“Optum CEO resigns from top NHS Job, Optum partner replaces him”

“This is an everyday story of the sordid revolving door between US Health insurance company United Health and the NHS.

In the UK, United Health’s subsidiary Optum sells the NHS what it needs in order to morph into a version of United Health – the previous employer of NHS England’s boss Simon Stevens.

With NHS England’s blessing, Optum is all over the NHS, installing their technology & redesigning the NHS through its use.

Optum sells the NHS:

Commissioning support services
Scriptswitch decision support for GP prescribing (which United Health UK acquired in 2009) is in most GP surgeries.
Referral management services
GP Empower (accelerating large scale GP practices

Integrated Care Systems support: “Optum® brings practical hands-on experience having delivered integrated care for over 20 years in the US. Our tried and tested approach has helped systems deliver proven results.” This updates an earlier brochure on accountable care systems/organisations which is no longer available. However NHS For Sale quotes Optum’s now defunct webpage: “We currently operate 26 accountable care organisations in the U.S., and are supporting sustainability and transformation partnerships in the U.K. to manage population health risk and deliver care as an integrated group of providers.”

The overall aim is to control, sideline and override doctors’ treatment decisions – as we can see through NHS England’s consultation on stopping funding numerous elective care treatments and its mandatory Integrated Urgent Care Services specification. This removes patients’ direct access to clinicians and redirects them through NHS 111 to a clinical advisory service that works off the algorithms in a clinical decision support tool.

And now it has its finger firmly in the National Institute of Health and Care Excellence pie – the organisation responsible for providing evidence-based guidance and advice to the NHS.

The revolving door that connnects United Health, Optum and the National Institute of Health and Care Excellence

This concerns:

former United Health Director Andrew Witty
Lord Darzi (head of the Imperial College department which is partnered with OptumLabs, a United Health business); and
a new public-private partnership in the National Institute of Health and Care Excellence called the “Accelerated Access Collaborative“, that’s about pushing new technology and drugs through the NHS.
It puts Optum centre stage in the Accelerated Access Collaborative. Now there’s a surprise. Or not. If you have been following United Health’s relatively rapid takeover of the NHS.

As a result of these shenanigans, we would treat any new recommendation from NICE with a pinch of salt.

Here is a short Witty timeline:

March 2017 – Andrew Witty leaves CEO position at Glaxo Smith Kline
August 2017 – Witty joins UnitedHealth’s Board of Directors
November 2017 – Following the Accelerated Access Review, the Department of Health appoints Witty as head of the Accelerated Access Collaborative. The job is to fast track drugs & technology into the NHS, to start April 2018
March 2018 – United Health announces Witty to be new Optum CEO, to start July 2018
Andrew Witty must have been rumbled somewhere along the line as he graciously resigned from the Government position in March 2018, due to the enormous conflict of interest of him starting as Optum CEO in July 2018. Ignored of course was the huge conflict of interest in hiring Witty in the first place while he was a Director of UnitedHealth.

And who replaced him? Lord Darzi.

Who is Lord Darzi

I am tired of writing about Lord Darzi. He stalks the NHS like a zombie. He was behind the New Labour government’s massive, failed and costly privatisation of elective NHS services in the horrible Independent Sector Treatment Centres – one of which totally messed up my son’s broken wrist – twice, before an NHS hospital fixed it for him.

This is what his nasty scheme has come to now. Regardless, he has returned to push his idea a second time as Accountable Care – with the apparent support of the Labour Shadow Health Secretary Jon Ashworth. This time from his perch in the Institute of Global Health Innovation (IGHI) at Imperial College, London.

Which, surprise surprise, is an OptumLabs partner.

What is OptumLabs

OptumLabs (launched in 2013) is all about United Health number crunching and framing raw patient data for academics to play with to derive the “best treatments” for patients.

OptumLabs is desperate to pass itself off as pioneering and respectable in the academic research field. But reality of the profit motive and UnitedHealth’s track record of

“deception, manipulation of data and outright fraud”

(see the Ingenix case ) means their number crunching will most likely point to treatments that United Health finds most profitable, not what’s best for patients. And OptumLabs is useful cover to collect patient data.

We pointed out some time ago Optum’s invidious position as a provider of commissioning support services, able to direct Clinical Commissioning Groups to commission Optum products. Now they have their fingers in the NICE pie too.”

Optum CEO resigns from top NHS Job, Optum partner replaces him

What can WE do to save our NHS?

“Greetings, KONP supporters in the South West!
Important information from Keep Our NHS Public on…

Integrated Care Providers

The Government likes to bury its plans to defund, break-up and privatise the NHS in jargon. KONP are producing a series of videos to help you understand what’s going on…

NHS England is consulting on the contract for a new model of health and social care provision that threatens the break-up of the NHS into units run by less accountable ‘Integrated Care Providers’ – or ‘ICPs’. Each of these ‘business units’ would control spend and rationing of healthcare for populations of up to 500,000. These huge contracts will be eminently open to the private sector to compete for.

The ICPs will deliver the dangerous new restructuring plans of government which could see fragments of the NHS managed by non-NHS, non-statutory and therefore less accountable bodies. They are the embodiment of government plans to disperse the NHS and its staff, drive down public funding, promote private contracts and put cost limits and profit before patient safety.

