East Devon Alliance DCC Martin Shaw responds to threat of full closure of Seaton Hospital

“Martin​ Shaw
County Councillor for Seaton and Colyton​

LETTER TO THE CHAIR OF NEW DEVON CCG

Dear Dr Burke,

We have seen draft notes prepared by 38 Degrees of your meeting with them on April 5th. According to these, Simon Kerr said (before your own arrival) that Seaton and Honiton hospitals were ‘at risk’ in the coming Estates Strategy. These remarks, written down at the time, have been confirmed to us by several participants. While we appreciate that no formal decision may have been taken, there seems little reason not to take them as a clear indication of CCG thinking.

As the two elected local politicians on the organising group of Seaton Health Matters, the community conversation launched together together with the CCG and RD&E, we hosted Dr Kerr at the launch meeting on 23rd March, which also heard Em Wilkinson-Bryce (copied in) appeal to the audience to trust in the ‘good intentions’ of the speakers from the NHS organisations. We have no reason at all to doubt her sincerity, but it is difficult for us to believe in the good faith of Dr Kerr and the CCG, as (unless he had only just picked up the names of the ‘at risk’ hospitals) it seems to us that you may have helped launched us into a discussion of local health needs knowing that you may be moving to deprive us of our major health resource, Seaton Hospital.

Our initial Health Matters discussion broached many areas of constructive cooperation between the local community and the NHS, which we are keen to pursue. However it also left no doubt of the need to maintain the 50+ outpatient services currently based in the Hospital, the desirability of bringing in additional services if place-based care is to be meaningful, and the needs of an elderly community (with significant pockets of deprivation and poor public transport) for as many clinics, etc., as possible on the doorstep rather than in other towns. We are ready to explore the possibility of a combined health hub for the Axe Valley, but on the basis that services would be more or less equally shared across the two hospitals and there would be no reduction in the overall level of services in each. The other thing that was clear from our discussion was that the community considers the Hospital a community resource since its building was half-funded by local donations and it has been maintained by local contributions ever since. I am sure that people in Axminster and Honiton feel the same about theirs.

You should not underestimate the local anger, only just subsiding, over the removal of beds from Seaton Hospital. It bears repeating that this was widely regarded, including outside Seaton, as an unjust choice based on a misuse of the JSNA data and misleading assumptions about the relative agedness of the populations of Seaton and Sidmouth (their age structure is in fact almost identical and the comparison did not justify a choice of Sidmouth over Seaton). It was also based on false claims that the Sidmouth option would involve a better geographical spread: a glance at the map would have shown that, on the contrary, it left the remaining community beds concentrated in the southwestern corner of East Devon with none in the Axe Valley. There is similar feeling in Honiton because the Your Future Care consultation did not even include an option which would have retained their hospital’s beds.

We mention this history not to try to reverse the beds decisions (although the shortage of beds in the recent winter should lead to it being looked at again) but because the treatment of Seaton and Honiton in those decisions should be a reason for generosity in the distribution of outpatient services and in the Estates Strategy. It is adding insult to injury to place Seaton and Honiton on a shortlist of potential closures. Having switched your decision last time against Seaton, you should now reconsider again in Seaton’s favour. This is not, of course, to suggest that any other hospital should be closed instead. On the contrary, all East Devon towns have community hospitals which reflect real local needs and you should be devising a system of health hubs which enables all communities to have a solid base for place-based care.

The next meeting of Seaton Health Matters is scheduled for 24th May. We do not wish it to be dominated by the fallout from Dr Kerr’s remarks but without an unequivocal assurance that Seaton Hospital will remain open, it is unavoidable that this will be the main topic of discussion.

We look forward to hearing from you at the earliest opportunity. We have also copied this to Sonja Manton since we discussed the Health Matters process with Em and her before it began. We should like to meet with you about this, but before the 24th any meeting would have to be late that afternoon or on the 23rd, as one of us is away until the morning of the 22nd.

Regards,

Martin Shaw
County Councillor for Seaton & Colyton

Jack Rowland
Seaton Town Council”

Seaton and Honiton hospitals “at risk ” of full closure says CCG

“CCG chair says Seaton and Honiton hospitals ‘at risk’ of closure in Local Estates Strategy”

POSTED ON MAY 14, 2018 by Councillor Martin Shaw

It has been revealed that Dr Simon Kerr, Chair of NEW Devon CCG’s Eastern Locality, told a meeting with representatives of 38 Degrees on 5th April that Seaton and Honiton hospitals were ‘at risk’ in the CCG’s Local Estates Strategy due in July. His remarks were taken down by the 38 Degrees member who produced draft notes of the meeting, and have been confirmed by other participants, but have not yet been confirmed by the CCG.

Although the hospitals both lost their inpatient beds last summer, Seaton Hospital currently hosts over 50 outpatient services (and there are probably at least as many in Honiton). Both are vital community health resources, created with decades of financial and practical support from people all around the Seaton and Honiton areas.

