Health Campaigns Together Conference on Social Care, 17th November.

SOCIAL CARE CONFERENCE BIRMINGHAM 17 NOVEMBER 2018

Report by Carolyn Pickering.

The conference was opened by Brian Fisher (I didn’t catch which organisation he represents).

He mentioned the UN finding of grave and systematic breaches in human rights in the UK caused by austerity and the shrinking of the state.

He also mentioned the motion put to the Labour Party conference:-

– social care should be free and publically provided

– that it is at present underfunded and privatised

– that this is a equality issue.

This motion was not debated at the LP conference; it is a premise of this conference, which is to explore what social care will be needed in the future.

 

John Lister

This campaign should run alongside campaigns for the NHS and other similar issues. There is some opposition to the integration of social care into the NHS but there are common starting points. It is an important issue of public health and has been starved of resources. It creates a burden on the NHS, as we ought to keep people in their homes and free up hospital beds. These people are called bed blockers but they are denied care that is needed, outside hospital.

Smaller nursing homes are on the brink of collapse and lack sufficient staff, and therefore the owners are tempted to sell the buildings.

The Labour Party is not providing direction, since there is no consensus. We need a new policy, not just the one put to LP conference, which was not even discussed.

There is lack of consensus in the TU’s, some are opposing nationalisation of domestic services. Most are in favour, but it is not unanimous.

Some key services, such as care of old, used to be in the NHS, but they have been taken out, are means tested and privatised. It has now been accepted that people should sell their houses and liquidise their assets to pay for care.

This should be a universal service and not subject to random charges. It should be publically funded and provided.

People are now subjected to eligibility criteria, the aim of which is to find almost all ineligible except for very extreme circumstances.

The cuts in finance have led to privatisation, staff cuts, 15 minutes appointments, untrained staff, and a fragmented, dysfunctional service.

This conference is to develop a common line of campaigning:- to prevent further erosion; to provide universal provision, free at the point of delivery; a professional service; properly trained staff. In other words, a new service of social care is needed.

The question is how to build a campaign to reclaim social care alongside the NHS.

 

Eleanor Smith MP

She remembered the time when we used to have care of the old.

The word “integrated” is now only a way of selling the new system. We do need an integrated service, but local government don’t want it because it would take it out of their control, and might make them irrelevant!!(my exclamation marks).

She has noticed that people are beginning to want tax ring fenced for social care and are willing to pay more taxes.

Allied Health Care are now in trouble and want to get rid of their obligations and send back to the NHS.

900 social care staff leave every week.

In 1948, the country had no money straight after the war, but we still set up the NHS anyway, so why can we not do that with social care.

The wrong people are being blamed – the system is being broken by the Government.

Campaigners for social care and NHS should work together, and minds in the LP and TU’s are beginning to change.

Eleanor Smith is willing to be involved in Social Care campaigning and could arrange meetings in Parliament and bring in other MP’s.

There is also a need to broaden out to include black and asian people.

 

Birmingham Care Workers

On strike against an employer-imposed rota with punishing hours, and which could lose them £11K p.a. in pay. Management is now agreeing to look at a new rota. Keeping the service for future generations is equally important.

 

Judy Downey – Chair/CEO Relatives and Residents Association

The value of this organisation is that it takes it out of the personal and speaks for users. Users have rights and it should not be up to the manager of the home to make the decision on eligibility. The Mental Incapacity Bill is dangerous as it gives the manager of the care home to right to make assessments, judgements and decisions.

 

Conor McGurran – NW Unison Dignity in Care Campaign

The campaign is about the bad care of users because workers are overworked, underpaid, exploited and bullied. One care worker had three days running with between 17 and 22 hours per day work schedule at £5 p.h. The homes are owned by huge global capital companies that are sucking out public money. We need to get rid of private companies and ensure minimum standards. There are new union members, activists and MP’s who are supporting the campaign.

 

Bob Williams-Findlay – “Being the Boss”/Reclaim our Futures, founder member of Birmingham Disability Rights Group – could not attend, so his speech was read out.

Power is in the hands of the few. People are disabled by society. Dependency is fostered. It needs to be recognized that disabled people are the best experts. “Being the Boss” is designed for people to reclaim their own rights to independant caring, co-created by disabled people and the Government.

 

Gill Ogilvie – GMB regional organiser, campaigner for saving childrens’ services, Labour MP for Walsall North.

We are the 6th richest nation but we have people living and dying on the streets because of Government cuts to local authorities. We are trying to save services: 1000 childrens’ centres have been closed; nurseries are being closed; adult services are being lost; funding of transport of children to schools is being cut. The result is that Walsall Council is having to attack the poorest and most vulnerable.

