LATEST ARTICLES
What will Devo Manc mean for the NHS?
22 March 2016
A huge experiment is about to begin in Greater Manchester. On 1 April, power
to manage the £6bn budget for health and social care in the metropolitan
county will be devolved, and an ambitious plan will be put in motion to change
every aspect of the health and care system in the next five years.
Foundation trusts will have surrendered their autonomy in the interests of
planning hospital care across the city region; GPs will no longer be
independent businesses but part of locality focused hubs (see box) providing
a wide range health and social care outside hospitals; and a projected £2bn
hole in finances will have been filled.
Taking Charge, the blueprint for change published in December by the
Greater Manchester Combined Authority and the NHS in Manchester, said
that GPs will become leaders of local care organisations (LCOs) running
primary, community, social, and mental healthcare services, as well as some
acute services, as part of a determined plan to move the centre of gravity
away from hospitals.
In a few years’ time GP services “will be fairly unrecognisable,” says Tracey
Vell, chair of the Association of Greater Manchester Local Medical
Committees. The plans have “largely landed well [with GPs] because we’re
seeing the crisis coming in some areas of general practice; everyone’s
worried,” she says.
Read the full article in the BMJ
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There’s little hope of avoiding NHS crash
18 March 2016
TThe public accounts committee’s verdict on hospital finances could hardly
be more damning. Its report on the financial performance of acute hospital
trusts concluded that they are deteriorating “at a severe and rapid pace”. In
case anyone was in any doubt, it says this trend is not sustainable.
The deficit could pass £2.5bn by the end of the financial year. Accountancy
games may get the final figure down to £1.8bn, but that will do nothing to
address the underlying problem.
Its criticism of NHS England and Monitor was severe, accusing them of
setting unrealistic efficiency targets that have caused long-term damage to
trusts’ finances. NHS England has conceded the point, and the efficiency
targets have been cut from 4% to 2% for the coming year. But even this
target is shaky, with many trusts flying blind because their data is so poor.
The MPs were dismissive of attempts to get the money under control,
pointing out that until the NHS sorts out its workforce planning it will not solve
the problem of spending on agency staff, and said there is not yet a
convincing plan for closing the £22bn efficiency gap and avoiding a black
hole in NHS finances.
Read the full article on the Guardian Healthcare Network
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What do NHS inquiries really achieve?
4 March 2016
The claim by the chair of the Morecambe Bay inquiry (pdf) that the NHS risks
“another avoidable disaster” by failing to implement the recommendations in
his report highlights the dangers of using inquiries to drive service
improvements.
According to Nursing Times, Dr Bill Kirkup claimed that almost a year after
the inquiry into failures in maternity care at Furness general hospital that
contributed to the deaths of at least 11 babies and one mother, there has
been progress on only 10 of the 26 national recommendations the report
made. Kirkup was particularly concerned that his calls for the introduction of
investigations by professional regulators, national reviews into isolated rural
services and a review of the NHS complaints system have yet to be fully
implemented.
Public inquiries are the weapon of choice for ministers faced with a public
outcry over scandals and avoidable loss of life. From the Piper Alpha oil rig to
the Clapham train crash and the poor care at Bristol Royal infirmary and Mid
Staffordshire foundation trust, inquiries are epoch defining, cathartic moments
in industries and public services. Smaller scale inquiries, such as the recent
investigation into Southern health foundation trust’s care of patients with
learning disabilities, pepper the NHS landscape.
Read the full article on the Guardian Healthcare Network
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Mental health needs more than money
20 February 2016
The impression is being created of unstoppable momentum towards
expansion and improvement of mental health services. Reports, cash and
pledges of action are piling up. But it is hard to identify what will change and
from where the money will come. Meanwhile, the problems that give rise to
mental illnesses are growing.
Hitting hyperbolic heights this week, NHS England promised “the biggest
transformation of mental health care across the NHS in a generation”. In the
wake of the report (pdf) by the Mental Health Taskforce, led by Mind chief
executive Paul Farmer, NHS England pledged to help millions more people
and invest more than £1bn a year by 2020–21.
The commitment of NHS England and the government to giving mental health
the focus it deserves is not in doubt. What is problematic is their ability to
deliver on the promises being made.
Announcing telephone number-sized quantities of cash to “transform” the
NHS is now routine, but the shine soon fades as the realities of tight funding
kick in.
Read the full article on the Guardian Healthcare Network
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Long-term patients need joined up NHS
5 February 2016
Transforming the care of long-term conditions is the key to ensuring the
financial sustainability of the NHS. But although there is wide agreement on
what needs to change, progress towards achieving it is painfully slow.
The seven innovation test beds unveiled by NHS England chief Transforming
the care of long-term conditions is the key to ensuring executive Simon
Stevens at the World Economic Forum in Davos last month are the latest
attempt to build some momentum behind change. The programme is focused
on long-term conditions and mental health, and is a collaboration between the
NHS and some big private sector names including Verily (formerly Google
Life Sciences), IBM and Philips. The idea is to use a mix of technology, data,
monitoring and training.
Examples include diabetes patients in the west of England having remote
monitoring and coaching technology to help them manage their condition
better, while in Rochdale, patients who are at high risk of becoming critically
ill will be supported with telecare monitoring in their homes.
Read the full article on the Guardian Healthcare Network
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A&E is overwhelmed despite the staff
22 January 2016
Accident and emergency services are the national symbol of the NHS. While
people may have complaints and grumbles about treatment elsewhere in the
health service, it is an article of faith that when you have an emergency you
will see the NHS at its best.
More than this, it exemplifies the principle of free at the point of need.
Extraordinary human and technical resources can be mobilised in minutes to
save your life, irrespective of your wealth and status, or the cost to the state.
But increasingly A&E is also coming to symbolise a health service struggling
to cope, with multiplying pressures and no sign of a long-term solution.
Between 2003-04 and 2014-15, according to King’s Fund analysis, annual
A&E attendances jumped from around 16 million to more than 22 million. For
most of this time, the majority of the increase went to walk-in centres and
minor injuries units.
Read the full article on the Guardian Healthcare Network
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Is it time for a debate on an NHS tax?
8 January 2016
The call this week by three former health ministers for a cross-party
commission on the future of the NHS and social care is a sign of the growing
desperation among the care services’ most passionate supporters that they
are sinking into a crisis from which it will be difficult to escape.
The proposal was made in parliament by Liberal Democrat former health
minister Norman Lamb, and supported by Labour’s Alan Milburn and
Conservative Stephen Dorrell – now chair of the NHS Confederation. It
shows that there is convergence between the main political parties in terms of
diagnosing the problems, but important ideological differences remain in the
prescribed solutions. Could a consensus be emerging by the time of the next
general election?
Although the chances of such an all-party approach at the current time are
vanishingly small, it was attempted as recently as 2010, just before that
year’s election. Lamb was one of the driving forces behind it. Then the brutal
realities of electoral politics took over, and it soon collapsed in acrimony.
Read the full article on the Guardian Healthcare Network
January to March 2016
Public Policy Media
Richard Vize