Shock revelation suggests the NHS’s ‘new model of care’ is more about switching intermediate care from community hospitals to ‘block bookings’ in private nursing homes – saving costs and freeing up assets

Martin Shaw, East Devon Alliance councillor for Seaton and Colyton, Devon County Council:

Press release:

“There was a staggering revelation yesterday at Health Scrutiny from Liz Davenport, Chief Executive of South Devon and Torbay NHS Foundation Trust, that they had made ‘block bookings of intermediate care beds in nursing homes’ when they introduced the ‘new model of care’. South Devon has closed community hospitals in Ashburton, Bovey Tracey, Paignton and Dartmouth and is currently consulting on the closure of Teignmouth – where I spoke at a rally last Saturday.

The ‘new model of care’ is supposed to mean more patients treated in their own homes, and there does seem to have been an increase in the numbers of patients sent straight home from the main hospitals.

But the idea that all patients can be transferred directly from acute hospitals to home is untrue. There is still a need for the stepping-down ‘intermediate care’ traditionally provided by community hospitals – the only difference is that now it’s being provided in private nursing homes instead.

It’s likely to be cheaper to use private homes, because staff don’t get NHS conditions, and crucially it frees up space in the hospitals so that the CCGs can declare buildings ‘surplus to requirements’ and claim the Government’s ‘double your money’ bonus for asset sales. It seems NEW Devon CCG has also made extensive use of nursing home beds, but we don’t yet know if there were ‘block bookings’.

However the private nursing home solution may not last – DCC’s chief social care officer, Tim Golby, reported that nursing homes are finding it difficult to keep the registered nurses they need to operate, and some are considering reversion to residential care homes.

This may be where the South Devon trust’s long term solution comes in – it had already been reported that it is looking to partner with a private company in a potential £100m dealwhich will include creating community hubs that contain inpatient beds.

The new model of care is also about privatisation.”

Devon County Council Tories kill off community hospitals

From the blog of Claire Wright:

“Seven Conservative councillors today block voted down my proposal to “strongly support” retaining all Devon community hospital buildings and to “strongly oppose” any potential plans to declare them surplus to requirements.

And in what became a rather heated debate, one conservative, Cllr Richard Scott, disgracefully accused the assiduous and polite Independent Seaton councillor, Martin Shaw of abusing his right to address councillors.

I had requested an item on community hospital buildings at today’s Health and Adult Care Scrutiny Committee meeting, as there is a continual threat in the air of the possibility that the buildings may be declared surplus to requirements and be sold off. There remains anxiety and concern in local communities as a result.

Last month, NEW Devon Clinical Commissioning Group was forced to deny they had “any plans” to declare Honiton and Seaton Hospitals surplus to requirements, following comments made at a campaign meeting.

Dr Simon Kerr, the GP who was quoted in the notes published, later said his comments had been misinterpreted.

The Estates Strategy, which will set out what is proposed to be done with the buildings owned by the local NHS, is due out soon, possibly as early as next month.

In presenting my case I set out how the committee had been unable to secure assurances from health service managers for a long time that buildings were safe, that Dartmouth Hospital is being sold off and that the ownership of 12 community hospitals in Eastern Devon was in the hands of NHS Property Services which was charging over £3m rents for the upkeep of the buildings.

I believe these rents are still being met by NHS England, but this is only a temporary measure and soon the bill will fall on the doormat of the deeply in deficit NEW Devon Clinical Commissioning Group.

Cllr Brian Greenslade seconded my proposal.

Speaking in support were also Cllr Carol Whitton (Labour) and Cllr Nick Way (Libdem).

For some reason the conservative councillors were all opposed to my proposal. Several said there was no evidence, that it was just speculation that there was even a risk to the buildings.

Conservative councillor, Jeff Trail, didn’t appear to like my proposal but said he thoroughly supported Cllr Carol Whitton’s position, which was rather confusing as she had just said she backed me!

Cllr John Berry didn’t like my recommendation because the committee didn’t own the buildings. He wanted us to write to the CCG to ask what the status of the buildings was instead.

Cllr Sylvia Russell thought she had heard an NHS manager say at some point at today’s meeting that the buildings were safe so there was nothing to worry about. No one else seemed to recall this.

Cllr Richard Scott dismissed my proposal as “speculation” and claimed there was “no evidence” to back up my concerns.

Referring to Cllr Martin Shaw, who had just set out calmly and eloquently the concerns of his own community of Seaton, Cllr Scott added: “In some respects this is an abuse of a right to speak at this committee. There’s nothing here to consider.”

Chair, Sara Randall Johnson, wanted to take account of Paul Crabb’s view, which was that some hospitals might be old and in a poor state of repair, but I said we should have a simple and clear proposal or the CCG would drive a coach and horses through it.

I reminded the committee (yet again) that our committee was the only legally constituted check on health services in the county and it is our job to act on issues of public concern, which this very much was.

