Ambulances too slow to reach seriously ill patients, says report
 (The Guardian: 30 November 2016)

Ambulances are failing to reach dying and seriously ill patients fast enough as the service creaks under the strain of high demand, according to a report.

Only one of the UK’s 13 ambulance services, the Welsh ambulance service, is meeting the target to reach patients with life-threatening conditions within eight minutes, a BBC investigation has found.

Freedom of information requests by the broadcaster found more than 500,000 hours of ambulance crews’ time in England, Wales and Northern Ireland was wasted waiting at A&E to hand over patients to hospital staff.

Dr Mark Holland, president of the Society for Acute Medicine, said the significant strain on the NHS was due to the government’s failure to accept the social care crisis.

He said: “The government has continuously failed to acknowledge the scale of the crisis in social care and the record numbers of delayed discharges in our hospitals as a result – a significant factor in the buildup of pressure on our hospitals.

“Having the support and infrastructure in place to discharging medically fit patients safely is central to releasing pressure on emergency departments, acute medical units and ambulance services.

“It is essential that clinical and political leaders ramp up the pressure and hold the health secretary and government to account on this issue before it is too late.”

NHS England’s ambulance lead, Prof Jonathan Benger, said the rising number of calls the service received was a major factor in the delays.

He told the BBC: “In the face of rising demand it is not surprising we are having difficulty meeting these targets. It is time to look at the system.” more


NHS cuts putting patient safety at risk, TUC warns (The Guardian: 26 November 2016)

Improvements in patient safety made after the Mid Staffs scandal are being undone amid NHS-wide financial problems and chronic staff shortages, the TUC has warned in a report.

The report claimed that moves to make care in England safer, such as by placing greater numbers of nurses on wards, are under threat as services struggle to reconcile the need to provide high-quality care with growing financial pressures.

The report cites long waits for treatment, the greater rationing of care and patients trapped in hospitals despite being fit to leave. Temporary ward closures are also highlighted as a risk.

“The government’s relentless drive to find savings at a time of rising demand is unsustainable. Each month we are seeing patient safety put at risk by staff shortages, longer waiting times and cuts to services”, said Frances O’Grady, the TUC’s general secretary.

“Ministers need to re-read the Francis Review. You cannot deliver a world-class health service on the cheap,” she added, referring to Robert Francis QC’s warning that cuts in the nurse numbers at Stafford hospital contributed to the mistreatment of patients between 2004 and 2009. His mammoth report into care at the hospital, which followed a 30-month public inquiry, prompted hospitals across England to hire extra staff, especially nurses.


Care for elderly ‘close to collapse’ across UK as council funding runs out (The Guardian: 26 November 2016)

Theresa May is under intense pressure from senior doctors and a powerful cross-party alliance of politicians to avert a collapse in care for the elderly, as shocking new figures show the system close to meltdown.

The medical profession, together with Tory, Labour and Liberal Democrat leaders in local government, have demanded a funding U-turn, warning that the safety of millions of elderly people is at risk because of an acute financial crisis completely overlooked in chancellor Philip Hammond’s autumn statement.

New figures obtained by the Observer show that 77 of the 152 local authorities responsible for providing care for the elderly have seen at least one residential and nursing care provider close in the last six months, because cuts to council budgets meant there were insufficient funds to run adequate services.

In 48 councils, at least one company that provides care for the elderly in their own homes has ceased trading over the same period, placing councils under sudden and huge pressure to find alternative provision.

In addition, 59 councils have had to find new care arrangements after contracts were handed back by a provider who decided that they were unable to make ends meet on the money that councils were able to pay them.

The medical profession, council leaders and even the former Tory health secretary, Andrew Lansley, are appalled that the social care crisis – exacerbated by growing numbers of elderly people and the rising costs of paying staff – was not addressed in the autumn statement.

