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Enfield's largest voluntary organisation is calling on "everyone who values the NHS to make their voices heard" and write in opposition to "misleading" proposals that "mean that patients will no longer be treated for conditions ranging from hearing loss to gallstones, knee replacement surgery to hernias until we are insevere pain or the deafness affects our independence and social life".

The call comes from the Enfield Over 50s Forum and refers to the current 30-day consultation on "Adherence to Evidence Based Medicine".  For details of what the consultation is about, public meetings and how to respond, see our earlier article (You have 21 days to influence a decision on rationing of NHS operations).  It appears that Enfield Clinical Commissioning Group have rejected a request by a senior member of Enfield Council to extend the consultation until May.

In a letter to its members, the Forum urges everyone to write to Dr Jahan Mahmoodi, Medical Director, Enfield CCG, Holbrook House, Cockfosters Road, Enfield, EN4 ODR asking for the withdrawal of the Evidence Based Medicines scheme.  By everyone, the Forum is not limiting itself to the over 50s, since the proposed changes would affect people of all ages.

The Forum argues that the current NHS crisis is the result of underfunding: "Recent research shows that the UK’s health spendingis 9.1% of national income while Germany spends 11.3%, France 11.6% and the USA 17.1%."

NHS cuts mean more pain for patients

The Enfield NHS Clinical Commissioning Group (CCG) has launched a controversial plan which will mean that patients will no longer be treated for conditions ranging from hearing loss to gallstones, knee replacement surgery to hernias, until we are in severe pain or the deafness affects our independence and social life. At its Governing Board meeting on Wednesday March 15 2017 the CCG refused to either extend the minimal 30-day consultation period on its proposals, or withdraw them completely.

Because this so-called consultation ends on March 31, the Enfield Over 50s Forum, the largest voluntary organisation in the borough with more than 6,000 subscribing members, is calling on everyone who values the NHS to make their voices heard in opposing changes misleadingly called Adherence to Evidence Based Medicine - misleading because the proposals - which have been deliberately under-publicised to Enfield’s public - contain no supporting medical evidence. We refuse to endorse a “suffer in silence” future and urge everyone to write to Dr Jahan Mahmoodi, Medical Director, Enfield CCG, Holbrook House, Cockfosters Road, Enfield, EN4 ODR asking for the withdrawal of the Evidence Based Medicines scheme. The CCG’s intention is clearly to limit the role of our GPs in exercising their clinical judgement. They are seeking to impose new thresholds for a number of medical conditions, while concealing the real driving force for these changes is the need (as the CCG itself says) for “increased efficiency savings.”

The Over 50s Forum has constantly drawn attention to the years of under-funding health services in Enfield have suffered, leading to the CCG being placed under special measures by NHS England to balance the books. Our CCG, serving a population now estimated at 333,709, receives £396.8 million this year while other CCGs in North Central London with whom we are grouped. such as Islington with 242,341 residents, receives £335.7 million and Camden population 267,253 gets £355.3 million.

Recent research shows that the UK’s health spending is 9.1% of national income while Germany spends 11.3%, France 11.6% and the USA 17.1%. Our NHS is under-funded and we should not help to cover this up under the cloak of unsubstantiated “evidence based medicine”. The CCG is attempting to introduce a form of rationing to hide the nationwide financial plight of the NHS

We give just one example to expose how hollow and shortsighted are the CCG proposals. The Department of Health says that 71% of the over 70s have a hearing loss, yet the CCG want to deprive people with mild hearing loss from getting hearing aids from the NHS or a qualified private supplier. Their only “evidence “ is to claim that CCGs at Stoke on Trent and South Norfolk have adopted the proposed Enfield criteria. This is untrue.

The Department of Health in its Action Plan on Hearing Loss says that people with mild hearing loss have nearly twice the risk of developing dementia, compared to people with normal hearing. The DoH advocates early awareness, diagnosis and treatment of hearing loss to reduce the onset of isolation, loneliness and depression - treatments that would cost the NHS a lot more than a pair of hearing aids.

While we recognise the financial challenges facing the NHS, we cannot accept that the solution lies in refusing treatment for an arbitrary list of conditions until patients are in severe pain or lose their quality of life - betraying the foundation principles of the NHS.

We urge you to sign our petition www.change.org/p/enfield-borough-over-50s-forum-fairer-fundingfor-enfield .

Monty Meth MBE President
Christine Whetstone Chair
Tony Watts Secretary
Vivien Giladi Health Lead

Enfield Borough Over 50s Forum

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PGC Webmaster posted a reply
22 Mar 2017 23:38
  • Hearing charity joins in criticism of proposed restrictions
  • Consultation deadline extended by one month
  • Feedback from Wednesday's consultation event
  • Healthwatch Enfield say restrictions imposed by Enfield will be extended to other north London boroughs

Hearing charity joins criticism

Further criticism of Enfield Clinical Commissioning Group's proposals for restricting access to certain medical procedures has been voiced by the charity Action on Hearing Loss.

Chief Executive Paul Breckell said:

“Hearing loss currently affects one in six of us.

“We are deeply opposed to Enfield CCG’s plans to deny people with mild hearing loss the hearing aids they need.
“It could affect thousands of people in the area.

