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Tuesday 29th July 2014

Hospital Doctor

  • Indefensible that NHS is being privatised without public say.

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

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The Newstatesman

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

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

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HSJ

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

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

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Pulse

  • Scores of practices teetering on the brink of closure.

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

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  • Department of Health denies NHS 'privatisation' claims.

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

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The Guardian

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

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

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Monday 28th July 2014

Fermanagh Herald

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

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

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Independent

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

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

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The Cornishman

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

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

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Friday 25th July 2014

The Telegraph

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

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

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HSJ

  • More trusts with financial concerns.

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

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  • Hinchingbrooke backtracks on controversial £50 referrals offer.

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

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

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

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The Herald

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

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

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nhsmanagers.net

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

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

Thursday 24th July 2014

Uttoxeter Advertiser

  • Labour hopeful will fight cancer care privatisation.

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

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GP Online

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

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

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Leicester Mercury

  • Concern grows for Interserve jobs at Leicester Royal Infirmary.

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

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Yorkshire Post

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

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

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Eastern Daily Press

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

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

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Daily Mirror

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

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

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Guardian

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

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

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BBC News

  • Rise in NHS trusts in financial difficulties.

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

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Tuesday 22nd July 2014

Homecare.co.uk

  • Mears wins new care contracts in Rotherham.

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

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Bedfordshire on Sunday

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

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

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GP Online

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

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

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Guardian

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

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

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Thanet Gazette

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

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

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Friday 18th July 2014

GP Online

  • NHS will miss £20bn savings target, warn CCG finance leads.

    A total of 20% of CCG finance directors said patient care in their local area had got worse in the past year. The figures came from the King’s Fund think tank’s latest quarterly monitoring report which surveys NHS trust and CCG finance directors. The report found overall NHS finance ‘stretched to the limit’, although just 8% of the 61 CCGs covered by the report forecast they will end the current financial year in deficit. The report found ‘worrying inconsistencies’ in the plans of hospitals and CCGs, with 55% of CCGs planning a reduction in emergency admissions, while just 8% of NHS trust finance directors are working on that basis. CCGs are also forecasting less elective activity, with only a third (32%) expecting an increase in planned treatment compared to 69% of trust finance directors. The King’s Fund’s chief economist John Appleby said: ‘Our latest quarterly report paints a picture of a service under huge pressure, with cracks beginning to appear in NHS performance. It once again underlines the need for new funding if services are to be maintained. 'The increase in the nursing workforce signals a very welcome commitment to improving care, although it remains to be seen whether hospitals will be able to sustain current staffing levels when money becomes tighter later in the year. The disparity in the plans of providers and commissioners points to a worrying mismatch between activity and funding, which could have serious financial consequences.’ The numbers of CCG finance leads predicting the NHS was at risk of missing the £20bn savings, now in the final year of a five-year plan, has increased from 48.9% last quarter to 59.6%.

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The Guardian

  • Poll shows support for raising taxes to sustain NHS.

    Voters remain wedded to Britain's taxpayer-funded model of healthcare even as NHS leaders question its sustainability, according to a Guardian/ ICM poll. Analysis by NHS England and outside experts points to a large funding gap that could reach £30bn by the end of the decade, and last month 71 leading lights of the health service wrote to the Guardian to warn politicians that failure to level with the public about the black hole before polling day would jeopardise the service's future. Asked how they would tackle the future funding of medicine, voters are resolved by a margin of more than two to one that "raising taxes for everybody, to put more money in" is the right way to go. Tax-funded increases in expenditure are preferred by 48% of respondents, while 21% are in favour of charges, such as paying to see the doctor, and 19% would cut the range of available treatments. On the face of it, these results offer some support for the suggestion – debated in Labour circles – of going into the election pledging a ringfenced national insurance rise to cover NHS spending. Support for higher taxes rises to 60% among Labour voters and 61% among Lib Dems. But Ed Miliband remains decidedly wary; he recently ruled out any "massive" spending rise, not least because long Labour experience suggests that voters are sometimes more willing to support higher taxes in opinion polls than at the ballot box.

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  • The NHS is being taken over by Wall Street.

    And Cameron won’t stop it. Will David Cameron go down in history as the man who gave away this country’s greatest achievement to Wall Street, the man who enabled big American healthcare access to our hospital wards ? The answer will be yes – unless the prime minister makes it clear once and for all that he will protect the NHS from the world’s largest bilateral trade negotiations, happening right now in Brussels. Make no mistake, we are in the fight of our lives to save the NHS from being sold off lock, stock and barrel. But to make matters even worse a trade deal called TTIP (the transatlantic trade and investment partnership) will mean that reversing the damage done by this government could be impossible unless Cameron acts. This week faceless bureaucrats from Brussels and Washington are negotiating behind the closed doors of the European commission. You may well ask what trade negotiations in Brussels have got to do with the NHS. But these talks matter to every man, woman and child in the UK. In fact people across the country are campaigning up and down the high streets of our towns to raise awareness of the danger. From Dorset to Dumfriesshire there are growing numbers of people getting angry when they learn about Cameron’s continued refusal to use his veto to protect the NHS from TTIP. The trade deal would create a single market between the European Union and the United States, and the British government has given the negotiators a free hand to negotiate away our rights to control our health system. The government’s Health and Social Care Act 2012 opened the floodgates to the NHS sell-off. The act has massively increased the number of private providers in the NHS. Since this act came in to force, 70% of health services put out to tender have gone to the private sector.

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HSJ

  • NHS finances 'stretched to limit'.

    NHS finances have been ‘stretched to the limit’, influential think tank The King’s Fund has warned. The King’s Fund said that there are “huge pressures” on the health service’s purse strings after a quarter of finance directors at hospital trusts in England said they expect to overspend their budgets this year. Its latest report on NHS financial woes found “a distinct lack of optimism about the general state of the finances” with 85 per cent of the 73 finance directors polled saying they were fairly or very pessimistic about money for the next year. The King’s Fund said that “cracks are beginning to appear” in performance as a result of the growing financial pressures. A number of waiting time targets have been missed and the number of people on waiting lists for treatment in hospital is now at its highest level for six years, the report stated. While many organisations are worried about their finances, they have still taken to employing more nurses. Between August last year and March this year, the number of nurses, midwives and health visitors employed by NHS England grew by nearly 9,000, boosting the nursing workforce to its highest level ever, the authors said.

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  • Commissioning system belatedly balances £97bn budget.

    NHS England has belatedly managed to set plans to balance its £97bn budget for 2014-15. The budget has been balanced in part because clinical commissioning groups are expected to perform worse than was budgeted for against income linked performance targets, HSJ has learned. HSJ reported two weeks ago that plans submitted in late June by CCGs and NHS England’s own commissioners showed an aggregate overspend of £137m against the commissioning system’s £97.3bn spending limit for this financial year. This was driven by specialised commissioners in London planning a £65m overspend, and a £74m financial gap due to “small numbers” of CCGs planning for increased deficits or to invest surpluses they built up in previous years, according to an NHS England board paper. NHS England cannot afford for CCGs to reduce their overall surplus this year because it has allocated the entire £400m surplus that commissioners are permitted to “draw down” in 2014-15 to offset a potential £800m overspend in its own specialised commissioning budget. However, HSJ understands that plans are now agreed that would see both the CCG sector and NHS England’s specialised commissioners break even against their overall spending limits. For CCGs, this is due in part to a number of groups agreeing to reduce their planned level of surplus draw down.

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Thursday 17th July 2014

Practice Business

  • Move is likely to lead to hundreds of job losses among support staff.

    Administrative support services for primary healthcare in England are to be outsourced by open tender after NHS England opted to pass its responsibility to a third party, according to the BMJ. The decision came after a consultation on the future of NHS primary care support services. NHS England provides back-office support to NHS GPs in areas such as patient registrations, medical records, payments, and cancer screening. After a meeting of its governing body, NHS England rejected the option to retain in-house support services, arguing that an open commercial tender would “ensure the best deal for primary care and the taxpayer.” The move follows an earlier commitment by NHS England to reduce support service costs by 40% and is likely to lead to hundreds of job losses among support staff. The services were previously located within primary care trusts before their abolition in April 2013. Bob Morley, a GP in Birmingham and executive secretary of the Birmingham Local Medical Committee, which represents GPs in the city, criticised the move as another step towards NHS privatisation and said that it would remove local support that GPs had relied on over many years. NHS Clinical Commissioners warned that making support services more “distant and transactional” would hamper local commissioners. NHS England opted against devolving all the services to Shared Services Connected, a joint venture between the government and the private firm Steria, which is already operating some support functions and which launched an unsolicited bid last year to take over all primary care support services in England. However, despite being criticised by GPs for delays in processing payments to general practices, Shared Services Connected is expected to be in the running in the tendering process, in which NHS England is seeking a provider that can deliver “the required level of efficiencies.” NHS England will continue to oversee the services until the procurement process has concluded.

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Recruiter

  • CRG launches new branch following NHS contract win.

    National recruitment and health service provider Castlerock Recruitment Group (CRG) has opened a new branch in Bicester, Oxfordshire after securing a tier one staffing contract with Oxford Health NHS Foundation Trust. CRG will become a preferred partner for Oxford Health and work closely with the community-focused organisation to manage its staffing needs. CRG’s new branch, which will be headed up by senior recruitment consultant Lisa Boughen, will concentrate on placing agency nursing and social care workers, medical locums and GP locums, as well as allied health professionals to the NHS and healthcare providers throughout Oxfordshire, Buckinghamshire and Wiltshire.

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Edinburgh Evening News

  • Jim Sillars: ‘No’ vote means privatised NHS.