I added that it was important to take a position now and before the Estates Strategy was published so our views could inform the strategy.

My words fell on deaf ears. I had genuinely thought, that despite all the past political shenanigans on that committee – and there have been many – that the Conservatives might have backed this one, as not a single member of their own communities would have surely wanted them to vote a different way.

There was every reason for the entire committee to be unanimously in favour of my proposal.

What a huge shame.

Voting in favour: Me, Brian Greenslade (LibDem – Barnstaple North), Nick Way (LibDem – Crediton), Carol Whitton (Labour – St David’s and Haven Banks).

Voting against: (All Conservative): John Berry (Cullompton and Bradninch), John Peart (Kingsteignton and Teign Estuary) Sylvia Russell (Teignmouth) Richard Scott (Lympstone and Woodbury), Paul Crabb (Ilfracombe), Andrew Saywell (Torrington Rural), Jeff Trail (Lympstone and Woodbury)

The debate is available to view at item 10 from this link – https://devoncc.public-i.tv/core/portal/webcast_interactive/325480

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

Surprise, surprise – no new GP surgery in Newton Poppleford even after houses linked to its construction are completed!

Press Release:

“Statement From Coleridge Medical Centre and Clinton Devon Estates

To: Newton Poppleford Parish Council, District and County Council Representatives

Dear Paul

Please distribute to all Parish Councillors/add to Parish Council website/Newsletter

A statement from the Coleridge Medical Centre and Clinton Devon Estates regarding the proposed new medical centre in Newton Poppleford, near Sidmouth.

The Ottery St Mary-based Coleridge Medical Centre has withdrawn its interest in renting a proposed new GP surgery in the East Devon village of Newton Poppleford which was to be built by the landowner Clinton Devon Estates near to a development of 40 new homes at King Alfred Way.

A spokesman for the Coleridge Medical Centre said:

“It is with some regret that we have made a decision to withdraw from the intended move to new premises at King Alfred Way. Since 2012/2013, when this project first started, GP care and strategy for premises has evolved considerably across the country with much more emphasis on innovative ways of working and a broadening range of co-located staff to provide specialist support and in shared premises. Any changes to the existing premises landscape are referenced to move us towards, rather than away from, that deemed nationally as best practice for our populations.

We would like to thank the residents of Newton Poppleford for supporting the provision of a new branch surgery and to Clinton Devon Estates for committing to provide a building. We would also like to thank NHS England and NEW Devon CCG in assisting us reach this decision.

We are currently working with commissioners at NHS England and NEW Devon CCG to consider how best to meet the needs, not only of the people in the Newton Poppleford area but to our wider practice population. At this time we intend to continue to run the existing branch surgery within the village, while reviewing options for developing and integrating services in the longer term as the population grows and general practice continues to evolve.”

Planning approval for the GP surgery near to 40 new homes, 16 of which are designated as affordable housing for local people, was granted by the Planning Inspectorate in March 2017.

Leigh Rix, Head of Property and Land for Clinton Devon Estates, said: “As an organisation that has a very long association with this area we strive for sustainable development to help communities prosper for years to come. As well as providing a good mix of new open market and affordable homes, we had been very keen to provide a modern GP building for the village.
“After almost six years of jointly developing plans and specifications for a new surgery, it is understandably very disappointing that the Coleridge Medical Practice have felt unable to proceed in the current circumstances.

“Over the coming weeks, we will review the options available to us with our development partner Cavanna Homes.”

DCC Health and Social Care “Scrutiny” – Claire Wright continues her battle

“Health and Adult Care Scrutiny Committee meeting: A PACKED AGENDA….

I asked for several items, including the future of our community hospitals, the plight of local carers, the local NHS deficit and what is being done to reduce it.

Also, on the agenda is how the local NHS coped with winter pressures (something I have asked for, for months and even resorted to a Freedom Of Information request on – it was refused, I have issued a formal complaint)……..

I have been really disappointed in recent months and years at what I see as a systemic lack of accountability in the NHS. As a Health Scrutiny Committee member, I would expect to get straight answers to straight questions at meetings, but unfortunately this rarely happens, which is why I was forced to submit a Freedom of Information request about a basic set of data tables relating to winter pressures.

I will not hesitate to do this again.

The report on carers starts on page 55 of the link below. This came about after I read a detailed survey and saw that local people who are caring for loved ones may not feel very supported.

I subsequently had a meeting with senior officers and saw the raw (anonymised) data from local focus groups. It was disturbing and it appeared to me that many local carers are having a really hard time managing, because of the government’s austerity agenda. I asked for the report to be referred to the Health Scrutiny Committee, but was told this wasn’t possible as consent had not been given by the participants of the focus group.

A version of the report has been submitted instead. I am pleased that a number of measures have been put in place by officers to try and improve matters, however, I have already told senior officers that leaving out the comments has meant that the voice of carers has been lost, in my view.

