CUTS CAUSING INEQUALITY
NHS accused of shrouding £500m of planned cuts in secrecy (The Guardian: 28 July 2017)
Doctors’ leaders have accused NHS bosses of shrouding controversial plans for £500m of cuts to services across England in “totally unacceptable secrecy”.
Patients deserve to know how hospitals being told to “think the unthinkable” as part of the savings drive will affect their access to healthcare, the British Medical Association (BMA) said on Friday.
The doctors’ union voiced its frustration after trying but failing to obtain details of the cuts that are being planned in the 13 areas affected by the “capped expenditure process” (CEP), despite the NHS’s duty as a public body to respond to freedom of information requests.
NHS bodies in just eight of the 13 areas replied, and none gave anything other than vague, general details about what cuts were under consideration.
“It is bad enough that brutal cuts could threaten the services but it is totally unacceptable that proposals of this scale, which would affect large numbers of patients, are shrouded in such secrecy,” said David Wrigley, the BMA’s deputy chair.
In April organisations providing all types of care as well as clinical commissioning groups, the local bodies which hold the NHS budget in England, in the 13 areas were told to make an extra £500m of savings by the end of March 2018 over and above those already planned. The orders came from NHS England and NHS Improvement, the service’s financial regulator, which are keen that its books can be made to balance in 2017-18.... read more
Theresa May to oversee £85m in cuts to public health budgets this year, analysis reveals (12 July 2017)
Theresa May has been accused of taking her “eye off the ball” over public health as it was revealed budgets for a range of services including sexual health and help to stop smoking face new cuts of £85m.
Local authorities in England are being forced to spend more than 5 per cent less this year on public health initiatives than in 2013-14, according to a new analysis from the King’s Fund.
David Buck, the health think tank’s senior fellow in policy, used data from local governments and the Department of Communities to calculate that planned spending on sexual health services has fallen by £64m, or 10 per cent, over the past four years.... read more
Chickens coming home to roost: local government public health budgets for 2017/18 (Kings Fund: 12 July 2017)
The Department for Communities and Local Government has released new data on local authorities’ planned budgets for public health in 2017/18. It does not make good reading.
Since 2013, when local authorities were first given responsibility for many aspects of public health, they have received a grant for this from the Department of Health. It is easy to forget that in the first few years the growth in this grant was quite generous: 5.5 per cent in both 2013/14 (against an estimated primary care trust baseline) and 2014/15, reflecting the coalition government’s commitment at that stage to investing more in public health. But in 2015/16 things changed dramatically.... read more
Changing population means NHS faces real-terms funding cut this decade (The GP Online: 8 May 2017)
NHS spending in 2019/20 will be 1.3% lower in real terms than a decade earlier once growth and ageing of the population are taken into account, according to public policy analysts.
Research by the Institute for Fiscal Studies (IFS) reveals that real-terms DH spending will increase by 12% over the period from 2009/10 to 2019/20 under current government plans.
This equates to a 1.1% increase per year - outstripping the 0.8% per year rate of population growth over the same period, meaning that real-terms per capita spending will have risen 3.5% over the decade.
However, once changes to the 'age structure of the population' are taken into account, the IFS warns that current spending plans will in fact deliver a 1.3% drop in per capita spending...read more
Government spent £17.6m on consultants hired to draw up NHS cutbacks (The Independent: 21 March 2017)
Firms including KPMG, McKinsey and PricewaterhouseCoopers (PwC) have made millions of pounds from plans that could lead to the closure or downgrade of NHS hospitals.
Health bosses have spent at least £17.6m on management consultants to draw up the strategies, which earmark cuts to departments and some A&Es.
Sustainability and transformation plans (STPs) have been created in 44 regions in a bid to revolutionise services while saving money in the face of an expected £900m NHS deficit this year.
The Press Association used the Freedom of Information (FOI) Act to ask clinical commissioning groups (CCGs) how much has been spent on management consultants to formulate the plans.
The figures show £17,674,998 has been spent so far, though the final bill is likely to be far higher....read more
Hospitals could join prisons and social care in a cycle of “crisis, cash, repeat” unless they receive better financial planning and reforms, a Whitehall report has warned.
Without improvements, public services are doomed to fail or breach spending controls, the report by the Institute for Government and the Chartered Institute of Public Finance and Accountancy (Cipfa) said.
