Category Archives: DCC

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14 Jul 2017

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Accountability, Asset sweating, Austerity cuts, Council tax, DCC, EDDC, Inequality

“Transformation plans” – a mortal danger to the public?

Our council talks a lot about its so-called “transformation plans” which are supposed to make it leaner and meaner – doing more with less. Except, of course, for its relocation plans, which get more and more bloated with every passing week (“doing the same with more”?).

It trumpets its plans – nay strategy, here:

Click to access transformation-strategy.pdf

There are objectives in it such as “WorkSmart”, “centred”, “clear”, “simple”, “fast”, “organised” and “rational”. As if our council was currently WorkDumb, off-centre, opaque, complex, slow, disorganised and irrational was the alternative. Hhhmm – let’s not go there!

But one word is missing – SAFE.

In the light of the Grenfell Tower disaster, we have seen that ALL of the above can impact directly on council tax payers to make them less safe – as cost-cutting (the REAL meaning of transformation plans) is the major driver.

The London Borough of Newham is so concerned that it has paused its transformation plans on hold saying:

“… Inevitably…in a programme of this scale there are certain areas which have associated risks to delivery both in timing and quantum. Due to the sheer complexity and scale of what the transformation programme is trying to achieve, there are risks attached with the programme being able to deliver fully against its target. Therefore, an adjustment of c£2m has been made to recognise potential non-delivery of savings/income shortfall for 2018/19.”

http://www.room151.co.uk/151-news/news-roundup-borrowing-to-increase-cash-needs-newhams-transformation-savings-residents-audit-lambeth-cipfas-ethics-update/

So, we (and EDDC) must ask: how far is too far?

And is the council’s relocation being done at great expense, when that money ought to be ploughed back into services that have been cut to the bone and may be much less safe for us all? In its race to be bottom of council tax bills has it also been a race to the bottom for our safety?

This is, of course, a national problem – driven by austerity cuts. But have our councils (DCC and EDDC) and other institutions such as the NHS been too passive or even too welcoming of these cuts and too conveniently blind to see their consequences?

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12 Jul 2017

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Accountability, DCC, EDDC, Golden Triangle LEP, Local Enterprise Partnership, Scrutiny, Transparency

“Watchdog concern over “inherently complex” structures of combined authorities”

“The introduction of combined authorities has meant that inherently complex structures have been added to England’s already complicated local government arrangements, the National Audit Office has said.

The evidence that investment, decision-making and oversight at this sub national level was linked to improved local economic outcomes was “mixed and inconclusive”, it added.

In a report, Progress in setting up combined authorities, the watchdog did acknowledge that the Department for Communities and Local Government had worked “speedily” to make sure combined authority areas were ready for the mayoral elections in May 2017.

It also accepted that there “is a logic to establishing strategic bodies designed to function across conurbations and sub-regional areas, and there is a clear purpose to establishing combined authorities especially in metropolitan areas, as economies and transport networks operate at a scale greater than individual local authority areas.”

The report also found:

There was a risk that local councillors would have limited capacity for the overview and scrutiny of combined authorities.

In May 2017, six mayors were elected to combined authorities in England, with candidates having campaigned on manifestos which frequently made policy commitments beyond the current remits of these organisations. “This raises the question of whether mayors can be credible local advocates if they only deal with the limited issues under the remit.”

Combined authorities were not uniform, and varied in the extent of the devolution deals they had struck with government.

If the United Kingdom’s departure from the European Union resulted in reductions in regional funding, the economic regeneration role of combined authorities would become more pressing. “Combined authorities are generally in areas which receive the most EU funding,” the NAO noted.

The NAO highlighted how a number of authorities had been unable to bring local authorities together to establish combined authorities, while areas with a long history of working together had often found it most straightforward to establish combined authorities.

“The capacity of most combined authorities is currently limited and the lack of geographical coherence between most combined authorities and other providers of public services could make it more problematic to devolve more public services in the future,” the watchdog warned.

