Have you seen a story about the marketisation of the health service in your area that we have missed? Click here to contact us with news from your local paper or organisation about cuts, closures, outsourcing to the private sector, health service deficits, demonstrations, PFI deals - anything that you feel is relevant to the Keep Our NHS Public campaign.

You can search for key words. To find a phrase, put the words in quotation marks (such as "health service"). Leave blank to find all entries.
Search for

Tuesday 4th August 2015

Health Investor

  • NHS private pay income up 14% in two years.

    The amount NHS foundation trusts (FTs) earn from private patients has increased 14% in the last two financial years. This rose from £346.1m in 2012-13 to £395.9m for 2014-15 according to their annual accounts which were analysed by HSJ.

    Read more ...

  • Capita to cut nearly 1,000 NHS jobs following outsourcing contract win.

    Outsourcing firm Capita is planning to cut nearly 1,000 jobs once it takes on the £400 million primary care support services contract it won from the NHS. These plans were revealed as part of NHS England’s discussions with unions ahead of the transfer of personnel to Capita in September. Almost 80% of the employees in the primary care support services division will lose their jobs and 28 of 30 offices will be shut. Under the terms of the contract Capita take on back-office services such as payments administration and management of clinical records for NHS primary care providers including GPs, opticians, pharmacists and dentists. The £400 million contract was tendered through a framework that allowed for deals worth up to £1 billion. The difference in value is because the initial contract only covers NHS England but Capita could stand to earn up to £1 billion if NHS Wales or NHS Scotland agree to join the deal. The contract will last for seven years with an option to extend for a further three. Nick Bradley, national officer for Unison, told the Financial Times the job cuts were devastating and put three million patient records at risk. This would be because Capita would be centralising “functions like payments to every GP, pharmacy, dentist and optician in England; responsibility for cancer screening services and all notifications to the public”, he said. Dr Clive Peedell, leader of the National Health Action Party, also told the Financial Times: “The pursuit of private profit inevitably means staff cuts increasing the welfare bill and reducing spending power in local economies.” In May, Capita also won a 10-year, back-office support contract with Central London Community Healthcare NHS Trust worth £80 million.

    Read more ...

Stoke Sentinel

  • Funding crisis could force health centres to close, GPs have warned.

    Doctors have warned GP practices are at risk of closure because of a funding crisis. The nine health centres are facing an uncertain future after being hit by massive increases in utility, maintenance and cleaning bills. They include Goldenhill Medical Centre, Biddulph Primary Care Centre and Weston Coyney Medical Practice. Now GPs running the practices fear the increased bills threaten the future of the practices. The utility, maintenance and cleaning costs were subsidised by the NHS under the LIFT scheme until April 2014. It was part of moves to encourage surgeries to relocate to bigger and more suitable premises. But GPs have been left shocked at the size of the NHS bill handed out by the Community Health Partnership (CHP). Dr Chandra Kannaganti, who works at Goldenhill Medical Centre, was stunned to receive a £22,000 bill in January, backdated to April 2014. The bill rose from £5,000.

    Read more ...

Hull Daily Mail

  • Hull NHS bosses strike deal to reduce cost of locum doctors after paying millions.

    Hospital bosses have struck a deal with agencies providing NHS staff to drive down the cost of locum doctors. The Mail revealed paying doctors to work overtime and hiring agency locums had cost more than £8m in the past 15 months, with one doctor paid almost £2,000 for a single shift. Now, Hull and East Yorkshire Hospitals NHS Trust has reached an agreement with agencies providing locum doctors to reduce the bill. Unions, NHS campaigners and nurses have all reacted angrily after discovering how much the trust is having to pay locum doctors. Dermot Rathbone, of Save Our NHS Hull, said: "It is morally indefensible but the doctors are responding to the environment they have been placed in by the Government. If you create a market environment, people will behave according to that market and what we have seen is the marketisation of our health service."

    Read more ...

Independent

  • Less than one per cent of NHS consultants use control loophole to 'opt out' of weekend work.

    Jeremy Hunt’s justification for reforming NHS working practices has been called into question, after it was revealed that less than one per cent of consultants actually use a contract loophole to “opt-out” of weekend work. Freedom of Information responses from 23 hospital trusts show that only 35 out of the 5,661 consultants they employ “actively opt out” of doing non-emergency work at weekends. The Health Secretary, who has angered doctors by calling on their union, the British Medical Association (BMA) to “get real” over the need for more weekend working in the NHS, has said he wants to remove the “opt-out” clause for newly qualified doctors. He argues that 6,000 people were losing their lives every year because of a lack of a “proper” seven-day hospital service.

    Read more ...

The Star

  • Almost 50 jobs to go as Sheffield NHS blood unit’s closure confirmed.

    Around 45 people are to lose their jobs as the closure of a specialist NHS service in Sheffield that processes blood for use in patient operations was confirmed. The NHS Blood and Transplant board of directors have now agreed plans to shut the blood supply chain manufacturing facility on Longley Lane, close to the Northern General Hospital. Manufacturing services currently based in Sheffield and Newcastle are being transferred to Manchester. The plans follow the amount charged to hospitals for blood being reduced to save the NHS £3m per year. The two sites are not expected to shut until 2017 ‘at the earliest’. Fears had been raised by Unison that moving services to Manchester could put patients ‘at risk’ with the possibility of bad weather or heavy traffic affecting transport times across the Pennines. But the NHS has said safety and continuity of blood supply is a ‘top priority’.

    Read more ...

Guardian

  • How to sell off the NHS – in nine easy steps.

    So you want to sell off the NHS ? The 67-year old behemoth has radically improved people’s quality of life for nearly a century, so it won’t be easy. Here’s a handy step-by-step guide to privatising the health service.
    1. Know your enemy
    In 2010, a King’s Fund poll put NHS satisfaction at above 70% – the highest ever recorded approval rating. United Kingdom is joint fourth in the world for child mortality outcomes, joint fourth in the world for life expectancy (male), and joint eighth in the world for maternity mortality. However, it currently spends only 9.1% GDP on healthcare or US$3,598 per person, which is free at the point of service. The US spends twice as much (17.1% of GDP or US$9,146) and scores sixth in child mortality, sixth in the world for life expectancy and 24th for maternal mortality. To sum up, you’re faced with a well-liked, efficient, life saving machine. You won’t be able to try a head-on approach; public opinion will need to be swayed first.
    2. Misinformation
    The great thing about the NHS is most voters at any given election will not have had much experience of its services. Start early by pervading a message of improvement and efficiency. Steer every news piece towards this same message, regardless of context. Before you know it the NHS will be percieved as failing.
    3. Divide and conquer
    It doesn’t matter what you campaigned for – once you’re elected you only have to apologise occasionally and you can do whatever you want.
    4. Wash your hands early
    When no one is looking, make sure the government no longer has a legal duty to provide a NHS.
    5. Open market
    Everyone knows they get a better deal when one supermarket opens next to another one. Use that knowledge to your advantage. Meanwhile once the law has changed, open up the NHS to private contracts bit by bit.
    6. Undermine NHS staff
    NHS staff will see what’s happening, and people will listen to them if you don’t do something about it. Politicians are the least trusted individuals in the country, while doctors are the most; start early on with subtle denigration of the perception of all NHS staff.
    7. Make cuts
    Cut it, and cut it hard. People use A& E and the GP the most – keep these areas stripped of cash and drive up demand. Eventually, locum agency costs to cover staff gaps will cripple failing departments, and smaller GP closures will domino into bigger ones.
    8. It’s showtime!
    If you’ve followed the above steps then this will be a doddle. You’ve got a demoralised and depleted workforce, an unhappy electorate and you aren’t even spending very much on it all. You’ll need to do some handwringing, some lamenting, some explaining away. Hopefully by this time you will have got private companies into at least 20% of services.
    9. Sit back and relax
    All your hard work no doubt has been a lot of stress. And those long hours of drinking and smoking and missing the gym have really taken their toll. You deserve some time off. Don’t worry about the newspaper backlash – it’ll come eventually, and there won’t be a hint of apology as the same papers that supported you will hypocritically tear you down. And don’t worry about that chest pain you’ve been having. You’re insured right ? Oh you lost your job ? But what about the end game – the cushy seat on the board of the health companies ? Oh, you’re politically toxic now and all those backroom offers disappeared ? And you didn’t save anything ?
    Oh.
    Goodbye.

    Read more ...

  • NHS told to fill only essential vacancies due to 'almost unprecedented' finances.

    NHS trusts have been told by Monitor, the health service regulator, to fill vacancies “only where essential” as it warned that current financial plans are “quite simply unaffordable”. In a letter to NHS trusts, Monitor’s chief executive David Bennett warned of an “almost unprecedented financial challenge” as he said no stone should be left unturned to find savings. Bennett wrote in the letter, which was seen by the Health Service Journal, that financial forecasts for 2015-16 are unsustainable as he called for greater savings. The HSJ has reported recently that the provider sector has forecast a deficit of £2bn in 2015-16.

    Read more ...

Monday 3rd August 2015

BMA

  • Mr. Hunt: You want the NHS to fail, and you want it to be seen to fail.

    Dear Mr. Hunt, I know you probably won’t read this. But if you do, you might appreciate it; you might even find some useful advice in what I have to say. Don’t worry; I suspect that the nuances of the doctor’s contract negotiations confuse you, so I will speak to you in a language that you hopefully do understand: the language of Politics. Now, we doctors have generally been a pretty non-political bunch. We are too busy patching up the broken bones and broken spirits of our patients to pay too much attention to politics. We don’t philosophise much either. There’s no room for philosophy when you are trying to get a chest drain into a critically unwell patient’s chest. But, Mr. Hunt, it appears that although we had been generally uninterested in politics, Politics has been very, very interested in us. When, in the wake of the DDRB report, you made your disingenuous comments about us as a profession, we were initially rather puzzled. Why would you want to alienate doctors in your quest for a 24/ 7 NHS ? Why would you not even try to take us forward with you in a spirit of partnership and dialogue ? We then started to realise something. We started thinking about the events of the last few years. We started to see the big picture. And we are coming to the conclusion that you do not actually have the interests of a viable NHS at heart at all. 5 years ago, your Coalition government made a specific political decision to address the financial crisis of 2008 largely through public sector cuts. After systematically transferring the debts of the private banking sector into the public sector; the Prime Minister then informed us that our public finances were in crisis. Then, instead of increasing tax on those best able to pay, or regulating corporate tax avoiders effectively, your Government chose to place the burden of the financial crisis onto the shoulders of the ordinary people of this country. You called this Austerity. Now, the NHS is by a wide margin the biggest employer in the country. It’s also one of the single biggest areas of spending by Government. So of course, in the name of Austerity, you just had to drive through your so-called “reforms”

    Read more ...

Pulse

  • GPs to be offered 'simplified' conditions under plans to tempt practices away from national contract.

    GPs will be offered ‘simple and attractive’ conditions to encourage them away from the national contract and join the ‘new models of care’ that are being tested across the country, say NHS bosses. NHS England says that practices will be offered a ‘reimagined and simplified’ QOF and explicit ‘rights of return’ back to the national contract, under the plans published today. The document published today details the next steps for setting up the GP-led multispeciality community providers (MCPs) and hospital-led primary and acute care systems (PACS) that are designed to better integrate care. It reveals that there will be a ‘new payment structure’ that will see GP, community and - potentially also secondary care - budgets pooled together and given to the new organisations, which will be based on capitated payments. It says: ‘The MCP model is based on a GP registered list. The structure will build in additional community and mental health services and social care as appropriate, converting these into an amount per patient that can be combined with core general practice funding.’ But it admits that one of the ‘most complex issues’ will be how the new organisations will incorporate GP budgets and persuade practices to opt out of the national GP contract. The document said: ‘One of the most complex issues for the programme to deal with – both for MCPs and PACS - will be developing simple and attractive options for existing GP practices to migrate from their current funding and contractual arrangements, including ways to enable “rights of return”.’

    Read more ...

HSJ

  • Updated: DH proposes across the board public health cut.

    Local authorities look set to face a flat 6.2 per cent cut to their 2015-16 public health budgets under plans put out for consultation by the Department of Health this morning. The consultation comes almost two months after chancellor George Osborne first announced a £200m in year cut to the public health budget. This equates to a 6.2 per cent cut to the £2.8bn ringfenced public health grant, after funding for the commissioning of health visitors and other services for children aged 0-5, due to transfer to councils in October, is included. The consultation sets out four options for how the cut could be applied, but makes clear the DH’s preferred option is for this cut to be applied equally across all authorities with responsibility for public health. The other options would be: to devise a formula that resulted in greater cuts for the councils that receive more than their “target” allocation; apply greater cuts to councils carrying forward large underspends to 2015-16; or apply a flat percentage cut, except where councils can show that would result in particular hardship. The consultation says an across the board 6.2 per cent cut would be the “simplest and most transparent option to implement and would enable the department to provide [local authorities] quickly with certainty on what would be required of them”.

    Read more ...

BBC News

  • Staffordshire NHS trust pulls out of £690m cancer contract.

    A hospital trust has pulled out of a £690m, 10-year contract to run cancer services in Staffordshire. The BBC understands that University Hospitals North Midlands NHS Trust is worried about the financial risks involved. It was one of three partners in the private-public sector consortium. But one of the four clinical commissioning groups (CCGs) involved said the project was still on track and a consortium was still in place. It was formed after two of the original five bidders for the contract pulled out. The remaining bidders, private firm Interserve Investments, University Hospitals North Midlands and the Royal Wolverhampton Hospitals Trust combined forces. The contract is intended to streamline services across Staffordshire and improve the outcomes for patients. It would cover the areas controlled by Stafford and Surrounds, Cannock Chase, Stoke-on-Trent and North Staffordshire CCGs. But the trust foresees a 10% increase in cancer patients being treated without any extra money. Mark Hackett, trust chief executive, told BBC News: "We share the goals and objectives with the commissioners, but we don't think the context and circumstances are right and we will be announcing shortly our reasons for that."

