10 year plan for the NHS – Leeds KONP

The plan sets out how the NHS will use the extra £20.5bn a year by 2023-24 to drive improvements in the service over the next 10 years.

  • investment in “world class, cutting edge treatments,” including genomic tests for every child with cancer and artificial intelligence to potentially improve stroke diagnosis
  • a renewed focus on prevention to stop an estimated 85 000 premature deaths each year, including new dedicated alcohol and tobacco treatment services in hospitals, and an expansion of the diabetes prevention programme
  • a new guarantee that investment in primary, community, and mental health care will grow faster than the overall NHS budget2; the plan says this will include £4.5bn to fund integrated care across England
  • the “biggest ever” investment in mental health services, rising to at least £2.3bn a year by 2023-24,3 will include an expansion of community based services, including in schools, to help 345 000 more children and teenagers
  • a package of upgrades to improve neonatal services, including more specialists and expert nurses in units
  • extra investment in early detection in areas such as cancer and respiratory care
  • “every patient will have the right to online ‘digital’ GP consultations, and redesigned hospital support will be able to avoid up to a third of outpatient appointments – saving patients 30 million trips to hospital, and saving the NHS over £1 billion a year in new expenditure averted. GP practices – typically covering 30-50,000 people – will be funded to work together to deal with pressures in primary care and extend the range of convenient local services, creating genuinely integrated teams of GPs, community health and social care staff.”
  • The document warns that the H&SCA is damaging the NHS and stopping it from making vital improvements to the care patients receive.

Health Service Journal :

KONP website:

Rationing plan for 17 NHS treatments no longer to be commissioned by CCGs. Trusts are also urged to ‘grow their external (non-NHS) income’ and ‘work towards securing the benchmarked potential for commercial income growth’. They must set up systems to raise money by charging patients for treatment (‘overseas visitor cost recovery’) – a policy recently denounced by several medical Royal Colleges because of its impact on individual and public health.

The 44 discredited Sustainability and Transformation Plans, re-branded as Integrated Care Systems, will hold the regional budgets to control NHS Trusts. ‘Planning assumptions’ in each STP area are to be agreed by 14 January. Neither the STPs, nor the ICSs, nor the Long Term Plan has been mandated by an Act of Parliament, let alone by patients or healthworkers.

The private sector could gain control of individual ICSs through long term contracts to manage the entire health system within one region.

John Lister:

A depressing re-run of previous plans and gimmicks: the only novel proposals are for more central control and less accountability, for trusts to run more like and with private businesses seeking profits, and to raise money by undermining the principles and values of the NHS.

There is no reason to believe this plan, with even less local accountability and no serious plans for public consultation, will prove any more acceptable to the public or successful in implementation than the secretive STPs in 2016 or other previous failed efforts.

Campaigners have yet to see anything to recommend the new plans, or any indication NHS England is willing to come to grips with the crisis fuelled by chronic austerity limits on funding – or demand an end to chaos and fragmentation of the Health & Social Care Act.”

Kailesh Chand (GP; BMA)

Continuation of the NHS 2000 modernisation plan of the Tony Blair government. The end game is one where ‘NHS’ will simply be a ‘kitemark’ attached to institutions and activities of a system of private providers.

The whole of England is to be covered by integrated care systems (ICSs) in just over two years, with ICSs ‘central to delivery of the long-term plan’ which is essentially a market model of health care that can be taken over by the likes of Virgin and United Health.

ICSs and their focus on population health are seen as central to the plan: ‘triple integration’ – of primary and specialist care, physical and mental health services and social care. The private sector will be licking its lips at the prospect.

£20.5 billion funding will barely make up for eight years of austerity that have crippled the NHS and social care and undermined public health. The gap between policy rhetoric and supply has never been starker.

There is nothing in the plan’s outlined aspirations – keeping people out of hospital, caring for the vulnerable in the community, earlier diagnosis of treatable disease – that any right minded person wouldn’t want to do or make happen. The question is how are we going to meet the challenge? Where will the money and the personnel come from?

Analysis by the King’s Fund, the Health Foundation and the Nuffield Trust suggests the health service could be short of more than 350,000 staff if it continues to lose employees and cannot attract enough from abroad.

