People’s Hospital Review (Sheffield 2018) – Part 2

In part 2 of this blog post, by Deborah from Sheffield Save Our NHS, you can read how people responded to specific proposals made in the Hospital Services Review report published in May 2018 .



After our general questions about hospitals (see previous blog post), we asked about the main proposals listed on the Hospital Service Review page of the South Yorkshire and Bassetlaw Integrated Care System (SYBICS) website: .

These main proposals are summarised here:

images (9) 

Some respondents were cautiously optimistic about some of the proposals, but more were suspicious because of the lack of information and their fears of opportunities for privatisation.

What do you think about A&E Services?

In response to this question there was unanimous support for the Minor Injuries Unit in Sheffield.

There was also this comment:

“There is no slack in the provision, which means that in the case of an emergency that affects significant numbers the services would be under extreme pressure. This is not satisfactory for patients or workers.  There are also known times when numbers increase dramatically and it should be possible to manage these more effectively. Walk in clinics and minor injury units play a crucial part but they are (or have) disappearing. the problem often is that some people have difficulty accessing health centres or GPs so everything becomes an Emergency.”

What do you think about maternity services and proposals?

  • “‘Home choice’ is not a choice. Deliver a baby in a safe environment. i.e. hospital is better and the reason why we have a low death rate.  In case of sudden emergency, home is a bad idea.”
  • “No the resources are not there this is just a way to let in private providers”
  • “Although women may be classed as low risk things can change during labour. It’s bad enough with current arrangements where senior and expert help may be delayed.  It will be much worse if midwife levels remain low, if midwives are subjected to tick box procedures and if units are closed.  MLUs should only be instituted when there are adequate levels of trained and experienced midwives and medical advice and assistance are quickly available if necessary.”
  • “I have been very disappointed that some of the specialist services that supported young and possibly single mothers, have closed. These were crucial in their ability to support individuals and also to refer or signpost them on to other services where young parents can find longer term personal support”
  • “Encouraging less use of hospitals / maternity units and more home births is NOT ‘increasing choice for women’. It is a deeply irresponsible path to take, and surely just a cover for reducing maternity beds across the region, when capacity is already overstretched (Barnsley closed its doors only last week, and has frequently reported women giving birth in inappropriate circumstances).”

What do you think about Services for Acutely Ill Children?

Here are some ‘translations’ of the proposals:

  • “‘More care for children at home/in community’.   This means more parents looking after sick children.”  
  • “‘Explore focusing 24/7 paediatric units on few sites.’ This means further away from families.”
  • “It sounds like a cop out and less care overall. In the community’ can mean almost anything.”

Other comments included:

  • “Nobody wants their children to be in hospital but I feel this proposal is driven by staffing issues and cost issues, not by need. There is a real risk of overcrowding specialist facilities if IP units close.”
  • “Sheffield Children’s Hospital has a fine reputation locally ~ people tend to trust them. Whilst the case for more community services is a good, we mustn’t assume it’s a cheap one. So once again how these are funded and whether they are then classed as ‘social care’ responsibilities is critical to their success. We cannot see the problems associated with the elderly replicated within children’s health needs”
  • “Children’s ward @ Bassetlaw! Now moving ill children to Doncaster as no overnight facilities!  JUST WRONG!”
  • “They should be treated in their own local hospital whenever possible”
  • “I support increases of services in the community, short stay units and long stay units; we need to excel in all areas”
  • “I don’t think we can lose any hospital provision and retain patient safety.”
  • “Short stay units is a good idea as are community but would not like to see a reduction in the number of inpatient beds. This would not alleviate the issues as more children are being treated as inpatient because of their complex needs”

What do you think about Stroke Services?