Integrated Care Provider contracts:

Dis-integrate the NHS;
Give control to non-NHS bodies potentially beyond scrutiny;
Threaten public accountability;
Hand over control to these non-NHS bodies for 10-15 years;
Manage multi-billion-pound contracts for blocks of 500,000 population;
Open the door to private companies winning these contracts.

Please watch the video above and share on social media to help spread the word about the Government’s deliberate and insidious privatisation plans.

You can also visit our website:

https://keepournhspublic.com/privatisation/icps-what-are-they/

and our Facebook Page:

https://m.facebook.com/story.php?story_fbid=167804364127012&id=172710059485626&refsrc=https%3A%2F%2Fm.facebook.com%2Fkeepournhspublic%2Fvideos%2F167804364127012%2F&_rdr

for more information, videos and links.

For a written explanation of ICPs and what the represent for the NHS please read and share this briefing (broken link) by HCT co-chair and KONP campaigner Louise Irvine.

How can you help?
1. Along with our friends at We Own It

https://weownit.org.uk

and Health Campaigns Together

https://www.healthcampaignstogether.com

we have created a petition

https://weownit.org.uk/ICP-petition-NHS

calling on the Government to;
a) Abandon the Integrated Care Provider contract model:
b) Guarantee that any Integrated Care Provider organisations will be statutory organisations i.e. NHS bodies, not private providers.
c) Focus health improvement efforts on pressing the government for:

o Sufficient funding and staffing for health and social care.
o Social care to be brought into public provision, free at point of use
o Legislation to end the failed NHS contracting system and to renationalise the NHS: the only sound basis for service integration.

SIGN THE PETITION

https://weownit.org.uk/ICP-petition-NHS

2. NHS England have launched a 12 week consultation on contracting arrangements for Integrated Care Providers. You can read the full consultation document here

Click to access integrated_care_providers_consultation_document.pdf

Please let them know what you think by submitting a response before the consultation closes on the 26 October. You can do this online. HCT have created a document of a sample response

Click to access suggested.pdf

in case you wish to take some guidance from KONP and HCTs position.
You can also see a comprehensive written response:

Click to access Consultation_response_PeterRoderick_FINAL_01Oct18_1_.pdf

to the proposed changes from the JR4NHS team who, along with the late Stephen Hawking, took Jeremy Hunt and ACOs to Judicial Review this year.

3. Share the KONP video, HCT and KONP briefing and the JR4NHS response to the NHSE consulation around your networks and on social media.

“NHS hospitals warn of lack of preparation for winter as figures reveal next year will be ‘tougher than ever’ “

“The NHS is set to face an “even tougher winter” than the record-breaking crisis it weathered less than 10 months ago, as hospital bosses warn of staff and funding shortages.

Despite the government claiming the health service was “better prepared than ever” last year, ambulance queues tripled, there were fewer beds available and doctors wrote to Theresa May warning of patients “dying prematurely” in corridors.

Hospital leaders said the major issues of workforce, funding and social care remain unresolved, and figures released on Thursday show how an unprecedented summer heatwave has left no time to tackle the significant backlog in operations.

Theresa May has pledged an extra £20bn for the NHS by 2023 but this will not start to plug gaps until April 2019.

Meanwhile, hospital heads told The Independent funds usually held in reserve to add capacity in winter were already used up, or useless because there was no one to work.”

https://www.independent.co.uk/news/health/nhs-winter-crisis-emergency-care-extra-funding-summer-heatwave-hospitals-a8579481.html

Torbay GPs may hace scuppered merger of Devon Clinical Commissioning Groups

“The Breeze can reveal GPs in South Devon have voted against plans to merge the area’s CCG with the rest of Devon.

Bosses from the clinical commissioning group made the revelation at a Torbay Council meeting last night.

Apparently, unless a majority of GPs back the idea they can’t do it.

GPs in the area are now being asked to explain their reasons as bosses look to save the merger plans.

To date the two CCGs have saved £4 million by working closely together. [Owl: yeah, right – pinch of salt or whole salt cellar needed here …!]

Torquay councillor Swithin Long, who asked questions at the meeting, said: “At the Overview and Scrutiny Board last night the CCG advised that they were proceeding with the merger – however there is a fly in the ointment.

“In September a poll of GPs was done across the whole of Devon.

“In the rest of Devon (excluding South Devon and Torbay) 59 voted for the merger, 13 against and 3 abstentions.

“In South Devon and Torbay 12 GP practices voted in favour, 14 against and 2 abstentions (so 50% not in favour).

“The meeting was advised that the merger cannot go ahead without the majority of GPs in Torbay and South Devon voting in favour.

“Discussions will be proceeding with the GPs in Torbay and South Devon to see what their concerns are and the CCG will be coming back to Overview and Scrutiny at a date to be confirmed.”

A spokesperson for Devon’s clinical commissioning groups said: “Over the next two months we’re taking the time to meet up with local GP practices in South Devon and Torbay to listen to their views.

“The feedback we receive will help us shape what is the right thing to do next.

“In parallel we’re simply keeping the door open to the possibility of merger by working with NHS England on the next steps.”

For more about the meeting click here:
http://www.torbay.gov.uk/DemocraticServices/ieListDocuments.aspx

Failing our vulnerable children – we sink even lower

“The NHS and councils need to collaborate to develop a system to support children with mental health problems, the Local Government Association has said.

Its call came in the wake of a Education Policy Institute report, published yesterday, which revealed a 26% increase in the number of children referred to mental health services.