 

Jan Shortt – Gen Sec of National Pensioners Convention

When any care home owned by a corporation goes bust, the local authority cannot help. Social care should be set up as a national service alongside the NHS. If you have cancer you receive free care, if you have dementia, you pay for care, assessed on your assets. Social Care should be re-structured and re-nationalised – free at the point of delivery; publically accountable; what people actually need, not what money is available; a system of funding that is fair to all. There should dignity and respect and a better quality of life. This will cause radical mayhem in Parliament, but if everybody paid as they should in taxes, there would be no crisis. The public have no idea of what is coming and need to be energised.

 

Peter Beresford – Citizen Education, Essex university; Emeritus Professor of Social Policy, Brunel; author of “All our Welfare: Towards Participatory Social Policy

Social care now provides no safety net, no support, it is means tested as in the Victorian Poor Law, but there is now no notion of ‘deserving’ poor. People only qualify they are of low income and are ‘eligible’, but they won’t qualify if there is insufficient money in the system. Their needs are re-defined down to keep in budget. We need to support people with needs to have the fullest life possible, not regard them as a burden or fraud. This is the biggest domestic disaster and has not been noticed.

Investment in social care will work to help investment in health care. We must have an integrated social care service paid for out of taxation, free at the point of delivery; person centred support not based on the idea that there is something wrong with them. What would work would be a network of small organisations run by users. Decent support is crucial for modern civilisation.

 

Simon Duffy – Centre for Welfare Reform and Socialist Health Association

The failure of social care is the worst disaster in social policy. Adult social care has dropped 50% in the last two years. Reform of social care means a commitment to human rights. Power should be handed back down to local communities. There should be no means testing. Australia has gone to a universal, united, self-directed, non means-tested, positive and properly funded social care system for all.

 

WORKSHOPS

I attended the Campaigns Workshop, led by Larry Sanders – Green Party health spokesperson.

Suggestions were for: media; TU’s/Trade Councils; stalls; banners; public meetings; working with and learning from other organisations. We need to inform the public about social care and they would ask how to afford it. Before starting the campaign, we should establish principles first for a coherent policy and to demonstrate the economic value of proper social care; why it is important that it is free at the point of delivery; and argue that it could affect everyone sooner or later. It generates employment as well as taking care of people, so there is a huge economic argument in its favour. Good health gives back four fold on investment. Some carers have given up paid employment to care for relatives. The turnover in staffing costs £3bn (?per annum?). It was pointed out that there was an element of feminism here in that it is mainly women working for and looking after old women.

It was suggested that all health campaigns should get together soon to decide how to take this further. We could look at the Australian model; get young people and social work students involves as it concerns their future; get feedback from users.

Capitalism doesn’t care – we must.

Public Ownership Workshop Report

There is the need to:- understand what is happening in the corporate sector; change Labour Party policy; start pursuing a Social Care Bill; TUC seem to be silent so should be consulted. There should be universal provision and local control. Most people need knowledge.

Carers Workshop Report

Many organisations are working in this area. We need an independant regulator and a commissioner on legal powers for old people.

Users Workshop Report

Take out profit making; change from the grassroots; we cannot rely on councils; there needs to be nationwide group cohesion; users should have decision making powers.

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Our Stroke Care Re-organisation Freedom of Information Requests go unanswered and/or are delayed.

Members of SWKONP (Dennis McWilliams and Anna Pollert) have made repeated enquiries to the Leader of the Stroke Re-organisation plans, Andrea Green, and to NHS England, about the planned centralisation of all acute stroke beds to University Hospital Coventry and Warwickshire. None of these  have so far (26 November 2018) been answered.

A) Dennis McWilliams has summarised his attempts to find out about information available so far, and how this is communicated. 

Summary of Freedom Of Information Requests and Questions not sent originally as FOIs on Stroke Re-organisation from Dennis McWilliams

1) FOI – 057148 – Coventry Commissioning Unit – Andrea Green’s office – handled by FOI NHSE

18th August 2018 – submitted 

9 questions relating to different aspects of the “Business Case” for stroke reconfiguration, quoting in detail from the Midlands Clinical Senate papers and correspondence.

27.9.2018 NHSE reply – too early to release. Not in public interest. 1 letter of Andrea Green disclosed.

I made no appeal but requested further information instead, as here:

‘In the response dated 27th September 2018 to my FOI – 057148 request it is stated

  • that the information I have sought in questions one to six, eight and nine “is intended for future publication”
  • that there is a “planned publication date”, and that
  • “this information is to be published soon”.

