NHS : Privatisation Issues And Related News : Failings / Scandals / Rip Offs

Discuss news stories and political issues that affect carers.
Full patient records to be available online under NHS IT shake-up.

Plans for service in England aim to save clinicians time and cut delays, says government.

All NHS patients in England will be able to book GP appointments online, order repeat prescriptions and access their full medical history on a new cloud system as part of a shake-up of IT systems.

The changes, which aim to replace outdated IT technology and improve digital coordination between parts of the healthcare system, should allow GPs, ambulance services and other primary care providers to access patient records digitally in real time.

The announcement is the first major alteration to the NHS patient record system since a failed £12.7bn digitalisation project to link up the healthcare system, which was scrapped by the Conservative-Liberal Democrat coalition government in 2011.

The project was launched under Labour in 2002 but was beset by changing specifications, technical challenges and disputes with suppliers, leaving it years behind schedule and over budget.

Under the latest plans announced on Friday by the health secretary, Matt Hancock, technology companies will be encouraged to bid for contracts to deliver the changes, which will be regulated by new standards and minimum requirements developed by NHS Digital.

The government hopes the changes will save clinicians time and reduce delays, while also allowing GP surgeries to pick from a wider range of IT systems providers.

Hancock said: “Too often, the IT used by GPs in the NHS, like other NHS technology, is out of date: it frustrates staff and patients alike, and doesn’t work well with other NHS systems. This must change.

“I love the NHS and want to build it to be the most advanced health and care system in the world, so we have to develop a culture of enterprise in the health service to allow the best technology to flourish.

“I want to empower the country’s best minds to develop new solutions to make things better for patients, make things better for staff and make our NHS the very best it can be.”

Sarah Wilkinson, the chief executive of NHS Digital, said: “The next generation of IT services for primary care must give more patients easy access to all key aspects of their medical record and provide the highest-quality technology for use by GPs.

“They must also comply with our technology standards to ensure that we can integrate patient records across primary care, secondary care and social care.

“In addition, we intend to strengthen quality controls and service standards, and dramatically improve the ease with which GPs can migrate from one supplier to another. We are committed to working with existing and new suppliers to deliver these extended capabilities for the benefit of GPs and patients.”

Still , after 10 / 15 years of failure after failure , and £ BILLIONS wasted , light at the end of the tunnel ???
Bed blocking cost in Scottish NHS hits £500 million since Nicola Sturgeon became First Minister.

Bed blocking by patients who are well enough to leave hospital has cost the Scottish NHS more than £500 million since Nicola Sturgeon became First Minister, according to a new analysis.

Labour said official figures showed 2.1 million bed days were lost to 'delayed discharge' between November 2014, when she succeeded Alex Salmond, and October 2018.

With health service statisticians estimating that each day costs the NHS £234, the party said the total burden has reached £500.5 million.
More than 50 tonnes of food goes to waste at Mid Yorkshire Hospitals NHS Trust.

According to NHS data, the trust recorded 986kg of unserved food going to waste over one seven-day period in March 2018 - the equivalent of 51.3 tonnes every year.

The figure covers just the excess meals left on the trolley at the end of a meal service, and does not include food that patients leave on their plates when they have finished eating.

It includes starters, main meals and desserts during lunch and dinner, but does not include breakfast.

The government has announced a ten-year plan for the NHS, which includes a commitment to tackle waste.

However, more than 7,130 tonnes worth of meals are currently going in the bin across the NHS in England every year, the data suggests.

Food waste is a “big problem” in the NHS, according to the food and farming charity Soil Association, which campaigns for better food in hospitals.

Rob Percival, policy officer at the Soil Association, said it is often linked to the method NHS trusts use for catering services.

Many rely on pre-prepared meals that are delivered to sites which may not have the freezer capacity to keep any surplus, he explained.

“Trusts should be investing in fresh preparation of meals as opposed to bulk purchasing, which gives catering staff a greater degree of control,” he said.

