Devon Tory GP MP pours cold water on “extra” NHS funding promise

Owl says: surely “extra” money for the NHS means ALL CCG costings have to be revised? And all the arguments about WHY services have to be cut must be revisited.

“Theresa May has come under fire for promising that a Brexit windfall will provide an extra £400m a week for the NHS. May – who will pledge an extra £20bn in annual real terms from 2023-24 in a major speech – has been ridiculed for linking the money to Brexit savings. “At the moment, as a member of the European Union, every year we spend significant amounts of money on our subscription, if you like, to the EU,” she said on BBC One’s Andrew Marr show. “When we leave we won’t be doing that.”

Two senior Tory MPs, who are also doctors, took aim at May: “The Brexit dividend tosh was expected but treats the public as fools. Sad to see Govt slide to populist arguments rather than evidence on such an important issues,” tweeted Sarah Wallaston, who chairs the Commons health and social care committee. Dr Philip Lee, MP for Bracknell, tweeted: “There is no evidence yet that there will be a ‘Brexit dividend’ – so it’s tax rises, more borrowing or both.”

The PM’s decision to frame extra spending specifically as a benefit of leaving the EU has been widely seen as a sop to hardline Brexiters in her cabinet, echoing Boris Johnson’s suggestion during the EU referendum that Brexit would free up £350m a week extra for the NHS.”

https://www.theguardian.com/world/2018/jun/18/monday-briefing-nhs-windfall-is-brexit-dividend-tosh-says-tory-mp

Ottery Health Matters! Meeting 29 June 2018, afternoon and evening

Ottery St Mary & District Health & Care Forum, in partnership with:
RD&E, Coleridge GP’s, NEWCCG, Devon County Council, East Devon District Council & Ottery St Mary Town Council

Ottery Health Matters!

Health and Wellbeing Community Information Event

Date: Friday 29th June 2018

Time: Two drop-in sessions
2pm – 5pm
6pm – 8pm

Venue: The Institute, Yonder Street, Ottery St Mary, EX11 1HD.

Come along to this informal drop-in event to find out about the care and support available in Ottery and the surrounding areas. It will be a great opportunity to talk to health and care experts plus volunteers about the local services and activities to help people live well.

We need to hear from you about what’s important to you, what you think the challenges and priorities are to improve health and care for people in our community now and in the future.

Refreshments will be provided. Transport to and from may also be available. For any queries or feedback please contact:

Elli Pang via e-mail: ellipang@btinternet.com or Tel: 01404 812268 or Leigh Edwards via e-mail: leighp3@sourcemode.com or Tel: 01404 814889

Adult social care on its last wobbly, fragile knees

“Social care services for vulnerable adults are on the verge of collapse in some areas of England, despite the provision of extra government funding, senior council officials have warned.

The fragile state of many council social care budgets – coupled with growing demand for services, increasing NHS pressure, and spiralling staff costs – is highlighted in research by the Association of Directors of Adult Social Services(Adass).

It says councils “cannot go on” without a sustainable long-term funding strategy to underpin social care and warns that continuing cuts to budgets risk leaving thousands of people who need care being left without services.

“The overall picture is of a sector struggling to meet need and maintain quality in the context of rising costs, increasingly complex care needs, a fragile provider market and pressures from an NHS which itself is in critical need of more funding,” the annual “state of the nation” survey says.

It reveals English councils plan to push through social care cuts of £700m in 2018-19, equivalent to nearly 5% of the total £14.5bn budget. Since 2010, social care spending in England has shrunk by £7bn.

A government green paper on adult social care funding is expected in the next few weeks, and while councils are hopeful this could put budgets on a firmer footing over time, they warn that extra funding is needed to shore up services in the short term.

“Social care is essentially about making sure we not only look after people with profound and increasingly complex needs, but also help many transform their lives. Sadly, however, this budget survey reveals, once again this essential care and support is just not being given the resources it needs,” said the president of Adass, Glen Garrod.

He added: “We cannot go on like this. How we help people live the life they want, how we care and support people in our families and communities, and how we ensure carers get the support they need is at stake – it’s time for us to deliver the secure future that so very many people in need of social care urgently need.”

