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

 

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 rationing 'is denying patients care' as cash crisis deepens (The Guardian: 8 December 2015)

Patients are being denied mental health care, new hips and knees, and drugs to boost their recovery from illnesses including cancer as the NHS increasingly rations treatments to try to overcome its growing cash crisis.

A survey of doctors reveals that three-quarters said they had seen care rationed in their area over the last year – including treatments such as speech therapy, operations to remove varicose veins, Botox to help children with cerebral palsy move better and even potentially life-saving stem cell transplant surgery.

Disabled children were having to use ill-fitting wheelchairs, teenage girls were banned from accessing medication to tackle male-style hair growth and women had been unable to access surgery to have breast enlargements or reductions as a result of growing restrictions across England, the research concluded.

Medical organisations said the findings showed patients were paying the price because an underfunded NHS was having to force them to wait for care or deny it altogether...read more

 

Only support service for vulnerable people with HIV in Leeds to be axed by city council (Yorkshire Evening Post: 15 October 2015)

Leeds’ only HIV support service faces closure, prompting fears it could leave hundreds of vulnerable people at risk.

BHA Leeds Skyline, on The Headrow, has received notification from Leeds City Council that its contract will not be renewed as of March 31 next year. 

The council cited the £2.8million public health cut handed down by the Government earlier this year as a major reason for the decision but said it will work with service users and staff to address any uncertainty.

 

English people with rare eye condition may be forced to move to Scotland to 'save their sight', says charity (The Independent: 25 July 2015)

English people living with a rare eye condition may be forced to move to Scotland or Wales to “save their sight”, the country’s leading charity for the blind has said, after the NHS refused to fund routine access to treatments.

The Royal National Institute of Blind People (RNIB) said it was considering legal action over NHS England’s decision not to recommended routine use of the drugs Humira and Remicade for patients with a severe form of the inflammatory eye condition, uveitis.

Both drugs are routinely available in Scotland and Wales and their use is standard practice in many other countries. A trial of Humira for one group of paediatric uveitis patients, taking place in the UK, was stopped early because overwhelming evidence of the drugs’ benefit meant it was deemed unethical to continue giving some children placebo.

However, NHS England concluded there was “not sufficient evidence” to recommend routine use.

 

Eating disorder patients' lives at risk due to long waits for NHS treatment (The Guardian: 14 June 2015)

The lives of people seriously ill with eating disorders are being put at risk because they have to wait up to three years for NHS treatment.

Experts warn that specialist services are struggling to cope with a growing caseload and are so overstretched they have to prioritise patients with anorexia, because they are at greatest risk, ahead of those with bulimia – even though their condition is seriously affecting their lives.

Patients forced to endure long delays are at greater risk of serious damage to their health because it deteriorates while they are waiting. They also have a smaller chance of making a full recovery.

Some people wait so long they are forced to pay for help privately or get help abroad – in South Africa, the US and elsewhere – to tackle conditions that have the highest mortality rate of any mental illness.

Psychiatrists who treat people with eating disorders – often girls and young women – say NHS services are so inadequate that in some places patients who are very unwell have to lose more weight to qualify for treatment.

 

Mental health could retain Cinderalla status under Tories, warns ex-minister (The Guardian: 3 June 2015)

Mental health care will remain “a Cinderella service” and not get its long-planned equality with physical health in the NHS because the Conservatives will deny it the money it needs, the MP who was the minister for mental health until the election is warning.

Significant recent progress to improve mental health will stall, and a “historic opportunity” to ditch its status as the “poor relation” of physical ailments will be lost, if ministers do not put more than the promised £8bn extra into the NHS by 2020, Norman Lamb said.

The Liberal Democrat leadership candidate fears plans for new waiting time targets for people with conditions such as anxiety and depression to access treatment will be scrapped unless ministers plough £3.5bn into mental health over the next five years.

 

Obese patients denied surgery by NHS rationing (GP: 10 June 2015)

GP leaders slammed the ‘rationing’ of NHS services and warned that the restrictions on access to care appeared to breach the NHS Constitution.

NHS England’s national commissioning criteria for bariatric surgery could prevent GPs from referring patients for bariatric surgery in line with NICE guidance.

The NICE clinical guideline Obesity: Identification, assessment and management of overweight and obesity in children, young people and adults was issued in November 2014.

It recommends bariatric surgery as a treatment option for patients with obesity if they ‘have a BMI of 40kg/mor more’ or a BMI ‘between 35kg/mand 40kg/mand other significant disease’.

