A stall with information about the rapid privatisation of Calderdale NHS surprised many members of the public in Hebden Bridge on Saturday morning.
The stall, under the Christmas tree in St George’s Square, was run by members of Calderdale NHS 38 Degrees, a group which campaigns to keep the NHS public and stop backdoor privatisation of the NHS.
Janet Bertola, a member of Calderdale NHS 38 Degrees group, said,
“NHS privatisation’s going on before our eyes, but we just don’t see it.”
Eileen Wright, a Hebden Bridge resident, admitted:
“I don’t know anything about this.”
Many Hebden Bridge residents signed the Calderdale 38 Degrees NHS petition, addressed to Calderdale Clinical Commissioning Group (CCCG).
Calderdale Clinical Commissioning Group was set up under the 2012 Health and Social Care Act, in order to commission a range of NHS services for Calderdale, including elective hospital care, rehabilitation care, urgent and emergency care, most community health services, and mental health and learning disability services
The petition, already signed by over 1,200 residents in and around Halifax, tells Calderdale Clinical Commissioning Group:
“Our NHS is precious, and we’re relying on you to protect it. Please do all you can to stop local health services being broken up or taken over by irresponsible private companies.
- Protect local NHS services and consult patients properly before making changes.
- Spend money wisely and don’t do deals with irresponsible private companies.
- Adopt policies and a constitution which reflect these values.”
Jim Wilson, a member of Calderdale NHS 38 Degrees, said:
“We’re finding people are very concerned. Everyone’s very surprised to know the extent to which NHS privatisation’s already occurred.”
Time is of the essence – Calderdale A&E saved lad from brain damage
Helen Richardson-Foster, a Hebden Bridge resident who eagerly signed the petition, said she was extremely worried about the proposal to move Calderdale Royal Hospital A&E to Huddersfield:
“Living in the Upper Calder Valley, it’s quite a long way to Halifax as it is and you’re looking at a good hour to get to Huddersfield. My nephew was rushed to A&E in Halifax with a head injury last week and the fact that he could get to Calderdale Royal Hospital in a matter of minutes was vital. If he’d had to go to Huddersfield, he would have been brain damaged.”
Calderdale 38 Degrees NHS welcomes new members who want to join the group and take part in their campaign to keep the NHS public. Anyone interested in finding out more, or supporting the Calderdale 38 Degrees NHS campaign, can get in touch with the secretary, at Calderdale38degrees@gmail.com .
List of privatised health services in NHS Calderdale
The list of privatised health services in NHS Calderdale is already long. A partial list of privatised NHS Calderdale services follows, below. (There are probably more, but this is all I’ve been able to find. In response to a request from Calderdale NHS 38 Degrees, CCCG agreed to put its register of private contracts (PDF file) on its website.
Update 27 Nov 2016: Calderdale Clinical Commissioning Group’s September 2016 Register of contracts is here
There are three main causes of NHS privatisation in Calderdale:
- the Equitable Access (Practice Plus) scheme, introduced by the New Labour government, set up a number of new GP surgeries run by private companies like Care UK and Virgin Healthcare
- the Any Willing Provider/ Any Qualified Provider privatisation scheme introduced by the Department of Health under the Coalition government
- competition rules about commissioning healthcare, introduced by the Health and Social Care Act 2012, that came into effect on 1 April 2013.
Any Qualified Provider privatisations, based on Department of Health list of services
In 2011, the Department of Health introduced a national list of services that all NHS commissioning organisations would have to privatise from April 2013, by allowing “Any Qualified Provider” to offer services to NHS patients.
Calderdale NHS Primary Care Trust (the organisation that was abolished to make way for Calderdale Clinical Commissioning Group in 2013) decided to treat 2012/13 as a transitional year for privatising some services from the Department of Health list, starting with:
- Diagnostic Tests and Scans
- Sexual Assault Counselling
- Adult Psychological Therapies
In November 2011, the Calderdale, Kirklees and Wakefield District Cluster Board committed to “Increasing the range of providers in the local market”, and expected all “clusters” – i.e. NHS Calderdale, NHS Kirklees and NHS Wakefield – “to support the further development of competition and choice”.
At that time (November 2011) there were no privatised NHS services in Calderdale under the Any Qualified Provider (AQP)/Any Willing Provider rules.