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sign this urgent petition against the transfer of Facilities staff and estate out of Leeds Teaching Hospital

Please sign this urgent petition against the transfer of Facilities staff and estate out of  Leeds Teaching Hospital into a separate company set up by the hospital.

This is a serious step in breaking up the NHS and making services and estates ripe for  privatisation. It’s also appallingly unfair to staff, sows strife, will have a knock on effect on the whole of LTHT and could turn out to be a very costly bit of tax evasion.

LTHT Facilities transfer to a WOC Unison petition 15.3.18

Airedale and Harrogate Hospitals have gone down this route within the last few weeks but we are hopeful of a fight back at Harrogate where staff are being balloted about taking industrial action. Leeds are moving very rapidly from informal consultation to formal consultations with staff and unions and there could be a decision taken at the LTHT Board Meeting on 29th March so we must act fast. Please sign and share  the on line petition set up by Unison https://www.ipetitions.com/petition/dont-transfer-loyal-staff-out-of-the-nhs,  as widely as possible, download the attached paper petition and take it to work, social events , meetings etc.

Any completed paper petitions can be returned directly  to the UNISON Branch Office at St James Hospital (Level 1. Room 039/040. Beckett Wing St James’s Hospital Leeds, LS9 7TF or left for  Michael Parkinson at the UNISON Regional Office, Commerce House

Minutes from last meeting

Issue

update

Junior docs contract dispute

Junior docs due to ballot on the latest offer at the end of June – result 6th July BMA organising road shows early June. There’s already much dissatisfaction re the significant shortfalls in the offer but not sure whether there is sufficient appetite for escalating action. At least one court case is ongoing and the outcome of the challenge re inequality for women might have an impact. Christine noted that GPs and Consultants are hard on the heels of the junior docs in autumn re their contracts.

Sustainability and Transformation 5 year plans to reconfigure services and cut the deficit

All new footprints ( ours West Yorks) have to submit their plans to NHS England by 30th June. Consultation has been virtually non existent. Simon Stevens has asked the Footprints to leave consultation until after they have received and examined the plans ie expect consultation after the fact and in August !! Please sign the petition insisting on consultation re STPs and raise questions at all the CCG meetings

https://petition.parliament.uk/petitions/130617

STP Questions asked at Leeds North CCG

Concerns re Sustainability and Transformation Plans – for Leeds North CCG 5.16

1 That CCGs are being forced to try to make unrealistic cost savings by a Government that has driven down the % of GDP we send on health to near the bottom in Europe – just over 8% while France Germany and the Netherlands are all near 11%. The CCG shouldn’t be colluding with the devastation of our health service. and acting as puppets on a string.

2. It is clear that the footprints are a desperate attempt to create a fast route to closing A and Es and hospital beds. This is a heavy handed top down taking of control by a Govt. who said in 2011/12 that it was introducing the Health and Social Care Act to disperse power over planning to local GPs. Now they are panicking about a 2.5 bn deficit we are back to top down control with menace ! The S&TPs feel a bit like Stalin or Mao’s 5 year plans!

3. The plans have not been tried and tested over time. Not only is there concern re the lack of independent evaluation of the recent Vanguards , what evidence there is suggests that improvements in community care ( and these are likely to be pretty limited in the current financial situation ) don’t necessarily have a huge impact on the need for hospital care and what impact there might be will manifest over time, not magic right by 2020.

4. Health bodies smarting at the Hobsons choice they / you have been given will say that at least we will get extra money if we do what we have been told. However Chris Ham from the Kings Fund suggests the most of the front loading of the £8bn promised will be swallowed up paying off deficits not creating new services and the Chartered Institute of Public Finance and Accountancy ( Cipfa) , not noted for being left wing, suggests that the shortfall in NHS spending is likely to grow by £10bn by 2020 and the 5 year forward view on which these STPs are meant to be based has already floundered.

5. One of the positive aspects of the footprints which is closer working together between Health and Social care should flash red warning lights as Social Care has been seriously degraded and largely privatised with LA budgets almost halved so the NHS is not integrating up , it is integrating down and will find itself neatly aligned with a service that already has means testing and charging at its heart. Just in the last few weeks there has been a lot of talk on the radio and in the press re charging and rationing as the Govt try to convince people we can’t a afford a decent, public health care system.