    Jim Sillars writes: If Scots were aware of what has happened to the National Health Service in England, Dr Philippa Whitford’s warning that a No vote would lead eventually to its destruction in Scotland would cause a switch from No to Yes. Dr Whitford is a consultant. She, as has Professor Allyson Pollock of Queen Mary University of London, has been tracking the dismemberment of the NHS down there since the passing of the Health & Social Care Act 2012, which the latter describes as “repealing the legal foundations of the NHS in England”. Previous to this act, the government had a duty to provide or secure a comprehensive health service. The act repealed that duty. It also enabled private companies to enter public health services in a big way, making profits, while it blurred the “boundaries between free healthcare and chargeable health and social care”. As Prof Pollock notes, “NHS hospitals and services are being sold off or incorporated, land and buildings being turned over to bankers and equity investors. Virgin landed a £630 million contract. RBS, Serco and Carillion, to name but a few, are raking in billions in taxpayer funds for leasing out and part-operating PFI hospitals, community clinics and GP surgeries that we once owned.” A private company now runs an NHS hospital. US private medical companies are now involved in the privatisation process, such as HCA and United Health. HCA is in a joint venture with University College Hospital London, where it provides cancer treatment, but only for those who can pay. I have been tracking the English editions of the Daily Telegraph and the Daily Mail, which have been engaged in a consistent attack on the founding principle of the NHS – that it is free at the point of use to all. In a major piece on July 11, under the headline “Our national religion doesn’t have a prayer,” Jeremy Warner, of the Telegraph told his readers: “Britain can’t afford the ever-expanding NHS – it must charge for some services or do less.” As it privatises the English NHS, Westminster governments will start to question how our NHS is run. As the money is cut from Westminster, the reply to complaints from the Scottish Government will be to follow them down the private road. Pressure will be on our MSPs to comply. Remember, who pays the piper ultimately calls all the tunes.

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Financial Times

  • A quarter of NHS finance chiefs expect budget overspend.

    One in four finance directors of NHS trusts expect to overspend their budgets, according to the King’s Fund think-tank. In the latest evidence of the financial strains facing the health service, the think-tank’s quarterly monitoring report says the number forecasting a deficit stands at its highest since 2011 when it began reporting on the data. The King’s Fund warns that “cracks are beginning to appear in NHS performance as a result of the growing financial pressures and rising demand for services”. Although accident and emergency waiting times met overall targets between April and June, hospitals with major A & E departments missed it for 51 weeks in a row. A total of 4.9 per cent of patients spent four or more hours in A & E over the last quarter, the highest level for this time of year since 2004-5, the think-tank says. More than 3m people had been waiting at least 18 weeks for hospital treatment at the end of the quarter, the highest since 2008, it said. This included almost one in 10 in-patients, the highest level since early 2011. The number of patients waiting more than six weeks for diagnostic tests was more than 18,600 at the end of May 2014 – an increase of nearly 12,000 on the same month last year. Hospitals have been under pressure to increase nursing numbers following the publication of the Francis report into poor care at Mid Staffordshire NHS Trust. John Appleby, chief economist at The King’s Fund, said the report “underlines the need for new funding if services are to be maintained”.

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Belfast Telegraph

  • Poll: Public would support rise in taxes to save NHS.

    Nearly half of the public would raise taxes to resolve the NHS funding crisis, but 40% believe that either charges should be introduced or services cut instead, according to a new poll. The Guardian/ ICM survey found that 97% thought heart bypass surgery should not be rationed, followed by hip replacements on 94% and post-accident facial reconstruction (91%). Life-prolonging cancer drugs and IVF treatment were backed by 70% and 60% respectively. Asked how to deal with the looming multi-billion pound funding gap in the NHS, 48% backed “raising taxes for everybody, to put more money in”. However, 21% backed charging patients and 19% said the range of treatments should be reduced. Some 17% blamed the Coalition Government's “market-based overhaul” for the NHS’s problems, while 14% blamed self-serving health workers who were more interested in their pay than looking after patients.

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Health Service Journal

  • Third of CCGs do not plan to retender community services.

    More than a third of clinical commissioning groups have no plans to retender their community services, an HSJ investigation has revealed. The findings prompted warnings from competition experts that the groups could face legal challenge from would-be providers. Of 195 CCGs that responded to HSJ’s freedom of information requests, 72 commissioners holding community services contracts worth at least £2.3bn annually said they had no plans to retender. Seven CCGs had already retendered contracts worth around £156m in total, and 39 had plans to retender £998m worth of contracts by 2017. A quarter of respondents - 49 CCGs - are currently reviewing their procurement plans. Community services were transferred out of primary care trusts around 2011 under the Transforming Community Services programme. The majority went to NHS organisations on 3-5 year contracts. There was a widespread expectation among public and independent sector providers that these contracts would come up for tender between now and April 2016. Andrew Taylor, former Cooperation and Competition Panel chief executive, told HSJ it would be “legitimate” for CCGs to decide not to tender community services if they concluded through a review exercise that their arrangements were “the best possible for patients”. However, he warned this would be a high “hurdle to cross”. It was “highly likely” that some commissioners choosing not to retender would face legal challenge from providers, he said, but this would depend partly on “the extent of activity in the market”. If there was “a lot coming to the market” the likelihood of challenge would recede or “become more specific”. Robert McGough, partner at law firm Capsticks, noted that in some areas PCTs had run competitive tenders for the original TCS contracts. “So CCGs [that decide not to tender] may want to consider how to evidence an argument that there would not be another provider capable of providing the services, and whether there are other factors which support their decision,” he said. Commissioners in Haringey and Islington told HSJ they would not retender community services “while the new commissioning arrangements are settling down”. Mr Taylor said that would be a “very difficult position to sustain” unless commissioners could demonstrate it was based on robust analysis of the options available to them. A Monitor spokesman said it was important that commissioners “consider all their options, at every point in the commissioning cycle”.

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BBC News

  • Alex Salmond says Westminster a 'growing threat' to NHS.

    Scotland's first minister has said that only independence will lift the "growing threat" to the country's NHS. Speaking before a speech in Liverpool, Alex Salmond said the coalition UK government was pursuing a "privatisation agenda". Speaking prior to his return to Liverpool, where he will deliver his last major speech in England before September's independence referendum, the first minister said the process of "privatisation and fragmentation" of the health service in recent years had been "driven through by Westminster". Mr Salmond predicted that an independent Scotland would be a "progressive beacon" for people elsewhere in the UK who were looking for an alternative to Westminster policies. "By demonstrating that a publicly-funded, publicly-run NHS is more efficient and provides a better level of patient care than a privatised service, we will provide valuable evidence for those in England campaigning against the sell-off of their health service," he said. "In March, the BMA annual consultants' conference condemned the 'huge amount' of taxpayers' money going to private company profits, rather than being used for patient care." The first minister said that private providers have won the majority of tenders for service since the Health and Social Care Act came into effect in England.

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Tuesday 15th July 2014

Shropshire Star

  • Walk-in health centre set to close doors in Shrewsbury.

    A walk-in health centre in Shrewsbury used by 34,000 people is to close and services move to the accident and emergency department on the other side of town. Members of the Health and Adult Social Care Scrutiny Committee decided to close the Monkmoor Walk-In Centre and relocate services to the Royal Shrewsbury Hospital where an urgent care centre will be created instead. The decision was made after the scrutiny committee made up of councillors from Telford and Shropshire councils voted by five to four in favour of the plans to change A& E services at the hospital. Under the plans, which were drawn up by Shropshire Clinical Commissioning Group (CCG), the body that runs NHS services in the county, the centre in Monkmoor Road will be closed in November and moved to the town’s hospital to coincide with Women and Children’s Services moving to Telford. It will be run by private company Malling Health and will be open seven days a week, 8am to 8pm. It will remain there for up to three years. Shrewsbury Deputy Mayor Councillor Miles Kenny, who represents the neighbouring ward of Underdale, said he was disappointed by the decision, which he claims could have serious consequences on the people who use the service. He said: “There are a lot of people who live in my ward and the neighbouring ward who don’t have transport and live in sheltered accommodation or housing association housing who are vulnerable or single mums. The walk-in is perfect for dealing with things that are maybe not serious, like the baby has a cough, that you wouldn’t bother going to A& E or a GP with. Now you’re going to have to go up to Copthorne. There’s a bus but it’s not very regular, so then you might have to get a taxi, and that’s not fair expecting these people who already have a low income to pay for a taxi. What will happen is that they’ll think it’s not serious so they won’t go, and then we’ll end up with more serious cases further along the line where something’s got infected or got worse.” Councillor Kenny said he was also concerned about the lack of consultation with members of the public about the plans. Joyce Brand, secretary of the Shropshire Defend Our NHS campaign, said: “This is quite frightening. We believe there’s a very strong risk of the A& E at the Royal Shrewsbury being closed down. We’ll be left with an urgent care centre in its place, run by a private company.”

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Herald Scotland

  • NHS attacked over private treatment.

    Health chiefs have been criticised after it was revealed they have spent more than £7m in the past two years on sending NHS patients to private hospitals. New figures show NHS Grampian has sent more than 2,000 people to Glasgow, Edinburgh and Dundee for operations since 2012 to meet strict waiting time targets. The embattled health board, which is grappling with an unprecedented recruitment crisis, said it hoped to cut spending on private healthcare with the opening of four new operating theatres at Aberdeen Royal Infirmary and Woodend Hospital. But the spiralling bill has angered patient watchdogs, who say taxpayers' money should not benefit private healthcare companies. Jean Turner, of Scotland Patients Association, said boards had to be open with the Scottish Government on the challenges they were facing in meeting waiting time targets. She said: "It always makes me angry when the NHS is spending taxpayers' money in the private sector like this. I feel it is bad management that we don't have the core staff to deal with this problem. The private healthcare sector is in it for the easy bits. They don't train doctors or nurses and any problems with treatment tend to be fixed by the NHS. It is unacceptable when the NHS's bill for private healthcare goes up like this. Health boards are obviously struggling to meet targets and they have to rely on the private sector to make it work." New figures show that just under £4m was spent in 2012-13 on private hospital bills, up more than tenfold on the year before, and last year the total came to £3.1m.

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Guardian

  • Home Office accessing NHS records to help track down illegal immigrants.