The NAO’s recommendations were:

The DCLG should:

(a) continue to support combined authorities as they put in place their individual local plans for assessing their impact, including demonstrating the value they add;

(b) review periodically all frameworks and guidance in place for combined authorities and other bodies with joint responsibilities, to ensure that accountability for the delivery of services is clear to stakeholders in local communities; and

(c) continue to work with combined authorities as they develop sufficient capacity to:

deliver the functions agreed in the devolution deals;
support economic growth and the government’s industrial strategy; and
provide sufficient scrutiny and oversight to their activities.
Combined authorities should:

(d) work with the DCLG to develop their plans for assessing their impact, including demonstrating the value they add; and

(e) develop and maintain relationships with key stakeholders in delivering economic growth and public services in their areas.

Areas planning to establish combined authorities should:

(f) make sure they have and can clearly articulate a common purpose;

(g) form an area with a clear economic rationale, mindful of existing administrative boundaries; and

(h) develop relationships across areas where there is no history of joint working.

Amyas Morse, head of the National Audit Office, said: “For combined authorities to deliver real progress and not just be another ‘curiosity of history’ like other regional structures before them, they will need to demonstrate that they can both drive economic growth and also contribute to public sector reform.”

http://localgovernmentlawyer.co.uk/index.php?option=com_content&view=article&id=31779%3Awatchdog-concern-over-inherently-complex-structures-of-combined-authorities&catid=62&Itemid=30

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8 Jul 2017

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Accountability, DCC, EDDC, Inequality

Local government lawyers: powerful are more important than the powerless

“Local government lawyers should make sure they have access to the ‘top table’ and that they are listened to rather than necessarily feel the need to be “at every meeting”, the former Head of the Civil Service and Permanent Secretary at the Department for Communities and Local Government has suggested. …”

http://localgovernmentlawyer.co.uk/index.php?option=com_content&view=article&id=31773%3Aaccess-to-top-table-more-important-than-being-at-every-meeting-lord-kerslake&catid=59&Itemid=27

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7 Jul 2017

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Accountability, Austerity cuts, DCC, Health and Social Care (local), Martin Shaw (Seaton), NHS (local), Seaton/ Colyford / Colyton

Seaton County Councillor organises another demo on community hospital bed losses

PRESS RELEASE:

“Campaigners in the Seaton and Honiton areas are preparing for a crucial meeting of Devon County Council’s Health Scrutiny Committee on

Tuesday 25th July

Following a meeting in June when they postponed a decision, this committee will now decide whether to use its power to refer the decision of the NEW Devon Clinical Commission Group (CCG) to close all in-patient beds in Seaton, Honiton and Okehampton hospitals to the Secretary of State for Health.

In March, the Committee sent 14 questions, from a resolution proposed by County Councillor Claire Wright, about the proposals to replace 72 of East Devon’s 144 community hospital beds by care at home. The questions included the justification for the surprise last-minute switch of beds from Seaton to Sidmouth, which left no beds at all in the Axe Valley, since Axminster has already lost its beds. Cllr Wright and other committee members are expected to examine the 14 points in detail to see which of them the CCG has answered satisfactorily.

Among those who will be speaking against the plans are Seaton and Colyton County Councillor, Martin Shaw, Seaton Mayor, Jack Rowland, and the Chair of EDDC’s Scrutiny Committee, Councillor Roger Giles, with others from Axminster and Honiton. Cllr Shaw says, ”This is a crucial decision not only for the beds but also for the future of the hospitals. The CCG’s next step is its local estate strategy, which is likely to involve partial or even complete closures of hospitals. Seaton is more remote from acute hospitals than any other East Devon town and it is vital that we retain our hospital, which was built by the local community.’

As in June, protestors will gather outside County Hall from 1 pm, and will then observe the meeting which starts at 2.15. A bus is being organised to take people from Seaton to County Hall:

anyone who would like to book a seat should contact Cllr Shaw (cllrmartinshaw@gmail.com or 07972 760254).”

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5 Jul 2017

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Accountability, DCC, Democracy, Health and Social Care (local), NHS (local), Scrutiny, Sustainability, Transparency

Councillors turn on head of NHS: claim too much top-down cost-cutting and secrecy

“Councils have turned on the NHS over “secretive, opaque and top-down” reforms that they say will fail patients.

Simon Stevens, chief executive of NHS England, has staked his tenure on co-ordinating care more effectively and has said that local authorities are crucial to the process because they oversee public health and social care for the elderly.

However, only a fifth of councils think the plans will succeed amid widespread complaints that they have been shut out of the process by the NHS, according to a survey by the Local Government Association.

