Month: January 2018

Devon looking for care and support workers – new campaign

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Go to http://www.devonlive.com/special-features/devon-looking-care-support-workers-1115792

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34 per cent of children in Coly Valley, 24 per cent in Seaton, living in poverty says shocking new report

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From devonlive – The End Child Poverty coalition has collated the data: altogether 251 children in the Coly Valley (34 per cent) and 232 in Seaton (24 per cent) are likely to be living in poverty. The figures are estimates of child poverty in different areas, calculated using HMRC data and the Labour Force Survey.

Sam Royston, Chair of End Child Poverty and Director of Policy and Research at the Children’s Society said: “It is scandalous that a child born in some parts of the UK now has a greater chance of growing up in poverty, than being in a family above the breadline.

He added, “There can be little doubt that the Government’s policy of maintaining the benefits freeze despite rising prices is a major contributor to the emerging child poverty crisis.”

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Care at home – ‘When GPs ring the single point of access number asking for rapid response or night sitting, the carers are not available. This is partly due to lack of resources and partly due to difficulty with recruitment.’

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Claire Wright’s blog gives the speech made by Dr Mike Slot at Health Scrutiny: “If community hospital beds was intended to be offset by increasing the capacity of community care so that patients could be cared for in their own homes. This may or may not have been realistic since many of the patients in the hospital system cannot be managed in the community even with excellent community services.

However, with or without community hospital beds it is an excellent idea to expand community services so that all those patients who can be cared for out of hospital can remain at home. Unfortunately there is not sufficient capacity in the home care services to do this job.

When GPs ring the single point of access number asking for rapid response or night sitting, the carers are not available. This is partly due to lack of resources and partly due to difficulty with recruitment. I suspect that part of the difficulty with recruitment may be due to the terms and conditions. If the carers only get paid if they are required then this may not be particularly attractive.

We understand that a hospital only functions well with a maximum of 85% bed occupancy, and similarly with the home care service we need to accept that there will be some unused capacity otherwise the service is never able to accept unexpected cases. Thus we need to allocate enough resource so that we can offer both an attractive rate of pay and attractive terms and conditions.

This is in fact an essential part of the answer to the problem the entire NHS is experiencing. If the level of water in a reservoir is steadily rising and then overflows, you can either try and build the banks higher in which case it will just overflow a bit later, or you can look at the streams going in and going out of it.

Similarly when you see an overflowing A&E or hospital you can buy more A&E or acute beds (very expensive) or you can increase community capacity to prevent people going in and facilitate people coming out (relatively much cheaper but you still have to pay a proper rate for it).”

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Health Scrutiny hears there will be no precipitate decisions on community hospitals – local conversations with CCG and RD&E offer chance to shape ‘place-based health systems’ around towns

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In my third and final report from yesterday’s Health Scrutiny, I come to the report on the future of the hospitals by NEW Devon CCG and NHS Property Services, in response to the Committee’s request for clarification. (This arose from my presentations at the September and November meetings). While NHS PS stressed that in principle they will eventually have to charge market rents, Claire Wright elicited the useful information that currently NHS England are still paying for the buildings, and the company said they are ‘always happy to work with local communities to consider local services’. Scrutiny’s resolution requested that NHS PS ‘uphold this undertaking’ and keeps the Committee informed on the timeline for changes in the status of the hospitals.

The CCG’s Sonja Manton confirmed that the community conversations the CCG and RD&E are now promoting to develop ‘place-based systems‘ around ‘market towns’ – which have already begun in Honiton and Okehampton – can certainly include the services people want to have delivered locally in the hospitals. While there are cost constraints and not everything which people want will necessarily be delivered, local communities can certainly discuss these services with the NHS organisations, as well as how voluntary organisations can help the NHS and adult social care. Okehampton’s Conservative county councillor, Kevin Ball (below front left, with Non-Aligned Group leader Frank Biederman behind), stressed the progress his community had made in the recent meeting in the town. He and Okehampton’s mayor, Jan Goffey, mentioned that FORCE Chemotherapy will soon be opening a service in the hospital.

Health Scrutiny Jan 2018 with Kevin Ball

In my speech (1:34:20) I welcomed the new ‘place-based’ focus and stressed the importance for towns like Seaton – which is 45 minutes to an hour from acute hospitals – of using the free space in the community hospital to deliver routine treatments and operations for which people currently have to go to Exeter. I pointed out that constituents complain to me all the time about the stress, strain and cost of repeated travelling, often when unwell, without parking, park-and-ride space or bus services – while Exeter complains of congestion!

