What Swire’s mate Heffer thinks of local authorities

Just before the last general election, Swire made one of his very rare appearances at what he called a “hustings” in Exmouth. Except no other parties were invited to participate and his one guest was Telegraph journalist Simon Heffer.

In today’s Sunday Telegraph Heffer calls for privatisation of everything that currently makes any semblance of profit, or which might make profits in future, and hiving off the loss-making tasks to unitary authorities or, in our case, the unelected, unaccountable and opaque business-run Local Enterprise Partnership.

Oh to be a fly on the wall when Swire and Heffer have their fireside chats …

He says:

“… There is too much local government. Pointy-headed theorists have banged on about localism, but all that is missing is evidence that “local” people are either capable or motivated enough to deliver “local” services. The best way to deliver “localism” is to take councils out of the equation altogether, as has been done in many cases by removing schools from their control. …

But local government will not work well until it is stripped of duties that individuals or the private sector can provide for themselves: which brings us back to social care … the government must … develop an insurance scheme that will encourage private providers to take over what threatens to become a crippling state responsibility …”

Sunday Telegraph, Sunday Comment, page 16

Unfortunately Mr Heffer neglects to explain how private providers, with shareholders mouths to feed, will be able to do it more cheaply.

North Somerset grabs cash for care homes – London Borough of Westminster doesn’t

“F​amilies are facing a care funding lottery as new figures reveal wide variations in the lengths to which councils will go to stop people giving away assets in an attempt to make the state pay instead.

Local authorities means-test residents of care homes to check if they should pay towards their costs.

The cut off point is £23,250 – if you have assets above this figure you are expected to fund your own care. If your assets are worth less than £23,250 the council will help to meet the costs. Average nursing home costs reached £1,000 for “self-funders” earlier this year.

The spiralling cost of care has created an incentive for families to give away property, investments and savings to bring their assets below the £23,250 limit.

Councils have powers to claw back money from people it can prove to have “deliberately deprived” themselves of assets to claim state aid. Yet it has long been suspected that they find it nearly impossible to prove that someone has given assets away deliberately to dodge care costs.

Giving to children and grandchildren as a way to limit inheritance tax bills has become increasingly common. High house prices and buoyant stock markets have increased families’ wealth, while the headline amount you can pass on tax free has not been increased for nearly a decade.

A series of Freedom of Information requests submitted by Telegraph Money has uncovered how often councils use their powers and the amounts they have managed to claw back.

Of the eight local authorities approached, North Somerset council, whose jurisdiction includes Weston-super-Mare and the outskirts of Bristol, had used its powers the most. Since 2012 it recorded 64 “deprivation” cases in relation to care funding. The total value of assets involved in the cases was £1.3m.

By contrast, the London borough of Westminster had no recorded cases. This is despite the area having a similar population to North Somerset, at around 200,000, and a similar proportion of elderly residents.

Likewise Southwark, which covers a large part of south-east London, had not used its powers at all. The north London borough of Camden had the second-highest number of cases, at 14, with a total value of £158,000 over five years. Liverpool and Hertfordshire councils refused to provide figures on the grounds of cost, while Nottingham City Council said it did not keep relevant records.

Steven Cameron, a care expert at Aegon, the insurer, warned that greater scrutiny of the sector meant individuals who attempted to dodge care fees were increasingly likely to be caught by councils.

“A few years ago it was highly unlikely that a council would have paid much attention to people who gave away assets to avoid paying,” he said. “But with the care crisis getting worse daily and with more public interest in getting out of paying for care by giving away assets, the attention councils will pay is certain to increase considerably.”

Councils also take action that may not be reflected by official statistics, said Tracy Ashby a specialist legacy planner at Thursfields, the law firm.

She has seen cases in the West Midlands where instead of trying to claw back funds from families, councils simply cut off funding for care. Care homes are then left to pursue families themselves and in some cases have sought to evict patients, Ms Ashby said.

The “dementia tax” Telegraph Money has reported extensively on the anomalies of the care funding system.

Self-funding patients effectively subsidise those funded by councils, which set strict limits on the fees they are prepared to pay. This leaves homes in areas with few private customers battling to stay open.

The Conservatives’ radical plans for reforming the care system have been blamed for the party’s disastrous showing in the general election. Under the plan, councils would have started to pick up the tab for care costs once a person’s assets fell below £100,000, as opposed to the current level of £23,250 in England.

But, crucially, family homes would also have been included in the means-testing formula for “at home” care for the first time.

