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21 Nov 2016

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Accountability, Austerity cuts, Flooding

Devon worst hit by Storm Angus weather and floods – but little money for future prevention

“The government has been accused of being “all talk and no action” on flood defences, as the first named storm of the season brought flooding and power cuts to the south of England.

Storm Angus saw gusts of up to 106mph recorded 23 miles off the coast of Margate, while gusts of 80mph hit Langdon Bay, also in Kent.

While Met Office weather warnings connected with Storm Angus expired at 1pm on Sunday as the storm moved out to the North Sea, a new series of warnings were issued for Monday and Tuesday for heavy rain in south-west England, parts of northern England and Wales.

Andy Page, chief meteorologist at the Met Office, said Devon was likely to be most affected. “Although the more persistent rain should clear from Devon by early afternoon, heavy and possibly thundery showers are likely to follow,” he said.

UK government not funding natural flood prevention methods

“Around 20-30mm of rain is expected fall in a three- to six-hour period in places, with as much as 40-60mm possible locally through the whole of Monday. The ground has been left very wet from Saturday night’s rain and this increases the risk of further flooding.”

Page added that the band of rain affecting parts of southern England and Wales on Monday would extend to parts of northern England later on Monday and into Tuesday morning.

The warnings came as the government was accused of failing to deliver on promises to fund “natural” flood management schemes such as planting trees.

A freedom of information request by the environmental group Friends of the Earth to the Department for Environment, Food and Rural Affairs (Defra) revealed that there was no funding earmarked specifically for natural flood management, despite ministers saying they would fund such measures.

Natural flood management schemes aim to slow the movement of water downstream to prevent flooding. This can involve creating water storage such as ponds, planting trees along water courses and restoring rivers to their original meandering path.

In his budget in March, then-chancellor George Osborne announced an extra £700m for “innovative flood defence measures”. Friends of the Earth understands that former floods minister Rory Stewart earmarked £20m for natural flood defences before he left Defra in the June reshuffle.

In a recent letter to environmental charities, the environment secretary, Andrea Leadsom, wrote: “I fully support natural defence initiatives such as planting trees, which can slow the flow of water.”

Guy Shrubsole, climate campaigner for Friends of the Earth, said last winter’s floods “were a powerful reminder that we need to work with nature to reduce flood risk – and ministers wholeheartedly agreed”.

“So far it’s been all talk and no action,” he said. “The government has failed to spend a single extra penny on natural flood management.”

“Ministers must replace warm words with hard cash and announce a pot of at least £20m for natural flood defence in this year’s autumn statement. Anything less will be a betrayal of the communities that flooded so terribly last winter.”

A Defra spokesman said: “We’re committed to better protecting the country from flooding and natural flood management plays an important role in our strategy.

“We’re spending a record £2.5bn on flood defences to better protect 300,000 more homes by 2021 and many of these projects are already using natural flood management measures.”

The Environment Agency also issued nine flood warnings and 57 less serious flood alerts in the south-west and parts of the north of England.

Alison Baptiste, national flood duty manager at the Environment Agency, said teams had been working through the night and were now preparing for further flooding as rain continues over the next couple of days.

“People should remember not to drive through floodwater and be aware travel may be disrupted,” she said. “Environment Agency teams will clear blockages in rivers, continue to issue flood warnings and may operate flood gates and sea defences.”

https://www.theguardian.com/environment/2016/nov/21/government-criticised-for-lack-of-natural-flood-management-schemes?CMP=Share_iOSApp_Other

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East Devon Watch

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21 Nov 2016

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Austerity cuts, Health and Social Care (local), NHS (local)

One-third of doctors say they have not heard about projected NHS cuts!

Are they all working so hard they have no time to read newspapers?

“The BMA, which today reveals the £22billion spending shortfall, said a survey found two-thirds of doctors had no input in the plans and a third had not even heard of them.

Its council chairman Dr Mark Porter added: “Given the scale of the savings required, there is a risk these plans will be used as a cover for delivering cuts… starving services of resource and patients of vital care. It is extremely concerning that the majority of doctors have not been consulted on the plans, particularly as ministers have been so keen to insist that all stakeholders would be involved.”

The Lib Dems demanded an urgent £4billion cash injection for the NHS and social care services to stop the crisis getting worse. Health spokesman Norman Lamb said: “NHS and care services are on the precipice as we approach the winter months.

“Waiting lists are growing, deficits hit record levels this year and staff are under unsustainable pressure.

“In social care, thousands of people are seeing services withdrawn and 15-minute visits have become the norm as councils struggle to make ends meet.”

A report by health think-tank the Kings Fund blasted the secrecy surrounding the Sustainability and Transformation Plans, which are being finalised by health chiefs around the UK.

Cheshire and Merseyside is one of the largest affected areas. Three hospitals could be axed and “merged” on to a single site to plug its black hole. Birmingham and Solihull trusts face a £712million shortfall, putting services at risk of closure.

Somerset’s two main hospitals in Yeovil and Taunton may merge key departments including cancer and maternity wards. In Berkshire, Oxfordshire and Buckinghamshire, bosses are planning to cut the staff payroll by £35million to help meet a £479million deficit.

It is a similarly depressing story in most other regions as Tory austerity continues to batter services, morale and patient safety.

But NHS medical director Professor Sir Bruce Keogh insisted: “We are talking about steady incremental improvement, not a big bang, tackling things doctors and nurses have been telling us for years.”