I mentioned the request of the RD&E’s Em Wilkinson-Bryce, in Honiton last week, for the community to trust the NHS organisations, and said that a serious conversation about local services – in which the NHS takes on board what people want – would be the best way to create this. We wanted to keep the beds, but now they are gone proper ‘place-based’ strategies for each of our towns offer the prospect of working together with the NHS. Preparations are underway for a meeting similar to ‘Honiton’s Health Matters’ in Seaton in March, and I will give more information as soon as the date is fixed.

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Devon’s health system’s declining performance over last 12 months – and Health Scrutiny still waiting for winter crisis evidence

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Health Scrutiny 25 Jan 18At yesterday’s Health Scrutiny Committee, I presented evidence (at 2:10:45) of an across-the-board decline in performance by Devon’s four NHS trusts against 3 key national targets, over the last 12 months.

Devon’s A&E departments are slipping back against the target of 95 per cent of patients to be seen within 4 hours (as we were meeting the average waiting time in Wonford according to the ironically named NHS Quicker app was 5 hours 13 minutes). The hospitals are slipping back against the target of treating 85 per cent of cancer patients within 62 days of urgent referral by a GP – our trusts average between 75 and 80 per cent and one trust, Northern Devon, is seeing 17 per cent fewer within the target than a year ago . And they are further from meeting the target of carrying out 92 per cent of routine operations within 18 weeks – and this was before ‘elective admissions’ were ‘deprioritised’ (in the language of the report) in January. Similarly, it appeared that the SW Ambulance Service was getting to a smaller proportion of the most urgent calls within target.

My comments were a corrective to an over-optimistic report by the CCGs and the County Councils’ social care team, which stressed the halving of Delayed Transfers of Care from hospital (bed-blocking). While this is very welcome, it is less important to most patients’ experiences than the 3 main indicators which the NHS itself has chosen to measure its performance against. The delays in cancer treatment (which the report didn’t even mention) are particularly scandalous – they will cost lives.

Elsewhere on this item, Claire Wright made a valiant attempt to get information about the winter crisis in Devon from the CCG (and earlier from the Ambulance Service). She was promised that evidence would shortly be provided to the committee.

PERFORMANCE AGAINST KEY TARGETS OVER LAST 12 MONTHS ROYAL DEVON & EXETER TORBAY & SOUTH DEVON N DEVON PLYMOUTH England average
A&E Target: 95% treated or admitted in 4 hours. 87.2% (-5) 88.3 (-1.7) 88.5 (-6.1) 79.3 (-4.8)

85.1
CANCER CARE Target: 85% begin treatment within 62 days of urgent GP referral 80.4 (-2.9) 77.3 (-16.9) 75.3 (-12.9) 78.5 (+1.7)

82.5
PLANNED OPS Target: 92% waiting less than 18 weeks 88.4 (-3.2) 83.7 (-5.3) N/A 82.4 (-2.6)

89.5

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Health Scrutiny agrees to my request to scrutinise controversial plan for Accountable Care System in Devon from 1st April – I tell them there is no public consensus for private companies running our NHS

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Yesterday’s meeting of the Devon Health and Adult Care Scrutiny Committee agreed to my request for a special meeting to discuss the introduction of an Accountable Care System in Devon, if this goes ahead as planned on 1st April. However if the system is delayed, it will discuss the system at its scheduled meeting on 22nd March.
I told the Committee that in the light of the controversial nature of Accountable Care Systems, it was wrong that no consultation had been held with the Committee, the County Council or the public.
I pointed out that in Cornwall, an open inquiry into a similar proposal had been held, and that the parliamentary Health Select Committee, at the instigation of Dr Sarah Wollaston MP, had launched an inquiry into Accountable Care Organisations (ACOs), the new kind of contract proposed within Accountable Care Systems. Jeremy Hunt, the Secretary of State, had welcomed this inquiry and while the Committee was meeting, NHS England announced a 12-week public consultation into these organisations.
I said that a major concern was that ACOs would be 10-15 year commercial contracts and could be given to private providers. Although NHS England’s statements points out that the two contracts so far proposed are going to NHS organisations, Mr Hunt’s letter to Dr Wollaston on 22nd January makes it clear that they can equally go to private companies. ‘Especially after Carillion, there is no public consensus that private companies should run large areas of our NHS’, I told the committee.
Moreover, at the hear of ACOs is the idea of ‘capitated care’, which I told the committee ‘could lead to rationing of routine operations and treatments, forcing better-off patients into private care and leaving a second-class service for those who rely on the NHS’.