As part of a move to promote ‘place-based care’, the CCG and RD&E are currently taking part in two ‘community health conversations’, Honiton’s Health Matters and Seaton and Area’s Health Matters, which local voluntary groups, town and parish councils etc. are involved in. However if place-based care means anything, it should mean that communities should keep their local hospitals as health hubs, with more rather than fewer services.

Together with Cllr Jack Rowland, who stood down as mayor of Seaton last week but remains the town council’s representative on the Health Matters organising group, have written to Dr Tim Burke, Chair of the CCG, to ask for an unequivocal assurance that the hospitals will remain open.

I am hoping to shortly announce a meeting of the hospital campaign group.”

https://seatonmatters.org/

“Patients trapped by care closures: Elderly face being STRANDED in hospital wards” [or just stranded if there are no hospital wards]

“In the past financial year, 148 care home businesses entered insolvency – an 83 per cent rise on the 81 failing in 2016-17.

The figures sparked a call for urgent action from the Government to tackle a growing crisis in social care which could impact badly on the NHS.

And experts warn of a “care home crash” as closures cause a shortage. Although the Government announced a £2billion package for social care over three years last year, local authorities are spending £6billion less than in 2010. …

Mike Padgham, chairman of the Independent Care Group which advises care providers in north Yorkshire, said: “We have been warning for years that the £6billion cut from social care would eventually mean more and more care homes closing.

“For every home closure there are older and vulnerable people either forced to find somewhere else to live or unable to have a place.

“About 1.2 million people are now going without the care they need and unless action is taken this will very soon be us. We now face a further £2.3billion funding shortfall and that is going to mean more and more people not getting care. …

Local authorities in England and Wales had planned to make savings of £824million in their social care budgets in 2017-18 according to the Associate Directors of Adult Social Services, despite demand increasing as the population ages.

A Competition and Markets Authority report highlighted a £1billion shortfall in public sector funding of care homes in 2017 and the Local Government Association says that the sector faces a £2.3billion gap by 2020.

Accountancy firm Moore Stephens, which released the insolvency figures, found the cost of providing a high standard of care has increased over the years. The National Living Wage rose again last month to £7.83.

It stood at £6.70 just three years ago. The annual rise places increased strain on care home margins. The average home now spends 52 per cent of its turnover on wages. …

A report by the Public Accounts Committee in September said that an “intolerable” number of older patients were waiting too long to be discharged from hospital, costing the NHS £170million a year.

The MPs said that every day, 3,500 older people remain in hospital in England after being declared fi t to leave because arrangements had not been made for them to move. In 2011, operator Southern Cross shut down and as many as 31,000 elderly and vulnerable residents had to find somewhere else to live. …”

https://www.express.co.uk/news/uk/959234/care-home-crisis-uk-government-elderly-care-bankruptcy

The cost of austerity and underfunding – 20,000 extra deaths last winter

We cost the NHS and Social Services nothing when we are dead.

“Researchers have called for an urgent investigation to find an explanation for more than 20,000 ‘additional deaths’ so far this year, amid severe pressure on the NHS.

Figures from the Office for National Statistics (ONS) show that in the first sixteen weeks of the year, there were 20,215 more deaths in England and Wales compared to the previous five years.

In March, academics raised concerns that Britain was facing a rise in mortality and argued that “health chiefs are failing to investigate a clear pattern of worsening health outcomes”, in an editorial for the British Medical Journal (BMJ).

The piece centred on the finding that there were 10,000 ‘additional deaths’ in the first seven weeks of the year and concluded “that neither ‘flu, nor cold weather appeared to be the main cause.”

Now the authors have now updated their findings to account for fresh statistics covering the first sixteen weeks of the year.

Their response, published on the BMJ website this week, argues that the latest statistics “sadly provide little reassurance of this being a ‘blip’ as some have suggested.”

There were 198,943 deaths in the first sixteen weeks of 2018, compared to an average of 178,778 deaths in the same period over the previous five years. The rise represents an 11.3 per cent increase on the five year average.

The weekly average for the same period was 12,434 deaths, ahead of the five year average of 11,174. The 20,215 figure is equivalent to an ‘additional death’ every eight minutes throughout the first sixteen weeks of the year. …”

https://www.telegraph.co.uk/news/2018/05/11/calls-urgent-investigation-explain-20000-additional-deaths/

“Over a million elderly people missing out on help they need due to dire state of social care system, watchdog warns”

“More than a million vulnerable elderly people are missing out on help they need because of the dire state of the social care system, the UK’s spending watchdog has said.

The National Audit Office (NAO) called for urgent action as it published a detailed report citing evidence showing the number of people over 65 with unmet care needs jumped by some 200,000 in the last year alone.

The body said a spiralling turnover of poorly paid staff and increasing job vacancies are at the root of the problem, which is being worsened by ongoing deep cuts and fewer employees from the European Union since Brexit.