    Read more ...

New Statesmen

  • An open letter from a doctor to Jeremy Hunt.

    Your plans are neither safe, nor sustainable, nor morally okay. “Make the care of the patient your first concern.” This is the cardinal rule of Good Medical Practice, the handbook issued to every medical student by the GMC at the dawn of their training. Ask any doctor: we have this rule as deeply ingrained throughout medical school as any physiological action or pharmacological mechanism. We probably mumble it in our sleep. And we try to. We try so damned hard. Along with the nurses, the allied healthcare professionals, and all the auxiliary teams – we do what we can with meagre staffing levels and stretched resources pitted against relentless “efficiency savings“. We work and work and work, in a miasma of demoralisation that has only thickened over the past weeks and months as the true depth and breadth of the cuts has become horrifyingly apparent. The patients are more numerous and sicker than ever before; partly due to the ageing population, but also because the patients getting admitted to hospital have been disproportionately disadvantaged by the decimation of health and social care provision both in hospitals and nationwide in the community. The estimated funding gap for adult social care this decade ? £4.3 billion.Charity funding cut by £1.3 billion; personal care cut; mental health services cut ; disability benefits cut; carers in crisis; benefit caps inexorably tightening; all welfare increasingly inaccessible to the most vulnerable members of society: the unwell, the poor, the young, the disabled. Given the above, it is indisputable that the actions taken by this government and the last have made the British population sicker. The knock-on effect on healthcare resources is both predictable and inevitable. Vulnerable, isolated older people are arguably the worst hit; the sterling work by Age UK shines a light on the shameful state of things for this demographic. These are the patients who bounce in and out of hospital and “bed-block“, often due to multiple morbidities and complex psychosocial needs. Hospital admission should always be a last resort. Unfortunately, in so many cases, things are so bad in the community that last resorts are all we have.

    Read more ...

The Guardian

  • Government defeat highlights the limits of NHS devolution plans.

    A little reported Lords defeat for the government over its plans to devolve powers to major cities has major implications for local control of the NHS. Last week an amendment was moved successfully by Labour peer Norman Warner to the cities and local government devolution bill which stops the transfer of NHS regulatory functions held by national bodies. Crucially, if the amendment is not reversed in the Commons, it will ensure any devolved services adhere to national service standards and are still nationally accountable. The bill, part of the “northern powerhouse” drive to devolve responsibilities to major cities, has become the vehicle for devolving £6bn of health and care spending to Greater Manchester. The amendment underscores Labour suspicions that the Conservatives want to whittle away the health secretary’s ultimate responsibility for providing a national health service. This caused a row during the passage of Andrew Lansley’s NHS reforms during the last parliament, when the government had to accept an amendment spelling out the requirement for the health secretary to remain accountable no matter how much control was passed to NHS England. When the government announced the NHS devolution plans, shadow health secretary Andy Burnham immediately attacked the idea of one part of the country having a different version of the NHS. This amendment means Manchester will be unable to take on any regulatory or supervisory powers from the Care Quality Commission, NHS England or Monitor and its successor, NHS Improvement. As HSJ reported in February, the Greater Manchester authorities initially sought “a new set of relationships” with regulators and inspectors to give the oversight regime a clear focus on the local health economy. While the precise legal implications of the amendment would need to be tested, philosophically it goes to the heart of the moves towards devolving control of the NHS. Those who see themselves as the guardians of the NHS see any erosion of its national character as inimical to the idea of universal health provision; national oversight and accountability are bulwarks against those who are indifferent to the NHS’s long term survival and are willing to contemplate systems where personal payments play a much larger role.

    Read more ...

Friday 31st July 2015

Hospital Doctor

  • Massive support for vote of no confidence in health secretary Jeremy Hunt.

    A former Labour health secretary has pledged his support for a vote of no confidence in current health secretary Jeremy Hunt in response to an online petition. In a tweet, Andy Burnham stated: “On behalf of the 196,000 people who have no confidence in @Jeremy_Hunt, I will apply for debate when House returns.” Over 204,000 people have now signed the Parliamentary Petition which calls for a debate on the vote of no confidence. The petition was created in response to Mr Hunt’s threats to impose – rather than negotiate – a new contract on NHS consultants, which includes the intention to create a “seven day NHS.” Many doctors have pointed out that they already work over seven days, providing on-call services over night and at weekends. It led to the hashtag #ImInWorkJeremy trending on Twitter, with doctors sending selfies to the health secretary to prove how out of touch he is with the NHS workforce. Parliament is required to consider all petitions with 100,000 signatories or more for a debate. But the Government response didn’t address the calls for the no-confidence vote – instead presenting a defence against criticisms of the seven day NHS plan itself. It said: “The Government is committed to delivering seven day services to make sure that patients get the same high quality, safe care on a Saturday and Sunday as they do on a week day.”

    Read more ...

London Evening Standard

  • NHS needs thousands of nurses as London wards are shut in ‘perfect storm’.

    Hospital wards and operating theatres are being closed because of a “perfect storm” shortage of nurses in London, the Standard can reveal today. Barts Health, which runs five east London hospitals, has almost 1,200 vacancies — one in five of its nurses and midwives. Almost one in six nursing posts were vacant in May at the Royal Free trust, which has three north London hospitals; at Imperial College Healthcare, which has five west London hospitals; and at St George’s in Tooting. Experts believe the capital is short of “several thousand” nurses. Jan Stevens, interim chief nurse at Barts Health, said: “It’s like a perfect storm. Everyone is fishing in the same pond for nurses but there is a shortage. “This is not just for Barts Health — it just looks worse for us because we are the biggest trust in the country. Obviously the vacancies we have sound staggering, but there are a lot of vacancies across the country.” At St Bartholomew’s hospital the new Barts Heart Centre has been forced to close two theatres and two catheter labs. Staff shortages have forced the closure of 15 per cent of beds at the hospital in Smithfield, the Barts Health board was told yesterday. Professor Charles Knight, director of Barts Heart Centre, said it had 120 nurse vacancies. Eighty job offers have been made, including to 44 nurses from the Philippines. At Whipps Cross hospital, in Leytonstone, staff shortages have forced the closure of a midwife-led birth unit on 15 days so far this year. Beds were also closed on the trauma and orthopaedic wards at Whipps Cross. Inspectors from Health Education England have sounded the alarm over two “adverse incidents” at Newham hospital’s maternity unit relating to a lack of cover. Across the trust, 46 “red flag” warnings were raised in June in relation to staffing. The shortage of permanent staff has sent the trust’s bill for agency staff and overtime soaring to £14.3 ?million a month. As a result, Barts Health is facing a £134.9 ?million deficit by next March, the biggest ever seen in the NHS.

    Read more ...

Left Foot Forward

  • Times admits ‘scandal of NHS end-of-life care’ story was incorrect and misleading.

    The Times has admitted a story claiming hundreds of thousands of people endure a ‘painful, undignified or lonely death’ due to poor NHS care was completely false. The story published on May 20 was headed: Scandal of ‘appalling’ end-of-life NHS care. But today the Times’s corrections box called the story ‘incorrect and misleading’. The correction begins: “We stated that ‘Hundreds of thousands of people endure a painful, undignified or lonely death because of ‘appalling’ end-of-life care right across the NHS’ (News, May 20). It notes the parliamentary health ombudsman’s report on which the claim was based said nothing of the kind. The report in fact said: “there is a potential to improve the experience of care in the last year and months of life for approximately 355,000 people” [the number of expected yearly deaths]. The Times correction continues: “It [the report] did not state or suggest that the majority of NHS patients currently receive poor end-of-life care.” The paper says the word ‘appalling’ came from the Department of Health in reference to just 12 cases of very poor care in the report. Somehow, 12 cases were taken as representative of hundreds of thousands. A correction on this is welcome, even in a tiny box on page 28 and three months late.

    Read more ...

The NewStatesman

  • The long summer break can’t have come too soon for Jeremy Hunt.

    In the last 10 days alone, two separate waves of vitriol from the medical profession have come crashing down on him, and as he scarpers off to sun himself he must be wondering what type of mood he’ll be coming back to. First there was the #Iminworkjeremy campaign, a fierce rebuttal of Hunt’s attack on the BMA over consultants’ supposed unwillingness to work seven days. This must have seemed like a breeze though, compared with the last week’s bruising. Cue #weneedtotalkaboutjeremy, an even angrier backlash sparked by the government’s response to a petition which has gathered more than 200,000 signatures (and rising), calling for a debate of no confidence in the Secretary of State. The reply was meant to silence the mob – it’s had the opposite effect, and been branded as “manipulative and misleading” by Dr Hamed Khan who I know speaks for many doctors out there. The whole saga has yet further uncovered a bitter divide, a growing rift between the Secretary of State for Health and the medical profession. Yes, the government’s response to the no-confidence petition made the valid point that reports by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) and the NHS Pay Review Body (NHSPRB) both cited consultants’ rights to opt-out of weekend and evening work as something needing to be examined. But somehow that seems beside the point – the anger it sparked certainly suggests it is. It’s at best tactless, at worst downright insulting to effectively blame consultants – the vast majority of which do work weekends by the way – for 6,000 deaths a year without proper proof. Especially when you’ve just handed them another four years of pay-freeze; when you’ve already incensed a straitened profession by shrugging off doctors who tell you that they see dangerous levels of understaffing before their eyes; and when you’ve compounded their stresses and strains by cutting social care and public health funding.

    Read more ...

The Independent

  • NHS treatments such as vasectomies and hip operations to be rationed because of cost-cutting.

    More patients could be denied NHS treatments as a result of cost-cutting by health authorities, with hearing aids, vasectomies and knee and hip operations among services set to be rationed in some areas. An investigation into 19 Clinical Commissioning Groups (CCGs), which pay for NHS health services at a local level, carried out by the GP magazine Pulse, found that several are planning to restrict access to routine care. In some areas controversial requirements for smokers to give up and for obese people to lose weight before being offered certain surgical procedures, will be used to reduce costs. NHS Great Yarmouth and Waveney CCG introduced weight loss and smoking cessation criteria for all smokers and people with a body mass index (BMI) over 35 requiring hip and knee replacements, earlier this year. Patients in Luton will also have to undergo a weight loss programme or quit smoking before certain elective surgical procedures, Pulse reported. A plan to implement a similar scheme in Devon was dropped last year shortly after it was announced, following criticism from surgeons. Other rationing measures include an NHS North Staffordshire CCG plan to deny access to hearing aids to patients with mild and moderate hearing loss – a move labelled “cruel” by the charity Action on Hearing Loss.

    Read more ...

HSJ

  • Exclusive: CCG plans handover to 'accountable care organisation'.

    A clinical commissioning group is proposing to hand its budget and nearly all its functions to a provider led ‘accountable care organisation’, in what could be a first in the NHS. Northumberland CCG’s proposal is part of the health economy’s work to overhaul its models of care and contracting. It was one of the 29 national vanguard sites identified in March and is developing a primary and acute care system. Sources working on the move, which will be the subject of discussion in the area over coming months, told HSJ it would represent a very substantial reduction of the CCG’s functions, and a substantial move away from the current commissioner/ provider divide. They plan to establish a special purpose vehicle (SPV) organisation, which the CCG budget would be delegated to, along with the primary care budget for the area. Those leading the work said the SPV would be akin to an “accountable care organisation” – provider networks being developed in the US to take on substantial delegated responsibility and risk for planning and funding services for their populations.

    Read more ...

Thursday 30th July 2015

Stoke Sentinel

  • Lack of private care firms sparks new bed blocking crisis in Staffs.

    Elderly people are being trapped in community hospital beds because there are too few private companies to look after them at home. Health bosses say it is a problem throughout Staffordshire and particularly bad in Stoke-on-Trent. Last night they were trying to set up an emergency summit to look for ways round the crisis. Dozens of firms offering home-help services are in business in the area but officials say there are still "shortages in the market" which prevent patients being sent home on time. At times they are told just hours before they are scheduled to leave that they can't go home after all because the company brought in to provide the domiciliary care has suddenly gone bust. And other firms have to abandon care plans for homeward bound patients after their staff have quit their jobs to join new local employers setting up locally and paying better wages. Now leaders of the NHS trust running the community hospitals want to tempt the workers to stay with the businesses by linking their work to a career structure in the caring professions.

    Read more ...

Nursing Times

  • Hospitals struggling to hit own targets for nurse staffing levels.

    The ability of NHS acute trusts to employ sufficient numbers of nurses on hospital wards has worsened this year compared with 2014, despite record levels of recruitment. Despite the recruitment drive, there are still not enough trained nurses to fill shifts according to safe staffing guidance, nursing directors have said. Analysis of staffing levels at 135 acute trusts showed 83% failed to meet their own planned levels for registered nurses during both day and night shifts in April in at least one of their hospitals. This compared with 76% of trusts for the same month in 2014. According to the figures, published on the NHS Choices website last month, all 135 acute trusts that reported staffing data failed to hit their target for nurses working during the day in at least one hospital in April, compared to 86% last year. A total of 112 trusts did not meet planned staffing levels for nurses working at night in at least one site – the same as in 2014. In many trusts where nurse staffing levels were below target, they have turned to unqualified healthcare assistants to fill gaps. More than 120 trusts were overstaffing on HCAs by up to 140%.

    Read more ...

Local Government Chronicle

  • Trust calls for success regime to take over ‘shambolic’ procurement.