“Then you won’t be dealing with the scenario where you have 1,000 plated meals delivered but you only have 300 orders from patients and the rest goes in the bin.”

Maisie Borrows, research manager at the Reform think tank, said: “These figures are just the tip of the iceberg and highlight the need for reform.

“All NHS hospitals should strive to be as efficient as the ‘best-in-class’, looking at improving efficiency by harnessing technology and insight from data.”

The Mid Yorkshire Hospitals NHS Trust spent £5.3 million on food services in the 12 months to March, including labour, delivery and management costs.

During this time, there were 1,029,580 meals requested by patients.

This would give an average cost of £15.39 to feed one patient for a day, if no meals were wasted, compared to a UK-wide average of £12.59.

The lowest amount spent by an English trust was £4.20.

According to Mr Percival, ensuring high-quality meals are provided to patients could also help to reduce extra waste from food being left on plates.

“Adequate nutrition is important for a patient’s recovery and a huge amount of plate waste is generated because food is of a low quality - ready-made, reheatable meals that are highly unappetising.

“Freshly prepared meals are generally more appealing, in our experience, whereas pre-prepared meals can be pretty disgusting.

“When you freshly prepare the food it allows the chefs to monitor how much is being left on plates by patients and they can adjust how much they produce.”

A spokeswoman for NHS Improvement said: “While there will be legitimate reasons why NHS trusts spend different amounts on food, ensuring that all patients receive high-quality meals is the priority.

“We have recently launched a Healthcare Food Standards Strategy group to support trusts and drive improvement.”

Worksop hospital spending £14,000 a month transporting children to other sites due to staff shortages.

A Worksop hospital which is struggling to recruit paediatric nurses is having to ferry children to another hospital, at a cost of £14,000 a month.

For more than two years, Bassetlaw hospital has had to close its paediatric unit from 7pm until 8am, seven days a week.

Despite seven recruitment drives last year, the hospital still cannot find enough staff to be able to run the unit safely, so has been forced to close it overnight.

It has since spent £330,000 with a private ambulance company to have an ambulance on standby, ferrying severely ill children to hospital in Doncaster for treatment.

One ambulance is on standby, but others can be called upon if necessary.

It takes 35 minutes to drive between the two hospitals, or on public transport the trip takes around an hour and 20 minutes.

An average of 11 children per week have been sent to hospital in Doncaster since the closure, where there is a 24 hour paediatric ward.

Local Labour councillors have said more needs to be done nationally to address the shortage of paediatric nurses.

Coun Kevin Greaves, who represents Worksop South on Nottinghamshire County Council, said: “There are questions that need answering around the long term and ongoing failure to recruit the appropriate children’s ward nursing staff.

“I believe that the lack of bursary available for potential trainee nurses is, in part responsible for this failure.

“Aside from this it makes no financial sense for Bassetlaw hospital trust to pay £14,000 a month for an ambulance to be on standby to facilitate transfers of children overnight.

“At this stage that figure is in excess of £330,000 which could have been used to ensure that sufficient nursing staff were available at the hospital overnight.

“Instead a vast majority of this cost goes towards overnight accommodation for ambulance personnel at the local Travelodge.

For parents needing public transport ... local bus ... 2 an hour / nothing after 5pm ... 1 every 2 hours on a Sunday / Public Holiday ... and £ 6.20 return ... almost one tenth of Carers Allowance !
NHS hospitals overspend by up to £141m a year.

Underfunding and staff shortages are among reasons for deficit, says watchdog.

Some hospitals are overspending by as much as £141m a year due to NHS underfunding, staff shortages and demand for care, according to Whitehall’s spending watchdog.

King’s College healthcare trust, which runs two hospitals in London, ended last year £141.4m in the red – the biggest deficit among England’s 232 trusts that provide services.

Ten trusts recorded a combined deficit of £758m in 2017-18, which was 69% of the £991m loss that trusts collectively posted, the National Audit Office (NAO) said.

Another London trust, Barts Health, had the second largest deficit – £108.8m – while the United Lincolnshire hospitals trust was £81.23m in the red.