The government’s austerity programme of delivering good services while cutting spending “ran out of steam” in 2015, according to an analysis of official figures. Both organisations are urging the chancellor to ensure any measures in the budget have sound evidence behind them.
The findings come as Philip Hammond comes under pressure to use an unexpected rise in tax receipts to aid public services in his first full budget next week.
Julian McCrae, the Institute for Government’s deputy director, said that unlike others, this report was not calling for more money but instead better organisation to shore up the public sector.
“As we’ve seen with prisons, social care and now potentially hospitals, the government risks getting into a cycle of crisis, cash, repeat,” he said. “This report is a call for better financial planning and reforms that are robust enough to survive public scrutiny.
“It is fundamental to increasing the effectiveness of these public services that ministers, officials and the public know how well government is performing and use this information to guide decisions.” ....read more
NHS staff ask 'least bad' patients to sleep in corridors amid hospital demand crisis (The Telegraph: 28 February 2017)
Patients are being asked to volunteer to sleep in corridors in order to free up spaces on overrun NHS wards, a new report reveals.
An anonymous survey of front-line doctors found staff are deliberately approaching the “least bad” patient in their ward to ask them to give up their bed.
The report on NHS performance in December and January by the Royal College of Physicians also reveals concerns that “panicking” managers desperate to get new patients into recently vacated beds are sidelining proper infection controls.
Patients groups said the document showed that quality hospital care has now become “a lottery” and that, despite a relatively mild winter, the NHS is “on course for catastrophe”.
Approximately 60,000 patients visited A&E a day in England in the last week of December, and early data indicates that a quarter had to wait for more than four hours to be seen, with many having to wait for up to 12 hours.
Emergency medicine consultants reported that their departments were so busy at the height of the winter period that patients were frequently treated in A&E waiting rooms, rather than in proper beds....read more
The latest NHS bed occupancy figures are the highest ever recorded for a third quarter since quarterly data collections began in 2010, providing a further sign of the system’s capacity challenges.
The average occupancy rate for all beds open overnight between October and December 2016 was 88.3% – up from 87.2% for the same quarter in 2015-16 – against the 85% standard, according to data published by NHS England.
Higher bed occupancy figures have only ever been recorded in fourth quarters, which are usually the busiest period of the year for the NHS. Overall, bed occupancy rates were 89% in quarter four of 2015-16, and 88.5% in quarter four of 2014-15.
The average occupancy rate for general and acute beds open overnight in quarter three this year was 90.5%, compared with 89.1% a year earlier.
Health Service Journal analysis of the data shows six hospital trusts recorded average general and acute bed occupancy rates of over 99% for the quarter. Nine more recorded a rate of over 95%, while further 10 recorded average occupancy of over 95%...Read More
Government cutting beds across UK hospitals in NHS money saving measures (The Independent: 21 February 2017)
Hospitals will have to be closed and beds cut as part of a series of money-saving measures across the NHS in England.
A new report from The King's Fund think tank has warned that the number of hospital beds could destabilise services that were already "stretched to their limits" after the Winter.
Community services were also "feeling the strain" and could not currently cope with an increase in workload, it said.
Sustainability and transformation plans (STPs) have been put forward by NHS chiefs in 44 areas in England as part of a national programme to transform the health service and save money.
The included hospital closures and cuts to some specialist services such as accident and emergency and stroke care.
King's Fund Chief Executive, Chris Ham said that the NHS cannot “realistically” cut the number of beds when this winter had shown that they were needed.
But he added that also said it needs to throw its full weight behind the plans to stand a chance of pulling them off.
The cuts could include a 44 per cent reduction in inpatient bed days in south-west London and a cut in hospitals in north-west London from nine to five. Hospital beds in Dorset could also be from 1,810 to 1,570....read more
An unprecedented rise in mortality in England and Wales, where 30,000 excess deaths occurred in 2015, is likely to be linked to cuts to the NHS and social care, according to research which has drawn an angry response from the government.
The highly charged claim is made by researchers from the London School of Hygiene & Tropical Medicine, Oxford University and Blackburn with Darwen council, who say the increase in mortality took place against a backdrop of “severe cuts” to the NHS and social care, compromising their performance.
The Department of Health (DH) responded by accusing the authors of the paper and accompanying commentary, published in the Journal of the Royal Society of Medicine on Thursday, of bias.
