Daily Insight: Close ties

You may not have heard of Ben Davison but in 2020-21 he was the highest reported earner across all national NHS organisations and the Department of Health and Social Care and its partner organisations.

Mr Davison, who worked as NHS Digital’s executive director of products, had a salary band of £260,000 – £265,000. This was many thousands more than Sir Chris Whitty, Sir Simon Stevens and NHSD’s then CEO Sarah Wilkinson.

His salary alone is eyebrow-raising given his position, but wait for the next bit.

During Mr Davison’s tenure in charge of NHSD’s products, the agency awarded lucrative contracts to a very small firm called Axiologik, which had just five staff going into the pandemic.

These contracts were for work to help manage NHSD’s portfolio of products, which included covid-19 vaccination IT, 111 Online and the NHS.uk website.

One of the firm’s three directors is Mr Davison, whose NHSD role was to oversee the products which Axiologik were brought in to work on.

NHSD and Mr Davison both told HSJ measures were put in place to avoid conflicts of interest, and that Mr Davison was not involved in “any decision-making around any procurements in which Axiologik may have an interest”.

But David Rowland, director of public accountability thinktank Centre for Health and the Public Interest, said taxpayers and other tech firms would “rightly question whether Axiologik has been given favourable treatment”.

He added “conflicts of this nature should clearly be prohibited”.

A wake-up call?

An HSJ investigation has revealed striking differences in performance between 111 providers, with callers to NHS 111 services twice as likely to be judged as needing an ambulance in some regions as others – and up to eight times more likely to abandon their calls.

HSJ analysed NHS England’s new integrated urgent care data set from April to December last year – the first year this data set has been produced.

As an example, 15.7 per cent of answered calls to North East Ambulance Service Foundation Trust resulted in an “ambulance disposition” while just 7.7 per cent of calls to London Ambulance Service Trust did so. A total of 14.2 per cent of callers to the privately owned Practice Plus Group were judged to require an ambulance.

41.9 per cent of calls were abandoned before being answered by NEAS and 30.6 per cent of those made to the West Midlands Ambulance Service University FT ended the same way. In contrast just 5.2 per cent of callers from Lincolnshire to services provided by Derbyshire Health United abandoned their calls.

The “standard” for abandoned calls is just 3 per cent, but the average performance across England was 24.1 per cent.

There was no clear distinction between the performance of private and NHS providers of 111 services when it came to ambulance assessments.

However, NHS providers, generally ambulance trusts, did tend to have high numbers of abandoned calls and relatively low proportions of callers being assessed by a clinician. Read our full analysis here.