NHS Update

Its seems that, in order to meet government cuts, the NHS has so severely cutback on Nurses that it is now having to pay huge sums for agency nurses.  Clearly agency nurses cannot provide continuity of care and the cost of agency nurses is extortionate and of course represents yet another funneling of tax payers money into the hands of the private sector. In fact it seems that a major  beneficiary might be Tory donor  Lord Ashcroft.

Meanwhile, here in Salisbury, a freedom of information request has been submitted to Salisbury NHS Trust requesting further information on the supply of medical agency staff to the trust from 2009 to 2012 to including the following information: 1 Cost to the trust/authority; 2 Grade; 3 Supplier/Agency; 4 Speciality.

It will be interesting to see the result of the FOI request.

NHS pays £1,600 a day for nurses as agency use soars (D. Telegraph)

Lord Ashcroft’s Co. makes £7,000,000 supplying agency staff to the NHS as Lansley sacks 28,610 staff (Éoin Clarke)

Freedom of Information Request

NHS staff in the South West who don’t agree to pay cut face sack

As already reported here NHS staff in the South West including Salisbury Hospital face a pay cut and worsening conditions of service. This comes  as a result of the government’s enthusiasm for regional pay and the foundation of a “Pay Cartel” consisting of 19 NHS organisations across the South West.  This of course comes on top of a pay freeze and increased pension contributions.  Employers claim this will help them make the £20 billion in “savings” over four years required by the government, but coincidentally it could help to smooth the privatisation of the NHS where providers like Virgin and Serco will make their profits by driving down pay and conditions.

See here for more details: NHS staff who don’t agree to pay cut face sack

Salisbury NHS Watch

Hospital trusts’ joint talks on rising wage bill stokes fears of NHS pay cuts (Marlborough News Online)

Salisbury NHS Watch – Update

Not much to report, but the following updates may be of interest:

Virgin Care to take over children’s health services in Devon: As reported here previously, we already have fifteen GP surgeries in Wiltshire  partnered to Richard Branson’s “Virgin Care” and a GP from one of those surgeries appointed as Chairman of the new Wiltshire Clinical Commissioning Group.  So it may be of interest that Virgin Care have been named preferred bidder in a £130m deal that will see the privatisation of children’s health services in Devon.  See here for details.  It seems like Serco and Virgin have privatisation of the NHS in the South pretty well sown up.

It is important to point out that concern about companies like Serco, A4E, G4S, and Virgin Care taking over the running of our public services is not part of some left wing ideological agenda.  If the NHS were out sourcing parts of its work to small or medium sized, home grown businesses or organisations that are part of our community and have a track record of providing a quality service for a responsible and reasonable rate of remuneration then there would be no need for concern. But, in reality our services are being taken over by large national and international corporations that do not have a promising track record – they are essentially in the business of making large profits by employing members of our own community (Cameron’s hard working families) on lower pay with poorer employment conditions while providing the minimum service they can get away with.  Remember that these organisations will be signed up on confidential contracts, protected by commercial confidentiality and will not be open to Freedom of Information requests – they will be pretty much unaccountable and if things go wrong it will be the remnants of the NHS plus tax payers money that will be left with the problem. (Breast implant scandal: 3,500 private clinic patients referred to NHS)

Senior staff could be moved out of the ‘Agenda for Change’ pay framework under proposals devised by NHS Employers. Unfortunately this article is behind a pay wall but I suspect that the article will confirm what we already know – that regional pay for NHS staff (i.e. lower pay for everyone except for those who work in wealthy high pay areas) will not apply to the senior managers.  Sounds like a good way to encourage loyalty and enthusiasm from the staff or is it just a way to smooth the transition to the lower pay of Serco and Virgin Care?

Salisbury NHS Watch

Are Salisbury Hospital Staff to have their Pay Cut by 15%?

In light of the government’s move towards regional pay* in the NHS  – apparently a  euphemism for channeling cash from poorer to wealthier areas of the country, there has been an interesting development locally.

Following the revelation of the formation of NHS “Pay Cartels” in the South West, a freedom of Information request has been submitted to Salisbury NHS Foundation Trust by a J. Stewart.

