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Thursday 21st August 2014

nhs managers.net

  • The Duchess will be coordinated every three months.

    I'll have a bet with you; she won't. There are too many duchesses in Surrey. A named GP was announced. Tra-laa! I have no idea who it is. I've never met her. The Duchess has. Our normal doctor is retiring. The Duchess has been 'allocated'. There is a fast track phone number for her to bypass the switchboard - a very good idea. Two questions ? Oh, yes... here's one: 'Where would you like to die...' It came as a bit of a shock. The Duchess thought 'at home'. Here's cracking question number two: '... if you ever need cardiopulmonary resuscitation do you agree to Do Not Resuscitate'. You can read it for yourself in this document, page 33; the form template. NHS Employers have written this guidance along with the BMA and the Carbuncle. NHS Employers ? Yes, that's what I thought. Here are a few issues that come to mind: Agreeing with the district nurse and signing (yes the form has to be signed) to a DNR has what legal significance ? The form is not witnessed, does it matter ? How is the elderly person's competence judged as capable of signing ? How are relatives informed ? How is this decision transmitted to secondary care and when ? Oh, and has anyone got any idea how an unwitnessed, fire-side chat with a district nurse, who is a complete stranger, might fit into the GMC Guidelines para 132 and the responsibilities of the administering clinician at the time. Of course DNR discussions can take place as part of an advanced care plan. A chat with our-Gracie is not advanced care planning. It is a chat with our-Gracie and that's all; going over everything the practice already knows. Hospitals have been getting themselves into difficulties over pre-empting DNR decisions. Do they really think this form will help ? No, it is valueless. What of the vulnerable patient ? Some will think 'I don't want to go to hospital they will let me die... they need the beds'. Others might think 'if I don't give the answer they want I won't get taken to hospital'. And I'll bet the farm, when the District Nurse has gone frail elderly, stick-thin, porcelain-skin, house-bound grannies, who survive at the mercy of whoever is sent on that day to give her 15 minutes of attention, who sees her family only on high-days and holidays; will sit in their chair, look at the four walls and in a desperately lonely moment wont feel the tear splash into their lap; 'I'm going to die... the district nurse knows I am and I am frightened'. How compassionate can you get...

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On Medica

  • Private healthcare providers should have the same requirements as the NHS to report patient safety incidents and report on their performance, says a highly critical report published today.

    The report Patient safety in private hospitals – the known and unknown risks from health think tank the Centre for Health and the Public Interest (CHPI) says that patients undergoing operations in private hospitals are sometimes exposed to risk from inadequate equipment, lack of intensive care beds, unsafe staffing arrangements, and poor medical record-keeping. Spokespeople for the private sector, however, have rejected many of the report’s findings, saying it made “several questionable claims”. For the report, the authors studied Care Quality Commission inspection reports on private hospitals, data from national clinical audits, Freedom of Information requests and parliamentary questions. The Centre’s report says that 802 patients died unexpectedly in private hospitals in England and there were 921 serious injuries between October 2010 and April 2014. Currently, private hospitals are not required to make data on hospital deaths publicly available – unlike their NHS counterparts – says the report, which makes it difficult for the public to understand safety within private hospitals. The report’s authors said that although the private hospital sector received more than a quarter of its income from treating NHS-funded patients, there was significantly less information available to patients about the performance of private hospitals than about the NHS. The report also claims the NHS serves as a “safety net” for the private sector because thousands of people are regularly transferred to NHS hospitals following treatment in private hospitals. Report co-author Professor Colin Leys said: “The public and regulators have access to more information than ever before about how NHS services are performing but this report shows that the same cannot be said for private hospitals. “The government has recognised the crucial role of transparency in making hospitals safer but reporting requirements should apply wherever patients are treated.” The report recommends that private providers should be subject to the same requirements as the NHS to report on performance and patient safety and calls on the Department of Health to carry out a review of the nature and cost of admissions to the NHS from private hospitals.

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London Evening Standard

  • Chase Farm Hospital hit by influx of 40,000 extra patients after neighbouring A&E closes.

    Hospital managers were unprepared for an influx of almost 40,000 more patients after a neighbouring accident and emergency department was axed, a report reveals today. Nurses at North Middlesex hospital, in Edmonton, told inspectors that their workload “increased significantly” after the closure of Chase Farm’s casualty unit last December because of a shortage of recruits. Dead bodies had to be stored in temporary fridges after a 31 per cent rise in the mortuary’s workload, with the facility “full to capacity” at times.Despite the “underestimate of the resources” needed to maintain standards of care, the Care Quality Commission said staff at North Middlesex had “fully embraced” the increased workload. In a generally positive report, the hospital was rated as “requires improvement”. Professor Sir Mike Richards, the commission’s chief inspector of hospitals, said: “When we inspected North Middlesex University Hospital we saw that demand for services had increased, due largely to the closure of A& E at Chase Farm Hospital. “Staff were working hard to meet this increased demand, but more needed to be done by the trust to make sure that good quality care was maintained.” The report said the infrastructure at North Middlesex had been “stretched” and managers were “firefighting” rather than planning for the future. A total of 189,000 patients are expected to use its A& E this year, up from 150,000 last year. Despite praising mortuary attendants for their compassionate approach, the report said: “An example of this [increased workload] was the temporary fridge in the mortuary. While increases in A& E, wards and maternity services had been recognised, the need for care at the end of a patient’s life was not adequately catered for.

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Pulse

  • Serco to withdraw from UK clinical services market.

    Outsourcing giant Serco has announced plans to withdraw from the clinical health services market in the UK after making a multimillion pound loss on its NHS contracts. The move follows a review of the cost of delivering “improved service levels” and meeting the performance requirements of several existing contracts, the company said in a stock market statement. “During the period, the group continued to monitor performance in the UK clinical health operations against which an onerous contract provision was made in the prior year and where the group’s intention is to withdraw from the UK clinical health market,” it said. “The group has revised upwards the estimate of the costs of running the contracts to term, resulting in an additional non-cash exceptional charge of £3.9m in the period (year ended 31 December 2013: £17.6m).” Serco’s planned withdrawal could influence significantly how other private firms view the prospect of bidding for contracts involving patient facing services. It also follows months of speculation about the outsourcing giant’s clinical operation. The group had already made an early exit from its contracts to provide Cornwall’s out of hours services and clinical services to Braintree Community Hospital, the statement said. A spokesman for Serco said today it had made “a number of announcements regarding our future presence in the clinical services market”. This included the disposals of the Braintree contract and occupational health services, and the early exit from the Cornwall out of hours contract. The half year results statement confirmed this strategic direction.

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  • Why are GP contracts being thrown open to private companies?

    Read our Q& A on NHS England’s policy to only procure APMS contracts. Why can’t GPs just compete for contracts ? APMS competitive tenders would enable private GP providers and the voluntary sector to compete alongside GPs, but putting in a tender can cost tens of thousands of pounds and many small or single-handed GP practice might not have the backing to compete. Dr David Jenner, GP contract lead at the NHS Alliance told Pulse: ‘Often minimum requirements of IT, quality, financial backing, in practice can make it difficult for small providers to effectively compete. He added: ‘The other risks of tenders is that there is significant cost and opportunity cost [time] in procurements, especially for small scale ones. It can be a very inefficient way of procuring a service of limited value.’ When were these changes made ? Londonwide LMCs’ medical secretary Dr Tony Grewal told Pulse they had been aware of NHS England (London) area team’s preference for commissioning via APMS contracts since the health and social care act came into force. And Dr Jenner told Pulse procuring practices on APMS contracts had been customary for years. But Pulse’s findings are the first to show that NHS England has entirely rejected new PMS and GMS contracts. Why are GMS contracts ‘invaluable’ ? Dr Jenner told Pulse GMS contracts were invaluable, because unlike PMS they are not time-limited. Dr Jenner said: ‘My opinion is that, with general practice, which is about life-time care to people and local communities, actually a permanent contract makes really good sense for patients.’ While Dr Tony Grewal described APMS as ‘a short-term process, and it’s designed for people to go in, to make a profit, and to go out again. Which is not, in my opinion, what general practice is about.’

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HSJ

  • Exclusive: Hospital trust sector deficit could breach £750m this year.

    The NHS acute sector is expecting to record a net deficit in excess of £750m for the current financial year, exclusive HSJ research shows. The findings are based on the latest available figures from all but six of England’s 140 hospital trusts. They have prompted warnings that financial problems facing the sector are no longer confined to a few poor performers, instead appearing to be “systemic”. Nearly half the sector (66 trusts) is currently planning or forecasting a deficit for 2014-15. The gross deficit projected by those organisations is £940m. In contrast, the gross surplus projected by the 68 trusts planning to finish the year in the black is just £167m. This would mean an overall deficit of £773m for the acute sector - a steep decline on the already grim financial circumstances of the last financial year, in which the sector recorded a net deficit of £421m. Financial problems are spread across the country’s hospital trusts, with an overall deficit expected in a large majority of health economies. This analysis provides the most comprehensive picture to date of the scale of the financial challenge facing the NHS this year. It comes after HSJ reported signs the commissioning system is also under increasing strain, with NHS England unable to confirm plans to balance its £97bn budget until three months into the financial year. NHS finance experts said the latest figures add weight to the prospect that the health service will need a bailout in 2014-15. Health Foundation chief economist Anita Charlesworth said last year’s drive to increase nursing staff in the wake of the Francis report was a major driver of declining acute trust finances. She told HSJ: “We are seeing a rapid deterioration of finances as a result of fundamental underlying factors.

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The Guardian

  • Income from private patients soars at NHS hospital trusts.

    Some of Britain's leading hospitals stand accused of exploiting the coalition's controversial lifting of the cap on the number of private patients they can treat to increase their income as part of a "creeping privatisation" of the NHS. As new figures show that some hospitals have seen a big increase of up to 40% in their private income since the cap was lifted, Labour accused ministers of presiding over a scandal of declining standards for NHS patients while allowing paying patients to enjoy high standards of care. The determination of NHS trusts to make the most of the cap being lifted has been highlighted by the decision of the Royal Brompton Trust, a centre of expertise in treating heart and lung disease, to open a "private outpatient facility" in Harley Street, the world centre of private medical treatment. But less than a mile away from the Brompton Hospital, at the Chelsea and Westminster Hospital on the Fulham Road, west London, there is concern about the implementation of the lifting of the private patient cap. Its annual report lists it as one of the "principal risks and uncertainties facing the trust". Hospitals were given the right to generate up to 49% of their income from private patients under the terms of the Health and Social Care Act, which was the former health secretary Andrew Lansley's brainchild. Under the rules introduced by the last Labour government for foundation hospitals, the amount of private income was capped at the level reached in 2006. This averaged about 2% around the country but there were regional variations, with higher rates in London.

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38 Degrees petition

Tuesday 19th August 2014

Local Government Chronicle

  • Serco to withdraw from UK clinical services market.

    Outsourcing giant Serco has announced plans to withdraw from the clinical health services market in the UK after making a multimillion pound loss on its NHS contracts. The move follows a review of the cost of delivering “improved service levels” and meeting the performance requirements of several existing contracts, the company said in a stock market statement. Serco’s planned withdrawal could influence significantly how other private firms view the prospect of bidding for contracts involving patient facing services. It also follows months of speculation about the outsourcing giant’s clinical operation. The group had already made an early exit from its contracts to provide Cornwall’s out of hours services and clinical services to Braintree Community Hospital, the statement said. A third “loss making” contract with Suffolk Community Health will end next year, after running its full term. As reported in LGC’s sister title Health Service Journal, Serco announced in February it had signed a deal with another care firm, Bromley Healthcare, to help improve performance on the Suffolk contract. A Serco spokeswoman told HSJ at the time that it was “committed to directly providing community care services”. “Our commitment to the community healthcare market in the UK is undiminished,” she said. Serco’s former managing director of health services Valerie Michie, who left the firm in April, has previously denied claims its £140m bid to run the Suffolk contract was unrealistic.

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Kent Online

  • Swale West Tory veteran Keith Ferrin says privatise 'lousy' Medway Maritime Hospital.

    Former county councillor Keith Ferrin is calling for Medway Maritime to be privatised. The views of the veteran Conservative, who lost his Swale West seat in last year’s elections, comes just weeks after the chief inspector of hospitals said he still has “strong concerns” about standards at the Gillingham-based hospital. Health secretary Jeremy Hunt told MPs last month that Medway NHS Foundation Trust was one of five out of 11 said to be failing last year which will remain in special measures until improvements are made.

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Essex County Standard

  • Births at coastal maternity units "insufficient" to justify 24/7 opening, review finds.

