Newsletter August_2017 online

August 2017 Issue

Image: Jean Maighread

Our Facebook page: http://bit.ly/AnE008 Email: CSR.nhs.Campaign@gmail.com

Chorley & South Ribble Hospital Campaigner's Choir delivers the goods After months of preparation (well, three practises and two outdoor performances), the combined voices of Singitbig and our own NHStival singers, all under the incredibly talented direction of Karen Strickland and Debbie Jones-Randall (of Blues and Jazz band 'Tipitina'), had a professional recording made of our performance of Coldlpay's “Fix You”.

Photo credit: Barbara Barrow

Photo credit: Facebook – Party in the Park (Astley)

The full final recording, with accompanying video footage, can be seen/heard via this link ..

http://bit.ly/NHStival

Photo credit: Andy Humphreys, at the Summer Soirée concert

This was then 'mixed' with similar hospital choirs from around the country to produce our 'single' to show the Communities' support for our National Institution (the NHS) that the present Government is hell-bent on destroying through privatisation. 1

Our special thanks go to the choirs of Lincolnshire, Devon, Oxfordshire and Huddersfield for helping us celebrate 69 yrs of our glorious NHS.

Logo design: Jean Maighread

Closing/downgrading A&E and other acute hospital services

What are Sustainability & Transformation Plans?

44 Sustainability and Transformation Plans - each covering an area of England that NHS England has defined as “footprints” - outline how the NHS and social care in each area are to: • obey harsh new financial controls and sanctions that will eliminate the current huge hospital and commissioner “deficits”, that are the result of government underfunding of the NHS since 2010 • redisorganise the entire NHS so it is cheaper to run and sticks within the limits of a funding shortfall of around £25.5bn by 2020/21- without any possibility of running further “deficits”

STPs are not just about closing or downgrading a full accident and emergency unit or other acute hospital cuts and closures although a Health Service Journal survey of clinical commissioning groups shows that a “substantial minority” of STPs will do this.

Destroying the patient-doctor relationship There will be far fewer hospital beds, and more care at home via interactive digital technology, etc.

The whole patient - doctor relationship will be undone - GP and community services that • radically increase opportunities include many services formerly for private and third sector companies in provided in hospitals will be the NHS, by operating it as a set of delivered by huge “GP public/private partnerships like PFI, but Federations” in a number of “hubs” for services as well as buildings. that cover very big populations and They have to follow NHS England and provide standardised “care NHS Improvement instructions, so will all pathways” or “managed care” for be more or less the same, apart from local various illnesses. details Withdrawal and restriction of Copying American private health treatments insurance companies’ schemes, Withdrawal and restriction of “care pathways” tell doctors what treatments treatments they must give undermining their vocational skills Already the STPs mean withdrawal and restriction of treatments - particularly so- in identifying the best course of action based on an understanding called “over the counter” products like of and empathy for their patients' special feeding for the frail and elderly, and treatments like hip replacements and situation. cataract removal, that are not lifesaving This enables care to be delivered by but if not provided, leave people in pain new grades of less skilled, cheaper and with disabilities. staff. The 3 footprint STP says workforce spending is to be cut by 2

£42.9m compared to the amount that would be spent if there weren’t the funding shortage.

effective” patients The "care closer to home" schemes in the big GP/community hubs that replace many hospital services will be funded on a per capita basis for a given population. This is copied from US private health insurance companies that are notorious for offering "managed care" to only the most “cost effective” patients.

The STPs place a big reliance on unskilled voluntary sector people, family and friends, as well as on patients themselves managing their own care. The cost savings from this will be big.

Patient self-management

This will allow the organisations that hold the contracts for the care closer to home schemes and primary/community care hubs to make a profit. It also undermines the principle of a comprehensive health service.

STPs segment patients into groups according to their risk of hospital admission. The lowest risk groups will be subject to “preventive” care aimed at changing their behaviour to become healthier and teaching them to “selfmanage” their illness - ignoring all the social, environmental and economic determinants of ill health and the fact that these are outside individuals’ control.

And are GPs on board with all this?

A twitter survey of GPs and Practice managers found that 84% didn’t know what is in their area’s STP about General Practice/Primary care.

Already GPs are “inviting” their patients to register for selfmanagement courses run by companies like Self Management UK. This is about taking the “care” out of health care, to cut costs. But we are the sixth richest country in the world and the government funds corporate welfare to the tune of about £93bn/year. We can perfectly well afford a proper NHS.