    Northern Devon Healthcare Trust has called for a controversial community services procurement to be taken over by NHS England or the county’s ‘success regime’. The trust said Northern, Eastern and Western Devon Clinical Commissioning Group’s approach to the procurement had been “shambolic”. It also threatened to make the CCG or the new provider “buy out” cost savings earmarked for the contract. The trust’s comments came in a submission to Monitor, which is investigating NEW Devon’s decision to choose, without going to full tender, Royal Devon and Exeter Foundation Trust as preferred provider for a £100m community services contract in the eastern part of the CCG’s patch. The probe was launched in January following a complaint from Northern Devon, the incumbent provider, which claimed the CCG’s process was not competitive or transparent and was affected by conflicts of interest. Last month Monitor published its interim findings, which said while the CCG “would be likely to be in breach” of procurement regulations if it awarded the contract without further assurance work, it had not yet broken the rules. In its submission to the Monitor following the provisional judgement, Northern Devon said it disagreed with the findings. Northern Devon said the CCG’s approach to the procurement was “manifestly shambolic”. It called for the rest of the process to be overseen by NHS England or the “success regime” – the national programme for turning around troubled health economies. The county was placed in the regime in June. In its submission to Monitor, Northern Devon also made a new claim that a cost improvement plan worth “several million pounds” would be put at risk if community services transfer to Royal Devon. Monitor’s final judgment on the procurement is expected in the coming weeks.

    Read more ...

Pulse

  • GPs face increasing restrictions as NHS rations care to save money.

    GPs face increasingly tighter restrictions on their ability to refer for specialist care, reveals an investigation by Pulse into plans drawn up by the most cash-strapped CCGs in the country. The investigation reveals that CCGs are introducing policies that cap surgical referrals, require overweight patients to go a on a ‘weight loss programmes’ before an operation and deny hard-of-hearing patients hearing aids and audiological care. The investigation comes as GPs say they are finding it harder to refer for surgical treatment of conditions like ganglions or carpal tunnel and, in one area, requests for hysterectomies are simply being ‘fobbed off with a Mirena coil’. More than a third (36%) of GPs told Pulse they are facing new constraints on services to which they were previously able to refer. The investigation comes as the health service prepares to implement £22bn of efficiency savings by 2020. But only two years after coming into existence, 19 CCGs have been ordered by NHS England to devise emergency plans to cut their budget deficits. NHS North East Essex CCG chair Dr Gary Sweeney explained: ‘We have no choice other than to stay within budget. If we do not implement these decisions we will have to select other services to restrict.’

    Read more ...

Wednesday 29th July 2015

Socialist Worker

  • Slasher firms want to asset-strip NHS.

    Outsourcing giant Capita has announced plans to slash more than 1,000 jobs when it takes on an NHS contract worth £1 billion. The contract covers support and admin services, such as managing clinical records, across the NHS in England. Nearly 80 percent of workers in the NHS’s Primary Care Support Services will lose their jobs and only two out of 30 offices will remain open. The first six sites the firm plans to close down—Chelmsford, Yeovil, Derby, Mansfield, Leicester and Lincoln—could be shut by December. The Department of Health was expected to sign off on the deal later this week. This is still just the beginning of privatisation.

    Read more ...

Local Government Chronicle

  • CCG property sales 'will fund new care models'.

    Every clinical commissioning group in England has been directed to evaluate estate within its area to work out how much capital funding can be released by property sales. Under the major new national estates plan, money raised will be used to support new care models, LGC’s sister title Health Service Journal has been told. Each CCG will also calculate the total upfront investment needed to establish new care models in their area, and determine how much running cost cash can be saved by using estates more efficiently. The work is being coordinated by the Department of Health’s two property companies: NHS Property Services and Community Health Partnerships.

    Read more ...

Torquay Herald Express

  • Torbay respite care home parents: 'closure will put lives at risk'.

    Health chiefs have been accused of 'playing with lives' after deciding to close a Torquay respite care home. Torbay and Southern Devon Health and Care NHS Trust cite a decline in use as the reason to shut Baytree House in Croft Road. But angry parents of young adults who use the service say the closure is ridiculous and will cause harm. Baytree House is an eight-bed unit for adults from the age of 18 to 65 with learning disabilities, providing overnight respite care. The trust has assured carers and service users the service will remain fully operational until a new provision has been established.

    Read more ...

Oxford Mail

  • Ward to close at Witney hospital ‘to re-open beds at other hospitals’.

    A ward of 30 beds at Witney Community Hospital will shut for seven months to send staff elsewhere in the county and save money, it was announced. Oxford Health NHS Foundation Trust is consulting hospital staff over plans to close the Wenrisc ward from September 1 to March 31, 2016, so it can re-open 24 beds at other community hospitals. The trust say the move would save £600,000, but town officials are worried about the ward’s long-term future.

    Read more ...

Get West London

  • NHS Trust apologises for 'inadequate' mental health services in Hillingdon.

    The NHS Foundation Trust responsible for mental health services in Hillingdon borough has apologised for 'inadequate' care. The Central North West London NHS Foundation Trust (CNWL) came under fire in the Care Quality Commission's (CQC) inspection report. Healthwatch Hillingdon, a health and social care watchdog run by local people, welcomed the report as it reflected their own concerns and worries.

    Read more ...

Gloucester Citizen

  • GP surgery in Gloucestershire closes after 67 years due to no doctors to run it.

    Stroud GP practice St Luke's is to close after 67 years providing health care in the town. Now St Luke's 4,000 patients will have to find a new GP. The closure of the practice on Cainscross Road also means an end to the provision of anthroposophic medicine, within the NHS in Stroud, a system of healthcare based on the philosophy of Rudolf Steiner.

    Read more ...

Open Democracy

  • Why selling healthcare isn't like selling underwear.

    Former Marks & Spencer Sir Stuart Rose, hired by Cameron to advise the NHS, has reported back. The health service could learn from the management practices of the big high-street chains, he told us. NHS boss Simon Stevens responded grouchily that “the complexity of managing the NHS was greater than that of selling underwear”. More ‘market’ ideology, more ‘free market’, is the last thing the NHS needs. Healthcare cannot be marketed and run like M& S. Nobody disagrees that the NHS has got to be cost-effective. But purchasing care services from private providers with shareholders demanding profits can only lead to increased costs or reduced quality of care – or both. Private companies like Virgin and Care UK aren’t in business to promote your health – they are there to make a profit. There’s far more money in safe, elective procedures, like hip, knee, heart or cataract surgery than in unpredictable emergency treatment or labour intensive care for the chronically ill (unless you cut corners on the numbers and skill of your staff, of course). So healthcare cannot be sold like a commodity in supermarket. It must be largely paid for by some kind of central taxation like the NHS, or an insurance scheme like in the US. In either situation, someone other than the patient ends up making decisions about what is affordable. Choice and competition is nonsense when it comes to healthcare. For the last two decades, the leaders of all major political parties have been wedded to the idea that healthcare should be run as a ‘market’. Do they really believe that chosen private healthcare firms will treat all patients fairly, and not just select those based on the criteria of how much profit will be made ?

    Read more ...

Daily Mirror

  • Revealed - only NHS doctor in 4,000 who 'opted out' of weekends actually chose to work MORE.

    Jeremy Hunt's 7-day NHS claims are in tatters after it emerged a sole medic who 'opted out' of weekends actually chose to work MORE. Figures showed just one consultant in 4,095 chose to work Monday to Friday only - despite the Health Secretary declaring war on the practice. Now it's emerged this single medic isn't skipping weekends after all. Instead the doctor has 'opted out' of the 48-hour European Working Time Directive - a completely different measure which ends up meaning the opposite. Skipping the 48-hour limit doesn't cut the amount of time a doctor spends on the wards. It actually extends the time up to 56 hours a week.

    Read more ...

Monday 27th July 2015

Yorkshire Post

  • Exclusive: ‘Bias’ claim over £190m Yorkshire NHS contract.

    A Yorkshire health trust has called for an official inquiry into how a £190m contract was awarded amid claims of potential bias in the tendering process. Leeds and York Partnership Foundation Trust (LYPFT), which runs mental health services, has written to health regulator Monitor detailing a series of concerns over how it narrowly lost a five-year contract to run services in the Vale of York - and called for the transfer of services to another trust, due on 1 October, to be suspended. The Trust’s letter, seen by the Yorkshire Post, says Monitor should investigate the role of Louise Barker, a key member of Vale of York Clinical Commissioning Group (CCG), whose partner works for Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV). Dr Barker, the CCG’s lead on mental health, was directly involved in the decision to award the contract to TEWV in May. The letter, from the Trust’s chief executive Chris Butler, says the CCG breached NHS tendering rules and that the “breaches have undermined the integrity and legality of the Procurement.” It highlights concerns that Dr Barker was a member of the assessment panel judging the rival bids and that her scores for TEWV were significantly higher than her fellow panel members. It points out that Dr Barker’s role was potentially crucial when TEWV’s bid was given a rating just 0.5 per cent above Leeds and York Partnership. The letter says: “The Trust makes no allegations regarding Dr Barker’s integrity... Dr Barker’s position of conflict could have led to an unintentional preference for TEWV’s bid, which impacted on the outcome.”

    Read more ...

Open Democracy

  • A 24/7, transparent NHS – or the rise of the planet of the apps?

    This month Jeremy Hunt MP gave what he told us was his “most important speech as health secretary". The speech – delivered at the Kings Fund, and entitled “"Making healthcare more human-centred not system-centred" - fulfilled its function of generating blockbuster headlines, mostly focused on the ‘7 day NHS’ and consultant pay. But there's been relatively little comment on his new 'big idea' - a patient-centric transformation in a post-bureaucratic age, which he calls "intelligent transparency". Hunt was keen to tell NHS staff that the beneficiaries of this 'intelligent transparency' are NHS patients and staff. But who else stands to profit ? "The future is here", Hunt told us in his speech. "40,000 health apps now on iTunes, these innovations are coming sooner than most people realise." But how useful are these apps ? How safe are they ? Will they be effectively regulated ? Who will get their hands on the data they generate ? Who will be providing them ? You will perhaps remember Ali Parsa, who promised us his private firm Circle could run a full service NHS hospital at Hinchingbrooke. It collapsed after corner-cutting on staff led to severe patient care failings. Parsa’s new initiative is the 'Babylon app', which promises to put "a doctor in your pocket" – for a fee. The energetic ex-Goldman Sachs banker has managed to get this new ‘health service’ accredited by the official NHS regulator, the Care Quality Commission – as have others, such as Dr Now (which seems to be targeted at employers). Are apps preferable to healthcare professionals because they provide "better care" - or because they are easier to commodify and outsource ? Will Cameron and Hunt's promises of "24/ 7 NHS access" turn out to mean, not 24/ 7 access face-to-face with a trained and regulated healthcare professional, but 24/ 7 access to an app ? After all, the internet never sleeps.

    Read more ...

HSJ

  • CCG property sales 'will fund new care models'.

    Every clinical commissioning group in England has been directed to evaluate estate within its area to work out how much capital funding can be released by property sales. Under the major new national estates plan, money raised will be used to support new care models, HSJ has been told. Each CCG will also calculate the total upfront investment needed to establish new care models in their area, and determine how much running cost cash can be saved by using estates more efficiently. The work is being coordinated by the Department of Health’s two property companies: NHS Property Services and Community Health Partnerships.In an interview with HSJ, NHS Property Services chief executive Elaine Hewitt revealed that money from the property sales will be pooled nationally and allocated to areas in need of investment. Each CCG will review all the property within its area which is owned by the two bodies, which usually includes most community services estate, the offices used by commissioners, and some GP practices. It comes amid growing calls for adequate upfront investment in the Five Year Forward View. The Health Foundation and the King’s Fund this week jointly proposed a transformation fund worth up at least £1.5bn a year until 2020-21 to properly test and roll out new models of care.

    Read more ...

The Independent

  • NHS spends £1.8bn on staff redundancy pay-offs following Government restructuring.

    About £1.8bn has been spent on NHS staff redundancy pay-offs since the Government’s restructuring of the health service, according to new figures. More than 44,000 people have been laid off in the last five years with some 5,500 re-employed by the NHS in another job, Sky News reported. Some were given severance payments in excess of £200,000. The shadow Health Secretary Andy Burnham, who is standing for Labour leader, told the broadcaster: “Today the figures hit a new high – £1.8bn wasted. And what are doctors to make of this ? “No wonder morale in the NHS is at rock bottom. This was a reorganisation that didn’t need to happen. They’ve thrown money at redundancies, given people pay-off cheques like confetti at the NHS at a time when we’re not doing right by the staff of the National Health Service.” The Government insisted the restructuring had saved money and reduced bureaucracy. A Department of Health spokesman said: “New figures this week actually showed that our changes saved far more than expected at £6.9bn and cost less than originally estimated. “Labour oppose these reforms, but won't say how they would afford the 9,000 more doctors and 8,500 more nurses that the NHS can employ as a result.”

    Read more ...

The Guardian

  • Jeremy Hunt's seven-day plan for GP surgeries could cost NHS £3bn a year.

    Keeping a typical GP surgery open on weekends would cost an extra £500,000 a year, according to a report, which raises questions about the feasibility of health secretary Jeremy Hunt’s plans for a seven-day NHS. If extended to England’s 8,000 practices, the analysis, based on “a typical English GP surgery in the home counties”, suggests the NHS could be left with a bill exceeding £3bn. The calculations were carried out by Dr Morton’s, an online medical helpline staffed by GPs launching this month. It arrived at the £500,000 figure, “a conservative estimate”, by adding up staff costs (with a premium for weekend working), overheads and medical indemnity insurance for opening from 8am to 8pm on Saturdays and Sundays. The figures were all taken from a home counties practice with five GPs and 8,500 registered patients. “GP services are already at breaking point, and now we will have to find more staff willing to work weekends from GPs to nurses and admin staff. The vision of seven-day access to primary care is of course a good one if the finances are there. But the vision has not been underpinned by facts and figures.”

    Read more ...

Friday 24th July 2015

London Evening Standard

  • Revealed: Northwick Park hospital ‘faced crisis’ over four extra patients a day.

