Merton CCG AGM: KOSHH's concerns

We attended the Merton Clinical Commissioning Group (CCG) Annual General Meeting last Thursday night and our concerns for the future of St Helier Hospital remain as strong as ever. The AGM organisers called for questions in advance. Despite this, the only questions submitted were from KOSHH.

Our first question was whether all members of Merton CCG have read the Epsom-St Helier Trust Estates Review document. As this is a possible blueprint for the future of both Epsom and St Helier hospital sites, we expect everyone involved with all relevant CCGs to have read it. This is not an unreasonable expectation.

Adam Doyle, the Chief Officer, confirmed that all members of the governing body have read the Estates Review but not all members of the CCG. This is disturbing to say the least. Why wouldn't all CCG members be compelled to familiarise themselves with a document that will have far-reaching implications on local health services?

We asked if anyone from Merton CCG could share their thoughts on the review but nobody on the panel was prepared to offer any comment.

We then asked if the CCG members see the Estates Review as a threat to the future of St Helier Hospital. Despite this being a yes-or-no question, no yes-or-no answer was forthcoming.

Most critically of all, we asked if Merton CCG is committed to the preservation of all services at St Helier Hospital. Again, this is a yes-or-no question but we started to get an answer that talked of challenges, issues and the need for repairs at St Helier Hospital but no definite response.

We asked for a yes-or-no answer and were told that the CCG could not commit to preserving the services at any hospital.

Our final question was to ask if Merton CCG was going to prepare a response to the Estates Review and whether it would be made public. Given that 30 September is the closing date for responses, this is also a pressing matter. Adam Doyle confirmed that Merton CCG would respond to the Estates Review and that their response will be made public in November.

It is hardly surprising that members of KOSHH did not leave the meeting feeling relaxed and comfortable about the future of vital services at St Helier Hospital. Given that the meeting repeatedly made the point that the area has a high birth rate and a growing population, it is shocking that Merton CCG is not prepared to make a strong and public commitment to preserving vital services at any of the local hospitals, including A&E and maternity.

KOSHH campaigners will be meeting with Merton CCG on 13 October and we will share the outcome of that meeting in the interests of full transparency and keeping the public informed on the threats to our local health services. We have been accused of scaremongering in the past but we maintain our position that the threat to St Helier Hospital's vital services remains and it has only been through the tireless campaigning of dedicated members of the community over many years that we still have this essential facility.

Merton CCG is not the only CCG responsible for making decisions that will affect the future of our local hospitals. KOSHH campaigners will also be holding the other CCGs that make up South West London Collaborative Commissioning to account.

Diary date! This Thursday! Merton CCG AGM!

The Merton Clinical Commissioning Group (CCG) is one of the big decision-makers for healthcare services in South West London. Thanks to the Health and Social Care Act 2012, the CCGs are the groups that hold the pursestrings when it comes to the funding of our essential healthcare services.

Attending these meeting is one of the few ways that the people can engage with NHS decision-makers and ask questions.

The Merton CCG AGM is on this Thursday, it is open to the public and you can submit questions to ask of the governing body in advance of the meeting by emailing communications@mertonccg.nhs.uk - click here for more information.

To confirm your attendance, please email Tony Foote on tonyfoote@nhs.net

The vital info:

Merton CCG Annual General Meeting

Date: Thursday 24 September

Time: 6pm-8pm

Venue: Morden Assembly Hall, Tudor Drive, Morden, SM4 4PJ


Public transport directions: From Morden Tube Station, catch the 163, 293 or 413 from Bus Stop F. If you are on the 163 or 293, get off the bus at the eighth stop (Lower Morden/The Beverley). If you are on the 413, get off the bus at the 10th stop (Queen Mary Avenue).

From Raynes Park Station, catch the 163 towards Morden from Bus Stop S and get off at either Queen Mary Avenue (six stops) or Tudor Drive (seven stops).

From Sutton Town Centre, catch the 413 to Queen Mary Avenue (14 stops from Times Square, Stop J).

From Epsom Town Centre, catch the 293 bus from Stop C or Stop G (Epsom High Street) and get off at the Tudor Drive stop (22-23 stops).

Handy tips for journalists reporting on NHS stories

The standard of reporting on stories in the mainstream British media about the NHS is frequently lazy, inaccurate, incomplete or just poor. We received a terrific response to our blog post on 1 September about the terrible reporting across multiple media outlets on personal health budgets. We do not expect the standard of reporting on NHS stories to improve any time soon so we have put together some helpful tips for journalists who report on the NHS.

