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Thursday 11th September 2014

Reading Post

  • Campaigners protest in Broad Street against NHS trade deal.

    Campaigners gathered to collect signatures protesting against an international trade deal which they say could put the NHS at risk. Members of campaign group 38 Degrees asked people to sign a petition, joining almost 10,000 people across the country who took part in the national day of action handing out more than a million leaflets. The international deal – the Transatlantic Trade and Investment Partnership (TTIP) – would, if passed, force NHS trusts across the UK to open themselves up to competition from American private healthcare providers. The pact also includes provisions to allow multinational businesses to sue the Government if British laws dent their profits. Critics say this would expose the Government to lawsuits if for example, it tried to take privatised health services back into public ownership or if it did not allow American companies to sell GM foods in the UK. More than 125,000 people have signed a 38 Degrees petition against the deal. A YouGov poll commissioned by 38 Degrees found that 42 per cent of people say that they do not trust the Government to protect the NHS. And 39 per cent of those surveyed by YouGov said the treaty would be bad for the UK – three times as many as those who say it would be good for the country. For more information about the noTTIP campaign visit www.noTTIP.org.uk.

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Pulse

  • 85% of GPs believe NHS will be privatised within ten years.

    Almost 85% of GPs believe the NHS will be privatised within ten years, with 45% predicting it will occur within five years, a survey of 1,137 NHS staff has revealed. The survey, conducted by Cogora, which publishes Pulse, also revealed that GPs felt less engaged in the CCG decision-making than practice managers. It found that 91% of GPs felt the reforms resulted in more work, while 97% of practice managers believe workload had increased. The survey questioned 548 GPs, 418 nurses and 171 practice managers. It found that exactly half of practice managers felt that privatisation will happen within seven years, compared with 45% of GPs. Only 14% of GPs and 11% of practice managers felt that privatisation will not occur in the next ten years. Dr Richard Vautrey, deputy chair of the GPC, said that practice managers’ estimates could be more accurate as they are closer to commissioning decisions.

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Socialist Party

  • Labour lets down NHS protesters.

    The People's March for the NHS finished its 300 mile trek from Jarrow on 6 September when over 5,000 people joined it for a demonstration in London. Among the demonstrators were many NHS workers currently being balloted for strike action over pay. The protest ended with a Trafalgar Square rally. We heard from many of the angry 'Darlo Mums', who organised the march against the Con-Dems' destruction of the NHS. Other trade unionists and NHS campaigners spoke, including an activist from Staffordshire Hospital anti-NHS cuts camp. But another speaker was Labour's shadow health minister Andy Burnham. He repeated, to big cheers, Labour's pledge to scrap the Health and Social Care Act, but also said that Labour would make public providers 'preferred bidders' for NHS contracts! This is far from reversing privatisation or removing the impact of the Tory Act. Being 'preferred bidder' does not guarantee winning a contract, especially if the cheapest service wins. Private companies slash costs through cutting corners and attacking workers' pay and conditions, as was seen when non-medical NHS services were privatised, mainly under Blair's Labour government. It would also mean millions of pounds of public money being wasted in the bidding process. Burnham also said a Labour government would 'exempt' the NHS from the Transatlantic Trade and Investment Partnership (TTIP) proposed between the EU and US, which includes watering down workers' rights and compulsory privatisation. What about the rest of our services ? Why not reject it altogether ? The Socialist Party calls for the complete reversal of NHS privatisation.

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RT.com

  • Covert US-EU trade deal could make NHS privatization irreversible – trade unions.

    A group of high-profile trade unions have backed a growing campaign opposed to a new transatlantic trade deal critics claim will make the privatization of Britain’s National Health Service (NHS) irreversible. Three of the UK’s largest unions have tendered motions to the Trade Union Congress (TUC) in Liverpool, outlining their opposition to the cross-border agreement currently being negotiated by EU bureaucrats and US delegates. While the Transatlantic Trade and Investment Partnership (TTIP) is the largest bilateral trade deal ever brokered, it is currently being developed behind closed doors. Critics caution it threatens to culminate in the permanent privatization of NHS services by prioritizing profit-wielding corporate firms over domestic lawmakers. Once finalised, UK union Unite warns the deal would pave the way for US corporations, or any firm affiliated with American investors, to sue the British government if it ever embarked on an effort to place privatized health services back under public ownership. Such legal proceedings would be conducted in a secret court setting, the union says. Once a final agreement is reached, MPs are set to vote on the deal.

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Pharma Times

  • Vast majority of NHS staff say reform had negative impact.

    Only 5% of health professionals in the UK think reforms in the NHS have had a positive impact and many believe that improving patient care comes second to making savings. That is the outcome of a survey from public services polling company Dods. Its analysis is based on replies to an online questionnaire in July by 3,628 health staff who were asked about their experiences of reforms from the Health and Social Care Act 2012, the organisations driving change, and their expectations for the next 12 months. Money is a prime concern with only 2% saying their organisation had sufficient financial resource and 71% disagreeing with the idea that they have enough budgetary support to support their organisation.

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Guardian

  • Labour can only save the NHS by biting the tax bullet.

    Polly Toynbee writes: It hasn’t escaped Labour’s notice that the yes campaign’s recent surge came when Alex Salmond warned that the NHS in Scotland would be in peril from another privatising Cameron government. Scaremongering, said the other side, since health is devolved. But one thing is certain: Scotland’s block grant is a share of whatever the Treasury allocates across Britain, on health and everything else. The outlook for health spending is an almost unimaginable cut over the next five years. That’s why Labour plans to put the NHS centre stage at the election, the symbolic heart of its identity. Polls put Labour well ahead as the most trusted to defend it, while the NHS is Cameron’s achilles heel, after his broken promises. So far, Labour has failed to alert the public to what’s afoot for the NHS, though Treasury plans are open for all to see. Every health thinktank has done its best in recent months to sound the alarm. This isn’t shroud-waving – the figures show the NHS about to go into cardiac arrest. In 15th place, the UK is already low on OECD charts in health spending as a proportion of GDP, lower than in 2009, with even Portugal higher. Yet the plan is to plunge lower – just as the number of people over 80 doubles and the population rises by 3.5 million. The Office for Budget Responsibility figures are the same. The Institute for Fiscal Studies calculates age-adjusted spending on health will fall by 9% per person between 2010 and 2018. For an NHS used to an average 4% increase , a 9% per-capita cut is unthinkable. Look at the charts showing NHS spending falling off a cliff by Anita Charlesworth, as chief economist for the Nuffield Trust, who found the shortfall to be £28bn by 2021. NHS England reckons the sum is £30bn . There is no doubt at all that the NHS either needs more money, or it must cut its services beyond what the public would ever accept. Of course there must always be efficiency savings and rationalised hospitals, though integration is now harder: Bournemouth and Poole hospitals were banned by competition law from a sensible merger. Combining health and social care under one budget is essential, but it’s not a cheap answer: Kate Barker’s King’s Fund commission last week said it would cost £5bn a year. Raising tax while running a “cost of living” campaign looks contradictory, and last week came a foretaste of what’s to come. Lagging on economic credibility, a promise to raise tax for the NHS would show Labour can take tough and unpopular decisions.

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Tuesday 9th September 2014

Pulse

  • Practice set to close as GP says he was 'forced to retire'.

    A practice in the north of England is set to close after a partner claims he was ‘forced to retire’ by NHS managers, despite patients launching a campaign to keep the practice open. The Cauvery Medical Practice in Scunthorpe will close on 31 October after its two GPs retired following a performance review of the practice by NHS England. One of the GPs, Dr Shambhu, told the Scunthope Telegraph that he was ‘forced to retire’ and that he wanted to carry on practicing without being under scrutiny. Following the resignation in July of Dr Shambhu and Dr Ratna Ugargol opting to leave next month, NHS England wrote a letter to patients informing them that the practice will be closing – leaving 3,700 patients without a GP. Dr Shambhu told the Scunthope Telegraph: ‘I did not elect to retire, I was forced to retire. I want the people of Scunthorpe and my patients to know the truth. I was going to go in April 2016, and by that time, I would reach 70.’ In August, Unison’s Scunthorpe Health Branch launched a campaign to prevent the closure of the practice. Julian Corlett, a patient of the practice and leader of the campaign, said NHS England made ‘no steps to engage with patients.’ The impending practice closures come as Pulse has launched its Stop Practice Closures campaign, which among other areas seeks to highlight the problems caused when practices are allowed to close.