At the same time, a quarter of councils have phased out support they offer to children including schools-based services, family counselling and support for those exposed to domestic abuse.

One in four children referred for mental health support were rejected, the report said.

David Laws, chair of the EPI, said it was “very worrying” that services and support were being cut back just as demand was rising.

“A large number of children referred to mental health services are already rejected for treatment, and the follow up for these children looks unsatisfactory,” he said.

“It is also disturbing that many mental health providers seem unwilling or unable to provide even basic data on their services – the government should take steps to compel all providers to report regularly on their standards and performance, and this data should be collected and reported nationally.”

Responding to the findings, the LGA highlighted the £3bn funding gap that will face children’s services by 2025.

“As a result, many councils are being forced to cut early intervention work, including youth services, which helps children avoid reaching crisis point, perform better at school and avoid mental health issues in later life,” said Anntoinette Bramble, chair of the LGA’s children and young people board.

“This has been compounded by government cuts to councils’ public health funding, which also helps young people to get the best start in life.”

She said there was a need for an “urgent root and branch review” of children’s mental health services and local government and the health should together develop a system that “says yes” to children, rather than rejecting them.”

https://www.publicfinance.co.uk/news/2018/10/children-mental-health-problems-need-public-service-collaboration

Community hospitals in Devon lost to nursing homes in privatisation move

“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 deal which will include creating community hubs that contain inpatient beds.

The new model of care is also about privatisation.”

Shock revelation at Health Scrutiny suggests the ‘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. How long will it last?

Independents knock some sense into DCC Tories about health and NHS

Thank the Lord for independent Councillor Claire Wright and East Devon Alliance Independent Councillor Martin Shaw

Press Release:

“In a hour-long debate in yesterday’s meeting, the Council adopted proposals which Cllr Claire Wright and I, the two Independent members from East Devon, put forward, in place of the original recommendation by the Cabinet. The ruling Conservative group adopted (with a small addition) the wording of my amendment, which Claire seconded, which proposed to work with to influence NHS decisions ‘in the direction of retaining all community hospitals to be used as health and wellbeing centres for their areas’, in place of the original Cabinet recommendation to merely seek ‘decision making appropriate to individual circumstances, including population need and the quality of building.’

This is an important change in direction by the Council, which is now committed for the first time to work to retain ALL hospitals, as Claire (who proposed the original motion) had requested. The Conservative leader, Cllr John Hart, insisted on adding the words ‘where appropriate’ to my proposal, which we opposed because it provides the NHS with additional leeway to close hospitals. Cllr Hart’s addendum was too much for one Conservative Councillor, Jonathan Hawkins (Dartmouth), who voted with the opposition for my amendment without this addition, in the light of his community’s experience of the closure of Dartmouth Hospital.

The Devon Clinical Commissioning Groups could end this controversy with a clear policy statement that all remaining hospitals will stay open and will be supported as health and wellbeing centres for our communities. Until this happens, Claire and I, with the support of tens of thousands of people around Devon who are fighting for their local hospitals, will continue our campaign. On yesterday’s evidence, we are winning.”

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

New Health Secretary says no more community hospitals will be closed because they are vital to NHS!

Owl says: he makes no mention of what will happen to those already closed and up for sale. This also raises major inequality-of-care issues for the eastern side of East Devon (where all community beds have been cut) and western East Devon where the only community beds are in Sidmouth and Exmouth.

“The Health Secretary has promised to end the closure of community hospitals to ensure patients can be treated near their homes.

Matt Hancock said it was time to end the era of moving medical departments to large regional hospitals while smaller ones were closed.

He wants more patients to be cared for locally, particularly for routine procedures such as scans, physiotherapy and treatment for minor injuries.

Set up 150 years ago as cottage hospitals with just a few beds, Britain now has around 500 community hospitals that provide a broad range of services for local patients, including end-of-life care, rehabilitation for the elderly, scans, X-rays and minor injury units.

But NHS cuts mean dozens are facing closure across the country, including in Derbyshire, Gloucestershire, Cumbria, Leicestershire, Devon and Dorset.

Local health officials have been told to make savings and improve care, and many argue that patients can be treated more safely and cheaply in larger hospitals, even if they have further to travel.

But Mr Hancock believes that although patients should be prepared to go further afield for major operations such as heart bypass surgery, other procedures should be offered closer to home. …”

https://www.dailymail.co.uk/news/article-6233389/Health-Secretary-promises-end-cull-community-hospitals.html

“Let American firms run hospitals, urges free trade group”

“Ministers should allow American healthcare companies to compete with the NHS to run hospitals as part of a free-trade pact after Brexit, a think tank recommends.

The Initiative for Free Trade (IFT) said that Britain should also end its ban on imports of products such as chlorinated chicken and accept American environmental and food safety regulations as equivalent to those in the UK.

The moves, it claimed, would help clear the way for a UK-US trade deal that would “rewrite the rules” of global commerce and allow Britain to take advantage of trade freedoms offered by Brexit. The IFT has received backing from Liam Fox, the international trade secretary, and Boris Johnson.

The report, edited by Daniel Hannan, a Tory MEP, was partly written by the trade lawyer Shanker Singham who has been consulted on free trade by Dr Fox, David Davis, Steve Baker and other ministers since the referendum.

