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Tuesday 25th November 2014

Financial Times

  • NHS trust financing woes expected to boost private sector openings.

    Healthcare providers expect a significant increase in opportunities for the private sector as more NHS trusts fall into financial difficulty in the coming year.
    In a survey of more than 100 influential industry figures – including chief executives, investors and advisers – nearly 70 per cent said financial pressures on the health service will lead to a range of new business openings, while the vast majority also predicted an increasing number of NHS trusts will suffer economic hardship in the next 12 months. Independent providers say they have received a significant increase in business since the coalition government came to power in 2010, and now earn more than a quarter of their income from the NHS. But they say the pace of privatisation has proved disappointing compared with their initial expectations. The Healthcare Industry Barometer 2014, an annual study by HealthInvestor magazine and the law firm Nabarro, shows how the UK private health market is rebounding after being hit hard by the financial downturn in 2008. Despite this, not all ventures have proved profitable. The outsourcer Serco has faced losses on a series of contracts including a deal to provide community healthcare in Suffolk. Mitie, the FTSE 250 outsourcer, admitted last week that its new homecare business, which provides support for the ill, disabled and the elderly, was less profitable than expected and that it was struggling to recruit and retain sufficient numbers of care workers. The findings echoed research by the NHS Support Federation, an independent campaign group, which showed private health firms are on course to win more than £9bn of NHS contracts as a result of the coalition’s ramping up of competition in the health service. It found companies such as Care UK, Bupa and Virgin have so far won a total of 131 contracts worth a combined £2.6bn to provide NHS services since the Health and Social Care Act came into force in April 2013.

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The Cornishman

  • No replacement for Poltair beds six months after closure.

    Six months after the decision was taken to permanently close Poltair Hospital, it has been announced that its ten beds will not be provided elsewhere. The decision, publicised at the "Poltair Next Steps" stakeholder event last week, has been branded "a monumental error of judgement" by the former vice-chairman of the Royal Cornwall Hospitals Trust (RCHT). And campaign group West Cornwall HealthWatch says the "service is almost at breaking point, with no sign of an early improvement". But Peter Stokes, programme director for NHS Kernow, and St Ives' family doctor Dan Rainbow, who was involved with the Poltair consultation, say that the vision of an integrated health and social care service is beginning to take shape and that the loss of the Poltair beds has not had a negative impact.

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Daily Mirror

  • NHS strike: that 1% "pay rise" for nurses is actually a cut.

    They do life-saving work every hour of the day, but today doctors, nurses and other NHS workers have stopped because they say they're not paid enough. NHS workers are on a four hour strike to protest against the Treasury's decision not to give a 1% rise to all staff as recommended by a pay review body. A 1% pay rise doesn't seem like much - but half of NHS workers won't even get that. Earlier in the year the Treasury announced that public sector workers would get a 1% pay rise. But NHS staff who are set to get a progression pay increase - linked to seniority - will not benefit from the pay rise. This is around 600,000 people (over 50%) of NHS staff. The remaining will "benefit" from a 1% pay rise. And for those who do: a 1% pay rise is effectively a pay cut when you consider inflation.

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BBC News

  • NHS staff stage four-hour strike.

    NHS workers, including nurses, midwives and ambulance staff, have staged a four-hour strike in England as part of a pay dispute. They were protesting about the decision not to implement a 1% rise for all staff recommended by a pay review body. Members of nine unions walked out at 07:00 GMT in England and at 08:00 GMT in Northern Ireland. A Department of Health spokesman said it could not afford the rise without risking frontline jobs.

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Monday 24th November 2014

Hospital Doctor

  • Invest to transform the NHS into 21st century sustainable service.

    The next government has to invest to transform the NHS into a sustainable 21st century service. That’s the message from the Foundation Trust Network in launching its ‘Programme for the next Parliament’. It sets out what is needed from government, regulators, providers, commissioners and politicians to free and support the NHS to make the changes needed to continue providing excellent patient care. It also calls on the government to support an empowered and affordable NHS workforce with the right skills and in the right numbers. It must ensure improvement is owned and led by providers underpinned by regulatory assurance that the system is working in the best interests of patients and service users. And autonomous and accountable NHS providers must be enabled to drive new models of care in partnership with their local health and care systems. Five priorities are identified within each theme including multiyear funding and planning; staffing decisions to be based on local clinical judgements not blunt national targets; regulators being held to account for providing value for money; and higher standards being set for local and national commissioners. Chris Hopson, chief executive of the Foundation Trust Network, said: “At the recent party conferences and in the NHS Five Year Forward View, there was cross-party recognition that the combination of underfunding and rapidly rising demand makes it impossible for the NHS to sustain and improve the quality of care within its existing model. “We must transform how we deliver care but are running out of time to make these essential changes. This programme for the next Parliament gives our politicians and the NHS system leadership complete clarity on what’s required from day one after the election to enable the NHS to transform to meet 21st century patient needs.

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The Huffington Post

  • We Need a More Courageous, Robust Response If We're to Save Our NHS.

    Figures released this week show private health firms are on course to win more than £9billion of NHS contracts. This Friday, I'll vote for a Bill which seeks to challenge the stranglehold of privatisation on our NHS. That Bill - the National Health Service (Amended Duties and Powers) Bill, from Labour MP, Clive Efford - is a step in the right direction, and is welcome as such. The situation is grave and the Efford Bill gets the ball rolling. It stops short of what it needs to be (more of which soon) but it does step up the debate about the privatisation of our NHS. And not a moment too soon. The NHS is on the edge of being hollowed out into little more than a logo. There is good in Efford's Bill. The Health and Social Care Act 2012 (HSCA) fundamentally undermined healthcare in this country. It's been a costly, unnecessary and underhand waste of money, implemented by those who don't believe in a public health service but who do want to shrink successful public services to allow profiteers access to the £110billion a year NHS budget. This Bill would repeal the 'competition' sections of the pernicious HSCA 2012 - and I welcome its attempt to reduce procurement and tendering procedures. It also looks like it would revoke regulations that force commissioners to advertise new NHS contracts to the private sector (unless the services are only capable of being provided by a single provider). The 2012 Act united an extraordinarily broad coalition of opposition to its core purpose (being to permanently hollow out public provision in the NHS and instead create a cash cow for the corporate health sector) including the BMA, Royal Colleges, 38 Degrees - I worked closely with Liberal Democrat rebels and the Opposition on key amendments to the Bill.

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Yahoo

  • MPs warn on kidney dialysis plan.

    Kidney disease charities were "stunned" to have been told this week dialysis will no longer be a prescribed service on the English NHS from next year, MPs have heard. Labour's Madeleine Moon (Bridgend) said officials at the Department of Health revealed the "dangerous" decision in a meeting, and told the groups legislation would be put to MPs in February. Mrs Moon urged Commons Leader William Hague organise a ministerial statement by Health Secretary Jeremy Hunt to allow MPs to protest at the plans. Speaking during the weekly business statement, she said: "At a meeting in the Department of Health this week, kidney charities were stunned to be told that kidney dialysis was no longer to be a prescribed service and a period of consultation of six weeks would be held by the Department of Health. "And then a Bill would be introduced to Parliament during February and changes to CCG (clinical commission groups) commissioning will commence on April 1. Can we have an oral statement from a minister for the Department of Health so they can hear from MPs across the floor in this House what a dangerous decision that would be and how kidney patients will be placed at risk by that decision ?" Mr Hague replied: "I don't think there is any need for a statement because it is health questions within a few days. Next Tuesday (Mr Hunt) and the ministerial team will be here on Tuesday to answer questions so I think there is an early opportunity for you to pursue this issue."

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The Guardian

  • Number of GPs seeking to leave UK and work abroad doubles under coalition.

    The number of GPs applying to leave the NHS annually to practise abroad has doubled under the coalition, raising fresh concerns over its handling of the health service. The exodus risks exacerbating the current backlogs in GP practices and the pressures on A& E departments, according to the Royal College of GPs, which has warned that 600 practices may close in the next year due to poor recruitment and retention of staff. The most recent patient survey reports that one in four patients now wait a week or more to see their local doctor. New figures show that 529 GPs were issued in 2013 with a certificate of good standing, which allows them to practise abroad. That compares with 266 in 2009, according to figures provided by the General Medical Council. A spokesman for the Department of Health said that medicine was a mobile profession and that doctors often wanted to spend time travelling and gaining experience overseas before returning to the NHS. But last night the shadow health secretary Andy Burnham said that the increase in the number of GPs being issued with the certificates was a clear indicator of plummeting morale within the health service, as it struggled to deal with a burgeoning population amid tightening budgets. Burnham said: “The prime minister who promised to put GPs in charge of the NHS has instead presided over a crisis in general practice and a collapse in GP morale. This week’s misjudged GP ratings announcement has seen the profession’s morale plumbing new depths. “Cuts to the GP budget are placing intolerable pressure on services and forcing many GPs to move abroad or retire early in despair. People are already struggling to get GP appointments and things are set to get even worse.” The pressures on medical practices are largely a consequence of a changing demographic. The UK’s elderly population has grown 80% over the last six decades and is set to grow further. The number of people aged 65 and over is forecast to increase by 23% from 10.3 million in 2010 to 12.7 million in 2018, and to reach 16.9 million by 2035. A government report published last summer, Securing the Future GP Workforce, concluded that “there is a GP workforce crisis that must be addressed immediately”. The report states that the shortfall in GPs is “being compounded by increasing numbers of trained GPs leaving the workforce” and that “evidence is also emerging from the NHS information Centre that the GP workforce is now shrinking rather than growing”. Dr Maureen Baker, chair of the Royal College of GPs, said that current and prospective GPs were being put off from working in the NHS by 11-hour days. She said: “The mass exodus of GPs – driven by soaring demand and plummeting resources – is a clear and present danger to patient safety.

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Friday 21st November 2014

Daily Mirror

  • Revealed: The 21 private firms from India, Japan and America targeting £1billion NHS contract to manage patient medical records.

    Private firms from around the world are targeting a £1billion NHS contract to manage the personal medical records of every patient in the UK. Four IT companies in India, a tech giant in Japan, a US arms manufacturer and the world’s largest law firm are among 21 businesses in the frame, the Mirror can reveal. The 10-year contract is the biggest ever put out for tender by the NHS, after the Tory-led coalition decided to outsource primary care support services. Dave Prentis, general secretary of union Unison, branded our revelations “an absolute disgrace” and warned it could mean “handing over millions of patients records” to “huge worldwide firms”.

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BBC News

  • MPs to debate bill to repeal NHS 'privatisation' laws.

    MPs will debate a bill later which supporters say will roll back what they call the creeping privatisation of the NHS. The Private Members Bill seeks to repeal key parts of the government's 2012 reform of the NHS in England. Ministers say those reforms are saving the health service money, and they have no plans to repeal any parts of the legislation. The bill is backed by the major health unions, but is unlikely to become law. It is designed to repeal parts of the 2012 Health and Social Care Act that underpinned one of the biggest reorganisations of the NHS in England. Mr Efford, Labour MP for Eltham, says those reforms imposed privatisation on the NHS. "The NHS as we know it today will disappear if we continue to allow services to be forced out to private companies. It will seriously undermine the capacity of the NHS to provide services in the future, leaving us at the mercy of the private sector. This bill will halt the rush to privatisation and put patients rather than profits at the heart of our NHS."

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Open Democracy

  • Efford's "Save the NHS" Bill - does it do what it says on the tin?

