Cabinet and Full Council to overthrow DMC Knowle decision?

EDDC has updated its ‘Moving and Improving’ website after the decision by the Development Management Committee to REFUSE the PegasusLife planning application.

Owl always thought that planning decisions were taken by the DMC. It appears not. Which begs the question: why have committees at all?

It seems East Devon is turning into Trumpland.

This is what it now says:

December 2016

Development Management Committee refuse the planning application by Pegasus Life Ltd for Knowle.

Cabinet and Council (separately) will take the opportunity to review the Project. This is known as Gateway 7 which is to note satisfaction of the financial requirements and restrictions of the Final Design, confirmation of Contractors Project Costs, advice regarding Planning Application for EDDC at Heathpark and for Pegasus Life Ltd at Knowle.

December 2017
Relocation to refurbished Exmouth Town Hall.

April 2018
Relocation to Honiton complete.”

http://eastdevon.gov.uk/moving-and-improving/moving-and-improving-all-you-need-to-know-about-the-office-relocation/project-timeline-key-dates/

Oh, oh, trouble: a mini Local Enterprise Partnership or a maxi East Devon Business Forum on its way?

Another unelected, unaccountable, non-transparent secret society on its way?

Another shady group of “private sector representatives and business community” Tories wetting their pants with the excitement of yet another trough for their snouts?

Cabinet Agenda for 14 December, 2015
Item 19
Page 147

The “Exeter Travel to Work Area (TTWA) area recommendations:

Click to access 141216combinedcabagendafinals.pdf

“It is presently proposed that the desired formal body for the Exeter TTWA will be a ‘Greater Exeter Growth and Development Board’ (GEGDB) including the local authorities covering the Greater Exeter functional economic area.

The Board would be a Joint Committee under s101 (5), 102 Local Government Act 1972 and s9EB Local Government Act 2000 and pursuant to the Local Authorities (Arrangement for the Discharge of Functions) (England) Regulations 2012.

It will comprise the 5 local authorities [Exeter, East Devon, Mid Devon, Teignbridge and DCC] as voting members

and a number of non-voting co-opted private sector /other representatives drawn from the wider business community.

This approach was agreed by Exeter City Council in principle on 8 November and is now being considered by the other potential partners.”

Well done those EDDC Tory councillors! But watch your backs now

Unconfirmed reports suggest that Tory councillors Grundy (Exe Valley) and Pepper (Broadclyst) were the two sensible councillors who voted against the PegasusLife Knowle planning application.

So, no-one can accuse anyone of a “Sidmouth stitch up”.

It seems unlikely that the two councillors will be getting any gifts from under the Tory Christmas tree from Santa Phil Twiss – the official EDDC Tory Whip – who denies ever having used it but who is said to be less than chuffed at the result.

Of course, not being whipped, no-one will expect them to be removed from the DMC for not following non-whipped orders ….

The 30 [plus] questions to be answered BEFORE care at home is authorised

Owl has been passed a copy of the “30 [plus] questions” that must be asked BEFORE care at home can be implemented:

Pre-implementation

The model of care:

• Does the new model of care align with our overriding ambition to promote independence?
• Is there clinical and operational consensus by place on the functions of the model and configuration of community health and care teams incorporating primary care, personal care providers and the voluntary care sector?
• Is there a short term offer that promotes independence and community resilience?
• Is there a method for identifying people at highest risk based on risk stratification tool?
• Are the needs of people requiring palliative and terminal care identified and planned for?
• Are the needs of people with dementia identified and planned for?
• Is support to care homes and personal care providers, built into the community services specification?
• Is support for carers enhanced through community sector development support in each community?
• Has the health and care role of each part of the system been described?
• Have key performance indicators been identified, and is performance being tracked now to support post implementation evaluation, including impact on primary care and social care?

Workforce:
• Is there a clear understanding of the capacity and gaps in the locality and a baseline agreed for current levels and required levels to meet the expected outputs of the changed model of care?
• Is there a clear understanding of and plan for any changes required in ways of working:
o thinking
o behaviours
o risk tolerance
o promotion of independence, personal goal orientation

• Have the training needs of people undertaking new roles been identified, including ensuring they are able to meet the needs of patients with dementia?
• Do we have detailed knowledge with regards to investment, WTE and skill mix across the locality and a plan for achieving this?
• Are system-wide staff recruitment and retention issues adequately addressed with a comprehensive plan, and where there are known or expected difficulties have innovative staffing models been explored?

