Join us tomorrow evening

Everyone is very welcome to the next Leeds Keep Our NHS Public meeting this Wed 29th6.30 – 8pm in the Victoria Hotel ( Bridget’s room) immediately behind Leeds Town Hall.

We will be discussing the latest NHS news, the new GP contract and the development of primary care networks and Integrated Care partnerships.

Planning will focus on

Ø The Northern Health Campaigns Together Conference in Leeds on 29thJune -publicity and organisation.

Ø A meeting with Angela Raynor, Jane Aitchison et al in Pudsey at 2pm on June 1st as part of a Labour Roots meet campaigners initiative. The Pudsey meeting focuses on public services. Places are limited and you need to request an invitation here. I have also been asked to give the organisers an idea of the numbers from Leeds KONP so if you can let me know if you are coming that would be helpful. There is also a LP rally in the Armouries at 6pm on 1stJune. .

Ø potential Leeds KONP stalls on 1st and 8th June

Ø the KONP AGM in London on 15th June. John Lister and Cat Hobbs from ‘We Own It’ will be talking about privatisation, Dr. Helen Salisbury, an Oxford GP and BMJ columnist will be talking about ‘Integration- What Kind of NHS Services do we want ?’ and James Skinner from MEDACT and Sophie Williams from Docs Not Cops will talk about “Hostile environment in the NHS ; Migrant Charges”. Join KONP and register for the Conference at https://tinyurl.com/y53wacfs . We also need to think about whether we want to submit a motion to the AGM

Ø Marion McAlpine’s photographic exhibition on privatisation in the NHS.. Keighley Library are showing it from May 29th to June 8th but Leeds Library have turned it down. Any other ideas welcome as it would be good to keep it up north at least until the Conference on 29thJune.

Ø Space 2’s exhibition on the NHS birthday will be in the Central Library from 13th June to 5th July.

Ø NHS 71st birthday Friday July 5th – we need to start planning our protest( s) / celebration

Primary Care Networks – how do we campaign for primary care?

Apologies – now updated link:

https://leedskeepournhspublic.files.wordpress.com/2019/05/pcn.pdf

From Healthwatch and Public Involvement Association:

Primary Care Networks: Frequently Asked Questions

Please find below a number of frequently asked questions about Primary Care Networks that have come through various engagement sessions. If your question is not listed below, you can send this to the Primary Care Network national team who will share a response england.pcn@nhs.net

These frequently asked questions are also available as a PDF document: Primary Care Networks: Frequently Asked Questions

What is a primary care network (PCN)?

A primary care network consists of groups of general practices working together with a range of local providers, including across primary care, community services, social care and the voluntary sector, to offer more personalised, coordinated health and social care to their local populations. Networks would normally be based around natural local communities typically serving populations of at least 30,000 and not tending to exceed 50,000. They should be small enough to maintain the traditional strengths of general practice but at the same time large enough to provide resilience and support the development of integrated teams.

Can you be a PCN without signing up to the new Network Contract DES?

General practice is at the core of any PCN and £1,799 billion will be made available to GP practices in PCNs via the Network Contract DES by 2023/24 as well as an additional £14,000 each year that a typical practice will receive from April 2019, in return for their initial and then continued active participation in a Primary Care Network.  We are committed to 100% geographical coverage of the Network Contract DES by 1 July 2019.  PCNs will need to sign up to the Network Contract Directed Enhanced Service to be able to benefit from the investment to be allocated through it.

Which organisations form part of a primary care network?

Primary care networks will be expected to have a wide-reaching membership, led by groups of general practices. This should include providers from the local system such as community pharmacy, optometrists, dental providers, social care providers, voluntary sector organisations, community services providers or local government.

What are PCNs designed to do?

Primary care networks will provide proactive, coordinated care to their local populations, in different ways to match different people’s needs, with a strong focus on prevention and personalised care. This means supporting patients to make informed decisions about their own health and care and connecting them to a wide range of statutory and voluntary services to ensure they can access the care they need first time. Networks will also have a greater focus on population health and addressing health inequalities in their local area, using data and technology to inform the delivery of population scale care models. As an example, this will be supported by the introduction of a new Tackling Neighbourhood Inequalities Service Specification to be delivered by PCNs signed up to the Network Contract DES from 2021/22.

Primary care networks will also help ensure that the NHS designs support and services to get the best possible value out of their funding for their local communities.

How many PCNs currently exist across the country?

As of 30 November 2018, 93.4% of practices across England considered themselves to be part of a network. This is based on CCG responses to the monthly GP Forward View Monitoring Survey.  In light of the more detailed information included in the Long Term Plan and “Investment and evolution: A five-year framework for GP contract reform to implement The NHS Long Term Plan” about the role and requirements of PCNs, groups of practices will be reviewing their position.  PCNs will exist formally once they have met registration requirements for the GP contract Network Directed Enhanced Service (DES) and been approved by their commissioner. The Network DES will start from 1 July 2019.  Information is available in the recently published “Investment and evolution: A five-year framework for GP contract reform to implement The NHS Long Term Plan”.

How would members of each PCN be decided?

