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  • NHS England's proposals for new legislation mean business as usual Short statement and longer more in depth analysis of proposals on which NHS England has sought "engagement" with the public and campaigners, developed by KONP and HCT.
    The two statements make clear that the only NHS England proposal that can be supported the way it is argued is the call for repeal of the controversial "section 75" of the 2012 Health and Social Care act and the associated regulations designed to compel Clinical Commissioning Groups to carve up services and put them out to tender. KONP and most campaigners fought this legislation every step of the way as it was forced through Parliament by David Cameron's coalition with Lib Dem support, so there is no sensible reason why we would now oppose it being scrapped.

  • Theresa May's post-Brexit immigration plan could close a quarter of services in some hospitals say health bosses due to nurse shortages Daily Mail recycles Telegraph story highlighting potential impact of £30k minimum salary for migrants coming to UK.

  • How to fund social care? What are the different options for funding social care? The Nuffield Trust offers a tool to help direct further investigation.

  • Collapsed private provider to the NHS owes £11m (£) HSJ article on collapse of Coperforma the disastrous private provider of patient transport services brought in by Sussex CCGs -- before a predictable collapse.
    "Clinical commissioning groups in Sussex ... have claimed the company owes them £7.6m. In a statement, the county’s CCGs said: “The Sussex CCGs are actively pursuing all options to maximise recovery for the NHS of costs incurred as a result of the failure of the patient transport service contract."

  • Combined Performance Summary: February – March 2019 Another extremely useful round up of figures by Jessica Morris of Nuffield Trust reveals:
    "•The proportion of people waiting over 18 weeks to start elective treatment reached 13% in February 2019. It has been three years since the referral-to-treatment target was last met.
    •In February 2019, 2.3% of patients had been waiting over 6 weeks for a diagnostic test, which is a 1.3 percentage point drop on the previous month but 44% higher than it was in February 2018.
    •In February 2019, 23.9% of patients waited longer than two months to start their first treatment for cancer following a GP urgent referral. This is a small 0.1 percentage point increase on the previous month, but over 4.8 percentage points higher than in February 2018."

  • Telford hospice funding cuts 'heartbreaking' BBC report.
    Telford CCG shows more contempt for provision of services outside hospital by deciding to cut £250,000 of funding to a hospice.
    The decision is "heartbreaking" and "flawed", its supporters have said.
    Telford and Wrekin Clinical Commissioning Group (CCG) said it was a "difficult decision" to make the cut to its £1m grant, resulting in a loss of two beds at Severn Hospice in Telford. Staff at the hospice said they were "extremely disappointed" by the decision.

  • Patients Not Passports A 47-page report for campaigners fighting the charges that have been imposed by ministers on overseas patients treated in NHS hospitals. Published by Medact.

  • What does the UK spend on health and social care? Fascinating infographic from John Appleby in BMJ illustrates what happens to the UK’s spending on health and social care (a grand total of nearly £208bn—including £5.3bn of capital spending). It shows the money comes from two main sources, public (£157.6bn) and private (£44.9bn), and eventually flows through to various types of care: inpatient care, home based care, prevention, and medical goods.

  • Your Insurance Is Getting Disrupted — With or Without Medicare for All Well written article in The Intelligencer, a US magazine, points out the lack of any logical reason to continue to throw more money at a broken US system that excludes millions from any health cover, but is becoming less affordable for employers.
    "more and more firms will be unable to both retain profitability and provide their employees with decent coverage. Already, the quality of employer-sponsored insurance is steadily declining, as businesses pass rising costs onto their workers."
    It shows the reason why single payer is the obvious and more affordable alternative:
    "Canada has a single-payer system that enables it to save money on redundant administration, and to dictate reimbursement rates to medical providers. America, by contrast, subsidizes the private insurance industry (and its wasteful administrative bureaucracies), while allowing physicians’ cartels and hospital monopolies to dictate their own pay rates to private providers. Thus, a competently designed single-payer system would be less expensive than maintaining our existing one."

