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Legal challenge to NHS England shake-up plans

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Paul Clift
Member
Posts: 467
Legal challenge to NHS England shake-up plans
Posted on: April 24 2018, 05:46 am

From the Guardian 24th April 2018:

"NHS England faces a legal challenge to its plans to overhaul how the health service operates, which critics say are unlawful and could lead to patients being denied treatment.

Campaigners on Tuesday will try to derail plans to introduce of “ accountable care organisations” (ACOs), which they say could force doctors to decide what care a patient needs based on how much money is available rather than how sick someone is.

If the changes go through then individual hospital trusts and clinical commissioning groups (CCGs) will no longer each receive an annual budget of their own. Instead NHS bosses would give a joint budget to pay for healthcare in whole areas of England to an ACO that would be made up of all the acute, mental health and other providers of NHS care locally...

Rowan Smith of Leigh Day, the lawyer firm representing the campaign group, said the fixed pooled budgets of ACOS would end the system of “payment by results”, under which hospitals are paid for episodes, and lead to a “race to the bottom” in prices charged for care, which would hit patients."

The full article is here https://www.theguardian.com/society/2018/apr/23/nhs-england-legal-challenge-judicial-review-accountable-care-organisations
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Roy Trevelion
BHIVA Reps
Posts: 332
Re: Legal challenge to NHS England shake-up plans
Reply #1 on: April 24 2018, 12:32 pm

Thanks Paul,

The Memorandum of Understanding (MoU) on London Health and Social Care Devolution signed (Nov 2017) by Jeremy Hunt, Simon Stevens and Sadiq Khan will further fracture the NHS and widen it to further privatisation.

Any MoU that has to state that London will remain within the wider NHS should surely set alarm bells ringing. As should any health care plan that seeks "Subsidiarity to the lowest appropriate spatial level is the keystone to a framework of principles." And "Future proofing to accomodate further devolution," when we haven't had a say on this stage of devolution is unacceptable. Here are the governance arrangements:

Quote
London arrangements
London has a strong foundation of joint working. Improved collaboration and local accountability will enable more ambitious partnership working and help achieve the aspirations and objectives agreed for London. London-level governance aims to provide complementary functions to add value to local and sub-regional arrangements. Governance mechanisms in London will be phased to evolve from existing arrangements.
Underlying design principles:
• Subsidiarity to the lowest appropriate spatial level is the keystone to a framework of principles. The default position should be to the borough level.
• Multi-borough governance must have the agreement of all relevant parties and may vary according to locally determined need.
• Functions will only be aggregated to the London level where there is a clear case and it is preferable to all partners to do “once for all” to avoid duplication, enable scale or acceleration.
• Any new regional and multi-borough governance will be implemented with a view to rationalising the wider governance infrastructure to ensure duplication is avoided.
• Any arrangements must consider the implications for both devolution and wider transformation and operational governance. Approaches will be ‘future-proofed’ to allow evolution to accommodate further devolution, delegation and joint decision-making, with functions phased over time.
• The NHS in London will remain within the wider NHS and subject to the NHS Constitution and Mandate.

You can see the whole document here:
https://www.london.gov.uk/sites/default/files/nhs_hlp_memorandum_of_understanding_report_november_2017.pdf

All best wishes,
Roy
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