The News: Portsmouth

• Staff cuts as Portsmouth superhospital faces £13m deficit. Portsmouth Hospitals NHS Trust, which runs Queen Alexandra Hospital, Cosham, reported a deficit of £13.1m deficit at the end of December last year. The planned position was £2.6m. The trust has previously admitted overspending on staff, particularly temporary staff. Now, as 70 per cent of the trust's expenditure is spent on its workforce, a primary measure being taken to claw back some cash is making redundancies. But Robert Toole, the trust's finance director, said: 'We are spending more than we expected to do and we are doing everything we can to reduce that.'a total of 231 hospital staff were originally told they would be at risk of redundancy. Some have since left voluntarily. Ninety-six people now face losing their job, some of which will be redeployed into critical areas. Trust managers assure that where cuts are being made, reviews of how this will affect the quality of care are also being carried out, and the service the hospital provides will not suffer.
  
  http:/ / www.portsmouth.co.uk/ newshome/ Staff- cuts- as- Portsmouth- superhospital.6051029.jp

Metro

• The health service will fork out £63billion for privately financed hospitals - £52billion more than they are worth, according to figures released today. NHS Private Finance Initiatives (PFIs) - which are paid for by the private sector in a long-term 'loan' to the government - are worth just £11billion, the Liberal Democrats claimed. The first payments for hospital PFIs began in 1999 and the NHS still owes £58billion on 106 contracts over the next three decades. The most expensive PFI contract was for Wythenshawe Hospital, in Manchester, where the NHS will pay back 16 times what the Liberal Democrats say is the original capital value. Union Unison said 'big businesses' were 'making a killing' out of the NHS.
  
  http:/ / www.metro.co.uk/ news/ 812132- nhs- pays- 63bn- for- pfi- hospitals- worth- 11bn

Independent Nurse

• DoH plans to 'vertically integrate' community services with hospital trusts could threaten the future of general practice, GP leaders fear. The NHS Alliance has warned that PCTs have been told to put plans in place by the end of March to transfer services they currently provide themselves to hospitals, on the basis that this is the DoH's 'preferred option'. GPC chairman Dr Laurence Buckman last year said DoH plans to encourage acute trusts to run GP services - set out in NHS 2010-2015: From Good To Great - signalled health secretary Andy Burnham's desire to 'get rid of general practice completely'. The document said the DoH planned to 'remove the boundaries NHS foundation trusts face in expanding their services' and that they would be 'considered to run primary medical services'. GP leaders fear that moves to encourage hospitals to provide GP services coupled with the eradication of practice boundaries could create a two-tier system in which practices are forced to compete with a new breed of super-provider. NHS Alliance chairman Dr Michael Dixon warned of a 'very ill wind against primary care and general practice'. Dr Dixon said the aim of integration was to save money: 'The explicit reason for the move is that the NHS is going to have to save an enormous amount of money over the next couple of years, and this is a speedy financial fix.'
  
  http:/ / www.healthcarerepublic.com/ search/ GP/ news/ 981094/ Hospital- expansion- threat- practices/ ?DCMP=ILC- SEARCH

Friday 5th February 2010

Bronsgrove Standard

• Worrying plans for town's hospital. Shock proposals to merge the running of Bromsgrove’s Princess of Wales Community Hospital into a larger organisation have been unveiled by the Government. NHS Worcestershire revealed Whitehall chiefs had ordered them to carry out an immediate review of health service provision in the county. The stakeholder brief stated the aim of merging the organisation with either Worcestershire Mental Health Trust or Worcestershire Acute Hospitals Trust, which runs the major hospitals in the county including Worcestershire Royal. The move, seen by many as a threat to localised health services, is designed to remove the responsibility of providing services from PCTs.
  
  http:/ / www.bromsgrovestandard.co.uk/ news90481.html

Leicester Mercury

• Leicester's hospitals to axe 700 jobs in bid to cut £58m. At least 700 jobs will go at Leicester's hospitals as managers battle to slash £58m from spending over 12 months. From April 1, the Government has decided that cash for accident and emergency care, operations and treatments will be capped at current levels – effectively cutting the cash coming into the hospital. Managers in Leicester say that unless they can cut spending by £5m a month every month from April, they will run out of money to pay staff and suppliers.
  
  http:/ / www.thisisleicestershire.co.uk/ news/ 700- STAFF- FACE- HOSPITALS- AXE/ article- 1808688- detail/ article.html

