NHS trusts accused of creating ‘dozens of Carillion-style meltdowns’ (The Guardian: 6 March 2018)

rowing numbers of hospital trusts are transferring staff into newly created private subsidiary firms in a move health unions warn will create a “two-tier workforce” in the NHS. Trusts are starting to see subsidiaries as a way of saving money after seven years of below-inflation annual budget increases and mounting financial problems due to an increased demand for healthcare.

Nineteen NHS trusts in England have already established a wholly owned subsidiary and begun transferring thousands of non-medical staff to them. Sixteen other trusts are considering doing the same in a fast-growing change in practice that they insist is intended to save money as employers, especially through paying less VAT. While private firms working for the NHS can claim back any VAT they are charged by the government, an NHS trust cannot, under the terms of the 1994 VAT Act....read more


NHS England mulls specialised services payment overhaul (HSJ, 5 March 2018)

NHS England is considering a radical overhaul of the way specialised mental health services are paid for including a greater emphasis on rewarding providers for shifting care into the community, according to internal documents obtained by HSJ.

A paper, written for NHS England’s mental health programme of care board, which advises NHS England on commissioning policy for the sector, has set out a vision for the way tier four child and adolescent mental health services and adult secure mental health services should be paid for.

The document, obtained under the Freedom of Information Act, could see providers being paid a fixed amount for a set number of beds, with further payments for each specialised care episode and a top-up fee for reducing specialised inpatient care days.... read more


'Vulnerable patients' face ongoing caps to care funding (HSJ: 2 March 2018)

Commissioners have been allowed to continue applying cost caps to the more than £3bn of NHS Continuing Healthcare claims as long as they follow new new government rules.

The Department of Health and Social Care’s new framework, developed in partnership with NHS England, does not explicitly ban cost caps as long as commissioners take into account an individual’s needs when they do so.

CHC pays for ongoing care for adults, described by the DHSC as ”some of the most vulnerable in our society” and who are assessed as having a primary medical care need in a community setting. It is arranged and funded solely by the NHS and in 2015-16 cost the service approximately £3.1bn ...read more


NHS England treats too many patients as an emergency, watchdog warns (The Guardian, 2 March 2018)

Hospitals in England are admitting so many patients as medical emergencies that the NHS’s finances and ability to function are under threat, Whitehall’s spending watchdog has warned.

But one in four of the growing number of mainly older people who end up in inpatient care should not be in hospital in the first place, according to the National Audit Office (NAO).

The ageing population and other unexplained factors mean hospitals are now treating 5.8 million patients as emergency admissions every year, 24% more than a decade ago, the NAO found. Together they cost the health service £13.7bn, almost a 10th of its budget, and account for 33.59m bed days.

Its hard-hitting report, published on Friday, praises NHS England’s handling of the extra numbers but also criticises its failure to put in place enough services outside of hospitals to keep patients healthier...read more


Capacity to handle 999 calls at risk, warns London ambulance service (The Guardian, 2 March 2018)

Britain’s busiest NHS ambulance service may no longer be able to answer all 999 calls quickly enough because its control rooms are chronically short of call handlers, it has warned.

The London ambulance service (LAS) disclosed this week that its capacity to respond to medical emergencies has been under threat because of a 20% shortfall in its control room staff.

Campaigners for patients have voiced alarm over the findings, saying the risk to the service could lead to people dying of strokes or heart attacks because an ambulance has taken longer than it should to reach them.

In a report presented to its board on Tuesday the LAS identified an acute lack of staff at its two main bases as a key risk to its ability to function. Listing the risks faced by the trust, it said: “The trust may be unable to maintain service levels due to insufficient staff in the emergency operations centre (EOC)."...read more


Controversial ‘CareBnB’ firm returns to launch new trial (HSJ: 1 March 2018)

The company developing a controversial “Airbnb for social care” model allowing homeowners to rent spare rooms to recuperating hospital patients is bidding to launch a new trial in Cambridge.

Private start up CareRooms was forced to abort its first pilot, exclusively revealed by HSJ, with the NHS in Essex in November, after patient groups and social care directors raised safeguarding concerns about care being provided by non-care professionals.

