CWS survey is a must-do

16 Oct

Apologies for the long absence. Stuff happens!

Here’s a link to a survey launched by Coastal West Sussex CCG which will no doubt play a key part in informing decisions about health services in our area. Please fill it in and pass on the word.


Good news finally on MSK

1 Jul

Congratulations are in order. Commissioners in Coastal West Sussex have confirmed that musculoskeletal services (MSK) are staying with the local hospitals trust, after a turbulent and costly procurement exercise.

Western Sussex Hospitals NHS FT will become the MSK prime provider following an exhaustive renegotiation with commissioners. A statement from the CWS said commissioners “will now enter a period of close and intensive working with WSHFT to agree the detailed provisions of the service and a sustainable timetable to introduce improvements for patients. This builds on discussions with our providers and the public on the preferred service model.”

We hope and expect to see future MSK services which are more appropriate to each patient, more responsive, better managed, and delivered by professionals working for the NHS.


DWP renews attack on disabled people

11 May

The DWP is poised to cut the disabled access to work scheme that helps cover the cost of making proper provision for people with disabilities at work.

The biggest users of this fund are people who have difficulty seeing and people who have difficulty hearing, says Leanne Clifford who has launched a petition on Change Org.

In her petition to David Cameron she writes: “By cutting this fund you will be stopping many disabled people from being able to find and stay in a job which will mean they will be forced to stay on benefits which is against your ideals. If a disabled person wants to work then you should encourage them and assist them, not actively cut a grant which helps them get a job.”

Harness block ‘sold off’ at Southlands

30 Mar

A very good source informs us that the deed is done: the long-neglected Harness block has been sold off by Western Sussex Hospitals Foundation Trust. The building at Southlands Hospital, Shoreham, had been run down systematically since the reverse takeover by Chichester hospital.

No details are available yet but you can be certain that the site will not be used for the affordable social housing that the area needs so desperately.

The trust has publicly committed to upgrading what remains of Southlands, with a new ‘state of the art’ ophthalmology unit in addition to the much-used physiotherapy and day surgery units on site.

We have no clear timetable for any of this.


MSK: the TTIP of the iceberg…

16 Mar

A long-standing aim of this site is to help join up the dots in health and social care policy developments, so that we can all see what is happening – and how we can hope to stop it.

Difficult at the best of times when so much is being unpicked at such a rapid pace in public services.

Help is at hand: Worthing Trades Union Council is organising an event this Thursday which will examine one of the high-level threats to public services as we know them: the Transatlantic Trade and Investment Partnership, TTIP for short.

In a (rough) nutshell the TTIP talks going on right now between the EU and the US could leave future UK governments exposed to costly legal action from foreign ‘investors’ should they feel excluded from delivering public services in a future outsourced world.

This has resonance for us in Coastal West Sussex. Under TTIP the MSK debacle could have been very different. So a public service like Western Sussex Hospitals FT would be unsustainable if key services were taken away? Not the point!

Market competition is the only principle that informs this government’s stance on public services, and it refuses to intervene in any positive way on the TTIP negotiations.

Despite the fact that the market is failing in so many ways in public services, and social care is where we find the evidence of that. In West Sussex we have six care homes declaring that they will not provide places for council-funded residents any longer. They’re not getting enough to make ends meet, they say.

Bupa (again) closed its care home in the north of the county rather than putting in the right management to turn it around after residents suffered appalling indignities which neither the council nor the Care Quality Commission could stop.

Have a look at a recent SHA article which provides a good overview about the state of public tendering in the UK today. And why TTIP matters.

Western Sussex back at negotiations table on MSK

26 Feb

The botched exercise to tender out musculoskeletal (MSK) services in Coastal West Sussex has been cancelled — for now. Existing contracts with Western Sussex Hospitals trust and other NHS providers have been extended for another seven months, to September 30.

But the CWS CCG makes clear that is keeping all of its options open. “We will begin discussions with current providers of MSK services as our preferred approach,” said Chief Clinical Officer Katie Armstrong.

