Ealing Save Our NHS campaigners were out in force on 8th December to spread our Christmas message – “All we want for Xmas is our A&E”, and of course the beds and all the services that back that up too!  

Around 26 people joined in to help give out leaflets and stickers in Ealing, Southall and West Ealing shopping centres, whilst our colourful car and PA toured the street with our message.  

The demand for leaflets was amazing with a whopping 2500 given out in a few hours. The support for our local hospital is just as strong as when we first started campaigning 6 years ago and so very heartening.

It was also very encouraging to hear this week that Ealing’s NHS bosses plan to cut Ealing Hospital have had yet another setback as vital money to extend other hospitals and community services has been refused for a second time by national NHS bosses.

They clearly don’t believe that the closure are viable so why don’t our local NHS bosses just accept it. In the meantime with your support we will keep on fighting till we win.

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1. Time to Dump the failed plan called ‘Shaping a Healthier Future’.

 We now know that once again the NHS nationally have refused financial support for the North West London NHS re-configuration plans.  The capital bid for £260 million, which has been rejected, was intended to expand and develop services in several hospitals in North West London and in the local community to pave the way for downgrading Ealing Hospital from a major to a local hospital.

 It means the discredited ‘Shaping a Healthier Future’ still has no money for their plans to replace hospital beds. This “five-year” plan was adopted in 2012 although as we enter 2019, most of it has yet to be implemented.  The plan involved reducing emergency admissions and the need for hospital beds by caring for patients in the community.  Both Ealing Save Our NHS and Ealing Council have been clear this was wrong and unworkable.  Not surprisingly, the hoped-for reduction in bed use and emergency admissions (called non-elective admissions) has not come about – in fact all the statistics show that emergency admissions are actually rising.

 Nevertheless, in anticipation of the reduction in demand for hospital services, North West London NHS bosses went ahead and closed two much-needed A&Es as well as Maternity and Acute Children’s Services at Ealing Hospital. They have also, as reported in the national media, spent £66 million pounds on 41 different management consultancies.

The main area for expansion has been the development of new layers of NHS bosses including the North West London STP (Sustainability and Transformation Partnership), which overlaps with the ‘Shaping a Healthier Future’ team based in Marylebone, which both overlap with the North West London ‘Configuration of Clinical Commissioning Groups’.

 Oliver New from Ealing Save Our NHS said “Apparently there’s millions to spend on highly paid management consultants and NHS senior management projects, while at the same time front line services are desperate for funding.  It’s time our well-paid health bosses finally faced up to the fact ‘Shaping a Healthier Future’ isn’t working, won’t work and can’t work.  The resources should instead be put into Ealing Hospital, where long suffering staff have been working under a shadow.  Ealing should continue as a proper District General Hospital, not a so-called local hospital”

2. Contracting Out of Ealing NHS Services needs to stop

On Friday 13^th December, Ealing Save Our NHS will hand in a petition to the CCG Health Bosses opposing contracting out of vital services.

 The petition, which has been signed by over 1100 local people, rejects the plans to put district nursing and other community health services into a market-style “single contract”. It also rejects the notion that community care can replace 100’s of hospital beds at Ealing Hospital.

Eve Turner, Secretary of Ealing Save Our NHS said “Contracting out of services is completely the wrong medicine.  Instead of turning our health services into a market place with contracts and fixed budgets, The CCG should be spending our NHS money on urgently needed front line care. This contract made NHS Trusts bid against each other at a cost of millions. ESON also believes the unusual 10-year contract worth up to £1.3 billion is highly risky in the current economic climate.  Written into the contract is an aspiration to replace hospital beds with community services, which we also believe is both wrong and unworkable.”

 Petition wording:

STOP THE OUTSOURCING OF EALING NHS SERVICES

We call on Ealing Clinical Commissioning Group and NHS England to suspend the plan to give all Ealing community-based  NHS Services to a contractor for 10 years.*

Such a plan has never been tried before and includes proposals to replace Ealing Hospital beds with care in the community – which has never been shown to work.

We are opposed to the privatisation and marketisation of NHS services.  Running services to a fixed budget could mean that Ealing patients don’t get treatment which is now available.

*Services that would go out to contact include; district nurses, specialist children’s services, physiotherapy, mental health services, dementia support, audiology, occupational therapy, and more.

Although we are now in the season of goodwill, there is precious little of that coming from North West London NHS bosses, who as you will read below won’t give up their plans to cut our Hospital. Nevertheless we are determined to keep on fighting and we hope you will continue to support us. This Saturday we will be out on the streets for our Xmas Day of Action – so please come and join us, the more the merrier.

Ealing Save Our NHS Xmas Day of Action – Sat 8th December:

This is now an annual feature in our campaigning diary. It’s always good fun and we get a great response from shoppers as we tour round the local shopping centres. We will have our colourful leaflets and stickers to give out and a megaphone to draw attention. Adding to the impact in a big way is our poster- covered Car with P.A system spreading the ‘word’ with maybe a bit of singing “All we want for Xmas is our A&E”. 

We start off leafleting in Southall from 11.00 – 12 .00 noon in Southall, opposite the Town Hall while our PA car tours round. Then from 12.30- 1.30pm we will do the same again in West Ealing near Sainsbury’s before heading off for lunch in Pret a Manger in Ealing Broadway to have a sociable and well-earned chat and sandwich break. Our final session will be from 2.45 – 3.45pm in Ealing Broadway (M&S) where there should be lots of Xmas Shoppers.  If you can join us at any point that would be lovely (contact number on the day 07960 309457)

Threat to Ealing Hospital beds still present!!

In our last Newsletter we were pleased to inform supporters that NHS North West London bosses had been forced to admit that their projections for future bed numbers, made in ‘Shaping a Healthy Future’ in 2012 were wrong and that bed numbers were in fact going up, Following a ‘review’ (ha) they now expected bed numbers in North West London to remain the same for the next 5 years. Since the 500+ planned beds cuts were at Ealing & Charing X Hospitals this sounded like good news.

BUT, the trouble with our NHS bosses is that they are doggedly committed to the ‘Shaping a Healthy Future’ (sic) plans to downgrade our hospitals. So when we asked Mark Easton, boss of NHS NW London whether they would now disband their plans for Ealing Hospital, he said that whilst bed numbers in North West London would not be cut, the location and type of beds could still change in the next 5 years. In other words Ealing’s acute beds are still at risk.

One of the big factors is whether NHS NW London can get the capital from national NHS bosses, to create alternative beds. They are hoping that NHS Improvement will say yes to their second request for half a billion capital.  The first request was turned down last year (with a little nudge from ESON researchers) as their projections for reducing emergency hospital admissions were unbelievable. Nothing has changed in the last year, except emergency admissions are going up not down!  Of course they could try and cook the books and there is evidence for thinking they just might be doing that.

Campaign for Free, Publicly Run Social Care takes first steps:

Over a hundred people, including 6 from Ealing attended a hugely informative ‘Reclaim our Social Care’ Conference organised by Health Campaigns Together in Birmingham last month.

The state of social care and in particular the appalling conditions that care workers have to endure is shocking. For example around 1 million older people who need care don’t get it. Nearly half of the 1.3million people working in the care sector earn less that the real living wage of £9 an hour and one in four are on zero-hours contracts. Our social care system is definitely working well for private care providers who make a whopping 13% profits whilst at the same time local authorities are making 20% cuts!