    The Home Office has been given access to the NHS records of more than 6,900 people since 2010 as part of its efforts to track down illegal immigrants, prompting concerns from patients' and migrants' rights groups. Medical records are protected by data protection laws but new statistics show the Home Office has made use of a little-noticed exemption in the rules to access patients' non-clinical records, without any need for a court order. The exemption allows officials to see where people have made use of the health service and when, but not the details of the clinical conditions or medical attention they received. Police forces and the National Crime Agency have also accessed these records, the figures show, in pursuit of perpetrators of serious crimes such as murder and rape. Patients' groups said the use of NHS records by immigration and law enforcement officials could deter people from seeking treatment for themselves or their families, and so pose a public health risk.

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  • Patients denied vital operations by NHS bodies, surgeons report.

    Patients are being denied access to vital surgery by NHS bodies, which are ignoring guidelines and choosing to ration some operations, according to an investigation by the Royal College of Surgeons. The surgeon's report said that 73% of Clinical Commissioning Groups (CCGs) –the GP-led organisations involved in the delivery of a range of NHS services – do not follow rules set down by the National Institute for Health and Care Excellence and clinical guidance on referral for hip replacements, or have no policy in place for this procedure. It also found that more than a third of CCGs (44%) require patients to be in various degrees of pain and immobility – with no consistency applied across the country – or to lose weight before surgery. Clare Marx, president of the Royal College of Surgeons, said: "This report seems to show that local commissioners are imposing arbitrary rules governing access to some routine surgery. The motivation may not be financial but it is clear that some CCGs do not commission services using clinically accepted evidence-based guidance." The report, Is Access to Surgery A Postcode Lottery ?, analysed information obtained under the Freedom of Information Act and looked at tonsillectomy, hip replacement, inguinal hernia repair and surgical treatment for glue ear (Otitis media with effusion). Only 27% of CCGs reviewed were found to have had policies that complied with Nice or surgical guidance on inguinal hernia repair, while 58% have no policy at all. As many as 15% required evidence of a hernia increasing in size or a history of reoccurring problems, even if a patient is in debilitating pain. The Royal College of Surgeons recommended that the Government and NHS England need to review what further action is required to ensure the NHS is providing equitable access to high quality surgical care.

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  • NHS to charge non-EU patients 150% of cost of treatment.

    Patients from outside the EU are to be charged 150% of the cost of NHS treatment under government plans to deter so-called health tourism. The Department of Health said on Monday that the move could save the health service up to £500m a year and would prevent "abuse" of the system by visitors and migrants. The health secretary, Jeremy Hunt, said the charges would be accompanied by greater scrutiny of recovery of fees by NHS trusts, who will face fines if they fail to identify and bill chargeable patients. Last month, Hunt announced that trusts in England would be offered a premium of 25% on top of the tariff they receive for providing treatment from this autumn if they reported that it was given to a citizen of one of the 27 other EU member states. Hunt has also said that a health surcharge will be imposed on non-EU visitors who are in the UK for longer than six months, when they submit an application for leave to enter or remain in the country. Plans to charge migrants have received a frosty reception from the medical profession. Dr Mark Porter, chair of the British Medical Association council, said it was not a doctor's duty to act as a border guard. "Without more detail, there are question marks over whether or not these proposals will be workable and if the NHS has the infrastructure and resources necessary to administrate a cost-effective charging system," he said. "Plans to fine hospitals who fail to recoup costs would see them punished twice over to the detriment of other services. Above all, it is vitally important that these proposals don't have an impact on the care patients receive and that sick and vulnerable patients aren't deterred from seeking necessary treatment, which can have a knock-on effect on public health." Trials will start over the summer in some A& E departments to explore how details can be taken from patients with an Ehic when they register for care. Options for recovering the costs of primary care services are also being explored and eligibility for free NHS prescriptions, optical vouchers and subsidised NHS dental treatment will be tightened, the Department of Health said. The new charges for non-EU patients will come into effect in spring next year.

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Friday 11th July 2014

HSJ

  • NHS England to outsource £100m primary care admin function.

    NHS England has announced it will go to open procurement to outsource its £100m primary care support services functions. The authority said it decided to go to market after receiving legal advice on an offer to take over the service from Shared Services Connected Ltd, a Cabinet Office joint venture. A briefing document produced by NHS England for PCS staff, published yesterday, said: “Our lawyers have said that we must go to a wider pool of outsourcing options and this is why we are going to open procurement to ensure that we find the best solution.” An NHS England statement said it had opted for “full market testing” and an open public procurement, rather than restructuring in house, or transferring functions directly to SSCL. It said this would “ensure the best deal for primary care and the taxpayer” and that it had “not been possible to design a [in house] solution which made the required level of efficiencies”. Meanwhile, NHS England chair Sir Malcolm Grant has said in a letter to Unison that it could not legally transfer PCS directly to NHS commissioning support units, as the union had suggested, but was examining whether they can bid for the services through the procurement process. NHS England has previously said it intends to reduce annual spending on primary care support from £100m to around £60m. It will involve restructuring and removing several hundred posts from the current 1,600 total.

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New Statesman

  • Ed Miliband has said that this is going to be an “NHS summer”.

    He has sensed, rightly, that there’s something in the air, a tension over the precarious health service. Strain on services is rising, the number of hospitals in the red is surging up, patient concern is growing and doctors are quitting in disgust at the ominous developments from the top. As much as the coalition would love to suppress them, the figures point towards a potential full-blown crisis before the parliamentary term is through. In August, campaigners will march for 300 miles, through 23 towns from Jarrow to London to press home these fears, and there are activists up and down the country straining just to get the same message across to the public: the NHS is in danger. Labour has already made some firm commitments to undoing some of the harm done by the coalition. Andy Burnham has said in public, and behind closed doors to NHS activists, that he will repeal the Health and Social Care Act, and work to “scrap Cameron’s NHS market”. And the party has brought forward Clive Efford’s private member’s bill to rewrite rules forcing NHS contracts onto the market. Labour should be commended for this. But if Miliband is serious about rescuing the NHS, there is an ugly truth to face. The NHS is riddled with extortionate debt from decades of misguided PFI deals. NHS hospitals owe £80bn in PFI loan unitary charges – in other words, the ongoing costs of maintaining PFI hospitals and paying back the loans. Next year alone, trusts will make some £2bn in repayments. Trusts like Peterborough and Stamford Hospitals NHS Trust, which is locked into making £40m in repayments a year on the PFI it took for Peterborough City Hospital, or Sherwood Forest NHS Trust, which is spending 15 per cent of its annual budget on the annual repayments on a PFI loan it took to expand the King’s Mill Hospital, and so on. But there are plenty who do gain. The initial investment made by PFI companies is paid back in spades. As Joel Benjamin of Move Your Money points out: “Typically the unitary charge is three to five times the capital cost, and on more egregious PFI projects as high as seven times”. The even uglier reality for Miliband is that the New Labour era was a golden age for the PFI. The modern PFI is the child of John Major’s Conservative government, but it was adopted and thrived under Tony Blair and Gordon Brown. Between 1997 and 2008, 90 per cent of all hospital construction funding was under PFI agreements, which paid for 75 per cent of all hospitals built. The only positive, of course, is that 101 new hospitals were delivered in this time. New Labour invested heavily in the NHS, even if it did bring in some marketisation at the same time. Unlike this government, which has replaced marketisation with full-blown privatisation, and effectively cut budgets, especially for those with PFI debts, whose repayment rates are tacked to inflation.

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Our NHS

  • "Handing patients NHS cash" is just rebranding cuts.

    Personal health budgets are to be rolled out to many more patients and combined with social care personal budgets, Simon Stevens, NHS England’s new Chief Executive announced yesterday. The announcement has been framed as handing money over to patients and giving them more direct control over their lives. Unsurprisingly, this has so far largely been welcomed. Stevens talks of ‘north of five million patients’ having a combined personal health and social care budget by 2018. But as spending on both social care and the NHS contracts, what is the evidence underpinning this massive shift in resources ? It is helpful to look at what has happened in social care, where personal budgets have been operating for some years. There, advocates promised that they would make support better and cheaper and reduce bureaucracy. Instead, new layers of bureaucracy were created by the so-called ‘resource allocation system’ (RAS), according to the independent evidence to date. The RAS was intended to let people know the size of their budget upfront to make sensible decisions about how to spend it – but has conspicuously failed to do that. Unfortunately, it looks as though this is the same model that it is planned to run-out in personal health budgets. Trying to roll out social care personal budgets to millions of people, as the government has itself admitted, has often meant nothing more than many people receiving the same service – frequently getting less. As Coalition funding cuts hit home, they are rebranded as a ‘managed personal budget’. This has brought the policy into disrepute among many practitioners and service users. Where service users do seem to have benefitted greatly is where they have actually directly received a cash or ‘direct payment’. However, these lucky people have tended to get more than others, which may be the underpinning reason for the improvements they have experienced. And this sweetener is now diminishing as cuts bite. Consumerism has its limits when applied to long term care and health services. The consumer may be king or queen when it comes to buying a phone or choosing a holiday, but it can be a different issue when it’s a matter of dealing with a personal health crisis, the onset of impairment or mental health problem, the complexities of human services and running our own support system. If the new combined ‘personal patient budgets’ are to work, they need to invest heavily in supporting these new ‘consumers’. They need to offer help to enable access potentially empowering arrangements. Otherwise the evidence suggests that it is only likely to be the most confident, assertive and experienced patients/ service users who will really benefit. Those without such determination or committed family members to help them, may find themselves lost in a market that is still under-developed and increasingly being shaped by large corporate for profit interests.

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GP Online

  • Student protest over MPIG cuts at university practice secures offer of support.

