What is an Integrated Care Organisation? Stalybridge public meeting on 22 September will find out!

The Public Meeting organised by Tameside Keep Our NHS Public on Thursday 22 September at Stalybridge Civic Hall, in the District Assembly Room, starts at 18.30, with doors opening at 18.15. It will end at 20.00.

This meeting about Tameside Integrated Care Organisation is very useful for Kirklees and Calderdale  people, because Tameside NHS bosses have gone ahead and done what Calderdale and Kirklees Clinical Commissioning Groups and Health & Wellbeing Boards are still talking about doing – imposing a new form of public/private partnership on our NHS; and this time, not for new buildings, but for NHS treatments and services.

Tameside has now become an Integrated Care Organisation, with little explanation to or involvement of the public. “Seismic changes” are underway in Health and in Social Care, which will affect both patients and workers. It is important that local residents have the opportunity to hear about this and have their say. They are also entitled to hear the views of those who work in these vital services.

Speakers will include Milton Peña, former Consultant Orthopaedic Surgeon at Tameside Hospital, now a campaigner for the NHS; a Junior Doctor in psychiatry; a Social Worker with adults, and Paul Dunn, North West Operational Manager for the Royal College of Nursing.

If you’re planning to go please RSVP to: Konp.tameside@gmail.com

Integrated Care Organisations – another name for Accountable Care Organisations

Here’s info about Integrated Care Organisations from Monitor (since changed into NHS Improvement) , Ealing and Harrow Integrated Care Organisation and from the Kings Fund – which shows that Integrated Care Organisations are just another name for Accountable Care Organisations.

In American, an Accountable Care Organisation – aka a Health Maintenance Organisation – is a form of health company that provides managed care ( ie care that follows set protocols and pathways on the basis of a capitated budget (ie a fixed cost amount for each person in the area served by the ACO) for a private health insurance company.

Health Maintenance Organisations (HMOs) were promoted by President Nixon through the HMO Act of 1973, before he resigned in 1974 to escape impeachment for obstruction of justice, abuse of power, and contempt of Congress.  John Ehrlichman – later imprisoned for his role in the Watergate scandal – persuaded Nixon that HMOs were the future for American healthcare on the grounds that:

“All the incentives are toward less medical care, because the less care they give them, the more money they make.”

Jeremy Hunt, the Secretary of State for Health, advocates that the NHS turns itself into  Accountable Care Organisations or systems based either on the American Kaiser Permanente system or the Spanish Alzira/Valencia model.  The Alzira ACO model is a private/public partnership – like PFI but for NHS services as well as buildings. The Northumbria ACO was set up via a Special Purpose Vehicle – the same financial arrangement as for  NHS hospital PFI schemes.

ACOs/Integrated Care Organisations are clearly a route to the further NHS privatisation that is required as a condition of the Sustainability and Transformation Plans.

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Urgent letter to send to your MP; Defend the NHS in the Opposition Debate, Wednesday 14th September

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Westminster

Letter to your MP: speak out in the Weds 14th September Opposition Debate on NHS cuts.

Here is a template letter to send your MP.

You can copy the template and fill in the blanks and change it as you see fit.

Or download it as a .doc or .txt file here

Urgent letter to send your MP: Defend the NHS in the Weds 14th September Opposition Debate

You can find your MP’s name and contact details here:

http://www.parliament.uk/mps-lords-and-offices/mps/

Dear [insert your MP’s name]

On Wednesday 14th September,  there will be an opposition debate on NHS cuts in the House of Commons. I am asking you, as my MP, to attend the debate and to demand that Jeremy Hunt:

  • stops the STPs,

  • protects and reinstates full acute and emergency hospital services at district general hospitals,

  • protects other NHS services from cuts and privatisation.

These measures are necessary in order to make sure that the NHS is restored as a

comprehensive health service that is equally available to all who have clinical needs for it.

44 area “footprint” “Sustainability and Transformation Plans”, being drawn up in conditions of secrecy imposed by NHS England, will accelerate NHS cuts and privatisation.

NHS Improvement has instructed NHS organisations to list services which could be axed or centralised, making “rapid progress” during the current financial year.

The secretive preparation of Sustainability and Transformation Plans, which have only come to light in the last few weeks, is an appalling abuse of our democratic rights and is being met with protests at local authorities’ Health and Wellbeing Boards, Clinical Commissioning Group meetings and the offices of NHS England – all organisations with a role in the development and implementation of Sustainability and Transformation Plans.