Membership of a primary care network will be down to local agreement, dependent on the needs of the local population. However, each PCN should have a boundary that makes sense to: (a) its constituent practices; (b) to other community-based providers, who configure their teams accordingly; and (c) to its local community, and which typically covers a population of at least 30,000 and not tend to exceed 50,000. Each PCN will be required to appoint a named accountable Clinical Director who does not have to be a GP. Information is available in the recently published “Investment and evolution: A five-year framework for GP contract reform to implement The NHS Long Term Plan”.

What are the core characteristics of a PCN?

The core characteristics of a PCN are:

  • Practices working together and with other local health and care providers, around natural local communities that geographically make sense, to provide coordinated care through integrated teams
  • Typically a defined patient population of at least 30,000 and tend not to exceed 50,000
  • Providing care in different ways to match different people’s needs, including flexible access to advice and support for ‘healthier’ sections of the population, and joined up care for those with complex conditions
  • Focus on prevention and personalised care, supporting patients to make informed decisions about their care and look after their own health, by connecting them with the full range of statutory and voluntary services
  • Use of data and technology to assess population health needs and health inequalities; to inform, design and deliver practice and populations scale care models; support clinical decision making, and monitor performance and variation to inform continuous service improvement
  • Making best use of collective resources across practices and other local health and care providers to allow greater resilience, more sustainable workload and access to a larger range of professional groups.

How does a PCN differ from a GP federation?

A GP federation is generally a group of practices that come together to deliver services whereas a PCN is a broader collaboration of practices and other health and care partners’. There is also published material from the BMA and RCGP about the different structures federations can take. These are not mutually exclusive and can co-exist to deliver a broader set of integrated out of hospital services for their local communities. Work is underway to better understand/set out the relationship between PCNs and federations using practical examples.

Will areas that already have established federations need to change their delivery plans to fit smaller scales?

PCNs will typically serve populations of at least 30,000 and not tend to exceed 50,000. This is because they need to operate at a level which maximises economies of scale, but is small enough to ensure understanding of local population needs. PCNs can be bigger than 50,000 if they meet all the registration requirements under the Network Contract DES but in reality, may require organising themselves into smaller neighbourhood teams within the 30,000 to 50,000 population size. But it would create extra bureaucracy to require each of these internal teams to register as a separate network.

The guidance around PCN size is provided to help areas early in their journey of developing PCNs have some structure to work around. It is anticipated that those PCNs with very different sizes will be able to articulate a clear reason why; and how they are working in a network way with other partners.

If a PCN is smaller or larger than the 30-50,000 population as noted in the reference guide, will this be an issue?

PCNs will typically serve populations of at least 30,000 and not tend to exceed 50,000. This is because they need to operate at a level which maximises economies of scale, but is small enough to ensure understanding of local population needs.

In exceptional circumstances commissioners can agree to vary the 30,000-population floor most likely where there is a low population density across large rural and remote areas.

PCNs can be bigger than 50,000 if they meet all the registration requirements but in reality, may require organising themselves into smaller neighbourhood teams within the 30,000 to 50,000 population size.

What contracting forms will be available to PCNs to enable them to deliver services / employ staff, receive funds?

The Network Contract will be implemented as a Directed Enhanced Service (DES) for GP practices. It will start from 1 July 2019, subject to primary care networks having met the registration requirements and been approved by their commissioner.  The DES Directions and DES Enhanced Contract Specification will be published by 31 March 2019. Supporting guidance and information will be published at the same time.

Who will hold the Network Contract?

The Network Contract will be a Directed Enhanced Service held by GP practices, and underpinned by a Network Agreement between them. Practices with an in-hours (essential) primary medical care contract will be eligible to sign-up to the DES as part of their network. Federations cannot hold the Network Contract DES.

Given the integrated nature of PCNs, is the GP contract for general practice or for wider groups of providers?

If a PCN doesn’t have a core set of GPs and practices, it isn’t a PCN – the Network Contract DES is a mechanism for flowing funding to PCNs, and general practice is expected to be the  core around which PCNs are built upon.

Who will be accountable for delivering the PCN element of the GP contract, will it be the clinical leads or individual practices?

The Network Contract DES is contractually practice-based. It will be the collective responsibility of the PCN GP practices to deliver.

What if some practices are not included in a network, either through choice or through being left out?

Every practice will have the right to join a Primary Care Network in its CCG, but the Network Contract DES remains voluntary. Close working is needed between Clinical Commissioning Groups and Local Medical Committees to help ensure 100% coverage is achieved.

In the highly unlikely event that a practice doesn’t want to sign-up to the Network Contract DES, its patient list will nonetheless need to be added into one of its local Primary Care Networks to ensure all patients have access to network services. That PCN then takes on the responsibility of the Network Contract DES for the patients of the non-participating practice through a locally commissioned agreement. The practice remains responsible for delivering core contract services to its registered list,

From 1 April 2019, a new SFE Network Participation Payment will be introduced, payable for practice activity to support the delivery of network services to its population, thereby achieving 100% coverage of the population within a PCN. A typical practice will receive over £14,000 each year (this is a practice size of approximately 8,000 patients). This payment will only apply to practices who sign-up to the Network Contract DES on an ongoing basis as an active participant. The payment will be payable from 1 July 2019 following commissioner approval and will be backdated to 1 April 2019.

  1. If funding is to flow at a network level, what is to stop the highest performing practices joining together to get the gains – resulting in a two tier system where lower performers are forced to buddy with similar practices?

