As NHS relies more on volunteers, new report shows community car schemes in Devon under severe pressure

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The CCGs and hospital trusts like the RD&E are increasingly relying on voluntary community activity to support the NHS. However some existing voluntary services are under severe pressure.

NDVS car schemes.pngA new report by Tim Lamerton and Jo McDonald for NDVS, Community Car Schemes in Devon: State of the Sector 2018, documents the huge volunteer effort that goes into keeping people without their own cars moving throughout the County – especially to access healthcare. It also underlines a real crisis in this activity, which it estimates saves the NHS some £6.7m per year. These are quotes from the report:

  • What had been a valuable and pleasurable activity has become, at times, a stressful, highly skilled environment in which to volunteer, relied upon by passengers who have no other transport choices
  • The profile of their passengers is changing. They are older and increasingly frail, often living with multiple conditions. For example, they have reduced mobility and/or memory loss, often causing considerable concern to drivers.
  • The drivers are themselves also becoming older and more frail. They report finding the stress and effort involved with helping passengers attend medical appointments, often at busy main hospitals, is increasing to almost intolerable levels.
  • Job satisfaction managing schemes is reducing due to increased work-related stress.
  • Some schemes are also finding it increasingly difficult and time consuming to recruit volunteers; removing the sense of personal fulfilment and fun from being a driver is making this much more difficult.
  • Funding to a number of schemes across Devon has been reduced or cut by the CCGs with little or no notice. At least one surgery based scheme has been forced to close, putting immediate pressure on other providers on the area. Managers of schemes are finding such lack of consultation, and of investment, increasingly frustrating.
  • Schemes are also reporting a rising expectation amongst hospital staff that they can provide an increasing range of services at very little notice. They report that many NHS staff appear to have no knowledge of the role, purpose or motivations of car schemes and do not understand that they are not there to provide an immediate, on demand, taxi service.

Seaton Beach Management Action Plan published – important proposals which need to be taken forward

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The consultants’ report to go to EDDC is now available here. It’s extremely long, informative and thorough, and my first reaction is that we need to press EDDC to adopt the recommendations and – where necessary – look hard for funding so that more of this agenda can be carried out, to top up the relatively modest statutory funding. There are some ‘wish list’ items which are not included – like the extension of the West Walk to Seaton Hole, which was costed at £4m – but all the items in the list below are things which really must be addressed.

Upgrade concrete encased revetment at Seaton Hole.

Maintain ‘old and new’ revetment at Seaton Hole / Old Beer Road

Extend ‘new’ revetment at ‘The Pillar’.

Upgrade Check House wall.

Maintain West Walk Promenade including concrete / stone blockwork.

Do Nothing: Seaton spit, and consult with SMP (Shoreline Management Plan) group to guide future management of the landward side of the spit 

New defences west bank Axe Estuary.

Consider whether to undertake beach recycling, guided by ongoing monitoring, consultation with SMP group and new study

Cliff drainage measures. EDDC to investigate suitable options for cliff‐top drainage (that are agreeable environmentally and affordable), and for EDDC to identify a funding stream for this erosion risk management activity. A study into surface water flows on the cliff‐top would also be required in support.

Works to address undermining of Seaton Hole outfall.

Assessment of pathway along concrete encased revetment at Seaton Hole.

Address issue of pollution of beach at Old Beer Road. To be informed by an investigation and if relevant, development of suitable options.

More monitoring, extended to Beer

Important community conversation on health and wellbeing in Seaton and area to begin on 23rd March

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Sarah Reeves of Action East Devon is coordinating this event, which follows Honiton’s Health Matters which launched last month (the follow-up meeting in Honiton is on 6th March). I am happy to provide further information if you contact me. 

Seaton and Area Health Matters – Going Forward Together

Friday 23rd March 2018 – Seaton Town Hall

9.00 for 9.30 am start – 1.00pm

Book here:  https://goo.gl/forms/7laMUjhByt8F0w053  (right click on link to open booking form)

You are invited to participate in this community led event with key stakeholders around the future health and wellbeing of all the people in our communities, in response to  the new landscape affecting Seaton and surrounding area as a result of NHS and Government policies advocating Place-Based Care in health provision and cross-sector collaborative working with community groups

The aim: To discuss what we know, where there are gaps/challenges and how, as a community we will address these to ensure collaborative approaches to co-design and co-produce local health services/activities that meet the needs of all the people in our communities.