The researchers ruled out other possible causes of the increase, including cold weather, flu and the relatively low effectiveness of the flu vaccine that year, noting that fatalities from the virus rose “but not exceptionally”...Read More
Fears of 'two-tier NHS' as GPs allow fee-paying patients to jump the queue (The Guardian: 8 February 2017)
Family doctors in Bournemouth have set up the first private GP service at which people who pay up to £145 a time will be seen faster and get longer appointments than their NHS patients.
The creation of the clinic has prompted fears that other GPs will follow suit and that NHS patients will become “second-class citizens” as general practice increasingly becomes a two-tier health service.
The three doctors running the Dorset Private GP service are offering “the unhurried, thorough, personal care we believe is best for patients” – at a price. Patients pay £40 for a 10-minute phone consultation, £80 for a 20-minute face-to-face appointment and £145 for 40 minutes with a GP.
“With the NHS sometimes struggling to offer a quality service now is the time to choose a private doctor,” according to the website for the trio’s venture. They offer times that suit patients and the chance to see the same GP at each visit, benefits that few NHS patients are offered any more because of the heavy and growing pressures on family doctor surgeries.
Those who pay receive their appointment at the same Poole Road Medical Centre in Bournemouth where the GPs see the NHS patients on their practice list. However, private patients in effect jump the queue to be seen as they can get appointments on the day, whereas ordinary patients can wait up to four weeks for an appointment lasting just seven minutes.
GPs are barred under the terms of their contract from offering private medical services to patients on their practice list. However, the Dorset Private GP service is not breaking any rules because it is only offering the service to other people....read more
CCGs claim rationing decision based on Right Care programme (The HSJ : 8 February 2017)
Last month HSJ revealed that Redditch and Bromsgrove Clinical Commissioning Group, alongside South Worcestershire and Wyre Forest CCGs, intended to restrict knee and hip replacement operations on the basis of a patient’s Oxford knee and hip scores, which are usually used to asses patient outcomes.
The CCGs could save £2.1m a year by reducing operations
The Royal College of Surgeons said the move had “no clinical justification”.
Redditch and Bromsgrove CCG said in a board paper the CCGs had “utilised” NHS Right Care data packs to identify hip and knee replacement surgery as an area where the three groups could reduce expenditure by “circa £2,123,420 per annum”.
In a statement to HSJ last week, the CCG said: “We have worked with our NHS England appointed Right Care delivery partner to understand how to use the Right Care analysis packs properly before making decisions in this area.”
NHS Right Care is a national programme launched to tackle unwarranted variation in commissioning policies across England. Since April 2016, NHS England has published analysis packs for each CCG to use to reduce variation.
The packs compare outcome measures, activity and spending between CCGs with similar demographics for certain NHS treatments, including knee and hip operations.
Redditch and Bromsgrove said this week the Right Care packs indicated that all three CCGs commission 300 more hip replacements and 53 more knee replacements than similar CCGs...read more
NHS cash crisis in Kent halts non-urgent surgery until April (The Guardian: 2 February 2017)
An NHS body has run so short of money that it has banned patients in its area from having non-urgent surgery for up to 102 days in an unprecedented move that doctors have condemned as unfair and damaging.
Around 1,700 patients will be affected by West Kent clinical commissioning group’s (CCG) attempt to save £3.2m by delaying non-urgent operations from 20 December last year until the new financial year starts in April.
The CCG has introduced what the Royal College of Surgeons says is the longest ban in health service history on patients undergoing surgery to relieve pain, immobility, disability and other problems. The 1,700 patients include those waiting to have a new hip or knee fitted.
It is the latest example of cash-strapped CCGs implementing controversial restrictions on patients’ access to treatment which doctors have agreed they need. It follows a series of rows over the growing number of England’s 209 CCGs rationing care, including to smokers and those who are obese.
West Kent CCG has decided to suspend non-urgent surgery to help ensure that it does not bust its £616m annual budget. It pays for and supervises the care received by 463,000 people in Maidstone, Tunbridge Wells and surrounding areas.....read more
NHS spending per person will be cut next year, ministers confirm (The Independent: 28 January 2017)
The Government will cut the National Health Service’s budget per person in real terms next year, ministers have admitted in official figures for the first time.
