We must act now to save our crisis-hit NHS from collapse

Sussex Defend the NHS says the time is right to reclaim the NHS for the public and put a stop to sweeping changes that have led to cuts and disruption.

Dr Carl Walker from the group said its members were feeling increasingly desperate about what was happening and warned there could be a serious impact on services in the future.

He said there were big concerns over the growing use of private companies to run health and care services and the introduction of new sustainability and transformation plans (STPs)could lead to future cuts.

STPs will see health and social care services across Sussex and East Surrey working on a five year plan showing how local services will evolve and become sustainable.

Dr Walker, a lecturer in psychology at the University of Brighton, said: "We have a lot of concerns about this because it will inevitably lead to the need to make savings.

"We already have a number of problems in Brighton and Hove and this will only add to it. There is no way the NHS will be able to survive as it is if further cuts are made."

The group is backed by unions and Brighton Pavilion MP Caroline Lucas.

It wants commissioners responsible for making sure the right health and care services are available to be open about their processes.

They must get to grips with developments and challenge changes being ordered by the Government, they say.

Brighton and Sussex University Hospitals NHS Trust, which runs the Royal Sussex County Hospital in Brighton and the Princess Royal in Haywards Heath is being placed in special measures after the Care Quality Commission branded it inadequate and six GP practices in the city have closed over a two year period, leaving thousands of patients forced to go elsewhere.

Thousands of people across Sussex also faced disruption and delays after private company Coperforma took over the running of county-wide patient transport services from South East Coast Ambulance in April this year.

Concerns have also been raised about moves to put some children’s community health services such as health visitors and school nurses out to tender.

NHS and other health and social care services locally and around the rest of the country are facing nursing and doctor shortages and cuts in funding, despite an increase in demand for services.

Dr Walker said: "This charter is about getting a bit of a dialogue going and helping people to become more aware about what is going on and making their views about it known."

Ms Lucas tabled the NHS Reinstatement Bill last year calling for a stop to the increasing privatisation of services and to return the NHS to its principles of being truly public and fully protected.

She said: “People deserve better than this - and I applaud Sussex Defend the NHS for taking action to save our vital services.

“I will be working with MPs from other parties to reverse the damaging marketisation and fragmentation of our health service and to urge the Government to give the NHS the funding it so desperately needs.”

Gary Palmer from the GMB union said: “I think Sussex Defend the NHS and the blue print they suggest make a lot of very valid points and arguments in relation to open and meaningful public consultation."

A spokeswoman for Brighton and Hove Clinical Commissioning Group said it had to follow set procurement processes.

She said plans were already under way to help health and local authority services, including social care, housing and education, come together to support people better.

The Brighton and Hove Caring Together project aims to set up small clusters of teams around the city to serve between 30,000 and 50,000 people and target services specifically for those areas.

This includes providing more facilities and help in the community to prevent people from having to be admitted to hospital.

ACTION GROUP LISTS ITS TOP 10 CHANGES NEEDED FOR STARTERS

SUSSEX Defend the NHS has come up with 10 points it says health commissioners should take on board so it can start to get to grips with the issues that have been affecting services locally and nationally.

1) Commissioning health services

Organisations responsible for making sure the right NHS and social care services are available in the city include the clinical commissioning group (CCG) and council.

They are responsible for developing contracts and tenders for those services, following national guidelines when they do so.

Defend the NHS says commissioners need to work harder to ensure the whole process is easily accessible and clear right from the start so people can respond and make their views known.

It says: “Be honest about the process – who writes the tender documents, why have they been written that way, what are you seeking to achieve with a tender, how can you guarantee that the public involvement actually matters? We should be able to see every decision, not as an obscure spreadsheet hidden away in the recesses of your website but as a clearly outlined process showing us how we can give our opinion on what we want.”

2) Full public accountability

Commissioners gauge public opinion on their plans through meetings, focus groups, scrutiny committees, online comments or through groups such as the watchdog Healthwatch, which acts as a voice for the public.

Sussex Defend the NHS says further engagement could be made by commissioners getting out and about more and helping to ensure people understand exactly what is going on and why.

It says: “When a few of us spend two hours on the street we manage to get hundreds of people to fill our petitions. Commissioners can do likewise and when you do so you will start to see how the people of Brighton and Hove feel.”

