“Leicestershire school plans early finish on Fridays due to cuts”

“A school in Leicestershire is proposing to operate on a four-and-a-half-day week due to budget cuts, confirming warnings by unions that changes to the schools funding formula would lead to schools closing early.

In a letter to parents, Danemill primary school in Enderby cited the controversial formula as a reason for its decision to end the school week at lunchtime on Fridays from October.

The letter published by the Leicester Mercury said: “As you may be aware the fairer funding formula has resulted in schools receiving significantly less money in their annual budgets from the government and Danemill is not an exception.”

To cope in the “current economic climate” it proposed early closing on Fridays. It says: “Effective from October 24 2017 the school day would end on Friday afternoons at 1.05pm.” It argued this will help maintain quality teaching and give teachers time to prepare lessons.

Parents have reacted with dismay, according to the Mercury. One unnamed father told the paper: “This is in the middle of the working day. Lots of parents have to work to make ends meet. It is unworkable madness.”

The school has proposed a limited number of “enrichment activities” on Friday afternoons for some children. The proposal follow warnings by teaching unions that schools would be forced to consider early closing because of a squeeze on resources.

Tim Stone, the chief executive of the Discovery Schools Academy Trust which runs Danemill, said the proposal to close early on Fridays was being put out to consultation with parents. …”

https://www.theguardian.com/education/2017/jun/28/leicestershire-school-plans-four-and-a-half-day-teaching-week

Was “smug” Swire responsible for the Seaton/Sidmouth switch?

Owl says: we all know he is a pal of Jeremy Hunt.

Seaton County Councillor Martin Shaw (Independent East Devon Alliance) Facebook page:

“Was Hugo Swire behind the Seaton-Sidmouth switch? A smug Swire told BBC’s Sunday Politics this morning that East Devon had more community hospitals than western Devon and than the national average. He failed to mention that it has many more over-85s too. He backed the NEW Devon CCG’s plans to replace community hospital beds with care at home, and said we must ’embrace change’.

Swire knows that beds in Exmouth and Sidmouth, in his constituency, are safe from closure. So he is happy to write off Seaton (which he no longer represents after boundary changes a few years back) and Honiton.
Swire’s self-satisfied comments raise the question of whether he played any role in the CCG’s bizarre, unexplained, last-minute switch of 24 beds from Seaton to Sidmouth. Clearly had the CCG stuck with its original preferred option of closing beds in Sidmouth, they would have given Claire Wright a huge issue – which might well have seen her taking Swire’s seat in the general election.

Readers will recall that during the consultation, Swire was already saying that if beds had to go, they should stay in Sidmouth. Did Sir Hugo, or Tories acting on his behalf, lobby the CCG? How did the CCG respond?
Swire’s colleague Neil Parish MP told me and other Seaton councillors that the decision ‘smells’. Whose smell was it?

I appeared on the same edition of Sunday Politics as Swire, but was not in the studio to respond to him. Here I am being interviewed! (YOU WILL BE ABLE WATCH THE FULL PROGRAMME ON BBC iPLAYER SOON.)”

Claire Wright’s report on the disgraceful DCC NHS meeting and its disgraceful chairing by Sarah Randall-Johnson

“It is just as well I have left it almost a week to write this blog because I was very angry on Monday evening.

Before the meeting there was a public demonstration of angry residents mainly from Seaton and Honiton, which was attended by film crews from the BBC and ITV. The BBC and a reporter from the Western Morning News stayed for the whole meeting.

The committee had also received dozens if not, hundreds of emails from residents who were asking us to refer the decision to close 71 community hospital beds in Eastern Devon, to the Secretary of State for Health.

Devon County Council’s newly formed Health and Adult Care Scrutiny met for the first time last Monday (19 June) to review this decision.

Almost all the committee members are either new to the committee or new Devon County councillors.

At the last health scrutiny meeting in March before the elections, I proposed that there were 14 grounds that the committee needed assurances on or it would refer the decision to the Secretary of State for Health on the basis that it wasn’t in the interests of the health service in the area and that the consultation was flawed.

These are legal reasons for referral.

The new chair of the committee is East Devon Conservative member, Sara Randall Johnson, following the retirement of long-serving Labour councillor, Richard Westlake.

During the time between the March health scrutiny meeting and the meeting on 19 June, Richard Westlake had taken the time to instruct the scrutiny officer to draft two letters to the CCG one requesting further information and the second, dated 24 April, expressing concern about the availability of end of life care under the new model of care.

