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By 999 Call for the NHS, Nov 11 2019 09:33PM

999 Call for the NHS has been calling for the Renationalisation of the NHS since we marched for the first time in 2014. We've seen, and supported, FOUR attempts at getting the NHS Reinstatement Bill on the parliamentary table and now in 2019 the issue of Renationalisation/Reinstatement comes around again as we enter the election campaign period where after decades of Austerity...

The two main parties are now both the investors of the future and have sudden access to billions of pounds with which to show just how much they love the NHS and promise to keep it alive.

Labour are currently sitting on the most recent version of the NHS Reinstatement Bill, reworking it apparently. But are they talking about the "Renationalised with NO PRIVATE CORPORATE involvement" that we are calling for? How will we reinstate the NHS as a public service?

Easy answer. End contracts for outsourced clinical services. But there are difficult questions. What about the embedded web of "invisible" services that stretch throughout the NHS, beneath and behind the blue logo? For example...

"What the hell is this?" we hear you say.

Well... since the NHS was fragmented by the internal market brought about by the last Health & Social Care Act 2012 healthcare became a business model not a care model. The new Clinical Commissioning Groups (budget holders)made up of health people, knew next to nothing about auditing, tendering, legal technicalities? So they needed an advisory support service.

In 2015 this was known as the Lead Provider Framework - an easy to comprehend network of Commissioning Support Units divided into 9 geogprahical streams with a list of companies that was already fairly unpleasant.

As things progressed in 2017 with the NHS moving ever closer to the American model, based on the likes of Kaiser Permanante and United Healthcare , with an array of new "innovative and disruptive" models of care from federations, hubs, integrated neighbourhoods, multispecialty community providers, primary care homes and networks never mind a literal headfuck of contracting and financial measures designed to confuse everyone it seems.

But have no fear the Lead Provider Framework is here! Naturally shapeshifting in order to meet the needs of poor commissioners out of their depth in the mire of transformational change. Now so much more than legal, auditing and backroom services. Below is a hint of the changes in 2017/18 - End to End Commissioning... take note of the third red column.

Late last year the transformation of the Support Services became much more complex - reflecting the complex top down restructuring being forced by NHS England and all encompassing as the new 2019 NHS Long Term Plan continued to push the envelope of what is called the LEFT SHIFT - more care in the community, closing A&Es, centralising acute services, selling off public buildings... plus the major onslaught of Digital, Apps all tied up with allure of data trawling for profit.


This is part of NHS England's description:

The Health Systems Support (HSS) Framework provides a quick and easy route to access support services from innovative third party suppliers at the leading edge of health and care system reform, including advanced analytics, population health management, digital and service transformation... The Framework focuses particularly on services that can support the move to integrated models of care based on intelligence-led population health management. This includes new digital and technological advances that help clinicians and managers understand a population’s health and how it can best be managed.

The HSSF is divided into ten LOTS. Opening the lots is like opening Pandora's Box of USA & Global Corporates.Take a look at just one LOT No.6 - Transformation and Change Support

It is a shock but no real surprise to see some usual horses of the Apocolypse in there - KPMG, McKinsey, PriceWaterCoopers and Optum the subsidiary of United Healthcare of America (where SIMON STEVENS spent 9 years as President of Global Strategy) but then dig deeper into the "smaller names" and you discover more USA and global connections.

BDO, Capgemini, Centene, DGX Technology, GE Healthcare Finnamore Ltd are worth a look and even Moorhouse Consulting Limited looks innocent enough until you wonder what they are as "An Expleo Company" more of the same...

And what is Lot Number 6 all about?

Well NHS England kindly provide a description. Provision of a range of expert advice, analysis, transformational and change management capability to design and build the necessary infrastructure for an ICS / STP function effectively. Services include but are not limited to (edited list):

Patient pathway optimisation and care model design

Specialist advice on organisational redesign, governance and payment and contract reform

Communications and engagement

Primary Care at scale support

Is this supporting or twisting the arm of the NHS? Seems a great deal more significant that mere back room services.

Make up your own mind with THIS LINK

Our ask is simple. We know the task is epic and complex in its operation. But how are we going to rid the NHS of the corporate vultures? How do we remove the web of private providers who have now set up home in the framework? It can be done. But we need a government with the will to take it on. And that WANTS to see the NHS restored to a unified public service of support for all.

Renationalisation is about the stopping and rejecting of the USA Healthcare Model being promoted by NHS England, Health Secretary Matt Hancock with support from The Kings Fund, Nuffield Health and numerous other "think tanks". As an Addenbrookes innovation department staff member told us: "We're not innovating or integrating anything to do with clinical care. The only thing we're integrating is the accounts system".

So we need politicians who understand the future of our NHS rests on our ability to reject the profit & insurance model that is being foisted upon us.


By 999 Call for the NHS, Mar 20 2018 02:28PM

Steven Carne

Tues 20th March

To my horror this morning I came across a supreme example of all that we have been warning about for some time: profiteering private companies moving into controlling positions of our NHS, edging aside publicly accountable NHS organisations and local authorities.