Now, based on information gleaned from the Supply2Health website, the following community and mental health services in Calderdale have been privatised under AQP rules:
- Diagnostics – Primary care/Community/outpatient Magnetic resonance imaging
- Primary Care Psychological Therapies (Adults) – this contract seems to have gone to Oakdale MHCO
- Community Direct Access Non-Obstetric Ultrasound Service – this contract seems to have gone to Care UK Community Diagnostics
- Analysis of Respiratory Care Services in Calderdale, in order to make recommendations for future delivery of respiratory care
- Prevention in Asthma:reviews for Children and Young People in Calderdale – a project team to deliver asthma training and one to one support, across the 27 Calderdale GP practices
- Community Dermatology GP with Special Interest Service (2012) – a community dermatology service in Calderdale for one year, to support clinics in a central community location, staffed by specialists from our local GP workforce. Looking to develop a long term integrated model of dermatology provision in 2013. The contract went to Virgin Healthcare.
Equitable Access (Practice Plus) privatisation of GP services
Based on information from the Supply2Health website (some of which I can’t make head or tail of), the following GP services in Calderdale have been privatised:
- Three new GP surgeries – under a contract called NHS Calderdale Equitable Access (Practice Plus) ref no.Q32/10/0009 The provider is Assura LLP. There is information about this contract here.
- 2 GP surgeries for at least 9,000 people, Equitable Access to Primary Medical Care/Practice Plus programme Likely total contract value (minimum) £4,500,000.00 – £5,600,000.00 (maximum) Likely service start date 01/02/2012. Don’t know what this is. Think it may be the Care UK walk in centres in Tod and Halifax (now taken over by Locala CIC under a new contract for evening and weekend openings). More info about them here.
Calderdale Clinical Commissioning Group’s invitations to tender for various other NHS services – mostly to do with intermediate care beds, end of life care, telehealth and telecare gadgets for Care Homes
Presumably Calderdale CCG’s decision to invite private companies as well as NHS trusts to tender to provide all these NHS services was based on Health & Social Care Act 2012 “competition” rules. There is information about Calderdale CCG’s procurement policy here.
Many of these contracts are about providing Care facilities, so that people with ongoing health problems can be discharged from hospitals. Is this a way of making the NHS pay for cuts to care services? These cuts have caused bottlenecks in hospital wards that are unable to discharge patients, because they have nowhere to go; the bottlenecks are one reason for the pressure on A&E, because there are no ward beds to put people in who’ve come into A&E.
Here’s a list of the contracts/invitations to tendercompiled from the Supply2Health website:
- Intermediate Care Residential Beds (2013) – to provide intermediate care beds for adults who do not need to be in hospital, but who need a period of intensive rehabilitation before returning to their usual place of residence or agreed onward placement. The service will consist of 20 residential beds, to be located within Calderdale or its immediate surroundings. The contract for residential beds will be for one year only. A review of the demand for these beds will be undertaken during that year.
- A second contract for Intermediate Care Nursing Beds (2013 for 3 years, likely contract value: £430,000.00 (minumum), £2,600,000.00 (maximum). The service will consist of 30 nursing beds, to be located within Calderdale or its immediate surroundings.
- NHS-funded Domiciliary Care – Long-term care; Respite care; Home care. Calderdale NHS has set up a “framework” (ie a list of any qualified providers) for NHS funded domiciliary care provision, including care provided to people with complex needs, care funded under Continuing Care and end of life care. It is likely that the domiciliary care list will be in place for a period of 4 years. Providers who are successful in their applications to become a provider will contract under the terms of a contract based on NHS standard terms and conditions. There will be no guaranteed minimum level of work. (This is kind of like a zero hours contract for NHS services.)
- Safeguarding Specialist Health Assessment and Intervention. Reference number 5J6/13/0011. Likely total contract value (minimum) £90,000.00 – (maximum) £120,000.00 . Likely service start date 01/07/2013. To deliver a six month project that will:-Work as part of an integrated multi-professional health and social care safeguarding adult’s team, accountable to the jointly funded Safeguarding Adults Manager for Calderdale Council; Scope the themes and trends in relation to unsafe hospital discharges across community, nursing and residential care homes; provide the evidence about the long term resource requirements for a multi-agency safeguarding adult’s team.
- Calderdale In Hours Primary Medical Services to Intermediate Care Beds. Reference number 5J6/13/0013. Likely total contract term 1 year from 15th April 2013. Option to extend contract -No. Likely total contract value (minimum) £6,660.00 – (maximum) £134,275.00. Likely service start date 01/04/2013. To provide in-hours primary medical services to adults in intermediate care beds who do not need to be in hospital, but who need a period of intensive rehabilitation before returning to their usual place of residence or agreed onward placement. Nursing beds: 15 beds in Home 1 (in the Halifax area) 8 beds in Home 2 (in the Halifax area) 7 beds in Home 3 (in the Brighouse area). Residential beds:10 beds in Home 4 (in the Sowerby Bridge area), 5 beds in Home 5 (in the Halifax area), 5 beds in Home 6 (in the Todmorden area).
