Integrated Care Systems

Scroll down this page for:

1: We need an NHS for people, not profit 

2: Our major concerns about ICSs …. and ways forward

3: Email the Chair and Chief Exec of “North East and North Cumbria Integrated Care System” (NENC ICS)

4: Copy in key people and liaise with political groups and trade unions

5: Sign the new “We Own It” petition NOW: End NHS privatisation, save lives

6: “North East and North Cumbria Integrated Care System” (NENC ICS)

7: Much concern regarding public access to local NHS decision-making meetings and documentation – read the North East Joint Campaigns letter to NENC ICS, and the response from the ICB

8: “Integrated Care Systems” – recent Actions and Campaigns in the North East;    25.11.23 – Much concern regarding public access to local NHS decision-making meetings and documentation    |     9.5.23 – Poor response from new “Integrated Care Board” in North East      |      25.11.22 – KONPNE responds to the draft strategy for the NHS in the North East     |     1.9.22 – KONPNE contacts ICS Chair ….again    |      Summer and autumn 22 – Formal questions to seven NE Councils    |     9.7.22 – Durham Miners Gala    |    2.7.22 – Morpeth celebrates and protests    |     2.7.22 – July Rally at the Monument    |     26.6.22 – KONPNE writes to ICS Chair   |    May and June 22 – 1562 people in NE contact the Chair of the ICS

9: Private sector healthcare providers on the NENC ICS Board?

10: “Integrated Care Systems” – Bad news for patients and staff

11: “Integrated and Caring”?  Definitely not.

12: Impact on the pay, terms and conditions of NHS staff 

13: Impact on local decision-making and democracy 

14: North East opposes the Health and Care Bill

15: Links – newspaper items, opinion pieces, reports

16: “STPs” and “ACOs” – remember them? 

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1:

We need an NHS for people, not profit

Our NHS was reorganised on 1st July 2022. England was geographically divided into 42 health units called “Integrated Care Systems” (ICS). In our region, “North East and North Cumbria Integrated Care System” (NENC ICS) is now responsible for commissioning all health care in the North East and North Cumbria.

There remain a number of important issues to be worked on, and it is CRUCIAL that residents of this region make their views clear to the Chair and Board of the new NENC ICS.

“It is really important to understand that ‘integration’ as in Integrated Care Systems means ‘disintegration’, centralisation, loss of public accountability, opening door wider to private companies, driving down quality to reduce costs, rationing, and a fundamental shift way from a universal service providing comprehensive care to all, free at the point of use”   Dr John Puntis, KONP Co-Chair, 7th February 2021

Please remember: If we don’t fight to protect our NHS, we will always lose. But if we fight we have a chance of winning.

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2:

Our major concerns about ICSs …. and ways forward

There are eight major areas of concern, as identified below, together with our proposals about possible ways forward. Please discuss and review these important issues with your colleagues, political groups, social groups and Unions, and do all that you can to keep these issues on the agenda – it is OUR NHS, and they need to be resolved. Please also pick out some of these and write to the Chair of “North East and North Cumbria ICS” (see Part 3, below).

Each ICS is controlled by a Chair and a Board of Directors, with a duty to provide healthcare for people in this area – but with some flexibility in the way that they operate.  In short, the 2022 reorganisation of the NHS provides our local NHS leaders with an opportunity to reset the direction of travel of our NHS.

1: Maintain a free, comprehensive health service, available for all

The introduction of ICSs must not mean any departure from the provision of a comprehensive health service for anyone who needs health care and treatment, regardless of where they live.  The H&CA does not define the people for whom an ICS has ‘core responsibility’, so this must be included in the ICS constitution.

⇒ A commitment written into the ICS constitution that North East and North Cumbria ICS will maintain a comprehensive health service, free at the point of need, accessible to anyone residing in that area – including homeless people – at the time when they need health care or treatment.

2: No private sector representatives on any ICS bodies

A government amendment now included in the Act excludes those involved with private healthcare from ICBs and committees or sub-committees if the chair believes they “could reasonably be regarded as undermining the independence of the NHS”: this is open to wide interpretation by the chair and could still mean private company representation at Board level, let alone the committees, subcommittees and provider collaboratives which will have delegated powers and budgets – and where the real power lies.  Given their vested profit-making interest, private sector representatives should not have a say in decisions about what NHS services are provided and by whom and must not, therefore, sit on any ICB or committees.

⇒ ICSs should not include private sector representatives on any ICS boards or committees or any bodies with delegated powers from the ICB.

3: NHS as the default provider

The legislation allows for new procurement regulations, which are expected to allow contracts to be awarded, extended, or rolled over without any tendering process, which could open even more NHS services to be taken over by the private sector.

⇒ A commitment that NHS providers are the default providers of health services, care and treatment, and that as contracts with private sector companies come up for renewal the default position is that they will be awarded to NHS providers.

⇒ If any contracts do continue to be awarded to the private sector, there must be vigorous scrutiny to ensure that this is conducted in a transparent and accountable manner.

4: Emergency care

The Health and Care Act does not include the requirement for an ICB to commission emergency/urgent services for everyone who needs them, including those who do not reside in the ICS area.

By contrast, the current legislation in force until the Act is enacted and implemented requires each Clinical Commissioning Group to ensure the provision of emergency care for everyone present in their area. The Health and Care Act makes no reference to emergency care.

During the debate on the Bill, Lord Kamall, government spokesperson, said in the House of Lords that it gives NHS England the power “to publish rules that determine the people for whom each Integrated Care Board is responsible and those rules must make sure that everyone registered in the area, or everyone who may have need of services, is looked after”. However, he also said: “It would not be reasonable to expect providers to provide services regardless of whether they were funded by an Integrated Care Board to do so, and it is important that Integrated Care Boards should be able to make decisions about with whom they contract and where they prioritise their resources.” 

⇒ A commitment that anyone who needs emergency or urgent services while present in the ICS’s geographical footprint will receive the necessary treatment, whether or not they are registered with, or permanently reside within, the ICS area.

5: Democratic accountability and representatives with expertise

The legislation specifies that the main decision-making ICB must include one representative of NHS trusts/foundation trusts, one representative of providers of primary medical services and one local authority representative.  It is up to the ICS to decide on other members and how they are to be appointed and to include this in its constitution. A Government amendment requires at least one member with knowledge and experience in connection with services relating to the prevention, diagnosis and treatment of mental illness.

⇒ For the Integrated Care Board to include a councillor from each local authority covered by the ICS, not just one representative covering all the local authorities in an area.

⇒ A commitment that the Integrated Care Board must include representatives of professionals from Mental Health, Community Health, Maternity, Primary Care and Public Health, as well as from Acute services.

⇒ A commitment that Integrated Care Boards, Integrated Care Partnership body, place-based bodies, committees and sub-committees will include representatives of patients’ groups and of NHS staff trade unions.

6: Meetings involving the public with right to ask questions and receive answers

The legislation says that an ICB must make arrangements to involve individuals, and their carers and representatives, to whom services are being or may be provided, by consulting with them or providing information.  This relates to the planning of commissioning and the development and consideration of proposals for changes in commissioning where this would have an impact on the manner in which services are delivered or in the range of health services available.

⇒ A commitment that all meetings of Integrated Care Boards, Integrated Care Partnership bodies, place-based bodies, committees and sub-committees will be held in public, papers must be available in advance, and observers – from the public, trade unions, patients’ groups – must be allowed to ask questions and be entitled to written answers to those questions.

7: Discharge of patients and assessment of social care needs

The legislation repeals the requirements of the Care Act 2014 that a social care needs assessment be carried out by the local authority before a patient is discharged from hospital. It also revokes the provisions, which enable the NHS body to charge the local authority where a patient’s discharge from hospital has been delayed due to a failure of the local authority to arrange for a social care needs assessment. A government amendment only requires the Trust to take any steps that it considers appropriate to involve the patient and any carers, and to have regard to guidance from NHS England, which the government indicated will be developed with Carers UK.

⇒ There must be a commitment to ensure, before a patient is discharged from hospital, that it is safe to do so and that any unpaid carers expected to look after the patient are both willing and capable to do so, and that the operation of the discharge policy will be audited.

8: Workforce Issues

The legislation does not provide any help in filling the thousands of staff vacancies in the NHS and social care, so ICSs will need to develop their own plans. The Commons have twice rejected amendments for the Secretary of State to make regular reports to Parliament with independent evidence on staffing, demand for care, and how these will be addressed.  Recruitment and retention are not only linked to good pay and conditions but also to staff knowing there are sufficient resources so that they can provide services safely without risk to themselves or service users, as the Ockenden report demonstrated for maternity.

⇒ The ICS Constitution must specify that nationally agreed pay, terms and conditions, including pensions, as negotiated with the NHS staff unions, will apply to all staff employed by any NHS provider within the ICS area.

⇒ There must be discussion with NHS staff unions about safe staffing levels and what is needed to ensure they can be implemented.

Many thanks to national KONP / ICS Working Group for preparing the above information

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3:

Email the Chair and Chief Exec of “North East and North Cumbria Integrated Care System” (NENC ICS)

We need to inform local ICS leaders about how we want the ICS to be run in the North East. Please feel free to identify some of the concerns listed above – but try to put the issues into your own words. 

For your use, more information about the above eight issues is here

Please email  Professor Sir Liam Donaldson, Chair of “North East and North Cumbria Integrated Care System” and  Samantha Allen, Chief Executive, “North East and North Cumbria Integrated Care System”, both at this email address: necsu.nenc-icb.contactus@nhs.net 

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4:

Copy in key people

It will take around 10 minutes to email the Chair of NENC ICS – and the impact of your email will be magnified by copying in key people in the North East. National KONP suggest some possibilities here. We need to ensure that all people involved in NHS decision-making know that we need an NHS run for the public, not profit.

You don’t need to copy your email to all the people on this link. Pick the ones who are most important in your area and/or with whom you already have contact. Their responses will be crucial if this is to have any impact on the Board and Chair.

This is democracy in action – please ensure that your voice is heard. 

The email addresses of all North East MPs, local councillors and local Healthwatch groups are located on our links page here.

and liaise with political groups and trade unions

It would help greatly if supporters liaise with any political groups or trade unions they may be a member of – it is crucial that they hear your views about these issues. 