At the same time, the plan for a lifetime cap – which would have helped those who needed long periods of care – was dropped. The Tories quickly backtracked over the latter, which Labour called the “dementia tax”.

http://www.telegraph.co.uk/money/consumer-affairs/councils-failing-stop-people-giving-away-cash-dodge-care-home/

Doctors wake up to consequences of STP plans which have already closed most East Devon community hospitals

BUT DOCTORS – IT’S BEEN HAPPENING UNDER YOUR NOSES FOR MONTHS AND MONTHS!

Almost two in three senior doctors fear a controversial NHS shake-up that will downgrade or close dozens of hospital units will damage the care patients receive. The hospital consultants fear the sustainability and transformation plans (STPs) will lead to staff losing their jobs, will exacerbate workforce shortages and will act as a cover for cuts to services.

Of 450 hospital clinicians surveyed by the Hospital Consultants and Specialists Association (HCSA), 42% believe that STPs will have a “negative impact” on patient care. Barely one in 10 consultants who belong to the union expect a “positive impact”.

Three in four (77%) fear STPs are a way of making cuts to the NHS, while just over half (56%) fear they will lead to job losses and worse understaffing. …

“Many hospital doctors see STPs as a managerially driven process with no real clinical basis, and fear that a mix of underfunding, under-resourcing and service rationalisation can only damage patient care,” said Eddie Saville, the HCSA’s chief executive.

“This is, in effect, yet again an NHS reorganisation, but region by region, with management trying to plug the financial gaps rather than putting high-quality care of patients at the forefront. The fact that STPs are being planned against a backdrop of underfunding and cuts has led many doctors to conclude that this transformation programme is purely an attempt to mask further cutbacks.”

The Local Government Association, which represents local councils, criticised STPs as “secretive, opaque and top-down” reforms that would fail patients. …”

https://www.theguardian.com/society/2017/sep/09/nhs-hospital-reforms-closures-job-losses

DUH – where have some of these doctors been this last 2 years?

Budleigh “well being” hub has to have minibus to collect patients – but only from the “nine parishes” that contributed to it

Good for those people who have raised their own money for this service. Perhaps the CCG can now provide dedicated buses from the proceeds of the sale of assets from rest of East Devon, where Leagues of Friends also tirelessly continue to raise funds for their bedless hospitals, for similar buses to other “health hubs” or to the two remaining community hospitals in Sidmouth and Exmouth – otherwise those people outside the “nine parishes” will have an inequality of service.

And Owl loves the optimism of the last sentence: “When phone lines are established at the hub, residents will be able to ring up and arrange for the bus to collect them.” Anyone who has ever tried to maintain a rota for such a service and who has had to prioritise how such a service is funded, maintained and accessed will understand Owl’s qualms when the private company running the hub starts to make the executive decisions about who uses it and when.

“New community mini bus will help transport people to new health and wellbeing hub

A ‘ring and ride’ bus which will transport residents to the new Budleigh Salterton Health and Wellbeing Hub has officially been handed over.

The bus was purchased two years ago following an cash injection of more than £20,000 from the Parishes Together Fund.

Now, the bus will give residents in the nine parishes that contributed towards that initial cost transport, a form of transport to the former hospital. It will also allow people in the Budleigh area to get transport to Exmouth Hospital for appointments.

That includes Budleigh Salterton, Colaton Raleigh, Otterton, East Budleigh with Bicton, Exmouth and Lympstone.

Dr David Evans, chairman of Budleigh Salterton Hospital League of Friends, said: “The Hub Bus and local transport is of immense importance to the Budleigh Salterton Community Hospital Health and Wellbeing Hub.”

The tail-lift minibus will be kept at the hub in what used to an ambulance bay.

The running costs of the bus will be shared between Budleigh Hospital League of Friends and their Exmouth counterparts and the bus will be managed by Westbank Community Health, which has the lease of the new hub.

Hub project manager Rob Jones added: “What we wanted to try and do is to reduce worry about not being able to get to the hub.”

Dr Evans also revealed that a grand opening of the new health and wellbeing hub is due to take place this November.

He added: “The contractors have now finished the refurbishment of the hospital and moved out last week.

“They have completed an excellent assignment and the result is absolutely superb.

“It is desirable that the hub is fully functional for the grand opening in very early November.

“This will show what can be done when a community hospital faces closure.”

Furniture and fittings funded by the League of Friends are due to be introduced in the next month with services being phased in during September and October.

Royal Devon and Exeter Hospital is due to move some its services into the hub next month.

When phone lines are established at the hub, residents will be able to ring up and arrange for the bus to collect them.”

http://www.exmouthjournal.co.uk/news/budleigh-salterton-hub-bus-handed-over-1-5183505

“The Conservatives’ solution for unaffordable care? No care”

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

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

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

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

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

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

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

These harsh realities are brought home through the many cases I hear about, both in my constituency and in parliament. Cases like the woman whose homecare was cut suddenly from 10 hours a week to nothing. Her son had to step in to care for her, risking his job, which financially supported them both. Or the elderly people left without food or help with bathing when care staff did not turn up.

