DCC Ind. East Devon Alliance Councillor Martin Shaw will try again to get DCC to see sense on bed closures

“PRESS RELEASE
Tomorrow (Thursday) Devon County Council will discuss a new call to review the controversial closure of beds in community hospitals in Honiton, Okehampton, Seaton and Whipton.

I have been told my motion will be discussed, rather than referred to Cabinet as is normal with most motions.

The motion proposes to redress the widely perceived failure of the Health Scrutiny Committee to properly scrutinise NEW Devon CCG’s decisions, which has allowed the CCG to go ahead with the closures.

The motion asks Health Scrutiny, which alone has legal power to refer the decision, to look again the outstanding issues, while at the same time committing the Council to alerting the Secretary of State to the disquiet in the County over the issue.

The motion also highlights the urgent call by Simon Stevens, Head of the NHS in England, to free up more hospital beds in view of the danger of an extreme flu season this winter.

I will issue the text of my speech tomorrow morning.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

Devon to be one of worst-hit areas for inability to cope with ageing population

Devon will have largest shortage in number of beds, with a projected 1,921 short by 2022

“… Izzi Seccombe, from the Local Government Association, said: ‘These findings reinforce our warning about the urgent need to reform adult social care and deliver a long-term sustainable solution that delivers a range of high-quality care and support for the growing numbers of people who will need it.

‘It is absolutely critical that the Government uses the Autumn Budget to bring forward its consultation for social care announced in the Queen’s Speech, and that it works with local government leaders in delivering a long-term sustainable solution for social care.

‘To tackle the problems we face tomorrow, we must start planning today.’

http://www.dailymail.co.uk/news/article-4946632/Nine-10-areas-run-care-home-places.html

A Tory council leader pleads for cross-party initiatives and unitisation to cut costs

Owl sats: One has to wonder if he would be putting out the same message if his party had a majority.

Austerity means careful, selective investment is needed in core services, says Martin Tett, the Conservative leader of Buckinghamshire council

“… Less than a fortnight ago, the LGA sent chancellor Philip Hammond a 40-page submission ahead of the autumn budget which warned that services in England were at “tipping point” as a result of significant funding gaps, pointing to children’s services, adult social care and homelessness. By the end of this decade, English town halls will have seen £16bn of reductions to government grant funding – and from April 2019, 168 councils will not receive any funding for day-to-day expenditure.

Among its many appeals, the umbrella body urged the government to meet a £5.8bn funding gap facing existing local services by 2019/2020, of which £2.3bn is identified in adult social care. This figure includes £1.3bn that the LGA says is needed immediately to stabilise the adult social care market. This is despite an additional £2bn announced by Hammond in his spring budget to help councils cope over the next three years.

It also reiterated its call for greater financial flexibility and powers to allow town halls to build new homes in large numbers once more. …

… Alongside its urgent plea for cash for adult social care, the LGA has called for cross-party talks at national level to find a long-term solution to the social care funding crisis. The move echoes a call made by the Commons select committee for communities and local government in March that concluded that inadequate funding was having a serious impact on both the quality and level of care, and said a long-term fix was urgently necessary. Earlier this year, former Lib Dem social care minister Norman Lamb and a small group of cross-party MPs urged the prime minister to set up an NHS and Care convention to work on a sustainable settlement. A recent poll by the charity Independent Age showed that 86% of MPs believe a cross-party consensus is needed. The LGA has even offered to host the first round of discussions. …

… One way to save significant money would be to replace the two-tier system of one county and four district councils with one unitary authority. Having responsibilities split across two tiers of local government is crazy, says Tett. Districts, for example, are responsible for housing, counties for infrastructure – yet they are “two bits of the same jigsaw”. It would speed up decision-making, end the confusion about who is responsible for which services and allow a more holistic approach, such as joint commissioning across housing, health and care, he says.

The business case for unitary authority status has been in communities secretary Sajid Javid’s in-tray since last September. Tett is waiting to see if the reasoned argument will be heard.”

https://www.theguardian.com/society/2017/oct/03/martin-tett-social-care-decent-housing-austerity-neglect-investment

The destruction of trust in the NHS? Hunt has an app for that

“Jeremy Hunt spoke to the Tory conference in Manchester today about the NHS. It was a bizarre spectacle.

Hunt gave the Tories the credit for the fact that we have an NHS. He said he would increase the number of nurse training places – ignoring the fact that there aren’t enough student nurses filling courses now, thanks to the Tories’ decision to scrap bursaries for nursing students. And he tried to claim patient satisfaction levels are at an all-time high in an NHS that’s falling down around our ears amid ever-lengthening waiting times and hospitals running at record deficits.

But his nonsense entered the realm of the surreal when, after calling for a hypocritical round of applause for heroic medical staff who risked their lives to save others in the Manchester and London terror attacks, he said he planned to show nurses how valued they were and to help them manage their family commitments.

With an app.

And he screwed up and let slip that the ‘flexible working app’ he plans to make available is actually for NHS Trusts to be able to get their staff to work extra hours at short notice.