In a letter to the Observer, the leaders of the four main political groups in local government expressed their disquiet at the chancellor’s dismissing talk of a crisis despite calls from politicians, NHS leaders, doctors and more


Staffordshire £1.2bn cancer contract given green light (BBC News: 26 November 2016)

A £1.2bn plan to outsource cancer and end-of-life care in Staffordshire has been given the go-ahead by NHS England.

The project, which has attracted considerable opposition, was put on hold in January after a similar contract in Cambridge was scrapped due to financial concerns.

A 10-year contract in Staffordshire is expected to be up and running by April.

Bidders are believed to include private companies Virgin Healthcare and Interserve.

The deal includes a £690m contract to run cancer care across four Staffordshire clinical commissioning groups (CCGs) - Stafford and Surrounds, Cannock Chase, Stoke-on-Trent and North Staffordshire.

The successful bidder will be asked to co-ordinate cancer care throughout the county - from diagnosis through to treatment and end-of-life care.

The CCGs have previously said the aim was to streamline services and "provide the best cancer and end-of-life care for patients".

However, Labour MP for Stoke-on-Trent South Rob Flello, described it as an unpopular and dangerous project that could see a private provider take over NHS more


Labour pours scorn over autumn statement for ignoring sick and old (The Guardian: 23 November 2016)

John McDonnell accused the chancellor of failing the sick and elderly after his autumn statement gave no additional money to the NHS or social care, despite warnings from the opposition party that both are at a tipping point.

The shadow chancellor said he feared a crisis in funding and care over this Christmas, after Hammond offered £23bn for infrastructure but no additional help for health services.

“Tonight, many elderly people will remain trapped in their homes, isolated, and lacking the care they need because of continuing cuts to funding,” McDonnell told the Commons in his response to the autumn statement. “You can’t cut social care without hitting the NHS ...

“Across the country, hospitals are facing losing their A&Es, losing their maternity units, losing their specialist units. This Tory government is failing patients and failing dedicated NHS staff.

“It is the first time healthcare spending per head has declined since the NHS was created.”

Hammond mentioned the NHS in his autumn statement speech once to confirm the government’s commitment to spending an extra £10bn a year by the end of this parliament. There was no mention of social care and no additional money for either, despite warnings that shortages in funding are pushing hospitals to a tipping more


Virgin wins contracts worth £65m (HSJ: 23 November 2016)

Virgin Care has been awarded two five year contracts to provide community and urgent care services for a clinical commissioning group in Lancashire.

West Lancashire CCG launched a tender process for the services after the Care Quality Commission raised concerns about Southport and Ormskirk Hospitals Trust, the incumbent provider.

The community services contracts are worth £45m over five years

Private firm Optum, Lancashire Care Foundation Trust and Bridgewater Community Healthcare FT were also shortlisted for further discussions about the community services contract, which was previously advertised as being worth £45m over five years.

Optum and Virgin Care were the only bidders shortlisted for the urgent care services contract, including GP out of hours provision and a walk-in centre in Skelmersdale, for a contract worth around £20m over five years.

Virgin Care will start delivering the services in more


NHS financial problems endemic and no longer sustainable, say auditors (The Guardian: 22 November 2016)

The financial problems of the NHS are now “endemic” and have worsened so significantly in the past year that the situation is no longer sustainable, Whitehall’s official auditor has warned.

Two-thirds of health trusts in England are now in deficit, the National Audit Office has discovered, while their total debt has almost trebled since 2015 to £2.45bn. Auditors were particular alarmed by the decision to transfer £950m from the NHS’s budget for buildings and IT to pay staff’s wages.

MPs say the report amounts to one of the the most critical assessments of NHS finances by official auditors, as their reports usually err on the side of caution. The report will add to pressure on Theresa May and the chancellor, Philip Hammond, to set aside extra money in the autumn statement on Wednesday to plug the funding gap in the health service.

Meg Hillier, the chair of the public accounts committee, said the Department of Health was making “pie in the sky assumptions” about closing that gap.

She added: “I call on the prime minister to address [in the autumn statement] the realities of increasing deficits in NHS trusts, long-term workforce problems, unrealistic efficiency targets and the impact these financial stresses are having on the quality of services.”