    A university practice facing over a million pounds in MPIG cuts has been told it could be offered an enhanced to support it after students staged a protest. Rowhedge and University of Essex Medical Practice has already cut GP and nurse sessions and has had to close one afternoon a week due to cuts to its £290,000 MPIG correction factor funding. The practice says it faces cuts of £1.2m over the seven-year withdrawal of the funding top-up. GP partner Dr Michele Wall said the local area team called her in for a meeting following a recent campaign against the threat to the practice which culminated in a protest organised with the university students’ union. The practice has a village surgery branch with 4,000 patients, and a university practice with 8,500 patients. NHS England admits, said Dr Wall, that because of the age weighting factor in the funding formula the practice is only funded to care for under 70% of its 12,500 patients. In a meeting with NHS England officials and local MP Bernard Jenkin last Friday, Dr Wall said she was told the area team would examine whether there was anything which made the practice ‘an exception to the rule’ so it could be helped without setting a precedent. ‘They want to know why we are a unique practice and what services we provide that are not currently funded for, and if something like [an enhanced service] could be set up, and both NHS England and the LMC are looking to help us negotiate with the CCG,' said Dr Wall. Area team officials suggested funding could come from the CCG, ‘but of course they've got no money either’, said Dr Wall. In the longer term, Dr Wall said officials told her, money taken from PMS practices ‘might be ploughed back in’.

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  • GP funding cuts revealed as think tank predicts NHS cash crisis.

    Spending on general practice fell £10m in the final year before PCTs were abolished, according to research by a think tank that predicts an NHS financial crisis before the 2015 general election. The health service faces a major financial crisis by next year as NHS organisations begin to buckle under the strain of financial austerity, the Nuffield Trust analysis found. Almost one in 10 CCGs ended the 2013/ 14 financial year in deficit, and the groups made savings worth just 2% of their total spend that year – just half the level required by the government’s efficiency drive. The research found that spending on general practice fell £10m in the final year in which PCTs were in operation – 2012/ 13. NHS and foundation trusts as a whole were ‘at least £100m’ in deficit in 2013/ 14, compared with a surplus of £383m the previous year, the Nuffield Trust research revealed. Meanwhile, a poll of 100 health and social care leaders commissioned by the think tank found that more than two thirds of respondents felt NHS providers would have to go into deficit to provide a high quality service. Nearly half believe the NHS will no longer be free at the point of use in 10 years’ time. Nuffield Trust senior policy fellow and co-author of the report Andy McKeon said: ‘The NHS has risen to the challenge of living within its means over the past three years. But it has now reached a tipping point. Our analysis shows just how poorly placed it is to cope with the squeeze still to come.

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The Guardian

  • European official commits to safeguarding NHS in EU-US trade deal.

    Campaigners for a new EU-US trade deal. have been given a boost after an undertaking from Europe's lead negotiator that US healthcare companies will not be allowed to run NHS services. Amid trade union fears that the proposed deal could act as a cover to privatise the NHS, the main European commission negotiator has said that the NHS would be "fully safeguarded". Ignacio Garcia Bercero, director of the USA and Canada division in the European commission, made the commitment in a letter to the formerLabour shadow health secretary John Healey who is chairman of the all-party group on the trade deal. It is known as TTIP – the Transatlantic Trade and Investment Partnership. Bercero told Healey: "Although health services are in principle within the scope of these agreements and ongoing negotiations, we are confident that the rights of EU member states to manage their health systems according to their various needs can be fully safeguarded." The intervention by the European commission was welcomed by Healey who is facing a battle in the Labour movement against the EU-US trade deal. The Unite union published research at its recent conference which warned that the proposed partnership places the NHS at "unique risk" in the face of a "Tory drive towards privatisation". There are moves to table a vote at the TUC congress in September and there is pressure for an emergency motion to be tabled at Labour's annual conference. Healey said the commission letter should answer fears in the Labour movement about the threat to the NHS. Healey told the Guardian: "This letter confirms that the NHS can be fully exempted in any TTIP deal. Now it is for UK ministers and EU negotiators to make sure that the commitments the lead negotiator is making are put in place in full. This letter confirms that the biggest threat to the NHS is the Tories not TTIP."

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Thursday 10th July 2014

Nursing Standard

  • Petition to make hospital parking free for NHS staff.

    A healthcare assistant is leading a campaign calling for ‘extortionate’ staff car parking charges to be scrapped at NHS hospitals in the UK. Abigail Smith’s petition has been signed by more than 17,000 people since it was launched at the end of June. The matter could be debated in Parliament if the petition reaches 100,000 signatures. Ms Smith, who works in Suffolk, said she has received emails from nurses across the UK, with some paying more than £8 a day to park at work. ‘Staff often start early and work late, so the NHS is already making money out of its employees. Front line staff should not have to pay for parking on top of that.
    You would not want a nurse to rush through a patient handover just because they are worried about getting a ticket,’ she added.

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Mancunian Matters

  • No TTIPing! Manchester protest against trade agreement that opens door to NHS privatisation.

    Battlelines to defend the NHS from privatisation are being drawn up in a Manchester protest tonight against transatlantic partnership negotiations. The Transatlantic Trade and Investment Partnership (TTIP), is a trade agreement between the US and Europe that detractors say could have a catastrophic impact on the UK economy. Negotiations began in July last year and are expected to be finalised by 2015 to avoid clashing with the US presidential elections in 2016. UNISON say the agreement could lead the way to the privatisation of public services, including the NHS, and may also pose a threat to the regulation of chemicals used by the pharmaceuticals and food industries. Kevan Nelson, UNISON North West Regional Secretary, said: “TTIP gives multinational companies the right to challenge democratic decisions to provide services in the public interest rather than for private profit. We fear for what it could mean for our public services in the future – including the NHS. All the evidence shows that where services have been privatised, services and working conditions deteriorate. We believe more services need to be provided by the public sector directly, and we fear that TTIP would make it harder for a democratically elected Government to do this.”

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Health Service Journal

  • CCGs could co-commission specialised services.

    Clinical commissioning groups could be handed a role in commissioning a significant chunk of the £14bn specialised services budget. The move is being considered by a working group established by NHS England’s specialised commissioning task force. NHS England currently commissions the services. While discussions are at an early stage, HSJ understands that NHS England could ditch sole responsibility for up to half of the 143 services it commissions either through co-commissioning or the wholesale transfer of responsibilities. The commissioning of services such as renal dialysis and chemotherapy - collectively worth £1.7bn - could be transferred to CCGs.

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BBC News

  • Fears raised 'free NHS' will come to an end.

    Fears are being raised that the NHS in England will no longer be free at the point of use within 10 years. Nearly half of the 78 health and care leaders surveyed by the Nuffield Trust felt the status quo would not remain because of the squeeze on funding. The think tank warned of a "funding crisis this year or next" and that patient care could start to suffer. The government called this an "unrealistic picture", but Labour said NHS finances were in a "dire state". Currently the health service gets just over £100bn a year. The Nuffield Trust said another £2bn a year may be needed to keep pace with demand. The review of spending since 2010 highlighted the growing number of NHS trusts falling into deficit as a sign of growing problems in the health service. Provisional figures for 2013-14 show 66 out of nearly 249 trusts finished the year in the red. The overall deficit was about £100m, compared with a £383m surplus the year before. Report author Andy McKeon said the difficulties were likely first of all to lead to rising waiting times. The warning comes after similar claims by the Health Select Committee and bodies such as the Royal College of Nursing and Royal College of GPs in the past fortnight.

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Tuesday 8th July 2014

Our NHS

  • Cameron is wrecking our world-beating health system.

    After all the negative headlines over the last few years you would be forgiven for thinking that the NHS was a mediocre, failing, bureaucratic service destined to collapse. That is the message that Health Secretary, Jeremy Hunt, would like you to believe. Since becoming Secretary of State for Health, Jeremy Hunt has seen it as his primary role to talk down the NHS and undermine the staff that run it in order to justify hospital closure legislation, draconian cuts to staff pay, and the rapid privatisation of large swathes of our health service (70% of contracts going to the private sector at the last count). It was also the message used to justify the biggest top down reorganisation of the NHS in its history - David Cameron’s Health and Social Care Act 2012. That is why it was so galling when the Prime Minister told the House of Commons in PMQs this weekthat the NHS under his Government was the best in the world. David Cameron is misleading us. The Commonwealth Fund did release an international study in June saying that the NHS was top out of 11 major industrialised countries. But the report looks at survey data from 2011-13. This data pre-dates Cameron’s chaotic and unnecessary reorganisation, given the Health and Social Care Act 2012 only fully came into force in April 2013. In fact the report contradicts many of Cameron and Hunt’s claims about the NHS, while reinforcing what campaigners were saying at the time. The report shows that the NHS was not only better than the obvious examples such as the US health system, where even after Obama Care nearly 30 million people are still not covered, but actually it rated better than those countries with a better record of social security and welfare provision, such as Sweden, Norway, France, Germany and Holland. The United Kingdom ranked first overall, scoring highest on most quality, access, and efficiency measures reviewed. Patients in the United Kingdom were the least likely to report having cost-related access concerns (4%). Care was better integrated than in other countries through widespread and effective use of health information technology (HIT), high scores on the chronic care management indicators, as well as its performance on system aspects of preventive care delivery. Overall, the U.K. outperforms all countries on each of the seven chronic care management indicators. The UK also provided some of the best results for patient centred care, access and communication within the health service with for example the highest rates of follow-up visits with a doctor or other health care professional made upon leaving the hospital (87%). The UK had the highest ratings for timely information for patients and patient feedback systems. It also had the highest numbers who said that doctors always tell them about their options for care and ask their opinions, discuss goals and encourage them to ask questions, and give clear instructions about symptoms to watch for and when to seek treatment.

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HSJ

  • Revealed: The big spenders in specialised services.