Please adapt these motions to reflect the recent changes re the Health and Care Bill now attaining royal assent and has become law:

“Oppose Integrated Care Systems in the English NHS: Model motion for trade unions” – click here

“Oppose Integrated Care Systems in the English NHS: Model motion for Labour branches CLPs” – this can easily be adapted for use by other political parties and organisations – click here

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5:

End NHS privatisation, save lives; sign the new “We Own It” petition NOW

Sign the “We Own It” petition to demand that local NHS leaders in the North East and North Cumbria commit to end NHS outsourcing.

We were told that outsourcing was ‘the most efficient way to provide services’ and, for over a decade, the ideology of privatisation has been gaining a strong foothold in our NHS. But many people always knew that this wasn’t true, and now they’ve been proven absolutely right. A new national research study has found the evidence to be crystal clear: preventable deaths of 557 people have been linked to the outsourcing of NHS services. Ben Goodair, the Oxford academic behind the research, told over 300 people at the petition launch rally (20th October 2022): “My research found that wherever privatisation increased, deaths from preventable causes also increased. It is clear that there is a connection there”.

NHS leaders now have to face the facts: privatisation fails our health. 

Please add your name to the petition and demand that local health leaders in the North East and North Cumbria commit to end outsourcing in our NHS now…..and then share it with family and friends

CLICK HERE

to sign the “We Own It” petition

and 

CLICK HERE

to receive leaflets to distribute to houses on your street

Thank you for everything you do to protect our NHS from privatisation. 

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…..and read about the findings of the Goodair and Reeves research study (University of Oxford):

LSE British Politics and Policy    (3rd August 2022)    Areas of England with increased outsourcing of NHS services have more deaths of people with treatable conditions

The Lancet    (July 2022)     Outsourcing health-care services to the private sector and treatable mortality rates in England, 2013–20: an observational study of NHS privatisation

OpenDemocracy     (29th June 2022)    NHS privatisation linked to 557 ‘treatable’ deaths in five years

The Mirror     (29th June 2022)    ‘Treatable deaths’ rise under privatised NHS services, study finds

The Guardian     (29th June 2022)     NHS privatisation drive linked to rise in avoidable deaths, study suggests

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6:

“North East and North Cumbria Integrated Care System” (NENC ICS)

It is important that we, as people living in the region, continually liaise with the commissioners of healthcare – essential that commissioners are aware of the needs of residents, what is going well, what needs to be developed and, crucially, aware of our wishes about who provides it….

The new healthcare system, however, takes some navigating. Clinical Commissioning Groups (CCGs) no longer exist. Since July 2022, 42 “Integrated Care Systems” have been responsible for health commissioning across England. These “Integrated Care Systems” have a multi-layering of roles and functions and, as such, have a complexity of Boards and Committees. Below is an overview of the System and contact points in the north of England, as we understand it. 

In the north, health commissioning is now carried out by the “North East and North Cumbria Integrated Care System” (NENC ICS).  Within the NENC ICS there are three levels of operation / decision-making:

1 ⇒ North East and North Cumbria Integrated Care System (ICS) –  with Integrated Care Board – covers the whole of the ICS area (the largest ICS in England)

2 ⇒ The ICS is sub-divided into four Integrated Care Partnerships (ICPs) – North, Central, South and North Cumbria. These four ICPs meet independently in their localities. There is also a Strategic Integrated Care Partnership meeting and Board, which is made up of reps from the four areas – this Strategic ICP meets twice per year. 

3 ⇒ Each of the four ICPs are further sub-divided into Place-based teams. These follow 14 local authority boundaries / the previous CCG areas. 

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1 ⇒ Integrated Care System:

“The North East and North Cumbria Integrated Care System (ICS) is a partnership of organisations including local councils, voluntary and community services that provide health and care across our region. Led by the NHS Integrated Care Board (ICB) we are working collectively, joining up resources and expertise to provide the best health and care for our local communities”. NENC ICS website July 2022

“Our Integrated Care System is led by our NHS Integrated Care Board (ICB), a statutory organisation with responsibility for NHS budgets, functions and performance and an Integrated Care Partnership (ICP). It takes over the responsibilities currently held by the eight clinical commissioning groups in our region. Over time it will also take over some of the of the functions currently held by NHS England for the commissioning of primary care and acute services”. NENC ICS website July 2022

Contacts / Information for NENC ICS:

NENC ICS website: https://northeastnorthcumbria.nhs.uk

NENC ICS email: necsu.nenc-icb.contactus@nhs.net

Professor Sir Liam Donaldson, Chair, NENC ICS       Leading Health Care    (4th January 2021)     Professor Sir Liam Donaldson appointed Chair for the Integrated Care System for the North East and North Cumbria

Sam Allen, Chief Executive Officer, NENC ICS        NENC ICS website     (11th November 2021)   Chief executive appointed to North East and North Cumbria Integrated Care Board

NENC ICS website here confirms the availability of a Procurement Register, as follows: “NENC ICB maintains a register of procurement decisions and contracts awarded, which also includes a record of any related conflicts of interest as appropriate.  The register of procurement decisions will be published on a quarterly basis”. 

Information about current procurement and commissioning can be found at the GOV.UK website at https://www.find-tender.service.gov.uk/Search

NHS England website for ICSs across England: https://www.england.nhs.uk/integratedcare/

Integrated Care Board

The NHS North East and North Cumbria Integrated Care Board (ICB) is the statutory decision-making body of the North East and North Cumbria Integrated Care System (ICS). The ICB is responsible for the commissioning of health services and the effective stewardship of NHS spending for all of the people who live in the North East and North Cumbria. The Board meets every two months.

The Integrated Care Board meetings are available to view live on Facebook and via the ICS website:  https://northeastnorthcumbria.nhs.uk/       Members of the public can request to observe the Board in person by contacting Deborah Cornell, Board Secretary via email nencicb-sun.icbcorporateoffice@nhs.net

Submitting questions to the ICS Board: For questions to put to the Board re: items on the agenda, these are to be submitted in advance of the meeting by email to nencicb-sun.icbcorporateoffice@nhs.net at least three working days prior to the meeting. Where relevant, any questions will be addressed in the meeting and a written response will be sent directly to the individual who raised the question within 20 working days. 

The date and link to the next meeting, and links to the Minutes of previous meetings are here

The NENC ICB Constitution is here

Please read this Constitution in the context of this very helpful article from 999 Call for the NHS  (2nd December 2021) Responding to draft NHS Integrated Care Board Constitution public consultations – we have circulated this article to all North East MPs, councillors, Healthwatches and, of course, the new ICS 

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2⇒ 4 Regional Integrated Care Partnerships:

“Four local Integrated Care Partnerships based around the main centres of population.

-North Cumbria ICP

-Central ICP (County Durham, Sunderland and South Tyneside)

-North ICP (Gateshead, Newcastle, North Tyneside, Northumberland)

-Tees Valley ICP (Darlington, Hartlepool, Middlesbrough, Redcar and Cleveland and Stockton-on-Tees)

These local ICPs will develop a strategic picture of health and care needs from their constituent local authority ‘places’ working with a wide range of partners including existing health and wellbeing boards. These provide a vital forum for the NHS, local councils and other partners to assess the needs of local people and set local priorities for health and care improvement”.    NENC ICS website July 2022

 

Strategic Integrated Care Partnership:

The Integrated Care Partnership (ICP) is a committee comprising members of the ICB and the thirteen local authorities from across the North East and North Cumbria. This meets twice per year.  Information including the date and link to the forthcoming meeting, and links to the Minutes of previous meetings are here: https://northeastnorthcumbria.nhs.uk/integrated-care-partnership/

The Archive of Previous ICP Meetings is here: https://northeastnorthcumbria.nhs.uk/archive-of-icp-meetings/

Meetings are recorded and available to watch at the same web address.

Members of the public can request to observe the Strategic ICP Board in person by emailing nencicb-sun.icbcorporateoffice@nhs.net

Submitting questions to the ICP Board: If you have any questions to put to the partnership relating to items on the agenda, we ask for these to be submitted in advance of the meeting by email to nencicb-sun.icbcorporateoffice@nhs.net at least three working days prior to the meeting. Where relevant, any questions will be addressed in the meeting and a written response will be sent directly to the individual who raised the question within 20 working days. 

The terms of reference and operational information relating to the ICP are here at page 124

Members of the Strategic Care Partnership Board are listed here

In a FOI request (15th February 2023), we requested the following information re the Strategic ICP; the ICS response is in purple:

INFORMATION REQUIRED: I would be grateful if you would please clarify the following:
1) The arrangements for putting a question to the strategic ICP meeting

THE RESPONSE: The Strategic ICP is a statutory joint committee that meets in public at the following times and places…..

Questions from the public to the Strategic ICP can be submitted in advance via the ICB website – https://northeastnorthcumbria.nhs.uk/ . and their minutes will be available afterwards here:  https://northeastnorthcumbria.nhs.uk/meetings-and-agendas/

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The local “Integrated Care System” (now responsible for all NHS commissioning in the North East and North Cumbria) has developed a strategy which set outs ambitions and goals for the future.

Towards the end of 2022, the ICS invited feedback from the public and all stakeholders on their initial draft, and we responded accordingly – KONPNE supporters felt that there are a number of important issues to develop further in this document, including *the need for the NHS to be the default provider of services, to work towards decreasing outsourcing *a commitment to providing a free and comprehensive health service to all  *no private sector representation on NHS decision-making bodies  *Emergency Care for all – no need to be registered with a NE GP  *thorough assessment of needs prior to discharge  *commitment to nationally agreed pay and conditions for staff, and commitment to work alongside Unions.

CLICK HERE

to read our feedback to the local ICS about the initial draft strategy

An independent report summarising feedback is here – individual members of  KONPNE, and KONPNE as an organisation, submitted views, recorded mostly in Section 4 of the report.

“Better Health and Wellbeing for All” –  the Strategy for the North East and North Cumbria is here   (16th December 2022). This was agreed at NENC ICP on 15th December 2022.