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getwestlondon

  • 15,000 campaign against NHS 'sell-off' in Trafalagar Square.

    Save Our Hospital campaigners performed a 'die-in' in Hammersmith's Lyric Square before joining 15,000 others at a rally in Trafalgar Square, including Billy Bragg and Bill Bailey. They staged a ‘die-in’ to raise awareness of the borough’s threatened hospitals, just days before Hammersmith and also Central Middlesex Hospitals’ A& E is to be shut down as part of the NHS’s Shaping a Healthier Future programme. The Save Our Hospitals campaigners then hopped on a bus to join thousands of people in Trafalgar Square who believe the coalition government is ‘selling-off’ the NHS. Hammersmith MP Andy Slaughter spoke to the massive crowd which included Shadow London Minister, Sadiq Khan, Hounslow MP Seema Malhotra and a group of mothers from County Durham called the Darlo Mums who completed the last leg of a 300-mile march hoping to ‘save the NHS’. The rally comes a month after Imperial College Healthcare NHS Trust gave the green light to sell 55% of Charing Cross Hospital , move out integral services, sell 45% of St Mary’s Hospital, Paddington and the entire Western Eye Hospital in Marylebone. It is also just over two and a half weeks since getwestlondon revealed the trust needs £400 million more , after the hospital sales, to redevelop.

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Health Investor

  • NHS England to axe a quarter of senior roles.

    Up to 75 senior positions in NHS England could be cut within six months to cope with cost reductions, the body’s chief executive Simon Stevens has announced. This is out of 300 staff who are currently employed in high-end clinical or managerial positions. Stevens admitted that the prospective downsizing was “principally driven by the running cost cuts we are facing”. As part of this “streamlining for all directorates”, NHS England’s teams could be reorganised into single tiers. This single tier system has already been introduced in London which, Stevens said, “[had] proposed new ways of securing transformation and forward delivery”. A 45-day consultation period shall follow the announcement, with a final decision on the potential cuts expected this November.

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Nottingham Post

  • Lilian Greenwood: NHS is being dismantled before our eyes.

    We entrust ourselves to the care of our National Health Service at some of the most vulnerable, poignant and important moments in our lives. That's why I was proud to join the People's March for the NHS on the Nottingham leg of its 300-mile journey to Downing Street, led by a small group of Darlington mums with a simple message: "Hands off our NHS!" It's a message the Government needs to hear because, by opening our NHS up to market forces, they are undermining a national institution. Patients are finding it harder to see their GP, waiting over four hours in A& E and waiting longer for hospital treatment. Ambulance response times are rising and there are fewer frontline staff. Why ? Because David Cameron broke his pre-election promise to health workers and forced through an unnecessary top-down reorganisation, wasting £3 billion that could and should have been used to improve patient care. The Government says privatisation will make things more efficient, but people in Nottingham are seeing the real impact. My 84-year-old constituent Jean needs four hours of dialysis three times a week. Since a private company took over patient transport, she's been late for appointments and waited for hours to be taken home. Such poor service has a knock-on impact on other patients: our city's hospitals and the clinical commissioning group tell me that Jean's experience is typical of feedback. That's not the NHS I want for me, my family or for Nottingham. That's why I support Labour's promise to repeal the Health and Social Care Act and halt David Cameron's deeply damaging privatisation of the NHS.

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Practice Business

  • Small Private Hospitals a Burden to GP Practices.

    A senior GPC figure has warned that small private hospitals are placing intolerable burdens on practices and raising patient safety concerns by relying on local GPs to provide primary medical services to inpatients. According to GP Online, profit-making hospitals treating NHS patients are registering inpatients with local practices and expecting GPs to deliver care they should provide themselves, according to the chairman of the GPC’s contracts and regulations sub-committee Dr Robert Morley. Dr Morley said the problem was widespread across the country. The GPC is in talks with NHS England to review national guidance that makes practices responsible for providing this care. Birmingham LMC, where Dr Morley is secretary, recently secured agreement with the NHS England area team that GP practices would no longer be responsible for providing primary medical service to inpatients at an independent hospital. Dr Morley told GP Online the hospital in question provides very complex treatment with ‘minimal consultant input and no junior doctor input whatsoever’. “They are expecting general practices to provide not just GP care but basically to do the job of houseman,” he said. Practices had been put in ‘an impossible position’, expected by the hospital to provide ‘virtually all medical care’ to seriously ill patients with complex needs. An agreement between the LMC, practices, the area team and CCG means the hospital will now take full medical responsibility for its patients. Dr Morley said the issue affected not just psychiatric hospitals but all types of private hospital, and potentially any acute provider.

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Thursday 4th September 2014

Ekklesia

  • 'Save Our NHS' banner hung from Westminster Bridge.

    Opponents of National Health Service privatisation have hung a banner from Westminster Bridge in central London reading 'Save Our NHS'. Members of NHS Direct Action dropped the banner from the bridge, which is next to Parliament, at 8am on the day parliament re-opens after the summer break. They are protesting against what they describe as the “rapid dismantling, privatisation and destruction of the NHS”. They say the action was taken in solidarity with the “999 March”, a group of people walking from Jarrow to London. It also marks the 75th anniversary of the UK's entry into the second world war, the aftermath of which was the context for the creation of the NHS. The activists this morning pointed out that the post-war government faced a much larger budgetary deficit than exists in the UK. Critics point out that the Health and Social Care Act 2012 continues to allow private companies to buy up more and more of the health service. With the general election coming up in May, NHS Direct Action are calling upon the parties to make a stand for the NHS.

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BBC News

  • Norfolk and Suffolk mental health bed cuts criticised.

    A campaign group has criticised plans to cut 20 Norfolk and Suffolk mental health beds and a suite to assess people who may need to be detained. The local clinical commissioning group (CCG) plans are being scrutinised by Norfolk county councillors. The Campaign to Save Mental Health Services in Suffolk and Norfolk said the beds and the suite in Carlton Court in Lowestoft were vital to keep. The CCG said more care would be provided in the community.

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Ludlow Advertiser

  • Private sector to provide non-emergency ambulance service.

    Privately operated ambulances will in future take patients from Ludlow and south Shropshire to non-emergency medical appointments. Medical Services Ltd has been appointed to provide the service to non-emergency patients from November. They will take eligible patients attending appointments at the main hospitals and other NHS healthcare providers across Shropshire and surrounding areas. The service will use ambulances and a range of other vehicles.

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Financial Times

  • NHS hospitals struggle to lure private patients.

    The sums earned by the National Health Service from treating private patients have barely risen even though most foundation trust hospitals are struggling to make ends meet amid a historic budget squeeze. Rules introduced last year allowed a far higher percentage of turnover to be raised from non-NHS work, leading to warnings by critics of health service “privatisation”. But research by the Foundation Trust Network, based on an analysis of hospital accounts, suggests some parts of the sector are finding it far easier than others to earn money in this way. Big, specialist hospitals such as Moorfields Eye Hospital and the Royal Marsden can use their equipment, expertise and internationally known brands to attract private patients and pursue cash-generating research. Although district general hospitals have also entered into the non-NHS market, they must bear the costs of running a full range of services, including maternity and accident and emergency, for their local communities, making it harder for some to compete with independent providers able to focus on single specialities such as orthopaedics.

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Tuesday 2nd September 2014

Open Democracy

  • Why do private hospitals want to hide their patient safety records?