Here is the main focus of the request:

“Please confirm or deny that the proposal being considered includes the possibility that Salisbury NHS Foundation Trust Staff will be dismissed and offered revised terms and conditions of employment.

Please confirm or deny that the proposal being considered includes the possibility that Salisbury NHS Foundation Trust Staff will have their pay reduced by upto 15%, and or that staff will have their annual leave entitlement reduced, and or sickness pay entitlements will be reduced, and or no longer offering staff membership of the NHS Pension scheme.

Please also confirm whether all Trust Senior Management and Board members would be included in any proposed change in Terms and Conditions.”

The Trust has 20 days from 12th June to respond.

(* interestingly regional pay will not apply to top tiers of management – there’s a surprise)


FOI Request:

RCN Response (pay cartels):

Health Unions response:

NL Group blog:

Blog Post by Eoin Clarke:

Regional pay:

Salisbury NHS Watch

Salisbury Journal –  Possible pay cuts at Hosptial

Salisbury NHS Watch: News

In case you didn’t know, Clinical Commissioning Groups (CCGs) are taking over from the old PCTs (Primary Care Trusts). Our local CCG is the “Sarum NHS Alliance”.  However it seems that the Sarum NHS Alliance is merging with other Wiltshire CCGs to form one county wide CCG.

The news report linked below indicates that the merger is due to the work loads involved and to the need to avoid a “post code lottery”.  This last point is interesting because it is exactly what the previous , chief executive of Salisbury NHS Foundation Trust, Matthew Kershaw, admitted the reforms could lead to.

In an article from last year (see link below). Kershaw discussed the risk that neighbouring CCGs could offer different levels of service, refuse to provide certain treatments or allow longer waiting lists for more expensive treatments.  Conversely he warned of the possibility of CCGs merging together to provide a more uniform service in an area but that this would undermine and prevent the competition that the Government is aiming for.  Interesting issues – see link below for more details.

The new CCG will operate in shadow form and work closely with NHS Wiltshire this year before it takes over the reins in April 2013.

So What are Clinical Commissioning Groups?

Clinical Commissioning Groups are groups of GPs that will, from April 2013, be responsible for designing local health services In England. They will do this by commissioning or buying health and care services. (There is also the NHSCB and the four SHAs but more of those in a future post).  Apparently, aboard of 5 GPs and 2 non GPs was formed last April to run a Clinical Commissioning Group based around Salisbury Hospital, called Sarum NHS Alliance. It consists of 27 practices and approximately 150,000 patients.

This all sounds great – who better to control our health service than dedicated well known and trusted local GPs.  Unfortunately it might not turn out like that in the long run – the kind of GP who is dedicate to his/her patients and the community is unlikely to enjoy the management and committee work of a CCG.  Evidence is already appearing which indicates that CCGs are likely to end up consisting disproportionately of GPs who own stakes in non-NHS providers and could use their decision-making power to simply commission their own companies to offer services.  Here is an example. I stress that I have no reason to believe that any of this is true for our local CCGs and am sure that those that have got involved have done so for the best of reasons – to ensure that they can adapt and guide  the reforms for the benefit of their local communities. However, we all need to be vigilant to ensure that we spot the conflicts of interest that could develop in the long term.

A Salisbury GP has resigned as chair of Sarum NHS Alliance commissioning group. The Doctor, who was previously heavily involved in practice-based commissioning, said ‘The CCG role was becoming too much. I had to make a choice and in the end my priority was my patients’:  http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/13150087/gps-quit-ccg-roles-as-commissioning-enthusiasts-lose-heart

NHS reforms ‘risk’ creating a postcode lottery: http://www.onmedica.com/viewsArticle.aspx?id=ab2354d4-b1b2-4b85-8cbf-c7f3bf68ea98

Three Wiltshire CCGs (including Sarum NHS Alliance) to merge:  http://www.gazetteandherald.co.uk/news/9628367.Three_Wiltshire_CCGs_to_merge/

Half of GPs on clinical commissioning groups have financial links with private providers:   http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/13150087/gps-quit-ccg-roles-as-commissioning-enthusiasts-lose-heart