Numbers released by ministers show NHS England will face a sharp reduction of 0.6 per cent in real terms of per head in the financial year 2018-19.
The numbers corroborate claims by NHS chief Simon Stevens earlier this month that “in 2018-19, real-terms NHS spending per person in England is going to go down”.
The figures also fly in the face of the Government’s public insistence that it is investing more in the health service, with Jeremy Hunt and Theresa May repeating the mantra of an extra £10bn for the NHS.
That claim was debunked by the cross-party Health Committee in the summer, whose chair, Tory MP Sarah Wollaston, said the number was both “incorrect” and “risks giving a false impression that the NHS is awash with cash”.
The Liberal Democrats said the figures show Tory claims of investment were “disingenuous” while Labour said the Government should use the March budget to close the black hole opening up in the health service’s finances....read more
Care for elderly ‘close to collapse’ across UK as council funding runs out (The Guardian: 26 November 2016)
Theresa May is under intense pressure from senior doctors and a powerful cross-party alliance of politicians to avert a collapse in care for the elderly, as shocking new figures show the system close to meltdown.
The medical profession, together with Tory, Labour and Liberal Democrat leaders in local government, have demanded a funding U-turn, warning that the safety of millions of elderly people is at risk because of an acute financial crisis completely overlooked in chancellor Philip Hammond’s autumn statement.
New figures obtained by the Observer show that 77 of the 152 local authorities responsible for providing care for the elderly have seen at least one residential and nursing care provider close in the last six months, because cuts to council budgets meant there were insufficient funds to run adequate services.
In 48 councils, at least one company that provides care for the elderly in their own homes has ceased trading over the same period, placing councils under sudden and huge pressure to find alternative provision.
In addition, 59 councils have had to find new care arrangements after contracts were handed back by a provider who decided that they were unable to make ends meet on the money that councils were able to pay them.
The medical profession, council leaders and even the former Tory health secretary, Andrew Lansley, are appalled that the social care crisis – exacerbated by growing numbers of elderly people and the rising costs of paying staff – was not addressed in the autumn statement.
In a letter to the Observer, the leaders of the four main political groups in local government expressed their disquiet at the chancellor’s dismissing talk of a crisis despite calls from politicians, NHS leaders, doctors and others....read more
More than four in five (83%) staff working in mental health surveyed said a postcode lottery exists in the level of care that patients receive. In some cases, people with severe conditions such as chronic anxiety and schizophrenia are unable to access help until they have reached crisis point.
The findings are based on a survey of more than 1,000 staff such as therapists, nurses and social workers employed by mental health care services including the NHS and councils across the UK.
The survey also highlights how increased patient demand for services, coupled with cuts in services have left those staff left behind facing intolerable pressures.
More than four in five (85%) surveyed said they had experienced cutbacks, and nearly nine in ten (88%) reported an increased workload. This has led to longer waiting times for patients before they can get help, according to more than half (52%) of staff, says UNISON.
UNISON head of health Christina McAnea said: “The government has pledged £1.25bn for mental health but services are still having budgets reduced. No-one should have to wait weeks to get the support they need, and staff shouldn’t be placed under such pressure that they risk using mental health services themselves.
“With fewer staff and more people seeking help, it’s no wonder that employees who dedicate their lives to helping others feel at breaking point. Funding for mental health services must reach those in need and not be diverted to plug gaps elsewhere in the NHS.”....read more
NHS funding and rationing: The debate intensifies (http://www.bbc.co.uk: 31st October 2016)
In 2014, ahead of the general election, George Osborne, the Chancellor of the Exchequer, conjured up an extra £1.9bn for the NHS in England for 2015-16, after warnings there had been an unbridgeable gap in the finances.
Under the usual funding formula, this became £2.2bn across the UK, on the assumption the devolved administrations spent their allocations on health.
This was unveiled with a hospital photo opportunity involving Mr Osborne, Simon Stevens, of NHS England, and the Health Secretary Jeremy Hunt and was widely welcomed by health commentators and think tanks.
The election came and went, and it was not long into the 2015-16 financial year before hospital trust bosses were warning of mounting deficits and the sums not adding up.
Fast forward to the autumn of 2015, and Mr Osborne was publishing his Spending Review for the years up to 2020...Read More
It is “foolish” of the NHS and the government not to focus on meeting the needs of children with mental health issues, the Royal College of Nursing (RCN) has said, as a poll revealed seven in 10 specialist nurses find CAMHS services either ‘inadequate’ or ‘highly inadequate’.
