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1
The Rationing of Health care and the Delaying of Operations Should Not Be Happening in a Modern Society

http://www.rcpbml.org.uk/wwie-17/ww17-08/ww17-08-05.htm

4
Seven patients an hour visiting South Shields hospital A&E ward
South Shields Gazette
Read more at: http://www.shieldsgazette.com/news/health/seven-patients-an-hour-visiting-south-shields-hospital-a-e-ward-1-8327322


Seven people an hour are using South Tyneside District Hospital’s A&E department, new figures show. Statistics released by the NHS show that 67,783 patients used the site’s emergency room in 2015/16.

Of those, 63,266 or 93.9%, were treated in under four hours. The Department for Health-set target for trusts to treat patients in four hours or under is 95%. window.

Of all trusts in England, 91.9% of patients were seen in the target time frame during 2015/16.A&Es across the country continue to be put under pressure, with attendances particularly high during winter. Ken Bremner, chief executive of South Tyneside and City Hospitals Sunderland NHS Foundation Trusts, said: “The last few years have been particularly challenging ones for the NHS nationally in many ways, not least in terms of the ever-increasing demand on accident and emergency services, which we have experienced in our own trusts and which we continue to experience today.

“Despite this, our staff continue to do a magnificent job in ensuring our patients are managed quickly and safely through the system and receive the right care for their needs. “We appreciate patients’ understanding and patience if they do come to A&E and find they have to wait longer than normal. “They can be assured that our staff are doing their very best to attend to them as quickly as possible in order of clinical need.”

The news comes a week after NHS bosses warned thousands of patients used the North East’s A&E departments during the run-up to Christmas when they didn’t need to for ailments including broken finger nails, toothache and over-drinking alcohol.Between December 1 and Christmas Day, over 53,000 people attended major A&E departments in hospitals across the region, yet less than 30%, just over 15,000 people, actually needed admission to hospital for emergency treatment.

South Tyneside NHS Foundation Trust saw 3,902 visitors to its A&E service in the 25-day period, but just 1,017, or 26%, had to be admitted in an emergency situation.Emergency hospital teams are calling upon the public to stop misusing A&E services for minor ailments which are not serious or life threatening.Trolley waits of more than 12 hours in A&E among elderly people have more than doubled in two years, the new figures also show.Data shows a huge jump in the number of very long waits among those aged 70 and over - from 34,088 in 2013/14 to 88,252 in 2015/16.

Among all ages, there were 185,017 trolley waits of 12 hours or more in 2015/16 - up from 157,895 the year before and 87,213 in 2013/14. Of the waits in 2015/16, 56,013 were for people over the age of 80.Other data published by NHS Digital shows 37% of people going to A&E are discharged with no follow-up needed, while 20% are discharged to their GP and another 20% are admitted to hospital. Monday is the busiest day of the week, the figures also showed.

On Monday, Health Secretary Jeremy Hunt suggested he planned to alter the four-hour target for patients to be dealt with in A&E, saying it should only apply to the most urgent cases.Hospitals have not hit the target nationally since summer 2015.Mr Hunt told MPs in the Commons that up to a third of patients do not need to be seen in A&E. In 2014, Mr Hunt took his own children to A&E because he did not want to wait to see a GP.   

But Chris Moulton, vice president of the Royal College of Emergency Medicine, said there were many valid cases among the 37% of people discharged with no follow-up.  He said: “Many people go to A&E departments and leave with the advice and reassurance they need.“An example is a child who has been taken to A&E with a big lump on their head after falling over.“We might check them over and say we think they’re OK and they are discharged, but that is still a good and valid use of an emergency department’s time.“Even if we did get rid of that 37% of people from A&E, it still wouldn’t do anything about these old people laying on trolleys waiting for beds.”

