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Posted on

22 Aug 2017

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Accountability, DCC, Health and Social Care (local), Honiton/ Gittisham, NHS (local), Seaton/ Colyford / Colyton

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County councils say they cannot meet bed-blocking targets

Owl bangs on: Closing Seaton and Honiton hospital beds was NOT about patient care it was simply about THIS. And no use whinging Devonians – if you voted Conservative (and you did in sufficient numbers to ensure a majority on EDDC and DCC) this IS what you voted for and the buck does stop with YOU as much as them – and if you keep voting them in, it will get even worse:

“County council leaders have written to health secretary Jeremy Hunt asking him to reconsider proposals to withhold social care funding if bed-blocking targets are not met.

Under new guidance produced by the Department of Health last week, county authorities would have to reduce delayed discharges from hospitals by an average by 43% within the next few months – double the target of London.

Herefordshire has a target of a 69% reduction whilst Suffolk has a target of 67%, which county leaders have called “undeliverable” and “arbitrary”.

Colin Noble, County Councils Network health and social care spokesman, described the targets as a “backwards step” and said the resulting lack of funding would push services to breaking point.

“It is perverse that this money – designed to ease pressures – could be taken away if we cannot hit virtually undeliverable and arbitrary targets within a very short time period,” he said.

Noble highlighted that counties are the least well funded councils for social care and urged the government to draw up a sustainable solution not a “double whammy” of underfunding and the prospect of funds being withdrawn.

The CCN notes that the problem facing rural councils is even more acute because they contain the fastest growing elderly populations yet are the worst funded councils for social care.

In total, the 37 county authorities receive £2bn less funding for health and social care than other parts of the country, according to the network.

The CCN argues that there is no quick fix to the issue of delayed discharges and only one third of them nationally are attributable to social care.

Noble called on the government to develop long-lasting reform to social care that makes the system work better. He said counties, which spend 47% of the nation’s total expenditure on social care, want to work with the government to better integrate services.

However, the network argues the social care funding crisis will only be solved if funding discrepancies between rural and urban councils are resolved in tandem with a long-term sustainable funding settlement for all councils.

A Department for Communities and Local Government spokesman said: “No one should stay in hospital longer than necessary. It puts unneeded pressure on our hospitals and wastes taxpayers’ money.”

http://www.publicfinance.co.uk/news/2017/08/counties-urge-hunt-rethink-bed-blocking-targets

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East Devon Watch

Posted on

22 Aug 2017

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

Care homes – a dying industry

“Care homes are teetering “on the edge” and a chronic shortage of funding risks “catastrophic failure” within the National Health Service, the businessman expected to be the biggest operator of residential homes has warned.

Chai Patel, chairman of HC-One, which could take over more than 120 homes from Bupa, predicted that six national chains would emerge to dominate the market by benefiting from economies of scale. The acquisition would enable his company to expand to about 350 homes with 22,000 care beds and become the biggest in the sector.

There is immense pressure on care homes amid government funding cuts and an increase in costs since all adults over 25 became eligible for the national living wage. Some small operators are quitting, with 144 care homes closing last year and a loss of about 2,000 beds a year. Many more are “zombie” homes, feared to be close to bankruptcy as struggling councils force down the rates they pay.

A shortage of capacity means that the number of people in residential homes has not increased in line with rising longevity, forcing many frail and elderly people to rely on specialist care in their own homes.

In an interview with The Times, Dr Patel admitted: “There is no question the sector itself is on the edge.” He added: “The impact of chronic under-funding of social care will result in catastrophic failure in the NHS.”

and underneath this article:

“An investment group that is set to be the biggest care homes owner in Britain has vowed that it will not become the next Southern Cross.

HC-One is poised to acquire about 120 homes from Bupa, possibly through a debt and equity deal amid unease about the implications for the group’s debt levels and with memories of Southern Cross’s collapse fresh in the memory.

Southern Cross, which once ran more than 750 care homes and had 37,000 beds and some 41,000 staff, failed in 2011 when all its homes were taken over by their landlords.