We anticipate that practices will work together in geographically coterminous areas, rather than because of historic performance. The ongoing development of PCNs should be reinforced by strong system leadership, which should dispel some of this fear locally.

All Primary Care Networks will have a Network Agreement, even those with one large practice. This is because the Network Agreement is both the means by which the Primary Care Network describes how the practices will work together to discharge the Network contract but also how it will partner with non-GP practice stakeholders. It is needed for the PCN to claim its financial entitlements and deliver national and local services to its whole Network list and area. Delivery and achievement of the contract requirements will depend on collaborative working by network members.

How do you know if you are in a PCN – is there an “official” designation / national recognition or do you just call yourselves a network?

As set out in Investment and evolution: a five-year framework for GP contract reform to implement The NHS Long Term Plan, there will be a registration process whereby PCNs will need to be recognised and meet minimum requirements to sign-up and participate in the Network Contract DES and be eligible to claim financial entitlements. The core characteristics of a primary care network are set out in the PCN reference guide (available in draft at https://future.nhs.uk/connect.ti/P_C_N). Practices should refer to the reference guide to help guide the development of their network and to help provide further details about some of the core components of a PCN. The guide is intended to give a sense of the starting point for a network and each step along the way as practices begin to work together.

How does the governance structure of each PCN work – do you anticipate a board style set up with a clinical lead?

It is a requirement of the Network Contract DES that every primary care network would have a named accountable Clinical Director who does not have to be a GP. However the governance structure within a PCN will be determined locally and recorded as part of completing a nationally mandated Network Agreement. We anticipate there will be a variety of staff engaged in the structure of each network.

If each PCN is to have a Clinical Director, how are these to be appointed?

Each PCN will be required to appoint a named accountable Clinical Director. A description of the role is available in the recently published “Investment and evolution: A five-year framework for GP contract reform to implement The NHS Long Term Plan”. Work is currently underway, as part of the national support offer, to review the core characteristics and skills needed for this role and further information will be made available shortly.

If clinical leadership is seen as key to the development of PCNs, is there funding for this as part of the contract?

A Primary Care Network must appoint a Clinical Director as its named, accountable leader, responsible for delivery.

Together, the Clinical Directors will play a critical role in shaping and supporting their Integrated Care System. They will help ensure the full engagement of primary care in developing and implementing local system plans to implement the NHS Long-Term Plan. These local plans will go much further than the national parts of the Network Contract DES in addressing how each ICS will achieve the commitments set out in the Long Term Plan.

In recognition of the importance of this role and as a contribution to the costs, each Network will receive an additional ongoing entitlement to the equivalent of 0.25 FTE funding per 50,000 population size. The amount will vary in proportion to network list size. The legal entitlement under the Network Contract DES starts from 1 July 2019.

We want to develop our own version of the PCN maturity matrix locally; can we?

PCNs are a critical building block for the development of the NHS to a population focus for health and care improvement. They need to align with and support work at neighbourhood, Place, and System levels. For this reason, it is important that whilst they should develop in a way that meets their specific local needs, they must also provide a consistent level of support and integration with the wider health and care system. The maturity matrix is designed to enable local innovation within a national framework. All systems should use the provided maturity matrix in the first instance to assist with assessing relative maturity of their networks. We are aware that in some instances, building on this maturity matrix and adapting it for local use has led to positive engagement of all networks, which we would encourage.  All PCNs will need to consider the evolving requirements of the Network Contract DES as they mature and plan for this.

Will the PCN maturity matrix be used for performance management?

The maturity matrix is not an assurance vehicle for PCN performance. It is a key tool to be used to assess both current maturity and provide direction to developing PCNs. PCNs will need to consider the evolving requirements of the Network Contract DES as they mature and plan for this.

How do you make GP partnerships (that are separate businesses in their own right) collaborate with other practices/partnerships?

The Network Contract DES will support practice/partnership to achieve collaborative working and the Network Agreement will set out how they will do this.

Where is the evidence that large scale networks are more financially sustainable than individual practices?

Joint working between practices is nothing new.  The new Network Contract DES provides significant funding to support practices to formally work together, irrespective of their individual motivations for doing so.

There have been a number of reports conducted into the sustainability of primary care networks all over the world.

A selection of these can be found below:

How do you balance these proposals against the evidence that patients get better care from small practices that provide the most continuity?

The development of PCNs does not take away the need for a local neighbourhood ‘presence’ in terms of a GP practice, it enables a local focus set in the context of collaborations that bring together those services that need to be provided at scale. A PCN approach will drive continuity of care for those patients with complex long term conditions as ultimately it will ‘free up’ GP time to focus in more complex areas whilst using alternative practitioners to see those with routine needs. A PCN’s role is about looking at the population health needs and this is will involve working with patients and the public to understand their needs and requirements to deliver the best solutions to meet these.  This will involve balancing for example choice and convenience of services and the scale the services are delivered at.

To read about the research completed on continuity of care and primary care networks

What monitoring and assurance will the national team be asking of CCGs?

We are working with local teams to develop an appropriate approach that helps provide the right level of assurance. This will initially focus on confirming practices are all part of a PCN by the end of June 2019.

CCGs (or NHSE local teams for the small number of CCGs without delegated primary care commissioning), will be responsible for overseeing the Network Contract DES registration process and ongoing assurance of PCNs’ delivery against the requirements of the DES. A new Primary Care Network Dashboard will be introduced from April 2020 to support the assurance process. CCGs, working with LMCs, must ensure all practice lists are covered by a Primary Care Network in their area for the provision of network services.