    In February 1999 Mrs Laura Touche, the wife of an American lawyer in London, died of a brain haemorrhage after giving birth to twins by caesarean section at the private Portland Hospital in London, the favoured choice for maternity care of the Royal Family and many celebrities. It emerged that unlike NHS hospitals, the Portland had no protocol requiring patients’ vital signs to be checked at frequent specified intervals following a delivery. Although complaining of a headache Mrs Touche was not checked for two and a half hours, by which time it was too late. In the UK maternal deaths directly due to pregnancy are extremely rare – around five in 100,000 live births. A coroner’s jury found that neglect had contributed to Laura Touche’s death. Her husband Peter Touche said the facts disclosed at the inquest had convinced him that his wife’s death was ‘completely avoidable’. He added: ‘This all took place in a private hospital at the end of the 20th century. I understand that the Government is now contracting out NHS operations to the private sector. The NHS is opening up and publishing statistics. So should the private sector. The irony is that often, as in Laura's case, a patient is transferred to an NHS bed and so the death is registered at the NHS hospital.’ And it is not just deaths that are a cause of concern. Serious incidents short of death can be devastating too. For example over the past year no fewer than three patients at one private hospital in Southend had the wrong joints replaced – ‘never events’, in NHS parlance. The key lesson from all such cases was actually drawn in 2002 by George Osborne, then a backbench MP. Referring to the Touche tragedy he moved a private members’ Bill ‘to require private hospitals to publish independently audited information on clinical performance and on complaints from patients on the same basis as that required of NHS hospitals. But as a new report by the Centre for Health and the Public Interest points out, this information is still not available. Sir Robert Francis reporting on Mid Staffs, Sir Bruce Keogh reporting on 14 NHS trusts, the American Don Berwick reporting on the safety of NHS patients in general, and more recently Jeremy Hunt, all stress the importance of openness. But what George Osborne called ‘an endemic culture of secrecy in many private hospitals’ persists. This makes informed choice impossible, even for private patients. There is a separate Private Hospital Information Network website. But it compares private hospitals only with each other, and for most indicators does not provide the data on which the comparisons are based. And having informed choice is only one reason for transparency. Even more crucial is that only full information allows risks to patients to be identified, trends to be analysed and lessons to be learned so that mistakes are not repeated. Yet the Care Quality Commission acknowledges that it has comparatively little information on private hospitals. Given that the taxpayer is now the second largest source of funding for the private hospital sector and that this has, according to the Competition and Markets Authority, sheltered private hospitals from the economic downturn, there is no good reason why they should not be subject to the same reporting requirements on patient safety as NHS hospitals.

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  • Brand new NHS Reinstatement Bill from Allyson Pollock gives hope to campaigners.

    Leading public health experts have launched a consultation on a new Bill that aims to reverse the failings of the Health and Social Care Act 2012 and fully restore the National Health Service (NHS) in England as an accountable public service. The NHS Reinstatement Bill proposes to abolish competition and the purchaser-provider split, re-establish public bodies and public accountability, and restrict the role of commercial companies. It draws on some of the best examples of NHS administration over its history, retains some features of the reforms laid out in the Health and Social Care Act 2012, and would be implemented on a timescale determined by the secretary of state. The Bill would reinstate the government’s legal duty to provide the NHS in England re-establish district health authorities in England as a special health authority with regional committees and modified functions re-establish district health authorities (coterminous with local authorities), with family health services committees to administer arrangements with GPs, dentists, and others abolish competition and marketised bodies such as NHS trusts, NHS foundation trusts, and clinical commissioning groups, as well as Monitor, the regulator of NHS foundation trusts and commercial companies
    end virtually all commissioning and allow commercial companies to provide services only if the NHS could not do so and otherwise patients would suffer re-establish community health councils to represent the interest of the public in the NHS
    prohibit ratification of the Transatlantic Trade and Investment Partnership and other international treaties without the approval of Parliament (and the devolved bodies) if they would cover the NHS. This Bill is a vital public health measure. It will both restore the NHS in England and reverse more than two decades of policies which have been intent upon privatising NHS services and funding, ultimately to its demise. As the failures of the 2012 Act become daily ever more obvious, this Bill provides a template for very necessary reinstatement and reform. The Bill has been drafted by barrister Peter Roderick with the assistance of Prof Allyson Pollock. They have benefitted from discussions with individuals and organisations concerned about the increasing role of the market in the NHS in England over the last 25 years. They wish to consult on the Bill with those who share their concern and our commitment to reinstating fully the NHS as an accountable public service as smoothly as possible and with only a minimal and exceptional role for commercial companies.

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Independent

  • TTIP trade agreement: Critics driven ‘by anti-American sentiment’ says minister Lord Livingston.

    The minister in charge of leading Britain’s negotiations in the giant and controversial “TTIP” trade agreement between the US and Europe, said critics were misguided and possibly driven by antipathy towards America. The Trade minister Lord Livingston was speaking after another round of almost weekly protests against the Transatlantic Trade and Investment Partnership talks, which unions and non-governmental organisations (NGOs) such as War on Want claim will weaken hard-fought legislation to protect consumers and workers, and jeopardise the National Health Service.

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BBC News

  • Ambulance boss Anthony Marsh claimed £30,000 expenses.

    The £232,000-a-year chief executive of two health trusts claimed up to £30,000 in hotel and transport expenses over the past 16 months, it has emerged. The BBC has obtained records of 92 hotel stays by West Midlands and East of England ambulance services chief Anthony Marsh. They included 20 nights at a four-star hotel that cost the taxpayer £4,514.Mr Marsh, chief executive of the West Midlands Ambulance Service (WMAS), took on the part-time role as head of the troubled East of England Ambulance Service (EEAS) in January this year.

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Daily Telegraph

  • Safety of private hospitals questioned as report reveals hundreds die unexpectedly.

    Patients in Britain's private hospitals may be put at unnecessary risk and the NHS is left to pick up the pieces, a report has warned, as 800 people died unexpectedly and a further 921 suffered serious injury following private medical treatment. Private hospitals rarely have intensive care beds, dedicated resuscitation teams and the surgeons and anaesthetists often work in isolation, the report by a think tank said. When things go wrong in private hospitals, patients are often transferred to the NHS to pick up the pieces, it was warned, with 2,600 patients transferred as emergencies and 6,000 patients moved in total in 2012/ 13. It is not known how much this costs the taxpayer, the report said.
    The Centre for Health and the Public Interest cited examples where an anaesthetist covered two operating theatre lists simultaneously, risking the lives of both sets of patients and a surgeon operated in an unsuitable setting because the main operating theatre was not available, putting a patient at serious risk. The report said that a lack of data available from private hospitals makes it difficult for patients to judge the safety of their care. This is despite many private hospitals treating NHS patients, funded by the taxpayer. The CHPI obtained from the regulator, the Care Quality Commission, under the Freedom of Information Act figures on patient safety relating to private hospitals. It was found that 802 people died unexpectedly and a further 921 suffered serious injuries in England in the last four years. It was not possible to determine if these cases could have been avoided, the report said, but private hospitals tended to carry out relatively low risk procedures in which complications should be rare.

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Monday 1st September 2014

International Business times

  • TTIP: UK Government Not Trusted to Protect NHS from American Investors.

    Despite government claims that public services will be protected from the EU's free trade agreement with the US, 42% of British people don't trust them to protect the NHS from privatisation. A new survey, conducted by YouGov on behalf of 38 Degrees, found that a further 39% think the controversial Transatlantic Trade and Investment Partnership (TTIP) "would be bad for the UK", with just 13% saying it would have a positive effect. When asked specifically about the NHS, 24% said their trust in the government to shield the NHS from privatisation has fallen over the course of a year, with just 4% saying it has risen. Supporters of TTIP claim it will create jobs and wealth on both sides of the Atlantic. However, protestors have said it will simply place more power in the hands of the corporate sector. Many fear that the NHS and other public services will be sold off to US investors and that if the NHS is not open to investors, they may be able to sue the government, using the investor-state dispute settlement (ISDS) clause which could be included in the free trade agreement. At the moment, ISDS is off the agenda, after the EU Trade Commissioner Karel De Gucht temporarily removed it in January, pending the results of a public consultation, which are currently being analysed. However, he has since told this publication that he wishes the clause to return to the discussions, despite senior figures in global trade questioning its necessity. The government told IBTimes UK earlier in August that the NHS is not an area that is up for discussion during TTIP negotiations. A Department of Health spokesperson said: "We have no intention of allowing the TTIP to dictate the opening up of NHS services to further competition; and it will not do so. The NHS will always be free at the point of use for everyone who needs it."