No one else knows either - if we are to believe replies from Council Leaders to members of the public who have asked them to publish the STP for their area.

Of course, NHS England and almost all the NHS and Local Authority organisations involved in the STPs are spinning them as being about improvement to the quality of NHS and social care services and reduction of health inequalities through preventive care.

About the only good thing about being ill is that someone kind & knowledgeable looks after you. Take that away and what have you got left?

Someone shouting at you to look after yourself. How unkind is that?

Don’t believe the spin.

So, what is the reality?

Incentive to cherry pick most “cost 3

 no viable or sustainable plans for staffing  proposals to divert services away from hospitals  services proposed are not sustainable because there is virtually no finance in place to implement the STP’s  financial figures do not add up as there is lack of financial detail  with little or no evidence to suggest that proposals are workable as none of them have any tried and tested evidence that things are workable, in practice; safely, efficiently effectively  the priorities should always be patients and staff  health and wellbeing should come before cuts and the apparent privatisation of the NHS  unparalleled reliance on charitable sector, is it morally right to rely on charity in this way, whilst essential services are disappearing  unprecedented use of private sector contracts

The Reality of STP’s  members of the public, NHS staff and even some politicians are only just becoming aware of the gravity of the situation which is unfolding with Sustainability and Transformation Plans.  imposed from a directive from NHS England just before Christmas in 2015 as part of another major shake-up of the NHS.  dramatic reorganisation of England’s NHS into 44 ‘footprint’ areas,  with all NHS bodies collaborating with local government, social service agencies, private sector providers and charities on these new 5 year plans  it has been suggested that this is NHS England’s best hope of balancing its budgets by 2020-21 or is it?  the mismatched, changeable and unreliable series of 44 STP records have clearly fallen far short of NHS England chief executive Simon Stevens’ targets  the STPs are behind schedule  lack public knowledge and support  no public involvement in the STP design process  will not deliver the promised results

John Lister’s report for the Centre for Health and Public Interest (CHPI) in January 2017 results concludes, “when the innovations in STPs don’t deliver savings for the NHS, NHS 4

CAR PARKING FEES HIKE

England will again resort to cuts and rationing. Indeed many knowledgeable people see the STPs as a smokescreen to divert attention from cuts at local NHS trust level, carving 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)”.

Only 2 years ago (2015), Paul Holt, from Lancashire Teaching Hospitals NHS Foundation Trust (which includes Chorley Hospital), said “its car park revenue was spent on operating the car parks which includes staffing, maintenance, security and CCTV, processing permits, parking space data displays, and operating park and ride schemes”. He said: “The maximum charge for a 24-hour period for any patient or visitor is £3, which is less than the national average. Free parking is provided for long-stay patients, cancer patients and renal patients, as well as for visitors of critical care and neonatal patients”, and added, “Parking is free for blue badge holders and hospital volunteers, and a reduced weekly £10 parking ticket is available for anyone visiting a long-stay patient. As an NHS hospital any surplus income we make from car parking charges is invested in providing patient care”.

MARKET STALL STILL needs volunteers to help staff it! If you CAN spare an hour or two, please contact the Facebook page “Chorley A+E Market Stall” We have tombola 3 tickets £1 Football card £1 per go [winner £30] Mugs £4 T-shirts £4 Hi-viz £4 Pens £1.50 Donations always welcome.

Open every Tuesday and Friday

Just 2 years later, Carole Spencer (Non-Exec Dir), for Lancashire Care NHS FT (on their website), categorically stated, “In line

1000-1430 5

with government guidance, the current flat rate is being replaced with a sliding scale of charges, so that the amount charged reflects the time spent in the carpark. This new charging system is similar to other hospitals in the region …...” - only IF you select those hospitals very carefully.

The guidance to which she refers is quoted, verbatim, below: “Charges should be reasonable for the area”.

“Concessions, including free or reduced charges or caps, should be available for the following groups: • disabled people (consideration should be given to the needs of people with temporary disabilities as well as Blue Badge holders) • frequent outpatient attenders • visitors with relatives who are gravely ill, or carers (*as officially defined) of such people • visitors to relatives who have an extended stay in hospital, or carers (*) of such people • carers (*) of people in the above groups where appropriate • staff working shifts that mean public transport cannot be used”

Other concessions, eg for volunteers or staff who car-share, should be 6

considered locally.

Priority for staff parking should be based on need, e.g., staff whose daily duties require them to travel by car (to other sites or home visits).

