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Wednesday 28th March 2018

Oxford KONP - Gus Fagan

  • The Independent Reconfiguration Panel critical of CCG's handling of the Horton. But has the Horton been saved?

    In 2016 Oxfordshire Clinical Commissioning Group announced the planned closure of obstetrics at the Horton Hospital in Banbury and the centralisation of obstetrics at the John Radcliffe Hospital.

    The Horton would retain a midwife-led unit.

    The closure was part of Phase 1 of the Oxfordshire Transformation Plan. The first of a two-phase

    consultation on the Plan was announced in January 2017. This plan included the permanent closure of obstetrics at the Horton.

    The consultation was described by Oxford Keep Our NHS Public (KONP) as 'a sham' and there was strong popular opposition to the plan in Banbury, led by the campaign group, Keep the Horton General (KTHG).

    As a result of popular opposition across the county, the Health Overview and Scrutiny Committee (HOSC) of Oxfordshire County Council referred the matter to the Secretary of State. HOSC made the referral to the Secretary of State on two grounds – that the consultation undertaken was inadequate and that the proposal would not be in the interests of the health service in its area.

    The Secretary of State sent the referral to the Independent Reconfiguration Panel (IRP) for advice.

    In February 2018 the IRP delivered its advice. It agreed with campaigners and HOSC that the consultation, especially the way it was split in two

    “… has added more to the confusion and suspicion than helped move matters forward. In the Panel’s view, decisions about the future of obstetrics at the Horton must inevitably influence proposals that remain to be consulted on including around the future provision of MLUs in Oxfordshire.”

    According to Oxford University Hospital Trust, the unit at the Horton needed to close because it had been unable to recruit obstetricians to work there. The IRP agreed with critics that, since the Trust had already decided it wanted to close the unit,

    “… it is not surprising that scepticism exists in some quarters about the extent of the Trust’s efforts to attract the skilled and experienced staff required to reopen the unit.”

    The IRP concluded that the CCG needed to look again at its options for the Horton:

    “In the Panel’s view, a further, more detailed appraisal of the options, including those put forward through consultation, is required and needs to be reviewed with stakeholders before a final decision is made.”

    The MP for North Oxfordshire, Victoria Prentis, said it was a 'huge relief' to hear the IRP's conclusion.

    "The IRP’s conclusion that further work needs to be undertaken comes as a huge relief and is recognition of what many of us have been saying repeatedly since the flawed consultation process began.”

    But on the heart of the matter, the future of obstetrics at the Horton, the advice from the IRP was anything but a clear victory for the Horton:

    “First, that action to consider alternative options is needed because the problems with sustaining the obstetric service at the Horton that led to its temporary closure in 2016 are real and the prospects for returning to the earlier status quo are poor given a national shortage of obstetricians… Secondly, that this consideration must be driven by what is desirable for the future of maternity and related services and all those who need them across the wider area of Oxfordshire and beyond rather than a search for any possible way to retain an obstetric service at the Horton.”

    The campaign group, Keep the Horton General, was more critical of the IRP decision:

    “The IRP is effectively leaving the CCG to its own devices in terms of the final decision for maternity, in spite of significant evidence that it would be unsafe to leave vast, semi-rural population without reasonable access to obstetric services. … KTHG considers the IRP has missed the opportunity to examine or take into account the national factors that are being used as a justification to downgrade hospitals all over England - e.g hospitals being denied training accreditation at precisely the time when shortages of specialists were anticipated.”

    According to Roseanne Edwards of KTHG

    “Everyone's talking as though the Horton is reprieved but I see it as a severely weakened hospital that they can see is needed with the extraordinarily dire winter pressures, but it will only, effectively, have an A&Ee and childrenss ward, which will be highly vulnerable. Already they are sending anything that needs a senior consultant down to the JR.”

    In March 2018 the Clinical Commissioning Group gave its first response to the IRP proposals. On the core issue of the campaign, it made no commitment to retaining obstetrics at the Horton:

    “… the future provision of an obstetric service or change to a permanent freestanding midwife led unit at the Horton General Hospital will be determined by the outcome of the work undertaken to address the recommendations from the Secretary of State."

    It also decided that “there will be no phase two consultation". Instead, a new phrase has entered the CCG vocabulary: 'co-production'. Rather than consult the population in the county about a general plan, there will be engagement at

    “a more local level in looking at the population’s health and care needs so we may co-produce a health and social care system that is fit for the future”.