What is the PCN development programme?

The PCN development offer will provide support to the system to meet policy commitments and enable the creation of effective and sustainable PCNs. It will have a focus on providing capacity to local teams and building capability in two key areas:

  • Leadership development (including relationship management)
  • Organisational development (including team development and change management)

Delivery options for the development support offer are still being agreed.

How do you envisage securing and funding sufficient and appropriate local organisational development (OD) capacity and expertise?

We have carried out significant engagement with the system and continue to do so as we develop the PCN offer.  Our aim is to ensure that we secure ‘the right’ support and that it gets to ‘the right’ place based on need. The support must add value and not duplicate offers that are already available.  Understanding the local context is essential to this, hence the focus on engaging with the system and regions.

What will the process be to access the development offer funding?

The process to access the PCN development support offer is still in discussion. However, it is likely that funding will flow to ICS/STPs for them to draw down specific development support from a nationally agreed framework based on their local needs.

Have LMCs been involved in decisions on how development funding will be allocated?

The national team have engaged with a range of stakeholders which has included local LMC representatives, regional teams, CCGs and primary care staff, including GP federations and practice managers in designing the primary care networks development programme.

There is a lot of health and care wider work being implemented in relation to PCNs, however some areas are broader that – working with schools, community development, fire service etc. When NHS England talks about funding and support, are we talking specifically about funding general practice to develop PCNs, or is this funding for systems to develop integrated working?

Any funding specific to PCN development will need to be used based on the needs of the local system. Nationally we would support using the development funding to support integrated working, however the decision about this will be for local determination.

Is the support offer aimed at practices or all partners of a primary care network?

All practices and partners within a PCN, in line with local context and need.

Who will be providing the development support offer – will it be CSUs or an external provider?

Work is underway to determine the best way to deliver the development support needed by the system. It is likely that there will be a ‘menu of support’ covering a number of elements which will be provided by a variety of providers.

What do you mean by values and behaviours on your leadership development support?

This is about giving teams the space to discuss the sort of environment that they would like to work in, what values are important to them so that local teams can develop a culture whereby staff feel valued and supported and are aligned with the values of the NHS. By behaviours we mean leading by example, whatever role you may be in, it is about treating others with dignity and respect.

Many ICSs have recognised that much of the PCN maturity matrix (especially stages 2 and 3) is dependent on developing population health management skills and capability. Will there be any provision for this in the support offer?

Support is already being provided to ICSs to help them build population health management capabilities to turn data into actionable insight for primary care networks and integrated teams. The learning from this early work is being bought together to provide a range of practical resources and further advice and support. To access the practical guidance and learning to date, please email england.STGPHM@nhs.net to join the PHM Network.

Are there opportunities for networks to help improve workforce health and wellbeing (which might be challenging at practice level), and is this something that would be supported as part of the development support offer?

Yes, this is integral to the development offer that is being developed based on feedback from the recent workshops and is exactly where we want to focus resources.

How will the time for care programme be used going forward to support the OD and QI skills to be developed across general practice? Will the programme be continued beyond March 2019, and in what context?

The Time For Care Programme is continuing in 2019/20 and beyond. The programme will continue to focus on quality improvement and change management working with practices, groups of practices and PCNs depending on local need.

Is this a replica of the NAPC offer?

NHS England has worked with NAPC to provide support to local areas to develop Primary Care Homes (PCH).  The NAPC Primary Care Homes approach has created a number of strong demonstrators of how excellent PCNs will work in the future and has informed our approach to designing PCNs, but it is not the only model. The NHS England PCN development programme will be designed to offer a range of support whereby ICS/STPs can draw down support relevant to them and their local PCN needs. Local systems should work with the partners who can best support the approach to PCN development that fits with local ambitions.

Is consideration being given to core contracts development for dentistry, pharmacy and optometry so they dovetail with what is being asked of medical primary care to align strategic direction of travel for all?

The national PCN programme team are linking with a number of stakeholders to ensure all future planning is aligned.

Are there any examples or resources available for us to share with practices on what’s worked well?

Further examples and case studies are available on the NHS England website at www.england.nhs.uk/pcn. Information is also being shared via weekly webinars involving presentations from local areas who are already working as part of primary care networks. Full details are listed on the above web page.

Additional resources and guidance related to the development of primary care networks are also available on the primary care networks FutureNHS site at https://future.nhs.uk/connect.ti/P_C_N/grouphome and further documents are being produced. Please email england.pcn@nhs.net to request an invitation to join to platform.

How can I contact the national PCN team with any further questions?

Please email england.pcn@nhs.net and a member of the team will be in touch.

Latest news

Opportunities for influencing Labour policy:

Individuals and groups can read Labour’s key policy papers on line and contribute comments, criticisms
ideas etc . There are also 2 papers on forms of ownership and co-production of services. ( Alternative
Models of Ownership and Democratic Public Ownership.

We can put motions through branches and CLPs to Conference. D noted that for the first time this
year branches can put motions relatively late in the day without them having to flit the slot as a
contemporary motion. S/he thinks the deadline is late July.

We can try to influence the local election manifesto. This was attempted via the campaign group mtg, for the recent election but most of the input from KONP LP supporters didn’t make the final cut which
focused more on Labour’s local achievements such as having developed much better preventative
services in mental health.