Cllr Westlake alluded to the Francis Report, which was published following deaths at Mid Staffordshire Hospital and which criticised the health scrutiny committee there for lack of challenge.

Points were also made relating to the committee having been told several times previously that the new model of care to be provided in people’s homes instead of in a community hospital, was actually cost neutral, despite claims to the contrary.

The cost of people being cared for at home surely will increase as many people have co-morbidities (multiple conditions), the former chair had pointed out.

His letter also made references to the lack of information relating to the future of bedless community hospitals, given the ownership of NHS Property Services, the exclusion of Honiton and Okehampton Hospitals from the consultation process and the small number of staff who responded to the consultation (less than 2 per cent).
*****************************************

The team for the NHS present at the meeting included Rob Sainsbury, director of operations for NEW Devon Clinical Commissioning Group (CCG), Adel Jones, integration director with the RD&E, Sonja Manton, director of strategy with NEW Devon CCG and Em Wilkinson-Brice, deputy chief executive of the RD&E.

I started my questions, but before I could ask anything the new chair interjected to tell me to ask all my questions at once to save time.

I was a bit surprised at this as it is poor scrutiny technique. Invariably any reply will miss out much information. I said I would ask them in sequence…

Question 1
This was one I asked in March which at the time could not be answered, despite a decision on the bed closures already having been made. What had been the number of objections compared with the number of responses of support for the bed losses?

Answer: We will get back to you (they said that last time).

Question 2
Finance: How much money would be saved given that mixed messages had been received. Even the information from the CCG in the scrutiny agenda papers was contradictory and referred to different levels of savings, which ranged from £2m to £7m. Given that a decision had already been made wasn’t this a bit vague? See pages 11 and 22 of the agenda papers – link at the bottom of this blog post.

Answer: There is a range of savings and this depends on staff and resources. A fixed amount cannot be set. Savings are based on workforce only.

Question 3
Was it true (as I had been informed by Tim Burke the CCG chair) that the numbers of staff had to double? Are the staff in place?

Answer: Yes the staff do need to double, there are 200 staff that are being consulted with. We don’t yet have the workforce in place because not possible to “double run” (services).

Question 4
What happens to community hospitals that lose their beds? Will they be sold off by NHS Property Services which has a remit for this?

There was an interjection by the chair at this point who asked the CCG to clarify whether this was true (NHS PS having a remit for selling off hospital buildings).

Sonja Manton replied selling off NHS property was a trend….

Answer: This was a piece of work not yet carried out. It will be carried out next. (I am afraid it is not credible that the CCG does not have a list of which hospitals they intend to declare surplus to requirements for selling off by NHS PS, even if there has been no formal decision made).

Question 5
An audit on people fit to leave Eastern Devon hospitals in March shows a marked increase compared with the 2015 acuity audit carried out by Public Health. The public health audit 2015 revealed that around 34 per cent of patients are ready for discharge in community hospitals across Devon and the March 2017 audit stated that 64 patients were ready for discharge. How is this doubling in two years, in the number of patients well enough for discharge possible?

And who carried out the survey?

Answer: Clinicians (mainly RD&E) carried out the survey and the results had changed partly because of a new at home palliative care service and hospital at home. (I am sceptical about this because my understanding is that these services are available only in limited places and were in existence previously anyway).

Other councillors asked questions and made their own points.

After a few councillors had spoken chair, Sara Randall Johnson, said she thought there should be a task group set up to obtain evidence on what the committee was being told.

I disliked this pre-empting of the end of the debate by the chair, especially when she knew I wanted to add to my earlier points.

When I was called to speak I made a proposal to refer the decision to the Secretary of State for Health on the basis that this was the committee’s prerogative at this meeting based on 14 grounds. These questions remained unanswered I said. And out of all the bed closure decisions that I had scrutinised over four years, this was the decision that caused me more anxiety than any other.

LibDem and former fellow committee member, Brian Greenslade, seconded my proposal.

But the chair refused to take a vote.

She said the committee was new and needed to be clear about evidence before any such action was taken. She suggested leaving it to the September meeting.

This was unbelievable! A refusal to take a vote on a seconded proposal is very unusual in council committees.

I pushed the chair to take a vote. The CCG had already admitted they would be closing the beds by then. The suggestion appeared to be to me, an attempt to kick the issue into the long grass.

She refused.

There was significant heckling from the public who were understandably very angry at not being listened to.

A range of other councillors (mainly Conservative) then spoke to back her up claiming that there was not enough evidence to refer and what was the point anyway because the Secretary of State would just “throw it out.”