The equity for the Bupa purchase, which is close to completion, is understood to be being provided by Stepstone Real Estate and Safanad, an investment firm, and the debt arranged through Deutsche Bank and Apollo Global Management.

The acquisition of more than 9,000 beds from Bupa would take HC-One’s total to almost 22,000 and catapult it above Barchester Healthcare and Four Seasons Health Care. HC-One rose from the ashes of Southern Cross when it acquired about a third of the homes and has expanded through two other acquisitions since 2015. The purchase of Helen McArdle Care, which had 20 homes, was funded through debt.”

Source: Times (pay wall)

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East Devon Watch

Posted on

21 Aug 2017

Posted under

Accountability, Austerity cuts, Health and Social Care (local), Honiton/ Gittisham, NHS (local), Seaton/ Colyford / Colyton

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2 Comments

Coverage of Seaton hospital bed closures

Owl still thinks THIS is the real reason for the hurried closure:
https://eastdevonwatch.org/2017/08/20/is-this-why-there-is-a-dangerous-rush-to-close-community-hospital-beds/

“Protesters waved banners and shouted ‘shame’ outside Seaton Hospital today (Monday, August 21) as health chiefs began implementing their in-patient bed closure plans.

A similar vigil will take place outside Honiton Hospital next Monday when the cuts are due to begin there.

Yesterday’s gathering was addressed by Seaton’s county councillor Martin Shaw who said the town had been badly let down, and town mayor Jack Rowland, who said that while they may have lost the fight to save the beds the battle would now begin to save the actual hospital.

The dates for the closure of in-patient beds in East Devon was announced by health officials last week.

In a statement the Royal Devon and Exeter NHS Foundation Trust said: “The NHS has given details of how it intends to implement its ‘Your Future Care’ plans to improve patient care across Eastern Devon, including creating new nursing, therapist and support roles.

“Your Future Care” set out proposals to move away from the existing bed-based model of care. Instead it proposed a model of care focused on proactively averting health crises and promoting independence and wellbeing.

“The plans were subject to a 13-week public consultation that closed earlier this year, following which the NHS NEW Devon CCG approved a way forward which enhanced community services to support more home-based care by redirecting and reinvesting some existing bed-based resources. The net result would mean an increase of over 50 community-based staff to support out of hospital care and a reduction in community inpatient beds across the Eastern locality of Devon.

“Detailed operational work began in this area with the introduction of the Community Connect out-of-hospital service in March which has already led to a reduction in demand for community inpatient beds.

“In order to achieve this transition safely, implementation will take a phased approach to redeploy and recruit staff to the additional nursing, therapy, care workers and pharmacist roles which will enhance community services in Exeter, East Devon and Mid Devon.

This will enable the reduction in inpatient beds – moving from seven community inpatient units to three.

The timetable for implementation is:

• 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.

“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.

“Over the past couple of weeks it has become apparent that the schedule for the closure of the in-patient units needs to be brought forward. This is due to the increasing pressures on safely staffing the current configuration of seven community inpatient units. Furthermore, now that the workforce HR consultation has been completed, 170 staff can be redeployed into the enhanced community teams and our hospitals to provide extra capacity and resilience to meet the demand for care for the people of Eastern Devon.”

Adel Jones, Integration Director at the Royal Devon and Exeter NHS Foundation Trust said: “It is acknowledged that getting to this point in the process has not been without its challenges and I would like to thank all who have contributed to the development of the implementation plans.”

Dr Anthony Hemsley, Associate Medical Director at the Royal Devon and Exeter Hospital said: “Although the decision to reduce inpatient beds will only affect a small number of patients per week, we, with the support of the clinical assurance panel, are confident that our plans to provide more care at home are safe and ultimately will help more people to be independent.