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3⇒ Place-based teams:

“As well as strategic functions, ICB staff also work at place level with local health and wellbeing boards in each of our 13 local authority areas. These teams also work alongside our 64 primary care networks which are groups of local GP practices, social care teams and other community-based area providers”.   NENC ICS website  July 2022

In a FOI request (15th February 2023), we requested the following information re Place-based teams; the ICS response is in purple:

INFORMATION REQUIRED: I would be grateful if you would please clarify the following:

The operational arrangements for ICB place-based teams, and the location of minutes

THE RESPONSE: Following the in-year transition from eight CCGs to one new ICB, we are working
to finalise our place-based teams and governance structures from April 2023.

also

In a further FOI request (3rd August 2023), we requested the following  information about Place-based teams; the ICS response is in purple:

INFORMATION REQUIRED: In relation to the Northumberland, North Tyneside, Newcastle and Gateshead place-based teams, please provide

– the governance structures and operational arrangements for these four ICB place-based teams

– the web address / location of minutes / agendas for committee meetings relating to service development, changes to service provision, the procurement and commissioning cycle, etc. We are particularly interested in any decision-making relating to the outsourcing of services away from NHS provision.  Please provide the web address where this information may be accessed for these four place-based teams.

– Please also clarify the webpage which holds information re where and when these place-based committee meetings are held, whether the public may attend in person or by streaming, the process for members of the public raising questions and other practical issues.

THE RESPONSE:   NENC ICB Place-based Teams
“The ICBs organogram are not currently published in the public domain.
The governance structures for place-based subcommittees can be found within item no:15 of the governance handbook.
The terms of reference (ToR) of the place-based subcommittees can also be found within item no: 16 of the governance handbook.
(Please see this link to the governance handbook detailing the items above: https://northeastnorthcumbria.nhs.uk/about-us/corporate-information/governance/)
The place-based subcommittees are not meetings held in public however minutes from these meetings are submitted to the ICBs Executive Committee monthly for assurance purposes, including any decisions taken in line with the ICBs scheme of reservation and delegation. The minutes for the Executive Committee are publicly available within the
published Integrated Care Board papers on the website on the following link: https://northeastnorthcumbria.nhs.uk/meetings-and-agendas/

The website address in relation to the following can be located within the published Integrated Care Board papers on the website on the following link: https://northeastnorthcumbria.nhs.uk/meetings-and-agendas/
–  Committee meetings relating to service development
– Changes to service provision
–  The procurement and commissioning cycle i.e., outsourcing of services away from NHS provision

If members of the public wish to raise questions in relation to the work of the ICB, they can do so via the ICBs general enquiries email address: necsu.nenc-icb.contactus@nhs.net

If you have any queries or wish to discuss the information supplied, please do not hesitate to contact me on the above telephone number or at the above address”.

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Saturday 25th November 2023 – Much concern regarding public access to local NHS decision-making meetings and documentation 

KONPNE, Save South Tyneside Hospital Campaign and KONP Sunderland  have, today, forwarded a jointly written open letter to North East and North Cumbria Integrated Care Board which focuses on openness, transparency and collaboration regarding decision-making at local sub-committees and Board meetings. Members of all three North East Campaign groups are increasingly concerned regarding hurdles to public access and involvement, a reduction in local democracy and restricted access to papers and information regarding some of these meetings.

We are aware that the North East and North Cumbria Integrated Care System is managed by a Chair and a Board of Directors, with a duty to provide healthcare for people in the area – but with some flexibility in the way in which it operates. We believe that the 2022 reorganisation of the NHS provides local NHS leaders with an opportunity to review ways forward, and we feel that attention to a number of practical process issues will lead to a healthier way forward for all. 

Go to part 7 (below) to read the open letter to the ICB

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>> Associated NENC ICS documents / links: 

Health Service Journal (17th January 2022) Councils squirm over NHS ‘power grab’

North Tyneside CCG Annual Report 2020/21   (1st June 2021)    Our Vision, Plans and Priorities (pp11-14)

ICS Strategic Five Year Plan    (20th January 2020)     Joint Overview and Scrutiny Committee presentation

In addition to our huge concerns, as identified in Part 3 (above), dissatisfaction has been voiced by Sunderland City Council leader Graeme Miller, who queried “how having an ICS that runs from the Scottish border down to the south of Yorkshire is going to deliver place-based service delivery to residents in Castle ward in Sunderland…..   This is a car crash coming, but the NHS will force it through. What we’ve got to try and do is get them to see sense, and hopefully listen to us and understand that the local authority structure is a very good partner for them. But they’ve got to then treat us like grown-ups. We’re not there as a tick-box exercise.”   Full article: Health Service Journal (17th January 2022) Councils squirm over NHS ‘power grab’

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7:

Much concern regarding public access to local NHS decision-making meetings and documentation – read the North East Joint Campaigns letter to NENC ICS, and the response from the ICB

25th November 2023: KONPNE, Save South Tyneside Hospital Campaign and KONP Sunderland  have, today, forwarded a jointly written open letter to North East and North Cumbria Integrated Care Board which focuses on openness, transparency and collaboration regarding decision-making at local sub-committees and Board meetings. Members of all three North East Campaign groups are increasingly concerned regarding hurdles to public access and involvement, a reduction in local democracy and restricted access to papers and information regarding some of these meetings.

Our open letter:

To:

Claire Riley

Executive Director of Corporate Governance, Communications and Involvement

North East and North Cumbria Integrated Care System

Copies to:

Sir Liam Donaldson,ICB Chair

Samantha Allen, ICB Chief Exec

Cllr Lynne Caffrey, North Area ICP Chair

Cllr Kelly Chequer, Central Area ICP Chair

Cllr Bob Cook, Tees Valley Area ICP Chair

Cllr Mark Fryer, North Cumbria Area ICP Chair

Christopher Akers-Belcher, Regional Co-ordinator, NENC Healthwatch Network

Paul Jones, Healthwatch

Victoria Atkins, Secretary of State for Health and Social Care

22nd November 2023

Dear Ms Riley

Introduction

We write on behalf of the membership of Keep Our NHS Public North East, Save South Tyneside Hospital Campaign and Keep Our NHS Public Sunderland and District.  These three groups serve different geographical areas and have separate structures, yet share a common purpose in campaigning for a publicly funded and publicly provided NHS. Together, we have a strong engagement and following, with proactive Campaign work being present in the North East region for over ten years. Links to our media are provided below.

There are, of course, many challenging issues associated with the concept of “Integrated Care Systems” and “Integrated Care Partnerships”, and we outline some of these at https://konpnortheast.com/ics/     This jointly written open letter to you today focuses on one specific area – that of openness, transparency and collaboration regarding decision-making at local sub-committees and Board meetings. Members of all three North East Campaign groups are increasingly concerned regarding hurdles to public access and involvement, a reduction in local democracy and restricted access to papers and information regarding some of these meetings.

We are aware that the North East and North Cumbria Integrated Care System is managed by a Chair and a Board of Directors, with a duty to provide healthcare for people in the area – but with some flexibility in the way in which it operates. We believe that the 2022 reorganisation of the NHS provides local NHS leaders with an opportunity to review ways forward, and we feel that your attention to the following practical process issues will lead to a healthier way forward for all.

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1: Integrated Care Board

1a: Under current guidance, there is a place on the Board for very minimal elected representation. There is reduced democracy and a very real danger that local voices will not be heard at the ICB at this top level. There needs to be more opportunity for elected Councillors to be co-opted to the Board.

1b: Four of the five ICB meetings this year have been held at The Durham Centre, Belmont Industrial Estate, Durham, the location of which is far from ideal regarding accessibility by public transport – 2.5 miles away from Durham city centre. Given the huge geographical footprint of the ICS, we recommend some consideration be given to arranging a more accessible location, ideally near a transport interchange served by train, bus, metro and with nearby parking. Given that members of the public may wish to attend from North Cumbria, Berwick and as far south as Whitby, with all places in-between, a location (for example) by Newcastle Central Station would seem to be a more obviously accessible choice. We note that the meeting is streamed online and, whilst this is helpful, the meeting undoubtedly needs to have increased physical accessibility to enable full public engagement.

1c: There is a need to know who is speaking – this is important for all verbal reports, and especially for the response to public questions. There would be a huge benefit if the officers at the meeting, when first speaking, would more clearly introduce themselves and their role and this, together with larger name cards, will enable a more fruitful experience for all, especially for those people with visual or auditory difficulties.

1d: Current ICS guidance states that questions to the Board must be based on the agenda – thus a question from a member of the public cannot be prepared before the agenda is published. The time period between the publication of the ICB Meeting agenda and the cut-off date for the receipt of Questions to the Board (questions must be received 3 working days before the Board meeting is held) is totally insufficient. Over the past year, the following very minimal periods were given to pen the question prior to the cut-off date.

I day	prior to November 2022 ICB Meeting
3 days	prior to January 2023 ICB Meeting
1 day	prior to March 2023 ICB Meeting
2 days	prior to May 2023 ICB Meeting
2 days	prior to July 2023 ICB Meeting
1 day	prior to September 2023 ICB Meeting

Given that the ICB meets every 2 months, this window for a member of the public to submit a question is ridiculously small and is an indisputable barrier to public involvement.

1e: We query why a question from a member of the public to the Board must be based on the Boards’ agenda. We require an openness and willingness for the Board also to engage with the patient agenda regarding Board-level activity.

1f: Placing questions from the public at the very end of the meeting gives a message of reduced importance and can, furthermore, add another barrier to engagement for people who may experience specific health or attentional difficulties. It is interesting to note that questions from the public are at the start of the local full Council meetings, which is a more helpful approach.

1g: An option to ask a question in person, and a right to reply would be welcomed

1h: Space is required on the agenda for receipt of petitions

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2: Integrated Care Partnerships

“These local ICPs will develop a strategic picture of health and care needs from their constituent local authority ‘places’ working with a wide range of partners including existing health and wellbeing boards. These provide a vital forum for the NHS, local councils and other partners to assess the needs of local people and set local priorities for health and care improvement”  https://northeastnorthcumbria.nhs.uk/integrated-care-partnership/

2a: At the Strategic ICP meeting held on 15^th December 2022, Sam Allen (NENC ICB Chief Exec) reported that there is an option for the ICP meetings to be held in public https://northeastnorthcumbria.nhs.uk/media/3clbnany/strategic-icp-notes-151222-final.pdf 

Yet, further to our recent (3^rd August 2023) FOI regarding access to the Central and North ICP meetings, we note the ICS response that “the Central and North Area ICP meetings have now met formally and are not currently held in public”.

Decision-making must be transparent, and it is crucial that such key area meetings are made fully accessible to the public at the earliest possible time – in person and streamed. Your timeline on establishing this important practice is welcomed.