I believe that there should have been an attempt to secure retrospective consent for the publication of the report, as without a proper voice, the government will simply carry on ignoring carers’ plight – and they deserve better.

If you want to read the reports – and if you care about our NHS I would urge you to! The link is here
http://democracy.devon.gov.uk/ieListDocuments.aspx

Members of the public are permitted to address the committee in the 15 minute slot at the beginning of the meeting, but need to register four days ahead to do so. Email Gerry.rufolo@devon.gov.uk

The meeting starts at 2.15pm on Thursday 7 June. It will be webcast from this link:

https://devoncc.public-i.tv/core/portal/home

and archived afterwards.

NHS and taxes: pay once, pay twice, pay three times

Once: original taxes
Twice: new additional tax
Thrice: means-tested assistance with care needs:

“Taxes are going to have to rise to pay for the NHS if the UK is to avoid “a decade of misery” in which the old, sick and vulnerable are let down, say experts.
The Institute for Fiscal Studies and Health Foundation said the NHS would need an extra 4% a year – or £2,000 per UK household – for the next 15 years. …”

Most interesting of all is this table:

The Lib Dems didn’t do themselves any favours in coalition did they!

http://www.bbc.co.uk/news/health-44230033

And here’s Owl thinking we paid once!

“Inpatients at Exmouth Hospital to be temporarily relocated during fire safety improvement project”

Owl adds: Did you know there were closed wards at Exmouth Hospital?

“News Release 16 May 2018

Inpatients at Exmouth Hospital are being temporarily relocated to another ward on the site while building owner NHS Property Services invests in fire safety improvements.

Beds on Doris Heard Ward are being moved to the vacant Geoffrey Willoughby Ward while a £50,000 project to safely remove asbestos and improve fire resistance takes place. A deep clean and air testing will also take place.

The works, carried out by Integral, will be undertaken from 21 May with the ward planned to be fully reopened during the week commencing 11 June 2018.
Due to the constraints of Geoffrey Willoughby Ward, the number of available beds will be temporarily reduced from 16 to 12 during this period.

Rosemary Kearney, Senior Facilities Management Business Manager for NHS Property Services (NHSPS) in the South West, said: “We’re working closely with our partners at the hospital to ensure services can, as far as possible, continue as normal.

“We’re sorry for any inconvenience but this is an essential project that will ultimately improve the fabric of Exmouth Hospital for patients for years to come.”

Donna Robson, Royal Devon and Exeter NHS Foundation Trust’s Matron at Exmouth Hospital, added: “Maintaining continuity of care for patients is our top priority. We’ve been working with NHSPS to ensure that any disruption is kept to a minimum during these necessary maintenance works. We’d like to thank our patients and visitors for their understanding during this time.”

All other services at the hospital are unaffected and patients should continue to attend their appointments as normal.

The need for the work was identified as part of a survey undertaken by NHSPS.”

The press release also includes background information for editors on NHSPS. This is not usually published with the press release but is information in the public domain, so Owl reproduces it here:

“NHS Property Services brings property and facilities management expertise to thousands of sites across the NHS estate.

At a time of major change and increasing demand for the NHS, NHS Property Services is reducing costs, creating a more fit for purpose estate and generating vital funds that are being reinvested to support improvements in frontline patient care.

The company’s portfolio consists of 3,500 properties – worth over £3 billion – which represents around 10 percent of the entire NHS estate. The vast majority of our sites are used for clinical, local healthcare and fall into one of three categories:

Health centres and GP surgeries; Hospitals/hospital- related properties; or Offices.

The company has a major role as both landlord and service provider for its NHS customers. Services fall into four main business areas:

1. Strategic estates planning – supporting our customers to deliver healthcare premises that meet future needs for patient services

2. Asset management – proactive asset management to create value and reduce overall costs of property

3. Construction project management – managing the development of new buildings and refurbishment of existing buildings, along with investment in our estate

4. Facilities management services – including health and safety, maintenance, electrical services, cleaning and catering.”

“NHS outsourcing ‘put patients at risk’ “

THIS IS EXACTLY WHAT OUR CCG IS ATTEMPTING TO DO – SLASH COSTS AND IMPLEMENTING NEW MEASURES AT THE SAME TIME YEY OUR DEVON TORIES ARE HAPPY FOR THE CCG TO EXPERIMENT ON US UN THIS WAY!

“Incompetent staff may have been allowed to carry on practising, the watchdog warned

“Patients were put at risk of cancer and other serious harm because of a botched £330 million NHS outsourcing deal, the spending watchdog has found.

An attempt at cost-cutting has led to more than two years of chaos in back-office services for GPs, opticians and dentists, the National Audit Office said.

Dozens of women were wrongly told that they no longer needed cervical cancer screening and incompetent staff may have been allowed to carry on practising, the report concludes.

