News

Integrated Care Provider contract public consultation starts (3/8/18)

NHS England have published this public consultation, as required following the court case earlier this year when five members of the public including the late Sir Stephen Hawkings, took them to Judicial Review and won!  They successfully argued that the Accountable Care (ACO) contract could not be used as it had not had a full public consultation. (This is the national public consultation mentioned in the news item below).

You can find the consultation documents on this page on the NHS England website.  It is described as the ‘Consultation on the contracting arrangements for Integrated Care Providers (ICPs)’, as they have changed the name of theACOs  to ICPs – or Integrated Care Providers

The deadline for responses is Friday 26th October 2018, which is the promised 12 weeks. The documents include a fairly short ICP questions and answer PDF – where they answer 25 questions they think people may ask. This could be helpful in seeing quickly exactly what is intended by this contract and what the implications of it may be for patients and staff – and for future NHS commissioning arrangements.

The NHS establishment has carefully hidden this, as with all public consultations, on the citizen pages of their website.  There was no announcement in their News page, unless they intend to do this tomorrow!  They have also changed the name – again – no doubt to stop people finding it by googling ‘ACO contract’.

But – we are on their case!

 

Accountable Care Organisation (ACO) process launched in Barnsley (12/7/18)

Barnsley submitted documents to NHS England and to NHS Improvement (the national bodies in England that ‘manage’ commissioners (CCGs) and providers (Trusts)) in order to start a process that will put all services in Barnsley ‘under one roof‘.

It is not clear exactly what is proposed – other than it will be one contract and strategy for an ‘integrated’ service involving Primary Care (GPs), Community Care (District Nurses etc) , Mental Health, and Acute care (hospitals).

This will be the second or third ACO contract in England (after Dudley and Manchester). Barnsley was the second or third Hospital Trust to create a Wholley Owned Subsidiary Company (WOSc) in 2017 after Gateshead did, and maybe another one or two.  Why are Barnsley people being used as guinea pigs for new systems for delivering or managing our services?

But they seem to have forgotten that:

  • a contract for delivering services describes the commissioning ‘function’ that all CCGs are required – by law – to involve the public in,
  • and the national public consultation on the ACO contract has not yet happened

So we will be asking a number of questions on this one – and expecting ‘honest’ answers!

 

 

NHS 70th Birthday (5/7/18)

The 70th birthday of our NHS was celebrated in South Yorkshire and Bassetlaw.  A number of local people with local banners and placards marched along the streets of London on 30/6/18 in scorching heat to hear inspiring speeches from the Labour Party Leader, the Shadow Health Secretary and many representatives from Health Unions and campaigns across the country.

On 5th July, the day 70 years ago that the NHS was actually launched, local campaigners presented birthday cards, signed by many members of the public, and offered birthday cakes to local NHS staff across SY & Bassetlaw.  This was to show our recognition of their dedication and care despite the chaos, the crisis and financial mess surrounding them.

 

Comments invited on the Hospital Services Review Report (12/6/18)

It was announced at the Joint Health Scrutiny Committee meeting in Wakefield that comments are invited on the Review Report. The deadline for comments is 12/7/18.

This means that 24 working days AFTER the report was launched organisations, staff and the public were invited to give their comments on 500 pages of detail – but with only 22 working days to do so.

The deadline was later extended to one extra week for public comments to be submitted by 19/7/18.

 

 

Judicial Review – Unsuccessful (25/5/18)

The re-application for a Judicial Review of the decision to close the Barnsley Hyper Acute Stroke service on 25th May 2018 was not successful.                                                The case was based on two challenges:                                                                                            1) Challenging the consultation process with the Joint Health Scrutiny Committee as not following the correct legal procedure – but the case could not be proved due to a lack of any recorded concerns in their minutes.  Also the lack of a clear definition of what is meant in law by a ‘proposal’ (how much detail is required to be able to make an informed decision).                                                                                                                             2) Challenging the way the telephone poll responses by selected members of the public were presented to the decision-makers – but again the case could not be proved due to a  lack of a clear definition in law of what is meant by ‘involvement’ of the public.  Also a lack of clarity in the Gunning Principles relating to a consultation process on how much detail is required to be able to make an informed decision.

