AT Medics re Operose and Centene takeover: 'We can't see how we can get this wrong'

 

NHS North West London CCG: W2U3Z (former CCGs: NHS Brent CCG, NHS Central London (Westminster) CCG, NHS Ealing CCG, NHS Hammersmith and Fulham CCG, NHS Harrow CCG, NHS Hillingdon CCG, NHS Hounslow CCG and NHS West London CCG) last week so that patients groups, councillors and the public could ask about the recent takeover of Burnley and Wembley GP practices by Operose Health and Centene.

Much of the meeting was taken up by a slide show from Operose and AT Medics.  The meeting was told that AT Medics had been started by 6 GPs who were all from a 'deprived background' and wished to 'give something back.' They had started with one practice but through 'process design' had grown to 47 practices across London. They run 6 vaccination sites across London which focus on hard to reach groups.

Answering questions from Brent Patient Voice they gave assurances that they did not share data for marketing purposes or without the permission of patients (caveats around care home patients  and medical emergencies),  They said that they could not extend Burnley Practice opening hours because they were  limited by their contract with the NHS, addressed criticism of health questions being asked by non-medically qualified staff at triage, promised improvements in patient access via IT when the surgery is closed and the ordering of prescriptions via the surgery App.

Robin Sharp of  got down to the nitty gritty to ask why AT Medics had approached Operose as a partner. He was told that the GPs were not business people and needed support for management  and governance and access to resources. The model they had been working with was not sustainable at the scale they had reached. They needed the skills, leadership and resources that 'like-minded' Operose offered.

AT Medics said that it was early days of the new arrangement, a honeymoon period, and doubtless there would be bumps in the road, but they were getting on well.

Cllr Gaynor Lloyd wanted more information on the claimed advantages of Centene's international links and the dependence of Operose on Centene's income. Operose itself  was loss-making and had AT Medics looked at Centene's exit from practices not making a profit? 

Mohammed Tahir replying said that there were multiple aspects to the issue. They had engaged with Centene and found them very different: 'We believe in them. We are successful and we can't see how we can get this wrong. We just needed the organisational back-up. All contracts were won on a competitive basis. As long as we are the people concerned we will be part of the NHS culture.'

On consultation with patients, AT Medics said no formal consultation was required as there was no change in the service offered but there had been a dialogue. On services that had closed Camden Road building lease had expired and no replacement building was available and a Child & Adolescent Mental Health Service provision had been found to be unustainable. 

AT Medics said that they were regulated by the Clinical Commissioning Group and like all NHS services were free at the point of delivery and were committed to increasing public access. They would always work with strategic NHS objectives and prioritised working with Primary Care Network. 

Robin Sharp felt some of the answers had been inadequate and people were still interested in why the takeover had taken place and wanted to know what Centene's intentions were.

Cllr Lloyd wanted to know about Population Health Management and if Operose was a joint data operator with AT Medic - if so could data be sent to the US?  AT Medics replied giving the example of data on diabetes checks where analysis was used to see how many patients had not had the 8 checks required and needed following up. They trained staff in how to use Population Health management as an approach.

Cllr Johnson asked AT Medics how many other providers they had approached but was told that the information was commercially sensitive and confidential.

Brent TUC Events this week: Take the Knee - Willesden Green May 25th, Stop GP Privatisation May 26th

 From Brent Trades Union Council

25th May is the first anniversary of the murder of George Floyd and the start of the Black Lives Matter protests.

 

This year, the TUC and Stand Up To Racism started a week of action on May 17 to mark the  anniversary of the murder of George Floyd with on-line meetings, 'Take the Knee' events and also requests for Town Halls and other public buildings to be lit on the 25th May.

 

TAKE THE KNEE AT WILLESDEN GREEN

 

Also, in line with many other places, we will be holding a socially distanced and covid secure event of 'Taking the Knee', outside WILLESDEN GREEN STATION on Tuesday, 25 May. AT 5.30pm.

 

We hope Black Lives Matter West London will  support the event and deliver a short speech.

 

Other speakers welcome.

 

 26 th May 

Stop our GP practices being sold off to Centene USA

 

                    

Johnbosco Lwongo from We Own It and Jonathan Fluxman from Doctors in Unite will outline next steps in building a Brent Campaign. Your contribution to this discussion will be valued.

                               Join Zoom Meeting HERE

 

Man charged with the murder of missing Agnes Akom

 

 Agnes (Dora) Akom

From Metropolitan Police

20-year-old Agnes Akom, who was also known as Dora and who moved to London from Hungary three years ago, was last seen in Cricklewood Broadway on Sunday, 9 May.

She was reported missing two days later and an investigation was launched.