In our constituency, there are public campaigns to keep services at Dewsbury hospital, support the Junior Doctors, stop the STPs and prevent Virgin Care getting the Children’ Services Contract, (soon to be launched).

This needs your support. Please show it, by telling Jeremy Hunt to stop his NHS cuts and privatisation policies, that are undermining, fragmenting and dismantling the NHS in our area.

Despite protests, campaigns and media coverage, many people still do not know about these cuts and privatisations and the STPs. By speaking out against them in the Opposition Day debate, you will help to increase the public’s awareness of them.

We urgently need to you to help get the information out there to the general public in this way – as well as making sure Jeremy Hunt knows the damage his policies are causing.

Only your effective opposition in the House of Commons, combined with mass public opposition, can stop and reverse the cuts and privatisations, stop the STPs and restore the NHS.

I call on you as my MP to commit to urgently support these local campaigns and protests in our constituency, and to oppose the STPs and NHS cuts and privatisation at every opportunity in the Houses of Parliament – including during the Opposition debate on

Wednesday 14th September.

The worst Secretary of State for Health the country’s ever had is slashing the NHS to pieces and privatising it at an accelerating pace. Secretive Sustainability and Transformation Plans (which campaigners call Slash, Trash and Plunder, because that’s   will do to the NHS), will mean the end of the NHS as a comprehensive service that is equally available to everyone who needs it.

One of the latest NHS cuts is the sudden restriction of A&E opening hours at Grantham Hospital – announced on the 11th August and carried out on the 17th August. https://www.facebook.com/groups/1585988212

Grantham A&E is now only open from 9am to 6.30pm. In the evening and overnight, Grantham people who need emergency care have to travel 45 minutes to Lincoln A&E or 1 and a half hours to Pilgrim Hospital in Boston.

Extra distance to A &E is association with increased emergency patients’ death rates, as reliable studies have shown. This is unsafe and unfair.

This is just the latest example of ruthless cuts to NHS services that threaten the safety and health of people in need of health care. That is all of us, at one time or another.

There are well over 50 non-party/cross-party groups campaigning across England to stop and reverse NHS cuts and privatisation and to stop the STPs.

The Opposition Day debate on the 14th September is your chance to support your constituents in the House of Commons and bring the fight to save our NHS right where it belongs – to the worst Secretary of State in the history of the NHS.

Signed:

[Give your name and postal address, MPs will only take notice of correspondence from

their own constituents]

The future health of people in England, needs YOU to do summat now!

We stand together

 

Reproduced from a blog By National Health Action’s Dr Walker.

Watching the battle lines emerging in the press reporting of the new mass cuts regime currently being implemented across the NHS is pretty instructive. On one side you have the government and their appointed spokespeople, scrambling to assuage a newly anxious population with the soothing language of consolidation, reconfiguration, efficiency, and modernisation. They are, of course, gambling on being able to sustain public obliviousness to the fact that these words are synonyms for service cuts, lost beds and staff lay-offs. On the other side, a variety of campaigning groups, doctors and politicians using an array of evidence to carefully unpack these reconfiguration fantasies.

The sheer scale and imminence of cuts is, even for seasoned austerity-spotters, truly shocking to behold. What is interesting now is the extent to which those who are pushing for, and making possible, these cuts have critically departed from reality. We hear that in Dorset, the new STP plan suggests that a ‘reduction in the number of sites’ would lead to a better provision of services ‘for more hours of the day and days of the week’.

In Hampshire and Isle of Wight, commissioners are planning to make general practice more sustainable by cutting GP workload by almost a third, while also significantly reducing patients’ face-to-face contact with primary care.

Stephen Dalton, chief executive of the NHS Confederation said, “These local plans are being made when funding is very tight but they are not about cuts, they are about modernising services to match people’s changing care needs.” I suppose if people’s changing care needs included a need to die of entirely preventable illnesses then he would be right. But it is not.

No amount of PR window dressing and STP gobbledegook will ever convince anyone that removing beds, services, A&E units and GP surgeries is going to lead to better patient care. Indeed the way in which STP plans are wrapping the extraordinary shrinking of our NHS in the language of better patient care has now stretched incredulity to a truly insulting level.

