Update on personal health budgets in South-West London/Surrey

We received an excellent response to our blog post on personal health budgets, the poor media reporting of these budgets and what they may mean for health services in our area. Thank you to everyone who took the time to read the blog post and share it.

We have now put in freedom of information requests with all six Clinical Commissioning Groups responsible for our end of South-West London/Surrey.

These are the questions they have been asked:

1. How many patients in the CCGs which come under SWLCC's administration are on personal healthcare budgets?

2. What is the average amount spent per patient on these budgets?

3. Can you provide a demographic breakdown of who uses these budgets?

4. Without naming patients, is there information available on what sort of treatments these budgets are funding?

5. What happens to a patient if their personal budget runs out and their health has not improved?

The six CCGs have 20 working days to respond to the FOI request. As such, we will report back on September 29 on any responses we have received.

Summer houses on the NHS? Cutting through the news reports with questions for our CCGs!

Sky News led its bulletin this morning with attention-grabbing headlines about summer houses, holidays and sat-navs being funded by the NHS. Sky News didn't actually research the story themselves - that was done by Pulse magazine, which investigated how personal healthcare budgets are spent. Plenty of other media outlets have also run this story including the BBC, the Mirror,

At least the Guardian, the Telegraph and the Independent mentioned that it is Clinical Commissioning Groups - or CCGs - that are allocating the money courtesy of the personal healthcare budgets. That would be the CCGs created under the Health and Social Care Act 2012. But you'd sooner find a report about the colonisation of the moon by unicorns wearing saddles made of cheese than ever see a news report mention this act, which was passed in the last parliament by the Conservative and Liberal Democrat MPs.

Of course, the truth is rather more complicated than any of these reports imply. Credit where credit is due though - the Daily Mail, while not accepting comments on the article online, had the insight to run a decent Press Association report. This report featured an interview with a professor who pointed out that while personal healthcare budgets may seem attractive on the surface, they do reflect an ideology that is "consumerist and individualistic" and not evidence-based.

But the way this story has been largely reported serves insidious dual purposes.

1. It demonises patients in the same way that stories about misuse of A&E departments and GPs demonise patients. While misuse of A&E and GP services creates problems, it makes for cheap headlines that ignore the bigger funding issues. It is easier to mock the person who rocked up to A&E with dog poo on their shoe than get properly angry about things like the cost to the taxpayer of rotten PFI deals and administering the NHS marketplace, both of which squander billions of pounds each year.

While personal healthcare budgets are not compulsory, can we be sure that patients, especially vulnerable and elderly patients, are not pressured into joining this scheme? It has echoes of Jeremy Hunt's plan to put the price of medications on the packaging so we know how much we are costing the NHS every time we take a pill that we need to get better. This plays into the "mustn't be a burden" mentality, the fear of wasting NHS time, even if someone is in genuine need of care.

If these budgets are targeting the vulnerable, it becomes questionable as to whether they really meet the goal of helping people take responsibility for their health and wellbeing.

2. It is more NHS-bashing by the media, feeding into the public appetite for cuts. By highlighting summer houses, holidays and sat-navs, it makes people angry about profligate NHS spending and removes any subtlety from the discussion. A holistic approach to healthcare is important - and defenders of personal healthcare budgets will use this argument - but holistic treatments need to be evidence-based, especially when they are publicly funded.

Are personal healthcare budgets a sneaky way to funnel more money to the private sector right under our noses? Will patients be encouraged to use their budgets to fund private health insurance?

The Pulse report does not mention our local CCGs, which fall under the umbrella of South West London Collaborative Commissioning. But in the interests of full transparency, we have some questions for them about how they use personal healthcare budgets. As we are still fighting to keep essential services, such as A&E and maternity as well as entire hospitals open, these questions need to be answered.

If a representative from SWLCC could respond to the following questions in the comments section of this blog post, that would be much appreciated:

1. How many patients in the CCGs which come under SWLCC's administration are on personal healthcare budgets?

2. What is the average amount spent per patient on these budgets?

3. Can you provide a demographic breakdown of who uses these budgets?

4. Without naming patients, is there information available on what sort of treatments these budgets are funding?

5. What happens to a patient if their personal budget runs out and their health has not improved?

KOSHH campaigners support the Newsquest journalists

KOSHH campaigner Colin Crilly has sent this message to Newsquest journalists in support of their recent industrial action:

On behalf of our group, I would like to wish Newsquest journalists all the very best of luck in your ongoing struggle.

It is essential that there are experienced local reporters, covering local issues, to help keep local people informed. For democracy to work, authorities, and their actions must be scrutinised, especially by those who are familiar with those issues.

We feel that this is what we have in common. Reporters and local media highlight these important news stories, and campaigning groups dissect and challenge them. Between yourselves and groups like us, the public are much more aware than they would otherwise be.

In the past, Newsquest journalists, in particular at the Sutton Guardian and Wimbledon Guardian, have reported on many of the issues that we campaign on, and we are very grateful that you have done so. We hope that this will continue for many years to come, and in doing so, you will assist us in saving not only St Helier Hospital, but also the wider NHS as a whole.

Best wishes,

Colin Crilly
Keep Our St Helier Hospital (KOSHH)




Photography by George Hodan

A victory with the CCGs!

We have achieved a victory this week with the local Clinical Commissioning Groups (CCGs)! The six CCGs which make the big decisions for Epsom and St Helier's health services are grouped together as South West London Collaborative Commissioning (SWLCC).

For a long time, we have asked that the meetings of all six CCGs, which are open to the public, be better advertised. The SWLCC website did not make it easy to find out when the meeting times are for the CCGs and the individual websites for each CCG were not much better. But after much agitation of the SWLCC Twitter account, we are pleased to report that the SWLCC website home page now has direct links to meeting times for all six CCGs.

