Revealed: GP training targets in doubt as applications tumble 5% (Pulse: 10 February 2016)

Applications for 2016 GP training have slumped by 5% on last year spelling disaster for the Government target of delivering 5,000 more GPs by 2020.

Leaked figures - obtained by Pulse - reveal that despite a national advertising campaign aimed at promoting general practice as a career, the proportion of doctors applying for GP specialty training starting in August 2016 has reached a record low.

Medical specialty training figures revealed by Pulse show just 4,863 applications for 3,790 GP training posts across the UK for August more


Junior doctors' strike to go ahead next week after talks fail (Pulse: 1 February 2016)

Next week’s planned junior doctor strike action will go ahead after talks with the Government have failed to produce an agreement over the contract.

The BMA confirmed the strike today, but said that junior doctors would still provide emergency care on 10 February instead of the ‘all out’ action originally planned.

It comes as the 48-hour action planned for 26-28 January was called off in favour of further talks facilitated by Acas.

Junior doctors already walked out on 12 January, but still provided emergency care.

The BMA said in a statement: ’Despite the best efforts of our negotiating team, and hours of talks facilitated by Acas, we have not managed to reach agreement with NHS Employers and the Department of Health on the new junior doctors more


Mass GP resignations 'likely' as union urges LMCs to back crisis conference vote (GP Online: 27 January 2016)

GPs are ready to back calls for the profession to resign en masse from practice contracts at this weekend's special LMCs conference, union leaders say.

Doctors from the Unite union said mass resignation was 'on the cards' as GPs faced a crisis driven by a recruitment crisis, soaring workload and falling income.

East London GP Dr Jackie Applebee, Unite representative on the GPC, urged the 400 GPs who will debate the crisis facing the profession on Saturday at a special LMCs conference in London, to back a motion calling for GPs to hand in undated resignation letters.

The union is also urging GPs to support a motion calling for the GPC to explore moving away from the practice-based contract model to a salaried GP more


More than a quarter of trusts asked to breach agency cap (HSJ: 26 January 2016)

More than a quarter of trusts asked Monitor to increase their agency spending cap last year, HSJ can reveal.

A Freedom of Information Act request shows 69 trusts applied to the regulator last September to alter their overall spending limit on agency staff.

Of the 239 NHS and foundation trust acute, ambulance, community, specialist and mental health organisations given a “ceiling” by Monitor, 54 made successful applications to have that altered.

The regulator would not reveal which the organisations were or by how much they had asked to lower their “ceiling”. It said of the 54, 31 applications were only “partially successful” – with the total being lower than the original but higher than the trust’s proposed total.

The news comes as Monitor prepares to further lower the maximum prices agency workers can be paid per shift.


NICE experts called for minimum staff ratios in leaked guidance (HSJ: 20 Janaury 2016)

Suppressed NICE safe staffing guidance for hospital emergency departments called for the NHS to implement minimum nurse ratios to ensure safe care, HSJ reveals today.

The National Institute for Health and Care Excellence’s unpublished final report on emergency department safe staffing, kept secret for months, has been leaked to HSJ alongside a number of related reports.

The guidance, reproduced by HSJ, shows NICE’s safe staffing committee pressed ahead with recommending minimum nurse ratios in English accident and emergency departments despite opposition to the idea of minimum ratios in government and senior NHS circles.

Shortly after the guideline was completed, last June NHS England controversially suspended NICE’s safe staffing work, which left areas such as mental health and community nursing without more


A&E departments may be too short-staffed 'almost half the time', says report (Independent: 20 January 2016)

Report recommends that A&Es should build in a 'margin of safety' into their staffing plans

A&E departments may be too short-staffed to cope with demand “almost half of the time”, according to a suppressed report by patient safety experts.

Experts at the National Institute for Health and Care Excellence (NICE) called for the NHS to introduce minimum nurse-to-patient ratios on A&Es last year, but the report was never published and NICE’S research was controversially suspended.

Ministers and NHS chiefs faced accusations at the time that they were seeking to hide the scale of the staffing crisis in the NHS and water down recommendations for more nurses that would have come at a huge cost to the Government.  

In a copy of the NICE guidance, obtained by the Health Service Journal after frequent requests for its publication were denied, experts say that A&E staffing levels set according to historical patient demand leave emergency departments unprepared to cope with frequent surges in demand.

The report recommends that A&Es should build in a “margin of safety” into their staffing plans, even if this meant they were overstaffed during quiet periods... read more


Industrial action: junior doctors provide emergency-only care (BMA: 12 January 2016)

Tens of thousands of junior doctors are today taking industrial action over their contract dispute with the Government.

Trainees in England are providing emergency care-only cover — similar to a Christmas Day service — in the first of three planned periods of industrial action.

Doctors are taking the action over the Government’s failure to address junior doctors leaders’ concerns about contractual safeguards on safe working, and proper recognition for those working unsocial hours.

