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  • 'Considerable risk’ over trust’s future warns NHSI (£) HSJ article flagging up the parlous state of the Brighton and Sussex University Hospitals Trust, noting NHS Improvement's warning that:
    "“It is therefore critical that the trust has a robust and stretching medium-term financial recovery plan in place.”
    Despite NHS Improvement agreeing that the trust has taken "effective action" to address its governance failures since the undertakings of March 2017, it argues that "further improvements are required."
    Indeed the trust reported 160 12-hour trolley waits in January and February this year while performance against the four-hour accident and emergency standard dropped to 76 per cent in February.
    There are so many other unresolved failures and poor standards that the question arises of how the Trust could have been let out of special measures and categorised as "good".

  • STP plans to axe all trauma services at DGH (£) HSJ picks up on yet another irresponsible plan from the cash-strapped and poorly-led Cambridgeshire and Peterborough STP, which after touting round the begging bowl to help reduce its deficit is now moving to finally kill off the A&E at Hinchingbrooke Hospital (which local people were promised would be preserved in the 'merger' with Peterborough City Hospital 20+ miles away).

  • NHSE declares emergency over IV shortage Shaun Lintern in the (£) HSJ breaking a story only later picked up by the BBC:
    "The shortage of intravenous feed supplies affecting hundreds of patients across the country has been declared a national emergency incident by NHS leaders.
    "The situation is so serious the NHS is considering importing supplies from other countries to meet the needs of patients who depend on the feed for survival.
    "Patients whose bodies can no longer digest normal food are reliant on intravenous feed known as total parenteral nutrition, or TPN. Some are already enduring long waits for deliveries of their prescriptions.
    "HSJ has spoken with some patients who have gone several days with no feed at all after restrictions were imposed on the manufacturer, Calea, by the Medicines and Healthcare products Regulatory Agency last month. Several patients, including one child, have been admitted to hospital because they were effectively being starved of vital nutrients."

  • Ebola now curable after trials of drugs in DRC, say scientists Guardian story highlighting the immense progress that can be made where sufficient resources and new drugs can be deployed against Ebola:
    "One of the biggest obstacles in fighting the year-long DRC outbreak, the second biggest ever and now with 2,800 cases, has been the reluctance of those who fall sick to seek treatment.
    "It has not helped that the chances of survival have been low – up to 70% of those infected in the DRC have died. Muyembe said many people saw family members go into an Ebola treatment centre and come out dead.
    “Now that 90% of their patients can go into the treatment centre and come out completely cured, they will start believing it and building trust in the population and community,” he said.

  • Summer in the City Is Hot, but Some Neighborhoods Suffer More New York Times reminder to climate change deniers that ill health from excess heat is a problem that affects the poor more than the rich:
    "As the United States suffers through a summer of record-breaking heat, new research shows that temperatures on a scorching summer day can vary as much as 20 degrees across different parts of the same city, with poor or minority neighborhoods often bearing the brunt of that heat."
    "Buildings and paved surfaces – like major roadways, uncovered parking lots and industrial zones – amplified heat, while large parks and other green spaces cooled down the surrounding areas. In cities like Baltimore and Washington, some of the hottest temperatures were recorded in dense residential neighborhoods with little tree cover and plenty of asphalt to absorb and radiate solar energy.
    "As climate change makes summers hotter, the health risks associated with these hyperlocal heat islands will grow. "

  • This is the power of nurse solidarity! Video from California Nurses Association shows how, even though Nevada state doesn't have SafeStaffing laws, solidarity from California union RNs helped nurses at Saint Rose Hospital in Henderson, Nevada win nurse-to-patient ratios in their union contract.

  • NHS staff face growing violence in east London's hospitals Shocking figures from research by the East London Advertiser reveal a rising tide of violent incidents against hospital and NHS staff:
    "There were 331 assaults against staff at the five Barts Health hospitals from April 2018 to March 2019 - 60 per cent more than the 12 months from April 2015, which saw only 206.
    This April to June has been the most violent over the past five years, with 98 recorded assaults. In 2018 there were 84 over the same period and only 50 during that period in 2017.
    The figures, obtained through a Freedom of Information request by this paper, revealed that Newham Hospital has seen 231 assaults since April 2015, Mile End saw 22 and St Bartholomew's saw 89."
    Over the past five years the worst hospital for assaults was the Royal London Hospital in Whitechapel, which had 504 incidents.

