Defend Camden NHS

Backdated from previous BA website

2009 will be a crucial year for the future of our health service as we know it. * Please find attached the response from CamdenPCT to the questions put to them by the Defend Camden NHS Campaign. It confirms they plan to put out to private tender the GP’s Urgent Care Centre at the Royal Free Hospital after a 3 month trial. And the consultation over the future of primary care, including a GP led health centre also to be tendered, will start soon. * Valentines Day demonstration and petition Saturday 14 February 11am Mornington Crescent. Our demonstration is perfectly timed to say we are not going to let them get away with it. Please use the attached petition to get as many signature to hand in on the day. * Meeting Tuesday 05 January 6.30pm Camden Town Hall. There will be lots to plan and lots to do. If you can’t make the meeting but can help in any way to publicise the demonstration or get signatures for the petition then do let us know.

See also

30th December 2008

Candy Udwin
Camden Keep Our NHS Public
194 Levita House,
Ossulston Street
London NW1 1EZ

Dear Ms Udwin

Following our meeting, I undertook to reply in writing to the questions you raised in your email.

I have addressed each of these questions below, and I trust this will provide you with further information following our useful discussion on the day.

1) What alternatives to tendering that could avoid private companies running services have been considered?

A1. The PCT has a number of options for commissioning new and existing services set out in its vacant practice policy and clinical service procurement guidelines.  The PCT also has to adhere to Department of Health guidelines on co-operation and competition and the NHS London Commercial Strategy.  The assumption is that in most cases tendering is the appropriate response, but our policies include assignment and dispersal of patient lists (applies to primary care) and re-commissioning from existing providers in very specific circumstances.  NHS commissioners are expected to take a market testing approach in all but exceptional circumstances.  This ensures that services are procured that offer a combination of both high quality and value for money. Once this route is taken we cannot exclude certain types of organization from the process.

2) If tendering has not been used by the PCT for some new Camden services (such as Hampstead Urgent Care Centre), why should it be used for any others?

A2 It was not used for the north Camden UCC as this is a pilot, designed to evaluate the service model.  Once we have evaluated the results, should we decide to commission a full service, it will be tendered.

3) Does the PCT believe that they have the final choice in this?

3A The PCT makes these decisions, but within certain parameters.  The PCT can be challenged by potential provider organisations through the Department of Health’s Competition Panel, and the PCT must operate within the policy context set by the Department of Health rules for Competition and Co-operation, and NHS London’s Commercial Strategy.

1) What health needs dictated the choice of the four proposed areas for polyclinics?

1A An exhaustive health needs assessment has been made of the whole of Camden.  The four polyclinics cover the whole of the Borough with the areas following natural community delineation.

2) Will money that was to be spent on UCLH polyclinic now be spent on existing surgeries?

2A Camden PCT has invested over £1m in existing GP surgeries this year.  We remain committed to the development of a South Camden Polyclinic.

3) Has money already been given to UCLH?
3A No.

4) How will patients be consulted over any proposals (bearing in mind we were informed that there would be a 3 month consultation over the proposals at UCLH)?

4A A paper setting out the overarching primary care service strategy for Camden will be going to the health scrutiny committee in early 2009.  Discussions will take place around the consultation approach at that meeting.

Urgent Care Centres
1. Will the UCC at UCLH be based in phase 1 building and who is proposed to run it?

1A Negotiations are underway with UCLH about the potential to develop an urgent care centre in Phase I of UCLH. There are no proposals at present in relation to potential providers.

Out of Hours service
2  How is it proposed for the OOH service to be integrated into these proposals?

2A  We agreed at the meeting that this referred to urgent care proposals.  We have extended the existing OOH contract to September 09 and have scope to extend further to March 2010.  This gives us some time to agree the strategic approach, although the contract currently covers four PCTs.  One option may be to integrate OOH with urgent care contracts, but it may be necessary for us to retain a separate OOH contract relating to face to face and home visits.  Clearly we need to work this through as we develop the specification for UCC and in consultation with the other four PCTs with whom we commission OOH.

GP led health centre
1) Is one proposed?
1A Yes.

