Wednesday, 9 January 2019

hospital trust employ 'bad' rated parking company

What 296 customers said about ParkingEye (source: Trustpilot)
When implementing an unpopular system, only to discover it's not working, rest assured you can watch your recruitment and retention rates fall, and your deficit grow. 

With all the chaos at Chorley and Preston hospitals due to the new hospital parking system, it's as though the hospital trust don't want anyone at their (OUR) hospitals at all.

Preston hospital car parks were strapped for space no doubt but the lack of ground maintenance was apparent for all to see, a rubble and shambles. The excuses used by the trust to justify bringing in the most hated parking company 'Parking Eye' doesn't wash with anyone.

At least anyone outside the 'trust board' fraternity.

A more friendly intercom barrier system has been replaced with a hostile 'Pay or Else' big brother camera that haunts your waking hours waiting to pound your front door carpet with its penalty charge notice.

A worrying and sickening thought for those already stressed about their loved ones who lay poorly in a hospital bed.

Not content with doubling the parking fees and charging disabled people to park, Lancashire teaching hospitals NHS trust then add insult to injury by bringing in the countries most hated private parking company 'Parking Eye' to ensure penalties and profits are maximised for both parties!

The new camera parking system implemented just before Christmas was a yuletide insult to staff, patients and visitors. How much disrespect can one show to those who pay their wages?

The trust claim there are teething problems with the new parking system, yet when the machines fail, the Parking company, apparently based in Buckshaw village, are nowhere to be seen.

This has left the trust having to send extra staff out to appease drivers stood ranting and raging at the faulty pay machines, whilst the queues get longer and longer...

The trust's website identifies the trusts 'council of governors' - (democratically elected by local people) as representing their local communities, and working together with the trust board to advise and influence how the hospital trust develop and deliver services.

Automatic Number Plate Recognition (ANPR)
The proposal for the new ANPR hospital parking system however was heavily criticised by the council of governors but instead of heeding the advice the trust tried to gag the peoples voice and when things went wrong they suspended the governor who spoke out.

Only 12 weeks ago it was reported that the Lancashire teaaching hospital trust charged their own staff over half-a-million £pounds to park at their place of work! They then reined in over £1.75 million in car parking fees taken from patients and visitors to the hospitals, sickening in itself.

This trust board were reprimanded in an independant review for not acting sooner and recruiting staff to avoid closure of the A&E at Chorley & South Ribble district hospital in 2016.
The board didn't listen then, and they've STILL not learned the lesson as they don't appear to be listening now. 
It's seems apparent the trust board do not have the interests of the public they serve as priority. With a £43m deficit, the new car parking scheme is just another funding stream that not only fails at the first hurdle, but has infuriated staff, patients and visitors to the extent nobody wants to visit or work there anymore.
Well done Lancashire Teaching Hospitals NHS foundation trust, pat yourselves on the back whilst you watch staff recruitment and retention rates fall, and your deficits grow


Related


(New parking charge strategies have been labelled "scrooge tactics" and "a tax on the sick" by critics).



Friday, 23 November 2018

Are Chorley and Grantham A&E closures being pushed through on safety grounds

Are Chorley & Grantham required STP changes being pushed through on 'safety grounds' ?

"STPs cannot solve the problem of inadequate funding. Ministers will have to fund the NHS properly or take political responsibility for its collapse".
following excerpt from The Sustainability and Transformation Plans: a critical assessment John Lister, Centre for Health & the Public Interest

At the end of the day, when the innovations in STPs don’t deliver savings for the NHS, NHS England will again resort to cuts and rationing. Indeed many knowledgeable people see the STPs as a smokescreen to divert attention from cuts at trust level, whittling away staffing levels, imposing smaller-scale service reorganisations, and preparing to push through controversial closures on ‘safety’ grounds (as has happened in Grantham and Chorley and is increasingly on the cards in Ealing).

Currenty, Lancashire Teaching Hospitals NHS foundation Trust are £43m in deficit.

How did the trust providers get into such a mess? 

The answer is pretty simple. Every year between 2010-11 and 2015-16 the amount hospitals were paid for each treatment they provided was cut, year after year. That meant that by 2015-16, a hospital was paid the equivalent of £820 to treat a patient they would have been paid £1,000 to care for in 2010-11.

