“MPs and peers in call to ‘age-proof’ homes in rural areas”

“Rural England needs more homes that are suitable for an aging population, an all-party parliamentary group has said.

Following a nine-month inquiry, the All-Party Parliamentary Group on Housing and Care for Older People, today published a report calling on local planning authorities to ensure provision of new homes for older people.

The inquiry found that 50% of rural households would be over the age of 65 by 2039.

The APPG’s report said the Department for Environment, Food and Rural Affairs needed to play a key part in the integration of policies for housing, health and social care in rural areas for older people.

Other recommendations were directed at the Ministry of Housing, Communities and Local Government, suggesting all new homes be built to the Lifetime Homes standard of accessibility.

Inquiry chair Lord Best said: “For all the advantages of living in the countryside, life can be pretty miserable if your home is no longer right for you; if you can no longer manage the steps and stairs, if maintaining the property is costing too much, if keeping warm is a trial and your energy bill’s a nightmare, if you can no longer tend the once-beautiful garden.”

Best said that the APPG was concerned that older people would face “a huge challenge to their independence and wellbeing if their homes are no longer suitable.”

Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said: “Councils want to see a desperately needed residential revolution in older people’s housing.

“It’s essential that housing for older people enables them to live independently at home for longer, by including adaptations which enable them to get around easily and support them at home.

“If councils are given the right tools, we could trigger that residential revolution and deliver the homes our older residents need, but with an ageing population, the clock is ticking.”

MHCLG has been contacted for comment.”

https://www.publicfinance.co.uk/news/2018/04/mps-and-peers-call-age-proof-homes-rural-areas

“RURAL RESIDENTS FACE SOCIAL CARE ‘LOTTERY'”

The government’s system of funding social care services is unsustainable and unfair for rural communities, the Rural Services Network has warned.

Service providers operating across rural areas face inequitable costs compared to their urban counterparts for both adult and child social care, said the network.

Rural council taxpayers also faced unfair costs, warned the network in response to an inquiry by MPs who are examining the long-term future of adult social care.

RSN chief executive Graham Biggs said: “Social care is a national issue but it is in crisis.

He added: “While continuing to be delivered locally with flexibility for councils to respond to local circumstances and priorities, it should be 100% funded by central government to provide an adequate core service level for all residents nationally – irrespective of where people live.

“Council tax is an unsuitable taxation vehicle for demand responsive services and means rural residents face a postcode lottery when it comes to social care provision.”

Mr Biggs said council tax should only be used to fund social care if a given local authority decided extra money was needed to boost services above a core level locally.

It should not be used to fund the core, national, service, he added.

Mr Biggs said: “It costs substantially more to provide social care in rural areas than it does in larger towns and cities – and there is higher demand for services in rural areas.

“As a statutory duty, services have to be prioritised and other budgets – such as rural transport support, for example – are being cut significantly as a consequence.”

This was because older people make up a higher proportion of the population in rural areas than they do in urban areas, said Mr Biggs.

At the same time, the twin challenge of isolation and distance made it harder and more expensive to deliver services to dispersed rural populations.

Such costs inevitably and unfairly penalised rural councils – and were compounded by issues such as poor economies of scale and poorer external markets for delivery.

Mr Biggs said: “A future formulae to fund social care services must fully reflect the different costs of delivery imposed by both geography and population.”

http://www.rsnonline.org.uk/rural-residents-face-social-care-lottery

THIS is how you hold a CCG to account!

“The NHS will face calls from leading county councillors to publish a comprehensive plan for public consultation on its controversial proposals for a major shakeup of health services in Lincolnshire.

Concerns have been raised by the county council over the lack of progress on the Lincolnshire Sustainability and Transformation Plan since an initial draft was first published in December 2016.

At the time, the plans outlined a required £205 million investment to improve the facilities at Lincoln County Hospital, Boston Pilgrim Hospital and Grantham Hospital.

The proposals revealed that Grantham A&E could be downgraded to an urgent care centre and maternity services centralised to Lincoln.

Over 500 jobs are also set to be lost by 2021 under the plans.

Lincolnshire County Council unanimously voted against the STP at a Full Council meeting in December 2016, just over one week after the report was first leaked to the press.

County council leader Martin Hill wrote to NHS chiefs in March 2017 adding his criticisms, claiming that “making things better for most people, at the detriment of others, is not good enough”.

Since then, the county council said that there have been delays in publication of the STP plan, with further concerns raised about the lack of answers to the financial struggles of the NHS in Lincolnshire as well as fears about the changes themselves.