It adds that ‘all appropriate non-surgical measures have been tried’ and the patient ‘has been receiving or will receive’ intensive management in a 'tier three' service.

The NICE guidance does not impose any time restrictions on access to care. But NHS England’s commissioning policy stipulates that the patient must have ‘received and complied’ with a tier three or four weight-loss management service ‘for a duration of 12-24 months’ in order to qualify for bariatric surgery. It also dictates that the patient must have been morbidly obese – BMI 40 or higher – ‘for at least five years’ to be eligible for the potentially lifesaving treatment.

 

NHS vasectomies rationed as health service forced to make cuts (Daily Mirror: 25 May 2015)

Free vasectomies are being rationed in some parts of the country, as the NHS is forced to cut costs.

One commissioning group has told GP practices to cap the number of snips offered to patients.

Each surgery in Basildon and Brentwood, in Essex, has been sent a letter assigning them a specific amount of vasectomies for the 2015/2016 financial year, ranging from 11 to one.

Three surgeries are believed to have been told they can refer just one man a year for the procedure, which is a permanent method of contraception.

 

NHS crisis: Damning report reveals nurses are too stretched to feed and care for patients (Daily Mirror: 13 April 2015)

Patients are being denied pain relief, food and water due to NHS cuts, a damning report has revealed.

Disturbingly, 65% of nurses said the sick are missing out on basic care because of the chronic understaffing.

It shames the Tories – who have slashed the health budget by £20billion – as they launch their election manifesto.

The Patients Association said the Unison report filled it “with horror”.

Now David Cameron’s boasts about the NHS being in good health are exposed as a sick joke.

The explosive report reveals vulnerable people are being left for hours because nurses are so overstretched that they are having to take responsibility for more patients than is safe.

The frail and elderly are going without basics such as food and water because of staff shortages.

 

NHS treatment cuts 'lack consistency' (Laboratory Talk: 2 March 2015)

During 2011, England’s NHS was tasked with finding £20 billion of efficiency savings over four years, in part by reducing the use of ineffective, overused or inappropriate procedures.

However, a report published today by researchers at Imperial College London (ICL) has found that an absence of clear national guidance about which procedures to perform less has caused inconsistency among NHS commissioning groups.

“Our research revealed a lack of consistency between commissioning organisations regarding which procedures were cut,” said Sophie Coronini-Cronberg, from the School of Public Health at ICL, who led the study.

“With little national guidance about which procedures to remove or restrict funding for and under which circumstances, commissioners may be turning to locally developed, unofficial lists and criteria of low-value treatments,” Coronini-Cronberg said.

“This urgently needs to be addressed to avoid local variations. Arbitrary decision-making needs to be replaced with objective, consistent, evidence-based policies.”

 

Women 'denied fertility treatment due to NHS cuts' (ITV News: 23 October 2014)

NHS trusts are denying thousands of women across Britain fertility treatment in a bid to cut costs, a health watchdog has warned.

The National Institute for Health and Care Excellence (Nice) said couples struggling to conceive are being subjected to unfair "postcode lotteries", causing "widespread inequality".

Meanwhile fertility groups have warned many women are having to resort to costly private care because NHS provision is so patchy and hard to access.

Nice warned that fewer than one in five commissioning groups are paying for the full number of IVF cycles recommended.

And the commissioning group covering mid Essex will not fund IVF treatment unless there are "clinically exceptional circumstances".

Professor Gillian Leng, deputy chief executive and director of health and social care at Nice, said: "Infertility can have a potentially devastating effect on people's lives - it can cause significant distress, depression and possibly lead to the breakdown of relationships.

 

Two-thirds of Britons with depression get no treatment (The Guardian: 13 August 2014)

Less than a third of people with common mental health problems get any treatment at all – a situation the nation would not tolerate if they had cancer, according to the incoming president of the Royal College of Psychiatrists.

While the health secretary, Jeremy Hunt, has pledged to deliver "parity of esteem" for mental and physical health services, the treatment gap is now so huge that it may prove impossible to bridge in the current financial climate, said Professor Simon Wessely of King's College London in his first interview since election to the post.

"People are still routinely waiting for – well, we don't really know, but certainly more than 18 weeks, possibly up to two years, for their treatment and that is routine in some parts of the country. Some children aren't getting any treatment at all – literally none. That's what's happening. So although we have the aspiration, the gap is now so big and yet there is no more money," he said.

 

The UK's small rural GP surgeries fear for their future (BBC News: 21 July 2014)

GPs running small practices in isolated rural parts of the UK say they fear for their future.

