Bury’s NHS Clinical Commissioning Group (CCG) has announced cuts of £5.2 million for the financial year just started, towards meeting an expected £7.3 million deficit for the year.

The cuts agreed are:
Primary Care (GPs etc) £1.1 million – the largest items being:
– Terminating the Vulnerable Patient Scheme, saving c£0.1m.
– Terminating the Clinical Pharmacist scheme, saving c £0.3m-£0.6m.
– Reducing the prescribing target by £0.5 million – though a decision about whether this will include stopping prescribing nicotine replacement options has been postponed.

Secondary Care (Hospitals) £1.8 million – the largest items being:
– Reducing the amount of treatments that are deemed no proven clinical benefit; or of potential clinical value but only in a clearly defined set of clinical presentations/criteria by £1 million a year.
– Reducing diagnostic tests by £0.8 million in a full year (out of £7 million a year so more than 10% reduction).

Community Services £0.5 million:
– Do not renew the Minor Eye Conditions Service, saving c£0.2m in year.
– Other service reviews, including some IVF, targeting saving c£0.3m in year. (Though the decision on IVF has been postponed).

Other: £1.8 million
Savings made centrally, including relocation the HQ building from Silver Street.

Liberal Democrats nationally have called for an extra £6 billion for the NHS, to be paid for by an extra 1p on Income Tax, because the NHS is having to make cuts like these in Bury.

Two important announcements in the last month about future housing construction in Greater Manchester.

The first is the publication, by the 10 Greater Manchester Councils (the Greater Manchester Strategic Authority, GMSA) of a detailed map of land identified for future housing and employment developments. The Councils estimate that this is potentially enough land for an extra 175,000 homes across greater Manchester over the next 20 years.

The Mayor said: “We’ve published this data so everyone can see the land we’ve identified for potential development. We’re now asking local people, community groups and others to take a look at these sites and let us know if there are any we have missed, or if there are other sites they think we should consider”.

The full map is available here. Most of these sites are what you might call ‘brownfield’ sites. For Bury, the heaviest concentration of them is in Radcliffe. Some of the sites (the East Lancashire Paper Mill site in Radcliffe, or the Cussons site in Rainsough) already have plans for housing. Some (land behind Tesco in Prestwich) are/have already being built on.

The second announcement is a deal that is being discussed  between the Government and Greater Manchester. Under the terms of the deal

• Greater Manchester has to deliver on a Strategic Plan to provide land for 227,200 new homes over the next 19 years (to 2035). (To put that into context Bolton, Bury and Salford added together currently contain 283,000 homes.)
• Greater Manchester would have ‘accelerated delivery’ getting up to 12,375 new houses a year (to put that into context that is a new Whitefield every year).

In return the Government will look at
Taking four Housing Infrastructure Fund Forward Funding bids through to co-development:
– Manchester’s Northern and Eastern Gateways;
– City Centre Salford Housing Growth Programme;
– Bolton and Wigan Key Route Network;
– South East Manchester Bus Rapid Transit Scheme.

–  Provide a Land Fund of up to £50m to provide support for the remediation of brownfield land for housing. The land fund should deliver at least 4200 homes and will be subject to value for money assurance.
– Provide up to £8m capacity funding to build the Greater Manchester Place Team to support the ambitious increase in housing delivery, building on the Manchester City Place team.
– Provide £10.25m to help regenerate the Collyhurst estate to deliver more affordable homes.

It is really important to notice that the current land identified has potential for 175,000 new homes, but the Council are committing to plan for 227,200 new homes. For us this rings massive alarm bells that the next draft of the Greater Manchester Strategic Framework being published (just after the local elections) in June 2018 will again include the destruction of Green Belt land (Draft 1 included massive loss of Green Belt in Prestwich, Whitefield, Unsworth and around Elton Reservoir).

So good news that so much brownfield land has been identified. Concern that the Councils are signing up to a plan that could see the Mayor going back on his pre-election promise of no net loss of Green Belt.

The last month saw two opportunities for us to raise residents concerns about what will replace our Walk-In Centres in the revised package of ‘Urgent Care’ across the whole of Bury. The was the regular meeting of Bury Council’s Health Scrutiny Committee, and also a meeting of the Liberal Democrat Council Group with the CCG (Clinical Commissioning Group) Chair.

All areas are experiencing very high demand at hospital Accident and Emergency Department . The current estimate is that 30% of patients that visit A and E do not need to be at such an intensive service. The Government has new guidance for Urgent Care Services for the whole of England.

