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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Leeds NHS and KONP updates

Leeds CC have written to West Yorks STP indicating that they are not in a position to sign up to an expression of interest in a memorandum of understanding for West Yorks STP. It was also said that Leeds Plan is being developed bottom up and is not just imposing a national or regional model; it may not be right yet but will be tested as they go along. Sometimes NHS national “ interference” not helpful. They think it is important that there is a “provider” space coming together and see integration as part of a long term programme. Standing by for a position statement / red lines soon.

Leeds KONP joined workshop looking at the plans for LGI rebuild. This being seen as central to development of a new “ innovation” district around the LGI, the 2 Universities and Civic Hall. There are aiming to build a tower on the site of the old nurses home in the middle of LGI to consolidate adult outpatients, day surgery plus additional critical care. Adult services to transfer out of Cndon to consolidate the Children’s Hospital. Maternity likely to remain split tween St James and LGI sites but might go for one consultant led and one midwife led. Gilbert Scott and Brotherton building to be retained ( or at least the shells) but looks like much of these will be sold off for development of retail, restaurant, open space etc on 4/5 years timescale. Was given no reassurances re PFI / sell offs , use of income  – different procurement options to be considered.

Kirklees going in same direction as Leeds as their Scrutiny Board has just scrutinized proposals for a Kirklees Integrated Care System. There is a big gap between LP policy made at Conference and what is happening on the ground in local Councils. Calderdale LP have passed a detailed resolution to pressure the councilors and Calderdale & Kirklees 999 Call for NHS took one to Dewsbury CLP.

Further details in the minutes:

Govt is trying to shred the NHS, here’s how you can help stop it

Join us in August – October, details below

Yorkshire “Health Campaigns Together” Conference in Leeds on Saturday October 15th from 11-4pm.  St. George’s Conference  Centre on Great George St. next to the LGI.

Coming up soon:

Wed. 17th Aug. 6.30- 8pm  Leeds KONP meets in O’Neill’s pub , Great George St. 

Wed 7th Sept.  6.30 -8pm   O’Neills,  HCT Conference planning with other regional activists

Sat 17th September    National Health Campaigns  Together Conference on Challenging the Sustainability and Transformation Plans in Birmingham  11-4pm Carrs Lane Conference Centre,  B4 7SX (opposite Moor St Station). To book  visit http://www.healthcampaignstogether.com/

19th & 20th September     Judicial Review re imposition of the junior doctor’s new contract at the Royal Courts of Justice, Strand, London. This will be held in public and there will be a gathering  outside.

Saturday 24th September       KONP stall. & Gig Up Our  NHS with bands in the Square. 

Wed 28th Sept. 6.30 -8    Leeds KONP in O’Neill’s pub

Sunday 2nd October    Protest at the Tory Party Conference in Birmingham

Sat October 8th    KONP stall/ event tbc

Requests for support : 

Dewsbury campaigners have a petition re saving services at Dewsbury Hospital https://you.38degrees.org.uk/petitions/keep-all-servces-at-dewsbury-district-hospital/

KONP is crowd funding to  employ a researcher to investigate  issues new NHS developments such as STPs, submit FOIs, share results widely etc.  If you can help, please contact http://www.crowdfunder.co.uk/keepournhspublic

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