Our NHS: There’s a lot going on

Shropdoc

Shropshire CCG and Telford and Wrekin CCG – the organisations that plan and buy local healthcare – met on 10^th February and took two very damaging decisions.

• They decided to turn off the Shropdoc direct phone number, forcing people to use the discredited NHS 111 call centre service instead. This takes away patient choice, and means people won’t be allowed to talk to a Shropdoc doctor unless the NHS 111 computer system and the call handler agree they can. This is likely to happen in the spring of next year.
• They also decided to put out to tender the GP Out of Hours service currently provided by Shropdoc. This means that Shropdoc could easily be replaced by a private company that puts profits before patient care.

These are both daft decisions. Shropdoc is a high quality service, provided by a local GP cooperative. A stunning 94% of Shropdoc users are satisfied with the service they get. Compare that with NHS 111: only 33% of NHS 111 users are satisfied with the service, and 52% are dissatisfied. Shropdoc, because it provides skilled and timely care, only has to refer 2% to 3% of patients to the ambulance or A&E services. NHS 111 – staffed by call centre operators with no clinical training at all – refers 10% of patients to these other services. We’re headed for a worse service, a more expensive service, and one that puts extra pressure on busy ambulances and A&Es. Ticking the bureaucratic boxes from NHS England is being put ahead of patient care.

Pressure from the public has made a difference. We got a promise that the Shropdoc number won’t be switched off unless the NHS 111 service is of good quality. We can’t rely on that, but it’s a small step in the right direction. More significantly, we won a ‘stay of execution’ for Shropdoc. The service will go out to tender in 2017, but Shropdoc is likely to continue providing the GP Out of Hours service for another 2½ years. The lesson here is that getting organised can make a difference. The campaign clearly has to go on. We’re talking to other organisations about what we can do to keep the Shropdoc number, and stop it being taken away next spring. There’s a petition here started by Ludlow GP Dr Beanland: http://bit.ly/shropdoc. Please sign and circulate.

A&E and Hospital Closure

The ‘Future Fit’ project, with its plans for closing one of our A&Es and hospitals, is moving ahead at speed. One of our A&Es, either at Shrewsbury or Telford, will be closed down if health chiefs get their way. One of the two hospitals will also go. It will no longer be an acute hospital, dealing with a range of medical conditions. Instead, it’ll be downgraded to a centre for planned care such as cataract surgery, hip or knee replacements – and will only have 20 beds!

The timetable is for a ‘Strategic Outline Case’ to be signed off this month, but they seem to be behind schedule on this. Health bosses are due to take a decision on which A&E to close – Shrewsbury or Telford – in July. Consultation on A&E and hospital closure will take place from December 2016 to March 2017.

The project is in utter crisis. The original plans promised new community services, care closer to home, local planned care centres, and better services for frailty and long-term conditions – but work on these things has barely begun. As health services spin into financial crisis, it’s now clear that the money is just not there for the new services that were promised in place of the A&E and hospital. In practice, the grand plans of ‘Future Fit’ have been reduced to taking away the A&E and hospital. It’s no wonder there’s so much public opposition.

Campaigning is 100% worthwhile. They’d wanted to close one of the A&Es on a ‘temporary’ basis over the winter – and we stopped this happening. Very importantly, we’ve just learned that we’ve also succeeded in stopping the dangerous plan of closing one of the A&Es overnight. Hospital leaders planned to do a ‘live test’ of overnight closure in April, and to set up an ongoing policy of overnight A&E closure if the A&Es hit a crisis and couldn’t cope. Under pressure, they’ve acknowledged that the risks of overnight A&E closure are just too great. The new agreement is that in the event of a crisis, they’ll call on help from neighbouring hospitals. That’s the right decision.

We’re proud of those achievements – but we know there’s a bigger and tougher fight ahead. You can download our petition and other material about the threats to our A&E and hospital from our Resources page: https://shropshiredefendournhs.org/resources/ .

