The 2012 Lansley Monster Act opened up the NHS contracts, but not as lucrative as hoped for the profiteers.
Current restructuring seems to create economies of scale and increased profit.

Accountable Care Organisations-rebranded as (Dis)Integrated Care Organisations-NHS is divided intro 44 Sustainability and Transformation Partnerships (confused already…?)
but sustainability means £22 billion in efficiency savings, £40 billion for the decade
“The NHS is no longer sustainable or affordable”-a PR narrative spun by the private healthcare lobby

Each STP involves consolidation of several CCG’s
Some then rolled out as Accountable/(Dis)Integrated Care systems (ACS/ICS) before becoming ACOs (Keep up!!!)

In the US, “Health Maintenance Organisations HMOs, dominated by large insurance companies, the most objectionable part of the US system
HMO’s deny patients access to medically necessary treatment, fighting claims, screening out the sickest, paying exorbitant salaries (Centene CEO $27 million), systemic fraud

-essentially low rent care with huge hidden costs-top-ups and deductibles…

-supposedly friendly providers, but the insurance industry (Aetna, United Health, Humana, Blue Cross)control the model

Insurance companies run HMOs, set up ACOs
United Health has contracts with 800 ACOs, has launched a national Accountable Care system available to employers

In the NHS, eight Accountable Integrated Care systems ACS/ICS are rolled out
ACS mean NHS Trusts, councils, private companies administer and control health and social care budgets, and delivery of services

This dovetails with devolution of regional health band social care budgets-as can be seen in the Devolution Manchester experiment
A single provider might be responsible for all of the above
NHS England Aug 2017 sees a group of CCGs will contract with a single provider-the ACO
-delivers to people on a list (Mikado?)-persons resident on it (the contract area)-entitled to register with the provider or seek acceptance as a temporary resident.

(Keeping up? Neither am I!)

An ACO can be an NHS provider or a private company-including a complex financial instrument called a Special Purpose Vehicle SPV

How many front line staff could be trained and recruited for these huge contract costs?

A separate Alliance Agreement will allow the CCGs and provider to decide how the contract will be administered!
DoH documents define new models of care as types of Accountable Care
These new models include multi speciality community provider MCP, and integrated primary and acute care system PACS
The MCP is primarily out of hospital based care model integrating primary care with community and mental health services
The integrated PACS similar to the MCP but incorporating many hospital based services

The horrible fact is that you and I have never heard of these terms: all set up already without any referendum, by Lansley, Hunt, Hancock, Sajid, and Boris...
all prompted by the privateers they second into thec D o Health...

(Boris, what have you done to me...?)

"Yes Minister-we’ve run out of acronyms…!”
Précis of Youseff el-Gingihy “How to Dismantle the NHS in 10 Easy Steps”


Accountable care dovetails neatly into the massive program of cuts and closures
Since 2010 over 60 NHS hospitals experienced closure, mergers or downgrades
NHS England intends to reduce major A&Es to between 40 and 70
1 in 6 A&E are at risk of closure or downgrades; 24 out of 33 hospitals are likely to lose full A&E-prelude to complete closures…

Chris Moulton, vice president of RC of Emergency Medicine: “these plans are crazy”
Where is the workforce??? Poached from the real NHS!!!
Dalton review: plan to create chains of super hospitals

Bed to population ratios plummeted below some eastern European countries,
(UK fifth/sixth biggest economy)

2016 66% of Red-1 ambulance calls (no pulse/no breathing) were responded within 8 minutes -target 75%

Excess deaths exacerbated by drastic reductions in welfare budget of £16.7 billion

Care in the community: problematic because of huge cuts in welfare and social care;
general practice chronically underfunded

650 GP surgeries have closed, merged or taken over since 2010
RCGps-further 600 surgeries could close.
40% of walk in centres closed since 2010
Plans to reduce GP surgeries from 7500 to 1500 super hubs

Diagnostic hubs

Bids for hubs from any provider-privatisation? Charges? Where is the staffing? Poached from the real NHS...