Royal College of GPs warn profession could reach 'breaking point' (The Guardian: 31 July 2017)
A government pledge to increase GP numbers by 5,000 within three years is falling short amid fears the profession “could reach breaking point”, the Royal College of GPs (RCGP) has warned.
The RCGP’s annual report on plans to improve GP services in England raises concern that many doctors are yet to observe significant changes in GP numbers under the recruitment drive, with GP numbers having fallen since September 2016.
A survey of GPs for the report found that 39% think they are unlikely to be working in the profession in England in five years’ time.
The professional body for family doctors in the UK said the findings sparked fears the profession “could reach breaking point” unless progress on the shake-up was accelerated.
Prof Helen Stokes-Lampard, chair of the RCGP, said: “It takes at least three years in speciality training for new doctors to enter the workforce as independent consultant GPs, so while it’s fantastic that more foundation doctors are choosing general practice this year, if more people are leaving the profession than entering it, we’re fighting a losing battle.
“Above all else we need to see efforts stepped up to keep hard-working, experienced GPs in the profession, and the best way to do this is to tackle workload pressures and improve the conditions under which all GPs and our teams are working.... read more
NHS accused of shrouding £500m of planned cuts in secrecy (The Guardian: 28 July 2017)
Doctors’ leaders have accused NHS bosses of shrouding controversial plans for £500m of cuts to services across England in “totally unacceptable secrecy”.
Patients deserve to know how hospitals being told to “think the unthinkable” as part of the savings drive will affect their access to healthcare, the British Medical Association (BMA) said on Friday.
The doctors’ union voiced its frustration after trying but failing to obtain details of the cuts that are being planned in the 13 areas affected by the “capped expenditure process” (CEP), despite the NHS’s duty as a public body to respond to freedom of information requests.
NHS bodies in just eight of the 13 areas replied, and none gave anything other than vague, general details about what cuts were under consideration.
“It is bad enough that brutal cuts could threaten the services but it is totally unacceptable that proposals of this scale, which would affect large numbers of patients, are shrouded in such secrecy,” said David Wrigley, the BMA’s deputy chair.
In April organisations providing all types of care as well as clinical commissioning groups, the local bodies which hold the NHS budget in England, in the 13 areas were told to make an extra £500m of savings by the end of March 2018 over and above those already planned. The orders came from NHS England and NHS Improvement, the service’s financial regulator, which are keen that its books can be made to balance in 2017-18.... read more
Labour demands inquiry into privatisation of NHS-owned recruiter (The Guardian: 27 July 2017)
Labour is demanding an inquiry into the privatisation of a government-owned NHS recruitment firm that saves hospitals £70m a year.
NHS Professionals helps the health service in England tackle its staffing crisis by arranging for doctors and nurses on its books to cover potentially harmful gaps in rotas.
Labour has asked the National Audit Office to look into why Jeremy Hunt, the health secretary, is selling a profitable and effective company his Department of Health owns. The firm should be kept in public hands and allowed to continue playing a key role in alleviating widespread NHS understaffing, the party says.
Justin Madders, the shadow health minister, has written to Sir Amyas Morse, the comptroller and auditor general who heads up Whitehall’s spending watchdog, asking him to intervene before a sale is finalised, possibly as soon as next month.
“On the government’s own estimates NHSP saves the taxpayer around £70m a year by organising last-minute or replacement staffing for NHS trusts in England, and ensuring hospitals don’t have to rely on expensive private agencies”, Madders writes.
He wants the NAO to “examine the business case that has been produced [by the DH] to ascertain a better understanding of what additionality the private sector can bring to what on the face of it is already a successful organisation.”
NHSP supplies staff cheaper than those obtained through private agencies which Simon Stevens, the chief executive of NHS England, has castigated for charging “rip-off” rates.... read more
CCGs face 'impossible' choices to deliver higher savings targets (HSJ: 26 July 2017)
Local commissioners must deliver efficiency savings of almost 4 per cent to meet their financial targets this year, despite failing to get close to last year’s target of 3.2 per cent.