  • “There should be a drive to staff these services in every dgh [District General Hospital]”
  • “Much of this depends on good and fast diagnosis; and provision of good rehab services locally. Have they looked at the whole pathway?  And do we have enough vascular nurses to help with the rehab locally?”
  • “I am worried that the acute stroke unit in Rotherham looks like closing. Stroke victims need to be seen as soon as possible, not transported miles to Sheffield or Doncaster. Irreversible brain damage is more likely with delays.”
  • “What exactly is the ‘standardised approach’? Discharge should be timely and patient-appropriate, not ‘early’ (too early?).”
  • “Centralising Hyperacute stroke unit services makes sense but acute stroke units must not be blighted. Consultant presence and support is important at these sites as well.  If acute stroke units fail, then the hyperacute service will get blocked up and people will spend longer further away from home with all the difficulties that causes.”
  • “I’m always suspicious of anything labelled ‘standardised’, it has to be responsive to local conditions. Having said that there have been significant advances in understanding and responses to Strokes, and certainly these need to be ‘standard’ in every area. If paramedics can receive the appropriate training so treatment can be given with as little delay as possible, this has to be a good thing”
  • “Hyper Acute should not be centralised, they should remain local. I disagree with early discharge. It is a cost cutting exercise & I dont know what you mean by ‘support services on… Acute Stroke Unit’. Do you mean there will be no doctors? If so, I disagree.”
  • “Personal experience was of a lacklustre service under pressure”
  • “Stroke patients and their families should be absolutely ready for discharge, never pushed or hurried into it. DO NOT CLOSE the HASUs at Barnsley or Rotherham: lives and post-stroke quality of life will be risked. all units should give the best, specialist treatment possible to enable quicker recovery times”

What do you think about Gastroenterology Services?

Responses reflected the lack of information given in the proposals:

  • “Which sites? Is this a review or half a review?”
  • “How will the public know which hospital to go to? Will this result in relying on the 999 service to know? Will patients always be discharged by ambulance? What arrangements have been made for inter-hospital transport (for visitors)? Has the proposed inter-hospital bus service been implemented?”
  • “I am unsure of the reasons for or practicality of this”
  • “We should extend the availability of emergency services to all A&E departments”
  • “All hospitals with A&E departments should be treating emergency GI cases. Reducing provision in any location risks patient safety. It is a faulty mentality to be referring to “out of hours” in relation to any kind of emergency; provision should be consistently available at all 7 hospitals.”
  • “Not sure how this differs from current but think at least 1 in each area”

What do you think about creating a Health and Care Institute?

[for South Yorkshire and Bassetlaw]

  • “What is this? It could be a good idea but I don’t know enough about it”
  • “What is it? Is it public and within the NHS? What would it do? Who would fund it?”
  • “Money should only be spent on this if it offers a genuine step forward and is welcome by those already providing workforce training”
  • “Sounds like a good plan. However, my recent experience in setting up an institute in a professional workforce is that although everyone says great, employers say excellent idea, the only people who will pay for it will workers themselves. It could be the neoliberal answer to Unions, and it is hard to see an institute being able or willing to mount the challenge to government that has been seen over the last few years”
  • “I have no idea what this is but no doubt it will involve private companies so I am against it”
  • “Only if it does not divert money from NHS services or Social Care provision. Underfunding is now so severe, and money is wasted in costly private contracts – we simply can’t afford to lose another penny. There are already very strong links with the universities in Sheffield; can this be extended to encompass the SY&B region more effectively?”

What do you think about creating an Innovation Hub?

[for South Yorkshire and Bassetlaw]

  • “Should not duplicate stuff elsewhere and not from clinical resources”
  • “Good idea, but every hospital should also practice innovation as part of their job too.”
  • “Another one? What is wrong with the existing one? What influence/pressure would it have on persuading consultants, GPs and CCGs to accept any new innovations?”
  • “I’d rather see money spent on getting our existing services right than on developments which may only have small effects despite costing quite a lot to develop.”
  • “What the Dickens is that?”
  • “Is this not already in place via HEE [Health Education England]?”


South Yorkshire & Bassetlaw NHS Action Group would like to hear your comments on what you’ve read in this blog.

It’s too late to forward your comments to the Reviewers – but your views are welcome.