Its conclusions will fuel suspicions that the think tank is being used as an “outrider” to align Britain with America on standards to secure a trade deal that would not be possible if the government signs a Chequers-style agreement with the EU.

The report, which was published simultaneously in London and Washington, was a collaboration between the IFT and the libertarian US think tank the Cato Institute.

It calls for Britain and the US to negotiate the most ambitious agreement ever that would allow British and American companies to compete on a level playing field in each other’s markets across both goods and services. Both countries should accept each other’s regulations on safety and environmental standards and open up all government procurement contracts to both sides.

It also suggests that any British or American citizen should be able to work in both jurisdictions if they have secured a job. It is the group’s proposals to open up the NHS to competition that is likely to prove the most contentious.

Daniel Ikenson, one of the report’s editors, described the NHS as an “incumbent” healthcare provider that should have competition. “The purpose of liberalising trade is to expose incumbent businesses to competition, including healthcare providers,” he added.

A Department for International Trade spokesman said: “We are currently seeking a wide range of views about four potential free-trade agreements, including with the USA, and we encourage all interested organisations and members of the public to make their voices heard through our online consultations.”

Source: Times (pay wall)

“Tories trigger ‘secret NHS firesale’ as land selloffs ‘soar 31% in a year'”

“The amount of NHS land being sold off is up almost a third, up from 1,300 hectares last year to more than 1,700 according to research by Labour.

Shadow Health Secretary Jonathan Ashworth said patients would be “alarmed” at the “huge rise” in the amount of health service land under consideration for sale.

Labour’s health chief said hospitals were being forced into a “fire sale” of assets because of the Government’s mismanagement of NHS finances.

Analysis by the party showed 1,750 hectares were listed – an increase of 31% in the last year.

And over two years the amount of land for sale has risen by a staggering 320%, meaning there is now more than four times as much NHS land for sale compared to 2015/16. …”

https://www.mirror.co.uk/news/politics/tories-trigger-secret-nhs-firesale-13221825

Meeting in Parliament on the failure of scrutiny of NHS changes

DCC Health and Wellbeing Scrutiny Committee- and particularly its chair Sarah Randall Johnson – take note:

“NHS campaigners meeting with MPs to call for better scrutiny and review to stop damaging cuts

Defend the NHS campaign groups from across England are to lobby MPs at a meeting in the House of Commons on Monday 10th September.

They will share their experiences of the need to improve the process of scrutiny and review of substantial changes to NHS services, in order to stop damaging cuts and changes.

The meeting is hosted by Paula Sherriff, MP for Dewsbury – where the District General Hospital has lost many of its key services.

Local campaign group, North Kirklees Support the NHS, will explain the risks this has created for the Dewsbury public.

Along with six other campaigns from Lincolnshire, West Yorkshire, Devon, Northumbria, Dorset and Oxfordshire, the Dewsbury group will tell MPs that there is an urgent need to address serious flaws in the process whereby Councils’ scrutiny committees refer proposals for damaging NHS cuts and changes to the Secretary of State for Health and the Independent Reconfiguration Panel.

Christine Hyde, from North Kirklees Support the NHS, said,

“The process of referral to the Secretary of State was opaque. The Independent Reconfiguration Panel is the key body with the power to advise the Secretary of State for Health to stop and/or require changes to major NHS cuts and “reconfigurations” – but there was next to no information about how it worked.

Once we had figured that out, we naively thought public opinion would have some weight. Together with the other five local NHS protector groups, we encouraged Independent Reconfiguration Panel members to visit Dewsbury.

We were ignored.

The Independent Reconfiguration Panel’s decision that local commissioners could sort out the failings in the hospital cuts proposals has not, for the most part, been borne out.

As the hospitals reconfiguration has been implemented, it has created huge problems for the most vulnerable groups – housebound patients, infants, children with disabilities and patients with life threatening illnesses like cancer.

The hospital changes were sold as being ‘better for patients’ but it really was all about the money and even so, the savings are recorded in a response to a Freedom of Information request as ‘nominal’.”

Campaigners will also demand political impartiality in the scrutiny and referral process.

The need for this is shown by Save Our Hospitals Devon’s observation of a discussion and decision by Devon County Council’s health and adult social care scrutiny committee, that reversed an earlier vote to refer the closure of community hospital beds in Eastern Devon to the Secretary of State.

Members of Save Our Hospitals Devon Netti Pearson and Sue Matthews said,

“The feeling among observers was certainly that the decision was a political one rather than one borne of effective and satisfactory scrutiny.”

Steven Carne from 999 Call for the NHS, the national campaign group which has convened the meeting, said,

“We are very excited about the campaign groups coming together from across the country to share their experiences of wrestling with the scrutiny and referral process.

This is key to stopping damaging NHS cuts, closures and inappropriate importation of insurance-based ‘care models’ from USA’s Medicare/Medicaid system. This provides a limited range of state-funded healthcare, on the basis of financial considerations – not clinical need, to people who can’t afford private health insurance. It is not what the NHS is about.

For the first time, campaign groups across England are pooling our knowledge and experience to lobby MPs to make this scrutiny and referrals process work better, because it definitely needs to.

And also to encourage other campaigns to get more actively involved with the process, in defence of NHS and social care services in their area.

The Department of Health guidance on health scrutiny says its primary aim is to strengthen the voice of local people in the commissioning and delivery of health services.

So it needs to make sure this happens.