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

In Labour’s manifesto, we set out comprehensive plans to tackle the short-term funding gap in social care, promising £1bn this year and £8bn over this parliament to stabilise the sector. This would enable us to close the funding gap, implement a living wage for care workers and enable an extra 36,000 people with high levels of need to receive publicly funded social care.

But we also recognised the need for a long-term funding solution to meet the needs of an ageing population. Labour’s national care service would be based on the principle of pooling risks, so that no one is left to face catastrophic care costs alone. A care cap would ensure those unlucky enough to develop conditions like dementia would not be penalised for doing so. And we would raise the asset threshold, so that no one loses everything they own, as well as introducing free end of life care.

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

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

Oxfordshire unites to fight for its community beds services – unlike Diviani and Randall-Johnson in Devon

Owl says: alas it doesn’t matter one jot what our district, town or parish councils think about the removal of community hospitals in general and removal of Honiton’s maternity services specifically, since the majority party cannot even trust their own Leader of our district council – Paul Diviani – to represent them.

(One more reason to turn up at Knowle on 13 September 2017 and watch those cowardly Tory councillors rally round him and turn out in numbers to overturn a vote of no confidence in him – even though it was THEIR confidence that he sabotaged at DCC when he voted against their instructions to refer bed closures to the Secretary of State- at the notorious scrutiny meeting where Sarah Randall-Johnson ensured that no contrary voices would be heard – only those echoing their Tory masters. Diviani being one of those enthusiastic voices.

“Campaigners backed by four councils have won the first round of their legal action over a claim that a consultation over changes at Horton General Hospital was flawed.

They want to prevent plans by Oxfordshire Clinical Commissioning Group (CCG) to downgrade maternity and critical care services at the hospital in Banbury.

Their campaign has been supported by nearby councils: Cherwell District Council, South Northamptonshire Council, Stratford-on-Avon District Council and Banbury Town Council.

A statement from barristers at Landmark Chambers said: “Campaign group Keep the Horton General has won an important first step in the battle against the downgrading of Horton Hospital.

“Fraser J today granted permission to apply for judicial review of the consultation process.”

The Administrative Court in July refused on the papers permission for a full hearing, but Cherwell successfully challenged that decision this week.
Oxfordshire CCG said last month that its proposed changes would “ensure safety, quality and better outcomes for patients”.

It said the critical care unit at Horton would be downgraded to cater only for less seriously ill patients and it would also lose some beds.

A single specialist obstetric unit would be created at Oxford’s John Radcliffe Hospital and only a midwife service would remain at Horton, though it would gain an improved diagnostic and outpatient service.

A CCG spokesperson said: “We are fully aware of the outcome of today’s oral hearing seeking permission for a judicial review and will co-operate with the process as appropriate.”

“NHS warns of ‘dangerous’ beds shortage this winter”

“Patients could die this winter because the NHS is alarmingly unprepared to deal with the surge of people who fall ill during the cold weather, hospital bosses warn today.

NHS Providers, which represents hospital trusts in England, fears lives could be lost because patients are being forced to spend long periods waiting in ambulances outside A&E, or on trolleys.

Hospitals are so “dangerously short” of beds that they may be unable to cope with the coming winter, Chris Hopson, the organisation’s chief executive, told the Observer. They will struggle even more than last winter – when chaotic scenes led the Red Cross to call the situation “a humanitarian crisis” – because a £1bn government initiative intended to free 2,000-3,000 beds by September has failed, he added.

That scheme aimed to reduce the proportion of beds occupied by patients who are fit to be discharged but cannot leave – called “delayed transfers of care” – to 3.5% of all beds by this month. It was 5.6% of beds at the end of 2016 and still 5.2% at the end of June, NHS figures show.

“That 3.5% target is going to be missed,” Hopson said. “Therefore, hospitals this winter will still be too full of people whom we can’t discharge, even though they are medically fit to leave, because of problems with social care. Failure to do so leaves us dangerously short of capacity.

“That means that it could be even worse than last year, when there were far too many patients waiting more than 12 hours on a trolley or in the back of an ambulance to be seen. We were running much greater levels of risk to patient safety than we had had for at least a decade and we don’t want to see that level of risk again.”

Hopson added: “If that does happen, it could result in patients having dreadful experiences. If people are ill, they need to be seen quickly or their condition gets worse or ultimately they die prematurely. Waiting unduly long can mean patients getting much iller than they should be and dying when they don’t need to.”