Also it would be good to know if you knew that:

  • the Review port was happening (July 2017 – April 2018)
  • the Report was published (9th May 2018)
  • that your comments on the Report were invited? (12th June – 13th July 2018)

People’s Hospital Review (Sheffield 2018) – Part 1

Sheffield 2018 – Sheffield Save Our NHS asked people in Sheffield to say what they thought was ‘good’ and what ‘could be better’ in a People’s Review of Hospital Services.


If you were asked to review hospital services, would you begin by looking for services to cut?

In Sheffield Save Our NHS, we thought that most people would want to build on strengths and improve areas of weakness, which is how we began our People’s Hospital Review.  We talked to people on street stalls and also sent out an online questionnaire.  Here are some of the comments.

What do you think is good about hospitals?

In total, there were 30 comments in response to this question.

Many people praised the commitment and efficiency of staff, in comments such as these:

  • “Whenever I’ve needed the NHS, they’ve been there”
  • “The dedicated staff working against the odds to look after us”
  • “Commitment of staff”
  • “They try their best”
  • “The expertise and specialism they all have”
  • “Friendly, helpful nurses – how do they do it when they’re so overworked?”

Some people mentioned specific services, for example:

  • “Great care and repair for my grandson (cleft lip and palate)”
  • “When admitted at 9 years old, it was good they let my mum stay overnight”
  • “Excellent surgery”
  • “Blood testing service at the Hallamshire is speedy and efficient”
  • “Good for preventative care, eg mammograms”
  • “Acute medical Care and A&E; Re eye clinic: fast appointments”
  • “Good service and follow-up”
  • “Been in hospital at Hallamshire and everything was good, from surgeon to cleaning staff!”

There were also some general comments about hospital services:

  • “They are good because they are local to communities”
  • “Quality of some of the services”
  • “Range of specialist services”
  • “Their apparent willingness to work together”
  • “Sheffield hospitals are linked to the medical school, which is good”
  • “A good spread of hospitals”

A few comments related to pressures on the NHS:

  • “Their capability of excellence is often compromised by the capacity of funds and the corrosive nature of targets and paperwork foisted in clinical staff”
  • “SY&B hospitals seem to have been fairly resilient so far in the face of continuous de-funding by Conservative-led governments”

What could be better?

There were 42 responses to this question.

Again, staff seemed to be at the forefront of people’s minds.  One response just said:

  • Ask frontline staff this question! “

There were also comments on treatment of patients, wastage of scarce resources and suggestions about management, structures and how decisions are made.

Here are some of the comments about improvements for staff:

  • “Give admin staff time to look up and smile when I go into reception”
  • “Nurses and professionals try hard but it is hard – no pay rises, not valued.  It’s all about computers rather than care”
  • Take care to employ the cleaning staff in-house to improve everyone’s chances”
  • “Staff are over stretched. The “good service” provided is because they work over and beyond their contracts – which puts pressure on them and their health”
  • “Reintroduce training bursaries better pay and shift arrangements for clinical staff”
  • “1 nurse able to administer a particular treatment for over 7 wards.  Grossly under-supported”
  • “Look after our staff!”

One respondent felt very strongly about the treatment of NHS staff and wrote that:

  • they [staff] “have been kicked around for years, underpaid and pushed to the limits. 
  • “You must reduce staff stress which causes massive amounts of sickness and loss of valuable and experienced staff. It also leads people to retire at the earliest opportunity. 
  • “Never mind bursaries, student nurses should be paid like they used to be. I worked on a ward where the majority of the nursing staff were mature entrants. How can these people get in now? 
  • “In my NHS years 1972- 2000, I didn’t know of one person being sacked but 2000- 2013, I saw dozens being sacked.
  • “A little more human understanding would reduce a climate of management intimidation.
  • “Please don’t bleat about staffing issues unless you are prepared to treat your workers properly.”