    A midwife shortage coupled with an “insufficient” number of pregnant women giving birth at Clacton and Harwich maternity units means keeping them open 24/ 7 cannot be justified, health experts have claimed. A review by NHS England has insisted an “urgent” review of midwife staffing should be carried out by Colchester Hospitals Trust, which runs units at Colchester General Hospital, Clacton Hospital and Harwich’s Fryatt Hospital. The report was commissioned by North East Essex clinical commissioning group, which is investigating whether the coastal maternity units should be staffed all day or just when mums-to-be choose to use them. The units reopened as “on demand” centres last month following a four-month closure for births due to a shortage of staff at Colchester General Hospital. NHS guidelines say units should have a midwife to annual birth ratio of 1:28. The report finds that despite a recruitment drive this year including the recruitment of a consultant obstetrician, the ratio is 1:30. Before they closed temporarily, Harwich and Clacton combined handled an average of five births a week, a level described as “insufficient” to justify a 24/ 7 service.

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Monday 18th August 2014

Teesdale Mercury

  • Paramedic cuts are a done deal, memo reveals.

    Calls are being made for a public inquiry amid allegations that changes to Teesdale’s ambulance service are being “steamrollered” through. A leaked North East Ambulance Service (NEAS) email reveals that “proposals” to change the make-up of ambulance crews have already been approved and instructions have been given to implement the changes. Instead of two paramedics in an ambulance in Teesdale, there would be just one plus an emergency care assistant with basic skills and a few weeks’ training. The NHS had arranged public meetings so residents could have a say on the proposals. But the leaked email shows that the Durham Dales Easington and Sedgefield Clinical Commissioning Group (CCG) has already put them into action.

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Pulse

  • Revealed: All new GP contracts will be thrown open to private providers.

    All new GP contracts will be opened up to bids from the private sector by NHS England in a move that GP leaders have warned marks the ‘death-knell’ of traditional life-long general practice. As a tide of practices face closure, managers have told Pulse that because of competition law they will not be replaced with GMS or PMS contracts, but with time-limited APMS contracts instead. The move has taken GP leaders by surprise, with the GPC seeking urgent legal advice about the move. Some have warned it will leading to the privatisation of the NHS with surgeries replaced with ‘short-term, profit making ventures’. APMS contracts were introduced in 2004 to open up primary care to ‘new providers’ and were famously used to procure the Labour government’s ill-fated ‘Darzi’ centres across the country. In October last year, Pulse revealed that NHS England’s London area team was planning to procure a ‘significant’ number of APMS contracts this year. And managers say this policy has been adopted nationally, to ensure that NHS England complies with competition regulations. Pulse has previously revealed an increasing trend towards APMS contracts. In February, NHS competion watchdog Monitor launched a probe on how to attract new general practice providers to regions with poor care, despite warnings from the GPC not to put ‘competition ahead of continuity’. GP leaders are warning that, with practices under increasing workload and financial pressure, strict tender requirements could exclude smaller practices from primary care and drive the invasion of private providers. And they are advising practices to seek alternatives to contract termination, for example by merging, when partners reach retirement in order to avoid losing ‘invaluable’ GMS and PMS contracts. GPC chair Dr Chaand Nagpaul said he was surprised to hear about the national policy that would ‘spell the death knell of the whole ethos of long-term, continuity of care in the way general practice operates’. He said the GPC was seeking urgent legal advice on whether NHS England was correct in asserting that APMS contracts were the only way to satisfy international procurement law. Dr Tony Grewal, medical director at Londonwide LMCs said they were worried about the moves in the capital that would replace family doctors with ‘short-term, profit making ventures that went against the ethos of primary care’. He added: ‘APMS is only for five years, potentially renewable, which means that you cannot invest time, you can’t invest in the long term. It’s designed for people to go in, to make a profit, and to go out again. Which is not, in my opinion, what general practice is about. What it means is, over a reasonably short period of time, given the rate at which practices are closing at the moment, you are going to have significant proportions of general practice services in London, being run by the commercials or big conglomerates.’ And Dr David Jenner, GP contract lead at the NHS Alliance and a GP in Cullompton, Devon, warned that the move would mean that independent GPs would struggle to compete with larger healthcare corporations.

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Northern Echo

  • People's March for the NHS organised by Darlington mums sets off from Jarrow.

    Hundreds of people joined a protest at NHS "privatisation" with campaigners following in the footsteps of the historic Jarrow March. The People’s March for the NHS, covering 300 miles from Jarrow to Westminster, has been organised by a group of working mothers from Darlington, who using the name #darlomums on social networking sites. Several hundred people attended a rally in Jarrow, before up to 300 set off on the first leg to Chester-le-Street. A 50-strong core group of marchers will follow the original route undertaken by the 1936 Jarrow marchers, in a bid to raise awareness around what they say is the growing privatisation of NHS care, the impact of cuts on the health service and to call for the return of responsibility for delivering NHS services to the Secretary of State for Health. The march takes them through 23 different towns and cities over three weeks and they are expected to be joined by more than 3,000 supporters along the route. Darlington mum Rehana Azam, who co-founded the group with Joanna Adams, said the 999 Call for the NHS campaign was created in response to the Government passing three pieces of legislation which have led to increasing privatisation of the NHS. Mrs Azam, who is a GMB union national officer for health, said: “We are outraged at the assault by Government on our most prized possession, the NHS. In just over four months, 3,000 people have registered to join the People’s March and we are seeing this number increase every day. We aim to collect local NHS stories from all over the country on our journey to London and we will present the concerns of the general public to MPs and serve notice to every politician who has voted to dismantle our NHS. We’re not going to let them forget what they have done.”

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Daily Mail

  • Failing hospitals in denial, says watchdog: Chief inspector says public's love of NHS should not blind them to the need to improve.

    Struggling hospitals are ‘in denial’ about their failure to provide safe care to patients, a leading health watchdog has warned. Professor Sir Mike Richards, the chief inspector of hospitals, said some NHS trusts had failed to learn from more successful ones for what ‘sometimes seems like decades’. Although there were many examples of outstanding NHS care in challenging circumstances, a few hospitals still deny they had problems and resist efforts to help them improve, he claimed. And he said the public’s loyalty to the NHS should not blind them to the fact that it does not always do ‘quite as good a job as we would like it to do’. He told The Independent: ‘Some of the struggling trusts [we have inspected] have responded incredibly well but others less so. 'Some have said we can get on with it on our own. But there are those that are somewhat in denial about their current position. That’s not a healthy state to be in.’

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Sunderland Echo

  • Sunderland medical practice faces closure.

    Thousands of people who use a city health centre could be looking for a new surgery after closure plans were announced. Patients at Wearside Medical Practice, which is based at Monkwearmouth Health Centre, in Dundas Street, have been sent a letter saying it is due to close at the end of next month. A review found that only a “low number of patients” are registered with the surgery, despite 2,000 people using it regularly. The current GPs’ contract to provide services there runs out in six weeks’ time. Despite patients getting the letter saying the centre is to close, bosses say the final decision has not been made yet and a review is ongoing. Pensioner Malcolm Cummings has been a patient at the practice for his entire life and will now have to find an alternative. “We’ll all have to change to another practice of course, but I think what is happening is they are removing our choice. The smaller practices, like this one, they seem to be doing away with, so we’ll end up being shoved into the bigger practices. It’ll not be long before we’re all at places with 50 doctors where you see a different person every time you have an appointment.”

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Thurrock Gazette

  • Politicians back campaign to scrap hospital car park charges.

    A local MP has spoken out against “unfair” hospital car parking charges. Stephen Metcalfe, MP for South Basildon & East Thurrock is backing a national campaign calling for an end to what has become a “stealth tax on the poor and vulnerable”. The national average for one day car park fees is a little more than £7. Mr Metcalfe believes what the money raised through these charges is spent on is unclear. He said: “One hospital in Bristol charges £12 for 4 hours and another in Crawley demands £25 a day. The charges are also not transparent. No-one knows what the money is spent on, or why hospitals increase the charges year after year.” Mr Metcalfe was also critical about the impacts that these charges have on both older people and cancer patients. Thurrock MEP, Tim Aker, has also thrown his support behind the national campaign led by the Daily Express.

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Friday 15th August 2014

Our NHS

  • 999 March for the NHS sets off tomorrow for 3 weeks.

    As the Coaltion Government’s dismantling of the NHS continues apace, actions are taking place across the country in an attempt to head off the assault on our most cherished institution. The latest initiative is the “999 March for the NHS” campaign launched by Darlingtonmums opposed to the Government’s sell-off of our health service. From August 16th to September 6th the 999 campaigners are marching from Jarrow to London echoing an earlier battle: the Jarrow Crusade of 1936, where unemployed workers brought much-needed attention to their plight during the Great Depression, which had been largely ignored by the government. The women have set themselves a big task: getting the country to rally behind the NHS and build the campaign needed to save it. As NHS workers, we believe it is vital that the unions publicly back the People’s March for the NHS and mobilise their members to support it. The march is a chance to demonstrate the unpopularity of the Government’s reforms and the determination of NHS staff to resist them. As such, we have sent this letter to circulate to union branches to appeal for their support for the march. But the March can also be seen as something more pivotal still: a rallying point for NHS campaigns which have remained fragmented and localised throughout the Government’s term in office. Despite all the cuts, closures and crises brought about by Coalition policy, there has been little nationally organised response to this from either the unions or campaigners. It’s time for this to change. Only by uniting the different local campaigns - whether over A& E closures, cancer treatment, GP surgeries, understaffing or whistleblowing - can we build the kind of strong national movement that has any chance of scoring victories, reversing Government policy and saving our NHS.

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Pulse

  • Practice survey reveals just one fifth of GPs expect their practice to survive.

    Only a fifth of GPs expect their practice to still exist in 10 years, according to devastating results of a wide-ranging survey of practice staff on the future of general practice. The poll was initiated locally by a practice manager in Oxford and ended up being cascaded right across England, receiving over 2,700 responses, three-quarters of which were from GPs. The final results showed only 20% of respondents were confident their practice would exist in 10 years, while a third said the exact opposite. Almost all the respondents – 97% – agreed their practice was ‘experiencing an ever increasing and unsustainable pressure of work’, while 68% said their referral rate was likely to increase in order to cope with increased demands on general practice. Worryingly, four-fifths of respondents said they believed one or more GPs in their practice was suffering from ‘burnout’. Andrew McHugh, medical practice director at the Horsefair Surgery in Banbury, Oxfordshire, said he initially sent out the survey to local practices in April but received such a strong response he then circulated a more extensive list of questions more widely. Mr McHugh has also analysed some 26,000 words of free text contributed as part of survey responses, with the most common themes ‘unsustainability’, ‘workload’ and ‘gp bashing in the media’. Mr McHugh told Pulse he hoped the survey would help get politicians to take more notice of the unfolding crisis in general practice. He said: ‘The whole purpose of producing this was try to get something out there. There is a crisis developing but at the moment I feel that I’m shouting “iceberg” and what I’m hearing from behind is “full steam ahead”.’

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The guardian

  • Cancer patients dying early because of postcode lottery.

    Thousands of people are dying early of cancer every year because of an "inexcusable postcode lottery" in how quickly the NHS diagnoses and treats the disease, a leading charity warns. Delays mean that cancer patients in some areas of England have up to a 61% higher risk of dying within a year of their diagnosis than those in other places, simply because of where they live. While one in four (24%) of newly diagnosed cancer sufferers in north-east Hampshire and Farnham in Surrey die within a year, 38% of those in the London borough of Barking and Dagenham do so, according to a new Macmillan analysis of data from the Office for National Statistics. The same proportion (38%) of patients also die within a year in five other places – Crawley, Sussex; Newham, east London; Swale, Kent; Vale Royal, Cheshire; and Thanet, Kent. Those areas are in stark contrast to Westminster in central London, which has the second-best record for patients not surviving for a year, at 27%. Richmond and Barnet – both in London – are next, on 28%, while six areas are on 29%, including those in Leeds North and the Dorset NHS clinical commissioning group (CCG) areas. About 6,000 more people a year would still be alive 12 months after being diagnosed if average survival across England could be made as good as that already achieved by the top 10% of England's 211 local CCGs, the charity says. "This analysis shows an inexcusable postcode lottery, which is responsible for 6,000 patients dying needlessly every year within 12 months of being diagnosed with cancer," said Juliet Bouverie of Macmillan. "It's a no-brainer. When patients have to wait longer for diagnosis and treatment, their chances of surviving are significantly reduced." Macmillan highlighted the fact that the CCGs with the poorest one-year survival rates are on average the same ones that are failing to ensure that cancer patients start treatment within 62 days of referral by their GP, as NHS waiting-time targets stipulate that they should.

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The Guardian

  • NHS faces legal bill as dozens suffer problems after private eye operations.

