Over 60 people from community groups in the Seaton area spent yesterday morning in The Gateway (Seaton Town Hall) discussing the challenges to health in the town and surrounding villages. The meeting, chaired by Cllr Jack Rowland and addressed by (among others) Em Wilkinson-Bryce of the RD&E and Dr Simon Kerr of NEW Devon CCG, had wide-ranging discussions which launch a process to try to define the health services the area needs and the challenges we face. A full report will be drafted based on the eight sets of working group discussions and I will report further when this is available. A follow-up event to lead to more concrete conclusions is envisaged, probably in May.
Following my request for Health Scrutiny to consider the CCGs’ plans (at the last meeting in January), and challenges to the Conservatives’ attempts to push them through at DCC’s Cabinet 10 days ago, this Thursday’s Health Scrutiny called for a slow-down in the rush to implement a major reorganisation of the NHS which the public hasn’t been informed about – let alone consulted on.
County Councillor Claire Wright (Independent, Otter Valley) writes: The brake on the process was applied at yesterday’s (Thursday 22 March) Devon County Council’s Health and Adult Care Scrutiny Committee, which also recorded its concerns at the plans, set to be put in place next month.
The new system, which is coming into force in health areas across the country, will mean a merger of the two clinical commissioning groups in Devon, at least at board level to start with, and is widely being seen by campaigners across the country, as the beginning of a break-up of the NHS – and a clear route through to more privatisation and less public accountability.
Nationally, there are legal challenges by senior medics who are convinced that the move to ‘accountable care’ as it was originally called, will be disastrous for patient care and the public functioning of the NHS.
We are repeatedly told by local NHS and social care managers that it is just about integration of health and social care and is another step on a long journey. But that is disingenuous.
This is the start of a very new style of working and no one is very clear where it will end up. What is certain though, is that it is being driven by Conservative Secretary of State for Health and Social Care, Jeremy Hunt and if he tells the NHS to move in a certain direction, they must do as he says.
So although this new system debated at Devon County Council’s Health and Adult Care Scrutiny Committee yesterday is at an early stage, its direction of travel is clear. We are heading for a more formal set up of groups of organisations and no one can reassure members of the public how the governance or funding will operate.
For example, the NHS is free at the point of use and social care is means tested. So if budgets are merged, will social care become free at the point of use? Highly unlikely. So what does this mean for NHS care?
At yesterday’s Health and Adult Care Scrutiny Committee meeting, very well informed and articulate members of the public from the Devon Save Our Hospital campaign group addressed councillors, as well as Cllr Martin Shaw. Also, Cllr Julian Brazil (speaking on behalf of the LibDem group) who are very concerned about the plans.
Cllr Martin Shaw (Seaton Independent) was successful in getting the health scrutiny committee to take on this issue earlier this year and is incredibly well researched and informed on the issue.
Feelings and anxieties were running high during the meeting. Some speakers were heckled by members of the public, which prompted chair, Sara Randall Johnson threaten several times to throw them out.
Committee members had received dozens of emails from members of the public who wanted councillors to object to the plans.
Most of the committee fortunately, seemed concerned. I made the following proposal, which was agreed unanimously.
The section in brackets was very disappointingly, deleted by the Conservatives on the committee, despite the NHS representatives agreeing to a period of public engagement . This is a great shame, but I remain pleased that the rest of my recommendations were supported.
(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;
(b) defer the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective (and when a full engagement process has taken place – the part on public engagement was deleted by the Conservatives unfortunately);
(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;
(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’;
(e) provide a copy of the business plan being developed and a summary of views from staff consultations.
Cabinet will now need to consider these recommendations.
Following news a couple of weeks ago that the Dermatology clinic in Seaton Hospital had been closed, whether permanently or not is not clear (it was GP-led and the GP stopped doing it, I am told), comes the information that Dermatology appointments are not currently available in Axminster, either. You have to go to Exeter, where they’re booking for June.
This is one of the most highly used specialities in both hospitals and it is a serious setback that it is not available locally!
Save Our Hospital Services (SOHS) Devon are lobbying against plans to introduce structural changes in NHS delivery of services from April 1st
with a demonstration at midday at County Hall, Exeter on Thursday 22nd March.