The outsourcing company Capita and NHS England are still bickering about the deal, leading to failures including a backlog of half a million patient registrations, the NAO warns.

“Trying to slash costs by more than a third at the same time as implementing a raft of modernisation measures . . . potentially put patients at risk of serious harm,” Meg Hillier, chairwoman of the public accounts committee, said.”

Source: The Times (pay wall)

CCG somewhat opaque on future of Honiton and Seaton hospital closures

Owl says: This is the sort of Press Release the CCG excels at. Telling us what the situation is at present but giving no guarantees that there will not be future cuts to current services (some of which, such as dermatology in Seaton, have already been closed.

Owl would also like to know how many of the extra 20,000 deaths noted in the first quarter of this year were in East Devon.

From EDA DCC Councillor Martin Shaw:

“NEW Devon CCG have issued the attached statement criticising ‘inaccurate information’ about Honiton and Seaton hospitals, after Dr Simon Kerr, Chair of the CCG’s Eastern Locality, was credibly reported as saying that these two hsopitals are ‘at risk’ in their Local Estates Strategy due this summer.

I welcome the CCG’s statement that it has no plans to close either hospital. However it has not denied that Dr Kerr said that they were at risk.

The CCG could end this controversy today if it gave an unequivocal assurance that both hospitals will continue for the foreseeable future with the present or enhanced levels of service. People in Honiton and Seaton were badly let down by the CCG over hospital beds and they won’t trust them now without a clear statement that our hospitals are safe in the coming Local Estates Strategy.”

The statement from the CCG reads:

“There have been reports today that the future of Honiton and Seaton Hospitals is under question.

NHS Northern, Eastern and Western Devon Clinical Commissioning Group wishes to make clear that there are no plans to close Honiton and Seaton hospitals.

In March 2017, the Governing Body of NHS Northern, Eastern and Western Devon Clinical Commissioning voted to implement a number of changes following a 13 week public consultation. This included the decision to close inpatient beds at both Honiton and Seaton hospitals.

Beds were closed in both hospitals in August 2017 as more care was introduced to look after people at home. Both hospitals are still open, thriving buildings providing more than 50 day services and clinics combined.”

Claire Wright responds on threat to close Honiton and Seaton hospital day services

“Seaton and Honiton Hospitals may be at risk, local GP and chair of the NEW Devon CCG’s Eastern Locality, Dr Simon Kerr reportedly revealed at a meeting with health campaigners last month.

Dr Kerr was apparently speaking of the long-awaited Estates Strategy, which will list all the assets held by the local NHS and what it plans to do with them.

NEW Devon CCG is in considerable financial difficulty. Devon is one of three most financially challenged health trusts in the country.

The background is that 12 community hospitals across Eastern Devon were acquired by the private company (wholly owned by the Secretary of State for Health) NHS Property Services, last year.

As yet, we haven’t heard about the fate of the remaining 10 community hospitals now in the ownership of NHS Property Services. This of course, includes our beloved Ottery Hospital, as well as Exmouth, Sidmouth, Whipton, Okehampton and Crediton.

Many of these hospitals, including Seaton, Honiton, Ottery St Mary and Okehampton and Whipton, have sadly now been stripped of their beds in cost cutting measures. But they still are home to a range of services and clinics that are very much needed locally.

Up until now, NHS England has been picking up the tab for the extortionate rents charged by NHS PS, of well over £3m a year, across the area.

A stupid stupid system, set up to fail. All over the country health trusts are being forced to sell off estate because it can’t afford the ridiculous rents charged by NHS PS for a building that used to be in NHS ownership.

Honiton Hospital has a treatment centre and is home to East Devon’s out of hours GP service.

The idea that the building could be lost and with it the treatment centre and out of hours service is totally ludicrous and appalling. The RD&E’s A&E department is full to capacity much of the time and staff are struggling to manage the volume of patients.

It means someone unwell living in the far east of the area – Axminster, for example, would have to travel around an hour to Exeter, to be seen by a GP if they were unwell out of working hours. It is quite unacceptable.

The amazing maternity unit which has been ‘temporarily’ closed for the best part of a year, was also based at Honiton Hospital.

There are so many cuts to the health service now it is difficult to keep up with them, let alone fight them.

Cllr Shaw has written to the CCG chair, Dr Tim Burke demanding assurances that the buildings remain open.

I have asked for an urgent item on the next Health and Adult Scrutiny Committee agenda, which is held on Thursday 7 June.

I will keep you posted.