- Integrated End of Life Care Pathway. Reference number 0CF/13/0011 Likely total contract term 2 year(s). Option to extend contract No. Likely total contract value (minimum) £0.00 – (maximum) £527,000.00. Likely service start date 01/06/2014. (Update: The Clinical Commissioning Group awarded this contract to Calderdale & Huddersfield hospitals trust).
- To support implementation of the end of life care pathway for Calderdale, “Calderdale CCG will commission an end of life facilitator to embed end of life tools, champion key quality standards across the pathway and coordinate training and education to meet local needs. There is currently no dedicated end of life care facilitator within the area. Key tasks of the facilitator role would include an Out of Hours Community Nursing Service. This would involve a dedicated nursing team, which will provide planned and crisis visits out of hours, as well as telephone support to patients and carers, and generalist palliative care advice and support to other professionals such as care home staff. It is proposed that this team is in addition to the existing structure and will be ring fenced for end of life patients. The Out of Hours team will facilitate and support discharge out of hours from Calderdale and Huddersfield Foundation Trust. The discharge will be facilitated safely with the individuals consent and will work in collaboration with existing care providers. The team will also work with existing care providers and ensure handover notes are in place for discharges in-hours. This will contribute to a reduction in length of stay in terms of acute bed day’s and will ensure more patients die in their preferred place of care.”
- Yorkshire Cancer Network Outdoor Marketing – Cervical Screening. Reference number 5J6/12/0006. Likely total contract value (minimum) £50,000.00 – (maximum) £60,000.00. Likely service start date 04/11/2012. Provision of an outdoor marketing campaign, over at least 4 weeks from mid-Jan 2013, aimed at women who do not attend cervical screening.
- Quest for Quality in Care Homes. Reference number 0CF/13/0002. Likely total contract term 2 year(s). Option to extend contract No. Likely total contract value (minimum) £0.00 -(maximum). £1,055,000.00. Likely service start date 22/01/2014. This is part of a 3 phase programme to purchase telehealth and telecare gadgets for up to 1,000 patients in the 25 care homes from private providers, and to develop a multi-disciplinary team “that will provide a structured, proactive and multi-disciplinary approach to care with co-ordinated teams working together, built on primary care and supported by a range of specialists including geriatric medicine, specialist community nursing, mental health and rehabilitation medicine. Partnership working between healthcare professionals care homes and social care professionals is crucial to the success of this model.”
- Another contract for Intermediate Care Nursing and Residential Beds- Reference number 5J6/12/0008. Likely total contract term 3 year(s). Option to extend contract No. Likely total contract value (minimum) £107,000.00 – (maximum) £3,000,000.00. Likely service start date 01/04/2013. The service will consist of 30 nursing beds and 20 residential beds, to be located within Calderdale or its immediate surroundings. The minimum number of beds that would be purchased in a home is five beds. There will be no more than 3 providers of residential care and 3 providers of nursing care. Providers are permitted to bid for both residential and nursing beds.
- Yorkshire and the Humber NHS 111 and West Yorkshire Urgent Care.Reference number Q32/12/0019. Likely total contract term 5 year(s). Option to extend contract No. Likely total contract value (minimum) £100,000,000.00 – (maximum) £150,000,000.00 Likely service start date 18/03/2012. “The NHS 111 service will provide a memorable three digit telephone number and provide call handling, clinical assessment and referral to an appropriate service. The NHS 111 telephone number will eventually replace the NHS Direct number when it is rolled out nationally by April 2013.” (Update: The Yorkshire and Humber NHS 111 contract went to Yorkshire Ambulance Service)
- Innovation Hub to support Altogether Better’s BIG Lottery Health & Wellbeing Portfolio (May 2013- March 2015) Reference number REZ/13/0002. The role of the Innovation Hub will be to support Altogether Better projects to work in their areas to deliver better health services coproduced (and delivered) by citizens/community health champions working with health and social care service providers and commissioners.
- National Framework for Health and Social Care Transport Reference number. CP4/13/0087
In addition, Calderdale CCG buys acute healthcare services from the private healthcare companies Spire (in Elland) and BMI (in Huddersfield). The contract with Spire Elland is worth £2,248,871/year and the BMI Huddersfield contract is work £363,130/year.
Updated 17 Jan with info that Calderdale CCG has agreed to puts its full contracts register online.