Monday, 2 September 2019

Is Chorley A&E closure being used to fill financial black hole


Are hospital service closures being used to fill black hole in Trusts finances?

The Chief Executive of Chorley and Preston Hospitals 'Karen Partington' stated in June 2018 that financial and operational performance are inextricably linked and this has had an affect on patient care and missing targets.

The fact that the Lancashire hospital trust are £37m in deficit [June 2018]  adds to suspicions by local NHS campaigners that their A&E in Chorley is intentionally being primed for closure to save the trust money.

The financial difficulties beset by the Lancashire hospital trust are a culmination of issues that have accrued over the years. In 2017 the hospital trusts financial director stated that A&E (Preston and Chorley) was 'driving all the deficit', indicating this service area would be a likely target for efficiency savings (cuts).

This was further evidenced in the regions 'Sustainability & Transformation Plan' (STP) which identified savings could be made by relieving pressures on acute hospital services by closing many hospital services and relocating them into communities. According to the regions STP, health bosses across Lancashire and South Cumbria need to save £583m between 2015 and 2021.

STP: In 2015, the head of NHS England Simon Stevens, an ex vice-president of U.S. private health insurer 'United Health', divided England into 44 footprint regions with each 'footprint' asked to prepare their own Sustainability & Transformation Plan. The plans were a response to deliberate government underfunding with the overall intention of pushing through American health models called 'Accountable Care Organisations' (ACO).

In 2017, a report from a program design team of advisers working on an STP plan for Central Lancashire recommended 80% of outpatients currently seen in acute settings at Chorley and Preston hospitals will not be seen there in future.

The Trust chief executive said “This month [June 2018] local health and care organisations met to map and review urgent and emergency care processes and pathways, to identify what’s working, and address what isn’t, so that together we can drive improvements to ensure that in the future our communities can access the care they need, when they need it, in the appropriate setting.

It's still not understood why the trusts chief executive believes a hospital is deemed an inappropriate setting for providing these services, as these services have served hospitals well for the last 70 years.

The STP however indicates the more lucrative and low risk hospital services will be shifted out of public NHS hospitals into private clinics within communities - all at the risk of being taken over by private ventures campaigners assert.

After all, the credentials of the man running the show Simon Stevens speak volumes (see link below).

Simon Stevens spent the best part of a decade as a senior executive at UnitedHealth – the largest private health insurer in the United States..
More: Who is the boss of NHS England 'Simon Stevens'?

NHS Chiefs trying to plug £37m black hole in finances







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





Thursday, 6 June 2019

NHS Assets up for grabs in fire sale

Sir Robert Naylor proposes selling off NHS land and buildings

NHS for SALE, SELLING OFF ASSETS by the POUND


As with KOSHH campaign and Epson & St Hellier hospitals, all NHS trusts are selling off NHS estate following the Naylor report well under market value, knowing they will recoup the losses due to the 2 for 1 offer (match funded) by the Tory government

There's also a threat in the Naylor report that states if hospital trusts don't accelerate the disposal of NHS estate (to private developers) they will not be eligible to access much needed money for patient care and equipment (running costs).


Fire Sale, it started long ago..

If your'e a hospital trust in deficit, and let's face it most are, there's a good chance you'll be advised to sell of some of the estate to private developers for LESS than market value: so the incentive is to flog off NHS estate using NHS Property services Ltd who own all NHS estate (assets) after they were transferred in-line with the 2012 Health & Social Care act.

The Naylor report is an NHS asset stripping document. NHS Property services Ltd is run by the CEO of NHS England Simon Stevens, the previous president of UnitedHealth, Americas largest private health insurer.

BELOW: CHRIS's video on Naylor report - A MUST WATCH!




Wednesday, 29 May 2019

STP lead apologises over poor state of mental health

Lancashire's STP lead 'apologises over poor state of mental health' on her watch

A recent report of urgent mental health commissioned by Lancashire & South Cumbria STP has been criticised after it was revealed mental health patients had received a lack of response from crisis teams, with some left on trolleys in hospital corridors overnight.