The Department of Health added: “The NHS already has its own plan, designed by NHS leaders, which sets out how we can transform services and improve standards of care in building a more responsive, modern health system.”

http://www.mirror.co.uk/news/uk-news/secret-plan-22billion-nhs-cuts-9299803

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East Devon Watch

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19 Nov 2016

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Accountability, Austerity cuts, Democracy, Health and Social Care (local), NHS (local)

The REAL-LIFE Devon NHS cuts

“The proximity of North Devon district hospital to Anne-Marie Wiles’ home – it is less than five minutes away – is crucial.

Her twin sons, Jed and Peirce, were given just six months to live after being born with multiple complex health needs. They are now doing well, aged 16, thanks in large part to the efforts of a loving family, but also the dedicated staff at the hospital in Barnstaple.

“I intentionally live opposite the hospital because when the boys stop breathing there is not enough time to call an ambulance,” said Wiles. Jed has been resuscitated three times at the NDDH and both have been nursed countless times at the Caroline Thorpe children’s ward.

“If these services end then my boys will for certain die once they become ill,” said Wiles. “I am fearful of losing my children.”

She is one of thousands who have joined marches, written to local MPs, organised benefit gigs, signed petitions over the Wider Devon STP – sustainability and transformation plan – which is proposing radical changes to healthcare in the county.

If the plan comes to fruition in its present form, 600 community and acute beds across this sprawling, largely rural county will be gone within five years.

Cherished community hospitals at Honiton in the east – nicknamed the Honiton Hilton because it so beloved – Okehampton in central Devon and Paignton and Dartmouth in the south would go. There have been howls of protest everywhere – but nowhere more than in and around Barnstaple.

Here there is deep alarm that the plan may lead to the shutting down of maternity, neonatology and paediatric services as well as triggering the loss of other departments, including A&E. The Royal Devon and Exeter hospital is 50 miles away – an hour and 10 minutes by car down a winding road if conditions are good, much more if not.

Tina Day’s son, Jaiden-Lee, was born at the NDDH with a collapsed lung and spent a week in the special care baby unit for a week before developing type 1 diabetes. “It terrifies me if services like maternity and A&E are re-located. People will die, guaranteed,” said Day.

John Tate claimed his wife and daughter would both have died had the NDDH not been near. “My daughter had her umbilical cord wrapped around her neck. She had breathing problems and was trapped head down. This caused my wife life-threatening problems. An emergency cesarean saved their lives. Both would have died if Barnstaple was not there.”

Crystal Steinberg said the closure of the maternity department would make her think twice about having a second child. She underwent an emergency caesarean section because her unborn baby, Dylan, was in distress. “I do not want to be stranded at the side of the road while my uterus ruptures and my baby and I die.”

It is not just mums who are worried. Tracy, 46, suffers from a mental health condition that leaves her suicidal. “I have been to A&E three times this month after being picked up by police.” Should the A&E close she believes she would be held in a cell or have to head to Exeter. “I’d have no way of getting there but to walk or hitch. Both are a scary.”

Jacob Egan, seven, was so concerned when he got wind of the proposals that he dictated a letter to Theresa May. He has brittle asthma, which can result in severe attacks, and has been admitted to the NDDH around 10 times.

“Dear prime minister,” he said. “Just think about it, every time any child in our area of north Devon needed to go to hospital they would have to go to Exeter. Exeter is a long distance away and if your heartbeat stopped you couldn’t just wait for a train or car to get you there.”

At the heart of the plan is a “new model of integrated care” that will “reduce reliance on bed-based care and enable people to live healthy independent lives for longer, closer to where they live”. In other words the idea is to look after people at home rather than in hospital.

According to the latest draft of the report, which is up for consultation, every day more than 600 people in Devon are medically fit to leave hospital beds but do not.

The plans argues change must take place. Health and social care services in Devon are likely to be £557m in deficit in 2020/21 if nothing is done, the plan says. It also says the system as it stands isn’t working. The 95% standard for patients being seen in A&E within four hours is not being met – the Devon system is currently achieving 91.6%.

Devon’s demographics also have to be taken into account. There are more elderly people here than in other parts of the UK – in one area of Torquay almost one in 10 are aged over 85. Some need a lot of care – in north, east and west Devon, 40% of people use almost 80% of health and social care.

Angela Pedder, lead chief executive for the plan, said she understood people’s concerns. “But if we sit back and say let’s just let things happen, that’s a much bigger risk not just for the whole of Devon.

“We have to be pro-active. We have responsibilities to make sure the service is safe and sustainable two, five, 10 years down the line. That’s what we’ve got to plan for. That’s the framework we are trying to put in place.”

Politicians, activists and patients are not impressed.

The East Devon Tory MP Hugo Swire said: “We are in danger of putting the cart before the horse. Until we can absolutely ensure that we have got social care right, we should not look at unnecessarily closing community beds.”

Jan Goffey, the mayor of Okehampton, called the proposals cruel and claimed the NHS was being “dismembered”. If the people who actually live in Barnstaple are worried, those that live even further north – and so even further from Exeter – are even more concerned.

Sarah Vander, who runs a shop in the cliff-top village of Lynton, 20 miles north-east of Barnstaple, said her mother had been saved from a stroke and her husband from a diabetic hypo – a drop in blood glucose level – because they got to the NDDH quickly. “We are incredibly remote and we must be able to rely on the excellent services of NDDH otherwise the simple fact is, people will die unnecessarily.”

The seaside town of Ilfracombe, 12 miles north of Barnstaple, suffers a double whammy. The town is isolated and some areas are deprived: life expectancy in central Ilfracombe is 75 compared with 90 in parts of east Devon.

Rebecca McGarry, from Ilfracombe, the mother of daughters aged two and three, said she felt sick thinking about the prospect of losing services. Both her children have received excellent treatment in Barnstaple including for severe croup, which makes it difficult for them to breathe.

