NHS market rent demand threatens the future of Brent Advocacy Concern

I asked to speak at the Brent Health and Wellbeing Board  yesterday on behalf of Brent Advocacy Concern who were at another meeting, as were Cllr Butt, Leader of the Council and Cllr McLennan, Deputy Leader.

Chair Cllr Hirani, who has the discretion to allow speakers, refused my request on the ground that I had not given 24 hours notice.

My request was in response to a request from Brent Advocacy Concern, a 25 year old charity in Brent, who work with people with disabilities.

NHS England, through NHS Estates, are now charging 'market' rents on spaces in their property and this is impacting on many charities and voluntary organisations who work on health issues.  As the STP proposals involve working in 'Hubs' bringing together different services, including voluntary organisations, this is clearly an issue.

You cannot have a policy of working with voluntary organisations and then pricing them out.  This impacts on the whole strategy of prevention and out of hospital care.

Brent Advocacy Concern received a letter from NHS England on January 11th, which had been sent to all Clinical Commissioning Groups, including Brent, about the move towards market rents.

John Healy of BAC wrote to me:

In order to stay in our office we know that we will have to pay 'rent' on the space. We will also be required to pay for 'capital costs'. Then comes the 'services charges'. Followed by the 10% Management fee. And finally  another 5% Management fee towards the overall lease. There may be other charges such as VAT but as a charity we might be exempt.

I cannot make it myself tonight, as I am booked for a council meeting at the same time.
Anyway, we will have been providing services in Brent continuously for over 25 years (we became a registered charity in Jan. 1991) but we will have to close down as soon as the NHS ASKS FOR THE MONEY.  So far they have not told us anything but I am expecting 'the bad news' anytime soon.

Maybe you or someone could ask a question as to what help might be offered to help small charities to stay within NHS properties such as The Willesden Centre for Health & Care.

That was the question I wanted to ask as it clearly affects more than just Brent Advocacy Concern. The organisation contacted Brent Healthwatch after the publication of an article outlining their situation on this blog LINK but received no response.  I spoke to Healthwatch at the meeting and gave them more details and hope that this results in some action, or at least a recognition of the problem.

John Healy added today (Wednesday):

At the last Community &Wellbeing Scrutiny Committee meeting on the 23rd of November, 2016 it was resolved that:-

(1) "Brent CCG together with NHS Property Services Ltd. develop 'a social value' policy detailing how to maximise use of void space in NHS buildings by the voluntary sector" Agenda item 5, 'NHS Estate in Brent'.

A RESOURCE THEY MIGHT FIND USEFUL CAN BE FOUND AT:-

How to keep it local--- A 5 step guide for councillors & commissioners.  It covers The Social Value Act

and it can be obtained from

Locality.org.uk

Vital public meeting on changes in GP Practices - Thursday December 1st

 From Brent Patient Voice

From cottage industry to the new world of Brent’s Accountable Care Partnership: Our GP Practices are destined for change

We look forward to seeing you at the Learie Constantine Centre, Dudden Hill Lane, NW10 2ET on Thursday 1st December from 6.45 onwards.

While commentators and the media are just waking up to the fact that the emerging NHS Sustainability and Transformation Plans are a cloak for massive and damaging cuts to services, we in BPV are attempting to shed some light on the plans for transforming General Practice.

Hence the title of our event is “From cottage industry to the new world of Brent’s Accountable Care Partnership: Our GP Practices are destined for change.” Our speaker, Dr Julia Simon, has recently left NHS England and thus is specially qualified to give an insider’s perspective on The NHS Five Year Forward View and the reasons why it promotes Accountable Care Partnerships.

What concerns us most is the NHS’s failure to explain properly what the changes to General Practice they envisage really mean so that the public and indeed doctors themselves can debate the pros and cons.

All this, of course, is against the background of the Chancellor declining to put more money into the NHS and social care when the leadership and the experts are pointing out that shortages of money and qualified staff mean it cannot deliver the service required for very much longer.

Health Partners Forum on Wednesday will discuss Brent STP

The STP is going to NHS England on Friday!