Trusts should consider installing ‘pay on exit’ or similar schemes so that drivers pay only for the time that they have used. Additional charges should only be imposed where reasonable and should be waived when overstaying is beyond the driver’s control (eg when treatment takes longer than planned, or when staff are required to work beyond their scheduled shift).”

What LCFT has instigated is a HIGHLY WEIGHTED sliding scale, clearly designed to MAXIMISE the fees extracted from patients! Why else would fees be so heavily skewed to the 1-3 hour stay – typical time for an outpatient appointment (if you include clinic delays, add a blood test and trip to Pharmacy).

You can judge relative fees in the Table opposite.

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THE FUTURE OF PATIENT (AND STAFF) MEALS AT CHORLEY & SOUTH RIBBLE HOSPITAL

Well, the Trust has decided to pull ALL food preparation out of Chorley & South Ribble Hospital and transfer it to Royal Preston Hospital kitchen (together with any 'willing' staff – willing to add at least an hour to their working day PLUS additional travel costs!).

BACKGROUND When the 'new' Chorley and South Ribble District Hospital was under construction in the mid 1980s, the then Health Authority took the innovative decision to contact the Environmental Health Department of Chorley Borough Council for advice.

So, NO food to be prepared and cooked at Chorlies – every-thing to be ferried from Preston (several times per day) in (hopefully) refrigerated lorries, to be microwaved, or whatever, by lesser skilled (?) 'food warmers'.

[Or they could just get Tesco to drop off a few hundred 'Cottage Pies' (at 95p each) and save a fortune!

The reasons for this were twofold: Firstly, the Health Authority wished to seek the Department's assistance and guidance that the new facility complied fully with all the Food Safety and Food Hygiene legislation in force at that time.

Secondly, the Authority needed to ensure that all necessary expenditure was 'value for money' and the most effective use of its monetary resources.

What are your views on this?

The guidance and assistance requested was readily provided by the specialist Environmental Health Officers assigned to this task by CBC. One of the benefits resulting from this collaboration was the installation and provision of the 'Cook-Chill' system to the Hospital Kitchen … a facility that has been appreciated by patients, staff and kitchen workers alike.

UPDATE (un) Accountable Care Systems In March 2017, NHS England (NHSE) published the ‘Next Steps on the NHS Five Year Forward

So why is this an item for our newsletter?

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View’, renaming the plans to Sustainability and Transformation Partnerships (STP) and creating Accountable Care Systems (ACS's) in some localities such as the Blackpool & Fylde coast with a view to spreading these later to the rest of Lancashire (incliding.Chorley).

us will be left with a very poor rump NHS, similar to the American Medicare/Medicaid system.

■ it’s now clear that eventually all STPs will become ACS's.

■ NHSE now want England to adopt a model of care from a country (U.S.A.) that has just been ranked LAST in provision of healthcare and the UK NHS ranked number one!

As of yet, the ACS models do not meet legal requirements since they involve dismantling the purchaser provide split thereby allowing all partners a say in buying and selling (commissioning). In other words, it is profit driven and invites all partners to make savings based on a fixed budget, the incentive is 'savings' which are then paid back as 'bonuses' to the shareholding partners.

These ACSs are strongly opposed by many organisations and we need to keep track of them and throw a spanner in the works at every opportunity.

One such organisation is the Royal College of Paediatric and Child Health (RCPCH), who produced a highly critical appraisal of the effects of STPs/ACPs on the state of child health, published in May this year. The report (entitled “State of Child Health short report: Sustainability & Transformation Partnerships”) was based on a review of the 44 published STP plans, which reveal major deficiencies - they are failing to take into account the needs of infants, children and young people.

ACS's are American-style models where commissioners and providers - often including but not limited to: hospital trusts, local authorities, GP surgeries and the private sector etc They take on collective responsibility for the budget, resources, and population health.

Most worrying, ACS's are a move to the American model of healthcare management and are financially driven. The ACS system has low fixed budgets that will not meet the public need and will transform the NHS into a two tier health system where those who can afford it will pay and the rest of

These deficiencies include: • Lack of a life course approach • Lack of recognition of the needs of infants, children and young people • Limited engagement with clinicians and the public 9

• Workforce shortages.

service.

A more detailed Press Release (and link to the full report) can be found here ...

The NHS isn’t overspending.

The government is underfunding.

http://www.rcpch.ac.uk/news/lackfocus-health-and-wellbeingchildren-majority-stps-‘majorcause-concern’

STPs exploit this defunding crisis to shrink the NHS and bring in healthcare models like accountable care organisations, from the US, where they base availability of healthcare on insurance and ability to pay, not on need, as it is now.

