Government ‘reneging on promise to fund 10,000 extra nursing places’ (The Guardian: 27 June 2017)

Universities are warning that the government is quietly reneging on its promise to provide 10,000 new nursing degree places, intended to relieve pressure on the NHS.

Student nurses must spend 50% of their degree working under supervision, usually in a hospital. But universities have told Education Guardian that not a single extra nursing training place has been funded or allocated for the future. It would cost £15m over five years to fund training placements for 10,000 new nurses, according to the Council of Deans of Health, the body that represents university faculties of nursing.

Applications to study nursing in the new 2017-18 academic year have slumped by 23% compared with last year, after the abolition of bursaries. The government said last year it would free up £800m and pay for an extra 10,000 places by ending bursaries and shifting student nurses to the standard system of £9,000-a-year tuition fees supported by loans. Angry academics now say this was a hollow promise.

Emily Heron, a 22-year-old healthcare assistant who works in a trauma unit in a hospital in Newcastle, says she will have to abandon her dream of becoming a nurse because she cannot afford a degree now. “I first realised I was good at caring for people when my dad became terminally ill and I had to leave college to look after him,” she says.

“I still care for him, and I live on my own with no family to support me. Without a bursary I’d have to take out a big loan on top of paying for my house and car. As a student nurse you basically work a full-time job in a hospital and fit your degree work around that, so there is no chance of doing paid work to help support yourself.” She adds: “I am really committed to nursing and I know I’d be good at it. But I feel like the government is saying to people like me that I’m not worthy of the training.”....read more

 

Disabled patients 'relying on crowdfunding' for wheelchairs (The Guardian: 27 June 2017)

Disabled patients are increasingly having to rely on crowdfunding to pay for wheelchairs, a leading doctor has warned. Cuts in services, a postcode lottery of availability and delays mean that patients are being forced to rely on the public to help raise funds online to buy suitable wheelchairs.

Medics at the British Medical Association’s annual representative meeting in Bournemouth unanimously passed a motion calling for users to have “timely access to chairs suitable for their individual conditions”.

Dr Hannah Barham-Brown, a junior doctor working in south London, said hundreds of patients were fundraising online for their wheelchairs. Standard NHS chairs can weigh around 44lb (20kg) and, for some patients, manoeuvring the devices risks causing damage, she said... Read more

 

NHS staffing agency moves towards privatisation (Financial Times: 26 June 2017)

The government is pressing ahead with the sale of NHS Professionals, the state-owned agency that manages more than 90,000 doctors, nurses and other healthcare workers, with a deal expected to be announced by the autumn. NHS Professionals was created in 2001 to provide a “bank” of medics who could work flexibly across the health service. It is used by about a quarter of the roughly 250 NHS trusts in England and saves the NHS £70m a year by supplying staff more cheaply than private sector agencies.

Bidders including private equity firms and recruitment agencies such as Staffline, the FTSE 250 company that also runs probation and welfare to work services for the unemployed, are understood to have submitted final offers last month worth about £50m for a 75 per cent share in the business. The government is understood to be keeping a 25.1 per cent stake in the company, with the option of selling the remaining stake within three to five years.

The government wants to cut back the use of temporary workers and is keen to build up NHSP, which is currently a limited company owned by the Department of Health that employs 506 people.  A statement by Philip Dunne, minister of state for health, in November said the partial sale was required to bring in “substantial investment” to improve and expand the service. “We want to see the company take advantage of this opportunity to expand its business, acting as a true alternative to expensive agencies,” he said.....read more   

 

Hundreds of patients potentially harmed by undelivered NHS mail (The Guardian: 27 June 2017)

More than 1,700 people may have been harmed by an NHS contractor’s loss of almost 709,000 pieces of medical correspondence, including patient records and cancer test results, an investigation has found.

But the real total could be much higher, as almost a third of the documents have still to be assessed to see if long delays in analysing them damaged human health, according to a report by the National Audit Office (NAO) into what MPs have called “a colossal blunder”.

The NAO – Whitehall’s spending watchdog – launched its inquiry into the unprecedented loss of such a huge amount of sensitive and medically important correspondence after the Guardian revealed in February that it had occurred.

The lost documents also included treatment plans, details of changes to what drugs patients should be taking, child protection notes and the results of various kinds of diagnostic tests.

Its report is a critique of incompetence and dubious decision-making over years by NHS Shared Business Services (SBS), a private firm jointly owned by the Department of Health that delivered letters between hospitals and GP practices and also between GP surgeries. 

It also highlights two key conflicts of interest faced by Jeremy Hunt, the health secretary, over the scandal – and raises questions about whether he sought to cover up its true scale.

“NHS England and NHS SBS have reviewed just under 709,000 items of unprocessed correspondence,” the NAO said.

“As of 31 May 2017, the review of the backlog of correspondence has found 1,788 cases of potential harm to patients.”....read more

 

NHS leak reveals 'shocking restrictions' on care in London hospitals as part of secret cuts programme (The Independent: 21 June 2017)

Secret cost-cutting plans described as a “death knell” for the NHS will result in longer waiting times, rationing of care, job losses and ward closures at hospitals in London, a new leak has revealed.

Details of the proposals, part of a national savings drive designed to cap NHS spending, have been called “shocking restrictions on care quality and access for patients” by politicians.