“At the point of implementation, we will be able to redirect some of the existing bed-based resource into local community teams. Additional staff including community nurses, therapists and personal support workers will be there to provide greater provision and access to care and support. However, we know that there is still much more work to be done, particularly around prevention, wellbeing, recruitment of staff and availability of domiciliary care. This can only be done in partnership with communities and we at the RD&E look forward to continuing this work.”

Rob Sainsbury, chief operating officer for NEW Devon CCG, said: “Reallocating resources away from hospital bed-based care into more home-based and community care will really make a positive difference to people’s lives.

“It will ensure that everyone who needs the service in our community has the best access to good quality and sustainable health services and help people to stay independent for longer, with the benefit of being cared for closer to family and friends.”

http://www.midweekherald.co.uk/news/protest-over-seaton-hospital-bed-closures-1-5157377

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East Devon Watch

Posted on

21 Aug 2017

Posted under

Accountability, Austerity cuts, Health and Social Care (local), Neil Parish, NHS (local), Paul Diviani, Sarah Randall Johnson, Scrutiny, Seaton/ Colyford / Colyton

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1 Comment

RIP Seaton Community Hospital beds – vigil, noon today

The town with the largest catchment area for elderly people – its community hospital closes the doors on its beds today.

Built by public subscription, funded by a hard-working League of Friends, only its outpatient services will remain – for now.

The heart of a community stops beating today.

Thanks to the vote of East Devon District Leader (Paul Diviani – who voted at EDDC against his own district recommendation) and former Leader and Chair of DCC Health and Social Care Committee Sarah Randall-Johnson, who voted along with all other Conservatives on that committee not to refer the closures of Seaton and Honiton (next Monday) to the Secretary of State.

This will leave the whole of the eastern side of the district with no community beds at all – the few remaining beds to be (for the time being) in Sidmouth and Exmouth, closer to Exeter and Cranbrook.

Posted by

East Devon Watch

Posted on

20 Aug 2017

Posted under

Accountability, Austerity cuts, Health and Social Care (local), Honiton/ Gittisham, NHS (local), Seaton/ Colyford / Colyton

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3 Comments

Is this why there is a dangerous rush to close community hospital beds?

Nothing to do with care at home”, everything to do with austerity cuts. AND much more opportunity for private companies to make big profits from home care instead of NHS costs in hospitals.

“Councils have been told to reduce hospital bed-blocking by up to 70% by next month or face funding cuts.

The warning came in a letter, seen by The Sunday Times, sent to council and NHS chief executives by the Department for Communities and Local Government (DCLG) and the Department of Health last month.

The letter sets out the “expectations” it has for local authorities to reduce delays in discharging people from hospital, with some councils facing demands to cut bed-blocking by up to 70%.

Councils that do not do enough to help NHS patients go home could have their share of a £2bn social care fund withheld.

Of the 152 councils with social care responsibility, 42 are required to reduce bed-blocking by 60% or more, based on their performance in February. Reading borough council has been given the highest target of a 70% reduction.

More than two-thirds are expected to reduce bed-blocking attributable to social care by 50% or more.

The letter accompanying the targets said progress would be assessed in November and 2018-19 allocations of the £2bn fund could be reviewed.

This could see poorly performing councils lose out on anticipated funding.

Last night, Izzi Seccombe, a Tory council leader who speaks on community wellbeing for the Local Government Association, said setting “unrealistic and unachievable targets” for councils to cut bed-blocking was “counterproductive.”

“The threat of reviewing councils’ funding allocations for social care . . . could leave many councils facing the absurd situation of failing to meet an unattainable target, losing their funding and, on top of this, potentially being fined by hospitals.”

Last month The Sunday Times revealed that the NHS had fined at least 22 councils for causing delays in discharging patients and threatened 11 others with charges.

A DCLG spokesman said: “No one should stay in hospital longer than necessary. It puts unneeded pressure on our hospitals and wastes taxpayers’ money.”

Source: Sunday Times (pay wall)

Posted by

East Devon Watch

Posted on

20 Aug 2017

Posted under

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

Does our councils promote social value when funding public services via charities?

This is i portant be ause, more and more, councils are sub-contracting their responsibilities for health and social care to charities.

