Briefing about cuts and tendering out of Brighton and Hove Children's services
from Sussex Defend the NHS workers sub group; June 2016
Brighton and Hove Children’s Services.
Also known as: Public Health Nursing.
Children’s Community Services
The Healthy Child Programme (0-19 or 0-5)
These services/contracts cover various things, and can be a bit different in different parts of the country. In Brighton and Hove we are talking about:
Family Nurse Partnership (FNP) (a specialist, licensed programme for first time parents under 19.)
Breastfeeding Support Service ( Breastfeeding peer support and targeted support in areas of the city with low breastfeeding rates)
So, all these services work closely with families looking at health and well-being. They are predominantly focused on the early years as research shows that what happens in pregnancy and early childhood impacts on emotional and physical health all the way to adulthood. School nursing obviously works with school age children.
Following the Health and Social Care Act 2012, ‘public health’ became the responsibility of Local Authorities and Health and Well Being boards (HWB) were set up – these have commissioning responsibilities. They have close links with the CCG’s but commission different services.
These Children’s services were commissioned by NHS England after the 2012 act, but moved to Public Health commissioning in October 2015 – nationally, not just B&H.
However, at the same time as this, there was a huge cut in the Public Health budget nationally – you may remember that George Osbourne announced an (unprecedented) in-year cut nationally of £200m for 2015-16. And then in Feb of this year the Public Health allocation was announced - a cut of £77m in 2016/17 and £84m in 2017/18. In earlier discussions about Children’s Services moving to Public Health/LA commissioning, there was talk of the budget being ring-fenced. This hasn’t happened.
So, the Brighton and Hove situation for these services:
The Public Health Nursing Commissioning Strategy, presented by Public Health commissioners, was agreed in March 2016 at the HWB.
There had already been cuts to the public health budget which other services had borne the brunt of (SMS) which had reduced the budget in 2015/16.
For Children’s services there will be a cut of £200,000 for 2016/17 and from 2017 a cut of £800,000, possibly over the next 2 years. So, over the next 2-3 years there will be a cut of £1m form a £5.5m budget (18%). One of the ways the PH dept is making these budget cuts is by decommissioning the FNP from April 2017 – ie this particular specialist provision will not be available for teenage parents, although they say they want some sort of service for young parents.
In addition, these services are being tendered out form April 2017. According to the Public Health department they are legally obliged to tender these services. (Although not all LA’s are but they could be subject to legal challenge).
Virgin Care has become a major player in Children’s services. They have contracts for similar services in Surrey and Devon, as well as other parts of the country. They are interested in West Sussex Children’s services.
Brighton’s first procurement event was (secretly) held on May 24th. It’s highly likely that Virgin Care attended.
What the current local provider, Sussex Community Foundation NHS Trust (SCFT) is doing:
They have stated that they would like to continue providing these services. However, their response to the £200,000 budget cut for 2016/17 is to fill vacant Health Visitor posts with Community Nursery Nurses. ( These Nursery Nurses are cheaper and don’t have the training and professional accountability that Health Visitors have). This has been done without the knowledge of staff side trade unions.
What is happening and what is to be done:
There are 2 focuses: the HWB and their budget cut /contract tendering/secrecy.
And the current local provider implementing these cuts with skill mix/downgrading.
What Defend can do:
Publicity: Press release has already gone out condemning the cuts. No take up. Needs a public/social media publicity campaign to raise the issues.
Lobbying of HWB etc. There will be a ‘presence’ at the meeting and questions at the June meeting (although Children’s Services not on the agenda). Current focus: reversing budget cuts and ‘NO’ to Virgin care in the city.
Lobbying of local MP’s, councillors etc. Information and letters have gone to local MP’s. No letters yet to councillors on HWB.
Keep eye on national picture. Link in with UNITE in Health and CPHVA – both lobbying the gvnt, DH, PHE to reverse the budget cuts. Link with other campaigns such as Bristol.
Work on legal challenge.
Challenge through the Overview and Scrutiny Committee (OSC)
Raising issue with other TU’s, political parties.
Tuesday 27th Oct health staff received formal notification that HM Treasury has given the final approval for the 3Ts Redevelopment of the Royal Sussex County Hospital.
The following statement has been made about this 3Ts development. Whether Hospital Staff are as happy as management we doubt.
According to hospital management:--
The £484.7 million redevelopment will be focused on the front of the hospital, where our most outdated buildings stand, but the benefit will be experienced by everyone using the site. From the new spacious main entrance on Eastern Road to the air ambulance pad on the Thomas Kemp Tower, the redevelopment will change the character of the hospital, beyond recognition.
The Stage 1 Building will open in 2019, with the Stage 2 Building due for 2023 and the entire redevelopment complete in 2024. There have been a lot of changes on site already to prepare for the 3Ts Redevelopment and there is much more to come. In January work will begin in an area which includes the Jubilee Building, the old HQ Building and the Stephen Raleigh Building. Towards the middle of the year the work will extend to an area that includes the Latilla Building and the Nuclear Medicine Building. Staggering the start of works on Stage 1 will make it easier to maintain all our clinical services on site in the early part of the main scheme. For reasons of safety all construction areas will have high hoardings around them and strict access controls will be in place until the building works are completed.
The redevelopment will not only transform the County site with modern, spacious wards and departments; it is the groundwork for a vision of our future. The environment only makes up a part of what our patients experience and we have ambitious plans to transform the care we provide for patients across the Trust. We all need to continue to seek out and make the changes to how we work which will ensure we lead the way in the excellent care we give our patients.
We know redeveloping the hospital won’t always be easy and we will have to balance the needs of our present priorities and our future improvements. We know it has been done successfully elsewhere, on sites even more constrained than our own, and we know that there is a compelling need to redevelop the County. Now we have the means to bring about that change. We all want a better hospital for our patients and together we will make the 3Ts Redevelopment a reality.