McGarry’s husband is a carer and needs the car for work so she often has to take her children to the hospital on the bus. “I honestly don’t know how we would manage if these appointments were moved even further away. The idea that such a remote region should lose these vital services is totally absurd. People will lose their lives if these closures do happen.”

https://www.theguardian.com/society/2016/nov/18/nhs-cuts-in-devon-if-these-services-end-my-boys-will-for-certain-die

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East Devon Watch

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18 Nov 2016

Posted under

Accountability, Asset sweating, Austerity cuts, EDDC

Poor commercial judgement and skills at local authorities worrying

Hot on the heels of news that EDDC’s development costs for Exmouth seafront have more than doubled from £1.5m to £3.2m comes this report:

“The increasing scale of commercial activity carried out by local authorities could put council finances at risk, and town halls might lack the necessary skills for such projects, the Public Accounts Committee has warned.

In a report examining the financial sustainability of local government, published today, MPs accused Whitehall of being complacent about the risk to local authority finances.

Today’s “Financial sustainability of local authorities” review highlighted that councils were increasingly undertaking commercial activity intended to generate revenue income from capital investment in properties and businesses in an effort to offset government cuts. This includes projects such as developing houses and commercial units for rent or sale.

But the MPs warned councils may lack experience of such schemes, and council tax bills or other services could be hit if they go wrong. They called on the Department for Communities & Local Government to review the commercial skills in different types of authorities, and provide an update by next summer on the scale and nature of these activities in order to better anticipate risks.

“We do not share the department’s confidence that the increased commercial activity in the sector adds no particular risk to the department’s own work,” the report stated. The department should also work with CIPFA to ensure the local government capital finance framework “remains current and continues to reflect developments”.

Committee chair Meg Hillier said funding cuts had led councils to rethink the way they use public money, and the government wanted councils to become largely self-financing, including through business rates retention. However, she warned that poor investment decisions could cost money that might otherwise be spent on public services.

“Our committee has previously highlighted gaps in the commercial skills of the civil service as a factor in the failure of some projects and we have similar concerns about local government,” she stated.

“Local authorities need the skill-set to invest wisely and the department must bear its share of responsibility for ensuring these skills are in place. But more fundamentally, the information central government uses is inadequate for understanding trends and associated risks in local government finance.”

This represented a serious flaw in DCLG’s ability to plan properly for the future and ensure councils are following a sustainable path, she concluded, but the department was complacent about the risk. …

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17 Nov 2016

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Accountability, Austerity cuts, Health and Social Care (local), NHS (local)

“Promised £8bn extra for NHS is not enough, says hospitals boss”

Theresa May will have to rip up the government’s financial plans for the NHS and commit more than the promised £8bn extra by 2020, a hospitals boss has said.

Chris Hopson, the chief executive of NHS Providers, said ministers must come up with a new plan to fix the health service’s crumbling finances or risk it becoming unable to function properly.

In a submission to the Treasury before next week’s autumn statement, NHS Providers, which represents 96% of NHS trusts in England, says a rethink is necessary because the calculations underlying the government’s £8bn pledge are flawed.

It says demand for care is rising faster than envisaged in the blueprint drawn up by NHS bosses in 2014, the Five-Year Forward View, and social care has deteriorated.

Hopson said: “Some of the key assumptions in the Five-Year Forward View, on which the current financial and NHS delivery plans for this parliament are based, have turned out to be wrong. There is now a clear and widening gap between what is being asked of the NHS and the funding available to deliver it.

“The NHS simply cannot do all that it is currently doing and is being asked to do in future on these funding levels.”

Andrew Lansley, the health secretary from 2010 to 2012 in the coalition government, recently said the NHS needed a “Brexit bonus” of £5bn on top of the £8bn already pledged, given the widespread public demand for higher NHS funding revealed by the EU referendum.

NHS Providers does not specify how much more it wants invested. But Hopson said more than £8bn was justified because “demand for care is a lot higher, social care is in a much worse state, general practice is turning out to be more unstable, and the starting point for the deficit among hospital, mental health, community and ambulance trusts has turned out to be much larger.”

He said the overall health budget would go up by only £4.5bn by 2020, not the £8bn ministers pledged last year, because money was being taken from key areas such as public health in order to give the NHS its promised increase. Independent experts agree £4.5bn is the true increase that healthcare will get.

The NHS’s inability to deliver the £22bn of savings it had promised to make by 2020 – a target that had always been “too ambitious” – further underlined the need for more money to be found before the end of this parliament, said Hopson.

May has been under pressure recently over her repeated claims that the government is giving the NHS £10bn more, and more than the NHS England chief executive, Simon Stevens, asked for in 2014. Sarah Wollaston, the Conservative chair of the Commons health select committee, and other members of the committee wrote to the chancellor Philip Hammond to say the claims were untrue. Labour has asked the UK Statistics Authority to rule on whether the £10bn claim is justified.

Jeremy Hunt, the health secretary, has subtly distanced himself from the £10bn figure and said the NHS will need a lot more money after 2020, at the end of its unprecedented decade-long budget squeeze.

Ministers have already told Stevens that the NHS will not receive a funding boost in the autumn statement. But NHS and local council leaders hope the chancellor may find some extra money to prop up the ailing social care system.

“NHS funding increases from next year onwards are not enough to maintain standards of care, meet rising demand from patients and deliver essential changes to services,” said Richard Murray, director of policy at the King’s Fund thinktank.

“If additional [NHS] funding is not forthcoming later in the parliament, the government will need to be honest with the public about the impact on quality of care and access to services.”

