Tuesday 4 October 2016

'Appalling' Brent STP engagement meeting short on detail and understanding

From the official video LINK

The following item is published with the permission of Eric Leach who publishes an occasional Newsletter  researched, written and edited by a group of concerned residents in Ealing, West London who want to preserve our NHS. 

This is his account account of the recent Brent 'engagement' event on theSTP (Sustainability and Transformation Plan) LINK  LINK

Appalling STP Public Meeting in Brent on 26 September 2016

I attended this STP public meeting which was organised by Brent Council and Brent Clinical Commissioning Group (CCG). Two of the five North West London ‘Footprint’ bosses spoke at the meeting. They were Carolyn Downs, Chief Executive of Brent Council and Local Authority STP lead in NW London, and ex-advertising executive Rob Larkman who is Chief Officer for Brent, Harrow and Hillingdon CCGs.

The STP aspirations were summarized as closing the ‘gaps’ in health and wellbeing, care and quality, and finance and efficiency. Ways to close these gaps will be prevention, self-help, more home care and less hospital care. Also care for those with long term conditions, and for old and mentally ill people would be improved.

What was sadly missing in the presentations was detail on:
+ The Brent STP
+ How the Brent STP relates to the NW London STP
+ Five years of cost cutting
+ Loss of 500+ beds
+ Changes to access to GPs
+ How integrating healthcare and social care will be implemented
+ Seven day working
+ Care staffing levels
+ Any mention of Accountable Care Partnerships (ACPs) – the future delivery vehicle for all care services and cost cutting
+ Evidence to support the STP.

No-one will ever argue with efforts to improve healthcare and social care. However it’s quite clear that many who spoke in the audience had serious doubts as to whether the money, staff and facilities would be available to make improvements.

Carolyn Downs seemed surprisingly ignorant about the national STP dimension. She stated that just two STPs out of 44 nationally had been published. In fact seven regional STPs have been published. It was news to me that when the initial STP submission was made by NW London each of the eight CCGs/Local Authorities submitted their own STPs. Given that Ealing and Hammersmith & Fulham Councils failed to sign up to the NWL STP, one could only wonder at the time what these local STPs actually contained. 

In the Q&A the issue of ACPs was raised twice. Rob Larkman gave hopeless answers to the questions. In his answers he failed to explain the nature of ACPs and refused to identify their supreme importance for care service delivery in the future.When asked about capitated budgets for ACPs he just waffled. One wonders whether he was genuinely ignorant about the ACP details or he was being deliberately economical with the truth.

Doctor Kong, a GP from Harlesden, was on the panel. She is Chair of Brent CCG. She repeatedly gave her spirited opinion that healthcare and social care would become integrated because everyone was so committed to make it happen. An ex-Brent Councillor in the audience said that in the 1980s we were all committed to make healthcare and social care work together. But commitment was not enough to bring about improvements then and she doubted it would be in the future. She also said that getting people to do what they were supposed to do has always been a problem. She asked how the performance of the new services would be monitored. This question was bizarrely (not) answered by a diatribe on the STP community engagement strategy!

Questions were asked about social care costings, delivering out of hospital services and improved provisions for respite for carers - but no clear answers emerged. This meeting was described as ‘community engagement’. How such a label could be attached to this event is baffling – given that the draft Brent STP was delivered to NHSE on or before 30 June 2016.

This occasional newsletter is researched, written and edited by a group of concerned residents in Ealing, West London who want to preserve our NHS. We view the wholesale engagement of private, for-profit healthcare service suppliers as unnecessary, profligate and dangerous. Process improvement is what is needed in our NHS – not revolution.


Nan. said...

There is a good reason why the Department of Health is encouraging the NHS world to now refer to the 'Sustainability and Transformation Plans' as 'local health and care plans'.

STPs are cuts dressed up - simple as that.

Nan. said...

Might we have hoped our elected councillors would have picked up on all the public concerns expressed at the public meeting and taken the opportunity to raise them at the Health and Well-being Board meeting last night?

Hope in vain then, because the meeting was over in short order.

No incisive questions on the progress of STP's from our feeble spokespersons - probably too busy fighting among themselves and plotting their onward career paths.

These people are not only elected, they are also PAID to represent us and they have actual responsibility for our health & social care services. Not that you'd ever know it.

Carolyn Downs, chief exec provided an opening by asking whether there was any evidence of ACP's saving money. (Never been tested in this country so we only have the American experience to go on).
Suffice it to say, elected, paid reps failed to pick up the ball and run with it.