Watford Observer

• Warning issued over private contract at Watford General Hospital. Patients could suffer if plans by hospital bosses to privatise the sterilising of surgical equipment are approved, it has been claimed. Watford General Hospital is currently in discussions with a private company to outsource its in-house Hospital Surgical Sterilising Unit (HSSU). Health bosses are negotiating with Ruislip-based IH Sterile Services to disband the existing Watford-based operation and transfer its 16 staff. If the deal goes ahead the company – which last month was forced to apologise for delivering contaminated equipment to two nearby hospitals – would be responsible for collecting, cleaning and returning hundreds of surgical tools every day. Staff members, who this week passed a letter of concern to the Watford Observer, fear the money-saving measure will delay the process of returning equipment to operating theatres, increase the risk of infection and reduce efficiency. They also raised concerns about their future working conditions, job security and pensions if and when they are transferred out of the NHS and into private hands. The comments come two weeks after the company issued a “wholehearted apology” for returning infected surgical kits to Mount Vernon and Hillingdon hospitals, causing operations to be cancelled.
  
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This Is London

• ‘Privatised out-of-hours care will put patients in danger’. Thousands of vulnerable patients could suffer from plans by NHS bosses to privatise out-of-hours GP services in London. More than 200 doctors have written to Health Secretary Andrew Lansley and Mayor Boris Johnson to protest at the transfer of evening and weekend care to Harmoni, a private health company. In the letter they warn the decision to put cost before care will reduce quality for the 950,000 patients in north London who use long-established Camidoc, a non-profit making company run by GPs which provides care and advice when surgeries are closed. They say the switch to a private provider means GPs will no longer be provided with basic medical equipment such as oxygen for lung patients or defibrillators for life-threatening heart problems. Some doctors are threatening not to work in “unsafe circumstances” where nurses will be used increasingly, instead of doctors, as well as GPs who may lack local knowledge. MPs have now called for an investigation into the decision by primary care trusts in Camden, Islington, Haringey, and City and Hackney to replace Camidoc with Harmoni, whose turnover rose from £3.5m in 2005 to £73m last year.
  
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Camden New Journal

• Tories may force Royal Free and Whittington hospital merger. The Royal Free and Whittington hospitals could be forced to merge if Conservative reforms to the NHS are approved, a council report has said. Health Secretary Andrew Lansley’s reforms aim to make every hospital an independently-run “Foundation Trust”. Despite years of trying under the previous Labour Government, the Royal Free or the Whittington failed to convince the regulator Monitor they could manage their own finances properly. Failure to do so again would push them into a merger, according to the report to Camden health and scrutiny committee. The number of patients treated would be slashed and campaigners warned there was a “real danger” of cuts to beds and staff. The trusts are already facing cuts of up to £900m because of changes to funding tariffs. Senior executives at both hospitals have held meetings with staff about a 7% budget saving across all departments. The council report adds that the upheaval to the NHS could leave Camden health services worse off. Under the changes, NHS Camden would be abolished and GPs given control of 80% of funding decisions. Campaigners believe this will bring about the mass privatisation of the National Health Service.
  
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Tayside and Fife Courier

• Ward closure fears acknowledged by NHS chief. Older people are becoming "frightened" by ward closures and a move to more community care, a Tayside health chief has admitted. NHS Tayside's deputy chief executive Gerry Marr said he and his colleagues need to get better at communicating with older people and help them to understand the fundamental changes that are happening to the way they are looked after when they fall ill or are coping with long-term conditions. At the health authority's annual review he insisted changes to older people's services were improvements, not just cost-saving measures. In recent weeks NHS Tayside has closed a ward for elderly people at Royal Victoria Hospital in Dundee and announced a relocation of elderly beds at Ninewells Hospital. In addition it announced the merger of two wards at Ashludie Hospital in Monifieth, then withdrew that plan — saying both wards would remain open until suitable alternative accommodation could be found for the patients.
  
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Healthcare Republic

• Managers question GPC's NHS anti-privatisation stance. The GPC's stance against the use of private providers could be illegal and is 'unwise', according to the NHS Confederation. The GPC's set of 'principles' for GP commissioning states that ‘wherever possible, consortia should ensure that NHS providers are the providers of choice.’ But Nigel Edwards, NHS Confederation acting chief executive, said GP commissioners should not ‘simply dismiss what non-NHS organisations can offer.’ ‘This principle is doubtful in law and unwise in practice,’ he said. Meanwhile the union Unison has started legal action to block health secretary Andrew Lansley’s White Paper reforms, after threatening to last month. The union is calling for a judicial review on the grounds that Mr Lansley’s reforms are already being implemented before adequate consultation. Soon after the White Paper was published, NHS chief executive Sir David Nicholson wrote to executives instructing them on how to start implementing aspects of the reforms.
  
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Lambeth Guardian

• Lambeth PCT criticised for £3.6m spend on management consultants. The borough’s public health provider has come under fire for spending £3.6m in the last financial year on management consultants, money that should have been spent on frontline services, critics said. Health watchdog London Health Emergency (LHE) said it was “absolutely scandalous” Lambeth Primary Care Trust (PCT) managers spent money on consultants to do work they should be capable of doing themselves. NHS Lambeth, part of the PCT, said the proportion of its £650m budget spent on consultants was under 0.5% and necessary because it did not have the level of in house expertise required to deliver the best possible services. But LHE chairman Geoff Martin said the cash could have funded 100 additional nurses at a time when there was a freeze on recruitment because of swingeing funding cuts. Details of the consultancy spend, totalling £114m across London, came in the last year of the Labour Government. The information was released by Health Secretary Andrew Lansley in what was seen as a highly politicised move.
  
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Pulse

• GPs face fight for control of new 111 service. GP commissioning groups are set to be plunged into battle with ambulance trusts and a skeleton NHS Direct service for control of the new 111 urgent care number. The Government’s decision to scrap the NHS Direct telephone hotline - which Pulse has uncovered cost the NHS £123m this year - has been welcomed by the majority of GPs. But both the ambulance service, which is spearheading the first pilot in NHS County Durham and NHS Darlington, and NHS Direct, set to run the next pilots in the East Midlands and East of England, will use fewer qualified nurses than NHS Direct does currently - and there are questions over how much say GPs will have in the running of the new service. A Pulse investigation earlier this year revealed NHS Direct already sends 22% of its 14,000 calls a day to GPs as urgent or next day cases. And leading Labour MPs, including shadow health secretary Andy Burnham, claim the 111 service will see this rise.
  
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• GPs may have to inherit some PCT debts, Buckman warns. GP consortia may have to accept taking on some PCT debts when they assume full commissioning power, but they should not be forced to prop up expensive Darzi centre and PFI contracts, GPC chair Dr Laurence Buckman has said. The GPC chair insisted PCT debts should be separated into those that ‘inevitably occur as a result of managing patients’, which GPs may have to absorb, and those incurred through expensive schemes imposed on local areas like Darzi centres, which GPs should not have to inherit. He added that consortia should not be responsbile for dealing with PCT debts incurred through brokerage arrangements where some PCTs have propped up neighborughing trusts who had fallen into financial difficulty.
  
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Thursday 2nd September 2010

The Press and Journal

• Community council urges board not to cut out-of-hours GP service. Proposals to reduce number of doctors on call prompt concern that patients will be put at risk. A north-east community council has written to NHS Grampian asking it not to cut the area’s out-of-hours service. The Press and Journal revealed in July that the number of doctors on call outside normal surgery hours could be halved in some parts of Grampian. NHS Grampian is trying to identify ways to cut its budget by £34million and it is understood that cuts to G-Med, the local NHS board’s out-of-hours service, could save more than £300,000 each year. An NHS spokesman said “discussions are still ongoing and no proposals are drawn up yet” and “measures being looked at include changes to shifts where nurses would replace GPs at times of low activity”. He added: “An example we previously cited was the changeover between GP and nurse taking place at 10pm rather than midnight, which would save that shift £40,000 annually. “Our aim is to maintain a safe, reliable service while trying to better match capacity to demand.”
  
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Guardian

• Towards a joined-up health service. We are a long way from an integrated NHS, says a new report – but local successes may point the way forward. The labyrinthine NHS is a mass of contradictions. Doctors, nurses and managers are exhorted to work together to keep people out of hospitals, for example by pre-empting crises to avoid expensive emergency admissions. Yet the introduction of more independence and competition means that these same hospitals, particularly the semi-autonomous foundation trusts, are competing for customers to drive up income. A new report published today by health thinktank the Nuffield Trust highlights a handful of NHS organisations that are beginning to break down some of these barriers between hospitals, community health services and general practice to provide more seamless care to patients. The report, Removing the Policy Barriers to Integrated Care in England, stresses that government and NHS must resolve some policy contradictions by devising more effective methods of rewarding caregivers in whatever setting, while still using the twin drivers of competition and collaboration to improve services. It identifies seven key "policy barriers" to greater integration of care. These include GP commissioning, which often fails to involve community health professionals; a lack of social care funding for frail and vulnerable people; and few incentives to support collaborative working.
  
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• The NHS will exist only as a brand name. The NHS provided the most most influential, economic model for state-funded healthcare services. Not any more, says Julian Tudor Hart. From its birth to the late 1990s, the NHS grew in both body and mind, but was always starved of resources. What else could we expect from governments that believed (as all still do) that healthcare as a universal public service cannot produce wealth ? The NHS became seriously sick only in the 1980s, when the managing director of Sainsbury's was invited to start the process of redesigning it as a business. Successive reorganisations all pursued the same goal: to break it up into competing commercial units, differing from the rest of the market place only in that the government, not the consumer, finally met the bills.
  
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Pulse

• Burnham launches bid to block GP commissioning plans. Shadow health secretary Andy Burnham today launched what he has billed as the ‘mother of all battles’ to stop the NHS reforms outlined in the coalition Government's health white paper, claiming they will fatally 'compromise' the role of GPs. The man whose Cabinet hot seat was taken over by Andrew Lansley and who is now standing as a candidate in the Labour leadership election claimed the top-down reorganisation represented a total U-turn by the Conservative and Liberal Democrat Government and was not wanted by either patients or GPs. Speaking at a meeting in Liverpool, Mr Burnham described the plans for GP consortia as ‘a postcode lottery writ large’, warning: ‘The creation of hundreds of new, untested GP groups means variable service standards, access and quality depending on where you live.’ He predicted that if the plans went ahead, patients would end up having to fight with their GP to get access to services, with GPs compromised by being both providers of services and commissioners. ‘Lobby your GP’, the Government cries. But people don’t want to have to fight for their healthcare, and GPs don’t want it either,' he said. ‘The role of GP as champion of their patient is compromised by their role as budget-holder. It is also the case that the GP will be both a provider and commissioner, placing a major conflict of interest at the heart of the NHS.'
  
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People Management

• NHS bosses to get £130,000 to resign. Chief executives at NHS trusts set to be scrapped by the government have been offered a £130,000 golden goodbye if they resign voluntarily, it has been reported. The mutually agreed resignation scheme (Mars), put forward by the government for NHS trust chief executives and senior managers, will be available until October. It represents the equivalent of a year’s pay with the first £30,000 tax free. Details of the offer, reported by the Health Service Journal, were sent to NHS managers in a letter from Sir Neil McKay, chief executive of the NHS East of England Strategic Health Authority, who will oversee the move. The news follows an announcement by health secretary Andrew Lansley earlier this year that NHS trusts would have to slash management costs by more than 46 per cent over the next four years. Lansley also announced plans to close all 10 strategic health authorities and 152 PCTs, which will affect more than 60,000 managers.
  
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Lancashire Telegraph

• Blackburn jobs fears over NHS Direct closure. Health workers in East Lancashire could lose their jobs as a result of plans to scrap the medical helpline NHS Direct. The Department of Health confirmed the service, which provides advice to 27,000 people a day on the number 0845 46 47, will be replaced by a new non-emergency number, 111. The move, announced via an apparent slip of the tongue by Health Secretary Andrew Lansley during a hospital visit, is expected to affect 12 staff working at the Royal Blackburn Hospital site in Haslingden Road. NHS Direct said the new phone number was intended to work in a 'more efficient' and integrated way with local GPs, ambulance services and hospitals, providing health advice and information about out-of-hours GPs, walk-in centres, emergency dentists and 24 hour chemists. But critics said members of the public would no longer be able to speak with nurses with degrees, but only call-handlers who have passed a 60-hour medical course. And the Royal College of Nursing said it would be 'short-sighted' of ministers to axe expert nurses. A NHS Direct spokesman said it could not comment on the future of staff working in Blackburn until three pilot NHS 111 schemes had been completed.
  
