Leeds KONP latest news: Social care crisis, #ToriesOut

Including: mounting criticism of Johnson et al – If you haven’t seen the Times shocking catalogue of inaction and delay in planning to respondi to the coronavirus pandemic see https://www.thetimes.co.uk/article/coronavirus-38-days-when-britain-sleepwalked-into-disaster-hq3b9tlgh
It notes that Johnson took 2 weeks holiday in February and didn’t attend any of the first 5 COBRA meetings called to prepare for the pandemic in the UK. Another newspaper has reported on his ideology putting the market ahead of life and healthcare in a speech in February. Since they were published, the Tories have been scrabbling to issue refutations and dig themselves out of a big hole. It’s only going to get bigger.

Also – DNR and PPE research, carry on clapping, Workers Memorial Day 28th April.

Newsletter: Konp Leeds newsletter 24.4.20

Upcoming meetings:

  • People Before Profit Covid 19 group now meeting Mondays at 6.30 pm
  • Leeds TUC public mtg : Wed 29th April 7pm Testing, PPE; Put our safety first: organise in your workplace. Joining instructions are : https://zoom.us/j/99227080107?pwd=eTdMaHZ2amppazAzalRvSE9uWUFSUT09
  • Yorkshire Health Campaigns Together network meeting Friday 1st May at 4pm
  • Trades Council May day celebration May 2nd – instead of the May Day march – tbc
  • KONP &HCT webinar 5th May 7.30 – 9pm

“Coronavirus Crisis: What now for the NHS ?” Speakers include: Richard Horton, ed. The Lancet, Prof. Allyson Pollock – Public Health Consultant & Director Newcastle Uni. Centre for Excellence in Regulatory Science, Dr John Lister ed. of Health Campaigns Together, co-ed. of The Lowdown. Dr Sonia Adesara – Junior Doc & member of KONP’s NHS Staff Voices group, Pam Kleinot – Producer of Under The Knife. Register here : https://us02web.zoom.us/webinar/register/WN_SeVsKXHHRIa2fvHiDRZVJg

The next LEEDS KONP meeting will be at 6.30 on Wednesday 13th May (sticking to the 2nd and 4th Wed of the month )

The all year round winter crisis

Latest minutes: Konp_Leeds_mtg_8.1.20

Wed 29th Jan. is the next meeting of Leeds Keep our NHS Public
at 6.30pm in the Victoria Hotel on Great George St. immediately behind Leeds Town hall

Sat 1st Feb: We will be aiming to have a stall in the City centre 11- 12.15ish on Commercial St near Accessorize just along from Boots where we will be advertising a big protest on 15th Feb. All support very welcome

Sat 15th Feb: 12 – 1.30. We will be taking part in a national day of protest about the Crisis in our hospitals ( Not enough beds, staff or resources ! ) on the roundabout outside the main entrance to Jubilee Wing ( A&E) Leeds General Infirmary .

Please help to make this a big event which attracts media attention . Bring colleagues, friends and family and urge your trade union., Labour or Green Party Branch and others to join us with banners, placards etc. We hope to have some musicians as usual, flags, bunting etc.

Evening Post’s latest comments about the lack of capacity in Leeds Teaching Hospitals and elsewhere
https://www.yorkshireeveningpost.co.uk/news/revealed-leeds-teaching-hospitals-trust-coping-winter-pressures-158224

We are working on confirming a date for our annual demonstration for the NHS

What is happening in general practice?

Derby KONP, 29 October 2019

Presentation (pdf) by Dr John Puntis of Leeds KONP

What is your experience?

GP Training: 5 years at medical school.

  • then 2 years Foundation training in hospital post
  • then 3 three years of GP Specialty Training, normally including 18 months in an approved training practice with a further 18 months in approved hospital posts
  • (some trainees will work in other specialties in hospital between finishing foundation years and entering GP specialty training)
  • minimum of 10 years to train a GP; UK medical school places increasing from 6000 to 7500, but will take a long time for NHSE’s ‘5000 new GPs’ – promised by 2021!)