    A private members bill that Labour say will “halt the rush to privatisation and put patients rather than profits at the heart of our NHS” is to be debated in parliament for the first time on Friday. Trade unions are urging MPs to “back the bill”, put forward by Eltham MP Clive Efford, whilst suggesting it is only “a start”. The Trade Union Congress says the Bill will “put patients’ needs before private profits and protect health services from privatisation”. It's supported by Labour affiliate, the Socialist Health Association, and by 38 Degrees. The Bill has also been given “qualified support” by the British Medical Association and a cautious welcome by Lord David Owen, a vocal critic of the Health & Social Care Act, who told OurNHS: "These are imaginative and constructive proposals that deserve not just a Second Reading but careful consideration in Committee. No small Private Members Bill can cover every important aspect of the NHS but this Bill gives us an opportunity to act quickly”. It appears to give the Health Secretary considerable power to determine what counts as ‘anti-competitive behaviour’ and what counts as an abuse of a dominant ‘market position’ within healthcare. It also gives the Health Secretary the power to decide just how much money Foundation Trusts should be allowed to make from private patients (currently capped at 49% of income) and adds some safeguards about patient detriment.

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The Independent

  • TTIP backlash: NHS needs protecting from US trade deal, says Labour.

    The NHS must be explicitly excluded from the controversial trade deal being struck between the EU and the United States, Labour will demand today, as David Cameron and European leaders face a growing backlash against the plans. The Prime Minister argues that the Transatlantic Trade and Investment Partnership (TTIP) could provide a £10bn boost for Britain and has promised to put “rocket boosters” behind efforts to clinch the deal. He has praised the planned agreement as “good for Britain, good for jobs, good for growth and good for the British economy”. However, more than 920,000 Europeans have signed a continent-wide petition against TTIP on the grounds it would cost large numbers of jobs, undermine consumer rights and environmental protection, as well as transferring power from elected governments to unelected international business corporations. Similar objections are also being raised against a parallel agreement between the EU and Canada, which is nearing completion. The surge in opposition across the EU to the huge trade deals, as well as in the US, coincides with a Commons debate today, in which Labour will demand a commitment for the health service to be excluded from the agreement. Critics claim the deal would leave the NHS vulnerable to takeover by American healthcare giants and undermine the principle of a service free at the point of delivery.

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HSJ

  • Exclusive: Multinational arms firm among those interested in £1bn NHS tender.

    Multinational companies including G4S and arms manufacturer Lockheed Martin are among those that have expressed interest in a £1bn contract to run GP support services outsourced by NHS England, HSJ has learned. NHS England issued a contract tender notice last week appealing for bidders to run primary care support services. The authority decided to outsource the functions last summer. With a contract value of £1bn over 10 years, the tender is one of the highest value single deals ever offered by the NHS. HSJ has learned that NHS England hosted a meeting in recent weeks for organisations interested in bidding for the contract. It was not attended by a single NHS owned organisation. However, among the companies that did attend were the weapons manufacturer Lockheed Martin, which makes the F-35 Joint Strike Fighter and the Royal Navy’s Merlin maritime helicopter, as well as supplying what their website describes as “ingenious IT solutions” to public sector clients including the Welsh government, the Metropolitan Police Service, and Golden Jubilee National Hospital in Scotland.

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Independent

  • TTIP backlash: NHS needs protecting from US trade deal, says Labour.

    The NHS must be explicitly excluded from the controversial trade deal being struck between the EU and the United States, Labour will demand today, as David Cameron and European leaders face a growing backlash against the plans. The Prime Minister argues that the Transatlantic Trade and Investment Partnership (TTIP) could provide a £10bn boost for Britain and has promised to put “rocket boosters” behind efforts to clinch the deal. However, more than 920,000 Europeans have signed a continent-wide petition against TTIP on the grounds it would cost large numbers of jobs, undermine consumer rights and environmental protection, as well as transferring power from elected governments to unelected international business corporations. Similar objections are also being raised against a parallel agreement between the EU and Canada, which is nearing completion. The surge in opposition across the EU to the huge trade deals, as well as in the US, coincides with a Commons debate today, in which Labour will demand a commitment for the health service to be excluded from the agreement. Critics claim the deal would leave the NHS vulnerable to takeover by American healthcare giants and undermine the principle of a service free at the point of delivery. British opponents say the so-called “investor-state dispute settlement” (ISDS) powers could enable American healthcare firms to take legal action if a UK government restricted private involvement in the NHS.

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Daily Telegraph

  • Labour NHS bill is 'misguided and disruptive'.

    Labour attempts to reverse Tory health reforms are “deeply concerning, misguided and disruptive,” a coalition of leading GPs have warned. In a letter to The Telegraph, the doctors urged MPs not to vote on Friday in favour of a bill which claims to repeal parts of the 2012 Health and Social Care Act, which put groups of GPs in charge of NHS budgets. Labour MP Clive Efford’s private member’s bill would reverse some of the changes introduced by then Health Secretary Andrew Lansley. Labour says the 2012 reforms have pushed a “privatisation” agenda, by promoting competition for NHS contracts. But a number of leading GPs, including those in charge of Clinical Commissioning Groups (CCGs), say those calling for the changes to be reversed are making “an ill-informed attack” on the doctors in charge of the system. In the letter, Dr Michael Dixon, chairman of the NHS Alliance, which represents GPs, and eleven other doctors, said that reversing the changes would be a “backwards step for patients” which would force a needless reorganisation of the health service. Last night Labour issued a statement asking Conservative and Liberal Democrat MPs with financial ties to private healthcare firms to stay away from Parliament. Clive Efford, shadow minister for sport, said: “The Bill takes a scalpel to the Coalition Government’s hated Health and Social Care Act and cuts out those bits that force services to be put out to tender - where the private sector can cherry pick the most lucrative services that yield the most profits. Our health service is not a market and this needs to end now before it is too late and the NHS as we know it ceases to exist.” The new bill would reduce the amount of income NHS hospitals could receive from the private sector and change the way the service is regulated.

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Thursday 20th November 2014

Uttoxeter News

  • Staffordshire NHS cancer service 'privatisation' moves a step closer.

    Several private companies have been shortlisted for what is believed to be the biggest outsourcing deal in NHS history. Twelve organisations, including two NHS hospitals, are in the running for £1.2bn of NHS cancer and end-of-life contracts across Staffordshire. Private bidders include Virgin Healthcare and US technology giant CSC. Union Unite and the organisation Cancer Not For Profit have said it could lead to the privatisation of the vital service.

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Brent and Kilburn Times

  • Maternity unit faces the axe under plans that closed Central Middlesex Hospital’s A&E unit.

    A maternity unit is set to be the next casualty of a controversial programme which led to the closure of the accident and emergency unit at Central Middlesex Hospital. Ealing Hospital will lose its maternity services under the Shaping a Healthier Future (SAHF) plans which were rolled out earlier this year. The plans, which also resulted in the closure of the casualty unit at Hammersmith Hospital, will also see Ealing Hospital stripped of its neonatal, paediatric and gynaecology departments. Last month, Ealing NHS Trust, which manages the hospital, merged with North West Hospitals NHS Trust, which looks after Central Middlesex, Northwick Park and St Mark’s Hospitals, to save £19million. The closure of the maternity unit comes six years after a £3million birth centre at Central Middlesex Hospital in Acton Lane, Park Royal, was axed just four years after opening due to a ‘lack of demand’. Ealing Hospital is claimed to have one of the highest birth rates in London leading to fears that other maternity units such as NPH could become too overcrowded with its closure.

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Daily Mirror

  • Tory cuts put 15,000 cancer patients in danger as they are forced to wait too long for treatment.

    More than 15,000 cancer patients’ lives have been put at risk because Tory-led NHS cuts have forced them to wait too long for vital treatment. Official guidelines say no one should wait more than 62 days to start care after an urgent referral by their GP for suspected cancer. Hospitals must meet this target in at least 85% of cases but new figures published yesterday by NHS England reveal it has been breached for the third quarter in a row. In total, 15,425 people told they have the disease between January and September this year then waited more than two months to start treatment. Experts warned the delays meant patients were being “failed” and were more likely to either die or see their condition rapidly worsen.

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Independent

  • International arms firm Lockheed Martin in the frame for £1bn NHS contract.

    Doctors have expressed dismay at reports that an international arms firm is considering a bid for a £1bn NHS contract to run GP support services in England. American defence giant Lockheed Martin was one of a number of private companies represented at a recent meeting hosted by NHS England, for those interested in taking over the contract, which largely involves administrative functions. G4S, whose handling of security at the London 2012 Olympics drew widespread criticism, also attended the meeting, as did KPMG and the US law firm DLA Piper. No potential NHS bidders attended, according to the Health Service Journal (HSJ). The contract, which is likely to be awarded early next year, is one of the biggest ever put out to tender by the NHS. Leading London GP Dr Louise Irvine told The Independent that it was “shocking” that an arms firm could be awarded such a major NHS contract, and warned that the company could profit from money “taken from front line care”. “[It is] just as shocking that no NHS organisation was allowed to bid to provide these services, which are mainly back office support for General Practice,” said Dr Irvine, who is standing the general election for the National Health Action Party. “NHS administration systems, with years of experience, are being displaced by organisations that have little or no experience in providing these services.” Dr Mark Porter, chair of the British Medical Association, said that the tender was “another worrying example of creeping privatisation in the NHS”.The 10-year contract is understood to be worth more than the current cost of running the services, which currently employ 1,600 people. Bidders have been told they will have to close some offices and invest in new technology, and should expect to bear some redundancy costs, the HSJ reported.

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Financial Times

  • NHS spending per patient to fall under all main parties’ pledges.

    The amount the NHS spends per patient would fall between £98 and £191 – a real term drop in spending of at least £5.5bn – by 2020 under the main political parties’ funding pledges, analysis reveals. The figures, based on NHS England’s own calculations, show that despite the ringfence applied to the service’s budget, spending – using health officials’ preferred measure of estimated patient numbers – has fallen £50 per patient since 2009. Under the Conservative party’s pledge to hold NHS spending in line with inflation, the fall per patient would be £191 from 2009 to 2020 – about the cost of one accident and emergency visit for a patient in England. Under the Liberal Democrats, funding would fall £174 per patient during the same period, while under Labour’s pledge it would fall £98 – about the cost of an outpatient appointment. The Financial Times worked on the figures with the health policy think tank, the Nuffield Trust.

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Guardian

  • Private firms on course to net £9bn of NHS contracts.

    Private health firms are on course to win more than £9bn of NHS contracts to look after patients as a result of the coalition’s ramping up of competition in the health service, research shows. Analysis by the NHS Support Federation, an independent campaign group, reveals that profit-driven companies such as Bupa, Virgin Care and Care UK have so far won a total of 131 contracts worth a combined £2.6bn to provide NHS services since the Health and Social Care Act came into force in April 2013. They have won two out of three of the 195 contracts awarded by NHS bodies in England in the 19 months since that legislation dramatically extended the enforced tendering of services in the NHS. Those 131 contracts represent about half the value of the 195 deals that have been agreed. Researchers tracking the awarding of NHS contracts say that, if the private sector continues its 50% win rate by value, it will earn a potential £6.6bn more of the £13bn of other contracts which have been advertised but not yet awarded. That would result in private firms earning £9.2bn as a direct result of the changes ushered in by then health secretary Andrew Lansley’s restructuring of the NHS, which a cabinet minister recently described as the coalition’s biggest mistake. The £18.3bn of services tendered include more than £1bn worth of contracts for elective surgery, diagnostics (£1.2bn), community care services (£1.9bn), musculo-skeletal care (£785m), ambulance and patient transport services (£583m) and pharmacy (£558m). The Department of Health said the figures were misleading and only a small proportion of the NHS’s overall spending was in the private sector. But Dr Mark Porter, chair of council at the British Medical Association, said the deepening privatisation exposed by the figures proved that ministers had not told the truth when they denied that Lansley’s shakeup would produce more of it in the NHS.