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Claire Wright reveals – CCG claims it isn’t in a position to give Health Scrutiny information on the winter crisis in Devon’s NHS

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CLAIRE WRIGHT, Devon County Councillor for Otter Valley, writes: I am really disappointed to report that despite me asking at the beginning of January for the winter pressures information to be available at the 25 January Health and Adult Care Scrutiny meeting, it is not going to be provided.

Given the avalanche of very worrying “NHS in Crisis” press stories I sent several emails to committee chair, Sara Randall Johnson, at the beginning of January asking for information such as delayed discharges, A&E waits, levels of norovirus, staff vacancies and various other pieces of information.

I am really disappointed to report that despite me asking at the beginning of January for the winter pressures information to be available at the 25 January Health and Adult Care Scrutiny meeting, it is not going to be provided.

I was told it would be published as part of the performance review. However, when the agenda papers were published last week, the performance review charts gave information until the end of November only.

I have since been told by the committee chair that a representative from the NEW Devon CCG claimed that they weren’t in a position to provide the information because it would give councillors an incomplete picture.

If this isn’t infuriating enough, winter pressures data is updated on a daily basis and circulated to NHS and social care managers. They have the information. And it’s as up to date as today.

The health scrutiny committee chair indicated during a phone call with me on Saturday that she thought this was acceptable and that this data not being provided until the March meeting was fine!

When I asked (as per the email below) for the data to be provided under ‘urgent items’ I was told the issue wasn’t urgent and there wasn’t time to get the paperwork out in any case.

The refusal to supply this information, is in my view, a deliberate obfuscation. An attempt to interfere with the democratic and legitimate process of scrutiny and the NHS should have been pressed to provide it for this meeting.

Here’s my email to chair, Sara Randall Johnson, sent last Wednesday (17 January).
……………………………………………………………………………….
Dear Sara

I am very disappointed that there will be no specific written report on winter pressures at next week’s meeting.

I think that most people, given that ongoing national crisis that the NHS is experiencing right now, would find it inconceivable that our committee did not have this important information to assess how our major hospitals are managing during winter.

I see that there is an agenda item for urgent items at the beginning of the meeting.

Can I ask that this information as I previously asked for, is included in the form of written reports from the four NHS acute trusts, as an urgent agenda item. This to include delayed discharges for the winter period and up until next week, A&E waits and numbers, staffing vacancies, levels of norovirus and all the other standard winter pressures reporting that the trusts do on a daily basis for their managers.

I look forward to hearing from you.
Best wishes
Claire

Pic: Demo at Totnes last month.

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Protest for our NHS in Exeter on 3rd February

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Hospitals_protest_Exeter_v3

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As above-inflation council tax rises loom – men’s real earnings in Devon fell by over 3 per cent in 2017

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A shocking figure leaps out from the Equality Impact Statement for next month’s Devon County Council budget – average male full time earnings in the county did not increase at all in 2017. The annual change was ZERO! Since inflation ended the year at 3.1 per cent per annum, this means average male earnings fell by this amount. Many families still rely wholly or mainly on a male full-time worker, so this means a drastic fall in many people’s income (indeed since the figure is an average, many will have lost more than this).

Average female full-time earnings did rise, by 3.8 per cent (a small real increase) but since many women work part-time, this doesn’t necessarily mean that overall women were better off. Taking male and female full-time workers together, there was a cash increase of 1 per cent, meaning a 2.1 per cent average decline.

Can Devon councillors go along with above-inflation council tax increases when their constituents already have falling real incomes?

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After Sarah Wollaston calls for delay in introducing Accountable Care Organisations, I have submitted evidence about Devon’s Accountable Care System to the parliamentary enquiry

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Sarah Wollaston, the chair of the Commons Health Committee, has written to the Health and Social Care Secretary urging him to delay a new contract for Accountable Care Organisations (ACOs), due to be implemented nationally later this year. She claims there is a “great deal of concern” over the plans which she considers “have not been well aired publicly up until now”.

This is precisely the point which I have made about Devon’s Accountable Care System -intended I believe as a precursor to Accountable Care Organisations – which is due to begin on 1st April. Neither Devon’s Health Scrutiny Committee nor the public has been made aware of this, and what it involves is still unclear.

I have submitted the paper – with 8 key questions – which I prepared for Health Scrutiny on Thursday to the parliamentary Health Committee’s Sustainability and Transformation Partnerships inquiry. Thanks to Mike Allen for drawing my attention to this just before last night’s deadline for submitting evidence.

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