HSJ also understands around 20 clinical commissioning groups have been asked to resubmit their plans with a “more challenging” savings target. If they do so, this would push the average savings requirement higher.
The financial plans for CCGs, which are based on their funding allocations and have now been assured by NHS England, demand average efficiency savings of 3.8 per cent in 2017-18, according to NHS England’s finance report for July.
In 2016-17, CCGs had to plan for savings of 3.2 per cent but only achieved 2.6 per cent.
Julie Wood, chief executive of NHS Clinical Commissioners, which represents CCGs, said the funding allocations and targets mean local leaders are having to make “really difficult, bordering on impossible, choices”.
She added: “Recent NHSCC analysis highlighted how rising inflation, along with a growing population, means that while on paper the funds allocated to CCGs are going up, in reality the value of the CCG pound is shrinking.
“Far more CCGs are in deficit or have deficit control totals. Their quality, innovation, productivity and prevention programme [efficiency] targets are getting higher and for many they don’t have formal plans for how they will deliver all of what is needed.
“Previous QIPP targets were lower but still the commissioning sector struggled to deliver them fully, so confidence to deliver these higher levels is low.”
In 2016-17, CCGs reported an in year overspend against their plans of £550m. If CCGs achieved the same level of savings in 2017-18 as last year (2.6 per cent) this could result in an overspend of around £900m.... read more
Lack of mental health support leaving children stuck in hospital – thinktank (The Guardian: 26 July 2017)
Children with serious mental health problems are becoming trapped in NHS psychiatric units, unable to leave because care is unavailable outside hospitals, a thinktank has said.
NHS figures show that between October 2015 and September 2016 children and young people in England spent almost 9,000 days in hospital after being declared fit to be discharged. Some end up stuck in units for several months.
NHS England did not tell the Education Policy Institute how many patients were involved in the 9,000 days, despite being asked this in a freedom of information request. But the thinktank said data showed the problem was growing.
The total number of what the EPI termed “wasted days” was 42% higher between December 2016 and February 2017 than in the same period in 2015-16. In January alone this year, under-18s spent 804 delayed days in mental health inpatient units, compared to 553 the previous January.
Delayed discharges of such patients can occur because their home area cannot provide the specialist support they need to ensure they remain safe.
Sarah Brennan, chief executive of the charity Young Minds, said: “Far too many young people are being left in limbo in mental health hospitals because the right support isn’t available in their community. In some cases they may have to wait weeks or even months before they are discharged.”... read more
Richards: NHS must protect waiting times and access to treatment (HSJ: 25 July 2017)
The NHS must protect waiting times for planned treatment and maintain access to evidence based care despite ongoing austerity, the outgoing chief inspector of hospitals has insisted.
Sir Mike Richards, one of the UK’s top medical leaders who has worked at the top level for more than a decade, is retiring at the end of this week.
He told HSJ in an exit interview: ”I would never support restricting access to evidence based care.”
Asked about concerns of national clinical leaders that clinical commissioning groups have introduced some restrictions on elective operations which they believe are not clinically justified, he said: “There are some patients who in the past may have had knee replacements who weren’t… likely to benefit from it, but where there is evidence for it I certainly want us to be able to deliver those treatments.”
He also warned that – with elective waiting lists and times growing – very long waits “mustn’t be allowed to happen again”.
Sir Mike added: “It is worth remembering about the 18 weeks, those that have been around long enough will remember, that why did they choose 18 weeks? Because it used to be 18 months, it is as simple as that. People used to wait 18 months for cardiac surgery.”
NHS England said in March that planned care was not one of the top priorities for the next two years, and that18 week elective waiting time target was, therefore, unlikely to be met.... read more
NHS England delay 'denies patients access to life saving treatment' (HSJ: 25 July 2017)
Patients are being denied access to heart treatments that could prevent strokes or save lives, after an NHS England project was delayed, a charity has told HSJ.