In addition, the Department of Health and Social Care had to make £3.2bn of emergency loans to trusts in acute financial distress. This was an increase of £2.8bn on the previous year.

Growing numbers of clinical commissioning groups, the bodies that hold the NHS budgets in local areas, are also spending more than they receive. Together they overspent by £213m.

After eight years of tiny annual budget increases, the health service as a whole is carrying an underlying deficit of £4.3bn, the NAO said.

The figures show that the NHS in England is grappling with budgetary problems that are unsustainable, the NAO concluded in its annual review of health service finances.

The watchdog said it welcomed the government’s pledge to increase NHS funding by £20.5bn a year by 2023-24 after years of the service struggling to meet soaring demand while receiving tiny budget uplifts since 2010.

It warns, however, that a series of risks and conspicuously widespread understaffing threaten to undermine the NHS’s ability to deliver the ambitious plans to improve care set out in the long-term plan it published last week.

The NAO’s report stated that: “Difficulties in recruiting NHS staff presents a real risk that some of the extra £20.5bn will either not be used optimally – more expensive agency staff will need to be used to deliver additional services – or will go unspent as even if commissioners have the resources to commission additional activity, health care providers may not have the staff to deliver it.”

It also warns ministers that continuing to cut spending on public health, capital projects and medical education and training, in order to give the NHS more money for frontline care, “could affect the NHS’s ability to deliver the priorities of the long-term plan”.

Richard Murray, the chief executive of the King’s Fund, said hospitals were not to blame for overspending, even by sums as large as £141m.

Murray added: “Despite some NHS trusts being in the red by more than £100m, NHS Improvement aims to clear all provider deficits within two years. Complex NHS finances are bedevilled by short-term fixes, fragile workarounds and unrealistic expectations that leave some trusts in significant deficit whilst others are in significant surplus.”

Anita Charlesworth, the director of research and economics at the Health Foundation, said: “Workforce shortages are the greatest threat to delivering high-quality care to all those who need it. But spending on training and education has fallen by 17% in real terms over the last five years.”

A government spokesperson said: “The long-term plan, backed by a significant funding increase of £20.5bn a year by 2023-24, rightly sets out that putting the NHS back onto a sustainable financial path is a key priority and is essential to allowing the NHS to deliver further improvements in care.”

The closest institution we have the proverbial " Money pit ? "

No matter how it's organised , always tends to run out of monies.

Add Social Care if it were ever under one roof !


Yep , general concensus emerging :
NHS not sustainable and Theresa May’s £20.5bn funding pledge won’t fix it, NAO warns

Auditors confirm ‘worst fears’ that NHS plan will fall flat without solution to staff and social care crisis
Deaths of up to 250 patients reviewed at " Toxic " heart unit.

The deaths of up to 250 patients who died following heart surgery at an NHS hospital are to be reviewed.

All the patients underwent surgery at St George's Hospital in Tooting, south London, between April 2013 and September 2018.

The review, commissioned by NHS Improvement, comes after the hospital suspended complex heart surgery last year to improve services.

A leaked report previously suggested that poor relationships at the cardiac unit contributed to a higher mortality rate.

The panel will also review deaths between April 2017 and September 1 2018, a period during which improvements were being introduced by the trust.

The trust said families of cardiac surgery patients who died during the review period will be contacted if the panel identifies "any significant concerns about their care".

Jacqueline Totterdell, chief executive at St George's, said: "It is absolutely essential that patients and their families have full confidence in the care our cardiac surgery team provide - and this review of past deaths will be a key part of that process."

The review only applies to cardiac surgery at St George's, and does not include other associated specialities - for example, cardiology.

The panel will examine the safety and quality of care that patients who died during or after cardiac surgery at St George's received during the review period.

They will do this by reviewing the medical records of deceased cardiac surgery patients, as well as any investigations conducted by the Trust at the time of the patients' deaths.

The panel is likely to review between 200-250 deaths as part of this process, which will take place between six and 12 months to complete.