    A tiny increase in patients plunged a London hospital into crisis after the closure of two neighbouring A& Es, a “hidden” NHS report has revealed. Northwick Park in Harrow saw the worst delays in the country when an extra 16 patients a day— four more than expected — needed to be admitted. The hospital’s emergency department and its sister A& E at Ealing usually admit more than 1,000 patients a week, but health chiefs failed to predict the impact of a rising number of sicker patients — mainly elderly people with multiple illnesses — who require care for longer periods, the report found. London North West Healthcare, which runs Northwick Park and Ealing, had the worst performance in the country for main A& E patients for at least three weeks last October and November, after two smaller casualty units at Central Middlesex and Hammersmith hospitals were closed in September. The NHS England London report, which critics said was “hidden in plain sight” on an NHS website, said the poor A& E performance in west London last winter was part of a national trend and was “not related” to the closures. Under the Shaping A Healthier Future shake-up of emergency and maternity care, Northwick Park was predicted to see an extra 18 A& E patients a day — 12 requiring admission. The report said: “In practice, 16 additional patients per day required admission ? ?the hospital had an effective bed deficit of over 20 beds, and this drove the deterioration in the hospital’s A& E performance.” Andy Slaughter, Labour MP for Hammersmith, who uncovered the report, said the NHS in west London was “absolutely fragile” and that the findings should make people rethink plans to downgrade other A& Es.

    Read more ...

  • #ImAtWorkJeremy: medical staff show how we're all learning to harness the political power of the 'backhash'.

    Last weekend, hundreds of members of the country’s medical profession took time out from saving lives to tweet wittily captioned pictures from work, accompanied by the hashtag #imatworkjeremy. It was a backlash against Health Secretary Jeremy Hunt, and his call for their union body to “get real” about weekend working, and perceived suggestion on his part that they are not treating their career as a vocation. One doctor with a short layer of stubble tweeted that he’d started his shift clean shaven. Another posted a pic of himself on the phone at 3.20am in A& E, saying to Hunt: “Could we conference call to discuss my lack of vocation ?” The tweets echoed another “back-hash” by members of an aggrieved profession in June, when women scientists mocked UCL biochemist Sir Tim Hunt for his comments about female colleagues by tweeting pictures of themselves at work with the hashtag #distractinglysexy. It was launched by the independent campaign group Keep Our NHS Public, who announced to their followers on Friday afternoon that “Hashtag for health workers who want to alert the world when working 24/ 7 is #ImInWorkJeremy” . But it coincides with the latest escalation of the minister’s battle with the British Medical Association over the Government’s plans to change consultants’ contracts. At present, consultants are uniquely allowed to opt out of weekend working, by which they forgo a potential extra third in earnings. Trainee GP Duncan Shrewsbury tweeted to clarify: “To be clear: #ImAtWorkJeremy is about celebrating our sense of vocation & camaraderie (that we’re told we don’t have) not wingeing re: job”. That element of positive professional solidarity seems to have been a big driver behind the spread of the hashtag but once a gag is up and running it’s tricky to control its direction. Rhiannon Lucy Cosslett, the feminist blogger who started the #distractinglysexy hashtag and who co-founded the Vagenda blog, says the rapid-response hashtags are a blunt instrument, but an effective one. “I think hashtags such as #distractinglysexy and #iminworkjeremy are a fun way of making a political point,” she says. “Both hashtags were joyful to see because they both involved demographics of people who had been belittled in the media fighting back and having their say in a funny way, without being vicious. It’s democracy in action, as well as being heartwarming and hilarious.” The same could be said of the short-lived #JeSuisEd campaign, where tweeters, aggrieved at the pre-election focus on Ed Miliband’s inability to eat a bacon sandwich, posted images of their own ham-fisted (and ham-chinned) attempts.

    Read more ...

The Mirror

  • Private NHS contractor 'boots out patients before finishing treatment to meet targets'.

    A private firm running NHS services is allegedly discharging patients before they have been treated to avoid breaching guidelines. An undercover probe into Care UK , Britain’s biggest provider of out-of-hours services, has revealed patients are put at “huge risk”. Healthcare providers face fines for missing the national four-hour target for all emergency departments to conclude 95% of cases. But covert footage has suggested doctors are discharging patients when they near the limit. They continue to receive treatment later on, but off the books. Suzanne Mason, professor of Emergency medicine at the University of Sheffield, said: “By discharging somebody off your system before they’ve left the department, there’s a huge risk something could happen to that patient.” The month-long probe by ITV’s Exposure, presented by Mark Austin and to be broadcast on Wednesday night, exposed major concerns at Care UK’s 24-hour Ealing Urgent Care Centre, West London.

    Read more ...

Open Democracy

  • Why does Downing Street want details of all your appointments with your doctor?

    The government is trying to get its hands on the personal details of millions of patients’ GP appointments. The government has written to the companies who provide IT for GPs to ask them to help it obtain the date, time and duration of each appointment for 18 million patients, including the “reason” for each appointment, and the gender, year of birth and most of the postcode for each patient. It wants the details for every appointment in the last two years, as well as all appointments going forward. The request came in a letter from one of Cameron’s key officials, Tracey Grainger, Programme Director for Prime Minister’s Challenge Fund Digital Team, who claimed it was backed by “the most senior levels of government including ministers”. The letter, which OurNHS has seen, insists on considerable haste, stating that "there is an urgent need within short delivery timescales" and that the extraction of the patient information “needs to be in place by September 2015”. After a media backlash today, NHS England claimed it would not after all be trying to extract the information through the back-door, via software companies - but would now be expecting GPs to deliver it to government directly. The move – the latest in a long list of ongoing attempts to wrest confidential patient data away from patients and their doctors - has outraged privacy campaigners. Last year there was an outcry when it emerged that patients could potentially be ‘re-identified’ from the new NHS ‘care.data’ records system, and that insurance and pharmaceutical companies could get their hands on the data. More recently it emerged that patients requests to opt out of the system had been ignored in an attempt by NHS bosses to hunt out ‘costly’ patients. But the prospect of Number 10 getting its hands on the reasons behind each individual doctor appointment takes concerns to a new level. Phil Booth of medConfidential said that NHS England’s claim that such information wasn’t “personal information” was “bizarre”. Booth added that in his view “the intentions of NHS England are clear - trample on every rule of confidentiality, and collect it all.”

    Read more ...

The Independent

  • Investigation launched over drug company payments to senior NHS staff.

    The Government is to investigate “extremely serious allegations” that senior health officials who help decide which drugs are bought by the NHS have been paid to work as consultants for pharmaceutical companies. Following an undercover investigation, The Daily Telegraph reported that some staff charge as much as £15,000 to arrange “advisory board” meetings for private firms. The allegations raised concerns that health service officials may have had a conflict of interest when deciding how to spend multi-million budgets for drugs. A Department of Health spokesman said: “If these allegations are true, this is completely outrageous and amounts to an abuse of the trust that patients place in NHS staff. “The NHS fraud protection body has launched an urgent investigation and we expect each Trust and Clinical Commissioning Group involved to launch a full inquiry.” And a spokesman for NHS England said: “These are extremely serious allegations so we have immediately directed NHS Protect to launch a full investigation of each and every case identified by this press report.” The Telegraph said two reporters had posed as drug company reps trying to sell an epilepsy drug and an adrenalin pen. A pharmacist at one NHS trust, who has since resigned, said he had a “network” of more than 100 health service officials, known as “payers”, who make decisions about what drugs to buy. “I’m talking about the payers who will make a decision on which drug they have on the formulary,” he told the undercover reporters. He said it would cost £15,000 for him to organise an advisory board meeting which would “give you a competitive edge”.

    Read more ...

HSJ

  • Acute trust pledges to protect specialist children’s service.

    Nottingham University Hospitals Trust is to take on more staff to stop a struggling specialist children’s service from collapsing. The trust will recruit more doctors to its paediatric dermatology service, which will be left with one full-time and one part-time member of staff at the end of this month. Trust leaders told Nottinghamshire County and Nottingham City councils’ joint health scrutiny committee last month that they are also working more closely with local GPs to support NUH’s paediatric services. A trust spokeswoman told HSJ: “Nottingham University Hospitals Trust is advertising for one paediatrician with a special interest in dermatology. We also recently appointed two paediatrics trainees who will develop an expertise in dermatology.” The service’s precarious situation was brought about by the departure of five consultants opposed to a decision by local commissioners to split its adult and children’s dermatology services between different providers. In 2013, independent provider Circle was commissioned to provide adult acute dermatology services, while the children’s service remained with NUH. The trust representatives explained to the committee how “the paediatric dermatology service [will be] maintained and protected”. The meeting minutes said: “There is agreement to recruit to paediatric dermatology and other paediatric services. The relationship with GPs will be built on and their work will be overseen by consultants and non-consultant staff will continue to support paediatric services. A trust document presented to the committee in March said that any further reduction in consultants would “immediately compromise the paediatric service”.

    Read more ...

Thursday 23rd July 2015

Pulse

  • NHS England requests data on GP appointments to support case for seven-day working.

    NHS England will ask GP practices for access to detailed information about their provision of patient appointments in order to analyse if the money spent on seven-day access is ‘wisely invested’. A spokesperson said NHS bosses had decided not to proceed with plans to bypass GP practices to access this information directly from IT suppliers, as reported in the national media. This is despite having asked EMIS for ‘patient level data’ excluding names but including birth year, gender and the first part of their postcode only last month. In the letter sent to EMIS on 19 June, seen by Pulse, NHS England’s head of primary care development Tracey Grainger said it needed EMIS to extract this data because there was ‘an urgent need within short delivery timescales’ to analyse ‘changes to appointment provision, appointment uptake and patient encounter patterns’ by this September. The data requirements sheet sent out by NHS England for comments from EMIS requested the date and time of the appointment; its duration; appointment type, face to face, skype, home visit; and whether the appointment was urgent or routine. But patient privacy campaign group medConfidential’s coordinator Phil Booth noted that GPs are the ‘data controller’ for patient records rather than ‘the companies GPs choose and pay to provide software’. He said: ‘It is GPs who have a professional and ethical duty of confidence to their patients. With this letter, NHS England has shown it will prioritise political motivations over patient trust. It quite evidently thinks it is above the law when it comes to protections around patient data. Its intentions are clear, route around doctors and patients, trample on every rule of confidentiality and collect it all.’

    Read more ...

Daily Mirror

  • Private NHS contractor 'boots out patients before finishing treatment to meet targets'.

    A private firm running NHS services is allegedly discharging patients before they have been treated to avoid breaching guidelines. An undercover probe into Care UK , Britain’s biggest provider of out-of-hours services, has revealed patients are put at “huge risk”. Healthcare providers face fines for missing the national four-hour target for all emergency departments to conclude 95% of cases. But covert footage has suggested doctors are discharging patients when they near the limit. They continue to receive treatment later on, but off the books. The month-long probe by ITV’s Exposure, presented by Mark Austin, exposed major concerns at Care UK’s 24-hour Ealing Urgent Care Centre, West London.

    Read more ...

Health Investor

  • NHS private sector spend rises by 7%.

    NHS private sector spend rose 7% year-on-year according to the Department of Health’s (DH) ‘Annual report and accounts 2014-15’. The figure increased from £6.5 billion in 2013-14 to £6.9 billion this year. The NHS purchased healthcare from the independent sector far more than the voluntary sector, where spend was also up 3% from £510 million last year to £526 million. Of 252 NHS providers, 131 ended 2014-15 with a financial deficit. Underlying deficit for NHS providers stood at £1.2 billion, while the net financial deficit was £842 million. Broken down, NHS trusts posted a £484 million net financial deficit, up notably from £241 million in 2013-14. NHS foundation trusts also posted a net deficit of £358 million compared to a net surplus last year of £108 million.

    Read more ...

Independent

  • NHS consultant writes open letter to Jeremy Hunt to prove he's getting less than minimum wage for working weekends.

    A consultant angered by Health Secretary Jeremy Hunt's claims that a "Monday to Friday" culture exists within the NHS has published an honest account of exactly how much he earns on call and at weekends. Karan Kapoor posted the no holds barred letter to his Facebook page, describing what he takes home as a newly-appointed NHS ENT (Ear, Nose and Throat) consultant when working outside his usual hours. His on-call supplement per month, he reveals, pays just £313.54 - the equivalent of £2.61 per hour and significantly less than the minimum wage. "My on calls per month add approximately 120 hours of work in addition to my normal working week," he writes. "This is made up of being on call one day per week and one weekend in 5 - 5pm on Friday to 8am on Monday. Simple maths says that works out as £2.61 per hour - significantly less than the minimum wage let alone the living wage." Mr Kapoor, whose post has been shared thousands of times, goes on to say that he has "never looked to opt out", even though financially "it would make sense". And he expresses his shock and horror over the South West Surrey MP's push for "seven day services" that will entail changes to contracts for NHS staff. Mr Kapoor writes, "I am no different to the thousands of Consultants, Junior Doctors, Nurses, Physios, Pharmacists, Secretaries, Speech Therapists, etc. We don't go on strike, we don't hold the country to ransom, we don't compromise patient care because we were meant to go home 2 hours ago, instead we go above and beyond, understanding the true meaning of professionalism and being exemplar to any health service in the world. Without this silent and diligent commitment, the NHS would have crumbled many years ago." In his Facebook post, Mr Kapoor asks Mr Hunt to justify his claims - and to reveal exactly how many NHS consultants have actively opted out of weekend work. He says that he has tried to find further information on plans for implementing a seven-day working week via the Department of Health website and NHS England - to no avail. "It is self-evident that either your expert advisers are missing or your speech writers incompetent," he writes. "I would urge you to simply apologise for the language you have used, and look to engage in a conversation rather than an ultimatum." Mr Kapoor concludes: "I, my colleagues and the Royal Colleges agree with the principle of the NHS working efficiently every day of the week. The NHS has spoken clearly that the current proposals do not address the problem, and are not a viable solution."

    Read more ...

Tuesday 21st July 2015

Guardian

  • Don't lecture us Jeremy Hunt, we doctors already work 24/7 in the NHS.