The news? Well for those of us who know the familiar chess moves of the privateers it seems that USA’s Centene - through its subsidiary Centene UK -may be set to take over the NHS Commissioner’s role in a recently- awarded £206m community services contract, once the Greater Nottingham Accountable Care System is implemented.

This would allow the company to manage the contract and determine/influence the award of any sub-contracts – effectively closing that much talked about problematic "Purchaser Provider Split". What better way to solve it than to allow a private company controlling a local health and social care system to be able to commission itself?

Centene UK’s discredited subsidiary Ribera Salud – which is being kicked out of the Spanish public health service by the Valencia Green/Podemos/Socialist government –  has just appointed former New Labour Health Secretary Alan Milburn as a Director and has sent lots of executives to the UK to help Centene UK with its plan of buying primary care and mental health companies. Am I just imagining it?

It seems campaigners' worst fears may be being realised. Now we have to decide what are we all going to do to stop this happening.

First of all, let’s not be like the Trojans

I remember making a speech in Manchester in 2015 in Manchester. I was speaking about the dangers of DEVOMANC, which was being rolled out after secretive meetings between ten Labour Councils and then Chancellor George Osborne (look at the expression on Osborne's face below).

The spin was that devolving £6bn NHS funding to Greater Manchester local authorities with an elected Mayor and LOCAL decision making body, would enable the public and councillors and community leaders to make better decisions, control the destiny of their LOCAL environment, communities...

My speech was all about the mythical Trojan Horse. The long suffering people of Troy welcomed the Wooden Horse into their gates believing they had won the long war and the Greeks were leaving - only to be butchered and slaughtered at night by the soldiers contained within the belly of the wooden structure...

For me this is a symbol of what is happening now in our NHS.

Pretty sure local people in Manchester can tell us more about what their horse is looking like.

So waking up this morning to the Nottingham alert about their Sustainability & Transformation Plam reminded me of Manchester. They are both in the first group of local NHS and social care services to become an Accountable Care System and the image of that Trojan Horse loomed in my head as the possibility of its treacherous shell being dragged in and celebrated by the unsuspecting public appeared to be very real.

Yesterday's blog post reported Nottingham Clinical Commissioning Group’s award of a £206m out-of-hospital community services contract to a non-NHS community interest company.

As if that’s not bad enough, this new contract seemingly includes the strange proviso that when the Greater Nottingham Accountable Care System is set up (presumably hoping two national Judicial Reviews will not touch them) there will be a contract variation - saying that it is likely to replace the Clinical Commissioning Group with a “Care Integrator” - oh surpise... Centene.

Quick reminder:

USA corporation awarded a £2.7m contract last summer to help set up the Greater Nottingham Accountable Care System.

Shares in Ribera Salud the now-disgraced private healthcare company currently being investigated for fraud and being kicked out by Valencia government

Alan Milburn is now on the Board of RIbera Salud

Their execs over here supporting Centene

Alarm bells anyone? Read the whole shocking article by CLICKING HERE

So...don't be a Trojan and dont let councillors claim

It's All Greek To Me!

That's not good enough. Put them on the spot. Especially with urban council elections coming up. Let's make our elected representatives and local NHS organisatisations come clean about EXACTLY what the local Sustainabilty and Transformation Partnership’s plans are for becoming an Accountable Care System (which NHS England is currently redecorating as Integrated Care systems to escape those pesky American health care connotations).

In most areas, there will be plans for both STP “footprint” and “locality” Accountable/Integrated Care Systems. Ask them questions and demand some answers.

What happens when a private company assumes the NHS commissioner’s role in a complex contract involving many Accountable Care System “partners” - both NHS and corporate?

Are they happy with the possibility of a private company in charge of a massive contract for a period of 7 years or more? Thus making it impossible for the next government - whoever they are - to change the circumstances?

And what about the lack of public accountability - since as a private company they will claim COMMERCIAL CONFIDENTIALITY and will not answer to Freedom of Information requests? Commercial interests are one thing. What about patient and medical interests?

And lo the Horse did stand in the centre of the city and the good people did sleep

Unware of the army inside the belly of the beast...

Take a look at your LOCAL politics. Behind the mask of devolution - seemingly benign and helpful and progressive in its concern that LOCAL Councillors and public service organisations are seen to be participating in LOCAL decision making - is there yet more shrinking of the government's duty to protect the welfare of the whole population through good quality healthcare, education, social care... ?

Is your area talking about LOCAL control, more joined up thinking, an elected regional mayor, with Council cabinets making executive decisions that the full Council doesn’t get to debate or vote on?All under the guise of making politics more LOCAL, ACCOUNTABLE and INTEGRATED for the local population?

The glorious Trojan Horse that is Accountable Care.

It is time to say NO to Accountable Care - don't be bamboozled by the name changes and games that some local councils are playing. Visit our latest #NHS4ALL page to find out more.

There are things we can and must do.

Visit #NHS4ALL

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