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Stv News

  • Scottish independence 'would defend a public NHS' says academic.

    Scottish independence is the clearest way to defend and promote the principles of a public NHS, according to a London-based health expert. Allyson Pollock, professor of public health research and policy at Queen Mary University of London, said the UK Government has "abolished the NHS in England as a universal service". Although health is devolved to Scotland, any reductions in funding in England will lead to reductions in Scotland's block grant, Professor Pollock said. "In the absence of any reversal of neoliberal policies in England, the clearest way to defend and promote the principle of a public NHS is to vote for Scotland to have full powers and responsibilities of an independent country," she told the Sunday Herald. "Although people find this extraordinary and can't believe it, the Health and Social Care Act of 2012 has abolished the NHS in England as a universal service. The NHS is reduced to a funding stream and a logo; increasingly all the services are going to be contracted in the marketplace. It abolished the duty on the Secretary of State for Health to secure and provide comprehensive healthcare; that is a duty that still holds in Scotland, but doesn't hold in England. If the basis for a national health service has changed so markedly in England - if there is no duty to secure and provide universal healthcare - then what will happen is (public) funding can be withdrawn, and private funding will take its place. If you are closing services and reducing them, people only have two choices - to go without care or pay privately."

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The Guardian

  • NHS patients have cataract operations reviewed after private treatment.

    Nineteen NHS patients have had the outcome of their cataract surgery reviewed after at least two had problems with their eyes following operations at a private hospital. The private provider concerned has offered its "sincere apologies to all patients that suffered complications" from their operations – an incident that will intensify the political debate over outsourcing NHS services. The problems arising from a new contract between NHS and private hospitals in south Devon came just weeks after it emerged that dozens of people who underwent similar procedures at a private provider in Somerset in May had suffered complications following their operations. Although the hospital and private company involved this time are different, the incident involving operations at Mount Stuart hospital in Torquay, part of Ramsay Health Care, will reignite debate about the increasing use of private companies in the state health service. The problems emerged on the first day of operations conducted under a contract to perform cataracts between the NHS's South Devon Healthcare Foundation trust, which runs Torbay hospital, and Mount Stuart. No further patients will be referred for such surgery while investigations continue into what happened on 26 July, when 19 NHS patients, including four who went via the NHS's 'choose and book' system, underwent operations. No patients have yet required further corrective surgery but most cases are still being reviewed. Some involved in the initial follow-up appear to have recovered normally, according to the trust, which has had a relationship with Mount Stuart for 10 years. Over the past year some patients needing orthopaedic, urology or general surgery have had their operations at Mount Stuart. There is no easy way of comparing healthcare outcomes between the NHS's own surgery and treatments and those that are contracted out. Neither the Department of Health nor NHS bodies with national remits collect comparative statistics. Earlier this month, it was revealed a contract between Musgrove Park hospital, Taunton, and Vanguard Healthcare involving cataract operations had been terminated four days after half the 60 patients who had undergone the surgery had suffered complications. Cataract surgery is often regarded as one of the most routine procedures.

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The Pulse

  • Patients should be aware of risks of private hospitals, says think-tank.

    Patients should be made aware of the ‘different’ risks of having surgery in small private hospitals compared to larger NHS ones, a think tank has warned. There were over 800 unexpected deaths and 900 serious injuries across England’s 465 private hospitals in the last four years, according to a report by the Centre for Health and Public Interest (CHPI) which studied available statistics, FOI responses and CQC inspection reports. However the reporting requirements for patient safety incidents were far less stringent than for NHS hospitals, including on mortality data, it said. According to the report, private hospitals often lack intensive-care facilities, equipment and medical support for when complications arise during surgery. The authors also warned that poor keeping of medical records was a recurring theme in CQC reports on private hospitals, including consultants often keeping records off-site. The CHPI has recommended that private hospitals become subject to new requirements, including full reporting of patient safety incidents and releasing information under the Freedom of Information Act ‘in respect of anything related to the treatment of NHS patients’. The report said: ‘Private providers should be subject to exactly the same requirements to report patient safety incidents (including mortality data) as NHS trusts and foundation trusts. All of the information should be published in the same way as it is for NHS providers and this should be a requirement of registration with the CQC.’

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HSJ

  • Government 'not trusted' over NHS.

    More than two out of five people do not trust the government to protect the NHS, according to a study. A further one in four said their trust had fallen over the past year, a survey of more than 2,000 adults for campaign group 38 Degrees showed. The research was published ahead of a protest on August 30 against a trade deal being negotiated between the European Union and the United States. Unions and campaign groups claim the deal, the Transatlantic Trade and Investment Partnership, would lead to health services being opened up to competition from US private healthcare providers. Blanche Jones, campaign director of 38 Degrees, said: “It’s no surprise that the public is worried about the fate of their local GPs and hospitals. Our NHS is being used as a bargaining chip in a deal done behind closed doors. “Most of us only need to take one look at American healthcare to know that that isn’t what we want in this country. “That’s why thousands of 38 Degrees members will be taking to the streets this Saturday to spread the word about this new threat to our NHS. This will be a bad deal for ordinary people. Politicians of all parties now need to explain exactly what they’re doing to get it fixed or scrapped.” The government has denied the claims from campaigners, insisting the trade deal would generate new jobs and be a boost for business.

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Friday 29th August 2014

Our NHS

  • Boots loots - what has happened to our friendly high street pharmacist?

    Our friendly high street pharmacists are turning into trojan horses for further NHS privatisation. Britain’s trusted high street chemist hasn’t been feeling well of late - and it’s getting sicker. The brainchild of agricultural worker John Boot in 1849, the Nottingham herbalist store rapidly grew from humble beginnings into the country’s largest chemists’ chain. By revolutionizing access to affordable medicines in the pre-NHS era, Boots became a household name. Since 1948 it has retained its central place in the functioning of the NHS. It is the largest single employer of NHS-trained pharmacists (6700) and pharmacy technicians (2500) outside of the NHS. Pharmacy has long-been held up by the pro-privatisation lobby as an example of how the private sector has in fact been providing NHS services for years, 'playing nicely'. Boots made its name on providing patient care to millions. For 165 years it had what other companies would do almost anything for: the trust of its customers. Repeatedly named as one of the UK’s most trusted brands, Boots symbolised reliability and quality, securing a prominent and enduring position amongst our national retail heritage. But times have changed. In 2006, Boots UK merged with European pharmacy wholesaler Alliance Unichem Plc to become Alliance Boots. And just one year later, the company went private in a £12 billion buyout led by US private equity firm Kohlberg Kravis Roberts (KKR). That’s when the fairytale took a dark twist. KKR is one of the largest private equity firms in the world, ranking with the likes of Goldman Sachs and Bain Capital. KKR and its fellow private equity beasts don’t want to be passive investors, but to take the reins of the business and use their controlling position to restructure the company before ‘flipping’ their assets and selling off at a profit. Now, KKR is selling its remaining stake in Boots to what will now become the biggest pharmacy chain in the world, US-based Walgreens. The complex deal is not likely to undo the damage inflicted by eight years of being one of the largest private equity buyouts in Europe. Walgreens have already said they will make $1billion of efficiency savings - or cuts - as a result of the deal, with no guarantees on protecting pharmacist and other staff numbers. A recent example was its decision by Boots to sell e-cigarettes despite warnings from the Royal Pharmacological Society (RPS) about their risks. The World Health Organization (WHO), British Medical Association (BMA) and the US Food and Drugs Administration (FDA) are all unable to vouch for their safety. But Boots has persisted in the multimillion dollar deal – joining up with Fontem Ventures, a subsidiary of Imperial Tobacco.