Amyas Morse, head of the NAO, said: “With more than two-thirds of trusts in deficit in 2015-16 and an increasing number of clinical commissioning groups (CCGs) unable to keep their spending within budget, we repeat our view that financial problems are endemic and this is not sustainable.”

The NHS overall entered the current financial year with a “worse than expected starting point”, which could hamper plans to close the estimated £22bn gap between patients’ needs and resources by 2020/21, auditors more


Government quietly privatises the NHS's in-house agency staff provider (The Independent: 19 November 2016)

The Government is to privatise the NHS’s in-house, publicly-owned provider of agency staff, ministers have announced.

NHS Professionals, the health service’s main staffing agency, provides 90,000 health workers to around a quarter of NHS trusts, covering two million shifts a year.

In a written statement issued on Thursday as most MPs headed back to their constituencies, the Government announced it would sell off a majority stake in the orgnaisation to the private sector with the aim of “creating a profitable business model”.

Labour says the sell-off amounts to further privatisation of a key part of the health service, while the Government claims the private sector will help provide new investment.

It is understood that the Government could invest public funds in the organisation directly through the Treasury but has chosen to use the private sector instead.

“Following market analysis and a thorough appraisal of a business case, the Department’s preferred option is to create a joint venture partnership to bring in the necessary investment and expertise to the business and give the Company greater operational autonomy,” health minister Philip Dunne said in the more


A&E, cancer and maternity units to close in major NHS overhaul (The Guardian: 18 November 2016)

Thousands of hospital beds are set to disappear, pregnant women will face long trips to give birth and a string of A&E units will be downgraded or even closed altogether as part of controversial NHS plans to reorganise healthcare in England.

A Guardian analysis of the 24 NHS regional plans that have now been published – more than half the total of 44 – has found that health service chiefs plan to push through an unprecedented centralisation of key hospital services across England.

Opposition to the plans is growing among campaign groups, councillors and a growing number of MPs, including Conservatives, in areas where major changes are planned amid fears that patients will be unable to access urgent care quickly enough.

Dozens of England’s 163 acute hospitals look likely to have services, including cancer, trauma and stroke care, removed as a result of the plans, which are at the heart of the new funding package for the NHS. The thinking behind the changes is that some NHS services can be rationalised and managed more efficiently, helping improve patient care, tackling understaffing and helping the NHS save £22bn by 2020 as part of the wider financial settlement agreed for the current more


NHS outsourcing contract collapses due to 'catalogue of failures' (The Independent: 16 November 2016)

A "catalogue of failures" resulted in the collapse of an £800 million NHS contract to outsource care of older and mentally ill people, the Commons spending watchdog warned.

An influential committee of MPs concluded that the NHS lacked expertise in procurement and it was "worrying" that untested contracting arrangements could form part of the plans being drawn up for further changes to services across England.

The Public Accounts Committee was scathing about the doomed deal between Cambridgeshire and Peterborough Clinical Commissioning Group (CCG) and UnitingCare Partnership, which collapsed after just eight months.

The cash-strapped CCG awarded a five-year contract to UnitingCare, an NHS consortium of Cambridgeshire and Peterborough NHS Foundation Trust and Cambridge University Hospitals NHS Foundation Trust, but the deal was scrapped in December 2015 after it ran into more


NHS bosses 'trying to keep cuts secret' (BBC: 14 November 2016)

NHS chiefs are trying to keep plans to cut hospital services in England secret, an investigation has found.

Full details of 44 reviews of services around the country - which involve closing some A&Es or, in one case, a whole hospital - are yet to emerge.

That is because NHS England told local managers to keep the plans "out of the public domain" and avoid requests for information, the King's Fund suggested.

Managers were even told how to reject freedom of information requests.

The King's Fund report did not include any details of cuts, but from the leaks and plans that have been published so far a partial picture is emerging of what is involved.

