On the face of it, this year’s budget was good news for social care. The chancellor recognised the immediate pressures facing local authorities and has announced £650m new grant funding for 2019-20 and another £45m this year for the disabled facilities grant.
But closer scrutiny of the detail paints a different picture. The £240m previously announced to help relieve NHS winter pressures this year will be repeated next year, with a further £410m to bring the total up to £650m. But this sum is expected to cover children’s social care as well, requiring councils to exercise the judgment of Solomon in prioritising the intense demands on services for disabled people, older people and children and families.
The amount available purely for adult social care next year is just £240m, falling way short of the £2.3bn estimated by the Association of Directors of Social Services as the minimum requirement for next year. Even this amount could be imperilled in the event of a chaotic no-deal exit from the EU.
So Philip Hammond’s declaration that austerity was “finally coming to an end” invites, for adult social care, the riposte “but not just yet”....read more
Chancellor’s budget boost to NHS frontline conceals £1bn cut (The Guardian: 30 October 2018)
Public health services and the education and training of nurses and doctors will be cut by £1bn next year as part of the government’s plan to boost the NHS’s budget by £20bn by 2023, it has emerged.
A leading expert in NHS finances warned ministers that their strategy of “robbing Peter to pay Paul” is a false economy that risks worsening already serious understaffing in England’s health service.
Prof Anita Charlesworth, director of economics and research at the Health Foundation, identified the £1bn loss of funding that will affect those two areas in 2019-20, as well as NHS capital investment, which the health service uses to refurbish its estate, build new premises and buy equipment....read more
NHS Digital paid management consultants £1.2m for advice on GP IT overhaul (Pulse: 30 October 2018)
NHS Digital has paid management consultants £1.2m to assist with its overhaul of GP IT systems, due next year.
McKinsey & Company was paid to carry out ‘strategy, engagement and procurement’ work on NHS Digital’s plans to launch a new GP IT systems framework in the summer.
The plans were announced in August with the launch of a contract tender worth £450m and could see GP practices forced to switch patient record IT providers.
GP leaders described the expenditure as 'extraordinary and unwarranted', adding that it is a 'kick in the teeth to frontline NHS workers' struggling with limited NHS resources....read more
Budget pledges on health and social care dismissed as 'sticking plaster' (The Guardian: 30 October 2018)
experts have said the chancellor’s £20.5bn boost for the NHS in England by 2023 will leave the service still struggling to cope with rising demand for treatment.
The pressure on already overloaded A&E and GP services will continue because Philip Hammond only gave an extra £650m to prop up crumbling social care services, it was claimed.
Theresa May has promised the £20.5bn increase in NHS funding over the next five years will yield major improvements in cancer and mental health care. But doubts were raised about how much progress to expect.
“After a financial squeeze of many years, much of this new money will be needed just to get the basics back on track – keeping up with rising need, addressing sliding [treatment] waiting times and fixing the worrying backlog of buildings needing repair,” said Prof John Appleby, the chief economist of the Nuffield Trust, a health thinktank.
Health, NHS and older people’s organisations said the £650m was enough only to “stave off total collapse” of social care services and amounted to “a sticking plaster” given the scale of unmet need....read more
Acute trust agrees Care UK deal for all elective orthopaedics (HSJ: 25 October 2018)
A hospital trust will move its entire elective orthopaedic service to a private company’s facility after agreeing an 18 month partnership.
Surgeons and anaesthetists at University Hospitals Plymouth Trust will move to a facility run by Care UK to operate on around 200 patients per month, in a bid to free up space during winter. They will remain trust employees but be managed jointly by Care UK.
The trust hopes the partnership with the company will “virtually eliminate” year long waits for orthopaedic patients, and improve its referral-to-treatment performance in the 18 week pathway by 3.5 per cent – both by the end of March next year....read more
NHS trusts fear this winter could be ‘more difficult than the last’ (The Guardian: 22 October 2018)
There are “clear warning signs” that the coming winter could be even tougher than the last for NHS trusts, staff and patients, a report has warned.
They include pressures across all hospital activity, higher levels of staff vacancies and a more tired and pressured workforce, according to the body which represents trusts. It voiced concern over the “weaker state” of social care, even when accounting for the recent announcement of £240m extra funding, and “more fragile” primary care.
Last winter, corridors were overflowing with patients and non-urgent operations were postponed as staff worked to clear the backlog. The pressure continued well into January, with A&E units diverting patients to other hospitals and thousands of patients being looked after by ambulance crews for at least half an hour before they could be handed over to nurses.
