Previous meetings

2016
5th December What do NHS Sustainability and Transformation Plans mean for our area? Can they be challenged?
44 NHS STPs are being developed for England. Our area is South Yorkshire and Bassetlaw. The plans will lead to new formations for the NHS, changes in services and the imposition of centrally dictated funding cuts over the next 5 years. Although broad versions have been published, details remain unpublished and the longer term implications of them remain obscure except in areas where definite hospital closures are planned. Two London Councils are applying for a judicial review.

F
or South Yorkshire and Bassetlaw see
http://www.smybndccgs.nhs.uk/what-we-do/stp
Sheffield Clinical Commissioning Group on 1 December 2016 agreed the 'direction of travel' and to approve the Plan for Sheffield. NHS Trust Boards and the Council will also be asked to agree the STP this month but the Council's current position is not to sign up to the STP. So what is likely to happen?
The Crisis in Primary Care
Following the Sheffield CCG meeting on 2nd July 2015 11 GP practices in Sheffield were put at serious risk of financial crisis and closure because of funding reallocations. These include Devonshire Green (see Dr Graham Pettinger's website petition) and Page Hall Medical Centre, both serving communities with special needs. SSONHS has actively supported their campaigns for fairer treatment and at a packed extraordinary meeting of the CCG on 16th July, the CCG pledged that no practice would be forced to close and that safety net measures would be enhanced. However any claims for special treatment will be closely scrutinised and the practices affected all face difficult challenges which will interfere with their work for patients.

In November the CCG informed Devonshire Green and Page Hall that they were accepted as special cases. 11 practices were not accepted and so face substantial loss of income. The special cases allowance will still only meet part of their revenue loss.

Contracts for the Clover Group and the Broad Lane Medical Centre were awarded to a partnership of the Health and Social Care Trust and Sheffield Primary Care Providers (owned by Sheffield GPs) but on a 30% budget reduction. Realignment of services such as sexual health is currently being implemented. However the Mulberry Practice has also received recognition that this is a unique service and a special case.

In addition two Sheffield GP surgeries have closed so far during 2016.

Bents Green Surgery closed at the end of April 2016.

Westfield Health Centre is also now scheduled for closure after a previous well respected local doctor retired and his successors, a small private consortium from outside Sheffield, failed to maintain services and walked away. No other takers were found by the CCG who have now arranged other care for patients.

2015
 
STHFT Wednesday 23 Sept 12.30-3.30 pm Sheffield Teaching Hospitals Annual Members Meeting Meeting 12.30 prompt followed by stalls highlighting research in SAHTFT. Sandwiches provided. Lecture Theatre 2, Medical Education Centre Northern General Hospital. It's usually quite full so reserve your place via jane.pellegrina@sth.nhs.uk. Chance to quiz them about stresses, plans, working conditions, bed management and finance (including their decision to opt out of the new national tariff)
 
Tuesday 15 September 2015 Sheffield Children's Hospital Annual Members' Meeting 5.30pm refreshments / 6.00pm start Helena Davies Lecture Theatre, Sheffield Children's Hospital. "The Annual Members' Meeting is a great opportunity to find out about what has been happening at the Trust during the last year and hear about plans for the future. This year's meeting will also have a special feature on the development of the Trust's Respiratory Team. " If you would like to attend please contact madeleine.parry@sch.nhs.uk."

Wednesday 16th September Right First Time Citizen Reference Group 1.00pm – 4.00pm Reception Room A Town Hall If you want to know more about it email practicedevelop@sheffield.gov.uk
 
(TUESDAY 22nd September 7pm SSONHS screening of Sell Off + guest speaker and performance. Theatre Delicatessen (The Moor, S1 where the old Woolworth's used to be )
 
Thursday 24th Sept. 2pm - 4pm Sheffield Health and Wellbeing Board 2pm - 4 pm Sheffield Town Hall. Papers will be available on line from 18th Sept at http://sheffielddemocracy.moderngov.co.uk/ieListMeetings.aspx?CId=366&Year=0. If devolution of health has featured in the local proposals submitted to government this week, this is as good a place as any to ask questions about it.
 
