Hospitals could join prisons in cycle of 'crisis, cash, repeat', says report (The Guardian: 28 February 2017)

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.

I don't remember such a dire state of health service emergency in my lifetimeJoyce Robbins, Patient Concern

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

 

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.

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

 

Health cuts most likely cause of major rise in mortality, study claims (The Guardian; 17 February 2017)

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”.

After examination of NHS performance data for the period, which shows the service missing almost all its targets, they concluded: “The evidence points to a major failure of the health system, possibly exacerbated by failings in social care.”

The rise in deaths from 2014 to 529,655 in 2015 was the biggest in percentage terms in almost 50 years and the mortality rate was the highest since 2008. The excess deaths were largely among older people who are most dependent on health and social care, the authors said....read more

 

Smokers trying to quit hit by postcode lottery as GPs ration help (The Guardian: 19 February 2017)

Smokers in England wanting to quit face a postcode lottery as cash-strapped councils and GPs restrict access to services that can help them.

The revelation has alarmed health experts and charities who claim that lives are being put at risk as a result of the fragmented provision.

Evidence obtained under the Freedom of Information Act shows that an increasing number of clinical commissioning groups – the 200 or so organisations that deliver NHS services in England – have been instructing GPs to stop providing the services. Many of the groups argue that it is no longer their responsibility.

In 2012, local authorities were made responsible for improving public health and given £2.8bn of ring-fenced grants to pay for it. But, as the grants have been pared back, councils have pulled their funding for stop smoking services.

This has led to a rationing of treatments – such as nicotine replacement therapies, bupropion (brand name Zyban) or varenicline (Champix) – in many areas. When used in conjunction with counselling, studies suggest the chances of a smoker quitting can be substantial.

Almost a quarter of a million people stopped smoking in the 12 months to April 2015 as a result of using the services, a quit rate of 51%. The services are said to have a high success rate in helping smokers in poorer communities stop.

“We are increasingly concerned that cuts in council spending, NHS cost pressures and a lack of joined-up thinking by central government are combining to block progress on cutting smoking, still the No 1 public health challenge facing the country,” said Deborah Arnott, chief executive of Action on Smoking and Health (Ash)....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

 

NHS Health Check: A&E waits for January 'worst ever' (BBC News: 9 February 2017)

Record numbers of patients spent more than four hours in accident and emergency units in England in January, figures leaked to the BBC suggest.

During a difficult winter for the NHS, January appears to be the worst performing month in the past 13 years.

The figures also suggest record numbers of people waited longer than 12 hours for a hospital bed once seen in A&E.

The BMA said the prime minister could no longer "bury her head in the sand" over increasing pressure in the NHS.

And it accused the government of failing to grasp the seriousness of the situation.

But a spokesman from the Department of Health said the vast majority of patients were seen and treated quickly, and busy periods in hospitals were supported by an extra £400 million of funding....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

  

 

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