This includes:

  • Plans in south west London to close one of five hospitals - St George's, Kingston, Croydon, St Helier or Epsom
  • The North Tees proposal to centralise specialist services, including A&E, on two sites. It would lead to services being downgraded at one of the three major hospitals in the area
  • In Devon bosses are looking at whether to close some A&E, maternity and stroke services at hospitals across the county so they can be centralised at bigger sites
  • In Merseyside there has been talk of merging four hospitals - the Royal Liverpool, Broadgreen, Aintree and Liverpool Women's - to plug a £1bn shortfall, according to leaked documents
  • Plans in Birmingham and Solihull involve reorganising maternity services with fears this could result in fewer units
  • Bosses at North Central London have talked about a consolidation of services on fewer sites, leading to fears that the Whittington Hospital could lose its A&E more


Landmark deal for private firm to run social work service approved (Community Care: 11 November 2016)

Virgin Care will run statutory adult social work services in Bath and North East Somerset from April 2017, in deal believed to be first of its type.

Richard Branson’s Virgin Care will run core adult social work services in Bath and North East Somerset after a £700m contract to reshape community health and social care services was approved last night.

The Conservative-controlled council voted 35-22 in favour of the deal. Earlier in the day the local NHS clinical commissioning group’s board voted unanimously in favour.

From April 2017, Virgin will run more than 200 services under the deal including three statutory services – adult social care, continuing healthcare and children’s community health. The deal marks the first time a privately-owned profit-making firm will deliver statutory adult social work functions.

Unlike in children’s services, there are no laws preventing councils from delegating statutory adult social work functions to profit-making providers.

But previous outsourcing deals by councils have only seen social work run by local authority-owned trading companies or not-for-profit social enterprises spun out of social services more


NHS trusts on course to overshoot budgets by £850m, figures suggest (The Guardian: 9 November 2016)

NHS hospital trusts are on course to overshoot their budgets by £850m this year, more than three times the deficit health service bosses said was acceptable, research has shown.

Such an overspend would be a setback for NHS England’s chief executive, Simon Stevens, and Jeremy Hunt, the health secretary, as they have pledged to ensure that trusts end the year no more than £250m in the red.

The impending deficit, uncovered by the Health Service Journal, threatens to derail the agreement the NHS reached with the Treasury in July to “reset” the service’s disastrous finances this year in return for receiving £3.8bn upfront of its planned £8bn extra funding.

The £850m sum emerged from figures supplied to the magazine by all but five of England’s 237 NHS trusts, now more than halfway through the service’s 2016-17 financial year, and its monitoring of trust boards’ financial reports.

“This is an embarrassment for Jeremy Hunt and shows the scale of the financial challenge in the NHS,” said Jonathan Ashworth, Labour’s shadow health secretary. “After ending the last financial year with a record deficit, we were told that NHS trusts would get their deficits down to £250m. These projections show that target lies in tatters, with the true deficit likely to be triple that.” more


Number of NHS mental health nurses has fallen by 15% under Tories (The Guardian: 1 November 2016)

The number of mental health nurses working in the NHS has dropped by almost a sixth since the Conservatives came to power in 2010, figures show.

The revelation has sparked fresh doubt that government pledges to improve mental health services are being matched by progress at the NHS frontline.

Philip Dunne, the health minister, has admitted in a written parliamentary answer that while there were 45,384 mental health nurses working in England in 2010, there were just 38,774 in July this year. That fall of 6,610 nurses represents the loss of about 1,000 such specialists a year, or almost 15% of the entire workforce providing that sort of vital care to patients over the last six and a half years.

“This is a very worrying downward trend that shows no sign of turning around, despite all the government’s pronouncements and pledges about equality for mental health care compared to physical health care,” said Labour MP Luciana Berger, the ex-shadow health minister who obtained the answer.

The loss of so many posts meant that patients are at risk of receiving lesser-quality care than before and their recovery is being jeopardised by having less contact time with nurses, who were likely to be busier than ever, Berger warned.

The Royal College of Nursing claimed the figures proved that patients were being let down and ministerial pledges of recent years were not being more



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