I would be very grateful if you could notify me of the “intended publication date” (or of any actual publication since 27th September) and particularise by reference to the material published or to be published where within it the information sought in my questions is located’.

I sent a chaser on the 16th Nov and received a response on the 17th, as part here:

‘Thank you for email on 1 November 2018 in relation to your Freedom of Information request (Our Ref: FOI-057148). I do apologise for the delay in response to your further query.

NHS England can confirm that the information will be published when the pre-consultation business case has been completed. This is still in progress and currently there is not an expected publication date’.

2) Question To West Midlands Senate

I requested the Senate publish a letter of the 6th August 2018 from Prof Williams (Senate Chair) to Andrea Green. It was published in their Stage II Assurance section later the same day.

I then wrote to Professor Williams asking for the Sentinel Stroke National Audit Programme (SSNAP) particulars referred to in his letter, which says ‘The senate noted that….the SSNAP data is good’.

On his behalf I was directed to Andrea Green.

3) Questions to Andrea Clark, Arden Greater East Midlands (Arden and GEM) Commissioning Support Unit Head of Engagement and Marketing

(‘Arden and GEM’ deals with all FOIs to Clinical Commissioning Groups – CCGs – and the STP – Sustainabilty and Transformation Plan. Questions on Stroke reorganisation originally to its ‘Leader’, Andrea Green, of Coventry and Rugby and Warwickshire North CCGs).

10 October 2018 – a question with 3 bullet points

  • date of final NHS England assurance panel
  • when familiarisation and/or learning sessions are to be held for relevant councillors
  • and what Committees are to be involved in such training

16 October – email that answer will be within a week or very soon.

1st week Nov – I rang and was told Andrea Green would be reminded.

No news.

4) 13.11.2018 FOI 18857 – seeking from Coventry and Rugby CCG and South Warwickshire CCG information already sought, but not under FOI terms.

The CCGs asked me to clarify. My clarification as here:

‘Thank you for your prompt response.  Trying to be succinct, the subject is stroke service reconfiguration, the focus is on SSNAP results referred to in a letter from the West Midlands Clinical Senate to Andrea Green of the 6th August, as here; http://www.wmscnsenate.nhs.uk/files/9015/4150/3990/Letter_to_Andrea_Green_06.08.18.pdf . In response to my suggestion to the Senate this letter was recently published on their website.

The SSNAP data mentioned relates to an ongoing process of measurement.  National figures are published from time to time, but measurement is ongoing.  The SSNAP website page is here: https://data.gov.uk/dataset/09517a13-6475-48b1-af5a-990a5a5cbd29/sentinel-stroke-national-audit-programme-ssnap-clinical-audit-results .

The Clinical Senate studied the Stroke Service Reconfiguration plans for Coventry and Warwickshire, and published a lengthy report in 2017.  That noted quite a few areas for clarification/improvement/further action.  In recent public engagement meetings Andrea Green said that the SSNAP figures were sufficiently good to allow movement of services onto the specialist hub in Coventry.  As you can see from Professor Williams’ letter Andrea felt it necessary to reassure him about this, and it was significant.  The figures the SSNAP published in 2017 or just before showed that SSNAP results appeared better in parts of Warwickshire from which treatment was due to be moved than in University Hospital Coventry to where the treatment was planned to be moved.

In the circumstances it seemed to me that it would be helpful and in the public interest to see what the ”good” SSNAP figures Andrea Green refers to are.  I do recall her saying at the public engagement meeting at the Sydni Centre in Leamington (September 21st 2018) fairly recently that the figures would be made available.

Reply of 15.11.2018 – now treated as FOI – reply will be by 12th December.

 

5) SSNAP Unit at Kings College UCL

I registered as an individual with the Royal College of Physicians and with the SSNAP Unit of Kings College UCL and requested the latest SSNAP figures. I quickly (late 20.11.2018) received directions to the SSNAP webtool from Kings SSNAP support. This is a substantial volume of material for Jan to March 2018.

No suggestion that an FOI request was required.

Footnote: In the Warwickshire County Council Adult Social Care and Health Overview and Scrutiny Committee meeting (21st November 2018) I noted that the minutes of the previous meeting (Sept 26th) stated (regarding the stroke service review):

‘There was no clear date for the conclusion of this review. Another member commented that many NHS reconfigurations were ‘process led’, without a visible service improvement. He asked if the portfolio holder would pass on these frustrations and the portfolio, Councillor Caborn, confirmed he did make these points in his meetings with health colleagues. The portfolio holder was asked to provide a briefing document, which identified the barriers delaying service reconfigurations and the options available, with a view to lobbying health service colleagues. He agreed to examine this request with officers and would report back to the Committee’.