    Dozens of people have been left with impaired vision, pain and discomfort after undergoing operations provided by a private healthcare company at an NHS hospital. One 84-year-old man claimed he has lost his sight and his family is calling for a full independent inquiry after it emerged that half of the 60 patients who underwent surgery suffered complications. The routine cataract operations were carried out by the private provider in May to help to reduce a backlog at Musgrove Park hospital in Taunton, Somerset. But the hospital's contract with Vanguard Healthcare was terminated only four days after 30 patients, most elderly and some frail, reported complications, including blurred vision, pain and swelling. Some of those who suffered complications, including the 84-year-old man, have contacted lawyers to discuss seeking compensation, which raises the prospect of an NHS hospital picking up the bill for procedures done by a private health company. The trust refused to talk in detail about what happened pending the conclusion of its own investigation. It also refused to discuss who would pick up any bill for compensation or details of its contract with Vanguard. But, when the problems surfaced, a senior member of staff at Musgrove Park appeared to concede that the hospital would be liable for any payments. Dr Colin Close, Musgrove Park's medical director, acknowledged compensation claims could be made and was quoted in a local paper saying: "Any financial responsibility would rest with us." The hospital now claims that Close was misquoted. The son of the 84-year-old patient, who asked not to be named, said his father was referred for the cataract surgery by his GP. The retired salesman, from the Somerset Levels, did not consider he needed the operation but agreed to the treatment.

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Thursday 14th August 2014

Our Kingdom

  • Modernise: de-privatise - new OurKingdom series.

    If such a thing is possible, there are two consensuses on privatisation. The first is the overwhelming agreement amongst almost all of the political class that it is inevitable and a thoroughly good idea. The second is among the public, who, more than almost any other issue than perhaps approval for motherhood and enjoyment of apple pie, are near unanimous in despising it. The truth is we simply can't afford privatisation any more - the prices it produces are far too high. Look at your water bill, your gas bill, your rail ticket (if you can afford one). Last year, the City shrieked in terror that the majority of the public have turned their back on privatisation - we want our assets back. Not by coincidence, it seems that the public are more in touch with their lived reality than their rulers. There is now a significant body of evidence to suggest the privatisation project has failed to improve services. To paraphrase Mr Keynes, the nastiest motives of the nastiest men do not somehow work out to produce the best social results. If privatisation was ever really intended to improve the lives of ordinary people in Britain rather than just to enrich the already rich, it has failed on a grand scale. Much of what we write here on OurKingdom bears witness to that failure. OurNHS challenges it specifically in the context of healthcare. Clare Sambrook's project, “Shine a Light”, has exposed the behaviour of G4S and other for-profit companies. But showing that a system doesn't work is not sufficient. It is also vital to demonstrate that there is an alternative. In some cases, of course, the other option is obvious. To everyone but the most ardent libertarians and anarchists, there is some sort of role for the state. It is pretty clear, for example, that the government owned NHS operated very effectively. Read the evaluations of the NHS from overseas medical clinicians, international institutions and public health academics, rather than the smears of the right wing press and think tanks in Britain, and you'll understand why. In other cases, though, what we ought to replace private control with is less clear. We might easily be able to agree that we want more democratic ownership, but what that adds up to is not always simple. State control certainly isn't always the answer and, because of the risk of alienating bureaucracy, perhaps it shouldn't even be the default.

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London Evening Standard

  • Royal baby NHS trust to slash NHS beds and boost private income.

    The NHS trust where Prince George was born is planning to double its income from private patients while slashing the number of NHS beds. Imperial College Healthcare NHS Trust’s plans are part of a controversial shake-up of care at its three main hospitals. It hopes to double its £39 million annual private income, including at the Lindo wing of St Mary’s hospital where the Duchess of Cambridge gave birth last July. Under the five-year plan the number of inpatient beds at Charing Cross will be slashed from 360 to 24. It will be left with 150 beds in total — including 86 for day cases and 40 for GP referrals. The number of inpatient beds at Imperial is to fall from 1,167 to 958 under changes designed to treat more people as outpatients or in day surgery. Hammersmith MP Andy Slaughter described the plans as “another slap in the face for everyday west Londoners”. They follow confirmation that the accident and emergency departments at Hammersmith and Central Middlesex hospitals will close on September 10.

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The Star

  • 1,000 march in Sheffield for NHS protest.

    Up to 1,000 people will march through Sheffield in a mass protest against cuts and changes putting the NHS ‘under threat’. Sheffield Save Our NHS is co-ordinating the event on August 25 and 26, which is part of a larger procession led by mums’ group 999 Call for the NHS. They are following in the footsteps of the Jarrow Crusade by marching 300 miles to highlight health cuts and privatisation. Sheffield’s first altruistic organ donor Dr John Carlisle - who gave a kidney to a stranger last year - is backing the protest and encouraging all donors and recipients to take part. The grandad said: “The journey of a donor from the first tests to the final operation and recovery illustrates all the strengths of this wonderful organisation. “Careful examinations, flawless handovers, caring nursing and brilliant specialists all co-operate to give someone a new life. Only an ignorant fool would think that competition is a good thing in health and social care.” Mike Simpkin, from Sheffield Save Our NHS, added: “We hope up to 1,000 people will join us.

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Our NHS

  • NHS protest camp and a new Jarrow march - whatever it takes to save our hospitals.

    This weekend a health-related camp issued a plea. 'Urgent appeal for long metal pins and heavy duty guy ropes/ draw ropes - urgently needed at camp!' Not a plea from Medical Aid for Palestine in ravaged Gaza, but from the ‘accidental camp' set up in the Hunt-stricken Stafford Hospital, now facing an additional threat from the remnants of Hurricane Bertha. Just a few short years ago, none would have believed it possible that a community would need to defend a hospital in this way. But the cuts are biting. Public health is crumbling. This week hospitals have reported a 71% rise in patients admitted suffering from malnutrition since 2010, including a 31% rise in the yesteryear Vitamin C deficiency disease, scurvy. Echoes of Daniel Defoe and Proust in the 21st century. We learn too that the equivalent of three early intervention Sure Start centres have been closed each week since the election. 623 communities with reduced life chances and the loss of important public health projects. Hospitals have been left “full to bursting”, in the words of Jamie Reed, Shadow Health Minister.

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Tax Research UK

  • The Observer features the strike by care workers in Doncaster as its main story today (August 10).

    I am delighted they have. This is a massive issue for the UK, for the people in question, for the poorest paid in this country, for the future of care services and the future direction of the NHS. As the Observer notes the issues relate to Care UK, a regular bidder for privatised care contracts in the UK. It won the the supported living contract in Doncaster after telling officials that it could deliver it for £6.7m over three years. Yet the wage bill alone for the service was £7m. The result was that it then demanded pay cuts of up to 35% from former NHS staff and has offered new staff a pay rate of £7.00 an hour, which is less than the living wage. There are many facets to this story, and the Observer covers them well: "Richard Murphy, a chartered accountant and anti-poverty campaigner who has analysed Care UK’s business model for another union, Unite, said he recognised similarities with all the major private equity-backed care firms. He said: “They often win contracts on the basis of making losses or small profits. At the same time they are putting in place what look to be tax-driven structures that are designed to mitigate taxes on profits. I believe that what a lot of these companies are trying to do is to undermine any chance that an NHS organisation can win contracts. “Once they have squeezed out the state sector, and the third sector, we will then see prices rise; then we will see profits; then we will see these tax-efficient structures working.” This is the ‘loss leader’ model at work. The dogma of privatisation is not only destroying livelihoods and care now, it is designed to cost us more in the long term.

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HSJ

  • Inadequate GPs will be told to improve or face closure.

    GP practices that persistently provide inadequate services will face closure if they fail to improve within a year, the Care Quality Commission has announced. The CQC today unveiled its special measures regime for general practice, which will be introduced in October, at the same time as its new style inspection process and ratings of individual practices will begin. The chief inspector of general practice Steve Field told HSJ that while the “vast majority” of practices “are providing care which patients would want to see” a “very tiny percentage are letting the rest of them down”. “Many of those people have known about for years, but unfortunately the concerns haven’t been addressed consistently across England,” he said. Under the new regime, if a practice that is deemed to be ‘inadequate’ does not improve within six months, it will be placed into special measures. If the practice was still found to be inadequate after a further six months, the CQC may cancel its registration and/ or NHS England terminate its contract. However, the CQC may place a practice in special measures immediately if it is “really worrying”, Professor Field said. Out of the practices that have been inspected since April, when the CQC began piloting its new-style inspections, the number of practices that would fall into the category is in “single figures”, he revealed to HSJ. He said “what you tend to find” at the worst performing practices “is a practice that’s failing generally on a number of areas, without good leadership”.

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  • NHS mental health providers have slashed beds and staff levels as they cope with real term funding cuts and the soaring cost of sending patients hundreds of miles away for treatment.

    These are the chief findings of an HSJ investigation based on Freedom of Information requests and financial accounts of all 57 NHS mental health providers. The analysis revealed that mental health trusts suffered a 2.3 per cent real terms funding cut between 2011-12 and 2013-14, when figures were adjusted for inflation. One in five trusts saw income reduce by 5-9 per cent, while five saw budgets plunge by more than 10 per cent. Data obtained under FoI requests from 52 trusts revealed an overall reduction in nursing staff of 6 per cent from 2011-12 to 2013-14. The number of doctors employed by mental health trusts fell by 2 per cent over the same period. Bed numbers also dropped, while the bill for sending patients out of area to other hospitals due solely to capacity issues shot up. These “placements” can be expensive and are considered poor practice.

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The Guardian

  • Brits, don't be fooled: the NHS is brilliant.

    And Aussies ? Don't let your guard down. We have lived in London since 2008 and not a day goes by when the National Health Service isn’t in the news, more often than not for mistakes, delays, apparent inefficiency or targeted for funding cuts. From the red top tabloids to the circulation busting, Daily Mail, sticking the knife into the NHS seems to have become a favoured British sport (paradoxically, Britons still gush with national pride about Danny Boyle’s London Olympics opening ceremony and his eccentrically, flamboyant homage to the NHS.) Paradoxically too, despite this background hum of complaint, just 11% of Brits have private medical cover, compared to the 54% of Australians who pay for some form of general treatment cover. Like most other Aussies, I’d paid for private health insurance since my mid 20s. Australia also has a world class public health system but “gap” payments – the costs over and above what is reimbursed by Medicare – can be significant, especially for specialist treatment. Having a family with four kids meant it made even more sense later although I was shocked by a rough, back of the envelope calculation that shows $70,000 went in medical insurance since the mid 1980s. In Britain, dentistry is pretty much the only medical procedure you pay for, and even that is incredibly cheap: £18.50 for screening and x-rays to a capped, one-off £219 payment for complex, multiple treatments like crowns, bridges and dentures. All GP visits and diagnostic tests are free while under 16s receive free prescription medicines as well as dentistry, including orthodontics such as braces.

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The Independent

  • Cuts leave NHS mental health services 'dangerously close to collapse'.

    NHS mental health services are “running dangerously close to collapse”, psychiatrists have said, after new figures revealed the full damage that cuts over the past two years have inflicted on staff, capacity and quality. An investigation by the Health Service Journal (HSJ) has revealed that there are 3,640 fewer nurses and 213 fewer doctors working in mental health in April this year compared to staffing levels two years ago. Freedom of information requests and analysis of workforce data revealed that the NHS’ 57 mental health trusts had lost 2.3 per cent of their funding, equivalent to £253 million. The cuts have led to a drop in the capacity of mental health services around the country. On numerous occasions, mental health patients in crisis have had to be moved, sometimes hundreds of miles, because there was no bed for them local mental health units. HSJ found that one patient travelled from Yorkshire to the South West – a journey of more than 300 miles. Across 45, mental health trusts, bed capacity has been cut by 846, their analysis revealed. Sir Simon Wessely, president of the Royal College of Psychiatrists, said that the figures were “a glaring warning sign” that mental health is “running dangerously close to collapse". The Government has been criticised for allowing mental health services to be cut disproportionately, as the NHS as a whole undergoes the severest budget squeeze in its history. Luciana Berger, Labour’s shadow health minister for public health, said that the new figures were “appalling”.

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Tuesday 12th August 2014

GP Online

  • Exclusive: GPs reject move to seven-day primary care service.

    NHS England national clinical director Sir Bruce Keogh revealed last month that delivering seven-day services across the NHS was his ‘number one priority’. Sir Bruce told an event in London at the end of July that ‘answers are beginning to emerge’ on how the NHS could provide a seven-day service. But of 600 GPs who responded to the GP magazine poll, 88% said routine GP appointments should not be made available seven days a week on the NHS. GPs who took part in the poll warned that the profession was already overstretched and would be forced to work even longer hours if practices opened seven days a week. Out-of-hours providers already offered weekend GP services to those who needed them, they said, and huge investment and recruitment would be needed to make a seven-day service feasible. Findings from the poll reinforce a vote at the 2014 LMCs conference in York earlier this year, in which GP leaders rejected moving to a routine seven-day NHS service. Under the government’s £50m Challenge Fund initiative, CCGs have been offered millions of pounds to pilot extended access to general practice. Some area teams have pledged millions of pounds of additional funding on top of the Challenge Fund £50m. One GP said: ‘To remain free at the point of delivery we have to be realistic about what we can offer and how much it will cost. Currently GPs are at breaking point and unable to offer more – definitely not without significantly more funding and more GPs.’ Another warned: ‘Practice already understaffed and recruitment almost impossible – we will have to reduce weekday cover and appointments to extend hours.’ Another GP said: ‘I feel very strongly that this would result in many employers refusing to allow patients time off work to attend their GP. The GP service cannot cope with all employed patients needing appointments at the weekend rather than Mon-Fri. I think utter chaos would result if this were put into practice, and I think many GPs would leave the profession.’