Moving people more quickly out of NHS hospitals into social care not only transfers the financial burden but also means that people have to pay, unlike for NHS treatment. No wonder the Government is so keen on so-called integrated care. We look forward to supporting this national campaign as it develops and working with the newly founded Ealing Social Care Action Group.

National ‘NHS Safe for All’ Campaign to be launched:  

We all know our NHS staff work hard to get us well and keep us safe. Yet 8 years of under-funding, NHS pay falling behind and rising staff shortages have all taken their toll. Inevitably things go horribly wrong and we usually hear about it in the media. Of course the real culprits don’t get the blame as the media loves a good scapegoat, usually a doctor or nurse or both when the real problem is a failure of the system.

This should be a really exciting campaign uniting, patients, families, NHS staff, campaigners and the wider public.

You can read more here in the Health Campaigns Together newsletter. –

Link to https://www.healthcampaignstogether.com/

Save the NHS money and have a little dance or go to the library!

In a recent speech Health Secretary Matt Hancock set out his ideas for ‘social prescribing’ asserting that “prevention is better than cure”. ‘Social Prescribing’ has existed in the NHS since the 1990s and allows a clinician to refer to or suggest, activities such as dance lessons or art classes to aid a patient’s recovery in certain circumstances.  Mr Hancock said that social prescribing can ‘help us combat over-medicalising people’ and help the NHS to save money.

To this end he is setting up a new Academy for Social Prescribing as a resource for GPs and others. Libraries are to play an important part in social prescribing “ If correctly trained on social prescribing referrals, librarians can play an important role in keeping people well in their communities, encouraging them to take dance classes, join choirs to tackle loneliness or become part of mental health reading groups, Mr Hancock said. So it seems GPs and Librarians are to become social workers too!

It would almost be laughable if it wasn’t the case that the Government’s austerity policies have led to library closures and drastic cuts in preventive health services such as substance misuse services.

More on this story here –

https://keepournhspublic.com/news/social-prescribing-fraudulent-fantasy/

Get Involved – come to our Campaign Meeting Tuesday 11th December:

It’s our last Meeting of the year so mince pies are on the Agenda as will a bit of a review of recent news and events. We always welcome new people to helping with campaigning and our campaign meetings are a good place to start so it would be great to see you.

Please come if you can: 7.30pm, Tuesday 11th Dec in Northfields Community Centre.

You can subscribe to our newsletter here

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It has certainly been an interesting couple of weeks. Our local health bosses, Ealing CCG, have picked the bidder who they want to run our community health services in a massive contract.  It’s a consortium of West London NHS Trust & several other partners using a “corporate structure”. Plus this week, we heard NW London health bosses have confirmed that Ealing & Charing Cross Hospitals were unlikely to lose any beds before 2023.  

NHS bosses forced to admit beds cuts at Ealing & Charing Cross Hospital can’t be done:

North West London health bosses have been forced to acknowledge that their plans to cut hundreds of beds at Ealing & Charing Cross have to be postponed yet again and that no bed cuts will be taking place in the next 5 years.  

In their statement on 18th October, NWL NHS said –  

“We have always been committed to revising our initial projections for future hospital bed numbers in line with actual activity. Our latest analysis suggests that the number of beds in NW London has gone up slightly since 2012 and we expect the number of bed numbers to stay more or less constant for the next five years at least.”  

Of course this is good news as far as it goes BUT these health bosses have STILL NOT CHANGED their plans to downgrade our hospitals merely delayed them until they think it’s safe. They have two problems – local opposition which has been very strong, combined with the fact that their plans would only work if they can reduce hospital admissions, which hasn’t been happening.

This obviously shows how right Ealing Save Our NHS, Ealing Council, health workers and the people of Ealing have been, and how wrong the management consultants and Health bosses have been.

Sadly, Ealing Hospital has been and continues to be deliberately starved of support in the meantime and has lost a number of services. Now more than ever our Hospital needs a big boost of funding and commitment if it is to survive. But there’s light at the end of the tunnel so let’s keep on fighting to save it!

The whole story has been reported in Get West London, which is the online Ealing Gazette.

Here’s how Ealing Council reported it to the public in a recent press release –

If you want to read it from the NHS bosses it’s here

Consortium of NHS trusts to ‘run’ our community health services

Ealing’s health bosses (Ealing CCG) have put our community health services on to the market place.  They asked for bidders to run these NHS services in a 10 year, £1.3 billion contract, claiming that Ealing community health services would be more integrated and co-ordinated if they were run by a so-called ‘single provider’. This is nonsense as most of our community health services are already provided by London North West University Healthcare NHS Trust (London North West Trust), who also manage Ealing Hospital.  There will probably be less integration, not more.

The latest announcement from Ealing CCG is that the contract has been won by a ‘consortium’ of NHS Trusts led by West London NHS Trust (previously – Mental Health Trust).  There may well be a single contract, but it is laughable to call it a ‘single provider’. The winning consortium consists of three NHS Trusts (Central & North West London, Hillingdon and West London) plus at least 2 charities and inevitably many sub- contractors.  On top of that the integration of Ealing Hospital and community health services has been broken, and the London North West Trust will be deprived of considerable finances.

Cuts to our community services seem inevitable as the winning consortium has to deliver a greater amount of community health services within a very tight budget. No wonder that both London North West and Central London Community Health NHS Trust pulled out of the bidding as they felt they couldn’t provide safe, quality services for the money.

Of course we are pleased that a private company didn’t win but this rotten contract system has pitted NHS Trust against NHS Trust, wasting millions of pounds of scarce NHS money in preparing rival bids.  It forces NHS Trusts to behave more and more like private businesses. In fact the contracting system probably wastes between £4 -10 billion pounds of NHS money a year – outrageous!

As the saying goes ‘it’s not over until the fat lady sings’.  This contract still has to be approved by the NHS at a national level and Ealing Save Our NHS has submitted a long list of objections so watch this space to see what happens. We have also requested that Ealing Council use its powers to scrutinise the contract and the impact on the local NHS including Ealing Hospital.

More NHS bureaucracy and name changes

One thing you can be sure of these days is that money can always be found for more NHS bureaucrats. Health bosses in North West London have set up yet another body, catchily called – ‘NHS North West London Collaboration of CCGs’, with a raft of highly paid officers to run it. This new body will be commissioning services across NW London, including acute services, so what we ask, will be the role of local health bosses, Ealing CCG, and any possibility of local accountability- none or next to none we think.

The NHS seems very keen on name changes these days, particularly when they become a bit unpopular, so the North West London STP (the mechanism set up to implement cuts under the guise of integrating health and social care) has now become the ‘North West London Health & Care Partnership’. It is a funny kind of partnership given that two local authorities, Ealing and Hammersmith & Fulham, didn’t sign up to the STP because it meant supporting the closures at Ealing & Charing Cross hospitals.  Since they didn’t toe the line they have been told they can’t be on the Partnership Committee!!

Get Involved – come to our Campaign Meeting Tuesday 20th November:

Ealing Save Our NHS always welcomes new people to helping with campaigning and our campaign meetings are a good place to start.  The latest announcements on the future of Ealing & Charing Cross and the Community Health Services contract will certainly be one of the main discussions. We will also be making plans for a Day of Action in local shopping centres before Christmas. We would love to see you on the 20th.

Please come if you can: 7.30pm, Tuesday 20th November in Northfields Community Centre.

Health tourism – fact or fiction?