Conciliation talks paused last week with both sides saying, while discussions had been ‘constructive’, they were not enough to call off today’s planned action by the BMA.

BMA junior doctors committee chair Johann Malawana said: ‘Junior doctors feel they have been left with no option but to take this action.

'We have been clear throughout this process that we want to negotiate a contract that is safe and fair, and delivers for junior doctors, patients and the NHS as whole.

‘This remains our goal and our door is open to talks, but the Government must address our concerns around safe working patterns and ensure the contract recognises the long, intense and unsocial hours which junior doctors do.’ more


All NHS staff support the junior doctors’ strike action (12 January 2016)

As health workers who are not junior doctors, we want to make clear that all of the NHS team are 100% behind their strike against attacks on unsocial hours arrangements. Proposals to stretch five days’ staff over seven days, paying each one less, will not improve anything for patients. Unsocial hours reduce life expectancy and impact on family and social wellbeing. Increases in unsocial hours, accompanied by further cuts in pay for doing this, is one of many final straws which we no longer feel we can allow to go unchallenged. As junior doctors say, it is “unsafe and unfair”. We know these proposals are coming to the rest of us next, impacting on our patients and our more


London nurse shortage 'critical' as vacancies rise to 10,000 (Nursing Times: 7 January 2016)

London’s NHS nurse shortage worsened last year, with trusts in the capital operating with more than 10,000 empty posts, new data has revealed.

According to research carried out by the Royal College of Nursing’s London branch, the shortage was equivalent to a 17% vacancy rate – meaning trusts had on average nearly one in five of their nurse jobs unfilled.

Some organisations had far higher vacancy rates though. According to the RCN’s analysis, the worst in 2015 were London North West Healthcare NHS Trust with 800 empty posts and South West London an St George’s Mental Health NHS Trust with 160 jobs unfilled – both equivalent to 30% of their funded nurse establishments.

Acute provider Barts Health NHS Trust had the largest actual number of vacancies out of the 36 organisations, with more than 1,000. This was equivalent to 19% of its establishment.

The data, which was collected from trusts in July using Freedom of Information requests (see attached PDF below), showed there were around 2,000 additional whole-time equivalent vacancies in 2015, compared with the same time the year before.

However, the majority of trusts have increased their number of nurse posts in that time. Since last year, funded establishments in London have gone up by an average of 4%.

But trusts have only managed to employ on average an extra 2% staff, compared with the year before... read more


GPs under 50 leaving profession due to fear of burnout, NHS study finds (Pulse: 7 January 2016)

GPs under the age of 50 are abandoning UK general practice as they feel ‘unsupported and vulnerable to burnout’, an NHS England-commissioned study has concluded.

The study, published today in the British Journal of General Practice, found that personal reasons were rarely a factor for GPs relocating abroad, changing jobs or leaving on medical grounds.

The researchers concluded that ’to improve retention of young GPs, the pace of administrative change needs to be minimised and the time spent by GPs on work that is not face-to-face patient care reduced.’ more


Junior doctors and Government to hold fresh conciliation talks (Pulse: 6 January 2016)

The BMA and the Government will hold fresh conciliation talks around the junior doctors’ contract in a bid to reach an agreement before strikes take place next week.

Strike action is set to take place on 12 January, after the BMA announced on Monday that its talks with NHS Employers had broken down.

However, mediation body Acas announced today that they ‘have invited the sides involved in the junior doctors dispute for Acas talks this Friday. Talks are expected to start at 10am’ more


New wave of practice closures could mean 25,000 patients lose their GP (Pulse: 6 January 2016)

Tens of thousands of patients could be forced to register with another GP, as several practices prepare to close their doors early in 2016.

Pulse has learnt that six practices in England and Wales are closing due to GPs retiring early or becoming ill, leaving over 25,000 patients facing the prospect of moving practices.

GP leaders say the figures are a ‘terrible concern’ for patient access to primary healthcare and are the result of years of underfunding.

This latest wave of closures comes months after Pulse revealed last year that 160,000 patients were displaced across the country between 2013 and 2015.

Pulse launched a ‘Stop Practice Closures’ campaign in 2014 to highlight the numbers of practices at risk of going under, but only recently have managers recognised there is a more


Directors to review NICE chief's decision not to release staffing guidance (Nursing Times: 5 January 2016)

Two non-executive directors at the National Institute for Health and Care Excellence will meet tomorrow to review a decision by its chief executive not to release evidence on safe nurse staffing levels.

The meeting is part of an appeal against the decision by Sir Andrew Dillon not to publish details of four evidence reviews into safe nurse staffing across a range of healthcare settings including community, mental health and learning disabilities.

Sir Andrew decided not to publish the information after a request by Nursing Times’sister title Health Service Journal under the Freedom of Information Act, claiming it would “prejudice the effective conduct of public affairs”. After an appeal against that decision, NICE has asked two non-executive directors to review whether the refusal was appropriate, which is the final stage of the appeal more


Junior doctor strike set to go ahead next Tuesday after talks 'break down' (Pulse: 4 January 2016)

Junior doctors in England are set to take to industrial action on Tuesday next week, after talks between the BMA and NHS Employers failed to produce an agreement, the BMA has announced.