    I am a specialist registrar who will be able to apply for consultant jobs in three years’ time. I am not alone in feeling unsure about what the future holds for me as a doctor in the NHS. And what appears clear from Jeremy Hunt’s seven-day proposal is that he has never directly worked for our world-renowned, precious institution. There is no doubt that the medical needs of the public remain significant at weekends and that I, along with the British Medical Association, fully support the idea of more seven-day NHS services. However, focusing on the need for consultant presence at weekends is merely shifting attention away from bigger issues that are staring government in the face. As a specialist registrar, I rely heavily on the guidance and experience of my consultants, most of whom have been practising medicine for more than 20 years. They, like most doctors I come across, are hard-working people. They work for the NHS, rather than for private firms, because earning lots of money isn’t their driving force for practising as a medic. Most of us actually really care about our patients, our colleagues and our communities. I’d be surprised if you could find me a doctor who hasn’t skipped lunch three days in a row or stayed two hours late because a patient has become acutely unwell, without receiving any time or monetary compensation and, quite often, no thanks. All doctors have had to spend a good chunk of their lives working weekend and night shifts. And while this antisocial pattern was “what we signed up for”, there’s no denying that such working patterns can be emotionally and physically tough, often to the detriment of family, friends and personal health. Studies have shown that working night shifts can increase your risk of serious health problems and that divorce rates are higher in those working in caring professions and with unpredictable working hours. And on a logistical note, transport and childcare costs can soar at the weekend, further adding to time and financial pressures. So if doctors are expected to work within these parameters for the extent of their career, we need to feel that we are being considered within this decision, not just being told what to do. Jeremy Hunt states that “timely consultant review when a patient is first admitted and consultant-directed interventions” will save lives. This is undoubtedly true. However, even consultants can’t do everything and if the health secretary wants consistent 24/ 7 care then he’s going to need to give them a hand. Doctors work as part of a cohesive team and rely on diagnostics in order to give patients the best care possible. So we need to know where the extra nurses, radiographers, laboratory staff, porters, administration staff etc are coming from too. What he likewise does not acknowledge is that healthcare professionals have many roles. Clinical care is at the forefront but don’t forget that consultants have important managerial, educational and health improvement roles alongside their practising duties that require adequate time to fulfil. This may be alongside trying to have a personal life too. So while working weekends may improve standards of patient care on a Saturday and Sunday, what happens on a Monday when that doctor has accrued much-needed time off the shop floor ? Again, something we need to know. What Hunt’s proposals also painfully neglect are the issues of elderly care and social placement. Significant numbers of accident and emergency admissions are for elderly patients or those with other social and long-term health difficulties that do not require emergency care but present as they “had nowhere else to go”. The government needs to look at how these groups of people can be effectively supported on a day-to-day basis to improve their individual outcomes and remove pressure from already bursting-at-the-seams emergency departments. Hunt also neglects to mention his recent public health cuts, which are taking money away from preventative health strategies and stealing decision-making responsibility from the very people delivering care. What our NHS needs now is more staff, adequate compensation and consideration during antisocial hours and sufficient budget to cover our expanding ageing population with ever increasing needs. It does not need stab-in-the-dark ideas to make it look like progress is being made. NHS workers are already working in low-morale conditions, demonstrated by the the high levels of stress and anxiety observed among staff and the falling numbers of new doctors wanting to train in general practice and accident and emergency medicine. The government’s unwillingness to propose any solid plan to implement a well-supported seven-day service for patients and staff alike is only further testing the goodwill and capability of its frontline workers, the consequences of which could be irreversible.

    Read more ...

  • Weekend hospital work needs weekend backup, Mr Hunt.

    Wendy Savage writes in a letter: Jeremy Hunt paints a dishonest picture in his talk to the King’s Fund by relating high death rates among patients admitted to hospital at weekends to the lack of seven-day elective work by consultants. One reason for excess deaths among weekend admissions (which happen all over the world) is that patients are not admitted for elective surgery at weekends, so all weekend admissions are emergency cases, which have a higher risk of death.
    The response on Twitter with the #ImInWorkJeremy hashtag confirms that all contracts require consultants and those in training to cover emergency work out of normal hours, which are defined as 7am to 7pm, Monday to Friday. Since 2003, contracts might include a requirement to work at weekends at enhanced rates of pay to do elective (planned) work. Mr Hunt wants all future contracts to require hospital doctors to do planned work at weekends, but this will do nothing to improve emergency cover. He does not explain where the money to pay for the extra support staff in the labs and imaging departments is to come from, and what will happen to weekday clinics and operating sessions if doctors are working at weekends. Without an increase in the number of doctors, who take years to train, and increased funding, seven-day routine working is not possible. The £8bn promised to the NHS by 2020 by the Conservatives before the election is insufficient to cover inflation, let alone this idea.

    Read more ...

Daily Express

  • 'Revolving door' NHS costs taxpayers £2.4 billion - and vulnerable elderly are worst hit.

    One million patients are readmitted to hospital in emergencies within 30 days of discharge because they were rushed out of NHS hospitals early - costing the taxpayer £2.4bn. A comprehensive report by Healthwatch England has revealed that many patients feel stigmatised during their stays in hospital, are not consulted in decisions about their ongoing care and claim they are "pushed out the door". The shocking survey of 3,230 patients catalogued a range of "common basic failings", and concluded that the worst hit by shoddy care include some of the most vulnerable people in Britain - the elderly, the mentally ill and the homeless. The health watchdog also suggested that an "undercurrent of ageism" could exist within the health service, with emergency readmission for the over-75s increasing by a staggering 88% over the past decade. Hospitals often fail to tell families that their loved ones have left hospital, fail to ask patients if they have anywhere to go, and do not discuss medication with GPs and carers, the Safely Home report revealed. Some of the worst cases laid out in the damning paper included a cancer patient sent home alone to his unheated home in winter, an 81-year-old stroke victim sent home late at night in a taxi only to be readmitted days later, and a man recovering from a suicide attempt discharged against his wishes who then killed himself a week later having received no follow-up care. Another man, who rang an out-of-hours number after being discharged from a mental health unit, was heartlessly told: "Can't you just read a book or do a crossword for the next five hours ?". The report went on to point out that such failings have been allowed to continue because "artificial boundaries" allow doctors, care workers and bureaucrats to avoid taking the blame - and a lack of communication means that too many patients are discharged when it is too soon, too late, or too unsafe to do so.

    Read more ...

Friday 17th July 2015

Open Democracy

  • Barts Health NHS Trust: England's biggest health trust slammed by inspectors as 'inadequate'.

    Imagine for a moment that you are the newly re-elected Conservative Prime Minister, and you want to launch an inquiry into whether the NHS should be paid for in future through user charges and insurance, not through tax. But you’ve got a problem - you’ve just won an election without breathing a word that you were considering such a fundamental change to the funding of the NHS. So how would you make such an announcement ? Very quietly, of course. Last week the government did just that. If David Cameron, or his Chancellor or Health Secretary had announced such an inquiry to re-consider a principle that has been sacrosanct since 1946, you’d expect front page headlines and Newsnight specials considering the implications. You’d expect a bit of a flurry (to say the least) about whether Cameron was back-tracking from his promises about what voters said was their number one issue. But the launch of this inquiry has not been reported in the mainstream media, at all. Why ? Because it was casually announced by a little known minister, the newly ennobled “Under Secretary of State for NHS Productivity", Lord David Prior, in the rarefied atmosphere of a House of Lords debate on the “sustainability” of the NHS, moved on 9th July by crossbench peer Lord Patel. The principle of how the NHS is funded has (mostly) stood firm since 1946, summed up in clause 4 of its White Paper: “All the service, or any part of it, is to be available to everyone in England and Wales. The Bill imposes no limitations on availability – e.g. limitations based on financial means, age, sex, employment or vocation, area of residence, or insurance qualification.” That is, the NHS is available to everyone, whether or not they can afford to pay user charges, or whether they are insurable. The question about whether the NHS could be funded through user charges or insurance is answered here: No it shouldn't.

    Read more ...

The Guardian

  • Health secretary Jeremy Hunt has given NHS consultants an ultimatum: agree to work weekends within six weeks, or a seven-day contract and cuts to overtime pay will be imposed from April 2017, he said in a speech at the King’s Fund in London.

    The British Medical Association (BMA) called Hunt’s plans a “wholesale attack on doctors” and said that the government was attempting to distract from its lack of investment in emergency care. The head of the BMA, Dr Mark Porter, told the BBC that doctors supported an improved, seven-day NHS service, but other factors were to blame, including a lack of resources. We asked NHS medical staff what they think of Jeremy Hunt’s comments, and the reality of imposing seven-day weeks on consultants. “Jeremy Hunt is making an easy target of consultants, when the the real problem lies across a wider spectrum of hospital staffing. The problem is that other services are not available at weekends: there is reduced availability of radiological and biochemical investigations, physiotherapy, dietetics, speech and language services, canteen facilities and so on. Imposing a contract rather than negotiating one is going to go down like a lead balloon and will serve to alienate even those consultants, such as myself, who have always willingly worked rostered weekends to provide best possible care for patients.” Dr Richard Wenstone:

    Read more ...

HSJ

  • US corporation brought in to help improve five trusts.

    An American healthcare corporation is being brought in to support five trusts in improving quality and clinical engagement. The health secretary will this morning announce a five year, £12.5m programme to bring in Virginia Mason to five hospital trusts with a combined turnover of more than £2bn. Virginia Mason are being paid £9m by the Department of Health, with a further £3.5m set aside to cover costs such as airfares and managing the project. The programme will see visits from Virginia Mason staff and the training of some staff at each trust on the Seattle based company’s methods and principles. The tender document for the work (attached, right) said each of the five trusts would receive “five days of provider time to use in [each of] the first two years”. The document added: “The provider will work with the chosen trusts to identify 2-4 people in each organisation to act as Leaders, including at least one senior leader per an organisation. The exact number will depend on the size and complexity of the trust. The work will be heavily focussed on clinical engagement and culture, with the tender information stipulating: “if clinical leadership is identified as a deficit that needs to be addressed, the provider will need to help find and vet resources to resolve this.” Each trust will be expected to establish a “transformation team and board to oversee its work within the programme.” Virginia Mason will also “develop and embed lean techniques and processes” in 120 members of the TDA team.

    Read more ...

Thursday 16th July 2015

Guardian

  • Jeremy Hunt gives NHS consultants ultimatum on weekend working.

    Britain’s medical consultants are to be told by the health secretary, Jeremy Hunt, that a new weekend working contract will be imposed on them unless they agree to the sweeping changes within six weeks. The new contract will have at its core the controversial weekend working provision, but will also contain the abolition of lucrative overtime payments that Hunt describes as extortionate. Hunt will send out “a get real message” to the British Medical Association, saying a new contract, including seven-day working, starting with new consultants, is essential if the NHS is to make efficiency savings and meet its target of becoming a full seven-day service by 2020. He wants the new contract to start from April 2017. Hunt’s move was described by the BMA as a “wholesale attack on doctors”. It said the ultimatum was a “blatant attempt” by the Government to distract from its “refusal to invest properly in emergency care”. At present, under a contract last negotiated by Labour in 2003, only consultants in A& E are expected to work weekends or evenings, and the remainder can opt out if they are asked to work outside the hours of 7am to 7pm Monday to Friday. A patient has a 15% higher chance of dying if they are admitted in a hospital on a Sunday than on a Wednesday, he will point out, clearly implying the inflexibility of consultants leads to unnecessary deaths. He will point to research showing that the pay of England and Wales 40,000 consultants rose by 50% between 2001 and 2005. His assault on the BMA comes in a speech to the King’s Fund setting out his 25-year vision for the NHS. BMA council chairman Dr Mark Porter said: “Despite whatever the health secretary may claim, his simplistic approach ignores the fact that this is a much broader issue than just doctors’ contracts. Today’s announcement is nothing more than a wholesale attack on doctors to mask the fact that for two years the government has failed to outline any concrete proposals for introducing more seven-day hospital services. The health secretary has questions to answer. How does he plan to pay for it ? How will he ensure there isn’t a reduction in mid-week services or fewer doctors on wards Monday to Friday ? Yet again there are no answers.”

    Read more ...

  • 750 avoidable deaths a month in NHS hospitals, study finds.

    About 750 patients a month in NHS hospitals are dying unnecessarily, the largest review of “avoidable deaths” has found. Researchers at the London School of Hygiene and Tropical Medicine said one in 28 deaths could be attributed to poor care such as inattentive monitoring of the patient’s condition, doctors making the wrong diagnosis or patients being prescribed the wrong medicine. The new study said measures used by health officials to rate hospital death rates, such as the standardised mortality ratio, “should not be used to benchmark hospitals’ quality of care … [because there is] no significant association between them and the proportion of avoidable deaths in a trust”. High death rates were used by Conservative ministers as justification for launching a public inquiry into Mid Staffs hospital – a process that led to its closure. Despite these flaws, an industry has grown up around death rate data. Proponents such as Sir Brian Jarman, a professor at London’s Imperial College who co-founded the hospital ratings company Dr Foster, argue that such measures are not a confirmation of poor care but rather should be seen as a “smoke alarm” in that they highlight a problem that needs investigating. The author of the paper, Helen Hogan, a former GP and public health expert, said that only by instigating an independent review into contentious patient deaths that one could describe a patient’s loss of life in hospital as “avoidable”. Her co-author Nick Black, professor of health services research at the school, has questioned whether mortality rates take into account factors such as burden of illness and are skewed by other factors such as the availability of hospice care in the area. (Where there is less hospice care, patients are more likely to be in hospital when they die.)

    Read more ...

  • 'We wouldn’t go back into the NHS': Plymouth's pioneering social enterprise.

    Mount Gould is not, strictly speaking, an NHS hospital – nor a private one. It is run by Plymouth community healthcare, which believes it is the UK’s largest social enterprise providing NHS services. As a community interest company (CIC), it has no shareholders and pays no dividends. It has recently taken over Plymouth’s social care under a £71m deal, making it a pioneer in health and social care integration. In 2011, the government forced England’s primary care trusts to transfer community care to other organisations. Most chose NHS trusts, but some set up companies. The south-west’s since-abolished strategic health authority favoured the latter, and Bristol, Cornwall, North Somerset and Plymouth all have CICs. On 1 April, it took on Plymouth’s social care work with the transfer of 172 social workers, occupational therapists, community care workers and management. The election campaign saw Labour accusing the Conservatives of having a secret plan for NHS privatisation. Plymouth community healthcare is a company, although one set up under what was until May’s local elections a Labour-controlled city council. Is this NHS privatisation in action ? Waite says that company status generated some opposition early on, particularly from national offices of trade unions. But he adds that many NHS services are provided by the private sector, including GPs. He says the fact that the CIC spends its money locally rather than supporting distant shareholders has helped win people over.