    In the meantime, the emergency department and paediatric services will be retained at the Horton. The CCG also is making no commitment to retaining community hospitals:

    “The community hospitals must be considered within the context of the health and care needs of the local populations they serve, the state of the actual buildings, the rurality and size of the local population (including growth). The CCG and OHFT have agreed that discussions need to be more about what services are required in localities and how best the community hospitals might support, rather than a county-wide consultation on whether they should be removed or remain.”

    In general, the initial response of KTHG seems correct:

    “The IRP is effectively leaving the CCG to its own devices.”

Tuesday 27th March 2018

Save Our Hospital Services, Devon

  • Devon: Victory for democracy at County Hall

    Devon County Council’s Health & Adult Care Scrutiny Committee has agreed to defer plans by the county’s two clinical commissioning groups (CCGs) to implement further changes called for by NHS England on the basis that there has not been sufficient information or time to consider the impact on Devon’s residents. 

    The decision by Devon’s scrutiny councillors is welcomed by campaign group Save Our Hospital Services (SOHS), which has been concerned that NHS England’s planned integrated care system (ICS), proposed to be launched on 1 April, would lead to a postcode lottery on access to NHS provision due to the ongoing cutting of £557 million from Devon’s healthcare budget by 2020/21.

    However SOHS is very disappointed that North Devon Councillor Paul Crabb from Ilfracombe moved an amendment which was carried, calling for no consultation involving the public, preventing his and other voters from participating in the democracy process. 

    Sue Matthews, a retired registered nurse and spokesperson for SOHS said: “ICSs will still have to operate under the conditions of austerity and cost-cutting, but the public have not been given a clue about their legal structure and obligations, about leadership or about how the funding system might work. From what we do know, it is beginning to look as if they could be run along the lines of a private business, protected from public scrutiny and without the accountability to central government which has been a cornerstone of the NHS.” 

    Campaigners had sent letters to councillors on the Scrutiny Committee, and SOHS speakers from North Devon made representations at last Thursday’s Scrutiny Committee meeting at County Hall in Exeter. The public gallery was packed with campaigners who had travelled from all parts of Devon to oppose further cuts in NHS provision in the county.

    SOHS had also put a number of questions to the NEW Devon Clinical Commissioning Group and the South Devon and Torbay Clinical Commissioning Group concerning the planed ICS.

    These cover important issues such as governance and accountability, funding, maintenance of consistent health provision regardless of where in the county patients live, and the budgetary implications of yet another restructuring of the NHS in Devon. These questions were taken on board by the Scrutiny Committee in its decision to defer approval of the CCGs’ proposed introduction of the ICS. 

    A joint meeting of the CCGs’ Governing Bodies took place at County Hall on the same day as the Scrutiny Committee meeting, and the CCGs indicated that they were willing to speak to campaigners about the details of the proposed ICS.

    Read more ...

Sunday 25th March 2018

KONP North East

  • NORTH TYNESIDE COUNCIL: UNANIMOUS CROSS-PARTY VOTE IN FAVOUR OF MOTION OPPOSING ACO/ACSs

    “This council agrees that there is a growing body of evidence questioning the wisdom of ….Accountable Care Organisations / Integrated Care Systems (ACO/ICS)….This council agrees to oppose any proposal to implement the delivery of healthcare in North Tyneside via an ACO/ICS, a project which in the North Tyneside CCG’s own report was stated to be high risk”.

    Well done Councillors Lesley Spillard, Sarah Day and Wendy Lott who brought the motion to the council, and to Councillors Leslie Miller, Kenneth Barrie, Margaret Hall, Gary Bell and Alison Wagott-Fairley who all spoke in favour of the motion.

    In her introductory speech at tonights full Council meeting, Cllr Lesley Spillard stated: “There are huge concerns and objections to the “elephant-in-the-room” which is not being widely promoted by NHSE and local CCG’s. It is not benign.

    The NHS England policy is to move STPs through “systems” (whether these be named “Integrated Care” or “Accountable Care”) en route to Accountable Care Organisations, with plans to put ACOs to tender inviting bids from the private sector. This is in conflict with current legislation, and will lead to the large scale privatisation of our NHS”.