A government spokesperson said: “We know the social care system is under pressure — that’s why we’ve provided an extra £9.4bn over three years. We will shortly set out our plans to reform the system, which will include the workforce and a sustainable funding model supported by a diverse, vibrant and stable market.”

The Adass survey says the social care market is “increasingly fragile and failing” in some parts of the country, with almost a third of councils reporting that residential and nursing home care providers have closed down or handed back contracts.

Although councils are spending an increasing proportion of their total budget on adult social care – almost 38p in every pound in 2018-19, compared with 34p in 2010 – social care directors admit they will have to continue to reduce the number of people in receipt of care packages.

The survey reveals councils are increasingly reliant on so-called “self help” or “asset-based” approaches to care – in effect using networks of family and neighbourhood groups to provide volunteer support for some social care recipients.

Half of local authorities overspent on adult social care budgets in 2017-18, the survey finds, with half of these drawing on council reserves to meet the overspend.

The National Audit Office has warned that about 10% of councils will exhaust reserves in three years at current rates of deployment, putting them at risk of insolvency.

Ministers acknowledged the financial crisis facing council adult social care services last year, when they provided £2.6 billion, enabling councils to raise extra social care funds locally through a council tax precept.

Adass says this injection of cash helped stave off financial collapse in some council areas. But it warns that the additional funding has “temporarily relieved, rather than resolved” the long-term funding needs of the sector and there is a danger council services could collapse before any new arrangements are in place.

Although councils have a legal duty to ensure there is a functioning care market in their area, nearly four in five say they are concerned that they are unable to guarantee this because of the fragility of many care firm balance sheets and rising care staff wage bills.

Councillor Izzi Seccombe, the chair of the Local Government Association’s community wellbeing board, said: “Councils and providers are doing all they can to help ensure older and disabled people receive high quality care, but unless immediate action is taken to tackle increasingly overstretched council budgets, the adult social care tipping point, which we have long warned about, will be breached and councils risk not being able to fulfil their statutory duty under the Care Act.”

Richard Murray, the director of policy at The King’s Fund, said: “This latest evidence, from every council in England, lays bare once again the need for, as the prime minister put it herself, a proper plan to pay for and provide social care.

“Older and disabled people and their families and carers continue to be let down by a system that is on its knees.”

https://www.theguardian.com/society/2018/jun/12/adult-social-care-services-collapse-survey-england-council

Devon CCG refuses to reveal crucial figures to independent county councillor

“Beds, beds, beds – Devon’s NHS couldn’t or wouldn’t give me their overall occupancy figure for the recent winter: but they were forced to buy in more capacity and there were ’12-hour trolley breaches’

Devon NHS’s Sustainability and Transformation Partnership (STP) admitted in a report to Health Scrutiny yesterday that they had been desperately short of beds during the recent winter. They had to buy in extra beds to keep up with more patients staying longer, because of complex conditions. There were ’12-hour trolley breaches’, where patients had to wait more than 12 hours to be seen.

Despite my asking them directly, they did not give a figure for overall occupancy levels, although they did not deny my suggestion that they had been as bad as or worse than the nationally reported level of 95 per cent. (The nationally recommended safe level is 85 per cent.)

Jo Tearle, Deputy Chief Operating Officer for the Devon CCGs, rebutted my suggestion that cutting community beds had contributed to this crisis, saying that these were not the kind of beds they had needed, and that there had been capacity in community hospitals most of the time. However this suggests that there was no capacity some of the time. It is difficult not to believe that extra community beds wouldn’t have given them more leeway.

Meanwhile, Kerry Storey of Devon County Council indicated the strains that the ‘new model of care’ at home had been under. She said that maintaining personal care at home during the winter had been ‘a real challenge’, requiring ‘creativity and innovation’ – you don’t need much imagination to see that it will have been a real crisis time with frail people at home in isolated areas, care workers and nurses struggling to get through the snow, and staff themselves suffering higher levels of illness.

I and others predicted that because of the closure of community beds, there would be severe pressure on beds in a bad winter or a flu epidemic (and actually, this was not overall a bad winter and the snow episodes were late and short; despite higher levels of flu, there was no epidemic this winter).”