It’s the equivalent of a selfish, idiot husband buying his wife a new iron or vacuum cleaner so she can do ‘her’ chores more efficiently – and expecting her to be pleased at the ‘romantic’ gesture.

Except this is an idiot Health Secretary insulting well over a million NHS workers, If he hadn’t already been the most despised in the history of the NHS, he would be now.”

Video: Hunt – “I’ll give nurses an app to work longer at short notice”

Rise in hospital deaths coincides with bed-blocking

Owl isn’t sure if The Times or the British Medical Journal realise that what they are saying is:

Sick people should have been turfed out of hospitals (where they died in the charge of nurses and doctors)and should instead have been sent to die at home (with carers).

One gets included with mortality statistics, the other doesn’t … Hhhmmm!

A sharp rise in deaths in England and Wales could be down to an increase in bed-blocking in the NHS.

Between July 2014 and June 2015 there were an additional 39,074 deaths compared with the year before. For England it represented the largest rise in nearly 50 years. The higher rate of mortality has continued since, with most of the deaths in older, frail people.

About a fifth of the increased deaths may have been caused by heightened levels of delayed discharge from hospitals, a study has concluded.

While the study itself can prove only a correlation, rather than causation, the researchers said that their findings required “urgent attention”, adding: “Greater investment in the NHS and adult social care to address the rising levels of delayed discharges may be needed to tackle the rapid rise in mortality rates.”

In February, a study published by the Royal Society of Medicine concluded that cuts to health and social care were “implicated” in the deaths.

The research team from the universities of Liverpool, Oxford, Glasgow and York found that while the total number of days beds were blocked increased from 2011, the rate of change increased from 2014, with the number of affected patients also rising rapidly. For each additional acute patient delayed, the number of deaths went up 7.32.

Mark Green, lecturer in health geography at the University of Liverpool, who led the research, said: “Since 2014, the number of patients admitted for acute conditions who were delayed being discharged from hospital has almost increased by 50 per cent. This creates blockages in the NHS where beds are not available for new patients.

“We detect an association only for acute patients and not non-acute patients. Acute patients require urgent medical care and therefore may be more susceptible to any delays.”

Hospitals have laid much of the blame on social care services, with patients waiting in hospital beds for the services they need to go home.

Saffron Cordery, director of policy and strategy at NHS Providers, representing hospitals, said: “We cannot say with any certainty how much delayed transfers of care are to blame for rising death rates. However, it is clear that they are bad for patients.”

The research is published in the Journal of Epidemiology and Community Health, a BMJ title.

Source: Times, pay wall

NHS: too little, too late? Hunt blames everyone …

“… The health secretary warned that the NHS would “fall down” without 150,000 EU citizens working in hospitals and communities across the country, saying he would use his conference speech on Tuesday to try to offer people reassurances.

Asked if the NHS was properly staffed – amid warnings of a crisis and the recent revelation that two junior doctors were left in charge of 436 patients at Derriford hospital in Plymouth – Hunt said it was not.

“No, we’ve got to do a lot better,” he said. ”Workforce planning has been woeful for a very, very long period of time.”

He said that health secretaries, including himself, had been too short-termist in their approach to the NHS, as he revealed his centrepiece announcement for a 25% increase in nurse training places from next year. Hunt said the rise was the biggest in the history of the NHS and there would also be more places available through the apprenticeship route. …

…Speaking about health, Hunt admitted that staffing was a significant issue as he reached out to EU citizens not to leave the UK.

“We want them to stay and we’re confident they will be able to stay with broadly the same rights as now,” he said, adding that the European workers were hugely valued and needed in an uncertain time. “We certainly can’t afford to lose them.”

He argued that more could be done on the issue of pay outside the basic salary, with plans to pilot a new app through which health workers could take on additional hours at short notice. Affordable homes built on NHS land would have to be first offered to health workers, he said.

… Admitting that the NHS was not properly staffed, amid warnings of serious strains, Hunt explained what he believed had been a key part of the problem.

“It has been a mistake made by successive health secretaries in all parties, that when you’re faced with a choice: do you put money into training more doctors and nurses [who] won’t come out of training in a nurse’s case for three or four years, or a doctor’s case six or seven years – or do you put the money into more cancer treatment today?

“Inevitably people take the decision to spend it on immediate priorities, even if it is not the right thing for the long term of the NHS.”
Hunt admitted that the party had to act on widespread concerns about public sector pay, many of which were raised during the election campaign, including by lifting the pay cap. But he admitted that could mean a challenge elsewhere for the NHS budget.

Hunt said properly resourced staffing was the priority for the health service but, asked where the money would come from, he said: “There is a big discussion to be had about that.”

He said the Tories’ biggest challenge was to take on Labour’s arguments, saying his party was ready to improve funding to the NHS and that services were improving despite challenging demographics.”

https://www.theguardian.com/politics/2017/oct/02/back-theresa-may-or-risk-labour-government-hunt-warns-johnson

Actually, the choice was: do we put more money into training doctors and nurses or do we employ them from other countries and save on the cost – the money WASN’T put into better cancer care OR better social care – the money wasn’t there and never has been.