Tuesday 29 September 2015 Sheffield Health and Social Care Trust Annual Members Meeting.
12.45pm to 4pm Executive Suites, 2nd Floor, Sheffield United Football Club, John Street, Sheffield. Information about the meeting will be available on the website in the next few days. Chance to quiz them about cuts and their idea of creating a company to reduce costs. To book a place email karen.jones@shsc.nhs.uk
 
Tuesday 29 September 2015 Yorkshire Ambulance Service Trust Annual General Meeting (AGM) 10.45am Presentation on NHS 111 Service. 11.15am - 12.30 pm AGM. Trust Board Meeting held in public between 1.00pm and 3.30pm Doncaster Racecourse, The Grandstand, Leger Way, Doncaster, South Yorkshire, DN2 6BB. If you would like to attend the meeting and lunch, please email foundationtrust@yas.nhs.uk or telephone 01924 584416.
 
Thursday 1st October Sheffield CCG Governing Body meeting in public 4pm Darnall.

Local consultations on 5 years forward, Urgent Care and redesigning Social Care continue. If you don't know much about what is happening or if you are a service user who wants to have a say about services, these can be useful to attend and you can also chat informally to some of the people responsible. However they are more to do with gathering consensus than with providing opportunities for challenge - though challenge is possible.
 

Changing the Balance - A 2020 Vision of Health and Social Care in Sheffield; (Health and Wellbeing Board) The notes of the first 2020 vision meeting in May are at https://www.sheffield.gov.uk/caresupport/health/health-wellbeing-board/what-the-board-does/events/engagementevent.html

Wednesday 12 August 2015, 10am – 12pm / Wednesday 16 September 2015, 6 – 8pm at The Circle, Rockingham Lane, S1 4FW

Friday 4 September 2015, 1 – 3pm at Medical Education Centre, Northern General Hospital, Herries Road, S5 7AU


**********************************************************
We have submitted a response to Sheffield CCG on their commissioning intentions including a call for particular attention to vulnerable populations in the city centre. Westfield surgery seems to have been saved but Devonshire Green Surgery is now at risk because of central funding cuts and launches a campaign on 26th January.

Although Sheffield services seem to have avoided breakdown so far, this can only have been at the expense of huge stresses for staff. Yet the government refuses to pay them a fair wage. We will be supporting strikers on the 29th January.
 

2014

There is a growing crisis in primary care - which is commissioned by NHS England not the CCG. Surgeries in Beighton and Westfield have been earmarked for closure although the latter (following the imminent retirement of the well-respected single practice holder) is still subject to consultation and protests are developing (Nov 14)

Sheffield Clinical Commissioning Group have decided to work with Sheffield Teaching Hospitals NHS Foundation Trust as the primary provider for a new commissioning for musculoskeletal services. They considered there was no need for competitive tendering. This is an important step in preserving NHS provision in Sheffield.

At the May meeting we asked the CCG how much had been spent on legal advice. We have now received the answer -
The amount spent on legal advice in 2013/14 was £161k. The amount spent on legal advice relating to competition legislation was £2.3k. Fortunately this is a relatively small amount.

Sheffield Council have begun a competitive tender for Supported Living Services including Learning Disability Services currently provided by Sheffield Health and Social Care NHS Foundation Trust. This appears to be for financial reasons rather than quality issues because of overspending last year. The process opens up the services to organisations like Care UK, where support workers transferred from the NHS last year are on strike against serious worsening of their pay and conditions. Sheffield Unison (?Community Health Branch) has been leading a campaign against this. The tenders are now in and the Council is consulting formally with users of the services about what is on offer.

Sheffield NHS meetings

Sheffield Clinical Commissioning Group-
business meeting in public 4th December 2014 4pm - 5.30pm
722 Prince of Wales Road Sheffield S9 4EU - This meeting will discuss the Stevens 5 year forward view: read it here.

Sheffield Health and Wellbeing Board

https://www.sheffield.gov.uk/caresupport/health/health-wellbeing-board.html
The web page also links to details about other consultation events for Adult Social Care

Sheffield Healthwatch, the Sheffield branch of the national patient watchdog on health and social care. http://www.healthwatchsheffield.co.uk/

Information Hub at The Circle, 33 Rockingham Lane, Sheffield, S1 4FW. The hub is on the ground floor of The Circle building with an internet connected computer which can be used, free of charge, by anyone wanting to find information on health or social care.


Healthwatch AGM Wednesday 16th July 2014 2 pm
The Circle, 33 Rockingham Lane, Sheffield, S1 4FW.