A weeny part of the NHS budget is spent on ‘health tourism’, but it’s a great excuse for the Government to pretend we have no money.  What are the facts? Check out this excellent leaflet hot off the press from Keep Our NHS Public.

Reclaim Social Care Conference –  Birmingham Saturday 17 November

This very welcome conference organised by Health Campaigns Together, aims to kick start a much needed major national campaign to reverse privatisation and demand decent publicly funded and accountable social care services for all.

It’s open to all – just register in advance. There will be speakers from Health Campaigns Together, MPs, Care Unions, Disabled People against the Cuts, National Pensioners Convention, Relatives and Residents Association, leading social care policy experts and more with plenty of time for discussion and debate.

More details here

Health Campaigners to get day in court to stop dangerous NHS reorganisation

NHS England is planning a new model of health and social care provision that could see multi billion pound contracts handed over to the private sector. These new contracts called ‘Integrated Care Provider (ICP) contracts will be enormous, covering up to half a million people for 10-15 years.

Health Campaign group, ‘999 Call for the NHS’ have challenged the legality of these plans on 7 grounds.  The protracted legal case is up at the Court of Appeal, probably on Tuesday 20-21 November (confirmation due any time soon) Once again – watch this space.

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Issue: 72

2 November 2018

NHS North West London’s ‘Transformation’ Strategy Crashes and Burns as it Finally Admits to Cancelling the Closure of 500 Beds

On 1 November 2018 NHS bosses in North West London (NWL) finally conceded defeat in their 2012 ‘Shaping a Healthier Future’ (SaHF) strategy. Reducing the number of ‘Major Hospitals’ from nine to five was the major plank of SaHF. In six years they managed to get it down to seven, but now concede (ostensibly till 2023) that the Acute hospitals at Ealing and Charing Cross will not have their Acute beds removed. In fact the number of beds at both sites are being increased.

Surely this is the last straw for SaHF. A list of previous SaHF failures can be found in my missing business case piece below.

NHS NWL is Still Confident it Will Soon Win Approval For its Re-Request for £513 Million for Building Work

Also on 1 November 2018, NHS NWL boss Mark Easton publicly stated that he expected the resubmitted SaHF ImBC SOC1 business case for £513 million for capital projects to be approved ‘soon’. With just months to go until the UK leaves the EU, with tens of £billions at risk, the idea that H.M. Treasury would agree to give NHS NWL £0.5 billion for building work is beyond ludicrous.

Ealing Out Of Hospital Services Contract Not Awarded to a Single Supplier

Our local NHS mental healthcare service supplier is the first company named in a list of five companies announced on 30 October 2018 by Ealing CCG as the winner of the 10 year, £450 million contract. This lead winner received poor CQC reviews in both 2016 and 2017.

The five organisations named in the press release are:

+ West London NHS Trust (was until very recently called West London Mental Health NHS Trust)

+ Central & North West London NHS Foundation Trust (the only other NHS mental healthcare service supplier in North West London)

+ Hillingdon Hospitals NHS Foundation Trust (which runs Hillingdon Hospital – regularly one of  the worst performing Acute hospitals in England since 2015)

+ Marie Curie (‘Care and Support through terminal illness’ charity)

+ Mind (mental health charity)

Also mentioned are ‘other local organisations’ (the number of which and their names are not identified).

There is no single supplier here. Surely this makes the whole procurement process flawed. There has been no overt attempt to create a consortium of the seven (maybe 10, 15…) organisations. What is even more bizarre is that the current supplier of 25 of the 36 OOH Services covered by the contract is our local Trust here in Ealing – the London North West University Healthcare NHS Trust (LNWUH). LNWUH, by the way, was one of two London Trusts which refused to bid for the contract on the grounds that the money on offer was insufficient to provide quality services.

I’m certainly glad that Virgin Care didn’t win the contract. But rumour has that they did submit a bid. If they did, they may well claim compensation – a stroke they have pulled before. I wonder whether we will ever discover, officially, which organisations – single supplier or a group of organisations – actually submitted bids. However, the ever secretive ECCG is unlikely to tell us.

Finally with our local mental health NHS Trust (‘West London’) taking the lead on this contract how might these new responsibilities affect its faltering core mental health services? In 2017, CQC rated nine of its eleven core mental health services as ‘Requires Improvement’. In another bizarre twist on secondary mental health services, it appears that all eight NHS NWL CCGs have delegated ‘upwards’ the commissioning role for this to the non-Statutory NHS NWL Collaboration of CCGs. How this will work is unclear as this collaboration appears on the face of it to be just a set of meetings. However as is the way seemingly in the NHS maybe the Collaboration now employs staff.

Maybe Jam Tomorrow for Mental Health Services According To Hammond’s Budget

On 29 October 2018, Chancellor Hammond announced an additional £2 billion for NHS mental health services in England. Was this new money? No it wasn’t – it’s part of the £20 billion for the NHS announced by Prime Minister May in July 2018. Allegedly ‘the increase’ will begin in 2019/20 but will not be ‘completed’ till 2023

The announcement says little specifically about increasing the number of mental health beds, recruitment and training of more psychologists and other mental health staff. The idea of mental health teams in schools seems helpful on the face of it. But who will staff these teams? Do schools have room for a mental health team? Will teachers be trained as mental help workers? Promising to add specialist mental health support to A&E departments shocks me as I naively thought such support was already universally in place across England.

There’s also no commitment to ring fence this money for mental health use. Both NHS Trusts in North West London which supply mental health services are no longer dedicated just to mental health. In future Integrated Care Providers will ultimately decide how or if this money is spent on mental healthcare and mental social care.

However the caveat to all this is that if Brexit goes pear shaped the NHS budget increase will just not take place at all.

Why Are Business Cases for NHS Transformations Being Withheld From the Public?

I’ve been tracking NHS ‘Transformations’ now for over six years. The NHS intentions for transformations are better outcomes for patients and cost reductions. In a conventional business you would probably borrow money from the bank in order to transform your business. You would write a business plan/business case which would which would have projections of costs and profits. For a private business this business case would only be shown to investors and the bank. For public businesses the investors would be the general public and the business case should be shown to them.

What happens in the NHS?

+ NHS North West London (NWL) ‘Shaping a Healthier Future’ (SaHF)

A ‘final’ business case for this project launched in 2012 appeared in the public domain in December 2016. In September 2017, NHS England (London) and NHS Improvement (London) both rejected the business case. This business case was entitled ImBC SOC1 and it requested £513 million for building work. The cash was intended for GP Surgeries and Acute facilities expansion and the creation of healthcare ‘hubs’. Deploying capital in this way would apparently justify the closure of Ealing and Charing Cross as Acute hospitals.

We have been led to believe that a revised version of SOC1 has been drawn up by NHS NWL bosses and submitted for approval to NHSE/I. NHS NWL has refused to place this new business case into the public domain. However it now appears that the original SOC1 has been resubmitted on a new, different set of forms. Wow! Maybe the new forms will make all the difference….

One of the ‘fragile’ elements of the original SOC1 was ambitious targets for reducing annual Non-Elective Admissions to Acute hospitals by 99,000 by 2015/26. These so called NELs are largely emergency admissions. A recent Freedom of Information (FOI) request to NHS NWL has revealed that NELs continue to rise (not fall) across NWL:

2013/14: 167,222

2014/15: 170,271

2015/16: 175,502

2016/17: 172,142

2017/18: 181,632

In fact the latest data for April, May and June 2018 show that for each month NELs were higher than each of the same months for the previous five years. So the trajectory is upwards not downwards.

