Saturday 3 August 2019

chorley population increase warrants own A&E


GP and commissioner claims Chorley's ballooning population massively missing from NHS shake up plans in Lancashire.

■ Population of the Chorley borough rose from 97,000 in 1991 to 116,000 this year [2019] and is estimated to increase by another 18 percent [in the 25 years] up to 2039.

■ Estimated growth in households in Chorley over the next two decades is the largest in Lancashire.

In a news article in July this year Dr Cairns, a GP and member of local clinical commissioning group (CCG)  highlighted the above facts appearing to be strengthening a case for retaining Emergency Services in the borough of Chorley & South Ribble - but stopped short saying he was 'reminding people of that fact' [population increase].

Lack of resources

A draft “model of care”, produced under the local NHS change program called 'Our Health Our Care] (OHOC)  last August [2018], recommended closing Chorley & South Ribble Hospital A&E, suggesting that the public would be presented with a proposal for:

■ a single A&E unit for the whole of Central Lancashire,
■ keeping the existing two urgent care centres at Preston and Chorley hospitals,
■ and the creation of a “ringfenced” facility for pre-planned operations.

But when the OHOC joint committee agreed a final model in March this year, references to the numbers of individual facilities had been removed. Plans for a public consultation in January were also put back by twelve months until 2020.

The CCG running the OHOC program couldn't identify any specific sites/locations to put services removed from hospitals so had to delay plans and put them back 12 months.

In September 2017, the solutions design team for the OHOC program recommended 80% of outpatient services be removed from hospitals and relocated to private clinics called 'Multispecialty Community Provider Clinics [MCP clinics] run by a consortium of primary care networks.

Plans to further privatise the NHS are being rushed through with little if any public consultation.

The plan for Lancashire and South Cumbria, called the Sustainability & Transformation Plan (STP) came about due to trusts building up large deficits and deliberate government underfunding of the NHS budget.

The original STP for Lancs released late 2015 calls for the American profit-based system of healthcare titled 'Accountable Care Organisations' (ACO) to be established to control demand and manage access to healthcare by implementing schemes such as 'self-care', digital access, prevention and up-front restricted 'capitated' budgets.

But the association with the unpopular single-payer American health insurance system resulted in NHS England changing the ACO name to 'Integrated Care System' or ICS for short.

NHS England have however now conceeded that the ultimate goal of every STP/ICS is to become an American style ACO.

In a further attempt to fool the public, there have been several other name changes, yet the same outcome is to have a single prime aco provider/contracter sub contracting services in a private-public network of providers [as with the American health insurer kaiser permanente]*.
* Kaiser Permanente has had disputes with its employees' unions, repeatedly faced civil and criminal charges for falsification of records and patient dumping, faced action by regulators over the quality of care it provided, especially to patients with mental health issues, and has faced criticism from activists and action from regulators over the size of its cash reserves.


Campaign update [24th Aug 2019 see shortlist of options link below]


■ A shortlist of options on which NHS services are to be reconfigured is set to be discussed at a public meeting of the joint OHOC committee on 28th August

■ Thirteen possibilities had been assessed and whittled down to six, but CCG now say a 'broader set of options' are back on the table.

■ shortlist of options due to be considered by independent medics from elsewhere in the North West in mid-September before being examined by NHS England in December [2019].

■ there is currently no legislation which permits either the ICS or ICP to exist as formal entities - and they are sometimes described as operating in “shadow form”.

■ NHS England have told the Integrated Care System (ICS) for Lancashire and South Cumbria they are required to publish their  own five-year plan for the NHS by November [2019].

■ In Lancashire and South Cumbria, the collective deficit is derived exclusively from the region’s hospital trusts and stands at seven percent of their combined annual budget of £1.6bn. The area’s CCGs, however, are aiming for financial balance with little consideration to how the ideological ACO plans may work.

■ Hospital trusts deficits will be shared and reduced by handing over NHS services to private primary care networks in the ACO which could be run by the private sector (as in the states). Currently Private Primary care providers such as GPs work under a GMS or APMS or similar contract which will change when they become partners in the ACO

■ CCG Accountable Officer claims Limiting overspend is priority to make savings

■ Local CCG have offered £4.5m support package to Lancashire Teaching Hospitals - the trust which runs the Royal Preston and Chorley and South Ribble Hospital - to help it meet its own individual control total, dependant on 'certain circumstances' which are currently unknown to the public.


RELATED LINKS

https://www.lep.co.uk/health/can-partnership-plan-for-lancashire-s-nhs-improve-care-and-bridge-funding-gap-1-9908020

https://www.lep.co.uk/health/central-lancashire-a-e-planning-needs-more-thought-gps-told-1-9908025