The governing body of Enfield Clinical Commissioning Group (CCG) is set to approve stricter criteria for access to specified surgical procedures at its meeting tomorrow (20th September). The meeting at Holbrook House, Cockfosters, is open to the public and starts at 12:30pm. Campaigners are planning to congregate outside the building from 11:30am to show their disgust at reductions the availability of NHS services masquerading as "clinically evidenced" changes.
The poster used to publicise the AEBM consultation. Hearing aids and knee replacements have now been excluded from the planned restrictions, but there are still a further 11 treatments that will be affectedThe decision follows a controversial consultation on so-called Adherence to Evidence-Based Medicine. However, during the consultation NHS campaigners, led by Defend Enfield NHS and the Enfield Over 50s Forum, were themselves able to produce evidence undermining the CCG's arguments that the changes are being brought in for purely clinical reasons, rather than as part of a set of desperate measures to balance the CCG's books.
The CCG claims that its financial woes are in part due to hospitals carrying out unnecessary procedures. However, a far more plausible explanation is that from the very time it was set up the CCG has never received adequate levels of funding from the Department of Health - a point on which both the Labour administration and Conservative opposition on Enfield Council are in agreement.
Hearing aids and knee replacements safe - for now
Two of the surgical procedures that were consulted on have been removed from the list. Patients with moderate hearing loss will continue to be fitted with hearing aids on the NHS, and the criteria for knee replacements will remain as now, at least for the time being. The CCG is, however, still planning to introduce stricter criteria for knee operations, once better arrangements are in place for patients to access physiotherapy and be helped to lose weight. When that time comes the changes will be implemented without a public consultation.
Stricter criteria to be extended to other north London boroughs
The CCG has stated that the Clinical Commissioning Groups in the other four boroughs that make up "North Central London" - Barnet, Haringey, Islington and Camden - "will be seeking to implement the same proposed changes over the next few months" despite the fact that the residents of those boroughs have not been consulted.
What procedures and treatments are affected?
The changes that were proposed in the Consultation Document will be put in place for the following procedures/treatments:
At the Palmers Green Ward Forum this evening Patricia Mecinska, Chief Executive of Healthwatch Enfield, gave a presentation. She was extremely critical of Enfield CCG for approving the list of 11 procedures and treatments that will from now on only be available for particularly bad cases.
She pointed out that feedback on the proposals from the public had been 100 per cent negative, yet the CCG had gone ahead with them. She said that people wishing to have these treatments will in future either have to pay for them or go before a funding tribunal with a small chance of success.
She warned that next year the CCG would be submitting proposals to do the same for no fewer than 197 procedures and treatments, including cataract operations. She urged everyone to register their disagreement with these cutbacks.
Though Patricia Mecinska didn't say as much, it's clear that we are moving towards an NHS that remains free to the user when it comes to emergency and urgent treatment, but where you won't get "elective" treatments, such as hip and knee replacements or cataract removals unless you pay privately. This was in no-one's manifesto at the General Election, but is clearly the way things are going unless something is done to put a stop to it.
On the wider outlook for north London, Patricia said that some departments at the North Mid would be relocated to the Royal Free in Hampstead, though the A&E would stay in Edmonton.
[Edited on 23rd September to remove inaccurate remarks about the CEO of the North Middlesex Hospital]
The Kings Fund, an independent English health and care charity, have produced a 6 minute video which helps explain the many parties and apparent direction of our NHS. It helps to cut through what seems to be an otherwise impossible to understand complexity.
No mention however of Brexit and the promised £350m per week windfall, rather the message is belt tightening and work to keep yourself as healthy as possible.