Here’s Cllr Shaw’s blog – https://seatonmatters.org/2018/05/14/ccg-chair-says-seaton-and-honiton-hospitals-at-risk-of-closure-in-local-estates-strategy/

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

East Devon Alliance DCC Martin Shaw responds to threat of full closure of Seaton Hospital

“Martin​ Shaw
County Councillor for Seaton and Colyton​

LETTER TO THE CHAIR OF NEW DEVON CCG

Dear Dr Burke,

We have seen draft notes prepared by 38 Degrees of your meeting with them on April 5th. According to these, Simon Kerr said (before your own arrival) that Seaton and Honiton hospitals were ‘at risk’ in the coming Estates Strategy. These remarks, written down at the time, have been confirmed to us by several participants. While we appreciate that no formal decision may have been taken, there seems little reason not to take them as a clear indication of CCG thinking.

As the two elected local politicians on the organising group of Seaton Health Matters, the community conversation launched together together with the CCG and RD&E, we hosted Dr Kerr at the launch meeting on 23rd March, which also heard Em Wilkinson-Bryce (copied in) appeal to the audience to trust in the ‘good intentions’ of the speakers from the NHS organisations. We have no reason at all to doubt her sincerity, but it is difficult for us to believe in the good faith of Dr Kerr and the CCG, as (unless he had only just picked up the names of the ‘at risk’ hospitals) it seems to us that you may have helped launched us into a discussion of local health needs knowing that you may be moving to deprive us of our major health resource, Seaton Hospital.

Our initial Health Matters discussion broached many areas of constructive cooperation between the local community and the NHS, which we are keen to pursue. However it also left no doubt of the need to maintain the 50+ outpatient services currently based in the Hospital, the desirability of bringing in additional services if place-based care is to be meaningful, and the needs of an elderly community (with significant pockets of deprivation and poor public transport) for as many clinics, etc., as possible on the doorstep rather than in other towns. We are ready to explore the possibility of a combined health hub for the Axe Valley, but on the basis that services would be more or less equally shared across the two hospitals and there would be no reduction in the overall level of services in each. The other thing that was clear from our discussion was that the community considers the Hospital a community resource since its building was half-funded by local donations and it has been maintained by local contributions ever since. I am sure that people in Axminster and Honiton feel the same about theirs.

You should not underestimate the local anger, only just subsiding, over the removal of beds from Seaton Hospital. It bears repeating that this was widely regarded, including outside Seaton, as an unjust choice based on a misuse of the JSNA data and misleading assumptions about the relative agedness of the populations of Seaton and Sidmouth (their age structure is in fact almost identical and the comparison did not justify a choice of Sidmouth over Seaton). It was also based on false claims that the Sidmouth option would involve a better geographical spread: a glance at the map would have shown that, on the contrary, it left the remaining community beds concentrated in the southwestern corner of East Devon with none in the Axe Valley. There is similar feeling in Honiton because the Your Future Care consultation did not even include an option which would have retained their hospital’s beds.

We mention this history not to try to reverse the beds decisions (although the shortage of beds in the recent winter should lead to it being looked at again) but because the treatment of Seaton and Honiton in those decisions should be a reason for generosity in the distribution of outpatient services and in the Estates Strategy. It is adding insult to injury to place Seaton and Honiton on a shortlist of potential closures. Having switched your decision last time against Seaton, you should now reconsider again in Seaton’s favour. This is not, of course, to suggest that any other hospital should be closed instead. On the contrary, all East Devon towns have community hospitals which reflect real local needs and you should be devising a system of health hubs which enables all communities to have a solid base for place-based care.

The next meeting of Seaton Health Matters is scheduled for 24th May. We do not wish it to be dominated by the fallout from Dr Kerr’s remarks but without an unequivocal assurance that Seaton Hospital will remain open, it is unavoidable that this will be the main topic of discussion.

We look forward to hearing from you at the earliest opportunity. We have also copied this to Sonja Manton since we discussed the Health Matters process with Em and her before it began. We should like to meet with you about this, but before the 24th any meeting would have to be late that afternoon or on the 23rd, as one of us is away until the morning of the 22nd.

Regards,

Martin Shaw
County Councillor for Seaton & Colyton

Jack Rowland
Seaton Town Council”

Seaton and Honiton hospitals “at risk ” of full closure says CCG

“CCG chair says Seaton and Honiton hospitals ‘at risk’ of closure in Local Estates Strategy”

POSTED ON MAY 14, 2018 by Councillor Martin Shaw

It has been revealed that Dr Simon Kerr, Chair of NEW Devon CCG’s Eastern Locality, told a meeting with representatives of 38 Degrees on 5th April that Seaton and Honiton hospitals were ‘at risk’ in the CCG’s Local Estates Strategy due in July. His remarks were taken down by the 38 Degrees member who produced draft notes of the meeting, and have been confirmed by other participants, but have not yet been confirmed by the CCG.

Although the hospitals both lost their inpatient beds last summer, Seaton Hospital currently hosts over 50 outpatient services (and there are probably at least as many in Honiton). Both are vital community health resources, created with decades of financial and practical support from people all around the Seaton and Honiton areas.