Improvements for patients were suggested, including:

  • “Shorter waits for transport home after treatment”
  • “Wrong to send somebody home poorly”
  • “Must respect DNR wishes”
  • “Make main entrances to hospital more welcoming and waiting areas child friendly”
  • “Improve the hospital environment on acute wards: give patients access to more gardens and green spaces.  Hospital wards are claustrophobic and oppressive”
  • “Seeing in-patients more as people not just bodies”

On the Northern General Hospital there were specific concerns, it was seen as confusing, polluting and dangerous:

  • “Better signage would help at Northern General”
  • “The ongoing concentration of services at the Northern General Hospital has led to increasingly high illegal levels of nitrogen dioxide in the streets around the hospital”
  • “Police treat the Northern General as a violence hot spot!  No more pressure please.”

Many suggestions for improvement related to wider issues of funding, privatisation and management structures and strategies.  Some people commented on underfunding, while others saw some policies, such as outsourcing, as wasteful.

On funding:

  • “More funding”
  • “More staff”
  • “More beds wards & staff”
  • “Targeted increased resources to restore service levels”
  • “More investment of staff and properties”
  • “Better funding, more staffing and better support for staff”
  • “Obviously a massive increase in capacity/funding”
  • “Stop closing beds and services”
  • “No cuts”
  • “Commitment to staff recruitment and retention”

On privatisation:

  • “In-source cleaners and reduce hospital infections”
  • “Eliminating private participation”
  • “Reversal of the privatisation of services”
  • “Ancillary staff who are employed in House and in permanent positions to increase the numbers of regular workers who are attached to wards, rather than workers who work to an outside private company with other priorities than patients comfort and service”
  • “The removal of private firms”
  • “Stop wasting money on buying in services that could be provided by the NHS”
  • “Stop giving over beds to private facilities within NHS hospitals”

On wasteful policies:

  • “Take away the paper work and let nurses do the job they love and are good at doing”
  • “Divide the tasks differently: senior staff doing breakfast and meds in one round takes longer and wastes their valuable time”
  • “More actual sharing (of specialist staff) and networking of key services”
  • “Stopping the reorganisations. Waste of money and resources”
  • better liaison with social care”
  • an elderly female patient who was on the same ward as my mother had been there for 12 months, as there wasn’t anyone to care for her at home and there wasn’t any social care facilities for her.”

Two respondents questioned the need for all of out-patients to be located in hospitals, and there was a suggestion of possible:

  • reform of out-patient services, better use of local facilities, linked to the hospitals”

On technology, one respondent commented on how to:

  • take advantage of the changes and improvements to treatments brought about by new technology and governments prepared to invest in these and train personnel to make best use of them”

Given the range of ideas put forward here, it would seem important to take on board the suggestion of another respondent:

  • “Involvement of patients and public in decision-making

while recognising the risk seen by another person that:

  • the NHS is being hollowed out so as to create space for privatisation”

In part 2 of this blog post, by Deborah from Sheffield Save Our NHS, you can read how people responded to specific proposals made in the Hospital Services Review report published in May 2018 at .


South Yorkshire & Bassetlaw NHS Action Group would like to hear your comments on what you’ve read in this blog.

It’s too late to forward your comments to the Reviewers – but your views are welcome.

Also it would be good to know if you knew that:

  • the Review port was happening (July 2017 – April 2018)
  • the Report was published (9th May 2018)
  • that your comments on the Report were invited? (12th June – 13th July 2018)

What do SYB people think about this SYBACS so far?

Generally not impressed:
“There are too many managers imposing these changes on the NHS in SYB.”
“The councils are not now included as full partners.”
“The governance and accountability is a mess.”


“Can’t believe we have no out of hours Drs in Retford having had family from Ireland staying on Saturday we needed a Dr . With no car how the hell dose the NHS expect people that don’t drive or have money for taxis or bus fares to get to worksop hospital this is something we must sort out because if we don’t people will die . I am hoping we can get in to a local Drs on Monday”

19598885_1658875687465383_5265024225487712143_n“BSONHS and the freedom riders had a great response from people in Barnsley town centre on Saturday 1st July. We asked people to sign the large HAPPY BIRTHDAY NHS card. individuals and families of all ages were more than happy to put their names to thanking the NHS and staff for being there for them.