2b:  Regarding access to the minutes of the Area ICP meetings, the same FOI response (3^rd August 2023) informs that “future meetings will be held quarterly with the updates provided by the appointed Area chairs at the biannual ICP meetings which are held in public”. Whilst we recognise that there have been only three of the Strategic / biannual ICP meetings to date, and that the feedback by the four Area ICP Chairs at the Strategic ICP meeting of 21^st June 2023 is available on video and is useful in providing an overview, it remains important that the actual agendas, minutes and associated reports from the Area ICP meetings are in the public domain. The ICP Terms of Reference specifically identifies that “Area ICPs can hold meetings in public if they wish, and their minutes will be published on the ICB website”   pg 6  https://northeastnorthcumbria.nhs.uk/media/v11hzbmh/north-east-and-north-cumbria-integrated-care-partnerships-terms-of-reference-08122022.pdf

Likewise, the FOI response informs that “the 4 Area ICP meeting minutes are also shared with the local authority Health and Wellbeing Boards and can be accessed through the respective Local Authority websites” – yet, on perusal, the minutes and actual detail of discussions at the Area ICP meetings are not published on these Local Authority sites.

It is apparent that there needs to be a clear and direct access to the agendas, reports and minutes of the Area ICP meetings – a general overview on such activity is insufficient.  It is suggested that these agendas, minutes and associated reports are made available on the ICB website, in the same way as the papers relating to the Board meetings, and as suggested in the ICP Terms of Reference.

2c:  Currently, the ICP Area meetings are not held in public and there is no public access to the agenda, minutes or reports. There is, thus, no process in place for a member of the public to put a question directly to the Area ICP meeting relating to healthcare provision in their own region.  This important channel of communication must be opened.

2d:  Part 1 of this letter (above) highlights some of the immediate practical issues regarding public involvement with the ICB meeting. There is a need to consider the same practical issues in relation to the Area ICP meetings and the Strategic / biannual ICP meetings.

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3: Place-based Teams

“As well as strategic functions, ICB staff also work at place level with local health and wellbeing boards in each of our 13 local authority areas. These teams also work alongside our 64 primary care networks which are groups of local GP practices, social care teams, and other community-based area providers”  https://northeastnorthcumbria.nhs.uk/

3a: The specific activity of the local place-based teams remains unknown to the public. In the ICS response to our FOI (3^rd August 2023), it is stated that “the place-based subcommittees are not meetings held in public however minutes from these meetings are submitted to the ICBs Executive Committee monthly for assurance purposes, including any decisions taken in line with the ICBs scheme of reservation and delegation”.

As with the ICB and ICP above, it remains our view that the minutes of the place-based sub-committees should be in the public domain. Decision-making regarding commissioning and procurement – the future of our healthcare – is taking place within the place-based and ICP teams, and this needs to be transparent.

————————————————————-

We welcome your consideration of these issues, given the stated commitment of the ICS to “put the voices of people and communities at the centre of decision-making and governance, at every level of the ICS” and to “provide clear and accessible public information about vision, plans and progress, to build understanding and trust” (pp 10-11, NENC ICS Communities and People Involvement and Engagement Framework 2022 – 2023  https://northeastnorthcumbria.nhs.uk/media/mdnhjzay/nenc-involvement-strategy-2022-23-final.pdf ) 

If possible, your written response to each of the above issues would be appreciated, so enabling a clear and effective way of circulating the information throughout the membership of the three North East campaign groups. This open letter is jointly written and reflects discussions at Campaign meetings throughout the year; for your information, this letter is reported on our websites and linked on social media, as will all responses.

Additionally, we feel that it may be helpful to arrange a one-off meeting at some point.

The letter has also been copied, for information, to Sir Liam Donaldson (ICB Chair), Samantha Allen (ICB Chief Exec), Cllr Lynne Caffrey (North Area ICP Chair), Cllr Kelly Chequer (Central Area ICP Chair), Cllr Bob Cook (Tees Valley Area ICP Chair), Cllr Mark Fryer (North Cumbria Area ICP Chair), Christopher Akers-Belcher (Regional Co-ordinator, NENC Healthwatch Network), Paul Jones (Healthwatch) and Victoria Atkins, Secretary of State for Health and Social Care

Yours sincerely

Jude Letham, Co-ordinator, KONP North East

Dr Helen Groom, Steering Group member, KONP North East

Roger Nettleship, Chair, Save South Tyneside Hospital Campaign

Laura Murrell, Secretary, KONP Sunderland and District

Dr Pam Wortley, KONP Sunderland and District

John Whalley, Steering Group member, KONP North East

Please reply to: konpnortheast@gmail.com 

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4th December 2023:

CLICK HERE

to read the response from North East and North Cumbria ICB.  We are meeting to consider this response, and to determine what needs to be developed or clarified further. Watch this space.

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20th December 2023:

and 

CLICK HERE

for our letter reported in The Lowdown

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8:

“Integrated Care Systems” – recent Actions and Campaigns in the North East 

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>>Saturday 25th November 2023 – Much concern regarding public access to local NHS decision-making meetings and documentation 

KONPNE, Save South Tyneside Hospital Campaign and KONP Sunderland  have, today, forwarded a jointly written open letter to North East and North Cumbria Integrated Care Board which focuses on openness, transparency and collaboration regarding decision-making at local sub-committees and Board meetings. Members of all three North East Campaign groups are increasingly concerned regarding hurdles to public access and involvement, a reduction in local democracy and restricted access to papers and information regarding some of these meetings.

We are aware that the North East and North Cumbria Integrated Care System is managed by a Chair and a Board of Directors, with a duty to provide healthcare for people in the area – but with some flexibility in the way in which it operates. We believe that the 2022 reorganisation of the NHS provides local NHS leaders with an opportunity to review ways forward, and we feel that attention to a number of practical process issues will lead to a healthier way forward for all. 

CLICK HERE

to read our open letter to NENC ICB – we will keep you informed of all responses.

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>>9th May 2023 – Poor response from new “Integrated Care Board” in North East

“North East and North Cumbria Integrated Care System” (NENC ICS) has been responsible for commissioning all health care in the region since July 2022. There are, of course, major difficulties with this organisational system, and these are identified on our webpage here.

The Board of the ICS meets every two months and, on reading the Agenda and papers for 28th March 2023 Board meeting, members of KONPNE were shocked to see the number of services in the region which, following CQC inspections, “require improvement” and, also, the required overall “efficiency” target of £48.4 million – all evidence of underfunding and the Governments strategic run down of NHS provision. Click here for the “Integrated Delivery Report” – scroll to item 8:1 on page 96

>> OUR QUESTION: With regard to this important issue, we submitted the following question to the March 2023 ICS Board meeting:

“Keep Our NHS Public North East (KONPNE) is a group of people who strongly believe that the NHS should remain a public service.

Members of KONPNE are very concerned to read in the North East North Cumbria ICB: Integrated Delivery Report February 2023 (Agenda Item 8.1) that a number of services within the ICS are inadequate, according to the CQC. We are aware that the Board have noted this. 

Please detail, specifically, what the Board’s plans are for addressing this situation, given the requirement for the ICB to meet an overall efficiency target of £48.4 million”

>> THE VERBAL FEEDBACK to our question at the meeting was astonishing in both content and brevity. The person who made the response (we remain unsure who it was, as no surname or role was provided) seemed keen to assure that there was nothing to see here, as follows:

No services were rated as OVER-ALL inadequate; North East Ambulance Service was rated inadequate in part and a support package has been put together to look at elements of that (yes – but our question asked for specific details, which  we need to know about)

There is a need for Enhanced Surveillance of some services (yes….details…?)

KONPNE notes that CQC rated a number of other services as “requires improvement” (this issue wasn’t developed in the response – it would have been a good opportunity to update on the actions regarding these services, instead of closing the question down)

Apparently the requirement to bank £48.4million in efficiency savings (flowery name – we know this as BUDGET CUTS) won’t affect the budgets of the services which require improvement (- so end of subject there, apparently no need to expand on that point….)

And the so-called “efficiency savings” / cuts will be made on “prescribing and CSE packages of care” (information about the effects of this and action plan regarding these services would have been useful). 

Thus, in short, we feel this to be a minimal and superficial reply to an important issue, deserving of a considered and respectful verbal  response. Click here to watch the video of the verbal response (click on the image for 28th March, go to 3:28 on the timer slide at the bottom of the video, and don’t blink), and click here to read the Minutes of the meeting (go to page 23).

>> As for the WRITTEN FEEDBACK to our question…. o dear, o dear….  the following, ….err….exceptionally brief written response was received from the ICB on April 23rd 2023, three weeks after the meeting….. what can we say…..:

“Thank you for your question. 

None of the 11 provider organisations in the ICB are rated as inadequate overall. In North East Ambulance Service’s (NEAS) recent inspection, they were rated as inadequate for Well Led but overall as requires improvement. NEAS are being supported by the ICB to work through the actions identified by the CQC.”

>> KONPNE: Obviously, “North East and North Cumbria Integrated Care Board” need to do better regarding public involvement. We read on the ICB website that “The ICB is committed to providing clear and accessible public information to build understanding and trust….. The ICB will provide good quality accessible information that meets the needs of all people in our communities”.  There’s some way to go, then.  We will, of course, be writing to the ICB regarding their paucity of response and  seeking more information about these issues.

>> PUBLIC INVOLVEMENT: And while we’re about it – some issues for the Board to develop around the PROCESS of public accessibility to the Board meeting…. that is, if true public involvement is to be welcomed….

1) We need to know who is speaking? Important for all verbal reports, but especially for the response to the public question!  2) The time period between the publication of the Agenda and the cut off date for the receipt of questions to the Board was NIL for both the November 2022 and January 2023 Board meetings and ONE DAY for the March 2023 meeting.  Given that the Board meets every two months, this window for submitting a question is either non-existant or ridiculously small and is an indisputable barrier to involvement  3) We query why a question from the public to the Board must be based on the Boards’ Agenda?  We require an openness and willingness to engage with the patient agenda regarding Board activity   4) Placing questions from the public at the very end of the meeting gives a message of reduced importance and can, furthermore, add another barrier to engagement for people with certain health or attentional difficulties. It is useful to note that questions from the public are at the start of the local full Council meetings.   5) An option to ask the question in person and a right to reply would be welcomed  6) Space is required on the agenda for receipt of petitions. 

