Author: Steven Carne

The theme of our stall at the Huntingdon Carnival next Saturday 10th August is GUESS! After much debate at our monthly meetings we came upon the idea because despite members regularly attending meetings of the Clinical Commissioning Group (the purse-string holders), the Sustainability & Transformation Partnership Board (the talkers) and the county Health Scrutiny Committee – the evershifting pieces of the local NHS Jigsaw make it almost impossible to get a firm grasp on the picture.

Huge changes are taking place but are being made largely unnoticed by the general public due to the secretive and oblique nature of the workings of the various committees and organisations involved – not to mention the big daddy Quango NHS England and NHS Improvement pulling lots of strings too…

So that is why at the Carnival we are asking people to GUESS what is going on with the local NHS? For example… Guess where this is?

We’ll also be asking people to guess the cost of SELF-PAY treatments and explaining why it is not a stupid question – self-pay/self-funding is becoming a common sight at NHS Foundation Trusts it seems. Guess how much the Clinical Commissioning Group are planning to CUT this year? Guess what hospitals are now merged into NWAFT?

And we’ll be inviting people to tell us their stories about the changes they have experienced as a patient in the local NHS. You can find us in the Marquee – Look for the big yellow duck and guess what it’s doing there!

We were as shocked as many other fellow campaigners around the country to see Warrington & Halton Hospitals advertising “SELF-FUND” NHS treatments last month. Due to the national outrage the hospital now says they have paused the scheme but we are taking that with a pinch of salt.

This is what attracted campaigners’ attention and caused a real storm.

Many campaigners have been warning this would happen for some time – particularly as NHS England has now put restrictions of some routinely funded NHS treatments. The 999 Call for the NHS graphic below lists those treatments now referred to as being of “Low Clinical Value”. This means your GP cannot refer you to a consultant without major stress and hassle – convincing the Clinical Commissioning Group that you are a special case.

Clinical Commissioning Groups – the ones with the purse strings – are being pressured by NHS England to make massive cuts. They should have a policy about these new restricitions. Mostly you can find these policies posted on the Clinical Comissioning Groups’ websites. But to confuse us all, they come under different names, such as:

• Prior Approval
• Procedures of Limited Clinical Value
• Criteria-Based Clinical Treatments

Cambridgeshire & Peterborough CCG you can find here

Campaigners are now asking their local hospital if similar schemes are in play – and we are joining them by asking Hinchingbrooke’s CEO – Caroline Walker – if, as part of North West Anglia Foundation Trust (NWAFT) they too are offering NHS Treatments as “self-fund” or “self-pay” services. This is our letter which we have sent this week.

Caroline Walker, CEO
NWAFT
Peterborough City Hospital
Bretton Gate
Bretton
Peterborough
Cambridgeshire
PE3 9GZ

Dear Chief Executive

In the light of nationwide concern regarding “low clinical value” NHS treatments no longer being routinely funded and the deep unrest surrounding these services becoming “Self-Pay” treatments as in Warrington NHSFT, please could you tell me:

Is North West Anglia Foundation Trust (NWAFT) currently offering “self-pay” treatment for elective services that are no longer routinely funded by the Cambs & Pboro Clinical Commissioning Group?
Is NWAFT planning to offer “self-pay” operations and elective surgery services that are no longer routinely funded?
If so please provide a copy of the price list
At which site(s) – Hinchingbrooke, Peterborough or Stamford – do self-pay treatments exist or are being planned?
How much income does NWAFT make from providing commercial sources?
Of this, how much comes from these “self-pay” elective operations?
What plans, if any, is the trust developing to increase income from self-pay elective operations?
Does NWAFT plan to increase private income by more than 5% in any one financial year? If so, have you got the permission of more than 50% of elected governors?

We look forward to hearing from you

We will keep you posted. We also want to ask the CCG for their list of treatments no longer available as routine NHS treatments. And to ask what are the options for local people suffering pain.

If you’re going to be at the Huntingdon Carnival in August why not come and say “hello” and we can tell you more about what we know about the changes being made to our NHS.

At our February meeting we decided to give our backing to the national legal challenge being led by 999 Call for the NHS. The Judicial Review is challenging the lawfulness of a new contract being introduced by NHS England – which sounds fairly dry and boring… until you look at the details of what is contained in this new contract.