Pulse

• PMS funding diverted to pay for ‘polysystems’. NHS managers are planning to scrap growth funding for PMS practices across London and use the cash to fund a new network of 100 ‘polysystems’ – the successors to Lord Darzi’s polyclinics. Plans show trusts plan to make huge savings by denying growth money to practices in the capital, and have earmarked it to finance their latest policy drive rather than pay off deficits. The Department of Health’s policy implementation arm, NHS Primary Care Commissioning, has lent its backing to a policy developed by controversial PCT NHS Camden to finance polysystems using PMS cash. At a meeting of PCT and DH representatives, PCC endorsed the Camden model and urged trusts to use ‘contractual levers’ to squeeze money out of PMS. It said: ‘NHS Camden has conducted a PMS review and illustrated how to reinvest into a 40% shift from acute medicine to a primary care polysystem.' NHS North Central London – a group of five PCTs including NHS Camden – plans to move 87,291 outpatient appointments into polysystems in 2011/ 12, which it claims will save more than £20m a year. Elsewhere, PMS practices in NHS Newham have been served with breach-of-contract notices after refusing to sign up to plans to cut funding. NHS London last week announced potential sites for more than 100 polyclinics across London, with care coordinated around each in a polysystem. But it admitted there was a high risk of local and national opposition jeopardising the plans, which will dramatically reduce the number of singlehanded practices and require those GPs who take part to extend their opening hours. The BMA is staging a rally at its headquarters on 25 February to protest against NHS London’s plans, and is strongly opposing the polysystem drive. Dr Kevin O’Kane, chair of the BMA’s London regional council, said: ‘Polysystems are being used to bring in multinational companies and increase competition. This will enable them to replace small practices.’
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=23& storycode=4124925& c=2

• Government to bring in national model contract for out-of-hours care. The Government is to introduce a national model contract and tougher minimum standards for PCTs to use when procuring out of hours services, in order to create tighter controls on GPs providing out-of-hours care. The announcement - which will also create more robust skills and knowledge testing for out-of-hours GPs - comes after a Government-sanctioned report into the standard of GP out-of-hours care revealed ‘unacceptable variation’ in commissioning and service provision around the country. Health minister Mike O'Brien also pledged to give GPs a bigger role in planning local out-of-hours services, but ruled out making it compulsory for GPs to commission, a central plank of the Conservatives' health manifesto.
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=35& storycode=4124936& c=2

Thursday 4th February 2010

News and Star

• Medical equipment for Millom Hospital bought by the town's community is safe but the number of beds is not. Friends of Millom Hospital (FOMH), a group set up to raise cash for the 35 year old facility, has raised over £1million for the Lapstone Road hospital. Medical instruments, beds and construction work have all been bankrolled by the fund-raising efforts of the team's volunteers. But NHS Cumbria, which runs the hospital, has announced it is planning to slash the number of beds in the hospital from 14 to nine in April. In coming years Millom is set to have a multi-million pound hospital built as part of the NHS Closer to Home scheme. FOMH has criticised a public consultation carried out for the project two years ago, which NHS Cumbria says warned residents of the bed cuts. But chairman of the group and Millom town councillor Reg Heathcote says the consultation was not clear enough about the cuts. He said: "During the consultation we thought the new hospital was going to be built within 12 months. But they haven't even started the work. We should keep the beds until the hospital is built."
  
  http:/ / www.newsandstar.co.uk/ equipment_ safe_ but_ bed_ cuts_ threat_ remains_ at_ millom_ hospital_ 1_ 667706 ?referrerPath=home/ news_ star_ search_ results_ page_ 2_ 1962

Ilford Recorder

• Fears over hospital privatisation claims. Fears are mounting that a private European company could be about to take over the running of a hospital trust's pathology departments - which critics claim will put patients' lives and doctors' jobs at risk. Pathology staff at Barking, Havering, and Redbridge University Hospitals NHS Trust were called into an emergency meeting on Friday as bosses broke the news. The medical diagnostics group "Labco", based in Paris, are offering to fund the debt-ridden trust. Prof Wendy Savage, from Keep Our NHS Public, puts forward the problem that the takeover may cause. "Private companies have an obligation to make money for shareholders and I fear this will be done by job cuts, which will in turn affect the quality of services." It's the latest blow for King George Hospital, Barley Lane, Goodmayes, which could lose its A& E under Health for North East London plans. Mr Gapes, MP for Ilford South, said: "I am appalled and shocked. This is a running down of services being made in advance of any public consultation decision. "What impact will this have on patients and employees ? Private companies often cut wages to increase efficiency."
  
  http:/ / www.ilfordrecorder.co.uk/ content/ redbridge/ recorder/ news/ story.aspx ?brand=RECOnline& category=newsIlford& tBrand=northlondon24& tCategory=newsilford& itemid=WeED04% 20Feb% 202010% 2009% 3A46% 3A20% 3A660

Ealing Times

• The NHS in London is on the brink of financial and organisational crisis, according to a report commissioned by the British Medical Association (BMA). The futures of Kingston Hospital, Mayday in Croydon, Epsom and St Helier Hospitals and St George's in Tooting were called into question last week after it was claimed a NHS report into south-west London had decided only three of the four hospitals should have an accident and emergency or maternity unit. The BMA report, entitled London's NHS on the Brink, is one of the pieces of evidence which Kingston and Surbiton MP Edward Davey believes backs up claims Kingston's A& E and maternity are being seriously looked at for closure or downgrading. The use of the phrase "local hospital", found in the NHS report, has sparked fears Kingston would be at risk of being turned into a community type hospital like nearby Queen Mary's Roehampton. The BMA report concludes hospitals will have to juggle a series of pressures including staff shortages and a reduction in the use of hospitals as more treatment of patients is offered in the community.
  
  http:/ / www.ealingtimes.co.uk/ archive/ 2010/ 02/ 03/ News+% 28news% 29/ 4886457._ NHS_ in_ London_ on_ brink_ of_ financial_ collapse_ _ _ report_ claims/