NHS England’s Commissioning Through Evaluation programme enables limited numbers of patients to receive treatment that shows “significant promise” but is not currently funded by the NHS.
Left atrial appendage occlusion (LAAO), which could reduce strokes in people with atrial fibrillation, is one of the CTE projects under consideration.
Patent foramen ovale (PFO) closure, aimed at preventing recurrent strokes and improving survival rates, and percutaneous mitral valve leaflet repair for mitral regurgitation (MitraClip) used to treat patients with heart failure and prevent the need for open heart surgery, are also part of the CTE scheme.
However, NHS England is warning patient groups and charities of a two month delay in evaluating data, making “a knock on effect” on future commissioning decisions possible.
A charity representing people with abnormal heart rhythms believes the delay will deny high risk patients access to treatment that could prevent AF related strokes or even save lives.
The Arrhythmia Alliance and AF Association said LAAO already has approval in the US and has written to NHS England expressing concern over the delay... read more
Soaring NHS vacancies prompt warnings of 'desperate' understaffing (The Guardian: 25 July 2017)
The number of vacancies in the NHS has soared by 15.8% over the last year, prompting warnings that the service is facing “desperate” problems of understaffing.
Figures for England released on Tuesday by NHS Digital show that the number of full-time equivalent posts available rose from 26,424 in March 2016 to 30,613 in March 2017 – the highest number on record.
A total of 86,035 such positions were advertised in the first quarter of this year, underlining the large number of health professionals and other staff that NHS trusts are seeking to fill.
However, NHS staff groups said the figures were a serious underestimate of the true number of vacancies, while NHS Digital itself admitted that they were undercounting, especially for nurses. The data also did not cover staff employed by GP surgeries, such as practice nurses.
NHS Digital said 11,485 (38%) of the 30,613 vacancies in March were for nurses and midwives – 17% up on the 9,784 in the same month last year – and another 6,575 (21%) for administrative and clerical staff. NHS Digital bases its figures on the number of positions advertised on NHS Jobs, the main NHS recruitment website.
But Janet Davies, the chief executive and general secretary of the Royal College of Nursing, said: “The true number of unfilled jobs is far higher than the number of online adverts and stands at 40,000 in England alone.”
NHS Digital data shows that the nursing workforce is shrinking. The total number of nurses employed by NHS organisations in England fell from 285,080 in April 2016 to 284,619 in April this year – down 461.
That follows the recent disclosure from the Nursing and Midwifery Council, the nursing regulator, that more nurses are leaving the profession than joining it....read more
General practice is being ground down so that private providers can take over (The Guardian: 24 July 2017)
“A GP, eh? Well I guess there are worse things you could do.”
That was the only careers advice I got in my final year at medical school.
The Royal College of General Practitioners (RCGP) has previously raised awareness of bad mouthing of GPs during medical school training.
The college highlighted the fact that many consultants teaching in medical schools talk about general practice as a second-rate career option to hospital medicine and that this is one of the reasons we are short of GPs.
I’ve no doubt that bad press does nothing to improve recruitment to our ranks, but the pressures on the family doctor service, which has led to the closure of dozens of practices across the country, has also played its part in making general practice less attractive to medical graduates.
GP surgeries are not part of the NHS in the way hospitals are. Most surgeries are still small businesses. In most cases the doctors own or rent their premises, they employ and pay their own staff and have all the usual responsibilities of running a business in addition to their work as doctors.
What many patients do not realise is how much general practice is being squeezed at both ends at the moment. Income for general practice is falling in real terms year-on-year, while the costs of running a practice are spiralling out of control.
Furthermore, 90% of all patient contacts in the NHS occur in general practice and in 2017-18 we were predicted to receive 7.29% of the NHS budget – general practice is exceptionally good value for taxpayers’ money. The RCGP is currently campaigning for general practice to receive 11% of the NHS budget....read more
GP appointment waiting times 'risk to patient safety', warns RCGP (Pulse: 24 July 2017)
Patients across England face waiting longer than a week for a GP or practice nurse appointment on more than 100 million occasions by 2022, according to new analysis from the RCGP.
