National Trades Councils Conference’s unanimous opposition to Accountable Care Systems

The 150th Annual Trades Council Conference has unanimously passed a composite NHS motion from Cheshire, Calderdale and Derby Trades Councils, that calls on the TUC to take action to oppose Accountable Care Systems (rebranded by NHS England as “Integrated Care Systems”) and Sustainability and Transformation Plans/Partnerships; and to support the campaigning activity of Keep Our NHS Public, Defend our NHS, 999 Call for the NHS and Health Campaigns Together.

At the Conference on Saturday June 11th, Trades Council delegates from around the country spoke of attacks from the government and its quangos on the NHS in their areas.

Calderdale TUC at Our NHS march, Leeds, April 2018

Calderdale TUC at Our NHS march, Leeds, April 2018

The motion (which you can download here) calls on the TUC to:

  • “Refuse to cooperate with plans to develop ACOs/ICSs.
  • Work with affiliates to educate members on the track record of ACO/ICS, and the circumstances of its introduction in England;
  • Remind MPs and Councillors of Labour party policy, adopted unanimously at its 2017 Conference, to oppose ACS and STPs, and to cooperate with unions and NHS campaigns to oppose them.
  • Support the campaigning activity of Keep Our NHS Public, Defend our NHS, 999 Call for the NHS and Health Campaigns Together.
  • Support the wider defence and reinstatement of the NHS as a health service which is:
    *universal, comprehensive, publicly provided, publicly accountable, publicly run
    *and adequately funded through general taxation, free at the point of delivery, with decisions on treatment taken by NHS clinical staff on the basis of clinical need.
  • This conference therefore calls on Public Services Committees to work with and coordinate trade unions, trades councils, NHS campaign groups and Labour councils/councillors in informing and educating members, developing activity to inform the public and devising a strategy/programme to resist developments the movement feels will undermine or harm the NHS. At the heart of such organisations should be STP area base meetings/conferences, leading to the establishment of campaign committees, which can feed back into Public Services Committees.
  • Although it seems that currently NHS England has decided not to authorise contracts based on capitated whole population annual payments, some Sustainability and Transformation Partnerships (STPs) are already setting up “informal” ACS/ICS.

We call upon this conference to oppose all forms of privatisation, cutbacks, and underfunding, of the National Health Service (NHS).
We call on the TUC to mobilise all sections of the trade union and labour movements, to bring all parts of the NHS under public control and accountability, and to demand more funding for the NHS.”

Mark O’Neill, Chair of Calderdale Trades Council, said:

“The motion was passed unanimously by delegates from all over the country who recognised the importance of exposing and fighting against this latest attempt to privatise the NHS. Integrated Care Systems, based on a cruel and destructive model  from the USA, do nothing to improve patient care or the pay and conditions of those  who work tirelessly in the health services but open it to profiteers to take enormous sums of public money to deliver inferior services.”

Seconding the motion for Calderdale Trades Council, Jenny Shepherd said,

“Conference has been talking about the threats to the pay and conditions of NHS staff. The new Accountable Care Organisation contract has a blank space for pensions. This suggests to me that national NHS terms and conditions are not intended to apply in Accountable Care Organisations.

This is an urgent issue.

A new nationally-mandated Integrated Urgent Care Service contract is being imposed by NHS England on all Clinical Commissioning Groups. By April 2019 they have to commission this service for an STP area – or for multiple STPs.

This huge Integrated Urgent Care Service looks very much like an Accountable/Integrated Care System, with a capitated budget that has to cover the whole population – regardless of the number of people treated or the complexity of their care; a lead provider; and loads of subcontracts.

The specification is very like  USA multi-partner urgent care services provided by Medicare – the state-funded health insurance system that provides limited health care for people who can’t afford private health insurance.
The Integrated Urgent Care Service will be largely phone-based. If the urgent consultation can’t be completed on the phone, patients will be booked into designated urgent care treatment centres staffed by bank clinicians working a few hours a week, and following standardised care protocols.

This is a cheap urgent care service without any continuity of care for patients, and relying largely on phone consultations followed by self care.  It is the means of restricting patient access not only to A&E – but to their own primary and community health services.

This is happening now.

It’s not only shaping up to be bad for patients and NHS staff – it’s also a nightmare for commissioners. In West Yorkshire and Harrogate Integrated Care System, the lead Commissioner for this huge Integrated Urgent Care service has admitted they don’t know how to procure it and are paying an untold sum to the management consultants Attain to do it for them. And they are not the only STP to be paying Attain to work out how to procure this Integrated Urgent Care Service.
Please support this motion.”

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