On the cost saving front, the original 2012 SaHF public consultation document projected annual cost reductions of  4%. In the first year alone this would have amounted to £144 million in savings. However NHS NWL SaHF has yet to announce any cost savings at all.

In a quite distasteful fashion current SaHF /NHS NWLbosses have just published their own review of SaHF 2012 to 2018. There are few performance metrics in the 11 pages and there are some shocking errors and omissions, which include:

+ The SaHF benefits statement in the review is completely at odds with the 2012 SaHF benefits statement. In 2012 the benefits are localising , centralising and integrated. In the 2018  SaHF review they are personalised, localised, coordinated and specialised. More to the point the 2012 SaHF mission statement says ‘….changes that will improve care both in hospitals and the community and will save many lives each year’

+ Getting a GP appointment takes much longer in 2018 than it ever did in 2012

+ There are no estimates of lives saved by SaHF

+ The 2012 SaHF is purely about NHS physical healthcare transformation and as such is at odds with the 2016 STP and the 2018 Integrated Care Provider contract as the latter two also involve Local Authority social care services transformation and its integration with physical and mental healthcare services

+ The 2012 SaHF changes were to take ‘at least three years to put in place’. Six years on, the SaHF changes are still not in place

+ It was planned in 2012 to close four hospital A&Es, but only two have been closed.

+ After the two A&Es were closed in September 2014, A&E performance deteriorated massively across the whole of  NWL, often being the worst in England. Whilst A&E demand has remained steady it’s only recently that there has been a modest recovery in performance

+ No reference to cost savings

+ So far SaHF has cost over £100 million

+ The 2016 SaHF ImBC SOC 1 business case requesting £513 for building work is still not approved

+ The SaHF ImBC SOC 2 business case requesting £314 million for building work has never appeared in public and little has been heard of it in recent years.

(+ Bed reduction strategy was dumped on 1 November 2018, and this really closes the book on SaHF).

When I ran my own business I performed performance reviews on my staff and on their projects. At school I was never allowed to mark my own homework – this was done by my teacher. It’s high time we had an independent review of SaHF. The last people who should be considered to review SaHF are past and present SaHF bosses.

You can view this partial view of SaHF history at:

www.healthiernorthwestlondon.nhs.uk/sites/nhslondon/files/documents/8._nhs_in_nw_london_-_overview_of_strategic_developments_since_2012.pdf

+ Ealing Out Of Hospital (OOH) Services Contract

Ealing CCG refuses to release the business case supporting this single supplier, 10 year, £450 million minimum contract. ECCG’s reason for withholding this document is that it is commercially sensitive. Well this might have been the case prior to bids being submitted. All bids were submitted by 23 August 2018, so why not release the business case now? What has ECCG got to hide?

ECCG has stated publicly that the single supplier OOH Services contract will not reduce costs. It said cost reductions would be achieved by reductions in NELs. FOI data tells us the ECCG NELs in 2013/14 were 31,335 but by 2017/18 they had risen to 32,561. So the trajectory is upwards not downwards.

As of 30 October 2018 we now know that at least seven organisations have been awarded this ‘single supplier’ contract. Bonkers or what?

+ Integrated Care Provider (ICP) Contract

ICP contracts could, when signed and implemented nationally across the coming decade, amount to £100s billions in value. But, where is the ICP business case? Where in fact is the Integrated Care business case? I can’t find them.

All that seems to exist are various papers written by McKinsey & Co from 2009 onwards containing the dogma that 40% of patients occupying Acute hospital beds shouldn’t be there. Along with this are somewhat dated performance metrics from some of the 50 NHS Vanguards, showing some reduction in the growth rate of NELs. Launched in 2015, these are grant funded experiments, whose results may not emerge till 2020/21. £389 million has already been spent on them but the National Audit Office (NAO) said in June 2018 that it could find no evidence of cost savings. In a stunning NAO statement it noted that ‘NHS England does not intend to continue measuring savings’.

Latest figures show community care can’t replace beds at Ealing Hospital

Winter is coming and already there are fears of another crisis. Ealing Hospital is readying itself with an extra 15 beds being brought in to cope with much needed demand for beds. As our latest story reveals, it is not just Winter that shows yet again the need for both Ealing & Charing Cross Hospitals A&Es and their beds to remain open. Please read on….

Rise in emergency admissions shows health bosses plans are failing

Ealing’s health bosses (Ealing CCG) plans to downgrade Ealing & Charing Cross Hospitals have taken a further knock, according to the latest figures on emergency admissions to North West London hospitals. The ‘Shaping a Health Future’ closure plans, which entail both Ealing & Charing Cross losing their A&Es and up to 600 beds, are dependent on  emergency admissions across North West London hospitals being brought down by a massive 99,000 per year by 2025. This reduction is supposedly to be achieved by treating people in the community and thus preventing admissions. So what do the figures show about how well they are doing?

Not well at all, according to the latest figures revealed under duress by Freedom of Information requests. In the last 5 years emergency admissions to Ealing Hospital actually increased from 33,000 per year to 34,000.  Across North West London, emergency admissions increased from 167,000 per year to 181,000 during the same 5 year period.

Of course local health bosses, Ealing CCG, must know their plans are not working but despite that they are still pressing ahead with their costly and extremely risky tendering out of our community health services. They vainly hope that this ten-year, £1.3 billion contract to be run by a ‘single provider’, which as readers know will be multiple providers, will magically reduce emergency admissions by tens of thousands by ‘transforming’ community health care.  Where, we wonder, will all the staff come from to treat people in the community given that there is a 30% vacancy rate for community nurses in Ealing?

Winter is almost upon us and how will the NHS cope?

Already warnings are being made that the Winter Crisis could be even worse than last year. The Government has responded by saying it’s giving local authorities £240 million extra this winter for social care to alleviate pressure on the NHS, by getting people out of hospital and freeing up beds. £145 million has also been provided for capital projects and equipment. So will it work?  According to ‘NHS Providers’, the body representing acute, ambulance, community health & mental health services, this new money will help but is likely to be undermined by increasing demand, worsening A&E performances and a yawning gap in nurse and other frontline NHS staff numbers. On top of this there is a gaping hole in the number of nurses working in the community too. No doubt our valiant NHS Staff will once again do their best to cover the gaps and keep us safe but they deserve so much better.

Read article here

4-hour A&E waiting time target scrapped for this Winter

Former Health Secretary Jeremy Hunt scrapped the 4 hour A&E waiting time performance target earlier this year. Struggling NHS Trusts were hard pressed to meet the 95% target, in fact they only met the 4 hour target on average last year about 60% of the time. No doubt many of them will be relieved, but without an effective measurement that highlights how each Trust is doing it will be much easier to hide failings and the impact of underfunding and cuts. One of Jeremy Hunts more mad cap ideas, currently on hold, was a plan to introduce an appointments system for attending A&E – surely it’s not called an accident & ‘emergency’ for nothing!

Do you have a story about delayed or poor referrals for treatment?

We regularly hear stories of delayed referrals and people wanting Ealing Hospital but being sent to Northwick Park or Central Middlesex instead.  Although under the NHS Charter patients have a legal right to choose their hospital, in practice bodies like Ealing’s Referral ‘Facilitation’ Service, run by private company Optum takes that right away.  

If you have a story to tell about your GP’s referral for your treatment we would love to know –  if you were referred to a consultant? was your referral knocked back? did you get the place of choice? was there a long delay, and did the referral go through as discussed with your GP?