1. "NHS bosses" is a lazy term constantly used by journalists. While the term is OK for a headline where space is tight and the attention of readers needs to be grabbed, it is too vague for proper reporting. Within a report, the journalist should always clarify exactly who the "NHS bosses" are. Do they mean hospital trusts? Clinical commissioning groups? Simon Stevens? Jeremy Hunt? Chances are, the reporter is referring to either trusts or CCGs. This needs to be made clear from the outset.

2. When reporters for national newspapers and news channels are referring to trusts and CCGs when they talk of "NHS bosses", it needs to be made clear that these bodies make different decisions in different areas. The way stories such as the personal health budgets funding "treats" and the NHS funding gluten-free food were reported in recent weeks seldom made it clear that these funding decisions vary wildly between areas. Instead, we ended up with a warped narrative that made it sound like the NHS was morphing into a giant, nationwide hybrid of Greggs and Butlins.

3. It is important that readers and viewers are aware of what CCGs actually are. As NHS campaigners, we need to keep in mind that not everyone understands what a CCG is or the powers they have to make massive decisions about our vital health services - they are making decisions on everything from gluten-free food and IVF to hospital cuts and closures.

4. We realise that it can be hard to explain what a CCG is in every single media report. However, for journalists whose work appears online, it is easy to provide links to pages that can explain what CCGs are. Despite the limitations of broadcast time or space in print media, even a brief one-liner to explain CCGs would be helpful.

5. CCGs are just one outcome of the Health and Social Care Act 2012. If you are reporting on the NHS, you have the responsibility of reading this act as it has shaped the NHS as we know it today. If you are interviewing an MP who voted for this act, ask them if they regret voting for the act. Ask them if they take responsibility for any negative outcomes that can be directly attributed to this act.

6. When you are reporting about something that has gone wrong in the NHS, it should not be used as a stick with which to beat the entire NHS or a rallying cry to close down entire hospitals. When something goes wrong, it should be an opportunity for improvement, for ensuring that "never incidents" never happen again. Find out what trusts and CCGs are doing to make improvements if something goes wrong and hold them to account. If people are killed or injured, they should not be seen as collateral damage, as a reason to cut services.

7. When something goes wrong in the NHS, investigate properly. Find out if any private companies may have been involved. If there is an outbreak of infection in a hospital, for example, find out if the cleaning has been contracted out to the private sector, ask about the cleaning company's training procedures and how well their employees are paid. Is the incident related to staff shortages? Is the trust relying heavily on agency staff? Are patients receiving inconsistent care because of a lack of permanent staff?

8. It is especially important to find out about the extent of private company involvement in the NHS, especially when things go wrong or if CCGs and trusts are spending our money on private management consultancy firms. Unfortunately, private companies are exempt from FOI requests. This makes it hard to properly report on the NHS. This is quite deliberate, a conscious attempt to reduce transparency and keep people unaware.

You can and should make FOI requests of CCGs and trusts in relation to their private sector partners. You might not get a complete answer because of commercial confidentiality, but this should be noted in your report. You should also ask the private companies involved for comment whenever it is relevant and note in your report if they refuse to comment or did not return phonecalls or reply to emails.

9. Attend CCG and trust board meetings, especially if you work in the local media. They are open to the public. They are where big decisions are made and hard questions should be asked. Such meetings are usually held during working hours so it is difficult for many people to attend. The media has a responsibility to attend such meetings and report on what is said. This should be seen by local and regional journalists as being as important as attending council meetings.

10. Find out about vested interests, especially on CCGs. Clinical commissioning groups, as the name suggest, commission services, they spend our money. If CCG members have vested interests in private healthcare providers, they should not be commissioning health services. If you are reporting on a CCG, find out if their declared interests have been published online. If not, call them out on it.

11. Ask local campaigners for comment. We are always happy to talk to the media, may have good information from meetings we have attended, such as CCG meetings, and might offer you perspectives that you had not previously considered.

Does anyone have any more tips for good reporting on the NHS? Please feel free to leave them in the comments section below.

SAVE THE DATE! KOSHH pub quiz! Thursday 1 October!

KOSHH is holding a pub quiz to raise awareness about our campaign and funds to help us spread the word and fight to keep our local hospitals open.

We always have a lot of fun at our pub quizzes and the quiz mistress is already busy setting the questions - as always, there will be questions for everyone with topics ranging from pop culture to history to completely random facts.

Spread the word! Bring friends and family! And if you can donate a prize, please get in touch with us either in the comments, via Twitter @Save_St_Helier or on our Facebook page.

Date: Thursday 1 October.

Time: 7.30pm for an 8pm kick-off.