We will be contacting the ICB about these issues as a matter of priority.

UPDATE 15.5.23: 

– We have contacted all seven Healthwatch organisations in the NE, so that they are aware of our concerns.

– NENC ICS have been in touch to offer a meeting to discuss our concerns – this is a positive development, we intend to accept this offer and will keep you updated.

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>> 25th November 2022 – KONPNE responds to the draft strategy for the NHS in the North East

The local “Integrated Care System” (now responsible for all NHS commissioning in the North East and North Cumbria) is in the process of developing a strategy which set outs ambitions and goals for the future. The ICS invited feedback from the public and all stakeholders on their initial draft, and we responded accordingly – KONPNE supporters felt that there are a number of important issues to develop further in this document, including *the need for the NHS to be the default provider of services, to work towards decreasing outsourcing *a commitment to providing a free and comprehensive health service to all  *no private sector representation on NHS decision-making bodies  *Emergency Care for all – no need to be registered with a NE GP  *thorough assessment of needs prior to discharge  *commitment to nationally agreed pay and conditions for staff, and commitment to work alongside Unions.

CLICK HERE

to read our feedback to the local ICS

&

CLICK HERE

to read the ICS draft strategy 2022

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>> 1st September 2022 – KONPNE emails Chair of “North East and North Cumbria Integrated Care System” – again…..

Of course, supporters of KONPNE have huge concerns about the “Integrated Care System”, which commenced very recently (1st July 2022) – these issues are identified on this page in Part 2, above. We wasted no time in contacting Sir Liam Donaldson, Chair of North east and North Cumbria ICS (see below, 26th June 2022) but no response – although, to be fair, the ICS had just started…..but, then again, these issues are fundamental and are of huge importance.

We have resent the original email today, again to the Chair of NENC ICS and this time to the NENC ICS new email address. We expect a response in the near future, and will keep all supporters updated.

CLICK HERE

to read todays email from Jude Letham (KONPNE Co-ordinator) to Sir Liam Donaldson (Chair of NENC ICS). with cc to Sam Allen (Chief Exec, NENC ICS) 

** update 30th September 2022 – no response from NENC as yet. We have updated supporters and reached out to NENC ICS via facebook and twitter posts – click here and here.

** update 13th October 2022 – Further to our facebook and twitter posts in early October 2022, we have now received a detailed response from Claire Riley, Exec Director of Corporate Governance, NENC ICS. We are grateful for the detail in this response, although remain very concerned about much of the content. We will be considering this further and, of course, discussing with supporters.

CLICK HERE

to read the response from Claire Riley

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>> Summer and Autumn 2022 – Formal questions to full Council meetings re ICS – Durham, Sunderland, Newcastle, North Tyneside, Northumberland, South Tyneside and Gateshead

 

>> 9th July 2022 – Sharing information about the ICS at Durham Miners Gala

Although it was baking hot in the marquee, one of the happy perks of campaigning by the side of the stall was that it proved to be a focal point for all our NHS friends and supporters – local and from across the country – and also a place to make connections with people who, we know, we will work together with in the future…. here’s to the future….!

 

>> 2nd July 2022 – Morpeth celebrates and protests

Excellent joint work by KONP / Morpeth and Pegswood Labour Party Branch –  a great joint team action, out and about in Morpeth to celebrate 74 years of NHS healthcare – and to protest some of the key features of the new “North East and North Cumbria Integrated Care System” (NENC ICS). This new body is now responsible for all health commissioning in the region and, yes, not many people had heard about it….
There was an excellent response from the Morpeth public – all leaflets went, the NHS birthday card was covered in messages, and many people scanned the poster/board’s QR codes and sent emails on the spot to the Chair of the new NENC ICS. Unsurprisingly, many people were outraged. It’s OUR NHS. It is not, as yet, totally privatised – but this new ICS holds many dangers.

For info about “Integrated Care Systems” – go to our ICS page here

Does your party or group want to get involved / need a speaker at your Zoom / require more information??? Contact KONPNE at konpnortheast@gmail.com

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>> 2nd July 2022 – The Integrated (?) Care (?) System (?) commences in the North East and Cumbria

Yesterday saw the start of the deeply flawed and curiously named “Integrated Care System” – it is a sad day that we now no longer have a “National Health Service” but, instead, 42 localised and stand-alone “health systems”….. together with their much baggage and many, many problems – see here

North East and North Cumbria Integrated Care System is now responsible for commissioning all healthcare across the region – a “development” which is hugely significant but one which is not widely known nor reported on. 

So…to inform and enlighten…health campaigners and community organisations took it upon themselves and were out in force in Newcastle-upon-Tyne city centre, to get across HUGE concerns. Hosted by “Keep Our NHS Public North East”, we thank speakers from a wide range of community organisations – Dr Helen Groom (Patients Not Passports), John Harrison (Disabled People Against Cuts), Sean Fahey (North East Pensioners Association), Angela Robinson (NHS Nurse – retired), Caitlin Southern (North East Peoples Assembly), Dr Gerard Reissmann (Newcastle GP – retired), Jan Shortt (General Secretary, National Pensioners Convention) and Jude Letham (Keep Our NHS Public North East). Watch this space and our social media for quotations and resumes of the speeches. Many thanks, one and all.

North East Poet Harry Gallagher was, of course, greeted very warmly. His book “Northern Lights” is a love letter to the people of the North, a region often buffeted and battered by stormy conditions – this new “North East and North Cumbria Integrated Care System” being no exception. Harry Gallagher, the People’s Poet, engaged the crowd with his dry humour, brutal honesty, and passionate conviction...and, starting and ending the rally, we were also very fortunate to welcome musician JohnE Thornton. JohnE has worked in the NHS for 10 years, and is now well-known on the Newcastle and coastal scene for the music gigs he hosts and plays in. Many, many thanks to both Harry and JohnE. 

We mustn’t forget that Tuesday next week marks 74 years of healthcare from our NHS. There is no celebratory gateau this year…we reckon 42 separately baked, cut-price cupcakes would be a more accurate motif….but that menu can be changed. Please sign the petition, email the Chair of the ICS, liaise with your local Councillor, contact your MP, link up with your Healthwatch, get involved in our actions and speak up – we need to fight to reinstate our NHS.

….and, so, it is now over to all people living and working in the NE to get involved with the Campaign and to continue the fight in this region. Click here for details of the Integrated Care System….and please be active – click here to find details about our forthcoming Campaigns.

If you want an NHS, you need to be an NHS activist.  

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>> 26th June 2022 – HUGE CONCERNS: KONPNE contacts Chair of NE Integrated Care System

There are, of course, HUGE concerns regarding the curiously-named “Integrated Care System” – a misnomer, if ever there was one.

It is a sad day indeed that there is no longer a unified national health service but, rather, a collection of 42 separate health divisions across England, each responsible for making decisions about treatments and commissioning services for their geographical area. “North East and North Cumbria Integrated Care System” (NENC ICS) is now responsible, as from 1st July this year, for the healthcare in the North East.

CLICK HERE

to read todays email from Jude Letham (KONPNE Co-ordinator) to Sir Liam Donaldson (Chair of NENC ICS). with cc to Sam Allen (Chief Exec, NENC ICS) 

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>> May and June 2022:  An electronic letter to the Chair of “North East and North Cumbria Integrated Care System”

We need to get the “North East and North Cumbria ICS” signed up to the pledge – no private companies on ICS Boards.

KONPNE campaigned jointly with “We Own It” and local residents against any further privatisation of NHS services within the new “North East and North Cumbria Integrated Care System” (NENC ICS). A HUGE total of 1562 people (1501 by electronic letter and 61 in writing)across the NE joined in the “We Own It” campaign by contacting the Chair of the new “North East and North Cumbria Integrated Care System” to demand the pledge: NO PRIVATE COMPANIES ON ICS BOARDS.

Each ICS is controlled by a board of directors with a duty to provide healthcare for people in the area – but with some flexibility in the way that they operate and with decision-making as to who sits on the Board – hence this focus.  In short, the 2022 reorganisation of the NHS provides our local NHS leaders with an opportunity to reset the direction of travel of our NHS. Instead of continuing full steam toward more and more privatisation, we demand that our local NHS leaders rebuild our NHS and get private profiteers out NOW. It is time for our NHS to stop working for private companies profiting from it and start working for local people who depend on it.

This leaflet from We Own It describes the Campaign action:

SUCCESS – following this action, the Chairs of 12 ICSs came out and pledged that private companies won’t sit on their boards.  These ICSs include Bath & North East Somerset Swindon & Wiltshire ICS  //  Bristol, North Somerset & South Gloucestershire ICS  //  Sussex ICS  //  Birmingham & Solihull ICS  //  Hertfordshire & West Essex ICS  //  South East London ICS  //  Suffolk and North East Essex ICS. 

We need to get the “North East and North Cumbria ICS” clearly signed up to to this pledge – the NENC ICS is somewhat nebulous about this…. (see above)

Remember: If we don’t fight to protect our NHS, we will always lose. But if we fight we have a chance of winning.

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9:

Private sector healthcare providers on the NENC ICS Board? 

The Board of the NENC ICS is set out in the Constitution at point 2.2.3, as follows:

“The board is therefore composed of the following members:
a) Chair
b) Chief Executive
c) Two Partner member(s) NHS and Foundation Trusts
d) Two Partner member(s) Primary medical services
e) Four Partner member(s) Local Authorities
f) Four Non Executive Members
g) One Executive Finance Director
h) One Executive Medical Director
i) One Executive Chief Nurse
j) One Executive Chief People Officer
k) One Executive Chief Digital & Information Officer
l) One Executive Director of Strategy and System Oversight
m) Two Executive Directors of Place Based Delivery – North and North Cumbria and Central and South
n) One Executive Director of Innovation
o) One Executive Director of Corporate Governance, Communications and Involvement
Other board-level Director roles of the ICB (attending as participants rather than voting members) will be at the discretion of the Chair and Chief Executive.

and, as far as disqualification criteria for Board membership is concerned, point 3.2.2 states:

“A person whose appointment as a Board member is considered by the person making the appointment as one which could reasonably be regarded as undermining the independence of the health service because of the candidate’s involvement with the private healthcare sector or otherwise”

and 4.6.6

“All members of committees and sub-committees that exercise the ICB commissioning functions will be approved by the Chair. The Chair will not approve an individual to such a committee or sub-committee if they consider that the appointment could reasonably be regarded as undermining the independence of the health service because of the candidate’s involvement with the private healthcare sector or otherwise”.

and 6.6.6

“As required by section 14Z30 of the 2006 Act, the ICB has made arrangements to manage any actual and potential conflicts of interest to ensure that decisions made by the ICB will be taken and seen to be taken without being unduly influenced by external or private interest and do not, (and do not risk appearing to) affect the integrity of the ICB’s decision-making processes”

Let-out clauses…..