In discussion, the local councillors say that there is little they can do about
the big political issues. What was folded into the manifesto was a commitment to give local people
open and honest information about wat is happening

We can raise issues/ make challenges to local councillors via direct meetings, e mails or letters. In
response to a question, we thought we had some impact doing this in 2018 when the ACOs were mooted and when the LA was asked to sign up to a Memorandum of Understanding for
setting up the West Yorks and Harrogate Integrated Care Partnership.

The Council refused to sign the NHS’s initial draft MOU and managed to get some significant alterations ( on paper !) regarding recognition of the social determinants of health, commitment to more transparency and accountability, avoiding being pinned down to a control total etc. etc.

West Yorks Campaigners have also had some influence in getting the Council to formally set up a West Yorks and Harrogate Joint
Scrutiny Board to scrutinise developments with the W Y&H Integrated Care Partnership/System.

In addition we can and do ask questions at Health and Wellbeing Board, joint West Yorks and Harrogate Scrutiny Board and local and West Yorks CCC meetings. There is no slot for questions at Leeds Scrutiny
Board although this is something we should take up. We could submit an issue for Scrutiny. If accepted
this would mean we get the opportunity to speak to the Board.

KONP is on the list to be invited to meet with Shadow Ministers et al in Leeds on June 1st, assuming
their visit to Leeds comes off. The plan is for several different sessions in different areas of Leeds, each
involving a mixed bag of local campaigns/ campaigners.

Influencing LP policy and Practice:

John Ashworth, Shadow Minister for Health has been talking to KONP and Health Campaigns Together. At
the recent HCT AGM he endorsed the broad sweep of our demands and the Reinstatement Bill. Barbara
Keeley , shadow minister for Social Care is doesn’t seem to be in the same space.

Local Councillors should be demanding that they have a say and we should be trying to persuade labour that it is not enough just to be preparing for Government ; they
should be building opposition at a local level.
We had a wide ranging discussion and identified a number of areas where we should be seeking to involve
and challenge the labour Party

Resolutions to Conference
2017 Conference reference back of the NHs policy and good resolution passed calling for non co-operation with Accountable Care Organisations has probably only just worked its ways through LP procedures so is still extant. No one was aware of any new draft motions to this Conference in circulation.

It is understood that the LP accept the gist of the NHs Reinstatement Bill .
Action :
– check whether the Socialist Health Association, KONP or anyone else close has a draft motion and
consider whether and what we might want to put to branches/CLPs.
– Ask people to put the Social care motion already circulating. Already putting it to Kirkstall branch

Working around Elections
Action:

We should consider producing a flier to use in the Euro elections and be prepared with a strategy if / when a general election is called. ( hustings ? , eliciting and publicising candidates’ commitments on
the NHS and Social Care / pledges etc.

Social care:

Action
We need to do more to challenge councillors to
– raise an outcry re shrinking social care services, patchwork of private providers, poor quality,
inadequate training and high staff turnover, undervaluing of the care economy etc
– bring domiciliary services back into public control – reverse outsourcing
– insist on ethical commissioning : living wage , standards of training , social value etc

Local privatisation CAMHS , private wards:
Sylvia has been taking up major concerns re the building of a new Child and Adolescent mental health Unit on St. Mary’s Hospital with MP Rachel Reeves et al on behalf of Leeds Hospital alert and Unison Retired
members are now supporting.

Interserve has the contract for building the unit and a fair degree of running it but they have gone bust / into administration, although there are manoeuvres to keep running.
Villa Care are running 5 step down wards within the NHs to try to get people off acute wards as there not
as there are not enough beds for new people. Many can’t go home because social services aren’t in place.

We need to get clear exactly what is happening now with Interserve and CAMHS and take this up widely with Labour MPs and councillors. We also need to publicise and challenge the use of Villa Care and the wards which are essentially warehousing people largely because of gross underfunding of Social Care.

Rapidly creeping changes in GP service/ Primary care:
John noted that GPs are being pressured into signing up to a new primary care network contract and by
carrot and stick ( bullying by any other name – G).

GPs are retiring faster than they can be replaced; they are struggling with endless new demands; people are waiting too long to see a GP, tasks are being pushed down a skills chain, the individual doctor patient relationship is on the way out, digital firms like Babylon are keen to move out of London and have mentioned Leeds.
Action
We need to take up campaigning / protesting about the shrinking and fragmenting of the GP service
with public and GPs and urge local Labour to get involved. KONP have just produced a draft primary
care charter, 999 and others are asking GPs not to sign up.
John is talking to /with SHA about this this weekend and we need to get our position firmed up and a campaign strategy implemented locally.

Migrant Charges, not right, not fair, not financially fruitful, risks individual and public health and thin
end of wedge:
Action
-Talk to the Trade Unions re launching a joint campaign and involve organisations s for asylum seekers .
( The Conference on 29.6 will raise the issue)
– Publicise through fliers, letter to YEP, facebook etc,
– press Labour to take up the issue with us.

