MK Council chamber, 24/01/2018, 16.00 – 18.30

Notes from Chris Coppock.  My comments in italics.  Salient points underlined.

This is not a decision-making body, but exists to hold decision-makers to account.

BLMK has operated a shadow ACS this financial year, but goes live on 1st April with the Bedford/L&D merger as Bedfordshire Hospitals NHS Foundation Trust.

This therefore appears a fait accomplit despite the lack of legal basis.

BLMK as one of 8 pilot ACSs has received £4.5m “Transformation Funding” for 2017-18.  For this, the 8 pilots have agreed to deliver fast-track improvements incl: reducing pressure on A&E; investing in GPs to enhance out-of-hospital services; delivering high quality cancer and mental health services

This small sweetener must be set against the predicted BLMK financial shortfall of £335m by 2020 (£22bn nationally)

Ongoing tasks include “developing the MK Accountable Care Partnership including the development of governance to support Health & Wellbeing Board (HWB) leadership” (NB from conversation on last Sat’s demo, this is also what Pete Marland (Lab, MKC Leader) wants).

Meeting notes

The public gallery was mainly us—I didn’t see anyone from MK Healthwatch.

Public questions came at the start (we couldn’t intervene in the meeting).  Several of us spoke at length: John Pinkerton was especially incisive, summarising the flaws of ACO/ACSs.

The meeting was quite orderly.  From Mid-Beds cllrs there was little fire–but some particularly fatuous comments blaming the NHS crisis on patients who don’t keep appointments!  The most vociferous critic of ACSs was Cllr David Agbley from Luton: I suggest local campaigners contact him.

Most questions were fielded by Emma Goddard, STP Exec. Director. (NB I noticed STP Communications Director (Sam Holden?) is also Comms lead for MK Hospital, suggesting MKH is fully on board).

EG seemed quite competent, though of course committed to the STP.  However one particularly worrying answer was on MK CCG’s recent cuts and rationing of e.g. hearing aids, podiatry and “procedures of limited clinical value”. EG denied any knowledge or role of the STP in this—hardly believable since this sort of rationing is just what the ACS exists to do!

The core of the agenda was Item 6: STP Progress Update.  These are just salient points:

2.1. Communications & Engagement

MKC delegates were very critical of the latest report, citing lack of evidence and hard figures.

Also concern re public ignorance (But I suggest this is red herring: typically blaming “poor communication” for unpopularity of policies).

There is currently no separate comms budget, the 16 STP partners covering their own manors. More work needed on police, fire authority, voluntary sector, etc.

Anyone can sign up to STP monthly newsletter.

2.2.  Bedford/L&D merger—and future for MK

Merger live from 01/04/2018.  EG states this won’t impair services provision at Bedford—A&E, Maternity, etc.

A summary business case for the merger was published last Monday (36pp). NB this does not promise more hospital beds, but assumes more care delivered “close to home”.  “Commercial sensitivity” was cited for not releasing the full document. To justify that, they said it raised bringing some private contacts back in-house.

Cllr Coventry (Lab, MKC) said there was lack of info, esp. on risk.  Was there any scope for a 3-way merger incl. MK?

Reply was that at present patient flows between MKH and Beds were very small. Also different ambulance trusts.  Once Bedford/L&D had settled down (poss. in 2 years) they would revisit MK.  In the meantime it would need more work to create the necessary infrastructure.  A “place-based” strategy would be specific to MK.

Cllr Coventry then asked why, then, is MK in the BLMK footprint and not e.g. Northampton or Oxford (I could add Stoke Mandeville). If the STP can’t support 3 A&Es, is MK’s thereby at risk?

Chair asked if Bedford/L&D merger might save enough to remove need for a further merger with MKH.

(It seems they really don’t know what to do with MK)

2.3. Update on progress (incomplete notes)

How would closing Bedford Walk-in Centre affect A&E? (NB news today: closure deferred 6 months).

2.4.  Transformation funding

Who signs off on expenditure from the Transformation funding? It’s CEOs of all 16 partners. STPs want local Transformation Boards and HWBs to work together.  Also “Provider Alliances” e.g. in Luton.  “The STP is about working co-operatively to restructure services”.

2.5.  Care home beds

Q: How seriously does the STP team take “later life” issues?  A: A lot, especially breaking down silos and duplication of people/roles which is a big concern for service users.

2.6.  Localities & systems (incomplete notes)

Cllr D Agbley (Luton) challenged if the STP would lead to more privatisation.  Reply: a “functional review” of commissioning is in hand.  But the STP majors on partnership working, not necessarily more privatisation.

Next meetings

26/02/2018:  Closed meeting.

26/03/2018:  Meeting in public. (NB just 5 days before the Bedford/L&D merger goes live).





Informal Joint Health Overview & Scrutiny – BLMK STP

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