As part of a move to promote ‘place-based care’, the CCG and RD&E are currently taking part in two ‘community health conversations’, Honiton’s Health Matters and Seaton and Area’s Health Matters, which local voluntary groups, town and parish councils etc. are involved in. However if place-based care means anything, it should mean that communities should keep their local hospitals as health hubs, with more rather than fewer services.

Together with Cllr Jack Rowland, who stood down as mayor of Seaton last week but remains the town council’s representative on the Health Matters organising group, have written to Dr Tim Burke, Chair of the CCG, to ask for an unequivocal assurance that the hospitals will remain open.

I am hoping to shortly announce a meeting of the hospital campaign group.”

https://seatonmatters.org/

“Patients trapped by care closures: Elderly face being STRANDED in hospital wards” [or just stranded if there are no hospital wards]

“In the past financial year, 148 care home businesses entered insolvency – an 83 per cent rise on the 81 failing in 2016-17.

The figures sparked a call for urgent action from the Government to tackle a growing crisis in social care which could impact badly on the NHS.

And experts warn of a “care home crash” as closures cause a shortage. Although the Government announced a £2billion package for social care over three years last year, local authorities are spending £6billion less than in 2010. …

Mike Padgham, chairman of the Independent Care Group which advises care providers in north Yorkshire, said: “We have been warning for years that the £6billion cut from social care would eventually mean more and more care homes closing.

“For every home closure there are older and vulnerable people either forced to find somewhere else to live or unable to have a place.

“About 1.2 million people are now going without the care they need and unless action is taken this will very soon be us. We now face a further £2.3billion funding shortfall and that is going to mean more and more people not getting care. …

Local authorities in England and Wales had planned to make savings of £824million in their social care budgets in 2017-18 according to the Associate Directors of Adult Social Services, despite demand increasing as the population ages.

A Competition and Markets Authority report highlighted a £1billion shortfall in public sector funding of care homes in 2017 and the Local Government Association says that the sector faces a £2.3billion gap by 2020.

Accountancy firm Moore Stephens, which released the insolvency figures, found the cost of providing a high standard of care has increased over the years. The National Living Wage rose again last month to £7.83.

It stood at £6.70 just three years ago. The annual rise places increased strain on care home margins. The average home now spends 52 per cent of its turnover on wages. …

A report by the Public Accounts Committee in September said that an “intolerable” number of older patients were waiting too long to be discharged from hospital, costing the NHS £170million a year.

The MPs said that every day, 3,500 older people remain in hospital in England after being declared fi t to leave because arrangements had not been made for them to move. In 2011, operator Southern Cross shut down and as many as 31,000 elderly and vulnerable residents had to find somewhere else to live. …”

https://www.express.co.uk/news/uk/959234/care-home-crisis-uk-government-elderly-care-bankruptcy

The cost of austerity and underfunding – 20,000 extra deaths last winter

We cost the NHS and Social Services nothing when we are dead.

“Researchers have called for an urgent investigation to find an explanation for more than 20,000 ‘additional deaths’ so far this year, amid severe pressure on the NHS.

Figures from the Office for National Statistics (ONS) show that in the first sixteen weeks of the year, there were 20,215 more deaths in England and Wales compared to the previous five years.

In March, academics raised concerns that Britain was facing a rise in mortality and argued that “health chiefs are failing to investigate a clear pattern of worsening health outcomes”, in an editorial for the British Medical Journal (BMJ).

The piece centred on the finding that there were 10,000 ‘additional deaths’ in the first seven weeks of the year and concluded “that neither ‘flu, nor cold weather appeared to be the main cause.”

Now the authors have now updated their findings to account for fresh statistics covering the first sixteen weeks of the year.

Their response, published on the BMJ website this week, argues that the latest statistics “sadly provide little reassurance of this being a ‘blip’ as some have suggested.”

There were 198,943 deaths in the first sixteen weeks of 2018, compared to an average of 178,778 deaths in the same period over the previous five years. The rise represents an 11.3 per cent increase on the five year average.

The weekly average for the same period was 12,434 deaths, ahead of the five year average of 11,174. The 20,215 figure is equivalent to an ‘additional death’ every eight minutes throughout the first sixteen weeks of the year. …”

https://www.telegraph.co.uk/news/2018/05/11/calls-urgent-investigation-explain-20000-additional-deaths/

“Over a million elderly people missing out on help they need due to dire state of social care system, watchdog warns”

“More than a million vulnerable elderly people are missing out on help they need because of the dire state of the social care system, the UK’s spending watchdog has said.

The National Audit Office (NAO) called for urgent action as it published a detailed report citing evidence showing the number of people over 65 with unmet care needs jumped by some 200,000 in the last year alone.

The body said a spiralling turnover of poorly paid staff and increasing job vacancies are at the root of the problem, which is being worsened by ongoing deep cuts and fewer employees from the European Union since Brexit.