A new NHS Providers report details its concerns about winter.

In an online commentary for the Observer, Hopson writes that, despite efforts by the NHS nationally to plan for the cold spell ahead, “NHS trusts are worried that they do not have enough staff, beds and other services to manage the risk to patient safety this winter”.

The warning comes as some hospitals continue to struggle with the number of patients seeking help, even though winter is months away. Last Thursday the NHS trust which runs Royal Stoke University Hospital and County Hospital in Stafford asked people to stay away from their A&E units, except in a genuine emergency, to help reduce the “extreme pressures” on the units.

“Currently, both sites are experiencing the type of demand usually only see in the middle of winter, so people are experiencing long waits and our staff are exceptionally busy. Please only attend A&E Departments for anything classed as an emergency including choking, chest pain, loss of consciousness, severe blood loss, broken bones, difficulty breathing, deep wounds or a suspected stroke,” it said.

On Friday, Gavin Boyle, the chief executive of Derby Teaching Hospitals NHS Foundation Trust, wrote in his blog: “Without wanting to come over all Game of Thrones, winter is coming! For many working in our hospitals, it feels as though winter never went away and indeed August was one of our busiest months for emergency admissions.”

Also last week, University Hospitals of Leicester Trust put in place plans to improve its poor performance against the four-hour A&E target before the start of winter. These include increasing the number of doctors working overnight in A&E, a daily “safety huddle” of senior doctors, ensuring full staffing and managers monitoring how quickly the emergency department is processing patients.

Two trust bosses said that their hospitals are already facing major problems, especially because of staff shortages. “The first quarter of this year [2017-18] has been as challenging as any I can remember; there has been no let-up. Acuity, attendances and admissions have all stayed high,” said Nick Hulme, chief executive of Colchester Hospital University Foundation NHS Trust. “Our major concern going into this winter is staffing. Going into August we are 50 junior doctors short on our rotas across the hospital. Every day is a constant struggle for junior doctors and registered nurses.”

John Lawlor, his counterpart at the Northumberland, Tyne and Wear Mental Health Trust, said itsinability to arrange packages of care to enable patients to be discharged, resulting in beds being occupied unnecessarily, was “a significant concern. [In addition] pressures on staffing, especially in psychiatry, are beginning to impact on services and these will become more intense until the new people trained begin to come on stream over the next five to 10 years.”

The health service regulator NHS Improvement warned that hospitals had experienced “extremely high levels of bed occupancy” during April, May and June, despite those usually being the service’s quietest months. The regulator said it doubted that the plan for hospitals to return to treating the required 95% of A&E patients within four hours by the end of 2017 would succeed.

NHS England admitted that this winter would be tough, and revealed that hospitals were already planning to open at least 3,000 beds, which should help manage demand and minimise the risks to patients.

“The NHS will face challenges this winter, as it does every year, but NHS Providers have stated that winter planning is more advanced than it was last year and – as they argue – special attention is being paid to areas where pressures are likely to be greatest,” said Pauline Philip, NHSE’s national urgent and emergency care director.

“We are currently in the process of assessing how many extra beds trusts are planning to open over winter and early returns indicate that this will be more than 3,000. This is something we will continue to review on the basis of evidence rather than arbitrary estimates. If the expectations for reduced delayed transfers of care outlined by the government are achieved, this would free up a further 2,000 to 3,000 beds over the winter period, on top of the extra 3,000 plus beds that hospitals now say they’re going to open.”

The Department of Health was more upbeat about winter. “Thanks to the hard work and dedication of staff, alongside record levels of funding to ease pressure on A&E departments, the NHS has prepared for winter more this year than ever before, ensuring patients continue to receive safe and efficient care as demand increases,” a spokesperson said.

“As new expert analysis shows, spending on the NHS is in line with other European countries, and once again our health service was independently judged to be the best and most efficient health system in the world.”

https://www.theguardian.com/society/2017/sep/02/nhs-warns-of-dangerous-beds-shortage-this-winter

Councillor calls for Randall-Johnson resignation

PRESS RELEASE

Devon County Council’s Health and Adult Care Scrutiny Chair, Councillor Sara Randall Johnson, should immediately consider her position following the stinging rebuke issued to her by the Council’s Standards Committee. The Council should also act to restore the credibility of Health Scrutiny, since its failure to fully scrutinise the removal community hospital beds in Honiton, Okehampton and Seaton has destroyed public confidence in its activities across a large swathe of Devon.

At its meeting on 29 August, minutes of which are published today, the Standards Committee agreed that while Cllr Randall Johnson had not broken the Members’ Code of Conduct, she should ‘be strongly reminded of the importance of the work of scrutiny committees – reinforcing the value of neutrality in scrutiny both generally and in calling the “health service” to account – and the need to be seen to be even handed and scrupulously fair, recognising that failure to do so may be perceived as a deliberate act.’