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Tuesday 18th November 2014

HSJ

  • Staffordshire CCG to hand £280m contract to private sector.

    Two private firms have been shortlisted for a £280m ‘prime provider’ contract in East Staffordshire in a competition that has seen all NHS bidders squeezed out of the race. Virgin Care and Optum - part of United Health - will now work with the East Staffordshire Clinical Commissioning Group to design the outcomes for the Improving Lives Programme. This will provide services for people with long term conditions, the frail elderly and those requiring intermediate care. The winning bidder is due to be picked in 2015 with a view to begin the revamped service in 2016. The CCG’s accountable officer Tony Bruce confirmed that NHS organisations that had expressed an interest in bidding for the contract had not made the shortlist. The programme is supported by the 19 East Staffordshire GP practices and serve around 38,000 people in the area who live with long term conditions such as heart disease or diabetes. It will also cover an estimated 6,000 frail elderly people. According to CCG modelling of future demand, the services would be unsustainable by 2018, at which time the CCG claims it will be overspent against its NHS England allocation by £10m.

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Open Democracy

  • Cameron faces TTIP showdown over NHS

    This Friday will see the first Commons debate of Eltham MP Clive Efford’s bill to save the NHS from irreversible privatisation. Members of the public will gather in Parliament Square from 7pm on Thursday for an all-night vigil to support the initiative. Further demonstrations are planned for Friday itself. The bill focuses on reversing some of the worst impacts of the Health & Social Care Act 2012, which has already seen 70 per cent of new NHS contracts outsourced to the private sector. Yet the final section also seeks to exempt the NHS from the Transatlantic Trade and Investment Partnership (TTIP), the controversial treaty currently being negotiated in secret between the European Commission and the US government. If passed into law, the bill declares that: “No ratification by a Minister of the Crown of the proposed Transatlantic Trade and Investment Partnership Treaty shall cause any legally enforceable procurement or competition obligations to be imposed on any NHS body entering into any arrangement for the provision of health services in any part of the health services.” Sadly, such national legislation would not be enough to save the NHS from TTIP. If health services are included in the deal, any future UK government will be bound by its treaty obligations as an EU member state over and above unilateral declarations such as the one envisaged in the bill. Even if the UK were to take the extreme option of leaving the European Union altogether, TTIP would still enable US health corporations to sue future governments for reversing NHS privatisation, thanks to the ‘survival clauses’ that ensure free trade agreements remain in force for years after a state has ceased to be a party to them.

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  • Seven things everyone should know about the Private Finance Initiative.

    1. What is PFI ? Rather than Central Government directly funding infrastructure works like schools or hospitals, Private Finance Initiative (PFI) means a consortium of private sector banks and construction firms finance, own, operate and lease them back to the UK taxpayer, over a period of 30-35 years. PFI financing of public infrastructure is now in use across the NHS, as well as the Departments for Education, Local Government, Defence, Transport, and Justice. 2. How much PFI debt do we owe ? UK taxpayers now owe £305 billion in PFI repayments across 700+ projects for the next 30 years. 3. Do PFI deals provide value for money ? PFI deals have been universally criticised as horrendous value for taxpayers, likened to “paying for a hospital on your credit card” by BBC Panorama. PFI is significantly more expensive than Government funded projects with the cost of borrowing at least two times higher than Government financed works according to a 2011 HM Treasury Report. PFI rewires the relationship between the citizen and the state, so that our public services are no longer owned by, or directly accountable to us.

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The Independent

  • The Colchester hospital crisis shows the NHS is still in need of major surgery.

    The more complex dimensions of the Colchester saga relate to funding and structure, the familiar unmet challenges. Demand for NHS treatments of all types is soaring. A& E crises are partly connected to the difficulty in seeing a GP quickly, and also have quite a lot to do with the growing pressures at weekends when drink and drugs play their part in the hell that hospital waiting rooms can become on Friday and Saturday nights. The head of NHS England, Simon Stevens, recently estimated that the NHS would require an additional £8bn a year by the end of the decade, an assumption based on sweeping efficiency savings. There will need to be tax rises and the introduction of co-payments to pay for a modern NHS, along with a renewed focus on preventative measures and personal responsibility. Stevens estimated the funding shortfall as part of his impressive vision for the NHS over the next few years, one for which he got the peak time slot on the Today programme for nearly 20 minutes, an honour usually reserved for a Prime Minister rather than a non-elected official. But is he in charge of the NHS ? It is the Health Secretary who will be held to account at a general election, not an official. NHS England is rather like the independent Bank of England but without the independence. Sometimes there are tensions between the Health Secretary and Stevens as to who pulls the levers. Cameron has been known to ask Hunt to act in relation to a particular sensitive issue. Hunt has pointed out politely that his government gave away the power to act to NHS England. The blurring of lines at the top is straightforward compared with the convoluted line of command below, where it can be impossible to identify who is precisely responsible for what. Until the funding gap is bridged and the hierarchy of responsibility is clear, those living in Colchester – not to mention a Health Secretary with an election to fight – will not be alone in having cause to be nervy.

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The Guardian

  • We should not forget the NHS is one of our greatest national achievements.

    It feels almost obligatory to mention money as soon as you’re saying anything about the NHS nowadays. And, as NHS providers and system leader colleagues head to Liverpool for the Foundation Trust Network’s annual conference on 18-19 November, you can be sure money matters will loom large over the proceedings. The NHS is in the middle of what looks to be the tightest funding squeeze in its history, with NHS finances rising far more slowly than demand. Of course, the result is real pressure and a system that, worryingly, is becoming increasingly fragile. In the NHS, as anywhere else, you get what you pay for. And we can’t go on failing to have a more honest debate with politicians and the public about some of the tough choices that NHS provider leaders are facing as a result. However, this article isn’t going to be all about money. Because we need to celebrate the NHS’s achievements. As Bruce Keogh and Dame Julie Moore have recently reminded us, we’re in danger of talking ourselves into a slump and we can better meet the challenges we face by focusing on what’s working rather than what’s failing. As I will say in my conference speech, one of the great privileges of leading the FTN is the frequent frontline visits I make to see how our members are delivering great care, even in these financially trying times. They’re also pioneering the new models of care and clinical innovations the Five Year Forward View rightly promotes. Indeed, it is NHS foundation trusts who are uniquely placed to drive these changes and improve patient care. The way, for example, that ambulance services like South West ambulance service are successfully extending their role beyond transporting patients to becoming a genuine mobile treatment service, as well as delivering the 111 gateway to the full range of NHS services. They’re treating many more patients at home, and preventing unnecessary admissions to hospital by directing people to other services that can better meet their needs.

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Monday 17th November 2014

On Medica

  • NHS to get £300m extra to deal with winter pressures.

    The Department of Health has made an additional £300 million available to the NHS to help it cope with winter pressures. The additional boost makes the extra money available to deal with winter pressures this year to £700 million, as £400 million have already been made available last year. The total sum is 75% more than the extra amount made available to cope with last year’s winter pressures. The money is being made available after an assessment by NHS leaders, GPs, social services and other health professionals has identified pressure points and a range of measures needed to address them, including more action to keep people out of hospital, closer involvement of GPs and social service organisations, and a public information campaign encouraging people with non-urgent medical problems to use the full range of NHS services.

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Left Foot Forward

  • No time to waste – six months to save our NHS.

    If the NHS continues down the road of privatisation, it will cease to exist as we know it. Today is an opportunity for all of us to fight for one of Britain’s greatest achievements – our National Health Service. Loved by most and used by the overwhelming majority of the public, our NHS is now under threat and we must fight to protect it. When the Health and Social Care Act 2012 was passed, our NHS was put up for sale and has been subjected to creeping privatisation ever since. Labour MP Clive Efford has put forward a Private Members Bill to Parliament which aims to reduce procurement and tendering procedures that provide a gateway to the private corporations to buy into our NHS and also sees millions of pounds wasted on competition lawyers. Receiving its second reading in Parliament next week on 21 November, the #BackTheBill campaign will take its message to the streets today. Backed by the TUC and several affiliated trade unions, campaigners will be telling the public tomorrow to put pressure on their MPs to vote for the bill. Keep Our NHS Public (KONP) members believe that although the Efford Bill is not completely satisfactory in its present form in meeting all of KONP’s demands for the NHS, it is worth campaigning for because it raises the public’s awareness of NHS privatisation. One of KONP’s founders, Professor Allyson Pollock, and colleagues Peter Roderick and David Price have produced a ‘NHS Reinstatement Bill’ which details the legal steps required to fully restore the NHS in England and reverse the failings of the H& SC Act. KONP along with other NHS campaigning groups fully support Professor Pollock’s Bill. Professor Pollock has voiced concerns that Efford’s Bill needs to go further and still requires some clarification in parts.

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Save Our Surgeries

  • Local fury as Tory councillor attacks neighbour’s rights to speak out over the NHS.

    The People’s NHS are taking legal advice to support local Balham residents who are furious at the behaviour of local Tory councillor Caroline Usher for attempting to gag them from legitimately protesting about the refusal of David Cameron to Veto Health out of TITIP (local residents available to interview on request) Hundreds of households across Balham in South West London are taking a collective stand against the irreversible sell-off of their health services to America, by raising Cameron & Hunt Estate Agency boards with the clear message to ‘Stop The Sale’ and to veto the NHS from the EU-US trade deal called TTIP. But Tory Councillor Caroline Usher tried to gag her neighbour’s concerns about local NHS services on Ramsden Road, London SW12 8RD by removing the boards in the middle of the night without permission and taking them away the privately owned property which does not belong to her. Local campaigners came along to support local residents in their outrage at the actions of the councillor. Rows of houses in streets across Balham have the estate agency style signs outside calling for Cameron & Hunt Estate Agents to stop the sale. The collective action is the beginning of a nationwide movement by the People’s NHS across hundreds of neighbourhoods in England, Scotland and Wales.

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The BBC

  • TTIP: Cameron pledges support for EU-US trade deal. David Cameron has pledged to put "rocket boosters" behind plans for an EU-US free trade deal.

    The UK prime minister said EU and US leaders had met and all agreed the Transatlantic Trade and Investment Partnership (TTIP) "is a deal we want". Speaking at the G20 summit, he said arguments against TTIP were "weak" and fears over the NHS were "nonsense". Many opponents are concerned about TTIP giving firms power to sue governments if they are hit by policy changes. Len McCluskey, general secretary of the Unite union, has called for the NHS to be excluded from the deal. Speaking about concerns over disputes between companies and countries, Mr Cameron said: "We've signed trade deal after trade deal and it's never been a problem in the past." On the NHS, he said: "Some people argue in some way this could damage the NHS. I think that is nonsense. It's our National Health Service. It's in the public sector, it will stay in the public sector. That's not going to change. It will remain free at the point of use. "There's no threat, I believe, from TTIP to the National Health Service and we should just knock that on the head as an empty threat." Anti-TTIP protests were held last month in the UK, Germany, France, Italy and Spain.

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The Guardian

  • NHS trusts chasing private patients at expense of waiting lists, warns Labour.