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Pulse

  • Patient pressure prevents practice closure.

    A practice in London has been given a reprieve from a potential closure after patients campaigned against NHS England’s proposals to disperse the patient list across several neighbouring practices. The local area team took the decision to keep the Soho Square General Practice open, having initially indicated the practice could close because Central London Community Healthcare (CLCH) NHS Trust said it had no intention of renewing the contract it holds when it runs out on 30 September. The decision followed campaigning from local patients, who sent leaflets to residents warning that the 40% of patients who were Chinese speakers would not be well serviced by neighbouring practices. The win for patients comes as Pulse has launched its Stop Practice Closures campaign, which among other areas seeks to highlight the problems caused when practices are allowed to close. As part of the campaign, Pulse revealed that scores of practices across the country face imminent closure.

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Monday 11th August 2014

Guardian

  • The care workers left behind as private equity targets the NHS.

    Cheryl Fawley knows that if she softly places her hand on John's cheek he will sip his water. "You need patience. He likes to be comforted. If you just gently put your hand on his cheek, he'll drink," confided Fawley. It's one of the many pieces of wisdom – trivial, and yet not – that this slight, nervous mother-of-three has picked up over her 16 years as a support worker looking after people in their homes who have been stricken by disability, disease and frailty. On Friday, though, Fawley couldn't be by John's side. She was picketing with colleagues and friends outside the imposing, grey-tinted windows of the four-storey central London headquarters of Bridgepoint Capital, the private equity firm that has a majority shareholding in the healthcare company Care UK. Fawley, 42, is one of 237 support workers who were transferred from the NHS to work for Care UK when it won the contract to run community care services for people with learning disabilities in Doncaster. And she is one of the 50 who are on strike, fighting pay cuts of up to 35% imposed by the private health company and the £7-an-hour wage paid to the 100 new staff replacing some of those who have walked away in disgust. This determined, indignant group of strikers will have withdrawn their labour for 48 days in all, with gaps in between where arbitration and a court battle against the imposition of the new terms failed. The strike will go on, though. Perhaps for many weeks. It's looking likely that this could be the longest strike the health service has seen. "I expect the strikers to support more action, and for this to intensify," said Jim Bell, the Unison organiser. Fawley and her colleagues believe they are fighting for a fair wage. Her £8.91 an hour used to go up to nearly £12 when she worked through the night helping John and others. It would go to around £14 an hour on a bank holiday or weekend. It wasn't a fortune, and it involved time away from the family, but an annual income of £21,000 "allowed us a life", she says. Care UK ripped up those NHS ways when it took over. Today Fawley, like her new colleagues who are on £7 an hour, receives an extra £1 an hour for a night shift and £2 an hour for weekends. Perhaps it shouldn't, but it smarts with some of the strikers when they hear that the highest paid director of Bridgepoint, Care UK's owner, received a salary of £1.1m in 2012, or that £14m was passed around its staff in bonuses. But Fawley isn't into envy. She loves her job. Loves the people she works with, and says for her this battle is as much about looking after the interests of the people she and others care for, here and elsewhere around the country, where firms such as Care UK are increasingly seeking to take over this type of service. "It's like we have had all these years building up experience, learning from our mistakes, and now it is all meaningless," she said. "The NHS encourages you to have these NVQs, all this training, improve your knowledge, and then they [private care companies] come along and it all comes to nothing." Fawley's husband Jason, 41, who works in a warehouse for Tesco, admits that recent months have been hard, and the pressure has told on their relationship at times. They face losing £400 a month – a quarter of their income. His wife's annual holiday has also been reduced by eight days and, should she fall sick, the first three days off work will now be unpaid. "She is up at night worrying about paying the bills," he said. "People are going to have to leave. They are bringing in people on £7 an hour who often don't want to do this sort of job. You have to pay the bankers their bonuses to keep the talent. Is this not as important or more important – keeping these people safe ?" For all the talk of this private provider being forced by circumstances to make difficult decisions, Care UK expects to make a profit "of under 6%" by the end of the three-year contract it has for running the service. In 1993 the private sector provided 5% of the state-funded services given to people in their homes, known as domiciliary care. By 2012 this had risen to 89% – largely driven by the local authorities' need for cheaper ways to deliver services and the private sector's assurance that they could provide the answer. More than £2.7bn is spent by the state on this type of care every year. Private providers have targeted wages as a way to slice out profits, de-skilling the sector in the process.

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  • Patients forced to wait in ambulances outside 'too full' A&Es, says Labour.

    Hundreds of thousands of patients in need of emergency care are being left at the doors of A& Es in ambulances because hospitals are too full, Labour has said. Figures obtained by the party show that last year almost 300,000 patients in England were caught in queues of ambulances outside emergency departments. In 2013/ 14, more than 279,200 ambulances were delayed for more than 30 minutes and a further 30,600 faced waits longer than one hour, Labour said. Labour said that the "handover delays" occur when ambulance crews cannot transfer a patient to A& E because of staff or bed shortages.

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Scotsman

  • Opening back door to NHS privatisation.

    A letter from Dr Evan L Lloyd reads: Having worked as an anaesthetic colleague with Professor Mike Dixon for many years, I hate having to write and tell him he is wrong about the safety of the NHS after a No vote. I agree that the NHS, particularly in Scotland, is a far better – and more cost-effective system – than that in the United States. However, there are still risks in a No vote. Even though I have retired, I remain a paid-up member of the National Health Service Consultants Association (NHSCA) and Keep Our NHS Public (KONP). Through their newsletters, I get information as to how the NHS in England is being dismantled. Through this I learn that the funding for the NHS in England is being reduced. This is likely to feed through to a devolved Scotland. However, the greatest risk is coming from what is called the Transatlantic Trade and Investment Partnership (TTIP), the fruit of long-running negotiations between the European Union and the US over trade liberalisation. One of its fundamental principles is that services, including state services, should be open to private competition from US multinationals. According to Ignacio Garcia Bercero, the EU commissioner with responsibility for TTIP, health services in Europe will be opened to private competition, but only where privatisation is already established. In other words, where there is an existing state monopoly, foreign companies cannot sue the government in question for unfair completion. The UK Health and Social Care Act opened the UK system to TTIP because it explicitly introduces a private market in health provision in England. After a No vote, private providers and insurance companies may argue that, since Scotland is not a sovereign state but a region of the UK, it cannot be exempted from competition for health provision. As the UK has made the NHS in England TTIP compliant, it seems highly likely that the Scottish system will be seen as an unacceptable anachronism in a unitary state. This is the major risk to the NHS and I know that consultant members of NHSCA and KONP in England are reaching the depths of despair. I don’t want to see this in Scotland, which is the reason I will definitely be voting Yes and I would suggest that all medical people in Scotland who want to preserve our current NHS, with all its faults, should vote Yes.

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Nottingham Post

  • Two hospital wards face axe.

    The county's mental health Trust is to launch a six-week public consultation over plans to close two in-patient wards at the City Hospital – despite one of them already having stopped taking patients. Bosses at Nottinghamshire Healthcare say a decision has not been taken over the closure of Bestwood and Daybrook wards and public meetings will be held to discuss the plans. But the Bestwood ward has already stopped taking in-patients, with its remaining patients sent elsewhere. The trust suggests it was mostly empty due to lack of demand so the decision had to be taken to ensure patient safety. If the wards are both permanently closed it will halve the number of inpatient beds available in the county for people suffering with mental illness from 80 to 40.

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Scunthorpe Telegraph

  • Campaigners bid to save Scunthorpe GP surgery.

    Action is underway to save a Scunthorpe GP surgery from closure. The Cauvery Medical Centre on Cottage Beck Road is set to close in October after both Dr NK Shambhulingappa and Dr Ratna Ugargol retire, meaning 3,700 patients need to find a new practice. Now Unison's Scunthorpe Health Branch is calling for urgent action to save it. Julian Corlett, UNISON's Scunthorpe Branch Secretary, said patients were not consulted on the closure. "Nothing can be done about the two doctors retiring and they have served the town extremely well over the years, but I think the decision to close is part of a cost cutting exercise. We are calling on NHS England to put locums into the practice at the end of October to allow time for permanent replacement doctors to be found to run it in future."

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Insider Media

  • Mitie boosted by first-half contract wins.

    Bristol-headquartered outsourcing group Mitie has hailed its "positive start" to 2014, with organic revenues boosted by a number of major private and public sector contracts. In the private sector, the group will manage facilities for the Royal Cornwall Hospitals NHS Trust over the next seven years after signing an agreement worth £90m.

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Friday 8th August 2014

Western Morning News

  • Firm who run private ambulance service given last chance, as fears grow on outsourcing.

    Health bosses have issued an ultimatum to a private company running non-emergency patient transport in Devon and Cornwall, saying it has one last chance to get services up to scratch. NSL, previously known as car park company NCP, took over patient transport from the South Western Ambulance NHS Trust last year but has since been on the end of numerous complaints. In a letter sent to Exeter MP and former health minister Ben Bradshaw, which has been seen by the Western Morning News, the group which holds the purse strings for buying healthcare indicated that its patience was wearing thin. The letter, signed by Caroline Dawe, the Northern locality managing director of the Northern, Eastern and Western Devon Clinical Commissioning Group (CCG), said they were aware of “NSL failings” and what patients encountered “often repeatedly”. She said talks were under way “to resolve issues” and a programme of re-negotiation had been embarked upon with the aim of ensuring the system worked for all. However, she added that further action had not been ruled out: “This is the final attempt to make it work before the CCG considers other options.” The letter admits that “NSL is not delivering the standard of the service that the CCG as commissioners expected to be delivered”

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The Guardian

  • Manchester's hospital reform plan has been a failure.

    The backlash over plans to reconfigure hospitals and primary care in Greater Manchester is a warning of what can go wrong if consultations are mishandled. The plan – badged Healthier Together – was launched last month by the area's 12 clinical commissioning groups. There are four problems: theconsultation document is vague and confusing; they are not being up-front about the need to cut costs; it has provoked a fight between four foundation trusts (FTs); and the proponents of change have alienated local MPs, who have torn into the exercise. The consultation document repeats a mistake made in other reconfiguration controversies in being concrete about what will be closed or downgraded but vague about the benefits, notably around primary and community care. The primary care standards and warm words about joint working mean little, and the scattergun examples of local progress do not add up to a coherent offer – residents need hard commitments. Are the changes driven by money or quality ? The consultation claims it's about improving services by removing performance variations, there is virtually no mention of cash. But the separate financial breakdownreveals "there is a strong financial case for change … without action now all providers will face an undeliverable challenge … it will not be possible to both balance the books and meet the agreed clinical standards." It forecasts a gap of £742m by 2017-18. The financial paper is not meant for the public. After a comical disclaimer from authors Deloitte that "no reliance may be placed for any purposes whatsoever on the contents of this document", it discusses the quality, innovation, productivity and prevention gap and earnings before interest, taxes, depreciation and amortisation margin. What bit of all that is going to give Mancunians confidence in the process ?

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HSJ

  • Beware the false solutions to the NHS's challenges.

    The term “groupthink” is a “psychological phenomenon within a group, which the desire for conformity results in an irrational or dysfunctional decision making outcome. Members reach consensus without critical evaluation of alternative or dissenting viewpoints and by isolating themselves from outside influences”. ‘Sadly, just saying something repeatedly and assertively doesn’t make it so’ .Supporting groupthink are “factoids”: “questionable, spurious or unevidenced statements presented as facts”. We currently have a glut of both, with “magic bullet” thinking evinced to solve a set of wicked and intractable problems in healthcare. Remember the American journalist and scholar H.L. Mencken who said: “For every complex human problem, there is a solution which is simple, neat and wrong.”Perpetrators include some big and experienced brains among the “commentariat”. Look no further than the Nuffield Trust’s Wisdom of the Crowd paper, various ministerial pronouncements or even certain articles in HSJ. See also people plugging “solutions” that serve their own commercial or organisational interests. ‘Respect for credible evidence is required rather than spin’. Sadly, just saying something repeatedly and assertively doesn’t make it so. Credible opinion leaders can drive down service redesign, creating costly and damaging dead ends. Realistic expectations are required; as is some respect for credible evidence rather than spin. By way of illustration, I have set out 10 examples of assertions which have been made repeatedly but are either demonstrably false or where the opposite view is just as valid but rarely heard. I won’t bother making the case for these assertions here – plenty of others have already. I am on the side of the underdog.
    1. We have too many hospital beds and the very existence of these beds drives activity into hospitals. Really ? We have lost around one-third of our acute beds since 1979; lost them faster than nearly all OECD countries; and have fewer beds per head of the population than nearly all.

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  • 'Safeguard our NHS' in trade deal.