The call for a Scrutiny Chair to ‘be strongly reminded of the importance of the work’ of her committee, and of the value of neutrality and being seen to be even-handed and fair, is unprecedented and should lead Cllr Randall Johnson to immediately consider her position. There is no public confidence that she will lead the committee to carry out full and impartial scrutiny of NHS decision-making.

The Standards Committee also ‘accepts that the events of the Health and Adult Care Scrutiny Committee meeting on 25 July 2017 may not reflect well on individual Members or upon the Council as a whole, and further recognises that the perception gained by persons present at the meeting or subsequently viewing the webcast is not that which would have been desired’.

This stark acknowledgement of the damage done to Devon County Council’s reputation also requires early action by the Council to reassure the public that the Committee will do its job properly in future and protect the NHS in Devon.

The Scrutiny Committee ignored the views of local communities and their representatives and has allowed the CCG to get away with damaging cuts. The Council must now consider how to restore people’s faith that it will protect all our community hospitals in the future. I shall ensure that this is discussed when the Council meets on 5th October.

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

“Nine in 10 MPs don’t believe UK’s social care system is fit for purpose”

And Owl thinks the other 1 in 10 are self-serving idiots – one of whom is Jeremy Hunt.

“Only 10 per cent believe pensioners needing help to stay living in their own homes are well served, found the poll of 101 English parliamentarians.

Just 13 per cent of Labour MPs and 35 per cent of Conservative MPs say social care services in their constituencies are up to scratch.

“Confidence that the social care system can deal with the UK’s ageing population has virtually evaporated among parliamentarians,” said Janet Morrison, chief executive of Independent Age, which carried out the research.

“The crisis in social care was front and centre in the election earlier this year, and it is clear from this poll that there is an overwhelming desire from politicians on all sides for the Government to work towards a cross-party consensus on a solution.”

Former Lib Dem health minister in the coalition government Norman Lamb said: “The health and care system in England is creaking at the seams.

“An unprecedented number of older people need support in later life but are finding high-quality care is hard to come by.

“Without lasting reform, the most vulnerable frail and elderly people are at real risk of falling through the gaps and not getting the support they expect and deserve.”

The Government has pledged an extra £2bn for social care over the next few years but it is only one-off funding which reduces each year.

Vital services caring for elderly and disabled people still face an annual £2.3bn funding gap by 2020, which will continue to grow, according to the Local Government Association.

Izzi Seccombe, chairwoman of the LGA’s community wellbeing board, said: “It’s encouraging to see so many MPs across all political parties recognising the need for action to find a sustainable solution to the adult social care funding crisis.”

Margaret Willcox, of the Association of Directors of Adult Social Services, said: “Older and disabled people and their families need and deserve high quality, reliable and personal care.

“For this to happen, and with MPs returning to Parliament next week, government needs to address adult social care as a priority so it can be future-proofed for people who will continue to need care and support in increasing numbers.”

The poll of more than 2,000 British adults also found that many under-estimate the cost of social care.

On average, UK adults estimate that residential care would cost £549 a week – when in reality it costs on average £866 for a place in a nursing home, the Centre said.

Meanwhile, another poll carried out by carehome.co.uk found that four in 10 of care home residents do not receive regular visits from friends and family.

A total of 1,154 care home owners, managers and staff were asked to estimate the percentage of residents that do not receive regular visits, with 42 per cent being the average figure given.

A Department of Health spokeswoman said: “This Government is absolutely committed to improving social care in this country, which is why we have provided an additional £2bn for the sector, introduced tougher inspections to keep driving up standards and committed to consult on the future of social care to ensure sustainability in the long term.”

http://www.express.co.uk/news/uk/847814/MPs-dont-believe-UKs-social-care-system-fit-purpose

Ambulance delays – a matter of life and death – underfunding blamed

“Almost two patients die a month on average after failings by the ambulance service, including delays or a failure to recognise the severity of symptoms, a review of coroners’ reports has found.

Coroners in England and Wales have written to ambulance services or call handlers 86 times since July 2013 warning them that they need to make changes to prevent future deaths.

Forty-eight of the warnings related to ambulance delays or problems with call handling, according to the review by Minh Alexander, a former whistleblower who now campaigns on patient safety. She said the volume of reports suggested a “significant decline in ambulance safety in recent years”.

She added: “Action is needed to rectify underfunding, related workforce and skill mix issues, and pressures on the whole NHS that spill on to ambulance services.”