The Barnsley resident who had applied for a Judicial Review was let down by the law, that did not define wording clearly enough, and also let down by an ineffective Joint Health Scrutiny process.

 

SYBICS Hospital Services (Sustainability) Review Report Published (9/5/18)

The South Yorkshire & Bassetlaw Hospital Services Review Report has been published, but only on-line – it can be seen on  https://www.healthandcaretogethersyb.co.uk/what-we-do/working-together-future-proof-services/looking-at-hospital-services/information-staff/recommendations-report/report-future-hospital-serv

The word ‘sustainability’ has been dropped from the original title when the Review was announced last August.

There are four documents that explain what is recommended for either transforming services that are described as ‘unsustainable’, or for restructuring if transformation will not sort out their problems.  The four documents add up to nearly 500 pages.

There are five hospital services being looked at these are:

  • Urgent and Emergency Care
  • Maternity
  • Acutely Unwell Children
  • Stroke
  • Gastroenterology

There are no hard copies, British Sign Language or Easy Read versions available of this report.

 

SYBICS News – ‘Accountable’ is now ‘Integrated’ (12/2/18)

New name, and new system wide policies, system wide budgets and system wide commissioning.  With new operational plans by 30/04/18 to describe how CCGs will spend their money – but these CCG plans must fit with the SYBICS’s system wide plans, policy and system wide budget intentions.

NHS England now works alongside NHS Improvement.  NHSE has statutory responsibilities to oversee how CCGs work and NHS services are delivered in England, with other absolute responsibilities for pharmacies, for dentists, opticians and specialist services for rarer conditions.  NHSI has statutory responsibilities for working with NHS Trusts (formerly the Trust Development Authority and Monitor).

Both NHSE and NHSI jointly published the planning guidance update for 2018/19 for CCGs (Clinical Commissioning Groups, responsible for funding local NHS services). The update can be found at Refreshing the NHS Plan 2018/19, with Ps 11-14 being about how Accountable Care Systems are affected – beginning with the change to their name to Integrated Care Systems.

Briefly the new changes that will affect SYB include:

  • that it’s all to be SYSTEM WIDE – money (under system wide total financial control sums)  & all decisions & policies ‘aligned‘ across the system
  • that SYSTEM LEADERS have more control than the individual statutory CCG / Provider / LA leaders (and who are these system leaders accountable to?)
  • Everything must be endorsed/approved by NHS England & NHS Improvement at all stages introducing much more ‘central control’ than before

SO our CCGs can’t decide how to spend money allocated locally – they must fit SYBICS system plans & NHSE/NHSI & System Leaders must approve it all.

AND the SYBICS System Leaders must sort out any disagreements between the way CCGs want to run their local services for their local population and the way the System wants to run our NHS in SYB for the wider population.

ALSO any of the extra money made available to struggling CCGs and Trusts will only follow compliance with all of the system wide plans –  with many more incentives built into the whole thing now.

BUT –  who are the System Leaders?   Nobody knows!

Are they the SYBICS staff?  Are they the CCG Chairs?  Are they just the 5 ‘places’ in the SYBICS ‘footprint’?   Or are people in North Derbyshire and Mid Yorkshire included in these system leaders that now have so much power?

None of this is quite within the law – but they are doing it anyway!

 

Local NHS funding announced for 2018/19 (8/2/18)

NHS England has now published the revised allocation of NHS funding for each of our 5  CCGs (Clinical Commissioning Groups) to provide the NHS services their local population needs over the next financial year.  You can see this information on the NHS England website – just look for the CCG name on this page Revised CCG Allocations 2018/19

TOWN 2016 forecast for 2018/19 (What CCGs expected) Total sum for 2018/19 (What CCGs actually get)    +/- £s
Barnsley £379.236m £377.332m -£1.904m
Bassetlaw £159.280m £159.737m +£0.457m
Doncaster £452.107m £451.375m -£0.732m
Rotherham £364.303m £363.665m -£0.638m
Sheffield £761.852m £764.771m +£2.919m
TOTAL £2,116.778m £2,116.880m +£0.102m

Please Note: there was an additional sum for Sheffield  (£3.496m) and for Barnsley (£1.532m) that is money for two years (2017-2019) only for delivering GP access projects.