Doctors’ leaders have claimed the Government’s plans to extend access to GPs in England are in “complete disarray”, after a report warned of “difficulties” recruiting and retaining enough family doctors to deliver them.The National Audit Office said shortfalls in training places, increased part-time working and early retirement mean there may be 1,900 fewer GPs by 2020 than health authorities had predicted.The Department of Health has promised additional funding and 5,000 extra doctors in general practice by 2020 to meet a Conservative election promise for weekend and evening access to GPs.But the NAO report found that the department had failed to evaluate the cost-effectiveness and consequences of the proposals or to show that they can provide value for money from existing services.

Some 46% of practices already close for part of their “core hour” opening times of 8am to 6.30pm Monday to Friday.Funding the extended hours commitment will require at least £230 per appointment hour for every 1,000 registered patients, compared with £154 during normal opening hours, said the watchdog.  The report found that efforts by NHS England and Health Education England to boost GP numbers are “at particular risk from falling retention, shortfalls in recruitment and increases in part-time working”, with just 3,019 out of 3,250 training places (93%) filled in 2016/17, up from 2,769 the previous year.

“The latest available data on part-time working in new GPs suggest that there may be 1,900 fewer full-time equivalent GPs by 2020 than Health Education England had estimated there would be,” the NAO warned. 

The chairman of the British Medical Association’s GP committee, Chaand Nagpaul, described the report as “further evidence that the Government’s plans for extending patient access are in complete disarray”.

“Policy-makers have underestimated the number of GPs required to deliver their promises by almost 2,000,” said Dr Nagpaul.   “This comes at a time when the NHS is already suffering from a chronic shortage of GPs with one in three practices having unfilled doctor vacancies.

”The chairman of the influential House of Commons Public Accounts Committee, Labour MP Meg Hillier, accused ministers of “trying to shoehorn in seven-day access to general practice without a clear idea of the additional costs or benefits it will bring patients or taxpayers”.

Ms Hillier said: “This is on top of problems for patients in accessing their GP even during a standard working week, when nearly half of all practices close at some point during supposedly core hours, and practices are struggling to recruit and retain enough doctors for existing services.”   Liberal Democrat leader Tim Farron said: “Jeremy Hunt says he wants a seven-day NHS, but under his watch GP surgeries are struggling to stay open nine to five.”

Read more at: http://www.shieldsgazette.com/news/health/seven-patients-an-hour-visiting-south-shields-hospital-a-e-ward-1-8327322

5
News / NHS crisis: Corbyn calls on May to face urgent Commons questions
« on: January 07, 2017, 05:41:47 pm »
 NHS crisis: Corbyn calls on May to face urgent Commons questions
Guardian
Lib Dems demand emergency health funding as NHS England boss disputes Red Cross claim of a humanitarian crisis
Ambulances outside an accident and emergency ward
Ambulances outside an accident and emergency ward. Photograph: Dan Kitwood/Getty Images

Chris Johnston and agencies

Saturday 7 January 2017 16.20 GMT
First published on Saturday 7 January 2017 13.23 GMT

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Jeremy Corbyn has called on Theresa May to attend the House of Commons on Monday to face urgent questions over the NHS, after claims the health service is facing a “humanitarian crisis”.

The Labour leader called on the prime minister to explain how the government will solve the problems, after the British Red Cross said it had been called in to help the NHS in England deal with heightened demand this winter.

In a series of tweets, Corbyn said: “The crisis in our NHS is unprecedented. People are lying on trolleys in corridors waiting to be seen.

“Hospitals have had to close their doors, unable to admit patients. The health service is at breaking point. But this crisis isn’t due to an outbreak of disease. It’s a crisis made in Downing St by this government – a crisis we warned them about.”

A statement added: “I am demanding that the prime minister comes to the House of Commons on Monday and sets out to the British people how she plans to fix her failure on the NHS.”

The intervention came after it emerged on Friday that two patients had died on trolleys in the A&E department of Worcestershire Royal hospital in the past week.

The former health minister Norman Lamb has called on Jeremy Hunt, the health secretary, to announce emergency funding to address the crisis.