This meeting is just a start. We are going to pursue this goal through thick and thin.”

http://999callfornhs.org.uk/scrutiny-failing-us/4594418128

“Almost 1,000 elderly people a day needlessly admitted to hospital amid social care crisis “

“Almost 1,000 elderly people a day are being admitted to hospital needlessly amid a crisis in social care, Age UK has found.

Analysis of NHS figures by the charity found that there were 341,074 avoidable emergency admissions for people aged 65 and over during the year to April 2017.

The number has risen by 107 per cent since 2003 for those aged 65 to 69, and by 119 per cent for older people aged 75-79.

Among the general population of England, the number has risen by 63 per cent.

The figures relate to admissions because of conditions such as ear, nose or throat infections, kidney and urinary tract infections, and angina, for which hospitalisation could potentially have been avoided had the person been better looked after.

Many older people rely on family and friends to help them in the absence of reliable social care, the charity warned.

One in three over-65s live alone, and one in ten have no children, and these figures are expected to rise as younger generations, who are less likely to have married or had children, reach retirement age.

Many of those who do have loved ones to care for them rely on elderly relatives who may have health problems of their own.

One case study highlighted by the charity involved a 67-year-old woman who has been a carer for 40 years, first for her parents and more recently for a younger sister who has Alzheimer’s disease.

In another case a 73-year-old woman has been the sole carer for her 75-year-old husband since he had a stroke and brain haemorrhage four years earlier. She cancelled previous at-home care because it was “unreliable and lacking in continuity”.

Its report also highlights the problem of older people stuck in hospital and unable to go home, putting more strain on the healthcare system.

Care not being in place was the main reason there were delays for older people leaving hospital in England last year, according to figures released by the NHS. …”

https://www.telegraph.co.uk/news/2018/09/04/almost-1000-elderly-people-day-needlessly-admitted-hospital/

“Court of Appeal grants NHS campaign group permission to appeal against NHS England’s new Integrated Care Provider contract”

“The Court of Appeal has issued an order granting campaign group 999 Call for the NHS permission to appeal the ruling against their Judicial Review of the proposed payment mechanism in NHS England’s Accountable Care Organisation contract.

The Accountable Care Organisation Contract (now rebranded by NHS England as the Integrated Care Provider contract) proposes that healthcare providers are not paid per treatment, but by a ‘Whole Population Annual Payment’, which is a set amount for the provision of named services during a defined period. This, 999 Call for the NHS argues, unlawfully shifts the risk of there being an underestimate of patient numbers from the commissioner to the provider, and endangers service standards.

In April, the High Court ruled against the campaign group’s legal challenge to NHS England’s Accountable Care Organisation contract – but the group and their solicitors at Leigh Day and barristers at Landmark Chambers found the ruling so flawed that they immediately applied for permission to appeal.

Although fully aware of this, on Friday 3rd August – the day Parliament and the Courts went on holiday – NHS England started a public consultation on the Accountable Care Organisation contract – now renamed the Integrated Provider Organisation contract.

The consultation document asserts that the payment mechanism in the ACO/ICP contract is lawful, because:

“The High Court has now decided the two judicial reviews in NHS England’s favour.”

Steve Carne, speaking for 999 Call for the NHS, said

“It beggars belief that NHS England is consulting on a contract that may not even be lawful. And a lot of public funds is being spent on developing the ACO model – including on the public consultation. We are very pleased that 3 judges from the Court of Appeal will have time to consider the issues properly. We shall shortly issue our stage 5 Crowd Justice appeal for £18k to cover the costs of the Appeal.

We are so grateful to all the campaigners and members of the public who have made it possible for us to challenge the lawfulness of NHS England’s attempt to shoehorn the NHS into an imitation of the USA’s Medicare/Medicaid system.

We will not see our NHS reduced to limited state-funded health care for people who can’t afford private health insurance.

Jo Land, one of the original Darlo Mums when 999 Call for the NHS led the People’s March for the NHS from Jarrow to London, added,

“All along we have been warning about the shrinkage of the NHS into a service that betrays the core principle of #NHS4All – a health service that provides the full range of appropriate health care to everyone with a clinical need for it, free at the point of use.

Since we first started work two years ago on bringing this judicial review, there have been more and more examples of restrictions and denials of NHS care, and the consequent growth of a two tier system – private for those who can afford it, and an increasingly limited NHS for the rest of us.”

Jenny Shepherd said

“NHS England’s rebranded Accountable Care Organisation contract consultation is a specious attempt to meet the requirement to consult on a significant change to NHS and social care services.

We don’t support the marketisation of the NHS that created the purchaser/provider split and requires contracts for the purchase and provision of services.

Integration of NHS and social care services, in order to provide a more straightforward process for patients with multiple ailments, is not aided by a system that essentially continues NHS fragmentation.

This new proposed contract is a complex lead provider contract that creates confusion over the respective roles of commissioner and provider. It requires multiple subcontracts that are likely to need constant wasteful renegotiation and change over the duration of the lead provider contract. This is just another form of fragmentation, waste and dysfunctionality.

The way to integrate the NHS and social care is through legislation to abolish the purchaser/provider split and contracting; put social care on the same footing as the NHS as a fully publicly funded and provided service that is free at the point of use; and remove the market and non-NHS bodies from the NHS.

Such legislation already exists in the shape of the NHS Reinstatement Bill.”