United Lincolnshire Hospitals NHS Trust, which covers the three main hospitals in the county, was put in special measures by the Care Quality Commission for performance failures and in financial special measures by NHS Improvement in 2017.

Even this month, ULHT has forecast an end of year deficit of £82.4 million, £5 million more than its deficit control target agreed with NHS Improvement.

In addition to asking the NHS to publish a plan for public consultation “without delay”, Lincolnshire County Council will also call for a review of governance arrangements for the STP to provide clarity over decision-making, accountability, democratic engagement and oversight of the process.

Glen Garrod, Executive Director of Adult Care and Community Wellbeing at Lincolnshire County Council, said in a report to councillors: “The county council has a long and successful track record of working with NHS partners in Lincolnshire. More recently and with the development of the STP programme the nature of the relationship has changed and, given the quality, performance and financial imperatives facing NHS services in Lincolnshire, more profiled.

“Disappointingly little progress has been made to address underlying budget deficits, performance continues to be poor at ULHT and successive inspections by the Care Quality Commission have reported on serious quality issues.

“This has been the picture for a number of years with little sign that ‘the tide has turned’ and these critical issues are getting better.

“Change is likely, indeed necessary and improvements critical if Lincolnshire residents are to receive NHS services that they deserve.”

In response, John Turner, Senior Responsible Officer for the Lincolnshire STP said that Lincolnshire County Council is a key partner for the NHS in the county but refused to be drawn on when it would publish its plans for public consultation.

He said: “We are fully committed to working together with Lincolnshire County Council in the best interests of patients and the people of Lincolnshire. The level of our integrated services between the NHS and Lincolnshire County Council already compares well nationally.

“There is much to be proud of in our local NHS, with our dedicated staff and partners working to provide the best care for our patients. At the same time, it is widely recognised that health and care services in Lincolnshire are very challenged – we struggle to provide consistent care and meet all quality standards, to recruit clinical staff in key areas, and we are currently overspending by £100 million a year.

“In recent months the STP has reported progress in areas such as mental health, GP services, integrated community services and operational efficiencies and improvements have been delivered for patients.

“In addition, the STP is also undertaking an acute services review which is examining what would be the future configuration of acute hospital services for the population of Lincolnshire.

“We look forward to discussing this openly across the county in due course.”

Councillors on the council’s Executive will consider the next steps to take at a meeting in Lincoln on Tuesday, May 1.”

https://lincolnshirereporter.co.uk/2018/04/nhs-under-fire-from-county-council-over-lack-of-progress-on-healthcare-shakeup/

Asset-rich pensioners should fund NHS says its chief

“The head of the NHS has suggested that pensioners’ housing wealth should be used to fund social care as he warned that the equivalent of 36 hospitals were “out of action” because of bed blocking.

Simon Stevens, chief executive of NHS England, said that given pensioners’ “relatively advantaged position” in terms of housing wealth, it was difficult to argue that working-age adults should fund the estimated £1 billion extra per year needed by social care services in increased taxes.

He was appearing in front of an inquiry by several Commons committees on the long-term funding of adult social care. …”

Source: Times, pay wall

“Sleeping rough more comfortable than army exercises – Tory MP”

Where to start? Of course, sleeping rough for a TV programme is easy! A nice warm bed to return to (not to mention a nice MPs salary) AND a film crew to keep you safe! AND he forgets to say he did his TV programme in 1991!

“A Conservative MP and former army officer has said that sleeping rough is “a lot more comfortable” than military exercises, in a debate he led on tackling street homelessness.

Adam Holloway, the MP for Gravesham in Kent, told parliamentary colleagues in the Westminster Hall debate on Tuesday that if a person is “able-bodied and sound of mind” there are resources that make it possible to sleep rough.

He said begging was also part of the problem, allowing homeless people to make “quite a lot of money”.

Holloway, a supporter of the pro-Brexit campaign group Leave Means Leave, also said that a rise in street homelessness was driven by eastern European immigration, claiming that many migrants from that region preferred to sleep rough than pay for accommodation.

He said mental illness and drug addiction were “real ingrained problems” behind homelessness that needed to be tackled to solve the crisis.

Holloway, who told MPs he had spent a number of nights during the parliamentary recess in February sleeping on the streets as part of a television programme on street homelessness, said: “One observation I do have, if you are able-bodied and of sound mind there are all sorts of services – not quite 24 hours a day – that make it possible to sleep out.