“We’ll be fighting these cuts in Enfield and anywhere else we feel people are being denied the only viable, cost effective treatment for hearing loss.
“Hearing aids are a lifeline to millions of people, enabling many to stay in work and not feel isolated.”

Both Enfield Over 50s Forum and Action on Hearing Loss are urging the borough’s residents to leave feedback and complete the CCG’s online survey - www.enfieldccg.nhs.uk/adherence-to-evidence-based-medicine.htm.

Deadline extended

In reponse to calls from councillors and NHS campaigners, the CCG today announced that it was extending the deadline for responding to the consultation on "evidence based medicine" by a month to the end of April. However, a two-month consultation is still short for such a complex and important issue.



For details of the meeting above see this event listing . It is not entirely clear whether this is a public event.

Tweets from Wednesday afternoon's consultation event hosted by Healthwatch Enfield.

The following tweets were sent by Patricia Mecinska of Enfield Healthwatch during the course of the consultation event:

Patricia Mecinska‏ @_PatriciaM19

'We would encourage @EnfieldCCG to engage with people more when proposing changes' people of #Enfield said @HealthwatchEnf @EnfieldCouncil

'The earlier we fit a hearing aid, the less impact this will have on bad quality of life' - @EnfieldCCG is under scrutiny @HealthwatchEnf

96% of people who have mild hearing loss benefit from a hearing aid - what does it mean for @EnfieldCCG consultation? @HealthwatchEnf

There are 2 areas of evidence: literature and looking at CCGs who adopted similar policies @HealthwatchEnf @EnfieldCCG #JoinTheDiscussion

@EnfieldCCG assures people in #Enfield - no decisions have been made on changing criteria for #NHS treatment in #Enfield @HealthwatchEnf

@EnfieldCCG @HealthwatchEnf @PGCommunity fresh off the press - consultation will be extended by another month if scrutiny agrees

Separately, Healthwatch Enfield tweeted as follows:

@EnfieldCCG proposal for changing access criteria to #NHS criteria will be replicated in Haringey, Islington, Barnet and Camden #speakUp
PGC Webmaster posted a reply
23 Mar 2017 11:27
At their meeting on 22nd March the councillors on the Health Scrutiny Standing Workstream (both Labour and Conservative) voted unanimously to recommend the CCG withdraw its current consultation on adherence to evidence based medicine and present a future more evidence based document. This followed detailed scrutiny and challenge from the committee and members of the public in attendance, including a call by Monty Meth of the Over 50s forum to withdraw the document in its current form.

As to whether or not the CCG follows this recommendation, we shall have to wait and see, but it was a good day for patients and local democracy.

An important factor was the contribution of Dr Martin Blanchard of Defend Enfield NHS, who provided forensic examination of the papers and developed detailed challenges and questions.
PGC Webmaster posted a reply
28 Mar 2017 13:23
The following announcement was posted to the Enfield Council Facebook page on 28th March.

Enfield Council requests more evidence for NHS consultation

Health chiefs have been asked to withdraw a consultation document by Enfield Council’s Health Scrutiny Panel, asking residents their views on what medical procedures should be offered to patients for conditions such as hearing impairment, hernias and knee replacements.

The Clinical Commissioning Group, (CCG), is in the process of reviewing which treatments will be offered for a range of health conditions, with a final decision taken based on which types of procedures and medicines are most cost effective. A consultation is being held to gather patients and residents views on the plans which, if agreed, would see some treatments deemed ineffective being withdrawn.
At a meeting held on 22 March, the Panel heard representations from the CCG, which gave an overview of the consultation process relating to the ‘Adherence to Evidence Based Medicine’ programme.

Members of the Panel discussed the consultation document and listened to the views of the public in attendance, before agreeing to request that the CCG withdraw the current consultation document and devise one which provides more comprehensive background data relating to medical evidence.

The Chair of Enfield Council’s Health Scrutiny Panel, Cllr Abdul Abdullahi, said: “The Enfield NHS Clinical Commission Group (CCG) is proposing a review of some non-urgent treatments to tackle its £7.7m annual deficit. Where medical evidence highlights that intervention is not effective, criteria will be applied to each individual case before a treatment pathway is confirmed.

“We have asked the CCG to provide clearer and more detailed medical evidence to demonstrate that they are able to withdraw these treatments without causing a serious impact on the health and wellbeing of our community.”

The Scrutiny Panel’s decision follows a call by Enfield Council’s Cabinet Member for Health & Social Care, Cllr Alev Cazimoglu, for the CCG to extend its consultation by two months until the end of May to enable more people to take part in it.

The consultation is scheduled to end on 30th April.
Julia Mountain posted a reply
30 Mar 2017 23:20
The CCG is listening to local people's concerns and has now extended the consultation deadline to 31st May. They are going to attend the Palmers Green and Edmonton ward forums in April to hear residents' views and will be holding another consultation event at Holbrook House on 26th April. These events are all in the evening, unlike earlier events, so those of us who go to work will also now get a chance to hear about the proposals and have our say. Latest information at this link; http://www.enfieldccg.nhs.uk/adherence-to-evidence-based-medicine.htm
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