Coverage of Seaton hospital bed closures

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

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

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

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

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

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

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

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

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

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

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

The timetable for implementation is:

• Seaton Community Hospital week commencing 21 August 2017

• Okehampton Community Hospital week commencing 21 August 2017

• Honiton Community Hospital week commencing 28 August 2017

• Exeter Community Hospital week commencing 4 September 2017.

“The provision of inpatient services at these locations will cease from these dates. All other services at these hospitals will continue as normal. Patients in these areas in medical need of a community inpatient bed will be accommodated at either Tiverton, Sidmouth or Exmouth hospitals, depending on where they live.

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

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

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

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

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

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

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

Care at home – in your dreams, sorry – nightmares!

A comment from Save Our Hospitals Facebook on the Seaton hospital beds closure today and Honiton next week:

“What utter tripe!!!!

Out of all our nursing auxiliaries at Honiton there is ONE, being redeployed in community. The rest have been shipped to Exeter and Sidmouth!!
How’s that for care in the community! The bloke [Neil Parish MP, who responds to worried constituents with an anodyne “round robin” but voted through the cuts] is a total liar, as is the rest of them!! When it came to the crunch,they all turned their backs on their community!! God help them!!”

RIP Seaton Community Hospital beds – vigil, noon today

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

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

The heart of a community stops beating today.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source: Sunday Times (pay wall)

“Managers on more than £400,000 a year at failing NHS authorities”

“Temporary NHS managers brought in by failing health services are being paid record rates of up to £400,000 a year.

Ministers have repeatedly ordered clampdowns on “excessive and indefensible” management pay and promised extra scrutiny of deals which pay more than the £142,500 salary of the Prime Minister.

But a Telegraph investigation of 32 clinical commissioning groups (CCGs) failing so badly that they have been taken over by NHS England shows that in fact rates have reached a record high.

Nurse leaders last night said executive pay was “spiralling out of control” amid warnings that “sky-high” remuneration packages were not being matched by improvements to frontline services. Health services insisted they were forced to pay “premium” rates to attract good managers quickly.

The figures, from NHS annual reports for 2016/17, disclose 21 managers at the struggling organisations on rates equal to at least £200,000 a year – including five on more than £300,000.

… “At North, East and West Devon Martin Shield cost over £90,000 for three months – an annual rate of £375,000 – as “turnaround director.” …

http://www.telegraph.co.uk/news/2017/08/19/managers-400000-year-failing-nhs-authorities/

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

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

Small charities that deliver public services have a problem.

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

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

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

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

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

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

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

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

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

Lower the financial threshold

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

Apply it to goods and works, not just services

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

Offer more support for potential providers

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

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

Promote the act more

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

Explain how social value is measured

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

Encourage councils to take risks

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

Make the act part of wider social change

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

Russell Hargrave works for Power to Change”

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