Hospital overcrowding caused by 'political maladministration', say MPs (The Guardian: 28 September 2016)

have become dangerously full and discharge patients too soon as a direct result of “political maladministration” by successive governments, according to a committee of MPs.

The failure to join health and social care services means that one in five patients are at risk of either getting stuck in hospital or being released before they are fit to go, according to a report by the Commons public administration and constitutional affairs select committee (PACAC).

So-called bedblocking costs the NHS in England about £820m a year, according to National Audit Office estimates.

The cross-party committee is highly critical of governments down the years for allowing two public services that need to work closely together to remain separate. “At a structural level, the historic split between health and social care means that interdependent services are being managed and funded separately. We consider this to be political maladministration,” the committee says in a report about unsafe patient discharges from hospital.

The MPs blame the split for creating a situation in which many hospitals become overcrowded and send patients home before they are fit to leave, in order to free up beds. “Pressures on resources and capacity within hospitals are leading to worrying and unsafe discharge practices,” the report says....read more

 

Junior doctors planning 'range of actions' after calling off strikes (Pulse: 26 September 2016)

The BMA has said that it will look into other forms of opposition to the imposition of the junior doctors contract after calling off the series of five-day strikes planned over the next few months.

The Junior Doctors Committee agreed to cancel the strikes following its meeting on Saturday, ’due to feedback from doctors, patients and the public and discussions with NHS England about the ability of the NHS to maintain a safe service if industrial action’ were to go ahead.

Strikes had been planned for five days at a time over October, November and December. Planned action for September had already been cancelled due to patient safety fears.

JDC chair Dr Ellen McCourt said: ’We still oppose the imposition of the contract and are now planning a range of other actions in order to resist it, but patient safety is doctors’ primary concern and so it is right that we listen and respond to concerns about the ability of the NHS to maintain a safe service.

’Our fight does not end here. For many people this whole dispute has turned on how the NHS will assure quality care over seven days. It has highlighted the need for an open and honest debate led by the BMA on how this will be achieved. We call on our colleagues across the medical profession, other healthcare professionals, and the Government and patient groups to engage with junior doctors on this.’...read more

 

NHS needs 3.5 per cent annual funding increase, economists predict (HSJ: 21 September 2016)

New economic projections from the Office of Budget Responsibility suggest the NHS requires real terms funding increases of 3.5 per cent a year to 2030.

The OBR’s projections suggest that UK health services would require a greater proportion of GDP to be spent on public healthcare, rising from 7.4 per cent currently to 8.8 per cent over the next 14 years.

John Appleby: ‘The increase in projected spending does not seem out of line with history’

The projections assume policy remains unchanged but take account of rising costs and population changes.

Following the government’s spending review in 2015, health spending in England is set to increase by around 1 per cent each year to 2020, so meeting the projection would require a significant increase in funding.

Analysts at the Nuffield Trust think tank said the new “cost pressures projection” would require an additional £40bn by 2030, or £2.7m a year, found through extra taxation or shifting spending from other departments....read more

 

RNIB report: Patients in England face 15-month wait for cataract surgery (The Guardian: 21 September 2016)

Patients in England are having to wait up to 15 months to have cataracts removed from their eyes amid increasing rationing linked to the NHS’s deepening financial woes, a new report has revealed.

People in the north London borough of Enfield face the longest wait – 467 days – between being referred for cataract surgery and actually having it, according to research by the charity RNIB published on Wednesday.

That is more than double the longest delay – 222 days – the RNIB found when it first examined waiting times for the procedure in England in 2013. That occured in Heywood, Middleton and Rochdale in greater Manchester

Other areas with notably long waits include those covered by the GP-led NHS clinical commissioning group (CCG) in Swindon (180 days), Havering in Essex (176 days) and Southampton (174 days).

Long delays caused by the NHS’s drive for “efficiency savings” are causing misery for the mainly elderly patients troubled with cataracts, the RNIB claimed....read more

 

Jeremy Hunt acted illegally over junior doctors, court hears (The Guardian: 19 September 2016)

Jeremy Hunt acted illegally and beyond his powers by deciding to impose a new contract on NHS junior doctors, the high court has been told in a legal challenge to the health secretary’s handling of the year-long dispute.

The court on Monday began a two-day judicial review of the legal challenge to Hunt brought by five junior doctors.

Their group, Justice for Health, claims that the health secretary has acted ultra vires (beyond his powers) by choosing to force new terms and conditions on 54,000 trainee medics in England despite their overwhelming opposition.

A barrister leading Hunt’s legal team told the judge, Mr Justice Green, that there was no evidence that NHS employers did not want the contract and that the claim was “wholly without substance”.

Hunt suffered an early setback when the judge rejected a claim by his counsel, Clive Sheldon QC, in pre-hearing legal argument that Justice for Health’s claims should be thrown out. Refusing Sheldon’s plea, Green said at the outset of the first session of legal argument that “this is plainly a serious case” which, in his view, “requires full judicial review”....read more

 

600 GP practices at risk of closure, says RCGP (Pulse: 19 September 2016)

Around 600 practices are at risk of closure by 2020 due to problems recruiting GPs, the RCGP has claimed.

These practices all have at least 75% of their GPs aged 55 and over, the college says, which will lead to a shortfall of almost 10,000 GPs across the UK within four years.

It comes as the RCGP has launched a new video campaign aimed at foundation doctors, medical students and sixth-form students.

