People from Leeds, Wakefield, Barnsley, Huddersfield, North Kirklees and Calderdale turned out with banners and placards, to gather outside the headquarters of the STP West Yorkshire footprint number 5, at White Rose House, Wakefield on 21 October2016, the very day NHS England had mandated for the submission of the Regional plan. Jo Webster, Chief Accountable Officer for Wakefield Clinical Commissioning Group (CCG) came out to meet the group and said that the plans were aspirational and at this time, contained little detail about service reconfiguration. She confirmed that they had been sent that morning.
What does Sustainability and Transformation Plans (STP) mean? The remit from Simon Stevens, NHS England and NHS Improvement is to usher in so called ‘new models of care.’ As Martin Barkley put it in the public meeting on 23 August, ‘hospital at home’.
There are 6 principles, published by NHS England as explained in the diagram. Three of them are very noticeably focused on volunteers. It is not only campaigners who lie awake at night, worrying about the impact on the current NHS workforce, of these changes.
Section 3 focuses on equality and narrowing health inequalities. This is a very fuzzy phrase. What does it mean, especially in the light of the cuts North Kirklees CCG is already making, to certain medicines and certain procedures? https://www.northkirkleesccg.nhs.uk/your-views-on-proposed-changes-to-healthcare/
We assume it is narrowing health inequalities downwards, to the lowest common denominator. Everyone seeking NHS treatment is due less treatment in the future. The diagram contains what one campaigner has dubbed “Happy Talk”. It is an occasion where words obfuscate meaning. These occasions are becoming more common. When NHS officials talk about ‘value for money,’ ‘sustainable,’ ‘reducing waste’, for example, reach for the ‘ bullsh*t alert’ buzzer.
The New Models of Care need a ‘modern workforce’. This means that in the future you will not necessarily see a doctor. The fashionable phrase is “skill mix”. Dr Kelly said at the 23 August meeting, that with these new ‘practitioners’ ie. nurses, nurse practitioners, auxilliaries, people who have trained for 2 years rather than the 5 to 7 it takes for a GP, then there will not be such a need for GPs. In the US the third most likely cause of death in insured people, after heart disease and cancer, is preventable medical error. This is down to two factors never before found in the NHS, that is i) ‘commercial in confidence’ contracts, where regulators are denied access to the business ‘secrets’ and also ii)the less qualified staff.
This is particularly relevant in the NHS today as the BBC has reported that Durham CCG has appointed a private company to vet GP referrals to specialists. Does their contract include bonuses for keeping people away from consultants?
North Kirklees CCG has been asked this question “Do you use a private company for GP referral vetting?”, It realises that while Musculo-skeletal services are vetted by the new private provider,
it says it has not commissioned a company to vet other GP referrals.
Barnsley is in the South Yorkshire footprint, but it’s stroke services are compromised by the lack of consultants, so people with strokes are brought to Mid Yorkshire Hospital Trust at Pinderfields. MYHT also has some contracts with Barnsley’s Hospital Trust.
At the MYHT AGM it was revealed that the Trust has put on hold the removal of any more services from Dewsbury Hospital, at least until May 2017. A small win for campaigners.
Now that the West Yorkshire STP has been sent to NHS England, there is no reason why the West Yorkshire Regional Plan should not be published. Get your buzzers ready.