Last summer a leaked report warned that a "toxic" feud between two rival camps at the unit left staff feeling a high death rate was inevitable.

St George's Hospital heart unit was consumed by a "dark force" and patients were put at risk, the investigation concluded.

The damning review was written by former NHS England deputy medical director Mike Bewick in response to higher mortality rates at the hospital.

He found the south London facility had a cardiac surgery death rate of 3.7 per cent - above the national 2 per cent average, reports said.

Internal scrutiny was said to be "inadequate" and the department was riven between "two camps" exhibiting "tribal-like activity".

Professor Bewick's review was quoted as saying: "Some felt that there was a persistent toxic atmosphere and stated that there was a 'dark force' in the unit."

Conversations with 39 members of staff revealed they were shocked by the death rate, but "most felt that poor performance was inevitable due to the pervading atmosphere".

The independent reviewer examined "disturbing and often difficult information", concluding an "existential threat" was posed to the unit because staff and patients would go elsewhere if problems persisted
Just a headline and a brief extract from the article ... that's all that's needed for this one :
NHS memo reveals two patients died after waiting for A&E care.

Deaths in Redhill and Margate occurred after patients had to wait because A&E was too busy.

Two patients have died this month after having to wait in hospital corridors with paramedics because staff in A&E units were too busy to care for them, the Guardian can reveal.

The deaths have come to light in a memo, seen by the Guardian, that the South East Coast ambulance service (Secamb) sent to its crews last week. Its personnel looked after both patients before they collapsed.

The memo was sent last Tuesday, 22 January. It says: “In the last week we have had two incidents where patients have died in hospital corridors.” Full details have not yet emerged, but it is known that the deaths occurred in the week beginning 14 January at Queen Elizabeth the Queen Mother hospital in Margate, Kent, and East Surrey hospital in Redhill.

Inquiries by the Guardian have established that while the patient at the Margate hospital did die in a corridor, the patient at East Surrey hospital – an elderly woman – became seriously ill in a corridor near A&E and died in the unit’s resuscitation area despite efforts by medical staff to save her.

The Secamb circular tells crews to ensure they fill in “delayed handover forms” as soon as they have been waiting 15 minutes to hand a patient over to A&E staff. It says this is necessary because “these forms are documented evidence that you are monitoring your patient and if anything does happen, it may highlight any early deterioration occurring”.

It adds: “Incidents like this are classed as serious incidents and are investigated by both the hospital and Secamb, so we need to ensure that we are doing our bit and that it is not our fault.”

Figures show that of the 4,795 patients who have arrived by ambulance at the hospitals run by the Surrey and Sussex Healthcare NHS trust, including East Surrey, so far this winter, 974, or one in five, have had to wait at least half an hour with paramedics until they could start their A&E care, and 225 had a delay of more than hour.

Buck passing , perhaps ?

Not all's well in that NHS dressing room ... the team are not functioning as a team !

Second half to come ... 0-3 down ... switch to 4-3-3 or stick with 3-4-1-2 ... ???
One from Norfolk ... a recurring theme ... when the best laid plans to improve things lead to the opposite ?

Even more so when one looks at the figures ?

Healthcare plan for region was " Over optimistic " as £96 million deficit is revealed.

Health bosses have admitted a plan to overhaul services published in 2016 was “Over optimistic " as it was revealed the budget for Norfolk and Waveney was £96 million behind where it should be.

The Sustainability and Transformation Partnership (STP) for Norfolk and Waveney was launched in 2016 - at the time the aim was to save £300m by 2021, and by 2018/19 the system was meant to be £4.7m surplus.

But Patricia Hewitt, former health secretary and independent chair of the STP, said: “It’s very clear that early plan was over optimistic.

“People were just adding up lots of different numbers from lots of different fragmented bits of the NHS.

“Because we’ve now got a much better understanding of what is driving the problem, we’ve got a much better chance of putting in place integrated plans including a financial recovery plan that will deliver in better outcomes and better quality of care for the people of Norfolk and Waveney.”