    Most voters in key battleground constituencies want to see the NHS safeguarded from a new trade deal which campaigners claim threatens privatisation of health services, according to a new survey. More than two-thirds opposed the inclusion of the NHS in negotiations over the Transatlatic Trade and Investment Partnership, a poll of more than 2,600 adults in 13 marginal Conservative constituencies for the Unite union showed. Opponents claim the trade deal is being negotiated behind the closed doors of the European Commission between EU bureaucrats and delegates from the US. The government denies any deal will lead to the privatisation of the NHS, saying it would create jobs. Unite general secretary Len McCluskey said: “The Tories’ Health Act of 2012 opened our NHS up to profit making US private firms and a new trade deal threatens to make the sell-off permanent. It’s clear from this poll that the NHS is going to be a major issue at next year’s election. “The results prove that people firmly oppose the inclusion of the NHS as part of the trade deal. A majority of people even think that David Cameron should use Britain’s veto. David Cameron’s silence is deafening. He is refusing to answer a very simple question: are we going to exempt health from the EU US trade agreement ?"

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  • The chief executive of NHS England plans to publish a ‘five year forward view’ of the NHS in October that will set out the consequences of continued curbs on healthcare funding.

    Around 15 workstreams have been identified to contribute to what is expected to be a pivotal document, HSJ understands. Simon Stevens is expected to use it to set out a strategy for the NHS and for the health of the public. The work is being coordinated by Jo Lenaghan, director of strategy and workforce planning at Health Education England, who is on secondment to NHS England three days a week. Mr Stevens told a board meeting last month that the work would set out the “prospects and options for the NHS”. Sources said the work was expected to make clear what could happen if demand for healthcare continued to grow while NHS funding stayed static in real terms. No major political party has yet pledged to significantly increase NHS funding after next year’s general election The “forward view” is expected to be much broader than the work on NHS England’s strategy that was carried out last year. The workstreams are understood to be examining the role of taxation in incentivising healthy behaviour, the potential for longer term financial settlements for the NHS, and the contribution of government departments other than health. Other areas being looked at include population change and demand, learning from international examples, the NHS contribution to the economy, and the role of employers, carers and individuals. The plan is also expected to research models for providing care; how different types of area could pursue different routes to sustainable services; and the future of specialised services commissioning.

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Thursday 7th August 2014

Local Government Chronicle

  • Private firms and local authorities in running to provide commissioning support.

    Private firms and two local authorities are in the running for a place on a “lead provider” framework that will determine which organisations supply backoffice services to clinical commissioning groups from next year. The announcement by NHS England of which bidders passed the first stage of its procurement process could herald the entrance of a range of new players into the support market. This is currently dominated by the 17 commissioning support units which sit within NHS England. Nine bids from CSUs - including some joint bids - have also passed the first stage of the process. Among the non-NHS organisations to make it through are Capita and Optum, which has submitted a joint bid with BT, KPMG and the Greater Manchester CSU. This CSU has also made a separate bid with Cheshire and Merseyside CSU, with which it is due to merge to form North West CSU. Two county councils – Essex and Surrey – and a consortium of public services company Mouchel; Engine and Dr Foster Intelligence has also made it through to the next stage.

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East Lindsey Target

  • Visitors to Lincolnshire should pay to see GP claim patient's group.

    Holidaymakers should be charged if they need to see a doctor while visiting Lincolnshire, says a patients' group. The call comes as it is revealed people who fail to turn up to appointments cost one local practice £49,000 in just three months. The Beacon Medical Practice, which has surgeries in Skegness, Ingoldmells and Chapel St Leonards, saw 695 people failed to turn up or cancel a booked appointment in June, costing an average of £17,375. In May, there were 587 Did Not Attends (DNA), costing £14,675 and in April the DNA figures were 678, costing £16,950. While the DNAs include both holidaymakers and locals, the surgery says it is under increased pressure during the summer months. Richard Enderby, chairman of the Beacon patient participation group said: "As a group we are continuing to lobby for more resources and to encourage temporary residents to become registered. In our view, the patient participation group would like to see changes in the NHS so that appointments made by temporary, unregistered patients are chargeable. That would be fair."

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Western Morning News

  • Fears 'creeping privatisation' will create a credit card healthcare system.

    Sick people will be asked for payment before treatment if a “creeping privatisation” of the Westcountry’s cherished NHS system continues unchecked, a former hospital director has warned. Rik Evans, who has worked at the most senior level of the region’s health sector for 25 years, said placing increasing numbers of services into the hands of the private sector threatened the heart of publicly owned health systems. He resigned from the board of the Royal Cornwall Hospital Trust (RCHT) over its plans to outsource 600 jobs in hotel services and said he feared the NHS was being pushed towards a US-style health system. “The majority of patients get extremely good healthcare from the NHS, but what they don’t see is the creeping privatisation which frankly, in the end, will mean a credit card every time someone needs care. The first question will not be ‘what are your symptoms ?’ but ‘how are you paying for this ?’ “People may think this is alarmist, but it’s really important they are aware of what is happening to the NHS.” Mr Evans resigned from his role as a non-executive director at the RCHT after nearly seven years, condemning as “scandalous” its decision to outsource hotel services, which includes cleaning and portering. He warned that the Truro-based trust putting its first major service out to tender was just the start. “What does it show about an organisation that is prepared to treat its loyal staff in this way and push them into a private company whose sole reason for existing is to make a profit for shareholders ? The staff were aghast at this proposal and there was a petition with 4,000 names on it presented to the trust board, but it was of no consequence. I believe that this is the thin end of the wedge and it wouldn’t surprise me if there was more privatisation to come.” Mr Evans said he feared the result of increasing private-sector input for core NHS services. “The NHS is the most popular institution in the country, but there are vultures out there who are just out to make money out of the NHS and that is not what it is for.” Mr Evans is a founder member of the Cornish branch of the national campaign group Keep Our NHS Public, which held its inaugural meeting in June. last month and will hold the next one on August 3. He said it would be a tragedy if the UK’s healthcare system ended up like that in the US, where most hospitals are owned by private companies with treatment determined by the level of health insurance held.

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  • Firm who run private ambulance service given last chance, as fears grow on outsourcing.

    Health bosses have issued an ultimatum to a private company running non-emergency patient transport in Devon and Cornwall, saying it has one last chance to get services up to scratch. NSL, previously known as car park company NCP, took over patient transport from the South Western Ambulance NHS Trust last year but has since been on the end of numerous complaints. In a letter sent to Exeter MP and former health minister Ben Bradshaw, which has been seen by the Western Morning News, the group which holds the purse strings for buying healthcare indicated that its patience was wearing thin.

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Shropshire Star

  • Cutbacks may hit Shrewsbury children's unit.

    Under proposals being considered by health chiefs, the children’s assessment unit at Telford’s Princess Royal Hospital would be open 24 hours a day, seven days a week. But the equivalent at Shrewsbury could only be open for 12 hours a day from Monday to Friday. Hospital bosses insisted no final decision had been made and it was only one of a number of options under consideration. But they have been accused of going back on an alleged promise to have specialist doctors and nurses for children at the Royal Shrewsbury for seven days a week. Shrewsbury MP Daniel Kawczynski and Shropshire Council leader Keith Barrow claim a deal was struck as part of an agreement to move services from Shrewsbury to the £28m women and children’s centre at Telford, which will open next month. Councillor Barrow said Shrewsbury and Telford Hospital NHS Trust chief executive Peter Herring assured him paediatric services would be on site at RSH for 16 hours a day, seven days a week.

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Huddersfield Daily Examiner

  • Huddersfield and Calderdale plan to slash 200 hospital beds "will not affect care".

    Hospital chiefs have stressed their plans to cut hundreds of beds will not affect care or mean large scale job losses. Owen Williams, chief executive of Calderdale and Huddersfield Foundation Trust, made the claim during a Kirklees Council meeting probing the plans to cut £39m from the hospitals’ budget over the next two years. Councillors and lay members on the Overview and Scrutiny Panel for Wellbeing and Communities said the public feared the cuts and did not understand how health care was evolving. As reported, health chiefs plan to vastly increase the amount of care outside of hospitals amid a controversial re-structure of services, that could lead to either the infirmary or Calderdale Royal Hospital losing its full A& E department. Clr Molly Walton, said hospital bosses needed to better explain why they could safely reduce the bed base from 836 to 636 across the two sites.

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North London Today

  • Post-mortem finds that toddler taken to closed A&E died of natural causes.

    A toddler died of natural causes after being mistakenly taken to Chase Farm Hospital a month after its accident and emergency unit was shut down, it has been revealed. Two-year-old Muhammad Hashir Naveed was taken to the hospital in the early hours of January 15 as his mother thought that she could still gain access to emergency services there. Muhammad later died at North Middlesex University Hospital, in Sterling Way, Edmonton, having been taken there by London Ambulance Service, which at the time said the boy was “in cardiac arrest”. This week, North London Coroner’s Court told the Advertiser that a post-mortem had concluded that Muhammad had died of natural causes. It was decided that an inquest would not be held. Since the closure of Chase Farm’s A& E unit, patients requiring emergency treatment are taken instead to the North Mid, or Barnet Hospital.

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Enfield Independent

  • 'Chase Farm is in a terrible condition' - says Royal Free chief executive.

    The chief executive of a hospital has slammed the facilities at Chase Farm Hospital - and says he plans a major rebuild of the site. The Royal Free London NHS Trust, which took over Barnet and Chase Farm Hospitals trust on July 1, will set up plans to comprehensively rebuild the site, according to its CEO David Sloman. Stakeholder group members this week trust directors, local MPs, councillors and local commissioning groups to discuss the Chase Farm site. Mr Sloman condemned the facilities at the Enfield hospital, which he described as ‘not fit for purpose'. The redevelopment is set to cost more than £100 million and the Royal Free has also absorbed the historical £16.9million debts.

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Tuesday 5th August 2014

Stoke Sentinel

  • MP Joan Walley calls for NHS to re-tender private ambulance contract.

    An MP has called on health managers to tear up a contract with a private ambulance company – rather than hand it more money. Stoke-on-Trent North's Joan Walley has pleaded with the head of the city's NHS body to re-tender the work to ferry thousands of patients to hospital appointments. The Labour MP stepped in after London-based NSL asked to renegotiate the £3 million-a-year deal just 11 months into a three-year contract. The firm blamed "potential operating losses" caused by an unforeseen increase in demand for requesting more cash for the rest of the tender. It has also denied claims it had put in a deliberately cheap price to beat off five rivals. They included one from the West Midlands Ambulance Trust which ran the service for the previous four years. Now Ms Walley has branded it "indefensible" if the contract is changed without re-tendering it. In a letter to leaders of the city Clinical Commissioning Group (CCG) which helps fund the service, she said: "I warned you of the dangers of allowing private contractors to undercut NHS providers while the NHS absorbs the cost." She said that in response to rumours that the contract was being adjusted she had already asked for assurances that it would be stuck to at no extra cost to the NHS. The work involves taking 600 people a day to appointments such as kidney dialysis or care in day hospitals. It was put out to tender jointly by the city and North Staffordshire CCGs plus the NHS trust running community services.

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North West Evening Mail

  • Campaign Demands Cap On Agency Costs at Hospitals in Cumbria.

    The premium costs of agency hospital staff should be capped by the government – according to a campaign group. The NHS trust which runs hospitals in Barrow, Kendal and Lancaster has paid out £4.3m on agency staff so far this financial year. University Hospitals of Morecambe Bay NHS Foundation Trust also paid an agency £2,500 to provide one doctor for a single bank holiday shift in May. But National Health Action Party spokeswoman Kathryn Anderson, a former nurse, has called for government action. NHAP is a political party formed in 2012 in opposition to the coalition’s Health and Social Care Bill. Ms Anderson said: “The outrageous amounts paid for agency staff is just a symptom of a situation created by this government through its cuts to NHS staff and funding. Health secretary Jeremy Hunt has decimated nursing numbers, with around 4,000 senior nurses axed since the Tories came to power, so hospitals are left with little choice but to hire extra staff to plug the gaps.” She called for the government to set a cap on the amount NHS providers can pay for using agency staff during the nursing shortage.

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Daily Telegraph

  • Pay rise for doctors and nurses blocked.

    Ministers will defy calls to give doctors, nurses and other NHS workers a pay rise next year amid concerns it would put patient care at risk. Danny Alexander, the chief secretary to the treasury, has written to NHS pay review bodies warning that the "case for pay restraint remains strong". He said that the Government intends to take the "same approach" as it did earlier this year, when it ruled out a 1 per cent pay rise for NHS workers in 2014-15. Mr Alexander said that in 2015-16 the government is again likely to rule out an all round pay rise for staff as many benefit from automatic increases in pay. Ministers have decided not to ask the NHS pay review body for its views. Trade unions have threatened industrial action over the decision.

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Staffordshire Newsletter

  • Stafford MP meets Health Secretary to voice "strong concerns" over future of hospital.