The report by NHS Providers says the challenges this winter are likely to be even more severe than the last, when the problems were compounded by cold weather and the worst flu strain in seven years....read more
Ten NHS trusts ‘wasted £235m to hire private ambulances’ (The Guardian: 21 October 2018)
England’s NHS trusts have spent almost a quarter of a billion pounds on private ambulance services in the last three years as emergency 999 calls and sickness rates among health service paramedics rise.
According to figures obtained under the Freedom of Information Act, South Central Ambulance Service spent almost £69m on private providers; South East Coast Ambulance Service spent more than £35m; and North West Ambulance Service spent almost £30m. In total, the 10 trusts spent £235m on private ambulances over the period.
The GMB union estimates the same trusts spent about £146m on private ambulances between 2011 and 2013. “The fact ambulance trusts spent almost a quarter of a billion pounds on private ambulance services in just three years is a disgrace,” said Rachel Harrison, GMB national officer....read more
Dying children face ‘postcode lottery’ with inconsistent quality of end-of-life care, MPs warn (The Independent: 21 October 2018)
Dying children face “unjustified health inequality” in palliative care due to inconsistency in the quality of services, MPs have warned.
Around 40,000 babies, children and young people in England have chronic illnesses but the quality of care has been criticised as “patchy”, according to an All-Party Parliamentary Group (APPG).
Council strips contract from NHS trusts and hands it to Virgin after High Court row (NHE: 18 October 2018)
Lancashire County Council (LCC) has awarded a controversial £104m healthcare contract to Virgin Care for the second time after a hearing in the High Court ordered a re-evaluation of the decision.
The contract to run LCC’s Healthy Child Programme ‘0 to 19’ was originally awarded to the private company, but two Lancashire foundation trusts contested the decision and, following a High Court hearing in April, a judge set aside the decision.
Mr Justice Stuart-Smith ordered a full reassessment of the bids after it was ruled that Lancashire CC hadn’t followed the evaluation and procurement process correctly.
But now, following a re-evaluation of the bids, Virgin Care has once again been chosen as the preferred bidder for the contract, a move heavily criticised by unions....read more
Trusts using HCAs in place of nurses (HSJ: 18 October 2018)
NHS trusts recruited a higher percentage of healthcare assistants than nurses over a two year period, new research has revealed.
HCA numbers increased by 6.5 per cent between December 2015 and December 2017, whereas nursing numbers in hospital trusts increased by just 0.5 per cent, from 270,725 to 272,476, according to analysis by BPP University School of Nursing.
The research, which comprised of data from 195 trusts, highlighted that HCAs now account for three in 10 care roles in the NHS.
Research has shown a link between a higher proportion of healthcare assistants versus registered nurses and a rise in patient mortality....read more
People in mental health crisis neglected by NHS, MPs warn (The Guardian: 16 October 2018)
Growing numbers of people who experience a mental health crisis are having to visit A&E or are detained for their own safety because NHS services to help them are deteriorating, MPs and peers have warned.
The 700,000 people in England with severe mental health problems such as schizophrenia and bipolar disorder also face increased delays to get treatment, they said.
“Those who are the sickest often wait the longest to get help,” said a report published on Tuesday by the all-party parliamentary group (APPG) on mental health. Delays make people feel they are “hopeless, and like nothing can help”, it said....read more
STPs to create new five year plans (HSJ: 16 October 2018)
Health economies have been told to create five-year plans by autumn 2019, to set out how they will improve services and achieve financial sustainability.
In a letter to local leaders today, NHS England and NHS Improvement said “sustainability and transformation partnerships” and “integrated care systems” will be expected to develop and agree their plans during the first half of 2019-20....read more
Thousands of terminal breast cancer patients 'abandoned' due to NHS nurse shortage (Independent: 14 October 2018)
Thousands of terminal breast cancer patients are being left “abandoned” amid a shortage of specialist nurses, Breast Cancer Care has said.
The charity released figures showing almost three-quarters (72 per cent) of NHS trusts across the UK do not provide dedicated nurses.
Brexit: most doctors and nurses now think NHS will get worse (The Guardian: 13 October 2018)
A clear majority of the UK’s doctors and nurses think that the NHS will deteriorate after Brexit, with the result being longer waiting times and staff shortages, according to a new poll of medical professionals.
The survey by YouGov also suggests that opposition to Brexit has grown among doctors and nurses, with 75% saying they would now vote to remain in the EU, up from 66% who said they voted that way in 2016.