In particular, the NAO struck out at the Department of Health and Social Care (DHSC) for being unable to demonstrate how it is going to fund care for the elderly in the face of burgeoning future demand.

Ministers know working out how to pay for social care is one of the biggest challenges they face, but have been unable to bring forward clear proposals of how to meet it.

The report said the DHSC’s own modelling had shown the number of full-time jobs in the care system would need to rise by some 2.6 per cent per year until 2035 to meet increased demand.

But the annual growth in the number of jobs since 2013 has been two per cent or lower.

The report said: “The failure of formal care to meet this increased demand may have contributed to the growth in individuals’ care needs not being met.

“Age UK estimated that 1.2 million people over the age of 65 had some level of unmet care needs in 2016/17, up from one million in 2015-16.”

The NAO found that In 2016/17, the annual turnover of all care staff was 27.8 per cent – with care workers. …”

https://www.independent.co.uk/news/uk/politics/elderly-people-vulnerable-million-missing-dire-poor-social-care-system-a8199506.html

Swire discovers “health hubs”

Written Answers – Department of Health and Social Care: Health Services (9 May 2018)

https://www.theyworkforyou.com/wrans/?id=2018-04-30.139412.h&s=speaker%3A11265#g139412.q0

Hugo Swire: To ask the Secretary of State for Health and Social Care, what his Department’s policy is on the establishment of health and wellbeing hubs in former community hospitals.”

Owl’s policy is that NHS community hospitals are much more important than commercial juice bars and personal trainers and should therefore be funded BEFORE health hubs, not abandoned to insert “health hubs” in their place.

” ‘Perfect storm’ over rural social care costs”

“Rural residents are unfairly penalised when it comes to Improved Better Care Funding, MPs have been told.

The Rural Services Network issued the warning in response to an inquiry by MPs who are examining the long-term future of adult social care.

The Long Term Funding of Adult Social Care Inquiry is being undertaken by the Housing, Communities and Local Government Committee of the House of Commons.

Submitting evidence to the inquiry, the Rural Services Network said the average predominantly urban resident will attract £37.74 per head in Improved Better Care Funding in 2019/20.

This is £8.20 more than rural residents who attract just £29.54 per head.

In 2017/18 Adult Social Care Core Funding is met by Council Tax to the tune of 76% in rural areas compared to just 53% in urban.

The Rural Services Network said there was no relationship between the numbers of people requiring social care and either Council Tax or Business Rates.

Growth in business rates or council tax income is in no way correlated to the service needs of care services, it pointed out.

“It is obvious that the rising costs of caring for the growing elderly population cannot be met by local taxation and must be funded per capita by central government,” said the network.

In rural areas, there are significantly more residents aged 65+, fewer businesses required to pay business rates and Council Tax levels are already much higher than in urban areas.

The network added: “Thus, there is created a ‘perfect storm’ of rising costs and limited income in the rural areas across England.”

Cost pressures in Social Care Services mean county and unitary councils serving rural areas are having to cut other budgets to the detriment of the well-being of rural residents and businesses.

Council tax per head is reflected in the Final Settlement for 2018/19 is £541.46 for Predominantly Rural Areas compared to £450.58 in Predominantly Urban Areas.

“The gap, at circa £91 per head, is inexcusable,” said the network.

There appears to be a conscious policy decision by the government that in rural areas Spending Power will be increasingly funded by council-taxpayers, it added.

In other words, the government appeared content for people in rural areas to pay more council tax from lower incomes and yet receive fewer services than their urban counterparts.

“This is manifestly unreasonable and totally inequitable,” said the network.

The role of preventative services in respect of adult social care was not formally recognised by government and district councils were not funded for public health.

With increasing pressures on district council budgets, there remained uncertainty as to how public health interventions delivered at a local level would be funded in the future.

http://www.rsnonline.org.uk/perfect-storm-over-rural-social-care-costs

Austerity and our NHS: in the relegation zone in football terms

Owl says: so, in football terms England has 8 men playing in a game with a full Barcelona premier, super-fit 11-person team. With our 8-person team consisting of six people waiting for hip operations and 2 blocking beds awaiting their home care packages!

“… The stark findings come from a new King’s Fund analysis of health data from 21 countries, collected by the Organisation for Economic Cooperation and Development. They reveal that only Poland has fewer doctors and nurses than the UK, while only Canada, Denmark and Sweden have fewer hospital beds, and that Britain also falls short when it comes to scanners.

“If the 21 countries were a football league then the UK would be in the relegation zone in terms of the resources we put into our healthcare system, as measured by staff, equipment and beds in which to care for patients,” said Siva Anandaciva, the King’s Fund’s chief analyst.

“If you look across all these indicators – beds, staffing, scanners – the UK is consistently below the average in the resources we give the NHS relative to countries such as France and Germany. Overall, the NHS does not have the level of resources it needs to do the job we all expect it to do, given our ageing and growing population, and the OECD data confirms that,” he added.

