East Devon community bed closures to be speeded up – Seaton to close next week, Honiton the week after

From the blog of Claire Wright – did Diviani and Randall-Johnson know this? Do they care?

“I have seen this SO many times.

A threat to hospital beds. Hospital beds close temporarily due to staffing shortages (because understandably staff leave) and then the permanent closures are brought forward.

What I am not reassured on here is how the loss of the existing beds will morph into the new care at home service and the message on staff redeployment is as vague as ever. Last autumn, I was told by the CCG chair, Tim Burke that around double the number of staff will be appointed… the CCG now talks in terms of ‘redeployment’ and ‘recruitment’ of 50 staff, which is difficult to get to the bottom of, given what we have already been told.

What we also still don’t know (because the CCG won’t tell us) is what happens to those hospitals that lose their beds…

Devon County Council’s health scrutiny committee needs to keep a very close eye indeed, on this issue.

The letter below has been sent to Health Scrutiny committee members:

Your Future Care

I am writing to let you know that we are ready to proceed with the changes to improve care for people across Eastern Devon as part ‘Your Future Care’.

These changes are intended to shift the focus of health and care services to keep more people well and independent at home. Part of this shift will be the redeployment and recruitment of over 50 nursing, therapy and support worker roles to enhance the existing community services in each local area. This will enable the reduction in the number of community inpatient beds across the Eastern locality of Devon.

In order to achieve this safely, we will take a phased approach – working closely with staff and partners – to implement the changes as per the following timetable:

• Seaton Community Hospital week commencing 21 August 2017
• Okehampton Community Hospital week commencing 21 August 2017
• Honiton Community Hospital week commencing 28 August 2017
• Exeter Community Hospital week commencing 4 September 2017 (this is the original closure timetable).

The provision of inpatient services at these locations will cease from these dates. All other services at these hospitals will continue as normal. Patients in these areas in medical need of a community inpatient bed will be accommodated at either Tiverton, Sidmouth or Exmouth hospitals, depending on where they live.

It has become apparent over the last couple of weeks that the schedule for the closure of the in-patient beds at Seaton, Okehampton and Honiton would need to be brought forward by a number of weeks due to the increasing pressures on safely staffing the current configuration of seven community inpatient units.

We have been preparing the comprehensive plans for each area since March 2017 and are confident that moving to the new model swiftly is in the best interests for our patients and our staff. For example, our new Community Connect out-of-hospital service, introduced this Spring, has already led to a reduction in demand for community inpatient beds.

Gateway Assurance Process

As you may be aware, part of the implementation process included a clinical assurance panel reviewing the implementation plans against a series of 30 gateway questions. These were developed to provide assurance of the RD&E’s and the wider system’s readiness to switch to the Your Future Care model.

The Gateway Assurance Panel has given its recommendation to proceed. The workforce HR consultation has been completed and staff have been informed of their new roles and working environments. We have also received the approval of the Equality and Quality Impact Assessments, which took place on the 4th August. We can now commence the redeployment of staff into our enhanced community teams and into the remaining community hospital sites. This change will provide extra capacity and resilience to meet the needs of our local population.

Your Future Care is just the beginning of the work needed to move fully to a model of care which proactively averts health crises and promotes independence and wellbeing for our population.

There is still much more to be done and we at the RD&E look forward to continuing this in partnership with you and our local communities.

Yours sincerely,

Adel Jones
Integration Director”

“Conduct of health committee members investigated by Devon council” – Diviani and Randall-Johnson heavily criticised for behaviour

“Devon County Council has confirmed it is looking into the conduct of members of one of its committees following a debate and vote not to refer a decision to close 72 community hospital beds in Devon to the secretary of state for health.

The matter was debated by the health and adult care scrutiny committee meeting at Exeter’s County Hall on July 25.

Among those who have expressed their concerns is Val Ranger, East Devon District Council ward councillor for Newton Poppleford and Harpford.

She says that at a meeting of East Devon District full council meeting on July 26, Cllr Paul Diviani, who sits on the committee as a representative of district councils, admitted he had not asked the opinion of other district councils about whether they wished to refer the decision to close local hospital beds to the secretary of state, and could offer no evidence on that basis that he was representing their views.

At the meeting Cllr Diviani was among those who voted not to refer the decision to the secretary of state.