Governance, communications and engagement:
• Is there a robust operational managerial model and leadership to support the implementation?
• Has Council member engagement and appropriate scrutiny taken place?
• Is there an oversight and steering group in place and the process for readiness assessment agreed?
• Have providers, commissioners and service users and carers or their representative groups such as Healthwatch agreed a set of key outcome measures and described how these will be recorded and monitored?
• Is there a shared dashboard which describes outcomes, activity and productivity measures and provides evaluation measures?
• Is there an agreed roll out plan for implementation, which has due regard to the operational issues of managing change?
• Is there a comprehensive & joint communications and engagement plan agreed?
• Is there a need for a further Quality or Equality Impact Assessment?

Implementation
• Is there a clinical and operational consensus on the roles of each sector during the implementation phase including acute care, community health and care teams, mental health, primary care, social care, the voluntary care sector and independent sector care providers?
• Is there an implementation plan at individual patient level describing their new pathway, mapping affected patients into new services?
• Are the operational conditions necessary for safe implementation met?
• Have the risks of not implementing the change at this point been described and balanced against any residual risk of doing so?

Post Implementation
• Is there a description of the outcomes for individuals, their carers and communities?
• Are the mechanisms for engagement with staff, users of services and carers in place and any findings being addressed appropriately?
• Is there a process in place for immediate post implementation tracking of service performance including financial impact to all organisations?
• Is longer term performance and impact being tracked for comparison against pre-implementation performance?
• Have we captured user experience as part of the process, and have findings been addressed and recorded to inform the planning of future changes?
• Are there unintended consequences or impacts (e.g. on primary care or social care) which need to be addressed before any further change occurs?
• Is there a clear communication plan for providers and the Public describing the new system and retaining their involvement in community development?

Source: http://www.newdevonccg.nhs.uk/about-us/your-future-care/publications-and-evidence-sources/102085
( point 14, page 94)

When and how will PegasusLife spring back to life?

Cynics amongst East Devon Watch’s readers (the majority one might suspect) are already considering aspects of yesterday’s refusal of planning permission for the Knowle site.

Of course, there is the prospect of an appeal. But there are also other scenarios being mentioned.

Some suggest that this refusal suits both PegasusLife and East Devon District Council – the former so that it can tweak its application in the light of the current economic climate and resubmit and the latter because a delay in building the new Honiton HQ might be in the council’s own interests, given the same current economic climate and the need to almost certainly raise more money due to increased costs. Also there have been some misgivings expressed by Tory councillors on the design of the new building (which does look rather like a people warehouse) and considered hardly befitting the status and importance of the people warehoused within it:

hq

Others suggest that, as “Greater Exeter” moves ever more quickly (and secretly) forward it might be better for EDDC to cut its losses on a new Honiton HQ which would only be a satellite amongst satellites and therefore not needed to be so large (or maybe not needed at all if the Exmouth premises are large enough). Not to mention the messy complications of devolution and its effect on all district councils in Devon.

Others have even suggested that EDDC has had a better offer from a hotel chain which shall be nameless!

Whatever the reason, we can be absolutely sure that, like the Terminator, it will be back!

Budleigh Salterton health hub – Swire proud to have pushed it forward

Delighted that the Budleigh Hub has been given the green light. Pleased to play my part in pushing this project forward.”

Hugo Swire, Twitter, 30 November 2016

Do remember this when, after doing your (private) art class, (private) yoga class and drinking your (private) juice you have your very public heart attack and wait for your overworked public ambulance crew to take you to your overcrowded public hospital, where you will wait for overworked staff to treat you.

http://www.midweekherald.co.uk/news/health_bosses_give_assurance_east_devon_hospital_beds_will_not_close_until_stringent_measures_in_place_1_4801160

and perhaps think about another post on his Twitter account:

@HugoSwire what are your thoughts on Budleigh LoF [League of Friends] needing to fundraise to cover not-for-profit rent of space. #NHSPS totally immoral.”