Hospitals tried to balance their books by cutting their costs by around 13 per cent over the same period. But the amount they were paid was cut even faster – by around 18 per cent, resulting in the expenditure-over-income deficit we see today.’

Under-funded hospitals are indeed failing to meet their targets.
More than 10% of elective patients (364,000) are waiting over 18 weeks to start treatment, missing the time limit supposedly guaranteed under the NHS Constitution.

....abstractions like ‘integration’ and ‘self care’, to be found in every STP, distract attention from unpopular changes, and ignore facts on the ground. Public health programmes are actually being cut back across the country as a result of cuts in local government funding, so there is no money for the new prevention schemes that would be required to reduce the need for care, or for projects to tackle seriously the social determinants of health – which in any case would take years to show any measurable reduction in pressure on the NHS. Yet many if not all STPs rely on public health action to significantly reduce the ‘demand’ for services.
  • Primary care is already floundering: with more and more practices unable to cope with ever-increasing pressure, many GPs are leaving and are increasingly hard to replace, while Jeremy Hunt’s promise to recruit 5,000 more GPs plainly lacks credibility.
Many STPs seek to paper over the cracks, proposing that other, less qualified – and yet to be recruited –staff will take over a lot of the work now done by GPs.
As for community health services, some rural STPs involve closing community hospitals, with Cumbria and Devon expecting patients to travel up to 50 miles on sometimes hazardous roads when they need hospital care. None of the STPs addresses travel issues for elderly, less mobile patients, or single parents.

Even where community and home-based health or care services have been shown to be effective in enhancing patient care, they don’t save money, but cost more.

Yet STPs are required to save money, to enable the NHS to deliver more services to more people and absorb more cost inflation and cost pressures over the next four years, and wipe out existing deficits.

Many questions also hang over the proposals, more developed in some STPs than others, for the development of new forms of organisation of health care through US-style Accountable Care Organisations (now called Integrated Care Partnerships), as outlined by Simon Stevens in the Five Year Forward View. Many of these schemes are for the medium or longer term, and none of the proposals explain how they are supposed to improve services while at the same time saving money.

Indeed far from being cheaper to run, ACOs in the USA receive and require far higher spending per head than any British equivalent could even dream of, with allocations between 3 and 5 times higher than the average £2057 spent per patient per year in England’s NHS – a figure which many STPs explicitly seek to further reduce.

Nor do STPs address the consequences for existing NHS and Foundation Trusts of establishing new contracts and provider organisations, or the proposed reductions in caseload and funding for existing providers which are central to the expected cost ‘savings’.

Since acute trusts are largely paid only for the patient care they deliver (‘payment by results’), a reduction in caseload in one service can trigger the collapse of viability of related services and pull the financial rug from already indebted trusts.

Conclusion

At the end of the day, when the innovations in STPs don’t deliver savings for the NHS, NHS England will again resort to cuts and rationing. Indeed many knowledgeable people see the STPs as a smokescreen to divert attention from cuts at trust level, whittling away staffing levels, imposing smaller-scale service
reorganisations, and preparing to push through controversial closures on ‘safety’ grounds (as has happened in Grantham and Chorley and is increasingly on the cards in Ealing).

Up to half of most STPs’ planned savings are in any case to be squeezed out of the hospital sector, through ever more relentless ‘efficiency savings’ and reductions in staffing levels, along with closures of beds, services and even whole hospitals.

With no alternative services in place, and no capital available to build new or extend existing hospitals, and with even community hospital beds and staff facing cuts, it is a recipe for a chronically under-resourced, chaotic and scandal-prone NHS.

Promoting STPs may seem an easier course of action for NHS England than to warn Mrs May that if the cash freeze begun in 2010 is extended to 2020/21, many services will collapse. We know that Simon Stevens’ effort to do this after she became Prime Minister was met with a frosty reception.

But STPs cannot solve the problem of inadequate funding. Ministers will have to fund the NHS properly or take political responsibility for its collapse.



Thursday, 15 November 2018

Primary urgent care privatisation in full swing in Lincolnshire



NHS England have just paved the way for the private health sector to run the front end of every major hospital in Lincolnshire. 