The Liberal Democrat MP said: “This government should be ashamed. It ignored calls for extra cash to support health and care services through the winter, and now it is patients who are paying the price.”
'It was manic': patients describe meltdown at Worcestershire hospital
Read more

Keith Willett, director of acute care for NHS England, rejected the Red Cross’s claim of a humanitarian crisis.

He said the NHS had worked with the Red Cross over recent winters. “But on the international scale of a humanitarian crisis, I do not think the NHS is at that point,” he said.

“Clearly, demand is at the highest level ever, but also our planning is probably more comprehensive than it has ever been. In many ways this is a level of pressure we have not seen before and the workload that the NHS is being asked to shoulder in terms of medical treatment and personal care is very high,” Willett said.
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“There are several reasons for that. There is the winter and many more people have breathing and heart problems, but we know it is also very difficult at the moment and social care and community services are not able to react fast enough to free up beds to keep up the flow through hospitals.”

He said the biggest problem was moving patients through the hospital. “Many commentators have said if there is more money to be had then it should be directed at social care in the community first, and that will help the NHS more than anything else at the moment.”

Figures show A&E departments shut their doors to patients more than 140 times in December. On Friday a national body said a third of health trusts in England issued alerts last month saying they needed urgent help, and seven said they were unable to provide comprehensive care.

Worcestershire Royal opened an investigation on Friday after the deaths of two patients who had been waiting on trolleys in corridors for many hours. It is believed that a woman died of a heart attack after waiting for 35 hours on a trolley in a corridor, and a man suffered an aneurysm while on a trolley.

It is believed that another patient was found hanged on a ward at the same hospital. Worcester Royal said it was under serious pressure partly as a result of the extra strain hospitals face during winter. The deaths are said to have happened between New Year’s Day and 3 January.
I'm a junior doctor in the NHS, and I'm terrified for this winter
Aislinn Macklin-Doherty
Read more

Separately, it was disclosed that the London ambulance service suffered a computer blackout on New Year’s Eve that forced call handlers to revert to pen and paper on the busiest night of the year.

Patients who visited Worcestershire Royal hospital this week told the Guardian of long waits in A&E, corridors lined with patients, and overstretched staff doing their best to cope.

Dr Mark Holland, president of the Society for Acute Medicine, said: “We are asking NHS staff to provide a world-class service, but with third-world levels of staffing and third-world levels of beds. That so many other hospitals in England are facing the same pressures as the one in Worcester means that other fatalities could occur. I would suggest that the same thing could happen in other hospitals, because lots of hospitals are under the same pressures.”

Dr Taj Hassan, president of the Royal College of Emergency Medicine, said figures it obtained from hospitals across the UK showed some were treating as few as 50%-60% of A&E patients within four hours – far below the 95% target.

6
NHA welcomes a new leader and a new year fighting for the NHS

My name is Alex Ashman. This new year message is to introduce myself and to look to the fight for our NHS. That may not be a message full of seasonal cheer, but with the Clinical Commissioning Groups signing 2 year service contracts on 23 December, which will hasten along the Sustainability and Transformation Plans, neither the government nor NHS England are taking a break from the dismantling of the NHS.

As a surgical registrar I have seen first-hand the costly bureaucracies and rationing of care that resulted from the growing marketisation and privatisation of our health service. That's why I joined the NHA in 2012.

I've been on the national executive committee since 2013. This year all party members who have voting rights were invited to elect the new executive in the week leading up to the online AGM of 17 December. I am in mid-term as an executive member and I was elected to one of the co-leader roles, the other being currently unfilled.

I want to be clear about what I stand for. Below are the words that Dr Taylor and Dr Peedell wrote in the constitution when the party was first created. They sum up the purpose and ethos of what we are fighting for.

"The NHS was more than just a structure for the delivery of healthcare. It was also a social institution that reflected national solidarity; expressed the values of equity and universalism; and institutionalised the duty of government to care for all in society. The NHS marked out a space in society where the dictates of commerce and the market were held in check so as to give expression to socially directed goals, for individuals and society as a whole."