Labour and Lib Dems fined for election rule breaking – no news on Conservative investigation

“The Liberal Democrats have been hit with a maximum £20,000 fine by the Electoral Commission for failing to declare hundreds of items of campaign spending at the general election.

The watchdog has notified the police of a possible electoral offence after 307 payments totalling £184,676 were found to be missing from the Liberal Democrats’ spending return “without a reasonable excuse”.

In addition, invoices supporting 122 out of the 307 payments were
missing from the return. It found the declaration to the Electoral Commission may have been signed recklessly, as there was evidence indicating some people in the party knew it was incorrect. …

… It comes after Labour was hit with a £20,000 fine in October for similar missing election expenses, including more than £7,000 on the “Ed Stone”.

It found two payments totalling £7,614 missing from the party’s
election return that were spent on the stone tablet on which the then
Labour leader, Ed Miliband, had carved his six key election pledges, promising to display it in the Downing Street rose garden if he won the election. …

… Conservative spending at the election remains under intense scrutiny after a Channel 4 investigation alleged some local spending was allocated to the national account to avoid tight limits for each constituency. About nine police forces have been investigating the accusations of higher-than-permitted spending in a number of marginal seats, which could have helped the Tories gain a majority at the election.”

https://www.theguardian.com/politics/2016/dec/07/lib-dems-fined-20000-for-undeclared-election-spending

Hospital trolley waits enormously increased

And when, if you were to be in North Devon, after projected cuts, you might already have taken 1-3 hours to get to your nearest hospital:

“More than one in 10 patients in England face long delays for a hospital bed after emergency admission.

BBC analysis of NHS figures showed nearly 475,000 patients waited for more than four hours for a bed on a ward in 2015-16 – almost a five-fold increase since 2010-11. Hospitals reported using side rooms and corridors to cope with the growing number of “trolley waits”.

NHS bosses acknowledged problems, blaming “growing demand” on the system.
But doctors said hospitals were now dangerously overcrowded, with three quarters of hospitals reporting bed shortages as winter hits.

Bed occupancy is not meant to exceed 85% – to give staff time to clean beds, keep infections low and ensure patients who need beds can be found them quickly. But 130 out of 179 hospital trusts are reporting rates exceeding this for general hospital beds. Hospital managers said the problem was causing “deeply worrying” delays for these patients.

They are people who have already faced a wait to be seen in A&E but whose condition is deemed to be so serious they need to be admitted on to a ward.
About one in five people who come to A&E fall into this category and it includes the frail elderly and patients with chest pains, breathing problems and fractures.

The BBC analysed official NHS England figures and found 473,453 patients waited more than four hours for a bed between October 2015 and September 2016 – 11% of the 4.2 million patients admitted in total during the period. More than 1,400 of them faced delays of more than 12 hours.

It compares with 97,559 “trolley waits” in 2010-11 – although NHS England pointed out a small fraction of the rise could be attributed to a change in the way the waits were measured in December 2015. Directly comparable figures are not available for other parts of the UK, although data suggests there is an increasing strain on beds.

While the delays are known as “trolley waits” not all patients find themselves on one. Hospitals use all sorts of areas, including side rooms, seats in the A&E department and spare cubicles depending on what is available.

Rupert Nathan, 55, was rushed to hospital in an ambulance when he started suffering chest pains at home in June. He had previously had two angioplasties – one in 2000 and one in 2001 – because of angina and feared he was having a heart attack.

He was taken by ambulance to Barnet Hospital in north London and was given blood tests and an electrocardiogram. At that point, staff decided to admit him for further tests. But he spent more than five hours waiting for a bed.
“I was left in a waiting area with my girlfriend. I was in pain and really concerned. There was little contact with staff and it was after midnight when I was finally found a bed.”

He asked for morphine and was told he would undergo scans in the morning. But when morning came, he was in a much better state and was discharged.
“I was told the delays were because it was very busy. I could see that, but it’s still not acceptable.” Mr Nathan has made a complaint about his care. The hospital said it was looking into the case.

‘Too few beds’
Siva Anandaciva, of NHS Providers which represents hospitals, said: “These figures are deeply worrying. We are heading into winter in a more fragile state than I have seen in the past 10 years or so.

“Even the historically top-performing trusts are being challenged, which shows that this is an issue affecting all parts of health.