The NHS: one doctor’s story

“An open letter to Prof Ted Baker, following his attack on the NHS
Dear Professor Baker,

It seems like only yesterday that another Professor – Stephen Hawking – felt compelled to raise concerns in the press about the current state of the NHS. If you recall, Hawking’s critique of Jeremy Hunt’s predilection for statistical cherry-picking prompted an extraordinary barrage of tweets from the Health Secretary, admonishing one of the world’s greatest scientists for his cluelessness on the matter of, well, scientific methodology.

Professor Baker, your interestingly-timed intervention today has prompted quite the barrage of headlines itself, hasn’t it? An NHS ‘unfit for the 21st century’, indeed? And that picture you paint of A&E departments’ disgraceful ‘unsafe practices’ – our ‘wholly unsatisfactory’ arrangements that ‘endanger patients, as well as denying them basic privacy and dignity’. It’s almost as if you think we’re somehow choosing to ‘keep piling patients into corridors where staff cannot even see them’ or to force patients to queue, hour upon hour, in ambulances outside log-jammed hospitals. Actually, you go further, don’t you? You directly blame us for the hellish conditions that patients and staff alike endured last winter, condemning our culture of ‘learned helplessness’ that leaves our patients abandoned, unmonitored, without even essentials like oxygen.

There’s just so much blame in your interview, isn’t there? Previous NHS staff, current NHS staff, ‘archaic’ NHS systems, bad managers, bad previous governments. Blimey. No-one, it seems, is immune from your blame. Except, that is, the one glaring exception. The one cherry you chose not to pick, so to speak.

Nowhere in your remarkable blame riff is there any mention of the funding climate in which frontline staff and managers alike are struggling – fighting tooth and nail, frankly – to keep on delivering a halfway decent standard of care for our patients. We are trying so unbelievably hard, Professor Baker. But we already have one of the lowest numbers of beds per capita of any country in Europe, as well as being one of the most under-doctored. And, of course, we have a government, currently, who has chosen to subject the NHS to the most draconian and sustained funding squeeze in NHS history. Right now, the NHS in my region is having to cut even more beds, hundreds of them. It simply cannot afford to do otherwise – like every acute Trust in the country. That’s not really going to help the patients stranded, bedless, in corridors about which you care so deeply, is it?

Of course NHS reform is needed. Of course we need greater community capacity and better integration between hospitals and primary care. But in omitting to mention the political context to your argument – the political choice to provide the NHS with inadequate resources safely to manage not only winter, but all-year-round rising demand – you come across, I’m afraid, as an oddly partisan chief inspector of hospitals. Why the omission, Professor Baker? Why blame the NHS and its dog, yet fall so shy and silent when it comes to acknowledging the political choices to underfund and understaff the NHS into a skeleton service in place of excellence?

Do you really think your admonishing letter to Trust CEOs, telling them to jolly well stop leaving patients in corridors, is going to do anything other than incense us all? Where else would you suggest we put them? Toilets? Broom cupboards? I believe Jeremy Hunt’s new toilet is rather lavish – perhaps we could squeeze one or two in there?

Anyone would think you were giving the Department of Health comms team a helping hand in the pre-emptive deflection of blame for the looming winter crisis away from the government and onto anyone else but Theresa and Jeremy. I thought nothing could surpass for sheer stupidity last week’s news that NHS staff were forced by NHS bosses to chant “we can do it” as an approach to managing ED winter pressures. But you, Professor Baker, have managed to out-Brent even that David Brent of a spectacle: instead of empty exhortation, you have apparently plumped for his more bullying style of management, through the medium of tetchy, head-masterly letters saying ‘you can and will pull your socks up – or else’. In all those years you’ve worked in the NHS since 1972, have you never noticed that nothing good ever comes from a caning?

Let me remind you what blame culture achieves, Professor Baker. First, it demoralises and undermines frontline staff. Then, it makes us feel hopeless and impotent. We stop trying to speak out, we become cowed and silent. And now, all that bullying and blame has managed to make the NHS less safe, not more, by allowing a culture to flourish in which no-one feels they can change anything, let alone risk speaking out for the sake of our patients.

In your interview, you’ve just achieved all of the above. I’m a hard-working NHS hospital doctor, and you’ve made me feel angry, demoralised, hopeless and incredulous – all in the same moment. That is not leadership, Professor Baker, and it is certainly not conducive to high standards of patient care. It serves only to present you to the public and NHS staff alike as a hospital chief inspector who seems to care more about playing a political game than the vital matter of patient safety.

How incredibly, bitterly disappointing.

Incidentally, please consider this letter my raising of safety concerns on behalf of NHS patients nationwide, as my duty of candour demands me to do.

Dr Rachel Clarke

Oxford”

An open letter to Prof Ted Baker, following his attack on the NHS

Playing politics with peoples’ lives

“Labour has called for an inquiry after the collapse of a private ambulance firm that has contracts with the NHS and other private health organisations.