Sarah Boston from ESON would like to use these stories as examples, along with the research she has been doing on patient’s rights for an article she is writing.  

If you have a story to share please contact Sarah at sarahboston44(at)icloud.com

Reclaim Social Care Conference – 17 November – time for a campaign

This very welcome conference organised by Health Campaigns Together, aims to kick start a much needed major campaign to reverse privatisation and secure quality, stable, publicly funded and accountable social care services for all.

There will be speakers from Health Campaigns Together, MPs, the unions, Disabled People against the Cuts, National Pensioners Convention, Relatives and Residents Association, leading social care policy experts and more with plenty of time for discussion and debate.

Sat 17 November 2018, 11:00 – 16:30 Carrs Lane Conference Centre, Carrs Lane, Birmingham, B4 7SX

More details here

A couple of fun things on the NHS:

22 October – 3 November: Check Up – Our NHS at 70  

Mark Thomas (comedian, presenter, political satirist and journalist) will be performing  at The Arcola Theatre in Dalston.  The show, directed by Nicholas Kent, is based on a series of interviews with leading experts and residencies in hospitals and surgeries.-  Mark is always well worth a watch!

For more information and tickets see the Arcola Theatre’s website

Tuesday 6th November:  “Happy Birthday NHS” 

In this show, Dr Phil Hammond, Physician, Broadcaster, campaigner & comic charts the course of the NHS from 1948 to as long as she lasts. Come and cheer the heroes, boo the villains and look to the future of robot surgeons, Fitbit nurses and iPhone GPs. 

It starts at 8.00pm at the Twickenham Exchange and you can book here:

Thanks for your support

Best Regards

Eve Turner

Secretary, Ealing Save Our NHS

Our latest newsletter:

As many of you will know Ealing Save Our NHS has been campaigning against local NHS bosses plans to place all our community health services in the hand of a ‘single provider’ in a fixed 10 year contract worth up to £1.3 billion pounds.  The bidding process is coming to an end and despite two NHS Trusts saying the budget available to ‘transform’ delivery of community health services (out of hospital services), would not allow them to deliver safe, quality services for patients, Ealing CCG (local health bosses) are determined to press on with other bidders.

An announcement could be made any day on who the new provider(s) may be.  We would have hoped there would be a pause for reflection but of course it’s not easy to stop a juggernaut! We have been in correspondence with these health bosses but they are at best totally evasive in addressing our concerns. Nevertheless we are determined to hold them to account and have written to them yet again.

We also have an interesting story on Virgin withdrawing from contracts in East Staffordshire and a shocking story about GP practices likely to close, so please read on….

ESON letter refutes health bosses claims of the benefits of Single Contract

In September ESON received a response from Ealing CCG to our written concerns. We have now written again to take up the CCG’s claims of the benefits of having a single provider of community health services; to obtain evidence of any assessments they have made of risks of the contract failing and the impact on Ealing Hospital; and to explain the perils of a fixed 10 year contract.

You only have to read this newsletter to see that in reality, based on those bidding, there is not one ‘single provider’ but many providers and likely to be more sub-contracting and an even more fragmented service. We say this because our local Trust (London North West University Healthcare NHS Trust), which manages Ealing Hospital, currently delivers around 80% of all community health services, but that link has now been broken as the Trust will not retain the services because it felt unable to bid on grounds of safety and quality of care.

The CCG has refused to provide any evidence that it is has fully assessed the risks of failure or the impact on Ealing Hospital & the London North West Trust, which we have detailed. We have called on the CCG to commission an independent impact assessment ,which has been done in other Boroughs, to try and protect our hospital and have asked Ealing Council for their help in getting this done.

You can read our letter here

Street Stalls and petitioning – all help very welcome

This Saturday 6th Oct we have a Street Stall in West Ealing (near Sainsbury’s)

11.00 -1.00pm with our latest leaflet and our ‘Stop the outsourcing of Ealing NHS Services’ petition. It would be great if you can spare some time to help.

We are aiming to get as many signatures as possible over the next few weeks. A valiant Team collected nearly 200 signatures in the early hours at the Ealing Half Marathon on Sunday.

We also have another Stall on Saturday 27th October, 11.00-1.00pm (Co-op Pitshanger Lane)

Who might be bidding to run community health services in Ealing?

We now know that West London (Mental Health) NHS Trust, who currently run mental health services in Ealing, but has dropped ‘mental health’ from their name, has put in a joint bid to run our community health services with other NHS Trusts. This was revealed in a letter to staff last month.

“We have…worked closely over the past few months with staff from across the Trust, from partner organisations (Central and North West London NHS Foundation Trust (CNWL), and The Hillingdon Hospitals NHS Foundation Trust (THH), local GPs, third sector organisations and patient representatives to design a proposal”

They seem to be very defensive about their bid in the letter and very conscious of all the media stories, mostly from us! They are keen to emphasize how they can deliver safe, quality services, partly by cutting out ‘waste’ and re-organisation.  A view clearly not shared by either, current community health provider, London North West or Central London Community Health Trust, who both thought the opposite! The West London NHS Trust bid with its multiple partners and Trusts shows what nonsense it is to claim that having a single provider will be so much more integrated and co-ordinated!!  

Government policy and legislation has created this wasteful and costly contract culture that now pits Trust against Trust, ties NHS staff up for months preparing bids and increasingly edges the NHS towards a business culture, losing its focus on what really matters – the patients!

Hot News – Virgin pulls out of Single provider role in East Staffs:

One of the other likely bidders for Ealing community health services, Virgin Care, is in the news again. This time according to the Health Service Journal (HSJ) Virgin has partially terminated its 7-year single provider contract with East Staffordshire CCG.

Virgin Care took on the responsibility for the commissioning and integration of services for frail elderly patients and people with long term conditions (basically the East Staffs CCGs role!)  Of course, Virgin ended up sub- contracting a number of services that they couldn’t directly provide, which included 111, out of hours services and hospital-based services. Virgin had been trying for 18 months to get the CCG to give it an extra £5m funding, but this was refused, so Virgin is no longer willing to commission or manage these services.  

This means the East Staffs so called ‘single provider’ completely failed and leaves their CCG having to enter into new contracts with everyone except Virgin after all. Lots of time and money has been wasted instead of being spent on providing patient care – what a disgrace and farce!  It also clearly shows how Virgin just walks away when it doesn’t suit the needs of the corporation.

GP practices in Ealing could close in next 5 years!

A recent article in ‘Pulse Today’ has revealed that according to Royal College of GPs research, over 750 GP practices could close in the next 5 years, as they rely on GPs close to retirement age. Unfortunately, Ealing is in the top 5 worse affected CCGs with a potential of 47,000 patients having to change practices.  NHS England and no doubt our local NHS bosses, Ealing CCG will say we are doing well on recruiting new doctors. However, the Royal College of GPs says that there has not been sufficient recruitment and even if they had, you are at best replacing the most experienced GPs with newly qualified one. This is yet another uncertainty to add to the good reasons not to have a fixed 10 year community health service contract!

Read article here

Well done SAGE for a lively and informative meeting:

Well done to Seniors Action Group Ealing for organising a very lively and informative Meeting on the impact on older people of the out of hospital services contract.  It is good to see other groups discussing and debating this serious risk to our community health services. Unfortunately, no-one from the CCG was brave enough to come along and face any questioning. However, the speakers had no difficulty in making the case against the new single contract nor answering any questions. Dr Louise Irvine (Keep Our NHS Public) myself from Ealing Save our NHS, Julian Bell and Steve Pound MP, kept everyone entertained and there was very good audience participation. We were also all kept in check by some excellent chairing from Martin Eady.