Many were worried about the running down and under funding of the NHS.”



“This is how the NHS has been taken over by a well-entrenched bureaucracy which is unaccountable then”



“Do not forget that it was politics that created the National  Health Service. And it is politics that can mess with it.

We do not want any American systems in this Country.

Our United Kingdom is ours and not to be messed with by anyone. “




“Fantastic turn out for the #ourNHS demo in London today.

The Sheffield Star asked us to send them photos from today.  Please send us any photos you have of the rest of the Sheffield delegation/banners as we all got split up as the demo was so big!”


PLEASE – tell us what YOU think!


If you live in South Yorkshire or Bassetlaw – join your local campaign!

(we can put you in touch with them)


Join us at the SYB NHS Action Group!







Why do we need to defend our NHS?

South Yorkshire and Bassetlaw NHS areas have been bolted together to enable unelected government officers to cut our NHS services to shreds.
They call it an Accountable Care System. But it is NOT accountable, it’s being done behind closed doors, in secret and at great speed.


The NHS in England is having a ‘top-down’ total reorganisation.

This is because of a government decision not to give it the regular annual funding increase it needs to stand still.  Since the 1950s the NHS has needed an average of 4% extra funds each year to cover medical technology costs and a growing population’s need for services.

BUT – since 2010 governments  have cut this from and average 4% to an average 1.1% annual increase.

Three years ago NHS England, that runs the NHS in England on behalf of the government, decided that to keep the NHS working and financially ‘sustainable’ in England there would need to be major ‘transformation‘ of how services are provided.

They produced the Five Year Forward View, a plan which described how the NHS could be run with hardly any extra money each year from the government, to help keep up with the usual increasing costs.

This extra money is needed for all the new technology now used for diagnosis and treatment and for all the extra illness that the growing population suffers from. However the government is refusing to give the NHS the money it will need for the next few years. So the NHS has to run much more cheaply.

You will have heard about the need for the NHS to save £22 million by 2020/21.    This is the extra money the NHS needs (to meet the usual costs) but that the government is refusing to provide.

In England there are over 200 NHS commissioners, over 250 NHS providers, nearly 7,500 GP practices and over 800 independent NHS providers (including the private providers).   There are also more than 350 councils in England, each providing social care and public health services.

SO – two years ago, to carry out their plan for more ‘efficient’ (cheaper) health and care services, NHS England told all these public bodies in England to reorganise themselves into just 44 areas across England.  They were told to work together to decide how to deliver services in a cheaper way in their area.

This was a massive reorganisation that was imposed (i.e. ‘top down’), and it introduces ‘post code’ access to services and takes away the ‘National’ nature of the NHS , but without any legislation or Parliamentary debate.

And – a year ago, each of the 44 areas had to submit a plan a year ago – an STP, (Sustainability and Transformation Plan) that said how they would provide the services more cheaply in their area, for a much larger population and how they intended to change all their management and decision-making structures to make it happen.


Going Further Faster!

In June 2017 NHS England announced that 9 of the 44 areas will be given the go ahead to put their STP into practiceand togo further faster‘  into an Accountable Care System. This means the public bodies in these 9 STP areas would now collaborate formally in a partnership way to start carrying out the restructure of their local services.

HCcongres-800 ?

South Yorkshire & Bassetlaw STP was one of the 9 areas ‘going further faster’!

In South Yorkshire and Bassetlaw the STP, now an Accountable Care System (SYBACS), has to make £571 million ‘efficiency savings’ before 2021.  In other words this is the money the NHS would normally be getting to cover increasing equipment costs and population need for services.

But remember this ‘efficiency saving’ is only being made by cutting back on service delivery costs so they don’t spend the extra money needed to pay for more people, with more illness, and more need for medical technology for diagnosis and treatment.

images (1)

So how will this SYBACS involve us – the people of SYB?