The campaign team say they are determined in renewing the fight to stop and reverse Accountable Care. Whether rebranded as Integrated Care or not, they see evidence that it is the same attempt to shoehorn the NHS into a limited role in a two tier healthcare system that feeds the interests of profiteering private companies.

Steven Carne emphasised,

“It is vital that we defend the core NHS principle of providing the full range of appropriate treatments to everyone with a clinical need for them.”

999 Call for the NHS hope the 2 day appeal in London will happen before the end of the year. The Appeal will consider all seven grounds laid out in the campaign group’s application – with capped costs.

Details on the first instance judgment can be found here:

http://www.landmarkchambers.co.uk/news.aspx?id=5630

and the judgment itself here:

http://www.bailii.org/ew/cases/EWHC/Admin/2018/1067.html

David Lock QC and Leon Glenister represent 999 Call for the NHS, instructed by Rowan Smith and Anna Dews at Leigh Day.

https://calderdaleandkirklees999callforthenhs.wordpress.com/2018/08/17/court-of-appeal-grants-nhs-campaign-group-permission-to-appeal-against-nhs-englands-new-integrated-care-provider-contract/

Devon CCGs want to merge (but looks like they already did it!)

Owl says: anyone recallveing consulted about this? And surely, if it is for cost-sVing, all previous financial scenarios at the two CCGs must be recalculated. And shouldn’t this be rescrutinised by DCC?

“North East and West (NEW) Devon CCG is hoping to merge with South Devon and Torbay CCG in April next year. Both CCGs have expressed an interest to NHS England to merge the organisations, in what they say is the ‘next natural step’. In May last year, NEW Devon CCG refuted claims it had ‘gone bust’ – though it did have a defecit of £42million in 2016/17.

Last year (2017/18) NEW Devon CCG had a planned defecit just shy of £50million.

It is thought the merger would help both organisations face funding challenges in the years ahead; they have already made a saving of £4million working together in the last year. This has includinged merging the two executive teams and establishing a common governing body and committees.
Executive directors now sit in Devon-wide roles working across both CCGs.

Dr Sonja Manton, director of strategy at the two CCGs in Devon, said: “We have made significant progress working as a health and care system in Devon over the past two years.

“As commissioners (buyer) of health care services for our local population, our two CCGs have worked more closely together for over a year, and this has brought many improvements and benefits such as speeding up decision making and making cost savings and efficiencies of nearly £4million on running costs.

“We have achieved much more together than we would have working separately. “A merger of our two organisations is the natural next step, and we have expressed an interest to NHS England to merge our two organisations from April 2019. “We are working with staff, clinicians, partners and stakeholders to ensure that everyone is involved in the changes as they develop. “This is an important step in our journey to better integrate health and care services to benefit our local communities.

“In Devon, we have well-established joint working arrangements with our local government partners and this will be strengthened as we design a new more integrated approach.”

https://www.northdevongazette.co.uk/news/proposals-to-merge-two-devon-ccgs-1-5642433

“Virgin awarded almost £2bn of NHS contracts in the past five years”

“Virgin has been awarded almost £2bn worth of NHS contracts over the past five years as Richard Branson’s company has quietly become one of the UK’s leading healthcare providers, Guardian analysis has found.

In one year alone, the company’s health arm, Virgin Care, won deals potentially worth £1bn to provide services around England, making it the biggest winner among private companies bidding for NHS work over the period.

The company and its subsidiaries now hold at least 400 contracts across the public sector – ranging from healthcare in prisons to school immunisation programmes and dementia care for the elderly.

This aggressive expansion into the public sector means that around a third of the turnover for Virgin’s UK companies now appear to be from government contracts. …

Sara Gorton, the head of health at the trade union Unison, said: “The company has been so keen to get a foothold in healthcare, it’s even been prepared to go to court to win contracts, moves that have cost the NHS dearly.

“While the NHS remains dangerously short of funds, taxpayers’ money shouldn’t be wasted on these dangerous experiments in privatisation.”

One former surgery manager who spoke to the Guardian said Virgin appeared to be paid more for doing less in her area, although the company said “because the contracts are generally not directly comparable, we don’t believe it to be true”.

Guardian analysis reveals the way the company that began selling records in the early 1970s has diversified in a bewildering way over recent years. …

In March 2017, it had almost 1,200 staff – a five-old increase from the year before. Over the same period, its turnover increased from £133m to £204m and its operating profit rose from £7.3m to £8m.

Though healthcare is a growing part of the group, Virgin still appears to make most of its money from transport.

Virgin UK Holdings, the UK business which holds its rail and healthcare ventures, reported revenues of £1.5bn in 2016 and paid £22m in tax.

Earlier this year, Virgin Trains had its west coast line franchise extended for another year. …

Paul Evans, the director of the campaign group NHS Support Federation, said: “Virgin Care are the biggest private sector winner to emerge out of the NHS experiment with competition and outsourcing.

“We don’t know the final shape of it, but players like Virgin and Care UK clearly see a big opportunities for business to continue to deliver clinical services for the NHS.”

https://www.theguardian.com/society/2018/aug/05/virgin-awarded-almost-2bn-of-nhs-contracts-in-the-past-five-years

Local Government Association debates tax rise to fund social care

“One of the many downsides of Brexit is that for the last two years or more it has sucked all the energy out of the Westminster policy making process, with the result that other problems are being ignored. It is a major opportunity cost. There are plenty of examples, but adult social care is probably the most glaring. Experts agree the situation is in crisis. The Conservatives floated some audacious plans in their manifesto, but they proved electorally toxic and since then they have gone silent on the topic, putting off announcements until the much-delayed green paper due later this year. Labour’s own plans are sketchy and, understandably, they are reluctant to propose reforms that will involve higher when the government won’t take the initiative itself.