“I’m 52, I was in the army; to be honest for me sleeping rough in central London is a lot more comfortable than going on exercise in the army.

“But if you’re mentally ill or you are old or you are personality disordered then it is a very different thing. Or if you’re drug addicted it is very difficult. We have to accept that some people are able to sleep rough because there are resources to do so.”

Holloway’s comments come after research revealed at least 78 homeless people died on the streets and in temporary accommodation this winter, bringing the number of recorded homeless deaths to more than 300 since 2013.”

“Why I started a petition against NHS privatisation”

by Jamie Snape:

Today in Westminster MPs will debate a petition calling on the government to stop the privatisation of NHS services. Now, if I’m entirely honest, the date of a petition debate isn’t something that would normally appear in my calendar, however this particular debate I’m responsible for myself.

Until starting this petition I’d never campaigned on behalf the NHS, nor had I any connection to the plethora of local or national NHS campaign groups. So what drove me to begin the petition in the first place?

Well, it was after I’d encountered for myself the already privatised NHS services in my local area. Following this I was left with a clear understanding of what it means in reality, when our healthcare is provided by a profit-orientated business rather than an organisation focused on patient outcome like the NHS, and indeed what it is we are losing by privatising it.

As a parent, seeing my young children’s well-being affected directly and indirectly by NHS privatisation on more than one occasion, it motivated me to a degree that I might not otherwise have been.

So I began reading more about NHS privatisation, and why people like the late Stephen Hawking were so concerned. I concluded I could perhaps make a little difference myself by using a petition as a vehicle to help voice the concerns that many people have and that I share about creeping NHS privatisation.

This belief panned out, indeed a single post I wrote on Facebook about the petition was shared over 73,000 times, meaning it was very likely to have been read by more than a million people.

There are over 6,500 petitions on the parliament website right now, and it’s fair to say the UK public are petitioned out. Despite that, not too far short of a quarter of a million people took the time to sign this petition, which ultimately resulted in the scheduling of today’s debate in parliament.

NHS privatisation can mean so many things as there are so many aspects to it, so in terms of the debate itself, my hope is simply that I will observe a well-informed one. I hope that all the MPs involved demonstrate a real knowledge of the issues relating to it, such as the scale of current NHS privatisation.

What simply must be covered are the concerns surrounding the introduction of Accountable Care Organisations later this year, and their potential for leaving a back door wide open for a massive new wave of NHS privatisation.

If the debate centres around the small part of NHS privatisation, where a few people get bumped up the waiting list by having a routine operation performed by a private company, then I will of course be disappointed.

The concept of the NHS is erroneously referenced by many now in historic terms, especially when they are arguing in favour of NHS privatisation.

Personally, I see the NHS as something very much of the future, indeed I’m entirely certain that in years to come, a nation will only be considered civilised if it provides comprehensive free healthcare to all of its citizens.”

Source: Times (pay wall)

Care at home? Not if there are no carers for the homes

Care for 13,000 Britons at risk as provider seeks rescue plan

“The care of more than 13,000 elderly and vulnerable Britons could be thrown into turmoil after one of the biggest providers of home care visits in the UK warned it would go bust unless creditors backed a rescue plan.

Allied Healthcare, which has contracts with 150 local authorities and also provides out-of-hours services for the NHS, is asking for breathing space on its finances after cashflow problems that have been triggered in part by an £11m bill for back pay owed to sleep-in care workers.

The loss-making company has 12,000 employees and cares for 13,500 people in their homes via a network of 83 branches around the country. According to the Allied website it is the country’s largest domiciliary care business, twice the size of its nearest competitor.

Its Primecare division provides primary and urgent healthcare services, including NHS 111 telephony services, GP-led medical centres and end-of-life care. It also provides healthcare services in a number of secure settings including prisons, immigration centres and secure training centres.

Allied was bought by the German private equity firm Aurelius in a £19m deal in December 2015 but it has struggled against a backdrop of local authority funding cuts.

In a letter to creditors seen by the Guardian, its chief executive, Luca Warnke, said it had “significant funding pressures on our customers that have impacted on their ability to deliver financially viable health and social care services”. It added that it had taken the decision to pursue a company voluntary arrangement (CVA), an insolvency procedure that will enable it to agree a payment plan with creditors that include landlords and members of its pension schemes. It expects to file for the procedure on Monday.

Warnke blamed rising agency labour costs for its woes, pointing to the shortage of doctors and nurses since the Brexit vote as well as a potential £11m bill for backdated “sleep in” payments depending on HMRC’s calculation of the pay period.

