The NHS is again undergoing radical reorganisation in 2017/18, this time at breakneck speed and without parliamentary consent.
- Integrated Care Systems Summary Briefing, January 2021
- Part 1. An alternative vision: achieving democratic accountability
- Part 2. Social care: relationship to ICSs
- Part 3. NHS E/I ‘Integrating Care’ – ICS Management
- How Keep Our NHS Public should be campaigning on Integrated Care Systems – what can be learned from the US?
- How Keep Our NHS Public should be campaigning on Integrated Care Systems
- KONP’s submission to NHSE public consultation on the Integrated Care Provider Contract. October 2018
- KONP statement in response to Health and Social Care Select Committee report on ACOs and Integrated care. June 2018
- Integrated care: organisations, partnerships and systems. HSC Select Committee report. June 2018
- Press release HSC Select Committee on report: Integrated care: organisations, partnerships and systems. June 2018"
- KONP supplementary written evidence 25/3/2018 to Health Select Cttee inquiry into Integrated care: organisations, partnerships and systems
- Health Select Committee inquiry into Integrated care: organisations, partnerships and systems 20/3/2018 Simon Stevens CEO NHSE et al
- Health Select Committee inquiry into Integrated care: organisations, partnerships and systems 6/3/2018 NHS organisations
- Health Select Committee inquiry into Integrated care: organisations, partnerships and systems 27/2/2018 Pollock, O'Sullivan, Hutchinson, Winyard, BMA, RCN, Unison
- KONP briefing paper on Integrated care systems and Accountable Care Organisations. Jan Savage. Updated March 2018
- KONP submission to Health Select Cttee inquiry into Integrated care: organisations, partnerships and systems, January 2018.
- KONP paper to Dr Sarah Wollaston, Health Select Cttee, November 2017 asking Cttee to examine ACOs
- KONP briefing paper on ACOs and ACSs. Jan Savage. December 2017
- KONP Summary of briefing paper on ACOs-ACSs. Jan Savage. December 2017
- KONP letter to MPs briefing on ACOs-ACSs. December 2017
- KONP letter to Councillors briefing on ACOs-ACSs. December 2017
- Accountable Care: Ribera Salud hospital fined €150,000 for exposing workers to carcinogens. Labournet, Greg Dropkin 2017
Our aging population is often cited by those seeking to privatise the NHS as grounds for dismantling the current system. It is a myth that the NHS cannot continue to be publicly funded because we are living longer and we have compiled a factsheet and some articles supporting that assertion.
Community based care literally refers to care in the community (e.g. outside hospitals) this can include home support, nursing, physiotherapy and other rehabilitation services. Part of the Government's proposal for the NHS is to shift more care into the community. Research suggests that this will be damaging to patients.
- Updated references on evidence on impact of community-based care and integrated care. November 2017
- The Nuffield Trust, Shifting The Balance of Care 2017
- The National Audit Office, 2017
- The King’s Fund, Mental Health Under Pressure 2015
- The Nuffield Trust, Evaluating Integrative and Community based Care 2013
In March 2020 the WHO announced a new pandemic, the coronavirus COVID-19. Our government was not prepared. Austerity, arrogance and ignorance let the UK population down
Please follow the links below for NHS hospitals and service currently under threat.
Devolution refers to the devolving of powers and funds from central government to government. The potential impact on the NHS includes loss of national overview and terms & conditions. Fragmented services and loss of national responsibility will escalate post-code inequalities of service provision.
It is important where possible to scrutinise past and current Government & NHS England (NHSE) and NHS Improvement (NHSI) policy and guidance, including their plans are for the future of the NHS. We include here some key documents (2014 onwards) that outline some of their strategies.
- KONP analysis of NHSE proposals for legislative change to facilitate NHS Long Term Plan. April 2019
- Short version: KONP analysis of NHSE proposals for legislative change to facilitate NHS Long Term Plan. April 2019
- Contracting arrangements for integrated care providers - response to consultation. NHS England. March 2019
- NHS England/Improvement joint paper: Building the case for primary legislative change. February 2019
- Long Term Plan threatens to create a remote, centralised NHS. John Lister, 22 January 2019
- NHS Long Term Plan, heralded as a 10-year plan for the NHS, with a 5-year government finance agreement. NHSE, 7 January 2019
- 'Rethinking acute medical care in smaller hospitals' - Summary. Nuffield Trust. October 2018
- 'Rethinking acute medical care in smaller hospitals' - Full report. Nuffield Trust. October 2018
- Next steps on the NHS Five Year Forward View. March 2017
- Naylor Review: NHS Property and Estates – recommending £5bn-plus sell-off of NHS estates. March 2017
- Delivering the Forward View NHS Planning Guidance 2016
- NHS Operational Planning and Contract Guidance 2017-2019. NHSE and NHSI September 2016
- NHS England, Implementing the 5 Year forward view and mental health 2016
- NHS England Planning Guide 2016/17-2020/21. December 2015
- Department for Communities and Local Government, Better Care Fund 2014
- NHS England Five Year Forward View Oct 2014
Below, you can find links to health union websites (BMA and RCN are currently not TUC affiliates)
Integrated health and social care delivered to patients and families is an important ambition. Enforced administrative integration of budgets, management and organisational forms, without consultation, guarantees of adequate funding and commitment to fully public service provision, funding and management, can be very damaging - an evidence base must be presented.
