Archive for the ‘Social Prescribing’ Category

Health Transformation Programme – The Next Step


 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reader Trigger Warning for those with sensitive disposition >>>>

Since March 2019 the mutterings of  merging assessments has been muted which sent shivers through people with disabilities as they felt another onslaught was coming and saw this as a negative move. Its linked in part to Health and Work Programme too, which Department of Health combined to help design,  to enable DWP plans to close the disability employment gap and get more people into work. This doesn’t exclude other groups in society as it all part of welfare reforms and part of Universal Credit  and Social Prescribing is likely to be part of this complex joined up thinking by the government.

Contracts were first noticed in 2019 when the then Minister was Amber Rudd made a statement  on Improvements to Universal Credit, so when I went looking and  it’s part of ‘Intergrated Health Assessment Services’ Contract.

I remembered reading about it in the government 2016  ‘Improving Lives’ the work,health and disability Green Paper,which like most things are slipped in under the radar, by the DWP Ninja’s with the date of 2021 start date. I also recall IDS flunky Charlotte Pickles writing about it and Dame Carol Black in think tank reports way back.  This week Theresa Coffey the new minister being grilled about  by the DWP Select Committee about universal failures of Universal Credit, where she lost the plot when Frank Field  challenged the minister ,and she blurted out they were not uncaring they were trying to make things better quoting the previous ministers statement, which jogged my memory. So off I went down the rabbit hole which is my archive documents to search for these mutterings. I recall Alex Tiffin Campaigner also wrote something on it at the time.

OBR & Rudd

“The idea of of this was the cost involved in repeat assessments which were costing the DWP millions when 72% of PIP appeals were overturned according to Rudd and ESA appeals on top were also very successful,which seriously highlighted the administration of this in turn cost the taxpayer a small fortune. Contracted assessors should have been shown the door and financially penalized, but no this government instead extended those contracts to continue carrying out the assessments while they still were getting the majority wrong. The OBR report showed:

The admission, quietly revealed in the Office for Budget Responsibility’s (OBR) economic outlook report, suggests the DWP never had sufficient staffing levels to carry out the repeat assessments for personal independent payments (PIP) alongside its other workloads.Repeat assessments to check eligibility for PIP, a benefit intended to help pay for extra living costs as a result of having a disability or long term condition, have been labelled “unnecessary and stressful” for claimants.

Those transferring from DLA to PIP were also being failed adding to the pressure in the dept and like it or not Rudd was one of the better ministers to hold this post before quitting over Brexit.”
The issue is as Coffey announced they are looking at more reforms, the new forms designs, the IT structure to enable this project will cost more taxpayers money but also cost disabled people a lot more in terms of stress. Is it for instance one assessment which means you are eligible for both benefits as suggested by many in field, or is it really one assessment lose all scenario as that could potentially mean PIP is going to become means tested which it currently isnt? Lots of disabled people also just get one of these benefits for instance and work already. many severely disabled people with chronic illnesses get both as they are deemed unfit to work, and others can be looking for some limited type of work they could manage. The last ten years have left many traumatised by the DWP and sadly some have taken their lives over DWP tyranny inflicted upon  the disabled community as a whole as fighting for what they are genuinely entitled to.
Many DWP projects are dressed up as the dept being helpful and inclusive with IDS mantra of ‘Work Sets You Free’ ideological warfare, this is unlikely to be a positive experience either.
Only last week they were caught red handed asking people to downplay their illness to make them more employable and use positive statements and avoid using certain words to describe their disability or Illness. What many have failed to spot is the managed migration of those deemed too ill to work date also starts in 2021-23 is the date coincidence, I doubt it!
Rudd stated

“The corporate empire will be able to rake in millions of pounds more from the ‘Work Capability Assessment’ – to pave the way for a massive shake-up in 2021.Benefits outsourcing giant Maximus will have its contract for hated ‘fit-for-work’ tests extended by more than a year, ministers announced today.

The corporate empire’s benefit testing firm will carry out ‘Work Capability Assessments’ for ESA payments for a further 16 months to July 2021.

The extension – the second since the contract began in 2014 – will allow the firm to rake in millions of pounds more taxpayers’ money from the tests.