Private Ambulance Service, which the trade union Unison described as running an “abysmal” operation, was issued a winding-up notice by the Inland Revenue on Friday. The firm is expected to stop trading on 9 October.

The company has been employed in Bedfordshire and Hertfordshire as non-urgent patient transport service. It worked for hospitals including Watford General and Bedford hospital.

Labour MP Justin Madders, the shadow health minister, said: “It is still staggering that under the Tories so many parts of the NHS are being packaged up and sold off to companies who are unable to run the services properly.

“Several hundreds of staff and thousands of patients are now faced with huge uncertainty because of the failings of another private ambulance firm, and it’s not the first time this has happened.”

Madders called for an inquiry into what went wrong, saying the government should place “an immediate halt” on issuing other patient transport contracts until “lessons have been learned”. …”

https://www.theguardian.com/society/2017/oct/02/labour-calls-for-inquiry-after-private-ambulance-firm-folds

Jeremy Hunt – drinking for US (that’s for the United States, not us the people)

Not at an NHS meeting, not at a social care meeting – special guest at a Boeing “drink tank”.

“Jeremy Hunt faced a torrent of criticism after it emerged he will be at a Boeing-sponsored “drink tank” while more than 4,000 UK jobs at rival firm Bombardier “hang by a thread”.

Theresa May has hinted that the UK Government could boycott Boeing after a trade dispute over aggressive tariffs broke out – a dispute which could ultimately see 4,500 workers at Bombardier’s Belfast factory made jobless. …”

Huffington Post UK
https://t.co/C3R5WiAPm5

“NHS ‘not fit for 21st Century’, says chief hospital inspector”

And not a word about austerity, cuts or underfunding!

“The NHS is not fit for the 21st Century, the new chief inspector of hospitals in England has said.

Professor Ted Baker, who started the role last month, said the system had not adapted to deal with the growth in the population.

In an interview with the Daily Telegraph, he said: “The model of care we have got is still the model we had in the 1960s and 70s.”

The Department of Health is yet to respond to his views.

Prof Baker succeeded Sir Mike Richards overseeing the hospital division of the Care Quality Commission (CQC), having been his deputy since 2014.
The former hospital medical director said the NHS had not modernised because of a historic lack of investment.

He said: “One of the things I regret is that 15 or 20 years ago, when we could see the change in the population, the NHS did not change its model of care.

“It should have done it then – there was a lot more money coming in but we didn’t spend it all on the right things. We didn’t spend it on transformation of the model of care.”

The number of pensioners has increased by a third in the last 30 years and he said the system had not been able to deal with the increase in the number of elderly people in particular.

He also criticised accident and emergency wards and has written to all hospital chief executives calling for action to improve safety.

Too many hospitals had “wholly unsatisfactory arrangements”, he said, such as letting ambulances queue up at the entrance or leaving patients in corridors.

The CQC is expected to highlight increasing pressures on hospitals, who are in danger running out of beds and staff, in a report next month on the state of the health and care services.

That was an issue that Prof Baker touched on in the interview, saying: “Capacity is being squeezed all the time. That is a real concern going forward – because there comes a point at which the capacity isn’t there”.

The BBC’s health editor Hugh Pym said Prof Baker’s comments come after predictions of a difficult winter for the service, with the chief executive of NHS England warning of the possibility of a serious flu outbreak.
NHS Providers, representing trusts, has said that without an emergency cash bailout the service faces the worst winter in recent history, our correspondent added.”

http://www.bbc.co.uk/news/uk-41451162

Privatised good, nationalised bad? Think again

The NHS has about 1,700,000 UK workers:

“In December 2016, NHS Improvement forecast that NHS trusts would end 2016/17 with a potential deficit of £750–£850 million.”

https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/trusts-deficit

COMPARE WITH:

Carrillion has about 48,500 UK workers:

Shares in the beleaguered Carillion construction group, which is working on the HS2 London to Birmingham rail line and the vast Battersea Power Station project, plunged by 20% on Friday after the company issued its second profit warning in two months.

Carillion reported a first-half loss of £1.15bn and said its full-year performance would be worse than previously expected. It described the loss as “disappointing”. The shares, which were changing hands at 190p little more than three months ago, closed at 51p.

The company is struggling with a large debt pile and badly-performing contracts. It said it would write down £200m on 23 support services contracts, and was taking a £134m charge relating to its UK and Canadian construction businesses. …”

https://www.theguardian.com/business/2017/sep/29/hs2-contractor-carillion-profit-loss-construction-debt

CCG agrees deal with North Norfolk Council to save facility

“The North Norfolk Clinical Commissioning Group have voted in favour of the Norfolk County Council’s £2 million offer to turn the Cromer unit into a re-ablement centre.

This should give patients greater access to short-term care, meaning they can leave hospital earlier but still receive further support before returning home.

The vote also means that the CCG’s original proposal to remove two of the beds at Benjamin Court will not come to light. The proposal saw 16 beds at the Cromer unit being used for palliative care, IV, and Discharge to Assess beds.

Dr Anoop Dhesi, Chair of NHS North Norfolk CCG, said: “Our public consultation allowed us to listen to the thoughts and views of the public and we are very grateful to all those who responded and gave us such valuable insights.