If you attend these events or want to have your say on Sheffield NHS news stories, please add a post or a comment at: www.ssonhs.blogspot.com

Sheffield CCG Commissioning Intentions
The Sheffield CCG has published its commissioning intentions in its April business agenda. These see the first attempts to shift spending from the acute sector to community and primary care provision. Desirable as this might be, it may be very difficult to do this under the new legislation without opening these services up to private bidders. Such proposals will therefore become even more controversial and may have to be opposed.

Any Qualified Provider November 2012
The first round of AQP contracts in South Yorkshire has now been announced. Very basic details are available at
http://www.sheffield.nhs.uk/procurement/Cardiology%20Diagnostics.php. See also http://www.rotherham.nhs.uk/foi/PCT%201561/Release%20of%20information%20letter%201.pdf which gives a little more information. The start dates for the contracts are not given, so there will be can more details of what is being offered and how it will work. The providers will be in competition with each other.
 
There are three services:

Cardiology Diagnostics + 24 hour ECG; (overall value £325,000pa) "high quality 24-hour tape ambulatory cardiology diagnostic services in a community setting across Bassetlaw, Barnsley, Doncaster, Rotherham and Sheffield as part of an integrated pathway of diagnostics and care. Providers will have responsiblity for an element of the adult cardiac pathway to investigate those at low risk who might have cardiac pathology. "

 

Carpal Tunnel; (overall value (£800,000pa). "To provide a community carpal tunnel treatment service to provide an accessible, prompt, comprehensive and confidential service whith increased patient choice on treatment options." This is a new service as such.

 

Flexible Sigmoidoscopy. overall value (£221,000pa). "A more responsive and local service model with the overall aim to provide routine, clinically appropriate diagnostic flexible sigmoidoscopies that help primary care clinicians manage a range of conditions commonly seen in the primary care setting and which do not need secondary care. The provider might wish to use existing endoscopy suites or provide new ones (which must meet the regulatory standards). The service may be mobile."

 
There are 20 providers (but some of them have been recognised for two or three of the services.)
10 of these are part of the NHS - Foundation Trust Hospitals in Sheffield, Rotherham and Doncaster and 7 GP surgeries. Of the 10 non NHS providers at least two have NHS connections, Rivelin Healthcare Ltd and Primary Provider Ltd, small local providers set up by Sheffield GP practices or associates.

We shall be advocating patients to choosing the NHS option where possible and practicable but until we have more details of the GP providers it will be difficult to say whether these will count as NHS provider services.


Between September 2011 SSONHS asked a number of questions at Sheffield CCG Committee meetings and the answers to these are recorded in the minutes. The questions covered GP financial interests and possible conflicts, issues around diabetes and dementia, and the Committee's attitude to privatisation. On the latter we received the following statement from Dr Tim Moorhead, Chair of the CCG, in September 2012:

"Our preference as clinical commissioners is to work in partnership with our current providers to provide first classs services. We don't plan to to pursue private alternatives unless we have no choice because of poor service quality or scarce service availability."



23rd of September, 2011

 
 
Questions to the NHS Sheffield Board 6 September 2011from Sheffield Save our NHS:Older People’s Health Care
 

Was NHS Sheffield consulted by STHFT over its plans to centralise older people's health care at the Northern General Hospital? Was any consultation undertaken with older people on this specific proposal

1. NHSS was fully aware that STHFT have been reconfiguring the services provided across the two hospital sites (RHH and NGH), which started in the summer of 2010. NHSS was approached to respond as part of the formal consultation process. This has also enabled the creation of a centre of excellence for stroke care and the introduction of ‘hospital at night’ service at the Royal Hallamshire Hospital, both of which have had significant patient benefits.

The centralisation of elderly care services at the Northern General Hospital site is part of the reconfiguration. The NGH site is where the majority of older patients are admitted, either through A&E or the Medical Assessment Units, and where the specialist services they need are located.

We know that older people generally prefer to receive care, if possible, in their own homes. According to STHFT over £3m has been spent to provide substitute non-hospital care. Has this been spent by STHFT or NHS Sheffield? Is this primarily home-based care or does it include a residential element? What effect has it had on reducing the number of people in hospital who are classed as not actually needing to be there? Is there an evaluation of whether the substitute health care being provided in the community is at a level acceptable to older people and their carers and if so what are the results?

