On 16th April, the Health Overview & Scrutiny Committee of Norfolk County Council held a meeting to review the disastrous ‘radical redesign‘ at Norfolk & Suffolk NHS Foundation Trust (NSFT). The Chief Executive of NSFT, Michael Scott, was accompanied by the Operations Director (Norfolk), Debbie White, and the Locality Operations Manager in West Norfolk, Marcus Hayward.
Here is the statement we made:
We would like to thank the Committee for inviting us to speak today. We are always ready to help the Committee and its members in any way we can.
We would like to give the Scrutiny Committee credit: it did investigate, it did call to account, it did do a much better job of investigating the radical redesign proposals than NHS England, Healthwatch, the CCGs and the rest of the NHS bureaucracy, with the notable exceptions of the CQC and HealthEast [Great Yarmouth & Waveney Clinical Commissioning Group].
However, given the failures at NSFT:
- Quality failure, as the CQC rated the trust ‘Inadequate’
- Financial failure, as Monitor put the trust into Special Measures after it wasted £17.25m on termination payments in only three years but still spends £2m per month on temporary staff
- Reputational failure, as NSFT would be a national laughing stock, if it was a laughing matter, but it is not because of
- Misery for staff, those who rely on services and their families and
- Deaths, unnecessary deaths, yes really, we hear stories we don’t have time to tell today and meet the bereaved relatives
then the decision to go along with the CCGs’ and NSFT’s narrow and self-serving interpretation of ‘substantial variation’ was a serious mistake given the catastrophe which followed.
NSFT’s plans should have been subject to public consultation and scrutiny and then referred to the Secretary of State. We recognise that HOSC’s powers are limited but it should not have been afraid to use the powers it does possess.
HOSC and the health bureaucracy must reflect. Read our submission to HOSC from January 2014. We forecast the financial crisis, the recruitment crisis, the community crisis, the bed crisis, the failure of AAT, the impact of the loss of link workers on demand for secondary services and the collapse of staff morale. There were others warning too. Were we, Unison, the BMA and individual carers clairvoyant or were the signs obvious yet ignored?
HOSC has been given assurances by NSFT and commissioners which have been repeatedly broken:
- HOSC was told no beds would be closed until community services were in place and they were no longer needed, but beds were closed and we have a bed crisis
- HOSC was told in January 2014 that the use of out of area beds would end by April 2014, but the situation got much worse and is still not resolved.
Michael Scott demanded a £35,000 pay rise: if he needs to be paid more than the Prime Minister, he and NSFT should expect to be rigorously held to account for performance.
There are serious concerns which HOSC should investigate:
- NSFT appears to have failed to give our campaign, and HOSC, data we requested which it subsequently appears it did have [relating to AAT]
- The impact of the Section 75 agreement collapse
- The financial sustainability of NSFT with the abandonment of the Trust Service Strategy and CCG underfunding
- The recruitment crisis in West Norfolk, where a substantial number of consultants have resigned and difficulties recruiting all types of staff threatens the safety and quality of services
- Cuts to secondary services as a result of the Wellbeing contract threatens the diversion of money away from those most in need when community services are already under severe strain or failing
- The evidence today presented by NSFT shows that the number of out of area placements is again rising and never reached zero, even with the opening of 12 beds on Thurne Ward. The adult acute beds at Carlton Court have yet to close. Does NSFT have a strategy for the provision of sufficient beds for local people as the CQC and Monitor demand?
In addition, we are deeply concerned about the leadership and culture of the trust:
- A refusal to accept criticism as some of the CQC report is dismissed internally as unfair
- This summer may see the return from secondment of the architect of the radical redesign, the former Operations Director, Norfolk
- Why does NSFT still have largely the same Board which has wasted millions and put lives at risk?
- Michael Scott refuses to engage with our Campaign, when the CQC, Monitor and the media will.
Afterwards, councillors from across the political spectrum told us how important our campaign has been, and remains, in holding NSFT and the CCGs to account. Our campaign is a moral one: it isn’t a matter of right or left, it is a matter of right or wrong.
Alan Yates, the Improvement Director appointed by Monitor, was in the audience as an observer. We had a constructive conversation thereafter.