The BMA suspended strike action over the junior doctors contract in December just a day before it was due to go ahead, after reaching an agreement with NHS Employers and the Department of Health to enter ’direct and meaningful’ negotiations.

The BMA said that the Government had failed to address junior doctors’ concerns about ‘contractual safeguards on safe working, and proper recognition for those working unsocial hours’.

Negotiations will continue in the hope of averting industrial action, but failing this only junior doctors with a role in emergency care will be working between 8am on Tuesday to 8am Wednesday next week.

If negotiations remain in a deadlock there will be a further emergency care-only walk-out – this time for 48 hours – between 26 January and 28 January and a full withdrawal of labour, including emergency care, between 8am and 5pm on 10 more


Junior doctors in England to strike next week after talks break down (The Guardian: 4 January 2016)

Junior doctors are set to go on strike for three days, starting next Tuesday, in protest at the threat by the health secretary, Jeremy Hunt, to impose a new contract on them after talks failed to resolve the dispute.

The British Medical Association – the doctors’ trade union – blamed the walkouts on “the government’s continued failure to address junior doctors’ concerns about the need for robust contractual safeguards on safe working, and proper recognition for those working unsocial hours”.

The first industrial action by junior doctors since November 1975 will result in the 45,000 junior doctors in England providing only emergency cover for 24 hours from 8am on 12 January, leading to a much reduced level of operation. 

They will stage the same withdrawal of labour for 48 hours from 8am on Tuesday 26 January, and then stage one all-out strike between 8am and 5pm on Wednesday 10 more


Higher ratio of nurses per hospital bed linked to fewer patient deaths (Nursing Times: 18 December 2015)

A higher ratio of nurses per hospital bed has been linked to a lower risk of death following emergency general surgery, according to new research looking at mortality rates in England.

A higher ratio of nurses per hospital bed has been linked to a lower risk of death following emergency general surgery, according to new research looking at mortality rates in England.

The study, published in the British Journal of Anaesthesia, analysed nearly 300,000 cases at 156 trusts over a five-year period.

Researchers behind the study – called Mortality of emergency general surgical patients and associations with hospital structures and processes – estimated the likelihood of patient death at 30 days after emergency surgery was 7% higher in trusts with the lowest numbers of nurses per bed.

In the nine hospitals that had lower than expected death rates 30 days after admission, they found a “significantly greater provision” of nurses, doctors and surgeons per bed than in the 14 organisations with higher than expected mortality rates.

Hospitals with the lower than expected mortality rates had on average 24% more nurses, as well as 44% more doctors, per bed than those with the highest rates.

In these better performing trusts, there were on average 2.3 nurses per bed, compared with 1.8 nurses per bed in those with the worst death rates.

The study also found the trusts with lower mortality rates had 65% more critical care beds per standard ward bed... read more.


Half of GPs willing to resign NHS contracts (Pulse: 10 December 2015)

Almost half of GPs support mass resignation from the NHS in protest at the current state of general practice, a Pulse survey has revealed.

The survey of 922 GPs found that 49% are willing to resign their NHS contracts to highlight issues such as chronic underfunding, relentless bureaucracy and the ‘misrepresentation’ of doctors.

However, 35% of respondents said they were against the measure, saying that mass resignation could enable the Government to divide the profession and privatise the NHS.

It comes as senior GP leaders prepare for a crisis summit in 30 January, which will look specifically at ‘what actions are needed to ensure GPs can deliver a safe and sustainable service’ and after junior doctors forced health secretary Jeremy Hunt back to the negotiating with their threat to strike earlier this month.

GPs said they were angry at the lack of Government action as practices faced an unprecedented shortage of GPs, their income falling to the lowest level for nine years and many being forced to close down.

They said that a ‘new deal’ announced by the health secretary earlier this year has failed to deal with the problems many practices were more


Number of ambulance staff quitting almost DOUBLES leaving NHS facing crisis (The Mirror: 10 December 2015)

The NHS faces an ambulance staffing crisis because numbers of workers quitting have almost doubled, experts warn.

Thousands more ambulance staff and paramedics plan to leave imminently, with poor working conditions and low pay blamed for the mass exodus.

The Unison, Unite and GMB unions were calling on the Government to review salaries or face the “catastrophe” of strike action.

In 12 months over 2010/11 a total of 845 ambulance staff quit, say NHS figures obtained by the three unions. In 2014/15 that had soared to 1, more


Almost half of junior doctors left NHS after foundation training (The Guardian: 5 December 2015)

Almost half of all junior doctors are opting not to continue their training in the NHS, threatening a “disaster” that senior medics fear will worsen the service’s shortage of frontline clinicians.