Of the 631 mental health nurses working in CAMHS surveyed, half said services are inadequate, whilst another 20% said they were highly inadequate. Just 13% believed they are good or very good, and the rest think they are simply ‘adequate’.
Fiona Smith, the RCN’s professional lead for children and young people’s nursing, said: “We are failing young people with mental health problems by not providing services and interventions in a timely manner.
“It’s foolish of the NHS and the government not to really focus on meeting these young people’s needs, because we know that with [the] three out of four adults with mental health problems, their symptoms began in childhood.”
The poll, undertaken by the RCN for the Guardian, also revealed that 43% of surveyed nurses said services were getting worse – despite government promises of extra cash and assurances that more young people would be able to access care.
Asked about the main problems with CAMHS services, around 73% of polled nurses cited a small workforce, whilst 72% argued delays in patients getting appointments were a major issue. Almost 70% cited young people being sent to get care out-of-area due to bed shortages and another 59% cited their inability to give patients as many appointments as they need.
One RCN member commented: “Children and their families are suffering due to poor CAMHS, support and availability....read more
NHS rationing under the radar (www.kingsfund.org.uk: 17th August 2016)
After years of increasing deficits, that last year culminated in the NHS posting the largest overspend in its history, local health systems have been told to balance their books.
This intensifies the difficult decisions that commissioners and providers have been facing for some time, about how to prioritise limited funding and balance their budgets in the face of rising demand. While the NHS has always had to set priorities, with these unprecedented financial pressures it is inevitable that some organisations will be forced to restrict access to certain services or dilute quality of care as they seek to curtail spending. In some areas this is happening already...Read More
Rising numbers could face 'crippling pain' as NHS rationing spreads (http://www.telegraph.co.uk: 9th August 2016)
Increasing numbers of patients will be left to endure “crippling pain” as rationing spreads across the NHS, one of Britain’s most senior surgeons has warned.
Stephen Cannon, Vice President of the Royal College of Surgeons said bans on all but the most urgent treatment would become “commonplace” without major changes to the funding of the health service.
The NHS is in the grip of the worst financial crisis in its history, with increasing restrictions on cataract surgery and lengthening waiting times for hip and knee operations in most areas.
Yesterday St Helens clinical commissioning group in Merseyside took the unprecedented step of making plans to suspend all non-urgent treatment for four months, in an attempt to tackle its overspend.
In a letter to The Telegraph, Mr Cannon, an orthopaedic surgeon, said such bans would become widespread without a “realistic” increase in funding.
He also called for changes in the way existing funds are spent, to divert more money away from bureaucracy towards front-line care. “I am concerned that we could end up going back to the days when patients waited two or three years for operations” Stephen Cannon, Vice President of the Royal College of Surgeons...Read More
Call for cross-party commission into NHS and social care 'crisis' (www.nursingtimes.net: 20th September 2016)
The call to Theresa May comes from two former government health ministers and a shadow health minister.
Liberal Democrat North Norfolk MP Norman Lamb, who was a minister in the coalition government, has joined forces with Dr Dan Poulter, former minister and Conservative MP for Central Suffolk and North Ipswich, and Liz Kendall, Labour MP for Leicester West and a former shadow health minister.
In a joint statement, the three senior health figures argued that health and care services in England faced a serious existential challenge, and that partisan politics had failed to come up with long-term solutions to ensure that services are properly funded and sustainable for the future.
Highlighting expert warnings of growing gaps in social care and the diminishing ability of the NHS to meet demand under current spending plans, they called on the government to start a “national conversation with the public and healthcare staff”...Read More
Exclusive: ITV News survey finds doctors 'rationing care' as cash crisis hits NHS (http://www.itv.com: 14th September 2016)
More than two thirds of doctors admit they have been left with no choice but to ration care as the NHS cash crisis intensifies.
Services and treatments including mental health care for children, hip and knee replacements and cancer drugs are being restricted in order to save money.
A survey of 1,000 doctors conducted exclusively for ITV News reveals patients are being denied treatments including varicose vein removal and cataract surgery, and forced to pay for care privately or wait for their condition to worsen.