NEXT MEETING Wed 29th May 6.30 – 8pm in the Victoria Hotel
NB Join the LEEDS KONP banner at Banners held High in Wakefiled Sat 18th May 11.30pm
in Smythe St. near Westgate Station

Northern Health Campaigns Together Conference flier and latest actions

HCT flier HCT_Northern_Conference_29.6.19_early_bird__flier_23.3.19

Minutes KONP_Leeds_mtg_24.4.19

Coming up

Sat. May 4th TUC Mayday march 11.30 at Art Gallery – need people to carry KONP banner, placards etc and give out fliers.

Wed May 8th 6.30 in the Vic : Leeds KONP discussion on Labour with Councillor Paul Trusswell – need to advertise and draw others in.

Sat. May 18th Banners held High Wakefield : parade, film, talks, theatre, stalls . Assemble 11am at Smyth Street, WF1 1ED near Westgate Train Station The theme this year is “A Land Fit For Heroes? “ in the aftermath of World War One so very relevant to us. The PCS Samba band will be there !

Sat 1st June and maybe also Sat 8th June : Leeds KONP stall – time and venues to be posted

Sat 15th June KONP AGM in London

Sat 29th June Northern Health Campaigns Together Conference at St. George’s Centre next to LGI ( see early bird flier attached )

NHS 71st birthday events ( on or around 5th July ) Ideas welcome; details to be decided.

Sat 13th July : Kirkstall Festival – looking at running a stall with support from Leeds Hospital Alert 11 – 4ish

Date of Next Meeting Wed. May 8th discussion on Labour policy and practice and how we can influence it from inside and outside the party. 6.30 -8pm in the Victoria Hotel, immediately behind Leeds Town Hall

 