Venue: Morden Brook Pub, Lower Morden Lane, Morden. SM4 4SS.

Cost: Gold coin donation per player.

Public transport directions: From Morden Tube Station, catch the 163, 293 or 413 from Bus Stop F. If you are on the 163 or 293, get off the bus at the eighth stop (Lower Morden/The Beverley). If you are on the 413, get off the bus at the 10th stop (Queen Mary Avenue).

From Raynes Park Station, catch the 163 towards Morden from Bus Stop S and get off at either Queen Mary Avenue (six stops) or Tudor Drive (seven stops).

From Sutton Town Centre, catch the 413 to Queen Mary Avenue (14 stops from Times Square, Stop J).

From Epsom Town Centre, catch the 293 bus from Stop C or Stop G (Epsom High Street) and get off at the Tudor Drive stop (22-23 stops).



Photography by George Hodan

Healthwatch Sutton diary date, for those who can make it...

Healthwatch Sutton is holding a semi-public meeting about the Epsom-St Helier Hospital Estates Review. We say "semi-public" because people who want to attend cannot simply turn up on the day. Instead, they must RSVP in advance.

We are not sure how many people will be able to attend this meeting as it is scheduled for Tuesday, 22 September, from 2pm until 4pm. This makes it pretty much impossible for anyone with a day job to attend or people with childcare commitments. As such, Healthwatch Sutton surely cannot expect a representative cross-section of the community to attend?

On Twitter, we have asked Healthwatch Sutton if they would consider changing the timing of this meeting. If we receive a response, we will update this blog accordingly.

The Estates Review is important as it could well set our local hospitals on a path of downgrading or closure. Click here to read more about our concerns.

For those who are free from 2pm-4pm on 22 November, you will need to email sara@suttoncvs.org.uk or call call 020 8641 9540 to reserve your place.

We have struggled to get Clinical Commissioning Groups to hold meetings at sensible times. Now it seems that Healthwatch Sutton is following suit.

Could it be that Healthwatch Sutton is afraid of audience members asking challenging questions? KOSHH campaigners were involved in a farcical situation in July last year when a Healthwatch meeting about local health services descended into chaos and was called to an end half an hour before the advertised end time. The meeting organisers tried to enforce a situation where they would only take pre-approved questions in advance.

After the pre-approved and largely uncontroversial questions were answered, there was plenty of time left so the chair reluctantly agreed to questions from the floor. The meeting was called to an abrupt halt after Dr Phillip Howard embarrassed the panel with statistics about the trust's excellent A&E performance.

On top of this, it was a very Liberal Democrat-heavy panel and RSVPs and questions-in-advance had to be sent through the office of Tom Brake, Liberal Democrat MP for Carshalton and Wallington. Healthwatch Sutton is meant to be non-political. We complained to the Charities Commission about this but, absurdly, got a response saying there was no problem with the event being administered this way. Nobody from the Charities Commission bothered to get in touch with KOSHH for more information.

In short, we are frustrated that not only are we having to beg CCGs to hold meetings in the evening so more people can attend but now Healthwatch Sutton is following suit.

If you can attend the Healthwatch Sutton meeting on 22 September, please feel free to comment at the end of this blog post about what happened.




Image by Linnaea Mallette

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?

Diary date! Free TTIP film screening

The Transatlantic Trade and Investment Partnership - or TTIP - will have far-reaching implications on the NHS. To find out more, come along to a free screening of The Trouble With TTIP, a one-hour documentary.

Linda Kaucher from the Stop TTIP campaign will be on hand to answer your questions about what can be done to stop this secret US/EU trade deal.

Date: Thursday 3 September

Time: 7.30pm

Venue: Gorringe Park pub/cinema, 29 London Rd, Tooting, SW17 9HW. The pub is right next to Tooting Railway Station between Amen Corner and Figges Marsh.

Click here to find the event on Facebook.

Here is a short video to tell you more:

CCGs (or why campaigning to save the local hospitals is so hard...)

Campaigning to save your local health services often feels like being at the foot of a mountain. You start to climb, you feel like you've made some progress, and then someone at the top of the mountain drops a giant bucket of mud down the slope and you're pushed back where you started from. And you're covered in mud so you might feel a bit demoralised as well.

Additionally, it can be hard to know where to direct your complaints, demands and questions about threats to your local health services. And, even if you do know, it can be hard to then mobilise people en masse to join the fight.

It is all well and good to be angry at the government and the Health Secretary. But we also need to be aware of how NHS England now works as a result of the Health and Social Care Act 2012, which was voted in by the Conservative and Liberal-Democrat MPs in the last parliament.