The £96m overspend is after £78m of savings were made across Norfolk and Waveney providers in 2018/19, and Mrs Hewitt put it down to demand increasing even more than experts predicted three years ago.

The STP paid consultancy firm Boston Consulting £500,000 to look into where there were issues and how to bring down the deficit.

And although that work had finished a new plan was not expected until around September.

She said: “What we now know from this very detailed work with Boston Consulting is actually as we change the whole system and as each of our three acute hospitals becomes as efficient and effective as they can, but they also work more closely together, we actually can make the whole system sustainable.”

However, Mrs Hewitt said more beds would be needed in the county’s hospitals to cope with growing demand.

She said: “We will need some more acute hospital beds in a couple of years time, but that’s not the main problem, we’ve got a much stronger plan.

“But we also have three trusts in special measures and a lot of change going on in the system.”

Mrs Hewitt also revealed new plans for 20 primary care networks in Norfolk areas.

There is already one up and running in Norwich, the OneNorwich partnership, where GP practices work together.

But this was set to be expanded to include things such as mental health support, social workers, and voluntary groups, to provide more support.

The aim is for GP practices within each network to work in partnership with each other and other professionals in community and social care to deliver care that is more joined up and delivered closer to home.

Mrs Hewitt said: “It’s just a way of making sure we build our community services around primary care to enable far more people to get the care they need close to home and in their own home.

“We have to keep people out of hospital wherever we possibly can and we need early intervention for those with mental ill health.

“It’s much better to intervene and give people the right support early.”

It is hoped the networks will pave the way for the STP to become an integrated care system (ICS).

The partners previously applied to become an ICS but their application was rejected.

However under the NHS’ long term plan all areas will eventually become an ICS.

Mrs Hewitt said the reason the STP missed out on becoming an ICS last year was due to the financial plan.

She said: “It did not go wrong, we just were not ready, we needed a much stronger financial plan and a much stronger understanding of why we’re in deficit.”

But she said there were lots of successes which meant Norfolk and Waveney was now ready for the change.

She said: “One of the biggest achievements of our STP cannot be measured by numbers and spreadsheets.

“We have brought health, social care and public health partners in Norfolk and Waveney together in a way which was not in place before.

“We are building closer bonds and confidence in each other which will help us in our ultimate vision to become an ICS.”

She said millions of pounds had also been attracted to the area because of partnership working, including £1.3m for cancer services, £2.1m for winter reliance schemes, and £585,000 for the central Norfolk wellbeing hub.

Whoops ... and if repeated nationwide ?

It's everyone's monies here ... NHS funded through general taxation.
The NHS lives by co-operation. The privatisers are still trying to wreck it.

The competition authority has no place in a state-funded health service. That should be blindingly obvious, but it’s not going quietly.

Some bad ideas are very hard to kill.

The NHS in England is finally trying to strangle the notion that competition between hospitals is like competition between supermarkets, an anti-cartel spur to quality and low prices. But, zombie-like, the competition mania keeps being resurrected by those who think nothing works without red-in-tooth-and-claw markets. This ideological fight has battered the NHS for decades.

The latest NHS England 10-year plan is all about urging everyone into closer collaboration between community, GPs and hospitals, and – at a stretch – social care too, without pointless duplication or destructive competition for staff and resources. With lengthening waiting lists, where’s the spare capacity to compete for patients? If that sounds like blindingly obvious common sense, it isn’t to privatisers and marketisers.

A bit of history: the Cameron-Clegg coalition appointed Andrew Lansley as health secretary to turbo-charge NHS private competition. Sarah Wollaston, now health select committee chair, called it “throwing a hand grenade” into the NHS. Lansley’s 2012 Health and Social Care Act blew the service into fragments, opening everything by law to private as well as NHS bidders. The Competition and Markets Authority (CMA) oversees enforcing competition to ensure the likes of Richard Branson’s Virgin Care can – as it has – sue the NHS if any service is not put out to tender. This chaos is colliding with the harshest NHS funding cuts in its 71 years.