In particular, the NAO struck out at the Department of Health and Social Care (DHSC) for being unable to demonstrate how it is going to fund care for the elderly in the face of burgeoning future demand.

Ministers know working out how to pay for social care is one of the biggest challenges they face, but have been unable to bring forward clear proposals of how to meet it.

The report said the DHSC’s own modelling had shown the number of full-time jobs in the care system would need to rise by some 2.6 per cent per year until 2035 to meet increased demand.

But the annual growth in the number of jobs since 2013 has been two per cent or lower.

The report said: “The failure of formal care to meet this increased demand may have contributed to the growth in individuals’ care needs not being met.

“Age UK estimated that 1.2 million people over the age of 65 had some level of unmet care needs in 2016/17, up from one million in 2015-16.”

The NAO found that In 2016/17, the annual turnover of all care staff was 27.8 per cent – with care workers. …”

https://www.independent.co.uk/news/uk/politics/elderly-people-vulnerable-million-missing-dire-poor-social-care-system-a8199506.html

Swire discovers “health hubs”

Written Answers – Department of Health and Social Care: Health Services (9 May 2018)

https://www.theyworkforyou.com/wrans/?id=2018-04-30.139412.h&s=speaker%3A11265#g139412.q0

Hugo Swire: To ask the Secretary of State for Health and Social Care, what his Department’s policy is on the establishment of health and wellbeing hubs in former community hospitals.”

Owl’s policy is that NHS community hospitals are much more important than commercial juice bars and personal trainers and should therefore be funded BEFORE health hubs, not abandoned to insert “health hubs” in their place.

” ‘Perfect storm’ over rural social care costs”

“Rural residents are unfairly penalised when it comes to Improved Better Care Funding, MPs have been told.

The Rural Services Network issued the warning in response to an inquiry by MPs who are examining the long-term future of adult social care.

The Long Term Funding of Adult Social Care Inquiry is being undertaken by the Housing, Communities and Local Government Committee of the House of Commons.

Submitting evidence to the inquiry, the Rural Services Network said the average predominantly urban resident will attract £37.74 per head in Improved Better Care Funding in 2019/20.

This is £8.20 more than rural residents who attract just £29.54 per head.

In 2017/18 Adult Social Care Core Funding is met by Council Tax to the tune of 76% in rural areas compared to just 53% in urban.

The Rural Services Network said there was no relationship between the numbers of people requiring social care and either Council Tax or Business Rates.

Growth in business rates or council tax income is in no way correlated to the service needs of care services, it pointed out.

“It is obvious that the rising costs of caring for the growing elderly population cannot be met by local taxation and must be funded per capita by central government,” said the network.

In rural areas, there are significantly more residents aged 65+, fewer businesses required to pay business rates and Council Tax levels are already much higher than in urban areas.

The network added: “Thus, there is created a ‘perfect storm’ of rising costs and limited income in the rural areas across England.”

Cost pressures in Social Care Services mean county and unitary councils serving rural areas are having to cut other budgets to the detriment of the well-being of rural residents and businesses.

Council tax per head is reflected in the Final Settlement for 2018/19 is £541.46 for Predominantly Rural Areas compared to £450.58 in Predominantly Urban Areas.

“The gap, at circa £91 per head, is inexcusable,” said the network.

There appears to be a conscious policy decision by the government that in rural areas Spending Power will be increasingly funded by council-taxpayers, it added.

In other words, the government appeared content for people in rural areas to pay more council tax from lower incomes and yet receive fewer services than their urban counterparts.

“This is manifestly unreasonable and totally inequitable,” said the network.

The role of preventative services in respect of adult social care was not formally recognised by government and district councils were not funded for public health.

With increasing pressures on district council budgets, there remained uncertainty as to how public health interventions delivered at a local level would be funded in the future.

http://www.rsnonline.org.uk/perfect-storm-over-rural-social-care-costs

“Care homes fear closure over night shift back pay”

“Two thirds of charities caring for vulnerable adults risk going bust if they are required to pay backdated wages to staff for night shifts, a survey suggests.

The findings come after a tribunal ruled that carers had been historically underpaid for the shifts. …

Only half of local authorities or NHS care commissioning groups that buy care packages for disabled people had agreed to fund sleep-in shifts for care staff at a rate that paid them the national minimum wage per hour.

The survey also found that care providers had decided not to bid for 273 new contracts with councils or NHS bodies as they judged the fees offered would not cover higher staff costs. Fifty-six per cent were considering handing contracts back and 70 per cent wanted to renegotiate contracts. …”

Source: Times (pay wall)

Austerity and our NHS: in the relegation zone in football terms

Owl says: so, in football terms England has 8 men playing in a game with a full Barcelona premier, super-fit 11-person team. With our 8-person team consisting of six people waiting for hip operations and 2 blocking beds awaiting their home care packages!

