NHS

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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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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Scandal of fundamental changes to Devon’s NHS, which open door to large-scale privatisation, pushed through without public discussion – I have put them on the agenda of next week’s Health Scrutiny Committee

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CCG logoDevon’s two Clinical Commissioning Groups (CCGs) are pushing ahead with far-reaching, highly controversial changes to the NHS in the County from 1st April – without alerting the public or even the public watchdog, the Health and Adult Care Scrutiny Committee at Devon County Council.

The changes will turn the Sustainability and Transformation Plan – which itself grew out of the misnamed ‘Success Regime’ which closed our community hospital beds – into a more permanent Devon Accountable Care System. The first phase, in the first part of the financial year 2017-18, will develop integrated delivery systems, with a single ‘strategic commissioner’ for the whole county.

However the real concern is the next phase, which will lead to the establishment of Accountable Care Organisations. These will lead to services being permanently financially constrained, limiting NHS patients’ options for non-acute conditions, and pushing better-off patients even more towards private practice.

Large chunks of our NHS will be contracted out for long periods, probably to private providers. The ‘toolkit’ for this fundamental change talks about ensuring ‘that there are alternative providers available in the event of provider failure’. In the aftermath of Carillion, do we really want most of our NHS contracted out to private firms?

Devon’s public are not being consulted about this change – unlike in Cornwall where the Council has launched a public consultation – and there is no reason to believe that they want a privatised, two-tier health system.

Devon’s CCGs have pushed the change through without publicity, and it is only because I have put it on the agenda that Health Scrutiny will have a chance to discuss in advance of April 1st. I have written a 7-page paper for the Committee outlining what we know about the ACS and posing eight questions which they should ask about it.

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Why we should be worried about Accountable Care Organisations – coming to Devon’s NHS in the next year

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Dr Graham Winyard explains. He is a former medical director of the NHS and deputy chief medical officer, and one of the people behind the crowdfunded legal action against ACOs.

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Three Devon emergency consultants sign letter to Theresa May on ‘intolerable safety compromises’ in A&E winter crisis

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Three leading Devon emergency clinicians, from different hospitals, are among doctors from 68 hospital trusts across England and Wales who have signed an urgent letter to the Prime Minister saying “the current level of safety compromise is at times intolerable, despite the best efforts of staff.” They demand more hospital beds and more money for social care.

They are Ann Hicks, Plymouth Hospitals Trust, Liam Kevern, Northern Devon Healthcare Trust and Nick Mathieu, Torbay and South Devon Foundation Trust. No one from the RD&E signed the letter – but does this mean that things are OK there?

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Coming to a site near us before long? Hospitals knocked down to build houses which nurses can’t afford

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from The Guardian 9 January 2018

Four out of five homes built on former NHS sites that have been sold off to private developers will cost more than nurses can afford, according to new research.

Fifty-nine NHS sites, including many former hospitals, have already been sold to housebuilders as part of the government’s public land sale programme to boost housing supply. But the large majority will be unaffordable to nurses, according to the New Economics Foundation (NEF) thinktank. It found that in London none of the homes will be in reach.

Neither are the new developments adding much to the supply of affordable or social housing, the NEF found. Across the UK, only one in 10 of the homes built on the sold-off NHS sites analysed will be available at social rent. The average sale price is expected to be £315,000 – 10 times a nurse’s average annual salary.

The Royal College of Nursing has previously warned that high housing costs could force 40% of nurses out of the capital by 2021. For newly qualified nurses the price of a typical first-time-buyer home is 16 times their salary in inner London, seven times in the West Midlands and six times in the north-west of England, the RCN said.

In Colchester, Essex, the former psychiatric hospital Severalls is being transformed into more than 700 homes, none of which will be affordable to nurses and only 87 of which are classed as “affordable”, the NEF research showed. In St John’s Wood, north London, an NHS site has been sold to developers building three five-bedroom homes expected to cost around £3.75m – 121 times a nurse’s annual salary. There will be no affordable housing.

Persimmon, whose chief executive, Jeff Fairburn, is in line for a bonus worth over £100m, is developing the site of Pontefract general infirmary in West Yorkshire with 117 homes, only seven of which will be social or affordable housing. However, the prices are mostly below £200,000.