Not one councillor who responded said they had been very involved in drawing up plans and nine out of ten said the process had been driven from Whitehall rather than locally. Cultural clashes with a “command and control” NHS that did not trust elected councillors meant that more local authorities believed the process was harming social care than helping it.

Mr Stevens has created 44 “sustainability and transformation partnerships” (STPs) where hospitals and GPs are meant to plan with councils on how to improve care and help close a £22 billion black hole in the NHS budget. However, four out of five councillors said the system was not fit for purpose and criticised the NHS for prioritising cost-cutting and closing hospital units over preventing illness.

Izzi Seccombe of the Local Government Association said: “Many councillors have been disappointed by the unilateral top-down approach of the NHS in some of the STP areas. As our survey results show, the majority of local politicians who responded feel excluded from the planning process. If local politicians and communities are not engaged then we have serious doubt over whether STPs will deliver.”

Half the 152 councils with social care responsibilities responded to the survey and 81 councillors with responsibility for health contributed. “The way in which the STP has been handled (top down, secretive, lack of engagement) has harmed relationships between the council and some NHS colleagues,” one said.

The NHS simply does not understand the decision-making of local government
Another said: “It is entirely driven from the top, via budget pressures. The process has been overly secretive and opaque. It has got in the way of closer working between councils and health.”

Councillors criticised STPs as “complex and full of jargon”, saying “the NHS simply does not understand the decision-making of local government”.

Ms Seccombe said that in a centralised NHS, managers often did not want to share information with party political councils accountable to local voters, saying that the process was “trying to mix oil and water”.

Chris Ham, chief executive of the King’s Fund think tank, said: “This survey suggests worrying numbers of council leaders are still frustrated by the process and lacking in confidence in their local plan. A huge effort is now needed to make up lost ground.”

A spokesman for NHS England said: “By creating STPs we have issued a massive open invitation to those parts of local government willing to join forces, while recognising that local politics can sometimes make this harder. The fact that public satisfaction is more than twice as high for the NHS as it is for social care underlines the real pressure on councils. It should serve as a wake-up call to every part of the country about the importance of joint working.”

Source: The Times (paywall)

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4 Jul 2017

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Accountability, Austerity cuts, DCC, Education (local), Inequality, Sidmouth/ Sidford/ Sidbury

Sidmouth mum exposes the reality of education cuts at primary academy school

Received by Owl:

“I wonder whether you’re aware/ could draw attention to the fallout from the budget cuts in our local school.

Parents discovered today that at Sidmouth Primary School funding cuts are having a direct impact on the children and structure of the school. They have had to reduce the number of classes in the school so children are being taught in mixed Year classes: Years 3&4; 5&6. This cost-cutting exercise means that teachers will be teaching an incredibly broad spread of abilities within the same class: they will have to differentiate hugely to cater for the weakest Year 5 and strongest Year 6 pupil for instance. Classes are heading towards 30 so it’s not as if these mixed groups are resulting in smaller groups.

When the school became an academy parents were told that this would mean more autonomy and access to more funds. This clearly has not materialised yet the former headteacher now seems to be sporting the title of ‘Executive Headteacher’. I imagine that his salary could cover the cost of a couple of those disbanded classes…”

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3 Jul 2017

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Accountability, Austerity cuts, DCC, Education (local)

Almost 300 staff made redundant in Devon schools due to cuts

“Nearly 300 staff at schools across Devon have been forced to take voluntary redundancy as a result of budget cuts at school, it has been confirmed. Schools all across Devon are on average funded £268 per pupil below the England average, which has resulted in a £24 million shortfall.

Figures released by Devon County Council show that while 212 schools in the county could benefit as a result or the new fair funding formula, another 129 would be even worse off than they are now. They include 24 secondaries, 103 primaries and two all-through schools. …

Matthew Shanks, Director of Learning at Education South West, which inclues Dartmouth Academy, Coombeshead Academy, Kingsbridge Community College, Teign School and primary schools at Christow, Blackawton, East Allington, Kingswear, Rydon and Stoke Fleming, said: “I don’t think there is a single school across Devon who hasn’t been affected by this.”