Coroners have a duty to write a report under regulation 28 of the Coroners (Investigations) Regulations 2013 if it appears there is a risk of other deaths occurring in similar circumstances. Dr Alexander, a psychiatrist who raised concerns about patient deaths, produced her report by analysing section 28 reports published by the chief coroner.

A number of the reports highlight delays caused by slow handovers at A&E departments, echoing warnings from the National Audit Office earlier this year. In many cases the delay was not found to have caused the deaths but coroners were sufficiently concerned by what they heard at inquest to warn ambulance service bosses that delays could be fatal in the future.

In April, Gilva Tisshaw, assistant coroner for Brighton and Hove, wrote to South East Coast ambulance service following the death of Ronald William Bennett, warning of “serious delays in ambulances arriving at the scene of an incident as a consequence of ambulance crews being delayed at the accident and emergency department”.

There were also a number of cases involving call handlers without medical training and their computer programmes failing to recognise the severity of a situation.

In June, Elizabeth Earland, senior coroner for the Exeter and Great Devon district, wrote to South Western ambulance service after the death of Colin James Sluman, 68, who had a burst varicose vein. He called an ambulance at 1.36am, but bled to death before an ambulance arrived at 3.03am.

Dr Earland said the protocol followed by call handlers, on which they were “completely reliant”, did not recognise reports of dizziness in a patient on their own “as important triggers for a rapid response”.

An ambulance service spokeswoman said the trust had taken action to address the concerns.

Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said ambulance services took coroners’ reports “extremely seriously” and would make changes in response where possible.

In 2016 English ambulances handled 10.7 million emergency calls.

Case study

Grant Benson, 21, died in a fire following a car accident in August 2014 after making a 999 call. Andrew Tweddle, senior coroner for County Durham and Darlington, wrote to the Yorkshire ambulance service after the event. He said: “It is clear from listening to the recording how frantic the driver became as the fire began and took hold.”

The car came off the road near Barnard Castle, County Durham, but the call handler at the ambulance service was based in Wakefield. She and two colleagues failed to pinpoint the crash location so an ambulance could be dispatched.

The inquest heard that it was not possible to transfer responsibility for calls between emergency services, and one ambulance service could not send a vehicle from another. Emergency services attended only after a further call had been made by a passer-by.

A Yorkshire ambulance service spokeswoman said it had “taken steps to review local practice.”

Source: The Times, pay wall

The “great and the good” should speak up for our NHS – but remember those who speak and vote against it

From Letters page, Guardian: remember it was Paul Diviani and Sarah Randall Johnson that took Honiton and Seaton hospitals from us.

• “I was thrilled to read Professor Stephen Hawking’s glowing tribute to our “finest public service”. At 75 years of age and a world-class scientist known by everyone in the country, Professor Hawking is in a perfect position to state his case for the prosecution of the Tories and Jeremy Hunt in particular, for their mendacity over what they say they are doing for the NHS, while undermining it by cuts, underfunding and demoralisation of staff, as well as introducing privatisation for years without proclaiming their real aim, which is to destroy the NHS and replace it with a US-style insurance system controlled by multinational companies.

Many ordinary patients like me have protested to our local MPs over the years about the political decisions the Tories have made to ultimately scrap the NHS, and their relentless pursuit of the drip-drip methods of convincing people that we cannot afford the NHS any more. This is a total lie, and I would like other well-known people who value and cherish the NHS to come out and say so before it’s too late.

Nye Bevan said the NHS would exist only as long as people were willing to fight for it. Let’s hear it from the great and the good in support of the treasure in our midst.

Lynda Mannix
East Grinstead, West Sussex”

https://www.theguardian.com/society/2017/aug/30/labour-ought-to-speak-out-about-the-nhs-as-strongly-as-stephen-hawking

More on that Diviani “No Confidence” vote

http://www.devonlive.com/news/devon-news/calls-made-east-devon-council-399289

REMEMBER:

A vote AGAINST means the councillor involved supports the decision to close community hospital beds and agrees that the EDDC vote to keep them open counted for nothing – party before people.

An ABSTENTION is as good as a vote AGAINST but means that the councillor involved wants to pretend it doesn’t – still party before people.

A councillor ducking the meeting without a very good reason is AGAINST the motion AND a coward and a disgrace to his or her community.

And remember too their votes in subsequent elections when YOU vote for what is important in East Devon.

RandallJohnson scrutiny behaviour – whitewash or justice today?

Owl’s prediction: a tiny, tiny tap on the wrist – barely contacting – then back to business as usual for her and her party.

“A standards committee is today meeting behind closed doors to consider whether a senior Tory broke the county council code of conduct, Devon Live understands.