HSJ

• SHA's are actively exploring cutting local NHS workforces by up to 10 per cent in order to make the £15bn-£20bn savings required by 2014. NHS South East Coast's latest board documents included a "near final" version of its operating framework for 2010-11, which said the 10 per cent increase in size of its local NHS workforce over the last two years "must be reversed". "The numbers must return to 2007 levels - or further - in the period to 2012-14, starting in the coming year," it said, suggesting a headcount reduction of 10,000. The SHAs' plans come after the 2010-11 operating framework for England set out a primary care trust and SHA management cost reduction target of 30 per cent by 2013-14. Speaking last December, NHS chief executive Sir David Nicholson said he wanted the NHS to "front load" the cuts with as much as half of them achieved in 2010-11. Sir David Nicholson was relatively open minded about how organisations made their cuts "I'm not interested in proposals. I want the money in the tin; I'm counting on the money."
  
  http:/ / www.hsj.co.uk/ news/ finance/ shas- plan- staff- cuts- of- up- to- 10pc/ 5011069.article

Tuesday 2nd February 2010

• Audit Commission Chairman and NHS Trust Chair to join private sector ‘advisory board’. Chairman of the Audit Commission, Michael O’Higgins, and Chair of the Royal Wolverhampton Hospitals NHS Trust, Alan Edwards are to join an advisory board for health management consultancy Finnamore. The two top-ranking public sector executives will advise the company’s directors on predicting the health sector’s forthcoming priorities and requirements, and advise on a growth strategy for the rapidly expanding company. Finnamore recently merged three consultancies together creating the largest specialist healthcare management consultancy in the UK.
  
  http:/ / www.hc2d.co.uk/ content.php ?contentId=13950

Guardian

• NHS trusts 'breaking law' on out-of-hours GP services. There is an "unacceptable" variation in the quality of out-of-hours GP services in England, a government report will say this week. Some NHS trusts are breaking the law by failing to check whether foreign GPs can speak English well, according to the review which was set up after a patient was killed by a German locum on his first UK job. The report will call for improved induction and training, and a national database of doctors covering out-of-hours services. However the report will also say that, overall, standards have improved since services were reorganised in 2004. The report, by David Colin-Thomé, clinical director for primary care at the Department of Health, and Steve Field, chairman of the Royal College of General Practioners, is also expected to say that measures such as induction and training of GPs who have never worked in an area before must be improved. There should be a national database that would allow trusts and private companies to check whether doctors had previously failed to get on to performers' lists, the ticket to work in the UK providing their medical qualifications are satisfactory, and they had proved their competence in English. These moves were recommended in a previous report unrelated to the Ubani case nearly a year ago but have so far not been implemented.
  
  http:/ / www.guardian.co.uk/ society/ 2010/ feb/ 02/ nhs- trusts- out- hours- gp

• Politicians need to rethink the role of the private sector in the NHS. Dr Hamish Meldrum and others write in an open letter: For all the pre-election pledges to protect its funding, the NHS is clearly threatened by major cuts. Yet one area of English health policy has remained apparently immune from the debate on cost savings – the main parties all still cling to the dogma that efficiency in healthcare is best achieved by promoting competition and encouraging the private sector to provide services. As practitioners of medicine and supporters of the NHS, we believe this consensus must be challenged. The NHS is spending £350m a year on external management consultants – often at the expense of its own, internal expertise. Repayments to companies profiting from PFI in the NHS are costing the taxpayer billions. There are many examples of independent sector treatment centres failing to carry out the volume of procedures for which they have been paid. GP-led health centres – often imposed on communities despite a lack of local demand as part of the costly drive to increase commercial involvement in primary care – are struggling to attract patients. Such examples of public money being wasted are particularly galling to those frontline workers who are being told to gear up for cuts. More­over, the purchaser-provider split has facilitated the diversion of NHS funding to a plurality of competing interests, and resulted in disincentives for doctors in primary and secondary care to work together to improve services for patients. The experience of other health systems indicates that the creation of a market results in a significant proportion of funding being absorbed by transaction costs. A recent survey by the Economist Intelligence Unit – hardly known for its hostility to business – found that less than a quarter of the UK population believes the NHS would be improved by a greater role for private providers. We share the commitment of our patients to a health service that is publicly provided as well as publicly funded. It is time for politicians in all parties to rethink their policies on the role of the market in the NHS in England.
  
  http:/ / www.guardian.co.uk/ society/ 2010/ feb/ 02/ nhs- private- sector- cost

Monday 1st February 2010

Pulse

• Half of all practice appointments will be handled by nurses under the latest set of cost-cutting plans revealed by NHS managers. New proposals published this week by NHS London call for the proportion of appointments attended by nurses or nurse practitioners to increase from 33% to 50%. The move, which it claims would save £290m, comes as NHS London issued a statement clarifying its plans to make savings from reducing GP appointment times, which have outraged GPs and their leaders. Details of the skill mix shake-up were revealed as NHS London revealed possible locations for more than 100 polyclinics in London, which would see three in each London borough. The SHA wants to shift 55% of outpatient appointments and 60% of A& E attendances into primary care, with GPs across the capital being moved into polyclinics - some of which may be privately-run - and working under so-called polysystems, each covering up to 80,000 patients. The report says it aims to 'adjust the skill mix with greater use of nurse practitioners, saving up to £290m,' and on the plans to slash appointment times it says it will be 'moving to best in class appointment length.' Dr Daniel Burrow, a GP in Darlington, says 'Indicator PE1 of QOF stated that appointments with patients must not be less than 10 minutes. Surely NHS London cannot legally override a national contractual agreement ?'
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=35& storycode=4124879

