Monthly Archives: March 2015

KONP Updates Part 2

Monitor could be asked to examine £350m contract. A decision by NHS England to hand more than half of the country’s PET-CT imaging services to one company could be the subject of a formal complaint to market regulator Monitor, HSJ has learned. News of the potential complaint comes after the government was asked in the Commons to reassure MPs that no “undue influence” was brought to bear over the £350m contract. The decision in January to award all four regional lots to Alliance Medical sparked fears over the long term impact of the decision on competition. Concerns have also been expressed by another provider over the near “monopoly” Alliance Medical will have over the provision of PET-CT services in England for the next 10 years, as well as the majority control of production and supply of a radioactive drug known as FDG, which is vital to the PET-CT imaging process. HSJ understands Siemens Healthcare, which is the only other producer of FDG in England after Alliance took control of two other companies in 2013-14, is taking legal advice over the decision by NHS England. The company was not a bidder in the PET-CT imaging tender but could be heavily affected by NHS England’s decision.

The Telegraph

Lancet condemns NHS for creating ‘culture of fear’ in wake of scandals. NHS reforms introduced following the disclosure of serious failings at the Mid-Staffordshire Trust have left staff feeling fearful of persecution, according to a respected medical journal. The stinging editorial in the Lancet criticises the NHS’ efforts to rebuild the reputation of the health service following a string of high profile scandals. The journal has taken the unusual step of publishing its own manifesto for health ahead of May’s general election. The article says: “The regulatory regime created in the aftermath of Bristol, Shipman, and most recently mid Staffordshire, has created a culture of blame, fear, and intimidation in the UK’s health system.” “Instead of regulation being a means to bring the best out of our health professionals, it is used as a tool to threaten, punish, and harm. The conditions we have created for health professionals in the NHS mean that few people are cherished. “Instead, they are seen as problems to be managed. An obsession with inspection has also blinded us from thinking about health as more than a health-sector issue.” The piece has been timed to create maximum impact ahead of the election, even carrying a distinctive ‘Election UK 2015’ logo, complete with a stylised ballot. An NHS England source said: “It’s a very interesting article. The bit that focusses on the regulatory regime, it’s the Government that sets that up. For us its business as usual, we deliver what’s set out by the Government. There should be an NHS voice in this. But as for why things are the way they are that’s Government policy.” The editorial calls for a more open-minded approach to the issues facing the NHS, demanding “immediate action to improve the interface between general and emergency medicine”, describing the current situation as “atrociously poor”.

The Guardian

Focus on targets in NHS poses threat to patient care, says thinktank. A “targets and terror” approach to ensure large hospital A&E departments in England treat, admit or discharge 95% of patients within four hours may undermine their care, a former senior NHS official has said. The micro-management culture within the NHS and Department of Health coupled with increasingly tight budgets will hasten the point at which entire urgent care system reaches breaking point, says Nigel Edwards, chief executive of the Nuffield Trust thinktank. Senior managers in hospitals are so busy collecting information on how they are doing each week to satisfy regulators, NHS bosses, health commissioners and politicians that they are not sorting problems on their own frontline, Edwards and two co-authors claim in a briefing paper. Major A&Es have not hit the 95% mark since summer 2013 despite all the attention paid to weekly figures in recent months, they say. But emphasis on the four-hour measure distorts the picture of how big hospitals are doing in the face of a 12% increase in attendances at their A&E units and a 27% increase in emergency admissions in a decade. The A&E rise is “entirely in line with what would be expected based on population growth”, according to the paper, which warns that 17,000 extra hospital beds could be needed by 2022 unless more could be done to treat people outside hospital. The NHS response was based “on the anxiety of the hierarchy rather than on the care of patients and the flow of patients through the system”, it said.

Hospital Doctor News

Extra A&E funding didn’t reach the frontline. Only 1% of the £700m allocated by the government was spent on staff or other resources in their emergency departments. This is the key finding of research by the Royal College of Emergency Medicine which surveyed 142 clinical leaders in emergency medicine across the UK – representing about two thirds of emergency medicine units. Off the back of the survey, the college has released a report – called Ignoring the Prescription – which finds that implementation of recommendations to reduce the A&E crisis has been patchy at best. Last year, four medical royal colleges and many other organisations met to discuss how to make the urgent and emergency care system more resilient. Their report Acute and emergency care – prescribing the remedy was published in June and was welcomed by the NHS confederation and the Department of Health in England. But progress has been slow despite an additional cash injection of £700m. Less than half of EDs in the UK have fully implemented co-located primary care out-of-hours facilities. Less than a third of departments have an appropriate skill mix and workforce in place to deal with their patient volumes and case mix. It also finds that more than half of departments are not assisted by senior decision makers from in-patient teams at times of peak activity. The College concludes that a combination of failure to implement consensus recommendations coupled with the failure to invest allocated monies in frontline services has led to extraordinary winter pressures which were largely avoidable.