The Royal College of GPs' Rural Forum claims recruitment and workload issues could result in some surgeries going the same way as village post offices.

The Forum accepts that its 800 members will need to find new and imaginative ways of working.

NHS England says better use of new technology and pooling administration could help many rural practices. 

 

Elderly patients are being failed by NHS, says new boss (BBC News: 4 June 2014)

The care of frail elderly patients has become fragmented because of the drive for hospital doctors to specialise, the new boss of NHS England says.

Simon Stevens suggested he wanted to see a European model of "generalists" adopted to work alongside specialists.

He told a conference of health managers that the rise in multiple conditions required greater co-ordination of care.

The speech builds on comments he made last week about ensuring there was a role for smaller hospitals in the NHS. In recent years there has been a focus on creating larger, specialist hospitals.

But Mr Stevens said that while that was desirable in areas such as stroke care, smaller hospitals still had an important role to play.

Mr Stevens said the large expansion in consultant numbers - up by three-quarters since 2000 - had led to more and more specialisation by consultants.

He told the NHS Confederation's annual conference that while this was desirable it had sometimes "fragmented care for older inpatients".

 

Councils using NHS funds meant for improved elderly and mental healthcare to prop up existing social care, study finds (Pulse: 14 May 2014)

Local authorities are using funds from the NHS to keep existing social care services afloat, it has been claimed. MHP Health, a healthcare consultancy, analysed how councils spent £1.5bn worth of funding transferred from the NHS in 2012-2014, which was aimed at improving care for vulnerable patients such as the elderly and the mentally ill. However, it concluded that the largest category of spend was on maintaining the eligibility of existing social care services, with relatively little spent on mental health services.

The report authors said these findings questioned whether the Government’s Better Care Fund - the £3.8bn fund to integrate health and social care budgets - would succeed. The MHP Health report, out today, found that ‘local authorities allocated £349m across the two years to maintaining eligibility criteria aimed at ensuring access to existing services’...read more 

 

Mentally ill ‘die earlier due to NHS failures’ (The Independent: 6 May 2014)

 People with mental illnesses and intellectual disabilities are dying earlier as a result of a failure to address their needs by the NHS, the doctors’ union has warned.

Urgent action is needed to ensure equal value is placed on both patients’ mental and physical health in the face of “distressing” evidence about the life expectancy of the mentally ill and people with learning disabilities, a report by the British Medical Association (BMA) board of science has said.

The physical health problems of patients with a mental illness or intellectual disability are “all too often” under-addressed, the report said, while the mental health of patients with a physical illness is frequently neglected.

Cuts to funding – which have seen 1,711 mental health beds closed since April 2011 while therapy sessions for those with a mental illness are limited to just 20 on the NHS – have compounded the disparity, the report said.

 

Reward healthy people with tax rebates to save the NHS, urges thinktank (The Guardian: 1 May 2014)

Britons should be rewarded with tax rebates for giving up smoking, staying slim or drinking less as a way of relieving the "mind-boggling" increase in demand for NHS care, a thinktank urged on Thursday.

20/20 Health says incentive schemes that reward healthy lifestyles would encourage people to be more responsible about looking after themselves and avoiding damaging habits. They should be available for those who do not become ill or prove good at managing conditions such as diabetes, it suggests.

"We propose 'payment by results', a financial reward for people who become active partners in their health, whereby if you, for example, keep your blood sugar levels down, quit smoking, keep weight off, [or] take on more self-care there will be a tax rebate or an end of year bonus," it says in a report on the NHS's future.

 

GP braced for shutdown after ‘toxic mix’ of loss of funds and high demands. (The Guardian, 16 April 2014) 

Under 16s 'refused access to mental health safe havens' (BBC News: 16 April 2014)

Treat your own dementia, Essex patients told (Open Democracy: 20 March 2014)

NHS care at home for elderly and disabled quietly slashed by a third (The Telegraph: 14 January 2014)

Fears for the elderly under new NHS drugs policy (The Telegraph: 9 January 2014)

Inquiry into conflicting accounts regarding NHS 'queue jumping (BBC News: 9 September 2013)

Suicidal patients turned away in Sussex as mental health service reaches crisis point (The Argus: 23 October 2013)

NHS hospitals performing record numbers of private operations in 'two-tier' health service (Daily Mirror: 20 September 2013)

Threat to diabetes sufferers as NHS rations test strips (The Independent: 1 August 2013)

 

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