“Small charities that deliver public services have a problem.

The government grants that once helped to fund this work are drying up fast – their total value halved in the decade between 2004 and 2014, according to the NCVO, and has continued to drop ever since. This leaves organisations dependent on income from local council contracts, where the complex tendering process is stacked against smaller providers. At risk of being squeezed out completely, they face what the Lloyds Bank Foundation earlier this year called a “broken commissioning landscape”.

The government knows this is a problem. The House of Lords select committee on charities expressed concerns back in 2016, recommending that the government takes steps to promote commissioning based on impact and social value rather than simply on the lowest cost.

The Social Value Act, introduced in 2012, is one of very few ways in which central government can influence who is commissioned to deliver local services. It requires councils to think about the social, economic and environmental benefits of their decisions when they commission contracts above a certain value (around £170,000).

This means officials are encouraged to do more than simply favour the lowest bidders; they are invited to consider what else a provider could contribute to the area. One organisation might be committed to employing local people, for example. Another might offer to work with small community groups, or bring together existing networks of GPs, schools and others to coordinate services more effectively. The aim is to level the playing field, and enable non-profit providers – such as charities, social enterprises and community businesses – to compete with big private companies.

The government promised a review of the act back in February, something tantamount to an acknowledgement that it is not having the desired impact. Those plans have since been derailed by the snap election and the review is now promised “in due course”.

With the review still pending, we at Power to Change spoke to (pdf) community businesses across England, to find out what changes could be made to improve the situation.

The organisations we spoke to were positive about the aims of the act, and confessed that the commissioning landscape would be “much bleaker” without it. Some councils even welcomed the fact that the act gave them, as they saw it, “permission to explicitly consider social value”.

But many community businesses dismissed the act as “tokenistic”, complaining that it made little practical difference to how councils commissioned or from whom. We found limited evidence that the act actually affected their decisions about whether to tender for contracts: organisations who wanted to work with their council said they would have gone ahead regardless.

If the government wants to improve the impact of the act, our research has some simple recommendations.

Lower the financial threshold

Fairer UK charity contracts will demand long-term government support
The act only applies to local authority contracts worth more than £170,000. Very few community businesses operate at that kind of scale, particularly those committed to working only in their local area. A lower threshold would bring more small organisations into play, either as providers or, more likely, as partners.

Apply it to goods and works, not just services

The principles behind the act are very popular with government, councils and community business alike, so extending it to contracts for goods and works would be another way to introduce social value into commissioning. In his report into the act in 2015, for example, Lord Young celebrated parliament’s decision to commission bottled water for two years from a social enterprise whose profits were shared with the charity Water Aid. There is no reason this sort of innovation shouldn’t be more widespread.

Offer more support for potential providers

Providing more support and guidance, especially some highlighting successful practice, could boost take-up of the act. For commissioners, this could mean giving examples of where they have made savings or improved outcomes through commissioning with social value in mind. For small voluntary or community-led organisations, this could be examples of similar organisations that successfully engaged with the process.

Access to data on the progress and effects of the act is also limited. We recommend the introduction of an open-source, central dataset on the use of the act across local authorities in England, including monitoring data on social value outcomes.

Promote the act more

Our research found an alarming number of social enterprises and community businesses either weren’t sure how the act worked or hadn’t heard of it. The government should give the act greater publicity, targeting community groups who might want to take up the opportunity it offers. For the same reason, the guidance surrounding the act needs to be much clearer and more accessible.

Explain how social value is measured

It can be fiendishly difficult to measure social value, but it can be done – and local groups told us that councils could do more to explain how they will be assessed. This could start with commissioners consulting interested parties locally on what sort of measurements they will be using and how they will be collected, not least so that local groups can decide whether or not to apply for a contract in the first place.

Encourage councils to take risks

New charities minister, but government isn’t interested | Asheem Singh
Local authorities like to praise the not-for-profit sector for bringing more innovation and greater flexibility to social problems. But this does not always extend to commissioning decisions, which can favour large, well-known private firms over smaller groups. This may be understandable, but councils will need to overcome this risk-aversion in the future.