But it is now establishing a “working group” with Cambridgeshire County Council and has begun advertising for “host” households in the county, which includes the East Cambridgeshire constituency of junior health minister Stephen Barclay.

The Conservative controlled council confirmed the new group would meet for the first time imminently to discuss the “innovative CareRooms concept”. The council has not committed to pilot the model yet....read more


NHS spending £350m a year to send mental health patients miles from home (The Independent: March 1 2018)

The NHS is reliant on private mental health services to treat seriously ill patients, often miles away from loved ones, and is doing too little to ensure they are not being kept in treatment longer than necessary, the care watchdog has said.

A report by the Care Quality Commission (CQC) today warns the health service is spending £350m a year to send these patients “out of area” for care.

Experts told The Independent this reliance is down to a lack of inpatient services to support patients locally, and a lack of incentives for “specialist” centres to send patients home.

The CQC is now calling on NHS managers to draw up plans to "repatriate patients" and to ensure every patient has a care plan aimed at getting them better to bring them back into the community. ...read more


Postcode lottery of care for breast cancer patients revealed ( The Darlingon and Stockton Times: 28 February 2018)

Women face “unacceptable differences” in breast cancer care across England, a new report has concluded.

The All Party Parliamentary Group (APPG) on Breast Cancer said women face a postcode lottery in the care they receive across the country.

Some women are being diagnosed at an earlier stage of their breast cancer than others, some offered life-saving drugs while others are not, and some women receive the care of specialist nurses while others have no such support, the group of MPs found...read more


GPs offered cash to refer fewer people to hospital (The Guardian: 28 February 2018)

GPs are being offered cash payments not to refer patients to hospital, in a move which leading family doctors have criticised as ethically questionable and a risk to health.

NHS bodies in four parts of England are using schemes under which GP practices are given up to half of the money saved by sending fewer patients to hospital for tests and treatment

The disclosure by the GP website Pulse about the controversial “profit share” initiatives operated by the four NHS clinical commissioning groups (CCGs) has triggered a row.

Critics said the schemes were the latest example of NHS bodies increasingly resorting to the rationing of care to help them operate within their budgets...read more


Exclusive: Vanguards dent emergency admissions but not bed days (HSJ: 26 February 2018)

NHS England’s national performance dashboard for the programme shows that, over the measurement period, there was a larger reduction in the rate of hospital bed days in non-vanguard areas than in the nine primary and acute care systems.

Across the 14 multispeciality community providers there was a slightly larger reduction than in the non-vanguard population.

However, the dashboard report shows that vanguards saw substantially lower growth in the rate of emergency admissions over the same period than the rest of England.

Bed days and emergency admissions are the “efficiency” metrics included in the new care models dashboard.

The vanguard dashboard report seen by HSJ compares the rate of emergency admissions and bed days in the 12 months to September 2017, to that in the 2014-15 financial year. It also reveals figures for all the vanguard sites. ...read more 


NHS England director appointed to lead integrated care system (HSJ: 22 February 2018)

An integrated care system early adopter has appointed an NHS England director to lead its transformation programme.

Louise Watson has taken on the role of managing director at the Buckinghamshire ICS, which was one of eight systems announced by Simon Stevens last summer.

She is currently director of NHS England’s new care models vanguard programme. She is stepping down from this role but will continue to work part-time for NHS England in an advisory capacity to help support the development of other ICSs.

In her new role, she will be accountable to the Buckinghamshire’s partnership board of chief executives from all the organisations involved in the ICS: Aylesbury Vale and Chiltern clinical commissioning groups; Buckinghamshire Healthcare Trust; Buckinghamshire County Council; Oxford Health Foundation Trust; South Central Ambulance Service FT; and the GP federation FedBucks. ...read more


Ambulance handover delays worst since first week of 2018 as NHS pressures continue (GP online: 22 February 2018)

A total of 13,302 patients waited more than half an hour to be handed over to hospital staff in the week to 18 February, while 2,948 waited more than an hour. Waits over half an hour were up 24% from the previous week, while waits of more than an hour were up 32%.

The figures reveal that pressure on hospitals is far from over despite the end of the national freeze on elective care that was in place through January, and in spite of evidence that flu levels are starting to ease.