“… The stark findings come from a new King’s Fund analysis of health data from 21 countries, collected by the Organisation for Economic Cooperation and Development. They reveal that only Poland has fewer doctors and nurses than the UK, while only Canada, Denmark and Sweden have fewer hospital beds, and that Britain also falls short when it comes to scanners.

“If the 21 countries were a football league then the UK would be in the relegation zone in terms of the resources we put into our healthcare system, as measured by staff, equipment and beds in which to care for patients,” said Siva Anandaciva, the King’s Fund’s chief analyst.

“If you look across all these indicators – beds, staffing, scanners – the UK is consistently below the average in the resources we give the NHS relative to countries such as France and Germany. Overall, the NHS does not have the level of resources it needs to do the job we all expect it to do, given our ageing and growing population, and the OECD data confirms that,” he added.

The report concludes that, given the dramatic differences between Britain and other countries: “A general picture emerges that suggests the NHS is under-resourced.”

The thinktank’s research found that the UK has the third-lowest number of doctors among the 21 nations, with just 2.8 per 1,000 people, barely half the number in Austria, which has 5.1 doctors per 1,000 of population.

Similarly, the UK has the sixth-smallest number of nurses for its population: just 7.9 per 1,000 people – way behind Switzerland, which has the most: 18 nurses, more than twice as many.

With hospital beds, the UK has just 2.6 for every 1,000 people, just over a third of the number in Germany, which has the most – 8.1 beds – and which places the UK 18th overall out of the 21 countries which the OECD gathered figures for. The number of hospital beds in England has halved over the last 30 years and now stands at about 100,000, though the NHS added about 4,000 more as an emergency measure in December, January and February to help it cope with the spike in patient numbers caused by the long, cold winter.”

https://www.theguardian.com/society/2018/may/05/nhs-lowest-level-doctors-nurses-beds-western-world

EDDC Independents lead call for action on local health provision

Owl can’t quite see why Tory Councillor Allen felt the need to table his amendment – perhaps he felt Independent councillors were rather too Independent and therefore needed a dash of Tory policy! Now we just have to hope that new Leader Thomas doesn’t go and do exactly the opposite of what was resolved when he attends to DCC health scrutiny meetings – as Diviani notoriously did last year.

“A motion calling for the community hospitals which have lost beds to be maintained as health hubs, that services and clinics should be moved out of Exeter to local community hospitals and that more outpatient services should be provided in each community hospital was discussed by East Devon District Council at their meeting last week.

Proposing the motion, Cllr Marianne Rixson [EDA, Independent] said that health hubs in local areas need to be supported by the Council.

She added that the need for less travelling and difficult local bus services needed to be taken into consideration and that if place-based care was to be effective then the level of out-patient services need to be increased overall or at least maintained in every town.

She was supported by Cllr Val Ranger [Independent] who added that those people discharged early from hospital, children and elderly living with long-term health conditions should be able to access out-patient services locally in every community.

Councillors voted for an amendment, proposed by Cllr Mike Allen [Conservative], that said that this Council resolves to welcome the proposal of the Devon CCG’s to develop placed-based health care where strong evidence suggested that it would deliver high-quality patient care and sustainable services.

It added: “However, due to lack of supporting clinical evidence and clear future planning, the Council has strongly opposed closure and removal of community hospital beds and hospital-based services throughout East Devon.

“All efforts are made, in consultation with local communities, to ensure the existing estate of community hospitals was retained for health care purposes, where appropriate, the potential development of ‘Health Hubs’ was investigated, and council members received from the Clinical Commissioning Group a review of service changes (bed-based to home/community based care) made during 2017/2018 in East Devon, to include clinical evidence highlighting levels of patient safety and outcomes achieved and an evidence-based forward plan of proposed changes to health services in East Devon, for initial discussion at a future Cabinet.

After the meeting, Cllr Martin Shaw [DCC East Devon Alliance], said that he has written to Cllr Ian Thomas, who is due to become the new leader of the council on May 16, asking for assurances that each of the hospitals which has lost its beds (Axminster, Honiton, Ottery and Seaton), as well as Exmouth and Sidmouth, to be kept open and that a formal public consultation in the affected town and surrounding area should a closure of any community hospital, involving substantial relocation of outpatient services, be proposed.”

https://www.devonlive.com/news/health/closure-removal-hospital-beds-should-1530794

The epidemic of community hospital closures shows no signs of slowing down …

We in East Devon feel your pain:

“Former MP slams plans to close Teignmouth Hospital – the first purpose build NHS Hospital in the UK”

The area’s former MP says:

“We need more hospital beds. The Germans have 8.13 beds per 1000 people but the UK only has 2.61 beds per 1,000, and this needs to improve as there is a local and a national need for beds.”

https://www.devonlive.com/news/devon-news/former-mp-slams-plans-close-1516807

https://www.devonlive.com/news/devon-news/former-mp-slams-plans-close-1516807