Conservative county councillor Sara Randall Johnson, chair of the authority’s health scrutiny committee as well as the Devon and Somerset fire authority, angered campaigners at a public meeting last month.

The former leader of East Devon District Council was jeered by the public gallery when she ignored a tabled motion by independent councillor Claire Wright designed to halt hospital bed closure plans by making a referral to the Secretary of State.

Instead, she allowed party colleagues to seize the momentum by kick starting the debate and swiftly proposing the exact opposite, a motion which narrowly won the day by just one vote.

Ms Wright protested at the meeting and after the meeting, which attracted around 80 members of the public, a dozen people are thought to have complained.

The council’s cross-party Standards Committee met on Tuesday, August 29 to debate the issue but invoked a so-called Part 2 exemption which allows proceedings to be held in secret.

A formal report is expected to be published by the group, which also includes former councillors, after the meeting revealing, explaining the decision.

Ms Wright said she did not complain formally but submitted a statement of her concerns and has been interviewed by the committee chairman.

Ms Randall Johnson and Ms Wright clashed at the bad-tempered and at times rowdy Health and Wellbeing committee meeting in July.

Randall Johnson used her new power of chairmanship to thwart her long-time opponent, whose first electoral success at district level in 2011 cost Randall Johnson her seat and leadership of the council.

Some observers claimed the move was a settling of old scores.

In the months prior to the meeting, protestors had been opposing plans by the Northern, Eastern and Western Devon Clinical Commissioning Group to axe 71 beds across four cottage hospitals in the Eastern locality.

Campaigners, angry that the case had not been made for the Your Future Care model of home visits, labelled the consultation a sham and turned to the Health and Wellbeing Scrutiny Group for help.

Under the previous chairmanship of veteran Labour councillor Richard Westlake, the scrutiny group was poised to refer the plans to the Secretary of State if 14 documented points were not addressed.

But he stepped down at the election and Ms Randall Johnson took up control.

At the first meeting of the newly constituted committee in June, it became clear that she did not support the move.

She refused to put Ms Wright’s proposal to the last vote at the June meeting and eventually members were persuaded to defer a decision to get more information.

Ms Wright again proposed that the plans be sent back to the Health Secretary, submitting a written motion before the meeting began.

She cried foul when her tabled motion was ignored, claiming she had never seen it happen in six years of committee meetings.

Unfortunately for her, the legal advice from the council backed Randall Johnson, stating that motions needed to be proposed and seconded in the meeting.

She then dismissed Ms Wright’s protest by telling her the power to choose was entirely at her discretion as chair, before moving to a vote against referring the proposals, which was won by a majority of one, with one abstention.

Former Lib Dem county council leader and respected political veteran Brian Greenslade remarked after the meeting that the move had been highly unusual.

He considered that not mentioning or circulating a table motion – one submitted before the meeting begins – was rare: not against procedure but definitely a departure from protocol.

The committee is now expected to rule on whether this departure from protocol breached the members’ Code of Conduct.

A council spokesman said the minutes will be published within the next few days.

“It’s too early to say whether this is a subject that will be discussed or raised by elected members at a future full council meeting,” he added.”

http://www.devonlive.com/news/devon-news/tory-chairman-faces-standards-inquiry-396146

A chance to show Diviani exactly what you think of him for destroying our community hospital beds

Remember, anyone who votes AGAINST this motion, or ABSTAINS or is not at the meeting for spurious reasons, is guilty of destroying our local health service and killing off Axminster, Ottery, Seaton, Budleigh and Honiton community hospital beds – and cares not one jot what you may think.

“13 September 6pm, EDDC extraordinary meeting:

Motion – Vote of no confidence in the Leader

“On Tuesday 25th July 2017, Cllr Diviani chose not to represent the opinions of this Council or the people we represent at the DCC Health and Adult Care Scrutiny Committee meeting when he was clearly expected to do so. This Council no longer has confidence in Cllr Diviani’s commitment to represent our collective interests nor lead our East Devon communities as the figurehead for local government. We call for his resignation.’

Proposed by Councillor Ben Ingham, seconded by Councillor Val Ranger and supported by Councillors Cathy Gardner, Matt Coppell, Marianne Rixson, Rob Longhurst, Dawn Manley, Geoff Jung, Peter Faithfull, Susie Bond, Roger Giles, Matt Booth, Peter Burrows, Steve Gazzard, Megan Armstrong and Douglas Hull.”

Please attend to show how you feel and speak if you want to.”

Source: East Devon Alliance, Facebook

Honiton Hospital beds closed – motion of “no confidence” in EDDC Leader 13 September 2017 6pm

Susie Bond, EDDC Independent Councillor, Feniton reports”

“This morning I attended a vigil outside Honiton Community Hospital. It was called to mark the end of inpatient care in the town. It was a sad day, as it now means that there are no inpatient beds in the hospitals in Seaton, Axminster, Honiton and Ottery St Mary.