Yorkshire Health Campaigns Together notes

Yorkshire HCT meeting 12.4.19
1. NHS national news : John highlighted victories in saving Charing X and Ealing Hospitals
2. Updates from local groups
Dewsbury: Christine organised 3 showings of John Furze’s film Groundswell in Dewsbury, Halifax and Huddersfield at which John talked and answered questions. The Save Dewsbury Hospital campaign is also going to cafes and surgeries to share info and collect personal stories about the loss of Dewsbury A&E. They plan to put these together in a bulletin to be sent to the CCG, councillors and MPs.
York : Anne and Sylvia noted that campaigners are putting on a photo exhibition to show people what they have lost with the closure of Bootham Hospital. They have been pursuing the re-purposing of the building as a hub for mental health services without much success so far and chasing what has happened to the antiques and other valuable contents which seem to have disappeared from the building. The building of the new mental health facility out of the centre is delayed. ( This means that plans to shut Harrogate’s Briary Unit and send patients to York are also delayed ) .
Gwen said they have also submitted a question to the CCG re closures in Scarborough and Bridlington which she described as part of the “death of rural health”
Bradford: Ann West Said that Unite the Community were proving to be good allies in the fight to save the NHS and the rest of the welfare state.
Barnsley: Nora said that South Yorks had a meeting on Digital services with someone well informed from which it was clear to her that NHS Digital are not bothered about the rules re info sharing.
The mental health forum are writing to the DWP re serious concerns re proposed plans to set up a team in the Dept. of Work and Pensions which will create a system to more quickly access people’s health data to help them to determine how much welfare support they are entitled to.
The 5 South Yorks and Bassetlaw CCGS are now developing a joint plan to delegate more decision making to the relatively newly formed Joint CCG. South Yorks and Bassetlaw NHS Action Group are working with Rotherham campaigners to challenge the CCG over the total lack public involvement.
Showings of John Furze’s film Groundswell have been arranged in Sheffield and Rotherham.
Nora has gate-crashed 2 webinars on patient involvement and suggested others might do likewise.
Leeds Hospital Alert: Sylvia noted that Leeds and York ( mental health ) Partnership Trust have cut services and are charging for groupwork. New models of provision exclude people with long term mental health problems such as bipolar disorder and schizophrenia. Cases get closed when patients are too easily said to be “not engaging, nearest relatives are not able to request assessments and people are expected to refer themselves for psychological therapies. She is pursuing concerns with MP Rachel Reeves who has promised to raise them with Matt Hancock.
Hands off HRI Chris noted that the campaign is now in its 4th year. They have managed to maintain a lively and powerful presence but are have to keep countering the notion that the plans to close A&E and other provision at Huddersfield are a done deal. They have specialists examining the latest proposals for HRI in detail and are conducting a People’s Commission.
Chris is also working through the Labour Party and standing for council in the Newsome ward at the local elections in May. NB from Gilda – Colin Hutchinson is doing good work on WY&H joint Scrutiny Committee as a Labour Councillor
Airedale : Judith Joy said that their biggest fight is to keep Castlebury Hospital in Settle. Community campaigners were told that it would be restored and a lift put in but are now battling against the argument that this is unaffordable.
The 38 Degrees group meets in Keighley and are talking to a local cinema about showing “Groundswell”. They have obtained agreement from the local library to show Marion MacAlpine’s recently updated exhibition on privatisation in the NHS from May 7th – 25th. They have tried other places in North Yorks without success but there is potential for keeping the exhibition up north for a while if other groups are interested.
G. said Leeds would be keen and would like to add some local examples. York may also be able to use it.
Judith and Viv noted that it is hard work trying to get people interested and fired up about campaigning for the NHS or even seeing what is going wrong. This sparked some discussion about de-politicisation and lack of info. which Anne put in some historical context. We also had more discussion and some disagreement about the trade unions and at least agreed that they are much weakened but we are keen to involve health workers and campaign together where possible. The issue of involving conservatives particularly in rural areas was also raised.
Sheffield : John Carlisle noted that he has been involved in helping to set up a Yorkshire Branch of the Socialist Health Association. They are going to focus on Economics, highlighting the cost of waste, including PFI. They would also like to assist groups and have an excellent expert on modern monetary theory- Frances Hutchinson from Keighley. They are planning to put themselves about, prepare questions and populate various debates, starting with Sheffield Festival of Debate !9th April – 1st June see https://static1.squarespace.com/static/58b55bf2197aeabd5a9d1604/t/5c86677753450a49a40deb08/1552312224055/FofD+2019+Brochure+for+WEB.pdf They are also aiming to focus on Simon Stevens – bringing him down! This prompted some discussion on the importance of pushing the economic argument that we can afford the NHS, the multiplier, MMT etc.
Leeds: Dawn noted that her community arts organisation SPACE 2 obtained heritage lottery funding for putting together an exhibition around the NHS 70th birthday (“Many Happy Returns”) based on people’s stories. They have been working closely with Leeds KONP and the stories are printed on to an armchair, screens, banner etc. Part of the exhibition is currently on show at the Thackray Medical Museum which closes shortly. The full exhibition will be on show at Leeds Central Library 13th June to 5th July.
Gilda noted that Leeds KONP have arranged to have a stall at Mark Thomas show “Check Up : NHS at 70” at Wakefield Theatre Royal on 18th April and would welcome material from other groups. The show is being filmed and Mark’s team have said it is Ok to bring banners etc.so we hope to have a lively presence both inside and outside the theatre with a spot of melodeon playing and potential singing as well. The show is at Sheffield on April 16th and 17th. Leeds KONP has also had some discussion with Unite and Leeds TUC re the possibility of bringing Banner Theatre’s NHS show to Leeds. It costs £800 so would need joint funding.
West Yorkshire County Association of Trades Councils : Pete Keal said that they are trying to instigate and co-ordinate joint action across the different TUCs and thought that at least one focus should be West Yorks and Harrogate STP/ICP/S . One place to start might be a workshop or mini Conference for TUCs but they are open to suggestion. Pete also mentioned that local TUCs can get development grants of up to £300 which might be relevant for Banner theatre or other such initiatives.
3. Update on the severe restriction of 17 interventions deemed to be of low value.
John Puntis reported that he has been challenging NICE re their guidance and involvement and had a letter printed in the British Medical Journa . This notes that some recommendations contradict NICE guidelines and concludes
“NHS England’s cost cutting approach enforced through financial levers disregards the principle that “at the centre of medicine, there is always a human relationship between a patient and a doctor.” Moreover, the essence of evidence based medicine as the integration of clinical experience with the best available research information and patient values is undermined if the view of the patient is ignored.”
Meanwhile local areas continue to impose their own rationing. IVF is severely restricted and subject to a post code lottery and the thresholds for cataract surgery have been raised so high that people are going blind before they can get treatment. Orthopaedics, particularly joint replacements are expected to be high up on the next list of treatments rationed.
We agreed that the private sector will thrive on ops the NHS rations and NHSE has been actively pushing CCGS to commission private providers to do ops to cut waiting lists. Nora noted that where clinicians did speak out against rationing in South Yorkshire they have experienced a backlash.
4. Brief Review of the Yorkshire March for the NHs and any ideas arising from the experience this year.
There was general agreement that the march was useful in getting our messages across via public and social media, bringing campaigners, trade unionists, Labour Party branches et al together and boosting the confidence and morale of campaigners which has been somewhat eroded by the Brexit smog. Many members of the public clapped and took pics.
In terms of what we might learn for the future Anne Leonard said , to general agreement , that given we have a national network there should be the opportunity to make such events happen up and down the country at the same time which would increase impact
5. HCT Northern Conference
Gilda noted that The NHS section is sorted. We need at least one more speaker on Social Care, ideally from the Disabled Rights movement, which she will chase. We have given mental health its own slot but only 45 mins as trying to cover three bases. KONP is putting together a very short video piece on mental health, Sylvia is sounding out a local consultant psychiatrist and we hope York Mental Health Action group will contribute. The aim in all sections is to have short, thought provoking contributions which leave plenty of room for discussion on the floor and formulating ideas for action.
6. Consultations on the NHS long term plan
NHSE’s short survey on legislation in the long term plan closes 25th April. You can complete at https://www.engage.england.nhs.uk/survey/nhs-long-term-plan-legislation/ Healthwatch are also running consultations, not just in Leeds. John wondered if other areas have positive relationships with or experiences of Health Watch but this doesn’t seem to be the case in Yorkshire.
John also noted that We Own It and KONP are joining forces to encourage people to say they want rid of S75 but want NHSE to go further and get rid of all privatisation in the NHS. People agreed that it was important not to give any illusions that getting rid of S75 would end privatisation.
7. Charging ‘migrants’
John is pursuing his FOI re migrant charges in Leeds. It is understood that Unison have a motion to their national Conference against the charges. If someone owes more than £500 for health care they can be reported to the Home Office. Quite apart from the deliberate intent to create a hostile environment for migrants, the unfairness, risk to life and health of a particularly vulnerable sector of society and dangers to public health, charging migrants is the thin end of the wedge to charging all of us in for health care. Sylvia said that charges in Social Care have been ratcheting up and debt collectors employed to pursue non payers.
8. Other upcoming events
1. Stacey Booth, GMB, advised that there is a protest outside Barnsley Hospital on Wed 17th April 10.30am organised by GMB to protest the change in payment system for ISS catering staff .
2. Sat. May 4th: Many areas have Mayday Marches. Groups will be taking NHS campaign banners.
3. Sat. 18th May in Wakefield : Banners Held High celebration of working class and labour history takes as its theme “A Land Fit For Heroes? “ in the aftermath of World War One. The parade assembles at 11am at Smyth St then there are films, theatre, talks, exhibitions and stalls. The event looks at the resonances for today and also welcomes the Labour Party pledge to repeal the Trade Union Act 2016.
Summary of shared ideas and action arising from our discussions
1. Film, theatre, comedy, exhibitions are a good way to expand our audience and reach out beyond a small circle of people already interested.
ACTION:
Judith Joy will check out and advise whether we can keep Marion MacAlpine’s photographic exhibition on privatisation : “How come we didn’t know” in the north after their showing at Keighley library 7th – 25th May. Leeds interested late June and maybe for our Conference 29.6. York might be able to use it. Anyone else interested please liaise with Gilda.
2. Preparing questions to intervene in debates, webinars, public meetings as well as at LA and NHS Boards and forums is worth a go.
ACTION
John Carlise and SHA Yorks can offer help and support. Nora is an expert on the duties on the NHS to engage with the public and will provide us with relevant info. She will also forward useful highlights from the meeting on digital services and suggested that if anyone wants to consider joining possible webinars , they see “ In Touch” magazine
3. It is worth focusing on simple messages aimed at what is important to people eg. highlighting rationing, the loss of the patient –doc relationship, continuity and face to face time, increasing distance to travel for GP and hospital care etc. along with challenging the notion that we can’t afford decent care and challenging the ideology which tries to turn the citizen into consumer and pits us against instead of for each other. People’s Commissions can be a useful tactic.
ACTION:
Where people have useful leaflets, please send to Gilda for sharing
4. Trying to keep inclusive : involving Conservatives, looking for joint action with the TUs and local TUCs.
ACTION
Chris offered to share a talk/ paper on involving Conservatives in campaigning which he could circulate
John could add info from Shropshire KONP where activists have managed to run a powerful campaign in a a very Tory dominated area so we should take heart.
Pete Keal will be talking to the West Yorks network of Trades Councils and share their ideas with us.