    Staffordshire NHS leaders are joining Stafford MP Jeremy Lefroy today for a top-level meeting over the future of Stafford Hospital, after the MP voiced "strong concerns" about threats to hospital services. Mr Lefroy is meeting Health Secretary Jeremy Hunt, the leaders of the University Hospital of North Staffordshire, Mark Hackett and John McDonald, and the head of the CQC, Professor Sir Mike Richards, plus other NHS leaders. Mr Lefroy said: "With the support of Stone MP Bill Cash, I wish to discuss in detail the plans for the integration of Stafford Hospital into the larger university trust, in particular the way in which the acute medical services and accident and emergency will operate. We have strong concerns about some of the proposals. I will ask when the NHS England review into consultant led maternity is to take place. We both believe that these services at Stafford are vital for women and children. I will also question the plans for paediatric services. It was our understanding that there would be a period of dual running at Stoke/ Wolverhampton and Stafford before changes were made at Stafford, to test the arrangements. Although Bill and I continue to oppose the paediatric proposals, we believe that dual running is essential as we have considerable concerns over capacity and the level of service which can be provided to our constituents."

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Nursing Times

  • Nurse leader jobs may be at risk from top level NHS restructure.

    Senior nurse jobs could be among hundreds of posts axed, as part of a major restructure of the national commissioning body NHS England. Nursing Times understands up to 800 jobs could go in the cost-cutting exercises that looks set to involve a re-organisation of the body’s 27 area teams, which cover local zones within four regions. According to senior sources, officials have discussed the need to lose 500 to 800 posts in a bid to reduce running costs by 10-15% in 2015-16. However, the total reduction in jobs is likely to be towards the smaller end if cuts focus on senior staff, as expected. NHS England would not comment on whether the cuts were likely to affect senior nurse roles or those working in the office of the chief nursing officer for England, which comes under the body’s remit. However, it did not deny that changes were taking place and could affect nurses who number among the body’s 5,500 or so full-time equivalent staff. Senior sources told Nursing Times’ sister title Health Service Journal that there were likely to be reductions and extensive structural changes in the area teams where many NHS England employees work.

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Thursday 31st July 2014

Independent

  • Sharp cuts leave NHS mental health services unable to cope, GPs say.

    Family doctors have warned of the deteriorating state of mental healthcare in England, after a survey revealed that one in five had seen a patient come to harm because they could not get specialist help. GPs reported that some patients had committed suicide or been sectioned because of a lack of available community mental health services. More than eight in 10 GPs now believe that their local mental health teams cannot cope with caseloads, and nearly half said that the situation in their area had got even worse in the past 12 months. The survey of 500 GPs, which was carried out by Pulse magazine, represents stark new evidence of the strain on England’s mental health services, which have been disproportionately affected by NHS budget squeezes in recent years. Despite Government commitments that mental health would be given "parity of esteem" with physical health, the amount spent on the services has been cut more severely than other sectors. Charities warned earlier this year that NHS England’s decision to cut tariffs for mental health by 1.8 per cent would cost lives, and Pulse’s findings, gathered from GP surgeries around the UK, appear to bear out those fears. Mental health receives around 13 per cent of the NHS budget, but is estimated to represent more than a quarter of the country’s disease burden. Most GPs said that they are now having to deal with mental health issues which are beyond their competence and required specialist help. Half of GPs said they had to step in “often or all of the time” because local Improving Accessing to Psychological Therapies (IAPT) services were not able to help a patient.

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Lancashire Telegraph

  • NHS pays out £2.5m to East Lancs private hospitals.

    Private hospitals have received more than £2.5million for treating East Lancashire NHS patients since 2012, compared to just £83,000 in the previous two years. The Royal Blackburn and Burnley General Hospitals have shelled out for hundreds of patients to be treated at the Beardwood and Gisburn Park hospitals, both run by private healthcare giant BMI. Over the last five years, the number of NHS beds and staff have not been increased in line with the rising number of patients needing treatment, which has led to the huge increase in referrals to private care. Figures obtained by the Lancashire Telegraph through Freedom of Information laws showed that between April 2012 and March 2014, more than £900,000 was spent on sending chronic pain patients to the BMI hospitals. It comes as shadow health secretary Andy Burnham called on the government to halt any further ‘privatisation’ of the NHS until next year’s general election, as there should be a ‘proper debate’ about the use of private firms. East Lancashire Hospitals NHS Trust said it had sent patients to BMI hospitals to avoid missing national targets for patients with non-urgent problems to be treated within 18 weeks.

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Independent

  • Hospitals spending 'extraordinary' amounts of money on locum staff, says report.

    NHS hospitals are spending “extraordinary” amounts of public money on temporary staff, health experts have said, after an investigation revealed that rates of almost £150 per hour were paid for locum nurses to work over the May bank holiday. Hospital bosses have come under fire for the large sums spent on locum staff, after it emerged earlier this year that £2bn had gone to staffing agencies since 2010/ 11. There are concerns that agency staff who are not familiar with the hospital ward they are working no can put patient care at risk. New figures uncovered by a Sky News investigation have revealed the extent of spending at a local level, with one locum agency paid £1,800 by University Hospitals Bristol to provide a nurse for the day - almost equivalent to an average nurse’s monthly salary. University Hospitals of Morecambe Bay, meanwhile, paid £2,500 for a locum doctor to work one day. Dr Peter Carter, chief executive of the Royal College of Nursing, said that the figures were “truly shocking”. “Many [of the nurses] will never have been to that ward before and will probably never be there again,” he told Sky News. “Agency nurses do not provide good value for money. The employers who use these extraordinary levels should be held to account for it. This is public money that is not being well spent. This is something that should be looked at with the utmost urgency.”

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Surrey Comet

  • Proposal to close mental health services, at Queen Mary's Hospital in Roehampton, and cut beds across south west London.

    Health bosses want to close mental health services at Queen Mary’s Hospital, which treats 500 patients a year, and reduce inpatient beds across south-west London by 10%. A review, set to transform mental health services across the region, proposes to axe services at the Roehampton hospital and centralise the region’s mental health services at Springfield University Hospital, Tooting, and Tolworth Hospital, Kingston. Health bosses predict that by investing in these two hospitals, and closing services at Queen Mary’s, they could save £25.87m in 50 years, than if they maintained the current three hospitals. This is despite recent warnings from the British Medical Association (BMA) that mental health patients were being put at risk by cuts. Earlier this year six mental health organisations also warned that NHS mental health cuts were putting lives at risk. A draft report by the South West London and St George's Mental Health NHS Trust (SWLSTG) proposes new facilities be built in Springfield and Tolworth serving people from Kingston, Merton, Sutton, Richmond and Wandsworth. Investment in these two hospitals, they estimate, would cost up to £160m which would come from selling NHS land. Another, less favoured proposal, is to maintain services at the three hospitals at an investment of £140m. However, this option would be much more expensive for the NHS in the long-run - £42.17m more than the preferred option over 50 years.

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Tuesday 29th July 2014

Hospital Doctor

  • Indefensible that NHS is being privatised without public say.

    Shadow health secretary Andy Burnham is calling for a halt to the privatisation of NHS services in England until after next year’s general election. In a speech later, shadow health secretary Andy Burnham will say “privatisation is being forced through at pace and scale”. He will say voters need a “proper debate” about the future of the NHS. Labour argues the restructuring of the NHS, which came into force in 2013, led to privatisation by the back door. This includes plans for the biggest outsourcing deal in NHS history which could see cancer care across Staffordshire privatised as part of a £1.2bn contract. The Department of Health said that since 2010 a further 1.3% of the NHS budget was being spent in the private sector, with the total standing at about 6%. In his speech, Mr Burnham will say: “Commissioners have been ordered to put all services out to the market, NHS spending on private and other providers has gone through the £10bn barrier for the first time. “When did the British public ever give their consent for this ? It is indefensible for the character of the country’s most valued institution to be changed in this way without the public being given a say.” Mr Burnham has written to the boss of NHS England, Simon Stevens, to call for a pause in privatisation unless patient safety or service is at risk. The government said Burnham was playing politics and pointed to his privatising instincts under the previous government, which introduced independent sector treatment centres and poly-clinics. “Andy Burnham himself signed off the privatisation of Hinchingbrooke Hospital during Labour’s final year so it is pure political posturing to try to interfere with doctors making the best clinical judgements for patients,” said a spokesperson. NHS Partners Network chief executive David Hare commented: “Private sector providers of NHS clinical services are an integral part of the modern health service and deliver extremely high standards of care.

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The Newstatesman

  • The NHS is becoming an ever-bigger headache for the Tories.

    One of Labour's priorities for the summer is raising the salience of the NHS, the issue on which it enjoys its largest poll lead. "After living standards, we need it [the NHS] to be voters’ priority," a strategist told me. If one of the defining questions of the election is "which party do I trust to run the health service ?" Labour's chances of victory will be improved. It is encouraging for the party, then, that both the Sun and the Times splash on the growing NHS crisis today. The former carries an investigation warning of record A& E waiting times and longer waits for GPs, while the latter reports that one in nine people trying to see a doctor cannot get an appointment, with GPs turning patients away more than 40 million times this year. The Tories have long regarded the NHS as the dog that hasn't barked, boasting that the oft-predicted "winter crisis" never came. But the dog is certainly barking now. Worse, the party's "top-down reorganisation" of the health service (for which, it should not be forgotten, it had no mandate. Indeed, it had a mandate not to introduce one) means Labour can easily lay the blame at the Conservatives' door. Having once aspired to establish themselves as "the party of the NHS", the Tories are now narrowly focused on neutralising the issue. As I've previously reported, Lynton Crosby has told ministers not to mention it on the grounds that it helps Labour. In his speech at last year's Conservative conference, David Cameron said: "Some people said the NHS wasn't safe in our hands. Well - we knew otherwise. Who protected spending on the NHS ? Not Labour - us. Who started the Cancer Drugs Fund ? Not Labour - us. And by the way - who presided over Mid Staffs ? Patients left for so long without water, they were drinking out of dirty vases...people's grandparents lying filthy and unwashed for days. Who allowed that to happen ? Yes, it was Labour...and don't you dare lecture anyone on the NHS again." But don't expect to see a similar passage in this year's pre-election address. One of Crosby's most consistent pieces of advice to the Tories is "not to play on Labour's side of the pitch". This means talking about issues on which the party is strong, such as the deficit, immigration and welfare, and avoiding those on which it is weak.

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HSJ

  • Exclusive: NHS England to cut hundreds of posts in restructure.

    NHS England is to cut hundreds of posts and is likely to carry out a major restructure of its 27 area teams over the next nine months, HSJ can reveal. The changes are a response to the organisation’s requirement to reduce its running costs by between 10-15 per cent in 2015-16. All changes need to be carried out by April next year. The plans could become controversial if they are seen as a further NHS structural reorganisation, following the completion just last year of the major upheaval which created NHS England and clinical commissioning groups. Controversy could also be sparked if the changes result in many large redundancy payments. The 2010-2013 restructure was accompanied by thousands of redundancies which cost more than £1bn and drew significant media attention. NHS England chief executive Simon Stevens was due to inform staff of the need for changes this morning. HSJ understands senior officials have discussed the potential need for 500-800 posts to go of NHS England’s total of around 5,500 full time equivalent staff. The total reduction will be towards the smaller end of the range if cuts are focused on senior staff, as is likely according to some senior sources. There are highly likely to be significant staff reductions in NHS England’s 27 area teams, as these account for many of its employees. Several senior sources said this was very likely to mean extensive structural changes would be made to the area teams. These have not been decided, but senior sources said directors were likely to be shared across groups of area teams.

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Pulse

  • Scores of practices teetering on the brink of closure.

    General practice is heading towards a precipice. Scores of GPs across the country are facing such hardship that they may be forced to shut their practice doors altogether. LMC leaders have told Pulse they are aware of more than 100 practices that have either closed or face imminent closure – and this is likely to be the tip of the iceberg. Local GP leaders say they have ‘not seen anything like it’ and warn of a ‘domino effect’ on surrounding practices if closures cannot be avoided. Some practices say they have ‘exhausted all other options’ and have no choice but to close, while others are preparing to merge with others in order to continue providing services. Either way, the grim reality is that, before the year is out, the profession could face an unprecedented mass closure of practices across the UK, unless the NHS steps in with emergency help. London has the highest number of practices in danger – with up to 30 practices contacting their LMC regarding closure. In Wales at least 14 practices are preparing to close, while Wessex, Northamptonshire and Devon each have six practices on the brink. One GP partner, who wished to remain anonymous, says her high-achieving practice has run out of options following struggles with recruitment. She says: ‘Despite all efforts to recruit or merge over a two-year period, there is currently one faint hope left. If this goes the way of all past hopes then closure beckons in the next few months.’ She adds that this is not because the practice has failed in any way: ‘This is because of the starvation and withdrawal of primary care funding and resources in the face of the relentless increase in unfunded and underfunded workload.’

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  • Department of Health denies NHS 'privatisation' claims.

