7 May 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.
Management Changes at NHS North West London (NWL)
Clare Parker resigned her job(s) in NHS NWL and has now departed. Up until 30 April 2018 she was one of the two Chief Officers for NHS North West London Collaboration of Clinical Commissioning Groups (actually running five of the eight constituent CCGs). She worked for NHS NWL for six years and in recent years has performed leading roles in the 2012 NHS NWL ‘Shaping a Healthier Future’ (SaHF) project and the 2016 NHS NWL Sustainability and Transformation Plan (STP). A requisite component for the SaHF (and by implication the STP) was the Government’s acceptance of the ‘final’ December 2016 SaHF business case (ImBC SOC1) which asked for £513 million for building work. Nothing more of the ImBC SOC1 has been heard of since NHSE/NHSI (London) rejected it in September 2017.
Ms Parker courted controversy last year when she and Tracey Batten, then boss of Imperial College Healthcare NHS Trust, went public in castigating Steve Cowan, the Leader of Hammersmith & Fulham Council. They claimed that Mr Cowan had been ‘inaccurate and misleading’ in his statements about the future of Charing Cross Hospital. Mr Cowan robustly defended his claim that Charing Cross Hospital was under threat of closure. Since then Ms Batten has resigned and returned to Australia, her country of origin.
A similar ‘leaving’ rumour is attaching itself to Rob Larkman who is currently Chief Officer of Brent CCG and is also running three of the eight NHS NWL CCGs. Apparently he is now also providing ‘provisional support’ until the new Accountable Officer for the eight CCGs takes over.
Of the five headline ‘promoters’ of the October 2016 NHS NWL STP, two of them have now resigned and a third is apparently on the way out. The two remaining NHS NWL STP heavyweights are Dr Mohini Parmar, Chair of Ealing CCG and STP leader, and Carolyn Downs, Chief Executive of Brent Council.
An astonishingly long, undated job description exists for ‘Accountable Officer: North West London Collaboration of CCGs’ It is 12 pages long and is the longest job description I have ever seen. A key ‘Main Duty’ is to create Accountable Care Systems (ACSs). This aspect rather dates the specification prior to February 2018, as it was in that month that NHS England annexed the term ACS and replaced it with the term ICS (Integrated Care System). Another interesting aspect of the job specification is the complete absence of any reference to the failing 2012 NHS NWL ‘Shaping a Healthier Future’ (SaHF) project. One can then reliably conclude that NHS NWL has now officially closed down this unfunded, cost cutting programme.
The head-hunter Veredus is no longer advertising this job, so maybe the vacancy has been filled. The rumour is that the new NHS NWL Accountable Officer role has, allegedly, now been filled by Mr Mark Easton. (On the run-up to this appointment Ms Parker and Mr Larkman both publicly declined to apply for this new top job). Mr Easton has had quite a ‘mobile’ NHS career filling eight different roles in just 12 years. Given that Ms Parker’s total annual remuneration for being accountable for five CCGs was £230,000 to £235,000, no doubt the remuneration for being accountable for running eight CCGs will be significantly more.
Has the Integrated Care System (ICS) Bandwagon Come to a Complete Stop?
Where is the new legislation on ICS promised by the Government in February 2018? Where is the 12 week public consultation on ICS promised by the Government in February 2018? Why are the two pioneer NHSE ICS Vanguards at Dudley and Greater Manchester still ‘paused’?
The first of many care ‘transformation’ Judicial Reviews (JRs) kicked off in Leeds on 24 April 2018. This one challenges the legitimacy of NHS Accountable Care Organisations (aka ICSs). The second ACO/ICS legitimacy challenging JR starts in Court on 23 and 24 May 2018. Further care transformation JRs are gestating at Barnsley and Rotherham, Dorset and Huddersfield.
According to NHS England the 10 Vanguard ICSs ‘are already assuming accountability for local operational and financial performance’. As from 1 April 2018 they are supposedly beginning ‘to gain financial flexibility and to use new tools for better understanding of local health data’. Well if this is the case they are all very shy about announcing this. In fact the last NHSE ICS news announcement is from February 2018 when ACSs were renamed ICSs.
‘Change but the name, and you are the subject of the story’
Horace 65BC – 8BC
UK Nears Bottom of List of 21 Developed Countries for Numbers of Doctors, Nurse and Hospital Beds
A recent report from the Organisation for Economic Co-operation and Development (OECD) places the UK amongst the lowest per capita number of doctors, nurses and hospital beds. Only Poland has fewer doctors and nurses than the UK. Only Canada, Denmark and Sweden have fewer hospital beds. In Germany there are 8.1 hospital beds/1,000 people – in the UK it’s just 2.6.
Central and North West London NHS Trust (CNWL) Hired More Mangers in 2017 Than Any Other NHS Trust
In 2017 CNWL hired 253 people into management roles. In 2013 it hired just 93 of them. This information was derived from NHS Digital and analysed by the BBC in April 2018. It’s interesting to relate these figures to the planned staff reductions in the December 2016 NHS NWL Sustainability and Transformation Plan (STP). In 2017/18, 3,658 staff were to be ‘let go’. This included 1,293 Registered Nurses, Midwifery and Health Visitor staff.
Nationally since 2013, 16% more managers were hired compared to 8% more doctors and 2% more nurses. Between 2015 and 2017 there was no overall increase in hospital nurses throughout England. Out of the 1.21 million NHS staff around 32,000 are managers. NHS Improvement says that there are still ‘too few managers’. This statement is backed up with ‘..research consistently shows…’. It does make one wonder what research this is and how it was conducted, and just how many managers too many might be.
According to the ‘Daily Mail’, the starting salary for an NHS senior manager is £65,000.
‘Most of what we call management consists of making it difficult for people to get work done’.
Peter Drucker 1909 – 2005
£4.2 Million Capital Grant To Be Spent On 17 New Mental Health Beds for Young People in NHS North West London (NWL)
12 safe environment beds will be for 13 to 18 year olds suffering from severe mental health problems in Chelsea & Westminster Hospital. Five beds in Brent will be used by young people with learning difficulties, autistic spectrum disorders and experiencing mental health difficulties.
Sadly this £4.2 million capital grant is just a drop in the ocean. It cost over £230 million last year to run the West London Mental Health Trust, just one of the two mental health trusts in NWL.
It seems the cost for a mental health bed in NHS NWL is £247,000.
Population of England: 66,573,504 – Number of Residents Registered at GP Surgeries in England: 59,039,595
What could these figures mean?
- There are 7,546,009 residents in England who are not registered at an NHS GP Surgery.
- Attempts (through Sustainability and Transformation Plans) to provide integrated social care and healthcare will fail for over 7.5 million residents as they only ‘exist’ in the social care system.
- In an Integrated Care System world, using Capitated/Whole Population Budgets, members of this 7.5 million unregistered healthcare population could be denied healthcare services on the grounds that they are not part of the defined healthcare patient population.