Integrated Care Provider contracts

If they are allowed to proceed, the way in which NHS Providers will be paid, including the new fixed budget process it contains, will have many profound negative effects on the way NHS services are delivered across the county and especially Huntingdonshire.

We are busy trying to figure out the landscape of the NHS across the county and where Hinchingbrooke fits in the scheme of things. The recently-announced NHS England Long Term Plan requires all Sustainability and Transformation Partnerships to become Integrated Care Systems and sees 2019/20 as a transitional year for changes to the area’s NHS financial framework and services.

So far we have discovered that there are now North & South Alliances of GPs and Providers (to do what exactly?)

There are Primary Care Networks with GPs hubbed together to cover patient lists of 30-50,000 people (can you get an appointment?).

There are also larger “Integrated Neighbourhoods” and on top of that there is the Integrated Care System – although at the last CCG meeting the Accountable Care Officer admitted that there hadn’t been much movement on that as the STP Board weren’t sure exactly who was in charge of that one.

Integration is being sold as the miracle cure by NHS England but it is clear to us that driving through a policy of forcing management systems together is not going to improve frontline medical care and is designed solely to justify yet more cuts – and mergers such as our situation here in Huntingdonshire. Hinchingbrooke is no longer an independent hospital and has to behave as part of the North West Anglia Foundation Trust (Peterborough to the public)

Lorna Mansbridge, HOH Secretary said:
“Making Cambridgeshire an Integrated Care System may mean centralising acute and emergency services to Addenbrookes and Peterborough. Which raises the question – what will we be left with at Hinchingbrooke? Introducing the USA Accountable Care Organisation contract will mean that providers will will be forced to restrict services in order to make a profit. This is not the NHS we want. That’s why we are supporting the 999 Call for the NHS legal challenge to stop the contract.”

If you have personal experiences of changes to Hinchingbrooke that have impacted on you or your family we want to hear them. Contact us by email.

Many thanks

Hands Off Hinchingbrooke

We are currently investigating more about the county plans (the Sustainability & Transformation Plan/Partnership) that will affect our local hospital. We are already asking what exactly is the nature of our A&E but now our list of questions is growing. Look at the following from the February Sustainability & Transformation Partnership Newsletter…

So £25million for Hinchingbrooke? Great if that is to maintain a full 24hr Blue Light A&E – what do they mean by “emergency medicine”? Plus we are a little bewildered at the phrase “a centre of excellence for rehabilitation”. Elective care (non emergency) is also mentioned in the announcement and this with “rehabilitation” is sending us signals that Hinchingbrooke could become the county hospital for planned operations – eyes, hips, knees etc whilst centralising all acute and emergency services to Addenbrookes and Peterborough. And it might become the centre for those not being served by social services. What do local people think?

This sudden input of money… is it a fund given with no strings attached?Or is it a loan to be paid back through ridiculous Private Finance Initiative style repayments?

But the biggest question at the end of reading the newsletter piece is: Will the building of a world leading Children’s Hospital for East of England mean losing the already existing award-winning Maternity & Paediatrics Wards at Hinchingbrooke and other hospitals in the region?

One of our members confronted the January STP Board meeting with this question:

I would like to ask about the new children’s hospital to be built on the CUH (Addenbrookes) site. Does this new development involve the planned closure of the paediatric ward at Hinchingbrooke and transfer of services? If it does not plan the closure of these wards then what steps will be taken to train and recruit additional paediatric nurses and doctors because there is a national shortage of paediatric nurses and doctors and the staff at Hinchingbrooke and PCH may understandably want to move to the new hospital so destabilising the peripheral units.

We will keep you posted when we discover some answers.

At our first meeting of 2019 we sat and assessed what we knew about the Cambridgeshire & Peterborough NHS situation. The changes to the local NHS and Social Care – dictated by the national ‘arms-length’ bodies NHS England & NHS Improvement – are hard to keep up with because of the speed with which they are now being thrust upon us.

