Please protest to Scrutiny Officer about the delay in publishing the hospital cuts Full Business Case

Please phone or email Richard Dunne, the Kirklees Council Scrutiny Officer – who will send your email to the Calderdale and Kirklees Joint Health Scrutiny Committee Chairs and members – and say something along these lines:

STARTS

It is not right or acceptable that the Clinical Commissioning Groups and the Hospitals Trust have failed to send Joint Health Scrutiny Committee members the Right Care Right Time Right Place Full Business Plan by the end of June, as the Joint Health Scrutiny Committee had required at their 23rd Feb 2017 meeting.

Is it correct that the Full Business Case is only going to be published on 14 July – one week before the scheduled 21st July Joint Health Scrutiny Committee meeting?

If so this is unacceptable, because it will not allow time for Councillors and the public to read and scrutinise the document. The Joint Health Scrutiny Committee meeting needs to be postponed so that – as the Joint Health Scrutiny Committee intended – there are 3 weeks for reading and scrutinising the Full Business Case.

I also want full publication NOW of all the associated documents that the Joint Health Scrutiny Committee and the public need to read and scrutinise before the meeting.

We the public need to see all these extra papers and documents too, because otherwise who is going to scrutinise the scrutinisers?

These were listed by the CCGs and CHFT in their report to the Feb 23rd meeting as:

Full Business Case in line with the Treasury’s Five Case model
Update of the Benefits and Outcomes in line with
any updated clinical standards and any changes to the proposed model.
Update of the Ambulance Travel Analysis
Activity modelling for Community Services
Update of Integrated Quality Impact Assessment across hospital and community
services.
Update of the Public Travel Analysis

In addition, I demand full publication NOW of all the other documents that the Joint Health Scrutiny Committee and the public need to read before the meeting, that are implied in the Reconciliation consultant’s advice that the Joint Health Scrutiny Committee should consider:

  • the wider context of other, parallel strategies and plans
  • the development of partnership arrangements and a whole system approach
  • any barriers to achieving this across health and social care and identify key lines of questioning for social care in addition to health services.
  • workforce capacity, taking into account the pressures and risks that exist in the current system
  • the relationships between health and social care and the pressures and risks that exist in the current system.

I am fed up with this shillyshallying by the CCGs and CHFT which has been a feature of the Joint Health Scrutiny Committee consultation right from the start.

ENDS

Background: the Clinical Commissioning Groups and the hospitals Trust are behind schedule with the hospital cuts and care closer to home full business case

Papers for the 6th July Calderdale and Huddersfield NHS Foundation Trust (CHFT) Board Meeting in public at 9.00 am in the Large Training Room, Learning Centre, Calderdale Royal Hospital, show that CHFT is not on track to meet Calderdale and Kirklees Joint Health Scrutiny Committee’s requirement that the Clinical Commissioning Groups and CHFT should submit the completed Full Business Case and associated documentation to the Committee  by the end of June 2017.

This was decided at the Joint Health Scrutiny Committee meeting on 23rd February 2017, which gave an update on the reconciliation process. This was set up after the November 2016 Joint Health Scrutiny Committee meeting, when the Clinical Commissioning Groups and the hospitals Trust failed to respond satisfactorily to the 19 recommendations in the Joint Health Scrutiny Committee report “ Response to proposals for future arrangements for hospital and community health services in Calderdale and Greater Huddersfield”.

The 23rd Feb 2017 meeting also ruled that a meeting of the Committee be arranged by the end of July 2017 to consider:

  • Whether the Committee’s recommendations contained in its report ‘Response to proposals for future arrangements for hospital and community health services in Calderdale and Greater Huddersfield’ have been satisfactorily addressed.
  • Exercising the Committee’s power of referral to the Secretary of State in accordance with the requirements of the regulations.

Lack of clarity on the sign-off process for the Full Business Case

The Risk Report in the Papers for the 6th July CHFT Board Meeting says (p107) that the delay with the Full Business Case is due to a lack of clarity on the sign-off process.

Why didn’t NHS Improvement tell the Trust in good time what their Full Business Case approval process is?

To deal with this problem, in July the Full Business Case is to go through internal governance processes and the Trust will seek clarity on NHS Improvement’s approval process.

Since NHS Improvement failed to tell them, why didn’t CHFT ask sooner?

The Board Assurance Framework (p107) puts the delay down to:

“insufficient capacity and capability across the organisation to manage the many schemes (Electronic Patient Records, Cost Improvement Programme, Care Quality Commission preparation and service reconfiguration) while keeping the base safe”.

Oddly though, a report on the 1 year Plan, (p 131 of the Board papers) says that the Trust is “on track” with submitting a full business case to NHS Improvement to secure approval of capital funding and agreement to implement. The person responsible for this seems to be Anna Basford, Director of Transformation and Partnerships

So what is going on?

And why hasn’t the Joint Health Scrutiny Committee told them this sloppiness and slowness was unacceptable?

Other possible causes for delay are given in the Clinical Commissioning Groups’ and CHFT report to the February 2017 meeting of Calderdale & Kirklees Joint Health Scrutiny Committee:

“We will assure our more detailed proposal through the Yorkshire and Humber Clinical Senate. We do not control the timescales or work scheduling for the Senate. The Senate’s findings may require us to do further work.

The Full Business Case will require sign off by the Treasury. The Treasury may require us to do further work.”

Loads of other documents that the Joint Health Scrutiny Committee and the public need to get our heads round before the meeting

The reconciliation report points out that the Joint Health Scrutiny Committee “needs sufficient and agreed time” for their consultation on the Full Business Case – and that the Joint Health Scrutiny Committee would identify how long it needs to review and analyse the Full Business Case.  This turned out to be three weeks.

The lack of time for reading and scrutiny due to the delay in signing off the Full Business Case is even worse when you factor in that the Reconciliation Report identified that the Joint Health Scrutiny Committee should also scrutinise a number of other documents, in order to get their heads around:

  • The Full Business Case within the wider context of other strategies and plans,
    the development of partnership arrangements and a whole system approach.
  • Any barriers to achieving this across health and social care and key lines of questioning for social care in addition to health services.
  • Key lines of inquiry in relation to the workforce capacity, taking into account the pressures and risks that exist in the current system. Clarity will be needed in identifying which questions relate to the FBC and which questions are not part of the business case but will need to be considered by an implementation plan in the future.
  • Care Closer to Home, taking into account the relationships between health and social care and the pressures and risks that exist in the current system. Clarity will be needed in identifying which questions relate to the FBC and which relate to parallel strategies and plans.

The papers for the 6th July 2017 CHFT Board meeting give an idea of what these “other” “parallel” strategies and plans are. (There will soon be a separate blog post about this.)

There is also another bunch of documents to read from the Clinical Commissioning Groups and CHFT, that will deal with the Joint Health Scrutiny Committee’s 19 recommendations:

  • An update of the Benefits and Outcomes in line with any updated clinical standards and any changes to the proposed model.
  • An update of the Ambulance Travel Analysis
  • Activity modelling for Community Services
  • An update of Integrated Quality Impact Assessment across hospital and community
    services.
  • An update of the Public Travel Analysis
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2 comments

  1. The CCG and CHT haven’t respect of timescale and transparency. No business plan for the Roght Care Right time Toght place within the extended time. Again they are allowed a time extension.. if this is the case it is only right the Joint Scrutiny are allowed the same extended time consideration grace. It should also be mandatory to produce all documentation for the public to view and evaluate. Otherwise yet again it is everything but open and transparent .

    Like

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