This year only 52% of junior doctors who finished the two-year foundation training after medical school chose to stay in the NHS and work towards becoming a GP or specialist – the lowest proportion in the health service’s history and down from 71.3% as recently as 2011.

The official figures reveal sharp rises in the number of junior doctors shunning the NHS and opting instead to work in academia, as a locum medic or simply taking a career break.

The extra pressure on NHS staff created by the growing demand for patient care, disenchantment among junior doctors, and an increasing trend towards gap years are all being blamed for the trend.

“To see such a large number of doctors leave the NHS in such early stages of their careers is incredibly worrying, and can only worsen the recruitment crisis we are already seeing in many parts of our NHS, such as A&E,” said Dr Johann Malawana, chair of the British Medical Association’s junior doctors committee.


NHS England cap on agency payments comes into effect (BBC: 23 November 2015

A cap on spending on NHS agency staff comes into force in England on Monday, to save £1bn over the next three years. By April, NHS trusts will not be able to pay agency staff, such as doctors and nurses, more than 55% more for a shift than a permanent member of staff.

Agency spending is one of the biggest costs to NHS trusts and is putting increasing pressure on the health service's finances. The health secretary said it would stop agencies "ripping off the NHS". But agencies complain they are being demonised when the problem lies in a shortage of trained staff. And some hospitals are likely to struggle to meet the targets they have been set. 

From Monday, there will be a limit on the amount companies can charge per shift for providing all staff, including doctors and non-clinical more 


40% of GPs to quit within five years (Pulse: 26 October 2015)

Four out of five GPs in England are planning to cut back or stop practising in the next five years, with half of those intending to quit for good, according to a survey carried out in the West Midlands.

Out of nearly 1,200 GP respondents, four out of five – 82% – said they would be leaving general practice, reducing their clinical hours or taking a career break.

And around two out of five – 42% – said they intended to leave the job completely, while almost a quarter – 23% – said they planned to take a break.

Only 67 (5.6%) respondents said they planned to increase their hours of clinical work.

GPs intending to leave cited the volume and intensity of their workload, too much time spent on unimportant tasks and introduction of a seven-day working week as major contributors to their more


Junior doctors: 7 in 10 to leave NHS if Hunt pushes through new contract (The Guardian: 21 October 2015)

Thousands of junior doctors in England will quit the NHS if Jeremy Hunt presses ahead with his threat to impose an unpopular contract on them, a survey shows.

The poll has prompted warnings that such an exodus would leave the NHS unable to function, given young medics’ key role in delivering care.

In all, 2,949 (71.4%) of the 4,129 junior doctors polled said they would move abroad, become a locum or give up medicine altogether if the contract is forced on them next year as part of the government’s move to a seven-day NHS. Fewer than one in three – 1,180 (28.6%) of respondents – said they would stay in the more


Staff shortages common theme across NHS, warns CQC (Nursing Times: 15 October 2015)

Staffing shortfalls have been identified as a key factor affecting patient safety in hospitals and care homes, according to a report from the Care Quality Commission.

Poor staff numbers and skill mix and a tendency to rely on agency staff were a common factor in services rated “inadequate” by the regulator, it said today in its State of Health Care and Adult Social Care in England 2014-15 report.

The regulator’s annual analysis on service quality, published today, stressed that “quality depends on getting staffing right”. However, the regulator found that safe care at some of the top-rated organisations was also being hampered by staffing issues.

While the CQC found the majority of health and social care services in England were “good” or “outstanding”, it also found big variations in quality with safety still the biggest concern.

More than one in 10 hospitals – 13% – checked so far under the CQC’s new inspection regime were rated “inadequate” for safety. This was true of 10% of adult social care providers and 8% of primary care services.

In its wide-ranging report, the CQC stressed that having the right number and mix of staff was crucial to delivering the best care. Insufficient staffing number and skills mix were among key factors putting safety at risk across all sectors, the regulator more


Trusts will struggle to achieve agency nurse spending caps (HSJ: 14 October 2015)

Several trusts will struggle to reduce spending on agency nurses in line with the targets set by regulators, HSJ has been told. 

Monitor and the NHS Trust Development Authority last month issued “ceilings” to each provider on the proportion of nursing expenditure they can spend with temporary staffing agencies. The new targets, which vary depending on the amount trusts have previously spent, came into force at the start of this month.

The ceilings vary from 3 to 12 per cent. HSJ asked trusts across the range if they thought they could reduce spending as required. The responses suggest trusts currently spending a higher proportion on agency nurses will find it more difficult to meet their ceilings. Tameside Hospital Foundation Trust spends 6-8 per cent of its nursing expenditure on agency staff and is expected to gradually reduce this to 3 per cent by 2018-19. 

Chief executive Karen James said: “It’s going to be impossible to achieve a significant reduction in our spend [and] we can’t achieve the level we are being asked to this year.

“We can make a slight inroad in terms of the ceiling but we’ve been clear we’re not going to be able to achieve it and other trusts are saying similar things.”