Invitees: Management and senior level employees and volunteers / trustees from community, voluntary and social enterprise sector as well as public and private organisations.

Area to include: Seaton, Colyford & Colyton, Beer, Axmouth, Branscombe

PROGRAMME:

Welcome: Mayor of Seaton – Cllr Jack Rowland

Community Context:

  • Dr Mark Welland – Chairman of Seaton & District Hospital League of Friends
  • Roger Trapani – Community Representative,  Devon Health and Care Forum
  • Charlotte Hanson – Chief Officer, Action East Devon

Strategic and Services Overview – Place Based Care:

  • Laura Waterton – Royal Devon and Exeter NHS Foundation Trust
  • Richard Anderson – Health and Social Care Community Services Manager
  • Dr Jennie Button – Social Prescribing Lead – Ways 2 Wellbeing project in Seaton

Workshop, Networking and Discussion will form the main part of this event:

  • Workshop 1 – What is working well and what are the challenges for Seaton and surrounding area?
  • Workshop 2 – Working together to improve health and wellbeing outcomes?   What support do we need?

 

Pay more and more council tax for fewer and fewer services – Devon Conservatives’ inspiring record of managing the County Council’s decline reaches a new low

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My last post but not least on yesterdays County Council meeting – it approved the budget and set an increase in Council Tax of 4.99 per cent. 

As my Independent colleague Cllr Claire Wright explained in her speech, health visitors, funding for foster care, the schools counselling service, among others are to be cut, cut, cut – while an extra £5m is stashed away in reserves (because of the unreliability of the Government’s new wheeze of letting councils keep business rates as a partial substitute for central funding).

County budget meeting 15.2.18I pointed out that – while we all want to protect spending on the young, elderly and disabled – another year of huge rises in Council Tax (making 14 per cent in the last 3 years) will hit hard those managing on modest incomes.

As a colleague pointed out, Council Tax is an unfair tax and the way in which the Government is loading social care costs on to it is a disgrace.

I said you’d have thought that it would be good for Devon to have the same party running its council which runs the national government. Actually it’s the opposite – the Tory Government takes advantage of the Devon Tories’ slavish loyalty, and the Devon Tories let them get away with it.

YOU CAN WATCH MY SPEECH BY CLICKING HERE AND FAST-FORWARDING TO 1:56.

County Council Cabinet member says of NHS changes, ‘What we’re not going for in Devon is an Accountable Care Organisation’ – but can we take this assurance at face value?

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At Devon County Council yesterday, I asked Cllr Andrew LeadbetterCabinet Member for Adult Care and Health, whether the Devon Accountable Care System (ACS) (which is being renamed the Integrated Care System!) is still due to start on April 1st. He replied that ‘What we’re not going for in Devon is an Accountable Care Organisation’ – only an Accountable Care System.

He said that the 1st April date was the one ‘on which the two CCGs [NEW Devon and South Devon & Torbay] are going to merge’ and that the ACS already existed in all but name. ‘It’s their plans, they don’t actually need our permission to go ahead with it’, he added – although DCC is ‘in partnership with them’. He didn’t answer Cllr Brian Greenslade’s point that DCC had glossed over it in a recent spotlight review.

You can WATCH THE EXCHANGES BY CLICKING HERE AND FORWARDING TO 2:57. 

However I think there’s a confusion in Cllr Leadbetter’s response and in the joint statement with the CCGs which he issued as a written report at the meeting and previously emailed to councillors:

  • No one has said that the Devon CCGs, through the Sustainability and Transformation Plan (STP), are currently introducing an Accountable Organisation (ACO), the new form of long-term NHS provider contract which has been developed by NHS England, could hand over large chunks of the NHS to private including American companies – and will shortly be judicially reviewed.
  • However according to the CCGs, Phase 1 of the Accountable Care System in 2018-19 will develop an ‘integrated delivery system for Devon’ with a ‘single strategic commissioner’. 
  • And according to the report Designing the commissioning system in an accountable care environment: A route map for Sustainability and Transformation Partnerships which describes how the Devon STP has been working – and which Dr Tim Burke, Chair of NEW Devon CCG says is the ‘route map’ for the accountable care system – this integrated system is designed to lay the basis for Accountable Care Organisations.
  • On page 18, the report says that the integrated delivery system, ‘Through bringing budgets together on a whole population and/or model of care basis, [will] provide signals to providers on how to organise. This will signal the number, shape and scope of accountable care organisations and how they will need to work together to deliver.’