We felt it was important to remind ourselves of what we knew for fact, what was rumour and hearsay and where our focus should be in 2019. It became clear that, once again, although we recognise that the situation across Cambridgeshire is part of the national picture of cuts to services, our focus remains our treasured Hinchingbrooke Hospital.

We are beginning to research exactly what kind of A&E we have at Hinch, what services are there – and more importantly we’ll be asking Cambs & Peterborough Clinical Commissioning Group and the Sustainability & Transformation Board what plans they have for the future.

We were also reminded by one of our members that we should continue to celebrate the NHS and our local hospitals – it’s the reason we are fighting to keep them! If you have stories of your experience of HInchingbrooke and other local services you can contact us via email on our contact page.

We were delighted to be invited to host a stall at Saturday’s Huntingdon Carnival on the 11th August. Meeting members of the public and asking their opinions about local changes to the NHS led to some unexpected but very welcome conversations. Many who came to the stall were staff from Hinchingbrooke who spoke of their first-hand experience of the changes and their fears for the future of their jobs.

The team at the Carnival

Jane Howell, campaigner felt the day was very worthwhile: “We were surprised to have so many people coming to the stall asking questions about our work and especially what was happening at Hinchingbrooke now that it is part of Peterborough City Hospital. It was a wonderful day and there is no doubt in our minds that there is still a great love and respect for our local hospital. The response we had made it clear to us that our campaign must continue to monitor all the local vital services such as A&E, maternity and surgical departments”

Huntingdon Mayor Sarah Gifford, after talking to members, agreed to a photograph to support the group – with a passing friendly Godmanchester Lion who got in the picture!

The Health Service Journal has made it known that a  private company – Care Rooms Ltd – have approached Cambridgeshire County Council with their money making scheme which they claim will “help the NHS”. The service known by many clinicians and campaigners alike as Care B’n’B is a rent-a-room scheme for (medically fit wahtever that means) patients leaving hospital after an operation.

The HSJ revealed that the company were forced to abort their first trial in Essex last year after patients and social care directors raised safeguarding concerns about care being provided by non-NHS trained non-care professionals. But in true entrepreneurial spirit the company have not been deterred and are ready to launch the scheme again… you know the old saying…

After talking to campaigners this week at Southend Save Our A&E we know that the trial scheme was disgraced by professionals up and down the country and was abandoned within one week of being announced. So now it appears in Cambridgeshire and the company are trying their luck with the local authority rather than the NHS. They have adapted the scheme so it is now merely a room for rent with no medical/clinical care required by the host – hence even more justification for the nickname Care B’n’B.

We’re looking deeper into the implications of the scheme and why the county council are, according to Anna Bailey – Chair of Adults Committee, setting up a “working group” to look at piloting the scheme. We’re grateful to the Hunts Post for listening to concerns and successfully raising alarm bells about this scheme which claims to provide choice (that word) but is clearly nothing more than a private company taking full advantage of a business opportunity  created on the landscape of a delberately under-funded NHS and social care system that is now ripe for more private company control. Read the full online article here

Paul Gaudin the CEO of Care Rooms Ltd. (a former bagel millionaire) wrote a lovely letter responding to questions being asked by us, the Hunts Post and HSJ.

Here it is. See what you think.

Full Support on hand for hosts

Last week’s front page article about CareRooms raised some important questions which I thought would be helpful to answer. The service is not funded by the NHS or the local authority. We have privately funded the project with the aim of providing choice to patients, families, the NHS and health and social care. We are therefore very careful to ensure that we have covered the risks, as much as possible.

Having personally experienced the pressures on our NHS and social care teams, I wanted to do something to try to help our communities to help their NHS to help them.

Hosts can be lonely, socially isolated people who’ve lost purpose and want to get involved in their communities and to earn some much needed income. They provide a short stay, safe room for low risk, medically fit patients (not those with dementia). This helps them whilst their home is modified or a care package is set up. Other uses are for those who are vulnerable after a fall at home or need some respite care.

Each host is carefully selected to be just the right person for the job. CareRooms provide the safeguarding system and training and we are on hand locally to help if there’s a problem.

We are using the latest patient monitoring technology to minimise the risk of ill health or in the unfortunate case of a sudden health issue or death, then we may well know before the host does and we have full procedures to support the family and to protect the host.