Regarding the financial challenge facing the NHS, she said: “Everyone’s been working towards the [safe staffing] guidance and this has increased demand for agency nurses. This all could have been predicted.”

She described the staffing guidance as a “very crude tool” and called for regulators to account for the roles played by allied health professionals in making wards safe.


NHS 'backtracking' on ward nurse numbers introduced after Mid Staffs (The Guardian: 13 October 2015)

The NHS has been accused of backtracking on improvements in patient safety made after the Mid Staffs scandal by reducing the number of nurses on wards because of its growing financial crisis.

NHS bosses have told hospitals they no longer have to ensure that one nurse is caring for no more than eight patients at a time, in order to help tackle a £2bn black hole that has left 80% of hospitals facing deficits of up to £100m each.

The letter states: “We would stress that a 1:8 ratio is a guide not a requirement. It should not be unthinkingly adhered to. Achieving the right number and balance of clinical and support staff to deliver quality care based on patient needs in an efficient way that makes the best possible use of available resources is the key issue for provider [hospital] boards.”

The move, set out in a letter to all hospital chiefs, has sparked fears that patient safety will be sacrificed to help hospitals cut costs. It makes clear that financial considerations are deemed to be as important as the safety and quality of care patients receive when deciding how many nurses should be on more


Devon and Cornwall agency nurses spend raises concerns (The BBC: 30 September 2015)

Health trusts in Devon and Cornwall spent almost as much on agency nurses in the first half of this year than they did throughout 2014, figures show.

Hospitals and other NHS health trusts spent £23.3m from January to June and £25.3m in 2014.

The figures came from a Freedom of Information request by the Royal College of Nursing.

Trusts, which have been ordered to reduce agency staff spending, blamed a national shortage in full-time more


‘I can’t sacrifice my family for the NHS’: the junior doctors forced out of jobs they love (The Guardian: 29 September 2015)

At what point does a dedicated doctor, with a lifelong commitment to the NHS, decide it is time to quit ? For Dr Singh, 34, a junior doctor in general medicine, the moment will come when he is no longer able to pay his mortgage and childcare bills, a situation he expects to find himself facing sometime next year. Dr Singh has worked in hospitals, with regular A& E shifts, for 10 years since qualifying, loves his job and describes himself as “the kind of doctor you’d want to see to your gran”. But, having done an online calculation assessing how the Department of Health’s new junior doctor contract will affect his household income, he believes he and his paediatrician wife face a 25% cut to their joint take-home pay, making life in London unaffordable. He plans to move into the pharmaceutical more


NHS call handler says service is 'dangerously short-staffed'. (ITV News: 29 September 2015)

A Derbyshire call-handler who worked for the NHS 111 hotline claims the service is dangerously short staffed. Irsah Tahir from Derby says often there is only one nurse on call to cover an area of over 2 million people. Derbyshire Health United say they offer an effective and well led service which performed within NHS guidelines.


London doctors stage Whitehall protest over government contract plans. (London Evening Standard:28 September 2015)

Scores of doctors marched through central London as the row over government plans to introduce new contracts next year intensified. Protesters said several thousand people helped close off Whitehall near Downing Street in the demonstration against the Department of Health's proposals. Critics say the changes include pay cuts of up to 30% as overtime rates would be scrapped for work between 7am and 10pm on every day except Sunday. Janis Burns, a 34-year-old doctor who works for the Royal Brompton and Harefield NHS Trust, told the Standard she had joined the protest because she fears the plans will lead to patients being harmed. "Removing mandatory safeguards and any financial disincentive that protects junior doctors from working unsafe hours will lead to tired and overworked doctors. When doctors are tired we make mistakes, and mistakes harm patients." The British Medical Association has announced it plans to ballot junior doctors on strike action over the proposals.


GPs to debate resignation from the NHS en masse. (Pulse: 28 September 2015)

GPs will debate whether the profession should resign from the NHS en masse at the Pulse Live conference tomorrow. The debate, taking place in Liverpool, will see delegates voting on the question ‘Is it time for all GPs to resign from their NHS contracts ?’, and will involve chair of the Family Doctor Association Dr Peter Swinyard and Dr Zoe Norris, media lead for GP Survival. The panel will be debating whether it is time for GPs to take the major step in response to health secretary Jeremy Hunt’s ‘new deal’, in which he pushed for GPs to offer seven-day access. It also comes as junior doctors are going to be balloted by the BMA on whether to take industrial action in response to the Government imposing a contract that will see Saturday working reclassified as ‘sociable’ more


Numbers of NHS doctors registering to work overseas could reach unprecedented record. (The Independent: 21 September 2015)

The Government’s decision to impose a new contract on junior doctors may risk an exodus of young medics, after figures revealed an unprecedented spike in NHS doctors registering to work overseas. Doctors seeking to work abroad must apply for Certificates of Current Professional Status (CCPS) from their regulator, the General Medical Council (GMC). In just three days last week, the GMC received 1,644 requests for CCPS documents. Typically, it receives around 20 to 25 a day. The extraordinary spike in demand began on 16 September, the day after the Government confirmed it would seek to impose a new contract on junior doctors, after their union, the British Medical Association (BMA), refused to return to more


NHS outsourcing deal loses 1,000 jobs (Financial Times: 26 July 2015)

Capita, the FTSE 100 outsourcer, is planning to cut nearly 1,000 jobs when it takes on a £1bn contract to supply administrative support to the NHS.

