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

Posted on

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

This entry was posted in NHS and tagged .

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

Posted on Updated on

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’.

This entry was posted in NHS and tagged , , .

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

Posted on

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.

This entry was posted in NHS and tagged , , .

Protest for our NHS in Exeter on 3rd February

Image Posted on

Hospitals_protest_Exeter_v3

This entry was posted in Uncategorized.

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

Posted on Updated on

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?

This entry was posted in Uncategorized and tagged , , .

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

Posted on

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.

This entry was posted in NHS and tagged , , , .

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

Posted on Updated on

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.

This entry was posted in NHS and tagged , , , .

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

Posted on Updated on

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.

This entry was posted in NHS and tagged .

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

Posted on

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?

This entry was posted in NHS and tagged , .

Progress on traffic calming in Colyford and Seaton Down Hill – MP, councillors and police thrash out solutions with Community Speed Watch teams and residents

Posted on Updated on

On Friday I chaired a meeting in Colyford in which interested parties discussed solutions to problems of speeding in the village and on Seaton Down Hill. Those present including Cllr Stuart Hughes (Cabinet member for Highways) and officers, Superintendent Elaine Hartley (Speed Watch Co-ordinator Peninsula Road Safety Partnership) and other police officers, Neil Parish MP (who had chaired two earlier meetings which had brought everyone together), and representatives of Colyton Parish Council and Seaton Town Council. In a lively meeting, progress was made including:

  1. Work should begin at the end of this month on a new pedestrian refuge in Seaton Down Hill.
  2. Surveys have established that the agreed crossing in Colyford would be best situated near the Memorial Hall, but problems associated with the school buses need to be resolved before this can go ahead.
  3. Devon Highways have accepted in principle that the 40 mph restriction on Harepath Hill could be extended past the A3052 junction with Seaton Down Hill (because of problems of visibility at the junction and the need for pedestrians to cross from the carpark to the footpath towards Holyford Woods). This change would mean that Seaton Down Hill would also be subject to a 40 limit, as asked for by the Speed Watch team and Town Council. However funding remains to be discussed and the change will need to go through the usual formal approval process.
  4. Two Vehicle Activated Signs (VAS) for Colyford (one at each end of the village) are under discussion between Highways, the Speed Watch team and myself.
  5. An additional uphill VAS sign for Seaton Down Hill is under discussion between Seaton Town Council, the Speed Watch team and myself.

The meeting was also a landmark get-together of local Community Speed Watch teams. Teams from Rousdon, Wilmington, Knowle, Ottery St Mary and West Hill, as well as the Colyford and Seaton Down Hill teams who organised the meeting, were present, and were unanimous in complaining about the slowness of police administrative procedures, the lack of data sharing, and uncertainty about how Highways and the police used Speed Watch results. Elaine Hartley acknowledged these problems and promised a meeting of teams from across Devon and Cornwall in the coming months.

This entry was posted in Uncategorized and tagged , , , .