Sources to enable comparison of the NHS with the healthcare systems in other countries in terms of resources, funding, performance and outcomes.
- Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better US Health Care
- Is the Commonwealth Fund’s Mirror, Mirror report a distorted lens? July 2017. Ormerod
- Health at a Glance 2016 OECD Indicators
- Health at a Glance 2015 OECD Indicators
- Health at a Glance 2014 OECD Indicators
- International Profile of Health Care Systems 2015
- Mirror, Mirror on the Wall, How the Performance of the U.S. Healthcare System Compares Internationally 2014
Keep Our NHS Public actively supported the Junior Doctors during their historic industrial action including strikes against the imposition of new contracts by Jeremy Hunt in 2015/16.
We use leaflets in our campaigning and below is an archive of our national leaflets. Those relevant to current events should still be available via the shop.
- Mental Health Crisis Summit
- NHS Long Term Plan top-down disruption for the NHS, 2019
- Facts about Health Tourism, 2018
- Scrap Integrated Care Partnerships, 2018
- GP at Hand, 2018
- Firesale: NHS land and buildings going cheap, 2018
- Migrant Charges, 2018
- Keep Our NHS Public on Privatisation, 2018
- Day of Protest Flyer - NHS in Crisis, 2018
- Our [email protected], 2017
- KONP general leaflet, 2017
- Virgin hands off our NHS, 2017
- NHS Roadshow Factsheet #VoteNHS, 2017
- 4th March Demonstration leaflet, 2017
- STP leaflet, 2016
- 5 things Doctors need to know about the NHS, 2016
- Junior Doctors leaflet, 2016
Legal information including Judicial Review. NB: legal changes may make some information out of date - check.
Policy and data on child and adolescent mental health services (CAMHS) and for adults.
[See also RACISM AND HEALTH] Statutory changes force trusts to check patients' eligibility for free NHS treatment. Processes are often brutal and wrongly applied.
- The “hostile environment” and charges for NHS care briefing for South East London MPs and Councillors, Save Lewisham Hospital Campaign, May 2019
- NHS charges in Lewisham - The hostile environment
- Notes on migrant charges campaigning for KONP groups
- Patients Not Passports - Challenging healthcare charging in the NHS. Medact, April 2019
- Excellent advice sheets on entitlements to NHS care, knowing your rights, how to cope with debts from NHS charges. Maternity Action. 2019
- Access to health clinics, Doctors of the World
- Facts and FAQ pages on rights for access to health, Docs Not Cops
- Department of Health's Pre-attendance form. Trusts NOT compelled to use this. 2018
- Guidance on implementing the overseas visitor charging regulations. Department of Health. December 2018
The clinical activity provided by the NHS is steadily rising, with failure of Government since 2010 to maintain fund in line with need.
See GOVERNMENT and NHS ENGLAND POLICY
NHS Property Services manages 3,500 properties. In 2016/17, a change was made in the way rent is charged, based on Market Based Rental charging on all freehold properties. The threat to NHS estate has escalated, embodied in The Naylor Review 2018, recommending massive sell-off of NHS estate.
Government policies have led to systematic underfunding of the NHS alongside privatisation. Please see a variety of links relating to funding levels and funding streams for the NHS.