The report concludes that, given the dramatic differences between Britain and other countries: “A general picture emerges that suggests the NHS is under-resourced.”

The thinktank’s research found that the UK has the third-lowest number of doctors among the 21 nations, with just 2.8 per 1,000 people, barely half the number in Austria, which has 5.1 doctors per 1,000 of population.

Similarly, the UK has the sixth-smallest number of nurses for its population: just 7.9 per 1,000 people – way behind Switzerland, which has the most: 18 nurses, more than twice as many.

With hospital beds, the UK has just 2.6 for every 1,000 people, just over a third of the number in Germany, which has the most – 8.1 beds – and which places the UK 18th overall out of the 21 countries which the OECD gathered figures for. The number of hospital beds in England has halved over the last 30 years and now stands at about 100,000, though the NHS added about 4,000 more as an emergency measure in December, January and February to help it cope with the spike in patient numbers caused by the long, cold winter.”

https://www.theguardian.com/society/2018/may/05/nhs-lowest-level-doctors-nurses-beds-western-world

EDDC Independents lead call for action on local health provision

Owl can’t quite see why Tory Councillor Allen felt the need to table his amendment – perhaps he felt Independent councillors were rather too Independent and therefore needed a dash of Tory policy! Now we just have to hope that new Leader Thomas doesn’t go and do exactly the opposite of what was resolved when he attends to DCC health scrutiny meetings – as Diviani notoriously did last year.

“A motion calling for the community hospitals which have lost beds to be maintained as health hubs, that services and clinics should be moved out of Exeter to local community hospitals and that more outpatient services should be provided in each community hospital was discussed by East Devon District Council at their meeting last week.

Proposing the motion, Cllr Marianne Rixson [EDA, Independent] said that health hubs in local areas need to be supported by the Council.

She added that the need for less travelling and difficult local bus services needed to be taken into consideration and that if place-based care was to be effective then the level of out-patient services need to be increased overall or at least maintained in every town.

She was supported by Cllr Val Ranger [Independent] who added that those people discharged early from hospital, children and elderly living with long-term health conditions should be able to access out-patient services locally in every community.

Councillors voted for an amendment, proposed by Cllr Mike Allen [Conservative], that said that this Council resolves to welcome the proposal of the Devon CCG’s to develop placed-based health care where strong evidence suggested that it would deliver high-quality patient care and sustainable services.

It added: “However, due to lack of supporting clinical evidence and clear future planning, the Council has strongly opposed closure and removal of community hospital beds and hospital-based services throughout East Devon.

“All efforts are made, in consultation with local communities, to ensure the existing estate of community hospitals was retained for health care purposes, where appropriate, the potential development of ‘Health Hubs’ was investigated, and council members received from the Clinical Commissioning Group a review of service changes (bed-based to home/community based care) made during 2017/2018 in East Devon, to include clinical evidence highlighting levels of patient safety and outcomes achieved and an evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet.

After the meeting, Cllr Martin Shaw [DCC East Devon Alliance], said that he has written to Cllr Ian Thomas, who is due to become the new leader of the council on May 16, asking for assurances that each of the hospitals which has lost its beds (Axminster, Honiton, Ottery and Seaton), as well as Exmouth and Sidmouth, to be kept open and that a formal public consultation in the affected town and surrounding area should a closure of any community hospital, involving substantial relocation of outpatient services, be proposed.”

https://www.devonlive.com/news/health/closure-removal-hospital-beds-should-1530794

The epidemic of community hospital closures shows no signs of slowing down …

We in East Devon feel your pain:

“Former MP slams plans to close Teignmouth Hospital – the first purpose build NHS Hospital in the UK”

The area’s former MP says:

“We need more hospital beds. The Germans have 8.13 beds per 1000 people but the UK only has 2.61 beds per 1,000, and this needs to improve as there is a local and a national need for beds.”

https://www.devonlive.com/news/devon-news/former-mp-slams-plans-close-1516807

https://www.devonlive.com/news/devon-news/former-mp-slams-plans-close-1516807

“RURAL RESIDENTS FACE SOCIAL CARE ‘LOTTERY'”

The government’s system of funding social care services is unsustainable and unfair for rural communities, the Rural Services Network has warned.

Service providers operating across rural areas face inequitable costs compared to their urban counterparts for both adult and child social care, said the network.

Rural council taxpayers also faced unfair costs, warned the network in response to an inquiry by MPs who are examining the long-term future of adult social care.

RSN chief executive Graham Biggs said: “Social care is a national issue but it is in crisis.

He added: “While continuing to be delivered locally with flexibility for councils to respond to local circumstances and priorities, it should be 100% funded by central government to provide an adequate core service level for all residents nationally – irrespective of where people live.

“Council tax is an unsuitable taxation vehicle for demand responsive services and means rural residents face a postcode lottery when it comes to social care provision.”

Mr Biggs said council tax should only be used to fund social care if a given local authority decided extra money was needed to boost services above a core level locally.