There were other suggestions that we simply work with the CCG to get a better deal. This was immediately dismissed by the CCG as they had already made the decision to close the beds some months ago.

Responding to this, I explained the process and how we had done this before as a previous committee and it was a very worthwhile exercise for guidance and feedback from the Independent Reconfiguration Panel, which looks at the process in fine detail before commenting and/or advising.

Without a referral we simply lie down and acquiesce to the worst decision I have ever witnessed as a health scrutiny committee member. And we let down every single resident who is opposed to the plans.

I also reminded the committee that we were there to provide a legal check (the only legal check) on health services in Devon and it was our duty to represent local people’s views. The evidence that a large number of local people were deeply unhappy with the decision, was overwhelming.

The scepticism among new members was extremely disappointing because the Referral is the ultimate in our powers and of course we had the grounds to do it. It had been already established from the previous meeting that we had the grounds to do it! And it had the full support of the previous chair.

We were told by the new chair that that this was the position of the old committee and the new committee could choose to take an entirely different view if it so wished.

This was also extremely disappointing and members of the public were clearly furious.

I then suggested we have an additional health scrutiny meeting in July to re-examine this issue. I suggested it be held on the day of the full council meeting but this was dismissed by the chair who said there wasn’t time. I asked for a different date but this was also glossed over….

… until Conservative leader of EDDC, Paul Diviani, also proposed a standalone meeting sometime soon about the issue.

Was there a seconder for this proposal, the chair wanted to know?!

I reminded the chair that I had already proposed this. It fell on deaf ears.

The debate continued and appeared to go around and around, with interspersed heckling from angry members of the public.

Eventually, I was asked if I would accept an amendment to my proposal of a standalone meeting of the committee in July. I agreed.

The committee voted in favour.

The meeting has now been booked for Tuesday 25 July at 2.15pm, at County Hall.

Here’s the webcast – https://devoncc.public-i.tv/core/portal/webcast_interactive/288543

Here are the agenda papers – http://democracy.devon.gov.uk/documents/g2581/Public%20reports%20pack%2019th-Jun-2017%2014.15%20Health%20and%20Adult%20Care%20Scrutiny%20Committee.pdf?T=10

The 14 grounds for referral to the Secretary of State for Health can be found on page 34.

**********************************************************************************************************************************************
Below is an extract from a letter to the chair after Monday’s meeting from one of the angry members of the public who was present

“Dr Sonja Manton offered for you to attend a meeting to see how the CCG works. Why didn’t one of you ask them to simply save everyone’s time and respond fully and completely to the requests for information made in March? Aside from which how can you both scrutinise and also collaborate – surely you have to be independent?

Meanwhile – the CCG are negotiating with nursing staff and nursing staff are leaving the hospital in Honiton. The RD &E is reducing or even not making admissions. By the time you get to your extraordinary meeting it will too late to do anything useful at all.

I expect members of the committee to have the will to ensure that residents in the county they represent have easy access to adequate and safe healthcare.

Why is it that the only member of the committee who consistently and unfailingly has the energy and the will to carry out their role efficiently and as effectively as the constraints of being on a committee permit is Claire Wright? Why do councillors agree to be on the committee if they’re just going to let the CCG do what they like?

Please take the time to reflect on yesterdays meeting and consider whether you and/or some of your colleagues were found wanting and then take steps to ensure that the committee becomes an effective scrutiny committee for the benefit of all the people who depend on it to safeguard them. The public may have the voice but it is the committee that has the power. Please use that power for the benefit of us all.”

Pic (on blog) : I was sent this pic of the demo before the meeting, by Honiton campaigner Gill Pritchett. The quote is by the founder of the NHS and says it all.”

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

The latest “under the radar” NHS sell-off plans

“All health and social care organisations that drew up plans to overhaul care in England will eventually become accountable care systems, according to new plans released by NHS England.

[Here is a post on these devious plans]:
https://calderdaleandkirklees999callforthenhs.wordpress.com/2017/03/01/wake-up-to-the-accountable-care-organisation-threat/

Regional organisations that created sustainability and transformation plans (STPs) will ‘evolve’ into accountable care systems (ACSs), with some acquiring the status as early as April this year.

NHS England’s Five Year Forward View delivery plan has said that hospital trusts, CCGs and local authorities in the new ACSs will ‘take on clear collective responsibility for resources and population health’.

However, the report notes that CCGs alone will be responsible for improving emergency admission rates, which will be measured and managed on an STP or ACS level from April.