So all credit to the cross-party Local Government Association that is today floating plans in a green paper (pdf) to raise taxes to put care funding on a sustainable footing. With councils in England receiving almost 5,000 new requests a day for adult social care, the LGA says this is essential.

Since 2010 councils have had to bridge a £6bn funding shortfall just to keep the adult social care system going. In addition the LGA estimates that adult social care services face a £3.5bn funding gap by 2025, just to maintain existing standards of care, while latest figures show that councils in England receive 1.8m new requests for adult social care a year – the equivalent of nearly 5,000 a day.

Decades of failures to find a sustainable solution to how to pay for adult social care for the long-term, and the Government’s recent decision to delay its long-awaited green paper on the issue until the autumn, has prompted council leaders to take action.

Short-term cash injections have not prevented care providers reluctantly closing their operations or returning contracts to councils and less choice and availability to a rising number of people with care needs. This is increasing the strain on an already-overstretched workforce and unpaid carers, and leading to more people not having their care needs met.

Increased spend on adult social care – which now accounts for nearly 40 per cent of total council budgets – is threatening the future of other vital council services, such as parks, leisure centres and libraries, which help to keep people well and from needing care and support and hospital treatment.

The LGA is publishing its green paper to start a public debate on how adult social care could be properly funded. There’s a summary here:

https://www.local.gov.uk/about/news/lga-launches-own-green-paper-adult-social-care-reaches-breaking-point

Source: https://www.theguardian.com/politics/blog/live/2018/jul/31/council-leaders-float-plans-to-raise-income-tax-or-other-taxes-to-fund-adult-social-care-politics-live

Very important case law on consultation

This has great relevance to NHS consultations, the wording of consultation comments, the treatment of those comments and the duties and respinsibility of the DCC Health and Wellbeing Scrutiny Committee to scrutinise evidence presented.

It is going to be much easier to challenge flawed consultations.

Those involved in these matters MUST read the full document (see source at end of post. Only a couple of the relevant sections are published here but should be read with the whole document.

“… “Commentary on
R (ex parte Kohler) v The Mayor’s Office for Policing and Crime
[2018] EWHC 1881

This Briefing Note considers the judgment handed down by Lord Justice Lindblom and Mr Justice Lewis on 20th July 2018. It details the circumstances of the case, its wider context and, in particular discusses practical issues which will be of concern to consultation practitioners.

Background

In common with other police forces, the Metropolitan Police has needed to make huge savings in its budget. Unsurprisingly it has led to a review of what premises they occupy and whether they still need over-the-counter services at their police stations.

In July 2017, the Mayor’s Office for Policing and Crime (MOPAC) published a Public Access and Engagement Strategy, a dual-purpose document simultaneously consulting the public about the future direction of public engagement on policing and seeking views on proposals to close or ‘swap’ 37 police counters.

The consultation was heavily criticised, and at the Institute, we published a detailed critique under the provocative title Is this the worst consultation of 2017?

https://www.consultationinstitute.org/worst-consultation-2017/

Some of the complaints were heeded and a revised set of questions emerged three weeks after its original launch.

The legal challenge

Professor Paul Kohler lives in Wimbledon and in 2014, was subjected to a serious assault. He believes his life was possibly saved only thanks to the prompt response by police from Wimbledon Police Station.

The MOPAC proposal included a provision for that facility to be transferred elsewhere in the London Borough of Merton – to Mitcham, so that the site at Wimbledon could be sold and generate capital receipts. These in turn, according to the consultation document, would help the Met Police fund technology improvements needed to support the case for changing public access and reduce the traditional reliance on police counters. …

The Kohler case spells an end to the practice of sending decision-makers a summary report (or an unreadable tome) with a message ‘Don’t worry, there’s nothing here to stop you from going ahead!’. If a failure to consider a specific argument can spell illegality following a consultation, someone somewhere has to decide what might constitute such an argument. Who can be trusted to decide?

The Consultation Institute View [on the case]

• The Kohler case is a game-changer, placing the Gunning Four Principle of ‘conscientious consideration ‘ at centre stage. There have been few comparable cases, as flawed consultations have, in the past failed the pre-determination or the sufficient information tests. It remains to be seen if the judgment opens the door to more claims that decision-makers never properly studied consultee submissions. It could happen!

• One consequence is that campaigners and other smart stakeholders will structure their comments to ensure that they cannot easily be summarised, and may specifically seek assurances that their submissions will have been read by decision-makers.

• To respond to such pressures and to safeguard themselves, consultors will need to look again at their data analysis practices, possibly strengthening the independent element both in analysis and in reporting to decision-makers. They will also need to be better at political risk assessments. Independent Quality Assurance becomes even more attractive for controversial consultations.

• The case for Public consultation hearings is further strengthened, as decision-makers will be able to prove that they heard and understood particular arguments. …”

Full document here:

Click to access briefingnote21-mopac.pdf

Seaton fights for Axe Valley health care

Owl says: good to see the deprived eastern side of East Devon banding together to fight for its (similarly deprived) health services.