    The Government has denied that it is ‘privatisating’ healthcare in England, in response to a unions’ campaign damning the Coalition’s NHS reforms. In a statement, published on the Department of Health website on Thursday (24 July), ministers stated that their reforms are ‘not about privatisation, but about… putting clinicians, rather than politicians, in control of healthcare’. The Unite union has campaigned since last year and had staged a 55,000-strong rally in Manchester during the annual Conservative Party conference, and accused the Government of outsourcing £7bn worth of NHS contracts to the private sector over the last three years at a greater cost to the taxpayer than if the contracts had been kept with NHS providers. It comes as Andy Burnham, Labour’s shadow health secretary, was due to make a speech on Tuesday where he would call for a ‘halt’ to the NHS privatisation at least until next year’s general election. He will say: ‘Contracts are being signed that will run for the five years of the next parliament, and beyond. This is not acceptable..." However the DH has now hit back at such claims, stating that its ‘modernisation’ of the NHS is ‘necessary, in patients’ interests and is the right thing to do to secure the NHS for future generations’. The DH said: ‘Ministers have stated that the Government’s reforms are not about privatisation, but about placing the financial power to change health services in the hands of those NHS professionals whom the public trust most, and putting clinicians, rather than politicians, in control of healthcare.’

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The Guardian

  • NHS deterioration under coalition is putting lives as risk, says Labour.

    The deterioration in the NHS under the coalition is putting lives at risk, with higher emergency waiting times, record numbers of patients visiting A& E, longer ambulance response times, more cancelled operations, waiting lists at a six-year high and declining standards of cancer care, Labour has said. Calling for a ban on any further privatisations until May 2015, Andy Burnham, the shadow health secretary, said there were figures that prove how far the NHS has gone downhill under David Cameron, with standards getting worse across the board. "The choice is clear: a part-privatised, two-tier health market under David Cameron; a public, integrated national health and care service under Labour," he said. Speaking in Manchester, he said the main patient care measures over four years since the government unveiled its reforms of the NHS showed that "something has gone seriously wrong". He said official figures reveal: The government is missing its target of treating 95% of patients within four hours of arriving in A& E compared with 98% of patients in July 2010. Hospitals across England are reporting that records for the number of A& E patients attending are being broken on a daily basis. Ambulances are taking on average over a minute longer to reach patients in a life-threatening condition, compared with three years ago. This means that in some places police cars and even fire engines are doubling up as ambulances. Around 18,000 operations are being cancelled every quarter, compared with 13,000 in July 2010. NHS waiting lists have now hit a six-year high, with more than 3 million people waiting for treatment. Average waiting times for treatment are now 9.1 weeks compared with 8.3 weeks in July 2010. Around 84.4% of cancer patients are starting their treatment within 62 days, compared with 87.1% of people four years ago. One in four people with lung cancer are now waiting longer than 62 days for treatment to start.

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Monday 28th July 2014

Fermanagh Herald

  • ‘Private’ ward in new hospital will cater for NHS patients.

    While the revelation that a ward in the new South West Acute Hospital is leased to a private healthcare company has created concerns in trade union circles, the Western Health and Social Care Trust stressed this week that ‘NHS’ patients are treated there as well. Geraldine McKay, the Trust’s director of acute services, in a statement, said that, historically in Northern Ireland, when demand for hospital services exceeded capacity to provide those services, Trusts had used Independent Sector Providers to ensure that patients are treated within appropriate waiting times. She went on : "In this case, such waiting list initiatives are reflective of our contractual arrangement with 3FiveTwo Healthcare. It will ensure that Western Trust patients are able to access these services locally in the South West Acute Hospital.” She revealed that 3Fivetwo Healthcare, a Belfast-based private healthcare provider, had approached the Trust about entering into a financial income lease to utilise Ward 4 at SWAH, and other facilities.

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Independent

  • 50m patients will be 'turned away' from GP surgeries next year, new research claims.

    The number of times GP surgeries in England are forced to turn away patients for appointments next year will pass the 50 million mark, new research predicts.
    Lack of investment is leading to an overstretched service in crisis which is struggling to meet patient demand, the Royal College of General Practitioners (RCGP) has said. Considering current trends in cities across the country where patients have complained about finding it difficult to get an appointment, the RCGP has forecast figures suggesting the situation will only get worse. The body, made up of more than 49,000 family doctors, said a recent patient survey showed worrying trends and called for 8,000 more GPs to help deal with the shortfall.

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The Cornishman

  • Private company running Cornwall's cottage hospitals is a 'failed experiment'.

    A private company controversially given a £315 million contract to run Cornwall’s cottage hospitals has been condemned as a “failed experiment” after it emerged that talks were under way which could potentially see it merge with an NHS organisation. Peninsula Community Health (PCH), a social enterprise, and Cornwall Partnership NHS Foundation Trust, which runs mental health services in the county, have revealed today that they are in embryonic discussions about closer working. The news drew exasperation from those who campaigned to stop Cornwall’s 14 community hospitals being placed in the hands of a not-for-profit company. Andrew George, MP for St Ives and member of the powerful Health Select Committee, said the best outcome would be putting the whole community health sector back in public hands. “I can certainly see some significant benefits which could be delivered by integrating NHS services rather than adopting competition between fragmented private providers approach favoured by the Conservative side of the Coalition.” The campaign group Health Initiative Cornwall was an outspoken critic of community hospitals being taken out of the NHS. Vice-chairman Graham Webster said he would be pleased to see PCH and Cornwall Partnership work closer together, but it had cost a lot of money which could have been spent on front line services to get to this point.

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Friday 25th July 2014

The Telegraph

  • Amid much fanfare, Simon Stevens, chief executive of the NHS, has announced his first major policy change since starting the job in April.

    Personal health budgets are being hailed as the solution to ever more financial cutting in the NHS, targetting the most vulnerable in society and reducing hospital admissions. It sounds a rather wonderful idea; empowering people to make choices about the health care they receive. Billions of pounds will be taken from health service and town hall budgets and handed over to patients, to the frail elderly, disabled children, those with learning disabilities and serious mental health problems. They will be able to choose which services they want, and buy them using the cash they have been given. It is claimed that the policy will also improve the quality of care. This is disingenuous to say the least. Personal health budgets have been tried in the Netherlands and are now being restricted because of problems that have arisen, including worsening fragmentation of care. It’s true that the care received by the most vulnerable and disenfranchised individuals in this country is often inadequate. But this supposed solution does not bear detailed scrutiny. In fact, it undermines the very NHS that these people rely on. Their care is inadequate because it is complex and not properly funded. The answer, surely, is to invest in the resources that are already there, not to bung patients some cash and tell them to find care elsewhere.

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HSJ

  • More trusts with financial concerns.

    The number of NHS trusts referred to the health secretary over financial concerns increased almost three-fold in a year, a report has revealed. Nineteen were flagged up to Jeremy Hunt this financial year - compared with five in 2012-13 - as well as 24 Clinical Commissioning Groups CCGs, according to the Audit Commission. Marcine Waterman, controller of audit, said auditors were reporting concerns about the financial resilience of a third of trusts this year, compared with a quarter for the previous 12-month period. She added: “This level of reporting is worrying and reflects the increasing risks to the financial sustainability of individual NHS trusts as they continue to face sizeable financial pressures due to a rising demand for services and the necessary focus on quality of care, whilst balancing the need for continued cost savings.” Among those referred to Mr Hunt for failing to meet their statutory break-even duty, were the University Hospital of North Staffordshire, Barnet and Chase Farm Hospitals and Ipswich Hospital Trusts. Mid Essex Hospital Services, North West London Hospitals and Worcestershire Acute Hospitals Trusts were also on the list. The report - entitled Auditing the Accounts 2013-14: NHS Bodies - covers the timeliness and quality of accounts, arrangements to secure value for money and auditors’ use of their statutory reporting powers at 101 NHS trusts and 211 CCGs.

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  • Hinchingbrooke backtracks on controversial £50 referrals offer.

    The NHS hospital run by private provider Circle has been forced to withdraw an offer to pay local GPs a £50 ‘administrative fee’ for surgery referrals, claiming the proposal had been ‘misunderstood in some areas’. The offer from Cambridgeshire based Hinchingbrooke Health Care Trust came in an email - seen by HSJ - that was circulated earlier this week to nearby GPs. The email - signed by Hinchingbrooke chief executive Hisham Abdel-Rahman - noted there were “system wide issues affecting capacity to perform elective surgery across hospitals in the region”. It added that the trust was “able to offer short waiting times for elective treatment”. “Should a patient contact our hotline and request to transfer their care from another hospital to Hinchingbrooke, we will contact their GP surgery on their behalf so that the re-referral can be processed without the need for the patient to visit their GP,” the email said. “We appreciate that re-referral of a patient will generate additional administrative work for the patient’s surgery. Therefore the trust will pay a £50 administrative fee for every re-referral that is made through the hotline.” The offer was withdrawn in a second email - also signed by Dr Abdel-Rahman - sent out the following day. The second email said: “[The trust] proposed a fee of up to £50 which we offered to assist with the complex administrative issues that can be experienced when re-referring patients from one organisation to another."

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  • Department of Health to establish an anti-fraud unit.

    The Department of Health plans to establish its own fraud investigation function by poaching senior officers from NHS Protect, shrinking the national body’s size significantly as a result. Internal papers seen by HSJ revealed that the DH expects the new in-house unit to be up and running within three months. Talks between unions representing staff at NHS Protect about the effect of its slimmed down structure have already begun. According to the papers, the DH’s new unit will support anti-fraud work within both the department and arm’s length bodies such as NHS England. It will also feed information into a fraud error and debt team in the Cabinet Office. Under the plans the unit will employ 11 staff, including the current managing director of NHS Protect, Dermid McCausland; its head of policy and standards, Martin Wiles; head of NHS security, Mark Richardson; and its special operations project lead, Patrick Nolan. Two further posts will be ringfenced for existing NHS Protect staff, while the remaining posts are advertised as DH vacancies. The papers claimed that the only effect on NHS Protect staff will be a change of pay date and “potentially a change of base (but still within central London)”. The DH expects NHS Protect to continue with a reduced staff structure from October with the number of senior managers halved from six to three. The department’s own unit will be tasked with a wider role than the one currently carried out by NHS Protect. It expects to be given a “horizon scanning” role to help the DH and its agency improve their response to “future cross government anti-fraud requirements”. This will include an “investigative capacity” for “national, large or complex cases that it is not realistic to expect the NHS to take on”.

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The Herald

  • Plymouth University investigate 100 per cent rise in complaints against doctors.

    A team at Plymouth University were tasked with finding out why complaints about doctors have doubled in five years. Complaints to the General Medical Council (GMC) about doctors’ fitness to practise rose from 5,168 in 2007 to 10,347 in 2012, an increase of 100 per cent. The report by the Plymouth team, published today, found a host of reasons for the increase in grievances, including a better informed public, people talking about their healthcare on social media and also negative portrayals of the NHS in the media. A large number of the complaints are not within the GMC’s remit to investigate, according to the report. The findings highlight a need for improvements to be made into how complaints are dealt with said Dr Julian Archer, lead author and director of Collaboration for the Advancement of Medical Education, Research and Assessment (CAMERA) at Plymouth University. “The findings show that the forces behind a rise in complaints against doctors are hugely complex and reflect a combination of increased public awareness, media influence, the role of social media technology and wider changes in society,” he said. “The report also indicated that there is much to do to improve the wider complaint-handling system, so that complaints made by the general public about their doctors are directed to the appropriate authorities.” An increase in complaints was seen across the UK, suggesting wider social trends rather than localised issues.

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nhsmanagers.net

  • The Trust Development Authority arrived, in a BOGOF with the Health and Social Care Act.

    For reasons that I never saw evidenced, all Trusts were thought to be better if they were Foundation Trusts with faux-freedoms. Deadlines were set, end-dates decided and lines drawn in the sand. After some date or other all Trusts were destined to be FTs... and that was that. The TDA had a clear task. Get on and deliver FTs. Don't ask why. The FTs that have done well were doing well long before FTs were invented. The rest are middling, many fighting with Monitor and the CQC. The FT brand is all but worthless. The TDA set about its business. Employing all the subtle techniques learned from the Neanderthal days of 1980's Strategic Health Authorities, they tried bullying, bunging, beating and bribing Trusts into submission. Not surprisingly they failed. The idea of a deadline was quietly dropped. We are now in a curious no man's land. Just short of 100 Trusts parked, under the benign tutelage of a group of bosses at the TDA, where, as far as I can see, only one of their senior team, Alwen Williams, has ever run a Trust and she does a moonlight gig for Boris. The rest have all the ornaments on the mantelpiece but have never put coal on the fire. Why has the TDA failed to deliver FT's with clean balance sheets ? Perhaps they are just not very good. The latest news is just under 100 trusts, in the purview of the TDA, have been referred to the DH by the Audit Commission. In a move that casts doubt over the competence and methods of the TDA, the Audit Commission say (in terms), 98 Trust are going broke and there are no viable plans to fix them. Amazingly, buried in the list, Hinchingbrooke, the hospital given to the private sector operator Circle to sort out and portrayed as god's gift to NHS management, paragon of virtue and the font of all goodness. Whoops! What's gone wrong at the TDA ? Well, by any measure... they have failed. They exist to turn ugly duckling Trusts into Swans... they failed. Their job is to deliver non-FTs in balance... they have failed. They are paid to deliver a cornerstone of Coalition policy... they've failed. They exist to motivate and encourage Trusts to reach for better and improved... they've failed.