Some patients ended up in A&E because they were refused treatment...Read More
Patient choice and private provision decreased public provision and increased inequalities in Scotland: a case study of elective hip arthroplasty (PubMed: 28 July 2016)
An increased use of private sector provision by NHS Boards was associated with a significant decrease in direct NHS provision in 2008/09 (P < 0.01) and with widening inequalities by age and socio-economic deprivation. National treatment rate fell from 143.8 (140.3, 147.3) per 100 000 in 2006/07 to 137.8 (134.4, 141.2) per 100 000 in 2007/08. By 2012/13, territorial NHS Boards had not recovered 2006/07 levels of provision; this was most marked for NHS Boards with the greatest use of private sector, namely Fife, Grampian and Lothian. Patients aged 85 years and over or living in the more deprived areas of Scotland appear to have been disadvantaged since the onset of patient choice in 2002.
NHS funding of private sector provision for elective hip arthroplasty was associated with a decrease in public provision and may have contributed to an increase in age and socio-economic inequalities in treatment rates....read more
Are commitments for mental health all talk and no action? (The Guardian: 29 July 2016)
Promises, platitudes and plans are piling up for mental health, but how much is going to be delivered?
Mental health accounts for roughly £12bn of the NHS budget. In parliamentary terms the current support for mental health is unprecedented – parity of esteem with physical health services is enshrined in the Health and Social Care Act 2012, plus last year’s spending review made explicit reference to improving quality, choice and outcomes in mental health.
But a recent report by the health select committee on the impact of the spending review on health and social care was sceptical about whether the rhetoric is being matched by actions. The committee called for verifiable evidence that the additional cash promised to mental health was reaching the front line, and that the cultural change necessary to deliver parity of esteem was happening.
The NHS planning guidance for 2016-21 instructs clinical commissioning groups to increase investment in mental health at least at the level which matches their overall spending increase, but whether this being done is disputed. NHS clinical commissioners insisted to MPs that this is happening while NHS Providers maintained the money is not coming through. It even accused commissioners of using “weird and wonderful calculation methodology” to justify their claims.
The government has made specific promises: more cash for young people with eating disorders, a “system-wide transformation” of children and young people’s mental health and perinatal mental health, and improved access to psychological therapies. But it is far from clear how the money for this will avoid being dragged into the black hole of the acute sector’s deficit....read more
Two-thirds of GP referrals for child mental health lead to no treatment
(Pulse: 4 July 2016
An increasing number of vulnerable children are being refused vital mental health treatment that is recommended by their GP, finds a major Pulse investigation.
Figures obtained from 15 mental health trusts reveal that 60% of GP referrals to child and adolescent mental health services (CAMHS) lead to no treatment and a third are not even assessed.
The situation for young people with mental health issues appears to be worsening, with the numbers of referrals that progress to treatment decreasing from 44% in 2013 to 39% in 2015.
GPs told Pulse that CAMHS were refusing to treat patients unless they had attempted suicide or self-harmed. Many cases are being sent to school counsellors or charity services, when GPs have requested specialist input.
The figures come despite Government promises to increase access to mental health services for children, with an increase in funding of £1.4bn and a call to all regions to produce plans on how they are going to work together to improve CAHMS services.
The freedom of information requests to mental health trusts found that in Norfolk and Suffolk NHS Foundation Trust the number of CAMHS referrals progressing to treatment was 20%, down from 46% in 2013. At Leeds and York Partnership NHS Foundation Trust the proportion treated fell from 42% to 26%....read more
A national disgrace: NHS fails to treat child mental health (Pulse: 4 July 2016)
A whole generation of children is being failed by mental health services, say GPs who struggle to access specialist help for their patients.
GPs are finding their referrals increasingly batted back, with three in five of those made to specialist child and adolescent mental health services (CAMHS) resulting in no treatment at all.
GPs report that local trusts are raising thresholds for care, with some only accepting patients who have attempted suicide or are experiencing symptoms of very serious mental illness. Cuts to mental health funding mean services have struggled to cope with a 40% increase in GP referrals since 2012. This has meant that young patients are being directed to local charities or school counsellors rather than receiving specialist care.
And this is all occurring as rates of suicide rise in the UK; it is now the leading cause of death among men aged 20 to 34 years.