    A group of just 19 acute trusts were paid almost half of NHS England’s £11.2bn budget for acute specialised services in 2013-14, exclusive analysis by HSJ revealed. The research also showed that England’s 19 standalone specialist hospitals shared 13 per cent of the national budget. The remaining 40 per cent was split between 51 independent and more than 200 NHS providers. The HSJ analysis of outturn spend for all providers with NHS England specialist services contracts in 2013-14 revealed for the first time the challenge the commissioning board faces inits bid to centralise such services into 15-30 centres. This plan is now in doubt after NHS England chief executive Simon Stevens indicated weeks after he took up the post in April that he still sees a role for smaller hospitals in delivering specialised care. The data confirmed that NHS England has contracts for acute specialised services with all NHS acute trusts, as well as with 10 community trusts. Of the 292 contracts, 24 were for less than £1m each and mainly with independent sector providers, for services such as dialysis and hyperbaric oxygen therapy. Spends at the 19 acute trusts ranged from £393m at Leeds Teaching Hospitals Trust to £175.5m at Salford Royal Foundation Trust. The next largest spend was £136.6m at North Bristol Trust, suggesting acute specialised services in England are already fairly centralised, as Mr Stevens indicated in his first Common’s health committee appearance. The analysis also indicated that some trusts received a significant proportion of their income from specialised commissioners. Almost half of University Hospitals Birmingham Foundation Trust’s income came from such commissions (see table, below). Of the 19 specialist trusts, nine received more than half of their income from NHS England, including the Clatterbridge Cancer Centre Foundation Trust which received 100 per cent from the board. Of the 141 acute trusts, 23 had contracts worth less than £10m, where work accounted for up to 5.6 per cent of turnover. Foundation Trust Network chief executive Chris Hopson toldHSJ that losing even these small amounts could make a huge difference to small and medium district general hospitals as it could be the difference between breaking even or going into deficit.

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  • NHS England faces 'most difficult budget year'.

    The health service faces its ‘most difficult’ year in balancing its financial plans, senior NHS England officials warned at a board meeting last week. Its chief operating officer Dame Barbara Hakin said: “[I will] put my hand on my heart and say that this is the most difficult year that we’ve faced in terms of balancing the plans.” Her comments came after papers submitted to the boardrevealed NHS England had not yet agreed on plans to balance its £97bn budget for 2014-15. NHS England chief finance officer Paul Baumann, who wrote the report, told the meeting: “I don’t think we’ve ever been quite this late in the year without a set of plans which are all laid to rest and ready to be acted upon. “[It] is just an indication of the difficulties around the country [that] different health economies have been facing.” NHS England deputy chair Ed Smith, who also chairs its audit committee, told the meeting the organisation had to “get into a rhythm of having a balanced budget on 1 April rather than on the end of the first quarter”. He said he was “sympathetic” to the task being “massively complicated and difficult” and that “we ought to be able to do it for the start of the year”. Mr Baumann said this year’s plans were the “riskiest” the NHS had faced “for a while”. He noted that last year there was a “large proportion of the draw down” available to NHS England not allocated. He said: “We needed some of it. Some of it led to a slightly higher surplus at the end of last year than we had anticipated. This year all of that draw down - of the £400m of money from previous years - has had to be allocated.”

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The Independent

  • Raise taxes or NHS will have to start charging patients, warn GPs.

    The NHS will have to start charging patients unless taxes are increased or major cuts are made to the service, leading health figures have warned. Officials from the Royal College of Nursing, Royal College of General Practitioners and Royal College of Physicians among others said in a letter that the NHS was “creaking at the seams” amid increased demands because of the ageing population – partly a result of improved health care. “We can all celebrate the success of rising life expectation. Yet because most of us are living longer, the next 50 years will see a growth of at least two and a half times as many people suffering from multiple problems,” the letter, which was sent to The Times, said. “Unless action is taken, by 2020 maintaining the current level of service provision will require an additional £30 billion for just the NHS — which is as much as we spend each year on defence. There is an equivalent budget crisis in social care and housing. The status quo is not an option. We are already seeing the signs of the system creaking at the seams. All financial options are difficult politically; higher tax spend, co-payments or changes to what is available.” The letter added that more should be done to “eliminate inefficiencies” and “wasteful variation in care”.

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The Guardian

  • Wendy Savage - Consequences of privatising cancer care.

    Last night I attended and spoke at a book launch of Mike Marqusee's book The Price of Experience: Writings on Living with Cancer, where he spoke movingly about his treatment at Barts and his fears that the attacks on the NHS will mean patients in the future will not have the excellent care he has received. Surely the combined CCGs in Staffordshire should have been talking to their existing NHS hospitals and asking them to collaborate to provide a more responsive and streamlined service before embarking on this huge experiment with taxpayers' money ? In the previous decade, the NHS (under Labour) made great strides in improving cancer services through networks such as that in east London, yet in 2011 Andrew Lansleywithdrew funding for these despite their proven successes. Now we have groups of GPs, with no training in epidemiology, oncology or commissioning, making plans to spend millions on an untried system with private companies, who have no experience in cancer care, eagerly waiting to make profits from these sick patients. Similarly, the Cambridgeshire CCG, which wants to try a radically different system of care for the elderly, is planning to spend over a billion pounds of our money. This is madness, and the dishonesty of the current government ("there is no privatisation"; "there will be no top-down reorganisation") is matched by the Department of Health's spokesperson who said: "NHS competition rules have not changed under this government." What about the Health and Social Care Act 2012, or the section 75 regulation that was passed this year ? It is time for the public to wake up, stand up and fight for our NHS by lobbying their MPs.

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  • The Beveridge report revisited: where now for the welfare state?

    As we claw our way out of the wreckage of a global economic crash that has had a warlike impact, triggering spending cuts unprecedented in modern times, there is a sense in which the UK faces another revolutionary moment. The battered remains of Beveridge’s welfare state need rebuilding and redesigning for the 21st century, for the digital era and for a society that expects a very different relationship with government. Beveridge, however, was on to something in basing his report on the need to tackle five “giant evils”: want, disease, ignorance, squalor and idleness. His list has stood the test of time so well that when the IPPR thinktank published recently itsCondition of Britain analysis, it revisited the five topics for an update. Verdict: work still in progress. But such is the scale and nature of the challenge facing our public services and the voluntary and community sector, which remains as much a part of the response to social need as it was in Beveridge’s day, that there is a strong case for recasting and redefining his five giants for 2014. As the new Society Professionals service is introduced, bringing together the Guardian’s networks for public services and voluntary sector professionals, we propose five “modern evils”. Some are close to Beveridge’s originals, others less so; but all reflect the concerns of practitioners, policy-makers and politicians in the run-up to next year’s general election. The first is that there is no foreseeable return to the levels of public spending of a decade ago. So draconian has been the regime of spending cuts enforced over the past four years, with the same again to come, that on some estimates the UK will by 2017 have the lowest share of public spending among leading capitalist economies, including the US. The second context factor is the changed relationship between the citizen and the state. In Beveridge’s day, people were hugely grateful for any public service – they queued in their thousands to register with a GP when the NHS opened for business in 1948 – and were unquestioning of what they were given or told. Today, society is far more consumerist: educated, informed and enabled to choose and challenge. Individuals know their rights and stand ready to insist on them. They increasingly expect, too, to be involved in the planning and transaction of public services: “co-production” is the buzzword, but in plain English it means much more of a partnership between the person delivering a service and the person receiving it.

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Daily Mirror

  • Cancer patients denied access to hospital's £2.5million radiotherapy machine because of cost-cutting.

    A hospital has stopped treating cancer patients with a £2.5million machine because of cost-cutting. Doctors at Northampton General last used the state-of-the-art radiotherapy device, used for people with lung, liver and other tumours, two months ago. MPs reacted with fury last night after discovering the technology, thought to cost £10,000 a time to use, is lying idle. Complicated funding issues in the new NHS England set-up are being blamed. The revelation comes as a summit is held at the House of Commons to tackle the “national disgrace” of poor cancer care in England. More than 30 of the country’s top cancer specialists – and 30 MPs – are attending the session set up by England rugby legend and health campaigner Lawrence Dallaglio, whose mother Eileen died of cancer in 2008. The Mirror’s revelation about the Northampton scandal has stunned them. The details came in a Freedom of Information (FOI) request by Lib Dem MP Tessa Munt, who asked hospitals if they had a programme for SABR Stereotatic ablative radiotherapy. Northampton confirmed they had – but had stopped using it back in April. Ms Munt told the Mirror: “This is madness. “NHS England is supposed to be expanding access to innovative radiotherapy not shutting centres down. The implications of this for the future of cancer care are appalling.” SABR, or stereotactic ablative radiotherapy, uses scans and specialist equipment to precisely target radiotherapy to destroy cancer cells accurately.

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Pulse

  • PMS practices fear closure as accountants predict losses of up to £400k.

    ndividual PMS practices are preparing for losses of up to £400,000 over the next two years, accountants have warned, with their viability now threatened. Pulse has learned of exceptional cases of GP practices facing losses of £300,000 and £400,000 but even ‘average’ PMS practices are preparing for losses of between £50,000 to £150,000 and are likely to have to cut staff and services, accountants warned. It comes as practices and accountants have begun to calculate how much England’s PMS practices – counting for roughly 40% of all practices so potentially covering around 20 million patients - are looking likely to lose as a result of the reviews being held by NHS England area teams during this year and next. The reviews are looking at £260m worth of funding received by PMS practices annually that a national review last year found was not linked to specific services. But while the plan was for the money to be ‘redeployed’ across GP practices to be fairer, accountants warned that this was a simplified way of looking at complicated GP funding and that patient services may come to suffer in the process. Debbie Wakefield, a partner at Essex accountancy firm Edmund Carr and joint chair of the UK200Group’s healthcare special interest group, said practices advised by the firm could be in line for total reductions ranging from £50,000 to £400,000, which is not linked to specific services. She said: ‘Losses of £400,000 is probably quite exceptional but I don’t think it is completely alone, unfortunately.’ In Essex, 63 of the 100 PMS practices have taken up a deal offered by the local area teams which offers them transitional funding when switching to GMS contracts. But medical accountant Lizzy Lloyd, a partner at Lloyd Hubbard, said some practicesfear they could lose up to £300,000 by giving up their PMS contract.

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Monday 7th July 2014

Daily Mail

  • Half a million facing 20-mile A&E trip in 'crazy' closure plans drawn up in the face of £30m funding black hole.