  • Australian junior doctors launch legal action against managers over working conditions (£) BMJ report on "The alleged plight of the doctors at Melbourne’s Sunshine Hospital", which has become "the latest instalment in a growing list of complaints among doctors in training over excessive workload pressures, exploitation, harassment, and bullying across the country’s public hospital system."
    According to the Australian Medical Association in Victoria, under the enterprise agreement setting minimum terms and conditions with the hospital, registrars are contracted to work 43 hours a week: but this total includes five hours that must be used for clinical training time.
    "AMA Victoria is now representing the registrars by taking Western Health, which runs Sunshine Hospital, to the Fair Work Commission."

  • Privatisation by stealth Fabian Society platform for a hard hitting article by Oxfordshire KONP campaigner Liz Peretz, slamming the ruthless top-down privatisation of PET-CT scanning services in Thames Valley by NHS England, riding roughshod over any serious consultation and near-unanimous protest from local politicians of all parties.

  • Does Boris Johnson’s NHS funding boost add up? Critique in Prospect magazine by Ruth Thorlby of the Health Foundation indicates how wide is the distrust and disatisfaction with Johnson's cynical pre-election handout to the NHS from the magic money tree.

  • Get ready to charge EU citizens under no-deal Brexit, NHS bosses told (£) Times reports yet another unpleasant xenophobic policy that is threatening to undermine our NHS in the event of a no-deal Brexit. It's bad enough diverting front line staff and admin resources into checking passports and IDs: medical royal colleges and campaigners have already been campaigning against this policy and its potential impact on health. But if this petty nastiness also triggers a retaliation and charges imposed upon the millions of citizens cashing in on free care in Spain and other EU countries, it could trigger a wholesale influx of expats and a massive new unfunded burden on our NHS and other public services.

  • NHS staff in Bradford go on ‘indefinite’ strike over ‘backdoor privatisation’ fears Extended article giving the background to the Bradford hospital strikes which are set to escalate to indefinite action from August 26. Health Campaigns Together is holding a solidarity rally outside Bradford Hospital that day (see Calendar of events)

  • Average GP waiting times exceed two weeks for first time ever Another excellent and widely repeated story from Pulse magazine, flagging up findings from their annual survey:
    "The average wait for a routine GP appointment is now more than two weeks, for the first time ever, according to Pulse's annual survey of waiting times.
    "A midpoint analysis of data from the survey of 901 GPs across the UK found that the average waiting time is now 15 days - the first time it has ever exceeded a fortnight.
    "More than 22% of GPs said that the wait for a routine appointment was more than three weeks, with 6% said that it was longer than four weeks.
    "This follows the news earlier this year that there was a 15% increase in month-long waits for GP appointments, according to the BMA."

  • For sale to the highest bidder? Future trade deals and the NHS Discussion piece by Kate Ling for the NHS Confederation, which includes private providers, correctly points the main finger of responsibility at government:
    "Operating on World Trade Organisation (WTO) terms after leaving the EU won’t force commissioners to invite bids from overseas companies to provide NHS services. It will be for the Government of the day to choose, when negotiating, what kind of services foreign providers can bid to supply. "
    But of course many people would be less than confident that a right wing Johnson-led government would have any hesitation in signing over sections of the NHS if that seemed to them useful in a post-Brexit trade deal with Trump's USA.
    Ms Ling goes on "Ideally, exclude publicly funded healthcare services completely from the scope of a future free trade agreement (FTA)."
    Sadly she then weakens the statements to concede "Or, if they are within scope, explicitly exempt them from commitments that would, for example, oblige the NHS to allow the trading partner’s companies to bid for NHS business (we would prefer this to be a choice, not an obligation)."
    Campaigners have seen too many CCGs and trusts choosing to privatise, despite strong arguments and protests from staff and public. We can't rely on the Confed to stand up for a publicly-owned and accountable NHS.

  • UNISON BRADFORD HEALTH-STOP THE WOS-STRIKE FUND Link to contribute to the biggest current set-piece confrontation with trusts' plans to hive off NHS support staff into tax-dodging "wholly owned subsidiaries"

  • Boris Johnson pledges £250m for NHS artificial intelligence Guardian reports that despite huge unresolved backlog maintenance and many staff struggling to cope with clapped out and painfully slow computers, the government has "announced its third successive hand-out to the NHS in as many days with a pledge by Boris Johnson of £250m to be invested in artificial intelligence."
    However in a critique of this decision Roy Lilley quotes Rashik Parmar, a the leader of IBM's European technical community and previously President of IBM's Academy of Technology, who has spent his whole career immersed in technology and artificial intelligence arguing “... there is no such thing as 'artificial intelligence'... not yet and not in the foreseeable, that we can use to improve healthcare.”
    Lilley comments: “Machines digest the people's data we feed them along with our prejudices, preconceptions and predilections. They swallow it all and regurgitate facts, analysis, history and take a stab at the future. They can make predictions. It doesn't make them intelligent.”