He added that the cuts in education budget have meant that 86 teaching assistants, 35 senior teaching leaders, 19 caretaking staff, 25 administrators, 55 teachers, and 52 curriculum support staff across 27 secondary schools in Devon will leave their jobs at the end of the summer term and won’t be replaced. …”

http://www.devonlive.com/education-funding-cuts-means-nearly-300-staff-have-to-take-voluntary-redundancies/story-30420745-detail/story.html

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28 Jun 2017

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Austerity cuts, DCC, Education (local)

“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

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25 Jun 2017

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Accountability, DCC, Health and Social Care (local), Hugo Swire, Martin Shaw (Seaton), NHS (local)

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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.)”

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24 Jun 2017

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

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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

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24 Jun 2017

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

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

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23 Jun 2017

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Accountability, Austerity cuts, Claire Wright, DCC, Health and Social Care (local), Hugo Swire, Martin Shaw (Seaton), Neil Parish, NHS (local)

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

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22 Jun 2017

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Accountability, DCC, Education (local), Inequality, Minority Government

“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

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22 Jun 2017

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Accountability, Austerity cuts, DCC, East Devon Alliance, Health and Social Care (local), Martin Shaw (Seaton), Midweek Herald, NHS (local)

Oooh – Midweek Herald gets political – and on its front page!

Well, it’s a start.  But, of course, it won’t offend EDDC as it is a DCC responsibility!

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20 Jun 2017

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

Sarah Randall-Johnson says we should “grow our own”

Chair of DCC’s Health and Adult Care Scrutiny Committee, Sarah Randall-Johnson, appears to think that one solution to the current care crisis is to encourage schools to promote careers in the health service:

“I am challenging schools, the council and other organisations in Devon to help promote working in the health service as a career, to help address the chronic shortage of staff in the NHS, and let’s grow our own.”

http://www.devonlive.com/potential-closure-of-devon-maternity-units-is-criticised/story-30400944-detail/story.html

Has she stopped to think of the reasons why young people are NOT joining the NHS?

Here are a few:

Chronic underfunding
Changing bursaries for student nurses into loans
Pay freeze on an already low base salary
EU staff leaving in droves and new EU staff refusing to come to the UK leaving local nurses to cope with unsafe conditions
Making hospital staff pay eyewatering charges to park while on shift
Never knowing if your hospital is going to be the next to close

The old Noel Coward song “Don’t put your daughter on the stage Mrs Worthington” might be adapted here.

The original lyrics:

Don’t put your daughter on the stage, Mrs. Worthington
Don’t put your daughter on the stage
The profession is overcrowded
The struggle’s pretty tough
And admitting the fact she’s burning to act
That isn’t quite enough
She’s a nice girl and though her teeth are fairly good
She’s not the type I ever would be eager to engage
I repeat, Mrs. Worthington, sweet Mrs. Worthington
Don’t put your daughter on the stage

might now be retitled

“Don’t put your daughter into nursing, Mrs Worthington”
as follows:

Don’t put your daughter into nursing, Mrs. Worthington
Don’t put your daughter into nursing
The profession is underpaid
The struggle’s pretty tough
And admitting the fact she’s burning to help
That isn’t quite enough
She’s a nice girl and though her health is fairly good
It’s not the type of job she ever would be eager to do
I repeat, Mrs. Worthington, sweet Mrs. Worthington
Don’t put your daughter into nursing

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20 Jun 2017

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Accountability, Austerity cuts, DCC, East Devon Alliance, EDDC, Health and Social Care (local), NHS (local)

DCC Scrutiny Committee “frustrating” for Seaton and Honiton community hospitals says Seaton DCC councillor

Posted by Martin Shaw, DCC Independent East Devon Alliance councillor for Seaton:

“The Health Scrutiny Committee meeting at County Hall yesterday was incredibly frustrating for the 60 or so supporters of Seaton, Honiton and Okehampton hospitals who attended. It resolved nothing and there will be another meeting before the end of July to consider the matter again (I will tell you when the date is fixed).

You can watch the meeting at https://devoncc.public-i.tv/core/portal/webcast_interactive/288543.

The speakers in the public participation at the beginning were good, much better than most of the committee discussion. My speech is at 0.34.50. You may have seen that we also made a good splash on regional TV.