    Half a million people will be left 20 miles from their nearest A& E under ‘deeply worrying’ plans to cut two neighbouring casualty units. The imminent threats are to the A& Es in Milton Keynes and Bedford, which between them serve at least 500,000 people in an area with a fast-growing population. GPs have drawn up the cost-cutting plans as they face a £30million black hole in their NHS finances. If both units close, emergency patients will have to go to Northampton, Kettering or Luton for life-saving treatment. All are at least 20 miles away from both towns.
    The latest threats mean there are now 16 units across England facing the axe.
    Both A& Es could close next year, despite warnings from Simon Stevens, new chief executive of the NHS, that England’s emergency services are already ‘quite concentrated’ and they should not be cut from ‘viable local hospitals’ without very careful thought. Politicians and health campaigners condemned the plans. The proposals are outlined in a new public document drawn up by Bedfordshire and Milton Keynes’s clinical commissioning groups (CCGs), the local NHS authorities that pay a large chunk of the hospitals’ bills. The GPs who run the groups have outlined 14 scenarios for the two hospitals. Only three involve both hospitals retaining full A& Es.

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ITV News

  • Trade unions demand apology from Cameron for NHS 'smears'.

    Trade unions called on the Prime Minister to apologise for what they describe as "irresponsible attacks and smears" on the NHS here in Wales. They say UK government criticisms of the Welsh Labour Government's handling of the health service here damage the morale of staff and their relationship with patients.There have been a series of negative headlines surrounding the NHS in Wales in recent months, over missed targets and complaints about standards of care. Last week, it was revealed that ambulances only reached life-threatening incidents within eight minutes in 54.1 per cent of cases - below the 65 per cent target. David Cameron has made repeated criticisms of how the Labour Welsh Government runs the health service here, particularly in clashes with Ed Miliband in the run up to the General Election next year. His most high-profile comments came at the Welsh Conservatives' conference in Llangollen in April, when he said: "When Offa's Dyke becomes the line between life and death - we are witnessing a national scandal." The Trades Union Congress, which represents around 400,000 workers across Wales, today called on the Prime Minister to apologise for that remark - and wider comments around the Welsh NHS.

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BBC News

  • Demonstration over GP funding cuts in east London.

    Hundreds of people in Whitechapel have demonstrated against cuts to the NHS which protesters claim could lead to the closure of GP surgeries. The government has started to phase out extra money given to deprived areas, which means a number of surgeries in east London, could close.

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GP Online

  • Video: Londoners take to streets for second GP funding protest.

    Just four weeks after their first protest, campaigners more than doubled their numbers on the streets and demonstrated across three boroughs demanding urgent government action. GPs and patients from Tower Hamlets, Hackney and Newham held rallies, a march, and an open-top campaign bus tour. The events were organised to coincide with the 66th anniversary of the founding of the NHS. Up to 22 practices in the three boroughs, which include some of the most deprived parts of the UK, are at serious risk from MPIG cuts and other funding threats. With backing from several local MPs, local councillors and CCG leaders, and support from the powerful Unite union, the grassroots East London Save Our Surgeries campaign brought significant numbers onto the streets for the second time in a month. Jubilee Street practice partner and campaign leader Dr Naomi Beer said all political parties had failed general practice over the years, but that the 2012 Health and Social Care Act failed the people of the country. She condemned inaction by the ‘ineffectual quango, NHS England’, and the failure to listen and act by ministers. Dr Beer called on government immediately to reinstate MPIG and reverse the ‘disastrous effects’ of the health and social care act. Addressing the Hackney rally in London Fields, RCGP chairwoman Dr Maureen Baker said without changes to NHS funding, practices would shut down. But, they ‘cannot be allowed to close’, she warned. The loss of MPIG funding will hit patients from the most deprived communities, she warned, and ‘that should be unacceptable to all of us’. Hackney North and Stoke Newington MP Diane Abbott said ‘more people will die’ if practices close. The campaign was part of a wider fight, she said, ‘against the privatisation of the NHS’.

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Eastern Daily Press

  • Doctor’s warning over “perfect storm” GP recruitment crisis.

    Senior doctors have warned that more health practices will be forced to de-register patients in East Anglia because of a national GP recruitment crisis. Patients spoke of their anger last month after Watton Medical Practice told 1,500 people that they would have to register with another practice because the surgery was unable to hire two new doctors. However, fears have been raised that more medical practices in Norfolk will have to de-register some of its patients as a result of a “perfect storm” with senior GPs retiring early and not enough new blood joining general practice. Officials from the British Medical Association (BMA) said that since January, Norfolk and Waveney’s local medical committee, which covers 120 practices, has advertised 56 vacancies for GPs, with around half of those remaining unfilled.

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BBC News

  • Leading health experts in NHS funding debate call.

    Leading figures from the health world are calling for a national debate on how the NHS in England is funded. In a letter to The Times, they say challenges from an ageing population mean the system is "creaking at the seams" and cannot continue as it is. Signatories include the heads of the Royal College of Physicians and Royal College of Nursing. The BBC's health editor says the group feels future options may include higher taxes or charges for some treatment. Without action an extra £30bn will be needed by 2020 to fund the NHS at current levels, their letter adds. They are asking for a cross-party, independent conversation on the way forward for the "scope, provision and funding of health and social care". The nine signatories say that in 50 years' time, at least two-and-a-half times as many patients will suffer from multiple health problems. BBC health editor Hugh Pym said while their letter is suggesting that further action is needed to make the NHS more efficient, this will not be enough as financial pressures intensify. Two signatories - Ciaran Devane, chief executive of Macmillan Cancer Support, and Turning Point chief executive Lord Adebowale - are non-executive directors of NHS England.

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Friday 4th July 2014

OnMedica

  • GP workload soars due to welfare reforms.

    GPs workload has soared due to the increased financial hardship of patients under new government rules. This is the finding of a survey* of GPs carried out by The BMJ. The results reveal that two thirds of GPs questioned, believe patients’ health is being harmed by benefit cuts, while many feel their professional opinion is regularly disregarded by those assessing people’s ability to work. The investigation** also reveals how employment advisers and welfare rights officers are an increasingly vital part of general practice during the austerity period. Since 2010, the UK government has introduced a raft of reforms to the welfare system in a bid to reduce the deficit. This BMJ survey aimed to explore the impact of these on GP workload and patients’ health and wellbeing. A total of 1,056 GPs across the UK completed the survey out of 28,602 who were contacted. The findings suggest that people receiving welfare support due to illness or disability are struggling to cope with cuts to their benefits and are turning to their GP practices for help. Most doctors say they are seeing an increase in patients with non-medical problems, such as debt, unemployment and housing issues, and many believe this is affecting patients’ health, particularly those with mental health problems. They are also being asked more frequently to provide medical information for their patients’ Work Capacity Assessments (WCAs) – and to help an increasing number appeal against the removal of their benefits under the new system.

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Hospital Doctor

  • More patients visit A&E where GP access worse.

    Patients with more timely access to GP appointments make fewer visits to accident and emergency departments, suggests a study published today. GP practices whose patients reported more timely access to appointments had lower rates of A& E visits in which the patient referred themselves and was discharged. In the largest analysis of its kind to date, researchers at Imperial College London related A& E attendance figures in England to responses from a national survey of patients experience of GP practices in 2010-11. One question of this survey, published in PLOS ONE, asked patients whether they had been able to see a GP within two weekdays when they had last tried. With A& E units across England straining under rising demand for urgent and emergency care, many have called for better access to GPs as a way to lower A& E attendances. However, there is no previous evidence to suggest this strategy could be effective at a national level. According to the analysis, the rate of A& E visits for the fifth of practices with the best access was 10.2% lower than the fifth of practices with the worst access. Lead author Thomas Cowling, from the School of Public Health at Imperial College London, said: “This is the first national evidence of an association between access to GP appointments and rates of A& E attendances in England. Policymakers should consider this relationship when designing plans to reduce the use of A& E departments. “A new era of service commissioning, led by GPs, has just started in the NHS. It will be interesting to see what effect, if any, this has on access to GP appointments and, in turn, on A& E visits.” If the bottom fifth had performed as well as the top fifth, the researchers estimate this would have resulted in 111,739 fewer A& E visits for the year. Clifford Mann, president of The College of Emergency Medicine, said: “We recently conducted our own research and found that 15% of patients who attended could be safely redirected to their GP. This is less than the number estimated in the research by Imperial College but still represents 2.1 million patients per year. “It is therefore unarguable that a significant number of patients could be seen elsewhere if that capacity existed.”

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HSJ

  • Public fear for the future of free healthcare.

    Voters fear the principle of free healthcare is in danger and that the NHS is threatened by the private sector, an exclusive HSJ/ FTI Consulting poll has found. The survey, conducted jointly with FTI Consulting, also reveals that the NHS retains extremely high levels of support among the general population. A huge majority would approve of a cash injection into the service as the economy improves. Our research polled a representative sample of 2,000 voters from across England in June. When asked to score out of 100 how much they agreed with the assertion “free care is under threat”, one in four said 100 per cent. The average score was 70 per cent, despite no major political party actually offering a policy to end the principle of healthcare free at the point of use. This survey also revealed widespread concern about the role of the private sector. An average score of 65 per cent was recorded in response to the statement: “The NHS is under threat from private healthcare companies”. Despite this perceived threat from private firms, half of respondents agreed it did not matter whether the NHS was privately or publicly managed as long as the service remained free to users. Further findings underlined the public’s continued support for the NHS, with 97 per cent of voters believing it was worth fighting for and 92 per cent that it was integral to maintaining social equality.

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Bristol Post

  • Bristol doctors resign in protest over cuts to NHS leaving thousands without GP.