Simon Stevens, the boss of NHS England and ex vice president of UnitedHealth, the largest private health insurer in the united states, announced his plan to convert the public NHS in England into his American counterpart called an 'accountable care system'.

He did this in what NHS England call the five year forward view, the blueprint document all regional Sustainability & Transformation Plans [STPs] are based on.

Decoupling hospital services such as outpatients and diagnostics and moving them into private-public community clinics is a crucial part of the STPs and privatisation process.

As is closing A&E departments and replacing them with urgent care centres, also ultimately with the facility to be run by the private healthcare sector.

The NHS England plan, that so far has received no public consultation, is to introduce Urgent Treatment/Care centres (UCCs) at 5 hospital sites across Lincolnshire in an attempt to reduce attendances at A&Es.

It's also been revealed there are 150 Urgent Care Centres planned for England by December 2019. It's anticipated the 150 urgent care centres will be located at various places throughout the community and could result in over one-third of A&Es in England either closing or being downgraded.

On a smaller scale this is what NHS England did over at Chorley & South Ribble hospital in Lancashire in 2015 with health bosses claiming the Urgent Care Centre was there to supplement the A&E and to reduce admissions to A&E. The reality is the ultimate plan revealed later in 2015 as the 'STP' was to downgrade the Chorley A&E and replace it with the extended UCC & and to send patients from the Chorley area over to the trusts other hospital A&E at Preston.

It's not necessary to build an urgent care centre adjacent to the A&E unless the UCC is to be privatised and to replace the A&E. With perhaps the exception of 1 or 2 A&Es in Lincolnshire, so is a trial to see if an A&E can still manage demand with reduced numbers redirected to the Urgent Care Centre before eventually replacing the A&E. *Urgent care review.
NHS England claim the walk-in urgent treatment centres will be open at least 12 hours a day and can also be booked via a GP or through NHS 111. They also claim attendances at urgent treatment centres will count towards the four hour access and waiting times standard.
Each hospital trust need stats across 4 quarters (1 year) to get the numbers (across 4 seasons) and to satisfy NHSE criteria for a downgrade.

Reports claim a walk-in centre at one hospital in Lincolnshire is to be replaced with a UCC which begs the questions as to how are they to be funded and were the plans scrutinised by the health committees long before the decision being made.

General Practice also stand to gain from further deals established in the five year forward view and a related document called the General Practice  forward view (GPFV).  The General Practice forward view expands the role of the dwindling GP practices by integrating them into a network partnership similar to that used by USA health maintenance firm 'Kaiser Permanente'. The GPFV provides an opportunity for private practices to invest in new ways of providing primary care.

And of course remember, the Clinical Commissioning Groups (CCGs) are those GPs and civil servants making the changes in the STPs and reaping any investments. Conflict of interests appear to have gone out the window with CCG co-commissioning. Delegated co-commissioning is illegal in local authorities due to the obvious conflicts of interest.

NHS England claim a urgent treatment centre is a type 3 or type 4 A&E.
The urgent care centres not adjacent to an A&E are nothing like an A&E department and the tag of 'type 3 A&E or 4 A&E' is assigned to appease the public that the 4 hour A&E target to be seen as in a type 1 A&E still applies.

The titles are irrelevant, they are just the same as a walk-in or a  minor injuries unit. Same services: lucrative/profitable, high-turnover, low risk, just right for the private sector.

NHS England have just paved the way for the private health sector to run the front end of every hospital in Lincolnshire.

LINKS


NHS England announce 150 urgent treatment centres
https://www.england.nhs.uk/urgent-emergency-care/urgent-treatment-centres/

NHSE Guidance telling local areas need hurry up and to get started on setting up the new urgent treatment clinics..
https://www.england.nhs.uk/publication/urgent-treatment-centres-principles-and-standards/

Lincolnshire health bosses identify five urgent treatment centre sites for county
https://www.sleafordstandard.co.uk/news/health/lincolnshire-health-bosses-identify-five-urgent-treatment-centre-sites-for-county-1-8703107

Monday, 29 October 2018

Chorley urgent care and the missing Hospital directors


In May this year, the local papers reported that four top directors were leaving the Lancashire Teaching Hospital NHS foundation trust. This sparked suspicion as to why such top executive figures had made the decision to leave?