There WAS progress, I think, in pinning down the irrationality of the decision to close Seaton’s beds. Speeches supporting Seaton were made by Martin Pigott, Vice-Chair of Seaton Town Council, Mike McAlpine, Chair of the committee for the Axe Valley Health Hub, Cllr Ian Hall of Axminster, as well as myself.

The issue was picked up on the committee, especially by Cllr Hilary Ackland, who twice challenged Dr Sonja Manton of the CCG on the issue. Manton declined to answer Ackland’s specific question.

I feel we can build on this at the re-run meeting. We also have an opportunity to challenge the CCG (who are answering questions from councillors) at EDDC’s Scrutiny Committee on Thursday at 6pm. EDDC doesn’t have any power but I think we should keep up the pressure on the CCG. I have put down to speak. If anyone else can do it – email Debbie Meakin dmeakin@eastdevon.gov.uk.

Would anyone who can come to this meeting – whether to speak or not – let me know (cllrmartinshaw@gmail.com)?

Thanks to all who came and who sent emails (they really had an effect).

A frustrating day, but further chances on Thursday and in July to challenge the CCG

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20 Jun 2017

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Accountability, DCC, EDDC, Mark Williams CEO EDDC, Paul Diviani

Can officers and councillors work together? Owl, donkey, fox or sheep?

“… Because the goals of officers and members are often incompatible, organisational conflict is inevitable and inherent, but it’s also important to remember it’s not, of itself neither “good” nor “bad”.

Political competence on the part of both political and managerial leaders is essential to the successful achievement of workable compromises. Politically competent managers expect resistance to their attempts to achieve the best outcomes, but nevertheless keep on using their small “p” political skills and attributes, including influencing and resilience, until they get the right results.

It’s important to remember that those tensions and conflicts — and the inevitable frustrations — do serve an important purpose. Political and managerial leadership should be collaborative but not collusive. Members and officers all need someone who can tell them when they are wrong to maintain a healthy balance between collaboration and mutual challenge.

Successful political leaders and senior officers are distinguished by their ability to construct trust, through collaborative approaches to leadership, to enable them to manage the tension and potential conflict between the different political and managerial logics.

Baddeley and James (1987) describe four types of political behaviour, which are distinguished by varying degrees of integrity and politically awareness. They use animal characteristics to describe the behaviours which help or hinder the effective management of the political and managerial interface.

A lot depends on the extent to which people are both politically aware and acting with integrity. We may hope that all senior political leaders and managers are “owls” — both politically aware and acting with integrity, but those operating at the political and managerial interface have to be prepared to recognise “foxes” and to limit the damage caused by compliant and naïve “sheep” or self-serving and politically incompetent “donkeys”.

You have an important role and invaluable expertise but that isn’t enough to ensure members will listen to your advice, no matter how right you are. Don’t forget that political and managerial logics are very different. We might like to think that everyone we work with is an ‘owl’ but we’ll all meet plenty of ‘foxes’ – as you’d expect in a political environment – and more than enough ‘donkeys’ and ‘sheep’.

The secrets of success for managing relationships with members: develop relationships of trust but don’t collude. And tell them the truth but not in a way that causes them to reject both you and the message. You are a professional but you should not try to assert your professional status by talking down to members or making them feel foolish — no good will come of it. You may need to spend more time on complex issues than you’d expect. Use questions to start difficult conversations: “How do you think we should tackle this?” rather than starting with a statement, “this is what we should do”. Enjoy!…”

http://www.room151.co.uk/resources/officer-member-relationships-trust-is-the-key/

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19 Jun 2017

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Accountability, Claire Wright, DCC, Health and Social Care (local), Martin Shaw, NHS (local)

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DCC community hospitals stitch up – part 2

“Councillors have delayed a decision to refer “Orwellian” plans to close hospital beds across Devon to the Health Secretary after a bad-tempered meeting at County Hall.

Placard-waving protesters gathered outside Devon County Council’s Exeter headquarters today to demand that controversial NHS plans be sent to Jeremy Hunt.

Critics of the NEW Devon Clinical Commissioning Group (CCG) scheme to close community hospital beds in Exeter, Seaton, Honiton and Okehampton, packed into a meeting of the health scrutiny committee on Monday.

A string of opponents were invited to speak and criticised the CCG for failing to demonstrate how adequate care would be provided in the community.