Beds, beds, beds – Devon’s NHS couldn’t or wouldn’t give me their overall occupancy figure for the recent winter: but they were forced to buy in more capacity and there were ’12-hour trolley breaches’

Shock revelation suggests the NHS’s ‘new model of care’ is more about switching intermediate care from community hospitals to ‘block bookings’ in private nursing homes – saving costs and freeing up assets

Martin Shaw, East Devon Alliance councillor for Seaton and Colyton, Devon County Council:

Press release:

“There was a staggering revelation yesterday at Health Scrutiny from Liz Davenport, Chief Executive of South Devon and Torbay NHS Foundation Trust, that they had made ‘block bookings of intermediate care beds in nursing homes’ when they introduced the ‘new model of care’. South Devon has closed community hospitals in Ashburton, Bovey Tracey, Paignton and Dartmouth and is currently consulting on the closure of Teignmouth – where I spoke at a rally last Saturday.

The ‘new model of care’ is supposed to mean more patients treated in their own homes, and there does seem to have been an increase in the numbers of patients sent straight home from the main hospitals.

But the idea that all patients can be transferred directly from acute hospitals to home is untrue. There is still a need for the stepping-down ‘intermediate care’ traditionally provided by community hospitals – the only difference is that now it’s being provided in private nursing homes instead.

It’s likely to be cheaper to use private homes, because staff don’t get NHS conditions, and crucially it frees up space in the hospitals so that the CCGs can declare buildings ‘surplus to requirements’ and claim the Government’s ‘double your money’ bonus for asset sales. It seems NEW Devon CCG has also made extensive use of nursing home beds, but we don’t yet know if there were ‘block bookings’.

However the private nursing home solution may not last – DCC’s chief social care officer, Tim Golby, reported that nursing homes are finding it difficult to keep the registered nurses they need to operate, and some are considering reversion to residential care homes.

This may be where the South Devon trust’s long term solution comes in – it had already been reported that it is looking to partner with a private company in a potential £100m dealwhich will include creating community hubs that contain inpatient beds.

The new model of care is also about privatisation.”

Devon County Council Tories kill off community hospitals

From the blog of Claire Wright:

“Seven Conservative councillors today block voted down my proposal to “strongly support” retaining all Devon community hospital buildings and to “strongly oppose” any potential plans to declare them surplus to requirements.

And in what became a rather heated debate, one conservative, Cllr Richard Scott, disgracefully accused the assiduous and polite Independent Seaton councillor, Martin Shaw of abusing his right to address councillors.

I had requested an item on community hospital buildings at today’s Health and Adult Care Scrutiny Committee meeting, as there is a continual threat in the air of the possibility that the buildings may be declared surplus to requirements and be sold off. There remains anxiety and concern in local communities as a result.

Last month, NEW Devon Clinical Commissioning Group was forced to deny they had “any plans” to declare Honiton and Seaton Hospitals surplus to requirements, following comments made at a campaign meeting.

Dr Simon Kerr, the GP who was quoted in the notes published, later said his comments had been misinterpreted.

The Estates Strategy, which will set out what is proposed to be done with the buildings owned by the local NHS, is due out soon, possibly as early as next month.

In presenting my case I set out how the committee had been unable to secure assurances from health service managers for a long time that buildings were safe, that Dartmouth Hospital is being sold off and that the ownership of 12 community hospitals in Eastern Devon was in the hands of NHS Property Services which was charging over £3m rents for the upkeep of the buildings.

I believe these rents are still being met by NHS England, but this is only a temporary measure and soon the bill will fall on the doormat of the deeply in deficit NEW Devon Clinical Commissioning Group.

Cllr Brian Greenslade seconded my proposal.

Speaking in support were also Cllr Carol Whitton (Labour) and Cllr Nick Way (Libdem).

For some reason the conservative councillors were all opposed to my proposal. Several said there was no evidence, that it was just speculation that there was even a risk to the buildings.

Conservative councillor, Jeff Trail, didn’t appear to like my proposal but said he thoroughly supported Cllr Carol Whitton’s position, which was rather confusing as she had just said she backed me!

Cllr John Berry didn’t like my recommendation because the committee didn’t own the buildings. He wanted us to write to the CCG to ask what the status of the buildings was instead.

Cllr Sylvia Russell thought she had heard an NHS manager say at some point at today’s meeting that the buildings were safe so there was nothing to worry about. No one else seemed to recall this.