The campaign is designed to show that general practice is ‘exciting and challenging’, and address the myth that ‘the role of a GP is somehow run-of-the-mill, with family doctors simply treating coughs and colds’....read more

 

NHS facing 'pockets of meltdown' this winter (The Guardian: 11 September 2016)

The NHS will experience “pockets of meltdown” this winter as the service comes under increasing pressure, a leading doctor has warned. Dr Mark Holland, president of the Society for Acute Medicine, said the resilience of medical units was being “put to the test like never before”.

It comes a day after the chief executive of NHS Providers, Chris Hopson, said the government would fail to achieve its aim of a seven-day NHS without more cash.

Writing in the Observer, he warned that hospitals are cutting services and the NHS risked “slowly deteriorating” as it did in the 1990s.

Holland echoed the warnings about a service under pressure, saying those parts of the NHS where performance was already weak would find the winter months particularly difficult.

He also pointed to the “national emergency” of medically fit patients not being discharged home from hospital. This is partly due to inadequate social care in the community.

He said the current concern was “that hospitals where performance is already weak will find it very difficult to cope during the winter and that will lead to pockets of meltdown”.

He added: “At the core of the issues facing the NHS is the rapidly increasing number of delayed discharges. The figures are spiralling and are fast becoming disastrous....read more

 

NHS chiefs warn that hospitals in England are on the brink of collapse (The Observer: 11 September 2016)

The body that represents hospitals across England has issued a startling warning that the NHS is close to breaking point because of its escalating cash crisis.

Years of underfunding have left the service facing such “impossible” demands that without urgent extra investment in November’s autumn statement it will have to cut staff, bring in charges or introduce “draconian rationing” of treatment – all options that will provoke public disquiet, it says.

In an unprecedentedly bleak assessment of the NHS’s own health, NHS Providers, which speaks for hospital trust chairs and chief executives, tells ministers that widespread breaches of performance targets, chronic understaffing and huge overspends by hospitals mean that it is heading back to the visible decline it last experienced in the 1990s.

“Taken together this means the NHS is increasingly failing to do the job it wants to do and the public needs it to do, through no fault of its own,” Chris Hopson, the chief executive of NHS Providers, writes in the Observer....read more

 

NHS 'in perpetual winter of Narnia' as waiting list reaches record 3.9m (The Guardian: 8 September 2016)

The NHS is missing so many of its key performance targets that it has entered “the perpetual winter of Narnia”, a medical leader has said, after figures revealed the highest ever number of patients on waiting lists.

Claire Marx, president of the Royal College of Surgeons, criticised the NHS’s failure to give patients planned care in hospital within the required 18 weeks, such as surgery for cataract removals, hernia repairs and hip and knee replacements.

The number of people in England who are awaiting such treatments has climbed to almost 3.9 million.

Hospitals met the 92% target in nine categories of RTT patients, including those requiring treatment for eye problems (92.7%), cardiac care (92.7%) and gynaecological problems (92.3%). However, it missed the target in 10 other categories. It treated barely four of of five (81.7%) of all those awaiting neurosurgery within 18 weeks, 86.9% of those needing plastic surgery and 88.9% of trauma and orthopaedic patients....read more

 

Demand for NHS care is dangerously high, says thinktank (The Guardian: 8 September 2016)

Demand for NHS care has reached record levels, with unprecedented numbers of patients being treated in A&E units, a new report reveals.

But that has left hospitals dangerously full and growing numbers of patients who need to be admitted are having to wait longer than they should because no bed is available, according to health thinktank the King’s Fund.

A total of 5,873,998 patients sought help in all types of A&E units in April, May and June – the largest number ever to do so in any three-month period – leading the Royal College of Nursing (RCN) to warn that the NHS had become “a pressure cooker” and was buckling under the weight of demand.

An unusually high number of patients were admitted to hospital during the same period, in a sign that the NHS is dealing with growing numbers of people who are so unwell they need inpatient care. In all just over 1 million of those who attended A&E ended up being admitted, one of the largest numbers on record.

Overall there were an extra 54,000 A&E attendances a month and 14,200 extra emergency hospital admissions a month in the first quarter of 2016-17 than in the same period the year before.

Experts said that the record high, revealed in official NHS statistics analysed by the King’s Fund, was surprising because it occurred in a period when hospitals used not to be especially busy....read more

 

Out-of-hours services 'broken' as single GP regularly covers 370,000 patients (Pulse: 8 September 2016)

Out-of-hours services in Northern Ireland are on the verge of collapse, with individual GPs regularly having to cover populations of 370,000 overnight on their own, GPs have warned.

Those in the South and West are being hit the hardest and are almost at the point of having to close completely, RCGP NI said.

Dr Frances O’Hagan, who is chair of Southern LMC chair and works for the out-of-hours service, described the service in the South as ‘broken’.

She said one GP was left to cover a population of 406,000 patients - although the health board claimed the figure was 369,000 - spread over a large geographical area, rather than the three required on 12 overnight shifts in August....read more

 

'Postcode lottery' revealed in NHS care (The Guardian: 8 September 2016)

Patients with dementia, diabetes and learning disabilities are being let down by their local health services in many parts of England, new figures show.

A postcode lottery of care across the country has been highlighted as new performance data shows that while some health bodies are performing well, neighbouring organisations are falling short.

More than half (57%) of local health bodies in England are not performing well enough on dementia, 71% are classed as “needs improvement” for diabetes care and 92% need to improve care for people with learning disabilities, the figures show.

The figures, released by NHS England, show that many clinical commissioning groups (CCGs) have been classed as needing improvement in the different aspects of care....read more

 

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