- 40 little white lies: Johnson’s hospitals are neither 40 nor new, September 2019
- Jt statement from KONP, HCT, PA in response to Govt announcemet on extra NHS funding, June 2018
- Executive summary: Securing the future: funding health and social care to the 2030s. Inst of Fiscal Studies, Health Foundation May 2018
- The bottom line: Understanding the NHS deficit and why it won’t go away, Nuffield Trust. August and November 2017
- Local Government Association, Public health funding in 2016/17 and 2017/18
- Lords Select Committee, NHS Sustainability Committee publications 2016
- NHS England, Indicative 2020/21 funding including transformation 2016
- How badly is the NHS underfunded? NHAP, 2016
- NHS Support Federation, NHS For Sale
- NHS Support Federation, NHS Funding
- Health at a Glance, 2015 OECD Indicators
- NHS funding: Health Foundation - Funding Overview: Historical trends in the UK. January 2015
- Department of Communities and Local Government, Better Care Fund 2014
- Centreforum, Hypothecated taxation and the NHS 2014
- Department for Communities and Local Government, Better Care Fund Policy Framework 2014
- Closing the NHS funding gap, how to get better value healthcare for patients 2013
- Globalization and Health, Does investment in the health sector promote or inhibit growth? 2013
There are many myths propagated in order to justify privatisation and STPs. Below are some KONP resources and others to highlight what these myths are.
The NHS's structure changed significantly with the Health & Social Care Act implemented April 2013. Clinical Commissioning groups replaced Primary Care Trusts and are responsible for their local area. Below is an in depth guide to the structure of CCG's and a paper detailing what, exactly, a Health and Wellbeing board are.
The NHS Reinstatement Bill is draft legislation co-written by Peter Roderick and Professor Allyson Pollock. It has been presented in parliament on several occasions, most recently in the session ending in April 2017 (National Health Service Bill 2016 2017). The draft Bill calls for a reinstatement of the NHS to a fully public service, ending internal markets and competitive tendering including private contracts; and a return to an NHS available to everyone equally, free of charge and publicly accountable.
It can often be difficult to sift through and discover what is actually happening. Here are some resources that can aid you in delving further into exactly what the current Government is planning for our NHS and to show others.
From the Junior Doctor's Strike to the scrapping of bursaries for nurses, the NHS staff have been hit hardest by the Hunt's policies over the last few years.
NHS England and Dept of Health are imposing 29 massive pathology networks, forcing NHS trusts to give up their services into network contracts so large they are likely only to go to private or public-private consortia. This follows the recommendations of the Carter Review 2008 and the Carter Report 2015/16; and now in the context of the NHS Long Term Plan January 2019
- Briefing No.3 on SE London Pathology contract. July 2019. Produced for elected reps.
- Updated briefing on SE London Pathology contract. March 2019. Produced for elected reps.
- News that SE London pathology contract will go to private bidder. The Lowdown. February 23 2019
- Save Lewisham briefing on the £2.25bn SE London Pathology Network where there is no NHS bidder. September 2018. Produced for elected reps.
A personal health budget is an amount of money calculated to support the identified healthcare and wellbeing needs of an individual. In theory, that individual has greater freedom to decide how the money is spent. It has the impact of reducing the overall size of budgets for services to be able to plan with.
PFI stands for Private Finance Initiative. It has been the dominant way of financing new hospitals since the late 1990s. As a result, the NHS spends £2 billion in PFI charges every year for its PFI hospitals in repayment and service charges. (That is £3,700 every minute).
- "The Private Finance Initiative: how come we are still paying for this?" Marion Macalpine and Helen Mercer, 2017
- KONP privatisation briefing 3: PFI, Buildings and Infrastructure
- CHPI report looks at the significant profits made by PFI companies from NHS contracts over the last 6 years. August 2017
- Independent, Crippling PFI deals leave Britain £222bn in debt 2015
- Open Democracy, Seven things everyone should know about PFI. November 2014
- Red pepper, Fingers in the PFI 2013
Primary Care and the role of the family general practitioner (GP) has been a fundamental part of the NHS since 1948. Major proposals from NHS England in 2019 threaten major changes. In particular there are two areas of proposals: the development of Primary Care Networks (PCNs) and new integrated Care Trusts (ICTs).
A mix of articles describing aspects of privatisation of healthcare and consequences for the NHS.
