The NHS Harrow Clinical Commissioning Group (CCG) meeting behind closed doors is considering its Initial Budgets and Financial Plan 2017/18 which presents most concerning picture.
The CCG, which works closely with Harrow Council on health and social care issues, is responsible for planning and buying (commissioning) many of the health services needed by the 239,100 people who live in Harrow.
Key points of the part II report before the CCG governing body are:  an in-year deficit of £21.2m for 17/18; to deliver £17.5m of QIPP (net of the budget review) and that to deliver a recurrent surplus of 1%, a further £21.3m of QIPP will be required in 18/19.
The Quality, Innovation, Productivity and Prevention (QIPP) programme is a large-scale programme developed by the Department of Health to make huge ‘efficiency savings’.
The Harrow CCG is not solvent from inception and has been bailed out each year with support from NW London.
The level of cuts means that residents will have rationed care and London Northwest Hospital trust, which has a big deficit, will also be badly affected.
Payments to practices would be significantly scaled down to stay within the overall savings budget, meaning serious implications for the quality of patient care as GPs would provide services that fit within the limits of the money they get.
They will also be more concerned about meeting their prescribed indicators. For example, the GP practices will need to achieve the antimicrobial prescribing indicators and participate in the wider National Diabetes Audit (some Harrow practices already have concerning Care Quality Commission reports).
Irrespective of the budgetary decision, given the Harrow CCG’s significant role in health care at these challenging times, it requires robust leadership to demonstrate how well the CCG will commission, contract for, implement service changes and come out with the required equalities and clinical impact assessment of the proposed QIPP.
There appear reservations about the present leadership and management of the CCG. Seemingly not entirely happy Chief Operating Officer left last December and now an interim is in place. Previously we have reported ‘shaky confidence in Harrow CCG transparency’ at the governing body level.
They cannot fudge the situation any more!

Harrow’s opposition Tory group leader Cllr Susan Hall attacks Labour London Mayor for approving plans to build 186 homes, of which 41 per cent will be affordable, in Palmerston Road, Wealdstone, saying that his tower blocks decision was “disrespectful” to people living nearby – Cllr Hall has a shop in the area.
The mayor Sadiq Khan who is prioritising building thousands of new homes a year to address the housing crisis in the capital, has previously expressed concern over a lack of affordable housing in Harrow.
It is very concerning that those playing political point scoring, don’t know or don’t care about the housing needs in Harrow or what the people in temporary accommodations go through.
Such is the dire housing situation in Harrow that 700 households are in temporary accommodation and an additional 700 families on the waiting list for social housing.
There is a substantial gap in supply and demand for truly affordable accommodation in Harrow.
Whilst Harrow is building their own homes for the first time in over a decade, and is also buying homes in and outside borough for temporary accommodation, the demand continues to outweigh the supply. This significantly adds to the plight of the homeless.
For example, when someone turns down temporary accommodation offered, the council’s housing duty under the Homelessness Act 2002 ends without any real second chance, even if a property offered has been repeatedly refused by many, raising a question about its suitability.
The internal reviews mostly reject the reasons for refusing council’s offer, leading to ‘intentional’ homelessness.
The information received from the Harrow council, includes:

Kenton East by-election called due to the sad death of Cllr Mitzi Green (Labour) will be held on 20 April 2017.
The Labour and Tory candidates for this marginal ward by-election, as we predicted, are likely to be Nish Patel, chairman Harrow East constituency Labour party and Nitesh Hirani, a temple activist member of the Conservative action team for Kenton East.
Tory share of votes was 35.7% compared with Labour’s 46.6% at the council election in 2014.
Drama has already started as one of the Kenton East Tory action team member Jagadish Vemuri (photos) has seemingly pulled out of the team and the Conservative Campaign Headquarters (CCHQ) is now playing an active part in the campaign, like telephone canvassing
Although the Harrow East Conservative Association, covering Kenton East ward, is more organised than Cllr Hall influenced Harrow West, the failing factor remains common to both constituencies.
The Tory opposition group has not been taken seriously under Cllr Hall’s leadership, confirmed by the crushing defeat at the recent Roxbourne by-election.
People point out the political immaturity of the group in terms of: the group failed to present a shadow budget at the last Council meeting to enrich the financial decision making which they owed to the residents (read more by clicking here), and Cllr Hall’s childish conduct at the council meetings and social media.
Also, Cllr Hall has not come to terms with the much-needed affordable housing in Harrow and keeps attacking the London Mayor Sadiq Khan who understands the dire housing situation.