Almost 80 per cent of employees in the Primary Care Support Services division will lose their jobs and 28 of 30 offices will be shut when the service is transferred from the public sector in September.

The staff provide back-office services such as payments administration and management of clinical records for NHS primary care providers including GPs, opticians, pharmacists and more


Massive leaked NHS privatisation plan could shut 29 centres and make 800 staff redundant (Mirror: 24 July 2015)

A massive NHS privatisation plan worth up to £1bn is threatening to shut 29 centres across England, leaked documents reveal today.

Outraged union reps at Unison fear the plans, handed to the Liverpool Echo , will put the jobs of 800 hard-working admin staff at risk.

The workers are based at 32 Primary Care Support centres, which keep medical records up to date and send out letters to millions of patients.

NHS England is planning to hand responsibility for the centres to private company Capita in September. Now proposals sent to staff suggest Capita is proposing to shut down 29 centres, leaving just three in Leeds, Preston and Essex.

NHS bosses insist the plans will free up cash for frontline staff as part of the Tories' vow to protect the NHS.


Why Jeremy Hunt is wrong: NHS medical staff respond to ultimatum (The Guardian: 16 July 2015)

Health secretary Jeremy Hunt has given NHS consultants an ultimatum: agree to work weekends within six weeks, or a seven-day contract and cuts to overtime pay will be imposed from April 2017, he said in a speech at the King’s Fund in London.

The British Medical Association (BMA) called Hunt’s plans a “wholesale attack on doctors” and said that the government was attempting to distract from its lack of investment in emergency care.

The head of the BMA, Dr Mark Porter, told the BBC that doctors supported an improved, seven-day NHS service, but other factors were to blame, including a lack of resources.


David Cameron unhappy about loss of NHS nurses (Oxford Mail: 30 June 2015)

Prime Minister David Cameron has said it was “extremely disappointing” Chipping Norton Hospital was to lose NHS nurses from its intermediate care ward.

The Witney MP made the comment after it was revealed nurses at the 14-bed unit at the London Road hospital, currently managed by Oxford Health NHS Foundation Trust, will come under the control of the Orders of St John Care Trust.

OSJCT runs the Henry Cornish care home, which is next door, as well as a number of other care homes across the south of England.

Campaigners have fought to keep the unit under NHS control, fearing a reduction in the quality of care.

Oxfordshire County Council, which commissions the service, has been consulting on the changes and believes it can cut the cost of each individual bed from £1,777 to £823 per week.

Mr Cameron said: “It is extremely disappointing to hear that, following a consultation, Oxfordshire County Council is returning to the original proposal that intermediate care beds are staffed by the Orders of St John Care Trust.”


GP surgery faces closure over NHS funding as doctors quit Limehouse practice (The Docklands and East London Advertiser: 9 June 2015)

The Limehouse Practice in Gill Street could be closed down after two GPs quit—leaving the surgery unable to cope with falling incomes and rising workloads. The remaining six GPs are now insecure and are also on the verge of leaving, after the NHS switched the way it funds practices in deprived areas.

The practice is “unlikely to find replacements” with the national shortage of GPs and could close within months, it warned.

“This will be a tragic waste if we’re forced to close,” one of the GP partners, Dr Naureen Bhatti, told the East London Advertiser. Doctors are now just another group of ‘key workers’ being forced out of the East End because we can’t afford to live here any longer.”

Closure of the Limehouse Practice would strain other surgeries, with 10,000 patients struggling to find a new GP, doctors warn. Embattled GPs across East London have been running a ‘Save Our Surgeries’ campaign since the latest round of cuts began to hit practices.

Stepney’s Jubilee Street Practice managed to get an 11th hour reprieve—but with only two years of funding and half the budget already spent keeping it open. It also fears for its future.


Thousands of patients forced to hunt for a new GP as staffing shortages accelerate practice closures (Independent: 1 June 2015) 

Thousands of patients have had to find a new GP because their local practice has closed, as staffing shortages and workload pressures take their toll on surgeries, new figures show.

In England, Scotland and Wales, 61 practices have closed since April 2013 which has forced more than 160,000 people to register somewhere new, figures obtained via Freedom of Information (FOI) requests show. Closures are being forced by problems both in recruiting new GPs and in retaining the existing workforce. The figures, obtained by the GPs’ magazine Pulse, were described as “the tip of an iceberg” by one senior GP.