The Department of Health did not respond directly to Hopson’s comments. A spokesman said: “This government has taken tough economic decisions that have allowed us to invest in our NHS, which is meeting record patient demand whilst improving standards of care. We have prioritised funding for the NHS with £4bn extra this year.”

https://www.theguardian.com/society/2016/nov/17/promised-8bn-extra-for-nhs-is-not-enough-says-hospitals-boss

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East Devon Watch

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17 Nov 2016

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Affordable and Social Housing, Austerity cuts, Developers/ Development

More/fewer unaffordable/affordable homes

“Fewer affordable homes were built in the past year than any time in the past 24 years, while there was a 52% fall in the supply of new homes in just 12 months.

Builders put the finishing touches to 32,110 affordable homes in England in the year to the end of March 2016, compared with 66,600 over the previous year, according to figures from the Department for Communities and Local Government (DCLG).

Of those, just 6,550 – about 20% – were for social rent, which critics say is the only truly affordable housing tenure, with the rest made available to rent or buy at “affordable” rates of up to 80% of market value.

Critics said the figures were disastrous, and called on the government to do more to encourage housebuilding. They come as the proportion of households that own a property is at a 30-year low and rising house prices have driven the cost of buying a home to more than 10 times the average salary in a third of England and Wales.

“The Tories have made ‘affordable housing’ a meaningless term”

Neal Hudson, a property market analyst for Savills, said the fall came as no surprise after 2014/15’s figures were inflated by developers racing to use up funds as the government’s previous affordable housing programme came to an end. Funds for a new programme were initially much lower, until more cash was released in last year’s autumn statement, he said.” …

https://www.theguardian.com/society/2016/nov/17/number-of-affordable-homes-built-in-england-slumps-24-year-low

Or, as George Osborne is alleged to have said: “Why should we build social and affordable homes? The people in them vote Labour”

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East Devon Watch

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17 Nov 2016

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Accountability, Austerity cuts, Consultation, Health and Social Care (local), NHS (local)

Health transformation “fantasy”: For Norfolk read Devon and the rest of the country

“… In Norfolk and Waveney, the latest Sustainability and Transformation Plan (STP), under guidance from NHS England, has only been seen by a small group of health chiefs.

It has been kept from MPs, councillors, NHS staff, GPs, unions and some hospital board members.

An initial version of the plan was published in June, which warned there would be a deficit of £440m by 2020 in the NHS and social care budget, if action was not taken.

The plan proposed keeping patients out of hospital by expanding community and social care, but little detail has been given so far about what that action might be or how they hope to save a proposed £160m.

The full STP plans have been published in several areas of the country, but Norfolk and Waveney STP is following NHS England guidance by not making their proposal public yet.

Managing director of Norfolk County Council Dr Wendy Thomson, who is leading on the STP, said their plan was “at an earlier stage in its development compared to many others around the country.”

““Plans are not yet at the point where they have clear messages about things the public want to know”
Dr Wendy Thomson, Norfolk County Council
“Plans are not yet at the point where they have clear messages about things the public want to know,” she said.

“As service plans are developed, EDP readers can be assured that changes will be subject to the right public engagement and statutory consultation.” The Norfolk and Waveney STP is expected to be published in late November, but it is understood there will still be little detail in the document about what health chiefs propose to do with Norfolk an Waveney’s health system to plug the financial blackhole.

North Norfolk MP and former health minister Norman Lamb said there would be little hope of the getting the public involved in the plans if they were presented as a “fait accompli”.

He said he supported the idea of saving money by having more people being cared for in the community and joining up health and social care, but said the idea that hundreds of millions of pounds could be saved through STPs was fanciful.

“It is in the realms of fantasy to imagine this is achievable,” he said. “I don’t think when it is published people will get that excited about it. It will not say anything significant in terms of detail of changes. What lies beyond that is much more disturbing for many.”

Jeff Keighley, Unison regional organiser, said STP leaders should have consulted the public “at the earliest possible opportunity”.

Although the union said it was not against “sustainable transformation”, Mr Keighley said he was concerned the proposals would not be sustainable.

“If they had found a wonderful way of saving this money by enhancing the services it would be amazing – and they would have not been keeping it a secret,” Mr Keighley said. …

… What’s happening in other areas

Some councils have objected so strongly to the lack of public involvement they have ignored NHS England’s demand to keep the documents private until a later stage and have published them on their websites.

The plans on how local NHS areas will move forward over the next five years focus on several key themes.

These include cutting costs, moving care closer to home, putting a greater emphasis on preventing people becoming ill in the first place and concentrating services in a smaller number of units or hospitals.

Some argue this will enable increased access to consultants around the clock and make the best use of specialist NHS staff and resources. There are also plans to streamline back-office functions.

So far, more than a dozen plans have been published or leaked. Here are details from some of the key ones:

•The plan for Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby set out how either Darlington or North Tees could lose their emergency department, with one becoming a “specialist emergency hospital” and another becoming a “local hospital”.

The plan says this will drive up standards, ensure a seven-day consultant presence with at least 16 hours per day consultant specialist access. More than 75% of patients could be assessed by a specialist consultant on admission and 100% assessed within 12 hours by a consultant.

Consolidating these services, together with other departments, could save millions of pounds, the plan said.

•The south-west London document outlines plans to cut the number of acute hospitals on the patch from five to four. Currently there are five hospitals at Croydon, Epsom, St Helier, St George’s and Kingston.

The plan says: “The only site which we believe is a ‘fixed point’ is St George’s Hospital in Tooting since it provides hyperacute stroke, major trauma and other services which are serviced by highly-specialised equipment and estates, which would be very expensive to re-provide elsewhere in south-west London.”