Cllr Ranger said: “He said he voted not to because it was unlikely that the secretary of state would overturn the decision.

This seems duplicitous on two count. The first for failing to adequately represent the views of the district councils.

“Secondly for assuming the role of the secretary of state by stating there was no point in referring the matter to him as he was unlikely to overturn the decision.

“At the EDDC scrutiny committee on June 22, EDDC’s views and recommendations were very clear; Northern, Eastern and Western (NEW) Devon Clinical Commissioning Group (CCG) has failed to provide the evidence needed to support their plans.

“However, Cllr Diviani failed to represent those views or the views of other district councils as he did not seek them. He has admitted he voted independently of both EDDC and other district councils, rendering his vote as entirely without integrity in his role at the DCC meeting.

“The vote is an entirely unsafe and undemocratic way of conducting business and brings both EDDC and DCC into disrepute.”

A spokesman for Devon County Council said: “We have received a number of comments, representations and complaints about the health and adult care scrutiny committee held last week and about the conduct of members at that meeting.

“We will be looking at all the points raised by Cllr Ranger and others under our normal procedures to see if there are any issues to be addressed.”

However, Cllr Diviani is confident the investigation by DCC will conclude there has been no wrong doing.

He said: “I take this predictable and entirely politically motivated complaint against me by people who contribute little or nothing positive to the debate at face value, and feel sure that DCC will dismiss the allegations as unfounded.

“I have neither seen or heard anything from Ms Ranger on how her party would address the huge challenges facing the NEW Devon CCG and the NHS.

“As the web cam at County Hall malfunctioned and didn’t record properly, the gist of what I said is as below. I did also explain that my position on that scrutiny committee is by virtue of my being elected by the other leaders of all the Devon districts to represent the county-wide views of the district councils, not just East Devon, and is a function I perform regularly both locally and in London through the District Councils Network where I represent the South West.

“There is a tendency to assume that everything is fine as it is, when it quite clearly is not, and that the government will keep throwing money at the NHS as they always have in the past.

“What that underestimates are the social care costs which are massive, but if tackled correctly will reduce the acute care costs, as evidenced by the Kings Fund report. We will still need our hospital buildings which in Honiton are already being used differently, for example, for kidney or chemotherapy treatments. Staffing is still a problem but that is not building dependent.

“Many of us have made a positive decision to live and indeed work in the countryside and a direct result of that decision is a diminution of accessible services we can reasonably expect the state to provide. When able, it is a price we gladly pay for the quality of life afforded.

“In straightened times, we need to cut the cloth accordingly. As is well documented, the largely under funded cost of adult social care is a significant factor in the problems besetting the NHS where the acute care service is the treatment of last resort, and very good it is too, but with the budget sliced off to the top tier local authority.

“As the truly excellent Kings Fund Report from 2016 made exceedingly clear, sorting adult social care comes first and if we tackle that with the help of the district councils the benefits will flow. The NHS cost pressures will diminish and the money can best be spent where most needed.

“In East Devon we have enormous and justifiable pride in our local hospitals and all our existing towns were well endowed. Costs are, however, never static and will always rise without innovation.

“But here we are talking service industry which is always people dependent and where low wages do not necessarily translate into low cost. Simply put, if one person falls, it will take two people to rectify the situation, and if not rectified speedily, the condition and costs multiply exponentially.

“And speedily must mean access to care, quickly. Our travel times are well known and until they are resolved, we will always need staging posts to either stop people occupying the acute provision when unnecessary or to maintain them in a degree of comfort until they can reach the comfort and safety of their own living space.

“The major flaw appears to me to be the ever present ‘one size fits all’. Flexibility is key and our response should be the start.

“Attempting to browbeat the secretary of state with a demand to overturn his own policies is counter intuitive. I prefer to ask him to rural proof our rural situation before allowing any further reductions in service which we on the ground can see will be detrimental, but our transformers would discount. But that is a local decision which should be made locally.”

Also among those who have raised concerns over the debate and vote at the scrutiny meeting is Claire Wright, Devon County Councillor for Otter Valley Ward.

She has said how she was “disappointed” by the behaviour of scrutiny committee chair Sara Randall Johnson who “appeared to do her utmost” to prevent any referral.

She said: “I am also disappointed with the attitude of the majority of the Conservative group who used a variety of ill-informed views and remarks to justify their determination not to refer, refusing to hear or see any member of the public’s distress, frustration and disbelief at the proceedings.