The NHS England plan calls for an end to the CMA’s role in the NHS – and quite right, too. It has no place in a state-funded service. But, as the Health Service Journal reports, the CMA is not going quietly – and it has the law on its side.

Since Simon Stevens became head of NHS England, he has striven to stitch Lansley’s fragments back together, to create collaborative, joint NHS and social care structures locally, not competing but cooperating. That’s proving a hard ask as it means tiptoeing around the law that enforces competition. Stevens wants a new health bill to abolish the CMA role, but this paralysed government dares not reopen the Lansley catastrophe in parliament. And the CMA is striking back.

It has produced a shock report that claims a massive death toll will result from taking competition out of the NHS. If true, these findings suggest patients are dying like flies in areas where hospitals merge or which only have one hospital: it claims a merger resulting in a monopoly increases mortality by a staggering 550% and adds 182% to other harms, such as ulcers and blood clots.

Nigel Edwards, head of the Nuffield Trust, fulminates against the report’s conclusion, calling it “completely illegitimate”. He tells me: “It’s purely hypothetical, based on a hypothetical hospital and hypothetical patients, viewed only through the lens of competition.”

In the real world, doctors, managers and patients don’t behave like an economist’s perfect competitive template. Doctors and nurses in charge of wards, we hope, check their success rates against the average – but don’t see themselves locked in combat with a nearby hospital: the patient problem is too many, not too few. Nor do patients do much choosing – most prefer their local, or else are carried there in an ambulance. Areas with no competition are mostly rural or hard-pressed district generals, struggling to recruit top staff, scoring worse than clusters of big city teaching hospitals – it’s nothing to do with the magic of competition.

In the real world, mergers usually involve a failing hospital taken under the wing of a thriving one: I just visited Ipswich, which has taken over previous basket-case Colchester. Its joint chief executive, Nick Hulme, is a respected troubleshooter who says: “It’s a nonsense for the NHS to be subjected to the CMA.” Colchester had the third worst A&E, but after the merger is now in the top 10.

Hulme is not closing units, but says mergers spread out top specialists and cut suppliers’ prices while attracting more staff and junior doctors to better careers across two hospitals and community services, now merged as well. Competition, he says, has nothing to do with it. He adds, with a laugh, that research shows no mergers happen in marginal seats: how does the CMA factor politics into its model?

The CMA is the essential protector of the public interest against cartels and monopolies in real private markets – but has no place in a capped, fixed-price, collaborative NHS. One of its first malign interventions was to stop two struggling hospitals, Bournemouth and Poole, from sharing services as it would “damage patients’ interests by eliminating competition and choice”. Six years later, the CMA was finally overruled, so the hospitals are now merging to collaborate.

The CMA only sees the world through the monocle of competition: it has a hammer so everything looks like a nail. But NHS statistics are notoriously tricky, correlations rendered meaningless by unmeasured other causes. For example, a frequent measure of failure is the number of readmissions to hospital. But recent research finds that 40% are due to success: these are frail people who used to die, but now live to be admitted more often.

So cast a cold eye on the multiple correlation/causation statistical problems in the competition authority’s self-serving scare report. Remember, the NHS will always be under threat from ideological competition merchants and privatisers. Incidently, as some NHS wags point out, if the CMA thinks nothing works without cut-throat competition, how come there’s only one CMA? That august organisation was itself the result of a merger.

• Polly Toynbee is a Guardian columnist
A&E waits at worst level for 15 years.

A&E waits in England have reached their worst level since the four-hour target was introduced in 2004.

The deterioration in performance came after hospitals appeared to be coping well in the early part of winter.

During January, just 84.4% of patients were treated or admitted in four hours - well below the 95% threshold.

It means nearly 330,000 patients waited longer than they should with hospitals reporting significant problems finding beds for those needing to be kept in.

More than 80,000 patients were kept waiting an extra four hours or more to be transferred to a ward after their wait in A&E.

All this comes despite relatively low levels of flu.