Due to the complexity and furtiveness of NHS England’s consultation on its proposed new Accountable Care Organisation contract – which it has renamed the Integrated Care Provider contract – 999 Call for the NHS have launched our own consultation.
It is far shorter (just 4 questions) and more to the point. Here is the link .
Please respond and share the link as widely as possible. We’ll send your responses to NHS England before their consultation ends on 26th October.
If anyone wants to print out the 999 consultation so that people who are not online can complete it, you can download it here (pdf file)
Please collect hard copy responses and post them to ICP Consultation Team, Area 2D NHS England, Skipton House, 80 London Road, London SE1 6LH, to arrive by 26th October.
If you still want to complete NHS England’s consultation, it’s online here.
999 Call for the NHS’s response is downloadable here (.doc file) – you’re welcome to use and adapt it for your own response.
NHS campaigners gave NHS England a grilling at their Integrated Care Provider Consultation event in Leeds. This is one of the questions we asked them:
Why is NHS England consulting now, before they even know if their new contract is lawful?
Later in the autumn, 999 Call for the NHS is challenging the the lawfulness of this contract in the Court of Appeal. It’s the only chance of stopping it.
We’ll be speaking about this at the Scrap the ICP Contract/Support the NHS Bill rally outside Parliament on 26th October. Please join us there if you can.
Massive thanks to over 770 people, NHS campaign groups and trade union branches who have crowdfunded the costs of the Appeal through CrowdJustice.
The CrowdJustice appeal remains open for a final stretch target – more info here. http://bit.ly/999CourtofAppeal
The proposed new contract might sound like a dry legal issue that’s hard to get bothered about. The reality is anything but.
This is about whether patients can continue to access the treatments they need, or whether the doctor – patient relationship will be undermined by making doctors put financial considerations ahead of patients’ clinical needs.
Because this new 10 year contract is driven by NHS England’s cost-cutting aim of avoiding a projected £20bn funding shortfall by 2020/21 – the result of nearly a decade of NHS underfunding.
The contract would pay a single legal entity for a whole range of NHS and social care services in a given area, using the same lump sum payment arrangement that has been used to pay for psychiatric intensive care – with disastrous results. Just think about the shortage of acute mental health beds.
It is explicitly intended to “manage demand” for NHS services – in other words, to restrict patients’ access.
Its cost-cutting payment mechanism would drive down safety standards as well as restricting patients’ access to care.
Imported from the USA’s Medicare system (that provides limited state-funded health care for people who are too poor or sick to afford private health insurance), the new care models that the proposed contract would cement are about cutting hospital services and delivering care closer to home using cheaper, less qualified new grades of staff – and even unpaid volunteers, friends and family.
NHS England laid out its plan for setting up these new care models in its 2015-2020 Five Year Forward View. Since then it has set up Vanguard schemes to trial these new ways of providing NHS and social care. There is just one small problem. There is no real evidence that they work. That is the conclusion of the National Audit Office report.
However, these new care models offer great opportunities to private healthcare companies.
The single legal entity that would hold the Integrated Care Provider contract could be an NHS organisation like a hospital Trust, or a GP Federation, a private company, or a joint venture or special purpose vehicle that could include NHS providers and private companies.
This is a complex contract where the legal entity that holds the contract would then subcontract to a number of different healthcare providers – whether NHS, private or 3rd sector companies. This comes with all sorts of risks and hazards.
Its wide loopholes would allow far greater privatisation of NHS services – under this contract, a private company could control the delivery of the whole range of out-of-hospital NHS and social care services for a large area. Or indeed could win multiple contracts across many areas, and so establish a near- monopoly.
NHS England has admitted that under current NHS and social care legislation, it is powerless to stop private companies bidding for this – or any other – contract.
So what is this really about?
The NHS quangos are aiming to change the whole architecture of the NHS, so it can deliver these American care models. All the better to open the NHS gates to American corporations post-Brexit.
This is already galloping ahead.
As Stewart Player writes
“[T]he aim is to impose a kind of global homogeneity of healthcare organization. Such standardization will attempt to safeguard and simplify investment strategies, and to embed corporate control of both purchasing and service delivery within rapidly evolving ‘mixed economies’ of care.
Homogeneity also gives meaning to attempts at trade deregulation; the TTIP, for example, would be somewhat limited if domestic systems weren’t fully investor compatible. The use of capitated budgets for ACO providers, for example, is expressly geared towards private investor interests, as the upfront capital can be invested in the global markets, with returns on equity in excess of 16%.”
You can read more about the contract and why we’re fighting it in the Court of Appeal here