  • Children who need help with mental health face postcode lottery – study Shocking figures in Guardian report reveal wide inequalities between areas in allocation of resources for child and adolescent mental health services -- despite years of empty NHS England and government rhetoric about "parity of esteem" and promises to improve services.
    "Researchers used spending data from local authorities and NHS clinical commissioning groups, which each contribute roughly half of funding, to calculate that local areas allocated £226m for low-level mental health services in 2018-19 – just over £14 per child.
    "while local authority spending per child in London was £17.88, it was just £5.32 in the east of England. According to the study, a few very high-spending areas mask a larger proportion of low-spending areas."

  • Surgeons demand clarity on private hospital safety Times article reports Royal College of Surgeons call for private hospitals to be forced to publish their safety records, to protect patients.
    "Regulators have backed the college’s demand that the hospitals share data on doctors’ performance, the results of treatment and patient records."
    The article explains:
    "While private hospitals must report problems to the Care Quality Commission (CQC), unlike the NHS they do not have to publish or share data on the number, type or outcome of their procedures and are not subject to freedom of information law. A report by inspectors last year said that 41 per cent of private hospitals were not doing enough on safety."

  • GP patient services at risk due to cuts in Birmingham BBC report on cuts that will hit some of the most deprived areas of Birmingham:
    "Tens of thousands of patients could lose access to specialist GP services when funding is cut, it is understood.
    "Some practices in Birmingham receive money through personal medical services (PMS) contracts to provide extra care to patients. But Birmingham and Solihull Clinical Commissioning Group said it will cut the contracts from April 2020, in line with NHS guidance. Doctors said the cuts will mean patient care suffers.
    "The BBC understands it will affect about 20,000 to 30,000 patients across more than 15 practices. The practices are in the some of the most deprived areas of the city, including Sparkhill and Balsall Heath and Alum Rock."

  • Britain's Version Of 'Medicare For All' Is Struggling With Long Waits For Care US Forbes magazine cynically exploits lengthened waiting times for NHS care as a reason to reject publiocly funded health care -- while ignoring the tens of millions in the US who cannot afford to access health care at all, and the long waits in US Emergency Rooms.
    "Long waits for care are endemic to government-run, single-payer systems like the NHS. Yet some U.S. lawmakers want to import that model from across the pond. That would be a massive blunder.
    "Consider how long it takes to get care at the emergency room in Britain. Government data show that hospitals in England only saw 84.2% of patients within four hours in February. That's well below the country's goal of treating 95% of patients within four hours -- a target the NHS hasn't hit since 2015."

  • Councils spend millions on agency social workers amid recruiting crisis Grim results from chronically low morale in fragmented, heavily privatised social care service include declining quality of service and lack of continuity of support for some of the most vulnerable service users. Guardian report reveals that
    "Data obtained through freedom of information requests shows that many English councils are routinely spending tens of millions of pounds – a total of at least £335m in 2017/18 – hiring agency social workers.
    "Experts said the difficulty experienced by councils in attracting permanent staff meant vulnerable children and families were often seeing multiple social workers in a single year, making it harder for them to engage with services."

  • ‘Second-class’ NHS workers struggle as pay gap widens Observer report based on UNISON research reveals that:
    "The estimated 100,000 low-paid cleaners, porters, security guards and catering staff who work for private contractors in hospitals across England are being treated as “second-class employees”, thanks to a growing pay divide between public and private sector workers, according to the country’s leading health union.
    "Concerns about the pay gap come ahead of tax and benefit changes in the new tax year, starting this weekend, which have fuelled fears of widening inequality, despite claims by the government that the era of austerity is over."

  • Countess of Chester Hospital says no to Wales' patients BBC report on struggling Cheshire trust:
    "An English hospital has said it will no longer take in patients from Wales except emergencies and maternity cases.

    The Countess of Chester NHS Foundation Trust decision will impact on thousands of people in Flintshire who currently use it, with immediate effect.
    "The decision follows a row over payments to the hospital for caring for patients from Wales. A Welsh Government spokesman said limiting access to Wales' patients on financial grounds was "not acceptable"."