Given the above, and as far as private sector involvement on the Board is concerned, KONPNE remains very concerned about Board membership….. obviously, the words “reasonably”  and “unduly” in the above Constitution can be open to interpretation.

Members of KONPNE were pleased to collaborate with the national campaign group “We Own It” in their “Rebuild Our NHS” campaign. Altogether, a MASSIVE 1,562 people from across the North East contacted Sir Liam Donaldson, Chair of the new “North East and North Cumbria Integrated Care System” to demand the pledge: NO PRIVATE COMPANIES ON ICS BOARDS (scroll down this page for Campaign report).

Click here to read the formatted letter from “We Own It”.

Sir Liam Donaldson, Chair of NENC ICS, provided the following response on the NENC ICS website here:

HEADING: “Thank you to people who contacted our Integrated Care Board (ICB) about the role of private organisations on the North East and North Cumbria ICB”.

CONTENT: Thank you for your email regarding the opportunities ahead for Integrated Care Systems, and in particular the role of the NHS within them. I fully share your desires for local communities and citizens to have a central role in the way we develop services and support for people across the North East and North Cumbria.

Your specific views about NHS contracts and conflicts of interest are noted. I would like to reassure you that the NHS must comply with national rules and laws around procurement and competition. We will seek to ensure all decisions made by the ICB are compliant with those rules, whilst robustly managing any real or perceived conflicts of interest. Our integrated care board exists to significantly improve health outcomes for people who live in our region by working collectively to provide the best health and care for our local communities

The ICB has no plans to delegate any of its functions to bodies or committees that include private healthcare providers. Our Constitution contains criteria for board membership which include specific safeguards against conflicts of interest regarding involvement in the private healthcare sector.  Members of the ICB and its related committees will be required to publicly declare interests, and they will be recorded and managed in line with the ICB’s conflicts of interest policy. Where and when any interest conflicts with the interests of the ICB, that person will play no part in decision making on that matter.

Healthcare services will be arranged in a transparent way, and decisions around who provides services will be made in the best interests of patients, taxpayers, and the population.

We are keen to hear the views of local citizens on a range of topics related to integrated care.  Please use this link to our website to find out further information about opportunities to get involved and have your say.

Yours sincerely,

Sir Liam Donaldson, Chair, North East and North Cumbria Integrated Care Board

Thus, at present, there remains no explicit ruling which absolutely disqualifies a person with professional or financial connections to private healthcare from involvement with the Board and Committees of NENC ICS…. and, with this, lies much scope for further campaigning. A start has been made, in that a huge number of people in the North East and Cumbria now know about this issue, hundreds have contacted the ICS about it, and NENC ICS know that we are closely scrutinising their operational structures and decision-making processes. Yes, definitely much scope for further campaigning – there is absolutely no place for private sector healthcare on ICS Boards and Committees. 

Read this article: Turning Calderdale Green      (July 30th 2022)     Government by diktat: adult social care companies must have decision making powers about NHS and social care commissioning

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10:

Bad news for patients….

The Health and Care Bill has now gained Royal Assent and has become law – this provides statutory powers to 42 Integrated Care Systems throughout England. The following gives an overview of what we are faced with:

and staff….

 

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The following video from Pubic Health Matters gives a good overview:

 

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11:

“Integrated and caring”?   DEFINITELY NOT.

More like “UNDERFUNDED, UNDEMOCRATIC, UNFAIR, UNSAFE”…..

 

April 2022 saw the Health and Care Bill gaining Royal Assent and becoming law – confirming “Integrated Care Systems” as new NHS bodies. From July 2022, the NHS will be divided into 42 pots of money with limited ‘population health budgets’ designed to find more ‘efficiency savings’ aka CUTS. The number of commissioning organisations is reduced from almost 200 to just 42 ICSs – this requires merging (and eventually abolishing) local “Clinical Commissioning Groups” (established as public bodies by the Health & Social Care Act 2012).

Here, in the North East, we sit within the “North East and North Cumbria Integrated Care System”, which covers a huge geographical area from Cumbria in the west, to Berwick in the north and to Whitby in the South – scroll upwards to see the map and the organisations involved. This (and a number of other ICSs across England) is already in place as a partnership organisation, but without legal status and statutory powers, and with no public accountability; in July 2022, this huge organisation will have statutory powers.

One of the major objections we have to ICSs is that they will lead to increased privatisation. Proposals for this top-down re-organisation include tight financial control from the centre and with even less public accountability. The result will be massive new opportunities for private companies through the ‘Health Systems Support Framework’ (HSSF) – set up to facilitate easy contracting by ICSs. The Framework consists of organisations accredited by NHS England to support the development of internal structure and management of ICSs, and, potentially, also to play a long-term role in direct management of ICSs. A quarter of the 83 organisations approved by NHSE to take on contracts with ICSs, and potentially also take seats on decision-making Boards of ICSs are American-based, offering expensive data-based systems designed to benefit US insurance companies and private hospital chains.

Additionally, NHS England argues that existing law, such as the Health and Social Care Act (2012), does not provide a sufficiently firm foundation for the work of ICSs, so they propose scrapping Section 75 of the Act, which, for example, requires commissioners to put any contract worth over £615,278 out to tender. Removing Section 75, by itself, won’t reverse the marketisation of the NHS. Worse still, it would involve revoking Procurement, Patient Choice and Competition Regulations, so turning the NHS into an unregulated market. The proposals also recommend that NHS services be removed from the scope of the Public Contracts Regulations 2015, allowing commissioners more discretion when procuring services. It means that ICSs would be able to choose whether to award a contract directly to a provider or go through a more formal procurement process. Such flexibility massively increases opportunities for cronyism.

It remains clear that ICSs will be instrumental in further developing privatisation and, indeed, opening up the NHS to very large-scale (ICS-size) takeovers by multinational corporations and institutions.

A second major objection we have to ICSs is the lack of democracy and accountability; there will be little scrutiny by our local Councils and it will be much more difficult to oppose any decisions to ration NHS services or deny access to care. The huge ICS organisation would be more remote from the needs and concerns of any local community. This point has been powerfully argued by the all-party Local Government Association (LGA), which represents the leaders of 335 of England’s 339 local authorities. Their response (29th December 2020) to the recent consultation states:

“We are concerned that the changes may result in a delegation of functions within a tight framework determined at the national level, where ICSs effectively bypass or replace existing accountable, place-based partnerships for health and wellbeing…. Calling this body an integrated care system is to us a misnomer because it is primarily an NHS body, integrating the local NHS, not the whole health, wellbeing and social care system.”

ICSs will be statutory NHS bodies and, as such, limited in their ability to work in partnership with others, such as with local authorities in addressing health inequalities.  

“In contrast to local authorities, ICSs are not subject to democratic control. NHSE’s proposals will give them the power to create publicly unaccountable joint committees, potentially including representatives from private business, to make legally binding decisions about major resource allocation and service provision….Although ICS Boards will supplant existing public bodies, there appears to be no requirement for them to meet in public, publish their Board papers and minutes, be subject to the Freedom of Information Act, or to have any democratic participation from the communities they cover.”    Keep Our NHS Public comment is here

Thirdly, KONP rejects the assumption, repeated frequently throughout ‘Integrating Care’, that social care might be managed through NHS ICS structures. KONP campaigns for a publicly provided national care and support service. At local level, we argue it is essential that social care continues to be managed by local authorities, retaining essential links to wider local authority responsibilities such as housing, education and leisure.

In its response to NHSE’s proposals, the Local Government Association (the national voice for local government) raises concerns that ICSs won’t be a partnership of equals across the broader health, wellbeing, and social care system. Instead, ICSs will be NHS-led, allowing a power grab that brings LA resources such as capital assets and funding for social care and public health under ICS (and thus NHS) control. There is also a risk that power won’t be devolved to local systems. Rather, central control will remain, with missed opportunities for real collaboration between the NHS and LAs to address the wider determinants of health, such as affordable housing and a safe environment.  Local Government Association response is here

Integrated and caring? Definitely not.

“Our concerns, based on hard facts, are widely shared by councillors, senior NHS management, GPs and seasoned analysts. NHS England’s proposed changes threaten to make the NHS less locally responsive, less accountable, more dominated by US and other management consultants and contractors, and more focused on policing cash limits than meeting the needs of patients. NHS England’s priorities should be on strengthening the NHS in alliance with local government and communities, not creating new remote bodies or adopting systems meant to maximise profits of private health insurance”   National KONP, January 2021

“It is really important to understand that ‘integration’ as in Integrated Care Systems means ‘disintegration’, centralisation, loss of public accountability, opening door wider to private companies, driving down quality to reduce costs, rationing, and a fundamental shift way from a universal service providing comprehensive care to all, free at the point of use”   Dr John Puntis, KONP Co-Chair, 7th February 2021 here

“The NHS is not a ‘religion’, as some would sneeringly suggest, but a hard-won right to receive medical care unconditionally when we are in need. It’s a right that we are losing fast”    Deborah Harrington, Public Matters, 12th February 2021 here

 

“People are amazed that the government is going ahead with a massive “reorganisation” of the #NHS, despite the chaos caused by the pandemic. But this is to misunderstand disaster capitalism. It’s going ahead now BECAUSE of the chaos, hitting when the NHS is least able to resist”.   12th July 2021 @GeorgeMonbiot

 

“These proposals are incoherent, de-regulatory, off-target, and badly timed. They will do next to nothing to remedy the serious shortcomings highlighted by the pandemic: a depleted NHS, a privatised social care system, with over-centralised, fragmented and part-privatised communicable disease control and public health systems. Joined-up legislation is needed to revitalise local authorities and to rebuild public services”   Professor Allyson Pollock and Dr Peter Roderick, Newcastle University, 11th February 2021 here

“This bill will help ease the way for more private funding and provision of health services. MPs and local authorities will have little influence over the decisions”    Professor Allyson Pollock and Dr Peter Roderick, Newcastle University   7th December 2021

Read the recent Opinion article in The Guardian by Prof Allyson Pollock and Dr Peter Roderick (Newcastle University) : 7th December 2021   If you believe in a public NHS, the new health and care bill should set off alarm bells    

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12:

Impact on the pay, terms and conditions of NHS staff

The Health and Care Act carries significant dangers for the NHS workforce. 