6. Care in the Community without proper funding is likely to put more pressure on families looking after their own with little help, which is most likely to mean increased burdens on women who probably form the biggest army of carers .This is quite apart from Agenda for Change pushing tasks down the chain and hoping for a barefoot army of volunteers to provide Custer’s last stand.

7. And how much do the public know about these changes or longer term vision for the CCGs to morph into Accountable Care Organisations like the Health Maintenance Organisations in the USA. Nothing I would suggest .

QUESTIONS

As I feel that the best hope for the NHS and quality patient care is that the public do understand what is happening, don’t like it and demand a change in the Government and society’s priorities to put health care pretty much top of the agenda, along with food in bellies and roofs over heads, I would like to know

  1. What the CCG is going to do about informing the public and seeing them as allies and not potential irritants to be kept quiet and

 

  1. What if anything this CCG is doing with other bodies like the H and WB Boards to tell it as it is and contest directives from NHS England and the Dept. of health, insisting on appropriate funding for the NHS before the NHs as we know it becomes little more than a rump service for the poor and most vulnerable. Some of the Hospital Trusts are now speaking out. Where are the CCGs?

Bootham Park and mental health services in York.

We went to the march in York on 12th June which had about 150 users and supporters of the mental health service. People are still being sent to Teesside for treatment and a large number of different sites are being explored for a new hospital unit.

We noted that we should give mental health a higher profile in our campaigning in Leeds.

Planned protest / stall outside Boots on Commercial St. Sat 4th June 2 – 3.30

John Puntis has put together an excellent piece on Boots drawing from the Guardian articles and sent it round staff at LTHT.

4th June is also the day for the Bursary or Bust demo in London so we will be collecting signatures supporting the nurses and other health workers who face loss of their bursaries

KONP at Triathalon Sunday 12th June

Agreed we aim for late morning on Sunday 12th ( poss 11-12. 30ish outside Brotherton Wing entrance of LGI when Millennium Square should be particularly busy

Public meeting with John Lister Wed 22nd June 7-9pm

Steady response to the facebook event invite. York Defend our NHS have said that some people from the mental health/ Bootham Park demo on 13th June have shown interest.

NHS Birthday

Tuesday 5th July

We have suggested to KONP that we try to highlight privatisation through protests outside private providers as well as doing any flag/ flower day / celebratory activities that week. Discussed a few possible targets for 4/4.30 – 6pm event on 5th . This likely to be discussed at KONP national Steering Group on Sat 11th June

There are now NO NHS dentists in Dewsbury !!

Possible Health Campaigns Together Conference in the autumn

Agreed we should offer a conference in Leeds. Adrian O’Malley’s mid Yorks Unison branch have offered to donate around £200 towards a venue. We though October good, avoiding school hols.

Next Leeds KONP Meeting Wednesday 8th June 6.30pm in O’Neill’s

TTIP trail today in Leeds

Take a break from shopping and join WDM, Leeds Uni students who have set up a trail across the centre of Leeds with different locations with each area affected/ threatened by  the Transatlantic Trade and Investment Partnership and learning about Leeds local history along the way:

11.15 The Corn Exchange –  trade  

11.45 Kirkgate market – food , local businesses

12.15  Briggate  – disputes  ( then brief lunch break)

1.15 Leeds Town Hall – democracy

2pm Millennium Square and Civic Hall – democracy and workers’ rights

2.45 Infirmary Street – health / NHS

3.15 City Square , Mill Hill Chapel, and Trinity – dissent

Press release: Leeds Council joins marchers ‘calling 999 for the NHS’

Councillor Lisa Mulherin proposed a  motion asking the council to support the founding principles and values of the NHS, and also called on the government to take the following immediate action:

  • Repeal the Health and Social Care Act 2012 and bring commissioning back together under local Health and Wellbeing Boards
  • Re-establish the Secretary of State’s statutory duty to provide and secure a comprehensive health service.
  • Remove the infrastructure which imposes competition on the NHS and which leaves it open to threat from the free market.
  • Ensure that decision-making at all levels in the NHS is open and transparent and that patients and the public are involved in designing services for the future.

