A LAST DITCH APPEAL TO THE PCT

Among the points made in the letter are the following:

·        Nurses, including those on Intermediate Care Beds, must be employed by the NHS on the same terms and conditions as those enjoyed by the original nursing staff team. Local GPs have confirmed that they consider this essential if confidence in the standard of Intermediate Care Bed treatment is not to be lost.

·        Our group feel that if secondment of the Intermediate Care Bed nurses is required it should be for the 30 year duration of the beds lease but certainly not less than the minimum three years identified in the agreement with the Joint Health Overview and Scrutiny Committee.  This should not be a problem because it has been confirmed to us that there is no significant difference between the cost of Secondment and TUPE. In addition NHS leavers must be replaced by NHS staff on the same grade, terms and conditions.

·        We think that NHS staffing is required to maintain the highest level of healthcare and believe that once the NHS model is chosen for the Intermediate Care Beds and other areas, transfer or secondment cannot be a matter of individual choice as this has the potential to de-stabilise the model as a result of personal preference rather than maintaining clinical standards.

·        The Intermediate Care Beds ward needs to be more closely associated with the rest of the Hospital services with, as Dr Skolar (Chair of the Joint Health Overview and Scrutiny Committee) put it, ‘a clear and separate identity’ with appropriate NHS hospital signage. Local people will have more confidence in the beds if they have NHS branding and the internal and external divisions between the Hospital and Care Home make the beds part of the Hospital. People cannot conceive of a Hospital without beds and will be reluctant to get behind this scheme and ‘let go’ of their much loved existing NHS War Memorial Hospital if there is insufficient NHS beds identity.

After four years of campaigning to keep hospital nurses in the NHS -
including a petition signed by 11,000 people - the new PCT break a firm promise made to us two years ago.
 

1. Nurses on the Intermediate Care Beds, to be employed by the NHS on the same terms and conditions as those enjoyed by the original nursing staff team.
2. Secondment of the Intermediate Care Bed nurses should ideally be for the 30 year duration of the beds lease but certainly not less than the minimum three years identified in the agreement with the Joint Health Overview and Scrutiny Committee. 
3. NHS leavers should be replaced by NHS staff on the same grade, terms and conditions.
4. Transfer or secondment should not be a matter of individual choice as this has the potential to de-stabilise the model as a result of personal preference rather than maintaining clinical standards.

The paper for the Board notes:
The strong local concerns over the maintenance of NHS employed status for those staff working in the intermediate care bed unit was again voiced at recent public events held in Chipping Norton (8th September 2007). The Hospital Action Group continues to petition members of the public for their views and it is clear that there is a great deal of support to maintain NHS employment lines in the new service when delivered. It is clear that there is support for a secondment of staff and objection to the use of TUPE in transferring staff from current to future service models. Whilst there is no evidence to suggest that the use of secondment would ensure an improved service over the use of TUPE the level of public feeling that staff in the intermediate care bed unit should remain NHS employed should not be underestimated.

After a full discussion  from every point of view - including the Order of St John's- which confirms that VAT and cost are no longer issues. the Board paper concludes:

Read the full proposal (its well worth it)
http://www.oxfordshirepct.nhs.uk/about-us/how-the-pct-works/trust-board/board-papers/2007/september/documents/ChippingNorton.pdf

Does consultation mean anything?

 11,000 residents, two Action Groups, the Town Council, the District Council, all the town's councillors, the local MP, the League of Friends and GPs think nurses in the new Chippy hospital should be employed by the NHS.

