Bolton CCG 23rd March :
* A very moving story about collaboration between the hospital and community health workers which allowed an elderly couple to come together in their final hours: who could possibly argue with this?
*sadly this is only a fragment of a much larger picture of future health reforms which is altogether much more unsettling and worrying.
* integrated care has to work not just i terms of the delivery of quality of care in its own right but it has to earn its bread and bitter as well: it has to be so effective that it dramatically reduces the number of people ( mainly older people ) who arrive at A & E and are admitted to hospital in serious condition.
* This is because the whole picture plans for 58 hosptal beds to be closed at Wigan and Bolton and a similar number built at Salford so that all emergency and all risky surgery will be done in one location
* Seriously ill people will be taken from Bolton and Wigan to Salford by ambulance for their surgery.
* At the moment the Ambulance Service , like all parts of the NHS, is struggling to provide a quality service : at the CCG meeting on 23rd March where the patient story was told , figures for ambulance performance were commented on by Board members : ` we are not where we want to be`. Most targets are being missed and most of the public know about the waits for ambulances and ambulances queuing at hospitals unable to hand over their patients
* Will the new models of care such as integrated healthcare in the community earn their bread and butter by keeping older people away from the much smaller hospitals locally?
* So far it is not looking good: the CCG report presented on 23rd March 2018 gives for month 11 performance: `New models of care- reduced hospital based activity: the scheme has not delivered any savings in 17/18 and the forecast has been removed`. Last year the Audit Commission came to the conclusion that £6 billion had been spent on the Better Care Initiative – integrated care in the community- – reforms without any significant reductions in A & E attendance and admissions of seriously sick people to hospital.
* Yet we plod on down this road trying to make integrated care, a good thing in itself, work miracles so that hosptials can be reduced in size.
* Our hospitals are already cut to the bone: £20.8 million cuts at the Foundation Trust Bolton this year and £4 million plus cuts at the CCG. Next year`s cuts are over £7 million and we do not yet have te new figures for the Foundation Trust.
* Whilst there are good intentions- focussing on quality care and focussing on people and what is best for them as in the patient story, the bigger picture remains one of cuts and underfunding and reforms, reforms involving the reorganisation of surgery and new models of care all of which look and feel unrealistic and frankly worrying.
Sat 10 March
Chorley A&E protest commemorating 100 weeks of protest over downgrading, 10am at Euxton Lane entrance to Chorley hospital. GMKONP supporters encouraged to attend in solidarity.
Join us on our Rally
“Crisis in Our NHS Fix it now!”
12-1pm Sat 24th Feb 2018 in Victoria sq
We have more protests planned.
Every Saturday 11am -12noon we protest at Bolton hospital
Plodder Lane entrance.
For more information about how to get involved go to our
Facebook page Save Bolton Health Service
Fury after elderly dementia sufferer sent home from Royal Bolton Hospital in taxi
AN ELDERLY dementia sufferer had to be taken in by a concerned neighbour after hospital doctors sent her back to her empty home in a taxi — still dressed in pyjamas and slippers.
Disorientated Florence Myerscough was unable to let herself in, and was ‘soaked’ in the rain before the neighbour came to her aid.
The 76-year-old, of Canada Street, Halliwell, was admitted to the Bolton Hospital with chronic back pain at tea time on Christmas Day, but discharged at about 10pm.
Daughter Karen Bye says she is furious the hospital did not contact her before sending her vulnerable mother home.
She said: “We were under the impression mum wasn’t coming home. If she was, then we should automatically have had a phone call to say she was being discharged. I got a phone call from her next door neighbour to say ‘I have got your mum here’. I said ‘You’re joking, it’s an impossibility’.
But Mrs Bye was left baffled and angrier still when she called the hospital to demand answers.
She said: “The doctor said he had cleaned up my mum’s foot. I said ‘what do you mean , she didn’t come in with a foot problem, you have got no right sending her home and saying take a few more tablets and she will be all right. That taxi driver has just dropped her off and driven off. She had no key, nothing.
“She has gone in with severe back pain and mood swings are up and down.
“He couldn’t stop apologising, but I said ‘I’m not accepting your apology, I’m taking this further.’
“I admit I was furious, but I couldn’t help it. I said I want to make a complaint, I can’t believe you have discharged by mum and have put her in a taxi.
“She was in her pyjamas and slippers, because when the ambulance crew came she was in bed. She was wearing a coat when she came out, but was still in her pyjamas and slippers.”
Mrs Bye, of St Matthew’s Terrace, Halliwell, says she believes the care her mother, who is also a grandmother of six, received fell short of an acceptable standard.
“I think they have failed,” she said. “He has said to me he is cleaning my mum’s foot. She didn’t go in with a foot problem and that’s negligence.”
Describing the confusion and disorientation her mother suffers due to her condition, Mrs Bye said: “If she goes outside to look in the back garden, she can’t open the back door again, even if she has the key.