I wasn’t sure what to expect … it’s a Bank Holiday and the weather was glorious … so I half expected to be there with just a handful of people.

I was wrong.

The event had been organised by Honiton Patients’ Action Group … a well-organised and furious bunch of people.

A group of about 50 turned up, armed to the teeth with placards, happy to vent their feelings to the local press about the parlous state of future community health provision.

Among those present this morning was Cllr Martin Shaw (county councillor for Seaton and Colyton) who spoke about his grave concerns for health provision. He had also addressed Devon County Council’s Scrutiny Committee meeting in July (https://seatonmatters.org/2017/07/26/the-health-scrutiny-committee-which-didnt-scrutinise/).

The decision to close the inpatient beds in Honiton had not been the subject of public consultation, so those present felt that this was sufficient cause for Devon County Council’s Health and Adult Care Scrutiny Committee to refer the decision to close the hospital beds to the Secretary of State, Jeremy Hunt. In turn, he would have had to refer the decision to the Independent Reconfiguration Panel (which describes itself as ‘the independent expert on NHS service change’).

Had that decision been made at their July meeting (https://devoncc.public-i.tv/core/portal/webcast_interactive/293466), those present at the vigil today would probably have still been worried about their future health care, but at least they would have felt that every avenue open to them had been explored.

Instead they were denied this last opportunity by political shenanigans of epic proportion.

I watched the webcast of the July meeting of DCC Health Scrutiny Committee (http://www.devonlive.com/news/devon-news/conduct-committee-members-investigated-devon-312213) and was frankly appalled at the charade being played out before my eyes.

Questions have been raised about how the meeting was conducted and the Standards Committee at DCC meets tomorrow to decide if the complaints are well founded.

Meanwhile, members of East Devon District Council have expressed dismay about the way an almost unanimous vote on a Motion expressing real concern about the conduct of the Clinical Commissioning Group was ignored and have called an Extra Ordinary Meeting of full Council to discuss a Motion of No Confidence in the leader, Cllr Paul Diviani, who sat on Devon County Council’s Health and Adult Care Scrutiny Committee as a representative of the leaders of all the district councils in Devon.

Cllr Diviani effectively voted against referring the decision to close inpatients beds in Honiton to the Secretary of State and later admitted under robust questioning that he had not canvassed the views of the other leaders.

The Extra Ordinary Council meeting will be held on

Wednesday 13 September
at EDDC’s headquarters at the
Knowle, Sidmouth,
starting at
6 p.m.

Honiton hospital beds close today; Seaton hospital Friends express dismay

“Seaton and District Hospital League of Friends has expressed its dismay at the loss of all its inpatient beds.

Speaking after the closure plans began last week chairman Dr. Mark Welland told the Herald: “We would like to express our deep gratitude to the many dedicated staff who have provided such a high quality of care to patients over the past 29 years, and also our sincere thanks to the numerous volunteers who have worked on the wards to support the patients and nurses.

“The League remains steadfast in its belief that beds are a necessary resource in Seaton, and will continue to explore every avenue that might lead to the reopening of the inpatient service in Seaton Hospital.

“At the same time, we would like to emphasise the ongoing work that will be taking place in Seaton Hospital – whilst it is true that no inpatient beds will be open, there are many more activities carried out at our hospital.

“These include the out-patient clinics which will continue to run, including rheumatology, ear nose and throat, audiology, spinal assessment, and general medicine clinics.

“The ever busy Seaton Hospital physiotherapy department will be continuing at full speed.

“Alongside these the hospital will continue to function as a base for community teams, including the rehabilitation team, speech and language therapy, community nursing, school nurse and health visitor teams, and the complex care team.

“There is now an opportunity for those hospital resources left under utilised by the bed closures to be put to new uses, and the Seaton and District Hospital League of Friends is currently active in establishing which services might be added to the above list to best serve the local community.

“The League continues to support the Seaton Friends Hospiscare at Home service, which will now be more vital than ever, with no opportunity to use hospital beds for end of life care. The Seaton Friends Hospiscare@Home service is entirely funded by the league, and receives no funding from NHS sources, even as the NHS support for end of life care locally is pared back. The League is very thankful to everyone who continues to support us, and to allow our work to continue.”

http://www.midweekherald.co.uk/news/dismay-over-seaton-hospital-bed-closures-1-5166084

And no thanks to our two MPs who simply turned up for photo opportunities and mouthed platitudes whilst voting in Parliament for these closures.