A ‘flexible’ (or malleable) workforce? The ‘flexible working’ envisaged would require NHS staff to move as required, and in some instances rapidly, to different organisations and locations. This could prove highly disruptive for individuals’ working and personal lives, especially bearing in mind the large geographical area most ICSs will cover. 

Nor is there any sense of concern that the lack of a stable workforce in any location could not only be hugely stressful but create a barrier to the kind of team building that is fundamental to good patient care and work satisfaction. It’s also a matter of concern that the kind of workforce flexibility expected could serve to undermine effective trade union work and so, over time, pose an indirect threat to employment terms and conditions.

Professional regulation?   What the Act does include are provisions for deregulation of the professions. And despite a recommendation from NHSE (and in contrast to the Health and Social Care Act of 2012 that ostensibly put clinicians at the centre of planning services), there is no statutory requirement in the Act for a seat on each ICS Board for a medical or nursing representative.  This absence seems consistent with the Act’s focus on professional deregulation.

The Act gives powers to the Secretary of State for Health to use secondary legislation to remove a healthcare profession from regulation, and abolish the regulatory body for that profession.  One of the stated objectives behind this move, outlined in the policy paper Health Care Bill: professional regulation is to support the development of a flexible workforce…..

Pay, terms and conditions?   Insecurity for staff is implied by the Act requiring each of the 42 ICSs to draw up its own constitution (to be approved by NHSE), setting out how an ICS Board (ICB) will carry out its functions, including how the terms and conditions of its employees will be determined (our emphasis).

Rachael Maskell (MP) picked up this point during the Bill’s second reading, apparently referring to provisions for the transfer of staff when CCGs are abolished. She expressed concern that the proposed legislation would allow an ICS to alter the terms of Agenda for Change (AfC), the national framework for ensuring equal pay for equal work for NHS staff.

The Health and Care Bill will have long-term and worrying implications for the NHS, not least for its staff. It potentially enables new structures and ways of working that will threaten pay, terms and conditions, undermine job satisfaction and patient safety, and devalue skills and experience while weakening professional autonomy and unionisation.

MANY THANKS to national KONP for the above analysis – the full article is available on the national KONP website here. To avoid confusion, we have replaced the word “Bill” with “Act”.

From Sharon Graham, UNITE General Secretary (22nd September 2021):

“The government’s new Health & Care Bill is a Trojan horse for more privatisation, cronyism, austerity and a licence for politicians to run down and sell off the NHS. Attempting to drive this through whilst we are still in the middle of a pandemic and without a care for staff and patients is a disgrace, Unite is opposed to this disgraceful bill and we will lead a serious and effective campaign to ensure this bill is stopped. We need you all to act now, wherever you work, whichever sector, community, retired, or young members we need you all to get involved and defeat these plans that will give our NHS to profiteers at the expense of staff and all patients.

If this Bill is passed, all of us will be impacted – we need you all to act now and write to your MP to demand they oppose this Bill. NHS staff and patients will be left in a vulnerable position with this Bill leaving the door wide open for Alternative Provider Medical Services (APMS) to cherry pick services and undermine current working practices. APMS contracts have been described by legal professionals as “the private sector’s gateway to providing primary health care to NHS patients”. They allow companies that are not owned or controlled by medical professionals to run GP surgeries.

This Bill is deeply flawed and creates pathways for health systems that are based on models developed by the private insurance industry in the USA and elsewhere, controlled for profit against patient care. We must not let this Bill pass and destroy the universal and patient care driven service we all cherish.

Our NHS needs investment not more privatisation – help us defeat this Bill and take action now.  Thank you

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13:

Impact on local decision-making and democracy in the North East

The North East and North Cumbria integrated care system (ICS) is the largest ICS in the country, covering a 3.5 million population spanning Northumberland, Tyne and Wear, County Durham, Tees Valley and North Cumbria – see map above. There is much concern locally about its size and the Bill says nothing about how “place” based decisions will be made for such a large population. Local participation on the ICS Board and Partnership Board appears to be minimal. In addition, the Secretary of State stands to acquire 138 new powers to intervene in local matters.

There is a real danger that local voices may not be heard at all under the current proposals – it will be much more difficult to oppose any decisions to ration NHS services or deny access to care. Currently, changes to health service provision are discussed and agreed between health, Local Authority and other stakeholders at the local “Health and Wellbeing Board”, and changes are scrutinised by local Councillors sitting on the “Health Scrutiny Committee”. All this will change, with much less input from local Councillors, our elected representatives, and thus decreased local democracy.

The point that huge ICS organisations would be more remote from the needs and concerns of any local community has been powerfully argued by the all-party Local Government Association (LGA), which represents the leaders of 335 of England’s 339 local authorities. Their response (29th December 2020) to the recent consultation states:

“We are concerned that the changes may result in a delegation of functions within a tight framework determined at the national level, where ICSs effectively bypass or replace existing accountable, place-based partnerships for health and wellbeing…. Calling this body an integrated care system is to us a misnomer because it is primarily an NHS body, integrating the local NHS, not the whole health, wellbeing and social care system.”

The Health Service Journal recently reported (27th July 2021) that 9 councils in Cheshire and Merseyside have recently set up a series of “red lines” and pre-conditions which they say must be met for an integrated care system to be successful. The fact that these Councils in the North West feel the need to set out any “red lines” is an indication that the Bill’s proposals will largely sideline local authorities and should be seen as an attempt by Councillors to ensure genuine collaboration to meet their responsibilities and determine outcomes.

In November 2021, all Conservative councillors in Oxfordshire County Council voted for a motion that was critical of the Health and Care Bill. See the motion here

……and, on 17th January 2022, dissatisfaction from Sunderland City Council leader Graeme Miller, who queried “how having an ICS that runs from the Scottish border down to the south of Yorkshire is going to deliver place-based service delivery to residents in Castle ward in Sunderland…..   This is a car crash coming, but the NHS will force it through. What we’ve got to try and do is get them to see sense, and hopefully listen to us and understand that the local authority structure is a very good partner for them. But they’ve got to then treat us like grown-ups. We’re not there as a tick-box exercise.”   Full article: Health Service Journal (17th January 2022) Councils squirm over NHS ‘power grab’

November 2021: Letter by Dr Pam Wortley, Sunderland and District KONP

The Lowdown      (6th February 2022)     NHS reorganisation proceeds before health bill has been passed

Health Service Journal     (17th January 2022)   Councils squirm over NHS ‘power grab’

999 Call for the NHS    (2nd December 2021)   Responding to draft NHS Integrated Care Board Constitution public consultations

The Lowdown    (20th September 2021)   Gaps in Bill question level of local control

Keep Our NHS Public    (2021)    Local Authority Scrutiny of NHS Provision

Health Service Journal    (27th July 2021)  HSJ- Council Red Lines

British Medical Association    (14th July 2021)    ‘Wrong Bill at the wrong time’ – BMA council calls on MPs to reject Health and Care Bill 

The Lowdown    (9th July 2021)     New Health & Care Bill will gag local voices 

Local Government Association    (29th December 2020)       LGA response to NHS England and NHS Improvement consultation on integrated care systems

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Sunny days, dark news, 2021/22: Spreading the word about the Governments plans to NHS staff, day patients and visitors outside the RVI, Freeman, and North Tyneside General, and also at Grey’s Monument (Newcastle), Whitley Bay, Consett, Blyth, and street theatre with a serious message in Newcastle, Blyth, Consett and Bishop Auckland.

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15:

LINKS – newspaper items, opinion pieces, reports  

Morning Star     (1st March 2023)        It’s time to call out Integrated Care

Turning Calderdale Green      (July 30th 2022)     Government by diktat: adult social care companies must have decision making powers about NHS and social care commissioning

Health Service Journal   (24th June 2022)   ‘We want you to feel liberated’ says NHSE    (Liberation???  More like abdication of responsibility….) 

Health Service Journal     (22nd June 2022)   Not all ICSs are created equal

West Country Voices    (11th May 2022)   Integrated Care Systems (ICS) are here. What do they mean for you?

National KONP     (29th April 2022)      The Health and Care Bill becomes an Act: Why it matters to us all 

999 Call for the NHS   (13th March 2022)     What kind of NHS will we have in West Yorkshire come July 1st?

National KONP      (10th March 2022)      This rushed-through Health and Care Bill is a threat to a truly universal NHS

Just Treatment    (March 2022)    2 minute video     The Truth about NHS Privatisation

The Guardian     (28th February 2022)     Patients will be endangered by flaws in health bill, says NHS ombudsman

We Own It     (10th February 2022)   Sajid Javid’s new powers: A massive threat to the NHS as we know it

Somerset Live     (9th February 2022)    Private firm’s involvement in NHS body “looks and smells bad” but has no powers

Health Service Journal     (17th January 2022)   Councils squirm over NHS ‘power grab’

Natalie Bennett, Green Party Peer       (12th January 2022)         Click here for a video of comments in the Lords 

Left Foot Forward    (10th December 2021)      The Health and Care Bill means entire Hospitals can be handed over to corporations

The Guardian     (7th December 2021)   If you believe in a public NHS, the new health and care bill should set off alarm bells    (Allyson Pollock and Peter Roderick) 

Open Democracy    (7th December 2021)   Why can’t the UK government explain what its Health Bill will actually achieve?

National Pensioners Convention    (6th December 2021)   Campaigners join with NPC to call on Lords to stop this bad Health & Care Bill

Consortium News    (6th December 2021)   US Empire Seizes UK’s National Health Service

999 Call for the NHS    (2nd December 2021)   Responding to draft NHS Integrated Care Board Constitution public consultations

Tribune    (24th November 2021)   There’s Still an NHS Left to Save

The Big Issue    (24th November 2021)    Health and care bill: What threat does it pose to the NHS?