Hospitals remain well above the target level of 85% bed occupancy considered safe, with 95% of hospitals beds occupied on average across England over the past week. Bed occupancy rates have now been at around 95% for six weeks in a row - with hospitals regularly completely full. ...read more


One in 11 posts unfilled in the NHS in England (The Guardian: 21 February 2018)

One in 11 posts in NHS England are currently unfilled, equivalent to almost 100,000 vacancies, official figures show.

The number of vacancies was published for the first time in NHS Improvement’s quarterly performance report for the three months ending 31 December. Released on Wednesday, the report warns that staff shortages are affecting performance.

The high number of unfilled posts has coincided with the NHS coming under immense pressure, with 250,000 more people visiting A&E than in the equivalent three-month period in 2016.

NHS providers reported a year-to-date deficit of £1.3bn, moving NHS Improvement to revise its estimate of the year-end deficit to £931m, 88% worse than planned...read more


Ambulances stuck at A&E 'unable to respond quickly to 999 calls' (The Guardian: 18 February 2018)

Patients who have a stroke or heart attack are at risk of harm because so many ambulances are stuck at A&E units that they cannot respond quickly enough to 999 calls, an NHS boss has said.

Wayne Bartlett-Syree, the director of strategy and sustainability at the East of England ambulance service, said the huge number of delays ambulance crews have faced this winter in handing over patients to hard-pressed staff of overcrowded A&E units was to blame. ...read more


Theresa May refuses to exclude NHS contracts from US trade deals (The Guardian: 7 February 2018)

Theresa May has refused to rule out giving US companies access to NHS contracts as part of a future trade deal with Donald Trump’s White House.

At prime minister’s questions on Wednesday, the Liberal Democrat leader, Vince Cable, challenged May over how she would respond if Washington pushed for access to Britain’s public services for US corporations.

“The prime minister knows that one of the key objectives of American trade negotiators in any future deal after Brexit is to secure access for American companies to business in the NHS,” he said. “Can she give an absolute guarantee that in those negotiations the NHS will be excluded from their scope? And can she confirm that in her conversations with President Trump she’s made it absolutely clear to him that the NHS is not for sale?”...read more


Hundreds of NHS staff forcibly moved to a private company, says UNISON (Nursing Notes: 7 February 2018)

Moving 350 NHS staff into a Trust-owned private company has put Yeovil hospital in breach of licence, public service union UNISON has set out.

In a letter to NHS regulators, UNISON argues the Trust’s decisions must be investigated.

Writing to NHS Improvement, UNISON set out Yeovil hospital’s failure to comply with the licencing requirement to have due regard for the NHS Constitution. The Constitution, which establishes what NHS patients and staff can expect from the service, states that NHS Trusts must “engage staff in decisions that affect them and the services they provide”....read more


Fix the NHS: Protesters rally in London to call for government action (The Guardian: 3 February 2018)

Health workers, activists and unions are marching in central London on Saturday to protest against government inaction over the NHS winter crisis.

Hospitals have been overwhelmed in recent weeks by a surge in admissions that has led to delays of up to 12 hours on emergency wards, patients left on trollies for hours and thousands of patients forced to wait in ambulances before receiving urgent care. 

Two pressure groups, the People’s Assembly and Health Campaigns Together, have organised the rally to call on the government to plug funding and resource gaps in the health service....read more


Stephen Hawking and leading doctors to take Jeremy Hunt to court (The Independent: 29 January 2018)

Professor Stephen Hawking has won permission to take Jeremy Hunt and NHS England to court over controversial proposals to restructure the health service, The Independent can reveal.
Mr Hunt has tabled a plan which could allow commercial companies to run health and social services across a whole region in what critics have described as allowing back-door privatisation. Leading healthcare professionals and Professor Hawking have argued an act of parliament is required, allowing MPs and Lords to scrutinise the proposals, before the policy is implemented and any changes to regulations are made....read more

Virgin set to bid for £260m children's services contract (HSJ: 25 January 2018)

Virgin Care has indicated it will bid for an NHS contract to provide children’s community and mental health services in Devon worth at least £259m over seven years, HSJ has learned.

The company is the incumbent provider of most of the services being tendered after winning a contract in 2012.

A company spokesman said: “We’re looking forward to… continue to integrate and improve services in Devon from April 2019.”