Brent hospital proposals must come under intense scrutiny on Thursday

Days after NHS England announced an inquiry into why waiting times at Ealing Hospital and Northwick Park A&Es have the longest waiting times in the country, LINK, Brent's Scrutiny Committee on Thursday will be examining several important aspects of local health care.

Representatives of the North west London NHS Hospital Trust will be questioned about progress on the recommendations of the Care Quality Commission's (CQC) critical  report on Northwick Park Hospital.

The report LINK sets out the issues to be examined clearly:

CQC made specific recommendations for improvement at Northwick Park Hospital concerning A&E and related services. These are set out below:-

• Ensure that there are appropriate numbers of staff to meet the needs of patients in the A&E department, surgical areas and critical care.

• Ensure that there are systems in place to assess and monitor the quality of services provided in A&E, critical care, surgery and maternity to ensure that services are safe and benchmarked against national standards.

•Review the coping strategies within A&E during periods of excessive demand for services.

•Empower senior staff to make changes to ensure that patients are safe in A&E in maternity.

•Review discharge arrangements in A&E and critical care to avoid re-admission to these areas.

Given the significant number of areas requiring improvement in the current A&E provision at Northwick Park Hospital reassurance is sought from the senior management concerning implementation of actions and the safety of the A&E services available to Brent residents.

Another area to be examined is the proposals from Shaping a Healthier Future and Brent NHS to close maternity and other associated services at Ealing Hospital. 

The committee is recommended to question representatives of the Brent Clinical Commissioning Group on:-

•the robustness of their modelling assumptions and assurance plan;

•the timescale for their implementation; and

•what contingency plans are in place in case any of the proposals turn out not to be possible or feasible

A puzzling aspect of the report LINK is the timing. This meeting is on November 26th and it looks as if key decisions on this issue are actually to be made by the CCGs on the same day:

The next stage of reconfiguration is the changes to maternity services and the inter dependent services at Ealing Hospital. Brent Clinical Commissioning Group is due to make a decision on delegating the decision on timing to Ealing Clinical Commissioning Group, along with the other CCGs across North West London, on 26thNovember 2014. Ealing Clinical Commissioning Group is due to make a decision on the timings of changes to maternity services, and the interdependent services at Ealing Hospital on 26^th November 2014.

One can only wonder if what the Scrutiny Committee thinks will have any impact given this timetable.

The report's authors reach a soothing conclusion:

The impact on Brent residents and NHS services of changes to maternity and inter-dependent services at Ealing Hospital is not expected to be significant. Local services have the capacity to receive additional activity from Ealing without causing a negative impact on accessibility for Brent residents

The final health report to be considered is on the future use of the Central Middlesex Hospital site LINK. Current proposals are:

•An elective orthopaedic centre.

•Mental Health inpatient facility relocated from the site at Park Royal.

•A GP and primary care ‘hub’.

•A Genetics laboratory relocated from Northwick Park Hospital.

•Relocation of rehabilitation beds currently at Willesden.

This is a crowded agenda with lots of 'suits' from Brent NHS Health, the Clinical Commissioning Group abd Shaping a Healthier Future attending.  At previous meetings the chair has seemed irritated by the searching questions posed by Cllr Mary Daly and tried to hurry through proceedings with so many of the scrutinised wanting to speak.

In fact Daly's interventions seemed based on the fact that, unusually, she is a councillor who has done her homework as well as being someone passionately committed to the health of local residents.

I hope that at this meeting, however inconvenient, she gets a fair hearing. I also hope, for the sake of the public, microphones are installed to get over the acoustic problem in the committee rooms as well as the suits' mumbling.

If all that Health material is not another there is a major and very interesting report  LINK by a Task Group on the Agenda.The Task Group, chaired by Cllr Neil Nerva, looked at promoting electoral engagement following the introduction of Individual Electoral Registration and is packed with information and ideas. The most innovative of which is the involvement of the campaign group Hope Not Hate.

Once again such a crowded and complex agenda raises the issue of the wisdom of reducing Brent Council's scrutiny committee to just one. This was a hasty decision made at the beginning of the administration with no prior consultation which took many Labour councillors by surprise.

These are decisions about vital issues, at the extreme perhaps a matter of life or death, and must have proper scrutiny.