The Star: Yorkshire

• Number of IVF cycles couples are entitled to be cut if plans for a Yorkshire-wide strategy are accepted. The NHS in Rotherham, Barnsley and Doncaster currently fund two cycles of treatment - still below government guidelines introduced five years ago which say health trusts should pay for three attempts if the woman is between 23 and 39. But consultation is underway about a Yorkshire and Humber-wide policy based on offering only one full cycle across all Primary Care Trusts in the region. The plans are being spearheaded by the Specialised Commissioning Group, who took over the commissioning and contracting of tertiary fertility services in April last year.
  
  http:/ / www.thestar.co.uk/ news/ CUTS- NHS- fertility- funding- blow.6028759.jp

News and Star

• Furness General Hospital staff 'under pressure' - nurse reveals. Staff are being put under 'too much pressure' after gynaecology services were cut. A ward 1 nurse, who does not wish to be named, said a system to close wards at weekends is not working. Ward 1, which deals with diagnosis and treatment of conditions of the female reproductive system, lost six beds and closed at weekends in October 2008. The Ward 1 nurse said some weekends are so busy that gynaecology remains open and the ward is often under-staffed. The nurse said: "Around 73 per cent of the time we are not able to shut the ward because no beds are available. "At the moment morale is so low. Everyone is strained. One nurse worked an 18-hour shift at the weekend." The nurse also referred to a patient who contacted the Evening Mail because she was unhappy with her experience as a gynaecology patient at FGH at the end of last year.
  
  http:/ / www.newsandstar.co.uk/ furness_ general_ hospital_ staff_ under_ pressure_ _ _ nurse_ reveals_ 1_ 666326 ?referrerPath=home/ news_ star_ search_ results_ page_ 2_ 1962

The Telegraph

• NHS target culture blamed for rising readmissions. The number of patients readmitted to hospital has increased by 50 per cent under Labour, raising concerns that sick people are being discharged too soon because of Government targets. More than 546,000 patients were sent home from NHS hospitals when they were not well enough in 2007-08, according to new figures. The rising rate of readmissions - the figure was just 359,719 in 1998 - has been blamed on a target culture which puts pressure on hospitals to free up beds.
  
  http:/ / www.telegraph.co.uk/ news/ uknews/ 7123434/ NHS- target- culture- blamed- for- rising- readmissions.html

Friday 29th January 2010

Pulse

• Private providers to cover GP extended hours. Private firms will be able to cover extended-hours shifts for practices that do not to provide the service, under the next stage of the Government’s controversial drive to widen access to primary care. Neighbouring practices could also take on the shifts, in a move the GPC has denounced as ‘a terrific recipe for fragmenting care’. A letter sent to PCTs and SHAs by Gary Belfield, DH head of primary care, sets out how the Government plans to implement prime minister Gordon Brown’s pledge that all patients would have access to evening and weekend appointments. The letter makes clear that practices will not be forced to offer extended opening themselves, but that other providers will be drafted in where a practice does not. One firm, the Practice PLC, which has won a string of GP-led health centre contracts, has already indicated its willingness to take on extended-hours shifts. Latest figures show around 77% of practices offering extended hours, but the Government wants access for all patients and has agreed PCTs should plough £161m into commissioning extended opening 2010/ 11 under the updated DES. GPC chair Dr Laurence Buckman attacked the proposal, calling it ‘an aggressive act against general practice’.
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=23& storycode=4124840& c=2

• Scotland confirms block on private providers. The Scottish Parliament has confirmed it is to press ahead with its decision to block commercial companies from running GP services north of the border. The tobacco and Primary Medical Services Bill, passed in the Scottish Parliament, has amended the 1978 NHS Act by removing the ability for commercial companies to hold primary medical services contracts. The decision marks a landmark divergence in health policy between the devolved nations and England, where the clause has been used to promote the rapid expansion of private providers running GP services. The move has been attacked by business leaders, but welcomed by the BMA, who said it would ensure that continuity of care for patients was maintained.
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=35& storycode=4124862& c=2

Thursday 28th January 2010

Daily Mail

• NHS jobs for nurses to be cut by 13,000, official figures show. The number of nurses in the NHS is to be slashed by more than 13,000, official figures suggest. They show that ministers are not planning to replace large numbers of staff who will quit over the next five years. The number of qualified nurses will slump by 13,409 - after years of increases under Labour - by 2014. The total will fall from 329,372 in 2008 to 315,963 by 2014. The revelation is a blow to Labour's election promise to protect frontline services while reining in public spending. There are already reports of an acute shortage of specialist nurses, particularly in A& E, critical care and operating theatres. The Department of Health figures show that 16,262 nursing graduates will join the NHS this year but another 19,056 qualified staff will leave - meaning there will be 2,794 fewer nurses. There will be similar losses of nurses over the next four years. Health Minister Ann Keen said: 'There are 80,000 more nurses working in the NHS since 1997.' She added: 'It is too simplistic to compare graduate numbers with potential leavers. There are many routes into the NHS as well as new graduates.'
  