The trust had a deficit of £42m and were rated as 'requires improvement' by the care quality commission - and has recently again been rated the same.

Gone...

  • operations director
  • divisional director for surgery
  • divisional director for medicine
  • divisional director for support services

At the time, our very own dedicated campaigner Steve Turner predicted that the departures of so many directors would mean "that audits by the Care Quality Commission will pick up on increasing failures at operational levels this puts our hospitals at risk.”

The prediction was accurate, and a few months later in October 2018 the CQC awarded the hospital trust another rating of 'requires improvement'.

Suspiciously, the trust chief executive  Karen Partington stated all directors who had left the Hospital trust had confirmed they'd got other jobs, and Ms Partington wished them every success. A strange congratulation considering they'd left Ms Partington and the rest of the board to collect the unfortunate accolade that would lead to requires improvement from the CQC.

The real reason of course is the ship has been putting plasters over its leaks for years; hoping someone won't notice - fortunately campaigners and health scrutiny found out the ship was heading towards the rocks and stepped in.

In 2017 the trust board were castigated in an independent review about Chorley A&E closure for refusing to ask health boards for advice and assistance. They were also criticised for not recruiting staff earlier.

The independent review panel looked at the arrangements at the time at both Preston and Chorley hospitals, to see if our A&E department at Chorley could reopen, within the current medical staffing available. And it was re-opened albeit part-time, but it was re-opened and apparently could have been reopened sooner.

Finally, there is one paragraph in the external review that I believe indicates the true intentions of closing Chorley A&E permanently under the local STP plan called Our Health Our Care.. here it is....
"Having the emergency department reopened at the same time as the opening of the new 24-hour urgent care centre, integrating the two services, will provide additional resilience. This is an opportunity to enable the service to reopen without compromising patient safety".
All along they've wanted to ensure a part-time A&E could likely run alongside a 24 hour Urgent care centre. This is the precursor for a permanent closure of the A&E as a simple expansion elsewhere (eg Preston hospital) could take up the slack leading to the permanent closure of Chorley A&E.

I stand by what I've always said: The urgent care centre was not built to supplement Chorley A&E but to eventually replace it. Now the urgent care centre is privatised, the CCGs, who hold the purse strings and no doubt pull them, intend moving other services out of hospital and doing the same to them.

There is of course another reason. 

In October the same year [2016], NHS England chief executive and ex vice president of Americas largest private health insurer 'Simon Stevens' had previously singled out the Lancashire Hospital chief executive Karen Partington for praise in an interview with HSJ, for making the “right decision about what was needed in Lancashire”. He said it was an example of how he would support and create a “safe harbour” for local leaders who would take brave decisions and who were “going to drive” change in the health service.



Well not while we're around you're NOT!

It's Our NHS, and we're not letting you give it away or to play dangerous game with!

Join our campaign to save Hospital A&E and other services in Lancashire.

Join our Facebook Group for more info...





Daft or Dangerous? What’s the reality of STPs?


Excerpt from Draft, Daft or Dangerous? What’s the reality of STPs?
By Dr John Lister, coordinator Health Campaigns Together
www.healthcampaignstogether.com

STPs won’t do what they say on the tin: they are not sustainable, there’s no
capital to finance any serious transformation, and many of them plainly don’t
add up: but they are seen as the future of England’s NHS.


..all STPs have one thing in common: just weeks before they are scheduled
to begin implementation, none of them has been subject to any serious public
engagement or consultation.

Indeed some plans were only published by irritated council leaders, allegedly
‘partners’ in the STP process, who lost patience with the secretive process
decreed by NHS England.

Most of the later drafts have some approval from NHS England, but it’s not
clear why some of the vaguest and least convincing plans have got through.
However one element among many unidentified “savings” plans is “Specialist
Commissioning” – controlled by NHS England. In NW London alone the gap on
this is £189m.

Campaigners and the local public have been understandably suspicious and
hostile.

Local councillors, as perhaps potentially the most politically vulnerable to
public anger over cutbacks, have emerged in some areas as unexpected vocal
challengers to the latest controversial plans – after decades of council
abstention or gullible connivance on NHS policy and resource issues (for which
they are not formally accountable, and have little knowledge). Councils have
largely failed for decades to use the powers they still potentially retain on
health.

Delayed reaction...