But ministers insist it is a temporary measure to ensure “stability” ahead of a huge shake-up of disability benefit tests to help claimants.

Two separate tests will be merged into “one unified, integrated service” from 2021, Work and Pensions Secretary Amber Rudd announced.

The tests are Work Capability Assessment for Employment and Support Allowance (ESA) or Universal Credit – run by a subsidiary firm of Maximus called Centre for Health and Disability Assessments Ltd – and separate assessments for Personal Independence Payments (PIP), run by Capita and an arm of Atos. Today’s extension comes despite more than two-thirds of appeal tribunals (68%) overturning fit-for-work tests last year.

Yet confirming the contract extension, Ms Rudd argued it would pave the way for “a more joined-up claimant experience” in future.She added: “This will allow for a safe and stable service now, and as we transition to the new integrated service.” The announcement came ahead of a wide-ranging speech by Ms Rudd vowing to improve the disability benefit system after years of warnings it is throwing people into destitution.She admitted disabled people feel “put on trial” by the DWP process and “we need to do more” to “close the gap” between intentions and reality. She said the enormous rate of appeals ruling against the government – 72% for PIP last summer – is “of particular concern” and the number is “too high.” according to The Mirror in March this year.”

IDS in 2015 when he launched Universal Credit claimed 

“I have said many times that I believe work is the best route out of poverty.

It provides purpose, responsibility, and role models for children.

As a one nation government, we believe everyone in the country should have the chance to benefit from the security and sense of purpose that comes with being in work.

That is why our guiding principle has been to place work at the heart of everything we do in our reforms.

Getting people into work is more than just earning a salary and certainly more than balancing the public purse.

These matter, of course, but they are not the primary reasons.

For culturally and socially, work is the spine that runs through a stable society.

Let me be clear – a decent society should always recognise that some people are unable to work because of physical or mental ill health – or both.

It is right that we protect these most vulnerable people in our society. And that support is there.

For despite the scaremongering, it is worth reflecting on the fact that we in this country spend more on sick and disabled people than the Organisation for Economic Co-operation and Development (OECD) average.

To put that in perspective – and according to the OECD, the UK spends more on incapacity than France, Germany, or Japan.

However, we are also ensuring that the resources are in place to support people into work.

I’m proud that we are providing significant new funding for additional support to help claimants into work – £60 million in 2017 rising to an additional £100 million a year by 2020.”

This will no doubt strike fear into the heart of the disabled community as it will many other groups who will be targeted on Universal Credit,via its Health & Work Programme and its Social Prescribing of  Intergrated Health Asessment Services. No Guidance is currently available. Its been a very long journey for many of us campaigners ,who are also trying to inform and support many as well as look after their own health and manage their own disabilities, but it appears that this journey still has still a long way to run.
“DWP under the Health Transformation Programme (HTP) are exploring the future delivery of Health Assessments with the objective to transform the health and disability assessment services provided for people with disabilities and health conditions.
The Health Assessments help by providing advice to DWP Decision Makers to determine eligibility for benefits paid to claimants across a range of benefits including Personal Independent Payments (PIP) Employment Support Allowance (ESA), Universal Credit (UC) and a number of smaller benefits.
Currently the services are delivered through a multi health assessment provider base with varying commercial and delivery operating models. The aim of the transformed service will be a more effective, efficient integrated service for customers.”
Please try to read some of the links provided below as I know this blog has been a long one for those who cannot deal with Info overload.

https://www.gov.uk/government/speeches/work-health-and-disability

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/564038/work-and-health-green-paper-improving-lives.pdf

https://www.gov.uk/government/news/millions-awarded-to-help-people-with-health-conditions-stay-in-work

https://www.gov.uk/government/news/40-million-personalised-support-package-for-long-term-unemployed-disabled-people-launched

https://inews.co.uk/news/dwp-quietly-admits-never-had-capacity-pip-reviews-pensioners-disabilities-dwp-benefits-505474

https://www.mirror.co.uk/news/politics/dwp-extends-maximus-fit-work-14089513

https://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Lords/2019-04-11/HL15269/