NHS Sheffield is working in partnership with Sheffield Teaching Hospitals NHS Foundation Trust (STHFT), the local Authority, Sheffield Health and Social Care NHS Foundation Trust (SHSCFT) and GPs to implement a strategy which results in the right patients being cared for in the right place at the right time and in the most efficient way. In addition to the 2011/12 programme, NHS Sheffield, STHFT, SHSCFT and Sheffield City Council have committed to a longer term transformational programme for Urgent Care that will develop the capacity and capability of community services to reduce avoidable admissions and to support the shortening of length of stay where clinically appropriate.

The strategy is predicated on delivering as much care as possible in the community, either in or closer to patients’ homes, and only admitting patients to hospital when it is clinically necessary to do so. Currently at any one time there are up to 150 patients in the City’s two adult acute hospitals who no longer require acute hospital care. Sheffield also has some of the highest rates of admissions for vulnerable elderly patients and many of these stay well beyond the national average length of time in hospital. By improving discharge arrangements, community or nursing home support and rehabilitation we can reduce the reliance on hospital care.

As part of the implementation of this strategy there is a joint plan this year that includes a range of initiatives to reduce delayed discharges and avoidable admissions, including:

  • increasing intermediate care capacity for general frail elderly, ortho-geriatrics and dementia
  • speeding up the process for those patients that will need to progress to long term nursing care (Home of Choice Scheme)
  • developing a primary care led assessment process for GPs to access as an alternative to admission
  • aligning social care and community care teams to reduce duplication of effort
  • extending the level of service coverage for the admission avoidance/early discharge services
  • ensuring all medical and ortho-geriatric wards release dedicated nurse time to "champion" the prompt discharge of all patients
  • developing a joint model with Sheffield Health and Social Care Trust for earlier intervention for dementia patients

 

These initiatives are being supported by over £3million of investment in 2011/12 from NHS Sheffield and will support the reduction of bed capacity at the hospital with additional services and intermediate care beds. The alternative services in the community will also be led by highly skilled nurses and Allied Health Professionals with the back up of GPs and Community Geriatricians.

 

It is too early to confirm that the combined efforts of the above schemes have produced a sustainable reduction in avoidable longer stays in hospital, but there are encouraging signs that the number of reported delays are reducing. In addition some of the investment this year is going into existing services (Community Intermediate Care Services as an example) that have already evaluated very positively in reducing length of stay and improving patient outcomes and experience

20th of July, 2011

Mental health changes plan

A SHAKE-UP of community mental health services in Sheffield is set to be introduced by bosses as they work to cope with a 10 per cent cut in funding over the next three years.

Sheffield Health and Social Care NHS Foundation Trust is consulting with people who use the Community Mental Health Teams in the city.  But they have been criticised for the short notice given to people of meetings organised.  Meetings took place yesterday and Monday, with another planned for today but people only received letters informing them last Friday or Saturday.

The proposals centre on the creation of four separate Community Mental Health Treatment teams in the south east, south west, north and west of the city.  These would replace the eight community mental health teams that work in the city.  The Sheffield Out Reach Team – for people with complex care needs – is also set to be reduced from dealing with around 160 people to around 100 in 18 to 24 months’ time.  Health chiefs hope the four teams will provide greater continuity of care, which can be delivered where people need it.  Staff would also work later with a centralised out-of-hours team in place to take over once the teams finish at 8.30pm.  Bosses have pledged there will be no redundancies as a result of the reconfiguration but have suggested a reduction of around 15 members of the teams as a result.

Sean Colliver, aged 50, a service user from Lower Shiregreen, said: “It will provide better continuity of care, more focused in the area where it is needed”

Jane Barrell, 54, who is supported by the Hillsborough team to help her manage her schizophrenia, said: “Nobody likes change, but the in the bigger picture it is going to happen.  “If they localise the service, it will be able to come to your home and that will make it a lot less intimidating for the patient.”

Sue Sibbald, 48, of Norfolk Park, who lives with borderline personality disorder, said: “My worry is that there is nothing for me now, there will still be nothing for me and if there are less staff, there might be less for others.”

Douglas Macdonald, whose son uses mental health services in the city, slammed the consultation exercise – criticising the short time frame given.