The document says reduction in sites is necessary to provide seven-day services with enough doctors and consultants – one of Health Secretary Jeremy Hunt’s main aims.

“We are very unlikely to be able to deliver services that meet clinical quality standards across five acute hospital sites. In particular, clinicians do not believe that we will be able to recruit or pay for sufficient workforce to deliver seven-day services at five acute sites.”

•In Birmingham and Solihull, the plan states that by 2021 there could be a deficit of £712 million across the health and care sector if nothing is done to address issues in the local health economy.

It says it will establish a single “lead provider” for maternity care and look to “immediately” implement a shared service for back-office functions across its four main acute providers and create a centralised laboratory for routine pathology work.

There are currently two main providers of maternity care – Birmingham Women’s Foundation Trust and at the Heart of England.

Plans to merge Birmingham Women’s and Birmingham Children’s Hospitals by next year have already been announced while University Hospitals of Birmingham and Heart of England FT announced in September the intention to create a “single organisation”.

•North-west London’s draft STP, seen by the Health Service Journal (HSJ) last month, aims to “consolidate acute services on to five sites” from the current nine.

Two London councils – Ealing and Hammersmith and Fulham – have said they cannot agree to a plan that assumes Charing Cross Hospital will be downgraded.

Stephen Cowan, leader of Hammersmith and Fulham council, said: “At the heart of the STP is an acceptance that Charing Cross Hospital will be demolished and replaced with significantly downgraded facilities, with the capital receipts from the sale of much of the hospital’s land intrinsic to the delivery of the STP. 1/8We are 3/8 strongly opposed to this, and therefore the STP.”

•The Cheshire and Mersey plan includes the downgrade of at least one A&E department along with a major consolidation of elective care.

The A&E at Macclesfield hospital would become a minor injuries unit. According to the Health Service Journal (HSJ), there will be a formal “major service review” at Southport and Ormskirk Hospital Trust, and the document includes options that could reduce the number of 24-hour A&E departments across three acute trusts.

•The north central London document sees officials over the next year examining whether some key services “would benefit from consolidation or networking”.

These services include maternity, out-of-hours emergency surgery, orthopaedics, mental health crisis care and dermatology.

http://www.edp24.co.uk/news/health/bid_to_transform_nhs_in_norfolk_and_waveney_and_save_160m_in_realms_of_fantasy_1_4774673

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East Devon Watch

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17 Nov 2016

Posted under

Austerity cuts, Health and Social Care (local), NHS (local)

“Elderly failed by ‘shameful’ care system”

“Age UK and the Alzheimer’s Society criticised both the quality of care and the way it was rationed as they published fresh evidence on the state of the care sector.

It includes figures that suggest the number of older people not getting help has risen by nearly 50% since 2010. …

… three pieces of research showed:

There are now an estimated 1.2 million over-65s going without help for care – nearly one in eight of all older people

Some 300,000 of them have difficulty with three or more tasks, including dressing, bating and going to the toilet

Councils agreed to help under half the 1.3 million people who approached them for care last year

The BBC identified 11 councils that rejected more than 75% of applications
Where home care was provided “serious problems” were identified in the way dementia patients were treated

Staff said they had not been given enough training to cope with the complex needs people had

Families reported examples of poor care, including loved ones not being given medication, being left in dirty clothes for days and going missing after homes had not been properly secured

Caroline Abrahams, of Age UK, said she was “extremely worried” about the “shameful” state of the care system.

“The sad irony is that it would be far more effective as well as infinitely more humane to give older people the care and support they need,” she said. …

…Councillor Izzi Seccombe, of the Local Government Association, said: “Unless social care is properly funded, there remains a growing risk to the quality and safety of care, and the ability of services caring for our elderly and vulnerable to meet basic needs such as ensuring people are washed and dressed or helped out of bed.”

http://www.bbc.co.uk/news/health-37992488

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East Devon Watch

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15 Nov 2016

Posted under

Accountability, Austerity cuts, Consultation, Health and Social Care (local), NHS (local)

Telegraph: “Secret plans to shut hospitals could put lives at risk, say doctors”

“STEALTH NHS plans for sweeping closures of hospitals and accident and emergency departments are “potentially catastrophic” and could put lives at risk, leading doctors have said.

The warning came as a major report by the King’s Fund lambasted health officials for ordering the suppression of proposals that will affect millions of people.

The respected think tank suggests the plans – being drawn up behind closed doors in every part of England – may be doomed to fail patients.
Secrecy about the process, combined with “breakneck” timescales and a lack of funding for new services means patients could bear the brunt of brutal cuts, they suggested.

Two weeks ago, The Daily Telegraph disclosed that half of NHS leaders are planning bed cuts, with one third intending to close accident and emergency departments.

It follows orders to produce “sustainability and transformation plans” (STPs) to tackle the greatest financial crisis in the history of the NHS and meet unprecedented patient demand.

On the critical list:

Some of the plans floated so far

♦ South West London: closure of one of five major hospitals
♦ North West London: closure of two A&E units
♦ North East: Darlington Memorial Hospital or North Tees Hospital to lose A&E unit
♦ Devon: cuts to almost 600 beds, with the loss of maternity and paediatric services from north Devon site
♦ Cheshire and Wirral: downgrade of at least one A&E department
♦ St Helens and West Lancs: possible closure of two A&E units

The country has been split into 44 areas, with each told to produce proposals to balance the books and change the way care is delivered.
NHS leaders have pledged to shift more care into the community, and to strengthen GP services, in efforts to boost health.