“The chair’s attitude made me angry and led to a protracted row where I repeatedly asked her why she had allowed a proposal to be made and seconded at the very start of the meeting by her conservative colleague, Rufus Gilbert, not to refer to the secretary of state for health, when I already had a proposal that I had lodged with her and the two officers, before the meeting.”

She added: “When they did what they did at the health scrutiny meeting, the Conservatives betrayed thousands of local people.”

The close vote whether to refer the decision was six votes to seven, with two abstentions. All those who voted with Cllr Gilbert’s motion were Conservative’s.

Cllr Wright, who is seeking advice on what happened at the meeting, concluded: “I am quite certain that with a different approach by the chair the outcome would have been different, and local peoples views would have been respected and acted upon.”

http://m.devonlive.com/conduct-of-health-committee-members-investigated-by-devon-council/story-30478465-detail/story.html

Claire Wright’s report on the shameful behaviour of DCC Health Scrutiny Committee Tories

“The Conservatives on Devon County Council’s health and adult care scrutiny committee on Tuesday, torpedoed local people’s views and any possibility of a referral to the Secretary of State for Health for a decision to close 71 community hospital beds.

I will keep this blog post short and instead post three articles that explain things just as well as I could have explained them.
Suffice to say that I am deeply disappointed.

Not just with the behaviour of chair, Sara Randall Johnson, who appeared to do her utmost to prevent any referral, both at the previous meeting last month and at Tuesday’s meeting.

But also with the attitude of the majority of the Conservative group, who used a variety of ill-informed views and remarks, to justify their determination not to refer, refusing to hear or see any member of the public’s distress, frustration and disbelief at the proceedings.

The chair’s attitude made me angry and led to a protracted row where I repeatedly asked her why she had allowed a proposal to be made and seconded at the very start of the meeting by her conservative colleague, Rufus Gilbert, NOT to refer to the Secretary of State for Health, when I already had a proposal that I had lodged with her and the two officers, before the meeting.

I had been indicating to speak since the start of the meeting, yet, Cllr Randall Johnson chose to call four councillors before me.

When I was finally called to speak I challenged her on why she had not made my proposal, which she had a copy of in front of her, known to the committee at the start of the meeting, which is the usual practice.

Cllr Gilbert’s seconded proposal before questions or the debate had even started had nullified my proposal, which was why I was so angry.

Cllr Randall Johnson admitted that it was her decision not make my proposal known to the committee and her decision on who is called to speak.

When they did what they did at Tuesday’s health scrutiny meeting, the Conservatives betrayed thousands of local people.

As I said in my final speech, local people had written letters, organised petitions, replied to public consultations, attended meetings, spoken at meetings, attended demonstrations, some had even spent significant sums of money on a legal challenge.

Time after time, month after month, the committee has asked questions which have not been properly answered on issues such as evidence that it will work, the staffing required, the finances, care of the dying. Local GPs are up in arms, staff have objected… yet the Conservative group knew best.

The vote was agonisingly close – six votes to seven, with two abstentions. All those who voted with Cllr Gilbert’s motion were conservative. Cllr Randall Johnson also voted with Cllr Gilbert – another unusual move at such a highly charged and significant meeting.

I am quite certain, that with a different approach by the chair, that the outcome would have been different. And local people’s views would have been respected and acted upon.

Councillors are elected by local people to represent their views.

Why was it so important to the chair and her colleagues that my proposal failed on Tuesday?

A whip at scrutiny committees, much least a legally constituted committee such as the health and adult care scrutiny committee of Devon County Council is strictly forbidden.

Yet to the members of the public present, who were repeatedly shouting “fix” it certainly appeared that way.

Since the meeting I have been inundated with messages from people who are disgusted at what happened.

Alongside two other councillors, I am seeking advice on what took place at Tuesday’s meeting.

The debate can be viewed on the webcast here – https://devoncc.public-i.tv/core/portal/webcast_interactive/293466

Seaton councillor, Cllr Martin Shaw, wrote an excellent account of the meeting here – https://seatonmatters.org/2017/07/26/the-health-scrutiny-committee-which-didnt-scrutinise/

My row with Cllr Randall Johnson has led to a local newspaper running a story about revenge… – see http://www.devonlive.com/tory-sara-randall-johnson-derails-claire-wright-s-health-campaign-six-years-after-election-defeat/story-30457493-detail/story.html”

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

“How Tory Sara Randall Johnson took down rival Claire Wright’s health campaign”

Owl says: So, Honiton and Seaton hospitals sacrificed to Randall-Johnson’s anger?

