Claiming to know nowt about Simon Stevens’ instruction not to cut hospital beds without first proving this won’t damage patient safety
This is the first citation on Carol McKenna’s double Stuplicity Award.
At the Greater Huddersfield Clinical Commissioning Group Governing Body meeting on 8th March, the Chief Officer Carol McKenna and Chair Steve Ollerton claimed they know next to nothing about the fact that Simon Stevens has told Sustainability and Transformation Plan leaders not to reduce beds without first proving they can do so without affecting patient safety.
Paul Cooney, Secretary of Huddersfield Keep Our NHS Public, said
“Both McKenna and Ollerton stated they were aware of the statement but were no wiser than us as nothing else had been published.”
Terry Hallworth added,
“They also said the Calderdale and Huddersfield hospitals reconfiguration was mentioned in the Sustainability and Transformation Plan, but would not have any effect on it.
They were completely off balance and making it up as they went on.”
Carol McKenna and Dr Steve Ollerton are the Greater Huddersfield Clinical Commissioning Group leads on the W Yorkshire and Harrogate Sustainability and Transformation Plan and their comments were in response to a question from a member of the public.
It is surprising that they claimed to know no more than the public, because you’d think the West Yorkshire and Harrogate Sustainability and Transformation Plan leader Rob Webster would have told them, since he is in full possession of the facts.
Curious about what info about Sustainability and Transformation Plans the duo had received, CK999 asked Greater Huddersfield Clinical Commissioning Group to send all correspondence on the subject since December 2015 from NHS England, NHS Improvement, West Yorkshire & Harrogate STP Programme Management Office and Rob Webster. They refused because it would take too much time to find it all, and cost more than £450 (the limit for Freedom of Information searches):
“This is due to the fact that the CCG is in receipt of regular communications from NHS England, NHS Improvement, the West Yorkshire & Harrogate STP Programme Management Office, and Rob Webster covering a wide range of issues.”
CK999 also asked Rob Webster what changes to the West Yorkshire and Harrogate Sustainability and Transformation Plan will be needed, in the light of NHS England’s new requirement that significant bed cuts can only be made if NHS England officials agree that:
- adequate alternatives are in place, such as bolstered GP and community services
- new treatments or therapies can be demonstrated to cut hospital admissions among certain categories of patients.
- hospitals which are not using beds efficiently can demonstrate credible plans to improve their performance without compromising patient care.
How this affects the proposal to cut 77 beds at Calderdale and Huddersfield NHS Foundation Trust hospitals is obviously of particular interest.
Rob Webster replied,
“Any implications of this decision will be taken into account as part of the work that is being undertaken by CHFT [the hospitals trust] and the Clinical Commissioning Groups to produce the Full Business Case and associated documentation. Any business case will have to meet the requirements of the regulators including NHS England.”
CK999 drew Rob Webster’s attention to the fact that, at their January 2017 meeting, Calderdale and Kirklees Joint Health Scrutiny Committee repeated their worries about the lack of alternatives to inpatient hospital care in the proposed Care Closer to Home scheme.
Rob Webster made no comment on that point.
The final point CK 999 made to Rob Webster was that, apart from the Calderdale and Huddersfield hospitals proposed bed cuts, it doesn’t seem clear from the West Yorkshire and Harrogate Sustainability and Transformation Plan what other hospital bed cuts the current version plans – although it does say that some hyperacute stroke services will have to go.
Rob Webster said,
The draft STP has been published. There are no specific recommendations regarding the total number of proposed hospital bed cuts in the current version of the West Yorkshire & Harrogate STP.
Misleading the Calderdale and Kirklees Joint Health Scrutiny Committee by saying Sustainability and Transformation Plan leaders will have no governance rights over the NHS organisations in their area
At the 8th March 2017 Greater Huddersfield Clinical Commissioning Group Governing Body meeting, a member of the public challenged Carol McKenna about her answer given at Scrutiny, denying that the Sustainability and Transformation Plan would become a body with a formal structure and power over the Clinical Commissioning Groups.
Paul Cooney said,
“They failed to clarify this to our satisfaction. But there is strong evidence in my view that the Sustainability and Transformation Plans will have control and priority over the Clinical Commissioning Groups and that rationing and or stopping some services will take place.”
On 27th February, as reported in the Health Service Journal, NHS England and NHS Improvement chief executives wrote to Sustainability and Transformation Plan leaders that:
- There will be a formal appointment process for STP leaders. This is expected to take place before the summer break.
- The national bodies will set out a small number of governance models “we see emerging across the country” and help spread them.
- Stronger STPs will be given “greater control over NHS England staff, together with CCG and trust resources, to enhance their implementation capability”, and “the right to make recommendations to us about local organisational governance, as well as other actions to overcome the inertia or organisational vetoes that are preventing improvements”.
- There will be a “relatively small amount of centrally held transformation funding” for some STPs, overseen by STP leaders, to “help create exemplars for elective and emergency care, and get the most advanced accountable care systems off the ground”. There will also be “some additional central funding to support the formation of primary care hubs or networks across the country”.
- The national bodies will also grant STPs one-off funding, ranging from £175,000 to £360,000 each depending on size, “as a contribution to operating costs and to help you assemble your teams quickly”.
Simon Stevens confirmed this in his evidence to the Public Accounts Committee on 27 Feb, where he said that:
“The STP process is simply saying that the best way of resolving a shared and unified plan of action is to ensure that there is no bickering locally as to what that should be. Instead people should unite around a plan to make the best of the funding envelope that they have got. That is what we are supporting them to do. There are certain changes that we have got to make to help them get that right, and we are going to be setting those out at the end of March as well… We are going to formally appoint leads to the 44 STPs. We are going to give them a range of governance rights over the organisations that are within their geographical areas, including the ability to marshal the forces of the CCGs and the local NHS England staff.”
This is why we must Stop the Sustainability and Transformation Plans. Because they are driving massive cuts, aiming to drive people to Switch to Private, and leave a rump NHS for those who are to poor or ill to be profitable for private companies to treat.