We are losing the NHS fast, particularly since the Footprints plan was published a year ago. But we need to keep in mind what the NHS is so that we don't get sidetracked into simplified demands for just more money or just keeping it free at the point of need. Funding must be for public service, not private profit. And the service itself must be comprehensive, accessible, universal and high quality, not a second or third class service for those who can't afford to pay..

If we lose these values we lose a lot more than a health service. We lose an enduring symbol of how we as a society care for each other. The NHS doesn't function alone. The work of the NHS is carried out against the backdrop of our wider society. We have increasing child poverty and homelessness, people being abandoned by the social security system, foodbanks and the erosion of health and care services. Once again this country has elements that Dickens would have recognised in a Christmas Carol.

This situation is totally unacceptable and it is not the country I want to live in. I want to retain the party’s original ideals whilst developing the NHA as a political and campaigning body. We have to save or restore our NHS, whatever it takes. What better new year pledge can we have?

This year you may be feeling disheartened, the cuts to savage, the destruction too deep but we must keep fighting for a better society, for real change to our democracy and a restoration of the public services of which we should all be proud.

Alex
 

7
News / NHS boss rejects claim of 'humanitarian crisis' in hospitals
« on: January 07, 2017, 03:49:10 pm »

NHS boss rejects claim of 'humanitarian crisis' in hospitals
Health service disputes Red Cross claim after charity said more funding was needed to make system sustainable

Chris Johnston and agencies
 
Saturday 7 January 2017 13.49 GMT  First published on Saturday 7 January 2017 13.23 GMT 

The NHS has rejected claims it is facing a “humanitarian crisis” as it deals with winter pressures after it emerged that two patients had died on trolleys in one accident and emergency department in the last week.

The Red Cross said it had stepped in to help NHS England deal with the increased demand put on the service over the colder months. The charity’s chief executive, Mike Adamson, said extra cash was needed for health and social care to make the system sustainable.

'It was manic': patients describe meltdown at Worcestershire hospital
 
“The British Red Cross is on the frontline, responding to the humanitarian crisis in our hospital and ambulance services across the country,” he said. “We have been called in to support the NHS and help get people home from hospital and free up much-needed beds.”


Keith Willett, director of acute care for NHS England, said the health service had worked with the charity over recent winters, funding and supporting its “excellent service at home and ambulance service”. He said: “But on the international scale of a humanitarian crisis, I do not think the NHS is at that point.”

Willett added: “Clearly, demand is at the highest level ever, but also our planning is probably more comprehensive than it has ever been. In many ways this is a level of pressure we have not seen before and the workload that the NHS is being asked to shoulder in terms of medical treatment and personal care is very high.

I'm a junior doctor in the NHS, and I'm terrified for this winter

Aislinn Macklin-Doherty
 
Read more
 
“There are several reasons for that. There is the winter and many more people have breathing and heart problems, but we know it is also very difficult at the moment and social care and community services are not able to react fast enough to free up beds to keep up the flow through hospitals.”

The biggest problem was moving patients through the hospital, Willett said. “Many commentators have said if there is more money to be had then it should be directed at social care in the community first, and that will help the NHS more than anything else at the moment,” he said.


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The latest figures show overflowing A&E departments have shut their doors to patients more than 140 times in December.

On Friday, a national body said a third of health trusts in England had issued alerts that they needed urgent action to cope last month, with seven of those unable to provide comprehensive care.

Worcestershire Royal hospital also opened an investigation on Friday following the deaths of two patients who had been waiting on trolleys in corridors for many hours. It is believed that one woman died of a heart attack after waiting for 35 hours on a trolley in a corridor, and another man suffered an aneurysm while on a trolley, and could not be saved.

It is also believed that another patient was found hanged on a ward at the Worcestershire Royal hospital, which admitted that it was under serious pressure, partly as a result of the extra strain hospitals face during winter. The deaths are said to have happened between New Year’s Day and 3 January.

Meanwhile it was disclosed that the London ambulance service suffered a computer blackout on New Year’s Eve that forced call-handlers to revert to pen and paper on the busiest night of the year.