Lancaster Guardian

Sneaky way to privatise. Greater Manchester to control £6bn NHS budget – Greater Manchester is to become the first English region to get full control of its health spending, as part of an extension of devolved powers. Chancellor George Osborne said the £6bn health and social care budget would be taken over by the region’s councils and health groups. Mr Osborne said it was a “really exciting development”. A Labour spokesman said NHS workers would “want to be persuaded of the case for a new layer of management”. The plan will come into force from April 2016. Mr Osborne added: “This is what the NHS wants to see as part of its own future. And it’s also about giving people in Manchester greater control over their own affairs in that city, which is central to our vision of the ‘northern powerhouse’, so it’s a very exciting development.” The plan would see local leaders, and ultimately Greater Manchester’s new directly elected mayor, control how budgets are allocated. The government hopes integrating health and social care services will ease pressure on hospitals and help to improve home care services for patients who need it. A shadow Greater Manchester Health and Wellbeing board will be appointed, which will work closely with existing clinical commissioning groups of GPs. The board is expected to run from April, before control of the budget is handed over a year later. Manchester City Council confirmed 10 local authorities, 12 clinical commissioning groups, 14 NHS partners, NHS England and the government are in discussions on a “groundbreaking agreement for health and social care”. What will happen if Greater Manchester over-spends? And if this ‘Grandiose Plan for the NHS’ is extended to other parts of the UK, who will provide health care, should Greater Manchester, other Health Trusts run out of money? Therefore it begs the question, does it not, that I firmly believe is this – privatisation of the NHS by the back door by the Tory Party, and the only people to benefit will be NHS consultants, GPs and medical manufacturers; and also not forgetting MPs, who will, no doubt, have their snouts in the trough with ‘interested parties’. Therefore, may I respectfully suggest that if David Cameron MP is elected Prime Minister in May will he please confirm his Electoral Pledge of many years ago – ‘that the NHS is totally safe in Tory hands’.


KONP Updates

Thursday 5th March 2015

Charities should be preferred NHS providers, says Andy Burnham.

Charities could get 10-year contracts to help deliver NHS services if Labour wins the general election, the shadow health secretary, Andy Burnham, has told voluntary sector leaders. Not-for-profit care organisations would be given “a form of preferred provider” status under legislation that a Labour government would introduce to replace parts of the coalition’s 2012 Health and Social Care Act. The move would recognise their contribution to strengthening communities. The announcement came as Burnham sought to allay fears in the voluntary sector that his plan to restore NHS trusts’ preferred provider status for delivery of health services would hit charities as well as private companies.
Winsford Guardian

NHS campaigners rally on streets against privatisation.

Protestors in Winsford joined thousands around the UK in taking to the streets to help gather support to protect the NHS from privatisation. Around 170 people signed the ‘Save our NHS’ petition in Winsford. The petition asks each MP candidate to commit to protecting the NHS from privatization and to keep it out of the Transatlantic Trade and Investment Partnership (TTIP) trade deal with the US. The day of action, coordinated by campaign group 38 Degrees, was held across England with more than 10,000 people taking part.
Health Service Journal

Monitor could be asked to examine £350m contract.

A decision by NHS England to hand more than half of the country’s PET-CT imaging services to one company could be the subject of a formal complaint to market regulator Monitor, HSJ has learned.

Left Food Forward

The NHS has never been in more danger.