NEXT CAMPAIGN MEETING – Tuesday 16th October

7.30pm in Northfields Community Centre.

You are very welcome to come to our friendly and informative Campaign Meeting. As well as the usual items on campaigning against the OOH Contract, the latest on Ealing Hospital and the Trust & future activities we need to have a full discussion on the Integrated Care Partnership ‘Consultation’ which closes on 26th October.  If this goes through unchallenged it will drastically change the way health service are delivered and increase privatisation overwhelmingly. Eric has been working hard on this and will be offering suggestions as to how we can best respond.

To receive the latest campaigning news, subscribe to our newsletter here

Issue: 71

3 October 2018

This occasional newsletter is researched, written and edited by a group of concerned residents in Ealing, West London who want to preserve our NHS. We view the wholesale engagement of private, for-profit healthcare service suppliers as unnecessary, profligate and dangerous. Increased financial funding is what is needed in our NHS – not financial cuts, closure of vital services or privatisation.

Ealing Out Of Hospital (OOH) Services Single Supplier Contract

Ealing CCG has, I think, admitted that it has received three ‘compliant’ bids for this 10 year contract.  Allegedly two of the bidders are:

+ Virgin Care, with some kind of association with Ealing Community Voluntary Service

+ West London NHS Trust (until very recently called West London Mental Health NHS Trust). The bid involves Central and North West NHS Foundation Trust and Hillingdon Hospitals NHS Foundation Trust.

ECCG has promised to make some formal announcement about the ‘outcome’ of the bidding process on 5 November 2018. The plan is that 36 OOH care services will be outsourced to one of these three suppliers beginning on 1 May 2019. The initial contract value is £450 million. Over the course of the contract an additional 24 OOH care services might be outsourced to this supplier and the final value of the contract could reach over £1.2 billion.      

ECCG has refused to place its business case for this contract into the public domain. With the bidding deadline having past there can now be no commercial confidentiality considerations. Has ECCG got something to hide?   

Virgin Care Terminates Elements of Single Supplier, £270 Million Healthcare Services Contract in East Staffordshire

‘Health Service Journal’ has reported that Virgin has terminated large parts of a controversial NHS healthcare contract in East Staffordshire. The contract was awarded in 2015. It was a seven year, fixed price contract. Termination notices have been served for all services for which Virgin is not the direct provider. These services include hospital services, 111 and Out-Of-Hours services. Virgin and the local CCG have been arguing for 18 months. Virgin had asked for £5 million extra funding.

Integrated Care Judicial Review Appeal – Financial Support Needed

On 18 August 2018, the campaigning group 999Callforthe NHS won the right to appeal the failed April 2018 Judicial Review (JR) about Integrated Care. The appeal will be heard before Christmas, but the campaigners need to raise money to cover their costs. Although the Court of Appeal has capped the cost liability, 999CallfortheNHS needs to raise £18,000 very quickly.

You can read the grounds for the appeal and donate money at:

https://www.crowdjustice.com/justice4nhs-stage5-courtofappeal/

If the appeal is successful it’s likely it will make a nonsense of the current public consultation about the Integrated Care Provider contract – as the contract under the microscope might be deemed illegal.

NHS North West London (NWL) Makes a Second Attempt at Extracting £100 Millions from H.M. Treasury for SaHF Building Work

In 2012 NHS NWL launched its ‘at least three year’ Shaping a Healthier Future (SaHF) plans. SaHF would cut costs annually by 4% and would close down four District General Hospitals (DGHs) and their A&E units. No cost savings have ever been announced. After just two of the DGHs and their A&Es were closed in September 2014, A&E performance across NWL immediately plummeted and has never recovered. The two further DGH/A&E closures failed to materialise.

There had been draft SaHF business cases in circulation for three years. The final SaHF ImBC SOC 1 business case finally emerged into the public domain in December 2016. It contained within it a cash-call for building work of £513 million. NHS NWL duly submitted this bid to NHS England and NHS Improvement. In September 2017 NHSE/NHSI (London) rejected the bid on the grounds that the large reduction in emergency admissions postulated were unrealistic. Fairly soon after this rejection the two NHS NWL Accountable Officers resigned.

It has recently emerged that an attempt to submit an updated version of ImBC SOC 1 is underway. Its patron is the new NHS NWL Accountable Officer Mark Easton. We don’t know yet whether as much as £513 million is being asked for again. A copy of this submission has not been offered, as yet, for public viewing. Mr Easton is quoted as saying he expects some response from NHSE/I by November 2018.

Let’s not forget either that in December 2016, yet another final SaHF business case was mentioned in dispatches – ImBC SOC 2. It was, apparently, a business case for SaHF building work in ‘inner’ NWL with a cash-call for £314 million. Here we are 22 months later and SOC 2 was apparently never submitted and has quietly disappeared.

Integrated Care Provider (ICP) Contract Public Consultation

Accountable Care Organisations (ACOs) first caught my eye in 2016. ACOs, an American ‘invention’, involve long term, fixed price care contracts held by a single supplier. The supplier could be a private company. They were touted as the future vehicles for delivering integrated healthcare and social care services. 32 of the 44 STPs published in October 2016 referred vaguely to Accountable Care Organisations/Partnerships as implementation engines for parts of the STPs.  

Nothing much happened with ACOs during 2017 except that two Judicial Reviews (JRs) were initiated challenging ACOs. In January 2018, the JR4NHS JR forced the Government/NHS England to commit to a 12 week ACO public consultation. In February 2018 the Government/NHSE decided to rename Accountable Care as Integrated Care. Integrated Care Systems (ICSs) became the new STP implementation vehicles. The two JRs ended in failure, but the 999CallfortheNHS JR was granted leave to appeal on 18 August 2018 and this appeal is yet to be heard in Court (see above).

In spite of the legal uncertainty surrounding the JR Appeal, the public consultation promised in January 2018 began on 3 August 2018 and will end on 26 October 2018. Of course, we have had another name change and the consultation is entitled ‘Integrated Care Provider contract’.

NHSE has made little attempt to list and explain the issues involved or the likely impact on healthcare patients and social care users under Integrated Care Provider (ICP) regimes.

The massive consultation paperwork is only available online at:

www.engage.england.nhs.uk/consultation/proposed-contracting-arrangements-for-icps/user_uploads/integrated-care-providers-consultation-document.pdf

Health Campaigns Together has assembled a very informative web page which contains lots of background information on ACO/ICS/ICP. It has also created a well considered set of summary answers to the consultation questions. See:

https://healthcampaignstogether.com/ACOmonitor.php

My consultation response also contains the following points:

+  ICPs will be 10 year, single supplier  contracts which will undermine the NHS as the provider of healthcare services and Local Authorities (LAs) as providers of social care services. ICPs will ‘sit above’ NHS Trusts and LAs and will, in effect, commission all care services

+ ICPs will make CCGs redundant – but there are no plans to eliminate CCGs

+ There is no compelling evidence that supports the notion that the integration of healthcare services and social care services leads to better care outcomes

+ No evidence is provided that supports the notion that the single supplier approach results in better healthcare and social care outcomes than employing multiple suppliers

+ The notion that GPs can either work or not work with an ICP is fragile and dangerous .