    Two doctors whose decision to quit has left a city surgery in crisis say they are overworked – and patient safety is at risk. Urgent talks are underway over the future of St Martin’s Surgery in Knowle, which serves 6,000 patients, after its remaining two GPs resigned. Dr Holly Hardy and Dr Karen Houghton say NHS reforms have left them with a mountain of new paperwork to deal with and are putting off newly qualified doctors from going into GP practice. That has resulted in a struggle to recruit new partners since the departure of two full-time colleagues in 2012 and 2013. Dr Hardy, 48, said: “It’s been absolutely horrendous to make this very difficult decision. “We don’t want to leave patients and the staff, some of them have worked here for longer than 30 years. But the way we were working wasn’t sustainable. It wouldn’t be fair on patients and we don’t want to have to compromise on patient safety.” The partners had tried to merge with another nearby surgery to ease pressure. This fell through after managers raised alarms about recruiting new GPs to deal with the extra workload. Dr Hardy, who has worked at the surgery for seven years, blamed NHS restructuring. She said: “We’ve been working extra hours – sometimes until midnight – to clear paperwork. There has been a move to bring services out into primary care (community-based services) from secondary care (such as hospitals), which is great, but the funding and resources have not followed. “Also there is an issue with recruitment. Young doctors don’t want to go into GP practice because they are seeing how difficult it is.” The surgery should have the equivalent of three full-time staff but is currently being staffed by Dr Hardy and Dr Houghton, who are supposed to work just three days between them, as they were brought in on a part-time basis. Dr Hardy will leave the practice in September but she intends to continue to work in Bristol as a GP.

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The Guardian

  • NHS patients waiting longer for routine operations under coalition.

    Delays faced by patients for common forms of surgery such as hernia repairs and cataract removals have risen sharply under the coalition, despite David Cameron's pledge to keep waiting times low, NHS statistics reveal. Patients are now waiting on average 15 days longer than in 2010 to have their tonsils taken out, 14 days more to have adenoids removed and 10 days longer for a hernia procedure. The findings, in a Patients Association report published on Friday based on official NHS performance data, come weeks after growing unease in Downing Street about lengthening delays for treatment led to the Department of Health (DoH) giving the NHS an extra £400m to tackle the problem. Information supplied by more than half of England's 162 acute hospital trusts also shows that patients are facing a postcode lottery in how long they have to wait before they get treated, with delays of as long as 215 days in some places. That is far more than the maximum 18 weeks or 126 days that patients are supposed to be treated within under the NHS constitution after being referred by their GP under the Referral to Treatment scheme. Katherine Murphy, chief executive of the Patients Association, branded the delays unacceptable. They mean that patients are suffering in discomfort or pain and may face immobility and social isolation when they have to wait, she said. Some are becoming so frustrated at not getting treated promptly that they are being forced to pay private health providers to relieve their symptoms. "While we appreciate the financial squeeze in the NHS, it cannot be at the cost of patient care and should not mean that patients are suffering, as these figures suggest that they are. It's unfair and unjust for patients to ha

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Pulse

  • Sixty GP practices across the country facing imminent closure.

    Around 60 practices across the UK are facing imminent closure due to issues over funding and recruiting staff, Pulse has learnt. In a measure of the recruitment crisis and funding squeeze facing the profession, local GP leaders have warned that they are witnessing an increase in the number of practices considering giving up their contracts altogether. Pulse surveyed 25 local GP leaders from across the UK, and found that 60 practices were either notifying their patients about their closure or were in talks about relinquishing their contract. The leaders of local medical committees (LMCs) or GPC representatives told Pulse that they fighting to keep practices open, but were facing a ‘slow train crash’. They also cited the ‘domino effect’ that would occur if practices were allowed to close and large numbers of patients had to be reallocated to other neighbouring practices. The BMA warned in May that practices were ‘imploding’ with the pressure on them, and that was leading to many being at risk of closure. The survey found:
    In Gloucestershire, three practices are under imminent threat of closure with GPs at one taking home no pay at all.
    Six practices in Hampshire have been in discussions with LMC representatives about relinquishing their contracts.
    One practice in Oxfordshire has closed this week because it could not afford the running costs, another is due to close due to a lack of investment in premises.
    In Wales, four practices are closing imminently, and a further 10 are considering doing so due to recruitment problems.

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Thursday 3rd July 2014

The Guardian

  • NHS is cash-strapped and fraying at the edges, warns BMA chairman.

    So many patients are facing long waits for treatment, GP appointments and diagnostic tests that the NHS is "palpably fraying at the edges", the leader of Britain's doctors warns on Monday. Crucial services are deteriorating because the cash-strapped health service cannot cope with rising demand from patients at the same time as ministers are "attacking the overall financial viability of the service", Dr Mark Porter said. Porter's intervention comes as research shows that one in four people arriving at A& E are there because they could not see a GP quickly enough. The study was funded by the National Institute for Health Research and collated by researchers at Imperial College London, and is the first of its kind. It shows that 5.77m attendances at A& E units England in 2012-13 – 26.5% of the total – occurred after patients had tried but failed to get a timely consultation with a GP. NHS performance could slip further in the next few months because of inadequate funding and ongoing increases in patients seeking treatment, said Porter, chairman of the British Medical Association (BMA), in an interview with the Guardian. "The year-on-year reduction in resources in many areas is leading to a service that's palpably fraying at the edges," he said. "You have a service that's suffering from a lack of proper investment, constant resource restrictions and cost control, and is demonstrably and noticeably in a number of places starting to fray at the edges."

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  • Jeremy Hunt should stop GP-bashing, or hospital referrals will skyrocket.

    I have more than 30 years' experience of being a GP and it saddens me to hear the continual denigrating of general practice by media and politicians. Jeremy Hunt, the health secretary, wants to expose GPs who cost lives by not sending patients for potentially life-saving scans quickly enough. Missed and late diagnoses of cancer are tragic. But how does Hunt define an "unacceptable" delay in diagnosis ? No one misses cancer on purpose, and we have all done it when we have only 10 minutes for a consultation. In many cases, the diagnosis is unclear at first. If somedoctors consistently diagnose earlier than others then there is a case to be made, but in my experience, that is not usually so. I can think of occasions when I have been very lucky and have detected a cancer ridiculously early, but it has always been pure luck. The health secretary has already revealed his underlying prejudices with the words he uses and the issues he is focusing on. GPs will, once again, see a bunch of academics looking for errors and poor performance, yet another factor that will demotivate GPs. I wonder if Hunt has a story lined up for every day from now until the general election next year. Rather than political gimmicks, what we need is more GPs, more practice staff, including nurses, and a programme of investment in GP practice buildings to bring them up to scratch. Primary care receives only 8% of the total NHS budget yet it carries out 90% of patient consultations. There is no doubt that we have variation in standards of primary care which needs addressing. However, by and large, the primary care model in the UK is undoubtedly one of the best. Let's take a tour of general practice in Europe and beyond, where GPs spend longer with patients, such as the 20-minute consultations that are common in Holland. Or where whole chunks of clinical care aren't even done by GPs, such as in Spain, where all smears are done by gynaecologists, Hungary and the Czech Republic, where all children are seen by pediatricians, and indeed in most of Europe, where patients see specialists freely, without any reference to their GP.

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Sunday Post

  • Grim reality of NHS cuts as hospitals axe 23,000 beds.

    A& E wards blocked and overcrowded – abandoned patients left on trolleys for hours Left writhing in pain for six hours on a waiting room chair, this little boy marks a hospital bed shortage which has hit crisis point. Today a damning Sunday Post expose uncovers the true extent of cuts to NHS hospital beds in England. We can reveal 23,000 overnight beds have disappeared from wards over the last four years alone. The vanishing beds scandal has left seriously-ill patients like two-year-old Callum Giles, who was fighting a blood infection, abandoned in waiting rooms or left on trolleys in corridors. The cuts have followed a savage scaling back of services by cash-strapped NHS chiefs. Medics argue the situation has been further compounded by cuts to social care budgets which means patients – often the elderly and vulnerable – cannot be discharged because care packages are not ready. These fresh revelations follow a report, published by the Organisation for Economic Co-operation and Development (OECD) in April, which revealed the UK had fewer hospital beds per person than most of Europe. It found in 2011 England and Wales overall had 2.95 beds per 1,000 people, compared with Germany which had 8.3, Austria (7.7), Hungary (7.2), the Czech Republic (6.8) and Poland (6.6). Jamie Reed, Labour’s shadow health minister who represents Copeland in Cumbria, accused PM David Cameron of setting the NHS “up to fail”.

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Our NHS

  • Scots NHS satisfaction soars as England's falls.

    Since devolution, the NHS in Scotland has taken a very different path to that of NHS England. It has embraced co-operation rather than competition. And new figures show that Scots reckon that it delivers for them. Findings just released from the Scottish Social Attitudes Survey (SSAS) 2013 have found satisfaction with Scotland’s NHS increased by over 20 per cent since 2005. The official survey of around 1500 Scots found that 61 per cent of people in Scotland were either very or quite satisfied with the NHS, compared with only 40 per cent in 2005. This high level of satisfaction is reflected in the patient experience as well. In last year’s Health and Care Experience Survey, 85 per cent of Scottish inpatients say their overall care and treatment was good or excellent, and 87 per cent also rated the overall care from their GP surgery as good or excellent too. The findings contrast with a reduction in UK-wide NHS satisfaction levels since 2011. Comparisons must be made with care - but the survey authors speculate that the different trend may be due in part to concerns about the changes in the English NHS following the introduction of the Health and Social Care Act in 2012. Scots continue to reject the commercialisation of care, both in hospitals - where few have ever wanted the private sector or even charities running things - and in care services.

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HSJ

  • NHS England struggling to balance £97bn budget.