We are looking for local Cambridgeshire hosts to help their communities by unlocking the potential of their spare rooms.

Paul Gaudin,
Founder of CareRooms.com
London

We’ll be responding very soon.

An energetic and animated meeting this month. Thanks to everyone who came along. Lots of updates from those who attended the Health Campaigns Together conference in London on Sat. 4th Nov. A one-day conference with campaigners travelling from as far afield as Devon and Cumbria to share news, information and ideas for the winter ahead. Members felt it was a positive day and well worth attending.

Stories and information from other groups provided yet more proof of the need to remain vigilant in watching our local services.

HoH Member Jane Howell found the day inspiring. ” Hearing other campaigners’ talk about the mergers, downgrades they had seen in their areas,  leading to full loss of some services helped me to understand that we’re right to be worried in Huntingdon. We are still very concerned about the future of Hinchingbrooke as a hospital with full 24hr Blue-light A&E Department.”

Fellow campaigner Margaret Ridley agreed: “We do have to ask the question. Surely with so many new towns popping up in the Huntingdon region and the population set to grow – now is not the time to be cutting NHS services at Hinchingbrooke. Is it?”

If you are worried too write to the County Council Health Board. Find out what they are doing about protecting our hospitals. You could even join members attending the meetings

The link to meeting info: Health & Wellbeing Board Meetings

At their first Auutmn meeting members of Hands Off Hinchingbrooke voted unanimously to continue monitoring the situation not only in Huntingdon but across the county as the cuts and closures begin to impact this winter.

Having attended Clinical Commissioning Group meetings, Health Scrutiny Committee and various other meetings over the summer, the group are under no illusion that services will be changed as they have been in other areas of East Anglia and nationwide.

The campaigners have decided it’s their duty to talk to local councils, MPs and NHS staff to find out more about the status of the 24 A&E Dept and changes to the entire hospital if it is downgraded.

Particular concerns were

• the lack of mental health facilities in Huntingdonshire even though Cambridgeshire and Peterborough Clinical Commissioning Group say that mental health is a priority
• little or no evidence of more community nursing teams that are supposed to be created for the “care closer to home” policy outlined in the Sustainability and Transformation Plan (STP) proposals

and, perhaps most worrying of all, is that the final STP, complete with details of cuts, changes to wards and workforce, still has not been published for the public. Why not?

Hands Off Hinchingbrooke are making direct enquiries to find out more and are urging the public to contact them if they experience changes to services at Hinchingbrooke and across the region.

Secretary, Lorna Mansbridge said: “The campaign team decided we would continue to fight to save NHS services for Huntingdonshire. Everything is subject to the county wide STP and also instructions from NHS England. We know from other campaigners around the country that NHS England wants to shrink services and our county will not be allowed to have 3 blue-light A&E departments. We have at least three new towns being built in the region and the idea of closing or reducing emergency services is absurd, not to say dangerous.”

Hands Off Hinchingbrooke members all agreed that it was very likely that Cambridgeshire would begin to see alarming changes this autumn and winter as NHS England deadlines to finalise hospital reconfigurations and changes to health service structures came closer.

Currently NHSE is demanding that the STP find £504million in what it calls “efficiency savings” and what Hands Off Hinchingbrooke call “excessive cuts”.

For more information about the status of the NHS in Cambridgeshire contact:

Cambs and Pboro CCG

Cambs County Council Health Board

Cambridgeshire Combined Authority

To make your views known contact Healthwatch

Hands off Hinchingbrooke are looking forward to their first Autumn meeting at the Community Church in Huntingdon on Wednesday Sept 13th at 7pm.

Earlier this year the group asked the question about the Hinchingbrooke/Peterborough merger:  “Is it a merger or an acquisition?”. It is clear that it is a reconfiguration that will have an affect. It has been a summer of reflection and talking to local people and NHS Staff about the changes taking place not only at Hinchingbrooke but across the county as a whole.

Members have also been in touch with campaigners across the country through Health Campaigns Together and believe that this winter will see unprecedented cuts and restrictions to services that will affect the Huntingdon Community directly and also those living in the more rural areas of Cambridgeshire.

For more information about the meeting contact the group by email.

Merger or Takeover?