2) Is there any proven need for it, if so what?
2A The 2008/9 Department of Health Operating Framework requires every PCT to procure a GP led Health Centre with a view to offering a wider choice of services to local people.

3) In what area is it proposed to be sited?
3A There is no firm proposal yet.

4) What discussion has there been with GPs?
4A  The LMC have been informed of the developments and local GPs are encouraged to be involved in the process.

5) Who will run it?
5A This will be unknown until the contract is let.

6) What consultation with patients is proposed?
6A This will be included in the public discussion regarding our Primary Care Strategy.

PCT managed services
1  What is proposed for services directly managed by the PCT?
1A The five PCTs in NCL are working together on the future of PCT provider services.  For the moment these services remain a semi-autonomous part of the PCT.

1) Can the PCT confirm that any future consultation will not exclude supporters of Keep Our NHS Public or any other group?
1A No groups will ever be excluded from commenting during consultations.

2) How is it proposed to ensure that consultation allows for a real chance for patients to affect the outcome?
2A The PCT listens carefully to what our patients and the public tell us.  Following the consultation on GP surgeries, we made 5 separate changes to the service specification based on the feedback we had received.

3) Will there be consultation over any private tendering?
3A It would be unlawful for the PCT to specify what kind of organizations can bid for services or to attempt to exclude certain organisations from a procurement exercise.

United Health (UH) contract
1) How is the contract being monitored?
1A The contract is monitored by formal quarterly performance meetings chaired by Liz Wise, Director of Contracts and Performance, attended by management and clinical reps from the PCT and UH.

2) Have there been many complaints?
2A No – there have been a small number of complaints, and these have been followed up by the PCT with UH.

3) Has United Health asked for additional money to run the services?
3A No.

4) Did the baby clinic at Camden Road close because the PCT decided that it should?
4A There is still a baby clinic (child health surveillance clinic), run by GP’s at Camden Road.  Health visitor input was withdrawn by PCT provider services, based on a low uptake of this service.

5) Were locum GPs let go because the PCT decided this?
5A No – workforce decisions are the responsibility of UH.  The complement of GPs at the UH practices is in line with others.  They have enhanced the workforce through additional senior nursing posts.

6) Are there as many doctors as previously?
6A There are not as many locums – UH has reviewed the workforce in the practice, and changed the skill mix, and numbers of doctors consistent with other practices.

7) Is it true that a substantial number of patients have left the Brunswick surgery?
7A No, to our knowledge the list is now stable.

8) Are the PCT aware of complaints that:

i)    Flu jab reminder letters have been sent out very late?
ii)    It is much harder to get an appointment on the same day?
iii)    That there is very little continuity and hard to see the same doctor because they keep changing?

8A  When these sorts of complaints are received in relation to any Practice they are addressed immediately by the PCT.

Liz Wise asked for KONP representatives to feed any further information through to her and promised to take up the issue of a patient participation group for Camden Road, which Dani Jayes, Vice Chair of the PCT, offered to facilitate.

I hope this provides you with the information you requested.  Should you require further information in future, please do not hesitate to contact me.

Yours sincerely

Rob Larkman
Chief Executive

Stop the privatisation of our health service
In the 60th year of the NHS we call on the Secretary of State for Health and the Camden Primary Care Trust
•    To keep our GPs local
•    To keep them in the NHS
•    To improve services by investing more money in existing GP surgeries

We oppose government plans which insist that each area should have so called “GP-led health centres”.
•    They threaten the closure of local GP surgeries
•    They risk losing the vital patient-doctor relationship
•    They might be put out for tender and run by private companies

In Camden three surgeries have already been taken over by United Health, one of the largest US private health insurance companies.
•    We don’t want public funding to move from GP practices to private companies who are primarily accountable to shareholders rather than patients. We want to be treated by GPs who see us as patients not as customers.
•    We urge the Government to halt its promotion of commercial companies in general practice because this threatens the comprehensive high quality care provided by the NHS. We call on Camden PCT to halt any plans for private tendering of GP services.

If you can help with the campaign

Return to:    Camden Keep Our NHS Public c/o 49 Rossendale Way, NW1 0XB  Phone 020 7383 3092 or 07946 480 261


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