But some reactions have been delayed and muted by confusion over the
contradictory content of STPs, which manage to talk abstractly about some
positive objectives, and getting commissioners and providers collaborating
together, even while developing more concrete and questionable plans to save
money.

An aspirational window-dressing of positive ideas camouflages the unpleasant
content of STPs like a sophisticated air-freshener masking the real scent of
sewage.

The 'sweeteners'

Every STP, following the new orthodoxy of Simon Stevens’ Five Year Forward
View, uses words for which nobody would consciously choose the opposite:
better “integration” of the under-funded, fragmented and largely privatised
‘social care’ system outside hospital with under-funded, fragmented and in
some cases arbitrarily privatised NHS hospital, community and primary care
services, for example.

Who doesn’t want more effective preventive and public health measures to
keep people from needing the NHS in the first place? Who rejects action to
address the “social determinants” driving ill-health?

Who would say no to fresh new resources to support and enhance primary
care, easier access to GPs – and the option wherever possible of care nearby or
even in your own home rather than trekking miles to overstretched,
overwhelmed “centralised” hospital services?
"But these sections, in each STP, are a smokescreen for unpopular changes, and ignore facts on the ground".
Public health programmes are being actually cut back across the country after
government funding cuts. There is no money for worthy projects on social
determinants – which in any case would take years to show any measurable
reduction in pressure on the NHS.

What about the staff?

Primary care is floundering, not flourishing: with many busy [GP] practices unable to cope with ever-increased pressure, many GPs are leaving and increasingly hard to replace, and Jeremy Hunt’s promises to recruit 5,000 more GPs are simply bogus. Many STPs merely seek to paper over the cracks, with other – yet to be recruited – less qualified staff, to take over some roles from GPs.

As for community health services, some rural STPs are looking to close
community hospitals, expecting patients to travel up to 50 miles on hazardous
roads when they need a hospital. None of them address travel issues for the
elderly, less mobile and single parents.

In town and country alike there is little plausible hope of developing properly resourced systems capable of delivering complex care in individual homes, with no funding, no staff, no plan – and no public acceptance.

Even where community and home-based health or care services can be shown to be effective in enhancing patient care, they don’t save money, but cost more. This contradicts STPs which have to save money, and close a total gap in excess of £22 billion by 2020.

Managing 'demand'

Where the fancy plans don’t deliver savings, old-fashioned cuts and measures
will be wheeled back out. At least half of STPs’ planned savings in most areas
are already expected to be squeezed out of the hospital sector, through
relentless, enormous “efficiency savings”, ruthless reductions in “back office”
support staff and staffing levels, and unpopular closures of beds, services and
whole hospitals.

A recipe for disaster?

With no alternatives and no capital available to build new or extend existing
hospitals, this is a recipe for a chronically under-resourced, chaotic and
scandal-prone NHS. The “transformation” might even see services declining to
the levels that triggered the major alarm in Mid Staffordshire Hospitals a
decade ago.

When the time comes to implement the STPs and there are howls of public
rage and protest, rocking local politicians, NHS England has nobody to blame
but themselves – for a secretive process forcing rapid adoption of often flawed
plans with no consensus.

STPs may seem easier than to speak truth to power and warn Mrs May that if
the cash freeze begun in 2010 is extended to 2020 many services will be
reduced to a state of collapse.

But STPs cannot solve this problem. Ministers must fund the NHS – or take full
political responsibility for triggering its collapse.


Friday, 26 October 2018

Tories at County Hall vote to exclude public from 'two A&Es' debate

Conservative councillors at County Hall voted this week not to include the option at a public consultation of having an A&E at both Preston and Chorley. 

County councillors earlier this week clashed over the future of our Accident and Emergency department in Chorley at a meeting of the the full council.

A motion was proposed calling for the Lancashire authority to state its “strong opposition” to plans for a single A&E unit to serve the whole of Central Lancashire.

As I read through an article on the issue, I noted an amendment had been added to the motion by Conservatives calling instead for "the public consultation process to be allowed to come to a conclusion".
It's hardly 'public consultation' if the potential for two A&Es are not being consulted on now is it? 
The regional hospital trust 'Lancashire Teaching Hospitals NHS foundation Trust' runs 2 acute hospitals in Central Lancashire.