Cuts

Shropshire Clinical Commissioning Group is planning to make a frightening £19 million cuts this year. We’ve asked about the impact on services – and each time, we’re told ‘It’s early days’. This is for cuts that will take place from 1^st April this year! It’s already harder to get hip and knee replacements in Shropshire, with restrictions imposed to save money. We know that there’s a risk to inpatient beds at community hospitals. There are likely to be new restrictions on bariatric surgery (surgery that helps people manage their weight). There’s no question that there will be many, many more cuts ahead. In Telford and Wrekin Clinical Commissioning Group, there are plans for £5.2 million cuts to local services. The impact on patients will be significant – but we don’t yet know which services will be hit.

It’s going to be harder and harder for the public to keep track of what’s happening. In Shropshire, a lot of the cuts have been suggested by a management consultancy called Deloitte. Across Shropshire and Telford and Wrekin together, the cuts plan is being steered through by Price Waterhouse Cooper, another management consultancy. The decisions about what to cut are then taken by a new body called the ‘Sustainability and Transformation Board’. This is made up only of the Chief Executives of local NHS organisations and a senior representative from each of Shropshire Council and Telford and Wrekin Council. The Sustainability and Transformation Board meets in private, its paperwork is not publicly available, and it does not publish minutes. Although its recommendations then go out to CCG and NHS Trust Board meetings, these will just sign off decisions that have been taken behind closed doors.

This is downright disgraceful. It’s our NHS, and our money that pays for it. Secret meetings are unacceptable. It’s essential that these meetings are held in public, so that we at least know what’s happening and have the right to challenge bad decisions. We have asked the leaders of Shropshire CCG, Telford and Wrekin CCG, and SaTH, the organisation running the two hospitals, to make sure that these meetings are public, and with members of the public entitled to ask questions. You might want to email your views to

• Dr Helen Herritty, Chair of Shropshire CCG: Helen.Herritty@shropshireccg.nhs.uk
• or to Dr Mike Innes, Chair of Telford and Wrekin CCG: Michael.Innes@nhs.net

The next opportunity to find out about next year’s cuts in Shropshire’s NHS will be at an Extraordinary Meeting of Shropshire CCG: March 30^th at 9am, at the Education and Conference Centre, Royal Shrewsbury Hospital. Come along to this meeting if you can.

The NHS Reinstatement Bill

This bill attempts to return the NHS to being a universal service, publicly owned and publically accountable. It has its second reading on 11^th March. Find out more here: http://www.nhsbill2015.org/

Events

• One of the big threats to the NHS is a proposed new trade deal called TTIP, currently being negotiated by the USA and the EU. Privatisation of the NHS is already progressing quickly. The plans for NHS 111 and Shropdoc reflect this. TTIP threatens to make things much, much worse. A recent expert opinion is that the whole of the NHS will be opened up to competition by TTIP – and individual governments will lose the right to veto or reverse privatisation.
  Find out more about TTIP. John Hilary, Executive Director of War on Want, is speaking at Ludlow Methodist Church, Broad Street at 7.30 pm on Thursday 10^th
• Shropshire & Telford and Wrekin Defend Our NHS is not affiliated to any political organisation – but we publicise meetings and events that are relevant to our campaign to keep good quality NHS services.
  Shropshire Labour Party is organising a Community Conference on ‘The Crisis in Health and Social Care in Shropshire’ on Saturday 16^th April, from 10 am to 4 pm. This will be at the Lantern, Meadow Farm Drive, Shrewsbury SY1 4NG. Speakers include Lord Philip Hunt, Shadow Health Minister; Tony O’Sullivan, Consultant Paediatrician and one of the champions of the victorious fight to keep Lewisham Hospital’s A&E; local GP Dr Mary McCarthy; and speakers from Shropshire Patient Group and Shropshire Defend Our NHS. There will be workshops on Adult Social Care, Mental Health, and Palliative and Hospice Care. Book your place in advance by contacting Martin Jones: martin.jones@shropshirelabour.org.uk