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Tuesday 31st August 2010

Western Mail

• Doctor says health service must resist market reforms. The NHS in Wales could inspire a fightback against the commercially-driven reforms of the Tories and New Labour, according to a leading health theorist. In an extensively rewritten and updated new edition of his book, The Political Economy of Health Care, Dr Julian Tudor Hart says the NHS in Wales remains true to the legacy of its founder Aneurin Bevan. The retired GP argues that the election of a Conservative/ Liberal Democrat coalition at Westminster gives Wales the opportunity to build the foundations of a progressive society for the second time in its history. The book describes how Dr Hart and his colleagues developed relationships based on trust with their patients in a “gift economy” untainted by commercial pressures. Dr Hart argues that since the Thatcher Government was elected in 1979, there have been successive damaging attempts to introduce a commercial ethos into the NHS, setting hospital against hospital. He cites examples from England where American-owned groups have bid successfully against local GPs to provide primary health care in specific areas. In Wales, however, Dr Hart sees the rejection of the Private Finance Initiative as a means of funding new health schemes, and the end of the purchaser/ provider split as a positive development that could mark a new direction.
  
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This Is South Wales

• Overtime pay axed to save hospitals cash. Angry health staff have been left reeling at a decision to put in place an overtime freeze in the wake of top level executives having their salaries protected for up to 10 years. They claim other departments are suffering as a consequence of the Assembly-led policy across Hywel Dda Health Board, which covers Llanelli's Prince Philip Hospital and West Wales General Hospital, in Carmarthen. In a letter entitled overtime constraints, from Simon Jones of the organisation, to all staff it said the situation had come into effect because of the current financial climate. The NHS is expected to save £1.9 billion over the next five years — but it is still shelling out on pay increases for executives who failed to win top jobs, following the mergers of NHS trusts and local health boards last October. And the maximum period of pay protection is 10 years, when an employee has 15 or more years service with the NHS. In the letter to all staff members, it said: "Please be advised that due to the current financial position I have been instructed to advise everyone that there is a restriction on overtime effective from August 2. This means that NO overtime must be allowed unless it has a direct impact on patient care/ safety and any request for overtime working MUST be approved by senior management in advance of it being worked."
  
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Scotsman

• Public flocks to sign NHS petition. An online petition launched by former deputy prime minister Lord Prescott, appealing for the government not to scrap NHS Direct, has passed the 10,000-signature mark. The Department of Health had said the nurse-staffed helpline, providing advice to 27,000 people a day, is to be replaced by a new, non-emergency 111 number. Lord Prescott is aiming for 100,000 signatures - a figure Prime Minister David Cameron said should trigger a Commons debate.
  
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Monday 30th August 2010

The Press Association

• Lib Dems urged to vote down NHS bid. Shadow health secretary Andy Burnham has written to all Liberal Democrat MPs urging them to vote against the coalition Government's plans for reform of the NHS. Mr Burnham also challenged Lib Dem and Conservative health spokesmen to a public debate with him on the reforms, which he will describe in a speech on Tuesday as the biggest threat to the NHS in its 62-year history. The Labour leadership contender warned that plans to give GPs control of an estimated £80 billion of NHS spending and to hand more independence to hospital trusts will destabilise the service, throwing it into organisational chaos at a time when it needs stability. His intervention comes days after the health union Unison launched a legal challenge to the reforms on the grounds that a consultation process being conducted by Health Secretary Andrew Lansley is a sham. In his letter on Monday, Mr Burnham said Liberal Democrat voters were not expressing support for reforms of the kind set out in Mr Lansley's health White Paper when they cast their ballots in the general election in May. He told Lib Dem MPs: "You hold the key to the future of our NHS. People who voted for you at the election did not vote for such a radical break-up plan. I urge you to listen to them and stand up for our NHS in the face of this attack, which threatens to unpick its very fabric." In a speech in Liverpool on Tuesday - shortly before the Lib Dems' annual conference in the city next month - Mr Burnham is expected to say: "There are former Lib Dem councillors here in Liverpool who don't know that their party stands for any more. "When Nick Clegg comes here the week after next, he must explain why these reforms are being forced on the NHS in direct contradiction to what the coalition agreement promised." Mr Burnham will argue that introducing massive structural reform at a time of financial retrenchment will "throw the NHS into chaos" at a time when it needs stability. Handing commissioning power to GPs risks a postcode lottery, with different standards and accessibility of care depending where patients live, he will say.
  
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Pipeline Review

• Criticism mounts over NHS reform but pharmaceutical firms may benefit. The UK coalition government is facing legal action from public services trade union UNISON over plans to shake up the National Health Service in a bid to find efficiency savings. However, the proposed reforms could benefit pharmaceutical companies, with patients gaining access to drugs previously blocked by the health service's cost watchdog. The UK coalition government is facing legal action from public services trade union UNISON over plans to shake up the National Health Service in a bid to find efficiency savings. However, the proposed reforms could benefit pharmaceutical companies, with patients gaining access to drugs previously blocked by the health service's cost watchdog. According to media reports, the government has requested that National Health Service (NHS) managers implement efficiency savings 'immediately', bypassing the white paper consultation phase set to end in October 2010. This could be unconstitutional, and has led to UNISON mounting a legal challenge. The proposed shake ups have already faced criticism from other quarters, with academics branding the reforms as a "gamble". Concerns have also been raised over the influence that pharmaceutical companies may have over general practitioners who will become the new key decision-makers. Furthermore, the Muscular Dystrophy Campaign has suggested that patients will suffer as a result of general practitioners not fully understanding the complex conditions for which they will now have control over budgets. The government has hit back, citing that consultants will work alongside GP groups as part of the planned changes. However, financial criticisms are less easily waved away, with the British Medical Journal having suggested that the proposals will cost some GBP3 billion but provide no efficiency savings.
  
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Wales Online

• Long-term NHS job vacancies rise by over 40%. The number of long-term NHS staff vacancies has risen by more than 40% in just six months. And official figures also reveal the sickness rate among NHS staff has increased slightly, now standing at 5.3%. There were 243 job vacancies, which have been empty for three months or more, at the end of March, compared to just 170 six months previously. Almost half of these are nursing and medical consultant posts, according to the statistics published by the Assembly Government yesterday. But despite the sharp rise in the last six months, long-term vacancies in the NHS have fallen significantly over the last eight years from a high of more than 1,700 in March 2002. Sickness absence figures, which were also published yesterday, show the rate for the first quarter of the year has increased slightly on the last quarter of 2009. The snows of the beginning of the year may have had an impact on this rate. The data shows of the seven local health boards and three NHS trusts, the Welsh Ambulance Service NHS Trust had the highest sickness absence rate at 7% compared to Public Health Wales NHS Trust at 3.8%. And of the six staff groups, the highest sickness absence rates were in the ambulance (7.4%) and healthcare assistant and support worker (7.3%) groups. The lowest sickness absence rate was in the medical and dental staff group at 1.3%.
  
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Sunderland Echo

• Axe to fall on NHS helpline. Medical helpline NHS Direct is to be scrapped and replaced with a scheme being trialled in the North East. Health chiefs were shocked yesterday when the Department of Health said the new non-emergency 111 number, which was launched in County Durham last Monday, would replace the existing service and claim they knew nothing about it. Health Secretary Andrew Lansley made the announcement, apparently in error, during a hospital visit. But the Department of Health yesterday released a statement confirming the news and said many of the services offered by NHS Direct would be "subsumed" by the 111 service. The switch has been criticised by people who say the pilot has not been tested yet and the cost-saving cuts the new service would bring were being rushed into. The Royal College of Nursing urged the government not to axe specialist nurses who work for NHS Direct. Chief executive Dr Peter Carter said: "The evidence suggests the expert advice of nurses has kept 1.5million people out of A and E and saved the NHS £213million a year. "It would be shortsighted to cut back on the experts who deliver these long-term savings." Former deputy prime minister John Prescot has labelled plans to replace the service as "madness".
  
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Friday 27th August 2010

Pulse

• NHS managers prepare to go head-to-head with private sector to provide GP commissioning support. NHS bosses are preparing to pitch themselves into competition with the private sector to offer support to GP commissioning consortia by re-inventing themselves as social enterprises, in moves backed by GP leaders. The Government’s plan to abolish PCTs by 2013 as part of its white paper reforms is expected to lead to GP commissioners employing management directly, or buying in support from outside agencies, with a host of private firms already throwing their hats in the ring. But GP leaders have backed moves for existing PCTs to morph into social enterprise-style agencies that could potentially support several consortia as an alternative to the private sector. And a group of NHS commissioning experts parachuted in to oversee one of Lord Darzi’s most controversial health policies said it too could reinvent itself as a social enterprise or even a private company to combat a projected loss in funding. Meanwhile, Commissioning Support for London, the 200-plus strong team of managers set up in April last year to drive forward the Healthcare for London proposals to shift huge amounts of hospital care to primary care as part of the polyclinic rollout - said it would re-assess its structure as the axe was likely to fall on £27m of its NHS funding. The group’s chief executive Sarah Pinto-Duschinsky said she was overseeing plans to re-design the body as an organisation which would seek to sell its services, including IT systems, service planning tools and referral management consultancy, to GP commissioning consortia in the capital and further afield. She said the group, which receives three quarters of its budget from London’s PCTs, hoped to be able to compete against what is expected to be massive competition from firms such as UnitedHealth, Dr Foster and Tribal. Elsewhere, Commissioning Business Service (CBS), which offers similar support to GP consortia in Greater Manchester, said it was also considering evolving into a social enterprise or private company following the white paper.
  
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BBC News

• NHS records move in East Midlands sees some 90 jobs cut. NHS patient record services in the East Midlands are being outsourced, with the loss of about 90 jobs. Nine Primary Care Trusts have agreed a contract with NHS SBS - a partnership of the Department of Health and IT firm Steria - with some work going to India. Health officials said the move will save up to £9m over six years and will not impact on patient care. But unions said staff had been "sold out" and having some tasks sent to India risked vital information. The move will see payment processing, cervical and breast cancer screening correspondence, medical records and patient registration done by the new firm. NHS staff have been told the current workforce of about 150 will be reduced to 65, based at offices in Leicester and Derby .
  
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News Shopper

• Union threatens trust with a strike. Last minute talks are being held in a bid to avert a strike by London Ambulance Service workers. The workers are due to transfer to a private contractor and are threatening to go on strike next week. Those who are members of the GMB union are protesting about alleged threats by their new employer to reduce their pay and conditions. South London Healthcare Trust is poised to sign a contract with Savoy Ventures Ltd to take over the transport of non-urgent hospital patients to and from hospital appointments. This work is currently done by more than 60 ambulance staff, who will transfer to Savoy Ventures when the contract begins on September 1. But the GMB claims at a meeting between the company and the affected LAS staff, Savoy Ventures told the workers it would not be keeping to the TUPE (Transfer of Undertakings Protection of Employment) regulations. Instead it told them they would lose their final salary pension scheme and their London weighting allowance, salaries may be lowered to those of the company’s existing employees and they would have to work different shift patterns. The union also claims the man who runs Savoy Ventures has been involved with four other failed companies. In an 85% turnout for a strike ballot, 95.8% voted for strike action starting next week. There may also be a mass protest.
  
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Aberdeen Press and Journal

• Trade unionists opposed to cut in hospital beds. Trades union representatives remain opposed to the drive to cut beds in far north hospitals. They insist the move can only make life tougher for the growing number of vulnerable, elderly patients and their families. They are also campaigning against a move to turn the minor injuries casualty unit at Thurso’s Dunbar Hospital into a 9-5 weekday operation. North Highland Community Health Partnership (NHCHP) has already shut four of the 16 beds at Dunbar and a further seven at the Queen Elizabeth ward of Caithness General Hospital at Wick. The health body is meanwhile consulting on its favoured option of doing away with the remaining beds at Dunbar and cutting back on the hospital’s casualty unit, which currently opens 24/ 7. They have pledged to re-invest half of the projected £600,000 annual savings in new community rehabilitation and palliative care services. Thurso and Wick Trades Council is pressing NHCHP to spell out exactly how its proposed new set-up would work.
  