    Hospital Trusts in some parts of England have more than doubled the income they receive from treating private patients following the coalition’s controversial lifting of a cap on such earnings, prompting concerns that cash is being chased as NHS waiting lists grow. Across the country there appears to have been a 10% increase in private income since 2010, but some trusts appear to have radically rethought their attitude to seeking private patients. The Royal Brompton and Harefield trust has increased its private patient income from £24.3m in 2010/ 11 to £33.6m in 2013/ 14. Moorfields eye hospital NHS foundation trust increased its income from £13.3m in 2009/ 10 to £21.3m in this financial year. Poole hospital NHS foundation trust has seen a 123% increase in its private patient income from £613,000 in 2009/ 10 to £1.5m in the past year. The increase follows the controversial decision to allow hospitals to earn 49% of their income from treating private patients as part of the health and social care act in 2012. They were previously capped at earning about 2% from private sources. On Friday, Labour MP Clive Efford will challenge Liberal Democrat MPs to back his private members bill to repeal the controversial act, which encourages a major injection of private provision of health care within the NHS. In a sign of how toxic the alleged privatisation of the NHS has become it is understood that the Tory defector Mark Reckless, who is standing as a Ukip candidate in the Rochester and Strood by-election on Thursday, is planning to support the Efford bill.

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Dorset Echo

  • Health chiefs set to spend £2.75million on review into saving money in NHS.

    NHS Dorset Clinical Commissioning Group (Dorset CCG) has hired consultants to look at ways of cutting costs and making the health service more efficient, it has been revealed. The news comes as a campaign against alleged privatisation of the NHS gathers pace in the county. A major review into the way healthcare is provided across the county was launched by Dorset CCG in October in a bid to make the service more efficient in the face of changing health needs across Dorset and dwindling funding from central Government. But it has now been revealed the group will spend £2.75 million on the review and has hired a consortium of consultants, headed by American-based international consultancy firm McKinsey & Company. McKinsey, which has also taken part in NHS reviews in Bedfordshire, was appointed as the lead supplier of consultants after a tender process, beating 14 companies to the contract. The firm specialises in management consultancy and will be joined in the consortium by Capsticks and PA Consulting. The consortium will play a pivotal role in the first phase of the review, which is set to run until spring 2015 and will evaluate every aspect of medical care the NHS provides in Dorset.

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Friday 14th November 2014

Our NHS

  • This morning Health Secretary Jeremy Hunt told NHS leaders that the service must undertake a ‘fundamental rethink’ of how it spends its £110bn budget.

    He has warned that the NHS needs to save £10bn a year by using fewer temporary staff and management consultants. Just how much NHS leaders are spending on, for example, management consultants is something that Hunt knows, but we don’t... yet. NHS England, unlike all other government agencies, does not make public how it spends our money. A petition launched this week, which has so far been signed by 68,000 people, is demanding that NHS England publishes its spending data without delay. (It said it would publish its receipts in September, then October. It has yet to). This would reveal how much of NHS funds are going on management consultants, lawyers, accountants, PR campaigns and private healthcare companies. Is Hunt trying to distance himself from NHS England by calling now for a “fundamental rethink” of how it spends our money ? Hunt cannot absolve himself of responsibility, however. It was the reforms brought in by this government that created NHS England, stewards of the NHS budget. The policies it has since pursued have been set out and encouraged by the Coalition. Whatever NHS England is doing with our money is Hunt’s responsibility. We just now need to find out what Hunt knows and we don't. Sign the petition here.

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Hospital Doctor

  • “Clinical need not cost should determine routine NHS surgery”.

    A royal college has called on NHS England to investigate a CCG which is proposing to limit access to surgical services. Devon CCG has said it will deny routine surgery to smokers and the morbidly obese unless they quit or lose weight. The GP-led Northern, Eastern and Western Devon Clinical Commissioning Group says the measures are “urgent and necessary” as it faces a £14.5m deficit and needs to reduce costs. However, Miss Clare Marx, president of the Royal College of Surgeons, said: “Access to routine surgery should always be based on an individual’s clinical need. “The government has been clear that restricting clinically necessary treatment on the basis of financial considerations is unacceptable. We urge the Department of Health and NHS England to review the situation in Devon if the CCG is indeed intending to deny patients treatment without enabling the clinicians and patients involved to make informed choices about their care.” Rebecca Harriott, the Devon CCG chief officer, said it would be prioritising services in the NHS Constitution. The group says hernia treatment, botox injections and cataract operations are also under review. Ms Harriott said: “We must act to protect essential services through our busiest winter months and ensure that care is there for our patients when they really need it.

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The Guardian

  • The National Audit Office’s (NAO) forensic dissection of the Better Care Fund fiasco is a harsh lesson in the dangers of ministerial interference in health and care systems under stress.

    Its report Planning for the Better Care Fund – published this week – exposes how the government mishandled the entire project. The fund was the coalition’s gambit in the battle with Labour over who would integrate the NHS and social care. Launched as a flagship policy in the 2013 Autumn Statement, it was a triumph of presentation over strategic thinking – big, bold, long on rhetoric, short on delivery detail and recycling old money as extra funding. It soon hit trouble. NHS England and the Local Government Association (LGA) published guidance on how it would work that December, and all local areas submitted bids by April on how they would spend their cut in 2015-16. Ministers then scrapped the guidance, dumped the bids and restarted the whole process. The broken wire at the heart of the machine was that the Department of Health and NHS England were planning on securing £1bn of savings on the back of the £3.8bn Better Care Fund, but robust thinking to achieve this was not put at the core of guidance for the 151 local bids.

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The Independent

  • Hospitals and A&Es to get extra £300m to combat 'unprecedented' winter pressure.

    Suffers of coughs and colds are being urged to visit their high street pharmacy instead of using their GP or attending their local A& E unit, as part of plan to help the NHS manage unsustainable pressures this winter. The call for patients to take the pressure off doctors came as the Health Secretary announced that hospitals and A& E units across England will receive £300m to help see them through “unprecedented extra demand” this winter. Health Secretary Jeremy Hunt said the new funding could provide the equivalent of up to 1,000 extra doctors, 2,000 extra nurses and 2,500 extra bed spaces. With many A& E units already running at “full stretch”, the injection of funds and call for patients to turn to their pharmacies reflects ongoing anxiety among health officials that the NHS is set to face a challenging winter with rising levels of flu and ward closures from norovirus outbreaks. Mr Hunt said: “Winter has always been particularly challenging for the NHS. We have been thinking about it particularly hard this year because of the growing pressure on A& E departments. ”Emergency admissions are growing about three to four per cent year in, year out. We are very aware that over this winter there is going to be some real pressure there.”

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Frome Times

  • Protect our NHS new Frome group launched to save the local NHS.

    A ‘Protect Our NHS’ group has been launched in the town and is already gaining wide support. Local campaigns have been set up in cities and communities across England and Wales to defend what they see as the growing privatisation of the publicly-owned and publicly-accountable NHS. Now, support has gathered enough locally for a Frome ‘Protect our NHS’ group to be formed. Last week Mike Campbell, coordinator of the Bristol ‘Protect our NHS’ group, joined the audience at the Westway Cinema to see Ken Loach’s ‘Spirit of ’45’ and to support the launch of a ‘Protect Our NHS’ group in Frome. Mike said, “It is fantastic that towns such as Frome with its local community hospital are forming campaigning groups. “It’s essential that local community NHS services are defended as they are equally vulnerable to privatisation. Many of us close to the health service believe that bad press is also deliberately orchestrated by the government to undermine the service’s credibility.” The Frome group is being supported by the mayor, cllr Peter Macfadyen, who believes that Frome is “fantastically” served by the NHS and the Frome Medical Practice. Rebecca Yea from Frome is also supporting the new group. She said, “The group is still forming but the support from the town has been very encouraging and it seems there is a lot of people who want to be involved. At the recent Ken Loach talk more than 100 people showed an interest.

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Thursday 13th November 2014

Nursing Times

  • NHS 'not for sale' boards go up in protest at international trade talks.

    Campaigners are to erect estate agency-style boards across the country today, as part of protests against a controversial trade deal. Houses in nine constituencies will display the boards opposing the Transatlantic Trade and Investment Partnership (TTIP), which is currently being negotiated between the European Union and the United States. Groups, including the Royal College of Nursing, have previously claimed that the deal would lead to more privatisation of health services and argued that the NHS should be excluded from any agreement. In the latest move, campaign group People’s NHS has erected “stop the sale” boards. Spokesman Brian Colman said: “Thousands of households across the UK are delivering a clear message by raising ‘stop the sale signs’ outside their homes in protest over the sell-off of their health services and David Cameron’s refusal to veto the NHS from the dangerous trade deal called TTIP. David Cameron never told us on the campaign trail in 2010 that his party was going to embark on the mass privatisation of the NHS. The government had no mandate to sell off the NHS,” he said. “This is a clear message to our MP and to the government that it’s time to take the ‘for sale’ sign down from our hospitals and GP services and put our cherished NHS back into public hands,” he added.

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GP Online

  • Practices to be paid £16 per appointment for out-of-area patients.

    Practices will be awarded £15.87 per in-hours GP consultation and £60 per home visit for patients registered away from where they live, under the out-of-area registration DES. The enhanced service, designed by NHS England, will support the updated choice of GP practice arrangements that will be introduced from 5 January 2015. From this date, all practices will be able to register patients who live outside of their traditional boundaries, without being required to provide home visits or out-of-hours care. Practices will not be obliged to participate in the scheme, and will remain able to refuse registrations from out-of-area patients. They will also not be obliged to offer home visits for patients registered elsewhere. The GPC warned it had 'lots of concerns' about the plans and said practices would have to 'carefully consider' whether the remuneration on offer was 'enough to cover their costs'. NHS England expects around 0.4% of the population – 200,000 people – to register with a practice outside of their local area, ‘although this might grow over time’. Any patient who requires ‘urgent and local care’ and cannot reasonably travel to their out-of-area practice will be able to access primary medical services nearer their home, under the new enhanced service. Practices participating in the DES will be expected to provide home visits to registered out-of-area patients in their appointed boundary area, where it is clinically required. If any practice chooses not to sign up for the DES, neighbouring practices that have signed up may have to provide services for wider areas. Patients registered out-of-area will be given a review to decide whether it would be more appropriate for them to be registered with a practice nearer their home, should they arrange at least four consultations under the DES within a 12-month period. This will also be triggered if they receive two home visits within the same period. GPC deputy chairman Dr Richard Vautrey said: 'Those practices that have lost patients, but are then invited to look after them again when they are too sick to travel to their new practice, will have understandable concerns about doing so.'

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Exeter Express and Echo

  • A letter from Ben Bradshaw: Worrying health cuts on horizon.

    The size of the financial black hole facing the NHS in Devon – £430 million – is staggering. That is more than 5% of the total £8bn national funding shortfall the head of NHS England, Simon Stevens, recently warned would hit the NHS in the next Parliament if the next Government fails to act. The consequences for Devon are here already: worrying proposals to ration some services and end or close others completely. Now Devon Clinical Commissioning Group – the body now responsible for commissioning or “buying” services on behalf of the public, is planning to deny operations to people who are overweight or smoke, restrict treatment for varicose veins, only allow cataract operations in one eye and end all IVF treatment for couples desperate to have children. National guidance from the National Institute for Clinical Excellence says people should be entitled to three courses of IVF. The CCG is also proposing to close our very popular and well used Walk-In Centre in Sidwell Street. This, despite the fact it has seen big increases in patients every year since it opened and it reduces pressure on our hard pressed A& E and local GPs. I haven’t spoken to a single local GP who thinks closing the Walk-In Centre is a good idea. They also tell me that the weight criteria proposed for operations would, in some cases, affect more than half of their patients and even some GPs themselves. The national Royal College of Surgeons has condemned the plan as “unacceptable”. We also had the decision by North Devon NHS, who, under the new structures, run community services in Exeter, to centralise stroke services in Ottery St Mary, not Exeter. Everyone agrees it makes sense to have stroke services as close to the RD& E as possible, yet now stroke patients and their families from as far away as Okehampton are going to have to trek to Ottery.