3) Let the Government know if commissioners are unhappy with what they are having to do

National guidelines say commissioners should consider putting new contracts for services out to tender, which means private companies can bid for them, something many people are unhappy about as they believe there should be greater investment in the NHS so it has enough staff and facilities to provide those services.

Sussex Defend the NHS says it is time for commissioners locally to be brave and make any concerns about changes they are having to make known at a higher level by saying “this is simply wrong”. Just because directions have come from above does not make them right.

It says the national system being used is “designed to fail” but commissioners can make their voices heard.

4) Plans for the future

We need to be clear about the future and where the NHS is going.

A national shake-up of the way health and care services are shaped will be coming into force next year. Sustainability and transformation plans (STPs) involve Clinical Commissioning Groups, councils, hospitals and other providers of care coming together to draw up blueprints covering health, care and finances over a five-year period. Sussex Defend the NHS believes this will lead to more cuts on already over-stretched NHS services and could lead to some towns losing services with patients travelling further for some treatment.

It says commissioners need to question the Government on what the STPs will mean for local services.

Brighton and Hove has already been setting up its own system called Caring Together, which will see health and local authority services including social care, housing and education teams working closely to shape services.

5) Commercial confidentiality

At the moment, details showing which private companies are bidding to provide services are generally not publicised until a decision is made or preferred bidders have been chosen.

Sussex Defend the NHS says commissioners should become a national leader and be prepared to publish names and details right from the start so people understand what is happening to their publicly funded services and can voice any concerns they may have about any particular firms or their owners and directors.

6) GP practices

Brighton and Hove will have lost six GP practices in two years by the end of 2016. This means thousands of patients have had to find a new GP, leading to longer journeys for some and causing extra pressure on already over-stretched surgeries. One of the closures was caused by a GP retiring and another was shut suddenly after concerns were raised about patient safety by Care Quality Commission inspectors.

The other four were caused when a private firm announced it was pulling out its contract at the start of the year.

A local and national shortage of GPs has added to the difficulties of replacing those who leave and keeping practices open.

Defend the NHS says CCGs and other agencies need to carry out a full public consultation and draw up a strategy to ensure not a single further GP practice closes in the city.

GP services in the city are currently commissioned by NHS England but the CCG is considering moves to get more local control by co-commissioning them from next year.

7) Privatisation

A growing number of services are now being provided by private companies because new contracts drawn up are sent out to tender.

This has caused a lot of anger from those who believe NHS services should be provided by the NHS.

Campaigners say there is national variation in the extent to which CCGs tender contracts and commissioners could avoid putting out a full-blown tender if they are satisfied there is only one capable provider.

It says CCGs need to write tenders in such a way only NHS organisations can provide the services. It says this is because they are the ones best placed to do so and this is what the public wants.

It cites the problems caused by private firm Coperforma taking over patient transport services in Sussex from South East Coast Ambulance in April this year as an example of how things can go wrong.

8) Hospital accident and emergency departments

NHS medical director Sir Bruce Keogh carried out a national review of A&E services in 2013 and among his recommendations was to provide specialist expertise in areas such as stroke and trauma concentrated in fewer hospitals. He also said too many people turned up who did not need emergency care and that services such as NHS 111 and support for vulnerable people in their own homes should be beefed up.

Sussex Defend the NHS says that could lead to the closure or downgrading of many A&E services around the country and local commissioners needed to fight this every step of the way.

9) Inpatient drug and alcohol treatment facilities

Two detox wards for people struggling to cope with drink and alcohol addiction in Brighton and Hove and Crawley closed earlier this year because of funding cuts. Sussex Partnership NHS Foundation Trust, which rans both wards, has said it can no longer keep the inpatient service going because it would not be financially viable.

It means patients who need treatment have to travel out of the county to get the services they need.

Campaigners say this “desperately” needs to be addressed as soon as possible.

10) Do your homework in public

Defend the NHS says commissioners need to trust the people of Brighton and Hove by being public about what is happening if they want to win back support.

Its final point says: “We can handle it when you start sharing with us just how bad things are. We might even start trusting that you have our best interests at heart when you commission services.”