“If you talk to her about what happened yesterday, she can’t remember a thing — it’s just the thought of her going from the hospital in Farnworth to Halliwell with a bag of medication.”
Mrs Bye was also unhappy that paramedics were initially reluctant to take her mother to hospital, only relenting when they spoke to her social worker over the them over the phone.
The incident has also been distressing for Mrs Myerscough’s 81-year-old husband, Ernest, who suffers from epilepsy. He is currently staying with his other daughter, Deborah, in Tonge Moor.
Mrs Byers said: “My dad is shocked that they have just sent her home in a taxi like that. With my dad not being well he is in bed, but she had to tell him, no matter what, and he has just jumped up in bed.”
Mrs Myerscough now being cared for at home by Mrs Byers. Says she is beginning to recover from her ordeal.
Heather Edwards, head of communications at Bolton NHS Foundation Trust, said: “Our protocol is that we instruct the taxi driver to ensure that the patient is not left outside their home, but seen to enter safely.
“We are not clear what happened in this particular case and would ask Mrs Bye to get in touch with our patient advice and liaison service (PALS) so we can discuss it further.”
A spokesman for the North West Ambulance Service said: “We always aim to provide the best possible care and we wholeheartedly apologise if Mrs Myerscough and her family do not feel that this was given.
“We would like to pass on our warmest regards to Mrs Myerscough, and would welcome her family to contact our Patient Experience Team if they would like to discuss this any further.”
from the Bolton News 1st Jan 2018
The Bolton News 5th January
It was very sad to read the headline article on 2nd January on the grandma returning home from hospital- so many things going wrong: the ambulance team would have `handed over` this lady formally to A & E and explained why they had brought her to hospital. Some confusion seems to have ensued in the pressured environment of the A &E department as she was treated for another complaint? Then the hospital having decided not to admit her failed to trigger the `take home and tuck up` service run by Age UK which plugs the gaps in the state system.
We read last year the Red Cross talking about a humanitarian crisis in A & E and others describing the NHS spiralling down into a `third world service`. Both descriptions now seem very apt: an old lady standing in the rain in her nightie at 10pm on a cold winter night.
This is what austerity in the NHS looks like. We spend less and less on the NHS : the USA spends 17% of its GDP on its health service, and France and Germany 11%. We spend 8.5% and we are cutting £22 billion from that up to 2020. Yet we are a rich country.
We need Bolton politicians both local and national to do much more to hold the Government to account for these failures in the NHS.
I also think we in Bolton need to support our doctors and nurses in the health service who are working so hard in dire conditions.
If we are casting around to blame someone for this sad incident we should blame the Government for underfunding the NHS.
Save Bolton NHS
Any one who wants to help is welcome.
We have our own Facebook page: Bolton A+E – Save It.
There has been a blizzard of articles in the local press recently `celebrating` the reforms to the health service which embed underfunding in the NHS.
The most interesting have been in the Bolton News: on 31st January there were no fewer than 4 big articles. The first praised the CCG for stepping up to plug a gap in funding imposed by the government to Public Health, which threatened the Bolton Health check programme, which the Bolton News had sponsored. The CCG has to raise its profile as it will shortly have to tell us about cuts to surgery to knees and hips under the `Right Care `programme.The second celebrated the signing of a `memorandum of understanding` between Greater Manchester Health and Social Care Partnership and GM Voluntary, Community, and Social Enterprise Sector who are now apparently `equal partners` in driving up standards in the Health Service ( as opposed to gamely plugging the gaps) The most startling was the 2-page centre-fold entitled ` Your Health- Treatments`:on closer inspection this turned out to be advertisements by private companies such as a personal trainer, a personal dental treatment company, and the private hair- laser treatment company of the Chair of Bury CCG, Dr Kiran Patel. The` health treatment` Dr Patel was advertising turned to be `getting your legs beautiful for Summer` The Daily Mail and Sunday Times criticised him for having been the benficiary of two contracts worth £130,000 for his two private companies, from his own Board of the CCG out of NHS funds. So there you have it: two fellow Chairmen of neighbouring CCGs, side by side, each responsible for an underfunded health service , the one telling us we `have to do more with less` in the NHS, the other hoping to attract a few customers to his laser-treatment business. Brass neck or what? You could not make it up.
The Locality Plans are about cuts and privatisation: trying to prove how this happens. Most Bolton Labour politicians are blinded by enthusiasm for integrated care, and dont see how the cuts work.