Neculai Paizan, 63 (11.11.57) was arrested on Tuesday, 18May in connection with Agnes’ disappearance.

On the evening of Sunday, 23 May, he was charged with her murder.

He will appear at Willesden Magistrates’ Court on Monday, 24 May.

Agnes’ body has not yet been found. Detectives are still pursuing all possible lines of enquiry and are appealing for the public to come forward if they see or have seen anything suspicious that they feel may be relevant.

HS2 vent next to South Kilburn primary school at Planning Committee tomorrow but its powers are limited

 

The development site outlined in red, school grounds in green and Canterbury House and Carlton House

A battle started about 6 years ago when Brent Council asked HS2 to site a proposed vent site for the high speed rail running underground at this point at a site next to a primary school in South Kilburn rather than one adjacent to Queens Park station.

In a  message to constituents, March 23^rd 2016,  Tulip Siddiq MP said:

Today in Parliament, I voted against the High Speed Rail 2 (HS2) Bill that will devastate areas of Camden and Brent.

I have campaigned against HS2 for the past seven years as I believe it is an ill-thought out scheme that will lead to bedlam on our roads, disruption to the education of school children and a compromised local environment. (my emphasis)

Further, these plans will cost taxpayers billions of pounds. I believe this money could instead be spent on projects that will actually bring real improvements to living standards across the country.

Having spoken against this Bill at the Select Committee, and again in today’s debate, I’d like to take this opportunity to thank residents who engaged with the lengthy and costly petition process. Though the Bill received support from across Parliament, it is your voice that will force HS2 to fulfil its assurances to compensate and mitigate the worst of the impacts.

My first priority as the MP for Hampstead and Kilburn is to protect residents in Camden and Brent. Therefore, I am proud to have voted against High Speed Rail 2 today in Parliament.

The scheme have now been granted permission by parliament, but I will keep fighting for mitigation for constituents.

Of course HS2 has gone ahead costing billions of pounds more than first suggested but for South Kilburn residents the question is still whether on South Kilburn the proposed vent will 'lead to bedlam on our roads, disruption to the education of school children and a compromised local environment.'

Unfortunately as officers note the legislation gives HS2 enormous powers and limits that of the Planning Committee:

The above mentioned approvals have been carefully defined to provide an appropriate level of local planning control over the works while not unduly delaying or adding cost to the project. As such the legislation states that planning authorities should not through the exercise of the Schedule seek to revisit matters settled through the parliamentary process, seek to extend or alter the scope of the project, modify or replicate controls already in place, either specific to HS2 Phase One such as the EnvironmentalMinimum Requirements, or existing legislation such as the Control of Pollution Act or the regulatory requirements that apply to railways.

 

For residents the immediate issue will be noise from the site and associated vehicle movements with extensive ground works required. These issues are not the subject of the report:

Mitigation includes a small strip of grass to be made available to St Mary's Primary School, walls and fencing around the perimeter of the site and  the widening of the cross-over with Canterbury Road from 3 metres to 6 metres.

There is only one objection recorded on the Brent Council Planning Portal froma resident of Canterbury House:

The current design is radically different from the original proposal. There are more buildings and the design height is much greater; the original proposal included the extraction fans installed underground but the revised plans are far more intrusive on residents neighbouring the development. The current proposed height of the headhouse building will have a major impact on natural light and views available to the properties at the rear of Canterbury House. Residents of Canterbury House bought their properties with knowledge of the original plans but there are deep concerns that the revised plans could significantly deter potential future buyers. If the first plan to construct the vents at Queens Park was withdrawn due to resident objections, why has the design at Canterbury Works revised in such a way that the impact on nearby residents will be significant and possibly more so than what was proposed at Queens Park. 

Planning officers say:

The committee report states at paragraph 16 that there would be no breach of the 30 degree rule when considered in relation to Canterbury Terrace. However, there would be a slight breach of the 30-degree rule from two of the ground floor units due to the greater height of the ventilation stacks which sit adjacent these homes. However, given the separation distance (approximately 18 m) and the fact that a daylight/sunlight report has been submitted to demonstrate that there would be no harmful loss of light, the breach is considered acceptable in this instance. It is also important to note that the Design and Access Statement confirms that the vertical ventilation stacks have been reduced in size to the minimum required in both plan dimensions and height. Therefore when having regard to the fact that the LPA are required to given consideration to whether the works 'ought to or could reasonably' be modified to protect local amenity, given the information provided the arrangement is considered acceptable.