Clive Clarke, executive director at the trust, said: “We need to make our services as efficient and effective as possible in a time of reducing resources.  “The trust does have to make cost savings and there will be some reduction in the overall numbers of staffing, but until the consultation period has been completed, we cannot be more specific. There will be no redundancies.   As we are reorganising services rather than ceasing provision of them, we are not required to conduct a three-month public consultation and therefore we are currently holding a one-month external consultation.”  He said staff talks would be held after the consultation before any changes are made


20th of July 2011
 

 

NHS Sheffield answers to questions to the NHS Sheffield Board 5 July 2011 from Sheffield Save Our NHS

GP CONSORTIA AND LOCAL COMMISSIONING ARRANGEMENTS

In Appendix 1 of item 9 of the Board papers, the governance structure chart at 31 March 2011 shows 10 committees under the NHS Sheffield Board; the proposed governance structure for 31 March 2012 (appendix 4) shows 12 committees under the NHS Sheffield Board. Will this represent an increase in cost from 2011 to 2012 and if so of what order? Under the now to be amended Bill how many bodies or committees for commissioning will there be in Sheffield from April 2013?

The proposals are subject to change and would be provided within the financial envelope.

As at 31 March 2011 there were 10 committees of the Board but by March 2012 it was proposed these would be streamlined to five committees.

How will the operation of these various bodies be supported administratively, professionally and managerially? Who will be the employer of the staff who will be needed?

The Health & Social Care Bill proposes that PCTs and SHAs will be abolished by 31 March 2013. The commissioning support, both managerial and transactionally, that Clinical Commissioning Groups require, will be delivered in a number of ways. First, CCGs will be able to directly employ staff who have the necessary skills to support the commissioning process. It is not envisaged this would be for all the commissioning functions. Much of the transactional type functions, such as IT, HR, Informatics, planning, could be provided by Commissioning Support Organisations. These would be developed by the clusters of PCTs to provide services across a range of CCGs. Finally, some of the residual functions of PCTs, such as primary care contract management and specialised service commissioning, would be undertaken by the NHS Commissioning Board and some of the PCT staff associated with these functions could be aligned to the NHS B.

Over the last 12 months (apart from the transfer of Provider Services) what staffing reductions have there been within NHS Sheffield in preparation for implementation of the Health and Social Care Bill? What further reductions are planned? How will the consortia replace the considerable expertise that has been allowed to leave the PCT under VR? Will this mean that some of these people released under VR will need to be re-employed?

There have been no staff reductions specifically in preparation for the implementation of the Health and Social Care Bill. There were staffing reductions in the 2010/11 financial year to support a £2m reduction in management cost expenditure in response to Quality, Innovation, Productivity and Prevention (QIPP) requirements and the NHS Operating Framework requiring reductions in such expenditure. This was achieved by a variety of initiatives including reductions in bought in services and disestablishing vacant posts as well as a small number of compulsory redundancies (6 staff). The target reduction in expenditure is also £2m for 2011/12 as part of our QIPP programme and a requirement to further reduce running costs. The Board has approved 25 voluntary redundancies as part of this arrangement. In each case it was felt that the functions could continue to be carried out as necessary through restructuring and sharing of staff with other local PCTs. As a result, we consider that the new Clinical Commissioning Groups will not suffer from a loss of considerable expertise which they will need to replace.

 

PRIVATE PROVIDERS AND PRIVATE PATIENTS
What are the amounts and proportions of the NHS Sheffield budget which have been used to commission healthcare service from private sector providers during the last three years?

    1. For secondary (including outpatient) or tertiary care?
    2. For continuing care?
    3. For primary care services?
    4. For Mental Health?

The table below provides information on spend with independent providers in the last three years.

 

2008/09

£’000

2009/10 £’000

2010/11 £’000

Secondary Care

4,429

8,232

6,760

Continuing Care

29,836

39,979

58,321

Primary Care*

0

1,960

2,239

Mental Health

7,678

8,131

7,488

Spend with private providers

41,943

58,302

74,808

Total NHS Sheffield spend

854,831

933,961

988,515

% of total spend

5%

6%

8%

 

* all primary care contractors are non NHS providers. However, we have not included them as private sector providers, with the exception of services provided at the new city centre GP led health centre which covers services for walk in as well as registered patients. For information, the total expenditure on services from GPs, Opticians, Dentists and Pharmacists is shown below:

Primary Care*

200,378

204,480

224,432

 

What are the current caps set in Sheffield for private patients in Sheffield hospitals and how is this situation predicted to change if the Bill is passed?