All you have to do now to find out when the meetings are on is click here and scroll down.

We thank SWLCC for making this small but important change to the website.

It is so important that information about meeting times is easy to find and that people are aware of the role of CCGs in our health system.

Our next request is for at least half the meetings of the CCGs be held in the evenings to allow more people to attend. At present, meetings are generally held in office hours which makes it impossible for many working people to attend. If the CCGs could look at addressing this issue in the interests of transparency, that would be much appreciated.

Additionally, we have been disappointed but not entirely surprised that local MPs have not been vocal on issues of transparency with CCGs. We urge all MPs to attend CCG meetings whenever possible, or to send representatives to ask questions on their behalf when they cannot make it because of other commitments. This is where the big decisions are being made about Epsom and St Helier Hospitals so it is vital they are well informed and challenge CCGs on how our money is spent.



Image by Piotr Siedlecki

Media coverage update: The latest on the Sutton Hospital site and Epsom-St Helier infection rates

This week, it was revealed in the Sutton Guardian that a planned school for the old Sutton Hospital site won't be built on the Sutton Hospital site. Instead, it is planned for Rose Hill. This seems to be in keeping with the "preferred option" as per the "traingate" leak for the Sutton Hospital site to be used for a new 800-bed hospital, at the expense of Epsom and St Helier Hospitals.

Click here to read the story.

It was also revealed this week that Epsom and St Helier Hospitals have not met infection targets. In 2014-15, there were seven cases of MRSA when the target was zero, and 42 cases of Clostridium Difficile (C-Diff), when the target was no more than 40. KOSHH does not believe that such figures should be used as stick with which to beat the hospitals and, thus, lead to demands for closures. However, it would be good to see figures on infection rates to see if the increase correlates with the use of private cleaning companies rather than NHS staff.

Click here to read the story.

Welcome to the official online home of the KOSHH campaign

It has been a long time coming but at last it is here - the official blog of the Keep Our St Helier Hospital (KOSHH) campaign - the campaign to keep St Helier Hospital open with all its services intact. We also recognise the importance of keeping Epsom Hospital open. Our end of London and Surrey needs both hospitals to be run properly, funded properly and for both sites to receive much-needed upgrades to meet the needs of our communities in the 21st Century and beyond.

Our local hospitals are under threat again

We have fought many battles over the past few years and we thought we might get some rest when the Better Services, Better Values programme - which threatened services such as A&E, maternity and renal - was kicked into the long grass. How wrong we were. Just before the election, the now-infamous "traingate" leak happened - the BBC broke the story of consultants overheard on a train to Waterloo discussing plans to close Epsom and St Helier Hospitals and open a so-called "super hospital" at the site of the old Sutton Hospital. That would be the Sutton Hospital that has been gradually closing down in recent years.

But apart from ripping away two hospitals, strategically located to serve people in our area, the "super hospital" would not be so super at all. According to the leak, it would have 800 beds - a reduction in the number of beds for the area. We have no details on exactly what services would be on offer, whether these services would be publicly run or farmed out to private companies, how much this would all cost, how much has been spent on private consultancy firms already, and whether any costings have even begun to factor in things like the massive road and public transport upgrades that would be required for the Sutton proposal to become a reality.

We need to lobby the CCGs. But what are CCGs?

We met with the Epsom-St Helier Trust CEO, Daniel Elkeles, a few months ago in good faith. At no point was the Sutton proposal mentioned. We find it very hard to believe he wouldn't have known anything about it when we met with him. This is very disappointing indeed.

But it is the Clinical Commissioning Groups - known as CCGs - that hold the pursestrings. Ever since the Health and Social Care Act 2012 was passed at Westminster, these groups, made up of clinicians, are the ones making the big decisions about how our money is spent and how our health services are provided. These groups need to be lobbied hard and held accountable.

Neither our MPs, local councillors, the Health Secretary or Daniel Elkeles are in a position to guarantee the security of our services. This is why we urge MPs and local councillors to attend CCG meetings whenever they can, as well as members of the public.

Of course, finding the times of CCG meetings is difficult and this is something else that needs to be changed. What we do know is they are almost always held during office hours, which makes it hard for many people to attend. This also needs to change.

What do we want?

In light of the leak about a possible hospital on the Sutton site at the expense of Epsom and St Helier Hospitals, we need to know whether Sutton Council can dispose of this land for other purposes, such as education or affordable housing. This is urgent.

We are calling for proper investment in both Epsom and St Helier Hospitals so they can continue to provide the vital services we all depend on. Cutting vital services such as A&E, maternity, renal and the children's hospital will impact on us all and overburden St Georges Hospital in Tooting, a hospital that, like Epsom and St Helier, is doing great work but in very trying circumstances.

We want our money to be spent wisely. We are deeply concerned about the impact of outsourcing services, such as facilities management and non-emergency ambulances, to the private sector. The increased use of agency nurses - which costs a fortune - instead of properly employing nurses on a permanent basis is another serious issue that needs to be addressed.

We do not want our money wasted on yet another consultancy that is a re-run of Better Services, Better Value - only this time, entire hospital closures are the real risk.

The road ahead

We have a lot to do. We have a big fight ahead of us. This blog will be a place where you can find out more about the KOSHH campaign, ways you can help fight to keep our hospitals open and upcoming events. Feel free to comment at the end of the blog posts. We welcome open discussion.

KOSHH has members from a range of backgrounds, we are not a political party and we are not a front for any other political party.

Feel free to share this blog with family and friends. All posts are open to the public for comments. Constructive comments and debate are welcome.