  • Suicidal student jumped off building after crisis team told her 'sound, you can go' Worrying Mirror report on case of a student who tried to leap to her death from a hospital car park after being discharged in the middle of the night by mental health workers she claims she had warned she was suicidal.
    The Mirror points to the link with previous failures by Mersey Care NHS Foundation Trust adequately to assess or respond to the distress, resulting in further suicide attempts:
    "another woman … had thrown herself from the building after being admitted following an overdose. … a man in his 40s fell from the second floor after being sectioned.
    "Sophie, who hopes to work as a mental health nurse, said she would have been seen as high risk after a similar suicide attempt around three months before the fall, when she took an overdose while an inpatient at Clock View Hospital in Walton."

  • Leading ophthalmologist vows to stamp out “unjustified” screening for cataract surgery (£) BMJ article publishes research to show that:
    "patients with cataracts are being screened and that those who don’t meet visual acuity thresholds are being denied surgery. This is despite NICE’s guideline, which says that cataract removal is cost effective and should not be restricted to the more severe cases.
    "In 2018-19 more than a fifth (22%) of patients in England who needed cataract surgery were screened, three times the proportion of 7% in 2016-17."
    It quotes Mike Burdon, president of the Royal College of Ophthalmologists, who also chaired NICE’s guideline committee, ho now says it is his mission before he steps down as president in a year’s time to convince clinical commissioning groups (CCGs) to stop rationing cataract surgery and not to label it a procedure of “limited clinical value.” He tells the BMJ that this approach is “unjustified whatever way you look at it.”

  • John Radcliffe Hospital trust 'crisis' as bed occupancy hits 100 per cent Oxford Times highlights the latest phase of the chronic crisis of the county's main hospital, making the point that the problems are exacerbated by huge shortages of staff, including almost 600 nurses:
    "Along with high demand, staffing levels were also so stretched that 16 beds were consistently being temporarily closed for safety reasons due to shortages.
    "As of the end of June there were 1,091 vacancies across the trust, with 588 of them for nursing and midwifery roles."

  • Next week... Roy Lilley puts the boot into Matt Hancock (No. 18), the superficiality of his policies and the fraudulent claims of "artificial intelligence" being used in the NHS.

  • Old Matt, new Matt: Mr Hancock’s diary Some light relief from the gloom of a Johnson dash to no-deal chaos: a very amusing spoof blog by Matt Hancock -- or is it really him?

  • US will be 'on doorstep' ready to sign UK trade deal after Brexit, says Pompeo Guardian article underlines determination of the Johnson government to turn to the US after Brexit, regardless of the cost and onerous strings attached.
    "The secretary of state, Mike Pompeo, has said that the US will be “on the doorstep, pen in hand”, ready to sign a new trade deal with the UK as soon as possible after Brexit.
    Pompeo was speaking alongside Dominic Raab, who was making his first trip to Washington as UK foreign secretary. Raab restated the British government’s determination to leave the EU at the end of October, and claimed that Donald Trump, whom he met at the White House on Tuesday evening, “was effusive in his warmth for the United Kingdom”.

  • Vital asthma and diabetes drugs could cost 7 times more in new Donald Trump deal Mirror article underlines another potential nightmare aspect of a no-deal Brexit forcing a supplicant British government to sign an exploitative trade deal with the US:
    "President Trump and senior members of his cabinet have said they are tired of ‘foreign freeloading.’
    "They say any new trade deal should bring prices into line with those in the US - which is bad news for the NHS.
    "Stats show the world’s top twenty best selling prescription were over three times more expensive in the US than in the UK."

  • Treat NHS patients in private hospitals to cut waiting lists, government urged For some reason The Independent has chosen to rehash the latest press release and PR spin of the private hospital sector, seeking to cash in further on the growing delays and waiting lists for NHS treatment:
    "According to analysis of council tax data by the Independent Healthcare Providers Network, […] about one in six households in England are likely to contain someone stuck on an NHS waiting list.
    The body is calling on the government to make better use of spare capacity in the private sector to cut waiting times."
    They would wouldn't they? With numbers paying for individual private health insurance static, and private hospitals dependent on NHS-funded patients to fill their otherwise empty beds, you would expect their trade association to lobby for even more lucrative work.
    The Indie report initially referred to the profit-hungry IHPN lobbyists as "campaigners", but has, fortunately corrected this error, as a footnote admits.