Private Patient Income (PPI) caps are set at individual trust level. Section 15 of the 2003 Act requires that the Trust’s proportion of private patient income in relation to its total patient related income does not exceed that same percentage whilst the Trust was an NHS Trust. The table below shows the caps and recent figures for the three main NHS providers in Sheffield.

 

 

PPI Cap Proportion

Actual PPI 10/11 proportion

Actual PPI 09/10 proportion

STHFT

0.79%

0.63%

0.53%

SCFT

0.18%

0.17%

0.04%

SHSCFT

0.00%

0.00%

0.00%

 

As shown above, the % of private patient income for both Sheffield Teaching Hospitals (STHFT) and Sheffield Children’s (SCFT) is small. Sheffield Health and Social Care Trust (SHSCT) do not have any private patient income.

The PPI caps are a relatively low percentage cap compared with most other hospitals. This reflects the specialist element of each of the Trusts’ services as well as the existence of Thornbury and Claremont Hospitals in close proximity who tend to dominate the mainstream private patient market in Sheffield. The STH PPI tends to occur in niche services, such as Stereotactic Radiosurgery, Assisted Conception and Sheffield Vision Centre (mainly laser eye surgery).

Given that STHFT are significantly below their cap, and they have no notified strategic intention to increase its proportion of PPI, the removal of the cap is not anticipated to have a significant impact. SCFT are closer to their cap and so removal of the cap might have a small impact, but we have not been notified of any strategic intention for the trust to increase its proportion of PPI.

PATIENT AND PUBLIC INVOLVEMENT
What is this year’s predicted NHS local spend on patient and public involvement (excluding council commissioning of the LINK) compared with the last two years? What service reductions in this area of work have taken place in any part of Sheffield’s health services?

This year (April 2011-March 2012) NHS Sheffield is planning to spend approx. £50k on patient and public involvement consultations and engagement. This is broadly in line with what has been spent on consultation exercises in previous years.

We have made a number of changes to the patient and public involvement service this year, however this involves only a small reduction in work. In line with Transforming Community Services, which aimed to ensure that NHS Sheffield’s primary focus was on commissioning rather than service delivery, NHS Sheffield transferred the patient information and advice service and volunteering service to Sheffield Teaching Hospitals (we did this through contracting and still pay for the service), a limited advocacy service that had been provided in some GP practices ended at the end of March, and the Expert Patient Programme transferred to the Public Health directorate at NHS Sheffield.

We cannot answer your question for the whole of Sheffield’s health services – other Sheffield NHS organisations will be able to help with the response to this question for you.

During the transition period and beyond, how will the proposed changes to commissioning deliver greater choice for patients and more involvement in their care, when consortia are likely already to have decided from which of the ‘any willing and qualified providers’ they will purchase services?

The Department of Health is currently developing guidance on the application of the Any Qualified Provider (AQP) policy following the recent “listening exercise”. At the moment AQP is a process to accredit providers for particular services and does not offer a guarantee of activity. We expect that new CCGs will be able to accredit a variety of AQPs.

Existing contracts with local NHS trusts have different expiry dates but all with a maximum notice period of 1 year and hence CCGs will have the ability to influence where services are purchased from in the future.

 
6th of July 2011

NHS Sheffield Responses To Questions Put At The 5th July Public Meeting
 
NHS Sheffield offers the public the opportunity to ask questions of the Board at its public meetings. To celebrate the 63rd birthday of the NHS we posed three sets of questions particularly around what the NHS might look like in 2013 when it reaches 65. The Chair of the PCT was anxious to assure us that they were working hard to ensure that they achieve the best handover possible.
 
The PCT meeting itself was a long one because of the care homes issue so we only got to ask verbally the first of our questions about the reforms - but we were assured we will get written answers to the questions about patient involvement and privatisation and we had brief but friendly conversations with some PCT directors before the private part of their meeting began.
The question we did ask centered around what the local NHS structure might look like under the amended Bill (part of the question about additional costs will be answered separately as well).
 