Last year the government changed its guidance on how sleep-in carers should be paid, advising that they were entitled to earn the national minimum wage for the entirety of the time they were present in a house rather than just a flat rate. At that time some charities warned it could cost the sector £400m and potentially bankrupt many social care charities and providers.

The company said in a statement: “As with many independent providers in the UK health and social care sector, Allied Healthcare has been operating in a highly challenging environment for a sustained period of time, which has placed pressure on the company.

“As a result of these challenges, Allied Healthcare has has taken the decision to pursue a company voluntary arrangement as part of a prospective business plan that will ensure safe continuity of care across our UK-wide operations, place the company on a sustainable long-term footing and maximise repayments to creditors.

“The proposed CVA will not impact on the safe continuity of care that Allied Healthcare provides across the UK,” it said. “Allied Healthcare will continue to trade safely and it remains business as usual for Allied Healthcare employees and customers.”

The company insisted there were currently no plans for redundancies or branch closures.

A spokesman for the Local Government Association (LGA), which represents local authorities, insisted that councils have “robust” contingency plans in place to manage the care of individuals if necessary if the company were to fail.

“The absolute priority for councils affected is to protect the vital care and support that older and disabled people rely on and ensure it is able to continue without interruption,” a spokesman said. “The LGA is working alongside the Care Quality Commission and the government to support Allied, where possible, as it plans to financially restructure the business and continue to provide high-quality home care.”

https://www.theguardian.com/society/2018/apr/20/care-for-13000-britons-at-risk-as-provider-seeks-rescue-plan

Telegraph: Why is the NHS under so much pressure? Their answer: its our fault for getting older and fatter!

“An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care.

[Owl: this has been known for DECADES and should have been built-in to spending forecasts]

Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home.

[Owl: the NHS budget has NOT been protected! In real terms, funding has fallen enormously]

Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice.

[Staff shortages are due to austerity cuts and an exodus of EU workers, who are not replaced. Changing nursing bursaries to loans had exacerbated this serious problem]

Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue.

[Many lifestyle problems are due to the government’s policies: allowing food and drink lobbies to dictate the sugar problem until it is too late, and not putting greater taxes on cigarettes and alcohol as this would reduce government income, shutting Sure Start services that promoted better parenting].


https://www.telegraph.co.uk/money/consumer-affairs/chances-getting-nhs-funded-care-depends-live/

“Families seeking care funding from the NHS face a “postcode lottery” as to whether they will be accepted.”

Under “continuing healthcare” (CHC) rules, those with complicated medical conditions can apply for full funding from the health service. Families are not means tested and the decision is supposed to be made solely on the person’s medical situation.

But, despite the criteria being clearly set out in a national framework, differing interpretations of the rules mean your chances of being deemed eligible depend on where you live.

Telegraph Money is aware of hundreds of cases where regional health authorities have applied the rules differently – including some where patients have been approved by one authority and rejected by another just days later.

Ron Laycock, 87, was admitted to Cheltenham General Hospital earlier this year with a vascular condition. Despite living in Wiltshire, he was taken to a specialist unit in Cheltenham, in neighbouring Gloucestershire.

After he was deemed to be “rapidly deteriorating”, medical staff at the hospital approved him for “fast-track” funding under CHC, meaning his care at a nursing home would be paid for.

However, upon arriving at a home in Wiltshire, the county’s clinical commissioning group (CCG) – the NHS body responsible for determining eligibility – refused to recognise the hospital’s decision and rejected his application. This left Mr Laycock’s family having to find the £1,450 weekly cost of the nursing home themselves.

His daughter Becky Nicholls, 44, who works in human resources, said: “My father had Alzheimer’s as well as this condition and then caught pneumonia as well. He stopped eating and taking on fluids. A specialist at the hospital said he was clearly rapidly declining as he had stopped eating but Wiltshire flatly refused to accept that.”

She was refused an explanation from the CCG and said an administrator was rude over the phone. “I was just shocked after that phone call,” she said. “I hadn’t slept for weeks and that night I lay there just hearing her words in my head. My father couldn’t have been released without a care home to go to, so how can he not be eligible?”

She added: “I felt my dad was going to pass away before they took the time to respond.”

The family paid around £5,800 to the care home and Mr Laycock lived there for two weeks before he died. Further to this newspaper’s involvement, Wiltshire CCG acknowledged it had made a mistake and agreed to refund the money backdated to when Mr Laycock was discharged from hospital.