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Guardian

  • NHS must use fewer temporary staff and sell land to save £10bn, says Hunt.

    Jeremy Hunt is to tell the NHS to save £10bn a year by using fewer temporary staff and management consultants, selling off unused buildings and reducing drug errors. The health secretary will warn an audience of NHS leaders on Thurday that the service must undertake a “fundamental rethink” of how it spends its £110bn budget in order to remain viable in the face of unprecedented demand for care. He will demand action to tackle the soaring cost of hospitals’ use of temporary staff – mainly nurses – who have been supplied by employment agencies to cover shifts in order to ensure wards are fully-staffed and patients receive good quality care. The bill has risen by £1bn under the coalition to almost £2.5bn a year as hospitals have increasingly struggled to recruit enough staff at a time of greater scrutiny of care standards and demands to provide “safe staffing”.Speaking to the Guardian, Hunt said: “[Then NHS chief executive] David Nicholson came up with the ‘Nicholson Challenge’ in 2009 to save £20bn by 2015. That has more or less been delivered. We now need to have a £22bn ‘Forward View challenge’.” However, while freezing staff pay and awarding them 1% pay rises has helped deliver that £20bn, Hunt said that saving the extra £10bn would have to come through innovation and greater use of technology to improve healthcare.

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  • Film shows Nigel Farage calling for move away from state-funded NHS.

    Nigel Farage has been caught on camera telling Ukip supporters that the state-funded NHS should move towards an insurance-based system run by private companies. The recording shows Farage saying he believes the marketplace could deliver better value for money when it comes to spending on the NHS. Farage’s remarks, made in September 2012 on his Common Sense tour of the UK, contrast with Ukip’s new claims that it is opposed to privatisation of the NHS. The Guardian examined videos of Farage touring the country in an effort to establish some of the Ukip leader’s views on issues other than immigration or Europe. Other footage showed him proposing that the BBC should not be completely dismantled but slimmed down to concentrate on radio rather than television, with a licence fee slashed to £40 or £50. He also suggested that benefit claimants could be made to clean up litter after six months, and that there was a big problem with employee rights and protections such as maternity leave for small firms. However, his comments about the NHS were the most striking, leading Labour to claim it was now “plain for all to see that a vote for Ukip is a vote for the privatisation of the NHS”. Speaking at a meeting in East Sussex, Farage said: “Frankly, I would feel more comfortable that my money would return value if I was able to do that through the market place of an insurance company than just us trustingly giving £100bn a year to central government and expecting them to organise the healthcare service from cradle to grave for us. But a Ukip spokesman said the NHS was an area where the party’s policy has developed the most over the past few years and Farage’s comments in East Sussex no longer represented his views. He also pointed out Ukip had taken the radical step of aligning with the trade unions to oppose TTIP (Transatlantic Trade and Investment Partnership) – a US-EU trade deal that its opponents say could allow American private health firms into the NHS. Farage’s party fought the Heywood & Middleton byelection and is battling to win Rochester & Strood next week on a platform of protecting the NHS. However, Labour has pointed out in its leaflets that Ukip MEP Paul Nuttall posted a letter on his website a few years ago praising the coalition for bringing a “whiff of privatisation to the NHS”.

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Tuesday 11th November 2014

Cambridge News

  • Hinchingbrooke Hospital: Unison calls for health firm Circle to be ‘sacked’.

    A union is calling on the NHS to end the controversial contract which put private health firm Circle in charge of Hinchingbrooke Hospital. Unison, the biggest health union which represents staff at the Huntingdon hospital, said Hinchingbrooke was facing penalty payments running into hundreds of thousands of pounds for missing targets. But Circle said the union had misinterpreted the figures and offered to meet representatives to discuss the situation. Tracey Lambert, Unison's regional head of health, said: "It is time for NHS England to step in and sack Circle. The whole franchise has been a farce from the beginning. The franchising experiment is now damaging staff, patients and the reputation of a previously well-respected local hospital." Circle was brought in to run the hospital which had been branded a "basket case" with £40 million debts. The union said papers for the Hinchingbrooke health trust's October meeting showed potential penalties of up to £200,000 a month for failure to meet targets for patients waiting longer than four hours in the accident and emergency department, more big penalties for failing to reach electronic discharge summary targets which already stand at £138,000 and £150,000 for failing to increase the number of patients discharged at weekends. Unison said the trust estimated that contract penalties and deductions could add up to £1.6 million over a full year, a further £800,000 could be clawed back if the trust lost out on validation of invoices and that a rising caseload in accident and emergency could trigger more penalties. It said this could push Circle's support payment above a £5 million ceiling which could trigger a renegotiation of the contract or Circle's withdrawal. Unison also said that staff were demoralised and leaving, with a turnover of more than 13 per cent. It said spending on agency staff could reach £2.4 million by the end of the year. Unison is calling for the hospital to be taken over by the Trust Development Agency and returned to professional NHS managers. But a spokesman for Circle said: "We would be happy to meet with Unison as we are sure this is an honest misinterpretation of Circle's track record."

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Huddersfield Examiner

  • Private firms battling for £284,000,000 NHS deal for Huddersfield and Kirklees.

    NHS activists in Huddersfield have said there “is no place for private profit in the provision of health and social care” and called on Kirklees and Calderdale councils to use their powers to stop the tendering process. A host of private health firms are battling for a £284m NHS contract for Kirklees. Greater Huddersfield Clinical Commissioning Group (GHCCG) and North Kirklees Clinical Commissioning Group (NKCCG) have embarked on a project to overhaul how health services are provided. They have now put out the multi-million tender for the so called “Care Closer to Home” community health services. NHS activists in Huddersfield have said there “is no place for private profit in the provision of health and social care” and called on Kirklees and Calderdale councils to use their powers to stop the tendering process. The new scheme will expand on the services currently provided by Batley-based community nursing firm Locala, whose contract expires in March next year. The CCGs held a “market sounding” open day for potential providers last week in a bid to probe what services could be provided as part of the £284m contract. The identities of companies competing for the five to seven year deal are not being revealed for commercial reasons. NHS organisations such as Calderdale and Huddersfield NHS Foundation Trust (CHFT), which runs the hospitals, are also allowed to compete for the lucrative deal. CHFT recently lost a contract to continue to run wheelchair services for Kirklees and Calderdale after it was undercut by private firm Opcare by several million pounds.

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Independent

  • NHS facing £700m black hole over failing Better Care Fund.

    A pioneering plan to save the health service £1 billion a year by keeping patients out of hospital has been branded a “shambles” after the Government’s spending watchdog found at best it would save less than a third of the amount projected at best. In a highly critical report, the National Audit Office said proposals to transfer nearly £2 billion of NHS funding to social care in a bid to reduce hospital admissions had been inadequately thought through and could have left the health service with a massive budget black hole. It added the plans had been based on “optimism rather than evidence”. Even after the scheme was redesigned to reduce the financial risk to the NHS, the NAO said it was still far from convinced that the Better Care Fund would result in its primary aim of reducing emergency admissions to hospital. The report is embarrassing for ministers as the Better Care Fund is seen as critical to the Government’s attempt to control rising healthcare costs, reduce waiting times for operations and plug the gaps in social care resulting from cuts to council budgets. But the NAO found early local plans for the fund, which will pool £5.3 billion of existing NHS and local authority funding from next year, would only deliver £55 million of deliverable financial savings compared to the £1 billion factored in by the Treasury.

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Monday 10th November 2014

HSJ

  • NHS finances ‘absolutely on the knife edge’.

    The health service is “absolutely on the knife edge” with no reserve left to cushion against unforeseen pressures, NHS England officials have warned. Speaking at the organisation’s board meeting yesterday, chief finance officer Paul Baumann said there was “no reserve left which will cater for things which we haven’t anticipated in the risk and mitigation analysis we’ve done”. He described 2014-15 as “the year in which we are absolutely on the knife edge of balancing or not balancing against the position we’ve got”. At month six he said the NHS was £184m off-plan, which accounted for 0.2 per cent of its total budget. The figures are “to be taken seriously, but not a vast deviation” from where the health service is expected to be”, he explained. Mr Baumann said the health service has “overall a good chance of squaring its [financial] position in most foreseeable scenarios through to the end of the year”. He said it was “really, really important that we contain our expenditure”, but “at the moment I can see ways in which it should be possible to do that”. “What I can’t guarantee is that there will be nothing that transpires between now and the end of the year that I wasn’t expecting, either in terms of activity trends going faster than we’ve got in the forecast, or any other calamities or disasters," he warned.In other years it might have been possible to say don’t worry about that too much, because I’ve got a reserve over here of a couple of hundred million that will deal with the inevitable bumps and turns that the NHS throws up in the course of given year.

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  • Bedford refuses to sign Circle MSK contract.

    An NHS hospital has pledged to compete with Circle Partnership, the private provider appointed to run Bedfordshire’s £120m integrated musculoskeletal service, after refusing to become its subcontractor, HSJ can reveal. Bedford Hospital Trust has refused to sign the contract after seeing the number of MSK referrals plunge 30 per cent after Circle took over the service in April. The trust claims the service’s arrangement “endangers the viability” of its trauma and accident and emergency services and could undermine its capacity to retain the seven trauma surgeons it employs. Circle was awarded the five year “prime provider” contract by Bedfordshire Clinical Commissioning Group in April. The deal consolidates 20 separate contracts into a single service and gave Circle the role of running it. Bedford Hospital’s board papers say it “would not be in the trust’s best interests to sign a contract without any mitigation to the consequent impact on trauma and linked services.The significant reduction in referrals since April, and associated potential loss of income (assuming these convert to elective work) mean a direct impact on the viability of the trauma service which in turn will undermine the ability of A& E to see and admit trauma patients,” they say.

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Pulse

  • Third of CCGs have requested powers to police GP contracts.

    A third of CCG leaders have requested new powers to performance manage the GP contract, in a radical move that could see them taking contractual action against their member practices. A Pulse analysis of proposals submitted by 145 CCGs in June found that 32% had signalled they wanted to take on performance management of the GP contract. At least 15% of CCGs said they wanted to take over complete control of the GMS contract from NHS England and 60% said they wanted a role with regards to PMS contracts, including negotiation of terms and PMS reviews. The analysis shows that local commissioners across the country are keen to take control of huge chunks of the GP budget, when they are given the green light in April next year. NHS Leicester City CCG said that a survey of member practices and the public showed that 53% supported CCG taking on a performance management role and deciding on sanctions, while NHS Surrey Downs CCG said that ‘performance measurement tools’ would demonstrate that ‘new innovations are not impacting on core service delivery’. CCGs are expected to submit their final co-commissioning applications to local area teams in January, with the intention for level two commissioning to begin from 1 March and level three from April. But the Pulse analysis gives the first indication of what additional powers they may be asking for.

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CHP

  • The risk of fraud in the new NHS: lessons from the USA and the need for a response in England.

    The NHS’s embarrassing failure to prevent large-scale malpractice by Serco in its out-of-hours contract in Cornwall has raised in a very public way the question of the Department of Health’s strategy for countering the risk of fraud posed by contracts with private providers. The issue has been taken up extensively in the media, reinforced by the Home Office’s even more embarrassing failure to notice that Serco and G4S had billed it for almost £200 for tagging prisoners who had already been released or had even died. The Department of Health, however, has remained silent. In July the Health Service Journal reported, based on a leaked document, that the Department of Health was planning ‘to establish its own fraud investigation function by poaching senior officers from NHS Protect, shrinking the national body’s size significantly as a result’. But the Department declined to comment and has made no further statement on the issue. The Cornwall case, however, and the reported problems of quality cuts and overbilling in Serco’s contract for diagnostic tests at Guy’s and Thomas’ hospitals in London, illustrate the way opportunities for both errors and fraud become much greater with complex and lengthy contracts. This is especially true of contracts with multifarious performance requirements linked to payments, which are typical of NHS clinical outsourcing contracts. This creates multiple opportunities for mistakes to be made which can often lead to overcharging. However, added to this complexity is the influence of profit.