+ The elephant in the room is that we need to spend more on healthcare services and social care services. The ICP initiative only serves as an unwelcome distraction to these financial deficiencies.

Integrated Care Provider (ICP) London-wide Public Consultation Meeting: Only 12 Members of the Public Attend

On 11 September 2018 in Newington, East London, NHS England mounted a London-wide public consultation event on Integrated Care Provider (ICP) contracts. ICPs are the preferred NHSE vehicles for providing future Primary, Secondary and Out of Hospital healthcare and social care services throughout England. This event was part of the 12 week ICP public consultation which ends on 26 October 2018.

Only 12 members of the public attended this London event. This is out of an adult population in London of over five million. How NHSE can seriously consider this attendance level acceptable is almost beyond belief. When challenged about this clear attendance failure, NHSE’s main speaker Ed Waller pointed out that the event was one of four to be held in England.

Some ICP facts, challenges and omissions thrown up by this event included:

+  10 year contracts only (the 2016 quoted option of 15 years has been dropped)

+  Not fixed price contracts any more (a change from what we were told in 2016) – budgets will be set annually

+  Single supplier ICPs with potentially lots of sub-contractors

+  GP surgeries could be ICP contractors if they wished – but they don’t have to be

+  No clarity of guidance on VAT issues

+  No evidence was presented which supported the view that the integration of healthcare services and social care services resulted in better outcomes for patients and service users

+  Mental healthcare and mental social care services were never mentioned

+  STPs were never mentioned

+  There was no clarity as to how many ICPs might ultimately exist in England -apparently ICP creation is all done locally by CCGs

+ The population of an ICP will be aggregations of GP lists but there will be geographic limits imposed

+  Local Authorities will buy services from ICPs

+  If the ICP is a private company (and not an NHS one) it will not be subject to Freedom of  Information legislation

+  There are potential data sharing problems for ICPs yet to be resolved   

+  No hard copy of the consultation paperwork was given to attendees

+  Dudley is clearly the flagship ICP

Latest news on who will run our community health services & more

The Summer is over but it has certainly was a busy one for Ealing Save Our NHS (ESON). Some of our worst fears about local health bosses (Ealing CCG) plans to get a single provider to run our Out of Hospital services (community health services), have been realised. Our local NHS Trust, who provide community nursing and many other services decided not to bid – definitely bad news.  On the bright side though we managed to give Virgin Care, who want to get their hands on our NHS, a bit of an upset when they came to Ealing last month – please read on….  

Who might run our local community health services?

The whole process of choosing who will win the 10 year, 1.3bn, contract to run our Out of Hospital services (community health services) is shrouded in secrecy but, we now know that at least two NHS Trusts felt unable to bid. These are:-

London North West University Healthcare NHS Trust (our local Trust) who did not submit a bid because there was ‘a significant difference between the cost of the quality of care required and the amount that the tender allows us to spend’. 

And Central London Community Health Trust (CLCH) who pulled out ‘because they can’t provide any decent safe service for the money the CCG was willing to pay’.

The fact that two Trusts felt unable to bid confirms our worst fears that the Contract is not safe, not financially viable and likely to fail as a similar one did in Cambridgeshire. And of course our local Trust is likely to face huge financial problems. Not only will they lose around £45 million in income, but have lost the benefits of sharing costs and staff across both the hospital and community health services. Ealing Hospital could well be a big loser in all this as we have pointed out in Letters to both Ealing CCG and national NHS regulators NHS Improvement. 

We have now asked Ealing Council to join us in pressurising Ealing CCG to commission an independent impact assessment of the single contract on our local Trust and Ealing Hospital as soon as possible.

Virgin Care not welcome here say protesters:

Despite having less than a week to mobilise people, ESON managed to get over 50 people, to join our Protest against profiteers Virgin Care, who came to Ealing Town Hall to sell their wares on 17th August. We were joined by Keep Our NHS Public campaigners from London, West London Unite Community members, Julian Bell, Leader of Ealing Council and Rupa Huq MP.  

Some of us went in to the Virgin Care Meeting, which exposed Virgin’s poor understanding of Ealing’s Community Health Services. They also didn’t seem to understand that they would be expected, if they won the single contract, to deliver a ‘transformation’ so that people would stop needing hospital beds or the A&E! And not surprisingly Virgin told lies about how good they were and tried to deny they had sued the NHS when they lost a contract in Surrey, which is well known!

NHS regulator says we will scrutinise Ealing Contract plans: 

In 2015, an £800 million, 5 year Older Peoples and Adult Social Care Contract in Cambridgeshire collapsed when the Uniting Care Partnership, an NHS Consortium terminated the contract as it was ‘no longer financially viable’.

After this debacle NHS England and regulator NHS Improvement set up strict guidelines to ensure this did not happen again. We wrote to NHS Improvement and NHS England and asked them if they would be scrutinising the Ealing Out of Hospital Contract tendering process and were assured they would. In their own words:-  

“We (NHSI and NHS England) shall collectively consider whether the Ealing CCG governing body and the preferred bidder, when identified, can demonstrate that: …. .. the commissioner (ECCG) and preferred provider have the capacity and capability to deliver the contract.

I think our readers know that we don’t think either the CCG or whoever wins the Contract can deliver but it’s good to know they are being scrutinised.

SAGE Public Meeting ‘Who is taking over our NHS’, Thurs 27th Sept 

Seniors Action Group Ealing (SAGE) is holding this very welcome Public Meeting to discuss how the care of older people will be affected by putting community health services out to tender and how it might impact on specialist services, care homes etc. Initially, the CCG Chair, Dr Mohini Parmar and Managing Director, Tessa Sandall agreed to speak but then withdrew saying it might prejudice the procurement process and therefore they wouldn’t be able to answer all of peoples questions. Perhaps they didn’t like the look of the other speakers?

There is still a very good line-up of speakers with Dr Louise Irvine for Keep Our NHS Public, Julian Bell Leader of Ealing Council, Steve Pound MP and Eve Turner for Ealing Save Our NHS. Please spread the word and come along.

The Meeting is at 5.30pm on 27th September in Ealing Town Hall.

AND another Consultation on restricting 17 treatments

Stories abound now of patients being denied treatment, long delays and alternatives being offered that worsen your condition. Here is yet another rationing of treatment right across England. This time there are 17 treatments/ procedures up for the chop. These include knee arthroscopies for osteoarthritis, injections for non-specific back pain, varicose vein surgery and haemorrhoid surgery. Although it’s ‘claimed’ many of these treatments don’t work, they also aim to save £200 million despite all the extra money that was supposedly given to the NHS.

NHS England are now consulting on their plans, which closes on 28th September via an online Survey, easy to fill in. You can register your views here–

News story with the full list –  here

Please come to our Campaign Meeting – Tuesday 18th September

We meet every third Tuesday in Northfields Community Centre to discuss and update ourselves on what’s happening in Ealing Hospital and our NHS, exchange ideas and thoughts and plan our campaign activities. We very much welcome new people and new ideas for things we can do.

Our friendly and informative meeting is at 7.30pm in Northfields Community Centre, 71a Northcroft Road, Ealing W13 9SS. Tea and Coffee also provided. It would be lovely to see some of you then. 

Street Stall this Saturday in Ealing

This Saturday 15th September we will be leafleting and running a Stall outside Marks & Spencer in in Ealing Broadway from 11.00 – 1.00pm. Why not drop by and help or just say hello. Our latest leaflet is attached for a read.