But cost-cutting has now taken precedence in many of the plans, the head of the King’s Fund warned. Today’s report criticises NHS England for telling local leaders not to publish plans until the details have been checked by senior officials.

In recent days, increasing numbers of NHS bodies and councils have broken ranks, publishing or leaking documents that set out plans for major changes to their services, arguing that the public deserves honesty.
The plans issued so far warn of the closures of whole hospitals as well as A&E and maternity units.

The King’s Fund criticised health officials for keeping patients in the dark, warning that the public has been “largely absent” from debate.
As well as telling local NHS managers not to publish their proposals, health officials also told them to block Freedom of Information requests seeking the information, the report says.

“National NHS leaders wanted to be able to ‘manage’ the STP narrative at a national level – particularly where plans might involve politically sensitive changes to hospital services,” the report says.

Local managers in the study said the approach was “ludicrous” and meant that controversial plans were being drawn up with no local involvement – which was likely to end in a “massive fight.”

Dr Tajek Hassan, president of the College of Emergency Medicine, said: “Secretly producing plans without involving those who are – or should be – at the heart of the NHS; the patients, is wholly unacceptable and will not result in effective or sustainable services.

“Transparency is also needed to address the current speculation regarding the potentially catastrophic closure of emergency departments, which – if true – would only add to the substantial difficulties emergency medicine faces and put lives at risk.”

Chris Ham, chief executive of the King’s Fund, said the NHS had been told by Government that “we don’t want too much noise” about the controversial plans.

Sir Bruce Keogh, the NHS medical director, said changes were needed to meet the needs of the country’s ageing population, and to ensure specialist care was available round the clock.

“We are talking about steady incremental improvement, not a big bang. If we don’t, the problems will only get worse,” he said. ”

http://digitaledition.telegraph.co.uk/editions/edition_1mboe_2016-11-14/data/239163/index.html

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East Devon Watch

Posted on

12 Nov 2016

Posted under

Accountability, Austerity cuts, Consultation, Health and Social Care (local), NHS (local), Rural communities

“GP defends plans to cut hospital beds across eastern Devon” – or does he?

Another example of post-truth journalism, this time from the Sidmouth Herald. Under the above quoted headline, this is what the GP ACTUALLY says:

“I share the concern that there won’t be enough provision in the community – that would be my number one concern. We can only reduce beds when we see corresponding change in the community. The timescale will centre on getting the services in place.

“I understand the huge financial pressures within the system, but it’s not in anybody’s interest to do it badly. Getting it wrong will inevitably cost the system a lot more. Moving our services in that direction is the right thing to do and trying to make sure we get the capacity right is very important. It will be a disaster if we do not.”

Dr Mejzner admitted there will always be people who require non-acute hospital care, but argued this could be provided in remaining community hospital beds, or with private sector contracts in nursing and residential homes.

He stressed the importance of responding to the public consultation to inform decision-making and raise issues that might have not been previously considered.

The GP added that if respondents do not agree with any of the four options presented – which each propose bed cuts – it is important that they state why the proposals are wrong in order to help health bosses determine the main concerns and issues.”

http://www.midweekherald.co.uk/news/gp_defends_plans_to_cut_hospital_beds_across_eastern_devon_1_4770586

Does that sound like he defends current bed cuts?

We have no system in place, and very little chance of getting it in place in a largely rural community where the costs will be very high and suitably qualified staff are difficult to find and will become more so with immigration controls.

Posted by

East Devon Watch

Posted on

11 Nov 2016

Posted under

Accountability, Austerity cuts, Health and Social Care (local), NHS (local), Scrutiny, Spin, Virgin Healthcare

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1 Comment

North Somerset and Bath: Goodbye NHS, hello Virgin Healthcare

Set to commence on April Fool’s Day next year

“Sir Richard Branson’s health firm, Virgin Care, has won a £700m contract to deliver 200 types of NHS and social care services to more than 200,000 people in Bath and north-east Somerset.

The contract, which was approved on Thursday, has sparked new fears about private health firms expanding their role in the provision of publicly funded health services.

Virgin Care has been handed the contract by both Bath and North East Somerset NHS clinical commissioning group and Conservative-led Bath and North East Somerset council. It is worth £70m a year for seven years and the contract includes an option to extend it by another three years at the same price.

It means that from 1 April Virgin Care will become the prime provider of a wide range of care for adults and children. That will include everything from services for those with diabetes, dementia or who have suffered a stroke, as well as people with mental health conditions. It will also cover care of children with learning disabilities and frail, elderly people who are undergoing rehabilitation to enable them to go back to living at home safely after an operation.

NHS campaigners warned that the history of previous privatisations of NHS services in other parts of England may mean the quality of care patients receive drops once Virgin takes over.

“This is obviously part of a big push by Virgin to dominate the supply of community health across England. The experience so far from NHS outsourcing is that companies struggle to deliver the level of service that patients need and make a profit,” said Paul Evans, co-ordinator of the NHS Support Federation, which monitors NHS contracts being awarded to firms such as Virgin.

“In too many instances outsourced healthcare has resulted in care being compromised to cuts costs. Patients need secure services that they can trust and rely on,” Evans added.

The collapse of the £725m UnitingCare contract in Cambridgeshire meant Virgin’s newly acquired contract would be the most lucrative ongoing deal for providing NHS care, he said.

Eleanor Jackson, a Labour member of Bath and North East Somerset council, told the Mirror she was “horrified” by the decision. “Make no mistake about it, what has happened here is the beginning of the privatisation of the NHS in this country. Woe betide you getting ill in this area if you are old, disabled or have learning difficulties in the next seven years. It is just a horrifying decision,” she said.