A spokesman said: “Wiltshire CCG takes all patient complaints and concerns seriously and can confirm that appropriate funding is being put in place for the care Mr Laycock received.

“We acknowledge the upset that Mr Laycock’s daughter has experienced and the director of nursing has spoken to her directly to apologise for any distress caused, as well as offering to meet with her in person in order to better understand the issues raised and ensure we learn from this.”

Andrew Farley, from Farley Dwek Solicitors, a firm specialising in CHC disputes, said his company is dealing with around 500 such disputes, many of which are related to cross-border discrepancies. “It’s clear from the national framework that if fast-track is granted, it should only be withdrawn in exceptional circumstances,” he said.

“The decisions should be the same wherever you are in the country, but they aren’t. There appears to be a postcode lottery as to whether you’ll get funding or not.”

CHC funding is available to anyone with “unpredictable” healthcare needs that go “over and above” what a local authority would be expected to provide, Mr Farley said. It is available for everyone, regardless of wealth.

He said families are often bamboozled by the complex nature of the system and suggested that the cash-strapped NHS may be encouraging assessors to deny funding.

“I think there is possibly a hidden agenda; that’s the impression I get having spoken to many families who have been through this process,” he added.

A spokesman for NHS England said: “Spending on CHC is going up as ever more people are being supported, but it’s CCGs that undertake eligibility assessments, using the national framework, based on each individual person’s specific circumstances.

“While recent improvements in practice mean variation in access to CHC has reduced, there is potential to make the process more efficient and effective for patients as the majority of people put through a CHC assessment turn out not to need it.”

https://www.telegraph.co.uk/money/consumer-affairs/chances-getting-nhs-funded-care-depends-live/

“Hospitals launch legal challenge over rates relief”

“A group of 20 NHS hospital trusts has launched a legal challenge for business rates relief. The trusts have started legal proceedings against 49 local authorities who want to be treated the same as private hospitals for relief on business rates bills. A preliminary hearing took place yesterday. The LGA is supporting councils involved in the case. …”

Source: Mail Online, Express p5

The scandal of hospital “ghost wards”

“Hospitals are mothballing scores of wards, closing them to patients despite the NHS’s ongoing beds crisis, new figures reveal.

At the last count in September 82 “ghost wards” were recorded containing 1,429 empty beds, the equivalent of two entire hospitals, according to data provided by hospital trusts across England. It represents a sharp increase on the 32 wards and 502 beds that were unused four years earlier, statistics obtained under freedom of information laws show.

The closures, often a result of hospitals not having enough staff or the money to keep wards open, have occurred at a time when the health service is under unprecedented pressure and struggling to cope with demand for beds.

Doctors’ leaders reacted with disbelief to the revelations, which come after the NHS endured its toughest winter for many years, during which many hospitals ran out of beds.

“Given the pressures on the whole system, which suggest the NHS is 5,000 beds short of what it needed this winter, [this situation] is amazing and is almost always caused by not having enough money or staff,” said Dr Nick Scriven, the president of the Society for Acute Medicine. …”

https://www.theguardian.com/society/2018/apr/13/revealed-82-ghost-wards-1400-empty-beds-nhs-england

DCC cabinet refuses to accept decision of Health and Social Care Scrutiny Committee and rushes in Accountable Care Organisation without checks and balances

Claire Wright’s blog:

“The all Conservative Devon County Council Cabinet has thrown out its own health watchdog’s unanimous resolution on deferring the implementation of Devon’s Integrated Care System, while a range of assurances were received.

Dozens of objections from members of the public came flooding in at the 22 March Health and Adult Care Scrutiny Committee meeting and my resolution on the thorny issue, which can be found here –

http://www.claire-wright.org/…/devons_nhs_asked_to_provide_…

… had been backed unanimously by councillors.

A revised resolution that the Cabinet supported yesterday, merely noted that a new system was being set up and everything else was so watered down as to be almost meaningless.

The message was repeated at length that this was not an endorsement but simply noting that it was happening and that progress will be monitored.

I reminded the cabinet of the County Solicitor’s advice to the Health Scrutiny Committee in November that it is unique in scrutiny committees in that we provide a legal check on health services – the only legal check – and that our remit is to take up issues of public concern. And we were flooded with emails of public concern.

I then went through the issues as I saw them.

When summing up, Cabinet member, Andrew Leadbetter, accused me of bringing a set of ‘pre-determined’ proposals to the Health and Adult Care Scrutiny Committee.