I advised Cllr Caborn before the meeting that I would raise this in my short time to speak. Cllr Caborn told me that getting information from NHS was very difficult. He did not suggest he had made any report back. As no one took it up under matters arising, I referred the Committee to this. There was no response. Cllr Caborn was silent.

In the same meeting John Linnane, Director of Public Health and Head of Strategic Commissioning stated that he had not seen the pre-consultation Business Case being submitted to NHSE. This went unremarked.

Dennis McWilliams 21.11.2018

………………….

B) Anna Pollert, on behalf of SWKONP, sent a series of questions about the risk assessment of the planned stroke re-organisation/centralisation across Coventry and Warwickshire. The questions, which were requested by Andrea Green at a meeting on 25th September 2017,  were first sent several times from September 2017. They were not acknowledged or answered.

At the stroke engagement meeting at the Sydni Centre on September 21st 2018, Anna raised this matter. Andrea Green implied she did not know anything about the questions being sent. Her colleague then wrote to Anna and said they would attend to these and get back soon. No further response.

On October 16th 2018, Anna re-sent the questions as a FOI to Andrea Green and NHS England.

Freedom of Information Request FOI Reference number: 18768 for attention of Andrea Green, Senior Responsible Officer for the Improving Stoke Outcomes Project on behalf of the Coventry and Warwickshire CCGs.

Please provide answer to Prof. Anna Pollert, Secretary/Chair of South Warwickshire Keep Our NHS Public, on the following questions:

1.Confirmation of what constitutes an acute stroke patient.

Will any stroke patient with less than 72 hours of presenting symptoms will automatically be conveyed to UHCW hyper-acute unit.

What will be the criteria in Warwickshire for sending patients to UHCW hyper-acute unit, rather than elsewhere. What will be the criteria for sending patients elsewhere to another hyper-acute unit? Where might this be?

Have discussions taken place with the West Midlands Ambulance service about what constitutes a FAST (positive or negative) patient? Please disclose any binding agreement in this regard.

Please provide sight of the proposed Service Level Agreement with the ambulance service (Emergency and Urgent as well as Patient Transport Services?)

2. Please provide a detailed breakdown of all the current stroke beds in Warwickshire and Coventry and their locations (Acute) and include

The details of the current number of acute beds at Warwick Hospital, George Eliot and UHCW.

 Current staffing levels and types of professional staff at these sites.
By this we mean nurses, consultants and other doctors, physiotherapists, occupational therapists, etc with stroke specialities.
The current level of bed occupancy at each site.

3. Please provide a detailed breakdown of stroke (non-acute and rehabilitation) services that will be delivered at Warwick/Leamington under the proposed changes, including at

a) Warwick Hospital
b) Leamington Rehabilitation Hospital
c) Community Care Teams,
including ‘Early Discharge Stroke Teams’ and ‘At Home Care Packages’

 Please provide a detailed breakdown of stroke (non-acute and rehabilitation) services that will be delivered at Nuneaton/Rugby, including at

a)George Eliot Hospital

b) Cross, Rugby.

c) Community Care Teams,  including ‘Early Discharge Stroke Teams’ and ‘At Home Care Packages’.

4. Please explain if/when the specialist stroke nurses transfer from (i) Warwick Hospital to the UHCW, who will provide specialist stroke care for those remaining at Warwick Hospital. (ii) Please explain if/when the specialist stroke nurses transfer from George Eliot to the UHCW, who will provide specialist care for those remaining at George Eliot.

5. Please provide a full description of the 300 packages of care proposed, what they constitute, how they are going to be delivered and by whom.

6. Please explain whether the ‘At Home Care Packages’ would be

Funded by the NHS.

Provided by the NHS.

If not provided by the NHS, then by whom (e.g. contracted to third sector? Private company?)

How specialist staff will be recruited for these services.

Who will train them and put the service in place.

What staff grades and numbers are in the plan.

How long the post-discharge, home care support will stay in place and how this will be assessed.

7. Please provide information on any contracts struck or explored with 3rd sector providers? If so, who? If not, are these being considered? With private companies? If so, who? If not, are these being considered?

8. Please provide assurance that the reconfiguration will not start and no beds will be closed before the teams that will provide the home care packages are in place.

9. Please provide full information on the planners’ arrangements to ensure that all the local Councils will be able to guarantee social care beds for the patients who are not able to be discharged home with care packages.

10.While there was a reassurance that the extra numbers of ambulances arriving at UHCW would be minimal, there is a perception that the number of healthcare services that are being transferred to UHCW is increasing. Please explain what measures will be put in place to ensure that ambulances carrying stroke patients are not stuck in ambulance queues, and go straight to the hyper-acute unit.