  
  
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Northern Echo

• Alarm at speed of NHS cuts. The Royal College of Nursing (RCN) has said it is alarmed at the speed at which job cuts are to be made in the North- East NHS. The NHS in the North-East has been ordered to make savings of £800m by 2014. One of the main areas of cost-cutting will be in primary care trusts, which are due to be scrapped by 2013. But the RCN, which has thousands of members in the North-East, said it understood that the first redundancies would begin on Teesside as early as October 11. Details of the timetable of redundancies at three primary care trusts have been obtained by the union. They state that up to 82 jobs will go from NHS Middlesbrough, 80 from NHS Stockton and five from NHS Hartlepool.
  
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Teesdale Mercury

• More than 100 NHS jobs to be axed in County Durham. More than 100 NHS jobs in County Durham look set to be axed as health chiefs outline plans to make massive cutbacks. By next April, North East Strategic Health Authority and the 12 primary care trusts (PCTs) in the region aim to save £27m through cuts to managerial and administrative staff. The NHS says the money will be reinvested in frontline services, but union leaders say they are concerned about the affect on the NHS. About 110 jobs are expected to go at County Durham Primary Care Trust and a further 37 at the North East Strategic Health Authority. In total, more than 500 positions are likely to go across the region.
  
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Bucks Free Press

• Day surgery ward closed at Wycombe Hospital. A day surgery ward at Wycombe Hospital has been closed, as health bosses consult on a shake-up of staff and beds. The closure of ward 8 looks set to have knock-on effects for at least two other wards in the hospital's Treatment Centre. Under the plans, set to be implemented by the end of September, most day cases will be sent to another surgery ward. Buckinghamshire Hospitals NHS Trust said the closure of ward 8 was due to less beds being needed, but said no redundancies were planned.
  
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Southern Daily Echo

• Protesters meet to fight threatened closure of centre. Angry campaigners have drawn up a battle plan to stop the axe falling on a city walk-in centre. Feelings ran high as the Socialist Party of Southampton hosted a public meeting to protest about the possible closure of Bitterne Walk-In Centre. Dozens packed the hall in Bitterne as health bosses consider the future. Leading the debate, Tim Cutter, said he believed the move would be dangerous to the health of vulnerable and elderly residents and accused NHS Southampton City of being driven by financial concerns.
  
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Thursday 26th August 2010

Pulse

• Single-handed GPs claim 'aggressive' PCTs are targeting them for closure. GPs have accused their PCTs of harassing them in a bid to drive them out of their surgeries, as a crackdown on smaller and single-handed practices gathers pace. Pulse recently revealed that more than one in six English trusts are planning a cull of GP practices as part of a £20bn cost cutting drive, potentially sounding the death knell for singlehanded practices. A number of GPs who have contacted Pulse say they are now being pressured by over-zealous PCTs, with managers looking for excuses to close them down. But NHS managers have denied they are pursuing a policy to close down small practices. One single-handed GP in Greenwich, South East London, who wished not to be named, said she feared she was being targeted for closure, as the trust scrutinised her contract using traffic-light style ratings. She said NHS Greenwich was zoning in on her practice’s QOF scores, and using the availability of services such as immunisation and cervical cytology to inspect her performance. She said: ‘I know it needs to be done, but I am being harassed. If they want to close single-handed practices, they should come out and say it. But PCTs are pushing doctors to retire by trying to highlight their weaknesses. Nobody is telling the good points of single-handed practices.’
  
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• GPC to push for optional commissioning DES to avoid GP contract rewrite. GP negotiators will resist the Government's attempts to make commissioning responsibility part of the core GP contract, and will instead push for it to be offered as an optional enhanced service, Pulse has learned. GPC leaders revealed this week that they have already begun preliminary dialogue with the Government over its plans, and will look to step up talks when the consultation on the white paper plans closes in October. But the stance appears to put the GPC on a collision course with ministers, who have pledged to write commissioning responsibility into the GP contract. The Government made clear in its NHS white paper that all GPs will be expected to join commissioning consortiums when PCTs are abolished in 2013, and outlined plans to link ‘a proportion of GP practice income to the outcomes that practices achieve collaboratively through commissioning consortia’. The far-reaching proposals would make all GPs contractually responsible for commissioning, and tie a proportion of their GMS income to the results of the consortia they belong to.
  
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People Management

• Unison launches court bid against NHS reform. Unison is taking legal action against the government over its plans to restructure the NHS, alleging the lack of a proper consultation process is “unlawful”. The public-sector union has applied for a judicial review in a bid to block the reforms from going ahead without a full public consultation on the “most fundamental changes to the way the NHS operates since it was created”. Unison says the consultation process currently underway is meaningless, as chief executives at NHS trusts were instructed to start implementing the proposals “immediately”, the day after health secretary Andrew Lansley published a white paper on the radical NHS restructure in July. NHS chief executive Sir David Nicholson, who sent the direction in a letter to other NHS bosses, said the consultation was limited to how the proposals should be implemented, not whether the plans – which involve giving GPs control of £80 billion NHS spending – were supported in principle.Karen Jennings, Unison’s head of health, said: “I find it incredible that the NHS chief executive would say he believes there is no legal duty on the secretary of state to consult on the merits of the proposals in the white paper. “The white paper contains sweeping changes to the NHS and how it should be run. The NHS constitution enshrines the principle that the public, staff and unions have an absolute right to be consulted. And that means not only on how the proposals are to be implemented, but also whether they should go ahead in the first place. She added: “The Department for Health’s refusal to recognise this clear and important legal duty leaves us no option but to issue legal proceedings as a matter of urgency. “The government has confirmed it will be contesting the legal challenge.
  
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Morning Star

• Lansley's deadly prescription. The debate over the government's controversial white paper, laughably entitled Liberating the NHS, is beginning to widen and the scale of opposition to many of its core proposals is becoming clear - even among the group who appear to have most to gain from it. GP magazine found less than one in five of the 300 GPs who responded to a poll believed that the changes would improve patient experience or the funding of primary care services. Twice as many (41 per cent) feared a fresh "postcode lottery," while 71 per cent expected the scrapping of primary care trusts and strategic health authorities to lead to an increase in private-sector involvement in commissioning. No wonder one of the leading apologists for the scheme, Dr Michael Dixon of the NHS Alliance, has issued a rather desperate appeal for GPs not to turn their backs on the government proposals, claiming that it would be "utterly disastrous" if they did not "embrace the white paper and make it work."
  
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Shropshire Star

• Nurses urged to cut shifts at Shropshire hospitals. urses and healthcare assistants at Shropshire’s two biggest hospitals are being asked to voluntarily cut short their daily shifts, as bosses try to make savings and stave off job cuts, it was revealed today. The move is among a number of new measures being introduced by Shrewsbury and Telford Hospital NHS Trust. The trust is under heavy Government pressure to make efficiency savings. Staff will be asked to consider changing the way they work and there will also be a continuation of a major drive to reduce the cost of hiring agency workers at the Royal Shrewsbury Hospital and Princess Royal in Telford.
  
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Tuesday 24th August 2010

Northern Echo

• NHS reform and cuts ‘no gamble’. The Health Secretary last has defended Government plans to reshape the NHS – despite claims the move will cost hundreds of jobs. On his first official visit to the region, Andrew Lansley denied his plan – in which more than 1,700 jobs will be axed in the North-East and Cumbria alone – was a gamble with the future of the health service. Mr Lansley visited the North-East Ambulance Service headquarters, in Newcastle, to launch the NHS 111 telephone service for callers who need non-emergency health care. His visit coincided with the publication of a report by the Royal College of Nursing (RCN) which shows the scale of the cuts to the region’s NHS ordered by the Government. The study, based on information obtained from every hospital and primary care trust in the Northern region – which includes the North- East and Cumbria – suggests that the £800m due to be cut in the next four years will result in 1,750 fewer health care workers and 403 fewer beds. One trust, County Durham and Darlington NHS Foundation Trust, aims to cut £60m by 2014, closing 300 beds and losing 300 nursing jobs through non-replacement. Mr Lansley has also been criticised by North-East health academics for taking a gamble with the future of the NHS by handing control of most of the budget to groups of GPs and abolishing two tiers of NHS administration. Mr Lansley said he thought it would be risky not to give GPs a role in commissioning care. He stressed that while the Government wanted to reduce management spending, it was committed to increasing overall investment in the NHS and switching resources from the “back office” to the frontline. Commenting on the RCN report, Mr Lansley said he was more interested in improving “patient outcomes” than the number of beds.
  
  

Health Investor

• Consultancy spend criticised by Lansley. Health trusts in England spent more than £300m on management consultants last year, the latest Department of Health figures have revealed. Secretary of state Andrew Lansley described the figure as “staggering” , after it emerged the figure is approaching the total cost to the health service of skin and lung cancer treatment. Data obtained from the Department of Health reveal the extent to which primary care trusts and strategic health authorities, both of which are soon to be abolished, have been engaging the private sector to help implement NHS reforms. Costs, critics claim, have been inflated by fees for some consultants who can charge up to £1,000 a day. Lansley blamed the previous Labour government for the rise in fees, but shadow health secretary Andy Burnham hit back by claiming the Conservative’s reforms of the NHS would give consultancy firms a field day. He said: “The NHS needs good managers. By wiping away the expertise currently in primary care trusts he is opening the door to consultancy firms who know that hundreds of new untested GP groups won’t have the experience to go it alone.”
  
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Monday 23rd August 2010

HSJ

• £300m spent on management consultants last year. The NHS in England spent more than £300 million on management consultants in the last year, figures show. The cost is almost the same as the amount spent on skin and lung cancer services combined, the data for 2009/ 10 showed. The government released the figures to show how much was spent on management consultants - as well as advice from architects, lawyers and surveyors - in the last year of the Labour government. Overall, primary care trusts (PCTs) and strategic health authorities (SHAs) spent £313.9 million on consultancy services. Nigel Edwards, acting chief executive of the NHS Confederation, which represents NHS organisations, said: “Any spending of taxpayers’ money has to be justified, and the NHS has been asked by successive governments to perform tasks for which internal expertise was not present or needed to be developed. “Dismissing all this spending as wasteful is unfounded." “External advice will be necessary if NHS organisations are to deliver change and, with the financial challenges and the size of the current reform programme, it is probable that NHS organisations, especially new GP consortia, will require external help to deliver what the Government wants.” Alan Leaman, chief executive of the Management Consultancies Association, said: “Research by the association has shown that on average, for every £1 spent on management consultancy, benefits worth the equivalent of £6 are returned to the client. “An organisation as complex and fast-changing as the NHS is entitled to benefit from the high quality advice and delivery that is offered by MCA member companies.”
  
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Sunderland Echo

• Axe set to fall on health jobs. Hundreds of health workers will lose their jobs and services face cuts under a planned multimillion-pound cost-cutting exercise, according to a union.
  The Northern Royal College of Nursing (RCN) has released information collected from every NHS Foundation Trust and Primary Care Trust (PCT) in the region detailing plans for cutting costs, shedding jobs and reducing bed numbers.Cuts affecting Wearside and Durham include:
  - City Hospitals Sunderland will cut £22.5million this financial year
  - NHS County Durham and Darlington is undertaking a three-year £200million cost-cutting exercise.
  - Sunderland TPCT has identified 85 posts for redundancy
  - County Durham and Darlington NHS Foundation Trust is cutting 300 beds and losing 300 nursing jobs through natural wastage. It will save £20million from the 2010/ 11 budget and £60million by 2014.
  Health chiefs estimate they need to make £800million of efficiency savings by 2014, and all cash saved will be reinvested directly into frontline services.Glenn Turp, regional director for the RCN, said: "It's inevitable that when trusts announce cuts to beds, staff or other areas, but do not announce new investment of equivalent value in, for example, key clinical staff, the suspicion is that this is not a genuine reinvestment programme but just plain old-fashioned cuts."
  
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Morning Star

• New nurses struggle to find jobs. Pressure is being piled onto the Scottish government to protect front-line services as newly qualified nurses and midwives struggle to find jobs in the NHS. The Royal College of Nursing Scotland accused health boards on Sunday of using "unsustainable tactics" in a desperate bid to save money, including freezing posts and not replacing staff who leave. RCN warned that this money-saving drive has led to a devastating drop in job opportunities for newly trained nurses. The union expects that the worse is still to come after the announcement by Scottish Health Secretary Nicola Sturgeon in June that almost 4,000 NHS jobs, including 1,500 nursing and midwifery posts, will be axed this year. RCN Scotland associate director Ellen Hudson voiced her concerns about the impact of any cuts on people trying to start a career in nursing. She also warned of the "devastating consequences" for future patient care if older nurses are not replaced by newly registered nurses. The Royal College of Midwives Scotland has spoken of similar concerns and suggested there may soon be no jobs at all for newly qualified midwives. Meanwhile, the Scottish Labour Party has accused the SNP government of wasting money on training nurses who cannot get jobs. Labour Party health spokeswoman Jackie Baillie said: "These cuts could have a devastating effect on the NHS. Ms Sturgeon has to address the fact money is being wasted on training nurses and midwives who can't get jobs. Labour has called time and again for the Scottish government to protect front-line services." But Ms Sturgeon has insisted patient care would not be affected by the cuts and said there would be no compulsory redundancies. "We are aware that some health boards have lower vacancy rates for newly qualified nurses and midwives than others, and we are working with them to find quick solutions," she said. "Our national one-year job guarantee scheme aims to ensure every newly qualified nurse or midwife receives the offer of a job either through their own means or with assistance."
  