This is a serious allegation and I immediately asked him to withdraw it. Leader, and Cabinet Chair, Cllr John Hart, backed me up and Cllr Leadbetter retracted his statement.

I had in fact prepared the proposals during the lunch-hour before the meeting. it is quite permissable (and very common) to conduct business in this way.

There was cross party support for the Health Scrutiny resolution with Cllrs Alan Connett, Brian Greenslade and Rob Hannaford also addressing Cabinet along similar lines.

Here is the Cabinet’s final resolution, which you can compare with my proposals which are set out in yesterday’s post below:

(a) that the original recommendations of the Cabinet (a – d), as outlined in Cabinet Minute *148 and reproduced below, be re-affirmed:

(i) that the key features of an emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, a Mental Health Care Partnership and shared NHS corporate services, be noted.

(ii) that the proposed arrangements in Devon as set out in paragraph 4 of the Report be endorsed, reporting to the Cabinet and Appointments and Remuneration Committee as necessary.

(iii) that the co-location of NHS and DCC staff within the Integrated Strategic Commissioner, subject to agreement of the business case, be approved; and

(iv) the Health and Adult Care Scrutiny Committee be invited to include Integrated Care System governance in its work programme.

(b) And, in light of the Scrutiny Committees deliberations, Cabinet further RESOLVE

(i) that the Health and Wellbeing Board is reformed to lead new governance arrangements for the development of integrated strategic commissioning of health and social care; and

(ii) that there is continued proactive communication to the public using clear and consistent messaging and where appropriate there will be relevant involvement and engagement.”

Here’s the webcast – https://devoncc.public-i.tv/…/po…/webcast_interactive/325467

“DCC cabinet decides tomorrow if to back Health Scrutiny resolution over controversial health plans”

Claire Wright’s blog, as she ploughs (with EDA DCC Councillor Martin Shaw) the lonely furrow of integrity and common sense – both sadly lacking in the DCC Health and Social Care Scrutiny Committee:

“Devon County Council’s cabinet will decide tomorrow whether to back the Health and Adult Scrutiny Committee’s resolution on deferring the implementation of the controversial Integrated Care System, which many local people have huge concerns over.

At the last Health and Adult Care Scrutiny Committee on 22 March, I proposed the following which was supported by the majority of the committee.

An additional line on a public engagement, was voted down by Conservative councillors:

Here’s what the cabinet will be considering. If it supports the resolution, it will be implemented with immediate effect…..

I will be speaking in support of the resolution tomorrow…… If you are keen to know the outcome or hear the discussion, the meeting is webcast live here – https://devoncc.public-i.tv/core/portal/home

(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;

(b) defer the implementation of the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective;

(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;

(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’; and

(e) provide a copy of the business plan being developed and a summary of views from staff consultations.

For more background on Integrated Care Systems see my blog
post –

http://www.claire-wright.org/…/devons_nhs_asked_to_provide_…

The Crowdjustice judicial review of Accountable Care Organisations – update

“Update on OUR NHS – Comprehensive Healthcare for All – STAGE 3

Hello Friends

As a backer you know our Judicial Review, challenging NHS England’s contentious Accountable Care Organisation contract, will be heard on Tuesday 24th April at Leeds High Court, 1 Oxford Row Leeds LS1 3BG

We’d like to invite supporters and fellow campaigners to a rally outside the courts from 9. 30am, to support the vital NHS principles our Judicial Review aims to defend. We will be inviting Press & Media.

This week we had a really good meeting with our legal team from public law firm Leigh Day and Landmark Chambers, to discuss the ‘skeleton case’ – a summary outline – which is due to be sent to the court in the next few days.

The skeleton case is based on our deep concern that the payment mechanism proposed for the Accountable Care Organisation contract is not only unlawful under current NHS legislation – but will lead to restrictions and denial of NHS care, and the abandonment of the core NHS principle of providing comprehensive care to all who have a clinical need for it, free at the point of use.

This would mean replacing treatment based on patients’ clinical need with treatment based on assessments of financial risk and returns – a total departure from core NHS principles, replacing them with health insurance company principles.

This is because the Accountable Care Organisation contract requires NHS commissioners to pay a fixed lump sum to cover the whole range of services for the population in a given area – rather than the present system which pays NHS providers an agreed price for the treatments they have actually delivered to patients.

Without reference to the number and complexity of treatments delivered to patients, the ACO contract’s proposed fixed population payment would pass financial risk to the providers – and from providers to us the patients.

