The future of the NHS (if any)

[Alan H]

Latest post of the previous page:

NHS healthcare: coming to you from the tax haven of the Bahamas:

The BBC has learned that 12 NHS GP practices and urgent care centres across the West Midlands are ultimately owned by a company based in a tax haven in the Bahamas. Malling Health exchanged bank loans with an interest rate of 4% for a loan at 20% interest with the owner of Bahamas-based Butterfly Ventures. The company says this arrangement is more flexible, but experts claim it's a way of diverting money into a low tax area.

[Alan H]

Is the government’s £10 billion NHS funding commitment more than NHS leaders asked for?

tl;dnr: No.

[Alan H]

At least 12,000 new GPs needed by 2020, new workforce data revea

Health secretary Jeremy Hunt’s pledge to boost GP numbers by 5,000 by 2020 will deliver fewer than half the number needed to fill the UK’s growing workforce deficit, new modelling by primary care researchers suggests.

The most ‘optimistic’ scenario produced by the team at Imperial College found that GP headcount will have to increase by 12,000 to compensate for growing population and consultation complexity.

And the commitment to 5,000 more GPs was again tweaked to ‘5,000 more doctors in general practice’ with GP trainees to be counted in the total and Pulse has shown why even this is a long way off.

[Alan H]

£10bn? £4.5bn? Whatever. The Government’s NHS funding policy

Sophistry

It didn’t take long for the figure to be debunked, with £2bn of the total figure revealed to be ‘old money’ announced in the previous year's autumn statement.

However, the lion's share of Whitehall sophistry lay in the terms used to define what exactly was being invested in.

The money, it became clear, applied only to NHS England's budget rather than the Department of Health as a whole.

This artful redefining of what constitutes NHS spending was crucial, as it meant that £3bn of the overall investment had to be sourced from cuts to health services outside of NHS England’s budget.

As a result, areas such as medical education, social care and public health were exposed to what ministers would diplomatically term as ‘efficiency savings’.

[Alan H]

More lies from the lying liar Jeremy 'liar' Hunt exposed. Is there no end to his lies? Councillors must look before they leap into secret NHS cuts plans

On Tuesday, Stevens told MPs that “we didn't get the funding that the NHS had requested [for 2017-2020]... So as a result we have got a bigger hill to climb.”

Jeremy Hunt was forced to stop claiming that he has given the NHS “all the money it asked for” and admitted to MPs it was only enough to “get going” on a restructuring plan.

So on Friday local NHS bosses had to submit their “Sustainability and Transformation Plans” to NHS England, to show how they are going to realise the impossible dream of realising £22bn of “savings” to balance the NHS books by 2020.

[Alan H]

Making the NHS a “hostile environment” for migrants demeans our country

[Alan H]

In the Independent: 'Myth' that NHS is best healthcare system in world 'must be debunked', says Conservative MP

The NHS is “failing” and it is time to "debunk the myth" that it is the best healthcare system in the world, a Conservative MP is due to say on Monday night.

Owen Paterson believes the UK lags far behind comparable countries in terms of health outcomes.

A critique of some of Owen's report: NHS is failing and must obviously be privatised

The authors’ conclusion is that we have no way of knowing what would happen if we spent more.

I think there is quite a lot of evidence about what happens when you spend more on frontline staff and services. People tend to get better, safer, care.

I don’t think this report can be treated as reliable evidence of what the NHS is, and isn’t, doing wrong. The data is unreliable leading to unsafe conclusions.

[Alan H]

Who could have predicted... Private companies see profits double while NHS waiting lists increase

A major Pulse investigation has revealed that private companies are boosting their profits by up to 100% as the health service struggles to cope.

An analysis of company reports and statements from all the major private hospital chains that make their figures available shows all have boosted their revenues this year.

They say they are gaining from the plight of the NHS, with patients more likely to pay for their care to avoid lengthening NHS waiting lists, which have led to 3.7 million NHS patients wait for treatment – the most since December 2007.

The investigation – the most comprehensive since the introduction of the Health and Social Care in 2012 – also shows that local commissioners are paying hundreds of millions to private hospitals and that hospitals have also boosted their income from private work.

It comes as Pulse yesterday reported that one private GP firm is expanding its service which promises to deliver a GP to patients’ doorsteps in 90 minutes for £120 – one of a number of companies taking advantage of long waiting times for GP appointments.

GP leaders say the Government is undermining the NHS in favour of the private sector through ‘scandalous’ underfunding, and ‘sleepwalking’ us towards a US-style health insurance system.