Make the act part of wider social change

The act requires councils only to consider social value in commissioning. But not every local authority limits itself to this: Oxfordshire county council and Somerset district council were celebrated last year by Social Enterprise UK for incorporating the act into a wider agenda for social change. This meant using the act to focus on a whole strategy to strengthen the local area, something commissioners all over the country could learn from.

Russell Hargrave works for Power to Change”

https://www.theguardian.com/voluntary-sector-network/2017/aug/15/seven-ways-improve-social-value-act

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East Devon Watch

Posted on

19 Aug 2017

Posted under

Accountability, Austerity cuts, Health and Social Care (local), Honiton/ Gittisham, Neil Parish, NHS (local), Seaton/ Colyford / Colyton

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2 Comments

“Neil Parish MP snubs Seaton Mayor’s request for urgent meeting with Health Secretary”

And Parish sends a circular letter as his reply – one exactly like others he sent to people also asking him to save their hospitals:

“Councillor Jack Rowland, Mayor of Seaton, has posted on Facebook:

As many of you know I wanted to arrange a face to face meeting with Neil Parish and Jeremy Hunt regarding the CCG decision to close the hospital beds at Seaton Hospital.

I’ve now received a reply from Neil Parish and the email I sent to him and the reply is reproduced below.

Dear Jack,

Thank you for your email on beds at Honiton and Seaton.

I am deeply saddened by the decisions to close beds at Honiton and Seaton Hospitals. I wanted beds to be retained at Seaton and Honiton, as part of a wider upgrade to health services in Devon. This closure is not the outcome I wanted. I would like to pay tribute to all the staff who have worked so hard to maintain fantastic inpatient beds at the hospitals over the past years.

We now have to make the best of the current situation. The CCG have stated they believe there is sufficient at-home care to replace the current beds. Hospital staff will now be redeployed into community care. Every patient who previously required care in the hospitals must now have the same level of care delivered to them at home or in a residential care home. This promise must be kept and I will be monitoring the situation carefully.

Regarding the future of Honiton and Seaton Hospitals, I want the buildings to continue to host vital health and social care services. Particularly, I want the sites to be used as health and social care hubs, with a positive future for each of the locations. I believe the hospitals still have an important role to play in community healthcare services. Any suggestions you could provide in this area, which would help maintain viable services at Seaton, would be appreciated.

I know this might be a disappointing response, but I hope we can continue to maintain excellent care in our community.

Thank you again for your email.

Yours sincerely,

Neil

Neil Parish MP
Member of Parliament for Tiverton and Honiton
House of Commons | London | SW1A 0AA
Telephone: 020 7219 7172 | Email: neil.parish.mp@parliament.uk
http://www.neilparish.co.uk

In response to this email:

From: cllr.jack.rowland@btinternet.com [mailto:cllr.jack.rowland@btinternet.com]
Sent: 16 August 2017 12:26
To: PARISH, Neil
Cc: townclerk@seaton.gov.uk; Martin Shaw ; Marcus Hartnell
Subject: Seaton Hospital – bed closures

Dear Mr Parish,

I’m writing to you in my capacity as the Chair of Seaton Town Council.

As you are no doubt aware the Health and Adult Care Scrutiny Committee of Devon County Council voted by 7 votes to 6 on 25 July not to refer the CCG decision to the Health Secretary for a review. An investigation has been called for regarding how the Scrutiny Committee Chair managed that meeting.

In the meantime the RDE Trust are accelerating the bed closure timetable from the original timetable and the beds in Seaton Hospital are now being phased out starting on 21 August and those in Honiton the following week.

This is despite no adequate answers being given to date regarding the concerns about the “Your Future Care” changes now being implemented. At the East Devon District Council Annual meeting all the Councillors present voted in favour of requiring more information on this subject and the EDDC Scrutiny Committee met in June to question representatives of the CCG and were not satisfied with the responses and maintained their opposition to Community Hospital bed closures.