The figures, from the GP Patient Survey, reveal that if current trends continue, the number of instances when patients will have to wait a week or more to see a GP or practice nurse will jump from 80 million in 2016/17 to 102 million in 2021/22.
The analysis comes after Pulse has revealed that the average wait for a GP appointment is around 13 days, despite measures introduced by the NHS to alleviate pressures on general practice.
The RCGP points out that the situation across England is patchy, with patients in some areas facing long waiting times even to see a practice nurse.
In 21 CCG areas, covering 5.6 million patients, waiting times for an appointment with a GP or practice nurse are at least a week for more than a quarter of the time, the figures reveal.
Some of the worst areas to secure a GP appointment include Corby (36%), Fareham and Gosport (34%), Swindon (31%) and Central London (Westminster) (31%) where currently more than three in 10 patients wait a week or more for an appointment with their GP or practice nurse.
Even in places where access is better there are still thousands of patients waiting a week or more for an appointment, says the RCGP. In Bradford City, for example, where access to general practice is best, one in 10 patients (9%) still has to wait a week or more.
The RCGP warns that if the situation does not improve there is a genuine risk to patient safety. It is now calling on the Government once again to deliver on the pledges made in NHS England’s GP Forward View as a matter of urgency, to ensure that patients get the timely, quality care they need, when they need it....read more
Cuts a huge step back for public health (20 July 2017)
Doctors have warned of a ‘huge step back’ in public health after research revealed big cuts to sexual health, quit-smoking and substance-abuse services.
The reductions were identified in King’s Fund analysis of financial figures from the local authorities, which took over the services from the NHS in 2013.
The think tank’s study shows a 5 per cent drop in planned expenditure in 2017/18 compared with 2013/14.
Planned expenditure on some services has fallen even further. Stop-smoking services have been cut by 15 per cent; support for drug addicts has dropped by 5.5 per cent.
Sexual health services have been reduced by 10 per cent over the past four years – despite significant rises in sexually transmitted diseases including syphilis and gonorrhoea.
BMA public health committee chair Iain Kennedy said such cuts signified ‘a huge step backwards for public health’.
The cuts will have a ‘damaging impact on people’s health and well-being, inevitably costing the NHS far more in the long term’, he added.
‘Public health services are more vital than ever in delivering preventive care.’
A third of Britons are projected to be obese by 2030 and smoking accounts for around 100,000 deaths a year in the UK.... read more
Thousands of mental health patients spend years on secure wards (20 July 2017)
Thousands of mental health patients are being kept in secure wards for years at a time when they should be being rehabilitated and preparing to leave hospital, a NHS watchdog has revealed.
The Care Quality Commission (CQC) criticised both NHS and for-profit mental health providers for forcing such a large number of patients to endure what it called “outdated and sometimes institutionalised care”, often miles from home. The practice leaves already vulnerable patients feeling isolated and less likely to recover, the CQC warned.
More than 3,500 patients in 248 mental health wards are kept locked-in. In 2015-16 some stayed for 45 days, but others had been there for up to 1,744 days – four and a half years – the care regulator found.
“More than 50 years after the movement to close asylums and large institutions, we were concerned to find examples of outdated and sometimes institutionalised care,” said Paul Lelliott, the CQC’s deputy chief inspector of hospitals.
“We are particularly concerned about the high number of people in ‘locked rehabilitation wards’. These wards are often situated a long way from the patient’s home, meaning people are isolated from their friends and families. In the 21st century, a hospital should never be considered ‘home’ for people with a mental health condition.” ... read more
Call for tighter checks on private hospitals used by NHS after MRSA case (20 July 2017)
Theresa May has been urged to tighten checks on private hospitals used by the NHS after a Labour MP raised the case of a young patient with an open wound who contracted MRSA on a private mental health ward.
Louise Haigh, a Labour frontbencher, called for the NHS to thoroughly investigate the quality of care before it commissions beds and treatment from private providers.