  • L’Arche: Failures are ‘systemic’ in NHS treatment of the disabled Catholic news agency draws on a recent example to argue there are serious and systemic NHS failures especially in treatment of people with leaning disabilities.

  • Having your fudge and eating it Another splendid long read from Sally Gainsbury of the Nuffield Trust on the manipulation and false claims about NHS funding
    "When is £2.1 billion of funding not actually £2.1 billion of funding? Seemingly when it’s awarded to NHS providers in exchange for pulling off £800 million in spending cuts they might otherwise not have troubled themselves with.
    "The NHS has engineered some pretty impressive accountancy fiddles over the last three years, with an underlying deficit of over £4 billion in the provider sector massaged down to the slightly more palatable £1 billion mark in the reported accounts. But as ever, the more audacious manoeuvres remain the preserve of Whitehall."

  • NHS offering £127m of contracts to private companies despite health secretary pledging: 'No privatisation on my watch' Independent article drawing on research by Labour Party and shadow health secretary Jonathan Ashworth:
    "The party released data showing 21 NHS contracts worth £127m are currently out to tender - 19 of which have been put out since mid-February. The figures were revealed by House of Commons Library analysis and include a £91m contract to run an NHS assessment service in the South East, a £16m deal to provide health services in Leicestershire and a £6m tender for a GP surgery in High Wycombe.
    "Labour accused Mr Hancock of breaking his promise to prevent further privatisation of the NHS."
    "Commenting on the latest figures, Jon Ashworth, the shadow health secretary, said the contracts should be kept in public hands.

    Speaking on Saturday at the annual general meeting of Health Campaigns Together, which opposes privatisation in the NHS, he is expected to say: “Since the Tories’ wasteful reorganisation of the NHS we’ve seen privatisation after privatisation of NHS services, breaking up integrated care, costing the taxpayer and leaving a poor quality service for patients.
    Commenting on the latest figures, Jon Ashworth, the shadow health secretary, said the contracts should be kept in public hands.

    Speaking on Saturday at the annual general meeting of Health Campaigns Together, which opposes privatisation in the NHS, he is expected to say: “Since the Tories’ wasteful reorganisation of the NHS we’ve seen privatisation after privatisation of NHS services, breaking up integrated care, costing the taxpayer and leaving a poor quality service for patients.
    "Commenting on the latest figures, Jon Ashworth, the shadow health secretary, said the contracts should be kept in public hands.
    "Speaking on Saturday at the annual general meeting of Health Campaigns Together, which opposes privatisation in the NHS, he is expected to say: “Since the Tories’ wasteful reorganisation of the NHS we’ve seen privatisation after privatisation of NHS services, breaking up integrated care, costing the taxpayer and leaving a poor quality service for patients."

  • Matt Hancock called in to settle Oxford hospital scanners row Guardian follow up to the most high-profile privatisation story in current news:
    "The health secretary has been called in to settle a row over a “murky and opaque” plan to privatise a key element of cancer treatment currently handled by one of England’s most highly respected hospitals.
    "The proposal to let the company InHealth take charge of the Thames Valley regional PET-CT scanning service ... has been set aside until the Department of Health completes a review of the procurement process.

  • Ministers accused of cover-up over migrant health reports Guardian report by Denis Campbell reveals that:
    "Ministers have been accused of a cover-up for refusing to release official reports into whether migrants’ health has been harmed since they began being charged upfront for NHS care before they can be treated.
    "The leaders of Britain’s doctors, nurses and midwives are demanding the release of three government reviews into how hostile environment immigration policies have affected access to NHS care.
    "In 2017, the Department of Health and Social Care (DHSC) commissioned three separate investigations into key aspects of its decision to compel NHS trusts in England to implement upfront charging from October that year.
    "It published a summary of its findings late last year. However, it has still not published the reports themselves ..."

  • Can we import improvements from industry to healthcare? BMJ article brings critical approach, noting that "Recounting oversimplified improvement examples from other industries (often aviation) can provoke considerable frustration and scepticism among clinicians exposed to the unique challenges and everyday complexities of trying to improve healthcare. Patients are not aeroplanes, and hospitals are not production lines. Nonetheless, many successful efforts to improve the quality and safety of healthcare have taken inspiration from other industries."