The PCT decided this week to ignore their views

Its really simple. People in the town want the beds in our new hospital to be manned by NHS nurses - not by Order of St John nurses. We have all had lots of experience of the skilled and highly-motivated nurses that Chippy Hospital has attracted over the years. We want to keep them. We want new recruits to be just as good. We believe that nurses who are part of an NHS career structure, who receive NHS training, who understand and support the NHS "ethos" of public service and patient care are most likely to continue to provide the high standards we have come to expect. We know about the Order of St John because they run Castleview Care Home and we (as well as the local nurses and the local GPs) don't have the same kind of confidence in them either as employers  or service providers. The Order of St John have little experience of running hospitals and we think its up to the NHS to prove to the community that there would be no drop in standards if the OSJ took over the employment of hospital nurses. (The NHS on their side keep telling us that there is no evidence that standards would fall and its up to us to prove they would!). Four years ago 11,000 people signed a petition asking for Chippy Hospital nurses to be retained in the NHS. Much discussion followed.  Smokescreens and complicated red herrings about VAT and costs and book values of property and John Radcliffe budgets were introduced - all of which have subsequently been shown to have been irrelevant. The Hospital Action Group accepted - kicking and screaming - that if direct employment by the PCT was not possible then they would reluctantly settle for "secondment" provided the nurses remained employees of the NHS. Two years ago the then PCT Chief Executive Nigel Webb told us that this deal was final and we could count on it. It was signed off by the Health Overview and Scrutiny Committee (the County's senior Health watchdog) and by the Configuration Panel in London who are the top body which advises the Health Minister on local disputes. If any promise was binding this was it and it's all in writing. The VAT argument rumbled on for another year until David Cameron finally nailed it in February this year. The "impairment" problem vanished. The local Health Budget is now in surplus. It was proven that continuing to employ NHS nurses involved no extra cost. All the hurdles had been overcome. So the Hospital Action Group was astonished when the PCT announced two weeks ago that it was recommending that hospital nurses should be employed by the Order of St John. The only reason given was that this is what the Order of St John wanted - it made managing the beds easier for them. A "compromise" was proposed. Hospital nurses employed at the present time would be allowed to opt for "secondment" and to continue as employees of the NHS - but only for three years. After that they would have to switch to the OSJ or opt for another NHS job somewhere else in the County. At the PCT Board meeting on Thursday (27th September) one Board member asked what the staff thought about it all. Jonathan Coombes said that in all of his recent discussions with the Chippy Hospital staff they were only concerned that standards should be maintained and the nursing staff were not worried about whether they worked for the NHS or the Order of St John. Some of us who had also talked to nursing staff had to pinch ourselves in disbelief. The NHS say - You needn't worry. We will set and monitor standards, We commission lots of our services. We know about contracts. There is absolutely no evidence that standards fall when we commission a  private company to supply nursing care. Trust us. ....Then another Board Member asked "Would this be reneging on something we have promised in the past?" You might think this simple question would warrant a simple answer. Ms Penny Astrop who was making the recommendation to the Board looked her questioner straight in the eye and said that in her recent discussions with the Chairman of the Health Overview and Scrutiny Committee he had not suggested that this would be reneging on a previous agreement but Penny recognised there might be other views about this. Hmmm. Real Sir Humphrey talk. She knew jolly well the NHS was reneging on a promise and she probably also knows what the rest of us are slowly realising - which is that the Health Overview and Scrutiny Committee is in imminent danger of looking more and more like a politicised group dominated by county councillors. In a case like Chippy Hospital the committee is taking "health" decisions in which the County Council has an enormous financial interest (The County owns the Castleview Care home as well as the site on which the new Care Home and Hospital will be built - as well as being a partner of the OSJ in the Oxfordshire Care partnership. All this role confusion surely can't be right). The ordinary ratepayer with concerns about local healthcare has nowhere left to turn for an independent judgement. Bring back the Community Health Councils!! This whole exercise has become a stitch up between the Order of St John and the OCC who are together developing a template community hospital/care home model which they can roll out round the county (Stand by Bicester, Wantage, Henley, Witney and all points in between). The economics of their model seem to require that the OSJ run the hospital beds. The Health Overview and Scrutiny Committee has rolled over and what is really shameful is that the NHS seem perfectly happy to wash their hands of their own staff. One can only guess that the NHS have probably achieved a quid pro quo from OCC on some other matter  - perhaps  over the split of Intermediate and Home Care costs in the county which has been a recent matter of great contention.  Whatever the details heavy-duty politics is at work and poor old Chippy Hospital is just a pawn on the board. 

