Before this evening’s Calderdale Council meeting on the People’s Commission Report,  two oddly assorted demonstrations took place on the Halifax Town Hall steps.

Calderdale 38 Degrees NHS campaigners huddled together with a placard proclaiming the People’s Commission as whitewash – not what the public wanted.

At the same time, red Unite and Unison banners waved above Labour Councillors posing with Save our A&E placards, for photographs taken by Jago Parker, Linda Riordan MP’s PA in the House of Commons.

No doubt this will look good in Labour’s election publicity.

This display of support for Calderdale A&E was not repeated in the Council meeting

Despite their antics on the Town Hall steps, Labour Councillors along with Tories and LibDems voted unanimously to accept the Report – although the People’s Commission Report says nothing about the need to keep A&E in Calderdale, which 1,689 people signed a petition about.

The People’s Commission Report on future NHS and social care services does not reflect what the public told the Commission.

The Report says nothing about the need to stop NHS cuts and sell offs, which has been the focus of the Save Calderdale Royal Hospital campaign for the past year.

Nothing about the dire situation of our hospitals Trust as a result of these cuts and sell offs.

The Council’s Adults Health & Social Care Scrutiny Panel can and must hold the NHS organisations to account for their proposals. It can and must tell them to formally consult the public; and it also has the power to stop proposals which are damaging to our local NHS, by referring them to the Secretary of State for Health.

But the Report ignores this power. Instead it is full of unwieldy bureaucratic proposals about how the Council should attempt to steer the NHS shake-up.

And the Report strongly hints at the likelihood of ending up without any A&E in either Calderdale or Huddersfield, instead sending patients out of the area to a “subregional” specialist emergency centre.

Some Labour Councillors, notably Cllr Adam Wilkinson and Cllr Tim Swift, made some fair points about shortcomings in the People’s Commission Report, and the issues that it failed to address. But no one thought they mattered enough to call for amendments to the Report.

Mostly, Councillors congratulated themselves about the wonderfulness of the People’s Commission.

In the end it felt like a showcase for Councillors to show the public they care about saving our NHS – while basically going along with what their NHS commissioning partners, Calderdale Clinical Commissioning Group, are going to do.

Both the People’s Commission Chair Prof Andrew Kerslake and various Councillors shook sticks at Calderdale Clinical Commissioning Group and at our hospitals Trust, regarding their lack of clinical and financial evidence about the benefits and reasons for the proposed NHS shake up.

So why didn’t the People’s Commission – or, more to the point, the Adults Health and Social Care Scrutiny Panel – ask for the missing evidence?

Surely between them Prof Kerslake and the Councillors know that in order to justify major changes in health services, NHS organisations have to carry out a set of planning activities, based on a set of prescribed planning data?

And surely they know that it is the job of the Adults Health and Social Care Scrutiny Panel to make the NHS organisations provide this planning data, together with the evidence that they’ve used it appropriately to justify their proposals?

If the Council won’t use the powers it has to make the NHS organisations present their evidence and the planning data its based on, what’s the point of complaining about the lack of evidence?

These are the planning activities that NHS organisations are required to carry out in order to justify major changes in health services

Activity
• All relevant patient flows and capacity are modelled and assumptions are clear and reasonable
• Changes in bed numbers are clearly stated
• Activity and capacity modelling clearly linked to reconfiguration objectives
• Evidence that activity links consistently to workforce and finance models
• Modelling of significant activity, workforce, and financial effects on other locations or organisations
Workforce
• Workforce plan is integrated with finance and activity plans with any risks to the workforce and mitigating actions clearly stated
• Secretary of state’s assurance that proposal makes most effective use of workforce for service delivery and is compliant with all relevant guidance
• Implications for the future workforce are set out clearly
• Evidence that staff have been properly engaged in developing the proposal

These are the planning data that should accompany any proposal for major health service reconfiguration:

• Demographic indicators (by local authority and clinical commissioning group (CCG)areas)
• Population by sex and five year age groups
• Epidemiological indicators (by local authority and CCG areas)
• Mortality indicators: deaths by age groups, sex, and specific causes
• Morbidity indicators: disease specific prevalence and incidence and socioeconomic group
• Provision of services (current and projected)
• Hospital and community services
• Acute beds number by specialty and per 100 000 population
• Medical equipment by category
• Nursing homes/residential homes (No of beds/100 000 population)
• Day centres (No of places per 100 000 population)
• Staffing (whole time equivalents and per 100 000 population)
• GPs
• Community nurses by category
• Community psychiatric nurses
• Occupational therapists
• Physiotherapists
• Medical hospital staff by specialty and training status
• Nursing hospital staff by specialty and training status
• Scientific and therapeutic hospital staff by specialty
• Technical and administrative hospital staff by specialty
• Use of services (current and projected patient flows, activity by specialty and by treatment//100 000 population)
• Hospital services
• Emergency department attendances/100 000 population
• Elective and day case admissions by specialty
• Non-elective admissions by specialty

(info sources: i) NHS Yorkshire and the Humber. A guide to service change. 2010 ii) Planning for closure: the role of special administrators in reducing NHS hospital services in England, Allyson M Pollock et al, Centre for Primary Care and Public Health, Queen Mary, University of London, London E1 4NS, UK)