Thus far, those who resist these cuts publicly have made salient points about poor public consultation and lack of democratic accountability, about GPs being excluded from the STP planning process, about how the delivery of integrated care is incompatible with mass service reduction and how poor community provision means it is impossible to transfer acute services to the community.

Huge numbers of people unable to see their GP means a massive increase in patient risk. People are going to die as a result.

For example, when Leicester, Leicestershire and Rutland region, reduce the number of acute hospitals from three to two people are going to die as a result of this. Or when in the Black Country region of the West Midlands the number of acute units are cut from five to four and when one of two district general hospitals closes people are going to die. You’ll find the same wherever you live.

The STPs are going to kill people.

Dalton is selling this as modernisation and improvement: it is not, it is the end of the NHS as a comprehensive, universal and accessible service. Most people out there have not been seduced or befuddled by the corporatisation of health discourse that has been designed to obscure mass public service vandalism. When NHS England, the Department of Health, The NHS Confederation and the poor sods charged with spinning STP straw into gold defend against accusation of cuts with their consolidating reconfigurations they remind me of playing hide and seek with my young son who thinks I can’t see him because he’s covered his hands with his eyes. The health mandarins can cover their eyes if they wish but we can still see them.

So where and how do we hit back and resist against this institutional policy barbarity? I have no doubt that many NHA members out there are already actively campaigning against STP but if not and you want to get involved then here are eight ways to campaign

1. sign this national petition again and again and again (share it again that is, only sign it once)
2. spread this fantastic blog far and wide letting people know the real figures behind this sorry mess
3. join a local NHS campaigning group, whether that be NHA, 999 Call for the NHS, Keep Our NHS Public or other. If one doesn’t exist in your area then get one moving with a few friends.
4. use the recent articles in the national press to push for local public consultations and work with friends and colleagues to drum up support to go to these
5. hold local public meetings once the detailed STP plans have been released in your area and the plans for A&E closures and GP closures are announced. Use these public events to inform people and as a base to develop further campaigning
6. it’s a thankless task sometimes but lobby local councillors to stand up in your interests. Let local newspapers know which of them are prepared to stand with the public interest against the STP cuts in their area
7. use the recent articles in the national press to push for local newspaper health editors to report on STP developments and to attend consultation events
8. start a local petition against the closures and coordinate with other groups across your STP area.

These are just a few ideas, there are of course many more. But if ever people were thinking of getting more actively involved in the fight to save the NHS then this is the time.

“The rule is jam tomorrow and jam yesterday – but never jam today”

‘The rule is, jam to-morrow and jam yesterday – but never jam to-day’

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Paula Sherriff MP chaired the meeting.

Public Meeting about Dewsbury Hospital Service cuts due mid September

The public meeting on 23 August 2016 at Dewsbury Town Hall was about the upcoming changes to Dewsbury Hospital services, which will kick in over the weekend of 17 September.

Consultant-led maternity services will no longer be available and will be replaced by a midwife-led birthing unit. Mothers expecting complicated births are due to be sent to Pinderfields. There will be reduced opening hours at the Dewsbury’s children’s assessment unit, from 10am-8pm.

North Kirklees Support the NHS have dubbed the scheme a “recipe for disaster” and say it is ludicrous to have a midwife-led unit so far away from the consultant-led and emergency surgery facilities. They point out that the difference between a low-risk birth and a high-risk birth can be as little as six minutes.

At the meeting, Mid Yorkshire Hospital Trust said that they are working with unprecedented levels of demand (i.e. need) for its services.

Why?

Care Closer to Home is Jam Tomorrow

In 2013, at the “Meeting the Challenge”http://www.meetingthechallenge.co.uk/home/ Consultation sign off – which everyone thought was unfair and without a shred of ‘independence’ anyway – North Kirklees Clinical Commissioning Group said that no changes to Dewsbury hospital would take place until Care Closer to Home was up and running and able to keep people out of hospital.

Even further back in time, the Grasping the Nettle reconfiguration of 2007 promised more Care Closer to Home. That didn’t materialise so why should anyone have confidence that there will be ‘improvement’.

In the “Through the Looking Glass” world of North Kirklees CCG, Care Closer to Home has turned out to be jam tomorrow:

‘The rule is, jam to-morrow and jam yesterday – but never jam to-day.’

‘It MUST come sometimes to “jam to-day,”‘ Alice objected.

‘No, it can’t,’ said the Queen. ‘It’s jam every OTHER day: to-day isn’t any OTHER day, you know.’