At the Seaton Town Council meeting on 7 August I tabled a motion to demonstrate concern at the decision reached by the DCC Scrutiny Committee and to seek an urgent meeting with yourself and Jeremy Hunt to be attended by myself, Marcus Hartnell (Town and EDDC District Councillor) and Martin Shaw (Town and DCC Councillor). All the Town Councillors present voted in favour of my motion.

In view of your stated opposition to the bed closures in Seaton and Honiton I hope you can facilitate the meeting I am requesting in view of the overwhelming opposition from the elected Councillors in East Devon.

I look forward to hearing from you in the near future regarding potential dates, times and venue – we would be willing to travel to London if necessary.

Regards
Jack Rowland
Seaton Town Council Chair / Mayor”

https://seatonmatters.org/2017/08/19/neil-parish-mp-snubs-seaton-mayors-request-for-urgent-meeting-with-health-secretary/amp/

Posted by

East Devon Watch

Posted on

18 Aug 2017

Posted under

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

Care for people without families

In many “care closer to home” scenarios it is assumed that the patient (Owl refuses to call them clients – this isn’t home hairdressing) have some sort of outside support – family, friends or voluntary groups. This is often not the case – especially in rural areas.

So, what should our health services be doing?

“… Firstly, we need to review our care services from the point of older people doing everything entirely without support from family. This includes everything from finding out information to getting their washing things in the event of unplanned hospital admission to creating a lasting power of attorney to arranging hospital discharge to searching for a care home. Only then can we see how much family support is required to make the system work and where we need to change things so it works for those without. Care services that work for people without family support will work far better for people who do have family too.

Secondly, care services must make a greater effort to understand why so many more people are aging without children and the issues that face them. It is not possible to design services that work if you do not understand the people you are designing them for. People ageing without children must be included in all co-production and planning on ageing as a matter of course.

Thirdly services must consider their use of language. Branding services with “grandparent/grans/grannies” unless they specifically mean only grandparents should use them exclude older people who are not and never will be grandparents.

Fourthly, people ageing without children should be supported to form groups both on and off line where they come together to form peer support networks. People ageing without children want to help themselves and each other.

Fifthly, the gap around advocacy must be addressed. People ageing without children have been very clear on their fears of an old age without a child to act as their intermediary and advocate in their dealings with care services particularly if they become incapacitated mentally or physically.

Finally, everyone, both people ageing without children and those who do have family, should be helped to plan for their later life.

People ageing without children must be brought into mainstream thinking on ageing. By working collectively we can as individuals, communities and wider society address the needs of older people without children or any family support. Only by working together so can we do care differently for people ageing without children.”

https://www.independentage.org/policy-and-research/doing-care-differently/designing-care-services-that-dont-rely-family-kirsty-woodard

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East Devon Watch

Posted on

17 Aug 2017

Posted under

Accountability, Austerity cuts, Health and Social Care (local), Honiton/ Gittisham, NHS (local), Seaton/ Colyford / Colyton

RIP Seaton and Honiton community hospitals – RIP some of their patients too?

by Barbara Worsley, Labour MP.

Most people who were rehabilitated in community hospitals will now be hostage to “care at home” and unable to access any other form of care – even residential and nursing homes.

“Seventy thousand older people with complex needs left to fend for themselves: Tory apathy on social care funding could turn a crisis into a catastrophe.

Despite evidence that life expectancy may be stagnating, the century-long rise should be a cause for celebration. However, for too many people – unsure whether they will be able to afford the care they may need or plan for the future – their later years are proving to be a time of fear and uncertainty.

Now we learn there will be insufficient care home places, even if people could afford them: 71,000 more care home beds will be required within eight years – according to a University of Newcastle study – to meet the demands of an ageing population living longer, with complex care needs. But there is little hope that these places will materialise.