  • Are public–private partnerships the future of healthcare delivery in sub-Saharan Africa? Lessons from Lesotho Free access BMJ article by Mark Hellowell on the first, notorious PFI-style hospital project in Africa "highlights several beneficial impacts of the transaction, including the achievement of high clinical standards", as well as "a range of key challenges—in particular, the higher-than-anticipated costs to the Ministry of Health."

  • Oxford hospital trust faced defamation threat from NHS More revelations on the determination of NHS England to force through a privatisation of PET-CT scanning service in Oxfordshire despite opposition of NHS consultants, trust board, staff and politicians of all parties. At the same time as NHSE claiming to want to end competitive tendering.

  • Liverpool hospital workers demonstrate over plans to withhold pay Union News reports:
    "Unite members are today spearheading a demonstration to protest against cleaning contractor ISS’ plans to withhold pay from low-paid hospital staff at the Royal Liverpool Hospital and Broadgreen Hospital.
    "ISS, Europe’s largest commercial provider of cleaning and one of the world’s largest providers of facility services, is moving staff from weekly pay to fortnightly pay and changing pay dates after introducing a new payroll system."
    GMB members are also involved in the campaign.

  • Elderly go blind as NHS ignores eye surgery rationing advice Times report, based on research warns that
    "Tens of thousands of elderly people are left struggling to see because of an NHS cost-cutting drive that relies on them dying before they can qualify for cataract surgery, senior doctors say.
    "The NHS has ignored instructions to end cataract treatment rationing in defiance of official guidance two years ago, a survey by the Royal College of Ophthalmologists has found."

  • NHS patients have cancer scans cancelled after supplier problems Guardian report says
    "Concerns have been raised that problems related to the supply of a substance used to screen for cancerous cells is causing delays for NHS patients in England, with many exposed to repeated cancellation of scans at short notice.
    "Choline is a radiotracer injected into patients an hour before PET-CT scans, predominately when patients are feared to have a recurrence of prostate cancer. Without it the scans cannot go ahead.
    "The worries surrounding its availability come as waiting times for cancer patients in England are at a record high, with almost one in four patients not starting treatment within the two-month target period."
    Scans using an alternative chemical are currently only available from the private sector at costs of £1500 or more.

  • When A Nurse Is Prosecuted For A Fatal Medical Mistake, Does It Make Medicine Safer? The answer is clearly 'no', and this US report highlights a common problem.
    "The American Nurses Association issued a statement criticizing the charges, saying that "the criminalization of medical errors could have a chilling effect" on health care workers' willingness to report errors.
    "The phenomenon of criminally charging health care providers after a patient is harmed is rare, "but it grows less unusual every year," says Stephen Hurley, a Wisconsin lawyer who has defended nurses in similar cases and advised hospitals on the topic.
    Most high-profile cases tend to involve death, a significant injury or a patient well-known in the community, he says. And prosecutors tend to focus on nurses, he says, rather than physicians or hospital administrators, though he's not sure why."

  • Government orders hospitals not to reveal Brexit impact assessments to protect 'commercial interests' Independent reports: "Requests for information about the impact on the supply of goods and services, and on EU staff numbers, should be refused, the department of health and social care has said.
    "Releasing the information could cause trusts “premature financial harm, and so possibly put public wellbeing at risk,” hospital bosses were told."

  • Commons Health Committee inquiry into NHS waiting times for elective and cancer care Link to send in a written submisssion. The background is explained thus:
    "Between 2010-11 and 2017-18, the number of patients referred urgently for suspected cancer increased by 94%. The NAO report found that, for cancer, this is due to NHS England’s policy of encouraging more urgent referrals to improve early cancer diagnosis; this has improved early diagnosis of cancer and improved survival rates. However, it also found that NHS England’s understanding of the increase in elective care referrals is limited. Nevertheless, the report found that constraints on capacity, including a lack of finance, staff and beds is linked with the decline in waiting time performance."

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