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Friday 20th August 2010

New Post Leader

• Jobs to be cut in NHS. Hundreds of NHS jobs in the region are to go. The cuts follow the news that by April 2011, North East Strategic Health Authority (SHA), and the 12 primary care trusts (PCTs) in the region, have to make savings of £27m. Across the region 516 jobs are to be slashed from the managements of PCTs, with all savings being reinvested in frontline services. A spokesperson for NHS North of Tyne said: "Our requirement is to reduce management costs by around 35%, which means we have to make significant changes to our staffing structures. To help achieve the management costs savings we are offering staff the opportunity of asking for voluntary redundancy. We would always hope that we can avoid compulsory redundancies but in this case, given the level of savings to be made this may not be possible." Unison lead officer for health in the North East Trevor Johnston said he was concerned a reduction would lead to frontline staff not being able to function effectively due to lack of administrative and managerial back up.
  
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Pulse

• Department of Health warns GPs could inherit PCT debts. GP consortiums may be lumbered with massive financial deficits inherited from debt-stricken PCTs as soon as they take over commissioning powers, the Department of Health has admitted. Radical plans put forward in last month’s NHS White Paper mean that GP consortiums will be expected to take on all of PCTs’ commissioning functions by April 2013, when both PCTs and SHAs will be abolished. But the Department of Health said this week it could not guarantee a clean financial slate for consortiums, amid fears that GPs could inherit hundreds of millions of pounds worth of debt from cash-strapped PCTs. The Government’s refusal to commit on the issue has placed GP leaders on red alert as they seek to ensure that consortiums are given a fair crack of the whip in trying to make a success of the plans.
  
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Healthcare Republic

• GPs demand practice income is protected from commissioning. Three quarters of GPs want the GPC to reject any bid to plunder existing practice income to fund 'quality premiums' for successful commissioners, a poll for GP newspaper shows. But the survey, in partnership with the Family Doctor Association (FDA), found that 47% of respondents remain unsure if the DoH’s commissioning plans are an opportunity or a threat for the profession. Many of the 315 GPs surveyed are concerned that the additional workload will not be adequately resourced. Under a fifth (17%) of respondents are confident that commissioning will lead to a better patient experience in the NHS, with many more (41%) concerned that quality of care will become more varied. More than half (55%) fear the reforms jeopardise GPs’ autonomy and independent contractor status. More than two-thirds (67%) of respondents wanted the GPC to hold a ballot to decide whether to embrace or oppose the reforms. The survey also showed that only a fifth of GPs think the White Paper will improve the NHS.
  
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Recruiter

• Discussions ongoing over private-sector investment into NHS Professionals. Discussions over the possibility of private-sector investment in NHS Professionals are ongoing, according to a spokesperson for the not-for-profit organisation. On 4 August, a Prior Information Notice (PIN) was published in the Official Journal of the European Union seeking potential investors from the private sector. This led to union Unison to voice its opposition to more private involvement in NHS Professionals, singling out recruitment agencies. However, an NHS Professionals spokesperson told Recruiter that no decision would be made until discussions have been carried out.
  
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hc2d.co.uk

• Monitor Board announces decision on Poole Hospital NHS Foundation Trust. Monitor, the independent regulator of NHS foundation trusts, has found that Poole Hospital NHS Foundation Trust is in significant breach of the terms of its Authorisation. This decision is based on concerns around the Trust’s financial position and its governance arising from its performance in 2009-10, when the Trust reported a deficit of £4.5m against a planned surplus of £2.1m. Having considered the available evidence, Monitor has decided not to use its formal powers at this stage. However, the Trust’s performance going forward will be reviewed against specific milestones; if it fails to demonstrate timely progress towards full compliance with its terms of authorisation, Monitor is likely to consider formal intervention.
  
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Herald

• Job fears as health board is warned to cut further. Fears of more job losses in the NHS have been raised after it emerged Scotland’s largest health board may have to cut spending by a further £10m. NHS Greater Glasgow and Clyde (GGC)– which employs 44,000 stafff – is already trying to save £56.9m this year and has announced plans to slash 1200 posts including 670 nurses and midwives. However, a new report has warned the board may well have to make further cutbacks worth £10m. A number of other health boards have also warned that they have spent more money than intended so far this year. NHS Grampian say they had overspent by £1.9m by the end of June. NHS Lothian say they had overspent by £2.7m by July, but that the board did not foresee increasing its current savings target. Collectively, Scotland’s health boards are having to make savings in excess of £270m to break even, according to information submitted to the Scottish Parliament earlier this year.
  
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Pulse

• Commissioning shake-up could be extended across UK. Plans to hand GPs a central role in NHS commissioning could be extended beyond England, with both the Scottish and Northern Irish governments set to re-assess their own health policies in light of the health White Paper. The dramatic move comes as both GPs and ministers in the devolved nations insisted the UK-wide GP contract could be preserved, despite the coalition's plan to tie a substantial proportion of GP income in England to commissioning targets threatening to drive a wedge between the four different countries' health policies. The devolved governments in Scotland and Northern Ireland said this week they are determined to hold on to the UK contract - and even appear willing to consider changing course on their own policy to retain some common ground with England. But the Welsh Government, which has already overseen the complete separation of commissioning and provision in Wales, said it had 'no plans to enable GPs in Wales to commission services'. Scottish health secretary Nicola Sturgeon said earlier this year that future contract negotiations would need to reflect the fact that policies north and south of the border were increasingly going their separate ways. But in a marked shift in tone, the Scottish Government has now pledged for the first time to discuss the possibility of introducing greater GP involvement in commissioning, as it looks at how to adopt aspects of the English White Paper north of the border. The Northern Irish government said it too would look at how to adapt aspects of the White Paper to its own policy. GPC Scotland chair Dr Dean Marshall said the Scottish Government may be looking for 'wriggle room' by pledging to look at commissioning, in case the policy becomes a success in England, and they decided to adopt it in the future.
  
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Tuesday 17th August 2010

Get Bracknell

• Health crisis over job cuts. A union has warned of a “healthcare crisis” in the Thames Valley after another hospital announced job cuts. The GMB has warned the Royal Berkshire Hospital’s (RBH) plans to remove up to 600 jobs over the next three years could compound the effects of cuts in posts planned by Heatherwood and Wexham Park hospitals. The RBH, which offers accident and emergency services to Bracknell and Wokingham people, announced the plans, warning that if it did not take action to arrest its financial problems it could face sanctions from hospital watchdog Monitor. Heatherwood and Wexham Park Hospitals NHS Foundation Trust announced plans in June to scale back its staff by cutting 470 posts as part of a long-running plan to turn around a deficit of £20m. It means, of the four hospitals serving Bracknell, only Frimley Park near Camberley is not making cuts. Since the closure of the accident and emergency department at Heatherwood last year, the RBH is the closest hospital with an accident and emergency department for most parts of Bracknell Forest.
  
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Financial Times

• Hard times call for a new rebate on PFI deals. Jesse Norman, MP for Hereford and South Herefordshire, writes: In this time of fiscal retrenchment, all parts of government must do their bit. But the private finance initiative, in particular, offers potentially huge savings. I have launched a campaign for contractors to contribute a “rebate” to the public purse, by reducing the interest payments they receive from public institutions. Some £210bn of PFI capital assets remain outstanding. A McKinsey study last year suggested that a reduction in interest charges paid to contractors by NHS hospitals of just 0.02 or 0.03% could save £200m. Taken across all existing contracts even this modest rebate could save £500m-£1bn. It is important to note that these savings would not go to the Treasury, but would instead be remitted back to each hospital or school. Mere encouragement from government might be enough to do the job, for the government has many points of contact with the different PFI consortia. Just as importantly, many investors in these companies are themselves public authorities. They may find it convenient to push fairer treatment for projects, rather than allowing contractors to make huge sums at a time of austerity. The idea that our public services are getting a bad deal here is gaining momentum, with the chief economist of the King’s Fund health think-tank recently calling for the NHS to renegotiate its PFI commitments. Indeed, there is a direct precedent for exactly this sort of rebate in the so-called “voluntary code”. The code was agreed in 2002 after several PFI providers made huge windfalls refinancing deals. Under it, 30% of gains from existing projects were returned to the taxpayer. The ratio is 50% for new deals.
  
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Lancashire Evening Post

• Petition rallying cry to try to save mental unit. A woman who has been treated at a mental health unit which is facing the axe will be collecting signatures for a petition to try to save the facilty from closure. Louise Daley, 55, of Avenham, Preston, has bipolar disorder, which is a form of manic depression and she has been admitted to the Avondale Unit based at Royal Preston Hospital several times over the years. Louise is outraged at Lancashire Care NHS Foundation Trust’s decision to close the unit at the end of the year and is joining the campaign to save it from closing.
  
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Healthcare Republic

• GPC in 'driving seat' on GP commissioning, says adviser. The GPC is 'in the driving seat' to make demands in this year's contract negotiations, according to a former health adviser to Tony Blair. Paul Corrigan, now an independent health consultant, says the BMA will push its anti-marketisation campaign when negotiations to make GP commissioning compulsory start. His comments came as health campaigner John Lister said the BMA was making a ‘historic mistake’ by engaging with the DoH’s White Paper reforms. ‘I very much hope that the BMA will take immediate steps to strengthen the very limited critique which seems to inform its current policy,’ he wrote in a letter to BMA chairman Dr Hamish Meldrum. He said the BMA stance put a ‘fig leaf of credibility’ over Conservative plans to privatise large swathes of the NHS. GPC chairman Dr Laurence Buckman said he opposed the DoH’s ‘any willing provider’ policy, but did not think the BMA could stop it. The BMA is still ‘finding out what things mean’, and responding to White Paper and GP commissioning consultations, said Dr Buckman.
  
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• GP at first Darzi centre facing closure warns on APMS contracts. A GP in charge of the first Darzi centre to face closure has warned the profession of the dire implications of APMS contracts. The Alma Road Primary Care Centre in Peterborough has been given six months’ notice to close as the city’s PCT looks to generate savings. APMS contracts contain a ‘no cause’ clause meaning the PCT can cancel the contract without giving any reason. Dr Rupert Bankart, medical director of 3Well Medical, the GP-led firm running the health centre, said many more GPs would face the same fate. According to data from 2009, there are 173 practices in England that operate under APMS deals, which allow non-clinicians to hold the contracts. The recent White Paper Liberating the NHS signalled a move towards a single GP contract which will include aspects of APMS. The Alma Road health centre currently sits in a temporary building. It is one of 150 GP-led health centres built under the last government’s plan to set up one in each PCT. The BMA argued as the centres were being developed that they would be costly and surplus to requirements. The GPs at 3Well Medical say they have little grounds for appeal legally because they were unable to remove the ‘no cause’ clause during tendering. They hope the support of patients, local councillors and GP consortia may help their cause.
  
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Monday 16th August 2010

Guardian

• The magnificent PFI wheeze goes wrong for the NHS. The bonanza for some private sector firms is now translating into significant funding problems for the health service. The private finance initiative (PFI) was a wheeze devised by the Conservatives. It flourished under Labour. In the days in which public policy was dominated by concerns about the size of the public sector or the public sector borrowing requirement, the PFI was seen as a means of funding public sector capital needs, but defining this as private rather than public debt. Successive governments used PFI to mask the expansion of public debt. The optimistic authors of PFI believed that continuous increases in affluence would enable society to pay the excessive costs of this subterfuge. The obvious analogy for PFI is a mortgage where you initially think it is affordable on the optimistic basis of short-term growth in personal income, but then disaster strikes, income growth collapses and repayment becomes a nice challenge. The PFI contracts are very detailed, providing not only for the construction of new hospitals and schools but also for their maintenance, cleaning and other services. Some of these contracts cost several million pounds to draw up and, once agreed, tie contractors to often onerous payments for 30 years and more. Furthermore, they include clauses facilitating the passing on of costs to the NHS when, for instance, national standards of cleaning or safety change. Now the NHS faces declining real income. Of course the Con-Dem coalition is saying the NHS budget is ringfenced. However, this fence is porous. First, the NHS will have to pay increased VAT and national insurance rates. Second, the ringfencing may be eroded by inflation. Third, government cuts in local authority spending mean that social care funding will have to be augmented by transfers from the NHS to council budgets. If this does not happen, "bed blocking" will reduce hospitals' capacity to manage increasing patient demand. Last week it was announced that £500m would be transferred from NHS to social care funding.
  