Amanda Doyle, a doctor and lead officer for the currently trialled non-mandated 'integrated care system' which includes mental health, admitted the report painted “a clear picture of where we have gone wrong and what we need to do to improve”.

Caroline Donovan, chief executive of Lancashire Care NHS Foundation Trust, said: 

We welcome this report and its recommendations even though it makes for very difficult reading for all of us involved in the delivery of mental health care. We are so sorry that our services have, in many instances, fallen way short of what we aspire to, and that our patients and families deserve".

Full story from the Lancashire Evening Post
 Mentally ill patients in Lancashire suffer distressing waiting times

Tuesday, 9 April 2019

whilst you were distracted with BREXIT the NHS shrunk

WHILST YOU WERE DISTRACTED.....THE NHS SHRUNK..


In 2016, Labour Peer Lord Patrick Carter was asked to carry out a review by the then Conservative health secretary Jeremy Hunt as part of Hunt's aim to make the NHS a more efficient healthcare system.

Ten years earlier, Jeremy Hunt and others wrote about how this 'efficient healthcare system' was to be implemented in a Tory policy paper titled 'direct democracy'.

The policy paper called for the NHS to be replaced by an insurance system "breaking down the barriers between public and private providers, effectively 'denationalising' (privatising) the NHS in England".

The ball was rolling, all was needed was support,,,,, from anywhere and any party.....

As per Hunt's wishes, Labour peer Patrick Carter [lord Carter of Coles] spent 18 months visiting hospitals across England reviewing productivity to ensure the NHS gets the best value from its £102 billion annual budget and help the NHS to implement Jeremy Hunt's 7-day service, much hated by junior doctors and NHS staff .

Pathological Traitor?

As a reward, Lord carter of Coles, 73, become a non-executive director of the regulator NHS Improvement in April 2016 and was given carte blanche to transform how pathology should be reduced to a hub and spoke model, vastly cutting hospital pathology labs and replacing them with one or two county-wide labs serving smaller clinics/hospitals. A model VERY similar to that in the USA.

Since 2016, Labour peer Lord Carter has been adviser to Health Secretary Jeremy Hunt and the link below shows his final report.

In his review, Lord Carter looked at healthcare systems abroad, including the United States, to see how savings made in the private healthcare sector could be introduced into the English NHS.

Following on from Carters US healthcare 'efficiency savings' ambitions, NHS England are in the process of 'transforming' the NHS into a system used in the USA called Accountable Care Organisations (ACOS).

The CEO of NHS England is non other than ex Labour councillor and adviser to Tony Blair 'Simon Stevens'. Mr Stevens spent 10 years working for American private healthcare firm United health, and moved back to England in 2012 to implement what he had learned from the private sector into the NHS in England.

WIKI
Simon Stevens was educated at a state comprehensive, St. Bartholomew's School, and won a scholarship to Balliol College, Oxford University where he was president of the Oxford Union in the same academic year as friend Boris Johnson.

Simon Stevens 'healthcare manager'?
https://en.wikipedia.org/wiki/Simon_Stevens_(healthcare_manager)

Lord Carter's Review - cuts and shrinkage of the NHS in England
https://www.gov.uk/government/news/review-shows-how-nhs-hospitals-can-save-money-and-improve-care

Tuesday, 2 April 2019

outpatient services to be fragmented across private clinics


Bulk of hospital outpatient services to be fragmented across private clinics...

Lancashire County Councils 'Health scrutiny committee' have agreed as an accurate record a report in the previous minutes about the 'integrated care system' (ICS) proposed for Lancashire (and south of Cumbria). The ICS system consists of a mean-spirited 'up front loaded' budget that will be 'demand managed' by a plethora of private/public bodies with little accountability to the public.

The ICS was established in an attempt to curtail the demands placed on hospitals and the NHS budget after the introduction of 'GP-led clinical buying and selling groups' (clinical commissioning groups or CCGs for short).

The minutes from the 5th Feb 2019 meeting say "The proposals to change the [hospital] services provided aimed to improve public health and wellbeing and therefore reduce the demand on hospitals".

Those pushing the ICS however do not reveal just 'how' the closure of hospital outpatient services would result in improvements to the health and wellbeing of the public.