11.Please explain how the funding of the reconfigured Stroke Service takes into account the costs of extra ambulance provision.

The issues relating to bottlenecks and cost of extra provision can also be applied to the services provided by Radiology, Pharmacy, Physiotherapy, Occupational Therapy, etc. Please can you also show how you have investigated the impact of the extra stroke patients (including costs) on these services.

12.Please explain what provisions there are for when the hyper-acute unit is full and cannot accept any more patients.

If the UHCW is on divert, which hospitals will be utilised to accept UHCW patients?

13.What assistance will be provided for the patients’ families in terms of helping them to get home from the UHCW following emergency admission, during periods where there is no public transport.

Not everyone has access to a car or lifts. At a stressful time to be told your family member/friend/loved one (the patient) is stable and you can go home now does not necessarily mean you have the means to do this. Will they be assisted to return home?

14. Please provide detail of Risk Assessment, of net loss of 30 acute stroke beds across Coventry and Warwickshire.

15. Please provide mortality rate outcomes risk assessment for centralising acute stroke care at UHCW, based of the current 2016/17 standardised stroke mortality (SMR) rates shown in Mortality for SSNAP admissions April 2016 to March 2017  https://www.strokeaudit.org/Documents/National/Clinical/Apr2016Mar2017/Apr2016Mar2017-MortalityResults.aspx

The question requiring full explanation pertains to the methodology for SMR:

“Unlike the Dr Foster data, we have adjusted for case mix including stroke severity. The model used for this has been published in Stroke, and the published paper shows that the model is very reliable when externally validated. Briefly, the model takes account of the age of the patient, whether they are in atrial fibrillation (AF) before stroke, stroke type (haemorrhage or infarction), and the NIHSS score at arrival (where this is not available, the level of consciousness at arrival).”

Ratios above 1.0 imply more people have died than would have been expected by the model.

Both Warwick (0.92) and George Eliot (0.95) hospitals score better than the expected 1.0 on the Standardised Mortality Ratio. UHCW does worse – 1.2.

Please provide full independent analysis and explanation of these figures.

16.Please provide evidence of the current initiatives in Coventry and Warwickshire by General Practices to reduce stokes and their effectiveness.

17. Please provide evidence of Equality Impact Assessments.

18.Please provide evidence of measures being taken to guarantee the care provided by the Stroke Unit at UHCW is fit for purpose.

19.Please provide evidence of how much the new initiative for Early Discharge/Home care costs

  1. To set up
  2. To run (year on year provision, and for how long).

20. Please explain the source of the budget for the stroke re-organisation and where there is a need to divert monies from other services to fund this initiative.

If so, what services are going to be compromised?
Could this lead to job losses to help fund the proposal?

——–

On November 13th 2018 Anna Pollert received the following reply to the FOI:

Dear Anna

Our ref: 18768

Thank you for your request of below.
I am processing your request under the terms of the Freedom of Information Act 2000 (FOIA). Section 1(1) of FOIA requires us to confirm or deny whether we hold information requested. However, I will need more time to consider your request. I will
explain this further below.

We have a duty to confirm or deny whether we hold information as soon as possible and in any event within 20 working days after receiving your request.  However, the FOIA allows us to extend this deadline if a qualified exemption applies and we need
more time to consider where the balance of the public interest lies.  Please note that this means we are not required to confirm or deny whether information is held until such time as is reasonable in the circumstances.

Under section 43(3) of FOIA the duty to confirm or deny does not arise if doing so would, or would be likely to prejudice the commercial interests of any person.

We will need to take additional time (in accordance with section 10(3) of FOIA) to consider whether the public interest favours (or does not) the confirmation or denial whether we hold this information. We have not yet reached a decision on where the
balance of the public interest lies, so I will not be able to provide a full response within 20 working days. I will endeavour to let you have a response by 11 December, or sooner if at all possible.

Additionally we have identified that one question may take in excess of 18 hours to process and are reviewing that in detail.  However in the interests of transparency and the spirit of the Act we wish to provide that information we can.

If you have any enquiries about this response, please contact me in the first instance.  Details of your appeal rights are below.

Please remember to quote the reference number at the top of this letter in all future communications.

Yours sincerely,

Philip Humphreys

FOI Manager

If you are dissatisfied with the handling of your request, you have the right to ask for an internal review. Internal review requests should be submitted within two months of the date of receipt of the response to your original letter and should be addressed to

NHS Arden & GEM Commissioning Support Unit, FOI TEAM, Scarsdale, Nightingale Close, Chesterfield, S41 7PF.

