Mental health support 'denied to children' (BBC News: 28 May 2016)

More than a quarter of children referred to mental health services in England in 2015 - including some who had attempted suicide - received no help, a report says.

A review by the Children's Commissioner also found that 13% with life-threatening conditions were not allowed specialist support.

She said the system was "playing Russian roulette" with their health.

NHS England said it was "clearly the case" that services need to expand.

The commissioner obtained data from 48 of England's 60 child and adolescent mental health service trusts, and discovered 28% of child referrals were denied specialist treatment - mostly on the grounds that their illness was not serious enough.

This group included children who had attempted serious self-harm and those with psychosis and anorexia nervosa.

It also found that those who secured treatment faced lengthy delays, with an average waiting time of more than 100 more

GPs like me can't help mental health patients in 10 minutes – it's cruel (The Guardian: 16 May 2016)

The word compassion in all Latin derived languages combines the prefix, with (com) and the root, to bear or suffering (passio). For a doctor and all health professionals this is a given prerequisite. We suffer with our patients. It is the essential penance we shoulder in return for the wondrous joy of helping those in need.

I am a GP, and as such I act as one of the gatekeepers to the health service. People of any age and problem can walk through our door. Wherever possible we either treat or reassure. If not then we direct the patient to another NHS service for help.

In general practice we see a large number of patients in need. Few people more so than those struggling with mental health problems. There are 10 times more people suffering with major depression compared to 1945. It is utterly heartbreaking to see a depressed person who is struggling, only to reply to them: “Sorry, but the counselling you need is at least a six-week wait”. To this patient, six weeks is 42 days (and nights), 1,008 hours, 60,480 minutes or 3.63 million seconds.

These seconds are not ordinary seconds. Life feels like constantly walking in oversized wellies through knee-high wet mud. It is backbreaking, emotionally draining, gloomy and painful. As their GP, I have to condemn my patient to at least 3.63 million seconds of further torture without hope. I feel so helpless and more


NHS mental health funding is still lagging behind, says report (The Guardian: 9 May 2016)

Government pledges to put more money into mental health are being broken because the NHS is not passing the money on to the NHS trusts that treat patients, a new report has revealed.

Care for people who need psychological help will suffer unless a chasm is bridged between ministerial promises and cash reaching the frontline, campaigners warn.

The disparity also threatens to undermine the historic change in 2012 that compelled the NHS in England to give physical and mental health equal priority or “parity of esteem”. Although mental ill-health accounts for 28% of the total burden of disease, it gets just 13% of the NHS’s budget.

New research undertaken by NHS Providers and the Healthcare Financial Management Association, revealed on Monday, found that only half of the 32 mental health trusts they spoke to – 55% of the total – had received a real-terms increase in their budgets in 2015-16. And only 25% said they expected NHS clinical commissioning groups (CCGs) to increase the value of their contracts for 2016-17, even though the 209 CCGs have seen an average 3.4% rise in their budgets this more


Mental health services must get the funding they need - Saffron Cordery (The Guardian: 9 May 2016)

The phrase “parity of esteem” when used to describe the treatment of mental health services in the NHS is rightly being put under the microscope. It has been widely used to communicate a commitment to improving quality, broadening access to services and boosting funding. However, recently it has become clear that there is a gap between this intention and the reality on the ground.

Our report, Funding Mental Health at Local Level: Unpicking the Variation, published in partnership with the Healthcare Financial Management Association, shows just that, and it makes for difficult reading. Despite a number of funding boosts, it is clear that the necessary investment just isn’t reaching frontline mental health services. Our survey found that only half of mental health trusts received a real-term increase last year, despite the fact that the commissioners who fund them were required to increase their investment in line with their overall financial allocation.

Particularly concerning is the finding that NHS England is not necessarily leading by example. It is responsible for setting the rules and for holding local commissioners to account for their spending plans, yet its own specialised commissioning teams are not consistently meeting parity of esteem commitments towards mental health services, with only a third of trusts receiving a real-terms increase in 2015–16.

The situation does not look like it will improve this year either. Although we are still concluding the contracting round for 2016–17, providers were even less positive about receiving additional investment, with only a quarter confident that they would see a real-term increase...(read more)


Vulnerable people regularly refused access to GPs, says charity (The Guardian: 30 April 2016)

Some of the most vulnerable people in the UK are regularly refused access to a doctor, according to a report.

Pregnant women, children and homeless people are among those who have been wrongly turned away from practices. Medical care is also refused to sex workers, domestic workers and people who have suffered torture, trafficking, domestic and sexual violence, research has found.

In some cases, vulnerable people have been refused registration on more than one occasion.

The research conducted by Doctors of the World (DoTW) found that medical centres and GP surgeries were refusing to help at least two in five people, despite their being eligible for free primary more


Mental health trust forced to cut services (Pulse: 6 April 2016)

A mental health trust in Manchester has cut seven frontline community-based services to save £1m, in one of the first major decisions taken since the city was given total control over its health budget.

Manchester Mental Health and Social Care Trust (MHSC) proposed the cuts in October and, despite a huge public outcry, decided last week to push through with plans.