And so the PCT Board approved the proposal.  To hell with 11,000 residents, two Action Groups, the Town Council, the District Council, the local MP, the League of Friends, the GPs, the Hospital nurses themselves............The Order of St John will employ the nurses looking after the 14 Intermediate Care Beds in the Hospital.

This decision means that the Hospital Action Group now needs to get back in discussion with the Reconfiguration Panel in London who brokered the binding agreement last time. The Overview and Scrutiny Committee have already (predictably) said to the Press that they won't support this move. So perhaps the Action Group must make a direct appeal to the Minister and beg him to stop the local bureaucrats and councillors playing political games with the most important civic asset that this town of ours has or ever will have.

The Secretary of the Hospital Action Group Clive Hill made a five-minute presentation to the Board at the beginning of their meeting. It was a brilliant summary of the issues. You can read his detailed notes HERE

This article consists of the personal views of the EDITOR alone and should not be taken to represent the  views of the HOSPITAL ACTION GROUP who will be making their own official statement within the next few days.

The Fight Goes On

The move has been criticised by the Royal College of Midwives, which said it would affect the number of women who leave hospital breastfeeding. Currently, about nine out of every 10 women at Chipping Norton, Wallingford and Wantage leave the hospitals breastfeeding, compared to seven out of every 10 leaving the JR and the Horton. RCM regional officer Judy Slessar said: "For women who have had a perfectly normal labour and delivery, there isn't any reason why they shouldn't go home within 24 hours, but there should be an element of choice for women. "I think staying in hospital for postnatal care can only help and encourage women to persevere with breastfeeding. Obviously, in a maternity unit, a professional is on hand to give guidance 24/7." Pregnant women in Oxfordshire are receiving a letter explaining that if they have a normal birth they can expect to stay between two and 24 hours. The letter asks women to bring their baby car seats to hospital "to prevent any delay in your transfer home".

Chipping Norton and Wallingford Hospitals have Unicef Baby Friendly accreditation, which means they offer the right help to encourage breastfeeding. Baby Friendly Initiative deputy programme director Anne Woods said reducing the amount of time mothers could stay at the hospitals would not necessarily jeopardise their accreditation. She added: "They have to meet a minimum set of standards, and it doesn't matter whether they are met in the hospital or the community. The difficulty is whether the same standards will be provided in the community when midwives are very thin on the ground and other things are pressing on their time."

Claire writes in our Forum:

If the report in the Oxford Mail is accurate, this could be the beginning of the end of our much loved maternity unit. Most of the beds in the maternity unit are used for post-natal care when women who have given birth in the JR or Horton transfer back to Chippy. The quality of care is fantastic. It's a calm environment with lots of one-to-one support from the midwives which is invaluable to any first time mum - or, indeed, second, third and fourth time mums who need a bit of peace before returning to the family. Everyone I know who has stayed in the unit sings its praises. I don't know the current figures, but some years ago the number of actual births in Chippy was about 100 or so. And you won't need half a dozen beds for 2 mums a week ... My concern is that, if they stop women transferring here for post-natal care or staying in for more than 24 hours after giving birth here, then some NHS bureaucrat will question the need for an in-patient unit at all. Yes, we would still have the ante-natal care, but that could be delivered in a far smaller space. The maternity unit here offers an outstanding service of which we should all feel very proud. This latest cut looks like the thin end of the wedge to me - maybe the Hospital Action Group should add the maternity unit to its remit?

HOSPITAL PLANNING APPLICATION DELAYED UNTIL NEW YEAR.  JUST WHAT IS GOING ON?