A supplementary report responds to a late comment:

Since the publication of the agenda one further comment has been received in relation to the application. This comment raises concerns about a lack of mitigation or compensation for protecting or safeguarding South Kilburn's residents' quality of life. It also makes reference to the new tree planting HS2 are doing in the Chilterns and the lack of any similar mitigation for Brent. The potential impacts on surrounding properties is discussed within the committee report.

Firstly, it is important to note that HS2 works in South Kilburn and the Chilterns are very different. It is also important to note that the character of the areas differ greatly with South Kilburn being a far more urban environment. As this is not a planning application, the Local Planning Authority are unable to seek obligations to secure funding for tree planting in the area.

However, whilst the committee report focuses on the works for approval, the submission does include a number of 'For information' drawings to show future intentions of the site. As stated in the committee report a follow up application for 'Bringing into use' is required to be submitted, whereby HS2 are required to demonstrate that the impact of the development has been mitigated as far as possible. This is expected to include a detailed landscaping and tree planting scheme on site and the provision of a 'pocket park' to provide educational opportunities to neighbouring St Mary's PrimarySchool. However, it important to note that these works are not for approval under this application.

 

 

 

Brent among 4 NW London areas targeted for PCR testing for B.1.6172.2 (Indian) Covid-19 variant, Government announces, following confirmed cases

 From Government Website

Additional coronavirus (COVID-19) PCR testing is to begin in the coming days in targeted settings and postcodes within Harrow, Ealing, Hillingdon and Brent.

 

Surge testing will start from today (Saturday 22 May) in some areas following the identification of confirmed cases of the B.1.617.2 variant, first identified in India. 

 

The cases have been instructed to self-isolate and their contacts are being identified.

 

Working in partnership with the local authorities, NHS Test and Trace is providing additional testing and genomic sequencing in education settings and targeted areas across the 4 boroughs. Testing will be deployed in different ways in each borough in order to meet local needs. Local authorities will shortly confirm the areas where additional testing will be offered in their boroughs, and reach out directly to residents to ensure people come forward for testing to stop the spread of the virus.

 

Everyone who lives, works or studies in the targeted areas and settings, including children, are being strongly encouraged to take a COVID-19 polymerase chain reaction (PCR) test, whether they are showing symptoms or not. By using PCR testing, positive results can be sent for genomic sequencing at specialist laboratories, helping us to identify variant of concern (VOC) cases and their spread.

 

If you have symptoms you should book a free test online or by phone so you can be tested at a testing site or have a testing kit sent to your home. If you have no symptoms, you should visit your local council’s website for more information.

 

In tandem with increased testing, enhanced contact tracing will be used for individuals testing positive with a VOC. This is where contact tracers look back over an extended period to determine the route of transmission.

 

People across the country are encouraged to take up the offer of twice-weekly free rapid testing, alongside the PCR test as part of surge testing.

 

The government and its scientific experts are monitoring the evolving situation and rates of variants closely, and will not hesitate to take additional action as necessary.

 

Appointments for a second COVID-19 vaccine dose will be brought forward from 12 to 8 weeks for the remaining people in the top 9 priority groups who have yet to receive their second dose. This is to ensure people across the UK have the strongest possible protection from the virus at an earlier opportunity.

 

The move follows updated advice from the independent experts at the Joint Committee on Vaccination and Immunisation (JCVI), which has considered the latest available evidence and has recommended reducing the dosing interval.

UPDATED WITH BRENT CEO'S RESPONSE: Bobby Moore Bridge “footballers” mural – we need this dispute resolved!

 Guest post by Philip Grant in personal capacity

 SEE UPDATE AT FOOT OF THIS ARTICLE

 

As you had not seen yet another “guest blog” by me on the “footballers” tile mural since 13 April, when I set out the reasons that Quintain does not have consent to cover it with adverts and asked “Why won’t Brent concede?”, you may have hoped that this question had been settled by now. I’d hoped that as well!

 

The “footballers” mural in the Bobby Moore Bridge subway at Wembley Park.

 

Unfortunately, Brent Council Officers don’t want to “play ball”, and get this issue properly resolved. It seems they would prefer to “kick it into the long grass”, so that Quintain and its Wembley Park subsidiary can continue to claim they are “entitled” to cover over this heritage asset and public artwork with adverts for big events at Wembley Stadium, starting with the Euros football tournament next month.

 

It should be unthinkable for this mural, showing England footballers playing at the old “twin towers” Wembley, to be hidden away behind advertising material when fans are going to the stadium to watch their team play. The adverts would also cover-up the plaque which shows they are walking through a structure dedicated ‘in honour of a football legend’. Even if you are not a football fan, I hope you would agree it would be wrong for any adverts to be placed there unlawfully, and that is what I believe would be the case.

 

The plaque in the centre of the “footballers” tile mural.