It should not be used to fund the core, national, service, he added.

Mr Biggs said: “It costs substantially more to provide social care in rural areas than it does in larger towns and cities – and there is higher demand for services in rural areas.

“As a statutory duty, services have to be prioritised and other budgets – such as rural transport support, for example – are being cut significantly as a consequence.”

This was because older people make up a higher proportion of the population in rural areas than they do in urban areas, said Mr Biggs.

At the same time, the twin challenge of isolation and distance made it harder and more expensive to deliver services to dispersed rural populations.

Such costs inevitably and unfairly penalised rural councils – and were compounded by issues such as poor economies of scale and poorer external markets for delivery.

Mr Biggs said: “A future formulae to fund social care services must fully reflect the different costs of delivery imposed by both geography and population.”

http://www.rsnonline.org.uk/rural-residents-face-social-care-lottery

THIS is how you hold a CCG to account!

“The NHS will face calls from leading county councillors to publish a comprehensive plan for public consultation on its controversial proposals for a major shakeup of health services in Lincolnshire.

Concerns have been raised by the county council over the lack of progress on the Lincolnshire Sustainability and Transformation Plan since an initial draft was first published in December 2016.

At the time, the plans outlined a required £205 million investment to improve the facilities at Lincoln County Hospital, Boston Pilgrim Hospital and Grantham Hospital.

The proposals revealed that Grantham A&E could be downgraded to an urgent care centre and maternity services centralised to Lincoln.

Over 500 jobs are also set to be lost by 2021 under the plans.

Lincolnshire County Council unanimously voted against the STP at a Full Council meeting in December 2016, just over one week after the report was first leaked to the press.

County council leader Martin Hill wrote to NHS chiefs in March 2017 adding his criticisms, claiming that “making things better for most people, at the detriment of others, is not good enough”.

Since then, the county council said that there have been delays in publication of the STP plan, with further concerns raised about the lack of answers to the financial struggles of the NHS in Lincolnshire as well as fears about the changes themselves.

United Lincolnshire Hospitals NHS Trust, which covers the three main hospitals in the county, was put in special measures by the Care Quality Commission for performance failures and in financial special measures by NHS Improvement in 2017.

Even this month, ULHT has forecast an end of year deficit of £82.4 million, £5 million more than its deficit control target agreed with NHS Improvement.

In addition to asking the NHS to publish a plan for public consultation “without delay”, Lincolnshire County Council will also call for a review of governance arrangements for the STP to provide clarity over decision-making, accountability, democratic engagement and oversight of the process.

Glen Garrod, Executive Director of Adult Care and Community Wellbeing at Lincolnshire County Council, said in a report to councillors: “The county council has a long and successful track record of working with NHS partners in Lincolnshire. More recently and with the development of the STP programme the nature of the relationship has changed and, given the quality, performance and financial imperatives facing NHS services in Lincolnshire, more profiled.

“Disappointingly little progress has been made to address underlying budget deficits, performance continues to be poor at ULHT and successive inspections by the Care Quality Commission have reported on serious quality issues.

“This has been the picture for a number of years with little sign that ‘the tide has turned’ and these critical issues are getting better.

“Change is likely, indeed necessary and improvements critical if Lincolnshire residents are to receive NHS services that they deserve.”

In response, John Turner, Senior Responsible Officer for the Lincolnshire STP said that Lincolnshire County Council is a key partner for the NHS in the county but refused to be drawn on when it would publish its plans for public consultation.

He said: “We are fully committed to working together with Lincolnshire County Council in the best interests of patients and the people of Lincolnshire. The level of our integrated services between the NHS and Lincolnshire County Council already compares well nationally.

“There is much to be proud of in our local NHS, with our dedicated staff and partners working to provide the best care for our patients. At the same time, it is widely recognised that health and care services in Lincolnshire are very challenged – we struggle to provide consistent care and meet all quality standards, to recruit clinical staff in key areas, and we are currently overspending by £100 million a year.

“In recent months the STP has reported progress in areas such as mental health, GP services, integrated community services and operational efficiencies and improvements have been delivered for patients.

“In addition, the STP is also undertaking an acute services review which is examining what would be the future configuration of acute hospital services for the population of Lincolnshire.

“We look forward to discussing this openly across the county in due course.”

Councillors on the council’s Executive will consider the next steps to take at a meeting in Lincoln on Tuesday, May 1.”

https://lincolnshirereporter.co.uk/2018/04/nhs-under-fire-from-county-council-over-lack-of-progress-on-healthcare-shakeup/

Asset-rich pensioners should fund NHS says its chief

“The head of the NHS has suggested that pensioners’ housing wealth should be used to fund social care as he warned that the equivalent of 36 hospitals were “out of action” because of bed blocking.

Simon Stevens, chief executive of NHS England, said that given pensioners’ “relatively advantaged position” in terms of housing wealth, it was difficult to argue that working-age adults should fund the estimated £1 billion extra per year needed by social care services in increased taxes.