Residential and nursing homes are already under unprecedented pressure. By the end of this financial year, £6.3bn will have been cut from social care budgets since 2010, with local authorities facing a £2.3bn care funding gap by 2020. These severe cuts, along with rising costs and problems of retaining and recruiting staff, mean that one in six care homes is now displaying signs of financial stress, and across England residential homes are closing.

And in the coming months, the signs are that things will get worse. The Association of Directors of Adult Social Services has reported that councils will have to cut social care budgets by a further £824m this financial year alone – meaning fewer older people getting the help they need with basic tasks such as washing, dressing and eating.

The Conservatives’ policy of cutting funding and leaving people to fend for themselves is simply not working. It has left us with 1.2 million older people living with unmet care needs, one in 10 facing catastrophic costs, and relatives forced to give up work to look after them. It has also left the Tory “dementia tax” alive and well – more than 70% of people in residential care, who face the highest care costs, have dementia.

If this apathy towards finding a solution for the social care crisis continues, there is a risk not only of insufficient care beds, but of serious care failures.

In Labour’s manifesto, we set out comprehensive plans to tackle the short-term funding gap in social care, promising £1bn this year and £8bn over this parliament to stabilise the sector. But we also recognised the need for a long-term funding solution to meet the needs of an ageing population. As Andrew Dilnot made clear, this must include pooling risks – so that no one is left to face catastrophic costs alone – and raising the means-test threshold, so that no one loses everything they own.

Enough is enough. This government has had ample wake-up calls. Now it must give social care the funding it needs and develop a long-term plan to put the sector on a sustainable footing – so that today’s generation of older people and those to come get the care they need and deserve.”

• Barbara Keeley, Labour MP for Worsley and Eccles South, is shadow minister for social care and mental health

https://www.theguardian.com/commentisfree/2017/aug/17/conservative-solution-unaffordable-care-crisis

Posted by

East Devon Watch

Posted on

15 Aug 2017

Posted under

Accountability, Austerity cuts, DCC, Health and Social Care (local), Honiton/ Gittisham, NHS (local), Privatisation, Transparency

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1 Comment

Honiton fighting back on bed cuts

Since this article was written, it has been announced that all Honiton Hospital’s community beds will close on 28 Augusy 2017:

“A BAND of angry residents calling itself Honiton Patients Action Group says it plans to keep hospital beds in Honiton by taking direct action to stop the removal of ward beds and equipment.

The group, consisting of several local patients and their families, say they have become increasingly frustrated at the ‘failure of NEW Devon CCG to listen to the voice of local people and their representatives’.

They claim some end of life patients have already been informed by local GPs that Honiton Hospital will not be available after September and, if they need a local hospital bed, they must be prepared for an out of area transfer to Tiverton, Exmouth or Sidmouth.

A spokesperson for the action group said: “It is quite clear that NEW Devon CCG have never been prepared to fully engage in a sincere dialogue.

“There has been a failure to listen to the voice of local people and our representatives. We believe they decided in advance they would close these beds despite the fullest and proper representations that have been made by locals and their representatives, including MPs, district and town councils. We have tried sitting down and discussing it with them. We have tried large public meetings, marches, deputations and lobbying including the county council. Now we intend to sit down to stop the closure.

“We feel we have been disgracefully let down by the Health Secretary Jeremy Hunt, by Devon County Council and their local representative Cllr Sarah Randall Johnson, and by Cllr Paul Diviani who seems to be representing no one except himself.

“While they prevaricate, the rundown of the wards has begun and it may well be more serious than they are letting on.

“With the closure of the maternity unit and privatisation of the site Honiton Hospital could be scrapped in the near future – this has happened at 45 other hospital sites.

“Meanwhile there is not a scrap of evidence the promised alternative care system is ready or will be effective.

“As patients we will not meekly accept this and at a time of our choosing we plan to take direct action to prevent the removal of beds and equipment and the stripping of wards.

“This will be a peaceful, non-violent, direct action to prevent contractors gaining access to remove the beds and equipment using whatever peaceful methods we can.

