NHS Devon via their One Devon website are carrying out another on-line survey to garner opinions from patients and the community in Devon, ostensibly, to help them create a new Strategy for the next 10 years.

This is excellent, I hear you say; that they should actually ask questions of the Community about what they want in their local NHS.

But hang on a minute ….. in their words, “…. a new 10-Year Health Plan for the NHS. This is a once in a generation opportunity to make the NHS fit for the future. Together we can fix it. We need your voice.” but did they not produce a ten year strategy only in the April of 2023! Yes here it is!
On 11th April 2023, the One Devon website published the following page with a headline that read "A strategy that sets out how health, care and other support services will be planned and organised in Devon has been published.”. Indeed, I have a copy of that Plan and have been criticising it’s contents ever since.

Now, it appears that along with a new Chair and new Leadership at the Integrated Care Board for Devon, they want to go over the same ground, all over again! 

Some might say, and I would certainly be one of them, that this is a complete waste of time and money. As far as I am concerned, this is just another exercise in distraction ….. it will have absolutely no effect on the fundamental problems that affect the NHS – that it does not have sufficient money to do its job - and the current (and past) Governments do not have the money available, to fund it properly.

Thus such surveys will have very little effect on the day to day situation in Devon in general or in our area, in particular. One might say that the survey has been published, just to keep the peasants and critics content!

Let’s talk about feedback. 
NHS Devon already has a feedback mechanism, it does not really need to publish and promote new surveys. Each year, NHS Devon funds an organisation to act as the statutory feedback mechanism. For many years it has funded Healthwatch Devon to do the job. In my conversations with Kevin Dixon, Chair of Healthwatch, I inquired why his criticism of NHS Devon was so benign. Considering just how many apocryphal problems and reported issues there were across the County, for example our campaign to prevent the closure of Okehampton Hospital Wards, why was there so little mention of such issues in his magazine or reports? His answer was straightforward. He explained that each January, he had to ask for the funding for his eight staff from NHS Devon and simply put, he admitted that if he was too critical in the previous year, they would simply just stop funding his organisation and find another. He did not relish the task of making his eight staff redundant. I said to him, that I really hoped that he was part of the solution, not part of the problem.

Let’s talk about waste of money.
To my way of thinking, if our NHS pays money to private organisations and they in turn put a proportion of that money into their own personal pockets or then give it as donations to a major national political party, that is a waste of our money. That statement is compounded if the department in question is not using the services of the private organisation properly.

Let me give you a local example of where that is probably happening. Okehampton Health Centre has recently installed SystmConnect. This is a web based software application that is written, published and sold by a Company called TPP. This Company is owned by Frank Hester. According to the information published by the Conservative Party, this gentleman has given the Conservative Party around 15 million of his money as donations this year (2024) up to the time of the General Election. It is absolutely no surprise that the new Leader of the Tory Party, Kemi Badenoch, is on record as saying that continued privatisation in the NHS is a good thing and the correct way forward in order to maximise effectiveness and value for money in the NHS.

Thus we can say that a proportion of the money given to Okehampton Health Centre is being given to the Tory Party and not to us, to provide better health care. However it does not end there! As far as I can tell, the Health Centre is not using the software system as it was intended or designed. It is supposed to provide a facility (for all who use it, which is far from universal as it is only capable of working for those using its online service) that “triages” the patient request and directs it automatically to the correct member of staff. In practice, the software uses the magic of “Artificial Intelligence”, which in the right software package could be a fantastic boon to our stretched NHS Staff but our local Okehampton medical staff have to trust it and I cannot see any evidence that they do. How do you want to be contacted, the software asks, by email I replied. What happened? A member of the Health Centre attempted to telephone me on a mobile phone which has no signal. 

In one sense, the TPP website is transparent about the charges it levies for the use of its software and talks about how SystmConnect is integrated into other software that a Health Centre uses and is dependent on the number of users accessing it and so on. What I could deduce was that the Health Centre is likely to be paying £800,000 per year for the use of this software. This is scandalous, if they are only using it like a glorified messaging service, which any self-respecting computer dealer could provide to the Health Centre for little to no money as a one off payment.

Let’s talk about strategies.
So NHS Devon is going to publish another 10 year strategy, when the last one is less than 2 years old. To write a strategy must cost time and resource and I presume that NHS Devon carried out another exercise in research before the last one. 

If the research and the strategy were fit for purpose at the time, what has changed and  why do they need to repeat the process, starting at the end of 2024? Certainly somebody needs to ask why the last activity has been ditched! 

When I was analysing the June 23 Strategy, I could certainly find various things wrong with it, both on a local and a County wide basis. I found it particularly upsetting to find in a section under staff and human resources, where the Strategy proudly stated that it considered that the NHS in the County were overstaffed and overpaid and a proposal of the Strategy was to put this right. Obviously I found and have railed about in this Newsletter, the concern that the North Dartmoor Primary Care Network (that includes Okehampton) had been lumped in with the Eastern Subregion, along with the City of Exeter and the likes of Exmouth and Axminster. While at the same time Tavistock and Kingsbridge were allowed to be a Subregion with just 15% of the population compared with the Eastern Subregion.

As I pointed out, it was no wonder that the Subregion was desirous to close all the Community Hospitals in its area and concentrate patient care on the RD & E in Exeter. Oh! And by the way, this was deemed possible because 85% of households in the Subregion drove cars and the same proportion lived within 25 minutes of the Hospital.

If the next unnecessary Strategy is produced by the same incapable Team, who have obviously been deemed not to have done a good enough job the last time, produce the same inappropriate and undesirable result, this time around, what is to be done! In that sense of the word, I do agree with the current Government Minister for Health who has said that he believes that much of the management structure of the NHS is ineffective and needs changing, the problem is, how do we set about doing that, here in Devon!