She cited the case in her of a “young women with MRSA with open wounds” on a child and adolescent mental health ward at Cygnet hospital Sheffield, which a report by a healthcare watchdog rated as inadequate in terms of safety.
“NHS England commissions child and adolescent mental health beds at a private hospital in my constituency, which recently received a damning Care Quality Commission report,” she said.
“Does the prime minister share my concern that a shortage of mental health beds risks the NHS placing vulnerable young people in unsafe environments, and will she consider giving NHS England the responsibility for, and the resources to investigate, the quality of care before it commissions?”
In response, May promised to ask Jeremy Hunt, the health secretary, to investigate, while highlighting a “a number of steps to improve mental health” provision in the NHS, including an increase in funding.... read more
NHS England 'urgently needs 2,200 more A&E consultants' (19 July 2017)
Hospitals are being urged to urgently more than double the number of consultants on duty in A&E units in order to ensure that patients receive safe care. The NHS in England must recruit 2,200 extra A&E consultants in the next five years, more than the 1,632 who already work there, according to the body representing emergency medicine doctors.
The increase is needed to help the NHS avoid the sort of winter crisis that occurred last winter and to stop A&E doctors quitting due to burnout, the Royal College of Emergency Medicine (RCEM) claims. Dr Taj Hassan, the college’s president, said the costs of such a dramatic rise could be covered by redirecting the £400m a year hospitals currently have to spend on locum and agency A&E doctors as a result of understaffing.
“It is vital that we get our staffing right. Each emergency medicine consultant in England is responsible for around 10,000 patients a year. Our staff are working to the very limits of their abilities to provide safe, compassionate care. This is leading to burnout and doctors leaving the profession, creating a vicious circle,” said Hassan, a consultant in Leeds.
The growing number of doctors choosing to work part-time, and the continuing rise in demand for A&E care, also help explain why so many more consultants are needed, Hassan added. The 1,632 existing consultants make up over one in four of the 6,261 doctors overall who work in A&E in England; the others are mostly trainees.... read more
HPV vaccine: anger over decision not to extend NHS scheme to boys (19 July 2017)
A decision not to vaccinate boys against a cancer-causing sexually transmitted infection has been condemned by health bodies and campaigners.
The Joint Committee on Vaccination and Immunisation (JCVI), which has been reviewing the human papilloma virus (HPV) vaccination programme, concluded that it was “highly unlikely to be cost-effective” to extend the scheme to include adolescent boys as well as girls.
Since 2008, all girls aged 12 to 13 are offered the HPV vaccination as part of the NHS childhood vaccination programme, and the JCVI has been considering whether to include boys on the scheme since 2014.
Up to eight out of 10 people will be infected with the virus at some point in their lives and it has been linked to one in 20 cases of cancer in the UK, according to health professionals. Campaigners have been calling for a gender-neutral approach to the vaccination, which would ensure that 400,000 school-age boys are not left at risk.
The committee, which has yet to publish its final recommendation, said in an interim statement that studies “consistently show” boys are afforded “considerable herd protection” when there is high uptake of the vaccine in girls.
Critics called the decision “indefensible”. The Faculty of Sexual and Reproductive Healthcare (FSRH), a membership body for healthcare professionals who work in sexual and reproductive health, said the decision should be reversed when the JCVI meets again in October.... read more
Three years ago the county council formed the East Sussex Better Together programme with clinical commissioning groups, the trust running Eastbourne’s District General Hospital and Hastings’ Conquest Hospital, and Sussex Partnership NHS Foundation Trust.
By 2020 a new accountable care organisation would be established, which could involve the creation of a new East Sussex Health and Care NHS Trust taking a lead role across the health system and providing the majority of services in the ESBT area.
Becky Shaw, chief executive of the county council, added: “It has been a megalithic undertaking by the director but also the teams across a number of county council departments.”... read more
Midwives call for 'urgent' funding for mental health care for new mothers after postnatal depression death (18 July 2017)
There is an "urgent need" for more funding for mental health care for expectant and new mothers, leading midwives have said.