In the eleven months since they submitted their STP the now SYBACS, has made many decisions – in secret – about the future of our local services. These decisions were made by NHS and Local Government Officers, at the SYB Collaboration Partnership Board, where the plans of how to make the changes were made.  But there were no democratically elected councillors or MPs involved.

The public weren’t involved either – even though there is a legal duty for commissioners (those who plan and buy NHS services) to involve the public in their commissioning arrangements, plans, proposals for change and decisions.

The local Healthwatches have been sat around the table at the SYB Collaboration Partnership Board all this time, but they don’t share any of this information with the public. They also make little attempt to inform the public about it all or to find out what the public think, to allow them to represent any public concern when they sit at the ‘top table’ listening to all the proposals to change our local services.

There is now a plan to have fifteen members of the public to ‘represent’ the rest of us on a Citizens Panel – that will be created to advise the SYBACS on ‘public engagement’. However these 15 people are not required to have any knowledge or experience of public involvement best practice, nor are they required to demonstrate how they can represent the wider public views.

This is not following the legal duty to involve the public, as there is no recognition of the need for these five people to have meaningful discussions with the public to enable them to “offer a fair reflection of the views of others”, which is what the law requires commissioners to do.

CCGs are the Clinical Commissioning Group responsible for planning and buying local NHS services. There are 5 CCGs in the SYBACS responsible now collaboratively, for the ‘system wide’ commissioning of NHS services planned to be happening by next summer.

The 15 public members on the SYBACS Citizens Panel are NOT required to have knowledge or expertise in public involvement best practice (a CCG legal duty) but they are appointed to ADVISE the SYBACS on public engagement!

There is no suggestion that these 15 public members are expected to be accountable to the public for anything they say on or behalf! 


And HOW will the move from STP to ACS affect us?

The first thing we have noticed, as patient activists, is that the speed of making changes has stepped up and our local services will look totally different by this time next year.

  • As patients and as carers we will need to travel ‘further‘ to be treated
  • Many local services will be closed – once closed they will be difficult to reopen
  • The hospitals taking more patients could become ‘overcrowded’ and ‘unsafe’
  • There is a staff shortage so to treat everyone we will not be seen any ‘faster’
  • The relationship and trust between patient & health professional could be lost


Many of the decisions have already been made and are already happening – or about to happen very soon:

  • Barnsley Emergency Stroke service closed about a year ago
  • Bassetlaw Children’s ward closed at night some time ago
  • Much children’s surgery is to close in three of the five ‘places’ in early 2018
  • There is no out-of-hours GP service in parts of Bassetlaw NOW – at all

The following decisions are already being considered and are planned before or by April 2018:

  • Bassetlaw & Rotherham Emergency Stroke services will close too
  • Many local hospitals’ overnight stays for ‘ Acutely Unwell Children’ will stop
  • All local hospital services in SYB are being reviewed for ‘sustainability’ with a report in April 2018 on those services found to be unsustainable (to be closed)


WHO will be responsible if any of these changes go wrong?

The agreement for the former SYB STP now called the South Yorkshire & Bassetlaw Accountable Care System (SYBACS) excludes councils from decion-making – they only get to ‘agree the direction of travel’ of the SYBACS.

The SYBACS agreement also states clearly that it has no legal status but that the individual NHS bodies, specifically the Clinical Commissioning Groups, responsible for local NHS commissioning, carry all legal accountability, and liability.

The SYBACS (non-legal) agreement – the Memorandum of Understanding (MoU) – says:

Our health and care organisations are already coming together to form partnerships in Place; integrating health and care, commissioning and providing, including voluntary, community, GP, mental health and hospital services. These are taking varying forms and the governance and how this best supported in an overall ACS will be a key priority in 2017/18 and will be an area for which we will receive national guidance and support.

(our emphasis)

By PLACE they mean the 5 Council & CCG areas:  Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield.

The MoU also says that: “All of this ‘pushes’ at the boundaries of the existing legal frameworks…”






So please join us and help us to tell the people of SYB what is happenning, how secretly it’s being done and how FAST!


Tony Benn on rowers & steerers