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Daily Mail

• Doctors face £10,000 cut in NHS bonus squeeze. Doctors face a £10,000 pay cut in a major revamp of the NHS bonus system after concerns that they are spending too much time working for the private sector. Health Secretary Andrew Lansley will shake up the profession by announcing a review of the controversial ‘distinction awards’, which reward senior consultants with bonuses on top of their high salaries. The annual bonuses – worth more than £75,000 for some – cost the NHS £230 million last year. Mr Lansley will announce on Wednesday that the Doctors and Dentists Review Body – which sets pay and bonuses – will have to reduce the millions paid out to doctors.
  It will be told to make the system ‘fairer’, which could see other NHS workers eligible for bonus payments. Mr Lansley is under pressure to scrap the current bonus scheme amid concerns that doctors are spending too much time working for the private sector. The new scheme would cut bonuses by as much as 15 per cent, with some doctors losing more than £10,000 a year. Last night, an NHS source said: ‘We need to bring down the cost of the system while looking at the possibility of extending it to include other hard-working NHS workers. To pay for this, we would have to take away money from consultants.’ A spokeswoman for Mr Lansley said last night: ‘The awards will be looked at. We want to reward consultants who provide an exceptional service for the NHS, but we need to ensure we are doing so in a cost-effective way.’
  
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Pulse

• GP consortiums will take 'several years' to make savings. The current state of GP commissioning is weak and GPs are likely to take ‘several years’ to develop the adequate skills to hold the £80bn purse strings of the NHS, according to a health policy think-tank. The analysis of the coalition Government’s plans for sweeping NHS reforms by the Nuffield Trust dismisses GPs’ ability to lead commissioning, and concludes that there is ‘a real concern whether this level of reform can be implemented without risk of major failure’. The proposals in the White Paper ‘carry significant risks’ the report warns, as PCT commissioning is weak and GP commissioning consortia are likely to take several years to develop adequate skills for the job.’ Pulse recently revealed that a quarter of GPs have already begun to spearhead the takeover of commissioning by entering into talks with their PCTs in order to increase take on more commissioning responsibilities. But the report claims that GP consortiums will lack the financial nous to take on the role, as they are ‘used to acting as small businesses, not large conglomerates handling millions of pounds.’ ‘To make efficient savings in the NHS and improve quality, it is widely recognised that more effort should be made to prevent costly hospital care where avoidable, through integrated care. ‘The ability of underdeveloped GP consortiums to make these changes, in part through commissioning negotiations with hospitals, is very doubtful in the short term. ‘This poses the considerable risk that consortiums are unable to manage demand within the budget allocated, and incur deficits.’
  
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BBC

• More than 500 NHS jobs to be cut in north-east England. More than 500 managers and administrators face redundancy in a huge shake-up of the NHS across the north-east of England. The proposed cuts will affect NHS trusts on Tyneside, Wearside, County Durham and Teesside and aim to deliver annual savings of £27m. NHS North East said it hoped to avoid significant compulsory job losses. Union leaders expressed concern at the planned cuts, arguing managers carried out "important NHS functions". David Stout, executive director of finance and communications at NHS North East, said: "Like all public sector organisations, the NHS in the region must deliver substantial savings in order to meet the challenges of a difficult economic environment. "The management cost reductions we have outlined will inevitably impact on many people and we are of course committed to keeping staff fully informed throughout this difficult process. "The savings made will be reinvested directly in front-line NHS services so that we can meet the future challenges of coping with an ageing population, the introduction of new treatments and technologies and increasing our focus on prevention." The proposed savings are due to take effect from April 2011.
  
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London Today

• Patient care facing cuts as hospitals struggle to pay private finance debt. Three London hospitals have been left so debt-laden by the Private Finance Initiative they are spending more than an eighth of their income on repaying “loans”, it emerged today. The South London Healthcare NHS Trust, which includes Bromley Hospital, Queen Elizabeth Hospital in Woolwich and Queen Mary's in Sidcup, uses 13 per cent of its money to cover debts rather than treat patients. The hospitals have projected deficits of £36 million this financial year. They are locked into paying back the money the private firms spent building them and are paying for maintenance, cleaning and catering in 30-year contracts. New hospitals across England have this “NHS mortgage”, with the total national PFI debt now £65 billion over the lifetime of the schemes, new figures show. The hospitals were worth £11.3 billion when first built. Hospitals are so expensive to build that PFI has been seen as the best answer. But the non-negotiable debt fees, which rise each year, mean government demands to slash spending can only be met by cutting patient care, economists said. South London Healthcare NHS Trust said there are “undoubtedly some constraints from having these fixed costs”. Now the financial crisis has changed conditions beyond recognition, trusts tied into PFI deals have even less freedom to make business decisions that protect services, making cuts and closures more likely.” The Department of Health said the schemes were providing “value for money” and were “affordable”. A spokeswoman added: “One of the benefits of PFI is that the buildings are always contractually required to be kept in good condition. Good maintenance will always cost more than not maintaining facilities to a high standard.”
  
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Friday 13th August 2010

Blackpool Gazette

• Hospital beds to go in service shake-up. Hospital bosses have confirmed Clifton Hospital will not be closing – but 24 beds are to be lost along with 40 jobs. Chiefs at Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust have insisted they have "no plans to close" the hospital, which provides renal care and dermatology services. The reassurance comes after concerned patients heard rumours the hospital was to shut. But bosses say they are changing some of the services at the hospital. The changes will mean a loss of 40 jobs at the hospital, but the trust says it "is committed to no redundancies." Staff are being interviewed to discuss whether they want to work in a new orthopaedic rehab unit at Clifton or would prefer to work elsewhere in the hospital trust. One 24-bed ward, which was temporarily closed in October last year for refurbishment, has remained closed as rehabilitation care for the elderly was provided from other facilities.
  
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Witney Gazette

• Doctors issue warning on mental health cuts. Top mental health consultants have voiced “grave concerns” about proposed cuts to mental health services in Oxfordshire in a letter. About £5.3m worth of service cuts are being planned to hit Oxfordshire, which could result in a 19% reduction in frontline and administration staff. The Oxfordshire and Buckinghamshire Mental Health (OBMH) trust plans to make the savings by 2014. A letter sent anonymously, but signed on behalf of six key mental health consultants, has outlined serious worries about cuts to front line staff, home visits and risk to patient care. Unison Health Oxfordshire called an emergency meeting to discuss a plan of action.
  
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Darlington and Stockton Times

• PCT criticised over ‘sham consultation’ on health cuts. A row has broken out over how people have been allowed to respond to a proposal to close minor injuries units at three community hospitals. A 12-week period is under way to gather views and hear concerns that people have about the plans to axe the minor injuries services at the Friary, Richmond, the Lambert, Thirsk, and St Monica’s, Easingwold. The plans have caused concern in rural areas, with fears that other services may be downgraded, resulting in journeys to Darlington, Northallerton or York for anyone needing help at night or at weekends. But a senior county councillor has accused NHS North Yorkshire and York of conducting a “sham consultation”
  
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Haringey Independent

• MP puts pressure on NHS to halt Horsney clinic closure. MP Lynne Featherstone has called on NHS Haringey to halt plans to close a Hornsey walk-in clinic revealed this week. The Hornsey and Wood Green MP said closing the 8am to 8pm walk-in service at Hornsey Central Neighbourhood Health Centre, in Park Road, without consultation was "unacceptable". The scheme was running as a pilot that started in April and was due to end in July and its success would be reviewed. But health chiefs said there was no chance of the pilot continuing because it could not afford to fund the walk-in clinics. NHS Haringey has extended the pilot for an additional month to give it time to break the news to patients.
  
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Pulse

• Private providers 'should be paid less for less complex work'. Independent sector treatment centres should be paid less to reflect the fact they treat less complex patients than NHS providers, according to leading health economists. A national analysis of all elective procedures carried out in NHS hospitals and ISTCs showed that the NHS has been left to deal with the most complex elective procedures, prompting the researchers to urge the Department of Health to pay private providers less and create a ‘fair reimbursement system’. Critics of private providers have often accused them of unfairly profiting from ISTC contracts by specialising in a small number of high volume procedures, such as hip replacements or cataract removals, and avoiding taking on more complex – and costly – operations. A team at the University of York analysed hospital episode statistics for 30 different procedures performed on every NHS and private sector-treated patient in England in 2007/ 8. Only 93,000, or 1.3%, of all elective procedures were carried out in ISTCs – fewer than the 250,000 per year originally anticipated by the DH, and far fewer than the 6.7 million carried out in NHS centres. Researchers then compared the complexity of patients treated. Across all 30 procedures - which account for more than 80% of ISTC work - patients treated in the private sector had significantly fewer recorded diagnoses, significantly fewer procedures and came from significantly less income-deprived areas. Under new contractual arrangements ISTCs will be paid according to the same Payment by Results tariff as NHS providers for particular types of operations. But the researchers argued that paying private centres less, to reflect the less complex patients they treat, would be fairer. A second analysis of coding quality found that 36% of all procedures were not properly coded. Ms Mason said: ‘If treatment centres don’t code their work properly, it’s impossible to assess what patient care has been delivered and, therefore, to hold private providers to account in their use of NHS funds.’
  
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• Talks between GP groups fail to bring consensus over commissioning plans. Frantic behind-the-scenes talks are being held between national GP groups in a seemingly impossible bid to reach some consensus over the Government’s plans for commissioning. Organisations including the RCGP, the NHS Alliance, the National Association for Primary Care and the Family Doctor Association have been meeting to try to thrash out common ground, as the Government consultation on the plans splits the profession. However there are huge differences to resolve, with some senior NHS Alliance figures now calling for the Government to shelve its plans to scrap all PCTs by April 2013, claiming that some trusts should be allowed to remain in place, if not permanently, at least until GP commissioning groups have proved themselves capable of taking over. The NAPC has blasted the suggestion, arguing that with every day that goes by, tens of millions of pounds of NHS money is being wasted and urging the Government not to dilute its plans. NHS Alliance leaders have been trying to convince other GP groups that the Government’s plans are overambitious and that it should instead launch a series of pilot schemes in areas where GP commissioning is the most advanced. The RCGP and the Alliance yesterday launched a major consultation exercise with GPs to gauge grassroots opinion, with plans for a joint submission to the official Government consultation, which ends in October. NHS Alliance GMS lead Dr David Jenner said talks between the various GP factions had found much common ground, with broad support for the general direction of travel of commissioning. But major differences remain over the timescale and extent of the changes, including the plans to cull PCTs.
  
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• Trusts risk wrath of Lansley as they ignore GP opposition to hospital closures. NHS managers are ploughing ahead with plans for massive cutbacks to services in the face of GP opposition - despite health secretary Andrew Lansley’s claim that GPs should have the final say over any major service reconfiguration. The BMA, the NAPC and the Family Doctor Association have all told Pulse that trusts in different parts of England have been forging ahead with proposals, including the closure of hospital A& E departments, maternity units and children’s services, against the wishes of the local GPs. In Kent, the Maidstone division of the BMA today called for the immediate intervention of the health secretary, claiming he was being made to 'look stupid' by local NHS managers. Maidstone and Tunbridge Wells NHS Trust, backed by NHS West Kent, is pressing ahead with plans to close the maternity and paediatric services at Maidstone hospital, and to transfer them next summer to a new PFI hospital in Pembury. Yet a survey of local GPs shows overwhelming opposition to the plans. The GPs’ intervention in Kent comes on the same day as the BBC revealed the NHS in England faces a massive £65bn bill for new hospitals built under the controversial PFI initiative, with trusts left with annual repayments accounting for more than 10% of their turnover. In a recent letter to all trusts, NHS chief executive Sir David Nicholson made it clear all service reconfigurations must have 'support from GP commissioners'. In the capital a string of trusts in northeast London are pushing ahead with plans to close the A& E unit at King George Hospital in Ilford, claiming that the majority of the workload can be switched to polyclinics, despite a string of LMCs expressing their outrage at the plans.
  