Many other patients who visited Worcestershire Royal hospital this week told the Guardian of long waits in A&E, corridors lined with patients, and overstretched staff doing their best to cope.

Dr Mark Holland, the president of the Society for Acute Medicine, said: “We are asking NHS staff to provide a world-class service, but with third-world levels of staffing and third-world levels of beds. That so many other hospitals in England are facing the same pressures as the one in Worcester means that other fatalities could occur. I would suggest that the same thing could happen in other hospitals, because lots of hospitals are under the same pressures.”

Dr Taj Hassan, the president of the Royal College of Emergency Medicine, said figures it obtained from hospitals across the UK showed some were treating as little as 50%-60% of A&E patients within four hours – far below the 95% target.

8
News / NHS bosses trying to keep cuts secret -STPs
« on: November 14, 2016, 03:47:35 pm »
NHS bosses trying to keep cuts secret

NHS chiefs are trying to keep plans to cut hospital services in England secret, an investigation has found.

Full details of 44 reviews of services around the country - which involve closing some A&Es or, in one case, a whole hospital - are yet to emerge.

That is because NHS England told local managers to keep the plans "out of the public domain" and avoid requests for information, the King's Fund suggested.

Managers were even told how to reject freedom of information requests.

The King's Fund report did not include any details of cuts, but from the leaks and plans that have been published so far a partial picture is emerging of what is involved.




This includes:
◾Plans in south west London to close one of five hospitals - St George's, Kingston, Croydon, St Helier or Epsom
◾The North Tees proposal to centralise specialist services, including A&E, on two sites. It would lead to services being downgraded at one of the three major hospitals in the area
◾In Devon bosses are looking at whether to close some A&E, maternity and stroke services at hospitals across the county so they can be centralised at bigger sites
◾In Merseyside there has been talk of merging four hospitals - the Royal Liverpool, Broadgreen, Aintree and Liverpool Women's - to plug a £1bn shortfall, according to leaked documents
◾Plans in Birmingham and Solihull involve reorganising maternity services with fears this could result in fewer units
◾Bosses at North Central London have talked about a consolidation of services on fewer sites, leading to fears that the Whittington Hospital could lose its A&E

During its research, the King's Fund carried out interviews with staff involved in four of the reviews, known as sustainability and transformation plans (STPs). These were done on an anonymised basis.

The local managers said they had been told to keep the process "private and confidential", which one described as "ludicrous", while another said the leadership had made the "wrong judgement call" in its approach to managing the process.

Another person involved complained about being in meetings and wondering why there were no "real people", such as patients and members of the public, involved.
The King's Fund was told senior leaders at NHS England and NHS Improvement, which regulate NHS trusts, wanted to "manage" the narrative around the process, because of the sensitive nature of some of the changes.

But the approach has meant that the views of the public and frontline staff have largely been absent in the process so far, the think tank said.

Researchers said there were signs from the plans they had seen so far that services were being centralised at a smaller number of hospitals to make care safer and more efficient.

The King's Fund said such plans had the potential to improve patient care, but warned the process had increasingly become financially driven in recent months, which could be risky.

The think tank suggested there were "clearly anxieties" among ministers and the NHS leadership over the way the plans could be interpreted by the public.

But King's Fund chief executive Chris Ham said the process had gone against the established "rules" of good engagement and consultation.

He said the idea of reviewing local NHS services was still the "right thing to do", but questioned whether there was enough money and time to make a success of the shake-up.
STPs stands for sustainability and transformation plans. They are aimed at overhauling NHS services and saving money.

Each area of the country has been asked to come up with its own plans and so local NHS managers have divided the country into 44 "footprints".

It is all part of NHS England's five-year strategy to release £22bn of efficiency savings by 2020. As health is devolved, the plans do not affect the rest of the UK.

The 44 areas started reviewing local services in early 2016 and and all have now submitted proposals to NHS England and NHS Improvement.

Consultations on major changes are expected to take place early next year, with implementation following soon after.