Campaigners will also address the DCC Health & Adult Care Scrutiny Committee at 2.00pm on Thursday with 12 key questions about Integrated Care Systems (ICS)
planned for introduction by NHS England from April 1st without consultation. SOHS have sent these 12 questions to Dr Tim Burke, Chair of the NEW CCG
which meet also at 1.00pm on Thursday at County Hall.
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I learnt this week that the Royal London Homeopathic Hospital has been renamed the Royal London Hospital for Integrated Medicine, now that the NHS has finally withdrawn funding for homeopathy’s wholly unproven treatments.
Meanwhile on 1st April, Devon’s CCGs will launch what was supposed to be an Accountable Care System (ACS) for the NHS and social care. Now it too has been rebranded as an ‘Integrated Care System’ – because ‘accountable care’ smacks of an American-style Accountable Care Organisation which could have opened all of Devon’s NHS to being run by a single private provider.
If it walks like a duck … quack! quack! seems particularly appropriate.
A passionate demand by Labour Councillor, Hilary Ackland (below), for greater democratic control in the new Integrated Care System for health and social care made a major impact as Devon County Council’s Cabinet finally considered the proposals which the Clinical Commissioning Groups have been developing since September.
Cllr Ackland said that a revamped Health and Wellbeing Board should be an Integrated Commissioning Board with decision-making powers in the new system, and proposed broader, cross-party representation.
I agreed that ‘democratic control is not an optional extra’, and said that governance proposals should be discussed before the Council approved the system. Replying, the opportunity for greater democratic input into the local NHS was emphasised by Chief Executive, Phil Norrey. Conservative Cabinet member, Cllr Andrew Leadbetter, had proposed a paper which agreed that governance issues needed to be addressed but made no specific proposals. The issue will now go to Health Scrutiny, hopefully on 22nd March.
In my speech, I welcomed the CCGs’ retreat from the idea of an Accountable Care Organisation, for which I said the judicial review joined by Stephen Hawking, as well as the hung parliament and local campaigners’ pressure, should take the credit.
I also drew attention to uncertainty about how the financial organisation of the new system will impact on chronic failures of patient care.
I warned that attempts to equalise funding between areas of the county could lead to even sharper cuts in Eastern Devon.
I pointed out that the CCGs, even after 6 months, had failed to produce a single paper describing the Local Care Partnerships which are a key element of the system.
The paper called for ‘public engagement’ – but there has been none, and even councillors do not understand the proposals.
I called for a delay in decisions until fuller information on all these points, as well as governance, was available. But the Cabinet unanimously adopted the proposals as they stood – the issues will go to Scrutiny before coming to full Council.
The debate is at 1.44, resumed at 2.22, in the webcast.
A reminder to all involved in local community groups, especially those with an interest in health and wellbeing in the broadest senses, that Seaton and Area Health Matters will convene in the Town Hall on Friday 23rd March, 9 for 9.30 until 1 pm. There is still time to register!
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:
• Em Wilkinson-Bryce – Royal Devon and Exeter NHS Foundation Trust
• Chris Entwistle – Health and Social Care Community Services
• 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?
If you would like further information please contact –
We are trying to move on and secure the best provision of community health services in the Seaton and Honiton areas – in partnership with the RD&E and CCG – after the flawed ‘consultation’ which resulted in our hospitals losing their beds.
The citation, which does not mention Carnall’s position as chair, says: ‘A key area of work has been reducing the number of fit-to-leave patients in community hospital beds, which would pave the way to reduce beds. This has been achieved through developing community-based models of care, with clinical hubs and health and wellbeing centres.’ – No one seems to have told them that we have yet to see our health and wellbeing centres!
To rub salt into the wound, it concludes: ‘These changes have been managed without referral to the health secretary and with Carnall Farrar standing alongside local leaders at public meetings.’ – If this is what the award is for, surely it should have gone to East Devon Conservatives who scotched the referral? Or did Carnall Farrar do behind-the-scenes deals with our local Tory politicians?
the Clinical Commissioning Groups have been developing since September.
However Carnall Farrar, the consultancy set up by Dame Ruth Carnall – who was also the chair of the Orwellian-named Success Regime – has 
Seaton & Colyton MATTERS 