……….

We await a reply on December 11th 2018.

 

 

 

 

Health Campaigners want answers – SWKONP, COVKONP, NWKONP Petition hand-over to councillors November 7th 2018

Our local KONP groups (SWKONP, COVKONP and NWKONP) handed in our petition, with 1,425 signatures, to Coventry City and Warwickshire County Council councillors, Cllr. Kamran Caan and Cllr. Les Caborn yesterday. Cllrs. Helen Adkins and John Holland joined us, and Helen produced an instant press release, to which I have added today:

Health Campaigners want answers

Petition hand-over to Cllrs. Caan and Caborn 7th November.

Wednesday November 7th, campaigners ‘Warwickshire and Coventry Keep our NHS Public’, joined by Councillors John Holland and Helen Adkins, handed a petition, signed by 1,425 members of the public, to The Chairs of Coventry City and Warwickshire County Council Health and Wellbeing Boards, Cllrs Kamran Caan and Les Caborn. The petition wants full transparency about plans for local Health and Social Care services, including how the planned ‘savings’ (cuts) announced in 2016 of £267 million from the NHS will be implemented.

Professor Anna Pollert, Chair of South Warwickshire KONP, says:

The public is still being kept in the dark, and wants no more vague jargon and secrecy by the STP planners. The petition says it all: ‘We call on our elected representatives involved in the Coventry and Warwickshire ‘Better Health, Better Care, Better Value’ (formerly ‘Sustainability and Transformation Plan’ – STP) to require Andy Hardy (STP lead) to respond to our petition handed to him on the 11th September 2017 requesting him to publish full details of the financial, workforce and site plans of the STP’.

Autumn Budget 2018 October 29th – Adult social care in England needs at least £1.5 billion more per year (King’s Fund) but only getting £650m; two billion pounds for mental health is part of £20 billion promised and not new money and not enough.

King’s Fund

Responding to today’s Budget, Richard Murray, Director of Policy at The King’s Fund, said:

‘The social care system cannot continue to get by on last-minute, piecemeal funding announcements. Adult social care in England needs at least £1.5 billion more per year simply to cope with demand, meaning that the funding announced today – which will also need to cover children’s social care – falls far short. This highlights the need for a long-term plan for how social care will be funded and structured so that it can meet increasing demand. Successive governments have dodged tough decisions on social care and the forthcoming Green Paper must now ensure social care gets the long-term plan it so desperately needs.

‘Two billion pounds for mental health confirms the early signals that this would be a key priority for the forthcoming NHS long-term plan. But years of underfunding have taken their toll and this is no more than a small step on the road to parity of esteem. Mental health services need more than money to meet demand. A chronic shortage of mental health staff means that, despite the new funding, the service won’t improve until the government and the NHS provide a plan to increase the workforce.’

https://www.kingsfund.org.uk/press/press-releases/2018-budget.

…..

Patients’ Association“A Budget that tells patients nothing”

Responding to today’s Budget, Rachel Power, Chief Executive of the Patients Association, said:

“The Chancellor had several key questions to answer at this Budget, so that patients could understand how he would be ensuring the health and care system has the resources it needs. Instead, he has produced a Budget that tells patients nothing.

“We already knew that he had committed to five more years of below-trend growth in the NHS’s funding. But we had not yet heard what the equivalent settlement would be for vital NHS functions outside the so-called ‘front line’ ring fence, such as public health, workforce training and capital investment.

“We also wanted to hear how he would address the ever-deepening crisis in social care. And finally, how would he pay for these essential services?

“Impressively, the Chancellor failed to answer a single one of those questions.

“We now know that essential NHS functions supposedly not part of the ‘front line’ will get no new funding ahead of the 2019 spending review, when the NHS will have to make its case. In the meantime, those budgets will be falling yet again for next year. This will make it much harder to reverse ongoing slippages in the NHS’s service standards.

“There was another emergency cash top-up for social care – £650 million, split between adults’ and children’s services, against an estimated funding gap for adult social care of £1.5 billion. With the green paper finally expected next month, we hope this is the last time we will have to comment on such inadequate, short-termist tinkering in response to such a fundamental long-term challenge. People who are going without the social care they need today will not be able to rely on this injustice being put right as a result of today’s announcement.

“While the sums all add up, the Chancellor again missed an opportunity to be frank with the public about the need to fund essential services properly. If we want high quality health and social care we will have to pay for it, and eventually the Government will have to mobilise a meaningful chunk of our national wealth through taxation, rather than relying on a range of small measures and unexpected tax windfalls, as the Chancellor seems to have done today.”