To date, a third of the 44 plans have been published, but in some cases that has relied on local councils releasing them against the wishes of NHS managers.

A spokesman for NHS England said that by the end of this week, plans for at least half of the reviews would be published - and the intention had always been to consult on the final plans if major changes were going to be made.

"I am sure there are things that could be learnt about the process. But when you are trying to improve care across a whole system, things are never going to be straightforward," added Prof Sir Bruce Keogh, NHS England's medical director.

However, Councillor Izzi Seccombe, of the Local Government Association, which represents councils, suggested the stance was a sham - as the public would in effect be consulted on "pre-determined solutions".

And Jeremy Taylor, of National Voices, which represents patients, said: "Developing plans behind closed doors, and presenting near-final proposals, does not count as meaningful involvement." 
 

9
Now Is the Time For an NHS Based on the Right to Health Care! - See more at: http://www.rcpbml.org.uk/wwie-16/ww16-04.htm#sthash.FvlrPZVw.dpuf

10
NHS In Crisis – Save Lewisham Hospital Campaign Conference and Discussion Day

Workers' Weekly March 8 2016

http://www.rcpbml.org.uk/wwie-16/ww16-05.htm#fifth

11
What Does this “Alliance” of South of Tyne Health Services Really Mean?

North East Workers & Politics, March 7, 2016

http://www.rcpbml.org.uk/wwie-16/ww16-05.htm#seventh

12
Families of People with Mental Health Problems Fight for Mental Health Services

North East Workers & Politics*, March 7, 2016

http://www.rcpbml.org.uk/wwie-16/ww16-05.htm#sixth

13
Now Is the Time For an NHS Based on the Right to Health Care!
Workers' Weekly Fevruary 13-2 72016

http://www.rcpbml.org.uk/wwie-16/ww16-04.htm

14
The People Must Continue Their Fight to Safeguard Mental Health Services

North-East Workers & Politics*, February 13


http://www.rcpbml.org.uk/wwie-16/ww16-04.htm#second

15
Jeremy Hunt vetoed deal backed by NHS officials in junior doctor row

Jeremy Hunt personally refused a deal to end the row with junior doctors despite it being backed by NHS negotiators, it has been claimed.
According to the Independent, the Health Secretary vetoed an offer which would have resolved the final contentious issue in the dispute – over pay for evening and weekend work. The offer was apparently cost-neutral to the Government and considered by NHS Employers and Department of Health officials as a way to end the fight. A British Medical Association source told the paper: “The one person who would not agree was Jeremy Hunt. “Even though the NHS Employers and DoH teams thought this was a solution he said no.” The source from the body representing junior medics added: “Negotiations have completely broken down.” “There are no more dates planned for talks. The BMA wants to continue negotiating but the other side have walked away.” A Department of Health spokesperson insisted the claims were “completely untrue”. CONTRACT The Government is trying to change the terms of junior doctors’ contracts in order to make it easier to schedule staff for weekends. That includes extending the hours that are not eligible for overtime pay to go further into the evening and on Saturdays. Basic pay will increase, and the Government says no doctor working hours within the legal limits will lose out. But doctors have argued that the protections in place to stop doctors working an unsafe number of shifts are being diluted. The latest 24-hour walkout, after the first on 12 January, is due to start tomorrow morning. - See more at: https://www.politicshome.com/health-and-care/articles/story/jeremy-hunt-vetoed-deal-backed-nhs-officials-junior-doctor-row?utm_medium=email&utm_campaign=NEW%20MON-FRI%20Breakfast%20Briefing%20%20Events%20box%20copy&utm_content=NEW%20MON-FRI%20Breakfast%20Briefing%20%20Events%20box%20copy+CID_d428ce642400f2bb21bf085a52eb2b13&utm_source=Email%20newsletters&utm_term=Jeremy%20Hunt%20vetoed%20deal%20backed%20by%20NHS%20officials%20in%20junior%20doctor%20row#sthash.x2BBsHoS.dpuf
 

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