SO – Cllr Leadbetter is right, the emerging ACS is not an ACO. But the ACS is designed to lead to the setting up of ACOs.

Unless, of course, they have changed their mind. Is the route map still the route map – or not? This is the question that the CCGs and Cllr Leadbetter need to answer, before his ‘assurances’ can be considered meaningful. As he mentioned yesterday, I and other councillors will be meeting with him and the CCGs to discuss these issues further.

(Other noteworthy point:

NOTE FOR BAFFLED READERS: I know this is an incredibly complicated subject, not helped by their tendency to change the name of what we’re talking about as soon as objections are raised – as though that makes it better! If you’re confused – you’re not alone. However it MATTERS A LOT to the future of the NHS. Read this report explaining the issueswhich I submitted to the Health Scrutiny Committee last month.

 

Devon’s Conservative leader blocks pro-Europe rally being held in County Hall grounds – Tory councillor says protest is not the way to do things

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Whether or not you agree with Devon for Europe (D4E) it is worrying that Devon County Council leader, Cllr John Hart, refused a request for the campaign group to hold a rally in the County Hall grounds because he didn’t think it was appropriate for a political rally to be held there.

County officers had told the D4E there were all sorts of practical reasons why the rally would cause difficulties for the Council. D4E had approached me to help and I was surprised that the Council hadn’t discussed the reasons with them – I thought the issues should be possible to negotiate.

However at yesterday’s Council, after I put the decision on the agenda, Cllr Hart gave the game away, and fellow-Conservative Cllr Christine Channon backed him up by saying protest wasn’t the way do things. Cllr Channon – who voted Remain but thinks now that we should let the Government get on with its negotiations without making our views known to them – may not want to protest, but many do and it is their right to do so. WATCH THE DEBATE – FORWARD TO 2:45 FOR THIS EXCHANGE.

Councils control most of the public space where a fairly large number of people could assemble. So they should go out of their way to facilitate peaceful protest even at the cost of a bit of inconvenience. It is essential for democracy that peaceful protest and assembly – including by people we disagree with – should be able to take place!

I make the case for the County Council to lobby government for the least damaging Brexit trade and migration deal – the Conservatives vote it down

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The majority of people in the Seaton and Colyton area, and Devon as a whole, voted for Brexit. But they did not vote to make themselves or the country poorer. At Devon County Council yesterday, the Cabinet gave their response to a motion I submitted supporting staying in the Single Market and Customs Union, which would be the best deal for Devon’s exporting companies, farmers, universities, tourism industry and especially our NHS.

However the Cabinet took out all references to post-Brexit options and just said they would assess the ‘opportunities and impacts’ of Brexit. I then proposed an amendment that the County Council should lobby government for the least damaging Brexit trade and migration deal. In the end, every single Conservative councillor voted against this – some, I’m pretty sure, against their beliefs – although Lib Dem, Labour and other Independents supported it. You can WATCH THE DEBATE HERE – FORWARD TO 3:38 FOR THIS RESOLUTION.

Neil Parish seems to have gone AWOL on this issue, along with all Devon’s MPs except Conservative Sarah Wollaston and Labour’s Ben Bradshaw. So all the more important that the County Council should speak up loud and clear for the post-Brexit deal which will best safeguard Devon’s economy.  Unfortunately DCC’s Conservatives put party unity and loyalty to the Government before the interests of Devon.

Devon for Europe County Hall 15.2.18I’m pictured here with other councillors and DEVON FOR EUROPE supporters attending the meeting. Anthea Simmons (second from the right) gave an excellent speech in the public speaking session.