Why? Because if providers were to get more patients needing more complex treatments costing more than the fixed lump sum they receive, they would face spending money they don’t have. They’re not likely to want to do that. The only way to avoid that would be to restrict or deny patients’ access to treatments. Particularly patients whose treatments are more costly and whose prognosis means their treatment is not such good value for money.

In our view, NHS England is playing fast and loose with existing NHS law about how prices are set and payments are made for health care provided to NHS patients.

Although we don’t in any way support the 2012 Health and Social Care Act, which increased private companies’ access to NHS contracts, fragmented the NHS and removed the Secretary of State’s duty to provide a universal, comprehensive health service in England, it is the law.

If NHS England wants to change price setting and payment methods for the provision of NHS services, it should do it in accordance with the law. If changing payment mechanisms means changing the law, that is something for Parliament – and the public that puts MPs there – to decide.

Ask yourself… “what happens when government and its quangos decide they are above the law?” It doesn’t bear thinking about.

As well as being undemocratic, NHS England’s proposed changes to how NHS services are priced and paid for would undermine the NHS as a comprehensive health service for all who have a clinical need for it.

They are about enabling moves to a cut price, bargain basement NHS that uses the same business model as the USA’s limited state-funded health insurance system that provides a restricted range of health care for people who are too poor or old to pay for private health insurance.

Thanks for your support so far.

Please share this with friends and campaigners.

We will fight this all the way.”

“There’s enough tax money to feed hungry children – it’s just in the wrong pockets”

” … Over the past two years, health bosses have charged £5.8m on taxpayer-funded credit cards to finance their lavish lifestyles.

Purchases included helicopter lessons, go-karting outings, bookings at five-star hotels, trips to cocktails bars, and stops at fast-food joints.

This behaviour shines light on a deep hypocrisy from health bosses, who on the one hand work to implement a sugar tax – effective today – to discourage taxpayers from consuming sugary drinks, and on the other hand use the same taxpayers’ money to fund their own trips to McDonalds.

Putting the hypocrisy aside, there is a wider issue here, of how taxpayer money is spent once it’s in the hands of the state.

We are always told that the solution to any given problem is more spending, and consequently calls to ramp up taxes naturally follow. But that argument fails down flat when nearly £6m that could have been used to top up a low-income parent of three, or go towards a health service we are perpetually told is “in crisis”, has been spent on public officials to live their weekends like rock stars.

The UK government is already spending around 40 per cent of GDP – the majority of that is from tax intake, but tens of billions are still borrowed from future generations.

There is no justification for increasing the burden on taxpayers by a penny more. There are already funds in the system that could help the most needy. They are just sitting in the wrong pockets. …”

http://www.cityam.com/283465/theres-enough-tax-money-feed-hungry-children-its-just-wrong

“BBC investigates rural hospital transport”

“Broadcast on Friday (30 March), the whole episode of BBC Radio 4’s Farming Today programme on Friday (30 March) examined the issue of hospital transport.

The programme details the impact of large-scale cuts on bus services since the introduction of austerity measures.

At the same time, medical services have been increasingly concentrated in ‘centres of excellence’ in towns and cities, with few specialist facilities available in local community hospitals.

Rural Services Network chief executive Graham Biggs told the programme more and more services were being centralised into larger towns.

“Accessing those services is increasingly difficult whilst at the same time public transport is being reduced,” said Mr Biggs.

It was true there was a shortage of medical specialists but something had to be done around accessibility – whether via public transport or some other means, he said.

Patients in rural areas needing to use public transport to get to hospital often faced painfully long journey times, reported the programme.

Presenter Emma Campbell travelled to hospital with a listener called Sandra, who has to take three buses in each direction to get from her home in Somerset to her appointment in Bath.

Sandra faced a travel time of over three hours each way, for a 10 minute appointment – a situation which was “not uncommon at all” for rural residents, said Mr Biggs.

The programme also heard from representatives of Age UK’s ‘Painful Journeys’ campaign, who also explained the extent of the problem in rural areas.

The full programme can be heard by clicking here

https://www.bbc.co.uk/programmes/b09wpn4f
(available until 28 pril 2018)

“Social” “Care”

Just watch this – being seen at an Age UK reception for MPs tonight and see just why our independent councillors are so important to us – all that stands between us and EDDC and DCC Tory councillors who deliberately bury their heads in the sand:

https://www.ageuk.org.uk/our-impact/campaigning/care-in-crisis/

“I don’t believe it!” – NHS Providers say we are short of at least 10,000 hospital beds and are treating our elderly shamefully!