“We are very pleased that a further idea was proposed by our colleagues at Norfolk County Council. Using the beds for re-ablement will still help reduce pressure on hospitals and dovetail with our Supported Care service.”

Bill Borrett, chairman of the Adult Social Services Committee at Norfolk County Council, said: “We care about people who have had a stay in hospital and we understand that most of them want to be able to return home and live independently for as long as possible. Our re-ablement services allow that to happen by helping those who need some extra support for a short period of time.

“Re-ablement services can mean shorter stays in hospital and less reliance on long-term care as people return home. We are looking to develop more of these services across the county and think that leasing Benjamin Court will improve our ability to support people in Norfolk.”

However due to the County Council taking over the building with their own staff, some redundancies may be made when the takeover takes place.

Lorrayne Barrett, Director of Integrated Care for Norfolk Health and Care NHS Trust (NCH&C), said; “While NCH&C are confident that this decision is the best way forward for the local community, reducing pressure on hospital beds, we are aware that this will have implications for our staff.

“This is a highly experienced, skilled and committed staff group and we are continuing to support and consult with them to provide clarity during this prolonged period of uncertainty, and we will work hard in partnership with them to retain them in the local health and social care services.”

http://www.edp24.co.uk/news/health/benjamin-court-s-18-beds-saved-thanks-to-north-norfolk-health-leaders-vote-1-5210438

Do not shut hospital beds – closures not evidence-based says influential King’s Fund – too late for East Devon

Independent DCC Councillor Claire Wright – RIGHT
Independent DCC East Devon Alliance Councillor Martin Shaw – RIGHT
All Independent Councillors at EDDC – RIGHT
All Tories at DCC – Wrong
All those Tories (DCC and EDDC) who voted to support Diviani and Randall-Johnson in closing community hospital beds – WRONG

ALL the time the Independents have called for REAL evidence about bed closures.
ALL the time DCC Tories have acceptec waffle and jargon and “death by Powerpoint” instead of REAL evidence
EDDC Tories sort-of got it right and then allowed their Leader to vote WRONG so they still got it WRONG!

Why on earth are people still voting for these useless excuses for Tory representative councillors!

Kill beds, no community alternative = kills US!

“NHS bosses have been urged to halt plans for more ward closures as experts warn that hospitals do not have enough beds to accommodate patients.

Britain has fewer hospital beds per person than almost any other rich country and numbers in the NHS have fallen to 142,000 from the 299,999 that were available 30 years ago, according to an analysis by the King’s Fund health think tank.

Thousands of further cuts are being planned as part of a strategy by Simon Stevens, head of NHS England, to improve out-of-hospital care and make £22 billion in efficiency savings.

The King’s Fund said that this plan was unrealistic at a time when wards are more than 95 per cent full, well above the 85 per cent level generally thought to be safe. Hospital bosses in London are hoping to cut hundreds of beds, but the King’s Fund estimates that the city will need 1,600 more by 2021 to keep up with population growth.

Helen McKenna, a senior policy adviser at the think tank, said: “There are opportunities to make better use of existing beds and initiatives to capitalise on these should continue, but with many hospitals already stretched to breaking point, reductions on the scale proposed in some areas are neither desirable not achievable.”

Chaand Nagpaul, head of the British Medical Association, said: “Serious questions need to be asked about whether these plans are realistic and evidence-based given it defies logic to cut bed numbers when we already don’t have enough.”

Mr Stevens said that he would only allow bed closures where NHS bosses could demonstrate local alternative treatments were being put in place first or where hospitals were remedying inefficiencies. The King’s Fund said that these tests lacked any real detail.

Saffron Cordery, of NHS Providers, said: “One of the key lessons from last winter was the importance of avoiding unsafe levels of bed occupancy.”

Mr Stevens agreed that hospitals would need to free more beds during the winter, promising an extra 3,700 would be opened for the busiest time of year as hospitals were told to prevent “bed-blocking” by elderly patients.”

Source: Times (pay wall)

“Pensioners are STILL being failed by 15-minute care visits as they go without showers and proper meals”

“Vulnerable pensioners are going without showers and proper meals because ministers have failed to stamp out 15-minute care visits.

Three quarters of home helps say they are simply too rushed to do their jobs properly, according to the survey by public sector union Unison.

Almost two thirds of case workers said they have just 15 minutes to help people eat, drink, get washed and go to the toilet – despite government pledges to end the scandal.

And nine out of 10 of those questioned said they did not have time to chat, even though the person they looked after may not see anyone else that day.

The union’s survey of 1,000 workers found that three quarters feared they were compromising the dignity of those in their care because they were pressured to fit in too many visits.

The care workers help pensioners suffering from dementia, strokes, Parkinson’s, or with learning disabilities.

Unison general secretary Dave Prentis said: ‘Care workers and those they look after are suffering because standards are routinely being breached.
‘Care staff try to do their best within a system that increasingly prioritises quotas over compassion. Elderly and disabled people are ending up lonely, without dignity and with their care needs unmet.