Services will be rationed. People will have to pay for some services or go without. If STPs go through, the NHS will no longer be able to meet all our health needs. It will become more difficult to access, and a limited service of last resort.

or scan this QR code ...

STPs - Slashing, Trashing and Privatising our NHS The NHS is in crisis and desperately needs more money. But the Tory government doesn’t care about public services and is forcing local health chiefs to make plans to cut NHS services - including ward closures, cuts in bed numbers, changes to GP practices and downgrades or closures of A&Es, maternity and children’s wards.

Now, more than ever, the NHS needs us to fight for its future.

These plans are called Sustainability and Transformation Plans (STPs). They have been prepared in secret and aim to limit NHS spending to £22 bn less than is needed to maintain the current ➢ 10

The problem is too few beds, not too many patients!

What can you do to help?

Your right to be consulted, by law, health chiefs must properly consult with the public and patients as these plans involve massive changes to the ways health and social care services are provided.

Our voices must be heard and acted upon. Let’s not make the mistake of waiting to be asked for our views the NHS is depending on us.

By choosing just one thing from this list and acting on it, you will be part of the fightback. · Vote for the party which is

supporting ‘Our NHS’ ➢

leaflets, donation buckets and most importantly a few people to be there and get the word out around the devastation currently happening within Our NHS.

· Ask your councillors to demand that full and proper consultation takes place with the public about your STP. Tell them to oppose the plans and do everything they can to stop them.

As we all know, the leverage any campaign has in front of politicians, medical boards and ultimately the government is people power. We not only need to recruit support from surrounding areas, but we also need the volunteers to help with that recruitment.

Contact them via: weownit.org.uk/blog/itsournh sdon’tslashtrashandprivatise ➢

· Lobby full council meetings, Health & Wellbeing Boards and Scrutiny Committees. Ask them to oppose STPs.

➢

· Join up with your local NHS campaign group and be ready to join in demonstrations to defend local services.

➢

· Spread the word amongst your friends and family.

We already have fantastic, proud campaigners who've kept the spirit going for an amazing 68 weeks at the gates of the hospital. I'm now asking for dedicated members to try to get to Wigan to help man the stall on Saturday 9th September from 9am4pm. (Time dependent on stall coverage).

If you're one of those people who can't stand to sit back and watch the decimation of our NHS and are available for a 2-3 hours, please comment within this event or message me. I'll be opening up while the Yellow Army man the gates on Campaign Hill 10am-11am for what will be week 74 protesting on the cuts and privatisation of our NHS.

Wigan Diggers' Festival Celebrates the life and ideas of Wigan born and bred Gerrard Winstanley & the 17th Century Diggers' (True Leveller) Movement. his year the Chorley & South Ribble Hospital Campaign have a stall to help get the word out about the plight of our NHS based around the immediate cuts to acute services at Chorley & South Ribble Hospital and the knock on effects to surrounding hospitals.

T

We'll have merchandise, information

Ask yourself, "If not me, then who? If not now, then when?"

Solidarity

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FACEBOOK PAGES

DIARY

The Campaign has a couple of public pages on Facebook, with distinct uses.

Aug/Sept 2017 Please post (on Facebook page) if you can attend any of the day or night events.

This is primarily because of the pure volume of posts of a national nature being posted, and reposted, resulting in local issue messages being pushed further and further down the page, often meaning they get missed.

Lancashire Health and Wellbeing Board Cabinet Room 'C' - The Duke of Lancaster Room, County Hall, Preston Tuesday, 5th September, 2017 10:00 am -=-=-=-=-

If you have the QRcode app on your mobile device, you can scan the codes below for direct access.

Joint Committee of CCGs (JCCCG)

So, our page for local issues is bit.ly/csrLOCAL

Chorley Town Hall Thursday, 7th September 2017 1.00 pm CHECK!!!

-=-=-=-=-

Health Scrutiny Committee Cabinet Room 'C' - The Duke of Lancaster Room, County Hall, Preston Tuesday, 19th September, 2017 10.30 am

and for national press stories is bit.ly/CSRmedia

-=-=-=-=-

Chorley & Gtr Preston CCG Clinical Commissioning Group Governing Body meeting Hallmark Leyland Hotel, Leyland Way, Preston, PR25 4JX Wednesday 27 September 2017 13:30 pm -=-=-=-=-

IF you are going to type the addresses into your device, CAPITALS and lowercase letters make a REAL difference.

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Regards - Sue, Andy, Jenny and Jim.