 

After I had sent the detailed reasons why Quintain did not have advertisement consent for this mural to Brent’s Legal Director and Chief Executive on 9 April, I had expected either to receive their agreement, or their counter argument. Instead, this is the full text of the email I received on 16 April from Debra Norman:

 

‘A substantial amount of council resource has been devoted to considering the concerns you have raised, including taking external legal advice.  I am afraid we are now at the stage where it’s not reasonable continue with correspondence about this matter upon which it is clear the council is not in a position to agree your view or take the action you wish.’

 

Because this matter does need to be resolved, I believe it was reasonable to continue! I wrote to Carolyn Downs, asking her to let me know the reasons why the Council did not “agree my view”, and making clear that if they had a stronger case than the one I had put forward, I would accept it. 

 

I will not accept the outcome that Council Officers want to impose without the evidence to back it up. I know, from past experience, that the Council will never share a copy of the ‘external legal advice’ they have received. But as they told me the QC’s advice ‘aligned with’ the view they’d already taken, surely they could share that view with me?

 

What I asked for was: ‘the substance of the reasoning for your view that the 2017 advertisement consent still applies to the "footballers" mural, and the documentary evidence on which that reasoning is based.’ The answer I finally received from Brent’s Chief Executive, on 19 May, was:

 

‘I have taken further legal advice on sharing our QC advice and have been advised not to so do.’

 

I don’t think it is fair or open for senior Council Officers to refuse to give their reasons for the view they have taken on this important matter, and I have said so. I will ask Martin to attach the full text of the latest email exchanges, so that anyone who wishes to can read them and make their own judgement.

 

We are now less than three weeks away from the start of the Euros football tournament, so this dispute over advertisement consent does need to be resolved without further delay. As Council Officers are reluctant to settle the issue, I have taken the initiative and suggested that Brent Councillors could help to do that.

 

I decided to ask the Lead Member for Culture and Leisure if he would be willing to organise a small panel of councillors to arbitrate and decide, on the facts and evidence, whether or not Quintain has consent to put adverts over the “footballers” tile mural. Any decision would need to be binding on both myself and the Council, so I copied my email to the Chief Executive.

 

I approached Councillor Nerva as he had expressed an interest when I suggested, in early January, that the Cabinet should consider the option of only allowing advertising on the Bobby Moore Bridge parapets, not covering the murals on the subway walls, when the advertising lease came up for renewal in August 2021. (That was before it was disclosed that a VERY dodgy deal had been made by Council Officers in 2019, to extend the lease until August 2024!)

 

At the time of writing, I have not heard back from Councillor Nerva, but I will ask Martin to attach a copy of the text of my email, so that if you are interested you can see what I have suggested. You are welcome to add a comment below, if you wish to suggest any improvements to my proposals, or to share any better ideas on how this matter can be settled, quickly and fairly, and at minimal extra cost. 

 

Hopefully, either this way or another, we should be able to resolve this dispute. If I have to admit that my view was wrong, on the basis of the facts and evidence, I can accept that. 

 

But if I did not have confidence in the case I have already put forward, openly and transparently to Council Officers and my fellow Brent residents, I would not still be fighting to keep the “footballers” tile mural on permanent public display.

 

Philip Grant.

 

UPDATE- CAROLYN DOWNS' RESPONSE

Readers of this "guest blog" may be interested to know the latest developments, from this exchange of emails which took place this afternoon (24 May):

1. Dear Mr Grant 

Cllr Nerva has asked me to respond. 

Thanks for your suggestion of a way to resolve your outstanding issue. 

I am afraid that even if a panel of Councillors agreed with you it would not change the legal right for vinyl advertisements to be attached to the tiles over the football mural. 

I have mentioned before that the contract for advertising is due to be re-tendered later this year and in the meantime, Quintain have said that they will not advertise over it. 

Yours sincerely 

Carolyn Downs
Chief Executive
Brent Council

2. Dear Ms Downs,

Thank you for your email, in response to my suggestion to Cllr. Nerva last Friday that a panel of councillors could settle our (not my) outstanding dispute over advertisement consent by arbitration.

It would probably save a more detailed reply from me if you would clarify two points from the final sentence of your email, please, as quickly as possible.

You have said that 'the contract for advertising is due to be re-tendered later this year.' It was my understanding that the November 2019 Deed of Variation extended Wembley Park Ltd's advertising lease until August 2024. Would you explain, please, what the re-tendering will involve, and when this will happen.

You say that 'Quintain have said that they will not advertise over it.' Does that mean that Quintain have given a guarantee that no vinyl advertising sheets will be placed over the "footballers" tile mural? If so, I would welcome a copy of the communication confirming that, please.