From 2006-13: (Nuffield Trust; https://www.nuffieldtrust.org.uk/resource/is- general-practice-in-crisis) –

  • GP posts up 4%; consultants in hospital and community up 27%
  • Health Education England – 50% of medical students should go into general practice, but actually only 40% do so at present
  • 1 in 10 GP training posts unfilled
  • 1/3 of GPs under 50 stated leaving clinical care in next 5 years (but 50% of GPs >50)
  • Number of single doctor practices halved, number of practices >10 docs up by 76%
  • 8% (£287m) reduction in spending on GP services https://www.rcgp.org.uk/policy/workforce.aspx
  • 16% increase in GP workload over last 5 years
  • by 2025, 9.1m people living with multiple serious long term conditions (55% of GP appointments)
  • 10,000 more GPs needed General Practice is changing
  • historically, businesses (independent contractors) – but part of the NHS
  • the number of full-time equivalent GP partners has fallen 4 per cent for each of the past three years to March 2019, while the number of Full Time Equivalent salaried GPs has risen by at least 5 per cent in each of the same three years (i.e. less appetite for taking on business aspects of general practice; discussion re salaried service or partnership model)
  • NHS Digital: number of FTE GPs down by 576 over past year; headcount increased 2.3% due to trainees (Matt Hancock praised increase in GP numbers across country!)
  • 720,000 more patients registered with GPs this year
  • half of all GPs taking part in recent survey said they work beyond their rostered hours at least weekly and feel they cannot cope on a weekly basis

Survey also revealed a third of all doctors intend to reduce their hours in clinical practice within the next year, and 10% intend to take a break from practising medicine over the next year

  • increasing workload comes from: long term conditions – complex patients; prevention; domestic violence; safeguarding, etc. etc. the “left shift” from hospital to community = more work for GPs
  • practices merging; mega-practises; not embedded in community; cant know patients in same way; therapeutic relationship not there (basis of general practice)
  • continuity of care in primary care reduces morbidity and mortality; also have role in protecting patients from health care – but not a policy priority. Good for doctors and patients

Workload is considerable:

  • 70% people see GP in 1 year, 90% in 5 years. Only 1 in 20 referred on to specialists (important gatekeeping role)
  • GP’s seeing >1m people a day; average GP seeing twice as many people/day as 30 yeas ago
  • 11 hour days, 41 daily contacts and half GPs working at unsafe levels Recruitment difficult:
  • early retirement; pension issues
  • increase in suicide rate: Office for National Statistics showing that 430 health professionals in England and Wales died by suicide from 2011 to 2015, including 81 doctors (= 1 every 18 days), and that female GPs have four times the risk of suicide than the general UK population
  • 244 surgeries closed last year; 583 since 2013
  • over past year FTE fully qualified GPs fell by 441
  • GPs get the blame/stress – e.g. nearly half GPs had patient referral bounced back on 2 week cancer pathway, or downgraded to non-urgent

Primary Care Network:

  • the stated aims of PCNs are to tackle the crisis in General Practice, in particular the crisis in recruitment and retention of GPs, by deploying a wider range of health care workers to “take the pressure off GPs”; to encourage GP practices to be part of wider multi-disciplinary teams to deliver improved community based care, thus reducing demand on hospitals; and to incentivise GPs to work together to tackle wider health issues, and reducing health inequalities, as outlined in the NHS Long Term Plan.
  • £2.3bn going into PCN by 2023 – welcomed by some as way of getting extra resources; others more sceptical (“nail in coffin of tradition general practice”?); most GPs ambivalent
  • core primary care contract still there
  • but this would change with an Integrated Care Provider contract – covers 1-2 million people, for 10-15 years – GP’s give up their own individual contract; GPs against ICP contract – say it will undermine benefits of working and collaborating together and improving community services

Is it all part of the big plan, or a bulwark against ICP (promoted by NHS England, whereby GPs would give up their practice contract and patient list and merge into a massive organisation covering hundreds of thousands of people)?

  • most extra funding in the new contract will not go into core GP services but into Primary Care Networks – a total of £1.8 billion a year by 2022
  • to access this funding GP practices in England must sign an extension to their contract to link up with other practices in neighbourhood groups of 30-50,000 patients
  • for signing up to the PCN each practice will be paid £1.76 per patient on their list
  • further payments will be paid directly to the PCN. This will include £1 per patient for all practices in the PCN; funding for clinical pharmacists, and social prescribers in the first year; and funding for a PCN clinical director. In future years there will be funding for physiotherapists, physicians’ associates and
  • most GPs are not paying attention to ‘restricting referrals’ incentive –

potentially hugely undermining of patient trust

  • GPs should be able to stay in control and develop sensible collaboration to improve services (says BMA)
  • equivalent of 270 GP taken away from font line care in role as PCN directors

Will PCNs rescue General Practice?