Care workers and the vulnerable people they look after will continue to be failed by a flawed system unless the government acts.’

Unison’s report, Making Visits Matter, highlights the ongoing crisis in England’ s broken care system.

Earlier this month the Mail revealed that regulators are called in to deal with four complaints about care firms every day.

The Care Quality Commission launched 1,512 enforcement actions against care homes and companies which provide home helps in 2016/17 – 68 per cent up on the previous 12 months.

The watchdog dealt with complaints about unsafe care, residents not being treated with dignity and poor staffing levels. Other issues included lack of food or water and ‘abuse and improper treatment’.

Campaigners are demanding extra cash to prop up England’s care system. Last year ministers took urgent action to allow town halls to raise council tax to avert a meltdown.

Anyone with savings must meet the full cost of the care they receive – no matter how substandard.

The Tories have failed to honour a 2015 manifesto promise to cap the maximum bill at £75,000 and during the last election campaign Theresa May indicated the pledge could be scrapped.

Unison’s survey found that just over half of the care workers it questioned were on zero-hours contracts and almost two in three said they were not paid for the time they spent travelling between visits.

Some 63 per cent of respondents said they got just 15 minutes to help with personal tasks such as eating and drinking, or taking a shower.
The majority (89 per cent) of home care workers do not have time for a short chat even though the person they look after may not see anyone else that day, according to the survey.

Earlier this month a separate survey revealed that one in four care workers believe the service they provide for the most vulnerable in society is no longer ‘fair or safe’.

And many town halls are effectively breaking the law by slashing home helps and other services, according to a damning survey by the Care and Support Alliance and Community Care magazine.”

http://www.dailymail.co.uk/news/article-4931848/Pensioners-failed-15-minute-care-visits.html

The “free market” PM shows how it’s done

As the article says: The NHS spends 1.02% of its budget on agency staff where the Cabinet Office has spent nearer 8% of its budget on such staff. But that is a mere drop in the ocean … read on …

“While all eyes were on the Labour Party conference, Theresa May’s Cabinet Office (CO) quietly published its accounts. And buried in the 114 pages was the fact that it spent a whopping £43.8m on agency staff in 2016/17.

But this was just the tip of a half a billion pound spending iceberg – with the CO blowing £8.86m on staff perks, and even giving [pdf, p89] former Lib Dem leader Nick Clegg £114,982 from the public purse. …

Excruciating figures

Some of the most notable spending compared to 2015/16 was:

£43.8m on agency staff, up 54%.
£2.47m on staff “termination benefits” when they left the CO, up 162%.
£8.86m on staff travel, food and “hospitality”, up 63%.
£196.8m on total staff costs, up 20%.
£50.2m on Police and Crime Commissioner elections.
£1.54m on Private Finance Initiative (PFI) contracts, up 387%.
£21.7m on renting buildings, up 38%.
Writing off £2.3m of “bad debt”, up 5,342%.

But the £43.8m spent on agency staff (7.8% of the CO’s entire budget) does not tell the whole story. Because another set of CO figures reveals that it only employed 299 agency, interim, or consultant staff in 2016/17. Meaning the average cost of one of these, including agency fees, was £146,488.

The CO spent, overall, £558.58m in 2016/17; down £1.24m or 0.22% on 2015/16. The spending increases listed above were mostly offset by savings from not having the cost of a general election, reductions in pension costs, and less being paid out for “professional services”.

But delve a little deeper into the figures and some of the CO spending is even more questionable.

Nudging paper

The full CO accounts reveal that it paid out [pdf, p89] £538,067 in total to all living former Prime Ministers as “public duty costs”. But this also included £114,982 to former Deputy PM Clegg; a 12.8% increase on his payment in 2015/16.

The CO has [pdf, p99] £210.6m worth of agreements with private contractors to pay out over the course of their durations. It also holds [pdf, p101] £64m of investments in six private companies that operate within the public sector/government. One of these is Behavioural Insights Ltd, also known as the controversial ‘Nudge Unit’. As writer Sue Jones noted in 2015, the Nudge Unit is:

aimed at ‘changing the behaviours’ of citizens perceived to ‘make the wrong choices’ – ultimately the presented political aim is to mend Britain’s supposedly ‘broken society’ and to restore a country that ‘lives within its means’, according to a narrow, elitist view, bringing about a neoliberal utopia built on ‘economic competitiveness’ in a ‘global race’.
The Canary approached the CO for comment on its accounts, but at the time of publication had not received a response.

May’s money for nothing

John Manzoni, Chief Executive of the Civil Service, said [pdf, p9] in his introduction to the CO accounts that:

This year the Cabinet Office celebrated 100 years… ensuring that government works efficiently and effectively for citizens across the UK.
Manzoni’s hopes of the CO “ensuring efficiency” are laughable, at best, when you have a government department that happily spends £43.8m on agency staff and nearly £9m on ‘perks’ for its employees.