As had been said earlier in the meeting, the situation changes week by week if not day by day and David Nicholson, the head of the NHS, will be making a key speech on Friday. Some of the national information plus a minor leak is at http://www.guardian.co.uk/society/2011/jul/05/leaked-paper-nhs-commissioning-board
 
We were told that the government does appear to have rowed back from its original intention to place the support organanisations for commissioning into a market. The Guardian article above refers to quite a large NHS commissioning Board at national level, with, presumably, local outposts. As of this week there will now be four Strategic Health Authorities (divisions not yet decided) plus, I think, London. To these will report a number of PCT clusters but these will not necessarily by the same as the ones which have just been developed (ours is currently South Yorks + Bassetlaw). The clusters will have clinical commissioning groups , one for each local authority area (to fit in with the new health and wellbeing boards) and GP consortia will be represented on these - along with the other reps added under the Bill amendments. Associated somehow with these groups will be the specialised regional networks (like the cancer network) which Lansley originally wanted to abolish. Also somehow associated will be the amendments' new construction of a 'clinical senate'.
 
Commissioning will be supported by a Community Support Services organisation with Community Support Units covering populations of around 1.5 - 2 million (? the size of a cluster?). The government's original intention was to put this out to tender but it now seems possible that this will not happen and the new organisations seem likely to be formed out of existing staff (for my comment see below.)
 
The 4 current consortia in Sheffield will work together and possibly move to forming one organisation but with a strong local service focus. Although GPs will have the key involvement in commissioning, fewer of them will actually be involved directly than seemed likely under the original Bill. More GPs in Sheffield are interested than there will be places, but others are getting put off as the bureaucratic implications become clearer.
 
The issue of the transfer of public health to local government etc awaits further pronouncement later this month.
 
The Bill's intention is that Clinical Commissioning Groups, once approved for competence by the National Commissioning Board, will be legal entities beginning from April 2013 when the PCTs will be abolished if the Bill becomes law. The National Commissioning Board itself will be established as a Special Health Authority in October this year. Clincial Commissioning groups will act as committees of the PCT Cluster Boards and operate as 'shadows' until they become legal. The Chair of the PCT commented earlier in the meeting that 'there are many transitional arrangements and they are not 100% clean" i.e. clearly defined.
 
I will only make two comments:
 
1) What on earth has been the point?
 
2) The remarks about the move away from a market for support organisations may provide some reassurance, but the status of the organisations is unclear (Will they be NHS? How will staff be employed there? Will they have to wind up their jobs and re-apply to the new organisation? Will they be TUPE'd.). There still seems to be no absolute guarantee that private organisations will not be involved.
 
 
6th of July 2011

The Deadly Lull Over The NHS Bill - Nick Clegg's Views & The Importance Of The Peedell Meeting

 

Below is an email from Nick Clegg's office to one of our list supporters who has had exchanges of correspondence with Clegg and attended his "listening" meeting.

Thank you for your further comments on the NHS. Your comments have been duly noted with interest. I am very proud of the influence that the Liberal Democrats have exerted to change the Government's NHS plans. It is now clear that the proposals to be taken forward are dramatically different to those originally proposed. And more improvements will emerge as the Bill returns to the Committee Stage for re-examination and passes to the Lords for detailed scrutiny and further revision in the autumn. There is also much more work to be done during the implementation process.

What will actually happen in your area will be crucially determined by the new local clinical consortia. The consortia will be publicly accountable bodies with lay representation answerable to the wider community through Health and Well Being Boards. Consortia practice will be scrutinised not only by the local council but by new powerful local organisations called Healthwatch.

As you are genuinely interested in the future of the NHS, I would urge you to consider this information and to consider applying to join your local Healthwatch when it is set up. You can help to ensure that we get things right in your local area.

With the Bill kicked into a committee with a built in coalition majority, the government amendments are going through. Labour's attempt to keep the duty of the Secretary of State to provide health services was kicked out on Thursday.

The government is proposing a lot of changes to the Bill but it it is difficult to tell how significant they are. The search is more for a form of words which will satisfy both the Right and the Lib Dems than for any sensible vision of how to go forward. Lansley has always said that presentation is the main issue at stake. The proposed local changes are a dog's breakfast and seem likely to cost even more than the present management system. And the latest news is that government will bring back Strategic Health Authorities after all!

During the committee stage, publicity seem to have died down. The result of the 38 degrees poll on what should be done next was to keep the NHS as top priority but do other campaigns as well, their recent circulations have been on the other campaigns. We need to keep the pressure on.

Clive Peedell, co chair of the NHS Consultants Association, has been a vociferous opponent of the entry opportunities which the reforms will bring for private companies. The meeting will be a vital opportunity to help disentangle the government's smokescreen and develop the arguments which we will need to deploy as the Bill goes to the Lords. Maybe the adopt a Peer idea (circulated last week) isn't such a bad idea.