    All Councillors spoke with great commitment and knowledge about the matter in hand, being clear about what is at stake. Absolutely no-one opposed the motion, and no abstentions – the vote was carried unanimously by North Tyneside Councillors….an example of excellent cross-party work by North Tyneside Councillors.

    The agenda from the meeting, and the motion in full is here:

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Saturday 17th March 2018

Hands Off HRI

  • On Thursday March 15th , Hands Off HRI made legal history in the Leeds Crown Court.

    Judge Mark Gosnall agreed there were important matters of law which must be tested in a full Judicial Review. We expect the hearing to take place in June. The Hospital Trust has so far considered itself to be beyond reproach but they will now have to account for their proposals in court. 

    This is a huge blow to the Trust and a massive victory for the people of Huddersfield who have stood shoulder to shoulder with this campaign. It has taken two years of hard work and perseverance to pull this off but we have been rewarded.  

    The Judge has approved the referral to the High Court on the following grounds:

    ·       A serious matter of public law needs to be tested

    ·       Consideration of the consultation exercise

    ·       Examination of alternative community care provision

    ·       Potential breach of Equality Law

    ·       Lack of Travel and Transport Provision 

    Our campaign group will now be shifting up a gear to ensure all possible approaches are explored to win this legal case. Of course we still await the outcome of the Independent Reconfiguration Panel which is now with the Secretary of State but undoubtedly this legal case will focus his mind! 

    Of course this is not the end of the road; we now have to win our Judicial Review but our legal team are up to the challenge and we know we will continue to have your support. This challenge has local and national consequences. 

    It is the first serious legal challenge of its kind. If we win, it doesn't just help our hospital, it will give encouragement to all campaign groups fighting for their own services. However we will need ongoing public support.  

    We estimate we need to raise another £10,000 to bring our legal case and that is where you come in. All supporters can help us in our next phase of fund raising. 

    We have now proved this is not a done deal and that People Power CAN work. 

    Join our facebook page; organise your own fund raiser or just donate to our legal fund (details below). This is a fight for Huddersfield and the wider NHS and we can win. Let’s do this together. HANDS OFF HRI!! 

    You can donate directly by bank transfer into the Hands Off HRI account. Sort code: 20-43-04 Account number: 93119130

    For local contact details, please email:

    info.handsoffhri@gmail.com    Facebook: HandsoffHRI

    www.officialhandsoffhri.org              Twitter: @HoHRIltd

    For more details: Cristina George 07747446005       Mike Forster 07887668740

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Friday 16th March 2018

Dorset KONP

  • Dorset campaigners win Full Hearing on their Judicial Review

    We’re delighted to report that we’ve been granted a Full Hearing for our Judicial Review into Dorset CCG’s plans, which are to downgrade 1 of our 3 A&E’s, close 1 of our 3 Maternity’s with a 2nd under threat, close Community Hospitals and/or beds in 5 of 13 Dorset locations, and close 245 acute beds. 

    The plans leave the future of Poole General Hospital in doubt. Poole Maternity site appeared in Poole local plan as ‘existing site allocated for development’ in June 2016, 6 months before the ‘Consultation’ on the changes even began. 

    We now need to raise the £10,000 Community Contribution needed for the final stage costs: https://www.crowdjustice.com/case/save-poole-ae-and-maternity-and-nhs-beds 

    Our JR could be of benefit to campaigners across the UK as the arguments the Judge has accepted for full hearing are: 

    1)    Unsafe Travel Times: That the plans to downgrade Poole A&E and close Poole Maternity will move emergency and Maternity services out of safe reach for tens of thousands of Dorset residents. We have a Claimant who has been granted legal aid who is severely affected by the loss of Poole A&E, as her condition can deteriorate rapidly, and potentially be fatal. She is blue lighted to Poole regularly (8 times last year).

    2)    Failure to meet Beds Duty: That it is unlawful for Dorset CCG to close NHS beds without having replacement staffed services in the Community that are proven to reduce the demand for NHS beds. 

    We are also arguing for a third argument to be heard at Full Hearing

    3)    That aspects of the Consultation were so misleading as to be unlawful. There are another group in Dorset who are aggrieved about the Local Government Unitary Authority Consultation. This was carried out by the same company, Opinion Research Services, who did the Consultation on the NHS cuts. This group are starting JR proceedings having been advised that it is illegal to create, or use, a Consultation designed to give a defined outcome. 