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Mail Online

  • Virgin boss Sir Richard Branson bids to take over cancer and end of life care in NHS privatisation deal worth £1.2billion.

    Virgin boss Sir Richard Branson is bidding to take over cancer and end of life care on the NHS in a privatisation deal worth more than £1.2 billion, it emerged today. The tycoon is looking to secure a controversial £689 million contract to provide treatment for terminally ill patients at four NHS clinical commissioning groups (CCGs). It will be the first time cancer care in the NHS has ever been privatised and the move has been described as the health service's biggest ever outsourcing of resources. The deal would see the private sector delivering all cancer and end-of-life treatment for children and adults across Staffordshire and Stoke on Trent. On Wednesday the four CCGs involved - which care for more than 767,000 patients - announced which organisations have pre-qualified for the 10-year contracts. Five bidders, including Sir Richard's Virgin Care Ltd, have now been short-listed for cancer care-while seven companies, including Virgin Care Ltd, are in the running for end-of-life services.

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Friday 7th November 2014

Our NHS

  • The NHS five year forward view - a wish-list for privatisers?

    Stevens' “Five Year Forward View”, published last week by NHS England, is a collaboration between the six main organisations now running the NHS - Monitor, Health Education England, the NHS Trust Development Authority, Public Health England, the Care Quality Commission and NHS England itself. The “5 year Forward View” reads like a wish-list for further privatisation of the NHS. It may ‘pack a punch‘ for the BBC - which has throttled mainstream media discussion of NHS privatisation. But talk of ‘accountable care organisations’, as developed in Spain and the United States, and the emphasis on preventive health packages so keenly sold by multinational corporates, are paradigmatic of a privatisation plan. The document is a naked shill, intended to carry on the ‘case for change’ made exhaustively by think tanks such as the King’s Fund. Such organisations were instrumental in giving the catastrophic policy of market competition in the National Health Service some legs in the first place. Take, for example, the seemingly-modest proposal of “integrated care commissioning”. In the full glare of sunlight, the policy of personal budgets looks incredibly anaemic. A big unanswered question is how a universal health system is going to be successfully merged with a means-tested social care system. NHS England tried, unsuccessfully to head this issue off at the pass as far back as 2012. Personal health budgets, which Simon Stevens is busy quietly rolling out, are the perfect vehicle for merging the two systems in a way that introduces 'top ups’ and ‘co-payments’, threatening the fundamental principle of universal, free-at-the-point-of-need.

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Hospital Doctor

  • Stop transatlantic trade deal threatening NHS.

    A free trade agreement between the European Union and USA is designed to meet the interests of corporations rather than patients and must be stopped in its tracks. This is the conclusion of an editorial in The BMJ this week. The Transatlantic Trade and Investment Partnership (TTIP) is a series of trade negotiations currently being carried out - in secret - between the EU and US. John Hilary, executive director of campaign group War on Want, says its main aim is to reduce regulatory barriers to trade for businesses on both sides of the Atlantic and includes things like food safety rules, environmental legislation and banking regulations. Public services like the NHS are also to be opened up to competition under TTIP. Hilary warns that the market liberalisation introduced by the 2012 Health and Social Care Act “ensures it will be effectively impossible to take the NHS back into public hands if the EU-US deal goes through”. Furthermore, he says both the UK government and the European Commission “have confirmed that TTIP’s investor protection provisions would grant US corporations the power to sue any future administration over such a move”. He points out that many groups are now campaigning for health services to be taken off the table altogether. Yet even if this were to happen, “there are numerous other ways in which the agreement would have damaging impacts on public health,” he warns. For example, at least one million people will lose their jobs, with all the attendant health consequences, while TTIP is also set to raise the cost of healthcare in Europe.

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The Guardian

  • Financial pressures putting NHS trusts at risk, says spending watchdog.

    Financial pressures are putting NHS trusts at risk, Whitehall’s spending watchdog has found. It revealed that ministers were forced to find more than half a billion pounds of emergency funds to prop up struggling health trusts last year. Margaret Hodge, the chair of the Commons public accounts committee, said the “deeply alarming report” showed the future sustainability of the NHS was at risk. A quarter of NHS and foundation trusts were in deficit by the end of the financial year, with the number in the red rising from 25 to 63 over 12 months, according to a report issued on Friday by the National Audit Office (NAO). The number of foundation trusts in deficit has doubled from 20 to 41 while the gross deficit of NHS and foundation trusts has increased by 150% from £297.2m to £743.3m, the report said. The figures – brought together for the first time by independent auditors – will heighten political tensions over the NHS, which is set to be one of the central issues of next year’s general election. Hodge said: “We all know that when trusts are under this kind of financial stress it is the quality and safety of patient care that can suffer. “An increasing proportion of foundation trusts cannot meet the terms of their licence, including meeting key measures of quality and outcomes, and the NHS Trust Development Authority had concerns about more than half – 55 of 98 – NHS trusts.” In the NAO’s third report on the financial health of NHS bodies, auditors sought to identify organisations in financial distress and decide if the NHS as a whole is financially sustainable. The report found that the Department of Health has now issued £1.8bn in cash injections to 46 NHS bodies since 2006-07, while just £160m has been repaid.

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The Independent

  • One in three NHS hospitals needed Government bailout funds last year.

    More than half a billion pounds in Government bailouts were paid to the NHS in last year, as the number of hospitals in need of extra cash more than doubled, Government auditors have said. In a new report on the parlous financial state of the NHS in England, the National Audit Office said there was growing stress on NHS trusts and warned the situation was “not sustainable”. Thirty-one hospitals required extra money just to maintain services in 2013/ 14 – up from 14 the previous year, the NAO’s report said. One in three hospitals recorded a deficit in March of this year - more than double the number that went into the red last year. To allow struggling hospitals to continue providing vital services, the Department of Health has had to pay out £511m in unplanned funding – up from £263m the year before. Margaret Hodge MP, chair of the Public Accounts Committee said the report was “deeply alarming”. I do not believe it is any exaggeration to say that the future sustainability of our National Health Service is at risk,” she said. “Some trusts are only getting by on handouts. Things are getting worse rather than better and we all know that when trusts are under this kind of financial stress it is the quality and safety of patient care that can suffer.” The report confirms longstanding concerns over the financial sustainability of the NHS England, which is struggling to cope with ever-rising demand, in the wake of the longest and most severe budget squeeze in its history.

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Pulse

  • Private GP providers will have to publish pay.

    GMS contract requirements to make GPs publish their pay will also be placed upon any primary care providers commissioned by NHS England or CCGs, including private APMS practices, NHS England has said. At the NHS England board meeting on Thursday, national director of commissioning strategy Ian Dodge laid out measures for the co-commissioning of primary care and said it was important for CCGs to ensure ‘consistency across different contractual reforms’, specifically citing the publishing of pay. His comments were made as part of the discussion on what co-commissioning involves, which also revealed that NHS England would be publishing statutory guidance on CCGs avoiding potential conflicts of interest. As part of the 2015/ 16 GMS contract, practices will have to publish their average GP pay, which NHS England plans to expand to individual GPs declaring their pay. But Mr Dodge confirmed at the meeting that this will also apply to PMS and APMS providers. He said: ‘It’s important to ensure consistency across the different contractual forms, on a number of areas where it would be self-evidently odd to allow variation. ‘So for example, we are introducing, in GMS, a new set of requirements around transparency of GP earnings, and CCGs collectively and the profession will absolutely want to make sure that that applies across all forms of contracting. So we will have a mechanism to be able to insist on national rules that apply across all forms of primary care commissioning.’

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HSJ

  • NHS bailouts under fire in 'deeply alarming' NAO study.

    Government bailouts for financially troubled hospitals have come under fire from a Whitehall spending watchdog in a report laying bare the deteriorating financial state of the NHS. The National Audit Office report found the “worsening” position and “growing financial stress” experienced by hospitals made the health service unsustainable as a public service. Its analysis found trusts expect to receive £2.2bn more than healthcare commissioners plan to spend in 2015-16 – a funding gap predicted to quadruple to almost £9bn by 2018-19. NAO comptroller and auditor general Amyas Morse described the “growing trend” for NHS trusts to fall into deficit as “not sustainable”. “Until the department can explain how it will work with bodies such as NHS England, Monitor and the NHS Trust Development Authority to address underlying financial pressures, quickly and without resorting to cash support, we cannot be confident that value for money will be achieved over the next five years,” he added. Margaret Hodge, chair of the Commons public accounts committee, described the report as “deeply alarming”. “I do not believe it is any exaggeration to say that the future sustainability of our National Health Service is at risk,” she said. “Some trusts are only getting by on handouts.” The report, called The financial sustainability of NHS bodies, suggests the DH should stop bailing out financially distressed hospitals by offering longer term and planned packages of support and investment instead.

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BBC News

  • Dover Medical Practice to close as private firm pulls out.

    Almost 3,500 patients have been told they will have to find a new doctor because their surgery is closing. Concordia Health, the private medical group which manages the Dover Medical Practice in Kent, told NHS England that it was bringing its contract to an end. Dr Ricky Allen, a GP at the practice, said it would leave a lot of vulnerable people without access to a local GP. Concordia Health, which also pulled out of a practice in Broadstairs earlier this year, has not commented. The Dover Medical Practice, in Maison Dieu Road, will close on 30 November. Dr Allen described it as a "disastrous" decision. "We have a very high proportion of non-English speaking people, people with chronic mental health conditions, severe learning difficulties, lots of people of no fixed abode, kids on the child protection register. "My concern is who's going to pick up the pieces when this place shuts down ?" he said. Dr Allen added that he feared a lot of people would be unable to find alternative GPs because they would not be deemed "attractive as patients". Concordia - they're a business - they come into things to make a profit, and I think they've found - something we've known all along - you won't really make a profit from general practice," he said.

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Thursday 6th November 2014

Sheffield Telegraph

  • Closure leaves 2,000 patients without GP.

    The impact of NHS funding changes and a shift in the way GP services are delivered are under the spotlight in Sheffield as a city surgery faces closure, leaving up to 2,000 patients seeking a new doctor. Westfield Health Centre, in Westfield, is set to shut at the end of next month, after NHS England decided not to replace its sole GP, Dr Gurcharan Singh Chadha, who is taking retirement. Staff have raised fears that the closure will cause waiting times to spiral, while Clive Betts, MP for Sheffield East, has joined the protest and is calling for a rethink on the plan. In an email to Dr Chadha, NHS England said handing his contract to another practice that could operate Westfield as a branch site was ‘not permitted under European procurement regulations’. Meanwhile, attracting another provider ‘did not seem likely’ because of a lack of a lease agreement on the health centre building, the ‘small patient list size’ and ‘future funding changes’.

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Ham & High

  • Camden’s bed-cutting mental health service under pressure over Peter Holboll killing.