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Thursday 12th August 2010

HSJ

• Two bidders left in NHS hospital franchise race. The outcome of a competitive process that will see a private firm involved in the running of an NHS hospital for the first time is expected to be announced before the end of the year.Two bidders remain in the running for the operating franchise for Hinchingbrooke Health Care Trust after Ramsay Health Care UK dropped out last week, NHS East of England has confirmed. Details of bids from Circle Health and a joint venture between Serco Health and Peterborough and Stamford Hospitals Foundation Trust are being further reviewed by the strategic health authority, trust and commissioners during the summer.The shortlist was reduced from six to three in March, although 11 organisations had originally expressed an interest. SHA director of strategic projects Andrew MacPherson said it was decided Ramsay’s plans were no longer suited to the trust’s circumstances. No details of any of the plans have so far been made public. He said a final invitation to tender would be issued in October and a decision made public in November or December. An NHS East of England spokesperson said: “Circle Health, Serco Health and Ramsay Healthcare were invited to submit bids as part of the second stage of invitation to participate in dialogue. Circle Health and Serco Health have submitted bids which meet [the invitation to participate] requirements and these are now in the process of being evaluated. “Ramsay Health Care, the third bidder, has chosen to submit a bid which does not meet those requirements, therefore it is not possible for [that] bid to be evaluated and they will not be taken to the invitation to tender stage.” The trust, which runs a small district general hospital in Cambridgeshire, has struggled financially and is thought unlikely to reach foundation status in its present form. Unions have criticised the decision to tender the franchise to the market.
  
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• Pessimistic foundation trusts set tough savings target. Foundation trusts are expecting their income to drop by an average 0.8 per cent a year from 2010-11 to 2012-13. The negative forecasts are set out in foundation trust annual plans submitted to their regulator Monitor. It is thought to be the first time the foundation sector has anticipated income reduction rather than growth. In the recent past Monitor has criticised foundations for assuming cuts in NHS tariff prices can be offset by simply increasing workload volumes. Last year, former executive chair Bill Moyes said such growth assumptions amid the recession meant roughly a quarter of foundation trust annual plans were “absolutely worthless”. This year the least optimistic foundations are acute trusts, which are anticipating a compound annual income growth rate of -1.1 per cent between 2010-11 and 2012-13. Specialist trusts are the most optimistic, forecasting average annual growth of 1 per cent. Monitor portfolio director Jason Dorsett said the pessimism in the acute sector was likely to reflect the marginal tariff, which sees trusts paid just 30 per cent of the tariff rate for cases over their 2008-09 volumes.
  
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Pulse

• Commissioning challenge laid bare as analysis reveals PBC cost £250m more than it saved. The huge challenge GPs will face in taking on £80bn of NHS budget has been laid bare by a Pulse investigation finding practice-based commissioning has cost hundreds of millions more than it has generated in savings. Our analysis of PBC since its inception in 2005 found GPs will take on budgets on a hugely uneven playing field, depending on whether GP commissioning has become established in the local health economy. Go-getting GPs in a handful of areas with well-developed commissioning economies have developed numerous services and saved millions of pounds. But in the vast majority of the 100 PCTs that responded to Freedom of Information Act requests, PBC struggled to reshape services and cost far more than it saved. Across the 100 trusts, £290m was spent on PBC since its launch in 2005 – on managerial support, data management, incentive payments and support from private companies – yet only £133m was saved. Extrapolated across the 152 PCTs in England, PBC was likely to have cost £441m and saved £198m – a deficit of £243m. Our investigation underlines the size of the task that will be handed to GP consortiums in England, following the planned abolition of SHAs in 2012 and PCTs in 2013. The findings are likely to alarm many GPs, as the Department of Health plans to tie a proportion of practice pay to the ability of consortiums to stay within budget. They may also fuel the belief among many GPs that the DH should not have pushed ahead with its commissioning plans without piloting first.
  
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• Post-Shipman fitness-to-practise overhaul falls victim to cuts. The Government is set to scrap plans for a massive shake-up of GP fitness-to-practise hearings, in a move it claims will save the NHS more than £60 million by avoiding an unnecessary new layer of bureaucracy. In the latest in a string of Labour initiatives to face the axe, proposals for an independent tribunal called the Office of the Health Professions Adjudicator (OHPA) appear to be doomed, after Treasury forecasts claimed the costs risked spiralling. A consultation published this week sets out three options for the future, with the Government's preferred option enabling the GMC to keep control of fitness-to-practise hearings, but on the condition that it slashes the bureaucracy and red tape involved in a bid to keep a tight lid on costs. The previous administration's post-Shipman regulation agenda has become a prime target for NHS cost-cutting in recent weeks. The GMC recently announced plans to streamline its revalidation process after Pulse revealed the Government was determined to slash the costs.
  
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Morning Star

• Hospital cuts 'put cancer care at risk'. Savage hospital cuts will mean that key targets for cancer care will not be met, the foundation trust regulator has warned. The annual plans submitted by Monitor revealed that a quarter of the country’s 129 foundation trusts (FTs) fear that hospital cuts will cause them to miss waiting time targets for treating cancer and the control of superbugs. More than 20 trusts said they may not be able to meet performance standards such as the maximum 62 days between GP referral and treatment for cancer. Eleven of the FTs admitted fears that they would be unable to adequately control superbugs such as MRSA and C.difficile, while a further three mental health trusts voiced concerns about meeting care targets. Monitor showed there would be a drop in trusts’ income for the first time of between 0.8 and 1.1 per cent by 2012-13. It also said unprecedented "cost improvement plans" would be required of trusts, which would need to make massive savings of 4.4 per cent this year compared to last year’s 3 per cent. Campaigners are expecting that care will be rationed and some operations could be ruled out altogether as a result of the financial strain. Campaign group Health Emergency chairman Geoff Martin said: "These shocking figures, coming before massive cuts across the NHS that we are expecting this autumn, nail the lie that the health service is somehow immune from the Con-Dem public services spending assault. "We can expect what is happening with cancer services to be replicated across the whole range of treatments and procedures as we head back to the bad old days of waiting lists and trolley queues in A& E. "Nobody should underestimate the scale of the crisis that’s brewing up in the NHS as we head towards the busy winter period." Monitor chief executive Steve Bundredsaid the annual plans reflected trusts’ “welcome dose of realism about the prospects they face."
  
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Tottenham Journal

• Out of hours GP service goes private. The out-of-hours GP service has been taken out of the hands of doctors - and handed to a private company. It has emerged that health chiefs have decided to take the service - which enables patients to see a GP in the evenings and at weekends - away from the co-operative of family doctors that has been running it for 12 years. In March, NHS bosses announced that health chiefs would continue to pay the not-for-profit cooperative, Camidoc, to continue providing evening and weekend care across Haringey, Camden, Islington, Hackney and the City. But now health chiefs have decided to take the contract away from Camidoc. They have instead entered into talks with private company Harmoni Ltd - which claims to specialise in out-of-hours care - to provide cover while a contract is re-tendered. The decision has devastated anti-privatisation campaigners. Maeve O'Connor, secretary of Camden Keep Our NHS Public, which campaigns for health services across north London, said: "Our group is horrified to hear that the contract has been revoked after they promised it was going to Camidoc. "It's very bad indeed that it's going to a private company. There is too much privatisation of health services going on and it looks like it's going to get worse." But Camidoc has also come under fire over the years - most particularly in 2005, when Islington journalist Penny Campbell, 41, died from multiple organ failure caused by septicaemia. In the four days before her death, she contacted Camidoc eight times - but its doctors failed to recognise the seriousness of her illess. NHS Camden said the contract was being taken away from Camidoc because of financial concerns. A spokesman said: "NHS Camden, NHS Islington, NHS Haringey and NHS City and Hackney can confirm that a new contract with Camidoc to provide a GP out-of-hours service will not be going ahead. The decision was based on issues around the ongoing financial viability of Camidoc and the proposed changes in government policy.
  
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Tuesday 10th August 2010

Guardian

• NHS funding should not be ringfenced, says citizens' jury. The government should rethink ringfencing funds for health and international development, consider appointing a "minister of the deficit", and do more to explain the need for a debate on which services should be cut, PricewaterhouseCoopers recommend. Those are the conclusions drawn from the research by the accountancy firm. PwC also warns against plans to involve ordinary people in drawing up proposed cuts ahead of the comprehensive spending review on 20 October, because members of the public feel they have "no real idea" what they are being asked to do and are ill equipped to participate. This, says the firm, will make people less likely to accept decisions put to them in the autumn. The government has drawn on the lessons of Canada and Sweden where support for drastic budget cuts are secured by educating and involving the public. People have been asked to send their suggestions to a new Treasury website and, from this week, the public will be asked to rate the ideas. PwC brought together a 24-strong citizens' jury to spend three and half days debating money-saving ideas, and polled another 1,780 people to gauge how well members of the public understand what the government has asked them to do.
  
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Healthcare Republic

• DoH announces review of Dr Foster Intelligence. The DoH has announced that the future of Dr Foster Intelligence, one of the UK's main providers of health information, is under review. The DoH was criticised by the Public Accounts Committee in 2007 for paying £12m for a 50% share in Dr Foster Intelligence even though DoH advisers valued it at £10-15m. Dr Foster Intelligence was launched in 2006 as a joint venture between the NHS Information Centre and Dr Foster Holdings LLP. The DoH owns a 48.75% stake with the rest held by Dr Foster Holdings LLP. The review is in line with the coalition government’s policy to maximise the value of assets and commercial opportunities.
  
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Halifax Courier

• Axed for making us healthier. NHS Calderdale has smashed all its health targets – just weeks after learning it faces the axe. The primary care trust has outstripped its goals in tackling obesity, smoking and drinking, and reducing hospital stays for over-65s. The news has prompted fresh scrutiny of Government plans to scrap England's 152 PCTs and hand over their powers to GPs. John Cafferty, regional head of health for UNISON, said: "It was quite clear from the evidence coming back that PCTs were gradually beginning to have an effect on a number of identified health problems across the country. It's just mind-boggling that a Government comes in and in one fell swoop smashes the organsations that were delivering results." Andrew Lansley criticised goal-setting within the health service. His plans for a radical overhaul of the health service, announced last month, aim to cut costs and bureaucracy. The shake-up is described as the biggest in NHS history and would put hundreds of Calderdale jobs at risk. At the latest NHS Calderdale board meeting, members supported a move to become an "early adopter" of the proposed changes. But Bob Heys, a former consultant at Calderdale Royal Hospital and member of patient forum Calderdale LINK, is calling for the scheme to be tested on failing PCTs before it is rolled out. He said: "If it's handed over to GPs, they'll have to put on staff to assist with the administration tasks so it's doubtful whether it will save cash. I think that's why it's necessary to have pilot studies to see both the financial and care consequences. It seems a great pity if the PCT is doing well that it should be abolished."
  
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Bolton News

• Community bus to health centre given the axe. A community transport service which gives people cheap access to a Bolton health centre is to be axed because it is not “commercially viable”, health bosses say. NHS Bolton, the borough’s Primary Care Trust, says it will not fund the North Bolton Local Link service because it does not make enough money, even though 2,500 people use it. As reported in The Bolton News, the service, which provides a direct taxi to Crompton Health Centre at bus fare prices, was given a stay of execution last week when transport bosses agreed to fund the service for a further three months while they negotiate with NHS Bolton.
  
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Leicester Mercury

• 'It would be a tragedy if children's heart centre at Glenfield Hospital closes'. An MP has said it would be a "tragedy" if the children's heart centre at Glenfield Hospital closed. Keith Vaz is among MPs who are backing the Mercury's campaign to save the service, which it is feared could shut as part of an NHS review. The review, being carried out by the National Specialised Commissioning Group, could see England's 11 children's heart centres reduced to seven. If the one at Glenfield is closed, patients and their families from Leicestershire and across the East Midlands will have to travel to Birmingham, Leeds or London for treatment. The group will publish its recommendations next month ahead of a public consultation in October. Leicester South MP Sir Peter Soulsby said cost-cutting must not be a driving force behind the review. About 30,000 people have signed a petition spearheaded by Heart Link to save the centre at Glenfield. Watchdogs the Leicester City and Leicestershire local involvement networks (Links) have joined forces to make sure they are ready to fight any recommendation which does not see Glenfield being kept.
  