    Please support us! https://www.crowdjustice.com/case/save-poole-ae-and-maternity-and-nhs-beds 

    We also continue to fight for our Dorset NHS at Local Authority Health Scrutiny Meetings. Follow our campaign on our FaceBook page: https://www.facebook.com/defenddorsetnhs/ 

    If you have any evidence that may support our case, for example research references evidencing delays to treatment cause increased mortality and morbidity, or references showing that the benefits claimed for centralisation of services are exaggerated or untrue, please let me know!


    Read more ...

Thursday 15th March 2018

KONP North East

  • North East March and Rally for the NHS; a loud and clear message to North East CCGs and NHS England

    OUR NHS: NO CUTS – NO CLOSURES – NO PRIVATISATION

    SATURDAY 10th MARCH 2018

    More than 1000 joined the North East March and rally to demand a healthy NHS … and the message has got out to tens of thousands through word of mouth, journalism and social media.

    EIGHT North East health campaign groups plus North East Peoples Assembly joined together to call for


    • a cash injection to restore the NHS budget, commitment to increased funding each year, and an end to the cap on NHS pay
    • abandonment of any plans for further cuts or cash-driven closures of NHS hospitals and services
    • a halt to the imposition of “new models of care” and “accountable care”
    • repeal of the 2012 Health & Social Care Act and reinstatement of the NHS as a public service, publicly accountable, publicly owned and publicly funded

    Check out the pictures and reports by following the link below.

    Read more ...

Thursday 8th March 2018

RCEM press release

  • Royal College of Emergency Medicine urges patients to take action after worst ever 4hr performance figures

    The Royal College of Emergency Medicine is calling on patients to write to their Member of Parliament asking for action to address the serious challenges facing Emergency Departments across the country.

     

    The unprecedented move comes after data released today showed the worst ever four-hour emergency care performance at just 76.9% at major emergency departments. Sitrep data also showed that in February bed occupancy was at 95.1%.

     

    Dr Taj Hassan, President of the Royal College of Emergency Medicine, said: “Unfortunately these figures are not surprising and reflect the acute and detrimental effect insufficient resources are having on our health service; patient care will continue to suffer until this changes.

     

    “Performance that once would have been regarded as utterly unacceptable has now become normal and things are seemingly only getting worse for patients. It’s important to remember that while performance issues are more pronounced during the winter, Emergency Departments are now struggling all year round.

     

    “Warnings and pleas for adequate resourcing have repeatedly failed to deliver with both patients and staff suffering as a result. We cannot continue in this situation - which is why we are calling on patients to contact their MP in support of our A&Es and the NHS.

     

    “Let’s be very clear. The current crisis in our Emergency Departments and in the wider NHS is not the fault of patients. It is not because staff aren’t working hard enough, not because of the actions of individual trusts, not because of the weather or norovirus, not purely because of influenza, immigration or inefficiencies and not because performance targets are unfeasible. The current crisis was wholly predictable and is due to a failure to prioritise the need to increase healthcare funding on an urgent basis.

     

    “We need an adequate number of hospital beds, more resources for social care and to fund our staffing strategies that we have previously agreed in order to deliver decent basic dignified care. We would urge our patients to contact their MP to tell them so. We hope that action from patients will ensure that our politicians give the NHS the due care and attention it needs and help them come together to find appropriate long-term solutions for the NHS that are so desperately required.”

     

    Mr Derek Prentice, the College’s lead patient representative and Lay Committee Chair, said: “Yet again patients have had to endure another winter of misery due to inadequate resourcing. Understandably public satisfaction with the health service has fallen. But patients are not blaming individual trusts or staff. They quite rightly understand that this is the fault of our politicians, which is why we are asking for their help to change the situation.

     

    “While the recent budget allocated extra funds to the health service, it was not what was made very clear would be required and was just about enough to stave off complete collapse. Just about enough should not be good enough. Our patients, staff and the NHS – now in its 70th year – deserve better. We need long term solutions, including more beds and more staff, and we would encourage patients to ask their MPs for them.

     

    “Ministers and decision makers must stop burying their heads in the sand and face the reality of the situation; overall performance is in decline due to the under-resourcing of health and social care. The data shows the reality, yet facts are being disregarded and the health sector is not being listened to. We hope that they will listen to the public who voted for them.”

     

    Read more ...