To do this, NHS England has committed to working with ‘upper quartile higher referring GP practices and CCGs’ to standardise the ‘clinical appropriateness’ of hospital referrals, using CCG data and ‘a new tool from NHS Digital’.

Simon Stevens, head of NHS England, announced at a Parliamentary Accounts Committee meeting last month that between six and ten STP areas would be launching as so-called accountable care organisations (ACOs).

However, the delivery plan says that ACOs are the next step after becoming an ACS, with some becoming an accountable care organisation ‘in time’.

In return for becoming an ACS, NHS England has promised the organisations ‘more control and freedom’ over their regional health system including receiving devolved national GP Forward View, mental health and cancer funding from 2018.

The healthcare systems will be set up in stages with the first to be implemented from April this year.

NHS England noted nine STP areas that are ‘likely candidates’ to become the first ACSs, including:

Frimley Health
Greater Manchester
South Yorkshire & Bassetlaw
Northumberland
Nottinghamshire, with an early focus on Greater Nottingham and the southern part of the STP
Blackpool & Fylde Coast, with the potential to spread to other parts of the Lancashire and South Cumbria STP at a later stage.
Dorset
Luton, with Milton Keynes and Bedfordshire
West Berkshire
The delivery plan added that areas applying for ACS status should have ‘successful vanguards, ‘devolution’ areas, and STPs that have been working towards the ACS goal’.

Chris Hopson, chief executive of NHS Providers, said NHS England’s new plans recognisethat the Health and Social Care Act 2012 ‘prevents the creation of a formal ‘mid level STP tier’ with statutory powers’.

He said: ‘The plan also recognises the importance of existing governance and accountability structures focused on trusts, but also the opportunity for shared decision making at the STP level.

‘Finally, it allows different STPs to move at different speeds: enabling the fastest to progress without delay but not forcing others to adopt a single uniform approach they neither want nor are ready for.’”

http://healthcareleadernews.com/article/all-stps-become-accountable-care-systems-under-latest-nhs-plans

STPs may not be introduced till after Brexit – but are ‘Success Regimes’ similarly doomed or not?

Owl has had to resort to CAPITALS it is so mad!

OWL DOESN’T UNDERSTAND: IF STPs WON’T BE LEGISLATED FOR TILL AFTER BREXIT – WHY ARE LOCAL COMMUNITY HOSPITALS AND MATERNITY SERVICES CLOSED OR BEING CLOSED?

HONITON AND SEATON COMMUNITY HOSPITALS ARE ALREADY BEING WOUND DOWN FOR CLOSURE LATER THIS YEAR – IS HUNT SAYING THIS IS NOT LEGAL?

OUR DOCTORS AND OUR COMMUNITIES ARE AGAINST THESE PLANS, WHICH HUNT SAYS NEED LOCAL SUPPORT, SO IS OUR CCG ACTING ILLEGALLY?

TIME FOR THAT REFERRAL TO THE SECRETARY OF STATE AND A JUDICIAL REVIEW. THIS POWER-MAD, ARROGANT CCG NEEDS TO BE TAMED OR, BETTER STILL, DISSOLVED.

BUT YOU CAN BET OUR TWO MPs WON’T TOUCH THIS HOT POTATO! AND THAT MS RANDALL-JOHNSON WILL BE DEAF TO IT, AND DCC TORIES SPINELESS TOO.

THANK HEAVEN FOR PEOPLE LIKE CLAIRE WRIGHT, MARTIN SHAW AND ROGER GILES!

What Hunt said yesterday:

“Given the result of the latest general election and with the negotiations around Brexit due to start later this month, it is now unlikely that the government will be able to introduce legislation for sustainability and transformation plans (STPs) in the next few years – if at all.

Speaking at NHS Confederation yesterday, health secretary Jeremy Hunt argued that the legislative landscape has changed after a hung Parliament was declared last week. Because of this, it is unrealistic to expect the government to enact legislative health changes before the Brexit process is finished.

“We said [in our manifesto] that we would legislate to give STPs a statutory underpinning if that was felt to be necessary,” he said. “To be clear, we’re expecting to be in power until 2022 and deliver a stable government to make that possible.

“But obviously, the legislative landscape has changed, and that means that legislation of this nature is only going to be possible if there is a consensus across all political parties that it’s necessary. I don’t think that is in any way impossible, but it’s realistically not something we would do while the Brexit process was carrying on.”

Post-Brexit, he added, the government will have “a lot better understanding” of the legislative changes required by STPs. But even then, changing the law would require cross-party support – a much greater challenge now that the Conservatives no longer hold the majority in the House of Commons.

