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  • Full spending review ‘unlikely’ in time for 2020-21 (£) HSJ picks up an important news item swamped beneath reams of coverage of Trump, Brexit and Tory chaos. A delay to next year in the spending review will leave all NHS plans on hold.

  • GP at Hand’s primary care network application to be ‘considered’ Digital Health reports more signs of undermined values and weakness in the NHS as it is assaulted by the slick marketing opportunism of GP at Hand.

  • Health and Social Care Committee invites Secretary of State to justify refusal of information The Health and Social Care Committee has called the Secretary of State for Health and failed Tory leadership contender Matt Hancock MP to appear before it to explain his refusal to provide it with information on the Government’s review of NHS overseas visitor charging.

  • Forget trade deals – there’s another attack on our NHS happening right now As another health trust prepares to offload its services to a 'SubCo', Richard Bourne's blog for Left Foot Forward looks at an under-reported threat to the NHS

  • Victory for Princess Alexandra domestics on eve of strike Good news story from UNISON, of a 99% vote for strike, determined call for 6 days of action, and a management retreat that will keep staff firmly in the NHS.

  • GP workforce increasingly fragile as reliance on older doctors grows Analysis by GP Online reveals that
    "In September 2015, 20.3% of the permanent, fully-qualified FTE GP workforce was aged 55 or over. By March 2019, 23.6% of GPs in this category were aged 55 or over".

  • Care For America’s Elderly And Disabled People Relies On Immigrant Labor US journal Health Affairs points out the obvious: "our finding that immigrants fill a disproportionate share of such jobs suggests that policies curtailing immigration will likely compromise the availability of care for elderly and disabled Americans"

  • Chief executive to leave troubled trust (£) HSJ report of Simon Wright, CEO for the failing Shrewsbury and Telford Hospital Trust, to step down next month – but found a cosy job "working with sustainability and transformation partnerships”.

  • Woman ordered to find work while lying in coma dies aged 48 Not the first such scandal, or sadly the last, but still shocking barbarism from DWP bureaucrats.

  • Could the NHS be the price of a US trade deal? Nuffield Trust's Mark Dayan warns that "Any trade deal with the USA will be a tough negotiation, with goals traded off carefully against one another. If we prioritise imaginary problems over real ones, the NHS risks getting the short end of the bargain."

  • Trump wavers after saying NHS must be on table in US-UK trade talks Back-tracking by Trump on his demands to open up the NHS to US health corporations after a rush of Tory leadership contenders and other politicians to make clear their opposition to this being part of any US trade deal. US-style commercialised health care is politically toxic: not even the Tories can explicitly accept any association with it,

  • NHS England to offer 'up to' £200k per selected network 'accelerator' site GP leaders have criticised "divisive" NHS England plans to give a £200,000 bung to up to 14 areas which launch Primary Care Networks. The BMA response is that
    "We have previously made our reservations about early-adopter schemes clear, which can often lead to a minority securing unfair additional funding that others are denied, and we would be concerned if this latest plan led to inequity across England."

  • IPPR 60-SECOND SUMMARY of report on social care 2 page whistle stop tour through IPPR plan - cuts out some of the waffle.

  • Implementing the NHS Long Term Plan: Ten key issues for the proposed legislative changes Just as everyone seems to have forgotten the Long Term Plan published less than six months ago the NHS Confederation (representing senior NHS managers, public and private providers and commissioners) wakes up with a jolt and fires off a response.

  • English 'short-changed on care funding' BBC report based on health Foundation research notes that:
    "Public spending on care for the elderly and disabled is much higher in Scotland and Wales than England, figures show.
    "In England, £310 per person is spent each year on services such as care homes and home help for daily tasks such as washing and dressing.
    "But in Scotland, £445 is spent - 43% more than in England - and in Wales it is £414 - 33% more."

  • Council spending on local services down 21% over past decade Guardian reports:
    "In a reflection of the austerity drive imposed on local authorities by Conservative-led governments during the past decade, the Institute for Fiscal Studies said spending on services in England had fallen by 21% between 2009-10 and 2017-18.
    "In a sign of the increasing difficulties facing local authorities across the country, the leading tax and spending thinktank also said the funds available to councils would become increasingly inadequate in the 2020s, rendering the current financing system for the country’s local authorities through council tax and business rates unsustainable."

  • Government pledges more NHS bailouts amid growing audit concerns (£) Exclusive story from HSJ on the parlous and worsening financial plight of many NHS trusts. It reminds us that:
    "Year-end accounts for 2017-18 showed trusts owed a combined £11bn to the department - more than total liabilities relating to the private finance initiative. Accounts for 2018-19 are expected to show another rise in these debts.
    "In 2017-18, 82 providers received audit reports containing paragraphs highlighting “material uncertainty” in relation to their going concern …"
    However NHS England are still conniving at massive and growing deficits: see for example https://lowdownnhs.info/news/debt-ridden-eastern-england-stp-shakes-a-collecting-tin/

  • Tory council chief warns of social care funding shortfall Somerset county council leader tells the Guardian that failure to find funding to cover soaring demand for social care would lead to increasingly difficult decisions about who would be eligible for state help: there will be less funding for complex cases, and those with lower needs will go unfunded.
    "His comments came as a report predicted that English councils risk insolvency if government does not move rapidly to fill a £50bn funding black hole opening up in local authority budgets, in large part because of the spiralling cost of paying for services for vulnerable older adults and children."
    [Obviously nine years of massive cuts inflicted by his own party colleagues in government are also a factor.]
    "The report published by the Conservative-dominated County Councils Network (CCN) ahead of the promised government public spending review says that without extra funding, rising demand for social care will see council finances “plunged into disarray” and services cut to legal minimum levels."