This act created the Clinical Commissioning Groups - the CCGs.

CCGs operated in every region of the country. They make the big decisions. They hold the pursestrings. They have been allocated budgets and it is they who make the decisions about what health services the NHS will fund in your local area.

When you see the phrase "postcode lottery" bandied about in the mainstream media about patients being denied treatment or patients receiving treatment that may be perceived as a poor use of public money, it is the CCGs that are making these decisions.

The postcode lottery situations we see today are a result of the Health and Social Care Act 2012.

Therefore, it is somewhat curious that when the media reports on postcode lottery NHS stories that this pernicious act of parliament is never mentioned. This week, the Daily Mail screamed at us about "Doughnuts and pizzas on the NHS"! This is the sort of journalism that relies on short attention spans and people not properly reading articles. This report, about patients with coeliac disease receiving gluten-free food on prescription, mentions how the system works but only in passing with a "NHS rules for prescribing food vary area by area" and the occasional "some NHS trusts" thrown in for good measure.

No mention of the role of CCGs in all this. That'd be the CCGs created by a government the Daily Mail supported then and, in its Tory outright majority form, supports now.

And it's not just the Daily Mail offering poor information on this story. Carole Malone writes a context-free opinion piece for the Mirror that seems to imply that the NHS has degenerated into a profligate cake shop for all. And the Daily Express fumes in a similar manner with no mention at all of how gluten-free food on prescription varies from region to region.

It also comes as no surprise that the Daily Telegraph, a long-time cheerleader for the Conservative Party, did not mention regional variations, CCGs or the Health and Social Care Act.

The Independent offers an opinion piece from a coeliac patient which at least calls out the reporting as "alarmist" but there is still no mention of CCGs or the Health and Social Care Act.

The BBC this morning, to its credit, did indeed mention CCGs when reporting on this story on the breakfast programme. But if you didn't happen to be tuned in to BBC1 at around 8.30am today, you probably missed the lesser-spotted CCG mention.

So what on Earth does all this have to do with saving Epsom and St Helier Hospitals?

Quite a lot, actually. The media hysteria over gluten-free food on prescription, while certainly a topic worthy of discussion, has become part of the NHS-bashing narrative of the mainstream media. As long as there is a drive to denigrate the NHS at every opportunity by a compliant media, the CCGs, and indeed the whole system that has created them in Westminster, will go unchallenged.

The mainstream media cannot be bothered to remind the public about how the NHS is now structured with CCGs or how that happened when they report on such stories, even though this is 100% relevant.

And here, in our end of South-West London/Surrey, we have been challenging the local CCGs, which are grouped under the umbrella of South West London Collaborative Commissioning, about their plans for Epsom and St Helier Hospitals as well as their declarations of interest.

If only the media would join us in this endeavour.






Photography by Maliz Ong

KOSHH speaks out on CCG staff taking lavish trips

The Epsom Guardian today reported that staff from Surrey Downs CCG and North West Surrey CCG went on a luxury spa trip to Germany funded by a pharmaceutical company.

Click here to read the story online.

We were asked to comment and, in short, we smell a rat. Why would it be necessary to go to a luxury spa in Germany to discuss a constipation drug? We understand that the NHS needs to buy drugs from pharmaceutical companies. It would be impractical for the NHS to start manufacturing every single drug it requires, obviously. But we do not understand why Clinical Commissioning Group staff would accept lavish hospitality from these companies?

The CCG system is problematic. It is undemocratic. It is clearly part of a larger agenda to privatise the NHS. There are members of CCGs with vested interests in healthcare. How can anyone who stands to win an NHS contract be in a position to commission such contracts?

Now we have supposedly independent commissioners taking luxurious trips at the expense of pharmaceutical companies. How is this OK?

The Surrey Downs CCG Director of Commissioning and Strategy, James Blythe, defended the trip. He said that Cosmocol, the constipation drug discussed on the trip, had already been commissioned before the trip took place.

But Cosmocol is not the only drug in Stirling Anglian Pharmaceuticals' range. Click here to see what else they have on offer. They also sell an osteoporosis drug. And who's to say the company won't add more products in the future?

Surrey Healthwatch communications officer, Lauren Ter Kuile, said that nobody has been in touch to suggest there was anything untoward about this trip.

Lauren, now we know about this and we thank Chris Longhurst from the Epsom Guardian for informing us, we are indeed suggesting that there is plenty that is untoward about this trip.

Will this lead to a change in policy? Are more CCG members taking trips at the expense of private companies? The public deserves to know and deserves better.