http://www.pulsetoday.co.uk/news/gp-topics/legal/government-could-automatically-access-gp-patient-data-for-benefits-assessments/20038333.article

https://www.independent.co.uk/news/uk/home-news/dwp-benefit-claims-medical-data-sharing-nhs-healthcare-doctors-charities-a8797991.html

https://www.theregister.co.uk/2019/02/19/dwp_health_data_tool/

https://www.digitalmarketplace.service.gov.uk/digital-outcomes-and-specialists/opportunities/8859

https://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2019-03-05/HCWS1376

https://www.huffingtonpost.co.uk/entry/dwp-universal-credit-pip-and-welfare-reform-outsourcing-contracts-bill-revealed_uk_5c17a7a9e4b05d7e5d84273e

https://blog.sense.org.uk/2019/03/is-combining-pip-and-esa-assessments-really-a-good-idea/

https://www.gov.uk/government/speeches/closing-the-gap-between-intention-and-experience

https://www.theguardian.com/society/2019/oct/08/jobseekers-told-to-call-their-depression-low-mood-on-applications

https://www.contractsfinder.service.gov.uk/Notice/359865b3-b1e1-4071-8bc6-f02067c9f216?p=%40FQxUlRRPT0%3DNjJNT08%3DU&fbclid=IwAR1l0AvqucHKCGYBU-cWx0V-0YwBSP0zV2id_2kh4UhgudPu4K6c7t9u9b4

 

 

 

 

 

 

 

The Death of the Welfare State-Joining the Dots Series -Part 4


 

 

 

 

 

 

 

 

 

By blueannoyed and Paula Peters

Finally we get to to the next stage of government bullying via the NHS. How this links in to Social Security Claimants and their ability to keep some sort of financial security while fighting off the despicable onslaught of the Government who is out of control  , whom have sociopathic  tendancies.

Today I discussed the situation of the NHS  10 year plan , The new 5 Year GP Contract , Social Prescribing,and the  needs of claimants trying to get support or access to services they need to maintain their well being, in this survival of the fittest campaign launched by their government with Dr Bob Gill,  a GP who has spoken out against the great NHS heist of Privatisation.

I asked Dr Gill How he thought the relationship between patient and claimant could be damaged with the new GP Contract which every GP will have to sign up to in May 2019?

I also asked him about social prescribing and its potential impact on patients who need state support and claim Social Security?

 

He described to me that Patients are already coming to surgery with anxiety and depression or ill health due to hostile environment that austerity is creating, and the system is making people ill, or in a lot of cases more ill than they were.  Making it unlikely they will be able to manage their conditions in same way they currently do.

He stated that perverse financial incentives for ‘sociopathic ‘ assessors are leading to really bad outcomes for claimants and  pressures upon the public purse, as well as increased workload on GP’s whose patients need help with appeals etc. This contract will effectively making GP’s Gatekeepers which is not what they chose to be when studying medicine to become a GP.

He said the Government is driving a wedge between the patient and their GP and pitting them against each other,  and that will most likely mean the good GP’s will leave while those without no consciousness will reap the rewards offered by the Government and DWP .

Social Prescribing, is blaming the patient for their situation and the whole treatment process of being denied to the proper care that the patient needs. I asked him about the potential that with ‘patient coaches’ (aka work coaches) who have too much power could lead to those who most need support and are extremely vulnerable ,are likely to  disengage with their GP and fall through the cracks and could ultimately end in their demise which he agreed with my assumption. He stated that Patients/Claimants and GP’s are victims of a government who doesn’t care.

 

The definition;  Sociopathic tendencies in people are often marked by lack of conscience within the person. They just care about their own needs and desires

 

Video:

 

This is the tip of the iceberg of how it could impact on claimants needing further medical evidence support, getting a Fit Note if they are off work through ill health to claim state support, which under Universal Credit they would need to do so repeatedly.

The breakdown of trust between claimants and GP or other NHS staff has the potential to cause a rise in further deaths which have happened already under its predecessor ESA. That’s without the 120,000 who died due to poor care in NHS, etc as diseases previously eradicated are now making a comeback due to austerity measures and abject poverty.

