Local health leaders are desperate to force through A&E closure, no matter what. Constitutions and Standing Orders? Transparency? Accountability to the public they are meant to serve? No, these are details, and to be disregarded if they get in the way of a cuts and closures agenda.
Tomorrow’s meeting of Telford and Wrekin Clinical Commissioning Group WILL be happening. This is meant to be a meeting held in public – but less than 24 hours before the meeting, it is STILL not advertised on the CCG web page that lists Governance Board meetings! The purpose of the meeting is to sign off the Future Fit ‘Strategic Outline Case’, the blueprint for closing an A&E and downgrading a hospital. They know that this is an incredibly controversial decision, but are apparently unconcerned by their failure to advertise the meeting properly.
Can you come to the meeting? It will be at 9.15 am on Tuesday 26th April, at the Reynolds Suite, Holiday Inn, Telford International Centre, St Quentin Gate, Telford TF3 4EH.
We need people there for two reasons:
- To tell them that the contempt for the public that is now on display is 100% unacceptable;
- To remind them that one A&E – wherever it is, the Princess Royal or the Royal Shrewsbury – is inadequate to meet the needs of Shropshire, Telford and Wrekin, and Powys. A&E closure WILL mean unnecessary deaths.
We’re lucky we know about tomorrow’s meeting at all. We found out about the possibility of a meeting on Tuesday from someone who had been given a lift by David Evans, and who picked up on the significance of a chance comment! An email follow up led to confirmation on Saturday that the meeting was taking place. David Evans was advised that the meeting was not listed on the CCG website (but evidently didn’t do anything about it, given that it still isn’t listed). Shropshire, Telford & Wrekin Defend Our NHS made a formal request to the Chair to cancel the meeting, and reschedule it giving notice in line with the CCG’s Constitution and Standing Orders. Our request is here. Dr Leahy had her ‘Out of Office’ set, so we forwarded the request to Chief Officer David Evans. This morning, that request was turned down by David Evans. His response is here.
This is the manoeuvring
Davis Evans – with no hint of apology or regret – says ‘The Board meeting is on our web site, if you look under publications and then click on Governance Board papers you will find the papers there.’ He’s quite right, but he doesn’t bother to explain how members of the public might find this page. The meeting is not listed on the Governance Board Meetings page, where every other meeting for 2016 is listed. A member of the public would therefore have to seek out the Board papers for a meeting that they had no way of knowing was happening, in a very obscure corner of the website that contains the agendas of meetings held in the past. To get to the meeting notice they would have to click on the “Past agendas can be found here” link on the Our Governance Board page. This is not a transparent way of doing business. If the CCG intended to advertise the Board meeting to the public, it would have been on the web page that lists Board meetings – just like every other Board meeting.
The CCG Constitution states: ‘Key communications issued by the group, including the commissioning plan, annual report, notices of procurements, public consultations, reports, Clinical Commissioning Group Governance Board meeting dates, times, venues, and certain papers will be published on the group’s website’ (10.1.2).
Similarly, the CCG’s Standing Orders require meeting details to appear on the CCG website: ‘Agenda and certain papers for the group’s Clinical Commissioning Group Governance Board, including details about meeting dates, times and venues, will be published on the group’s website’ (S.O. 3.3.3). Is that satisfied by publishing the details of particularly contentious meetings somewhere no one is likely to look? The Standing Orders also require the agenda for meetings to be circulated 6 days before the date of the meeting ‘save in emergency’ (3.3.1). The 26th April meeting seems to have been posted in its obscure corner on 21st April. The Standing Orders have either been breached by giving inadequate notice to Board members – or a decision has been taken to hold back the information from the public. There is clearly no emergency.
The CCG website states that ‘Meeting agendas will appear approximately one week before each meeting’. Except for this one, presumably.
They have a get out, though. David Evans says ‘The Board meeting was advertised in the Shropshire Star on April 19th and also in the Telford Journal on April 21st’. So members of the public are given a choice here! We can play ‘Guess the web page’ game, and search the CCG’s website just in case meeting details of an unexpected meeting have suddenly been posted somewhere other than the page that lists meetings. Alternatively, we can buy a local paper and read it cover to cover every day just in case the CCG has decided to call a meeting and not bother to list it on its meetings page. This is plainly nonsense.
The Chair’s role is particularly disappointing. She is a new Chair, and you might expect her to be mindful of her obligations under the CCG’s Constitution:-
The chair of the Clinical Commissioning Group Governance Board is responsible for:
- h) overseeing governance and particularly ensuring that the Clinical Commissioning Group Governance Board and the wider group behaves with the utmost transparency and responsiveness at all times;
- i) ensuring that public and patients views are heard and their expectations understood and, where appropriate as far as possible, met;
- j) ensuring that the organisation is able to account to its local patients, stakeholders and the NHS Commissioning Board;
‘Utmost transparency and responsiveness’? Hardly! We can’t know if the failure to publicise the meeting was accident or design. If it was an accident, though, the Chair and Chief Officer of the CCG should have apologised, and rescheduled the meeting. There is no emergency here. To insist on holding such an important meeting on this flawed basis is completely unacceptable. The refusal to even apologise is unimpressive in the extreme.
A history of trying to force through A&E closure
The background to this meeting is an interesting one.
On 12th April, the Board of Telford CCG met (in a meeting that was properly advertised on its website). They were asked by Chief Officer David Evans to give him and the Chair, Dr Jo Leahy, delegated authority to sign off the Future Fit Strategic Outline Case (the A&E closure blueprint). They had a chat about it, the Chair simply assumed that everyone agreed with her and David Evans, and they moved to next business without bothering to vote.
It took a member of the public to point out that they hadn’t actually taken a vote or made a formal decision in any way. The Chair then took a vote – and the general confusion and embarrassment gave several Board members the confidence to raise stronger concerns about the Future Fit plans. Dr Leahy and David Evans were forced to retreat; they were forced to abandon their plans for delegated authority, and agree to convene a special meeting on the Strategic Outline Case. This was to take place after a meeting of a different body, the Clinical Reference Group.
It’s a good job that the last meeting wasn’t being held in secret. The Chair and Chief Officer were unable to follow the most basic expectations of how public bodies do business, and it was a member of the public who steered them in the right direction. The outcome was completely different as a result.
The meeting tomorrow is the meeting they didn’t want to have in the first place; the one that we forced them to agree to last time around. It’s much easier to get on with the job of closing an A&E when you keep those pesky members of the public out of your business!
Where are we now?
This is an angry newsletter, and rightly so. We need people at tomorrow’s meeting. Please come if you can.
There’s a much bigger agenda. Future Fit is genuinely in chaos, with its future in the balance. In January 2015, the regional clinical experts in the West Midlands Clinical Senate urged local NHS leaders to develop a back-up plan. Sadly, they have completely refused to do so. As evidence mounts that Future Fit is dangerous and will risk lives, we need the David Evans and Jo Leahy’s of this world to start doing their jobs. They’re meant to be here to represent us, not just carry out the bidding of NHS England. It’s time to develop an alternative to Future Fit. This has to be part of our message to them.
And another part of the story is about money. Future Fit is intended to cut costs. It has nothing to do with high quality patient care, with any original positive proposals now dropped on the grounds they’re too expensive. There isn’t enough money coming into the NHS in Shropshire and Telford and Wrekin to enable decent patient care to be provided in the coming years. We need that to change – and that’s a message we have to start taking back to our MPs and councillors.