The ‘Independent’ (Oct 31 2018) Budget 2018: Extra £650m for social care a sticking plaster that ‘only just staves off collapse’, experts warn

Experts have criticised the government for again failing to tackle reform of care for the elderly with £650m in the Autumn Budget but no explanation of how it will be made sustainable longer term.

Chancellor Philip Hammond said the funding for 2019/20 will be available to local authorities to support older people and adults with long term disabilities.

This is the area where underfunding has heaped pressure on the NHS as cuts have made it more likely people will get seriously ill, and harder to send them home after they are in hospital.

Experts said the funding would “only just stave off total collapse” as councils require £2.35bn next year to cope with care for the rise in older people with complex care needs amid shrinking budgets. However the final Budget 2018 report makes clear that only £240m of the new money is earmarked for adults, and councils are free to spend around two-thirds of the funds (£410m) on children’s care services.

Mr Hammond also warned there will be “difficult choices” on reforming social care longer term, but these will not not happen until the next spending review, as a Green Paper promised earlier this year has already been delayed once.

The chancellor said: “We will shortly publish our Green Paper on the future of social care, setting out the choices, some of them difficult – for making our social care system sustainable into the future.

“But I recognise the immediate pressures local authorities face in respect of social care. So today, building on the £240m for social care winter pressures announced earlier this month, I will make available a further £650m of grant funding for English authorities for 2019/20.”

There was also £45m for facilities for people with disabilities, to help them live independently, and £84m for child social care.

The bulk of the health and social care funding announcement was made in the summer when Theresa May pledged a £20bn increase in funding for the NHS over the next five years.  Of this, £2bn will be earmarked to improve young people’s mental health and ensure crisis teams at every A&E, Mr Hammond said.

Alzheimer’s Society chief executive Jeremy Hughes said £650m may “prop up the broken social care system”, but “only just staves off total collapse”.

Glen Garrod, president of the Association of Directors of Adult Social Services (ADASS), said it was “positive to see a step in the right direction” and the new money would help older and disabled people – as well as the NHS.

“However,” he added, “this is still far short of the £2.35bn that ADASS identified would be needed for social care to stand still in 2019/20; councils have been struggling with funding shortfalls for years.”

Labour leader Jeremy Corbyn said the chancellor had delivered a “broken promises budget” which does nothing to address the damage of eight years of austerity. He warned that the country’s deficit had only been brought down at the expense of the NHS and other public services which now routinely report they will not meet their financial or performance targets.

Chief executive of the NHS Confederation Niall Dickson said: “Social care remains the Achilles’ heel – it has been consistently underfunded, neglected and unloved by politicians over many years and the extra funding announced today – again welcome –  is clearly inadequate.

“What we needed was support to get the system back on its feet but what we have is yet another sticking plaster.

“This means we will struggle on for another year. We hope that the social care green paper is not further delayed: this has huge implications for both health and social care and most importantly for the people who need these crucial services.”

EMIS surveys 300k GP patients on NHS privatisation and paying to skip queue

PulseToday 8th October 2018

EXCLUSIVE NHS IT system provider EMIS Health has sent out a survey to 300,000 GP patients asking whether they would consider paying to see their GP more quickly.

In a survey that was sent out earlier this week to patients, EMIS also asks whether patients would like to see the NHS privatised.

The survey was sent from Patient Access – EMIS Health’s website that allows patients to book GP appointments, order repeat prescriptions and view their medical records – without the involvement of GP practices.

It also requests patients’ personal information including age, residence and household income.

An email sent alongside the 79-question EMIS survey says its purpose is to ‘understand our users and their attitudes towards healthcare, so we can keep improving the tools and services we provide’.

The email, seen by Pulse, also said EMIS is looking for ‘as many of our users as possible’ to complete the survey.

Meanwhile the survey also asks whether patients have ‘heard of any of the following online healthcare services’, before listing providers including GP at Hand and their direct competitors Evergreen and My GP.

Babylon’s GP at Hand has caused continued concern amoung GPs, with RCGP chair Professor Helen Stokes-Lampard most recently saying the service could create a ‘two-tiered’ health service.

Hampshire GP Dr Neil Bhatia, who runs a website that helps patients to understand data sharing, told Pulse the survey is attempting ‘to maintain [EMIS’s] registered users … and/or to somehow attract people to register with them preferentially’.

He added: ‘If I was answering the survey, I would be very concerned with what Patient Access intend to do with all this information provided by me, and whether this was going to be passed on to a third party.’

GP Survival chair Dr Alan Woodall added that he is ‘very concerned at the ramifications’ of the survey.

He said: ‘This recent marketing survey ran by EMIS, which mentions services such as Babylon, seems to be a way to determine brand penetration of some online providers.