- Review of extent of penetration of private interests into the NHS - Trump's State Visit. Caroline Molloy. OURNHS/openDemocracy. June 2019
- Advertising Standards Authority ruling finding PushDoctor in breach of standards, April 2018. Follows complaints from Dr Tony O'Sullivan (KONP), Drs in Unite and 29 others August 2017
- How come we didnt know? Recently updated photographic exhibition 'Privatisation: the corporate take-over of our NHS' by Marion Macalpine. 2017
- KONP privatisation briefing 1: NHS Markets and Privatisation
- KONP privatisation briefing 2: Privatisation of NHS Services
- KONP privatisation briefing 3: PFI, Buildings and Infrastructure
- London Review of Books. Short Cuts. David Lindorff compares the NHS and the US health system from personal experience. 30 November 2017
- CHPI. Recommendations to reform the private hospital sector in England following the Ian Paterson scandal October 2017
- Independent June 2017, Hunt's intention to privatise NHS staffing agency
- CHPI. How safe are NHS patients in private hospitals? 2015
- CHPI. The Contracting NHS – can the NHS handle the outsourcing of clinical services? march 2015
- CHPI. At what cost? Paying the price for the market in the English NHS Feb 2014
- NHS FOR SALE(NHS Support Federation). Proving Privatisation up to date Oct 2014
- KONP Oxfordshire. NHS Myth Busting 2013
The articles below provide examples of where privatisation has had a direct and negative impact on care and/or where contracts have failed.
Information on public health and the link between poverty and health inequality.
[See also MIGRANTS AND HEALTH] Accusations have increased blaming vulnerable groups, im , 'health tourism' and minority communities for problems faced by the NHS. These have included accusations against migrants with no recourse to public funds racking up giant NHS bills. Unpaid bills from people outside the UK cost the NHS about 0.03% of it's budget in 2016.
Social Care is another area that has been severely affected by this Government cuts, social care is closely linked to health and the NHS. Between 2010 and 2017, local authorities cost 40% of funding.
England has been split in 44 'footprints' by NHS England since December 2015. Each area has produced a Sustainability and Transformation Plan created by groups of Clinical Commissioning Groups. It heralds the implementation of draconian cost capping (£22bn by 2020/21) and further fragmentation of the NHS.
- CHPI, Can Simon Stevens’ Sustainability and Transformation Plans Save the NHS? 2016
- GP Online, Shameful pace of STP rollout risks financial meltdown 2016
- HCT STP Watch
- HSJ, STP plans are undeliverable Oct 2016
- NHS England, Delivering the Forward View, NHS planning guidance 2016/17 – 2020/21. 2015
- NHS England, Indicative 2020/21 funding including transformation 2016
- NHS England, STP Consultations 2016
- NHS England, STP Footprints 2016
Trade agreements can be a major threat to public services such as the NHS, unless these are explicitly, and in binding manner, excluded. KONP has a Trades Agreement sub-group that works to expose risks to public services, especially the NHS, from new trade deals that the UK is negotiating after Brexit. Have a look in the Campaigns section of this website to see what action we have been taking and for some important information in the form of briefings etc. Resources listed here include background information about new deals, as well as older briefings, reports etc on EU negotiations pre-Brexit where these remain relevant to our new situation.
- The Trade and Co-operation Agreement between the EU and UK: What does it mean for the NHS?, January 2021
- Why the UK needs to change the parliamentary process for considering trade agreements, November 2020
- The case for reforming the UK Parliament’s role regarding trade agreements, November 2020
- The power of ‘big tech’ and new rules on digital trade: More reasons why the NHS must be kept out of trade deals. A briefing from Keep Our NHS Public August 2020
- Keep our NHS out of ALL trade deals – Keep Our NHS Public position statement June 2020
- Briefing on US-UK Trade Deal, May 2020
- KONP Fact Sheet CETA post Brexit, March 2020
- MP Briefing - why legislation is needed. August 2019
- 'Trading up for health: how to prevent trade deals from undermining health'. Briefing by Global Justice Now and co-sponsors. January 2019 - added Aug 2019
- 'Can the NHS be made exempt from [trade deals like] TTIP' KONP briefing on TTIP, November 2015. (Context: Trump and Brexit). Uploaded August 2019
- KONP interim briefing update on trade deals (context: Trump and Brexit). July 2019
- KONP Position Paper on CETA 2018
- CETA fact sheet 2017
- KONP Position Paper on CETA 2017
- Update on CETA 2017
- International Trade Committee Inquiry, letter from KONP, 2017
- The questionable economic gains from the Transatlantic Trade and Investment Partnership (TTIP)
- KONP Trade Deals Subgroup submission January 2017 to UK Trade Options Beyond 2019 Inquiry
- The Transatlantic Trade and Investment Partnership (TTIP): Myths versus Facts” December 2015
The 'weekend effect' refers to the finding of a difference in mortality rates for patients admitted to hospital for treatment at the weekend compared to those admitted on a weekday. It was misused by Jeremy Hunt, Secretary of State for Health, to attack junior doctors and to impose a new JD contract in 2015/16.
One important way of maintaining high standards in the NHS is to guarantee protection for genuine 'whistleblowers'. In many cases staff or members of the public raising important issues have been victimised and some have lost their jobs.