 

Harrow Council is consulting about the redevelopment, called Poet’s Corner, at the present site of the civic centre when it moves to Wealdstone.
Harrow stands on the brink of its biggest regeneration opportunity in decades, led by the chief executive, and needs wider support to deliver the programme in a borough that has diverse population and different but equally important social, cultural and religious aspirations.
The project, developed in a minimum of two phases, aims to provide between 800 and 900 new homes along with a community facility, which is likely to be a school, workspace, retail and public realm. Most new development is expected to be between six and eight storeys high.
The ‘Heart of Harrow’ area, comprising Harrow town centre where Station Road is located, was granted housing zone status by the London Mayor in 2015, meaning it will benefit from a share of a £31.5 million fund from the Greater London Authority to support the development of new homes.
The council’s planning policies require that 40% of the new homes be allocated as affordable.

We share the sad news  – Councillor Mitzi Green passed away yesterday after a period of illness.
Cllr Green was a Harrow councillor (Lab) for almost twenty years and recently a Kenton East  councillor since 2006. She held several positions at the Council, including the Children’s Services portfolio.
Cllr Green was friendly and passionate about the children and young people in the council’s care.
We have some good memories of Cllr Green’s receptiveness in children’s services matters.
Life goes on, and soon Kenton East by-election will be called. Following are the likely candidates from the main political parties:

Nish Patel, chairman Harrow East constituency Labour party
Nitesh Hirani, a member of the Conservative action team for Kenton East

The Tory opposition leader  tweeted “Labour’s inability to control the budget will cause many problems for our residents in Harrow”, but she failed to present a shadow budget at the Council meeting last Thursday to enrich the financial decision making – the opposition owed this to the residents.
Budget-making is a key function of the council where the opposition can play a positive role by suggesting budget alternatives.
But then the opposition Tory group, enjoying over £250,000 public money in allowances per year, is very weak under Cllr Hall’s punch & judy style leadership.
For example, the Harrow Times reported on 14 Oct 2016, “Cllr Hall continued to ask questions, despite being told her allocated time was up. She held up a megaphone created from a blue piece of paper, which she had made before the meeting, and said to Cllr Shah: I’m tired of you turning my microphone off.”
Criticising the administration is one thing but hateful personal attacks as indicated by the Cllr Hall’s tweets  about Cllr Sachin Shah taking his shoes off at a cabinet meeting and the way he was sitting, again reported by the Harrow Times, is a very different and concerning matter.
What is also concerning is that Cllr Hall appears to have no confidence in or respect* for the chief executive since his return to the post   that was ‘unilaterally and wrongly’ deleted by her short-lived fluke administration , forcing the chief executive Michael Lockwood to go.
*(hopefully some Retweets, seemingly by her, of the Childish impersonation of Michael Lockwood by @MikeJLockwood are still at @Councillorsuzie (e.g. her retweets of 18/1/17 & 16/2/17) – warning: in a hit & run action, some tweets and retweets are often deleted – we try to image these).
Therefore, no surprise that the Tory group members wish to use their voice to make an impact and aim for change of direction to unite and demonstrate strength to voters (Tory group lost the councils in 2010 and 2014 as well as two by-elections in between, under Cllr Hall’s leadership).
Cllr Hall now leads a highly divided group where 42.31% members of her group did not vote for her at the recent leadership election (the leadership challenge is likely to be more successful this time – for example, the potential challenger from Harrow East is taking active part in the forthcoming Roxbourne by-election in Harrow West).

Based on Harrow experiences, the Harrow Monitoring Group in an open letter to the health secretary Jeremy Hunt asked:
In view of your various and rather confusing statements about the GP work, we are not quite sure what exactly you expect the GPs to do, but focussing on the 10-minute appointment slot, the NHS Choices website does state that “GPs spend an average of 8-10 minutes with each patient” and advises patients to “plan ahead to make sure you cover everything you want to discuss”.
His reply of 16 February 2017 11:55 to us, informs, “as self-employed contractors to the NHS to provide primary medical services, it is largely up to GP practices how they run their surgeries” – almost declaring GP independence!
The NHS England that commissions primary care services had previously said, “How long to allocate to individual patient appointments is at the discretion of individual GP practices, based on patient need, and there are no national limits suggesting 10 minutes should be the norm”.
If what these good people are saying is true, then the government needs not to interfere in the work of the GPs, and the GPs should not be mindful of the clock ticking when attending to the patients.