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Nursing Times

• Private patients in NHS hospitals 'galling' for nurses. Expanding private healthcare in NHS hospitals could be “galling” for nurses and lead to conflict, a union leader has warned. The government has said it will lift the cap that prevents many foundation trusts from significantly expanding the number of private patients they treat. Unison, which has campaigned against the cap being lifted, fears the change will mean more private patients are treated in NHS hospitals. The union’s head of health Karen Jennings said: “Allowing hospitals to generate more money from private patients could undermine the very foundations of the NHS. Nurses will always act professionally. However, some may find it galling to work in a two tier system, where people with deeper pockets jump the queue. In hospitals with more private patients, there is a danger that the relationship between nurses and patients will change, leading to conflict. When someone has paid, they may feel that they have the right to priority attention.”
  
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Monday 9th August 2010

Islington Tribune

• Fears for hundreds of NHS and GP jobs as Camidoc contract is torn up. Hundreds of GPs and NHS staff have been warned their jobs are on the line after Islington’s out-of-hours doctors contract was torn-up and awarded to a private firm. Camidoc, a consortium of local doctors providing care across Islington when surgeries are closed, has been dumped amid concerns over its “ability to manage its finances” and “changes in government policy”. Doctors have rushed to the defence of the not-for-profit “clinicians on call” service, arguing it has not been properly funded under terms of a new deal agreed with health bosses in March. Hertfordshire-based Harmoni Ltd – one of the fastest-growing health firms in the country – is expected to run the service on a nine-month temporary contract from October 1. A leaked memo from Camidoc’s interim chief executive James Hood to staff said: “The reasons given boil down to their loss of confidence in Camidoc’s ability to manage its finances – they were very clear that there are no concerns about either the quality or the safety of our services.” Camidoc was hired in March by the four north London Primary Care Trusts – Camden, Haringey, Hackney and Islington – but Mr Hood’s memo said it no longer had their full support. The Tribune understands Camidoc ran into the red after demand for the service rocketed by 30 per cent. On March 25, 2010, NHS Islington’s acting chief executive Helen Pettersen said: “In awarding the out-of-hours contract to Camidoc we will ensure the continuity and high standard of service that I know local people value.” In fact, Mr Hood’s memo said the NHS Consortium had not signed the contract, leaving them in the clear to cancel the deal. His message said: “I realise that for most of you this may come as an unpleasant shock, and many of you will now be very worried about your jobs. I cannot give anyone any guarantees, but I will say that no one is saying these services should no longer run.” Candy Udwin, from Keep Our NHS Public, said: “This is exactly the kind of thing this government wants – for more private companies to take control of chunks of the NHS.” A joint statement from the consortium read: “We can confirm that a new contract with Camidoc will not be going ahead. The decision was based on issues around the ongoing financial viability of Camidoc and the proposed changes in government policy.”
  
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Pendle Today

• Pendle Community Hospital 'closure' rumours quashed. Rumours surrounding the future of Pendle Community Hospital have been quashed by directors following claims the centre is to close. A memo believed to have circulated among staff at the Leeds Road site suggested there may be a review of rehab and intermediate care. Although East Lancashire Hospitals NHS Trust has denied the claims, the trust announced it is facing "challenging economic times". The trust director of service development, Mr Martin Hodgson, said: "Given the challenging economic times we all face, the trust must consider options which will enhance both the quality and efficiency of the services it delivers to its patients. "There are no plans to change the services delivered at Pendle Community Hospital in the immediate future." But regional officer for Unison Mr Tim Ellis said there was "potentially a threat", adding: "We understand the trust is being required by the government to reduce spending. We would be very concerned at any proposals to reduce health service provisions and are certainly contesting these proposals which would affect the public most vigorously."
  
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Pulse

• Extended hours set to disappear as PCTs review funding. Almost two-thirds of GPs offering extended hours will stop next year if PCTs remove funding, with over half of trusts considering withdrawing local funding in light of the Government’s scrapping of national access targets, Pulse can reveal. Health secretary Andrew Lansley recently announced his intention to abolish the national target for 50% of practices in each PCT to provide extended hours as part of his bonfire of NHS targets. And a Pulse survey of 350 GPs currently providing extended opening, only one in seven said they would definitely continue to work early morning, evening and weekend shifts if funding was withdrawn - with the remainder undecided. Freedom of Information responses from 107 PCTs shows that over half of trusts are reviewing their use of extended hours LES’s for next year, with many likely to scrap funding if the national DES is removed following the abolition of the target. Only a quarter of the 98 trusts currently offering extended hours said they would definitely offer the service next year, with the majority set to re-examine their service and one in five yet to decide whether to review arrangements. These included NHS Hounslow, which said: ‘in light of the White Paper [the] Enhanced Services budget is likely to be reviewed with PBC Consortia’, and NHS Cambridgeshire, which said it would ‘review according to changing national priorities’. Dr Michael Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon, said GPs should be wary of giving up extended hours if it went against their patients’ wishes, regardless of how it’s funded. He said: ‘In an ideal world, each practice should be talking to its patients, rather than to Government targets. ‘Clearly, patient experience will enter the payment structure in one way or another even if not through the extra extended hours DES.’ He added it may also see some practices losing patients to practices that do offer the service, particularly when practice boundaries are abolished. ‘Practices that have wider opening hours are going to more competitive than the ones that don’t. So I suppose it’s a caution to those that are thinking of going back to what they had before.’
  
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BBC

• York Hospitals NHS trust needs to make £30m in savings. York Hospitals NHS Foundation Trust says it needs to make £30m in savings over the next three years. The trust, which runs York District Hospital, said the decision had been made in response to "financial pressures" facing the health service. Chief Executive Patrick Crowley said: "We have asked all of our staff to tell us their ideas for how money can be saved." He added staff car parking charges had been increased to raise income. A trust spokeswoman said it hoped the need for job losses would be avoided and front-line services could be protected.
  
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Friday 6th August 2010

Manchester Evening News

• Maternity hopes are dealt a further blow. Mums in Salford say they are ‘disappointed’ that a review of a controversial decision to close the maternity unit will not include any new public consultation. Health Secretary Andrew Lansley said he was prepared to review the decision to close the maternity unit at Salford Royal. Health bosses at NHS North West will now look again at the region’s maternity care, but will not seek new evidence from mums-to-be. They will, however, review the evidence of more than 250,000 people gathered in 2005. But mums’ groups in the city say they will continue to fight for the new unit.
  
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Islington Tribune

• 25,000 sign up to save Whittington Hospital. Campaigners fighting cuts to the NHS delivered a petition of more than 25,000 thousand signatures to the Department of Health. The Defend Whittington Hospital Coalition has swung back into action after NHS bureaucrats revealed proposals to dismantle the Highgate hospital were not dead and buried. It is feared that North Central London (NCL) will start hacking away at the Whittington’s vital emergency services before the health authority is itself axed under Conservative Andrew Lansley’s NHS reforms. DWHC chairwoman Shirley Franklin said: “We are talking about disgusting, horrible and frightening changes to the NHS. We stand against cuts, privatisation, closures and any cuts to the mental health service. Since winning the election, Mr Lansley stopped NCL’s review and announced plans to devolve NHS spending decisions to GPs. And now health bosses have said they will resurrect their north London hospital closure plans if GP leaders agree. They will be looking to make even bigger savings than NCL was anticipating before the election – placing the A& E, maternity unit and crucial mental health services back under threat. Many believe private firms will snap-up major NHS contracts, with commissioners looking for cheaper options at every step.
  
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Healthcare Republic

• Plug pulled on private firm's contract to commission for PCT. One of the first deals for a private company to commission NHS services on behalf of a PCT has ended, a year early. UnitedHealth UK signed a three-year deal to help NHS Northamptonshire commission NHS services in 2008. But a spokesman for the PCT confirmed ‘both parties’ agreed to end the deal this month. The deal was agreed under Labour’s framework for the procurement of external commissioning support, which approved 14 companies to help PCTs deliver services. Firms are now hoping to work with GP consortia as they take on commissioning under the health White Paper from 2013. The White Paper is out for consultation until 11 October.
  
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Pulse

• GPs express fears over out-of-hours funding Only one in seven GPs believe they will be given sufficient funds to be able to commission out-of-hours care safely, a Pulse survey has found. The Government’s overhaul of the NHS will see GP consortiums assuming full responsibility for commissioning out-of-hours services in England from April 2013, under much tougher regulation than has been the case for PCTs. But GPs responding to Pulse’s survey have expressed serious concerns that consortiums will not be given adequate funding to commission services safely, due to the huge financial pressures facing the NHS. Of 410 GPs surveyed, two thirds said they were not confident they would be handed sufficient funds to commission out-of-hours safely, with just 14% believing they would be given adequate financial backing. The fears come after the Government’s primary care tsar Dr David Colin-Thome told Pulse last week that the sum GPs gave up in return for the opting out of out-of-hours provision in 2004 would not be reimbursed under the revamp, but that the money will remain part of the overall funds available to support commissioning of out-of-hours services. The survey also showed that only one in eight GPs will choose to provide out-of-hours themselves when the changes come into force, despite health secretary Andrew Lansley's recent forecast that many GPs would choose to provide when they assumed commissioning responsbility.
  
  

• PCT to become first in the country to close 'unneeded' Darzi centre. A GP-led health centre in Peterborough looks set to become the first in England to be closed down after it attracted fewer than half of the patients it was supposed to register. NHS Peterborough is planning to shut down the Alma Road Primary Care Centre, run by GP-led company 3Well Medical, to make an estimated £800,000 in savings, as it struggles to tackle a £12.8m debt. The GP-led health centre was procured as part of the Equitable Access in Primary Care programme spearheaded by Lord Darzi, which forced every PCT in England to procure one new centre, regardless of local need. A spokesperson for the Alma Road centre said the PCT's termination notice had been served under the 'no cause' clause of its APMS contract, but the centre has struggled to recruit patients. It had aimed to register 1,500 patients by April this year - but had by the start of last month recruited just 618. Dr Rupert Bankart, medical director for 3Well Medical, said the proposed closure was due to the PCT's financial situation. Pulse revealed in March that Peterborough’s GP-led health centre was one of the best-funded in the country, earning £297.94 per walk-in session irrespective of patient numbers. However at the time the PCT told Pulse it had no plans to revise the terms of its contract.
  
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• Revealed: The 30-year contract with Care UK which GP commissioners will have to honour. NHS managers have saddled GP commissioners with a 30-year contract for an independent sector treatment centre after controversially paying more than £8m to the private company running it as part of a deal to renegotiate terms. News of the deal comes as primary care tsar Dr David Colin Thome told Pulse GPs would be responsible for sorting through and where possible renegotiating contracts when they take over the majority of PCT budgets under the Government’s planned reforms. NHS Derbyshire County has cancelled a previous under-used fixed-term contract with Care UK, private providers of the Balborough Treatment Centre in Chesterfield, and paid £8.2m to purchase the building and sign a new 30-year deal with the same company. Once GPs take over local commissioning, they will inherit the contract and won’t be able to terminate Care UK’s lease. It is the latest in a series of cases where the NHS has paid a high price to modify deals with private companies, including NHS London’s £10m payout to suspend a contract with Clinicenta after ‘significant clinical failings’. The Balborough Centre opened in 2005 but its original contract was cancelled earlier this year, after it was paid £21.9m to perform only £15.1m-worth of orthopaedic surgery on patients in south Yorkshire, Derbyshire, Nottinghamshire and Lincolnshire. NHS Derbyshire has since renegotiated the contract with Care UK on a paid-per-patient basis and is paying the company a further £8.2m to buy the centre – and leasing it back to Care UK. NHS Derbyshire County confirmed when GPs assumed commissioning responsibility in 2012/ 3 they would ‘need to honour the agreed lease’.
  
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Public Service

• NHS sheds 11,000 jobs. Union leaders are threatening to take the government to a judicial review over the pace and scale of NHS reform after the number of health service job losses planned so far this year topped 11,000. The latest proposed cuts are at the Royal Berkshire NHS Trust where 600 posts are to be axed over three years as part of a bid to save £60m. The announcement follows measures already planned across the UK with more than 11,000 health service posts earmarked to be cut, downgraded or left unfilled by the 106 trusts to have submitted data to the Royal College of Nursing. There are fears that in total more than 40,000 jobs may be lost throughout the NHS in England alone. Unison, which represents more than 450,000 NHS employees claimed hospitals were being "pressurised into making rash decisions" by ministers driving a reform agenda that was still out to public consultation. In a letter to NHS chief executive Sir David Nicholson the union claimed the changes being imposed were unlawful because the consultation process was still ongoing and the public, patients, staff and unions had "not had a proper opportunity to have their say". Unison has asked for a response from the government within seven days. Jennings added: "If we are not happy with the reply we reserve the right to issue urgent judicial review proceedings."
  
