Strife in the West Country – Celtic Fringe writes

Cornish flag

Down here in Cornwall in the West Country our local and only general hospital group, Royal Cornwall Hospitals Trust, which is not a Foundation Trust, is on black alert for the second time this year. NHS Kernow, the Clinical Commissioning Group, has a £14-16m deficit and has been placed under a Legal Directive by NHS England.  Earlier in 2015 the Chancellor indicated that he would like to devolve decision making powers for some part of Cornwall’s Health and Social Services.

In this context Cornwall Council and NHS Kernow are becoming concerned about public engagement. There is to be a ‘roadshow’ in March and they have launched an on-line survey. Responses are almost all in free-text and the questionnaire design makes it hard for members of the public to comment about the service as a whole. The focus is very much on the individual respondent’s health status. The introduction to the survey suggests its intention may be largely to prepare public opinion for inevitable cuts. It reads like this.

Have your say on health, care and wellbeing in Cornwall and the Isles of Scilly

Cornwall Council and NHS Kernow are seeking the views of people across Cornwall to help shape future health and social care provision and improve the wellbeing of our residents.

The way we commission and provide health and social care services was created more than 60 years ago and need redesigning. The Government has offered Cornwall more powers as part of the ‘Deal for Cornwall’, and as part of that we have been asked to put forward a new plan to meet the health and social care needs of Cornwall residents today and in the future.

Challenges facing us include rising costs because of increased demand for services as people live longer with more complex conditions. There are reducing levels of funding for some areas of health and social care. We also have some of the most disadvantaged neighbourhoods in the UK.

Given the financial challenges and the pressures on our health and social care system, we must better prepare our services for the future using the resources available in the best way possible.

Please let us know your health and social care priorities, which we will use to help assess the options to deliver improved services.

There seems to be a bit of an epidemic of consultation, nationally as well as locally, but it is not clear what, if any, notice will be taken of the response.  Dr Peter Levine writes on http://bit.ly/1WMIlYE about a consultation Kernow Clinical Commissioning Group (KCCG) conducted on their procurement ,and the response of the group to the replies it received. West Cornwall’s response, which he helped to draft, was particularly robust in its criticism but none of the responses, however diplomatically worded, seem to have been considered by the Board when it made its decision.

It is also interesting that the lay Board Member with responsibility for Public and Patient engagement is the former Chief Executive of NHS Wiltshire & Gloucester Partnership NHS Trust and is the founder and director of a consultancy specialising in support to organisational leaders facing personal and organisational change. These are certainly skills that an organisation like KCCG needs but I am not sure that he can really be considered ‘lay’ or that his experience will make it easy for him to champion the views of the public.

He lists his achievements like this:

2006 – December 2011 (5 years 2 months) Led the turn round of a failing organisation post merger. Created a high perrforming leadership team. Led regional and national service improvement work programmes.

March 2002 – October 2006 (4 years 8 months) Created the first integrated health and social care mental health service organisation. Unified three separate organisations and led them to achieve highest performance band in England 3 years running

Local health campaigners in Redruth find themselves in the interesting situation of defending a commercial Primary Care centre against closure. Cardrew Primary Care Centre in Redruth serves 3,000 patient and also runs a walk-in facility. The private provider, Nestor Primecare, part of Allied Healthcare, owned by Charterhouse, seems to have decided at short notice not to renew the contract. Or possibly NHS England decided this. There is an assumption that local GP practices and Community Health services will be able to pick up the work. Since they are already overstretched this seems unlikely. Redruth is a post-industrial town with high levels of deprivation. So we have the local Labour Party in the interesting situation of needing to petition NHS England to keep a for-profit facility open.

Celtic Fringe, February 3rd 2016

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