    Read more ...

Nursing Times

  • Staff shortages warning at Leicestershire mental health trust.

    Leicestershire Partnership NHS Trust has been told to address staffing shortages, after the Care Quality Commission raised concerns about the safety of services. Inspectors said they were worried about staffing levels at a number of inpatient wards and community teams across the trust and flagged up a “heavy reliance” on bank staff, especially in acute services and end of life care.

    Read more ...

Express

  • NHS crisis: Thousands of patients sent taxis instead of ambulances after ringing 999.

    Thousands of people are being sent minicabs instead of ambulances after dialling 999, it has been revealed.A staggering 6,300 patients in London were taken to A& E in private taxis between September and February, according to shocking new figures. The Yorkshire Ambulance Service even used taxis for 'Red 2' calls – the code for potentially life-threatening cases such as suspected strokes. The figures come as experts claim the country's 11 ambulance trusts face a major shortage of paramedics.

    Read more ...

CareAppointments.co.uk

  • New NHS Controls Unlikely to Have Much Impact on Agency Spending.

    More than 60 per cent of NHS trust finance directors think controls on agency spending announced in June will not significantly reduce the amount spent on agency staff, according to the latest quarterly monitoring report from The King’s Fund. Only one in ten trusts surveyed thought the controls, which set a maximum hourly rate and cap the amount trusts can spend on agency staff, will have much impact. The regular survey carried out for the report also found that three-quarters of trusts intend to recruit more permanent nurses in the next six months, suggesting that the NHS is continuing to prioritise quality of patient care despite rising financial pressures. With the majority of trusts forecasting deficits and no prospect of extra funding, it is clear that the NHS is heading for a financial crunch by the end of the year.

    Read more ...

Open Democracy

  • Government proposes inquiry into moving to a 'pay NHS'.

    Imagine for a moment that you are the newly re-elected Conservative Prime Minister, and you want to launch an inquiry into whether the NHS should be paid for in future through user charges and insurance, not through tax. But you’ve got a problem - you’ve just won an election without breathing a word that you were considering such a fundamental change to the funding of the NHS. So how would you make such an announcement ? Very quietly, of course. Last week the government did just that. If David Cameron, or his Chancellor or Health Secretary had announced such an inquiry to re-consider a principle that has been sacrosanct since 1946, you’d expect front page headlines and Newsnight specials considering the implications. You’d expect a bit of a flurry (to say the least) about whether Cameron was back-tracking from his promises about what voters said was their number one issue. But the launch of this inquiry has not been reported in the mainstream media, at all. Why ? Because it was casually announced by a little known minister, the newly ennobled “Under Secretary of State for NHS Productivity", Lord David Prior, in the rarefied atmosphere of a House of Lords debate on the “sustainability” of the NHS, moved on 9th July by crossbench peer Lord Patel. The principle of how the NHS is funded has (mostly) stood firm since 1946: the NHS is available to everyone, whether or not they can afford to pay user charges, or whether they are insurable. The question about whether the NHS could be funded through user charges or insurance is answered here: No it shouldn't. But where better to have the sort of debate that no one has voted for, and launch an inquiry that no-one has voted for, than in the House of Lords, which no one has voted for ? Prior – recently elevated to the Lords from his stint as the strongly pro-market chair of the Care Quality Commission, formerly a Conservative MP and deputy party Chair – led for the government in the Lords debate. Far from endorsing the tax-funded system that is widely acknowledged to be the fairest way of paying for healthcare, we have Labour peers suggesting the government should "help" the public to think of other ways to pay for healthcare. Labour peer, Lord Desai, suggested bizarrely that patients should be issued with an "Oyster card" which is deducted whenever a patient uses healthcare, and patients should receive a "bill" at the end of the year, saying this would “help make it clear to people that a free National Health Service is not a costless one." Once their Lordships had had their say, Prior concluded for the government: "I would like to meet the noble Lord, Lord Patel, and maybe two or three others, to discuss this in more detail to see whether we can frame some kind of independent inquiry—I do not think that it needs to be a royal commission. We are not short of people who could look at this issue for us; there are health foundations, such as the Nuffield Trust and the King’s Fund.” Prior ignores the fact that the Kings Fund has already recently carried out an inquiry, the Barker Review, which rejected user charges and called instead for more taxes to pay for healthcare, in particular through a review of inheritance tax and national insurance increases. Both of which George Osborne has just cut, of course. So Prior orders another inquiry, this time using people he has chosen and presumably people who will produce the desired result. Such a fundamental inquiry should involve the public and be held in public, but it appears Prior does not want the public involved. Is Prior, in announcing an inquiry into so fundamental an issue, acting above his paygrade as an unelected junior health minister ? And are we being nudged towards an inefficient, unfair ‘pay NHS’ in the only way possible – undemocratically ?

    Read more ...

Tuesday 14th July 2015

Open Democracy

  • Panorama and the NHS - the perfect missed opportunity.

    David Wrigley writes: The Panorama on the problems facing the NHS was public service broadcasting at its most disappointing. The programme - ‘NHS – The Perfect Storm’ had been due to air in early June but was postponed at the last minute by the BBC, prompting speculation that the politicians needed a look at the final edit before it was aired. When it did surface last night, the programme undoubtedly packed an emotional punch. How could we not be moved by patients’ touching stories and the dedication of our NHS staff ? But – lacking any real insight into what’s really going on in the NHS - the overall effect was sensationalist, with the narrators’ fatuous comments adding nothing - apart, perhaps, from softening us up for the (misplaced) idea we simply can't afford a universal health service ? There was just one brief mention of the situation I see many of my patients struggling with - left ‘stuck’ in hospital or struggling on at home in worsening health, hit by 40% cuts to the home support they used to receive from care assistants and social workers. The programme's talk of 'care in the community' glossed over how the bits of the NHS that always have supported patients in the community are being cut to the bone. There’s been no investment in General Practice for the past five years. Community services such as district nursing, occupation health and physiotherapy have been amongst the hardest hit by cuts – with a 40% fall in the number of district nurses in the last 10 years, for example – so again, patients become sicker and more vulnerable in their own homes. And the programme-makers then appeared to muddle up ‘social care’ with ‘community services’ – not leaving the viewer much faith that the hype about the benefits of ‘integrating’ health and social care, and delivering it ‘in the community’, would be critically examined. As indeed it wasn’t. Instead, most of the hour was indeed given over to how patients being old, demented, unemployed and obese were the main reason for the NHS crisis. It was as if these problems had just begun in recent years and the NHS was only now struggling because of them. But the world shown in the Liverpool slums is a world Jeremy Hunt and David Cameron will never visit or acknowledge. They have no understanding of the reasons behind these patients chaotic and unhealthy lifestyles. And even less interest – not much profit for 'insurers' and 'healthcare providers' in these people, after all, they're more interested in cherry picking the state cash to treat the cheap and easy patients and procedures. So the answer we were presented with for the fat, old, unemployed or simply poor, was more ‘self-care’. But there was no mention of how public health services which focus on preventing ill health are being decimated, with a further £200million being stripped from their budget. No evidence from public health professionals, who are decrying ‘austerity’ as worsening health outcomes and leaving people malnourished, over-stressed, and little able to focus on ‘healthy lifestyles’. The smiling GPs in ‘leadership’ roles on the local Clinical Commissioning Group were presented to us as the last chance for the NHS. The programme ignored how Lansley’s Health Act wrote hospital consultants out of planning local healthcare – a shortsighted move that has led to many of the unproven, untested and unevidenced ‘care in the community plans’ we now see planned by these ‘GP leaders’ across the country. The plan put forward by Liverpool CCG is being replicated across every CCG in the country. Some are already trying to take the rhetoric of 'self-care' to its extreme, denying all routine operations to patients who are overweight or smoke, or telling dementia patients to 'treat themselves'. But - though you wouldn't know it from last night's Panorama - it is the politicians, not the doctors and patients, who are culpable for the mess the NHS is in. It’s the politicians who have overseen falling NHS expenditure – confirmed by the UK Statistics Authority – and an across the board cuts of 10% to the money hospitals receive for treating us. It’s the politicians who have created an English NHS ‘market’ that wastes an estimated £10bn a year or more on bureaucracy, to enable their private health industry friends to ‘compete’ with our NHS hospitals (and rich pickings for the armies of lawyers, accountants, management consultants and bankers creaming off fees, too, of course). It's the politicians who have also created the Private Finance Initiative scandal – also unmentioned last night, even though Liverpool is still building hospitals under this expensively flawed, wasteful model. It’s the politicians who have wasted billions on agency workers, as they treated the NHS workforce with contempt, slashing training, increasing workload, reducing pay, and accusing them of ‘normalising cruelty’. It's the politicians who have overseen a halving in the number of hospital beds in the last 30 years, and maintained a level of healthcare spend lower than just about anywhere in the developed world. And who’ve nonetheless wasted a further fortune - £640million in 2014 alone – on management ‘consultants’ busy drawing up further ‘care in the community’ plans which even Panorama admitted were ‘untested’ – and which often seem driven more by a desire to free up hospital land for sell-offs, than serious evidence about what is an cost-effective and efficient way to deliver healthcare. It was a huge disappointment to see prime time TV on the BBC filled full of such tripe and blaming unwell patients for the failings of politicians. But then again the BBC are under the cosh with their Charter Renewal coming up…. If only those of us who have spent years campaigning to save the NHS from the misdemeanors of politicians were given an hour of prime time TV to get our message across. Imagine what we could do with that!

    Read more ...

BBC News

  • A Liverpool health experiment which just might save the NHS.

    A Liverpudlian doctor featured in a Panorama Special, NHS - The Perfect Storm tells it like it is: Unless we change the way we do things, the NHS in England will die.The new Healthy Liverpool programme - backed by the City Council and the Liverpool Clinical Commissioning Group - is the city's latest answer to its mountain of health problems. Presented as a manifesto of sweeping - even 'revolutionary' - change, it promises Liverpudlians longer, healthier and happier lives. The scheme involves an all-out attack on unhealthy lifestyles combined with a massive shift of care - and resources - from hospitals and into the community, and a joining up of the NHS with other health and social care services. At the core of the programme is a very simple idea: healthy people do not go to hospital. Everything possible must be done to prevent people becoming ill, by encouraging healthy lifestyles.We do not need hospitals, one member of Liverpool's CCG exclaimed - with only a little exaggeration. And as if to reinforce this message, the new Liverpool Royal Hospital is being built with fewer beds than the hospital it is replacing. In the future the only people who will be admitted to hospital, will be patients who really need to be there. At the end of Healthy Liverpool programme, a senior doctor told me, there will be fewer hospitals in Liverpool.

    Read more ...

Manchester Evening News

  • Number of mental health beds in Greater Manchester falls despite significant increase in admissions.

    The number of mental health beds in Greater Manchester has fallen in the last five years despite an increase in admissions. NHS figures obtained by the MEN show the number of people admitted by the region’s three mental health trusts has increased by 23% from 8,327 to 10,246 over five years. But the region has also seen a 5.9% cut in mental health beds from 1,491 to 1,403 during the same period. The MEN revealed in April how hundreds of mental health patients have been taken to private clinics up to 260 miles from Manchester due to a shortage of NHS beds in the region. Earlier this month, a health regulator said England’s mental health crisis-care system was ‘unsafe’, with a lack of available beds a key concern. Mental health charities have called for ‘proper’ resourcing of services to cope with growing numbers of people in need of help.

    Read more ...

  • 'Lives could be at risk' from cuts to public health in Greater Manchester, says town hall leader Sue Derbyshire.

    A town hall leader says plans to cut millions from public health in Greater Manchester could threaten lives. Sue Derbyshire, who leads Stockport council, criticised ministers for slashing funding while ‘continuing to claim the public health budget is fully safeguarded’. Coun Derbyshire said Stockport town hall set a balanced budget for 2015/ 16, taking into consideration its full public health grant allocation. But it looks as though bosses will have to find an extra £1m after new cuts were announced last month. Coun Derbyshire said it will mean scrapping a number of prevention services and campaigns. She said the announcement - six months after original savings targets were laid out by Chancellor George Osborne - came as a ‘shock’ and that the plans were ‘ill-timed and potentially life-threatening’. The region’s health devolution deal will see town hall chiefs in Greater Manchester handed control over the entire £6bn NHS budget. Public health cash, traditionally part of the same pot, is now handed directly to town halls and is ringfenced for services including help with substance misuse, sexual health, quitting smoking and obesity. Coun Derbyshire said further pressure on public health budgets will not help town halls roll out the devolution deal.The Lib Dem group on the council is urging the government to honour its previous funding settlement and ditch the new round of cuts. They argue public health ‘essential’ to the NHS’ sustainability, with preventative services easing pressure on over-stretched hospitals and saving money in the long-term.

    Read more ...

Guardian

  • Devolution could be just another path to privatisation of public services.