    NHS England this week confirmed it had still not managed to set plans to balance its £97bn budget for 2014-15, in what experts saw as a sign that the NHS overall could face financial crisis sooner than expected. A report to the national commissioning body’s board meeting this week by its chief financial officer, Paul Baumann, showed that three months into the financial year he was still unable to present it with a balanced financial plan for approval. Plans submitted by clinical commissioning groups and NHS England’s own direct commissioners in late June showed an aggregate overspend of £137m against the commissioning system’s £97.3bn spending limit for the year. NHS finance experts told HSJ it was a sign that the commissioning system - which has to date fared better than the provider sector amid prolonged austerity - was now under huge financial strain. They warned the NHS overall could tip into the red in 2014-15, ahead of a widely anticipated crisis of health finances in 2015-16. Richard Murray, the King’s Fund policy director and former chief analyst at NHS England, said while the projected overspend was small compared with commissioners’ overall resources, “the fact that they can’t get it down to zero is really significant”. He told HSJ: “It shows the commissioning system is really grinding its gears at the moment.” Mr Murray added that activity levels - particularly emergency activity - appeared to be “running really high” in parts of the NHS, and could already be ahead of plan for some commissioners. “I think there’s a reasonable chance that the NHS will go into deficit [in 2014-15],” he said. “At the moment, unless activity growth in the NHS slows down very quickly, this chance is getting higher and higher all the time.” Health Foundation chief economist Anita Charlesworth agreed that this was a “very significant moment”. It has been apparent for some time now that providers are finding life very difficult, but the commissioning system has always been more financially robust,” she said. “Now, if commissioner plans… don’t deliver balance that does threaten the overall financial viability of the NHS. “To date, deficits in the provider side have been offset by underspends on the commissioning side. This is a tipping point.”

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  • Big jump in private share of NHS community services market.

    The share of NHS community health service funding going to private providers has sharply increased in recent years, a new study reveals. One pound in every five spent on community services in 2012-13 was on private providers, according to the research by the Nuffield Trust, which it has shared with HSJ. This represented a 34 per cent increase in community services funding going to the private sector in one year alone. There has also been a big increase in funding for private providers of mental health services. This saw a 15 per cent real terms increase between 2011-12 and 2012-13. Funding for NHS provided mental health services dropped by one per cent over the same timeframe. The private sector’s penetration of the NHS community services market exceeds previous forecasts. The market intelligence company Laing and Buisson in 2011 predicted the private sector could secure a fifth of community health spend by 2016. The Nuffield Trust’s figures show this milestone was achieved three years earlier. The share of money going to voluntary providers of community health services has also increased from eight per cent of the total national budget in 2010-11 to 13 per cent in 2012-13. Over the same period, spending on NHS-provided community services fell in both absolute terms, from £7bn to £6.7bn, and as a share of overall spend on community health services, from 80 per cent to 69 per cent. Nearly one third of funding for these services is now with non-NHS providers.

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The Guardian

  • NHS cancer care could switch to private contracts in £700m plans.

    Cancer care in the NHS could be privatised for the first time in the health service's biggest ever outsourcing of services worth over £1.2bn. A host of private healthcare firms have already expressed interest in securing a £689m, 10-year contract to provide cancer care at four NHS GP-led clinical commissioning group areas in Staffordshire. The four CCGs involved, which care for 767,000 patients, are also seeking bidders for a separate £535m contract to provide end-of-life care. Together the contracts are worth £1.22bn, much more than the previous record high of £500m, secured by Richard Branson's Virgin Care for providing various health services in Surrey. Virgin, Care UK, Ramsay Health and other private firms, many of which have increased their role in providing NHS care amid an expansion of competition driven by the coalition's NHS shake-up, have attended briefings run by the charity Macmillan Cancer Support, which is advising the four CCGs on the cancer contract. Christina McAnea, head of health at the union Unison, expressed grave concerns about the plans. "This is by far the biggest procurement process in the NHS and is a dangerous experiment. We are talking about £1bn of taxpayers' money and contracts lasting 10 years in vital cancer services and end-of-life care," she said. "CCGs are potentially handing over all decision-making on cancer and end-of-life care to private companies. This is much bigger than just asking private companies to provide a service: this is asking them to design the whole system. With profit as the main driving force, how can it not lead to problems ?" While an NHS organisation could bid for the contracts, the four CCGs said they were open to the successful bidder being an independent commercial organisation, third sector group or consortium. The four CCGs – Cannock Chase, North Staffordshire, Stoke-on-Trent and Stafford and Surrounds – intend to overhaul cancer care in the county to make it more joined-up after some patients complained that they were "getting lost in the system, having to repeat themselves all the time, and that care [was] not always factoring in their personal circumstances". Whoever wins the cancer contract will then have to "transform the provision of cancer care in Staffordshire and Stoke". The prime provider will "manage all the services along existing cancer care pathways" for the first two years after which "the provider will assume responsibility for the provision of cancer care, in expectation of streamlining the service model", according to details posted by the CCGs on the main NHS procurement website. A new prime provider is needed to dramatically improve end-of-life care in Staffordshire because too many patients are not getting their wish to die at home, people needing palliative care are not being identified, and "patients and carers often report a negative experience, and their experience is of a fragmented, poor quality, unresponsive service", said the CCGs. Concerns have been raised that handing the cancer contract to a non-NHS firm could lead to job losses at some of the 13 NHS hospital trusts that currently provide cancer care and the array of organisations that provide care to people who are dying.

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Tuesday 1st July 2014

Pulse

  • Labour Party puts forward new Bill to end NHS 'privatisation'.

    The Labour Party is putting forward a Bill this week which aims to remove the compulsion for NHS commissioners to put services out to competitive tender, it has announced. The party said it will back a private member’s Bill from Clive Efford, the Labour MP for Eltham, which will repeal the ‘damaging’ competition rules that were ‘inflicted’ on the NHS via the Health and Social Care Act. The Bill, which Mr Efford said he was putting forward to address his constituents’ concerns over NHS ‘privatisation’, will focus on repealing section 75 of the Act - which places a duty on commissioners to put services out to tender unless they can prove their is only one potential provider - as well as the competition framework which established Monitor as a regulator of competition in the NHS. The Labour Party said the Bill would ‘rewrite the rules that force market tendering of services and that are seeing millions of pounds wasted on competition lawyers that should instead be spent on patients’. The Bill is due to be debated in the House of Commons in November, with Labour planning to lobby MPs from all parties for support between now and then by ‘highlighting examples of how the current rules are wasting money and fragmenting care’.

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Nursing Times

  • Most midwives in favour of ‘some form’ of industrial action over pay.

    Midwives and maternity support workers in England have overwhelmingly said they are prepared to take industrial action over NHS pay in a consultation exercise. The Royal College of Midwives will now decide whether to hold a formal ballot on taking industrial action. The consultation exercise asked NHS midwives and maternity support workers if they were prepared to take industrial action. It is the first time the college has consulted members over industrial action. Over 94% of midwives who responded to the consultation said they would consider industrial action of “some kind” over pay. In total 46.5% of the RCM’s members responded to the consultation. The RCM will take the results to an extraordinary meeting of its board in the next few weeks. A decision will then be made there about whether the RCM will take the unprecedented step of moving to a formal ballot of its members on industrial action – though it seems unlikely it will include the option of striking.

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Independent

  • Britain prepared to pay more tax to support the NHS, poll finds.

    A majority of people are ready to pay more tax to safeguard the NHS and head off a looming financial crisis, according to a ComRes survey for The Independent. Asked if they would be prepared to pay more tax to maintain the current level of care and services provided by the NHS, 57 per cent agreed and 41 per cent disagreed. The finding will encourage Labour, which is considering a plan to include an earmarked “health tax” in its general election manifesto next year. But the poll also contains worrying news for Labour. Ed Miliband enjoys only a narrow lead over David Cameron on health, traditionally one of Labour’s strongest issues. One in three people (33 per cent) trust Mr Miliband to protect the NHS, while 29 per cent trust Mr Cameron. Three out of 10 Labour supporters (31 per cent) do not trust Mr Miliband to safeguard the NHS, while 64 per cent do. According to ComRes, Labour’s lead has dropped from five to two points since last month. Labour intends to make a “big offer” on health and wants to make it a key election battleground. It is considering three options to boost NHS spending: a ring-fenced rise in national insurance contributions (NICs) for employers and workers; delaying the deficit-reduction programme and a budget increase once the nation’s books have been balanced.

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Monday 30th June 2014

Western Morning News

  • NHS 'in danger of collapse' David Cameron is warned.

    Totnes MP Sarah Wollaston is among a number of Tories calling for major NHS spending to prevent a collapse in the service. The NHS says 299,031 patients arrived at A& E departments last week – the highest number on record. As a result, A& E waiting time targets were missed for the 49th consecutive week and a record number of beds were filled last month by patients who could not be discharged, often because community or social care services were not in place. According to The Observer newspaper, Ms Wollaston, former Conservative health secretary Stephen Dorrell, and Paul Burstow, a former coalition health minister, say that with the economy growing the NHS must receive a real terms increase in spending over the next five years if it is to function properly. For the past four years, the government has ringfenced the health service budget from cuts and raised funding in line with inflation, but largely relied on efficiency savings to pay for a growing demand for its services. Ms Wollaston, elected this month as chairman of the Commons health committee, and Mr Dorrell, who she replaced, said the policy could not continue.

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Daily Mirror

  • NHS 'giving private patients priority and those who can't pay get shoved to back of queue'.

    NHS patients needing emergency treatment are having to make way for private users, it has been claimed. And OAPs are being denied surgery until their condition is life-threatening because staff are too busy dealing with those who pay for services, according to a whistleblower. University College Hospital in Central London touts for private patients on its website – a move allowed under David Cameron’s hated health reforms. But one worker there said NHS patients are being bumped down waiting lists to accommodate them. The insider raised the matter with the Care Quality Commission. It said in its log: “Concern private patients are taking priority over emergency cases. ­Allegations of bullying by managers and low morale. Elderly patients do not have operations until their case is life-­threatening. This is down to private practice.” Consultant oncologist and leader of the National Health Action party Dr Clive Peedell called for a “proper investigation” into the alarming claims. Mr Cameron’s reforms mean hospitals can earn up to 50% of income from private work. The NHS earned £434m from such patients last year – up £47m in 12 months. Experts warn there is growing evidence patients are being forced to go private because of long waiting lists. UCH offers The Fitzrovia Suite for maternity patients willing to pay.

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