[Alan H]

NHS rescue fund in jeopardy, says think tank

Of the £2.1bn earmarked by health secretary Jeremy Hunt for the ‘sustainability and transformation fund’ this year, just £300m is left to transform health services.

The lion’s share of the fund, £1.8bn, has been diverted by NHS England to keep hospitals out of the red.

[Alan H]

Who knew? NHS funds need urgent boost, say MPs

A group of MPs says the government is incorrect to keep claiming it is allocating an extra £10bn to the NHS in England over the next five years.

The Health Committee has written to the chancellor to say using the figure gives the "false impression that the NHS is awash with cash".

The group said the figure was closer to £4.5bn and called for more NHS funding in November's Autumn Statement.

[Alan H]

Allowing those who are not fully trained nurses to administer controlled drugs... it may be cheaper, but what could possibly go wrong?

Screenshot from 2016-10-31.png (279.49 KiB) Viewed 8851 times

[Alan H]

Jeremy 'liar' Hunt's stupidly simplistic wheeze of an idea is garbage: Knowing doctors’ death rates can’t help you avoid a bad surgeon

Publishing the performance data of thousands of surgeons is no help to those hoping to avoid going under the knife of a bad surgeon.

A review of death rates has found that even a surgeon whose scores are deemed “acceptable” may actually have had a high rate of needless deaths among their patients.

In 2013, a website was launched in the UK that enabled people to examine the data of individual surgeons, such as the proportion of their patients that died within 90 days of surgery. The UK health minister Jeremy Hunt said the website, called My NHS, would drive better care and could save lives.

But critics say that death rates are too crude a measure for assessing a surgeon’s performance, and in 2015, heart surgeons wrote to NHS England, asking for a rethink of the policy. They said that publishing death rates in this way was motivating some colleagues to avoid doing risky operations.

Far too few
Now researchers have examined the death rates for inpatients for six common procedures between 2010 and 2014. They found that this data was not enough to be able to work out which of the surgeons had an above-average death rate, because each individual surgeon does not perform enough procedures.

For example, when it comes to hip replacements, weight-loss procedures and thyroidectomy, fewer than 20 per cent of surgeons with death rates five times higher than the national average would be detectable using the current system.

Each hip replacement surgeon would need to carry out 500 hip replacements every year if just one failing surgeon was to be detected. At present, they perform about 48 to 75 operations per year.

“Publishing surgeons’ mortality rates is a step towards transparency in medical care, but it offers little help in identifying poor performance,” said Ewen Harrison, at the University of Edinburgh, who worked on the analysis. “We must use this data as part of a wider initiative to keep the quality of care in UK hospitals high.”

The team is calling for more focus on tracking how patients recover after surgery, as well as measuring their satisfaction. As death rates for surgical procedures continue to fall, measuring death rates will become even less useful for assessing surgeons, they say.

Journal reference: BMJ Open, DOI: 10.1136/bmjopen-2016-012471

[Alan H]

Labour requests inquiry into Theresa May’s £10bn for NHS claim

Labour has asked the UK Statistics Authority to investigate Theresa May’s statement that the government is giving the NHS an extra £10bn.

Jonathan Ashworth, the shadow health secretary, has written to the watchdog after five members of the Commons health select committee criticised the prime minister’s statement as “incorrect” and said it suggested the cash-strapped health service was “awash with cash”.

The authority, independent of the government but accountable to parliament, seeks “to promote and safeguard the production and publication of official statistics that serve the public good”. Its role is to ensure that official statistics used by Whitehall departments and the devolved administrations are accurate.

“I would be grateful if you would conduct an urgent inquiry into the government’s NHS spending plans and the accuracy of recent statements made by the prime minister and ministers, in particular claims that the NHS budget will increase in real terms by £10bn between 2014-15 and 2020-21,” Ashworth wrote in a letter to the authority’s chair, Sir Andrew Dilnot.

Labour’s attempt to expose what it says is spin on NHS funding by May came after Jeremy Hunt, the health secretary, told an emergency Commons debate the five select committee members were wrong to contest his and May’s claims.

[Tetenterre]

Sarah Wollaston was on about on the Today programme yesterday. Also HuffPo article:
http://www.huffingtonpost.co.uk/entry/s ... fc956304be

[Alan H]

BMA calls for clarity on government statements on NHS spending increases

The British Medical Association (BMA) has today written to the UK Statistics Authority (UKSA) over its concerns about misleading statements from the Government stating that the NHS budget will increase in real terms by £10 billion during this parliament.

In a letter to Sir Andrew Dilnot CBE, Dr Mark Porter, chair of BMA council, requests that UKSA advise on the validity of these statements with reference to the analysis carried out by the Health Select Committee.