How nursing agencies making billions are bleeding the NHS dry (The Telegraph: 31 May 2015)

The extraordinary boom in agencies supplying doctors and nurses to the NHS amid a rapidly deepening deficit in the health service is revealed today.

An investigation by The Telegraph shows how total revenue at 10 of Britain’s biggest medical recruiters rose by almost 40 per cent over three years, with the companies posting overall takings of £7.7 billion since 2009.

The businessmen running the agencies are earning up to £950,000 a year and living expensive lifestyles in properties worth millions of pounds, prompting warnings last night that the NHS needed “to get a grip”.

The chairman of one firm, which supplies both the NHS and the private sector, lives in a £9.5 million house in central London and drives an Aston Martin DB9 sports car.


'War of words' likely over seven-day GP opening (BBC News: 21 May 2015)

Complaints about the rising workload and lack of funding for primary care in England have been made loud and clear for some time now.

David Cameron's restated drive to make the NHS a fully seven-day-a-week service has added to their sense of grievance.

For the British Medical Association (BMA) to criticise the government over its handling of primary care is hardly new.

The BMA has already made clear its opposition to moving towards seven-day-a-week surgery opening before current shortfalls in staffing and resources are addressed.

But the tone of the speech by Dr Chaand Nagpaul, chair of the BMA's GP committee, represents an escalation of the rhetoric and a further souring of its relationship with Whitehall.

He refers to a "catastrophic timebomb ready to explode" in the shape of doctors leaving general practice. He says that without a turnaround in recruitment "we won't have a comprehensive general practice service in parts of the UK".


NHS staffing pressures risk 'stifling' cancer research (Nursing Times: 19 May 2015) 

The daily pressure facing nurses and other clinicians is having a serious impact on the ability of the NHS to support world leading research into cancer, a leading charity has warned.

Escalating pressures to deliver routine NHS services are squeezing out time for hospital staff to do vital research, according to a report from the University of Birmingham.

It also highlighted how financial pressures are affecting research infrastructure and the capacity of host organisations to fund additional research costs.


Staffing problems weaken NHS reform plans (Financial Times: 29 April 2015)

NHS staff shortages threaten to undermine proposed reforms to the way the health service cares for patients, according to a report from an independent think-tank.

Last October, Simon Stevens, head of England’s NHS, and other health leaders set out a plan to increase co-operation between different parts of the health service.

It involved closer links between primary and specialist care, physical and mental healthcare, and health and social care.

Yet the King’s Fund says that gaps in the workforce, combined with an increasing reliance on temporary staff, could put these reforms at risk.


Paramedics take 40,000 days off sick with stress as strain on NHS takes toll (The Guardian: 25 April 2015)

Growing numbers of paramedics are going off sick with stress as the demand for 999 services increases.

Freedom of information requests submitted to NHS regional ambulance services show that both the number of paramedics on stress-related leave and the amount of time taken have increased dramatically in the last three years. Paramedics in England took a total of 41,243 days off in 2014 as a result of stress-related illnesses – up 28% since 2012.

The surge in stress leave has coincided with the NHS facing growing pressures after budgets were frozen in real terms.

Gerry Egan, a paramedic and executive director of the College of Paramedics, said: “It is clear that there are very real concerns among our membership in regards to mental ill health and many are worried that they will not reach retirement age of 68 years as a result of physical or psychological injury.”


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.


Hospital staff absences for mental health reasons double (BBC News: 24 March 2015)

Staff absences for mental health problems have doubled at hospital trusts across England in the past four years.

Figures obtained by the BBC revealed 41,112 staff were off sick with anxiety, stress and depression in 2014 - up from 20,207 in 2010.

NHS England said it needed to do more to support staff.

The Royal College of Nursing said the figures reflected the "relentless pressure" staff were under.


Emma Mamo, from mental health charity Mind, said there had been funding cuts of about 8% to NHS services with 3,000 nursing posts lost.

"These figures could suggest sickness absence relating to mental health problems is on the rise among hospital staff.

"The impact of these cuts, through increased workloads and changes to services, is bound to have an impact on staff morale and wellbeing.


Nurses at breaking point as number off work with stress soars (The Guardian: 17 January 2015)

The number of nurses taking time off due to stress has soared as the NHS has struggled to cope with rising demand for care. Responses to freedom of information requests submitted to NHS organisations by the Observer show that both the number of nurses on stress-related leave and the amount of time taken off are up significantly in the past three years in London, Scotland and Wales.

The figures have prompted claims by health unions that the NHS’s 400,000 nurses are being stretched to breaking point as a result of having to work more demanding and longer shifts at a time when understaffing and the increasing complexity of illnesses add to more


Hospitals recruit nearly 6,000 nurses from oversees to tackle staff shortages (Health Service Journal: 17 December 2014)

A shortage of registered nurses to fill an increasing number of posts has driven nearly three-quarters of hospital trusts to recruit overseas, an HSJ investigation has revealed.