  • Combined Performance Summary: June – July 2019 The Nuffield Trust's Jessica Morris updates us with yet another series of summaries and graphics indicating the continued crisis of NHS provision. Note especially that:
    "In July 2019, 13.5% of people attending A&E spent more than 4 hours from arrival to admission, transfer or discharge – the worst performance for any July on record. There has been a sustained worsening of about 3 percentage points over the last four months compared to the same time last year.
    "The total number of A&E attendances exceeded 2.2 million in July 2019 – the highest number ever recorded. The average number of A&E attendances per day spiked at over 73,000."

  • NHI Bill to be released on Thursday Business Live magazine highlights historic moves in South Africa towards a much-needed universal health coverage:
    "The long-awaiting National Health Insurance (NHI) Bill will be introduced to parliament on Thursday, according to the health minister’s spokesperson, Lwazi Manzi.
    "The bill is important because it is the first piece of enabling legislation for the government’s ambitious plans for implementing universal health coverage, which it calls NHI.
    "A draft NHI Bill was released for public comment in June 2018, and then revised before being submitted to cabinet. The updated version, which has yet to be released to the public, was approved by the cabinet on July 10. It is expected to contain proposals for establishing an NHI fund, which will purchase services on behalf of patients from accredited public and private sector providers."

  • Babylon’s GP at Hand model risks ‘destabilising’ care, professor warns Digital Health turns to expert Prof Martin Roland for a sensible assessment of the impact of GP At Hand:
    "Babylon’s GP at Hand model risks “destabilising” care for patients with the “greatest need” if it continues to expand, a professor of health services has warned.
    He has warned the digital provider only attracts the “fittest patients” and that this leaves traditional GP services "struggling to look after those with more complex needs."
    "The problem lies in the way GP surgeries are currently funded, he told Digital Health.
    “GPs are largely paid by capitation, for example, for the number of patients on their list. Now imagine a situation where all patients attracted an equal capitation fee and the fittest half of a practice’s patients suddenly joined GP at Hand,” he said.
    “The practice would be left with half their income but would still have to look after the sickest patients. That would clearly destabilise care for those in greatest need as GPs would no longer have the income to support the doctors, nurses and other staff needed to look after them.”

  • Boris Johnson’s pledges on NHS investment need a full examination (£) Financial Times comment from Health Foundation boss Anita Charlesworth argues that new buildings should not be a priority for the capital-starved NHS:
    "Since 2017, 145 new spending schemes for hospital beds, buildings, medical equipment and information technology have been announced — that’s an average of more than one a week, totalling £2.5bn. But a recent analysis by the Health Service Journal found that less than £100m of this promised funding has actually reached the front line. There have been few, if any, ribbons to cut."

  • NHS needs reform, not another cash boost, to fix its ails Yet another reactionary blast of neoliberal ideology from the obscurely-funded IEA and its annoying American spokesperson Kate Andrews, which will almost certainly be further amplified by repeated appearances on various BBC 'news' outlets.
    The only unusual aspect of this latest re-run of the same old hackneyed nonsense is that the IEA is having a pop at Prime Minister Johnson's pre-election bribe of a £1.8 billion increase in NHS capital funding. While every analyst who knows anything argues it is not enough, Andrews argues the NHS should not even get this much!

  • The next Windrush: Relentless Home Office immigration fees try to drive out young Brits Politics.co.uk highlights the growing scandal of institutionalised racist policies implemented by government departments following on Theresa May's brutish "hostile environment".
    "Young migrants who've grown up in the UK are being driven into poverty by soaring fees, a neverending application process and kafkaesque examinations of national identity.
    "Fees have trebled since 2014, driving some young people into poverty. "They are charging people who are already vulnerable and have little money an extortionate amount," says Andrella, 20.
    "Limited leave to remain is granted in 30-month chunks, and has to be renewed to a strict timetable, each time with a new extortionate fee of £2,033. If a form is submitted late or incomplete in any way, it will likely be refused and the applicant loses their lawful status. It is only after ten years of unbroken limited leave to remain, that people can apply to be officially recognised as permanently settled in the UK."

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