This is Government Quackery on the cheap by unqualified people, dismissing medical opinion of professionals while eroding our NHS services and underfunding essential services that patients need and a NHS they can trust and flogging it to their mates. It beggars belief that the public would allow this to continue or collude with the government by being taken in about better services and cutting waste of NHS resources, or blaming migration, when they have slashed NHS budgets for decades along with New Labour who are not blameless in this re PFI acceleration under Blair.

Below Published with Kind Permission of ck999 Blog Page which has lots more  information,  link is  below in further reading.

Instead of caring for a few thousand patients, a primary care network will have anywhere between 30K-70K patients on its list. In order to provide out-of-hospital care, as hospitals are centralised and cut, it will “integrate” a range of services, provided by a “multidisciplinary team”.

 

A number of primary care networks will be linked to a “locality hub”. There are various versions of what this is, but the British Medical Association has endorsed locality hubs as “ alternative mechanisms to meet the urgent needs of patients when local practices have reached capacity”

 

 

A BMJ graphic shows other activities taking place at Locality Hubs, as well as handling GP “overspill”.

Only patients with complex needs will see GPs

Many GPs are not at all happy about this fundamental change to their role.

The way it works is that a care navigator signposts patients to other services, with no reliance on GPs. This has already been happening in GP surgeries for some time and as all GPs are forced to join Integrated Primary Care Networks, it will now become the norm.

Patients with complex needs – who are at risk of admission to hospital through A&E – will be identified through a process of “risk stratification” which segments patients into various categories.

Risk stratification requires the use of digital health technology (so called telehealth and telecare) and shared electronic patient records.

The concern of primary care networks is to cut the costs of the most expensive categories of patients

These are broadly:

  • Frail elderly with complex health problems
  • Mothers and babies
  • People suffering from the “modern epidemics” of obesity, diabetes, heart and respiratory problems
  • People with disabilities

However there is no real evidence that the “care models” designed to treat these categories of patients cut costs. Or give them better care.

Cutting most patients’ access to GPs will have extremely damaging effects on patients who need a Further Medical Examination for benefit claims, because they need access to a doctor to write letters. Without a Further Medical Examination, a disabled person won’t be able to claim benefits. This is about the destruction of the welfare state. It’s about taking rights away.

The DWP now have people in mental distress top of their target list to get back to work. Which is where Universal Credit will really come into play with this.

The mental health charity MIND won the Individual Placement Support contract – part of the DWP/NHS Health and Work Programme. Individual Placement Support is about the ‘health and work conversation’: Work is good for Anxiety and Depression. What barriers are there to you working?

This is where social prescribing link workers come into play – where they look at barriers to you working. And then prescribe self management. Self care. Via a behaviour change scheme most likely run by a cash-strapped 3rd sector organisation with no therapeutic skills.

The “work is a health outcome” programme – a dangerous partnership between DWP and the NHS – is creating a toxic environment that is compromising doctors’ ethics of Do No Harm.

This link between the DWP and the NHS needs to be broken once and for all.

But the NHS Long Term Plan has no such intention. It name checks Sheffield City Region’s “Working Win” large scale research trial.

It focusses on using a new type of Individual Placement Support to get people with mental health and musculoskeletal conditions into employment. (These are the two main conditions that prevent people from working.)

This list is in NHS England’s new Health Services Support Framework, which identifies approved suppliers that NHS commissioners and providers can hire to tell them how change to the way they work in order to fit the global corporate model of healthcare.

Unsurprisingly the approved suppliers include all the usual suspects and then some:

How did this happen?

The government and its quango NHS England – official name NHS Commissioning Board – have engineered this by drastically cutting primary care funding and driving hundreds of GP practices into bankruptcy, while GPs in droves have been taking early retirement or emigrating to places like Australia where the GP workload is far more manageable.

GP practices are folding at the rate of one a week. In the last year, tens of thousands of patients have found themselves losing a practice, or having it merged with some random practice more or less in the same neighbourhood.

Simon Stevens, the NHS England Chief Exec, has been saying for years that the corner shop version of family doctors has to go, to be replaced by a supermarket version of large scale integrated primary, community health and social care services.

Now he is making that happen.