  • PCN ideas of greater collaboration between practices, multi-disciplinary team working around the patient, especially the most complex and vulnerable, and a wider range of practitioners to provide patient care are not in themselves bad
  • wont reduce the need for GPs (7000 short)
  • the increased funding to General Practice is not enough to make up for the loss of £1 billion/year over the last decade
  • it is unclear where the extra staff will come from (there is a GP and practice nurse workforce crisis, as well as a wider NHS staffing shortage of 100,000)
  • cuts to public health, preventive services, social care and community services have further undermined the possibilities of improving care in the community. Add to that the on-going impact of austerity, poverty and inequality and it seems unlikely PCNs will have much impact on health inequalities, given that they have no power over those wider issues.
  • PCNs therefore are not the solution to the GP workforce
  • Government policy over the past decade has actively undermined General Practice and led to the crisis that it currently faces. The future of General Practice is in jeopardy

What you can do

  • locally – join Patient Participation Group at your GP practice
  • nationally – fight for proper funding – increase medical school places – increased GP training places – increased nurse training (N.B. no money for training in Mrs May deal)
  • recognise huge impact of austerity and poverty on patients and therefore GPs
  • demoralisation of GPs; KONP did not campaign against PCN – but did campaign for what we want for primary care (see below)
  • General Practice should be an attractive job; 10 minutes/patient, complexity and risk – lets have 20 minutes appointments, breaks, educational sessions – look after the staff – time for the patient, and nurturing the people – needs injection of funding (see also: https://www.england.nhs.uk/commissioning/wp- content/uploads/sites/12/2015/01/building-the-workforce-new-deal- pdf)
  • The Charter for General Practice – campaigning around positive demands:

 

KONP Primary Care Charter (DRAFT)

GP services in the NHS: our demands

SUPPORT THE CURRENT GP MODEL THAT GIVES CONTINUITY OF CARE

  • Support the traditional model of General Practice that enables personal and continuing
  • FULLY FUND IT: Significantly increase core funding to General Practice
  • NHSE must end its selective promotion of “GP at Scale” and practice mergers and increase its support to small and medium sized practices, to ensure their flourishing and survival.
  • NHSE must consult patients and public about any plans to merge or close practices, including the creation of “super practices”, and provide impact assessments of such plans on travelling time and distances, availability of GP appointments, and continuity of

 

OPPOSE PRIVATISATION AND CORPORATISATION OF GENERAL PRACTICE

  • We oppose the takeover of general practice and primary care by for-profit corporations, including digital providers such as
  • We oppose plans for Integrated Care Providers, and other corporate models of primary care
  • We note the risks inherent in Primary Care Networks (PCNs) and oppose any moves to privatise Primary Care Networks or incorporate them into private provider organisations such as Accountable Care

 

  • All staff employed by PCNs should be employed on NHS terms and conditions and

 

 

 

 

 

RIGHT TO SEE YOUR GP

  • We demand 10,000 more GPs as recommended by the Royal College of General Practitioners, to improve access and waiting times to see a GP, and to facilitate continuity of care with a known
  • We demand the right for patients to have face to face appointments with a GP if that is what they
  • We demand an end to the use of IT and APPs as barriers to accessing GPs. All IT must serve to enhance and support General Practice, not replace

 

MULTI-DISCIPLINARY TEAMS ADDITIONAL TO, NOT REPLACING GPs

  • Increase the training and funding for practice
  • Increase training and funding for other clinical staff to work in practices such as clinical pharmacists and counsellors. Such additional staff to be complementary to and not replacements for
  • Increase numbers of community staff such as district nurses, health visitors, school nurses, community diabetic and respiratory nurse specialists, community palliative care nurses and community mental health staff.
  • Fund adequate wider services to support primary care in the community including social care, public health and mental health services. This will require a reversal of cuts to local authority budgets, and increased budgets to make up for years of

 

PATIENT & PUBLIC ACCOUNTABILITY AND ENGAGEMENT IN PRIMARY/COMMUNITY CARE

  • Opportunities for genuine patient and public involvement in the development of health services including primary
  • No merger of CCGs. Retention of the right of CCGs to veto Integrated Care System plans if they consider they are wrong for the area the CCG
  • Enhanced rights for local government scrutiny committees to interrogate, challenge and veto decisions of the ICS which go against the interests of local

 