The Government insists it is ploughing more investment into CAMHS but experts say it may be too little, too late to address a crisis that is causing significant suffering and storing up major problems for the future....read more
Budget cuts leave occupational therapy posts unfilled as referrals rise (The Guardian: 28 June 2016)
Occupational therapists (OTs) make up 2% of the adult social services workforce but are responsible for around 40% of referrals, illustrating just how vital their expertise is. But cuts to council budgets are putting them under increasing pressure as vacancies are left unfilled and waiting lists for services increase. National figures show that the number of OT posts in adult social care in England fell by 4% in the year to September 2015. And in London, 18% of vacancies for experienced OT practitioners in adult and children’s services are being left unfilled. Harold Bodmer, president of the Association of Directors of Adult Social Services and director of adult services for Norfolk county council, says: “Some of that is down to the cuts. What we are trying very hard to do is to put occupational therapy expertise to best use, so that some of their work can be done by other people with OTs overseeing them.”
Julia Skelton, director of professional operations at the College of Occupational Therapists, says the figures speak for themselves: “OTs are working very hard to keep the waiting lists for assessments down. When you consider we make up 2% of the workforce and take 40% of referrals, the figures say everything.”
The picture is similar in the NHS. Some parts of the UK which historically find it hard to recruit – rural Lincolnshire and the north of Scotland – are still struggling to fill posts across the board. In London, NHS trusts are seeing nearly 20% of their band 6 posts left vacant – these are qualified OTs with around two years’ experience, who make up the largest OT group. Most of these vacancies are in acute care, particularly mental health...read more
Sex has got a lot to answer for. The UK is facing a rising demand for sexual health and contraceptive care. Unacceptable levels of sexual coercion and female genital mutilation (FGM) are being reported, sexually transmitted infection (STI) diagnoses are increasing [pdf], and the UK still has the highest rate of teenage pregnancy in western Europe.
Despite all of this, key services are facing monstrous budget cuts alongside so many other sectors of our increasingly weary NHS. This means clinic closures, the dissolution of preventative health programmes, further pressure on already overloaded GP practices, and horrifying long-term financial costs.
In truth, sexual health services have suffered financially for some time. With the implementation of the Health and Social Care Act 2012, responsibility for sexual health funding was allocated to local authorities and these services put out to tender.
Private companies can bid for control over them, which the government claimed would improve standards “through competition and choice”. In reality, the winning bids are often ones that offer immediate cost-saving rather than long-term financial benefits and the best possible standards of care.
In 2015, the government announced its £200m public health budget cut, resulting in local councils spending millions of pounds less than planned on sexual health services nationwide. Add to this a potential 40% cut in central funding to local authorities [pdf] and you can see how pressure is mounting.
Elizabeth Carlin, president of the British Association of Sexual Health and HIV (Bashh), is one of many specialists to express concern. “Sexual health services play a key role in protecting the health of the nation,” she says. “Coordinated care with sufficient funding is crucial.”...read more
‘This isn’t acceptable’: outcry at state of NHS mental health care funding (The Observer: 11 June 2016)
A cross-party inquiry by MPs into the funding of mental health services has received more than 95,000 personal submissions in an unprecedented display of anger over the state of the NHS.
One woman who submitted testimony linking the lack of support to suicide rates said the failure of the system to respond to people in trouble was often “what pushes you over the edge”. She wrote: “I’m scared my husband could become one of these statistics.”
A separate YouGov poll commissioned and crowdfunded by the campaigning organisation 38 Degrees found that 74% of voters believe that funding for mental health should be greater or equal to funding for physical health. The amount actually spent on mental health by the NHS last year, despite government pledges to establish parity, was just 11.9% of overall NHS spending.
Meg Hillier, chairwoman of the public accounts committee holding the inquiry, said the scale of the response underlined the strength of feeling that mental health was being underfunded. “We shall question NHS England and the Department of Health on how they can meet the government’s pledges,” she said.
The poll findings come as a new report, to be published on Monday by the NSPCC, says NHS commissioners are failing to take abused children into account when planning mental health services. The charity says the government’s £1.4bn investment in children’s mental health services is not being deployed to aid children who need help after abuse. Peter Wanless, chief executive of the NSPCC, said: “Often, it’s only when children reach rock bottom, regularly self-harming or feeling suicidal, that the services they need so desperately open up to them. This isn’t acceptable.”....read more