 

Your NHS is on life support, welcome to the American style  health care system you allowed to happen, hope you got deep wallets or insurance which is the real end game , if not  you will be one of those unfortunate that will meet a early end of life because you happen to be poor and can’t afford Insurance.

 

 

Gp Contract 2019 by Gail Ward on Scribd

https://www.scribd.com/embeds/403999299/content?start_page=1&view_mode=scroll&access_key=key-Jj5snwwqSUkSKkijC8SX&show_recommendations=true

 

Further reading can be found below: Also check out my Social Prescribing Blog

 

 

http://www.hcbgroup.co.uk/is-there-a-cure-for-the-healthcare-and-wellness-marketplace-confusion/

https://www.kingsfund.org.uk/sites/default/files/media/commission-appendix-uk-private-health-market.pdf

https://www.nhsconfed.org/resources/key-statistics-on-the-nhs

https://www.thetimes.co.uk/article/benefits-staff-want-permission-to-trawl-through-patient-records-qgfx3qwv6?fbclid=IwAR2_NnYlbY30iDY0R7A5g1kDduyMYQyz3jSVSEtwvuHDauSi2qFIBjQT7GI

https://www.digitalhealth.net/2019/01/hancock-gp-it-systems-shake-up/

https://digital.nhs.uk/services/gp-systems-of-choice?fbclid=IwAR17Oz6RjrDf3JwafPgYKoYNZpZaer6PccQ6CAfpp3F1UCILUbM0yM_NQ5Y

Scotland : https://bjgp.org/content/67/660/294

https://www.hsj.co.uk/policy-and-regulation/all-gps-expected-to-sign-up-to-network-contracts/7024128.article?fbclid=IwAR2n3-PhhNIqkIyk7koL68UUJgbjRvwfUk7oozFRn0r9sKT4j6a4hqkuQl4

https://calderdaleandkirklees999callforthenhs.wordpress.com/2019/02/16/large-scale-integrated-primary-care-networks-what-lurks-beneath-the-buzz-words/?fbclid=IwAR1UKBhGpV9lrEyZNHJAlrbIUhn4gyf1LTZzUhzwgXZY2zBeUDDl5RKvhDI

https://www.gov.uk/government/news/nhs-can-move-towards-more-coordinated-and-continuous-care?fbclid=IwAR1dV1Lsx0UW-eryC0hphKqR9H_kV8g7urVdcWRBRo8eMI14U1oueyonVi4

https://www.gov.uk/government/news/nhsx-new-joint-organisation-for-digital-data-and-technology?fbclid=IwAR2ekyJayhEU-K3qMZWBETmBEnj3JpLWxEDbhfjOADCSL-MrM85Fdu0nH9E

https://www.telegraph.co.uk/news/2019/02/12/nhs-ends-block-smartphone-gps/?fbclid=IwAR2UprOiA8MK8gTpJtKHcKw2wzFj4XZYvCVvVXFx5i67dCuiacfXBxMSVUk

https://www.theregister.co.uk/2019/02/19/dwp_health_data_tool/?fbclid=IwAR1fIqnGW0naqOcwRhVigQvi7RELPmbsnkcL58r8_dKMY8R9r-rhbqEKFvY

https://www.telegraph.co.uk/news/2019/02/12/nhs-ends-block-smartphone-gps/?fbclid=IwAR2UprOiA8MK8gTpJtKHcKw2wzFj4XZYvCVvVXFx5i67dCuiacfXBxMSVUk

https://www.england.nhs.uk/2016/11/back-to-work-support/

https://kittysjones.wordpress.com/2019/02/15/the-dwp-is-trying-to-co-opt-gps-in-forcing-ill-people-into-work/?fbclid=IwAR1DcTZFX3tIyJ4ogkvYaSf-p-y3zktL7W1mPqUYcRYVlZcmWotLlJe2I30

http://www.pulsetoday.co.uk/news/hot-topics/gp-contract-2019/20/all-the-headlines-from-the-2019/20-gp-contract-at-a-glance/20038181.article?fbclid=IwAR3mfOnFVg97TfSd0z2MwbdC_3SlFDzhi45MX350SynIJihZl3Ij7GpCw5U

https://www.independent.co.uk/news/health/tory-austerity-deaths-study-report-people-die-social-care-government-policy-a8057306.html?fbclid=IwAR2A_EzuW0s_CCrblXJMqvI5MlVwj6aT8Ca5GVeXiyGmp53lqvSz6aJNBKA

http://www.pulsetoday.co.uk/physician-associates-can-do-gps-work-more-cheaply/20009818.article#.XGgjirXD-vI.mailto