“We are also contacting health trade unions to set up a picket line. We shall invite nurses, doctors and local health groups to join in solidarity, along with Neil Parish MP who claimed he would ‘hold feet to the fire’ to stop the closure. Our MP has become very quiet but this is his last chance to show solidarity.

“When we have finalised our plans we hope that local people and families, all of whom could potentially require these beds in future, will join us to keep up the action as long as we can. We need help and support to organise and publicise this if we are to be effective.

“It is the last real chance for Honiton Hospital and our community and we appeal to everyone to search their conscience.

“While we have life and the will to fight ‘They Shall Not Pass’.”

https://www.viewnews.co.uk/honiton-patients-group-promises-direct-action/

Posted by

East Devon Watch

Posted on

15 Aug 2017

Posted under

Accountability, Austerity cuts, Claire Wright, Health and Social Care (local), Honiton/ Gittisham, NHS (local), Privatisation, Rural communications, Seaton/ Colyford / Colyton, Sustainability

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2 Comments

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”

Posted by

East Devon Watch

Posted on

13 Aug 2017

Posted under

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

Hospital staff shortages causing dangerous “nursing on the cheap”

Owl says: 20 people in a hospital ward being looked after by, say, 4 staff – 1 member if staff to 5 people, 3 shifts a day = 12 nursing staff. That’s with FULL staffing (plus, of course, other staff such as doctors, physios, etc). 20 people under their eagle eyes, at least one of them professionally qualified, assessing their needs, watching for deterioration, alert for emergencies.

If all those 20 people are being nursed at home – how would those same 12 staff care for the same 20 people in a dispersed rural geographical area? Which ones would get care from the qualified nurse, which ones the “cheap” alternative? No more staff – because already there is a shortage. And using their own cars (if they drive and can afford one) to get between them all, summer tourist season and winter snow.

In this government’s eyes, land to sell off to fund vanity projects and line pockets is more important than people being cared for when they are sick.

“Nearly all England’s 50 biggest hospital trusts are failing to hire enough nurses to ensure patients are safe.

Nine in 10 of the trusts, which oversee 150 hospital sites, are not meeting their own safe staffing targets, according to analysis by the Royal College of Nursing (RCN).

The data also suggest nurses are being increasingly replaced by cheaper, unqualified healthcare assistants.

To cope with the shortage of nurses, more than half the largest hospitals (55%) brought more unregistered support staff onto shifts, the figures show. The situation is worse at night, with two thirds (67%) of hospitals using unregistered support staff — which critics claim will lead to higher patient mortality rates.

Janet Davies, chief executive and general secretary of the RCN, said patients can pay the “very highest price when the government encourages nursing on the cheap”.

She added: “Nurses have degrees and expert training and, to be blunt, the evidence shows patients stand a better chance of survival and recovery when there are more of them on the ward.”

A separate study of staffing in NHS hospitals, published in the online journal BMJ Open, found that in trusts where registered nurses had six or fewer patients to care for, the death rate was 20% lower than where they had more than 10.

Hospitals have had to publish staffing levels since April 2014 in response to the scandal at Stafford Hospital, where hundreds died from neglect.

The RCN analysis, which calculates the average fill-rate across the month, reveals the worst affected site was the Royal Blackburn Hospital, which had on duty only three quarters of the nurses needed.

According to the RCN there are 40,000 nurse vacancies. Brexit, low morale, the end of bursaries for tuition fees, and the public sector pay freeze have all been blamed.

The Department of Health said: “Just this month we announced an extra 10,000 places for nurses, midwives and allied health professionals by 2020, and there are over 12,500 more nurses on our wards since 2010.”

Sunday Times (pay wall)

Posted by

East Devon Watch

Posted on

12 Aug 2017

Posted under

Accountability, Claire Wright, Consultation, DCC, East Devon Tories, EDDC, Health and Social Care (local), NHS (local), Paul Diviani, Privatisation, Sarah Randall Johnson, Scrutiny

Comments

1 Comment

“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

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