To receive the latest campaigning news, subscribe to our newsletter here

Issue: 70

1 September 2018

This occasional newsletter is researched, written and edited by a group of concerned residents in Ealing, West London who want to preserve our NHS. We view the wholesale engagement of private, for-profit healthcare service suppliers as unnecessary, profligate and dangerous. Increased financial funding is what is needed in our NHS – not financial cuts, closure of vital services or privatisation.

Ealing Out Of Hospital (OOH) Services Single Supplier 2019 – 2028

The bidding process for a minimum of £450 millions’ worth of work formally ended on 23 August 2018. We are now in the bid evaluation phase with the outcome to be announced at the end of October 2018. There are currently lots of rumours flying around about Virgin Care bidding and then not bidding. If Virgin Care decided not to bid it does seem strange that it should showcase its OOH credentials at a public meeting in Ealing Town Hall on 17 August 2018 (see below).

One organisation we know will not be awarded the contract is NHS LNWUHT, our local Trust which runs Ealing Hospital. On 29 August 2018 ‘The Pulse’ magazine quoted from a letter sent to 800 LNWUHT staff which stated that the money on offer in the Invitation To Tender would not allow the Trust to provide ‘the required quality of care’. So LNWUHT declined to submit a bid.

The question must be asked if one NHS Trust evaluates that there’s not enough money of offer to do the job properly, how could any other Trust come up with a different evaluation?

Accountable/Integrated Care Public Consultation is Underway – But Predictably It’s Not Straightforward

We all have until 26 October 2018 to comment on the draft Integrated Care Provider (ICP) contract. There are three draft Integrated Care Provider contract documents to review. In total there are 227 legal pages to peruse. These are legal draft contracts. It is virtually impossible for a lay person to figure out what these pages actually mean. This is way too much for the general public to deal with. This is an absurd public consultation. It is akin to asking end users of a new computer system to review it by giving them the machine code of the software programmes. Over and above this there is a plethora of supporting documents numbering up to 316 pages. In total there are 543 pages of material to review.

NHS England has provided us all with a set of consultation questions to answer, which could hardly be described as being unbiased. There’s also a questionnaire to fill in which again is ‘directed’ and is really quite long.

View this massive consultation library at:

www.engage.england.nhs.uk/consultation/proposed-contracting-arrangements-for-icps

There are consultation events in London, but you have to register to attend them, and we currently don’t know the venues:

11 September, 10:30am to 12:30pm.

www.events.england.nhs.uk/events/consultation-on-contracting-arrangements-for-integrated-care-providers-icps-34140

11 September, 2:00pm to 4:00pm

www.events.england.nhs.uk/events/consultation-on-contracting-arrangements-for-integrated-care-providers-icps-34144

Court of Appeal Grants Permission to Appeal Against Judicial Review Decision Legitimising NHSE’s New Integrated Care Provider Contract

In April 2018 The High Court ruled against a Judicial Review (JR) application by 999 Save the NHS which sought to question the legality of  NHSE’s Accountable Care (subsequently renamed Integrated Care) contracts and so-called ‘Whole Population Budgets’. 999 Save the NHS decided to appeal against this ruling. On 18 August 2018 it was announced that the Court of Appeal had granted 999 Save the NHS leave to appeal the April judgement. Apparently all seven JR grounds will be reviewed.

This is an enormous embarrassment for the Government. Success in the Court of Appeal could completely invalidate the public consultation on the Integrated Care Providers contract – as the contract itself may not be legally valid.

Over 60 People Demonstrate Against Virgin Care Outside Virgin’s Out of Hospital Services Sales Presentation

On 17 August 2018 Virgin Care presented its Out of Hospital services credentials at a public meeting in Ealing Town Hall. Outside the Town Hall some 60 people noisily protested about the possibility of Virgin Care providing any NHS services in Ealing. Speakers at the demo included Central Ealing and Acton MP Rupa Huq and Ealing Council Leader Julian Bell. The demo was organised by Ealing Save Our NHS. Virgin Care is one of the organisations rumoured to be bidding to run initially 36 care services in Ealing, commencing in May 2019. It’s a 10 year contract which is worth between £450 million and £1.2 billion – with ultimately up to 60 care services to be run by a single supplier.

It did seem odd that Virgin would do this presentation during the bidding process. Even odder was the fact that the presentation was ‘hosted’ by Ealing Community Voluntary Service (ECVS). Incompetently Virgin Care attempted to run this ECVS hosted event initially on 31 July 2018. Virgin Care pulled out of the event at 3 hours notice, but failed to tell all those people registered to attend. Those who turned up to find the event cancelled were none too pleased. I do find it hard to think that a company which can’t even run (and cancel) a sales pitch to the public in a competent fashion could be trusted to run over £1 billion OOH Services for 360,000 people for 10 years.

Ealing GP Federation Isn’t Keen to Discuss Local, Regional and National Care Transformations with Ealing Save Our NHS

Ealing GP Federation, formed in 2014, describes itself as ‘representing all 76 practices’. (There are some 200 GPs operating in Ealing). Since the launch of  NHS North West London’s (NWL’s) ‘Shaping a Healthier Future’ (SaHF) programme in 2012, there have been many care service changes proposed and implemented which directly affect Ealing residents. NHS NWL’s 2016 Sustainability and Transformation Plan (STP) and more recently Ealing CCG’s plans for a single supplier of Out of Hospital Services are having and will have profound impacts on care services.

On 9 July and on 13 August 2018, Ealing Save Our NHS (ESON) wrote to the federation requesting a meeting to discuss the issues raised by SaHF, STP and the Ealing OOH contract. The federation failed to reply to either of these letters until 21 August. Even though I’d spelt out in detail who we were and why we wanted to meet, the federation asked me to repeat all this. It’s inconceivable that the federation does not have opinions and policies relating to these transformation issues. Why would it not want to share its views with ESON or in fact with Ealing patients? The federation’s web site provides no information on its stance on these issues. The federation is not a statutory body and is a private company. It would be fruitless to submit Freedom of Information requests as the federation would have no legal liability to respond.

On the OOH Services front, the federation’s web site ( www.ealinggp.com) contains an undated news story stating that it has been ‘commissioned’ to take on 18 OOH services’. How this relates to the ECCG’s beauty contest to find a single supplier of 36 OOH Services is by no means clear.

ESON finally received a letter from the federation on 29 August 2018 in which it declined to meet ESON. The federation’s CEO stated that they were ‘an organization that wants to work collaboratively with partner organizations to try and facilitate excellence in local healthcare, but can’t directly influence commissioner’s decisions’. It does seem odd to refer to ‘commissioning’ as the federation is not ‘commissioned’ by any statutory body (i.e. not NHSE, ECCG or the Local Authority). It’s a private company whose shareholders are the 76 GP practices in Ealing. The federation clearly does not want to work with ESON.

Greater Manchester (GM) Care Devolution Stalling – Non-Elective Admissions Rising Not Falling

Greater Manchester’s efforts to reduce demand for Acute services (especially Non-Elective Admissions – NELs) are failing. According to ‘Health Service Journal’ in August 2018 NELs have consistently risen since the GM care devolution deal in 2016/17. The £450 million ‘transformation fund’ financial support doesn’t seem to have been much help.

The increase in NELs is a national and regional trend. In NHS North West London (NWL) increases in NELs have consistently frustrated any attempts to breathe life into the 2012 NHS NWL’s ‘Shaping a Healthier Future’ programme and the 2016 NHS NWL Sustainability and Transformation Plan.