EQUALITY OF ACCESS FOR ALL

  • Remove barriers for marginalised groups in accessing GP care
  • Oppose any moves to start charging migrants and others for GP care
  • Provide support to homeless people, migrants and other disadvantaged groups to register with a GP practice

 

  • Fully fund interpreting services for GP practices

 

 

 

NHS RATIONING AND BARRIERS TO SPECIALIST CARE

  • End referral management systems that act as barriers to GPs referring for further care
  • End restrictions on GPs’ freedom to
  • Allow GPs to prescribe medications that can be bought over the counter
  • End prescription charges
  • Abolish the current list of banned procedures on the NHS. All procedures for which NICE provides evidence of benefit should be available on

Join us – events calendar for March – June

Next Meeting  Wed 13th March 6.30- 8pm in the Victoria Hotel  immediately behind the Town Hall.

Please keep promoting support for the Yorkshire Health Campaigns  Together March for the NHS on 30th March and note a number of other events coming up.

Sat 9th March Leeds Summat  all day but KONP workshop with Space 2:  15.50 – 17.10 at Notre Dame College

Sat 9th March 11.30 – 4pm also National KONP Steering Group  at Swarthmore.

Sat 16th March  11-12.15 KONP stall on Commercial St. next to Monsoon, near Boots.( we will also be doing stalls 16.3 and 23.3)

Sat 30th March HCT Yorkshire grand march for the NHS assembles 11.30 outside Leeds Art Gallery

Tuesday 2nd April 7.30 pm Café Economique on privatistaion of the health service at Seven Arts in Chapel Allerton with KONP stall.

Mon 1st to Wed 3rd April Showings of John Furze film  Groundswell organised by 999 in Kirklees  Mon.1st  7 – 9pm Dewsbury Town Hall, WF12 8DG.

Tuesday 2nd 7pm:  Jo Cox House, 3Branch Road, Batley.  Wed. 3rd 7pm  Huddersfield Methodist Mission, 3-13 Lord Street, HD1 1QA.

Friday 12th April at new time 2.30-4.30pm  Yorks HCT network mtg also in new venue  Mill Hill Chapel on City Square opposite Leeds Train  Station

Thursday April 18th 7.30 Mark Thomas Check Up – our NHs at 70 on at Wakefield  Thetare Royal with KONP stall, banners and filming See flier attached & get tickets..

Sat 4th May Leeds TUC May Day March with KONP banner/ contingent

Sat 15th June  National KONP AGM in London

Sat 29th June Northern HCT Health & Social Care Conf.  in St. George’s Centre

There is also a prayer motion being put to the House of Commons by Jeremy Corbyn, John Ashworth et al to annul integrated care legislation which the Govt are trying to sneak through.  Please see   http://bit.ly/MPPrayerMotion and ask your MP to support it.

Join us at Health Campaigns Together Yorkshire conference 15th October #Leeds

Brexit promised £350m a week, deliberate underfunding is destroying your valued NHS services. Join us to find out more about what is happening in Yorkshire and what you can do about it. Patients and staff united to support our national treasure – our NHS.

Conference Agenda
10.15 Registration and refreshments
10.45 Dr David Wrigley on ‘What’s happening to our NHS?’ plus an update from a junior doctor
11. 30 Workshops on
– Sustainability and Transformation Plans (Slash and Trash Plans?) implications, cuts etc
– Mental Health Services – or lack of them !
12.30 Lunch ( small cost)
1.15 Brief summary of morning workshops then
John Lister on the fightback
2.00 Workshops on
– Influencing politicians to pursue the re-nationalisation of the NHS and funding
– Influencing CCGs, Trusts, Local Councils etc
– Upping our game in raising public awareness and galvanising people power
3.00 Tea/ coffee etc
3.15 – 4 Closing session : Working together to win !
Booking not essential but to guarantee your place and help us manage numbers and food, please e mail leedskonp@yahoo.co.uk or T. 0113 2622800

Flier

Join us for the Battle for the NHS – the People vs the Government, Leeds 22nd June

John Lister, founder member and national secretary of Keep Our NHS Public will give a round up of the attacks on the NHS- from Devolution and local cuts- to TTIP and privatisation. We will be focusing on what we can do locally to stop these attacks and save the NHS- free at the point of need.

WHEN 22nd June 19.00 – 21.00pm

WHERE Cosmopolitan Hotel, 2 Lower Briggate, LS1 4AE Leeds

Facebook event page: https://www.facebook.com/events/605453116284816/