How the CCG thinks that withdrawing money from MYHT for vanity projects like a renal specialist across the Healds Road in the GP surgery opposite the hospital, or a skin clinic at another GP surgery in the countryside somewhere is Care Closer to Home, I don’t know.

It all depends where you live. People with poorly children may have chosen to live near Dewsbury hospital to be within easy reach for trips to A&E and visiting. They will now need to go to Pinderfields if their child needs an inpatient stay. Care further from home.The CCG said that people with children who have ‘direct access’ to hospital services will get a communication soon, about the changes and advice about what to do.

Time and again at the 23rd August public meeting, the Mid Yorks Hospital Trust and North Kirklees CCG used the 2013 “Meeting the Challenge” sign off decision to legitimise the upcoming maternity and children’s service cuts and changes at Dewsbury hospital, but the audience was not convinced, because experience trumps rhetoric every time.

This bodes ominously for the proposed changes being hatched in secret by the architects of the West Yorkshire Sustainablilty and Transformation Plan.

Health and Social Care Act 2012 is source of problem

When we used to have a National Health Service, finance allocation would be distributed according to need and since deprived communities with low incomes and sometimes contaminated environments had more health need they would be allocated more resources.

Now this does not happen, because the Health and Social Care Act 2012 replaced the National Health Service.

The risk register compiled by civil servants ahead of the Act was illegally suppressed by the coalition government. When it was leaked last year, professionals could see that the predicted risks were coming to pass: reduced services, fragmented pathways and blind decision making.

North Kirklees CCG said it has to keep within budget. And a Mid Yorks Hospital Trust Board meeting had to review the policy to retain safe staffing levels by increasing spending on agency staff, otherwise the Trust would be subject to a ‘failure regime’. The Francis Report after the Stafford Hospital scandal counts for nothing with the regulators now, it seems.

We are 6 years into massive underfunding of the NHS

David Nicholson and Simon Stevens have both used their time as NHS England CEOs to implement successive governments’ public spending cuts, that have led to a shortfall in NHS funding of at least £17.5bn/year, averaged over the 10 years between 2010 and 2020.  
The NHS needs an increase of 4% per year, just to keep pace with population growth, increased complexity of treatments and price inflation in essential medical supplies - but has not been getting it. 
Between 2010 and 2015, the NHS needed a funding increase of £20bn/year but it got £7bn/year - suffering a total funding shortfall over that period of £65bn  (or £13bn/year).
Between 2015 and 2020, the NHS needs a funding increase of £30bn/year, but it is going to get an extra £8bn/year.  Over this period, the NHS will suffer a total funding shortfall of £110bn, (or £22bn/year).
As a result of these so-called “efficiency cuts”, the NHS is underfunded - actually spending less than it should on healthcare. That's quite the opposite of an 'overspend'! But even an injection of cash - although necessary - will not fix the ills of the health service.  
Through the NHS Sustainability and Transformation Plans, HM Government is conducting an experiment on the health of the English people on an unprecedented scale.  North Kirklees CCG’s move to 'integrated care' is an import from the US. Accountable Care Organisations, set up with a financial product called 'Special Purpose Vehicle' like those set up for the PFI hospital deals, are the next big thing to replace failing Trusts or CCGs and are themselves a failed US import. 
Time to say STOP!

https://www.opendemocracy.net/ournhs/stewart-player/accountable-care-american-import-thats-last-thing-englands-nhs-needs

Do summat: Come to the Public Meeting: Dewsbury Town Hall: 23 August 2016: 7:30pm

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Public Meeting about the changes to Dewsbury District Hospital from Mid September 2016, Dewsbury Town Hall: Tuesday 23 August 2016: 7:30pm

Paula Sherriff MP, in the chair

Invited:
Mid Yorkshire Hospital Trust
North Kirklees Clinical Commissioning Group
Healthwatch (now unable to attend)

Services at Dewsbury hospital have changed following the Meeting the Challenge Consultation plans which were approved by government, in 2013.

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No amount of shouting will change that now!

http://www.meetingthechallenge.co.uk/home/

The next changes are due to take place in mid September 2016, with a further set of changes in March 2017.

The residents of North Kirklees were promised that no changes would take place to the Dewsbury Hospital, without the Care Closer to Home provision being in place. But how do we know what that is and how to access it? How do we know if it is working?

Are you happy with the provision? Is it working for you?