  http:/ / www.mailonsunday.co.uk/ news/ article- 1246651/ NHS- jobs- nurses- cut- 13- 000- official- figures- show.html

BBC

• Flooding to cost NHS in Cumbria 'millions'. The cost of maintaining community health services in flood-hit parts of Cumbria is likely to run into millions of pounds, NHS bosses predict. Two GP surgeries were destroyed and hundreds of people were cut off from health services after the collapse of bridges in the November floods. NHS Cumbria claims it could cost almost £7m for temporary services before any permanent health facilities are built. The county suffered widespread flooding after unprecedented rainfall. A series of measures are currently in place to provide support for residents. These include, temporary accommodation for GP practices in Cockermouth, new health clinics for communities cut-off from the centre of Workington by road and additional GP and community nursing cover for flood-hit areas.
  
  http:/ / news.bbc.co.uk/ 1/ hi/ england/ cumbria/ 8484699.stm

The Guardian

• Leak revealing scale of proposed NHS cuts 'torpedoes' talks on jobs guarantee. Foundation trusts threaten job losses, abolition of bonuses and daytime working hours that end at 10pm. NHS staff are facing compulsory redundancies, consultants the loss of bonuses and district hospitals severely reduced funding, according a leaked health service document proposing savings to negotiate the economic downturn. The internal briefing paper circulated by the NHS foundation trust network (FTN) calls for wide-ranging reform of national wage scales, an end to guaranteed employment for trainees and a cap on pensions for those earning more than £100,000 a year. Such radical cost-cutting – being discussed by senior managers as part of the reconfiguration of the health service to deliver more community services – threatens to undermine the NHS employment guarantee proposed last month by the health secretary, Andy Burnham. The document, obtained by health service union Unison, has emerged on the day employers and staff are due to meet in the NHS social partnership forum to discuss the possibility of offering greater flexibility in working practices in return for protecting jobs. The leak signals growing union unease as the financial squeeze tightens. In December, Burnham promised to explore with the unions the possibility of "whether we could offer frontline staff an employment guarantee locally or regionally in return for flexibility, mobility and sustained pay restraint". The briefing suggests that semi-autonomous NHS organisations are anticipating a more severe squeeze on resources than the government has publicly conceded and are beginning to act to protect budgets before the general election. On the overall financial situation, the paper says: "There is now widespread recognition that ... with no third-year commitment from Treasury to even flat cash the situation could get worse than currently predicted."
  
  http:/ / www.guardian.co.uk/ society/ 2010/ jan/ 28/ nhs- cuts- leak- unison- foundation- jobs

HSJ

• SHAs return to topslicing budgets. Strategic health authorities are introducing stringent financial rules and mandatory topslicing in a bid to keep the NHS in balance next financial year. The measures go beyond the Department of Health’s operating framework for 2010-11 and include mandatory non-returnable topslicing of primary care trusts’ budgets and even harsher penalties for acute providers than the volume cap on the emergency tariff. The DH has asked all PCTs to end the year with a surplus of 1 per cent and to spend 2 per cent of their allocations on non-recurrent costs. NHS chief executive Sir David Nicholson told HSJ in December there were no plans for that to include “topslicing” - the term used to describe the mandatory removal of part of a PCT’s allocation by their SHA to form funds often referred to as “strategic investment” or “strategic reserves”. But at least three SHAs are already planning to do that. NHS South Central has said it will “require” all PCTs to deposit at least 1 per cent of their allocations into a “systems investment and reform fund” which will not be returnable.
  
  http:/ / www.hsj.co.uk/ news/ finance/ shas- return- to- topslicing- budgets/ 5010834.article

• Essex PCT to begin offloading GP surgeries. NHS South West Essex is seeking alternative providers to take over and run some of its general practices. The primary care trust currently runs 10 practices, with a further 71 run by GPs under general medical services and personal medical services contracts. It aims to start offloading the 10 it runs to interested parties over the next 18 months. An information event for potential providers will be held at the end of January and, following a tender process, contracts for the three practices will be awarded in the autumn. The second phase will start in autumn 2010.
  
  http:/ / www.hsj.co.uk/ news/ primary- care/ essex- pct- to- begin- offloading- gp- surgeries/ 5010785.article

Tuesday 26th January 2010

Ilford Recorder

• Health bosses come under fire over polyclinic plan. The Redbridge health roadmap was torn apart by an angry councillor who warned the borough would be lumbered with five run down polyclinics if it pressed ahead with plans to build more of the super surgeries. Fairlop Polyclinic is one of four new health centres set to be built over the next four years to go alongside the existing Loxford Polyclinic. But the centres are sparking unease. Residents had the chance to grill Rob Meaker, chief officer for the Fairlop Polysystem, and Adrienne Noon, head of communications and marketing for NHS Redbridge. Conservative Cllr Loraine Sladden warned building more polyclinics would be a mistake. She said: "A good business wouldn't open another company if they have problems with the first one. Do it over three years and then come back if it works. Otherwise we will be left with five run-down polyclinics."
  