Kailash Chand OBE writes: In 2010 David Cameron’s coalition government betrayed pre-election promises to protect the NHS. Instead they imposed savage spending cuts and pushed through ‘reforms’ which put at risk the health of the entire population. The Health and Social Care Act 2012 has been described as so ‘complex, confusing and bureaucratic’ that the organisation of the NHS ‘is not fit for purpose’ as a result. The NHS is now at the brink of extinction. The public has been misled about the objectives and consequences of the 2012 Health and Social Care Act. But the coalition’s repeated denials of NHS privatisation do not stand up to scrutiny. The 2012 Act has not just repealed society’s contract with the health service, it has put the NHS on the chopping block, ready to be sold in pieces to private corporations. The Health and Social Care Act raised the cap hospitals could generate from private income to 49 per cent from an average of around two per cent. Privatisation is an ideological luxury which wastes money and destabilises the NHS. It has no purpose other than diverting money to shareholders and enriching a privileged few. We all know people should always come before profit, but the current government thinks otherwise. In the past year, £9 billion worth of our NHS has been put up for sale, while thousands of jobs have been axed, including over 4000 senior nurses. Half of our 600 ambulance stations are earmarked for closure. 50 of the 230 NHS walk-in centres have been closed and 66 A& E and maternity units have been shut or downgraded. The coalition’s policies and privatisation mean the NHS as we know it will be gone in as little as five years if no one speaks up. The NHS will just be a logo; reduced from being the main provider of health services in England with one of the biggest workforces in the world, to a US-style insurance scheme, divorced from the delivery of care. Fewer treatments will be available as cuts start to bite. The ‘new’ NHS is now more fragmented than ever before. It has no primacy over provision, and money is squandered over lost causes such as procurement of contracts and fighting competition from within. There has been a proliferation of small and large providers in the NHS in the last two or three years and the other winners in this revolutionary reform are management consultants. The proliferation of private service providers spells serious problems for the future. For while the public sector seeks to maximise quality and coverage of services, the private sector aims to provide services in order to maximise profits. John Major attempted to suffocate the NHS by bringing in the internal market. David Cameron is fulfilling the dream of the ‘Tory right’ to privatise health care lock-stock and barrel.

Hunt To Supress the Rose Report


Toby Helm Observer political editor

Saturday 7 March 2015 21.16 GMT Last modified on Sunday 8 March 2015 00.09 GMT

Health secretary Jeremy Hunt faces allegations of a politically motivated cover-up after the Tory head of the health select committee said his department’s refusal to publish a damning report on NHS management before the general election was not acceptable.

Sarah Wollaston, a former GP who took over the chairmanship of the committee last year, said it was not reasonable or right that a report by former Marks & Spencer boss and Tory peer Stuart Rose, which was commissioned by Hunt a year ago and completed in December, was being kept from the public.

Senior government officials have made it known that Rose’s report is strongly critical of management systems in the NHS – findings that are potentially damaging for the Tories before an election in which the NHS is centre stage.

There are also suggestions that the report implies that the government’s own NHS reforms, steered through by Hunt’s predecessor Andrew Lansley, may have made matters worse.

Rose, who is said to be angry that the report has been put on the back burner until after the election, was unavailable for comment.

The Department of Health said it did not have a date for publication of the Rose report because its remit had suddenly been widened. “The remit of the Rose review has been expanded so that it takes into account the NHS’s own five-year forward view, which was published after Lord Rose’s work had begun. This means that further work is required before the final report is published.”

Wollaston told the Observer that reports which had been commissioned by government and paid for by taxpayers should be made available at the earliest opportunity on matters of such clear public interest.

“There is far too much of this going on, with uncomfortable information being withheld,” Wollaston said. “Just as with the Chilcot report into the Iraq war, it is not right that reports paid for out of public money are not made available to the public on such vital issues as soon as possible, particularly ahead of a general election.”

She said she was expressing her personal views, as she had not had a chance to discuss the issue with her committee. But she added that she would have liked to have been able to draw on the findings of the Rose report in an investigation of public expenditure in the NHS that is now being finalised by the select committee.

Rose, who is now chairman of the online retailer Ocado, was asked in February last year by Hunt to assess how NHS hospitals could keep “the very best leaders to help transform the culture in underperforming hospitals”.

But in a story that he has not denied, the Financial Times said recently that the peer had been dismayed by what he found and regarded the overall standard of management to be “totally shocking”.

Last night shadow health secretary Andy Burnham said: “Jeremy Hunt likes to claim that he stands for openness and transparency but this looks for all the world like a politically motivated cover-up in advance of the general election.

“If he wants to dispel or dismiss this suspicion, he must make arrangements to publish this report without delay.”

Rose would not be alone in thinking that the Lansley reforms made the management of the NHS less effective and more bureaucratic. A recent report by independent thinktank the King’s Fund said the Lansley overhaul left structures so “complex, confusing and bureaucratic” that the organisation of the service “is not fit for purpose”.

It also said the changes wasted the time of NHS bosses, who were “distracted as they were required to re-arrange the deckchairs rather than navigate safely past the iceberg” of growing demand at a time of acute financial pressure.

It also said the reforms led to a loss of talented senior NHS leaders by creating an array of new organisations, each responsible for areas such as hospitals or public health, meaning that no one was in overall charge and that there was a leadership vacuum.
More news

Jeremy Hunt
Sir Stuart Rose

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