  • English councils warned about 'exhausting' reserve cash BBC report noting that as a result of systematic and deliberate central government austerity in council funding cutbacks since 2010:
    "Some councils in England have been warned they risk running out of cash reserves if recent spending continues.
    "Analysis by the BBC has identified 11 authorities the Chartered Institute of Public Finance and Accountancy (Cipfa) said would have "fully exhausted" reserves within four years unless they topped them up.
    "The Local Government Association said councils faced "systemic underfunding"."
    All of which is exceedingly bad news for social care and public health.

  • Croydon hospital's performance got worse after new £21.5 million A&E unit opened My London report shows Croydon's hospital swamped with a rising tide of emergency patients needing beds. A gleaming new A&E unit in itself was never going to solve that problem.
    "A spokesperson for the trust said: "Growing demand on our emergency department means it now provides about 6% more major consultant-led care than it did in February a year ago.
    "Those are known as 'Type 1' cases. When we include all other types of cases, our emergency department now sees 21% more patients than it did a year ago."

  • In Greece, a life-transforming thyroid pill costs just £1 a month, but in Britain it’s £204 - so how can firms justify the drug daylight robbery? Daily Mail waxing indignant at capitalism rampant and a "market" for pharmaceuticals that forces prices ever upwards rather than down.

  • New issue of The Lowdown Issue 3 includes 4-page overview of privatisation, updates on Circle's defeat at High Court, Cambridge & Peterborough STP passing the hat, GP At Hand, strikes called against privatisation at Princess Alexandra Hospital - and much more

  • The absurdly high [US] cost of insulin, explained Interesting article on Vox.com begins by pointing out that:
    "When inventor Frederick Banting discovered insulin in 1923, he refused to put his name on the patent. He felt it was unethical for a doctor to profit from a discovery that would save lives. Banting’s co-inventors, James Collip and Charles Best, sold the insulin patent to the University of Toronto for a mere $1. They wanted everyone who needed their medication to be able to afford it."
    It goes on: "The US is a global outlier on money spent on the drug, representing only 15 percent of the global insulin market and generating almost half of the pharmaceutical industry’s insulin revenue. According to a recent study in JAMA Internal Medicine, in the 1990s Medicaid paid between $2.36 and $4.43 per unit of insulin; by 2014, those prices more than tripled, depending on the formulation."

  • Essex council proposes £25.92 'lifting charge' to help elderly up when they fall Independent report on the latest short-sighted efforts at "savings" by social care at the expense of increased demand on NHS services.

  • NHS bosses accused of breaking law in cancer scanning privatisation Guardian reports latest twist in the ongoing scandal of NHS England's attempts to privatise specialist scanning services in Oxford, Swindon and Milton Keynes. Tory-led Oxfordshire County Council has penned a powerful rebuke, accusing NHSE of ignoring legal duty to consult.

  • Major trust opens talks with Babylon, claiming GPs unable to stem demand (£) HSJ report on University Hospitals Birmingham (which has just recently gone into partnership with US-Based HCA to built a large new private hospital on its main site) now linking up with the firm behind GP at Hand.
    The deal is supposed to centre on ways of reducing demand for hospital services: by the new report on GP at Hand shows its subscribers make MORE than average use of hospital and other services.

  • Cuts may leave NHS short of 70,000 nurses, leaked report warns Guardian on a leaked report showing devastating projections:
    "The NHS could be short of almost 70,000 nurses within five years, according to a leaked copy of the government’s long-awaited plan to tackle the staffing crisis.
    "Blaming the government’s decision to abolish bursaries for nursing students, a draft of the NHS people plan says: “Our analysis shows a 40,000 (11%) shortfall [in the number of nurses needed in England] in 2018-19 which widens to 68,500 (16%) by 2023-24 without intervention, as demand for nurses grows faster than supply.”
    "That would mean that the NHS’s shortage of nurses increases from one in nine of the workforce to one in six, adding to the rising pressures on hospitals, GP surgeries and mental health care."

  • Sustainability of GP at Hand model questioned in major independent report Good, swift analysis by GP Online of new report on GP at Hand, which points out:
    "An independent report on the impact of GP at Hand on patients, the wider health service and the workforce - carried out by Ipsos Mori on behalf of the CCG hosting the service - was unable to conclude whether the service was affordable and sustainable in its current form.
    "It warned that the model required 'considerable numbers of GPs' to sustain and that a national rollout of digital-first services may need 'fundamental large-scale redesign of primary care services, which may require substantial changes in the way in which primary care is funded'."

  • NHS looks to cash in on worried patients with £24 blood-test kits (£) Times reports that
    "The NHS has entered the market to sell consumer blood tests that look for signs of serious illness in a controversial moneyspinning venture.
    "A leading hospital laboratory hopes that online shoppers will pay from £24 for tests that can prevent disease by assessing people’s risk of conditions such as heart disease, diabetes and osteoporosis.
    "But GPs fear it will lead to an influx of the worried well to overstretched surgeries and insist that “curiosity is simply not a good enough reason for medical testing”.

  • Babylon’s GP at Hand service runs up £21.6m deficit FT report highlights another dimension to the continuing rip-off of NHS resources to give preferential treatment to a needy group of wealthier, younger and healthier patients, leaving less resource for those with greater needs.
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    "Hammersmith and Fulham CCG expects that NHS England will reimburse it for the costs of GP at Hand, but declined to comment on when that would happen."

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