The report, No Homes for Nurses, estimated it would take a midwife over a century to afford the deposit for a market-rate home in Enfield where Chase Farm hospital is being redeveloped into 138 residential dwellings. Only 19% of them will be affordable, despite the borough having a target of 40%.

“These NHS sites are community assets – they should be used to deliver community benefits,” said Joe Beswick, housing lead at NEF. “Public land, which is owned by all of us, is being flogged off to developers so they can make massive profits, while producing a tiny amount of affordable housing.”

“This is a government with the wrong priorities on housing,” said John Healey, Labour’s shadow secretary of state for housing. “Ministers should be maximising the number of new genuinely affordable homes on public land, not treating low-cost housing as an afterthought.”

The government has identified surplus Department of Health sites with capacity for 26,000 homes. Between 2015 and 2017 it was expecting to sell sites for 4,000 homes.

In November, the government announced nurses would have first refusal on affordable housing generated through the sale of surplus NHS land. But the NEF argued that in London even affordable rent, which can be as high as 80% of market rent, is not affordable for nurses.

A government spokesperson said: “Since April 2010 there have been more than 357,000 affordable homes provided in England, but we’re aware that more needs to be done, which is why we’re investing over £9bn in affordable housing.

“For NHS staff in particular, we announced plans in October last year to give first refusal on affordable housing schemes built on NHS land sold for development.”

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‘Absolutely no change to physiotherapy services at Seaton’, I am assured, despite removal of some equipment 

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Residents have contacted me because some equipment has been moved from the gym, part of the radiotherapy area at Seaton Hospital. I have spoken to Theresa Denning, the Locality Manager based at Axminster who is responsible for physiotherapy, and she assures me that ‘there is absolutely no change to physiotherapy services at Seaton’. She tells me that some under-used equipment has been moved to make room for other equipment to be used by the community rehabilitation team to treat patients who are being brought in from home. Seaton Hospital reception also confirmed that they are continuing to book physiotherapy appointments as and when needed.

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CCG, RD&E speakers at Honiton community event to begin ‘co-designing and co-producing’ local health services/activities – we need a similar meeting in Seaton too

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Honiton’s Health Matters – Going Forward Together
Thursday 18th January 2018, Beehive Main Hall,   9.30 for 10am start – 1.30pm
 
Book a place here: 
 
Context:  This event is the start of a community conversation with key stakeholder organisations around the future health and wellbeing of residents in response to  the new landscape affecting Honiton and its environs as a result of NHS and Government policies advocating placed-based health provision and cross-sector collaborative working.
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 / volunteers / trustees across the public, private, community, voluntary and social enterprise sector.
 
Speakers:
Ø Professor Em Wilkinson-Brice – Deputy Chief Executive / Chief Nurse RD&E
Ø Dr Simon Kerr – Chair, Eastern Locality New Devon CCG
Ø Julia Cutforth – Community Services Manager,  Honiton and Ottery St Mary
Ø Ways2Wellbeing  – Social Prescribing, Speaker to be confirmed
Ø Charlotte Hanson – Chief Officer, Action East Devon
Ø Heather Penwarden – Chair, Honiton Hospital League of Friends

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Devon County Council’s Cabinet agrees to ‘work towards the adoption’ of the Ethical Care Charter

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At this week’s meeting of Devon County Council’s Cabinet I seconded a motion by Devon’s only Green councillor, Jacqi Hodgson, asking the Council to sign up to the Ethical Care Charter proposed by UNISON. The Cabinet resolved ‘that the Council notes the requirements of the Charter and recommends officers work with its contracted providers to work towards its adoption having due regard to affordability, market sufficiency and quality of commissioned care.’ I have no illusions that the financially challenging parts of the Charter – such as paying the real Living Wage and providing sick pay for care workers – will be implemented any time soon. But the endorsement in principle is welcome and I asked that the Council regularly monitor progress in implementing the charter – the Leader, Cllr Hart, suggested this could be done by the Health and Adult Care Scrutiny Committee.

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