“No-one wants to see people waiting in corridors, side rooms and emergency bays when they should be admitted to a hospital bed. These patients are still under the care of doctors and nurses of course, but it is not ideal for them and we know overcrowding leads to worse outcomes.”
Dr Chris Moulton, of the Royal College of Emergency Medicine, echoed the concerns.

“Patients who are delayed like this are still being monitored by staff. But we know that the overcrowding we are seeing is dangerous. It leads to worse outcomes for patients – higher infection rates, patients ending up on the wrong wards and generally a negative experience.”

Dr Moulton believes there are too few beds. There are just over 100,000 general beds in England – a fall of 40,000 in the past 20 years. “We simply don’t have enough. If you compare us to other European countries we are really short and the demands being placed on the health service means we are now struggling to cope,” he added.

A spokesman for NHS England said “growing demand” was putting pressure on the system – the number of emergency admissions having risen by more than 500,000 in five years to 4.2 million.

But he added it was “a tribute to front-line staff” that the NHS was able to handle so many patients.

http://www.bbc.co.uk/news/health-38228411

“Save our Hospital Services” calls for abolitition of “Success Regime”

ON THE NATURE OF INDEPENDENCE AND IMPARTIALITY

The ‘Success Regime’/STP Team in Devon

Save Our Hospital Services Devon (SOHS) is today calling for the abolition of NHS England’s Sustainability and Transformation Plan (STP) for Wider Devon and the suspension of the so-called Success Regime for North, East and West Devon that is now an integral part.

“These two programmes are false, flawed and fraudulent,” says Dave Clinch, a spokesperson for SOHS in North Devon. “They are riddled with public-private, professional-personal conflicts of interest.”

SOHS Devon points out that the Case for Change document on which both the Success Regime and the STP are based was produced by a private-owned health service consultancy, Carnall Farrar. One of the consultancy’s founding partners, Dame Ruth Carnall, is now the ‘Independent’ Chair of the Success Regime pushing through the STP in Devon.

“SOHS Devon believes that there is a pre-determined agenda in Devon to cut services, limit access and reduce demand by redefining medical need to ensure that government cuts are carried out. How can Ms Carnall, who produced the blueprint for the STP, be considered remotely independent in assessing our needs or services to meet them?” asks Mr Clinch.

SOHS Devon points out that to push their agenda for cuts to NHS services and staff, the Success Regime/STP team will have been allocated £7.4 million between 2015 and 2017. Some of this funding has been used to recruit senior staff from those same services they plan to cut; for example, Andy Robinson, who left his role as Director of Finance at the Northern Devon Healthcare NHS Trust to join the Success Regime in Exeter. What is more, Mr Robinson happens to be the partner of the Chief Executive of the Trust, Alison Diamond.

“Professional or personal? How can this relationship avoid directly impacting on the life-and-death decisions now being made?” says Mr Clinch.

Meanwhile, the proposed relocation to Exeter of acute services based at North Devon District Hospital (NDDH) is being overseen by the Success Regime’s Lead Chief Executive Angela Pedder, the former CEO of the Royal Devon & Exeter Foundation Trust.

“How can she be considered unbiased given her former role?” says Mr Clinch. It’s no coincidence that RD&E needs to cover a much bigger deficit than NDDH in Barnstaple.”

On top of this, the two leads on the STP’s Acute Services Review programme are both from hospitals in South Devon, namely Derriford in Plymouth and Torbay in Torquay. SOHS Devon can find no evidence that they are talking to the clinicians working in acute services at NDDH. And the fact is, if the proposed acute services cuts go ahead, people here in North Devon will suffer and die.

ENDS

Church of England closes care home – cannot get staff

“… Over the past couple of years, we have found it increasingly difficult to recruit and retain nursing and care staff, and we are now reaching the point where we will be unable to staff the home in a way that meets the needs of our patients.”

The reliance on agency staff was “not sustainable in the longer term”, Spencer said.

According to a C of E source, as well as the considerable cost of using agency workers, there were concerns about turnover, consistency of care, and levels of safety and standards.

About 40 members of staff are expected to lose their jobs when the home closes. …

https://www.theguardian.com/world/2016/dec/06/church-of-england-closing-manormead-care-home-hindhead-surrey-lack-of-staff