‘While the data may be anonymised, it will no doubt deep mine their age, geographical location, income and preparedness for exploitation by private online consultation services.

He added: ‘I find that ethically dubious at best, not in the spirit of patient sign up, and hope that NHS IT commissioners and the ICO look carefully at this situation.’

When asked why patients were questioned on NHS privatisation and co-payments, Jason Keane, chief executive of Patient Platform Limited, which runs Patient Access, said: ‘This survey is part of ongoing work by Patient Access to understand more about our users and their attitudes to healthcare, to enable us to better serve them.’

He added: ‘The survey was sent to around 300,000 users of Patient Access who opted in to receive communications including surveys.

‘We have had a high and positive response rate from them. The results are confidential, and the survey was funded by Patient Platform Limited, which operates Patient Access as part of EMIS Group.’

The survey asks patients whether they are ‘in favour of the privatisation of NHS services’, allowing them to explain their answer.

It then asks: ‘Would you be interested in a service that for a small fixed monthly fee (under £10) allows you to avoid long waiting lists for medical consultations, diagnoses and treatments?’

This comes after leading doctors rejected calls for the BMA to consider charging patients for GP appointments in order to fund the NHS at this year’s Annual Representative Meeting.

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GPs have said the survey is ‘ethically dubious’ in determining patients’ ‘preparedness for exploitation’ by private providers.

NHS staff vacancies rise nearly 10% in three months amid unfolding ‘national emergency’

‘Independent’ 11th September 2018.

Report shows Brexit upheaval and ill-considered immigration policies have contributed to a spiralling vacancy rates.

Staff vacancies in the NHS have increased nearly 10 per cent in just three months, as experts warned of an unfolding “national emergency” with nearly 108,000 jobs unfilled.

Official data from the first three months of 2018/19 released by watchdog NHS Improvement have laid bare the parlous state of the NHS with winter just months away.

Vacancies rose by 9,268, from 98,475 in March 2018 to 107,743 in June, meaning one role in 11 is vacant. This is despite national and international recruitment campaigns to attract key health workers.

Experts said issues have been made worse by a “botched Brexit” and government immigration policies which mean health workers have no certainty over visas and UK-trained doctors have had their careers put in jeopardy.

Siva Anandaciva, chief analyst at the King’s Fund think tank, said the figures show the NHS is heading for another “tough winter”, adding: “Widespread and growing nursing shortages now risk becoming a national emergency and are symptomatic of a long-term failure in workforce planning, which has been exacerbated by the impact of Brexit and short-sighted immigration policies.”

There were 11,576 vacant doctors posts and 41,722 unfilled nursing jobs in English trusts – with the biggest nursing gaps (14.8 per cent of posts) in London where cost of living makes recruitment even harder.

The number of nursing vacancies rose by 5,928 (17 per cent) in three months and the Royal College of Nursing said the government should immediately investigate the sudden rise.

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NHS hospitals warn of lack of preparation for winter as figures reveal next year will be ‘tougher than ever’

‘Independent’ October 12th 2018

Healthcare bosses say funding intended to add capacity has already been spent dealing with record summer demand.

The NHS is set to face an “even tougher winter” than the record-breaking crisis it weathered less than 10 months ago, as hospital bosses warn of staff and funding shortages.

Despite the government claiming the health service was “better prepared than ever” last year, ambulance queues tripled, there were fewer beds available and doctors wrote to Theresa May warning of patients “dying prematurely” in corridors.

Hospital leaders said the major issues of workforce, funding and social care remain unresolved, and figures released on Thursday show how an unprecedented summer heatwave has left no time to tackle the significant backlog in operations.

Theresa May has pledged an extra £20bn for the NHS by 2023 but this will not start to plug gaps until April 2019.

Meanwhile, hospital heads told The Independent funds usually held in reserve to add capacity in winter were already used up, or useless because there was no one to work.

“All the money for winter has been spent managing this summer,” one trust director from the northwest of England, who did not wish to be identified, told The Independent.

“The demand is basically constant all year round now, if you look at the figures, so there are no ‘extra’ beds because they’ve all been kept open.”

Another director, from a hospital in Greater Manchester, said that although they had around 70 beds on wards they could use to boost capacity, they would have no one to safely staff them because of more than 100 vacant nursing roles.

“The reality on the ground is that we are seeing huge workforce gaps,” Saffron Cordery, deputy chief executive of NHS Providers, which represents health service trusts, told The Independent.

“The gap has gotten bigger [in the past year] but whether it’s growing or shrinking is immaterial because the gaps are there and demand is only going one way”

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