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Guardian

• Government accused of 'promoting privatisation' of NHS. The government has been accused of "promoting privatisation" of the NHS after a surprise announcement of sell-off plans for an agency which provides thousands of nurses and other health workers to hospitals across the country. The department of health said it would explore options for private sector investment in the state-owned NHS Professionals, which has 50,000 workers on its books and places staff for two million shifts a year at 77 health trusts. Unions were furious over the sell-off. Karen Jennings, UNISON Head of Health, said that "the whole reason that NHS Professionals was set up was because private agencies were ripping off hospitals by charging them outrageous fees for recruiting or finding staff for shifts. It makes no sense at all to bring back private companies who will want their slice of the action in return ... This is purely about promoting privatisation ...regardless of the consequences on patient care. A sell-off may bring a short-term cash injection, but cost NHS Trusts vast sums in the longer term." However the department said the plan "is in line with the government's policy to maximize the value of assets and commercial opportunities," the department said in an e-mailed statement today. The department will hold meetings with the private sector on "options and opportunities," the statement said. There are concerns that the move may be illegal. One website, chiefofficers.net, claimed that "[a] question arises as to whether this is a lawful activity under securities laws [governing the public sector in Europe]. The general principle is that it is illegal to seek investment in a company except in very limited circumstances. A public offering that does not fall within those exceptions will often result in serious penalty for those who are convicted of the various offences related to the conduct.." Unison said said that this may be the "thin end of the privatisation wedge" as European rules exclude the NHS from having to contract out services – yet such a sell-off signals that the government is prepared to aggressively promote the private sector in the NHS. The union said it was now contemplating a "judicial review" of the decision by NHS chief executive, Sir David Nicholson, to press ahead with reorganisation plans that have "neither parliamentary approval nor legal backing". Nicholson wrote to NHS managers outlining a series of "actions that we need to start now" that may see wards shut and hospitals closed. Last week health secretary Andrew Lansley backed the move of specialist cancer surgery from Royal Cornwall Hospitals Trust to Plymouth Hospitals Trust." The Government's White Paper will change forever the NHS as we know it. These sweeping changes were not part of any party manifesto and it is outrageous that these changes are being brought in without consulting the public, patients, staff and unions," said Jennings. "In writing to NHS managers, Sir David is working on the premise that the consultation is only about the best way to achieve pre-determined outcomes – this makes it nothing more than a paper exercise and a sham.'
  
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Thursday 5th August 2010

Healthcare Republic

• Private firms eye changing NHS With GP consortia due to run an £80 billion annual commissioning budget by 2013, the private sector is widely expected to cash in on their lack of management expertise. But what are the opportunities for private firms and how bold are their ambitions ? Will they offer back-office support to consortia, or aim to take over commissioning altogether ? Firms such as UnitedHealth UK, Tribal and Humana already provide support services to PCTs across England. They collect data, analyse health systems and manage contracts. Assura Medical has developed around 30 partnerships with groups of practices, helping them redesign local services - a model which now looks highly relevant. But unions and campaign groups say the White Paper Liberating the NHS represents a massive step towards private-sector-led commissioning. Health secretary Andrew Lansley has yet to fully explain who will step in where local GPs fail. The BMA fears the private sector will be invited to take over if consortia slip up. Dianne Conduit, director of commissioning support at Humana, says the firm would consider taking over commissioning in areas where GPs fail. 'We can provide elements of the service or look at providing the whole package,' she says. Others are more cautious. Kingsley Manning, director of Tribal, questioned whether Mr Lansley's reforms will go that far. 'It could happen down the road I suppose, but it's difficult to see how legislation could ever devolve responsibility for NHS services fully to a private company,' he says. Assura Medical 'hasn't considered it at all', says its chief executive, Bart Johnson. He says the firm is 'committed to working in partnership' with local GPs, who 'know best what needs fixing in their area'. Similarly, UnitedHealth UK seems determined to support, not compete with GPs at this stage. A spokesman said: 'Ultimately it'll be for consortia to decide which levels and types of support they need.' GPs are not hugely confident about commissioning, suggesting they may want to buy in help. A recent GP survey found that more than 70 per cent think they will lack the skills and resources to commission well. But Dr Darin Seiger, chairman of Nene Commissioning, says consortia can work effectively with a small team of in-house managers. 'You could keep out the private sector if you wanted to,' he says.
  
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Pulse

• GPs express fears over out-of-hours funding. Exclusive: Only one in seven GPs believe they will be given sufficient funds to be able to commission out-of-hours care safely, a Pulse survey has found. The Government’s overhaul of the NHS will see GP consortiums assuming full responsibility for commissioning out-of-hours services in England from April 2013, under much tougher regulation than has been the case for PCTs. But GPs responding to Pulse’s survey have expressed serious concerns that consortiums will not be given adequate funding to commission services safely, due to the huge financial pressures facing the NHS. Of 410 GPs surveyed, two thirds said they were not confident they would be handed sufficient funds to commission out-of-hours safely, with just 14% believing they would be given adequate financial backing. The fears come after the Government’s primary care tsar Dr David Colin-Thome told Pulse last week that the sum GPs gave up in return for the opting out of out-of-hours provision in 2004 would not be reimbursed under the revamp, but that the money will remain part of the overall funds available to support commissioning of out-of-hours services. The Government announced last week that GP commissioners would have to meet rigorous new standards for OOH care after some high-profile failures in services commissioned by PCTs. The survey also showed that only one in eight GPs will choose to provide out-of-hours themselves when the changes come into force, despite health secretary Andrew Lansley's recent forecast that many GPs would choose to provide when they assumed commissioning responsbility.
  
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Scotsman.com

• NHS in Scotland could face cuts as ring fencing of funds is ruled out. Scottish ministers have held back from offering a cast-iron commitment to maintaining or increasing spending on the NHS next year, when Scotland's public services will be hit by cuts of nearly £2 billion. Finance Secretary John Swinney has warned the NHS will face "serious financial challenges" come next April, and has ruled out any ring-fencing protecting the health service from cuts. In June, Mr Swinney had said it was ministers' "crystal clear" position to either maintain or grow health spending next year. That is despite the fact that the Scottish Government faces savage cuts to its budget. But the Scottish Government is saying that the final decision on spending on the NHS in Scotland will have to wait until Scottish ministers receive clarity from the UK Treasury on their own budget later this autumn. The matter centres on extra funds which will be granted to Scotland this October known as Barnett consequentials. These will be given to Scottish ministers as a consequence of spending increases to the NHS in England. Scottish ministers have pledged to hand all that cash straight to the NHS in Scotland. But analysts say it does not necessarily follow that, as a result, the NHS in Scotland will have an increase in actual money. Mr Swinney was asked in June whether he wanted to maintain or grow health spending next year. He replied: "That has been our position throughout." Asked the same question on Tuesday evening's Newsnight Scotland, he said: "What I have said throughout this process is that the Scottish Government is committed to pass on the Barnett consequentials." He went on: "There is fundamental difference between that commitment and ring-fencing. Ring-fencing suggests that there isn't any financial pressure on the NHS and that isn't the case". In England, the coalition government says it will increase spending on the NHS putting pressure on ministers in Scotland to follow suit. However, the IBR last week recommended that, given the scale of the cuts to come, no one area should be protected.
  
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Guardian

• Leeds MP criticises 'dangerous' NHS reorganisation. A Leeds MP has criticised government plans for a huge structural upheaval of the NHS, including the abolishment of NHS Leeds. Leeds West MP Rachel Reeves said the changes represent the biggest change to the NHS in its 62-year history. The proposals will mean handing most of the NHS budget to GPs. Primary care trusts like NHS Leeds will be phased out and groups of GP practices will instead commission health services from hospitals. GPs will be free to ask the private sector to help them plan and contract services for patients – the role currently carried out by NHS Leeds. NHS Leeds staff may be forced to move on, or reapply for the same jobs in new organisations. Reeves said today: "I am extremely worried that patients could end up waiting longer and thousands of NHS workers could face redundancy. "A top-down reorganisation is the last thing the NHS needs right now. It needs to focus all of its efforts on meeting the financial challenge it faces. This reorganisation will distract attention, reduce motivation and cost billions. I am determined to fight the Health Bill when it comes before Parliament to stop this dangerous legislation. "Patient guarantees like the maximum 18-week wait for an operation and four-hour wait in A& E have been scrapped or downgraded. "Waiting times are set to rise, leaving patients with the familiar old Tory choice – wait or go private. Services will vary so widely between the new GP groups that, in time, the N in NHS will be redundant – a postcode lottery for patients." Shadow Health Secretary Andy Burnham said the the proposed reforms 'represent the break-up of the NHS'. Health Secretary Andrew Lansley warned that NHS job losses were "inevitable" but said it was vital to switch cash from bureaucracy into frontline services. Evidence suggesting GPs will be more effective than health trusts at commissioning NHS services "is weak", a report has said. Meanwhile, more than 130 NHS Leeds managerial jobs are to be cut over the next three years in a bid to save £5 million.
  
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HSJ

• Oxford Radcliffe Hospitals Trusts paediatric cardiac surgery unit to remain closed. The paediatric cardiac surgery unit at Oxford Radcliffe Hospitals Trust should remain closed, according to a report published last week. NHS South Central commissioned an investigation, led by its director of clinical standards Bill Kirkup, after four deaths there at the start of the year. The unit, the smallest of the 11 paediatric cardiac surgery units in England, performed roughly half the number of procedures per year as the next smallest. The investigation panel recommended paediatric cardiac surgery remains suspended “until arrangements are put in place that will create a critical mass of clinicians who, working as a single team and dealing with an adequate caseload, can maintain their expertise”. The unit previously had one surgeon, who also carried out adult cardiac procedures, but appointed an additional surgeon last year. All four deaths followed procedures carried out by the second surgeon, who has now left the unit. The report said: “We found no errors of judgement that directly led to any of the deaths. The panel’s experts, however, considered several cases may have had a better outcome with different surgical management.” Monitoring systems were also criticised, as was the handling of the four deaths. The report noted it took an enquiry from journalists 12 days after a surgeon first raised concerns for the trust to declare a serious untoward incident. In a statement, the trust said it would develop plans to tackle the issues raised in the report as “a matter of urgency”. The unit will remain closed until at least September, when the strategic health authority board next meets.
  
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• Royal Berkshire Hospital Trusts to cut 600 jobs. The Royal Berkshire Hospital Trust will axe up to 600 jobs under moves to make £60m savings in the next few years, it was announced today. Frontline staff would not be affected by the cuts, which the trust said it hoped to achieve through natural wastage and retirement. But unions said frontline services were bound to be affected by such huge cuts and accused the government of “conning” people into believing that its massive clampdown on public spending would not hit services. The trust, which has a hospital in Reading, an eye clinic in Windsor and provides some services at a hospital in Newbury, employs 4,500 staff. Jobs to be cut will be in human resources, IT, facilities and general backroom roles, said a spokesman. Chief medical officer at the trust Dr Jonathan Fielden said: “Over the past few months we have shared with staff our triple aim of providing the best possible patient experience, the best possible health outcomes at the lowest possible costs. “Everyone is now well aware that we are working to achieve our aim in a challenging financial situation which is facing the whole country and in particular the public sector. “This year we have to identify and deliver a savings plan of £20 million (around 6.5% of our total budget), and over three years need to save a total of £60 million.
  
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• Wakefield District PCT managers face axe. More than 40 management positions at Wakefield District Primary Care Trust are in jeopardy as part of wider cost-cutting measures, the Yorkshire Post has revealed. The trust said workforce cuts were “unavoidable” as part of efforts to slash £1.4m from its management costs before the end of March next year. According to the Yorkshire Post, which submitted a freedom of information request for the details of a private board meeting in June, this will put 42 management positions in the firing line. Alan Wittrick, chief executive of the trust, said: “In line with many other NHS organisations, we have to achieve a total of over 40% savings in our management costs over the next three years. “Unfortunately this means that savings in our workforce costs are unavoidable. We are already working through a process of voluntary and, potentially, compulsory redundancies with our staff.” The trust said savings of £1.4m would be followed by further cuts of up to £3.4m over the next two years in response to the government’s plans to shed thousands of management posts at PCTs across the UK. Front line positions are also in jeopardy at the trust as local hospitals plan to cut costs by £55m in the next two years, the Yorkshire Post reported. The announcement is the latest in a string of cuts across Yorkshire, with more than 130 managers set to leave NHS Leeds over the next three years, the paper said.
  
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