    Adam Fineberg, an adviser on public service design and provision, writes: In the debate over government’s devolution plans to move more power from central to local government, no one seems to have spotted that they could lead to the creation of sub-regional markets of public services, ready to be privatised. Just as the previous government reorganised the NHS to create commissioning and separate provider organisations, leading to further outsourcing of public services, so devolution will ultimately disrupt the traditional organisation of council services, potentially bundling them into parcels suitable for outsourcing. Devolution will relaunch the previous government’s attempts to privatise more public services – with this government’s offer to local government potentially leading to several unintended consequences. Local authorities are joining forces within combined authorities, particularly when negotiating a devolution deal with government. The claim is that this enables them to deliver better, cheaper services, with the new emphasis on boosting growth and productivity. There is a question mark, however, over how far these combined authorities will be able to realise growth, or make local public services more productive and efficient. Spreading local authorities around different sub-regional groupings to influence policy and funding is not always the most effective way to deliver improved, integrated services, as they become too distant from local people. By organising their own combined authority, local councils are also taking the risk away from central government over the potential turmoil that might be created by a top-down reorganisation of local government. This enables central government to claim that it’s “localism” in action and avoid blame if things go wrong. By making devolution dependent upon their being an elected mayor with oversight over new combined authorities, the government is attempting to demonstrate a sort of democratic legitimacy built into its devolution agenda. But the current devolution plans – devolving centralised activities around health, transport and welfare to regional coordinating bodies of individual local authorities (often very different in political colour, nature and needs) – just create greater complexity and promotes further managerialism. Though many public services have already been privatised, the greatest problem for the current Conservative government – and those like the Confederation of British Industry who seek further privatisation – has been the scale at which it is feasible to provide profitable contracts for private sector providers. Private sector returns are more easily achieved by delivering a wider range of services over an area bigger in population than a typical local authority. By packaging together the range of public services across a sub-region, a private sector provider will be able to present more successful bids on the basis that they can redesign and integrate services.

    Read more ...

Nuneaton News

  • Nuneaton hospital's agency costs hurting funds.

    An over reliance on costly agency staff has put the George Eliot Hospital's financial plans in jeopardy. At the latest meeting of the board it was revealed that the Nuneaton NHS Trust has spent almost a quarter of a million pounds more than it intended to. The figures, for May of this year, will make for worrying reading as the hospital is only two months into the new financial year.The Trust is currently finding it hard to recruit permanent staff and is having to book agency staff, which are high priced temporary workers, to cover wards and units at a safe level. An open day was staged in a bid to redress the issue, however it may be some time before new staff are formally appointed.

    Read more ...

Essex Chronicle

  • NHS protesters march through Chelmsford against international treaty.

    Protesters marched through Chelmsford against an international treaty they say could herald the privatisation of the NHS. The People's NHS took to High Street to raise awareness of the potential impact of the Transatlantic Trade and Investment Partnership (TTIP) on public services. The group say this treaty, being negotiated between the US and the EU, could have disastrous consequences for the future of the welfare system across Europe.

    Read more ...

Monday 13th July 2015

On Medica

  • Companies fined for supplying faulty pre-filled insulin syringes.

    Two linked companies have been fined for supplying hospitals with defective pre-filled insulin syringes that contributed to the death of a patient with diabetes. The faulty syringes were supplied to Sheffield Teaching Hospitals NHS Foundation Trust by Fresenius Kabi Ltd as a licenced wholesaler for Calea UK Ltd, which manufactured the product. Both companies, based at the same address in Runcorn, Cheshire, were fined at Sheffield Crown Court yestereday after being prosecuted by the Medicines and Healthcare products Regulatory Agency (MHRA). Fresenius Kabi was convicted for its role in a ‘medicinal failure’ that a coroner had earlier ruled was a ‘major contributory factor’ in Mr Judge’s death. The court heard that supplying faulty syringes wasn’t an isolated incident and that Calea also manufactured a batch of pre-prepared tobramycin syringes— used to treat infections— given to a patient with cystic fibrosis at the Royal Shrewsbury Hospital in August 2011. These syringes, which were prepared and delivered direct for the patient by Calea, each contained triple the prescribed daily dose. This came to light when the patient reported a fizzing sensation, although there were no lasting effects.

    Read more ...

BBC News

  • NHS staff make 'staggering' complaints over shortages.

    NHS workers in Wales have made more than 10,000 complaints about staff shortages since 2012, according to research by the Liberal Democrats. Health boards received 3,000 complaints in 2012, slightly less in 2013, then 3,471 in 2014, and 955 so far in 2015. Welsh Lib Dem leader Kirsty Williams said the "staggering" figures showed staff were "in desperate need of help". The Welsh government said NHS staff numbers had risen by a third since devolution in 1999. The Welsh Lib Dems asked health boards how many complaints they received from workers about a lack of qualified staff. "These figures paint a picture of a Labour-run NHS that is under enormous strain and in desperate need of help," Ms Williams said. "The Welsh Lib Dems' More Nurses Bill would see Wales become the first country in the UK with a legal duty on safe nurse staffing levels. "It will save lives by ensuring a safe level of nurse staffing in our hospitals." A Welsh government spokesman said: "Our commitment to the NHS is clear - more than 43% of the total Welsh budget is invested in our health service every year. "There are more doctors, more nurses, more midwives, more paramedics and more dental staff working in the Welsh NHS today than there were 10 years ago."

    Read more ...

HSJ

  • Trust to complain to Monitor over £285m contract award.

    A foundation trust in Yorkshire is set to lodge a formal complaint with Monitor after a £285m contract was awarded to a rival group of bidders. HSJ revealed last month that social enterprise Locala Community Partnerships was the preferred bidder of the “prime provider” contract for community services in Kirklees, and the deal was confirmed this week. The Locala bid also involved South West Yorkshire Partnership Foundation Trust, a local hospice and other third sector organisations. The consortium was chosen by Greater Huddersfield and North Kirklees clinical commissioning groups. Calderdale and Huddersfield Foundation Trust had led a separate consortium bid for the contract with GP federations. It said in a statement: “As a partnership we do not agree with the decision nor the process undertaken by the CCGs in evaluating and making the decision on the contract. “As such we have informed the CCGs that we intend to lodge a formal complaint with Monitor asking for them to commence an investigation into the CCG’s procurement process and its impact on the outcomes for patients. Our overriding reason for doing this is to ensure that patients and their families can be confident in the process and confident that they will receive the very best care as a result.” The trust, which forecasts a deficit of £23m for this financial year, reported in its board papers that losing the contract would result in lost income of £5m. Winning the contract would have resulted in a £30m growth in income.

    Read more ...

The Guardian

  • Public health cuts could cost NHS extra and cause more unplanned pregnancies.

    The number of unplanned pregnancies is likely to rise and cost the NHS an extra £250m on abortions and maternity services because of proposed cuts to public health spending, leading sexual health experts have warned. The Advisory Group on Contraception said on Friday that the government’s £200m in planned savings were a false economy as cutbacks in sexual health advice and provision would have a direct impact on unwanted pregnancies. Leading doctors’ groups had urged the chancellor, George Osborne, to pull back from his planned 6% cuts to local authority public health grants from the summer budget, but the Treasury is pushing ahead. The AGC – which includes doctors as well as representatives of the Family Planning Association, Marie Stopes International, the Sexual Health Forum and the British Pregnancy Advisory Service – warned that contraception services would inevitably be hit given that they amounted to 10% of council spending on public health. It forecast that if budgets were sliced to affect all services equally, it would cost the NHS at least £250m extra this year alone, as well as having a significant impact on the lives of many women. The AGC’s meetings are funded by Bayer, a manufacturer of contraceptives, but its members are unpaid and independent. The group’s position was backed by Labour’s Luciana Berger, the shadow minister for public health, who said there was a “real risk that this decision could cost more money than it saves”.

    Read more ...

Friday 10th July 2015

OnMedica

  • Doctors and colleagues in the NHS should not have to continue to bear the burden of the government’s failure to put NHS finances on a sustainable footing, doctors’ leaders have insisted after George Osborne announced an effective ‘pay freeze’.

    They warned that students from low-income families will be more disincentivised than ever from studying medicine, as student grants are being scrapped completely in favour of loans. And they criticised the government’s ‘contradictory’ decision to cut £200m from the public health budget at a time when it claims to be investing in preventive health to reduce unnecessary demand on the NHS. In his 2015 budget speech yesterday the Chancellor of the Exchequer pledged an extra £8bn for the NHS by 2020-21 – but said that the 1% limit on public sector pay rises will continue for next four years. Many were quick to point out that this is, in effect, a pay freeze once inflation is taken into account, and insisted that doctors should not have to suffer the consequences of the government’s failure to solve the NHS’s financial difficulties. Chair of BMA Council Dr Mark Porter (pictured) pointed out that the government had failed to explain how it would achieve the extra £22bn in efficiency savings needed to plug the gap in NHS finances. He said: “So far the majority of savings have been found through cutting tariffs paid to hospitals and cutting staff pay. The health secretary himself has admitted that continued pay restraint is unsustainable and the Chancellor’s cynical disregard for NHS staff is shown by this announcement of a pay freeze for another four years at a time when he knows that inflation will rise above that.

    Read more ...

Upper Calder Valley Plain Speaker

  • Hospitals Trust calls for Monitor investigation into award of £238m contract to Locala.

    Calderdale and Huddersfield NHS Foundation Trust (the hospitals Trust) has told staff that it is lodging a formal complaint with Monitor (the NHS competition enforcer) about the Clinical Commissioning Groups’ (CCGs) award of the £238m Kirklees community health services contract to Locala. The hospitals Trust had also bid for the contract, in partnership with the three Federations representing GPs across Kirklees (PHH, Rowan and CURO), Mid-Yorkshire Hospitals Trust and Forget Me Not Children’s Hospice. Once Greater Huddersfield and North Kirklees CCGs had publicly announced that Locala had got the contract, Owen Williams, the hospital Trust Chief Executive, emailed staff: “You should know that we do not agree with the decision nor the process undertaken by the CCGs in evaluating and making the decision on the contract. As such we have informed the CCGs that the Trust and our partners intend to lodge a formal complaint with Monitor asking for them to commence an investigation into the CCGs’ procurement process and its impact on the outcomes for patients… I realise that some of you have been aware that this was likely to be the case for some time, however we have not been in a position to inform you formally until now due to the CCGs’ request for us to maintain confidentiality during the procurement process”. On Wednesday 8th July Greater Huddersfield and North Kirklees Clinical Commissioning Groups announced that they had contracted Locala as the “lead provider” for the community health services (called Care Closer to Home). The Locala company was set up in 2011 as part of the New Labour Government’s Transforming Community Services scheme.

    Read more ...

Keep Our NHS Public

  • The Devo Manc plan is a blitzkrieg attack to fast- track the reconfiguration of the NHS into new business models ready for private company take over.

    Greater Manchester Association of Trades Union Councils ( GMATUC ) called a mass NHS emergency protest rally to protest against the devolution of the Greater Manchester NHS Budget, called “Devo Manc”, without public scrutiny. An emergency resolution passed by GMATUC stated in part, “ As trade unionists we can only suspect that the break up, dismemberment, rationalisation and further privatisation of the NHS in England ( under the banner of public service reform) is precisely what it’s all about, and being hurriedly imposed to avoid any such thorough examination, scrutiny and proper public debate of the issue.” The motion ends by calling for a referendum on ALL the Greater Manchester devolution issues. On 27th February 2015 Chancellor George Osborne, and the chief executive of NHS England Simon Stevens held a press conference to announce a “Memorandum of Understanding” for “Devolution of health and social care in Greater Manchester” ( GM ). This marked a deal to parachute in a £6bn pooled health and social care budget, direct from the Treasury to a new GM Strategic Health and Social Care Partnership Board – in shadow form from April 2015, and statutory by April 2016. This board contains leaders of 10 Local Authorities ( LAs ) ( 12 Clinical Commissioning Groups ( CCGs) and representatives of NHS England ( NHSE ), as well as providers and voluntary organisations. The Combined authority of GM consists of LAs ;Bolton, Bury, Manchester, Oldham, Rochdale, Tameside, Salford, Stockport, Trafford, Wigan,- an area of 5000 sq miles, and 2.7m population. This deal came as a complete surprise to everyone but a few top council leaders, such as Sir Howard Bernstein and Sir Richard Leese, who had secret negotiations with Osborne for six months and then persuaded the 10 LA leaders ( 8 Labour ) to agree. Members of the public, NHS staff, trade unions, and Members of Parliament, had no idea.

    Read more ...

Open Democracy

  • You could be forgiven for thinking the NHS has done well out of the Budget.

    While spending on unprotected government departments will have fallen by about a third between 2010 and 2020, the NHS has managed to secure an ‘extra’ £8 billion a year, thanks to some pre-election politicking from Simon Stevens, head of NHS England. In reality, the next five years for the NHS in England look less and less rosy, the closer you look. Stevens’ own financial predictions outline the size of the problem - if demand for healthcare continues to grow at the same pace, there will be a £30 billion shortfall by 2020. Osborne has committed to closing just over a quarter of that funding gap – but it is unclear when and how this £8 billion will be phased in, and crucially, where exactly the money will come from. More concerning still is the remaining £22 billion. By 2020, the English NHS will be running up an annual deficit nearly five times that of the Greek government, even with Osborne’s unfunded extra money. The cracks are already beginning to show. The UK lags behind its peers on a range of health outcomes, including heart attack mortality, stroke deaths, and suicides among inpatients with mental disorders. Health spending as a proportion of national income is among the lowest of the advanced economies. As the BBC’s health editor Hugh Pym put it, ‘if we are not spending as much as the others, perhaps it’s not surprising that many of the results are mediocre’. So what to do ? Can the funding gap be closed while improving care quality and keeping the government's promise not to raise taxes ? This is where Stevens, for all his nimble manoeuvering before the election, may prove to have come unstuck. As part of the deal to secure the fabled £8 billion, NHS England committed to make £22 billion of efficiency savings, chiefly by introducing redesigned ‘models of care’. Jeremy Hunt considers this the NHS’s ‘side of the bargain’.

    Read more ...

BMJ

  • “Beyond aid” investments in private healthcare in developing countries.