By P Goodwin, Western Morning News

“As the old saying goes: revenge is a dish best served cold.

For Conservative county councillor Sara Randall Johnson the wait to gain the upper hand on old rival Claire Wright stretched to six years.

When she did, the result was painful and public.

At this week’s bad-tempered and rowdy council health scrutiny meeting, Ms Randall Johnson used her new power of chairmanship to thwart the independent rebel and stamp her authority on the newly-elected authority.

In a move which prompted jeers and cries of “fix” from the public gallery, Randall Johnson ignored a tabled motion to halt hospital bed closure plans and instead allow a fellow Tory, Rufus Gilbert, to seize the momentum by kick starting the debate and swiftly proposing the exact opposite.

She then dismissed Ms Wright’s protest by telling her the power to choose was entirely at her discretion as chair, before moving to a vote against referring the proposals, which was won by a majority of one, with one abstention.

It was a swift and brutal piece of politics. The result: bad headlines averted, no need to trouble Jeremy Hunt with the protests of a rebellious council and the upstart put firmly in her place.

Former Lib Dem county council leader and respected political veteran Brian Greenslade remarked after the meeting that the move had been highly unusual.

He considered that not mentioning or circulating a table motion – one submitted before the meeting begins – was rare: not against procedure but definitely a departure from protocol.

In other words: a low blow but not quite below the belt.

It was clear from the tetchy exchanges during the meeting that there is little love lost between the two women and this is perhaps no surprise.

Wright pulled off a shock victory when she ousted Randall Johnson from her East District Council seat and her position as leader, relegating her into third place in a race for two seats, by the slender margin of just 25 votes.

The defeated leader put on a brave face, claiming she had got her life back after 20 years of public service, but this hardly sounds like the words of a woman who just two years earlier was vying with Sarah Wollaston to become MP for Totnes.

Since that victory, Wright, an outspoken independent campaigner, has become a painful thorn in the side of local Tories at district and county level, particularly around the NHS, where she worked in PR before launching her political career.

She has led the opposition ever since, including two general election campaigns in which she gave MP Hugo Swire a run for his money.

But the campaign to halt bed cuts and hospital closures has been a major factor in her rallying call to local people, the jewel in her campaigning crown.

The recent background to Tuesday’s meeting went like this:

Plans by the Northern, Eastern and Western Devon Clinical Commissioning Group to axe 71 beds across four cottage hospitals sparked anger in the Eastern locality.

Amid fears the NHS is planning to sell off the hospitals, relations between the public and NHS officials deteriorated with many accusing executives of lying about their true intentions.

Campaigners, angry that the case has still not been made for the Your Future Care model of home visits, labelled the consultation a sham and turned to the Health and Wellbeing Scrutiny Group for help.

It could refer to Mr Hunt though in reality it the plans would have gone to an independent reconfiguration panel who would make recommendations.

What many people wanted was a change in the way the CCG operates and communicates. they wanted a more open approach and they felt this might give the health trust a jolt.

Under the chairmanship of veteran Labour councillor Richard Westlake, the scrutiny group was poised to refer the plans to the Secretary of State if 14 documented points were not addressed.

But he stepped down at the election and Ms Randall Johnson took up control.

At the first meeting of the newly constituted committee in June, it became clear that she did not intend to let this happen.

Ms Wright had proposed to the last meeting that it was time to vote to refer to the Health Secretary and the chair repeatedly came under fire for not putting this to a vote.

There was a lack of clarity among one or two members about the whole process and eventually, members were persuaded to defer a decision until yesterday to get more information.

It appeared that the Conservatives had their ducks in a row on Tuesday.

Wright cried foul when her tabled motion was ignored, claiming she had never seen it happen in six years of committee meetings.

Unfortunately, the legal advice from the council backed Randall Johnson: Motions needed to be proposed and seconded in the meeting.

Would it have changed the vote? Maybe not. It was close though. East Devon leader Paul Diviani rebelled against his members and voted not to refer and one Tory did admit he was wavering.