Priorities identified for Axe Valley healthcare provision

“A ten point plan to safeguard healthcare provision across the Axe Valley has been drawn up.

The list of priorities has been agreed following a series of meetings between representatives from statutory and voluntary health groups along with local councillors.

Following the workshops, organised by Seaton Area Health Matters group, 10 priorities have emerged:

* To take an area approach for the Axe Valley, not just Seaton.

* Improving communication and co-ordination between voluntary organisations.

* Maintaining and extending NHS services in GP practices and at Seaton Hospital.

* The challenges in older age groups (chronic diseases, loneliness and isolation).

* The challenges in younger age groups (drug and alcohol addiction, housing, poverty).

* Mental health support.

* Transport difficulties to access services.

* Promoting health and wellbeing

* Communication on what is available.

* Co-ordination and ownership to tackle the challenges.

To look at these challenges a steering group has been established under the chairmanship of Seaton town councillor Jack Rowland.

A Terms of Reference was agreed at the last meeting on July 12 and two initial working parties have been established to work on the priorities and report back on progress at the September 6 meeting of the steering group.

A website and Facebook page will also be set up to communicate what is happening and enable people to contribute their views and receive answers, where appropriate.

Explained Cllr Rowland: “The working parties will utilise the experience and knowledge of whoever they need to as part of producing recommendations for approval by the Seaton Area Health Matters Steering Group and then potential approval and support from the Clinical Commissioning Group (CCG) and the Royal Devon and Exeter Trust (RDE).

The next meetings of the Seaton Area Health Matters group are:

Thursday, September 13, at
2pm

and

Thursday, December 13, at 2pm

both at the Marshlands Centre, Harbour Road, Seaton.

Anyone who has an interest in healthcare in the Axe Valley is welcome to attend.

Representatives from groups involved in health, care and wellbeing are actively invited to become members of Seaton Area Health Matters by attending the meetings.

Other members of the steering group are: Cllr Geoff Pook (vice chair), Cllr Marcus Hartnell, Victoria Parry (Healthy eating charity and Clinical Commissioning Group community representative), Cllr Martin Shaw, Roger Trapani (CCG community representative) Tina Trapani (Devon Senior Voice representative), Dr Mark Welland (Seaton GP and chairman of Seaton and District Hospital League of Friends).”

http://www.midweekherald.co.uk/news/group-identifies-patients-needs-1-5616100

Sky News claimed 55% of the NHS budget is spent on over 85s – the REAL amount is VERY different

A Sky News article claimed that 55% of all NHS spending went on people 85+:

https://news.sky.com/nhs-in-numbers

An independent fact-checking charity decided to research this claim.

Sky News told them it calculated the figures based on data published by the Institute for Fiscal Studies (IFS), but the IFS told us they don’t recognise these figures. They have asked Sky for more information.

Other figures the charity has seen from the IFS suggest that the proportion of health spending across the UK (rather than just the NHS budget) which goes to those aged 85 and over is likely to be around 10% by 2021/22.

The Institute for Fiscal Studies (IFS) told them it wasn’t familiar with the figures used by Sky News, but did provide them with other information.

When compared to a 30 year-old, spending across the UK on health (not just the NHS) for an 85 year-old is projected to be 5.6 times higher in 2021/22, and twice as much for a 65 year-old. That’s taking account of the fact that not all people of those ages will necessarily need to use health care.

But that doesn’t mean that 85 year-olds will require 5.6 times as much of the budget as 30 year-olds, because there are fewer people at that age.

Using population projections for 2021 we can see that those aged 85 and over are projected to make up just 3% of the population of the UK. Those aged between 65 and 84 made up 16% and those aged 30-64 made up 45%.

Based on this, 10% of health spending across the UK would go to those over the age of 85 by 2021/22, 32% would go to those aged 65 to 84 and 35% would go to those between the age of 30 and 64.

https://fullfact.org/health/how-much-nhs-budget-spent-people-over-85/

Claire Wright concerned about unpaid carers – asks for them to contact her

Could you imagine Swire being concerned about this – concerned, not just anodyne words.

“Some of Devon County Council’s Health and Adult Care Scrutiny Committee will visit Westbank League of Friends to hear from staff who support unpaid carers, later this month, following my proposal for a spotlight review into how unpaid carers who look after friends and family members are faring.

I have seen a confidential report of a focus group meeting that took place last year, which indicates that the 24 people in Devon who took part, are suffering from a lack of support, a lack of money and a lack of respite care….. many reported that their mental and physical health was suffering as a result.

I asked for the (anonymised) report to be published with the June health scrutiny papers, but this was refused as the focus group report was not ever intended to be made public and consent had not been given. Instead a rather more neutral version of the report was published, but as I told the committee, this did not reflect the original report and I don’t believe people’s voices have been heard.

The media reports today that unpaid carers save the economy a massive £60bn a year – https://www.bbc.co.uk/news/uk-40560827 – here’s the BBC story on the subject.

Anecdotally, my conversations with local people 100 per cent support the findings from Devon County Council’s focus group. Many unpaid carers are at their wits end.

I did propose a spotlight review into how unpaid carers are faring but this was not voted on unfortunately. There didn’t seem support from around the room. However, the issue will return to the agenda in September and I will pursue it then.

If you are an unpaid carer and wish to get in touch I would be very pleased to hear from you.

Email me at claire@claire-wright.org

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