He was appearing in front of an inquiry by several Commons committees on the long-term funding of adult social care. …”

Source: Times, pay wall

“Don’t save it for the duchess. All new mothers should be treated like royalty”

Very difficult to do that when local maternity units such as Honiton are closed so many routine births AND emergencies have to travel 20-30 miles plus to Exeter:

https://www.theguardian.com/commentisfree/2018/apr/24/duchess-cambridge-new-mothers-royalty

“Why I started a petition against NHS privatisation”

by Jamie Snape:

Today in Westminster MPs will debate a petition calling on the government to stop the privatisation of NHS services. Now, if I’m entirely honest, the date of a petition debate isn’t something that would normally appear in my calendar, however this particular debate I’m responsible for myself.

Until starting this petition I’d never campaigned on behalf the NHS, nor had I any connection to the plethora of local or national NHS campaign groups. So what drove me to begin the petition in the first place?

Well, it was after I’d encountered for myself the already privatised NHS services in my local area. Following this I was left with a clear understanding of what it means in reality, when our healthcare is provided by a profit-orientated business rather than an organisation focused on patient outcome like the NHS, and indeed what it is we are losing by privatising it.

As a parent, seeing my young children’s well-being affected directly and indirectly by NHS privatisation on more than one occasion, it motivated me to a degree that I might not otherwise have been.

So I began reading more about NHS privatisation, and why people like the late Stephen Hawking were so concerned. I concluded I could perhaps make a little difference myself by using a petition as a vehicle to help voice the concerns that many people have and that I share about creeping NHS privatisation.

This belief panned out, indeed a single post I wrote on Facebook about the petition was shared over 73,000 times, meaning it was very likely to have been read by more than a million people.

There are over 6,500 petitions on the parliament website right now, and it’s fair to say the UK public are petitioned out. Despite that, not too far short of a quarter of a million people took the time to sign this petition, which ultimately resulted in the scheduling of today’s debate in parliament.

NHS privatisation can mean so many things as there are so many aspects to it, so in terms of the debate itself, my hope is simply that I will observe a well-informed one. I hope that all the MPs involved demonstrate a real knowledge of the issues relating to it, such as the scale of current NHS privatisation.

What simply must be covered are the concerns surrounding the introduction of Accountable Care Organisations later this year, and their potential for leaving a back door wide open for a massive new wave of NHS privatisation.

If the debate centres around the small part of NHS privatisation, where a few people get bumped up the waiting list by having a routine operation performed by a private company, then I will of course be disappointed.

The concept of the NHS is erroneously referenced by many now in historic terms, especially when they are arguing in favour of NHS privatisation.

Personally, I see the NHS as something very much of the future, indeed I’m entirely certain that in years to come, a nation will only be considered civilised if it provides comprehensive free healthcare to all of its citizens.”

Source: Times (pay wall)

Care at home? Not if there are no carers for the homes

Care for 13,000 Britons at risk as provider seeks rescue plan

“The care of more than 13,000 elderly and vulnerable Britons could be thrown into turmoil after one of the biggest providers of home care visits in the UK warned it would go bust unless creditors backed a rescue plan.

Allied Healthcare, which has contracts with 150 local authorities and also provides out-of-hours services for the NHS, is asking for breathing space on its finances after cashflow problems that have been triggered in part by an £11m bill for back pay owed to sleep-in care workers.

The loss-making company has 12,000 employees and cares for 13,500 people in their homes via a network of 83 branches around the country. According to the Allied website it is the country’s largest domiciliary care business, twice the size of its nearest competitor.

Its Primecare division provides primary and urgent healthcare services, including NHS 111 telephony services, GP-led medical centres and end-of-life care. It also provides healthcare services in a number of secure settings including prisons, immigration centres and secure training centres.

Allied was bought by the German private equity firm Aurelius in a £19m deal in December 2015 but it has struggled against a backdrop of local authority funding cuts.

In a letter to creditors seen by the Guardian, its chief executive, Luca Warnke, said it had “significant funding pressures on our customers that have impacted on their ability to deliver financially viable health and social care services”. It added that it had taken the decision to pursue a company voluntary arrangement (CVA), an insolvency procedure that will enable it to agree a payment plan with creditors that include landlords and members of its pension schemes. It expects to file for the procedure on Monday.

Warnke blamed rising agency labour costs for its woes, pointing to the shortage of doctors and nurses since the Brexit vote as well as a potential £11m bill for backdated “sleep in” payments depending on HMRC’s calculation of the pay period.

Last year the government changed its guidance on how sleep-in carers should be paid, advising that they were entitled to earn the national minimum wage for the entirety of the time they were present in a house rather than just a flat rate. At that time some charities warned it could cost the sector £400m and potentially bankrupt many social care charities and providers.

The company said in a statement: “As with many independent providers in the UK health and social care sector, Allied Healthcare has been operating in a highly challenging environment for a sustained period of time, which has placed pressure on the company.