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Public Technology

• NHS IT programme’s legal fees top £40m. The Government’s unwieldy National Programme for IT (NPfIT) accrued nearly £40m of legal fees in seven years, according to minister for health, Mike O’Brien. O’Brien, the Member of Parliament for North Warwickshire, revealed the cost of legal fees between 1 April 2002 and 31 March 2009 in a written answer to his Conservative counterpart and MP for Eddisbury, Stephen O’Brien. Two legal firms, Allen & Overy and DLA Piper UK, charged £39.1m for their services including the drafting of contracts. The minister for health revealed that DLA Piper UK had been paid £28.9m during the seven year period, whilst Allen & Overy (which ceased working on the NPfIT after 2006) had been paid £10.3m.
  
  http:/ / www.publictechnology.net/ modules.php ?op=modload& name=News& file=article& sid=22434

Richmond Times

• Kingston Hospital's A&E and maternity services under threat. Kingston Hospital’s accident and emergency and maternity units could face the axe, after it was revealed that they were on a shortlist for closure. Liberal Democrat MPs Susan Kramer and Edward Davey said they had met with high-ranking officials and been told NHS London plans to close A& E and maternity units in south-west London. They said a shortlist of two options had been drawn up by health bosses and one of them was to close Kingston's A& E and maternity departments. The MPs have launched a pre-emptive campaign - with a website, savekingstonhospital.org.uk - to try and stop the closures and Liberal Democrat leader Nick Clegg joined them at the hospital. Ms Kramer and Mr Davey, said they had been told London had been divided into sections and reached the conclusion only three A& E and maternity units were needed in the area, rather than the four that currently exist - St George’s Hospital, Tooting, Mayday Hospital, Croydon, St Helier Hospital, Carshalton, and Kingston. NHS London had been due to publish a report looking at options for reducing the services in December but it was delayed until this week and the MPs have now been told nothing will be revealed to the public until after the general election, believed to be earmarked for May 6.
  
  http:/ / www.yourlocalguardian.co.uk/ news/ local/ richmondnews/ 4870597.Kingston_ Hospital_ s_ A_ E_ and_ maternity_ services_ under_ threat/

Scotsman

• Rural families unite to save five hospitals from the axe. Rural communities in Dumfries and Galloway are fighting NHS plans that could lead to the closure of five community hospitals. Among those under threat is Thornhill Community Hospital, which mainly provides recuperative care to the elderly. Dumfries and Galloway Health Board is currently consulting local communities to consider three options. The most radical is that all cottage hospitals in the area are replaced with community teams delivering care in the home, with four community rehabilitation units created to support Dumfries and Galloway Royal Infirmary and Galloway Community Hospital.
  
  http:/ / news.scotsman.com/ scotland/ Rural- families- unite- to- save.6012542.jp

Friday 22nd January 2010

Pulse

• Buckman bites back over out-of-hours care. GPC chair Dr Laurence Buckman has issued a robust response to mounting criticism over out-of-hours care, warning that giving back personal responsibility for its delivery to GPs would be ‘dangerous to patients.’ An inquest into the death of a patient has prompted a storm of negative coverage in recent days, with two highly critical columns in the Independent and in the Times, and renewed calls from Conservative health spokesman Andrew Lansley for GPs to be ‘collectively responsible’ for out-of-hours care. In a letter to the Times and the Independent Dr Buckman insisted he had ‘never worked a 9-5 day’ and strongly defended the decision of most GPs to opt out of responsibility for out-of-care. ‘The current out-of-hours sytem desperately needs improving, but we can’t go back to where we were before 2004 where doctors were on call 24 hours a day, meaning many were operating in a constantly sleep-deprived state,’ he wrote. ‘We are where we are now with out-of-hours because right from the start of the new contract many primary care trusts were more concerned with cutting costs rather than ensuring patients go the best quality care. There must not be a return to the system we had before the new contract. That would just mean replacing the current, poor system with a potentially dangerous one.’
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=23& storycode=4124787& c=2

Thursday 21st January 2010

BBC

• London healthcare 'heads towards crisis', say doctors. London hospitals "could close as healthcare in the capital heads towards a major financial crisis", the British Medical Association (BMA) has said. As much as £5bn could be cut from NHS London's budget by 2017, it claimed. The BMA's report, London's NHS On The Brink, predicts that from 2011 there will be a freeze on NHS budgets, with the worst cuts falling in London. But an NHS spokesman said: "To give people leading expert care we also need to centralise some services." The BMA's report, written by health expert Dr John Lister, criticises many of the proposals that NHS London has made public. The report surveyed board papers and other published material from primary care trusts (PCTs) in London.
  