“The NHS is more than 10,000 beds short of what it needs to look after older people properly, hospital leaders have said.

NHS Providers, which represents hospitals, said that it was impossible for waiting time targets to be met this year and warned that the government’s pretence that they would be met created a “toxic culture” similar to that which led to the Mid Staffordshire scandal.

This week Theresa May promised that a long-term plan for NHS budget rises would be agreed within months, and will be under pressure to agree increases of up to £20 billion over five years.

However, Jonathan Ashworth, the shadow health secretary, said that “a nod and wink from the prime minister” was not enough for patients.

The NHS has not hit any of its main targets for more than two years. Chris Hopson, chief executive of NHS Providers, said: “The levels of performance expected and the savings demanded for next year are beyond reach. While we strongly welcome the prime minister’s commitment to increase long-term funding for the NHS, it makes no immediate difference to the tough task facing trusts for next year.”

Mr Hopson’s report estimates that 3.6 million patients will not be treated within four hours at A&E over the next year and 560,000 will be denied routine surgery within 18 weeks. He said that hospitals could make £3.3 billion in savings next year but that ministers had demanded 20 per cent more than this.

“This creates a toxic culture, based on pretence, where trusts are pressurised to sign up to targets they know they can’t deliver and then miss those targets as the year progresses,” his report said.

The NHS is probably somewhere between 10,000 to 15,000 beds short on a bed base of about 100,000.”

One hospital chief executive suggested that hospital overcrowding pointed to deep social problems. He said: “As a country we don’t look after old people well. We have too many people living by themselves in houses that are unsuitable . . . In the end they get really unwell and call 999.”

Source: The Times, pay wall

Health Cheque Up

£20bn for the NHS over 5 years!

Does that mean that the CCG will cease its destruction of Devon’s NHS services? Does it mean that current numbers are now meaningless?

Or does it mean that the cash will arrive too late to prevent this or not arrive at all?

Or does it mean that most of the cash will be directed to marginal Tory seats before a General Election?

Should Randall-Johnson remain chair of the DCC Health and Social Care Scrutiny Committee (or even be a councillor at all?)

We all know our problems with Randall-Johnson as Chair of DCC’s Health and Social Care Scrutiny Committee (or, if not, we should). Here are just a few of many Owl posts on this councillor and her behaviour as its Chair:

https://eastdevonwatch.org/2017/08/12/conduct-of-health-committee-members-investigated-by-devon-council-diviani-and-randall-johnson-heavily-criticised-for-behaviour/

https://eastdevonwatch.org/2017/06/24/claire-wrights-report-on-the-disgraceful-dcc-nhs-meeting-and-its-disgraceful-chairing-by-sarah-randall-johnson/

https://eastdevonwatch.org/2017/08/31/councillor-calls-for-randall-johnson-resignation/

NOW, it seems, she was EXTREMELY reluctant to allow the CCG’s Sustainability and Transformation Plans to be a standing item on her committee’s agenda and inly the intervention of a “committee adviser” led to this being agreed. See Claire Wright’s blog for details:

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

“… Essentially, the NHS in Devon is looking at a £500m overspend by 2020 unless major cuts and centralisation of services take place.

It is absolutely vital that the committee keeps a very close eye on what cuts are to be made and how this is affecting patients. We are their only ears and eyes on this.

When I made this proposal yesterday – that we receive a detailed report at each committee meeting. Chair, Sara Randall Johnson appeared to be reluctant to introduce such a standing item, given all the other issues that needed to be examined.

I could not see her point of view at all. Surely, this is the most important issue facing Devon’s patients today?

Committee adviser, Anthony Farnsworth suggested that councillors have sight of the CCG’s own financial reports relating to the STP on a regular basis and this was a legitimate area of scrutiny. …

This was agreed.

Here’s the webcast – https://devoncc.public-i.tv/core/portal/webcast_interactive/318671

What is this woman’s problem? Is it simply that she knee-jerks a “no” on any and every proposal from Independent Claire Wright” – putting personalities before what is best for Devon, its healthcare and its scrutiny? We know she has problems with Ms Wright’s forthright defence of our NHS against cuts and privatisation (though the problem seems to stem from further back when the then Leader of East Devon District Council was ousted from her seat by the likeable, knowledgeable and planning policies aware winning candidate – Claire Wright).

Or is it even more dangerous than that? Putting HER personal political beliefs and ideology above those of others – including moderate DCC Tory councillors – and forcing them on others by whatever means she has at her disposal?

Questions, so many questions, and so few answers.