“As a result of these challenges, Allied Healthcare has has taken the decision to pursue a company voluntary arrangement as part of a prospective business plan that will ensure safe continuity of care across our UK-wide operations, place the company on a sustainable long-term footing and maximise repayments to creditors.

“The proposed CVA will not impact on the safe continuity of care that Allied Healthcare provides across the UK,” it said. “Allied Healthcare will continue to trade safely and it remains business as usual for Allied Healthcare employees and customers.”

The company insisted there were currently no plans for redundancies or branch closures.

A spokesman for the Local Government Association (LGA), which represents local authorities, insisted that councils have “robust” contingency plans in place to manage the care of individuals if necessary if the company were to fail.

“The absolute priority for councils affected is to protect the vital care and support that older and disabled people rely on and ensure it is able to continue without interruption,” a spokesman said. “The LGA is working alongside the Care Quality Commission and the government to support Allied, where possible, as it plans to financially restructure the business and continue to provide high-quality home care.”

https://www.theguardian.com/society/2018/apr/20/care-for-13000-britons-at-risk-as-provider-seeks-rescue-plan

Telegraph: Why is the NHS under so much pressure? Their answer: its our fault for getting older and fatter!

“An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care.

[Owl: this has been known for DECADES and should have been built-in to spending forecasts]

Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home.

[Owl: the NHS budget has NOT been protected! In real terms, funding has fallen enormously]

Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice.

[Staff shortages are due to austerity cuts and an exodus of EU workers, who are not replaced. Changing nursing bursaries to loans had exacerbated this serious problem]

Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue.

[Many lifestyle problems are due to the government’s policies: allowing food and drink lobbies to dictate the sugar problem until it is too late, and not putting greater taxes on cigarettes and alcohol as this would reduce government income, shutting Sure Start services that promoted better parenting].


https://www.telegraph.co.uk/money/consumer-affairs/chances-getting-nhs-funded-care-depends-live/

“Families seeking care funding from the NHS face a “postcode lottery” as to whether they will be accepted.”

Under “continuing healthcare” (CHC) rules, those with complicated medical conditions can apply for full funding from the health service. Families are not means tested and the decision is supposed to be made solely on the person’s medical situation.

But, despite the criteria being clearly set out in a national framework, differing interpretations of the rules mean your chances of being deemed eligible depend on where you live.

Telegraph Money is aware of hundreds of cases where regional health authorities have applied the rules differently – including some where patients have been approved by one authority and rejected by another just days later.

Ron Laycock, 87, was admitted to Cheltenham General Hospital earlier this year with a vascular condition. Despite living in Wiltshire, he was taken to a specialist unit in Cheltenham, in neighbouring Gloucestershire.

After he was deemed to be “rapidly deteriorating”, medical staff at the hospital approved him for “fast-track” funding under CHC, meaning his care at a nursing home would be paid for.

However, upon arriving at a home in Wiltshire, the county’s clinical commissioning group (CCG) – the NHS body responsible for determining eligibility – refused to recognise the hospital’s decision and rejected his application. This left Mr Laycock’s family having to find the £1,450 weekly cost of the nursing home themselves.

His daughter Becky Nicholls, 44, who works in human resources, said: “My father had Alzheimer’s as well as this condition and then caught pneumonia as well. He stopped eating and taking on fluids. A specialist at the hospital said he was clearly rapidly declining as he had stopped eating but Wiltshire flatly refused to accept that.”

She was refused an explanation from the CCG and said an administrator was rude over the phone. “I was just shocked after that phone call,” she said. “I hadn’t slept for weeks and that night I lay there just hearing her words in my head. My father couldn’t have been released without a care home to go to, so how can he not be eligible?”

She added: “I felt my dad was going to pass away before they took the time to respond.”

The family paid around £5,800 to the care home and Mr Laycock lived there for two weeks before he died. Further to this newspaper’s involvement, Wiltshire CCG acknowledged it had made a mistake and agreed to refund the money backdated to when Mr Laycock was discharged from hospital.

A spokesman said: “Wiltshire CCG takes all patient complaints and concerns seriously and can confirm that appropriate funding is being put in place for the care Mr Laycock received.

“We acknowledge the upset that Mr Laycock’s daughter has experienced and the director of nursing has spoken to her directly to apologise for any distress caused, as well as offering to meet with her in person in order to better understand the issues raised and ensure we learn from this.”

Andrew Farley, from Farley Dwek Solicitors, a firm specialising in CHC disputes, said his company is dealing with around 500 such disputes, many of which are related to cross-border discrepancies. “It’s clear from the national framework that if fast-track is granted, it should only be withdrawn in exceptional circumstances,” he said.

“The decisions should be the same wherever you are in the country, but they aren’t. There appears to be a postcode lottery as to whether you’ll get funding or not.”

CHC funding is available to anyone with “unpredictable” healthcare needs that go “over and above” what a local authority would be expected to provide, Mr Farley said. It is available for everyone, regardless of wealth.