Come to hold the decision makers to account.

If you would like to participate but can not be there in person, please tell us you have a question. You can do this by leaving a message after clicking on the comments button on the website www.northkirkleesnhssupportgroup.org.uk and we will get back to you in private.

Are you clear about what service to use for your illness or complaint? Is your GP your first port of call? Is the 111 service working for you?  Do you know how complain?

The West Yorkshire region in general has been told to get together to cut the deficits in the Trusts by next year. It has to come up with local and a regional plan. (STP) West Yorkshire is number 5.

https://www.england.nhs.uk/wp-content/uploads/2016/02/stp-footprints-march-2016.pdf

Why? The money given to the health service  is an arbitrary sum.  The Trusts have run up deficits largely by treating people they have not been paid for and using expensive temporary staff  to fulfil their desire to keep waiting lists down.  No more will they want to do that! Waiting lists are bound to go up. NHS England has said it will assume control and possibly establish some sort of US style Accountable Care Organisation instead, if they do not save money. ‘Accountable’ means for the money by the way, not patient health.  Will the STP fund be enough?

https://chpi.org.uk/wp/wp-content/uploads/2016/07/Sustainability-and-Transformation-Fund-.pdf

About us

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We are a coalition of ‘Defend the NHS’ Campaign groups, working to highlight the policy and processes behind the changes to hospital provision in Dewsbury.  These sorts of changes are  also happening all around the country. The photo shows some of us at a recent “Hands Round Dewsbury Hospital” event. We are building on the success of the Save Our Local Hospital Services group (SOLHS).  SOLHS alerted the Joint Kirklees and Wakefield Health Overview and Scrutiny Committee,(JHOSC) to the dangers of the changes proposed to Dewsbury Hospital.

Because of issues highlighted by the SOLHS campaign, the JHOSC decided that the changes were ‘not in the interests of the local population’ and referred the plan to the Secretary of State for Health,  Jeremy Hunt. He gave their report to the inappropriately named Independent Reconfiguration Panel who decided that it was government policy and the Clinical Commissioning Groups should go ahead and reconfigure the services.

No sooner had this decision been taken, than the news in the Daily Mail highlighted the risks to patients at the neighbouring hospital, when Newark A&E was closed.

http://www.dailymail.co.uk/news/article-2323141/Shocking-proof-Accident-Emergency-closures-cost-lives-Death-rate-jumps-THIRD-department-closes.html

So we believe local patients are at risk due to longer ambulance travel time and the people of Wakefield will also be at risk because people will not be able to be admitted to hospital in Dewsbury, but have to be transferred to Pinderfields, putting extra pressure of numbers, on to the facilities and staff.  The Chair of the North Kirklees Clinical Commissioning Group stresses that the A&E at Dewsbury is not closing, but from September 2016 the only Acute, that is, emergency cases it will be admitting, are Acute Medical cases such as people with pneumonia and serious life threatening asthma attacks. The plan is to eventually admit these patients to Pinderfields as well, when the conditions are right!

Keep All Services at Dewsbury District Hospital

100_1671The Bronte Tower

On 6th July 2016 the Governing Bodies  of Kirklees and Wakefield Clinical Commissioning Groups met in the Rams Stadium, Dewsbury, to approve their decision for Mid Yorkshire Hospital Trust, to move Acute services except for Acute Medicine, from Dewsbury District Hospital to Pinderfields Hospital in Wakefield. The Joint Kirklees and Wakefield Health Overview and Scrutiny Committee wrote a report in 2013 which concluded that this move was not in the best interests of the local population. This report was discounted by the decision makers at Coalition Government level.  But it was not ignored by us. The Bronte Tower, home to the Consultant led Maternity facilities, pictured above, will close in September to be replaced by a newly built six bed midwife led unit, for 550 low risk births per year. However, the difference between a low risk and a high risk birth can be as little as 6 minutes. A FOI question to Yorkshire Ambulance Service revealed that as of April 2016 they did not know how many extra ambulance hours, or indeed vehicles would be needed to cope with the changes. They were still ‘working with’ the CCGs and Mid Yorkshire Hospital Trust at that time.

Babies are born on the Elland bypass, as mums in labour travel from Huddersfield and surrounding districts, to Halifax’s Calderdale Royal Hospital.  There is a midwife led unit at Huddersfield.  We await developments between Dewsbury and Pinderfields.