Virgin’s contract was due to expire in the spring but last October it was given £35m to continue to run the service for another 12 months while Northern, Eastern and Western Devon Clinical Commissioning Group prepared for re-procurement.

The re-procurement process will begin next month, subject to the proposal being approved at a governing body meeting today....read more


NHS hospitals facing serious shortages of vital equipment (The Guardian: 25 January 2018)

Hospitals are suffering serious shortages of vital medical equipment such as ventilators, pumps to administer drugs, and oxygen cylinders during the NHS’s ongoing winter crisis, the Guardian can reveal.

The surge in numbers of people needing care has also led to some hospitals running out of beds for patients to sleep in, mattresses to lie on and trolleys to use while they wait for admission.

NHS England has said the service is under the most strain it has faced since the 1990s. Patients have faced long waits for beds on trolleys in overcrowded hospitals, more than 100,000 patients have been stuck in ambulances waiting to get into an A&E unit, and senior doctors have written to Theresa May warning that patients have been “dying prematurely” in hospital corridors....read more


NHS doctors warn medical care is deteriorating as nearly 75% report staffing shortages on wards (The Independent: 23 January 2018)

NHS doctors are warning that care being delivered across the health service has deteriorated in the past 12 months, according to a survey by the British Medical Association.

This may be driven in part by chronic staff shortages, which the BMA warns is forcing doctors to "juggle patients".

Seven out of ten hospital doctors (71 per cent) warned there are gaps on shift rotas in their department, but only 65 per cent reported gaps when asked the same question in May 2017....read more


Ambulance crisis 'led to 20 deaths in east England over Christmas' (The Guardian: 18 January 2018)

Twenty people died while waiting too long for ambulances in the east of England after the ambulance service there failed to seek outside help during the busy period over Christmas, a Labour MP has said, citing a whistleblower.

Clive Lewis, the MP for Norwich South, used a point of order in the Commons to highlight what he said was an “exceptionally serious issue” with the East of England ambulance service, highlighted by the whistleblower.

The ambulance service became critically overstretched from 19 December, and senior managers wanted to move into what is called Reap 4, the fourth stage of the resource escalation action plan, which involves seeking outside help, Lewis told MPs....read more


Care cuts could put patients' safety at risk, warn MPs (The Guardian: 17 January 2018)

Calls for cuts to the cost of care for some ill and disabled patients could put safety at risk, MPs have said. 

Officials want local health bodies to cut the amount spent on the NHS’s Continuing Healthcare (CHC) funding packages and NHS-funded nursing care by hundreds of millions of pounds over coming years.

The Commons public accounts committee said it was unclear how this could be done without raising the threshold for eligibility or limiting the packages available, “both of which will ultimately put patient safety at risk”....read more


NHS ‘haemorrhaging’ nurses as more leaving than joining (Nursing Notes: 17 January 2018)

The NHS is “haemorrhaging” staff with 1 in 10 nurses leaving the NHS in England each year, official figures show.

NHS Digital figures that show 1 in 10 nurses are leaving the NHS in England each year, with more than 33,000 leaving last year alone. The news comes amid an ongoing winter crisis, where NHS trusts have taken the extraordinary measures of asking for the assistance of medical students and turning to social media in order to plead staff to work....read more


Patients 'dying in hospital corridors' (BBC News: 11 January 2018)

Patients are dying in hospital corridors as safety is compromised by "intolerable" conditions, doctors say.

The warning has been issued in a letter to the prime minister signed by 68 senior A&E doctors, spelling out the danger patients are facing this winter.

It comes as reports have emerged of people being left for hours on trolleys in corridors and stuck in ambulances....read more


'Desperate times' for overcrowded hospitals, senior doctor warns (The Guardian: 1 January 2018)

Pressures on the NHS have “escalated rapidly” over the festive period, with hospitals experiencing significant bed shortages, a leading doctor has warned.

Dr Nick Scriven, president of the Society for Acute Medicine (SAM), said many hospitals reported more than 99% capacity in the week before Christmas.

He said services are being placed under significant strain as they enter the new year and called for non-urgent operations to be postponed until at least the end of January.

Doctors have described corridors overflowing with patients and used social media in a bid to find extra staff to cope with demand....read more  


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