    The UK government’s investment in commercial hospital chains merits greater scrutiny An inquiry by the House of Commons International Development Committee published in February 2015 proposed a transition to “beyond aid” policies. The rationale for this transition was clearly stated: traditional forms of aid address the symptoms of poverty “at a substantial short-term cost.” Investments by development financing institutions tend to be made using criteria of job creation and returns on investment. It would seem that their effects on health systems, health equity, and poverty have largely avoided scrutiny until now. But easy assumptions about the contribution of the commercial sector to improving health coverage for poor people need to be challenged. High throughput models of profitable healthcare treatments are being rapidly rolled out in the absence of robust evidence of their affordability or appropriateness. A recent rigorous review found “very limited evidence” that such models offer good prospects for extending services to the poor in the future. Impoverishment caused by healthcare costs is also a documented concern in many countries.Although catastrophic costs can be incurred in public sector hospitals that have user fee systems, the problem is far greater in the profit generating sector. In India alone an estimated 2.5 million households are pushed below the poverty line each year by the costs of inpatient care. We also know from research supported by the Department for International Development that many more users of private healthcare are impoverished each year in India than users of the public sector (48% compared with 15% incur catastrophically high out of pocket health spending). This situation is compounded by the distortions in the provision of care that are known to be encouraged by commercial interests. Interestingly, it is the World Bank that has become the latest voice to draw attention to a worldwide epidemic of medical overuse—the prescribing of unnecessary medical tests, procedures, hospital admissions, and operations—citing the role of “aggressive marketing of services by hospitals, pharmaceutical firms and the medical device industry” and “incentives inherent in the way providers are paid for their services.” The bank highlights the marginal benefits of many procedures and notes that they can lead to unnecessary suffering, particularly among frail and elderly people. This scenario arouses concerns that a transition to beyond aid in the health sector as currently envisaged may undermine attempts to achieve equitable universal health coverage. Greater scrutiny is required of beyond aid investments in commercial hospital chains and other related areas in order to better determine their effect on poor people’s access to healthcare, on catastrophic out of pocket health expenditure, and on opportunities for developing countries to create unified health systems with an appropriate focus on prevention and on primary healthcare.

    Read more ...

The Guardian

  • Nice to publish report on NHS staffing levels despite being told to stop work.

    Ministers and NHS bosses face an embarrassing row over safe staffing levels for nurses in hospital A& E departments in England after it emerged that the government body told to stop work in this area is going to publish its recommendations anyway. The National Institute of Health and Clinical Excellence (Nice), which is legally independent of the NHS, plans to release its work at the end of the month. It is also continuing evidence reviews for staffing mental health care for both inpatients and those in the community, for learning disability services and for other community health services. The move, revealed by the Health Service Journal (HSJ), comes a month after news that NHS England, which is far more tightly controlled by the Department of Health (DH), had decided to take such work in-house. This was seen by critics as likely to lead to lower, and cheaper, standards in terms of staffing within the financially challenged service, which has already been told by health secretary Jeremy Hunt to stop using expensive staffing agencies, which, he says, have been “ripping off the NHS”. The Nice publications will not be billed as official guidance but will be sent to NHS England in any case. Nice is concerned also that both its own work and that of NHS England has been hampered by only looking at nursing numbers. Safe staffing levels were recommended by Sir Robert Francis, the QC who investigated the Mid-Staffs scandal, who had specifically wanted Nice to do the work because of its evidence-based approach and independence. Nurses’ leaders and patient safety groups are worried by the switch of work away from Nice which, they believe, has more credibility in this area. It had already produced safe staffing levels for adult acute wards and maternity units. Nice is an independent non-departmental public body, and Mark Baker, director of its centre for clinical practice, told the HSJ the A& E work had already been sent to Jane Cummings, the chief nursing officer for England. Its reviews of evidence would also be sent to her “to be done with as she wishes”, said Baker.

    Read more ...

Thursday 9th July 2015

Dorset Echo

  • Hospital campaigners gather outside board meeting.

    Campaigners fighting to protect children's services at Dorset County Hospital have been making their voices heard again. A group of protestors gathered outside a board meeting at the Dorchester hospital's Children's Centre to once again voice their determination to keep service for youngsters in the county town. Services at the Kingfisher Ward are currently facing an uncertain future with the Dorset Clinical Commissioning Group's (CCG) clinical services review proposing an option that could see some services transferred to Poole or Bournemouth. Previous events organised by the campaigners have included a march of nearly 2,000 people through Dorchester. The latest protest saw a small group of campaigners gather outside the board meeting to send a message out that they will not be going away.

    Read more ...

Grimsby Telegraph

  • Care Plus Group confirm six staff could be made redundant.

    The Care Plus Group has announced it has entered a consultation period into a maximum of six people being made redundant. The NHS organisation, like many other publicly funded organisations, continues to face significant cuts to funding due to national cuts in spending. The organisation is facing a reduction of £1.75 million in its adult social care budget over the next two years. Lance Gardner, Chief Executive of Care Plus Group said: “As a result of these cuts we are indeed having to consider making a small number of staff redundant. As an organisation we feel for the loss of any members of staff and we are working with the individuals affected to support them.

    Read more ...

Independent

  • Budget 2015: Prospect of strikes looms after public sector pay cap prompts fury from the unions.

    The prospect of strikes closing schools and disrupting hospital services moved a step nearer as Chancellor George Osborne announced a four-year curb on public sector pay - limiting rises to just one per cent a year. Unions reacted with fury to the move, which is likely to amount to real terms pay cuts for public sector staff, warning that it could lead to a staffing crisis across the public sector. Britain’s biggest nurses’ union the Royal College of Nursing (RCN), which has already threatened strike action if the Government attempts to cut out-of-hours pay, said the annual cap would be met with “shock”.

    Read more ...

  • Budget 2015: George Osborne promises £8bn more annual funding for NHS by 2020.

    The NHS is the government’s “priority”, George Osborne has said, as he confirmed that the health service will receive the £8bn more in annual funding by 2020 promised before the election. However, the Chancellor admitted that £22bn in efficiency cuts required of the NHS in England by that date would be “very challenging”. The NHS is the government’s “priority”, George Osborne has said, as he confirmed that the health service will receive the £8bn more in annual funding by 2020 promised before the election. However, the Chancellor admitted that £22bn in efficiency cuts required of the NHS in England by that date would be “very challenging”. Some of the savings will likely come from further pay restraint for NHS staff, with Mr Osborne confirming that public sector pay increases would be capped at one per cent for four years.

    Read more ...

Tuesday 7th July 2015

Health Investor

  • Private healthcare spending by Welsh NHS up to £6m.

    The Welsh NHS has spent more than £6 million on private providers over the last two years. According to BBC Wales, the Welsh health boards relied on private providers after facing issues in recruitment, long waiting lists and winter pressures. Five out of six health boards paid for so-called ‘spot contracts’ which are short-term unplanned contracts awarded to private healthcare providers to carry out NHS work. Marcus Longley, director at the Welsh Institute for Health and Social Care questioned the decision to pay the private sector. "In Wales the policy is to do everything in-house within the health service whenever possible” he said. "The difficulty is that if you go to the private sector in January wanting lots of operations done by March you'll pay through the nose for that." The Hywel Dda health board, which spent six times more than any other board, said difficulties with recruitment had led it to use external providers, although it said it will continue to review this.

    Read more ...

Isle of Wight County Press

  • Isle of Wight NHS cancels non-urgent operations.

    Non-urgent operations have had to be cancelled at St Mary’s Hospital because of a shortage of beds. Further surgery may be cancelled later this week because of the sheer number of patients. In addition, some patients who are well enough to leave hospital don’t have suitable places to go home to according to the Isle of Wight NHS Trust. Now, the trust is looking for additional staff to cope with the demand. Extra capacity has been put in place at the hospital but the trust would like more staff to come forward to work additional hours so it can cope. Families and carers of patients who are fit to be discharged from hospital are being asked to do all they can to help ensure their relatives and clients can leave hospital to be cared for in a more suitable environment as soon as they are ready. Any staff, nurses, nursing assistants or allied health professionals who want to work additional hours are being asked to ring the trust’s hospital control room.

    Read more ...

Independent

  • Budget 2015: George Osborne urged to reverse public health cuts that will leave services 'gutted'.

    George Osborne must use Wednesday's Budget to reverse £200m of planned cuts to public health spending that will leave services, “gutted”, the leader of Britain’s doctors’ union has said. In a letter to the Chancellor, Dr Mark Porter, council chair of the British Medical Association, said that cuts would leave obesity and smoking prevention services unable to cope with growing patient demand, storing up problems for the NHS. Dr Porter also accused Mr Osborne of “a deliberate attempt to deflect attention and mislead” the public by classing the cuts as “non-NHS”.“At a time when a third of Britons are projected to be obese by 2030, 70 children a day are smoking their first cigarette, and the total cost of alcohol has been estimated at £20bn in England alone, public health services are more vital than ever in delivering preventative care,” Dr Porter writes. “This is not the time to be cutting funding.”

    Read more ...

Monday 6th July 2015

Yorkshire Evening Post

  • Health: Is NHS devolution on its way to Leeds?

    The National Health Service is undoubtedly one of our country’s crown jewels. Healthcare that is free at the point of access for all is something we’re fortunate to have grown up with but some say that talk of healthcare devolution could signal the end of the NHS as we know it. News broke earlier this year of a seemingly radical move by Central Government to syphon off a £6billion health and social care budget to 10 local authorities and local NHS bodies in Greater Manchester by April 2016. A pioneering pilot project over the Pennines has added fuel to devolution talk in the White Rose, with the idea of seizing control of transport and housing budgets from Whitehall top of the agenda. A Greater Manchester-style health devolution deal is not yet part of the Leeds City Region’s immediate plans, but could it form part of its future ? Coun Lisa Mulherin, Leeds City Council’s executive member for health and wellbeing, thinks being able to tackle local health inequalities with a fair share of national funding is essential. But Coun Mulherin believes there is work to be done in developing the kind of cross-council links that have seen Greater Manchester take the NHS reins. She said: “Within Leeds we are several paces ahead of where Manchester is in the city but we don’t have the tradition of working together with other neighbouring local authorities. They have worked effectively over many years punching above their weight across that sub region. We are working effectively in Leeds but it’s that wider working with partners we need to work on.”

    Read more ...

BBC News

  • NHS decisions 'could be removed from political control'.

    Final decisions about changes to the health service could be taken out of the hands of politicians under new proposals by the Welsh government. The public would be given a say on a range of ideas, including a merger of the health and social care watchdogs. There would be a legal duty for NHS staff to be more open with patients, not just when things go wrong. Patients would also be asked if they would be willing to share personal health data for medical research. The 50-page document will look at potential legislation which could be taken up after the next assembly elections in May 2016. The Green Paper says a culture of more transparency, and not just when things go wrong, is needed at all levels of the health service. Patients will also be asked if they would be willing to share personal health data for medical research. A national expert panel could take over from the health minister in having the final say on controversial decisions like hospital changes.

    Read more ...

HSJ

  • Exercise 'extreme' caution on integration deals, councils told.

    Councils should exercise “extreme” caution before agreeing to ambitious health and social care integration deals, the chief executive of the Local Government Association has warned. Carolyn Downs told HSJ sister title Local Government Chronicle that authorities should carefully weigh up the risks of merging services and budgets with sectors such as health, which are better protected by politicians. Ms Downs, who announced last month she was resigning from the LGA to become Brent Council chief executive, said the “whole issue of shared risk is something which could get in the way of integration”. Local government will need to be extremely careful that it can afford to take on any additional risk,” she added. Health and social integration harboured greater risks for authorities than the NHS because of the health service’s higher political priority, she indicated. “There is a clear recognition that local government is effective, efficient and gets things done. The NHS shouts loudly and gets what it wants. That’s because it is a top political issue in a general election and because it is a national service.” Unlike the NHS, local government was not a “protected budget”, Ms Downs added. She predicted the next three years would be “extraordinarily difficult” for local government and referred to her return to a frontline local government job as like “going into a fire storm”. She named the biggest regret of her four-year tenure as the failure to secure a “transformation fund” and longer-term funding for the Better Care health and social care integration project.

    Read more ...

  • Primary care capital funds underspent by nearly half.

    The government owned company set up to manage thousands of primary care premises and other NHS buildings spent only around half of its planned capital budget last year. In its working estimates for 2014-15, NHS Property Services set an overall forecast for capital spending of £150m. Actual spending for the year was £81m. The company, formed in 2013 and owned by the health secretary, delivers strategic estates management for about 4,000 buildings, such as GP surgeries, health centres and community hospitals. Its capital budget is primarily meant to be used to develop these facilities. It is generally accepted that there is a need for major development of primary and community care facilities. An NHS Property Services spokeswoman said the main reason for the underspending was that some schemes that had previously been in its pipeline had become “outdated” due to NHS structure changes, while new quality criteria meant “only the strongest” business cases could proceed. The bulk of the actual spending related to day to day maintenance, while £13m was spent on more significant work, such as refurbishments or new buildings. This was against an estimated spend of £34m. These budgets were previously controlled locally, by the now disbanded primary care trusts.

    Read more ...

The Guardian

  • Private health lobby advised on NHS privatisation review.

    The authors of a major report on changes to NHS hospitals failed to declare that a lobbying network for the private healthcare industry was on its advisory panel, new documents suggest. The Dalton review, a government-commissioned report which last year concluded that private companies could oversee management of NHS hospitals, was advised by a panel of experts that included Jim Easton, the managing director of private health firm Care UK. The report claimed panel members were advising “in a personal capacity, rather than as representatives of their organisations”. But documents obtained under the Freedom of Information Act reveal Easton was in fact representing the NHS Partners Network, the UK’s primary lobbying group for the private healthcare sector. When asked by the Guardian about his role, Easton, a senior civil servant at the Department of Health until 2012, denied that he had breached rules preventing him from lobbying the government for two years. The NHS Partners Network’s undeclared representation on the panel of the review is revealed in correspondence between David Hare, the group’s chief executive, and Lord Howe, aka Frederick Curzon, the hereditary peer who was a Conservative health minister at the time. Emails released in 2010 revealed how the NHS Partners Network previously helped to draft a letter for an NHS regulator calling for an inquiry into “maverick behaviours” by health commissioners who might be resisting private sector involvement.

    Read more ...

Click here for items older than 30 days