One at Preston and the other at Chorley.

Chorley A&E is currently only open part-time so no doubt would be the initial target for closure if a choice between the two had to be made.

The Tory 'amendment' excludes debate at the public consultation around whether or not two A&E departments should be considered and debated on by the people who use the services, the public.

Tories exclude the public - let them get on with privatisation plans

By refusing to support the motion, the public won't be in a position to query why a single A&E option was selected and why indeed it was proposed in the first place considering the demand for two A&Es across central Lancashire had increased over the last few years.

Supporting the amendment, Conservative councillor Shaun Turner then said "It’s a clinically-led consultation and we should have an open mind,” County Cllr Shaun Turner said. [So] for that reason, I’m proposing we let the consultation run in full...and see what it finds.”

One thing Cllr Turner seemed to omit was that the consultation on service provision on both sites, although called by clinicians, is actually a public consultation, not a clinician consultation.

Leaving the proposals as they are without public scrutiny throughout the consultation is simply playing into the hands of those wishing to have a single A&E for central Lancashire. It's a done deal, not an 'option'.

One thing the concillors didn't debate, was the A&E closure is being used as a distraction to the real intentions of the 'NHS transformation plan' to cut services and hand them over to the private sector wholesale as per the Health & Social Care Act 2012.

The Conservative amendment was carried, with Tory Councillor Eddie Pope claiming a victory for common sense. Ironically, it was Cllr Pope who the week previous opposed scrutinising two A&E's when the same issue arose at the health scrutiny committee he also sits on.

The Conservative governments view, and no doubt that supported by Conserviative councillors across many councils, is that the NHS needs to change to a more market-based system that includes much more involvement from the private health sector.

A profit driven NHS where competition is meant to drive up standards.

In reailty, the NHS doesn't work that way, but nevertheless the general concensus as stated in a Conservative 2005 policy paper is to 'break down the barriers between public and private provision, effectively denationalising [privatising] the NHS".

To emphasise just how serious the Tories are about privatising most of the NHS, this week they awarded a £104m children 0 - 19 yr old contract to private company Virgin Care Ltd.

LINKS

LEP news article report on council clash this week

Tories at Lancashire county hall sell off £104m NHS contract to Virgin Care

NHS for Sale - Virgin Care

Tuesday, 23 October 2018

Health & Social Care legislation, an Act of cruelty

Your NHS - they're taking it all away... 

The 2012 Health & Social Care act removed the duty for the secretary of state to 'provide' health services to citizens of England. This was replaced with a duty only to 'promote'.

The provision was handed down to newly formed Clinical Commissioning Groups (CCGs) in April 2013. These CCGs are now rationing and banning certain medicines and procedures, some say readying to place them on a health insurance list for people to pay for when NHS reforms take hold in late 2019/20. 

Legal basis for CCGs arranging fewer government funded health services

Under the H&SC act, CCGs are allowed to arrange fewer statutory services than provided previously by their predecessors Primary Care Trusts PCTs.

Previously, the “functions regulations,” were that PCTs must provide or secure the following services on behalf of everyone in a specified geographical area:

  • Accident and emergency services and ambulance services
  • Services provided at walk-in centres
  • Facilities and services for testing for, and preventing the spread of, genitourinary infections and diseases and for diseases
  • Medical inspection and treatment of pupils
  • Services relating to contraception 
  • Health promotion services • Services in connection with drug and alcohol misuse 
  • Any other services that the secretary of state may direct. 

These regulations were repealed, and the act does not require CCGs to secure the above services. They have to arrange only ambulance services and “emergency care” for everyone living in the area defined in their constitutions.

The H&SC act therefore established a legal basis for CCGs to secure fewer government funded health services. The act also transferred from the secretary of state to CCGs the power to determine what is “appropriate as part of the health service” for certain individuals.

The services concerned are care of pregnant and breastfeeding women, care of young children, prevention of illness, care of people with illnesses, and aftercare of people who have been ill. In this way CCGs may decide what is appropriate for government funding.

Moreover, decisions about what is appropriate can be delegated to commercial companies and, under rules set out in schedule 2 of the act, need not be made by general practitioners, other clinicians, or NHS staff.

All the above was predicted in an article from 2011 by the BMJ, and it is now all coming to fruition.