  http:/ / news.bbc.co.uk/ 1/ hi/ england/ london/ 8469907.stm

HSJ

• Care UK chief hits out at renewal process as ITC contracts expire. The process for renewing contracts for the first independent treatment centres has been described as a “pig’s ear” by the chief executive of the largest independent provider in that sector. Ten of the “first wave” contracts are due to expire in the next six months - with the general election expected midway through that period - and the future of many of the centres is uncertain. At least one, the Kidderminster treatment centre in Worcestershire, is likely to close its doors. The centre will return to NHS use from next month, although the team running it plans to continue doing NHS work at a local independent hospital. The future of the Greater Manchester surgical centre hangs on whether owner Trafford Healthcare Trust decides to use the site itself or to rent it out. Many of the others are likely to continue but will offer treatment at tariff through patient choice, rather than through a block contract. The firms running the centres have been told they have to go through a tender process to rent the buildings from the NHS - leading to uncertainty for staff and patients. Mike Parish, chief executive of Care UK, which operates two sites coming up for renewal, said this had led to a “pig’s ear of a process”, with firms being offered short term contract extensions at the last minute because primary care trusts still had the contracts out to tender.
  
  http:/ / www.hsj.co.uk/ news/ finance/ care- uk- chief- hits- out- at- renewal- process- as- itc- contracts- expire/ 5010516.article

• Rise in acute admissions will be ‘unsustainable’ for PCTs. Just 10 per cent of primary care trusts have successfully reduced emergency admissions to their local acute trusts. Only 15 PCTs cut emergency admissions between 2007-08 and 2008-09, according to analysis of hospital episode statistics data by independent health intelligence provider CHKS, shared exclusively with HSJ. The rest of PCTs recorded an average increase in emergency admissions of 5 per cent. The analysis has prompted warnings that an increase in admissions at this rate is financially unsustainable for the health service as a whole.
  
  http:/ / www.hsj.co.uk/ news/ primary- care/ rise- in- acute- admissions- will- be- unsustainable- for- pcts/ 5010521.article

Tuesday 19th January 2010

• NHS out-of-hours care review promised by Conservatives. The Conservatives have said that they will review NHS out-of-hours care if they win the forthcoming general election, following the death of a 70-year-old Cambridge man who was given an overdose by an overtired locum.Shadow health secretary Andrew Lansley said Labour had made a “serious error” by taking responsibility for out-of-hours care away from GPs, adding that a Conservative victory at the polls would see the spotlight turn on GPs again to make them “collectively responsible” for out-of-hours services. Primary care trusts are currently responsible for providing out-of-hours care services by employing private companies or co-operatives to fill in for GPs. The British Medical Association is expected to oppose Conservative plans, as changes to GPs’ contracts were made after doctors complained that they were overworked and underpaid.
  
  http:/ / www.nursingtimes.net/ whats- new- in- nursing/ primary- care/ nhs- out- of- hours- care- review- promised- by- conservatives/ 5010490.article

Friday 15th January 2010

Times

• Private hospitals cash for Conservative health spokesman. The Conservative health team is being funded by the wife of the chairman of one of Britain’s largest private hospital companies. Andrew Lansley, the Shadow Health Secretary, received £21,000 in November from Caroline Nash, wife of John Nash, the chairman of Care UK, according to official registers. Mrs Nash works with her husband running a charity to help the underprivileged young. Care UK runs a network of GP practices, NHS walk-in centres, out-of-hours services and NHS treatment centres. The company says that 96% of its business, amounting to more than £400m last year, came from the NHS. It would be well placed to benefit from a Conservative promise to make it easier for private providers to perform more NHS work. Mrs Nash is a regular Tory donor, who together with her husband, has given a further £107,000 since 2006. Mr Nash, 60, last gave money in December 2006, according to the Electoral Commission. He was the founder, in 1988, of the private equity fund Sovereign Capital, which owns several healthcare companies, as well as the independent schools group Alpha Plus. The couple have not previously given to Mr Lansley’s office.
  
  http:/ / www.timesonline.co.uk/ tol/ news/ politics/ article6989004.ece

Pulse

• Tories open up talks with private firms. The Conservatives have opened talks with a series of private firms after pledging to step up the role of the independent sector in the NHS. Talks are ongoing with ‘a wide range’ of providers from the private and voluntary sectors, as part of moves to create a more competitive NHS marketplace should it win the election. But the policy puts the Conservatives on a collision course with the BMA, which has issued a fresh appeal for politicians to slam the brakes on private sector involvement in the NHS. A draft health manifesto, unveiled by leader David Cameron, confirmed plans for GPs to take control of real commissioning budgets, which could see practices working in partnership with private firms. It states a Conservative government would ‘open up the NHS to include new independent and voluntary sector providers’, which would be allowed to compete on a level footing with NHS providers.
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=23& storycode=4124736& c=2

• GPs to be paid to offer extended hours to patients at neighbouring practices. The Government is to allow practices offering extended hours to take over the evening and weekend care of patients from neighbouring GPs who refuse to provide the service. In a major new drive to give all patients the right to evening and weekend appointments, the Department of Health has ordered PCTs to pay other practices or commission out-of-hours providers to plug gaps in GP take up. Health minister Mike O'Brien told MPs claimed that the Government’s policy was driving uptake by making GP practices see that if they failed to take part they would lose out financially to their colleagues, claiming further pressure was being put on practices by the rollout of Darzi centres.
  