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The Guardian

  • Why did Salford Royal NHS foundation trust score more highly for overall staff engagement than any other acute trust in the 2013 NHS staff survey?

    Is it because it has left public ownership and been turned into a mutual ? No, that cannot be the reason, because it hasn’t. So is it because it hasn’t ? If that’s your explanation you might struggle to explain why mid Yorkshire and north Cumbria NHS trusts came joint bottom of that league table. Somewhere around the middle – just below average, in fact – came Hinchingbrooke health care NHS trust, the only one to have been privatised but still presented by government ministers as though it proves that mutualisation works wonders. Let us leave to one side the fact that Circle Health, the company that has run Hinchingbrooke since 2012, is not really a mutual at all, since most of its shares are owned by a hedge fund and only a minority by its staff. More to the point is that its strengths and weaknesses – like those of Salford, mid Yorkshire and north Cumbria – tell us little or nothing in general about the relative merits of public, private or mutual control. What the experience of each can contribute to the debate about how to improve the NHS is in the detail of what they have or have not done to innovate in leadership, staff involvement and governance, and the values that have guided them. No research captures any experience exactly, but the annual NHS staff survey is the best guide we have to trends in staff engagement in the service, and its results matter because they correlate with care outcomes and reported patient experience. Yet Francis Maude appears to have paid it no attention at all before earlier this month, urging NHS trusts to reconstitute as mutuals. Like the government-commissioned King’s Fund report a couple of weeks earlier, which paved the way for Maude’s announcement with a flawed argument, Maude chose not to mention that Hinchingbrooke’s job satisfaction score in the latest NHS staff survey is in the bottom 20% of all trusts.

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BBC News

  • Stafford Hospital protesters vow to stay as long as necessary.

    Campaigners fighting plans to downgrade a Staffordshire hospital have vowed to stay in their protest camp for as long as is necessary. Protesters have already been camped outside Stafford Hospital for six weeks. Karen Howells, from the Support Stafford Hospital group, said: "We are honest people (who) just want our health services for our community." The downgrading was announced following the high profile public inquiry into the failings of the Mid-Staffordshire NHS Trust.

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The Independent

  • Government told to invest in ambulance services as complaints soar.

    Paramedics have called on the Government to urgently invest in ambulance services after new figures revealed complaints about delayed emergency responses have soared in the past year. Demand for ambulance and patient transport services has soared in recent years, and emergency services are increasingly having to leave low-priority patients waiting for hours for a paramedic response. New figures from the Health and Social Care Information Centre show that complaints against ambulance crews increased by more than 28 per cent last year, a sharper rise than for any other medical profession. General complaints about patient transport including ambulances were up by 43 per cent, totalling nearly 10,000 complaints against the ambulance sector in 2013/ 14. The College of Paramedics said that the biggest single cause of complaints was delays. The number of emergency calls to ambulances has increased dramatically in recent years. Despite a small decrease last year, operators still handled 8.5m calls. Martin Berry, executive officer of the College of Paramedics said that he was not surprised by the rise in complaints. “We have seen a massive increase in demand and there has not been the financial investment to meet that increase in demand,” he told The Independent. NHS organisations around the country have had to tighten their budgets in recent years in the wake of the biggest squeeze in Government spending on the NHS in recent times. Increasing demand from a growing and ageing population has seen calls to emergency services rise quicker than the health sector is recruiting the paramedics required to respond on time.

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Independent

  • Overcharging by outsourcing giant Serco costs NHS millions.

    Outsourcing giant Serco is embroiled in a fresh misuse of public funds scandal after a company it set up overcharged NHS hospitals millions of pounds, The Independent can reveal. Internal documents leaked to Corporate Watch indicate Britain’s biggest pathology services provider, which was established by Serco in partnership with Guy’s and St Thomas’ hospitals, overcharged the NHS for diagnostic tests. The venture - first called GSTS and now trading under the name Viapath - has also been dogged by allegations of cost-cutting and clinical failings. Internal documents show increasing concern amongst senior consultants who claimed that staff cuts and a lack of investment since privatisation left some laboratories close to disaster. In internal emails clinicians said the company had an “inherent inability… to understand that you cannot cut corners and put cost saving above quality.” The trust and Viapath say the problems have now been resolved. But this only happened after the intervention of senior medical staff and changes to the structure of the joint venture that reduced Serco’s role. A 2013 internal audit by the trust into three of the 15 laboratories run by Viapath found its invoicing and billing systems were “unreliable” and contained “material inaccuracies”, amounting to an overcharge of £283,561 over a sample three month period. The auditors found invoices included double-counting of tests charged to the hospitals, with both samples and patients included in bills, and that the Trust had been “indirectly providing a free pathology service” to other NHS bodies by being billed for outside work done. They estimated this could represent approximately £1 million in 2012 alone. But The Independent has also seen documents highlighting concerns raised by senior NHS managers over the accuracy of billing from other laboratories. One department raised a dispute over £1 million in 2011 due to what they said were errors including the suggestion that two different labs were charged for the same tests. Margaret Hodge, chair of the Public Accounts Committee said: “After a series of high profile failures, Government claims it has a grip on contracts with private companies to deliver our public services. Clearly it hasn’t. This is not just about ripping off the taxpayer, but about a failure to provide acceptable quality in a service that is vital for diagnosing what it many cases are serious or even life-threatening illnesses.

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HSJ

  • Circle's Hinchingbrooke contract losses approach £5m limit.

    The losses built up by Hinchingbrooke Health Care Trust in its first two years under private management are just £150,000 short of the £5m ceiling at which the contract could be terminated. According to the half yearly report of Circle - the firm contracted to run the hospital - it made £4.85m in “cumulative support payments” to the trust since the contract started in February 2012. This represents an almost 40 per cent increase on the accumulated loss for 2012-13 of £3.5m. Under its 10 year contract with Hinchingbrooke, the firm has agreed to pay any deficit at the trust - in the form of support payments - up to a cumulative total of £5m. After this point “both parties must agree the basis for the continuation for the franchise”, today’s report said. Although either Circle or the trust could then terminate the deal, this would require Circle to pay Hinchingbrooke a £2m fee. Circle’s report admitted to “uncertainty over Hinchingbrooke’s profitability over the next year”, raising the possibility that the limit could be broken this year.

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Thursday 28th August 2014

GP Online

  • NHS England criticised for 'opaque' decisions over practice closures.

    A health watchdog has criticised NHS England for how it conducted a public consultation on the future of three practices facing closure in London, saying it failed to notify some patients and gave out contradictory information. HealthWatch Central West London (CWL) said it was 'most disappointed' by the way local commissioners carried out the consultation after an NHS trust said it was handing back two GP contracts. NHS England has disputed some of the accusations. Central London Community Healthcare NHS Trust (CLCH) said in July it no longer wished to run Soho Square and Milne House practices after losing half a million pounds on the services last year. The trust gave notice to NHS England and will stop providing the services from 30 September. NHS England said either the practices would be closed and patients dispersed, or the services reprocured. A third local single-handed practice, West Two Health, is also closing following the GP’s retirement and was also being consulted on.

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Derby Telegraph

  • Derbyshire campaigners join People's March to support NHS.

    Placards were waved and songs were sung as campaigners from across Derbyshire joined a national 300-mile march to protest against the privatisation of health services. The People's March reached the north of the county and made its way through Derbyshire yesterday on the way to Mansfield. It started from Jarrow, in Tyne and Wear, earlier this month and is following the route of the 1936 Jarrow Crusade – a protest march against unemployment – to London. Marchers taking part are protesting against what they call the "rapid privatisation of health services under the Health and Social Care Act of 2012".