North Central London is one of 14 regions across the country in which senior NHS managers have been told to make “difficult choices” to curb overspending.

A document leaked to The Guardian sets out how care at 10 hospital trusts in Camden, Islington, Haringey, Barnet and Enfield – including the Royal Free and Great Ormond Street children’s hospital – could be cut back.

These include job losses to reduce “admin costs”, increasing waiting times past the current 18-week limit, and the closure or downgrading of services, likely to put smaller hospitals such as North Middlesex Hospital in Enfield at risk, reported the newspaper.

The document is said to outline plans to plug a £183.1 deficit at the London trusts – singled out by health bodies NHS England and NHS Improvement as one of the most severe in the country.

But Jonathan Ashworth, Labour’s shadow health secretary, said the proposals, known as the “capped expenditure process”, would result in “a postcode lottery where healthcare varies depending on where you live”.

He said Theresa May’s “weak and unstable” Government has “huge questions to answer about this new NHS ‘capped expenditure process’”, which is “in reality a Tory NHS ‘hit-list’ drawn up in secrecy during the election campaign.”....read more

 

The NHS must act to tackle its looming workforce crisis (The Guardian: 20 June 2017)

The workforce crisis enveloping the NHS could soon eclipse funding as the most serious problem.

There are tens of thousands of vacancies, far too few new staff are coming through; the pressure on those in post is relentless and morale is dangerously low.

The number of clinicians in the NHS has risen by 26,000 since 2012, but this has been outstripped by the creation of 62,000 more posts – including many established in the wake of the Mid Staffordshire scandal – which means vacancy rates are climbing.

The number of emergency medicine consultants has grown 32% in five years, yet demand for specialists to cope with rising A&E attendances means many hospitals are unable to fill their vacancies. Trust managers live in dread of being accused of running unsafe staffing levels, but there are 29,000 unfilled nursing posts.

The consequences of cuts have been severe. According to the National Audit Office, annual nurse training places were slashed by more than 3,000 (pdf) – 19% – in the decade up to 2014-15.

The NHS has always struggled to match the supply of staff to its needs. In another effort to grip the problem, Health Education England (HEE) was set up in 2012 to oversee workforce planning. Many health service managers claim it is out of touch with the needs of hospitals and clinics, underestimates the size of the problem and lacks a sense of urgency.

HEE’s commissioning of training is driven by intelligence from local NHS organisations, but it is questionable whether modelling reflects the staff numbers or skills required to deliver new models of community-based care.

HEE’s room for manoeuvre is constrained by money and the long timescales for training staff. The first nurses in training commissioned by HEE will only graduate this year, and the benefits of work being done now to increase the number of consultants will be felt at the end of the next decade....read more

 

Leak shows 'devastating' impact of planned NHS cuts in London (The Guardian: 20 June 2017)

Patients will be denied treatment, waiting times for operations will lengthen and A&E and maternity units may be shut under secret NHS plans to impose unprecedented cuts to health spending in London.

According to an internal NHS document seen by the Guardian, doctors in five London boroughs will have to spend less on drugs, fewer patients will be referred to hospital and support for people with severe health needs will be cut as part of the plan.

It outlines the “difficult choices” NHS bosses nationally are forcing the 10 hospital trusts in north-central London to make in the next few months in order to plug a £183.1m gap in their finances.

The 31-page document was circulated among dozens of top NHS officials in the area on 25 May. It outlines how the “capped expenditure process” will hit the provision of NHS care to the 1.44 million people who live in the boroughs of Camden, Islington, Haringey, Barnet and Enfield.

It admits that pushing through such cutbacks will be unpopular and hard to explain – and result in poorer care. “We recognise that these choices may be difficult for a number of reasons [because they include] … options that impact on quality of care [and] options that would be difficult to implement,” it says.

The hospitals that have been told to implement draconian cost-cutting measures include some of the NHS’s best-known names, such as the Royal Free, University College London and Great Ormond Street children’s hospital.

North Central London (NCL) is one of 14 areas of England where NHS England and NHS Improvement, the service’s twin regulators, are forcing hospital trusts to make far-reaching cuts during 2017-18 as part of the “capped expenditure process”. They have told local NHS leaders to “think the unthinkable” in their quest for savings....read more

 

Thousands of children's operations cancelled each year, NHS figures show (The Guardian: 5 June 2017)

Thousands of operations on children are being cancelled each year, often because NHS hospitals do not have enough beds, staff or equipment.

Procedures to repair broken bones, remove rotten teeth or insert grommets are among the 46,211 operations that have been cancelled over the last four years, NHS figures show.

A total of 12,349 surgeries on children and young people were cancelled during 2016-17 alone, in the latest sign that under-pressure hospitals are struggling to give patients timely care.

The real number of cancellations is likely to be much higher as the figures obtained by Labour under freedom of information laws cover barely half of England’s 153 acute hospital trusts.

Prof Neena Modi, president of the Royal College of Paediatrics and Child Health, said: “These figures are shocking, all the more so as they clearly reflect only the tip of the iceberg, and are further evidence that the NHS is being pushed to the brink. Children are harmed by delays in operations, and for some the damage may be long-term.”

Hospitals are under increasing pressure amid rising demand, staffing problems and an unprecedented financial squeeze. The figure of 12,349 cancelled children’s operations last year was 35% higher than the 2013-14 figure of 9,128....read more

 

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