Our NHS in Crisis
1 November 2019
Management Recruiter Hunter Healthcare Publicises NHS North West London (NWL) ICS/ICP Aspirations As Part of Its Search for Five NHS London ICS Bosses
In many ways this is an extraordinary set of documents from an unusual source. An NHS activist in Brent spotted them. No-one in NHS NWL thought to send these NHS London/NHS NWL background documents to Ealing Save Our NHS (ESON) which has been attending NHS NWL commissioning and service delivery meetings now for some seven years.
Before we get into the nitty gritty ‘clinical’ content of these papers it’s interesting to note that the person doing the hiring is a Sir David Sloman. He was appointed NHS London supremo in February 2019. Wikipedia alleges that when he ran the Royal Free Hospital in Hampstead (2009 – 2018) he ignored the concerns of patients. He did, apparently, fall foul of the Data Protection Act in 2017 when he was discovered to have transferred data on 1.6 million patients to the Google DeepMind AI unit. Ironically 2017 was also the year he was Knighted.
What is rendered by Hunter Healthcare are NHS London and NHS NWL web pages on Integrated Care Systems (ICSs) and its Integrated Care Partnerships (ICSs). Confidence in the information presented as early as page 1 is dented by NHS NWL stating there are 400 GP Practices in NHS NWL. However the NHS NWL Collaboration of CCGs in 13 September 2019 stated there were 360. Who is right? And why is someone wrong?
Also on page 1 any flag waving is undermined by stating that, as at April 2019, the NHS NWL had an underlying deficit of £324 million, as well as there being financial challenges also present for our Local Authorities. Surely it’s time for NHS NWL to stop bleating about debts/deficits and get on with how It’s going to spend £4+ billion annually caring for its 2.4 million citizens much more effectively than it did each year 2012 to 2019. And care planning should be on a 10 year basis – as is Local Authority spatial planning. North west London’s population will probably reach 2.7 million by 2030 with a ten year accumulated spend of £40+ billion over that period. Plenty of cash here to do a lot of good. Cutting the £80+ million it cost to run the eight NHS NW CCGs in 2018/19 would be a great way of freeing up a bit more cash, as long as all these folks are not re-hired to staff up the new regional CCG and the eight local ICPs.
Some text and graphics (sometimes in such small type that it’s unreadable) have been thrown together (as a brace of slides each perhaps) for each of the eight NHS NWL ICSs. The only footprint/territory I really know anything about is Ealing. Comments on the Ealing ICP:
- It’s unlikely any of the NHS NWL ICPs will begin to function much before autumn 2021. An awful lot can happen over the next 17 months. Bit early to start ‘specing’ the Ealing ICP.
- The NHS Trust (LNWUHT) which runs Ealing Hospital (albeit from Harrow) is not an ICP ’partner’.
- Ealing Hospital itself is not an ICP partner. Ealing currently has a registered patient population of 441,683. Ealing Council’s super ambitious home building programme will probably attract some 70,000 new residents by 2030. No partnership with the only hospital in the future town with over half a million patients? What kind of madness is this?
- A truly obscure graphic is included which contains the following words and numbers:
London North West (48)
Chelsea & Westminster (10)
Whatever does this mean? Does no-one in the NHS NWL office read material for sense before it’s published?
The London Vision
In the papers relating to ‘London NHS’ we have ‘The London Vision: The next steps on our journey to being the healthiest global city’. This motherhood and apple pie aspiration is clearly at odds with England’s, London’s (and Ealing’s) broken planning ‘system’.
Visit areas of London where intense, dense development (so-called ‘regeneration’) is taking place , around Wembley Stadium, North Acton and central Southall are good examples. Hundreds of residential tower blocks which will house tens of thousands of new residents, students and office workers are being built or planned over the next ten years. 85 towers of over 10 storeys or more have been counted in Ealing alone, which will house over 76,000 new residents – 25,000 in Southall alone.
What Primary Healthcare, Secondary Healthcare, mental health care and social care long term capacity planning is taking place in Ealing or London to cope with this population expansion? None that I can see. However, sadly, no long term care capacity planning is evident in education, housing, law & order, transport, business, culture and sport. These deficiencies are to be found nationally, regionally and locally. The notion that there is any possibility of maintaining or developing communities with an adequate range of current and future public and private services is but a distant dream.
‘Our NHS London Region Values’
‘Integrity, Compassion, Consistency, Courage, Effectively’
‘Core Values, Aspirational Values, Permission to Play Values’
All marvellous, uplifting words, but as my mother used to say ‘handsome is as handsome does’.
NHS NWL 2012 – 2019 wasted up to £1.3 billion of public money, including over £72 million into the pockets of management consultants, on a disastrous failed Acute reconfiguration/transformation. Why should the 2.4 million registered patients throughout NHS NWL believe a word NHS NWL bosses now utter about future care provision?
Over £4 Million Wasted on Ealing CCG’s Ineffective Referral Facilitation Service (RFS)
Ealing Save Our NHS (ESON) finally got a response to its Freedom of Information request about the now cancelled Ealing CCG RFS. Between 16 March 2015 and 8 November 2019 the cost of the outsourced RFS was £4,161,746. The heart of the RFS is/was a group of Ealing GPs, employed by US healthcare giant UnitedHealth, who were paid to ‘double-guess’ consultant referral requests made by the GPs at Ealing’s 76 GP practices. Clearly there was a cost cutting intent to reduce the number of consultant referrals. From June 2015 to March 2016, 85% of the GP consultant referrals were upheld. During 2018/19 referrals acceptance shot up to 95%. Sanity finally prevailed and the CCG decided that the RFS was a complete waste of money.
NHS Pension Crisis Puts Patients At Risk This Winter
This was the disturbing headline in the 14 October 2019 issue of the ‘Financial Times’. NHS Providers, which represents hospital, mental health, community and ambulance services, has warned the Government it urgently needs a backdated solution to its disastrous 2016 pension changes. These changes limit the amount of tax relief doctors can claim on pension savings. This is a disincentive to work additional shifts during busy winter periods. It is thought to be the main reason many clinicians have opted for early retirement and cutting back their hours of work.
However with Brexit mania rife, a General Election and/or a Referendum in prospect the Government’s pre-occupations might be elsewhere in the coming months.
Drug Shortages Affecting 21% of Prescriptions Dispensed July – September 2019
A survey carried out by the Pharmacists Defence Association (www.the-pda.org) found that pharmacists were dealing with angry patients every day whose drugs were unavailable. 25% of pharmacists had suffered harm from drug shortages. 81% felt shortages would get worse.
Brexit is the quoted culprit.
Cuts in Alcohol Duty Linked to 2,000 Extra Deaths Since 2012
A research report by the University of Sheffield has proposed that some 5,000 lives and £500 million could be saved by raising taxes on alcoholic drinks. Scrapping the alcohol escalator – which raises taxes on alcohol by 2% above inflation – led to a 1% rise in alcohol consumption between 2012 and 2019.
This led to 61,000 extra hospital admissions at a cost of £317 million. The researchers concluded by stating that if the duty policy is not changed, 9.000 additional deaths could be expected by 2032.