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Daily Telegraph

  • Sick could be monitored by video as NHS looks to US.

    Critically ill NHS patients could be monitored by video link under plans to learn from models of care used in the United States. Hospital watchdogs have announced plans to examine the way care is delivered in other countries, including the US, France, Germany and Canada, and recommend changes which the health service could introduce. Monitor, the regulator for NHS foundation hospitals, said its experts will examine systems used by other countries, including the use of “remote intensive care units” which are common in the United States.

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Nottingham Post

  • NHS: Debate rages over the future of health care.

    The future of the National Health Service is set to be one of the key political battles as the country heads towards a general election next year. Campaigners arriving in Nottingham today say the future of the service is threatened by creeping privatisation. But with costs rising each year, governments face an increasingly tough task to fund the health service. Last year, the King's Fund – an independent think-tank – produced a report suggesting health spending would take up around a fifth of the total wealth of the United Kingdom within 50 years, if current trends continued. The debate centres on how much money is needed to fund the NHS, how it is spent, and whether further introduction of private companies can deliver better value. The Department of Health says that nearly £9.5billion is already handed out to external contractors, and this is likely to increase under a Conservative government. Tory Mark Spencer, MP for Sherwood, said: "It's simple to me. If you need a blood test and your GP says it costs the NHS £100 but a private clinic can do that for £60, then as long as it does not cost you any money, it seems sensible to use a private company to deliver. What really matters to people is that when you are poorly, you are given a high level of quality care that does not cost you anything, as you already pay in tax." But Labour's Chris Leslie, MP for Nottingham East, claims the result of increased privatisation would be a two-tier service where those with money got better care. The People's March for the NHS, which is travelling across the country, will arrive in Nottingham. More than 500 campaigners are expected, claiming the NHS is under-funded and in danger of being broken up. Organiser Rehana Azam said: "Politicians can't just kill off our NHS. We won't take it lying down.We want them to pause, listen and stay true to the values of the NHS – access to all and free at the point of delivery."

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Independent

  • Overcharging by outsourcing giant Serco costs NHS millions.

    Outsourcing giant Serco is embroiled in a fresh misuse of public funds scandal after a company it set up overcharged NHS hospitals millions of pounds. Internal documents leaked to Corporate Watch indicate Britain’s biggest pathology services provider, which was established by Serco in partnership with Guy’s and St Thomas’ hospitals, overcharged the NHS for diagnostic tests. The venture - first called GSTS and now trading under the name Viapath - has also been dogged by allegations of cost-cutting and clinical failings. Internal documents show increasing concern amongst senior consultants who claimed that staff cuts and a lack of investment since privatisation left some laboratories close to disaster. In internal emails clinicians said the company had an “inherent inability… to understand that you cannot cut corners and put cost saving above quality.” The trust and Viapath say the problems have now been resolved. But this only happened after the intervention of senior medical staff and changes to the structure of the joint venture that reduced Serco’s role. A 2013 internal audit by the trust into three of the 15 laboratories run by Viapath found its invoicing and billing systems were “unreliable” and contained “material inaccuracies”, amounting to an overcharge of £283,561 over a sample three month period. The auditors found invoices included double-counting of tests charged to the hospitals, with both samples and patients included in bills, and that the Trust had been “indirectly providing a free pathology service” to other NHS bodies by being billed for outside work done. They estimated this could represent approximately £1 million in 2012 alone. The full scale of the over-charging is not known because a full audit has never been conducted. But the Independent has also seen documents highlighting concerns raised by senior NHS managers over the accuracy of billing from other laboratories. One department raised a dispute over £1 million in 2011 due to what they said were errors including the suggestion that two different labs were charged for the same tests. Senior consultants have raised concerns over the effects of the “financial squeeze” by Viapath on some Guy's and St Thomas' labs. The review accused Viapath of ignoring consultants' concerns, “inadequate” investment and haemorrhaging experienced staff by introducing “a large pay cut with no improvement in working conditions”. It claimed disaster was avoided “only just” in 2013, and that the rate of “near miss 'never' events has climbed dramatically”, with new chemistry analysers brought in by Viapath apparently unable to read barcodes on a quarter of specimens and too slow to cope with peak demand compounding staff shortages. The service previously came under fire after it emerged that more than 400 clinical “incidents” had happened with its tests in 2011 – including losing or mislabelling patients’ blood and cell samples.

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Hartlepool Mail

  • Councillors speak out against proposals to close three Hartlepool GP surgeries.

    Councillors have spoken out against proposals which threaten the future of three GP surgeries in Hartlepool. The Mail reported on a backlash to NHS plans to close Hartfields Medical Practice and merge Fens and Wynyard Road surgeries with the likely loss of one. Councillors for the wards where the three surgeries are located have hit out at the plans. They say the proposals go against pledges by health leaders to provide services in the community. NHS England says the contracts provided by the three surgeries have not secured the patients expected in five years and are not cost effective in the long term. Hartlepool Borough Council’s audit and governance committee will discuss the outcome of the review on Friday, October 10, when it will come up with a formal response to the proposals.

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Bournemouth Echo

  • Councillors label E-zec transport service “diabolical” and a “gargantuan failure” after damming report.

    The transfer of a patient transport service to a private company has come under a stinging attack from councillors who have labelled the process ‘diabolical’ and a ‘gargantuan failure’. Patients due to visit hospitals for vital procedures like chemotherapy and dialysis were not picked up or arrived late for treatments after a catalogue of errors in the transfer of Dorset’s non-emergency transport service, a committee of councillors has been told. And E-zec Medical’s operations have also been slated in a report by the Care Quality Commission (CQC). The company was told it needs to improve in four out of five areas examined. After Primary Care Trusts were dissolved, the Dorset Clinical Commissioning Group (CCG) took responsibility for a single non-emergency patient transport service for Dorset. Deputy director at Dorset CCG Margaret Allen told a meeting of the Dorset health scrutiny committee that E-zec Medical was awarded the contract and the service officially went live on October 1, 2013 – six months later than planned. Mrs Allen said issues included problems with patient data transfer while for the first four weeks, E-zec received around 1,600 calls a day, compared with the expected 470. The results saw patients picked up late while some were not picked up at all. Mrs Allen said the CCG had pumped extra funds into the service on a short-term basis.

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Tuesday 26th August 2014

Practice Business

  • Care Bosses Share GP Axe Fears.

    Care managers of a Hartlepool retirement complex have spoken of their fears of a proposal to close its on-site GP surgery. The Joseph Rowntree Housing Trust, which runs Hartfields retirement village, says the loss of its medical practice, would have a detrimental effect on its residents. NHS England is conducting a review of the GP contract provided at the practice, and is recommending its closure, with over 2,000 patients having to find other practices. The NHS says the practice has not reached the level of patients in five years under the Alternative Provider Medical Services (APMS) contract. Fens Medical Practice and Wynyard Road Primary Care Centre, are also under review. The NHS is proposing to merge them with fears by Fens residents’ that their smaller surgery will close. The Fens Residents’ Association is spearheading a campaign to save it by encouraging patients to take part in the consultation.

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Monday 25th August 2014

Pulse

  • Dr Naomi Beer: ‘We cannot let practices be forced to close'.

    While the concession is not exactly what Dr Beer was fighting for – her campaign specifically calls for a long-term funding solution and not a ‘sticking plaster’ – this represents an undeniable victory for GPs and patients in Tower Hamlets. Dr Beer particularly believes it sends a message to those disheartened GPs who argued when Pulse launched its Stop Practice Closures campaign last month that ‘we should let practices close’ to make the Government learn the hard way how their policies affect their voters. ‘GPs have been backed against the wall and are angry at the position we have all been put in and the way we have been treated. I can understand some people saying, out of desperation, that isn’t it better that some practices fail,’ she says. ‘But I would argue so strongly against that because the practices that initially are going to be affected are serving very vulnerable populations. ‘If you let those practices go you cannot replace the level of care that we are giving and that means that you are condemning a whole group of the population to having a lesser standard of care than they are receiving at the moment. I think that is totally irresponsible and we cannot let it happen.’ With admirable calm, Dr Beer explains how she and her practice manager had to move quickly when they discovered in March – three weeks before she was due to sign her new contract – that the practice would be forced to close within a year on its current level of funding.