Responding to audience questions after his keynote speech, Hunt – who survived Theresa May’s recent political reshuffle – also hinted that the NHS could be in line to receive some more transformation funding.

Asked by a West Hampshire GP about the possibility of supporting transformation with ringfenced investment in order to enable new models of care elsewhere in the country, the health secretary argued “that is what the STP plans are about”.

But the biggest risk to pouring in more capital funding, he noted, is “if we don’t maintain the financial rigour and discipline that we started to see coming back into the system in the last year”.

“That was really what slowed down this process in the 2015-16 financial year, when we would’ve liked to put a lot more money into transformation,” the health secretary said. “But I think now we’re in a much, much better position to do that. We absolutely want to make sure that money is not an impediment to the rolling out of the STPs, because they are central to our vision.”

In fact, the recent NHS response to the horrific terrorist attack in Manchester, which saw staff working around the clock to cope with the unexpected demand, is a “very good reason for exactly what we’re trying to achieve with the STP process”, Hunt argued.

“The interesting lesson for me about the response in Manchester was how joined-up it was as a result of the terrific progress, under Jon Rouse’s leadership, that trusts have made in coming together as part of their STP,” he added. “I think they’ve probably gone further and faster than anywhere else in the country. I know it’s not been easy to do that, but it was extremely streamlined and effective.”

He also suggested that the government would be prepared to boost the region’s cash pot “if there are specific aspects of the response to those terrible events where there have been unexpected costs that the NHS incurred that wouldn’t be part of its normal response to emergency situations”.

STPs need local support
Asked by another audience member to explain the importance of bringing all local communities together into designing and delivering change, Hunt emphasised that the reasoning behind STPs is to bring about “fantastically beneficial” changes for patients.

“It’s a transformation that is wholly positive for the public,” the secretary of state said. “But people are passionate about their NHS and they obviously worry about any change that happens, and that’s why we have a responsibility to communicate that change. And that change is usually best not communicated by politicians, but by clinicians, because frankly you guys are trusted a lot more than we are.

“That’s why I think it’s really important to have that local engagement, and that’s why, when it comes to the big transformation plans, Simon Stevens and I are supporting them with every fibre in our bodies at a national level.
“But at a local level, we need you to be making the arguments. The evidence is that when you do that, even with potentially controversial changes, it’s quite possible to win the case to do them. But it does involve a lot of local engagement and I think that’s going to be one of the central challenges for the next few years.”

http://www.nationalhealthexecutive.com/Health-Care-News/election-result-means-stp-legislation-now-due-only-after-brexit#.WUvMkaIufac.email

“Heads warning of ‘cash starved’ schools”

“Heads are writing to parents warning them of deepening funding problems for schools.

Head teachers in England are keeping up the pressure on school funding, sending a letter warning about “cash-starved” schools to almost two million families.

As the government prepares to set out its plans in the Queen’s Speech, school leaders across 17 councils are calling for urgent action over a funding gap.

Claims over school funding shortages became an election battleground and a doorstep issue with voters.

The Conservative manifesto promised an extra £1bn per year from savings.
But there have been doubts cast on the biggest slice of this extra funding – with uncertainty over whether the government will go ahead with scrapping free meals for all infants.

With no majority in the House of Commons it would be more difficult to get through legislation to scrap the free meals for infants, introduced three years ago.

The plan to remove the meals came under fire from chef and healthy-school-food campaigner, Jamie Oliver.

Cutting staff

The funding warning letter will be sent by head teachers to parents in more than 4,000 schools, saying that many schools are going to have to cut staff and subject choices.

There were warnings before the election of schools having to reduce hours or even go down to a four-day week for some pupils.

School governors backed the concerns over funding, with the first ever “strike” by governors in West Sussex.
The letter will go to parents in the following councils: Brighton, East Sussex, Northamptonshire, Surrey, Cambridgeshire, Essex, Oxfordshire, Thurrock, Cornwall, Hertfordshire, Peterborough, Wokingham, Devon, Norfolk, Suffolk, West Sussex and Dorset.

Parents will be told about analysis from the Institute for Fiscal Studies which said that the Conservatives’ plans for school spending would mean a “real-terms cut of 2.8% in per-pupil funding between 2016 and 2022″.
The head teachers sending this letter are part of a regionally based campaign over school funding shortages.

Teachers’ unions are also demanding greater investment in schools. …”

http://www.bbc.co.uk/news/education-40344057