5. We should seek to for alliances with health workers eg over migrant charges as well as safety, conditions of service etc.
ACTION
Gilda to speak to Unsion re their motion on migrant charges and how to take this forward locally. .
John suggested we circulate the Medact charter.
Further action to be discussed at the Northern Conference – the issues is tucked into discussion in the morning
Anyone who can please send info to Sylvia re the vast hikes in charges for Social Care services

6. We should seek and plan for more co-ordinated days of action on various issues. G thought that there might be potential to do something collective over migrant, indeed all health charges but agreed with others who suggested that this that this might not be the most unifying place to start a series of co-ordinated actions.
ACTION
All think about potential areas for shared days of action Motions can be put to KONP and HCT

G : In retrospect I wonder if mental health , particularly children’s mental health or out of area mental health placements would be a good focus for co-ordinated action ?

7. We need to finalise the programme for the Northern HCT Conference on 29th June, get a final flier out at the beginning of May and publicise as widely as possible
ACTION : Gilda, John and Mike Forster with support from all groups

NEXT YORKSHIRE HEALTH CAMPAIGNS TOGETHER NETWORK MEETING :
Friday 12th July pm : Venue and time tbc.

Thank you and get stuck in

Thanks to everyone who helped us have a lively  presence both inside and outside the theatre at Mark Thomas’s NHS at 70 show in Wakefield on Wednesday. He was feisty and to the point and the theatre was packed out !  There are some pics on our facebook. https://www.facebook.com/groups/141710829185241/

LA and health meetings coming up if anyone wants to join the public gallery!

  • Leeds Adults and Health Scrutiny Board 23rd April  1.30 in the Civic Hall,
  • Leeds Health and Wellbeing Board 25th April 10am – venue to be confirmed

More opportunities to march with the Leeds KONP banner and help get our messages across at

  • Leeds TUC May Day march Sat 4th May, assembling at 11.30 at Leeds Art Gallery
  • Banners Held High Sat. May 18th in Wakefield  For the march/ parade assemble 11am  Smyth St. nr. Westgate station. Later there are stalls, films, theatre etc until 5
  • Save the date – 29th June for our Northern Conference in Leeds.

For more events see the minutes and for more info re NHS England’s  public consultation on possible changes in legislation affecting the NHS (https://www.engage.england.nhs.uk/…/nhs-long-term-plan-leg…/) which closes on 25th April and KONP’s position on proposed legislative changes, see John Puntis latest post on our facebook: https://www.facebook.com/groups/141710829185241/

You are all very welcome at the next meeting of LEEDS KEEP OUR NHS PUBLIC this Wednesday 24th April 6.30-8pm in the Victoria Hotel, behind Leeds Town Hall

The next meeting on 8th May we are aiming to have a discussion about Labour Party policy and practice re the NHS with  Councillor Paul Truswell.

Read the Minutes for more