Underwhelmed with information from Newcastle Gateshead CCG

Openness, transparency, partnerships, collaborative working, joint decision-making, engagement and consultation??? Sound familiar??? Fantastic ideas, but in addition to doing the talk, there is then a need to actually walk the walk.

The draft Northumberland, Tyne, Wear and North Durham Sustainability and Transformation Plan had an inauspicious start to life in November 2016. Cloaked in secrecy from the very start, this top-down decree from NHS England via the local CCG had local North East councillors scratching their heads. The claim was that it came from both health and local authority – when Councillors hadn’t even seen it. Inspires a lot of confidence in our local CCG (not).

And now, over four months down the line, we still don’t have the full picture. Most people (including many local Councillors) are blissfully unaware that we have been provided with just half a draft Sustainability and Transformation Plan.  The all-important appendices to the STP, which contain key operational information, have been kept tightly under wraps by Newcastle Gateshead CCG despite both informal requests (in conversation and in emails) and formal requests (Freedom of Information applications) from Keep Our NHS Public North East. We wonder why this is the case?

Newcastle Gateshead CCG respond to our request to see the Appendices by maintaining

“an early release of this information could potentially result in a reduced quality of data, which clearly would not be helpful….it is in the wider public interest to ensure that this information becomes available to all members of the public at the same time through an official publication process”

Mark Adams, Chief officer, Newcastle Gateshead CCG, 20th March 2017

Well, our first request to have sight of the draft STP appendices was made on 30th November 2016. And still no sign. If we were of a suspicious nature, we may think that the CCG has something to hide.

—————

But, interestingly, the plot thickens.

The CCG have just hosted what they feel to be a period of “engagement”. The part of the draft STP which was made public is a process heavy weight which is largely undecipherable and remains inaccessible to anyone outside CCG land, and thus requires translation.

In considering the six acute hospital sites in the STP footprint, we find the following words tucked away in a corner of the draft STP document and we quote:

“The analysis considers a range of scenarios in which either one or two of the six sites would be turned into cold sites by shifting out non-elective procedures and using freed up capacity to shift in elective procedures from the remaining hot sites in the patch”

from “Optimal Use of the Acute Sector” page near the end of the Nov 2016 NTWND draft STP document.

Now, our understanding is that to be a ‘cold’ site patients must be stable and unlikely to need intensive medical input – so this means no A&E, no medical admissions, no surgical admissions, no ITU or HDU. This is what Northumbria have done – Cramlington is ‘hot’ and N Tyneside and Wansbeck are ‘cold’. So, in reading the draft STP, our initial thought is that the closure of A&E and other acute services are being considered as an option for one or two more hospitals in our STP footprint, with the shifting out of non-elective (emergency, unforeseen) procedures to ‘hot’ hospital sites, and shifting in planned (non-critical) treatments and care to the one or two proposed ‘cold’ sites.

Important stuff – no doubt. Tucked away in a corner of the document – certainly. Highlighted so as to welcome peoples feedback – no. A great move in building trust (not).

 A local population has a right to information and a right to present views – and that is what true engagement is about. KONPNE asked about this specific hot and cold clause at one of the “engagement” meetings, but the response was inadequate and fudged. We remain interested, and when we wrote to Newcastle Gateshead CCG within the engagement period and listed four very specific questions about this one specific issue, we were disappointed in that the CCG considered it fit to reply again with a totally fudged

“Since the publication of the draft plan, ‘the optimal use of the acute sector’ workstream has been analysed, and we are in the process of developing a more detailed plan which will help to support the sustainability of services”

Mark Adams, Chief officer, Newcastle Gateshead CCG, 20th March 2017

Back on planet earth, the process is straightforward. The CCG write a draft paper and invite comments or questions. A person reads the paper, find that clarification of part of the document is required, and writes with clear, specific questions. The convention is that the questions are then answered in a full and timely manner. What we have, in fact, received back is more CCG doublespeak –  vague and coded, and with absolutely no answer to any of the questions. Quite frankly, we consider this response to be dismissive and disrespectful.

We have written to Newcastle Gateshead CCG again on 24th March 2017, as we still require a response to the four specific questions we originally posed about the hot and cold sites, but we still have no reply. Maybe they have gone cold on us. But we will persist.

We will persist because a very important principle is at stake. It is, of course, both ironic and unacceptable that any large scale proposal for service change which professes to be both transparent and engaging should withhold key information.  Newcastle Gateshead CCG have asked members of the public for their opinion about an important issue, but without providing the full detail – both regarding the appendices to the STP and, as described above, regarding a specific part of the document. When additional information about these issues has been requested by members of the public, this has not been forthcoming from the CCG.

This does little to instil a sense of joint working, ownership and confidence in the process.

Initial engagement? Totally underwhelmed.

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