There are concerns that handing the work to Virgin Care will take important income away from the many local NHS, voluntary, charitable and housing bodies that currently provide some of the services. They include the Royal United hospitals Bath NHS foundation trust, Great Western hospitals NHS foundation trust and the Avon and Wiltshire mental health partnership NHS trust. Charities affected include Age UK’s Bath branch and the Alzheimer’s Society.

Virgin will also run the urgent care facility at Paulton community hospital, which is 12 miles from Bath, and subcontract a number of other services to other providers, including the provision of dementia and end of life care and a “hospital from home” service for recently discharged patients.

“I am pleased that we can now start the process of transferring services. Following extensive consultation with local people and a very rigorous procurement process, the CCG board is assured that Virgin Care is the right organisation to deliver the personalised and preventative care that local people have asked for,” said Dr Ian Orpen, the clinical chair of Bath and North East Somerset clinical commissioning group.

“We will be working closely with the council and our new partners, Virgin Care, over the coming months to ensure that services and staff are transferred across safely on 1 April 2017 and to minimise disruption to the care and support that people currently receive.”

A spokesman for Virgin Care said: “We are really pleased to have been chosen by the council and CCG to deliver more joined-up care for people across Bath and north-east Somerset. We have a strong track record over the last decade of overseeing integration and improvement of NHS services across England and we’re looking forward to working with the many outstanding professionals, and a range of great partners, to provide and oversee high quality, easy-to-navigate services which are shaped by the people who use them.”

http://www.theguardian.com/society/2016/nov/11/virgin-care-700m-contract-200-nhs-social-care-services-bath-somerset

Posted by

East Devon Watch

Posted on

9 Nov 2016

Posted under

Accountability, Austerity cuts, Consultation, DCC, EDDC, Health and Social Care (local), Independent Councillors, NHS (local), Paul Diviani, Scrutiny

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2 Comments

Diviani votes against Claire Wright DCC motion to re-examine Honiton hospital closure

Reblogged from the site of Claire Wright, indefatiguable independent councillor fighting non-stop on health service cuts.

NOTE: EDDC Tory Leader Paul Diviani sabotaged her effort to “stop the clock” on cuts to re-examine the effects of closing Honiton and Okehampton hospitals.

REPORT FROM CLAIRE WRIGHT, DCC HEALTH SCRUTINY COMMITTEE

“• CCG does not know how many more staff it needs

• No answer (yet) to public health stated assumption that care at home costs the same as care in big hospitals

My proposal at yesterday’s health and wellbeing scrutiny committee meeting to suspend the consultation which proposes to halve the remaining community hospital beds in Eastern Devon, fell by two votes.

There was a packed public gallery. Several members of the public, including Di Fuller, chair of Sidmouth’s patient and public involvement group and Cathy Gardner, EDDC Independent councillor for Sidmouth spoke powerfully, expressing deep concerns about the bed losses.

Di Fuller said the consultation should be rejected as “invalid.”

Cathy Gardner called on the committee to demand more funding from central government.

Councillors, Kevin Ball and James McInnes from Okehampton made strong representations on behalf of the town relating to the hospital being excluded from the consultation.

(I am part of a sub-committee of health scrutiny that meets tomorrow to scope an investigation into the funding formula for Devon’s health services, which many people, including me believe is unfair, despite the government’s claims that Devon receives more funding than its fair share).

Staff from the NEW Devon Clinical Commissioning Group presented to the committee. They were Rob Sainsbury, Jenny McNeill and GPs – Joe Andrews and Simon Kerr.

We were shown a video of patients happy with the hospital at home scheme which operates in Exmouth and Budleigh Salterton only, as evidence that care in people’s homes work.

This to me didn’t seem to be adequate evidence given that hospital at home is limited to Exmouth and Budleigh Salterton, is consultant led and mirrors the kind of care one might expect in a hospital. It is a good service but expensive to run.

This is not what is being proposed for the remainder of Eastern Devon.

The four presenters tried their best to sell us their new model of care. Some of us weren’t convinced.

Cllr Andy Boyd was critical of the plans and other members asked questions about housing and various NHS procedures.

I asked how many more staff they would need to operate their new system. We heard they needed more “therapy staff” and other disciplines, but not how many more of each. We were told that a staff analysis was currently being carried out.

I said I was surprised that this information was not known, halfway through the consultation, with an expected figure of savings at around £5-£6m. How can the CCG be confident that the new system will save money when basic information is not known, such as how many staff are required?

Under the previous agenda item I had turned to page three of the October 2015 public health acuity audit – a document used by the CCG to back up its case for shutting beds, where it states as an assumption: “Caring for a patient in an acute care setting is either more expensive than, or at least as expensive as, caring for a patient in alternative setting, including at home.”

I asked for a reaction to this statement. Angela Pedder, Success Regime chief, said she would get back to me about it.

It is surprising that in a document the CCG is using to back up its case, where they say caring for people at home will save money, it states that this care costs the same as acute care (such as the care provided at the RD&E for example).

I raised the issue of Devon County Council’s adult social care budget being £5m overspent and how this overspend will need to be brought back to zero by April 2017. This will surely have a potentially significant impact on any NHS care that is provided in people’s homes.

But Rob Sainsbury said that social care packages could be organised in a different way to support care in people’s homes.

I said that earlier NHS (incorrect) statements about a third of community hospital beds not being used has now morphed into third of bed space not being used. If this is the case surely it is due to previous community hospital bed cuts over the years!

And the other CCG claim relating to Eastern Devon having far more beds than other parts of the county is surely because they have been cut in other parts of the county!