Analysis of data from all 140 English acute hospital trusts shows that 103 recruited a total of 5,778 nurses from overseas in the 12 months to September 2014.

The numbers illustrate the scale of the shortage of UK based nurses and mean that overseas recruits constituted a substantial proportion of the total hired by hospitals.

HSJ’s figures indicate overseas recruitment increased dramatically compared with the same period in 2012-13. In that year, of 105 trusts that provided information, only 40 reported recruiting a total of 1,360 nurses from outside the UK.


Service hit by staff 'exodus' after CCG transfers contract to Circle (Health Service Journal: 16 December 2014)

One of the biggest teaching trusts in England has been forced to axe its once renowned acute dermatology service following an “exodus” of medical consultants following the transfer of their contract to private provider Circle.

Nottingham University Hospitals Trust has confirmed it will cease to provide acute adult dermatology services – including emergency services – from February next year, due to a lack of staff.

The workforce crisis comes after Nottinghamshire commissioners awarded Circle a contract that made it the main provider of dermatology services delivered across the trust and Circle’s Nottingham NHS Treatment Centre.

The trust’s own bid for the contract was unsuccessful and the services were passed to Circle last year, despite warnings from the trust’s 11 dermatology consultants that senior staff would leave rather than be transferred out of the NHS.


Labour warns of skills gap after exodus of senior nurses from NHS (The Independent: 7 December 2014)

The NHS in England has lost more than a thousand matrons and 3,400 other senior nurses over the past four years, new figures have shown, leading to warnings that hospitals may be lacking “vital experience and knowledge” needed to cope with unprecedented levels of demand.

Despite continued calls to put matrons and nursing leaders at the heart of NHS care, figures obtained by the Labour Party reveal the number of senior nursing posts has dropped since 2010.

Official data from August also shows that more than 1,028 “modern matrons” overseeing care in wards and 216 community matrons co-ordinating care across different services have been lost since May 2010.

The combination of an ageing workforce and cuts to staffing are thought to be behind the falling figures. Nurses have also warned that an ongoing pay freeze and ever-increasing job stress were driving them out of the profession, and discouraging experienced professionals from coming back.

The total number of full-time equivalent nursing staff working in the NHS has been on an upward trend in recent months. But the recruitment drive has been expensive, and some hospitals have cut senior posts or not replaced retiring senior nurses to help balance the books.


NHS staff stage four-hour strike (BBC News: 24 November 2014)

NHS workers, including nurses, midwives and ambulance staff, have staged a four-hour strike in England as part of a pay dispute.

They were protesting about the decision not to implement a 1% rise for all staff recommended by a pay review body.

Members of nine unions walked out at 07:00 GMT in England and at 08:00 GMT in Northern Ireland.

A Department of Health spokesman said it could not afford the rise without risking frontline jobs.


Dave Prentis, general secretary of Unison, told the BBC: "Really it is to get over a message to the public about what is happening and to get the message to the government about the importance of our members providing our health services.

"An independent pay review body that looks at public service workers recommended a 1% increase in line with the government's own pay policy.


Number of GPs seeking to leave UK and work abroad doubles under coalition (The Guardian: 23 November 2014)

The number of GPs applying to leave the NHS annually to practise abroad has doubled under the coalition, raising fresh concerns over its handling of the health service.

The exodus risks exacerbating the current backlogs in GP practices and the pressures on A&E departments, according to the Royal College of GPs, which has warned that 600 practices may close in the next year due to poor recruitment and retention of staff. The most recent patient survey reports that one in four patients now wait a week or more to see their local doctor.

New figures show that 529 GPs were issued in 2013 with a certificate of good standing, which allows them to practise abroad. That compares with 266 in 2009, according to figures provided by the General Medical more


NHS spending on agency nurses soars past £5.5bn (The Guardian: 1 November 2014)

 NHS spending on agency nurses and staff has spiralled to more than £5.5bn over the past four years and is continuing to rise amid a debilitating recruitment crisis in the health service. Budgets for temporary staff this financial year have already been blown apart, it can be revealed, with spending in some parts of the 

Key Facts

Since the Coalition came to power in 2010 the NHS has lost as many as 6000 nursing posts.

Paramedics stress-related sick days increase by 28% between 2012 and 2014

Hospital staff absences for mental health reasons double

Key Trends:

Between May 2010 and July 2012: the total NHS workforce decreased by 2%.

Within this change:

The number of doctors rose by 7.5%, qualified midwives by 5%, and qualified scientific, therapeutic and technical staff by 2%.

The number of qualified nurses decreased by 2%.

Largest decrease in NHS infrastructure support at 9%

A decrease in support to doctors and nursing staff by 2.5%.

As of 2014 the number of doctors applying for certificates to work abroad has increased by a fifth since 2008 to around 3,000 a year.


Health and Social Care Information Centre Workforce Statistics
"The latest statistics show that the cuts to NHS staff show no sign of slowing down" Peter Carter, chief executive and general secretary of the Royal College of Nursing

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