The BMA believes that the statements made by the Health Secretary on NHS funding over the course of this parliament do not reveal the true value of provision to the NHS as a whole and could potentially be misleading.

Dr Mark Porter, chair of BMA council, said:

“The BMA has been urging the Government to be honest about NHS funding and, not for the first time, questions are now being raised about the Government’s use of figures. It is vitally important that patients, the public and those working in the NHS have confidence in Government claims related to NHS funding, and that if misleading figures are found to have been used, these are highlighted and challenged.

[Alan H]

From red to black: Private sector profiting as NHS crumbles

‘No extra cash,’ was reportedly the message from Prime Minister Theresa May to the NHS at a recent private meeting.

It seems the Conservative austerity programme will continue, despite lengthening waiting lists, greater rationing and mounting concern over how the NHS will get through the winter.

In contrast, a special investigation by Pulse shows private healthcare in the UK is buoyant.

Pulse has learned major healthcare companies are seeing profits more than double, uniformly citing the pressures on the NHS as the driver for increased activity. But the companies benefiting are not the usual suspects, like Virgin Care and Care UK, who rely on winning contracts to run large parts of the NHS.

Instead, it’s those companies offering an alternative to the decrepit NHS that are cashing in. Private hospitals are capitalising on the underfunding of the NHS by expanding their services, focusing on areas subject to rationing drives or long waiting lists – such as cataract treatment and hernia repair.

[Alan H]

Tory MP calls for debate on introducing NHS charges

A Conservative MP called for an “honest debate” about introducing charges for NHS treatment, arguing that they would help the health service focus on “the essentials”.

Sir Edward Leigh, who sits on the Public Accounts Commission, said the Government might have to “think the unthinkable” and charge patients because of increased pressure on A&E departments.

Ministers did not explicitly rule out new fees when asked by the Tory MP, instead noting they were attempting to avoid overburdening the health service.

“In terms of A&E we do have problems, particularly with people coming from rural areas. For those of us who rely completely on the NHS this obviously a matter of vital concern,” Sir Edward asked ministers during Health Questions in the House of Commons.

“I just wondered whether we should have an honest debate about this, to try and recognise that we do have an ageing population, that our A&E times are stressed, and we may have to either tax people more, or even think the unthinkable, and charge people for non…”

After he was interrupted by heckling from other MPs, Sir Edward continued: “Ah, see, it’s unthinkable, but you have to concentrate on the essentials. Let’s have an honest debate about the finances of the NHS.”

[Alan H]

Testing sore throats at pharmacies won’t solve anything

Are GPs to throw away the traditional box of wooden tongue depressors? People with sore throats are soon to be offered a new service – at the pharmacy. The NHS Innovation Accelerator, an organisation responsible for helping “with the adoption of promising new treatments and technologies”, has approved a new Sore Throat Test and Treat service that NHS England says is “evidence based and cost saving”.

My head is in my hands. This is neither evidence based nor shown to be cost effective, and may actually make pressure on the NHS worse.

Faced with a wait for to see a GP, it means effectively people will be able to access care faster if they pay for it
The pilot study – which occurred in Boots stores (whose head office analysed the data) – was not a randomised controlled trial. It showed it was possible for pharmacies to assess people with sore throats and use a “point of care” rapid antigen test to determine who should get antibiotics. This might sound superficially sensible. But the National Institute for Health and Care Excellence (Nice) does not recommend this rapid antigen test because it has a poor sensitivity for picking up relevant bugs.

It is already known – from randomised clinical trials – that this test does not help beyond normal care. Furthermore there has been no full cost-effectiveness analysis – let alone an independent cost-effectiveness analysis – of the Boots scheme. Without comparing the pilot to usual care, we have no way of knowing whether more or fewer antibiotics were prescribed. It is a travesty of evidence-based policymaking.

This is very much the theme of Margaret's latest book. I'm still reading it but I'll post something about it later. It is, however, a must for all those interested in the NHS and evidence: The State of Medicine: Keeping the Promise of the NHS

[Alan H]

Government quietly privatises the NHS's in-house agency staff provider

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”.

[Alan H]

No shit! NHS transformation plans may be used as cover for cuts, says BMA

The BMA says the plans have a potentially positive role to play if they help develop health policies more suited to local needs and integrate services across health and social care. It fears, however, that they are being driven by other priorities and claims there has been a lack of consultation.

[Alan H]

Hospitals may require patients to show passports for NHS treatment

Pity about those who don't have a passport. Or homeless.

But there'll be a solution just around the corner. ID cards...