Left Foot Forward    (24th November 2021)       How every MP voted on the ‘NHS Corporate Takeover Bill

The Lowdown       (15th November 2021)       The Health and Care Bill “a wasted opportunity” – Justin Madders MP gives an insider’s view

The Lowdown    (14th November 2021)   More flaws exposed in ‘integrated care’

Morning Star    (4th November 2021)     Majority of people in England fear Tories risk extending NHS privatisation, new poll finds

Open Democracy    (28th October 2021)   Vote looms on health bill that would subject English NHS to cronyism and cuts

The Lowdown    (2nd October 2021)   Exploring flaws in the Health and Care Bill 

99% Organisation     (September 28th 2021)    Amending the Health and Care Bill     

Richard Burgon MP (Leeds East)      (25th September 2021)           click here to watch a brief 3 min video / speech in Parliament

999 Call for the NHS    (23rd September 2021)   Health Minister’s Health and Care Bill anti-privatisation amendment is a dead cat

The Lowdown    (20th September 2021)   Gaps in Bill question level of local control

The Lowdown    (20th September 2021)   U turn: No private firms to sit on new Integrated Care Boards

The Lowdown    (15th September 2021)   Sources say no private firms on ICS boards

National KONP    (15th September 2021)    The Health & Care Bill and the new NHS Data Grab

We Own It blog    (13th September 2021)    Justin Madders MP: NHS Bill opens the door to Richard Branson

The Lowdown    (9th September 2021)   Health and care bill takes deep flaws into committee stage

We Own It    (9th September 2021)    The BMA’s Dr Chaand Nagpaul just explained really simply why private companies sitting on NHS boards is such a bad idea.  

Keep Our NHS Public    (17th August 2021)    The Health and Care Bill and what it means for the pay, terms and conditions of NHS staff

Byline Times    (17th August 2021)   THE CORPORATE TAKEOVER OF THE NHS: What Does ‘Privatisation’ of Health Services Really Mean?

Health Service Journal    (12th August 2021)   Change the Health Bill to strengthen governance and democracy 

“Just Treatment” video   (20th July 2021)    Tania and Amy’s Story

999 Call for the NHS    (16th July 2021)     US Health Insurance Provider in prime position to take over new NHS Integrated Care Systems

Zara Sultana MP (Coventry South)      (14th July 2021)           click here  for Parliamentary speech

BMA (14th July 2021)     ‘Wrong Bill at the wrong time’ – BMA council calls on MPs to reject Health and Care Bill    

openDemocracy   (14th July 2021)    Protestors and doctors’ union call on MPs to block new English health bill

The Guardian   (14th July 2021)   Proposed reforms to NHS ‘institutionalise cronyism’, claims Labour 

The National    (14th July 2021)     Health and Care Bill: NHS ‘takeover’ legislation passes second reading

BMA    (14th July 2021)      ‘Wrong Bill at the wrong time’ – BMA council calls on MPs to reject Health and Care Bill   

Allyson Pollock website   (13th July 2021)    Key points and questions for the Second Reading

Also here: Key points and Questions re Bill from Prof Allyson Pollock and Dr Peter Roderick    (13th July 2021)    Click here

999 Call for the NHS    (13th July 2021)      Health and Care Bill – key points and questions ahead of 14 July second reading

openDemocracy    (13th July 2021)     Forget the spin – new English NHS bill is all about cutting our right to healthcare

The Lowdown    (9th July 2021)    New Health & Care Bill will gag local voices

Mirror    (6th July 2021)    Tory health bill published today despite fears it puts ‘private firms at heart of NHS’

The Guardian    (6th July 2021)   Health bill could see NHS contracts awarded without tender process

Guardian   (4th July 2021)   Johnson to announce controversial plans for greater NHS control

The Lowdown    (28th June 2021)    Tory splits on Health Bill

The Lowdown    (28th June 2021)     NHS Reorganisation – a never ending story

Letter from Margaret Greenwood MP to Matt Hancock (11th June 2021) is here

The Lowdown   (28th May 2021)    Virgin given seat on ICS Board

National KONP     (7th May 2021)        Statement on the Health and Care Bill 2021 is here

Leading Health Care    (4th January 2021)     Professor Sir Liam Donaldson appointed Chair for the Integrated Care System for the North East and North Cumbria

We Own It    (11th May 2021)     16 organisations call for NHS Bill to be halted

Socialist Health Association    (10th May 2021)   Centene: The real agenda

We Own It   (7th April 2021)    More privatisation, less accountability – this government’s plans for the NHS

Bright Green   (27th March 2021)    Matt Hancock’s proposals for our NHS are bad news

Private Eye   (March 2021)   A Practice Run

The Lowdown   (21st March 2021)     Bleak prospects for troubled ICSs

Laura Murrell, Secretary, KONP Sunderland and District re “Consultation”   Click here  (obviously some “consultation” responses are more equal than others…..)

Twitter (16th March 2021)  Hancock talking about ‘the false dichotomy’ between public and private… and equating GPs with companies like Virgin   Click here

The Lowdown (6th March 2021)   Can campaigners unite over coming health Bill?

National KONP    (Early 2021)     An overview of the Governments White Paper proposals and why we need to campaign against these proposals is here

Labour Outlook   (26th February 2021)     Hancock’s NHS plans would see the ramping up of privatisation on a scale we’ve never seen before

The Lowdown  (24th February 2021)    The great consultancy boom – from Covid to ICSs

National KONP (18th February 2021)    2021 NHS White Paper: government seizes on the pandemic as an opportunity

The Canary (16th February 2021)    The reasons why Matt Hancocks proposed NHS reforms should worry us all 

Tribune (12th February 2021)   The Next NHS Sell-Off

British Medical Journal (11th February 2021)   A new bill to reform the NHS in England: the wrong proposals at the wrong time     (Prof Allyson Pollock and Dr Peter Roderick)

Stewart Player, National KONP (2021)    Integrated care or healthcare imperialism?

Guardian (11th February 2021)  Matt Hancock to publish plans to give ministers more power over NHS

Mirror (11th February 2021)  Tories unveil plans today to unpick their own disastrous NHS reforms

Dr John Lister: “We have another massive top-down reorganisation which retains the fragmentation and chaos of outsourcing…leaves huge contracts to be allocated without any competition”

John Lister      (11th February 2021)     PRIVATISATION IS NOT BEING REVERSED, BBC News –   Click here. 

Morning Star (11th February 2021)    All spin and no substance in Tories’ health and social-care plan, Unions and NHS campaigners warn

John Kennedy  (early 2021)      for themes, proposals and questions in his paper, click here.

rs21 (10th February 2021)    Are the Tories really reversing NHS privatisation?

Institute for Government (8th February 2021)   Leaked NHS reforms would take us back to the wrong sort of future

The Lowdown (9th February 2021)  White Paper: power grab, sea change or cementing in the status quo?

National KONP (6th February 2021)   Government used crisis to increase privatisation – NHS white paper will endorse

Duncan Poundcake (5th February 2021)    #NHS Not all Privatisations are equal, some are worse and some are Evil…

Health Service Journal (27th January 2021)  CCG mergers must still go ahead in April, says NHS England

National KONP (January 2021)    Integrated Care Systems Summary Briefing

The Lowdown (8th January 2021)   Councils concern about NHS shakeup

National KONP  Integrated Care Systems: The threat to the NHS, social care and public health

Click here for many links to articles about ICSs at “The Lowdown.” 

999 Call for the NHS (January 2021)  Integrated Care – the US Danger

999 call for the NHS (7th January 2021)  We say NO! to proposed NHS legislation that would restrict access to care and profit global companies

Chronicle (17th December 2020)  City leaders back groundbreaking new partnership to transform health and social care services

CK 999 Call for the NHS (14th December 2020)    US companies poised to run NHS following proposed legislation

The Lowdown (6th December 2020)    NHS England pushes for “integration” … but not as we know it

KONP (10th December 2020)   Dangerous NHS restructuring to go ahead despite Covid

The Guardian: Years of underfunding leave NHS ‘woefully short’ for Covid second wave   (5th November 2020)

CCG mergers > ICSs: The Lowdown (September 28th 2020)

https://lowdownnhs.info/integrated-care/crunch-time-for-ccg-merger-bids

Who’s cashing in on ICS’s?    The Lowdown (October 12th 2020)

https://lowdownnhs.info/integrated-care/whos-cashing-in-on-icss/

CK999 Call for the NHS (2nd February 2019)    What changes will patients notice when the NHS is run by Integrated Care Systems and Providers?

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Further detailed analysis of the ICS proposals is given in the three part National KONP document (January 2021) linked below:

• Part 1: Corporate Agenda for Integrated Care  on the themes running through NHSE’s ‘Integrating Care’ including the use of digital and data to drive system working, reform of the NHS payment system, and the influence of multi-national corporates through the NHSE’s Health Systems Support Framework (HSSF);  

• Part 2: An alternative vision: achieving democratic accountability, addressing the lack of democratic accountability in ICSs; 

• Part 3: Social care: relationship to ICSs, considering threats to social care from ICSs. 

All documents are linked here

 

KONPNE Briefing Papers (October 2019)

These two Briefing Papers are for use by all members of the public – copies were sent to all Councillors in the NE in October 2019 …. they were warned….

Accountable Care Organisations and Integrated Care Systems        2019 KONPNE briefing – ACO and ICS

We need to be worried about the NHS Long Term Plan, Integrated Care Systems and Primary Care Networks          2019 KONPNE briefing – We Need To Be Worried

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16:

“Sustainability and Transformation Plans”(STPs) and “Accountable Care Organisations” (ACOs)

Remember them? 

CLICK HERE

for information about the forerunners to the Integrated Care System

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Website notes

From the 1st of July 2022 our NHS across England was reorganised. England was divided into 42 new NHS bodies / “Integrated Care Systems”. Each ICS is controlled by a board of directors with a duty to provide healthcare for people in the area.

THE REALITY: Integrated Care Systems 1) Allow private companies like Deloitte to sit on boards that make decisions about how to spend NHS money   2) Introduce the American model into our NHS where unaccountable decision making bodies prioritise profit margins and making savings over caring for people’s health. This model is likely to lead to cuts and closures of NHS hospitals and A&E   3) Push more people to go private as cuts are made. Patients have already been promised greater rights to choose private treatment and have it paid for by the NHS   4) Open the door to more cronyism –  yet more contracts would be given to government pals like Serco, as we’ve seen in the pandemic, but without any competition – that’s what the government means by ‘reducing bureaucracy’   5) Encourage private companies to take the NHS to court if they’re unhappy. 

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