But it appears that allocation money is moving from Doncaster to Bassetlaw and Sheffield, but more money is moving from Rotherham and especially from Barnsley to Sheffield.  This is before the new system wide budget is set up from the individual CCG 2018/19 budget allocations.

It is important to note that the projected CCG allocations for 2018/19 that were published in 2016 was information that the new partnerships across SY & B used about available funding when they were writing their Sustainability and Transformation plans. 

They thought the amount of savings they were expected to make was £571 million, before 2021, but it turns out they will have to save a bit more money, as they are getting less funding next year than they expected when the STP was written.

 

What happened in SYB in 2017 (3/1/18):

SYBSTP (South Yorkshire & Bassetlaw Sustainability & Transformation Partnership) was given the go-ahead to work as an Accountable Care System, and to carry out the proposals in their STP plan.

They are making these changes by creating a complex bureaucracy (with management costs) to run services across the SYB area, and also at local level (more management costs).

This is to run our NHS services on the cheap.  Why? – Because the government won’t be giving SYB £571 million of the money our area needs in the next couple of years, to provide the NHS services that SYB people need.  So the money, staff, and their skills, will be stretched across a wider area by creating specialist centres and closing local units along with many smaller community care services.

Here is a snap shot of what happened in each of the 5 ‘places’ in 2017:

In Barnsley:

  • Hyper Acute Stroke Service partly closed & decision made to close the whole service
  • Mount Vernon hospital – community hospital – closed
  • Decision to close non-specialist Children’s Surgery and Anaesthesia in 2018
  • Free NHS Pain service acupuncture treatment service closed
  • Keresforth Centre for young disabled people to be closed
  • Hospital Review threatens Emergency Unit, Children’s Ward, Maternity & Neonatal

In Bassetlaw:

  • Children’s ward closed overnight – children transferred 18 miles to Doncaster
  • Out of hours GP service unavailable in some areas

In Doncaster:

  • Earmarked as a specialist stroke centre – potential overcrowding issues
  • Also potential specialist centre as part of hospital review and overcrowding issues

In Rotherham:

  • Decision to close Non-specialist Children’s Surgery & Anaesthesia services in 2018
  • Decision to close Hyper Acute Stroke Service in July 2018
  • Hospital Review threatens Emergency Unit, Children’s Ward, Maternity & Neonatal

In Sheffield:

  • Earmarked as a specialist stroke centre – potential overcrowding issues
  • Also potential specialist centre as part of hospital review and overcrowding issues
  • Minor Injury & Walk In Centres to be closed in city centre

REMEMBER – the NHS ‘belongs to the people’ – DON’T LET THEM STEAL IT!

We should all get a say in any changes to OUR NHS!

JOIN US – to oppose the destructive changes to OUR NHS!

 

Sheffield News (29/11/17)

  • Sheffield SSONHS have been working hard to collect signatures for our petition against the closure of the Minor Injuries Unit at the Hallamshire Hospital – we are getting a good response on street stalls and in the hospital itself, and  have made new contacts through this as well.  We’ve been invited to speak at 3 meetings so far – and counting.  The CCG public meeting was well-attended, with many people opposing the changes.
  • Scrutiny Committee called in the decision to endorse the Accountable Care Partnership shadow board for Sheffield and will discuss this at a special meeting on 5 December.
  • Our members continue to write monthly articles for the local paper.  In August they published this piece about commercialisation in the NHS, in September an article about Accountable Care and in November another on inspiration from Cuba.
  • MP Louise Haigh has been actively campaigning for the NHS for some time, for example here.

 

 

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