The motion passed with the full backing of all Labour and Green Councillors on the 2nd of July, roughly a month before thousands of campaigners will come together to recreate the historic 1936 March from Jarrow to Parliament. They plan to present a petition to MPs asking them to halt the dismantling and privatisation of the NHS. Marchers will leave Jarrow on the 16th of August and arrive outside Parliament on the 6th September, with campaigners passing through Leeds on the 22nd and 23rd of August.

Advocating for her Motion Councillor Mulherin said

“this government’s reforms put private profit ahead of patient care, tying the NHS up in competition law, paying lawyers instead of putting money into patient services – Despite damaging headlines of failures in different parts of the system in recent years, the nation is rightly proud of the NHS, a publicly funded health service that provides universal care free at the point of need”

“People want an accountable NHS where resources go into improving outcomes and patient experience, not into private profits”

Councillor Truswell also expressed worry over the growing role of the private sector in the NHS.

“Research shows that private providers have won 70% of tenders for NHS services since the Act took effect and some CCGs have even contracted out their contracting staff. It is no wonder that Dr Mark Porter, Chair of the British Medical Association, the GP body, recently warned of a bumper year for multinationals and market lunacy diverting money away from patient care into the cost of contracting out services.”

The march comes from Harrogate on the 22nd August, arriving in Leeds around 5.30pm and leaves Leeds the following morning around 9.30am to march to Wakefield. A number of campaigners intend to complete the route in full from Jarrow to London.
Further pictures and comment available on request.

Contact: Joe Salmon, (Joesalmon1985@gmail.com) Mobile 07443 649879

Privatisation of the NHS in Leeds, the Better Care Fund, the Council

Health & Wellbeing Board and Health Scrutiny last week – trying to find unnecessary savings with another £2billion stolen from the NHS by the Treasury recently.

  • Leeds trying to save £24million out of a projected £163 million based on predicted demand with Better Care Fund (BCF) which is not new money but requiring savings to existing NHS acute care
  • Final version ofBCF submission signed off in March, 3 key high level risks:
    • consequences of proposals resulting through the complex nature of the Health & Care system and interdependencies
    • ability to release expenditure from existing commitments without destabilising system
    • due to short timescales to prepare submission (Leeds KONP suggest this is the ongoing rush to privatisation by Coalition), the inability to fully articulate the financial savings of the proposed scheme
  • CCGs preparing Quality Premiums with risks:
    • inability to effectively communicate variations in ambitions to citizens may cause disquiet
    • misalignment with provider plans may result in capacity issues in the system to meet demand
    • financial risk of non-achievement of Quality Premiums – needs to be a balance between realism and aspiration

In the Better Care Fund submission – p53 very high level risks scream out in particular

In order for the hospital sector to release efficiencies, it will need to close beds as activity drops

Sound familiar?

 Question: A member of Leeds KONP who regularly attends the meetings asked at Health and Wellbeing:

I would like to ask about the influence and attitude of this Board towards the commissioning of health services by the Local Authority. I understand that

  • the bidding process is now closed for a five year contract for Integrated Sexual Health Service starting April 2015 and
  • bidding for a five year contract for Community Drug and Alcohol Treatment and Recovery Service closes at the end of the month

If you are doing or will do anything at all to try to ensure that Addiction, Sexual Health Service and any others yet to be procured are run by people who will put the principles of the NHS before monetary concerns? I would also be interested to know how the Board envisages not just themselves but members of the public having a real say in the procurement process, having as one of your Board members said a few months ago – INFLUENCE not just VOICE?

Answer in summary: We want to improve services so the focus will be on improving in particular, quality.

The full answer will be in the minutes which will post here. It is no doubt delicate for a board to answer in front of a range of colleagues and the public but if members of the public are to be involved in decision making and allocated a few minutes to ask a question as others also want to ask questions on a range of issue that may be related to health (one was about noise pollution), what is our role in influence?

Its our NHS, developed, owned and paid for by the public. And we intend to keep it that way.