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Hospital Doctor

  • HCSA to ballot doctor membership on industrial action over pay.

    HCSA members have said they are prepared to take industrial action over the government’s rejection of the pay review body’s recommendations on pay. The HCSA has been consulting with doctors working for the NHS in England for the past three weeks. The consultation, which closed on Monday 18 August, asked if HCSA members would be prepared to take industrial action. Just under 40% of the HCSA membership in England responded to the survey with nearly 80% of members voting ‘yes’ they would be prepared to take some form of industrial action Members were asked two questions, firstly if they would be in favour of taking strike action, secondly if they would be in favour of taking action short of strike action. The response to both questions was clear, over 52% of those voting ‘yes’ said they would be willing to take strike action and over 68% of those voting ‘yes’ said they would be willing to take action short of strike action. The HCSA executive held an extraordinary meeting last week and agreed to progress to a formal ballot on industrial action. The consultation on pay came after the government rejected the recommendation of the independent Doctors and Dentists Review Body (DDRB) to award NHS medical staff a 1% consolidated increase. The DDRB said when it made its recommendation that this was affordable for the NHS and the government. The government instead awarded a 1% non-consolidated payment for 12 months, but only to those on the top of their pay scale.

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The Guardian

  • NHS patient groups warn more doctor assistants may be 'healthcare on cheap'.

    The government is launching a recruitment drive to hire more doctors' assistants to try to help take pressure off a straining NHS under plans announced on Thursday. The physician associates will have two years of intensive training instead of the seven completed by doctors, and will provide support in the diagnosis and management of patients in hospitals. But patients' groups have warned that it could result in healthcare being provided "on the cheap" and that patients would not be able to tell the difference between who was a doctor and who was not. Jeremy Hunt, the health secretary, said: "The NHS is treating record numbers of people. That's why we are growing the workforce further with a new class of medic so busy doctors have more time to care for patients. The British Medical Association warned that the new posts could not replace doctors. The chairman of the BMA council, Mark Porter said that although the concept could be useful if done properly, the government needed to be clear about its limits, the Times reported. "Only doctors can provide certain types of care, so the government needs to ensure that standards won't be affected by these changes and the quality of patient care will be protected," he said. Katherine Murphy, the chief executive of the Patients Association, told the newspaper: "We are concerned that, as physician assistants are cheaper to recruit and pay, hospitals managers may become reliant upon them to bring up staff numbers on their wards. We have previously expressed our concern about the use of healthcare assistants in place of registered nurses, and it would appear that the medical profession is now heading down a similar path."

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The Independent

  • New patient privacy threat at sexual health clinics.

    Patients will be put off visiting sexual health clinics, leading to a rise in sexually transmitted infections, if the Government removes legal safeguards in a controversial shake-up of privacy laws, medical charities say. Strict confidentiality regulations are being dropped because the NHS organisations they apply to were abolished in the Government's controversial health reforms. Historically known as venereal disease regulations, or VD regs, the measures require that information shared at a sexual health clinic is stored within the clinics' own medical records only, and not shared with the wider NHS, or even within the same hospital, without the patient's consent. Although the Department of Health is still consulting on what laws or regulations might replace the old VD regs, leading sexual health charities say they are concerned that assurances given over legal protection are weak. If it is decided that information from clinics can be shared without consent throughout the NHS, patients will be put off visiting clinics or talking about intimate details of their sex life, the charities warn. Yusef Azad, director of policy and campaigns at the National Aids Trust, said there was a real risk, if the regulations were not updated with full legal force, that STI rates could go up as a result. "People don't want their local hospital A& E to know they got gonorrhoea on holiday last year," he said. "Or their family doctor to know about their recent fling. If people are deterred from going to sexual health clinics that would mean less testing, less diagnosis, less treatment, more STIs spreading, with serious implications for our health."

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The Telegraph

  • 'Superior’ private health is a myth.

    In recent years, a series of tragedies has focused attention on the NHS and patient safety. Quite rightly, the public believes that the NHS must take responsibility for its failings so that scandals, such as that in Mid Staffs, can never happen again. But until recently the private health-care sector has managed to avoid significant scrutiny. However, following a freedom of information request to the Care Quality Commission, figures released last week showed that there were more than 800 unexpected deaths and nearly 1,000 people injured in private hospitals over a four-year period. Given the relatively small amount of patients treated within the private sector, this is shocking. If it was the NHS, there would be an outcry, with claims that it was further proof that the service was no longer fit for purpose. What these figures expose is the outrageous lie of private medicine in this country: that, because you have paid directly for your treatment, it is in some way better than the NHS, that the doctor you see is superior to those you see in the health service. In fact, the only advantage over NHS treatment is that you are seen quicker and dine on better food. If your treatment is straightforward then there’s nothing to worry about. It’s when there’s a problem that the cracks suddenly appear. These health-care companies don’t invest in resources for dealing with acutely sick patients because it’s costly and they know the NHS is there to pick up the pieces. The new figures showed that in one year, 2,600 patients were transferred to the NHS as an emergency and in all, 6,000 patients were handed over to it.

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Friday 22nd August 2014

Pulse

  • NHS England to review unplanned admissions care plan following ‘do not resuscitate’ controversy.

    NHS England is reviewing the care plan template for the unplanned admissions DES following the recent controversy over a ‘do not resucitate’ question. The forms would be reviewed in light of ‘poor patient experiences’ reported in the media, NHS England told Pulse, after the Daily Mail alleged on Tuesday that care coordinators for the DES were ‘callously’ asking patients to sign DNRs as part of some of the questions on the form. The questions are included towards the end of the template form, developed by NHS Employers, NHS England and the BMA, and titled ‘Other relevant information (‘if appropriate)’. The form states ‘[Was] emergency care and treatment discussed’ - adding: ‘if yes, please specify and outcome e.g: cardiopulmonary resuscitation – has the patient agreed a DNR or what treatment should be given if seizures last longer than x do y etc.’ Pulse revealed earlier this month that palliative care leaders were warning the unplanned admissions DES could cause harm to elderly patients if GPs were forced to treat it as a tick-box exercise. This came after Pulse revealed NHS England issued strict guidance to its area teams that they should offer no leniency over DES deadlines, including completion of the 2% of care plans, creating fears GPs would be forced to ‘cut corners’. Pulse understand that any reviews of guidance will have to be done in conjunction with the GPC and NHS Employers, and is awaiting further information from NHS England on future use of the form. NHS England’s chief nursing officer Jane Cummings said: ‘There is one question on the form relating to emergency care and treatment and it mentions resuscitation as a possible discussion point.’ The story broke when health commentator Roy Lilley revealed that his mother’s care coordinator, a district nurse who they hadn’t previously met, asked the questions while discussing the care plan. There were also reports of the questions on DNR being asked over the phone.

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Our NHS

  • Why do private hospitals want to hide their patient safety records?