The CCG is sticking to its guns on the need to redesign the way MSK services are delivered (as well as setting new thresholds for patients accessing medical treatment). The decision to halt the existing procurement process does not impact on the CCG’s desire to introduce the new service.

“The MSK service model was designed by clinicians and patients and is a strong and well-supported model,” said Katie Armstrong, repeating the message she gave campaigners at an MSK workshop recently.

This is not a Damascene moment. The commissioners have told us often enough that  market competition has a part to play in driving change in our NHS. In effect the commissioners are buying time: Two years after they decided to stop negotiations with WSHFT. Katie Armstrong stresses in her statement that the existing procurement process has been withdrawn.

The commissioners were forced to confront the fact that contracting out would have a major impact on trauma and other hospital services. BupaCSH pulled out as preferred bidder in January after the CCG and WSHFT spent £130,000 on an independent impact assessment focusing on just those issues.

So let’s welcome the decision by the commission’s executive body — and look forward to seeing the minutes of their meetings published in future (another victory for transparency). But remember there is an election looming. After that, who knows….



MSK outsourcing: the motive that dare not speak its name?

11 Feb

This Thursday campaigners and interested members of the Coastal West Sussex public will be taking part in a vital conversation about musculoskeletal (MSK) services in the area: What next?

The clinical commissioning group (CCG) is calling together everyone who’s expressed concern over the attempt to outsource the whole MSK service, posing a demonstrable risk to remaining services (and finances) of the Western Sussex Hospitals FT. Contract negotiations collapsed after the private consortium BupaCSH walked away in January.

There will be a lot of questions raised tomorrow about governance and transparency — there HAS to be. And we can expect the CCG to be challenged again over its assertion that it had no option but to put the service out to tender — something that could have been tested legally at the time, but sadly wasn’t.

The CCG has paved the way for tomorrow’s consultation workshop with a set of well-packaged arguments about the need for change and to improve services which of course is beyond doubt: there is always room for change and of course everyone will sign up to joining up services around the patient. (See the CCG’s latest statement about MSK services here.)

But we remain more than a little troubled about the decision to take services out of the hands of the NHS provider and hand the controls over to a company with no experience of delivering services of this scale in this area. A company which of course would have no qualms about managing a new system designed to restrict patient access to NHS services.

To explain: we asked the people who run the CCG’s back office various Freedom of Information questions at the start of the year. We wanted to know how much the impact assessment by PWC had cost so far. (Answer is £130,000, split jointly between the CCG and the WSHFT.)

We then asked how the CCG had weighed the benefits of the exercise against the obvious costs — because putting something out to tender on this scale costs a lot in management time and money.

The commissioning support unit replied with an excerpt from the financial analysis discussed by the executive of the CCG in 2013.

The only focus here is on the implementation of new pathways to bring about savings. The document sent to us says: “To make the predicted 2013/14 savings target of £2.8m the pathways described below need to be finalised and implemented. Development of these new evidence based pathways has been clinically led and implementation of some of these pathways is already underway. Clinicians from WSHT and SCT met with the clinical lead for MSK to agree the way forward for carpal tunnel, foot procedures and knee arthroscopies, however, delays have occurred in the agreement of revised hip and knee replacement thresholds.

“Whilst the savings targets have been developed in line with benchmarking, the evidence for the thresholds for hip and knee replacements is equivocal and will need to be developed further with our providers before implementation. The pathways for arthroscopies have already been implemented and the carpal tunnel pathway is in its final stages of clinical development. Implementation of these changes will reduce acute activity supporting the achievement of the 18 week RTT targets. The full year effect of these changes will make £5.3m savings for 2014/15.”

Is THIS the motive that dare not speak its name? Were the clinicians at WSHFT equivocating rather too much? Was it just easier to hand the whole thing over to BupaCSH and get them to deliver the £5.3m savings?

Answers on Thursday please!