The decision comes as Greater Manchester has been given complete control over its £6bn health budget following the implementation of ’DevoManc’, becoming the first region of England to have devolved healthcare powers.

Services to be cut include those for chronic fatigue and psychosexual disorders, as well as gardening more

Eye risk from 'overstretched NHS' (BBC News: 16 March 2016)

Eye specialists say hundreds of patients suffer irreversible sight loss every year in England because services are overstretched and under-resourced. The president of The Royal College of Ophthalmologists, Prof Carrie MacEwen, writing for the BBC's Scrubbing Up, warns the NHS is struggling to keep up because of a "perfect storm" of increased demand, caused by more eye disease in an ageing population which requires requiring long term care.

She says the current treatment targets fail to reflect the critical importance of follow-up appointments, which may be delayed for months or even more


Charity warnings over clinical reference group cuts (HSJ: 11 March 2016)

Charities have written to NHS England raising concerns about plans to cut the number of clinical reference groups and reduce their membership, HSJ has learned.

The Brain Tumour Charity and Sarcoma UK have sent a letter to Simon Stevens, the chief executive of NHS England, warning that the move will “dilute” the specialist advisory knowledge currently provided about different cancer types.

Charities are worried about specific CRGs being merged into a broader “cancer surgery CRG”

The Neurological Alliance and the British Kidney Patient Association have also said that reducing CRGs’ membership will impact their ability to represent patients.

Last month NHS England announced it was planning to cut the number of CRGs from 71 to 38. The groups are responsible for advising NHS England on how it spends its £14bn specialised services budget, and help it to develop commissioning policies and service more


Jeremy Hunt urged to act against avoidable deaths from epilepsy (The Independent: 12 March 2016)

The Epilepsy Society has launched a new campaign calling on the Health Secretary Jeremy Hunt to act against avoidable deaths from the condition.

Although sufferers are at greater risk of premature death, almost four in 10 of those deaths are avoidable, according to the charity, which says better care, treatment and services are urgently needed. It has also launched an online campaign urging MPs to write to Mr Hunt requesting that a National Clinical Audit into the condition take place – for the first time since 2002. 


The Epilepsy Society said the most worrying aspect is the postcode lottery for the 500,000 people in England living with the condition. Data from the Office for National Statistics shows that rates of premature death vary vastly: for example, someone with epilepsy is 49 per cent more likely to die prematurely in West Yorkshire than in Cheshire.

The Department of Health’s removal of two of the epilepsy performance indicators that are used to evaluate local commissioners has left local health decision-makers in the dark about how services are performing in averting premature death in epilepsy, the charity more


Why are more children being prescribed antidepressants? Funding cuts (The Guardian: 11 March 2016)

New research published this week shows that between 2005 and 2013 there was a 54% increase in the number of children and young people prescribed antidepressants in the UK. The World Health Organisation’s director of mental health, Dr Shekhar Saxena, has expressed concern about the reasons behind this rise.

Antidepressants are not licensed for prescription for under-18s, with one exception. The National Institute for Health and Care Excellence clinical guidelines state that fluoxetine, a type of selective serotonin reuptake inhibitor, can be used in under-18s, but should not be prescribed without first referring the child for talking therapy. The two treatments should coexist and the child should be monitored carefully, particularly in the first few weeks after starting the drug, when the risk of the “major harm” Saxena speaks of is at its more


Liverpool NHS jobs face the axe because of community health funding cuts (Liverpool Echo: 17 February 2016)

Up to 30 NHS staff in Liverpool could lose their jobs as services including exercise classes for dementia patients and anti-smoking sessions face the axe.

Liverpool council is cutting the amount of cash it gives to Liverpool Community Health NHS Trust (LCH) – leaving staff in a “difficult and uncertain time”, according to trade union Unison.

Services that could be cut include healthy eating campaigns, stop smoking sessions for pregnant women, exercise classes for dementia sufferers and work to promote dental health.

Unison warned the cuts will damage the city’s health in the long run by storing up problems for the future.

A statement from the union said 30 LCH staff now fear losing their jobs due to the more


Spike in mental health patient deaths shows NHS 'struggling to cope' (The Guardian: 26 January 2016)

A sudden spike in the number of mental health patients dying unexpectedly in NHS care has prompted calls for a wide-ranging investigation into “threadbare” services that are “struggling to cope”.

New NHS figures show that the number of deaths annually among mental health patients in England has risen 21% over the last three years from 1,412 to 1,713.

The number of those killing themselves or trying to do so has also increased, by 26% from 595 in 2012-13 to 751 in 2014-15. It covers both those being treated as inpatients for serious mental health problems and also those who are being cared for while still living at home.

Figures obtained by Norman Lamb, the Liberal Democrat MP, show that the overall number of “serious incidents” – involving unexpected or avoidable deaths, serious harm, injury and abuse – has climbed 34% to 8,139 a year. They have become so common that one trust, North East London foundation trust, had a total of 633 last year – almost two a day... 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 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’ 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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