  http:/ / www.pulsetoday.co.uk/ story.asp ?sectioncode=35& storycode=4124766& c=2

Tuesday 12th January 2010

Health Investor

• Competition panel to review Burnham's 'preferred provider' policy. The NHS Competition & Cooperation Panel will review Great Yarmouth & Waveney Primary Care Trust's decision to exclude independent and third sector firms from being primary contractors. The PCT told non-NHS bidders that they would not be considered to deliver services following health secretary Andy Burnham’s “preferred provider” statement, where he appeared to renege on Labour’s commitment to competition. NHS Partners Network and Acevo, the Association of Chief Executives of Voluntary Organisations, put in a joint complaint to the NHS's Co-operation and Competition Panel which the committee has accepted. However, the competition panel has limited powers to enforce any decision.
  
  http:/ / www.healthinvestor.co.uk/ ( X( 1) A( tG8JIkjJygEkAAAAMzIyMzg3MDEtYWMxMi00YmE3LTg3OGYtMmIyOWExN2U3MzQ 0CGCc2mnZ_ tbGhNMeb8VYVVy5_ g41) S( 1xbor555yykms345zdxpohzf) ) / ShowArticle.aspx ?ID=929

Financial Times

• Private sector eyes historic hospital takeover. Five private sector operators have been listed alongside Addenbrooke’s Hospital in Cambridge for what could become the first private sector takeover of a district general hospital. The five have been shortlisted, alongside the Cambridge NHS foundation trust, to take over the running of Hinchingbrooke hospital. The winning bidder is likely to be given a seven-year franchise.The hospital has struggled financially and has almost £40m of historic debt to clear on a £92m turnover. Under the terms of the initial invitation, providers were told they must keep open the existing accident and emergency and maternity services, that staff would continue to be employed by the NHS and that the NHS would retain the hospital assets. The new operator, however, would be expected to help reduce the outstanding debt while making the hospital viable for the longer term. Care UK, Circle, Interhealth Canada, Ramsay and Serco have all qualified to enter an initial dialogue on the hospital’s future.
  
  http:/ / www.ft.com/ cms/ s/ 0/ 5fb43b0a- ff03- 11de- a677- 00144feab49a.html

Derby Evening Telegraph

• Private unit's £7m taxpayer bonus. A controversial Derbyshire private hospital has cost taxpayers in the county £21.9m but only delivered £15m worth of treatment. Barlborough Treatment Centre opened in July 2005 as part of the Government's plans to slash NHS waiting lists by using privately-run hospitals to perform routine hip and knee replacement operations. Health bosses, keen to cut waiting lists, tied themselves into a five-year contract which involved paying a set amount to the centre, regardless of how many patients it treated. The contract will not be renewed when it expires in April, casting doubt over the future of the hospital. Now figures have revealed that health bosses in Derby paid £7.5m for £3.1m worth of treatment, while in the rest of the county those figures were £14.4m for £12m worth of care.This means that patients in Derby got just 42% of the care they paid for, while in Derbyshire they got 83%. The centre is owned by the NHS but run by a private company called Care UK. Health bosses said they would like Barlborough to continue to provide knee and hip operations for the NHS, but without the cost and commitment of a long-term contract. Health bosses are inviting companies to come forward.
  
  http:/ / www.thisisderbyshire.co.uk/ news/ Private- unit- s- 163- 7m- taxpayer- bonus/ article- 1697241- detail/ article.html

Financial Times

• Fear over quality of care if NHS centralises. There is a real risk that the next government will resort to central control of the NHS, reversing the gains of recent years and damaging patient care, warns the outgoing chairman of Monitor, the independent regulator of the self-governing NHS foundation trusts. "As public expenditure tightens, the natural response of governments of any colour is to think that central control and central dictation is the only way to keep control of the money," said William Moyes. The autonomy of foundation trusts, the growing separation of the commissioning of care from its provision, the use of diverse providers, with a degree of competition and choice, might be seen as "just too risky" so "everything becomes pulled into the centre". That would be "a huge mistake" when "the only way to run a healthcare system in a developed country in the 21st century" was to have a decentralised approach where "people are not looking up to the secretary of state to see if they have done the right thing, but are actually looking at the patient and asking themselves: 'Is this the right thing for the patient ?'" Reflecting on his six years as head of Monitor, Mr Moyes said progress with reform of the health service had moved much too slowly because "at the official level there is still not enthusiasm [for the programme] in the Department of Health. All hospitals were meant to have had the chance to become foundation trusts by early 2008. But half have still not achieved that. The fact that in many parts of the country the NHS remained a mix of foundation trusts and hospitals still answerable to Whitehall and the secretary of state meant that the full benefits of the reform programme were not being felt. "The culture, and the unsaid assumptions of a lot of people in healthcare is that this is an integrated system that is managed from the top, and therefore they can't see the logic of the reform agenda". That "underlying culture of corporatism" remained the biggest single obstacle to the decentralised approach that was essential to deliver the best healthcare.
  
  http:/ / www.bbc.co.uk/ programmes/ b00plzyz#segments

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