According to a public health audit from last year, there are 94 per cent bed occupancy levels in Eastern Devon. They are far from being half empty.

Finally, I raised the issue of a government watchdog – the Independent Reconfiguration Panel – that examined the Torrington Hospital case for bed losses. It stated in its response that communities must feel they have a genuine opportunity to influence the outcome of a consultation.

I proposed that the consultation be suspended while the CCG included both Honiton and Okehampton in the options to retain beds.

The proposal was seconded by Brian Greenslade but unfortunately was lost 5-7.

Instead, chair, Richard Westlake asked for urgent talks between the CCG and Honiton and Okehampton communities.

In other news, two motions calling for more funding to Devon’s NHS and for the Success Regime to be paused, were agreed by the committee and will go before full council in December.

To view the webcast see – https://devoncc.public-i.tv/core/portal/webcast_interactive/244717

To comment on the consultation email: d-ccg.yourfuturecare@nhs.net
The deadline is 6 January.

http://www.claire-wright.org/index.php/post/proposal_to_suspend_plans_to_cut_71_east_devon_community_hospital_beds_fail

Posted by

East Devon Watch

Posted on

8 Nov 2016

Posted under

Austerity cuts, Transport (local)

South-West to Paddington rail link upgrade shafted

The upgrade work was never going beyond Bristol but many of our local Tory MPs had lauded the decrease in travel time from the south-west that the upgrade was supposed to bring.

“Work to electrify key branch lines on rail routes to Oxford and Bristol has been suspended, the government has announced.

The troubled programme has been beset by delays and cost overruns, with its budget trebling to £2.8bn.

Although a review of the works by Network Rail in 2015 led to the project being replanned on a “more efficient footing”, on Tuesday the rail minister Paul Maynard announced that four parts of the programme would be indefinitely “deferred”. These are electrification of tracks between Oxford and Didcot Parkway, between Bath Spa and Bristol Temple Meads, between Bristol Temple Meads and the city’s Parkway station, and of the Thames Valley branch lines to Henley and Windsor.” …

http://www.theguardian.com/business/2016/nov/08/great-western-electrification-branch-lines-oxford-bristol

Posted by

East Devon Watch

Posted on

8 Nov 2016

Posted under

Asset Management Group, Asset sweating, Austerity cuts

Call for £1 billion fund to protect community assets

“Community action charity Locality has called for a £1bn fund to safeguard public buildings and spaces under threat of sale.

It said in a report Places and Spaces – The future of community asset ownership

Click to access Locality-Places-and-spaces-report-final.pdf

that budget cuts were increasingly forcing local authorities to sell buildings and spaces instead of transferring them for continued use by local residents.

Locality chief executive Tony Armstrong said such sales were “short sighted” and “put communities at risk of permanently losing important public buildings and spaces for the sake of a quick buck.

“Transferring public assets to communities can safeguard them for generations to come,” he said.

Locality said the £1bn fund should comprise £500m from the Dormant Assets Commission, £200m from social investors, £125m each from central government and the Big Lottery Fund and £50m from other funders.

It would use 80% of its money for capital grants and finance, which Locality said was the equivalent of delivering one project per year in every English local authority, while 10% would be devoted to development planning and feasibility studies and the remainder to management and a national advice centre.

Armstrong said the problem of lost public facilities was particularly acute in less affluent areas, where people often lacked skills to negotiate taking facilities over and then running them.”

http://www.publicfinance.co.uk/news/2016/11/locality-calls-ps1bn-fund-protect-public-assets

Posted by

East Devon Watch

Posted on

7 Nov 2016

Posted under

Accountability, Austerity cuts, Health and Social Care (local), NHS (local)

Comments

1 Comment

Health Select Committee: winter pressures unsustainable

Is our CCG crazy when it tries to cut community hospital beds? It would seem so from the report quoted below. So why is it happening? Because the NHS is underfunded and not overspent but our CCG is too lily-livered to say so. Or too well-recompensed for the cuts.

Please don’t go down the “immigrants taking our beds” route! Immigrants in the NHS are fighting this battle with us and for us as front-line staff, and no-one is saying that Hinkley C is being built to keep immigrant lights on!

Our NHS is being destroyed under our noses.

“… The increase in attendances in the last 5 years is equivalent to the workload of 10 medium sized departments in England alone–none of which have been built. Moreover, during the last 5 years the number of beds available for admission of acutely ill and injured patients has continued to fall and we now have the lowest number of beds per capita in Europe and England has the lowest number within the UK.” …

“… This is the figure recorded at midnight—daytime occupancy rates frequently exceed 100% in many hospitals. Such occupancy levels mean there is no surge capacity, rendering hospitals hostage to fortune.” …

… “Whilst increasing bed capacity is not regarded as a viable option by the Nuffield Trust, their evidence identified further utilisation of capacity within the community as being a mechanism for easing pressure in acute trusts. They said that “investment in new rehabilitative ‘step-down’ beds, where patients can recover outside hospital, could deliver substantial gains”. It was therefore encouraging that the Minister said in evidence that as part of the process of developing sustainability and transformation plans:

“we will see the whole healthcare economy players look to develop a more integrated pathway and rehabilitation beds. Intermediate care beds, I am sure, will form part of that”.

During the seminar we held with national policy experts the point was made that there is often an emphasis on community rehabilitation beds to enable discharge from acute hospital. There is, however, less attention paid to the ‘step-up’ element of community provision which can prevent emergency attendance and admission. …”

http://www.publications.parliament.uk/pa/cm201617/cmselect/cmhealth/277/27706.htm#_idTextAnchor027

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