31 Accountable Care Systems we know about – We’re fighting for the NHS, NOT Medicare!

Thanks to info people have sent us, we know of 31 Sustainability and Transformation Plans that intend to become Accountable Care Systems in the next year or two. Of these, NHS England has only announced 8 that are to go live from April 2018, but we know they are not the only ones – although some aim to take longer than the next few months.

We are fighting for the NHS – NOT Medicare!  And for democratic accountability – which is NOT what Accountable Care is about

An Accountable Care System is a new local public/private business model for the NHS and social care, based on the USA’s Medicare/Medicaid. Medicare/Medicaid is a publicly-funded, insurance-based system that buys managed care from private health companies for people who are too poor or ill to get private health insurance.

Managed care is about targeting patients at risk of A&E admissions or visits, because of their chronic health problems, and “managing” their care through keeping them on a list of such patients and providing care designed to keep them out of hospital; and/or having care coordinators in  hospital to intercept intercept patients before they enter A&E and direct them elsewhere.

Accountable Care Systems in England would slash spending by 2020/1, take the National out of NHS, open it wide to private companies and threaten patient safety standards and restrict patients’ access to treatments.

We are therefore determined to expose the unaccountable – and stop and scrap Accountable Care Systems.

Please help us!

If you know of more planned Accountable Care Systems that are not on our list of 29 (below), please tell us.

Either in the comments box, below, or by email.

Sustainability and Transformation Partnership Committees, Boards and what-have-you mostly seem to meet in private without publishing agendas, papers or minutes. So finding out what your Sustainability and Transformation Plan is up to isn’t easy.

Here’s how to find out:

• Identify your Sustainability and Transformation Partnership here on the NHS England website.
• Once you’ve found your STP from that link, please email them and ask if they are planning to become an Accountable Care System, and if so, when.
• Get in touch with a local NHS campaign group
• Tell your Council’s Health Scrutiny Committee to grill the STP Partnership on what is going on.

So far, we know these Sustainability and Transformation Partnerships are preparing to become Accountable Care Systems/Organisations in the next year or two

This is all being done pretty much under the radar – even some MPs don’t know that their area’s Sustainability and Transformation Partnership intends to become an Accountable Care System, or even what an Accountable Care System is!

So the more information we can publish, the more we can hold these secretive organisations accountable to the public and our elected representatives.

Here’s the current list:

1. South Yorkshire and Bassetlaw
2. Frimley Heath (Surrey)
3. Nottinghamshire;
4. Blackpool and Fylde Coast;
5. Dorset;
6. Luton, Milton Keynes and Bedfordshire;
7. West Berkshire;
8. Buckinghamshire
9. West Yorkshire and Harrogate
10. Barnsley
11. Greater Manchester
12. Cornwall
13. Mid and South Essex Success Regime
14. One Northern Devon place-based system with Northern Devon Healthcare Trust.
15. Castle Place GP Practice, Tiverton with Royal Devon and Exeter Hospital Trust (we think this is a PACS)
16. Devon STP, which includes NEW (Northern, Eastern and Western) Devon CCG and S Devon and Torbay CCG, is planning to convert itself into an ACO from 1 April 2018.  Devon County adult care services are supposed to be part of this, but despite only 3 months to the start of this the County does not appear to have discussed/decided its participation. Proper scrutiny of this is urgently needed.
17. Northumbria
18. Portsmouth Hospital Trust (PHT) and South East Hampshire, Fareham & Gosport and Portsmouth CCGs
19. Wirral Integrated Care – Update 25.1.23 – Five years on, Wirral Adult Social Care and Public Health Committee has decided to dismantle its “truly integrated health and care service”, which was formed by a June 2017 contract with the local community healthcare trust that included provision of Wirral social care services. Wirral Council outsourced the bulk of its social care services to Wirral Community Health Care Foundation Trust, transferring around 240 staff in the process. The contract had an annual cost of £10m. The staff transferred included those who commission social care provision in the borough, as well as assessment and reablement workers. The trust also had delegated responsibility over the wider social care budget. As the contract ends, Wirral Council will take back social care services. The Council says that “their priorities were not always reflected in how the services were being run” and there has been no evidence of significant and sustained improvement of service outcomes for people.
20. St Helens Accountable Care System
21. Weston Accountable Care System
22. Coastal Care Accountable Care System(West Sussex)
23. Leeds
24. Airedale, Bradford and Bradford City
25. Somerset
26. Suffolk
27. NE Essex
28. Central Sussex & East Coast Alliance – This ‘place’ is set to be a Multispeciality Community Provider (MCP). The aim of the changes is to reduce spending on hospital care by £80 million by 2020/21.
29.  East Sussex Better Together- This ‘place’ will form an accountable care organisation (ACO) with capitated funding and pooled budget
30. Kent and Medway are working on a model of two Accountable Care Partnerships (East and West Kent) under one Accountable Care System with one commissioner. Save our NHS Kent reported this, on the basis of information from Medway Foundation Trust Board Papers. They added that the local Conservative MP (S Thanet, Craig MacKinlay) is very pro- Accountable Care Organisations.
31. Eight Accountable Care Partnerships are being developed in North West London, according to a report “Accountable Care in NW London”, presented to the NW London Joint Health and Overview Scrutiny Committee meeting on 5 December 2017. Of these eight Accountable Care Partnerships, Ealing’s  “wraparound contract – the Ealing Standard” for an integrated community services provider for out of hospital services is intended to be fully operational from  April 2018. Full details of NW London’s Accountable Care Partnerships are available   here.