Social Prescribing -Whats Next at your GP Surgery


 

 

 

 

Image Courtesy of Social Prescribing Network

 

 

 

 

 

 

 

 

 

Social Prescribing  in the NHS is a part of NHS 10 yr Plan. How will it affect you?

Well here is a video and documents to explain what it is  but one thing it is leading to is Privatization on  ‘speed ‘ as the Government  implement  STP and ICS throughout NHS  and a reworking of the GP Contract. will it affect us all of course it will under this regime who are flogging the crown Jewels of to leave us with an Americanized welfare system of two tier. The insurance lobbies are waiting patiently to make a killing while many wont be able to access quality health care as under the NHS that was created as part of the Welfare State delivered to us by Nye Bevin.

 

My Interview with Dr Gill:

22/2/19

I asked Dr Gill How he thought the relationship between patient and claimant could be damaged with the new GP Contract which every GP will have to sign up to in May 2019.

I also asked him about social prescribing and its potential impact on patients who need state support and claim Social Security.

 

“He described to me that Patients are already coming to surgery with anxiety and depression or ill health due to hostile environment that austerity is creating, and the system is making people ill, or in a lot of cases more ill than they were.  Making it unlikely they will be able to manage their conditions in same way they currently do.

He stated that perverse financial incentives for ‘sociopathic ‘ assessors are leading to really bad outcomes for claimants and  pressures upon the public purse, as well as increased workload on GP’s whose patients need help with appeals etc. This contract will effectively making GP’s Gatekeepers which is not what they chose to be when studying medicine to become a GP.

He said the Government is driving a wedge between the patient and their GP and pitting them against each other,  and that will most likely mean the good GP’s will leave while those without no consciousness will reap the rewards offered by the Government and DWP .

Social Prescribing, is blaming the patient for their situation and the whole treatment process of being denied to the proper care that the patient needs. I asked him about the potential that with ‘patient coaches’ (aka work coaches) who have too much power could lead to those who most need support and are extremely vulnerable ,are likely to  disengage with their GP and fall through the cracks and could ultimately end in their demise which he agreed with my assumption. He stated that Patients/Claimants and GP’s are victims of a government who doesn’t care.

This is the tip of the iceberg of how it could impact on claimants needing further medical evidence support, getting a Fit Note if they are off work through ill health to claim state support, which under Universal Credit they would need to do so repeatedly.

The breakdown of trust between claimants and GP or other NHS staff has the potential to cause a rise in further deaths which have happened already under its predecessor ESA. That’s without the 120,000 who died due to poor care in NHS, etc as diseases previously eradicated are now making a comeback due to austerity measures and abject poverty.

This is Government Quackery on the cheap by unqualified people, dismissing medical opinion of professionals while eroding our NHS services and underfunding essential services that patients need and a NHS they can trust and flogging it to their mates. It beggars belief that the public would allow this to continue or collude with the government by being taken in about better services and cutting waste of NHS resources, when they have slashed NHS budgets for decades along with New Labour who are not blameless in this re PFI acceleration under Blair.

Your NHS is on life support, welcome to the American style  health care system you allowed to happen, hope you got deep wallets or insurance which is the real end game , if not  you will be one of those unfortunate that will meet a early end of life because you happen to be poor and can’t afford Insurance.

 

.Dr Bob Gill speaks out : https://youtu.be/l4wQ577Me30

 

Below is the Video of Tim Owen Jones in Bromley

 

 

 

 

 

 

 

 

Link to Making Sense of Social Prescribing

 

 

For more info  :

 https://www.westminster.ac.uk/patient-outcomes-in-health-research-group/projects/social-prescribing-network

 

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