This does mean though a large bulk of hospital outpatients services, those in demand by the private sector, will be closed and shipped out of hospitals into private-public run clinics cited in CCG literature as 'Multi-specialty Community Provider' (MCP) clinics.

Currently, the hospital services are provided by Lancashire Teaching Hospitals NHS foundation Trust who recently declared a substantial deficit along with its hospitals in Chorley and Preston being found 'requiring improvement' overall for the second year running by the Care Quality Commission.

NHS campaigners fear that due to its large deficits the hospital trust may agree to any scheme CCGs propose, including selling off NHS hospital land, buildings, and NHS service contracts.

The proposal to close many hospital services tallies with an earlier report from a task group named the system design team setup by the local CCGs to analyse feedback from public events regarding proposed radical changes to local GP, hospital, and socially provided and means-tested services...
In Feb-2017 the system design group proposed moving 80% of patients currently seen in an acute [hospital] setting will not be seen there in future. source: Solution Design Event 5 Feedback Document. Exercise 1: Modelling Assumptions with Locality and Hospital Care group validation
Subsequently, in a news article out yesterday about long hospital waiting lists the Lancashire Teaching Hospital NHS 'foundation' trust say they are looking at sourcing 'alternative providers' in an attempt to reduce the backlog of 'NHS' patients waiting for elective operations.


Wednesday, 13 March 2019

County Council cut ill-health prevention services and tell people to go for a walk instead


Cutting prevention services across Lancashire will result in increases in demand on other NHS services. Yet Lancashire County Council can't seem to grasp this concept...

The Conservative ruling elite at county hall in Lancashire have come up with proposals to CUT over 6 social health intervention & prevention services that affect the most vulnerable in society.

At a national level, government claim they wish to strongly promote prevention services as these support their 10-year NHS plan. Yet in the same swing of the axe, the Tories intend CUTTING benefits and services forcing more people into needing the very social services they are cutting. Here's hypocrisy.....

"We propose to stop offering specific physical activity and healthy weight programmes which currently target those people exercising for less than 30 minutes three times per week and/or with a BMI of between 25 and 34.9".

In its place, the Tories say people can go for a walk in the park instead...

"However, we are proposing to develop a programme for everyone in Lancashire, promoting the use of the county's existing assets ..in particular in open and green spaces. This would be through activities such as walking, running and cycling in urban, coast and countryside locations.."

Chorley, South Ribble & Preston are under threat of losing A&E services along with many outpatient services under a program ineptly titled 'our health our care'.

A plan has been drawn up by health bosses which totally sidelines the issues of emergency care in the region and instead wishes to 'create an atmosphere of prevention of ill-health leading to a healthier lifestyle to prevent people visiting hospital or the doctors".

They can't have it both ways, health intervention and prevention services will need to be increased to offset any existing NHS service closures.
County hall needs to understand that cutting prevention services is contrary to the 'our health our care' plans they are consulting on later this year [2019].
If they are hell-bent on cutting prevention services; then existing NHS support services will continue to be heavily used and demand will only increase.

It's not rocket science, they can't have it both ways. Cutting prevention services will result in increases in demand on other NHS services!

 You really couldn't make this up!

for the chop.....


  • Lancashire Wellbeing Service (LWS) : LWS supports those adults most at risk of a health or social care crisis to remain healthy and well.
  • Active Lives Healthy Weight service
  • The Integrated Home Improvement Service (also known as Care and Repair).  home improvements and adaptations for disabled people - provides help to people in need of extra support to make their homes safe and accessible, by assisting homeowners to maintain, repair and improve their properties.
  • drug and alcohol rehabilitation service:  mainly residential based programmes, with a small number of day programmes. Rehabilitation is an abstinence-based set of interventions to address the underlying causes of addiction in order to establish new ways of coping in real-life situations following treatment.
  • Stop smoking services - Health Improvement Service consultation
  • Lancashire Break Time: a county-wide service providing short breaks for parents or carers of children and young people with special educational needs and/or a disability (SEND). The child or young person will attend a fun group activity whilst their parent or carer gets a short break from their caring role.

Related Link(s)