Survey About Integrated Care Systems NHS England are conducting a survey about Integrated Care Systems (ICSs). If you already know about ICSs, you may want to go straight to these links. The Integrating Care Document link is here and the Survey link is here
If you are unfamiliar with ICSs a good starting point isthis articleand there are many more links to articles and KONPNE briefings on our website or at “The Lowdown.”
In short, NHS England (NHSE) is consulting on their latest plans for ‘integrating care’, including changes to legislation. The proposals include a top-down re-organisation of the NHS in England under 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). 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.
The main objections we have to ICSs is the lack of democracyand accountability (there will be no 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) and increased privatisation as ICSs will be instrumental in opening up the NHS to very large-scale (ICS-size) takeovers by multinational corporations and institutions.
This Spring we are facing the introduction of parliamentary legislation designed to confirm what are known as ‘Integrated Care Systems’ as “NEW NHS BODIES”. These will divide up the NHS into approx. 42 pots of money with limited ‘population health budgets’ designed to find more ‘efficiency savings’ or as we know it – CUTS.
Click here and read on – American Accountable Care (“Integrated Care Systems” in UK) has no place in our NHS. Please take a few minutes to explore the following link – it clarifies the situation we face in 2021….
>>>Cuts and closures: Sustainability and Transformation Plans (STP’s)
The NHS is underfunded. The Government says that we can’t afford more, but we know that this underfunding is a political choice – along with the subsequent cuts, closures, lengthening waiting lists and demoralisation of staff.
The reality is that the UK, the worlds sixth largest economy, chooses to spend significantly less per head on health than Germany or France – and less than half what is spent in the US or Switzerland.
>> Draft Northumberland, Tyne, Wear and North Durham Sustainability and Transformation Plan (Nov 2016) Full document: NTWND-STP-final-submission-combined
>> April 2017 Guidance from Newcastle City Council’s “Wellbeing for Life Board” about the “Communities and Neighbourhood model” ishereThis paper proposes ways in which the STP may fit within organisational structures.
>> NHS England guidance on engagement and consultation re STP’s is here:engag-local-people-stps
>>>Privatisation of the NHS: Accountable Care Systems (ACS’s), Accountable Care Organisations (ACO’s), Integrated Care Systems (ICS)
The growing privatisation of our NHS includes awarding large commercial contracts for hospital, community and general practice to private businesses and corporations such as Virgin Care, Care UK, and HCA. Services such as ambulance, laboratory, cleaning and IT are also outsourced. The competition for contracts leads to aggressive cost-cutting, with loss of services and deskilled, poorly paid and demotivated staff.
Now, Government plans for “Accountable Care Organisations” risk wholesale NHS privatisation by tendering a single massive contract to run all of the hospitals, community services and, sometimes, social care services in one geographical region. Bidders are likely to include US healthcare giants and, equally deadly, private – public partnerships between finance corporates and NHS Trusts. The Government claims that these commercial contracts are needed for the “joined up” services that we all want. In reality, they will destroy our NHS. We need to restore our NHS as a publicly planned, run and publicly owned NATIONAL service, funded through taxation
>> Jon Ashworth identifies serious concerns re STP’s and ACO’s: Changes regarding healthcare provision must be debated and voted in Parliament New Statesman 8.12.17
>> Legal Challenge to the ACO’s number 1: 999 Call for the NHS is here
Working with public law firm LEIGH DAY, 999 Call for the NHS believe that the ACO contract is unlawful under current NHS legislation, on the grounds that the contract does not link payment to the number of patients treated and/or the complexity of the medical treatment provided. It fails to ensure that there would be sufficient money to meet the cost of delivering NHS services to the required quality standard.
>> Legal challenge to the ACO’, number 2: Judicial Review for the NHS (JR4NHS) is here
Working with public law firm LEIGH DAY, the JR4NHS team believe that ACOs would fundamentally change the NHS and many private businesses could profit from this radical reorganisation of health and social services. These private businesses would have control over the allocation of NHS and taxpayers’ money. Their accountability for spending it and their obligations to the public would be under commercial contracts, not statutes. This is not in the public interest. It is also against the public interest that ACO’s are being introduced by stealth, without proper public consultation and without full Parliamentary scrutiny.
>> Parliament debates e-petition on NHS Privatisation (April 2018)
Petition: Stop the privatisation of NHS services
We call for a ban on the outsourcing (privatisation) of NHS services, and stop the renewal of any outsourcing contracts already signed. Companies should not be profiteering from NHS contracts, when every pound of NHS budgets is desperately needed for more doctors and nurses, and to pay them more.
Research by Bain & Company published by the Financial Times in January 2017, found that private-sector companies had been invited to bid for 14 per cent more NHS contracts in the 12 months to August 2016 than just a year previously. In March 2017 the Financial Times also reported of the extra £2bn given to the NHS in 2014 to try and bolster NHS services, according to data analysis carried out by the Health Foundation, an independent charity, only about half this extra money was spent in the NHS.
>>> Presentation to North East Joint STP Health Scrutiny Committee by Amanda Hume, Executive Lead for Transformation and Strategic Commissioning (Jan 2019) – click on item 5 An Aspiring Integrated Care System
Local and national NHS documentation relating to ACO’s
>> National report from The Centre for Health and the Public Interest; this report was published in April 2015, but still provides some important information and pointers for future action
>>> Backdoor privatisation of the NHS: “Wholly-owned Subsidiary Companies” (SubCo’s) / “Arms-Length Companies“
“A wholly owned subsidiary is an organisation set up at arm’s length but still owned by the trust. It means that those services currently provided in-house will be provided by a separate company that will employ staff who currently work for the NHS.
Trusts claim that money will be saved by exploiting a tax loophole, but the major savings will come from employing new staff on non-NHS terms and conditions with no access to the NHS Pension Scheme.
….this is a form of backdoor privatisation, with direct consequences for healthcare staff and potentially damaging ramifications for the NHS.”
The 2017 Naylor Report proposes selling off NHS assets. This latest Public / Private Partnership scam involves the government working with property developers to force a “fire sale” of valuable NHS buildings and sites. These developers will then build “community hubs” and lease them back to the NHS, making massive profits. These sales are going ahead without planning for future need and with no public consultation.
Please click on the website NHS Property Services for details of NHS building and land currently under offer / recently sold. Once the land and buildings have gone, it makes privatisation all the more easy…..