    Camden’s mental health service has come under intense scrutiny after it emerged a paranoid schizophrenic killed his mother after being denied a hospital bed. Camden and Islington NHS Foundation Trust (C& I) was said to have presided over a “scandal” after the Old Bailey heard Peter Holboll, 44, was allowed to remain at his mother’s home on May 7, when no beds were available. Holboll and his mother had repeatedly pleaded with C& I professionals for him to be taken into hospital in the two days before he killed her. At one point, Mrs Holboll wept as she begged staff to admit him, fearing he would turn violent as his mental state deteriorated. The case has put C& I under severe pressure over the missed warning signs and its decision to axe more than 100 beds in the past four years. Marjorie Wallace, chief executive of the mental health charity Sane, who lives in Highgate, said: “Camden and Islington Foundation Trust has shut down more than 100 beds in the last three years, relying instead on community teams. While mental health services are in meltdown, we will see more heart-rending tragedies like this.” Referring to the conclusions of a psychiatrist who examined Holboll after the killing, prosecutor Edward Brown QC said: “It is likely he would have been admitted to a psychiatric hospital if a bed was available.” Between 2011 and 2014, C& I lost the second-biggest proportion of beds of any mental health service in the country, with 19.1 per cent being scrapped. It also had the largest reduction in nursing staff, losing 18 per cent. The closures have meant nearly 200 patients have had to be sent elsewhere for treatment since 2011. The Holboll case comes after a recent Care Quality Commission report highlighted a number of failures at C& I.

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Local Government Chronicle

  • Stevens warns leaders that funding increase will depend on A&E performance.

    Senior NHS chiefs have begun ramping up the pressure on providers and commissioners to improve performance in accident and emergency during a round of high level meetings which began last week. Held already in Portsmouth and Brighton, the meetings are headed by the chief executives of the NHS “tripartite” organisations: Simon Stevens from NHS England, David Bennett from Monitor and David Flory, from the NHS Trust Development Authority. They come amid growing high level concern that any demand for extra resource will depend in part on the service’s ability to use additional income already received to hit national A& E targets. Around a dozen areas are expected to be summoned to the tripartite meetings over the next month, LGC’s sister title Health Service Journal understands. The meetings are being held with members of each area’s “system resilience group”, which brings together providers and commissioners to plan how to hit key emergency and elective surgery targets. The national leadership is understood to be concerned that failure to hit the four hour A& E standard, despite more than £600m of extra cash being ploughed into the system resilience group regime, could undermine the case for extra investment in the NHS. Mr Stevens last month told senior NHS leaders gathered at regional meetings that failing waiting time standards could hamper efforts to secure funding increases, HSJ has learned.

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Spalding Guardian

  • Backing for our hospital campaign.

    The Spalding Guardian’s crusade to save A& E and maternity services at the Pilgrim Hospital in Boston is going strong, with many of our readers sending in their coupons to support the campaign. The Guardian joined the campaign to save the future of the A& E department and maternity services at the hospital after it became evident cuts will form a key part of a widespread money saving review.

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Tuesday 4th November 2014

Pulse

  • CCGs to be given green light to agree local QOF deals.

    CCGs will be allowed to replace the national QOF agreement with their own locally agreed deals without NHS England approval, under new proposals announced by NHS England. In its board papers, NHS England opened the door for regions across the country to develop their own deals, similar to that announced in Somerset last year, as part of its plans to allow CCGs to ‘co-commission’ primary care. Under the proposals, which will be finalised at the board meeting on Thursday 6 November, GPs will still have the right to continue with the nationally agreed QOF deal, regardless of whether their CCG has introduced a local deal. The Proposed next steps towards primary care co-commissioning document sets out the parameters around what areas of primary care CCGs will be able to commission, after NHS England chief executive Simon Stevens outlined plans earlier this year to give commissioning groups greater responsibility. As part of the proposals, CCGs will be able to take on responsibility for procurement of new practices. It also proposes that the committees responsible for co-commissioning within CCGs must not be chaired by clinicians, and must not have a GP majority in an attempt to manage potential conflicts of interest.

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Open Democracy

  • The NHS Five Year Forward View - a wish-list for privatisers?

    In October Simon Stevens set out his “five year plan”for the NHS. As a piece of marketing, it is nice and succinct. It sets out a stall for the role of the NHS in a global economy. As a piece of strategy, it is dreadful. It’s dreadful whether you take the view that health provision entirely market-driven - or you view it through a more sophisticated clinical prism. Stevens' “Five Year Forward View” is a collaboration between the six main organisations now running the NHS - Monitor, Health Education England, the NHS Trust Development Authority, Public Health England, the Care Quality Commission and NHS England itself. The “5 year Forward View” reads like a wish-list for further privatisation of the NHS. Talk of ‘accountable care organisations’, as developed in Spain and the United States, and the emphasis on preventive health packages so keenly sold by multinational corporates, are paradigmatic of a privatisation plan. The document is a naked shill, intended to carry on the ‘case for change’ made exhaustively by think tanks such as the King’s Fund. Such organisations were instrumental in giving the catastrophic policy of market competition in the National Health Service some legs in the first place. Take, for example, the seemingly-modest proposal of “integrated care commissioning”. In the full glare of sunlight, the policy of personal budgets looks incredibly anaemic. A big unanswered question is how a universal health system is going to be successfully merged with a means-tested social care system. NHS England tried, unsuccessfully to head this issue off at the pass as far back as 2012. Personal health budgets, which Simon Stevens is busy quietly rolling out, are the perfect vehicle for merging the two systems in a way that introduces 'top ups’ and ‘co-payments’, threatening the fundamental principle of universal, free-at-the-point-of-need. It’s fairly incredible the Stevens report contains no mention of trade agreements such as TTIP and the investor/ state dispute settlement framework that many see as threatening the NHS. If this ‘5 year forward plan’ had been at all serious, TTIP would have been included as a headwind which could drastically throw off course further the direction of travel of the NHS as a state-run health service.

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Guardian

  • Labour supports NHS bill for anti-privatisation.

    Labour will try to move the national debate to the NHS by backing an anti-privatisation bill as Ed Miliband comes under renewed pressure over a record low personal rating. Andy Burnham, the shadow health secretary, will be in Rochester to support Naushabah Khan, the party’s byelection candidate, who will challenge her rivals to say they would use their first day as an MP to support a Labour-backed bill to repeal some of the coalition’s health reforms. Labour is trying to focus debate on the NHS amid fresh worries over Miliband’s public popularity, with a YouGov survey finding he had less support that Nick Clegg, the Liberal Democrat leader. The NHS is likely to figure heavily in campaigning over the next six months, as surveys show it is near the top of people’s concerns and they associate Labour with protecting the health service. Burnham will say that there will be a vote on Labour MP Clive Efford’s bill on 21 November – the day after the byelection – which will be heavily backed by the leadership. This would exempt the NHS from the EU-US trade treaty known as TTIP, repeal the ‘section 75’ rules that force compulsory tendering of all NHS contracts, remove the freedom that allows NHS hospitals to earn up to 49% of their income from treating private patients, and restore the secretary of state’s responsibility for the NHS.

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Monday 3rd November 2014

HSJ

  • Burnham sets out role for private providers in his NHS vision.

    Private health providers could play a significant role in providing NHS services under a Labour government, the shadow health secretary has suggested. In an exclusive interview with HSJ, the Andy Burnham gave his most detailed account of how his flagship policy that the NHS being the “preferred provider” for state run services would work. Mr Burnham, who first floated the model in 2009 while health secretary under the last Labour government, said the “simplest way to put it” was that the “first chance” would be given to the NHS. He said: “So, there is going to be change, but the NHS will get the first chance to change. “You don’t immediately go to an open competition, [the NHS] gets the chance to embrace the model. But [if commissioners judge the] change isn’t acceptable or not embraced fully, then [we] say: ‘We’ve given you first chance to change but it’s not worked. We now need to open up to different ways of doing things.’” The MP for Leigh also gave the all clear for NHS organisations bidding for contracts to bring in a private or third sector provider to deliver some of the work. He said: “The NHS preferred provider principle in non-negotiable for me. Because in the end the public NHS matters to me. “Once you’ve got that principle, then saying that in any locality, allowing people to develop systems that work from that principle but involve others, absolutely, that’s a healthy thing. I think you’d want that to be honest.

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  • Ministers take first steps to imposing contract deal on doctors.

    Ministers have taken the first step towards imposing a contract deal on medical consultants and junior doctors, HSJ has learned. The government has asked the independent Review Body on Doctors’ and Dentists’ Remuneration to consider recommending changes to the medical contracts to “better facilitate the delivery of services seven days a week, in a financially sustainable way.” This could result in substantial proposals from the review body to amend the medical contract terms and conditions. Any proposed changes could then be unilaterally imposed on the medical workforce by the government. The government’s request to the review body follows a collapse in negotiations between the British Medical Association and NHS Employers after 18 months of talks. The BMA has accused the government of refusing to offer safeguards to doctors on the impact of proposed reforms. NHS Employers says such safeguards were under discussion. In a letter to the review body, health minister Dan Poulter asked it to “make observations” on contractual reform to deliver seven day services as well as examining possible changes to the Clinical Excellence Award Scheme. He has also requested the body investigates proposals for pay progression linked to responsibility and performance and arrangements in other industries, where seven day services are already provided.

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New Scientist

  • TTIP: Healthy profits, but what about people?

    The UK Faculty of Public Health will shortly publish a manifesto recommending a range of policies designed to protect and improve public health. These include a sugar tax, a minimum price for a unit of alcohol, a ban on junk food advertising to children and a living wage. All are evidence-based. All could be torpedoed by TTIP. TTIP rides roughshod over national law, undermining the entitlement of states to legislate to protect their citizens. We believe it will damage public health and make prospects for future laws protecting and promoting health less likely. A lot has been written about implications for publicly funded health services, like the UK's NHS. The fear is that TTIP will open them up to private commercial interests which will cherry-pick the profitable areas of patient care, leaving the most vulnerable patients and least attractive services at risk. The government could request that the NHS be exempt from TTIP, but it has shown no inclination to do so. Why would it ? Its stated objective is to open the NHS up to competition. Assurances from European ministers that the NHS is protected are groundless; under the Investor to State Dispute Settlement (ISDS) process (see chart and "TTIP: How the world's largest trade deal affects you") any company that feels its NHS pickings are not adequately protected could cry foul, take recourse to the dispute process and claim compensation. TTIP also threatens public health by potentially weakening legislation such as consumer safety standards, workers' rights and environmental controls.

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The Independent

  • A senior executive at the company used by the Government to oversee disability benefits has attempted to amend his career history amid anger from disability campaigners that the welfare state is now being run by private sector “henchmen”.

    Professor Michael O’Donnell, the former medical director of Atos, now plays a senior role in the American company Maximus, which has won a £500m Government contract to decide whether disabled people are able to return to work. His previous company walked away from the contract, which was supposed to end in 2015. Despite Government promises of a fresh start, Professor O’Donnell now works as the medical director of Health Management Limited (HML) which is a subsidiary of Maximus. The company claims he will not be directly involved in the delivery of the new contract, but all reference to Professor O’Donnell’s previous role at Atos was removed from his career history on the business networking site LinkedIn this week - which MPs and campaigners fear is an effort to conceal the close relationship between the two organisations. Tom Greatrex, Labour MP for Rutherglen and Hamilton West, said: “Government has said Atos is leaving and there will be a new start, but this just reinforces my anxieties and concerns that they may have changed but the process and individuals and the level of service are going to be pretty much the same. It suggests to me that they are not being fully open about the continuity between Atos, who failed so spectacularly to provide a satisfactory service, and Maximus.” Professor O’Donnell also previously worked for the controversial insurance company Unum, which campaigners say has had major influence over reform of the welfare state. Last year the Disability News Service obtained a document written by Professor O’Donnell for Unum which stated: “We know that our views and understanding are not yet in the mainstream of doctors’ thinking, but Government policy is moving in the same direction, to a large extent being driven by our thinking and that of our close associates.”