The way the meeting was handled did little to foster good relations between the council and the community.

Ms Randall Johnson may have done nothing wrong but she certainly didn’t make any new friends in the public gallery.

As for old foes among the membership – no change there.”

http://www.devonlive.com/tory-sara-randall-johnson-derails-claire-wright-s-health-campaign-six-years-after-election-defeat/story-30457493-detail/story.html

Bed closures at Honiton and Seaton – the final stitch-up by Tory Councillors

Councillor Martin Shaw (EDA, Colyton and Seaton) reports:

[Names of those voters have been amended – it does not affect the result]

“The 7 councillors who voted NOT to refer the decision to close Honiton and Seaton hospital beds were:

Sarah Randall-Johnson
Paul Diviani (Leader of East Devon District Council, representing Devon district councils), and county councillors
Richard Scott (Exmouth),
Rufus Gilbert,
Sylvia Russell,
Paul Crabb and
Ron Peart.

The 6 councillors who voted against this motion, i.e. to refer the decision, were Claire Wright (Otter Valley, Independent), Brian Greenslade and Nick Way (Liberal Democrat), Hilary Ackland and Carol Whitton (Labour) and Phil Twiss (Honiton, Conservative).

Jeremy Yabsley (Conservative) abstained as did John Berry. Two other Tories,
Jeffrey Trail (Exmouth) and
Philip Sanders, gave their apologies.

Six public speakers, Cllr Roger Giles (Chair of East Devon’s Scrutiny Committee), Paul Arnott (Colyton), Cllr Jan Goffey (Mayor of Okehampton), Cllr Mike Allen, Bob Sturtivant and Stephen Craddock (Honiton), spoke eloquently against the closures for two and a half minutes each. County Councillor Ian Hall (Axminster) and I also addressed the committee for five minutes each.

Three representatives of NEW Devon CCG and the RD&E (who run the hospitals and are working with the CCG) were then allowed to make a very lengthy Powerpoint presentation and contribute freely to the discussion – which none of the public speakers, Ian Hall or I were allowed to do.

Claire Wright had prepared a detailed motion to refer the closures and had submitted it to the Chair before the meeting. However when debate began, Cllr Randall Johnson chose not to call Claire to speak but called Rufus Gilbert who immediately proposed the motion not to refer, which was quickly seconded by Sylvia Russell.

This blatant manoeuvre by the Chair meant that the committee never considered point by point, as Claire’s motion would have required it to, the 14 questions on which it had asked the CCG to satisfy it. Despite an excellent report from Hilary Ackland which concluded that the CCG had failed to convince, the Committee basically abdicated its scrutiny role and blocked a referral without discussing most of the objections which we had raised.

Claire and I are planning to complain about the way the meeting was handled. If you want to watch it, it’s online at

https://devoncc.public-i.tv/core/portal/webcast_interactive/293466.

Thank you all for your support for the hospitals over the last 9 months. Be assured, however, that this is not the end of the matter, since the CCG and RD&E are both developing ‘estates strategies’ which will centre on what to do with space freed up by the closures. “

Claire Wright’s information on Health Scrutiny Committee meeting on Tuesday

“The Health and Adult Care Scrutiny Committee will decide whether to refer a decision to close 72 community hospital beds in Eastern Devon, on Tuesday (25 July), to the Secretary of State for Health.

It follows protracted discussions at the previous meeting last month about whether this was the preferred course of action, after I made a proposal to do so.

Dozens of people were in the public gallery waiting to hear what the committee had to say.

A full account of this meeting can be found here –

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

In the end it was decided that a special meeting should take place in July to debate the issue.

The agenda papers for Tuesday’s meeting include a legal paper which sets out some issues that the committee may consider before coming to its decision.

Since the June meeting it has been announced that Honiton Maternity Unit is set to close along with Okehampton and Tiverton’s. The loss of the general medical beds has been a factor in maintaining the viability of those units.

There will be a demonstration from a coachload of people from Seaton and Honiton that will take place at 1pm on Tuesday on the steps of County Hall.

The meeting starts at 2.15pm.

Pic: Giving an interview to ITV about the sad closure of Ottery Hospital’s beds back in 2014.

Here’s the link to the papers: – http://democracy.devon.gov.uk/ieListDocuments.aspx?CId=429&MId=2643&Ver=4