But the CO’s seemingly frivolous spending should contrast with other government departments. Because during 2016/17, the DWP cut Personal Independence Payments (PIP) for 164,000 people living with mental health issues. It reduced their payments from the enhanced to the standard rate, saving it £27.45 per person, per week. So, this saved the DWP £234m, or 0.11% of the welfare budget.

Also, the NHS spends around 1.02% of its budget on agency staff, but is criticised for doing so. So, when the CO claims “efficiency” but sees fit to spend 7.8% of its budget on agency staff, yet the DWP cuts crucial support from some of the poorest in society to save it a mere 0.11%, we have a truly broken government.

DCC EDA Independent Councillor joins DCC independent Councillor Claire Wright as one of the few NHS champions at DCC

“After the failed Health Scrutiny Committee meeting in July – which has led to repercussions in the County’s Standards and Procedures Committees as well as at EDDC – the full Devon County Council will be asked to look again at the issues on Thursday 5th October. I have proposed the following motion, which Claire Wright will second:

The County Council regrets the failure of the Health and Adult Care Scrutiny Committee on 25 July 2017 to be seen to scrutinise the decision of NEW Devon Clinical Commissioning Group to close community hospital beds in Honiton, Okehampton, Seaton and Whipton, especially in the light of the subsequent urgent recommendation by the head of the NHS in England, Simon Stevens, which is supported by evidence from the Royal College of Emergency Medicine and the King’s Fund, that more beds need be made available for the coming winter.

Noting also the Standards Committee’s conclusion that events at the Scrutiny Committee meeting ‘may not reflect well on individual members of the Council or upon the Council as a whole’, its recommendations for the Committee’s Chair and its general recommendations to both members and chairs of Scrutiny Committees, the County Council therefore

requests the Health and Adult Care Scrutiny Committee to scrutinise those issues identified by the County Solicitor in her paper for 25 July which were not directly and fully addressed at the Scrutiny Committee in that meeting;
consistent with the Council’s ‘community champion’ role, alerts the Secretary of State to the strength of feeling in the locality at the overall STP process throughout the County and the significant numbers of objections made by the public to the CCG’sproposals and that in the interests of democracy and democratic accountability he might wish to satisfy himself that all relevant process were properly undertaken and assessed and that the CCGs subsequent decisions are supported by the evidence; and
welcomes the agreement of the Health and Adult Care Scrutiny Committee to examine, subject to the advice of the County Solicitor, means of safeguarding community hospital buildings throughout Devon as facilities for the provision of place-based health services.

Seaton and Axminster – combined health hub?

As I have reported before, Seaton Town Council, the League of Friends and I have been discussing the future of Seaton Hospital in the light of the removal of the beds. Full details of the proposals have not been finalised, so I can only quote the report of Councillor Jack Rowland, Mayor of Seaton, to next Monday’s Town Council:

‘The next campaign is to ensure that the site is retained with a compelling case for retaining the existing services and extending these. To this end I attended a meeting on 6 September to discuss the next steps. I cannot give fuller details at this stage, but broadly the idea is to set up a Steering Committee for an Axe Valley Health Hub and to work in conjunction with Axminster to build a case for retaining both sites with complementary services.’ “

After the failure of the July Scrutiny meeting, I am asking Devon County Council to look again at hospital bed closures on 5th October

NHS winter crisis – all year round

With most of our community hospitals now on the “for sale” list:

“Crisis will outlast the winter, warns NHS chief

NHS Confederation Chief Executive, Niall Dickson, has warned that the NHS faces a prolonged crisis as hospitals deal with “unsustainable and unsafe” bed occupancy rates. He said the winter crisis “is actually an all-year-round crisis” with hospitals struggling to meet demand.”

Source: Local Government Association

Update on Honiton maternity care – and if you believe this …

“Expectant mothers in Honiton and Okehampton have been dealt a further blow after it was revealed that the temporary suspension of birth services at both towns’ birth centres is to be extended.

The Royal Devon and Exeter NHS Foundation Trust announced the news and cited on-going staff vacancies and long-term sickness absence across the maternity service as the reason.

The extension means that women will not be able to give birth at either site for a further three months until safe staffing levels have been attained. The suspension will be reviewed again early in 2018. .. .”

http://www.midweekherald.co.uk/news/blow-for-expectant-mothers-as-suspension-of-birth-services-in-honiton-to-be-extended-1-5211040

And the proverbial pigs might also take to the skies in early 2018 too!

The Red Tape Initiative – West Dorset MP and pal of Swire’s new, er, initiative

Does anyone else find this declaration of interest by Oliver Letwin, West Dorset MP, oldxEtonian pal of Swire and Cameron, champion of privatisation of anything and everything, but particularly the NHS, somewhat worrying?

Remember Letwin has been the centre of several controversies and foot in mouth incidents as well as authoring, with John Redwood (1988) “Britain’s Biggest Enterprise – ideas for radical reform of the NHS”.

https://en.m.wikipedia.org/wiki/Oliver_Letwin#Controversies

He is now, as of April 2017, the founder and Chairman of the Red Tape Initiative, which he describes in his Parliamentary Declaration of interest:

https://publications.parliament.uk/pa/cm/cmregmem/170502/letwin_oliver.htm

as:

“From 19 April 2017, Chair (unpaid) of the Management Board of the Red Tape Initiative; a cross-party think tank established to identify regulatory changes that can be made by political consensus speedily after Brexit. (Registered 19 April 2017)”

https://redtapeinitiative.org.uk

which is made up of:

“Leading Conservative, Labour and Liberal Democrat politicians [who] have agreed to join the Advisory Board, alongside other distinguished people entirely independent from any political party.