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The Guardian

  • NHS spending on agency nurses soars past £5.5bn.

    NHS spending on agency nurses and staff has spiralled to more than £5.5bn over the past four years and is continuing to rise amid a debilitating recruitment crisis in the health service. Budgets for temporary staff this financial year have already been blown apart, it can be revealed, with spending in some parts of the NHS running at twice the planned figure. Reliance on agencies – at a cost of up to £1,800 per day per nurse – comes as the number of nurse training places in England has been cut. In the last year of the Labour government, 20,829 nurse training positions were filled in England. That fell to 17,741 in 2011-12 and to 17,219 in 2012-13, rising to 18,009 in 2013-14. According to the latest figures, there were 7,000 fewer qualified nurses in August 2013 compared with May 2010, excluding health visitors, school nurses and midwives. Ministers were accused on Saturday of “truly incompetent planning” by the Royal College of Nurses. Many of the agency nurses filling the gaps are from abroad, which means their home countries are robbed of medical expertise. Last year 6,228 foreign nurses registered with the Nursing and Midwifery Council, 22% of the total number of new nurses qualified to work. This compares with 4,305 the previous year. Dr Peter Carter, general secretary of the Royal College of Nursing, said: “These spending figures beggar belief and are the result of truly incompetent workforce planning. Nursing staff are sometimes seen as an easy target for cost savings, only for the NHS to find itself dangerously short- staffed and having to plug the gap. This means individual hospitals and the NHS as a whole are spending too much on agency staff and recruitment from overseas.” New figures released by the government following a parliamentary question show that NHS Foundation Trusts spent £4.3bn between 2010-11 and 2013-14 on agency and temporary staff. Other NHS Trusts spent £1.2bn in 2013/ 2014, but figures were not available for these trusts over the previous years, meaning the total bill for the last four years could be closer to £10bn.The figures show that, despite repeated pledges to cut spending on this, the cost to NHS foundation trusts has gone up by around 20% for each of the four financial years of the coalition government. In the last year of the Labour government, NHS foundation trusts spent £734m. In 2013-14 that had doubled to £1.3bn.

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Thursday 30th October 2014

Pulse

  • Practices placed in CQC ‘special measures’ could face bill of up to £5,000 to be given support.

    GP practices that are placed in CQC ‘special measures’ will have to pay half the costs of essential support, which will cost them up £5,000, in a move described by GP leaders as potentially the ‘final straw’ for many practices. The 12-month pilot support programme developed by the RCGP and NHS England has been offered to practices that enter special measures after being given a rating of ‘inadequate’ in some areas by the CQC’s new inspection regime, and will include expert professional advice, support and peer mentoring from senior GPs co-ordinated by the college. But the GPC has warned that practices most likely to need the support will be under-resourced, with this extra fee potentially leading to practices closing.

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Sheffield Telegraph

  • Disabled petition triggers debate.

    A major protest over the future of Sheffield’s learning disabilities service will be heard at a council debate. More than 5,000 people signed a petition opposing the ‘potential privatisation’ of the service, triggering a debate next Wednesday at the Town Hall. The council is considering hiring a private firm to run the supported living service, which includes the learning disabilities department, with trade union Unison claiming it will be sold ‘to the cheapest bidder’. Losing the contract and winding down the service would cost the NHS millions, according to the union.

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New Statesman

  • NHS reform and the hollow marketisation myth.

    When the chief executive of NHS England produces a 39-page, 15,000-word rescue plan for the health service that, a senior doctor later told me, “doesn’t even mention the real problem in the system”, you know something is up. Not that it’s any great surprise. Simon Stevens isn’t likely to agree with my source that the real problem in the NHS is a prevailing ideological dogma that “private is good and public is bad” among top brass, nor that the aggressive marketisation programme currently underway is all based on a myth. The private healthcare man turned NHS-saviour has only been in his post for seven months after 10 years at global giant United Health Group, and old habits die hard. But the real paradox at the heart of Stevens’ five-year plan is that he calls for ruthless efficiencies and then turns a blind eye to the sort of “grotesque financial waste” that consultant clinical oncologist and National Health Action Party (NHAP) co-leader Clive Peedell says is crippling the system. Peedell says: “Wasteful internal markets, commissioning support units, management consultancy fees, the cost of procurement of clinical services, profit-taking by private providers, the cost of fragmenting pathways due to outsourcing components to private contractors, and PFI deals bankrupting our hospitals; they are draining billions from frontline care in our NHS”. A metamorphosis is taking place; a mutation of the NHS from a public service into a lucrative marketplace. None of this is particularly new – but since the Health and Social Care Act kicked in two years ago, trusts have been legally obliged to compete with private providers over contracts, and take on the extra administrative costs of doing so. Allyson Pollock, professor of public health research at Queen Mary University of London, says: “It’s quite clear that the government wants to contract out as much as it can before the general election, but there’s no data about the costs for trusts such as lawyers and management consultants in doing this”. And after a slow start, the scrum has really kicked in now. Campaign group NHS Support Federation has recorded five times more contracts coming onto the market between July and September this year, a cool £2bn’s worth, than in the first three months of life under the Health and Social Care Act when only £266m was up for grabs. Bound by competition laws, NHS trusts find themselves in the position of having to spend tens, maybe hundreds of thousands bidding to carry on running services they already deliver, or, even worse, to then lose out to private providers that have cherry-picked the contracts and put all of their corporate weight behind winning them.

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Open Democracy

  • MP's plan to send 'NHS cost statement' will make sick people feel more of a burden.

    Tory MP Jesse Norman today proposes that we should send everyone who uses the NHS an Annual Healthcare Statement. The statement would show them how much they have cost the NHS and 'by implication the value of NHS services'. It is designed, it says, to dissuade people from presenting to hospital or GP surgeries unnecessarily. The report also suggests 'more incentives' could be added in the future. Fear that a free NHS would result in overwhelming demand has been around since the very idea of an NHS arose. It’s an idea that has been superbly deconstructed by Julian Tudor Hart. Politicians and economists couldn't believe that free healthcare wouldn't result in unsustainable demand. In a panic they introduced prescription charges, which led to Nye Bevan's resignation. But in fact: “In 1951 the first postwar Conservative government set up a Royal Commission to measure abuse and extravagance. After painstaking studies the Guillebaud Commission found no evidence of either, only hard-working staff and stoical patients, underfunded and lacking investment." The most vulnerable patients already fear that they are a burden on the NHS. As a result they attend too little. Or they fail to attend because they are feeling ashamed, or even when they are feeling too unwell. Parents of young children struggle too, feeling “strongly influenced by a sense of responsibility to act as competent parents and the fear of overwhelming guilt should they fail to do so”. It will encourage a superficial view of healthcare as a commodity, rather than care as something complex that happens between people. Something recorded as a minor illness on a hospital letter happens to someone with a history and a home-life, hopes and fears.

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Nursing Times

  • Difficult choices on pay will be 'on-going reality', says Burnham.

    A Labour government would use pay restraint and make “difficult choices” about the wages of NHS frontline staff if the party wins the election next year, Andy Burnham has said. The shadow health secretary said he wanted a deal for staff that was “right and fair” and which reflected rises in living costs and other pressures, such as increases in professional fees for nurses. In an exclusive interview with Nursing Times’ sister title Health Service Journal, he said he accepted there was “always a trade-off between what you can pay and job numbers”. Asked if he would use pay restraint to address the health service’s long term financial challenges, he said: “Of course.”

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Tuesday 28th October 2014

Open Democracy

  • The People vs. PFI – Giving PFI a run for our money.

    The Private Finance Initiative is an unfair, unaccountable rip-off, destroying our NHS. A conference on 1 November aims to show campaigners how to fight back. Here’s how it works. A private finance initiative (PFI), also known as a public private partnership (PPP), is a government programme that is funded and operated through a partnership between the government and one or more private sector companies. A PFI hospital isn’t owned by you and managed on your behalf to make sure you get the best care. It’s owned by a private company and run to make shareholders rich. The fact that people receive medical care in their building is only incidental. We were told the high costs of PFI were because the private sector was taking on the ‘risk’. But this is nonsense. Private companies usually form a new front company, called a “special purpose vehicle”: a separate legal entity which allows them to isolate themselves from the financial risks involved in the PFI project. If a PFI project goes bust, the government usually has to bail it out, because as a public utility its continuing function is vital. This is regardless of how much profit the private sector investors have accrued from their involvement. PFI is unfair - communities have to live with the results of badly designed, rip-off contracts for decades. PFI is unaffordable because the iron-clad contracts demand a total of £10bn a year in unnecessary extra costs from the public purse, which forces the closure of other essential services. And PFI is unaccountable because commercial confidentiality means we can’t fully understand how costly these contracts are, or challenge the people responsible when things go wrong. And things do go wrong – all the time. Hereford Hospital found that their hospital had been in breach of fire safety regulations for over a decade. Birmingham’s flagship PFI hospital is under investigation for chlorine contamination and a possible link to the deaths of two patients. Local authorities get charged ridiculous fees for additional works: such as £965 to replace a single TV aerial or £22 for 65p light bulbs. And residents in a PFI housing estate in Lambeth who challenged repairs that hadn’t been completed are now being sued for ‘causing trouble’. PFI has far-reaching political consequences too: who owns the infrastructure and how it is financed determines who gets to use it - and at what price. It even determines what kind of infrastructure does or does not get built in the first place. That’s why many PFI hospitals built with too few beds are now finding themselves chronically overcrowded, making effective treatment even more difficult in an incapacitated NHS. But you’re unlikely to ever know that there’s a problem, until all of a sudden you find your public services at risk of closure – remember Lewisham ? The implications for equality, social mobility and environmental stability are obvious. On November 1, the People vs. PFI campaign will officially launch at the London School of Hygiene and Tropical Medicine. Put together by a small group of activists, academics and journalists, this campaign has been gaining steam and attracting the support of organizations such as Medact, Unite the Union, and We Own It. PFI affects all aspects of our lives. It represents a ‘financialisation’ of our public infrastructure - and so, a common ground for campaigns and struggles on many fronts. In the last year we paid PFI companies £10bn. That’s £ 27,945,982 per day, £19,407 per minute or £ 323 every second. In the time it’s taken you to read this article alone that could have paid for the annual salary of at least 3 staff nurses; in total it could have wiped out the entire NHS “funding gap” many times over. And yet the Tory-led coalition tells us that 4,000 senior nurses had to be axed since they came into power because “we can’t afford it”. The only way NHS trusts can pay off these extortionate PFI debts - and avoid liquidation - is to sacrifice staff, standards and service quality. The People vs. PFI campaign is for those who believe enough is enough.

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Financial Times

  • Public sector executives face redundancy rule change.

    Well-paid public sector workers laid off and reappointed later will have to pay all or part of their redundancy money back to the government. Public sector executives who earn more than £100,000 a year who are made redundant but then re-employed in the same area of work will be subject to the law, to be included in the government’s small business bill next month.

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Get West London

  • More ambulances missing target response times as private spending rockets.

    Ambulance waiting times across west London have shot up in the last six months, according to new figures. The proportion of ambulances failing to arrive within eight minutes of being called in Brent rose from 22 per cent in March this year to 43 per cent in August. There were also sharp increases in the percentage of ambulances missing the government's emergency response target in other west London boroughs, including Ealing (20 per cent) and Hounslow (15 per cent). Across London, the proportion of ambulances missing the target doubled to 38 per cent during that period, the latest statistics from the London Ambulance Service (LAS) show. The huge rise comes as new figures show spending on private ambulances in London has increased tenfold in the last two years, from £795,635 in 2011/ 12 to £8,841,808 last year.

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