Thursday 24th July 2014

Uttoxeter Advertiser

  • Labour hopeful will fight cancer care privatisation.

    Campaigners have gathered to promote opposition to the privatisation of cancer services in Staffordshire. Members of the Trades Union Council of East Staffordshire have been joined by Jon Wheale, Labour's prospective parliamentary candidate for the town, to stand firm in their battle against the possible changes facing the NHS. They are now urging people to show their support and sign a petition against a move by four clinical commissioning groups (CCGs) in Staffordshire to put their cancer services out to tender. East Staffordshire CCG had originally been part of the tender, but later pulled out to pursue its own contracts. The group said that it fears that privatisation could lead to charging for services.

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GP Online

  • GP provider hits back against 'politically motivated' criticism of practices.

    A commercial primary care provider run by GPs in the north west of England has hit out at 'politically motivated' criticisms of its practices after questions were raised in parliament. Local commissioners are set to meet MP Bill Esterson (Lab, Sefton Central) this week after he asked health secretary Jeremy Hunt to intervene. Mr Esterson told MPs that when SSP Health took over practices in Merseyside last year it had promised full-time GPs and improved services. ‘Yet after well over a year several of the practices are still run by locums. We have seen vulnerable, elderly people unable to get appointments for many days, if not weeks, and those who can have gone to other practices,' he said. SSP, which is run by two Manchester GPs, holds contracts on over 40 practices across Merseyside and greater Manchester. The company says that 'objective assessments show clear improvements' since it took over the practices. A spokeswoman said: ‘It appears that there is a politically motivated drive against private providers from various quarters.' APMS contracts for around 20 practices serving 65,000 patients were won by the firm in spring 2013. The practices were previously run by a local community NHS trust, the PCT and another private provider. The new contracts involved a cut in funding, and SSP says it was given short notice to take over the practices following the tender process.

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Leicester Mercury

  • Concern grows for Interserve jobs at Leicester Royal Infirmary.

    About 65 porters and emergency department support workers at Leicester Royal Infirmary have been sent letters telling them they could be at risk of redundancy. The letter, dated July 18 and headed "redundancy consultation", invited recipients to two staff meetings today. Interserve, the private company responsible for employing porters at Leicester's hospitals, said: "Due to the need to re-configure the portering and ED PSA (emergency department support worker) services to meet the requirements of the contract at Leicester Royal Infirmary your role could be at risk of being made redundant. Although every effort will be made to minimise any impact of this review, it could result in the termination of your services by reason of redundancy." Colin Whyatt, regional organiser for GMB union representing a number of staff, said he hoped for no redundancies. "This is another example of profit before patients. Staff are still suffering problems with pay month in, month out when the company should be bending over backwards to make sure it is correct." One staff member said: "We have to wait one or two months to be paid. It is often wrong." Interserve received a seven-year £300 million contract to run catering, maintenance and security services in more than 550 NHS buildings in the county. About 2,000 people from the NHS and other private companies transferred to Interserve when it took on the contract in January 2013.

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Yorkshire Post

  • Experts warn longer waits in A&E will become ‘inevitable’.

    Patients should expect “inevitable” greater waits in A& E units - with older people left waiting longest for care, experts warn today. A report by the Nuffield Trust and the Health Foundation said there is a “perfect storm” leading to increasing in waiting times in casualty units across England. It comes amid growing concerns over A& E waits as more people and more with complex problems seek treatment. The charities analysed 41 million A& E attendances from 2010 to 2013, finding both very cold and hot weather led to extra pressures and higher rates of waits of more than four hours. But they also found that the number of people in emergency departments has risen as the population has grown and aged. People over the age of 75 spend an average of three and a half hours in A& E compared to two and a half hours for younger patients.

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Eastern Daily Press

  • Yarmouth and Waveney mental health bed cuts on the agenda.

    Health chiefs in Great Yarmouth and Waveney will meet today to discuss the results of a public consultation into mental health bed cuts. More than 1,000 people responded to a three month consultation run by HealthEast - the Clinical Commissioning Group (CCG) for Yarmouth and Waveney - into proposals by Norfolk and Suffolk NHS Foundation Trust to reduce the number of acute and older people’s beds in the area. Eighty percent of respondents rejected a plan reduce the number of acute beds at Northgate Hospital in Yarmouth and Carlton Court, near Lowestoft, from 28 to 20 and relocate onto one site. 78.4pc of respondents were against the plans to close older people’s and dementia wards at Carlton Court. The mental health trust has come under fire this year for sending some patients outside of Norfolk and Suffolk because they had no available acute beds. A final decision on bed numbers in Yarmouth and Waveney will be made in September.

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Daily Mirror

  • Firms cashing in on tax loopholes after NHS services privatised.

    A tax loophole is driving a £1bn sell off of vital NHS services, the Mirror can reveal. The Government is pushing ahead with the privatisation of dozens of in-hospital pharmacy services despite unfair VAT rules giving private companies a huge advantage. The NHS has to pay 20% VAT on prescription medicines but under a five-year-old HM Revenue and Customs decision private chemists don’t. This is being exploited under the Government’s controversial NHS reforms by firms looking to run lucrative hospital pharmacy services for profit, trade union Unite claims. More than 30 NHS trusts have already chosen private companies to run their outpatient pharmacy services and another 18 are out to tender. The total value of the contracts top £1bn. A tendering document seen by the Mirror that the VAT loophole is being promoted by one NHS trust as a “key business driver” to attract bids from private firms. Companies that have already taken over pharmacies from the NHS include Lloyds Chemists, Sainsburys and Boots, which has been accused of avoiding £1bn in tax since moving headquarters to Switzerland. Parent company Alliance Boots denies the allegations and says it follows all tax rules. Unite said that 70 per cent of health services put out to tender since the government’s Health and Social Care Act came into force have gone to the private sector.

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Guardian

  • Study reveals vast disparities between what NHS trusts pay for products.

    With the NHS's financial problems set to worsen next year, how efficient is its spending ? The Department of Health has released a price comparison for 120 commonly used NHS products to find out. The report shows some trusts pay over 135% more for certain products, such as white paper – where 2Gether NHS Foundation pays £4.34 for 80mg, while Moorfields Eye Hospital pays just £1.84. Another big cost difference is examination gloves: Newcastle Tyne and Wear pays £5.57, which is 117% more than the Royal Wolverhampton, which pays £2.56. Even allowing for the different functions of trusts, the price differences are alarming. There appears to be no link between geography and a trust's size. So the cost differences are largely due to procurement management. This is concerning because the NHS is failing to make use of its own national purchasing organisations, such as Supply Chain , to improve procurement.

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BBC News

  • Rise in NHS trusts in financial difficulties.

    Nineteen NHS trusts have been referred to ministers after auditors raised concerns about their financial health. The Audit Commission made the move after reviewing the health of 98 trusts running a combination of hospital, ambulance and community services. The referrals have been made because the trusts have failed to break even and do not have robust enough plans to balance the books in the coming years. The number represents nearly a four-fold rise from five last year. It is another sign of the growing financial problems being seen in the health service. Earlier this month the Nuffield Trust warned that a quarter of trusts had finished the year in deficit, but that included nearly 250 trusts across the whole health service. The Audit Commission looked in-depth at only those trusts that have not achieved foundation trusts status - given to the elite performers - and, as such, they tend to be the most financially-challenged organisations. Overall the watchdog had concerns about a third, but the 19 hospital trusts who got referrals are effectively the ones with the most deeply-rooted problems. Not only did they fail to break even in 2013-14, but they were unable to convince auditors they could rectify the issues in the medium term. The referral to Health Secretary Jeremy Hunt means the trusts will face closer scrutiny from the authorities. One of those referred is Hinchingbrooke, which is the first hospital trust to be run by a private firm, Circle. The 19 trusts are: Barking, Havering and Redbridge University Hospitals NHS Trust; Barnet and Chase Farm Hospitals NHS Trust; Epsom and St Helier University Hospitals NHS Trust; George Eliot Hospital NHS Trust; Hinchingbrooke Health Care NHS Trust; Ipswich Hospital NHS Trust; Leeds Teaching Hospitals NHS Trust; Mid Essex Hospital Services NHS Trust; Mid Yorkshire Hospitals NHS Trust; North Bristol NHS Trust; North Cumbria University Hospitals NHS Trust; North West London Hospitals NHS Trust; Shrewsbury and Telford Hospital NHS Trust; Surrey and Sussex Healthcare NHS Trust; The Princess Alexandra Hospital NHS Trust; United Lincolnshire Hospitals NHS Trust; University Hospital of North Staffordshire NHS Trust; Weston Area Health NHS Trust; Worcestershire Acute Hospitals NHS Trust.

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Tuesday 22nd July 2014

Homecare.co.uk

  • Mears wins new care contracts in Rotherham.

    Mears are delighted to announce that their Rotherham care branch has been awarded new contracts by the NHS Rotherham Clinical Commissioning Group to deliver continuing healthcare. The service currently supports 350 clients with a local team of over 130 professional care workers.

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Bedfordshire on Sunday

  • NHS skin care services in Bedfordshire privatised in three year deal.

    Dermatology services in Bedfordshire are to be privatised. From August 1 Optum will begin a three year contract to take over the delivery of services from the NHS, Bedfordshire Clinical Commissioning Group (BCCG) has announced. This follows the privatisation of musculoskeletal care in the county, which was handed over earlier this year, but raised concerns from trade unions which claim healthcare will end up being run like a business. Optum will cater for common skin conditions like eczema, dermatitis, acne and psoriasis.

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GP Online

  • GP premises: Bedfordshire reflects national crisis, says Dr Mary Hawking.

    In 1998, GPs calculated that existing practices in the town provided only 60% of the space required. Since then, the town has lost one practice. Now Dunstable’s population is set to balloon – with 30,000 new homes planned. Recently retired local GP Dr Mary Hawking is concerned about the likely impact on health services. In the late 1990s a co-located health centre proposed by GPs never came to fruition after NHS reorganisation scuppered the plans. A second attempt to get the health centre built in 2007/ 8, with funding released from housing developers under section 106 of the Town and Country Planning Act, never attracted sufficient NHS capital. Dr Hawking says PCT leaders chose to fund secondary care services and a practice in another town. Now the council has recognised the need for a medical centre in town centre redevelopment plans for Dunstable, but Dr Hawking fears there has been little consultation with GPs. Existing local practices cannot afford to take on additional GPs, and even if they could, they have no space, she says. ‘In Dunstable there is already a crisis,’ says Dr Hawking. Under previous NHS arrangements, she says, PCTs were able to set up their own practices to serve new developments which could be contracted once they had a viable list size. But now, it seems, no one has the powers or responsibility.

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Guardian

  • Survey reveals managers' concerns about integrating health and care.

    Moves to integrate health and social care are regarded by many to be the turnkey solution to take the pressure off our healthcare system. The drive towards closer integration of services does makes sense. The case has been made rather convincingly by the leaders in our healthcare system. However, making integrated care a reality will fall to our health and social care managers. In our latest survey of Institute of Healthcare Management (IHM) members, more than half said they didn't believe that integrated care would take the pressure off the NHS. Doubts were raised about whether the Better Care Fund will be used for its intended purpose, to help reduce occupancy in costly acute services and improve care pathways. Health and wellbeing boards in England have to approve proposals on how the funds are used locally, but managers working for acute providers, particularly foundation trusts, are concerned about their lack of involvement as proposals are developed, and are wary that the funds would not be used to achieve the significant step changes needed. Another anxiety centred around the heavy workloads created by the need to set up new infrastructures for collaborations and integration between the health and care sectors. Managers pointed out that staffing and financial resources were already stretched to breaking point. Many IHM members also signalled their anxiety about whether everybody involved in the integrated care agenda was being fully consulted and, given the significant changes that were already underway in the NHS, whether the timescales envisaged for its implementation were realistic.

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Thanet Gazette

  • Concordia Health pull out of contract for The Broadway Practice.

    The Broadway Practice faces an uncertain future after Concordia Health pulled out of the contract to run the GP surgery. The 5,500 patients received letters today dated July 16, informing them that the surgery could be taken on by another provider in April or closed leaving people to join other practices. Concordia Health Limited is contracted by NHS England to provide the care but they asked if their contract could be brought to an end. NHS England has accepted their request and their contract to provide services at The Broadway Practice will end on 31 March 2015. The NHS is now seeking people’s views on whether they should identify an alternative provider or ask patients to register with another GP. The announcement comes after all of the permanent GPs left the practice in June 2012 just seven months into Concordia's takeover. This exodus led to angry protests from patients about the new management.

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