    In February 1999 Mrs Laura Touche, the wife of an American lawyer in London, died of a brain haemorrhage after giving birth to twins by caesarean section at the private Portland Hospital in London, the favoured choice for maternity care of the Royal Family and many celebrities. It emerged that unlike NHS hospitals, the Portland had no protocol requiring patients’ vital signs to be checked at frequent specified intervals following a delivery. Although complaining of a headache Mrs Touche was not checked for two and a half hours, by which time it was too late. In the UK maternal deaths directly due to pregnancy are extremely rare – around five in 100,000 live births. A coroner’s jury found that neglect had contributed to Laura Touche’s death. Her husband Peter Touche said the facts disclosed at the inquesthad convinced him that his wife’s death was ‘completely avoidable’. He added: ‘This all took place in a private hospital at the end of the 20th century. I understand that the Government is now contracting out NHS operations to the private sector. The NHS is opening up and publishing statistics. So should the private sector. The irony is that often, as in Laura's case, a patient is transferred to an NHS bed and so the death is registered at the NHS hospital.’ And it is not just deaths that are a cause of concern. Serious incidents short of death can be devastating too. For example over the past year no fewer than three patients at one private hospital in Southend had the wrong joints replaced – ‘never events’, in NHS parlance. The key lesson from all such cases was actually drawn in 2002 by George Osborne, then a backbench MP. Referring to the Touche tragedy he moved a private members’ Bill ‘to require private hospitals to publish independently audited information on clinical performance and on complaints from patients on the same basis as that required of NHS hospitals.’ He pointed out that: Unless the hospital volunteers the information, it is impossible to know how many deaths occur within 30 days of surgery or how many emergency readmissions take place, yet information of that kind is now freely available in the NHS. Although private hospitals now need to have a proper complaints procedure, there seems to be no requirement for them to publish complaints in the same detail. Other prospective patients therefore cannot judge the hospital's record for themselves.

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The Conversation

  • Scotland Decides ’14: is the NHS fair game?

    David Cameron and other prominent unionists have accused Alex Salmond of desperation over his decision to question the future of the NHS in Scotland if it stays in the UK in recent days. Since devolution, there has been more divergence in health policy, none more evident than in 2011 when Scotland joined Wales (2007) and Northern Ireland (2010) to abolish prescription charges. In recent years, rhetoric surrounding the direction of travel seems to have been diverging apace, with only minority voices supporting a greater role for the private sector north of the border (even if spend contracted out from public to private sector has also increased in Scotland in recent years). In the longer term, these gaps might well widen. The mixed economy in the NHS down south will probably ramp up as the years go on. If this eventually leads to less public spending on the NHS south of the border, the financing rules for the UK’s other nations under the Barnett formula would mean that there would be less money to spend on health here. This is more of a hypothetical than a real threat in the short term, but it’s perfectly legitimate to raise the issue in this referendum debate. Is it realistic for the Scottish government to avoid going down the same route as England ? It is certainly true that there will be increasing demands upon the public purse. Partly this is demographic, because of the ageing population, and partly technological as treatment possibilities keep improving. But the principles are important here. There appears to be more commitment in Scotland to a health service that is free at the point of delivery. We don’t like it when that begins to unravel. Obviously plenty of people believe in a public health service down south too, but there are many others who want it scaled back, whether for ideological or pragmatic reasons. The tenor of the debate is different in Scotland.

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London Evening Standard

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

    Hospital managers were unprepared for an influx of almost 40,000 more patients after a neighbouring accident and emergency department was axed, a report reveals today. Nurses at North Middlesex hospital, in Edmonton, told inspectors that their workload “increased significantly” after the closure of Chase Farm’s casualty unit last December because of a shortage of recruits. Dead bodies had to be stored in temporary fridges after a 31 per cent rise in the mortuary’s workload, with the facility “full to capacity” at times.Despite the “underestimate of the resources” needed to maintain standards of care, the Care Quality Commission said staff at North Middlesex had “fully embraced” the increased workload. In a generally positive report, the hospital was rated as “requires improvement”. Professor Sir Mike Richards, the commission’s chief inspector of hospitals, said: “When we inspected North Middlesex University Hospital we saw that demand for services had increased, due largely to the closure of A& E at Chase Farm Hospital. “Staff were working hard to meet this increased demand, but more needed to be done by the trust to make sure that good quality care was maintained.” The report said the infrastructure at North Middlesex had been “stretched” and managers were “firefighting” rather than planning for the future. A total of 189,000 patients are expected to use its A& E this year, up from 150,000 last year.

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The Guardian

  • NHS privatisation keeps on failing patients – despite a decade of warnings.

    We have learned this week that the NHS is footing the bill for dozens of people left damaged by eye operations provided by private healthcare operations. This comes as no surprise to those of us who have been following the disastrous implications of the privatisation of public health services. Since 2003, government policy in England has been to divert more than £5bn of scarce NHS funds to the for-profit private sector under a policy known as the independent sector treatment centre programme (ISTC). Doctors have been warning about how catastrophic the policy is for the NHS, for quality of care and above all for the safety of patients. For the private sector and their shareholders it is a dream scenario: the NHS trains and educates the junior doctors and nurses at taxpayer expense who, together with NHS consultants, may then moonlight in the private sector; the taxpayer underwrites the risks and costs of care allowing the private sector to cherrypick the profitable patients, ie the healthy ones with no complications; and the NHS takes back the risks when things go wrong as the private sector doesn’t have the intensive care facilities. The NHS also takes on the legal liability when patients sue the facility. The private sector quite simply offloads the revisions, readmissions, emergency treatments and clinical follow-up and law suits to the NHS and the taxpayer. And to crown it all the private sector has a poor record of doing the work it is contracted to do, with the NHS paying for work that the private sector has not performed.

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  • Private hospitals should be put under the same scrutiny as NHS services.

    Earlier this week a report published by the Centre for Health and the Public Interest (CHPI) called for much greater transparency about the quality of healthcare in the private sector. The health thinktank claimed that patients undergoing operations in private hospitals are sometimes exposed to risk from inadequate equipment, lack of intensive care beds, unsafe staffing arrangements, and poor medical record keeping. They are right to raise this issue. As it stands, private hospitals are under no obligation to make data on patient outcomes available to the general public. For patients treated in private hospitals there is no information available to allow any independent organisation to assess the quality and safety of care provided. The private sector needs to catch up with what the public now expects in terms of transparency. This is increasingly urgent as we move to a system where more and more of our public healthcare is delivered by private providers. Parity of information needs to become the norm. The public does not know how a private hospital is performing on even the most basic measures of quality and safety. This is astounding at a time when an increasing number of people are having NHS operations performed in the private sector. Reports suggest that the private hospital sector has received more than a quarter of its income from treating NHS-funded patients. Notably, NHS patients can, in many cases, choose to be treated in private hospitals but are likely to lack the information about the hospital’s outcomes that they would need to make an informed choice.

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BBC News

  • Call for review of Alexandra Hospital downgrade plan.

    Three MPs have called on health bosses in Worcestershire to hold a fresh review of plans to downgrade services at Redditch's Alexandra Hospital. Under the £35m proposals, emergency care and maternity services could be moved to Worcestershire Royal Hospital. An option for University Hospitals Birmingham Trust to adopt the facility was dismissed earlier this month. But Conservative MPs Sajid Javid, Karen Lumley and Nadhim Zahawi have said they want that option looked at again. The Redditch and Bromsgrove clinical commissioning group said earlier this month that an independent panel had ruled out bringing in University Hospitals Birmingham NHS Trust to help run services. It said: "This would have resulted in a significant inequality in the provision of safe and sustainable services to the population of Worcestershire."

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Thursday 21st August 2014

nhs managers.net

  • The Duchess will be coordinated every three months.

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

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On Medica

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

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

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London Evening Standard

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

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

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Pulse

  • Serco to withdraw from UK clinical services market.

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

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

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

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HSJ

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

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

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The Guardian

  • Income from private patients soars at NHS hospital trusts.

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

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38 Degrees petition

Tuesday 19th August 2014

Local Government Chronicle

  • Serco to withdraw from UK clinical services market.

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

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Kent Online

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

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

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Essex County Standard

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

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

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Monday 18th August 2014

Teesdale Mercury

  • Paramedic cuts are a done deal, memo reveals.

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

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Pulse

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

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

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Northern Echo

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

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

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Daily Mail

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

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

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Sunderland Echo

  • Sunderland medical practice faces closure.

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

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Thurrock Gazette

  • Politicians back campaign to scrap hospital car park charges.

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

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