Bury will have just one Urgent Care Centre, which will be built adjacent to the Accident and Emergency Department at Fairfield General Hospital. (Manchester will be providing a similar Urgent Care Centre at North Manchester General Hospital.) The Urgent Care Centre has to have access to diagnostic services (e.g. X-Ray) which means it realistically does have to be on the hospital site which is where this equipment is. Being next to A and E will help reduce the number of people who currently attend A and E for more routine urgent needs, which can be dealt with at the Urgent Care Centre.

The full urgent care service across Bury will be:

Pharmacy – there will normally be a consulting room were the pharmacist can give advice and propose medication etc for minor ailments and wounds etc.
GP Surgery – All of the current services will be provided.
Integrated Health and Social Care Hub – initially three (Prestwich, Bury and Radcliffe, but eventually one in each township area)  – A mixture of Medical professional will be based in the Hub.  This will allow patient to have face to face advice from a GP. This will also allow elderly and vulnerable patients with complex issues to be seen in the local community, and will reduce hospital visits.
Urgent Treatment centre – will be located at the hospital in a separate building along side A & E.
A and E – Will treat all emergencies.

We asked a lot of questions about the Integrated Health and Social Care Hub, which will be replacing the Walk-In Centres at Prestwich and Moorgate in Bury, with a new one in Radcliffe. What was clear to us is that the Hub will be very different from the current Walk-In Centre which has general ‘walk-in’ access to Senior level of Nurse. In the future there will be some element of ‘walk-in access’ to the services at the Hub – e.g. GP appointments, this will not be particularly advertised or promoted and access to services by phone will be the preferred route. It was hoped that some of the clinics and other services that currently take place in Outpatients Departments in hospitals could take place at the Hubs, which means less trips to hospital for some people with longer term health needs.

We raised a concern that the some in the media were being too simplistic saying that Walk-In Centres have been ‘saved’ and will continue as they are now in the future, which is clearly not the case. Bringing local services together under one roof at the ‘Hub’ is a good idea, but it is certainly not the Walk-In Centre we currently have. It is important to note that the Hub will only be for people who are register with a GP in the Borough of Bury, so will not be for people who are registered with GPs outside of Bury.

Another big change proposed is access to services by telephone. The first number that people in Bury will be encouraged to phone is their GP practice where staff will be able to take calls to guide the patient to the appropriate medical professional. Outside working hours this number will be redirected to a 24/7 number. We asked questions of the CCG about the capacity of reception staff in GP practices to help people in this way and how staff would be trained to be able deal with a variety of issues. We also asked about confidentiality in GP practices (e.g. where the phone is answered next to the waiting room).

The 111 phone number will be still available if you need advice on such things as urgent dental appointment, the availability of pharmacy out of hours etc

Hope this information is useful please get in touch if you want more information. More details too at these FAQs from the CCG.

The Liberal Democrats have launched a package of education reforms that would inject greater parental and teacher trust in the English schools system.

The education reforms proposed include:
-Replacing Ofsted with a reformed independent schools inspectorate system that assesses teacher and pupil well-being, as well as results, and a focus on whether school leaders can deliver future improvement
Replacing league tables with a broader set of indicators, including qualitative data on pupil well-being
– Qualitative information would come from getting pupil and parent feedback on how well a school is doing, as well as looking at indicators such as what happens to a pupil when they’ve left a school, like attaining university places
Scrapping mandatory Sats for years two and six and replacing with moderated teacher assessment and lighter-touch testing
– A ‘curriculum for life’ that includes relationships and sex education, financial literacy and first aid
Establishing a specific individual responsible for mental health in schools to help children
An end to Conservative cuts to education, such as protecting per-pupil spending in real terms, including in further education

Liberal Democrat leader Vince Cable said:
“Children must have a well-rounded education and our systems should not just be tick-box exercises. The Gove revolution has produced a Dickensian approach to education. We need to take account of information from teachers, parents and children views as part of improved qualitative and quantitative assessments of our schools.”

Liberal Democrat Education Spokesperson Layla Moran said:
“The over-emphasis on high stakes testing has meant the system has overlooked so many other elements of the development of the child. Parents want to know there children’s well-being is looked after and that they are taught lessons for life, such as first aid and financial literacy, and have the prospects to succeed.

“We need inspectorate and league table systems that recognise these values, in addition to looking at exam and test marks in maths and English.”