The comments from the Royal College of Midwives come after a report claimed services across the UK are "under resourced".
Researchers wrote the report following an online petition which gathered more than 55,000 signatures calling for the NHS to review how it treats and cares for women with postnatal depression.
The petition was set up by Lucie Holland, whose sister Emma Cadywould died following a battle with postnatal depression.
The report states that Ms Cadywould took her own life six months after giving birth to her first son - despite having been under NHS-led mental health care.
Her family urged health officials to look into the care of women with the condition, saying that if she had been referred for specialist care she would have recovered.
Dr Alain Gregoire, chairman of the Maternal Mental Health Alliance, added: "Emma's tragic death as a result of a severe perinatal mental illness offers us all an urgent wake-up call.
"We must act now to prevent more women from suffering or dying unnecessarily.
"Recovery through good support and care should be the norm if women and families everywhere have access to high quality specialist services, but it is still a postcode lottery. This has to change." ...read more
NHS staff shortages to blame for big rise in cancelled operations on children and young people, Labour warns (17 July 2017)
Operations on children and young people are being cancelled in huge numbers as NHS staff shortages bite, Labour reveals today.
More than 12,000 procedures – including for broken bones and treatments under anaesthetic – were scrapped last year, a rise of 35 per cent in just three years, the party said.
A lack of available anaesthetists, surgeons, consultants or theatre staff, as well as bed shortages and a lack of theatre time, were key reasons given by health bodies for the cancellations.
Labour’s research had uncovered 12,349 cancellations of surgical procedures planned for children and young people in 2016-17, across 76 health trusts, Mr Ashworth said.
This was 35 per cent higher than in 2013-14, when 9,128 cancellations were recorded, he said.
The total number of cancelled children’s operations since 2013-14 was 46,211 – with by far the highest number in London at 12,904.... read more
Sick patients dying ‘unnecessarily’ in NHS because of poor care (15 July 2017)
Some of the sickest patients that hospitals treat are dying unnecessarily because they receive poor care, blighted by shortages of staff and equipment, a new NHS inquiry has revealed.
A death rate of one in three among inpatients who need emergency help with breathing is already high by international standards, and is getting worse.
The analysis by the National Confidential Enquiry into Patient Outcome and Death of NHS services for the 50,000 patients a year who receive emergency oxygen treatment uncovered a series of major flaws in the care they received. It described its findings as “shocking”.
The growing numbers of patients who receive non-invasive intervention (NIV) – oxygen through a face mask – usually have chronic obstructive pulmonary disease, pneumonia or other conditions which mean they cannot breathe unaided. Despite their lives being at risk, the vast majority receive sub-standard care, according to an in-depth examination of 353 patients during February and March.
“The care of these patients was rated as less than good in four out of five cases. The mortality rate was high: more than one in three patients died,” the inquiry found. “Supervision of care and patient monitoring were commonly inadequate. Case selection for NIV was often inappropriate and treatment was frequently delayed due to a combination of service organisation and a failure to recognise that NIV was needed.” In addition, investigators found from examining case notes that “the quality of medical care provided was often poor. This poor care included both non-ventilator treatment and ventilation management, which were frequently inappropriate”.... read more
Ambulance trust accused of jeopardising patients by sending cars (13 July 2017)
Health chiefs have been accused of putting lives at risk by sending cars instead of ambulances to emergencies. East of England Ambulance Trust is sending rapid response vehicles (RRVs) to 999 calls to hit targets, even when the patient needs an ambulance for transport to hospital, a paramedic has claimed, with the result that patients sometimes wait for hours for an ambulance to reach them.
Patient safety is being compromised by the trust’s focus on hitting response targets, the paramedic told the Health Service Journal (HSJ). Speaking on condition of anonymity, he said: “The trust has become so fixated with hitting the target by sending out RRVs to stop the clock.