Sunday 4th March 2018

SHA blog: https://www.sochealth.co.uk/2018/02/28/lies-dishonesty-boards-go/

  • Lies, Dishonesty and Boards that Should Go

    by Richard Bourne

    Trusts around the country are setting up wholly owned companies to deliver services so they can take advantage of taxation changes this allows.

    This great VAT saga shows the NHS at its very worst.   Bullied from above, local managers believe the hype from consultants. They can’t write a proper business case but still launch a project in secret, refuse to consult with staff, totally mislead the staff and public about the real intentions, refuse to give information claiming everything is commercially confidential and plough on regardless – all with the active collusion of a Regulator that is supposed to stop such poor behaviours. Those involved continue to refuse even to respond to FoI requests. Questions in both Commons and Lords get stock answers saying this has nothing to do with Ministers – it’s local decision making – nothing to see here.

    Unison has been active in opposing the outbreak of wholly owned companies for 18 months. On the face of it this represents money for nothing – the same staff doing the same job in the same way with the same managers but with “savings” in £millions from tax changes. No increase in productivity, no innovation, no efficiencies at all – just a tax scam. The staff loose out by moving out of the NHS and become collateral damage, but this does not matter as they are not nurses or doctors – that may come later.

    Tactically the Trusts also get to break out of the national pay and conditions and can pay new staff and even promoted old staff on worse terms and conditions. This alone should set red lights glowing somewhere.

    Oh, and two fingers up to any local plan about working together, collaboration and that guff – this is every Trust for itself – they even all claim that they will be selling services to each other.

    And big issues like the consequences of transferring ownership and control over public assets to a private company (even one which for now is wholly owned) have simply been ignored or lied about.

    Facts as opposed to the lies, are slowly emerging. To take one well documented example. Late in 2016 a Trust did preliminary work with outside consultants on going down the wholly owned companies route. In December 2016 in secret the Board agreed to go ahead using a particular model solution pitched to them by the consultants. 

    They did not look at the overall strategy involved and failed to look at other options. This offer was too good to be true and others had done it; so why not? The “Business Case” to the Board was laughable being a few pages of platitudes and 63 pages of tax advice.

    The Trust worked on in secret, despite being under a very clear duty to engage with the staff on a decision which affected hundreds of them. 

    Eventually, late in 2017, they had to come clean and start TUPE consultations, but they consistently refused in every forum to consult or engage with staff on what was being proposed – they would only talk about the consequences. They knew their whole case was entirely bogus.

    In public the Trust simply avoided telling the truth. They maintained throughout that what they were doing had to do with somehow professionalising the facilities management services. 

    Strangely the Trust had never reported its concerns with these services before they were sold the VAT dodge. They never engaged with staff to see how they could improve services at all.

    The Trusts maintained the fiction that this was nothing to do with tax as they had been instructed to do. They gave a presentation to staff which had a dozen slides but none of them even mentioned VAT or tax. They signed a secrecy agreement with the consultants they used. But because information was coming out of other Trusts doing the same thing, but slightly more honestly, they were caught out anyway.

    After enormous pressure from Unison the Trust finally revealed at least some of its documents but only after it was already implementing its decision. 

    What the documents showed was what everyone already knew – the savings almost all came from changes in taxation. Savings from other sources such as reducing pension rights or bringing in a two tier workforce were tiny in comparison. 

    This was and is all about tax. All about a Trust in severe financial straights doing anything to make savings. Doing what it was told. It was more afraid of external intervention for not trying hard enough than it was afraid of the outrage from its own staff.

    Utterly dishonest from start to finish. But with active collusion from NHS Improvement – the Regulator which knew exactly what they were doing and why, even if they now refuse to release the information and ignore FoI requests. 

    We know from parliamentary answers that NHSI signed off the deal. We also know the relevant CCG opposed it and appealed to the Trust not to go ahead – yet again the lie is that everyone was in agreement.

    A disgrace from start to finish. Staff disillusioned, staff relations soured for years to come, further fragmentation of the NHS and a wholly uncertain cloud over the future ownership and control of vital NHS assets. And NO SAVINGS. Anything saved in one place is lost to the exchequer in another – it's our money and we get no benefit at all.

    No Board that agrees to this kind of subterfuge and secrecy is fit to stay in place. But they will.

    NB: See also the piece from Caroline Molloy, link below:

    Read more ...

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