For cuts look at Right Care which is related to Bolton`s first cut to hospital care which is operations/procedures 13%: Right Care is an argument from GPs that eg 18% of patients report no clinical improvement after knee replacements. They then move on to say this procedure is of `low clinical value` ( even though 82% report improvement). Similar arguments are then made for gall bladder, hysterectomy, etc.These procedures will be delayed/axed. `Right Care at the Right Time in the Right Place`. Under the Bolton final plan A & E attendances will be reduced by 18% and non-elective admissions by 22%: one means of achieving this is by raising the bar very high for admission to A & E: in the Plan a newly designed `Urgent care `system turns out to be a re-jig of urgent care and emergency care: you can only get into A & E if you have a` life threatening illness`- everyone else will be syphoned into a GP facility with the ethos `care outside the hospital`. Entrepreneurial GPs have been meeting at Royal Bolton to discuss ` social enterprise businesses` which may be profit making. It seems all urgent and emergency care bar ` life threatening ` stuff will go into these businesses. Privatisation in Bolton is straightforwardly commissioned eg Beaumont Hospital / Care UK under the concept of `choice` and also covert ie privatisation in the form of `social enterprise ` businesses like BARDOC who have a contract for `discharge to assess` called `take home and tuck up`. They are owned and run by GPs.
BARDOC was a PLC . They are now a Social Enterprise Company with an £8 million turnover. Will this be the future-the Memorandum of Understanding with the Voluntary Sector in Bolton News includes Social Enterprise Companies? Most other Voluntary Agencies will be registered charities, Social Enterprises are not. The movement of healthcare out of hospitals to either the private sector or to the GP sector under the auspices of Social Enterprise is on the increase: the new Local Care Companies, end-stage integrated care organisations, plus the new Urgent Care Organisations will syphon off work from the hospital A & E- Will this reform in the Bolton Plan see a bigger, more lucrative contract for Bardoc – they already take their £8 million from urgent care/out of hours in Rochdale Bury and Bolton. The profits made are syphoned off in turn to other orgs- in the case of Bardoc to `Rock Health Limited` which looks like a little company of GPs in Bury.
Local Care Organisations which in the Bolton Plan are end-stage partnerships of Integrated Care (LA)/ GPs/private care homes and home care businesses(who are trained by the NHS and provided with capital grants). The LCO can then act as a` provider`yet be delegated with a budget and they in turn can commission eg alternative services to the NHS from the private sphere?
Older folk can have integrated care, but cant have a knee replacement or a gall bladder operation, because these are hospital based and hospitals have to be cut. Ironically if prevention actually works – we could be living a tiny bit longer but in considerable pain and discomfort!
A KONP supporter Bolton
Below is a copy of a letter sent to Bolton Labour MPs and councillors
I am writing on behalf of Save Bolton Health Services campaign. One of our members was at a recent trades council meeting which was told that Ian McCartney the chair of Wigan Labour Party had announced at the last CLP meeting that either Wigan or Bolton A+E would definitely close, it was just a matter of deciding which one.
We are deeply disturbed by this as we keep being accused of scare mongering by suggesting that the closure of Bolton or Wigan A+E is even being discussed, let alone a decision made that one will shut and they are just deciding which one.
We would be concerned about either option. If one closed it would affect the attendance at the other, as people would have to go somewhere. Bolton is already way above capacity. Wigan is well attended. Transport between them is not easy. Evidence shows for every 10 miles traveled to A+E your chance of dying goes up 20%. History of other closures of A+E shows us that a hospital without an A+E is quickly downgraded to not much more than an out patient and diagnostic centre. We still have a petition with over 45,000 signatures on it and have kept the window posters just in case. We are ready to restart the campaign to defend the A+E.
Yet, we keep being adamantly reassured that Bolton A+E is not under threat and a campaign is not necessary.
Can you shed any light on this? Have you heard anything? Can you raise this on our behalf with the decision makers?
1) Healthier Together still have no date for announcing exactly what their plans are for each area. What was clear from the last public meeting they held was they do want 3 different types of hospitals – “super-hospital” with all functions, lesser hospitals with no emergency, trauma, etc and hospitals which are not really hospitals but have out patients, some investigation and walk-in centres.
Bolton Salford and Wigan are all now talking about working closer together. It is not clear whether this means within this 3 type of hospital structure.
2) Bolton Ft NHS Trust have still to make £18m cuts this year and needed 500 job cuts to achieve this. They have got rid of 220 by mainly voluntary redundancies and people leaving, with a tiny number of compulsory redundancies. They are saying they still need to lok at have to get rid of 280 more. Staff seem very demoralised by the whole process, which when combined with the loss of jobs and increased workload and stress on staff, cannot be good for patient care.
As a campaign we remain concerned that the priority for the trust is financial not patient care and that this risks the same drastic drop in quality of care and saftety of care that we saw at Mid Staffordshire hospital.
The £20billion national cut in NHS funding is now producing redundancies in a wider layer of trusts eg 300 Warrington, 500 Liverpool, 800 Pennine Acute etc.
3) Privatisation continues to be driven by this government in the NHS. Section 75 regulations force all Clinical Commissioning groups to expose all services to the tendering process. They specifically cannot refuse to accept a bid because of who provides it ie they can no longer choose to keep a service NHS provided because it is NHS.