“Care, patient safety and dignity are really being badly compromised. Everyone has horror stories. It’s as bad as I can ever remember.”
The paramedic said “elderly, frail patients” were sometimes left “lying on the ground waiting up to two or three hours for an ambulance to turn up”. “Often they’re in pain, maybe with a broken hip. When it’s in the winter, it’s often in cold, frosty conditions. Sometimes they are lying on a limb, and who knows what damage is being done as a result?” ...read more
NHS faces staff crisis as student nurse applications plummet after Tories scrapped their grants (13 July 2017)
Nursing leaders today warn the NHS faces a staffing crisis after figures showed a sharp fall in applications for training places.
The number applying to be student nurses has dropped from 65,620 to 53,010 - a fall of 12,610 on last year.
The fall comes after the Government axed student bursaries for trainee nurses and midwives.
From this September they have to take out loans to cover living costs and £9,000 a year fees.
The Royal College of Nursing said the figures case doubt on the ability to train enough nurses to fill the 40,000 vacant nurse posts in England.
The figure by the university applications service UCAS showed applications in England for student nursing places were down 23% in England.
There was also a 28% fall in the number of people aged 25 and over applying and a 27% fall in number of male applicants.... read more
Theresa May to oversee £85m in cuts to public health budgets this year, analysis reveals (12 July 2017)
Theresa May has been accused of taking her “eye off the ball” over public health as it was revealed budgets for a range of services including sexual health and help to stop smoking face new cuts of £85m.
Local authorities in England are being forced to spend more than 5 per cent less this year on public health initiatives than in 2013-14, according to a new analysis from the King’s Fund.
David Buck, the health think tank’s senior fellow in policy, used data from local governments and the Department of Communities to calculate that planned spending on sexual health services has fallen by £64m, or 10 per cent, over the past four years.... read more
Chickens coming home to roost: local government public health budgets for 2017/18 (Kings Fund: 12 July 2017)
The Department for Communities and Local Government has released new data on local authorities’ planned budgets for public health in 2017/18. It does not make good reading.
Since 2013, when local authorities were first given responsibility for many aspects of public health, they have received a grant for this from the Department of Health. It is easy to forget that in the first few years the growth in this grant was quite generous: 5.5 per cent in both 2013/14 (against an estimated primary care trust baseline) and 2014/15, reflecting the coalition government’s commitment at that stage to investing more in public health. But in 2015/16 things changed dramatically.... read more
Exclusive: NHS needs 5,000 more beds, warn leading A&E doctors (HSJ: 7 July 2017)
The NHS needs at least 5,000 more beds to achieve safe bed occupancy levels and hit the four hour waiting time target, according to a report by senior medics shared exclusively with HSJ.
The Royal College of Emergency Medicine winter flow project said the NHS needed to add to its 130,000 beds to “combat exit block, overcrowding in emergency departments [and to] maintain flow through the system”.
The college’s report tracked performance of 50 trusts running 60 sites across the UK between October 2016 and March 2017 on a weekly basis. It also found some trusts saw their four hour waiting performance drop to under 50 per cent over winter, against the 95 per cent target.
The vast majority of the sites were in England (50), with two from Scotland, five from Wales and three in Northern Ireland. The trusts, which the RCEM said were representative of the sector, provided the data on the condition of anonymity.
The 4 per cent bed base boost would equate to an average hospital with a type one accident and emergency department, of which there are 184 in England, adding only around 20 beds, although there would be significant variation across the system.... read more
NHS bosses warn of mental health crisis with long waits for treatment (The Guardian: 7 July 2017)
Mental health services are so overwhelmed by soaring demand that patients are facing long delays to access care, a powerful group of NHS mental health trust bosses have warned.
Widespread shortages of specialist nurses and psychiatrists mean Theresa May’s pledge to tackle the “burning injustice of mental illness” is at risk according to chief executives and chairs from 37 of England’s 53 specialist mental health trusts.
Their concerns are contained in a new report by NHS Providers, which represents almost all of England’s providers.