The CBI, BCC, IOD and FSB are working with the RTI to construct groups of experts from a range of industries – as well as representatives of environmental and other NGOs – who can help us identify changes that could quickly be made in specific areas of EU regulation, with immediate benefits for jobs and businesses in the UK and with no adverse effects on our ecology or our society. We will be consulting relevant trade unions – via the TUC – on the proposals that emerge, in order to ensure that they are acceptable to employees as well as employers.”

Unfortunately, there is no list of the Management Board or of people, other than Letwin, who make up this group, other than someone called Nick Tyrone, whose blog can be found here:

https://nicktyrone.com

who had had a couple of relatively short tenures as leader of think tanks Radix and CentreForum, and who seems to work from a Centre in Westminster Kingsway College according to the postcode on the RTI website, but we do know its first three priorities:

The first three areas that the RTI will address are:

1) the construction of housing

2) the construction of infrastructure

3) training and apprenticeships”

Ah – developers and zero-hours employers? Oh, Owl is SO excited!

“’More transparency is needed about big decisions affecting our NHS’ “

“Eddie Duller OBE, a director at Healthwatch Oxfordshire, the county’s watchdog on health and social services matters, asks why the authorities are not more open about the big changes ahead

IT may sound bizarre but the Information Commissioner’s Office, which is the UK’s independent authority set up to promote openness by public bodies, appears to be saying it is alright to plan changes to health and social care in Oxfordshire and neighbouring counties in secret.

At least, that is my interpretation of a ruling as a result of Healthwatch Oxfordshire’s attempt to find out what was happening in the biggest health and social services shake-up for many years.

We raised the query in July last year under the Freedom of Information Act with the Oxfordshire Clinical Commissioning Group (OCCG), which has been tasked by the NHS to save money and change the way services are delivered.

The main reason for this was that a new authority was introduced by the NHS: the Buckinghamshire, Oxfordshire and Berkshire West (BOB) area, which was supposed to create savings by joining up services from several areas.

Secondly, our view was – and is – that the public should have been involved earlier in the detail of the plans.

However, our request was turned down by the OCCG on the grounds that ‘releasing the information into the public domain at this time would be likely to inhibit the ability of public authority staff and others involved to express themselves openly, honestly and completely…..’

But what really got me going was the fact that the OCCG claimed that the new BOB organisation was not a statutory organisation and therefore the Freedom of Information Act did not apply.

That means that BOB could – and still can – take decisions in secret. I still think that is wrong.

They appear to want their cake and eat it by claiming it is not a statutory authority but at the same time giving it enormous powers to change the health service over a large area of the country.

The final version of the plan was published and the first explanations were made available just before Christmas last year – six months after we asked for information.

The Information Commissioner’s Office backed up the OCCG just a few days ago, 14 months after we queried their secrecy.

In effect it rather belatedly backed up the OCCG by saying it was alright to consider matters in secret as long as the proposals were published at a later date.

So what was the problem in giving out the information earlier?

When it was finally published the BOB transformation plan, which includes Oxfordshire, promised that there would be “meaningful engagement and consultation activity on services, such as those at the Horton General Hospital in Banbury and community hospitals in Berkshire West to help inform commissioning of future services”.

So why did it take so long to get round to it? Why not involve the public earlier?

The outcome of some of the changes in services at the Horton is that the question over the downgrading of the maternity department has been referred to the Secretary of State for Health after pleas from thousands of people to keep it as a consultant led service were ignored, and there is still no detail about what is to happen to the rest of the hospital site.

In effect the resulting judicial review is holding up the whole of the other services referred to in the first phase of consultation, although some of them are not contentious.

I hope the OCCG will learn from this and tell the public what it is thinking about in relation to the rest of the county much sooner.

In fact, now would do.

They should, in my view, form advisory bodies in each market town and Oxford as they did when creating the new “health campus” in Henley so that local people can have a greater say in designing the services.

It is an opportunity to involve the public through voluntary organisations and GP practices participation groups among others.

The BOB plan talked about the risks involved in changing the services, among them public sensitivity and cynicism.

It says grandly that “people view the programme as a money saving exercise which has no positive effect on health services in their community. “

It adds: “Stakeholders need to be openly engaged and involved in the process so that they are able to develop a proper understanding and can become ambassadors for the programme.”

I think it follows that if they practised what they preached and told us what is going on at an earlier stage they would stand more chance of getting a reasoned reaction and discussion for a plan which may have some potential merits.”

http://www.oxfordmail.co.uk/news/15538285.HEALTHWATCH__More_transparency_is_needed_about_big_decisions_affecting_our_NHS/