the West that’s nominally outside of the NHS itself, and employs thousands of people from Weston to Yate and Bristol.
But Bristol Live reported that, in May 2024, both the chairman of the board and the company’s chief executive both stood down, and Sirona struggled to fill the gaps in leadership.
The NHS report found that there was a ‘loss of organisational memory’ at Sirona. “In the months prior to and following the stepping aside of the Chair and Chief Executive the licensee experienced turnover in several board members,” the report said.
“This led to a loss of organisational memory and delays in addressing known shortcomings in governance arrangements. Further to this the new board has yet to demonstrate that it is performing as a fully matured unitary board,” it added.
The report said NHS England had identified ‘several areas where governance arrangements were not of a standard expected’. “There was insufficient assurance at board level over operational and strategic risks,” the report said. “There were several long-outstanding internal audit recommendations including those related to risk management. There were shortcomings in the way that conflicts of interests are understood, managed and recorded.
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“The licensee has not been able to adequately demonstrate that there is a fully embedded culture of raising concerns or speaking up at all staff levels. There was insufficient rigour around documenting of key decisions taken by the board and its sub-committees or the members group, and governance arrangements sometimes deviated from those set out in the Articles of Association or Governance Framework.
“Members were not adequately supported to fulfil their responsibilities monitoring the performance of the CIC and its directors. Throughout the period of investigation, the governance team has been reliant on interim staff at most grades and has lacked the capacity to address issues as they arose,” the report added.
NHS England said it had now agreed a rescue plan with Sirona Health & Care in the form of enforcement guidance, and NHS bosses have decided to accept Sirona’s ‘enforcement undertakings’ which include a monthly meeting between NHS bosses and Sirona’s leadership.
“The licensee will develop a ‘workplan’ with the independent improvement director that sets out the actions to be implemented by Sirona and timescales to deliver the signed enforcement undertakings,” the NHS report said.
As well as care in the community with health visitors and nurses making home visits, Sirona also run outpatient services at Cossham Hospital, the Henderson Ward at Thornbury Hospital and services at 20 clinics and health centres from Yate to Weston. The company describes itself as ‘England’s largest provider of Adult’s and Children’s Community Services’.