He said families are often bamboozled by the complex nature of the system and suggested that the cash-strapped NHS may be encouraging assessors to deny funding.

“I think there is possibly a hidden agenda; that’s the impression I get having spoken to many families who have been through this process,” he added.

A spokesman for NHS England said: “Spending on CHC is going up as ever more people are being supported, but it’s CCGs that undertake eligibility assessments, using the national framework, based on each individual person’s specific circumstances.

“While recent improvements in practice mean variation in access to CHC has reduced, there is potential to make the process more efficient and effective for patients as the majority of people put through a CHC assessment turn out not to need it.”

https://www.telegraph.co.uk/money/consumer-affairs/chances-getting-nhs-funded-care-depends-live/

DCC cabinet refuses to accept decision of Health and Social Care Scrutiny Committee and rushes in Accountable Care Organisation without checks and balances

Claire Wright’s blog:

“The all Conservative Devon County Council Cabinet has thrown out its own health watchdog’s unanimous resolution on deferring the implementation of Devon’s Integrated Care System, while a range of assurances were received.

Dozens of objections from members of the public came flooding in at the 22 March Health and Adult Care Scrutiny Committee meeting and my resolution on the thorny issue, which can be found here –

http://www.claire-wright.org/…/devons_nhs_asked_to_provide_…

… had been backed unanimously by councillors.

A revised resolution that the Cabinet supported yesterday, merely noted that a new system was being set up and everything else was so watered down as to be almost meaningless.

The message was repeated at length that this was not an endorsement but simply noting that it was happening and that progress will be monitored.

I reminded the cabinet of the County Solicitor’s advice to the Health Scrutiny Committee in November that it is unique in scrutiny committees in that we provide a legal check on health services – the only legal check – and that our remit is to take up issues of public concern. And we were flooded with emails of public concern.

I then went through the issues as I saw them.

When summing up, Cabinet member, Andrew Leadbetter, accused me of bringing a set of ‘pre-determined’ proposals to the Health and Adult Care Scrutiny Committee.

This is a serious allegation and I immediately asked him to withdraw it. Leader, and Cabinet Chair, Cllr John Hart, backed me up and Cllr Leadbetter retracted his statement.

I had in fact prepared the proposals during the lunch-hour before the meeting. it is quite permissable (and very common) to conduct business in this way.

There was cross party support for the Health Scrutiny resolution with Cllrs Alan Connett, Brian Greenslade and Rob Hannaford also addressing Cabinet along similar lines.

Here is the Cabinet’s final resolution, which you can compare with my proposals which are set out in yesterday’s post below:

(a) that the original recommendations of the Cabinet (a – d), as outlined in Cabinet Minute *148 and reproduced below, be re-affirmed:

(i) that the key features of an emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, a Mental Health Care Partnership and shared NHS corporate services, be noted.

(ii) that the proposed arrangements in Devon as set out in paragraph 4 of the Report be endorsed, reporting to the Cabinet and Appointments and Remuneration Committee as necessary.

(iii) that the co-location of NHS and DCC staff within the Integrated Strategic Commissioner, subject to agreement of the business case, be approved; and

(iv) the Health and Adult Care Scrutiny Committee be invited to include Integrated Care System governance in its work programme.

(b) And, in light of the Scrutiny Committees deliberations, Cabinet further RESOLVE

(i) that the Health and Wellbeing Board is reformed to lead new governance arrangements for the development of integrated strategic commissioning of health and social care; and

(ii) that there is continued proactive communication to the public using clear and consistent messaging and where appropriate there will be relevant involvement and engagement.”

Here’s the webcast – https://devoncc.public-i.tv/…/po…/webcast_interactive/325467

“DCC cabinet decides tomorrow if to back Health Scrutiny resolution over controversial health plans”

Claire Wright’s blog, as she ploughs (with EDA DCC Councillor Martin Shaw) the lonely furrow of integrity and common sense – both sadly lacking in the DCC Health and Social Care Scrutiny Committee:

“Devon County Council’s cabinet will decide tomorrow whether to back the Health and Adult Scrutiny Committee’s resolution on deferring the implementation of the controversial Integrated Care System, which many local people have huge concerns over.

At the last Health and Adult Care Scrutiny Committee on 22 March, I proposed the following which was supported by the majority of the committee.

An additional line on a public engagement, was voted down by Conservative councillors:

Here’s what the cabinet will be considering. If it supports the resolution, it will be implemented with immediate effect…..

I will be speaking in support of the resolution tomorrow…… If you are keen to know the outcome or hear the discussion, the meeting is webcast live here – https://devoncc.public-i.tv/core/portal/home

(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;

(b) defer the implementation of the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective;

(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;

(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’; and

(e) provide a copy of the business plan being developed and a summary of views from staff consultations.

For more background on Integrated Care Systems see my blog
post –

http://www.claire-wright.org/…/devons_nhs_asked_to_provide_…