At yesterday’s health and adult care scrutiny committee, to repeated heckling from the public gallery, Sonja Manton from NEW Devon Clinical Commissioning Group gave an update on the plans to slash around £500m by 2020, as part of Devon’s Sustainability and Transformation Plan (STP).
The county’s STP is one of 44 across the country and is the government’s main programme of major cost cutting and centralisation in the NHS, to stem a £30bn shortfall by 2020.
I asked a number of questions mainly on staffing, budgets and buildings, along the following lines:
What are the vacancies and how do you plan to fill them and when do you plan to make redundancies (which has been previously hinted at)?
The answer was woolly (and no amount of pushing would encourage Dr Manton to reveal more). It contained no information on numbers, but she did mention that there is a 30 per cent turnover rate across Devon, in home care staff and that 75 per cent of the NHS budget is spent on staffing.
Next I asked whether pregnant women would still have a genuine choice where to give birth, as three community maternity units at Okehampton, Tiverton and Honiton were set to close (two have already closed temporarily due to staffing issues).
The answer was that the new service would meet national guidelines, so I pushed and asked whether pregnant women would be able to have a choice of a midwife led unit and how far they would have to travel. The answer was that there will be a new midwife led unit at the RD&E, adjacent to the consultant led unit.
So essentially women from all over Devon will soon have to either have a home birth, or travel to Exeter to give birth, whether that’s at a midwife led unit or a consultant led unit. There was a bit of a disagreement about me saying the current midwife led units were closed, despite the announcement having already been announced that this was the intention and two being temporarily closed due to staffing pressures.
Next I asked how many more beds were planned to be cut.
I pushed. Was the figure of 600 bed cuts recognised, which was the broad figure in the first draft of the STP?
Yes this figure was recognised but it depended on a raft of issues.
Finally, I asked about the selling off of redundant estate. How many, where and when? Another non answer ensued. It was the next piece of work.
Entirely frustrated at the refusal to answer questions, not because I believe, the answers are not known but because there is a total refusal to get into any detail whatsoever, I expressed my complete frustration and disappointment at the answers. It made no difference.
Other councillors asked other questions.
At the end of the debate I proposed a resolution that the committee express significant concerns over the STP, its potential effect on patient care and the lack of transparency so far.
I called for urgent information on staffing, beds, buildings and budgets, in particular.
The proposal was seconded by Chair, Sara Randall Johnson, who added that a piece of work would be done on this.
Unfortunately, my wording appeared to upset the conservative group. Cllr Philip Sanders said he didn’t like that I had said the process appeared not to be transparent and wanted this word deleted. I replied that that it was entirely justified and refused to amend my proposal.
But fellow Conservative, Phil Twiss, wanted ANY mention of concerns deleted.
He said: “We don’t need the emotional language.”
Three years ago, Cllr Twiss reported me and this blog to the police cyber crime unit. You can read about it here, if you like – https://www.claire-wright.org/index.php/post/eddc_tory_whip_reports_me_to_the_police_for_a_comment_on_this_blog
Cllr Twiss then proposed that ALL my words were deleted, simply retaining the section that relating to a task group being set up.
This was voted through by the vast majority of the Conservative group.
Letting down every single resident in Devon who relies on the NHS.
Yes, I think that’s everyone.
Ambulance Trust response targets are failing and RD&E unable to discharge its patients in good time
Later in the meeting we were examining the performance review.
The South West Ambulance Trust which used to meet the national target of eight minutes largely without a difficulty, are now significantly under target. Only 59 per cent of calls were answered within eight minutes, across Northern, Eastern and Western Devon, in July of this year. The target is 75 per cent.
Lives are surely being put at risk. Certainly news of the failures are hitting the local media.
The narrative attached to the graph claimed that the reason was the rural nature of the South West. Yet the South West has been rural for years and this wasn’t a problem previously. Of course there have been cuts to budgets, and reductions in the number of ambulances so that is more likely to be the cause of the failure.
Problem with delayed discharges at the RD&E
Similarly, the RD&E was shown to have a significant problem with delayed discharges.
In June this year a daily average of 66 beds were occupied by patients who were well enough to go home.
It was obvious from the graph that the problem was clearly way out of kilter with other local NHS trusts.
This was largely to do with major staffing problems in the care sector, an officer confirmed.
of course it is these staff among others that we will rely on, to look after people in their own homes following community hospital bed cuts.
I proposed a resolution that the committee record its concerns at the ambulance response rates and the high level of delayed discharges at the RD&E and invite both trusts to the next committee meeting.
I had to argue with the chair that the proposal should retain the bit about recording concerns, before it was seconded by Cllr Brian Greenslade.
One of the Labour councillors was unhappy with me mentioning the RD&E at all in my resolution because she was chairing a piece of work looking at delayed discharges. I tried to point out that the resolution supported her work but she was adamant …
Then Cllr Twiss started up again. He said he didn’t like my wording and that I was simply making a statement that “looks good in the press.”
I reminded Cllr Twiss that the committee is legally constituted to scrutinise health services on behalf of the people and our job is to hold the health service to account. In fact such words had been used recently in a standards committee hearing minutes.
Anyone who is familiar with the basic requirements of an audit trail will recognise the importance of the committee recording concerns about service failures in this way.
I told Cllr Twiss that I intended to ask in the work programme agenda item, that the county solicitor attends the next committee meeting and outlines our responsibilities.
The final amendment removed my words about concerns about the RD&E’s delayed discharges but retained the words about the ambulance trust target failure.
So Ambulance Trust representatives will be invited to the next meeting.
I have certainly heard anecdotally that things are very challenging indeed within the Trust, with too few ambulances and low staff morale.
I duly asked in the final agenda item for the County Solicitor to attend the next meeting to remind the committee of its remit.
Some councillors appear to be in sore need of training.
Playing politics with health service scrutiny is a dirty and unacceptable game.
NHS Property Services and buildings
Cllr Martin Shaw spoke to a report he submitted to the committee on this. The upshot will be that a sub group will examine the future of community hospital buildings.
The speaker itemised webcast can be viewed here – https://devoncc.public-i.tv/core/portal/webcast_interactive/301904
Photo: Protesters on the steps of County Hall before the fateful health scrutiny meeting in July.