Cllr Richard Scott dismissed my proposal as “speculation” and claimed there was “no evidence” to back up my concerns.

Referring to Cllr Martin Shaw, who had just set out calmly and eloquently the concerns of his own community of Seaton, Cllr Scott added: “In some respects this is an abuse of a right to speak at this committee. There’s nothing here to consider.”

Chair, Sara Randall Johnson, wanted to take account of Paul Crabb’s view, which was that some hospitals might be old and in a poor state of repair, but I said we should have a simple and clear proposal or the CCG would drive a coach and horses through it.

I reminded the committee (yet again) that our committee was the only legally constituted check on health services in the county and it is our job to act on issues of public concern, which this very much was.

I added that it was important to take a position now and before the Estates Strategy was published so our views could inform the strategy.

My words fell on deaf ears. I had genuinely thought, that despite all the past political shenanigans on that committee – and there have been many – that the Conservatives might have backed this one, as not a single member of their own communities would have surely wanted them to vote a different way.

There was every reason for the entire committee to be unanimously in favour of my proposal.

What a huge shame.

Voting in favour: Me, Brian Greenslade (LibDem – Barnstaple North), Nick Way (LibDem – Crediton), Carol Whitton (Labour – St David’s and Haven Banks).

Voting against: (All Conservative): John Berry (Cullompton and Bradninch), John Peart (Kingsteignton and Teign Estuary) Sylvia Russell (Teignmouth) Richard Scott (Lympstone and Woodbury), Paul Crabb (Ilfracombe), Andrew Saywell (Torrington Rural), Jeff Trail (Lympstone and Woodbury)

The debate is available to view at item 10 from this link – https://devoncc.public-i.tv/core/portal/webcast_interactive/325480

http://www.claire-wright.org/index.php/post/health_scrutiny_conservative_councillors_block_vote_down_proposal_to_protec

A surgeon speaks on community hospitals and NHS privatisation

David Halpin FELLOW OF THE ROYAL COLLEGE OF SURGEONS knows what is needed – see his letter………

LETTER sent by DAVID HALPIN FRCS to the WESTERN MORNING NEWS

Dear Letters Editor, 25th April 2018

I reply to the letter from B Gelder (WMN April 23rd) entitled ‘Cottage Hospitals ease strain on the NHS.’ I have written before on this vital subject and listed their functions.

Recovery from serious illness or major operations requires loving and professional care, good nutrition and sound sleep. These were provided in good Community Hospitals. The last thing patients might get in the District General Hospital is a good night’s sleep. The noise, the moving of beds and the distress of disorientated patients do not allow sleep.

This retreat, supposedly for economy, from past high standards is part of what I call the ‘atomising’ of all that we hold dear. The dogmas of capitalism win out all the time. ‘Private good, public bad’. So with the privatisation of OUR railways under the Major government, the wheels were stupidly separated from the tracks to meet EU competition rules. There are about 3000 separate contractors working on the permanent way. There are probably more ‘contractors’ working in OUR NHS.

This is a sign of these shabby and confused times. Walking to Paddington Station past St Mary’s Hospital where I qualified as a doctor in 1964, I saw an ambulance – ‘NHS working in partnership with DHL.’

I understand that Teignmouth Community Hospital is likely to be closed completely. That catch phrase ‘not fit for purpose’ is being applied – ‘going forward’. The Philistines who order this will know that the original hospital was bombed by the Luftwaffe. Seven patients and three nurses were killed. They do not ‘remember them’. The first hospital to be built by the NHS, when the UK was on its uppers, was Teignmouth Hospital. Patients were treated for acute illness there by good GPs, nurses and physiotherapists, and others taken for further care from the big hospitals. It is being bombed again.

When this good hospital, with its views over Lyme Bay, becomes a 5 storey block of ‘luxury’ flats and second homes, the capital from the sale of the site will disappear in a puff of smoke. Taxpayers money is being burned in the NHS. The non-clinical staff in one Devon hospital now outnumber the clinical staff – nurses, physios, doctors etc. Watch BBC’s ‘Hospital’ from Nottingham as a quart fails to be squeezed into a pint pot. The proliferation of managerial personnel with unusual titles is excruciating and the distress of patients likewise.”