Independent East Devon Alliance County Councillor for Seaton and Colyton Martin Shaw said the CCG has never made the case for the “unmanageable” and “Orwellian” plan.

Fellow independent councillor for Ottery St Mary Claire Wright told the committee that a raft of assurances had failed to materialise from the CCG despite repeated requests.

Devon County Council’s Health and Wellbeing Scrutiny Committee had previously objected to the decision by NEW Devon CCG to reduce the number of community hospital beds in Eastern Devon from 143 to 72 and regardless of cost no bed closures be made until it is clear there was sufficient community care provision.”

They said: “If adequate assurances are not given to the above and the issues set out below, the CCG’s decision be referred to the Secretary of State for Health on the grounds that it was not in the in the interests of the health service in the area and the consultation was flawed and there is no clear explanation of what care at home will look like or work and this model has frequently been mixed up with Hospital at Home which is entirely different.

Representatives from the CCG, who were questioned by the committee, asked councillors to work with them locally in a “constructive way” rather than involving Mr Hunt.

A spokeswoman said 200 staff were under consultation as the new plan to provide home care took shape.

However, they failed to satisfy members of the newly-formed committee on 14 separate grounds drawn up by the previous committee prior to the May election.

Ms Wright proposed a motion to refer the matter to the Secretary of State for Health, which was seconded by Liberal Democrat former county council leader Brian Greenslade.

Conservatives on the committee questioned the usefulness of such a referral, a complicated procedure which requires that a fully-financed alternative plan be submitted.

A suggestion by committee chairman Sarah Randall Johnson that a decision on the referral be postponed until September was met with jeering from the public gallery.

Protesters shouted down the move, claiming time is pressing as bed closures have already begun, prompting the chairman to threaten to clear the meeting.

After two hours of debate, an amendment which postponed the decision unto an emergency meeting no later than the end of July was unanimously agreed.

Speaking after the meeting, campaigner Gillian Pritchett, who chairs the group Save Our Hospital Services in Honiton, said she was “totally unhappy” with the decision.

“Beds are being closed, the system is already in place,” she told Devon Live.

“The whole thing is a waste of time as (the CCG) will continue to close beds.”

Ms Wright said the meeting had been “incredibly frustrating”

“There was incontrovertible evidence to refer this to the Secretary of State,” she added.

“Those 14 grounds the committee came up with still stood.”

http://www.devonlive.com/committee-delays-plan-to-refer-devon-hospital-bed-closures-to-secretary-of-state/story-30398766-detail/story.html

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19 Jun 2017

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Accountability, Claire Wright, DCC, Health and Social Care (local), NHS (local)

Crucial health meeting at DCC this afternoon

“Devon County Council’s Health and Adult Care Scrutiny Committee will today examine the case for closing 72 community beds across Eastern Devon to see whether it can be justified.Back at the March health scrutiny meeting it appeared that a decision had been made in a huge hurry with a large range of important issues left unresolved. See my report of that meeting here –

http://www.claire.wright.org/index.php/post/hospital_bed_cuts_to_be_referred_to_secretary_of_state_for_health_unless_ra

The Northern, Eastern and Western Devon Clinical Commissioning Group has now responded to the proposal I made at the last health scrutiny committee, requiring justification on 14 grounds.

It was agreed at the March committee that if those grounds were not deemed to be satisfactory, then the committee would have the option of referring the decision to the Secretary of State for Health. I have read the paperwork and corresponding related papers and I don’t believe there the slightest justification for the decision to halve the remaining community hospital beds in Eastern Devon.

The meeting is held at County Hall and starts at 2.15pm and will be live webcast here –

https://devoncc.public-i.tv/core/portal/home Here are the agenda papers -http://democracy.devon.gov.uk/ieListDocuments.aspx?CId=429&MId=2581&Ver=4

Source: claire-wright.org

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19 Jun 2017

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

Demonstration against community hospital cuts today 1 pm County Hall

BBC Radio Devon
Posted at
8:42

“Health Secretary Jeremy Hunt may be asked to review the decision to close community hospital beds in east and mid Devon.

The county’s new health and adult care scrutiny committee is discussing the plans to close beds in Honiton, Okehampton, Whipton and Seaton at its meeting today.

Local councillors said they needed assurances over staffing and the future of buildings.”