About 64% of those polled said they thought the NHS would get worse after Brexit, compared with just 7% who thought it would get better, while 57% said that the overall quality of care provided by the NHS would go down...read more
NHS hospitals warn of lack of preparation for winter as figures reveal next year will be 'tougher than ever' (The Independent: 11 October 2018)
The NHS is set to face an “even tougher winter” than the record-breaking crisis it weathered less than 10 months ago, as hospital bosses warn of staff and funding shortages.
Despite the government claiming the health service was “better prepared than ever” last year, ambulance queues tripled, there were fewer beds available and doctors wrote to Theresa May warning of patients “dying prematurely” in corridors.
NHS watchdog warns good healthcare is becoming more of a postcode lottery (The Guardian: 11 October 2018)
Patients in England are increasingly being subjected to “care injustice” in which they can access either no or poor quality hospital, mental health and social care services, the NHS watchdog has warned.
Access to good care is more and more of a lottery depending on where people live, with some areas providing only services that have been deemed substandard, according to the Care Quality Commission (CQC).
“Some people can easily access good care, while others cannot access the services they need, experience ‘disjointed’ care or only have access to providers with poor services,” the CQC’s annual report says....read more
Child mental health services will not meet demand, NAO warns (The Guardian: 9 October 2018)
Mental health services for children and young people will fall well short of meeting a growing demand for help, despite pledges by ministers to increase funding, a report by Whitehall’s spending watchdog has found.
The National Audit Office said even if current plans to spend an extra £1.4bn on the sector were delivered, there would be “significant unmet need” because of staff shortages, poor data and a lack of spending controls on NHS clinical commissioning groups.
At present, one-quarter of young people who required mental health services were able to access help from the NHS, the report said. The Department of Health and Social Care hopes to increase the proportion to 35% – estimated to be equivalent to treating an additional 70,000 children and young people per year between 2015-16 and 2020-21....read more
Body parts scandal: firm stripped of NHS contracts (The Guardian: 9 October 2018)
Healthcare Environment Services (HES) has been stripped of NHS contracts after hundreds of tonnes of waste from hospitals, including human body parts, were allowed to pile up at its facilities, the health minister has announced.
In a statement to parliament, Stephen Barclay said the watchdog NHS Improvement (NHSI) concluded that HES “had failed to demonstrate that they were operating within their contractual limits. Consequently, 15 NHS Trusts served termination notices to HES formally to terminate their contracts at 4pm on Sunday,” he said.
New arrangements have been made with the outsourcing firm Mitie to “step in and replace this service” and “NHS services continue to operate as normal”, Barclay told MPs...read more
Fraud in the NHS could have paid for 40,000 nurses (The Times: 8 October 2018)
Fraud costs the NHS £1.29 billion every year, according to the health service’s anti-corruption watchdog.
The money would be enough to pay for more than 40,000 staff nurses or buy more than 5,000 frontline ambulances, the NHS Counter Fraud Authority said in its annual report.
The organisation was established on November 1 last year. The new figure is higher than the £1.25 billion identified at its launch. The estimated total loss includes £341.7 million from fraud by patients and £94.2 million by staff
[…] Simon Hughes, the authority’s interim chairman, said: “Ensuring public money pays for services the public needs and doesn’t line the pockets of criminals means we all benefit from securing NHS resources.”...read more
Advert for GP access smartphone app banned by watchdog (The Guardian: 3 October 2018)
A watchdog has banned adverts for a smartphone app that promises to let patients “see an NHS GP in minutes for free”.
The Advertising Standards Authority (ASA) has told the private health firm Babylon Health not to advertise its GP at Hand service, which has been endorsed by the health secretary, until it corrects factual errors used in its promotion.
It criticised Babylon for not making clear in the adverts that patients signing up to GP at Hand first had to deregister from their existing family doctor, a move that GP leaders warned would prove damaging....read more
Contract extended over 'integrated provider court case' (HSJ: 2 October 2018)
A community provider’s contract has been extended by four months, pending a court dispute over an integrated care deal.
Central Surrey Health, a social enterprise providing community services in the county, is taking Surrey Downs Clinical Commissioning Group to court, claiming it breached a contract by continuing with an integration project in which the partners had fallen out.
CSH was one of five members of the Integrated Dorking, Epsom and East Elmbridge Alliance, which comprised of the company, three GP federations and Epsom and St Helier University Hospitals Trust.
The alliance was awarded a £100m contract in February, with the hospital trust the formal holder of the contract, but CSH has since said it has been “marginalised” out of the agreement....read more