Lowdown 100 – our recent content

Wes Streeting’s new package of “reforms” seems set to deepen inequalities in health and access to health care. It includes a return to ‘league tables’ to rank trust performance, threats to cut pay or sack senior management in struggling trusts, and incentives for those who are already doing well. This approach is not new or

ICB WATCH – data collection October 2024 An investigation by The Lowdown of all 42 Integrated Care Systems (ICS) in England has found that nearly all are making decisions to restrict spending by a collective total of around £8bn. You may be forgiven for thinking the cash from the budget has eased the situation—it will

November 2024 Birmingham and Solihull Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target Break even 51.3 6 70 £220m Birmingham & Solihull has submitted a plan to break even in 2024/25 on the basis of delivering £220m of efficiencies. (p213) But for the first two months of the

NHS Bath and North East Somerset, Swindon and Wiltshire ICB Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target Deficit of £30m 7.1 4 21.1 £141.9m Having agreed on a control total of £30m deficit with NHS England (reduced from the initial plan of £35.7m), BANESSW ICB reported a Month

NHS England regional ICB update - (latest Nov 2024) In England Integrated Commissioning Boards plan and commission the majority of local health services. This is the latest (Oct-Nov 2024) in a series of Lowdown investigations into their financial state and how these decision-makers are responding to financial challenges. Each snapshot is based upon the latest

November 2024 NHS Buckinghamshire, Oxfordshire and Berkshire West ICB (BOB) Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target 60 20 4 61.5 252 BOB ICS has agreed on a control total deficit of £60m (of which ICB -£13.7m), reduced from the initial plan of -£92m. The target for efficiency

November 2024 NHS Cheshire and Merseyside ICB Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target 150 38.6 4 138 440 In this highly challenged NHS region, Cheshire and Merseyside ICS has the lowest agreed target deficit at £150m (with ICB to deliver £62m surplus, and providers’ deficit limited

Humber and North Yorkshire ICB Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target £50m deficit 3 5 60.9 235 The system has agreed a planned deficit of £50 million for 2024/25, but by Month 5 was £60.9m in deficit, slightly above a planned level of £58.9m. Achieving the

As winter approaches, with the days growing shorter, the warnings from the Royal College of Emergency Medicine are growing more frequent and anxious. Responding to the Labour government’s first Budget Dr Ian Higginson, Vice President of the Royal College of Emergency Medicine, said: “We commend the government’s ambition to start rebuilding the NHS which has

This is Part 1 of the latest Lowdown overview of the financial state of the NHS, drawing on ICB and trust board papers and other sources. Most of the work was done in the second half of October. Since this draft was completed, the Health Service Journal has published a hard-hitting interview with Hardev Virdee,

When The Lowdown first started in early 2019, the backlog maintenance bill for England’s NHS was estimated at £6 billion. By 2021, it had risen to £9 billion. In 2022, it reached £10.2bn. But with the Tory government’s infamous policy of ‘austerity’ in full swing and restricting capital spending in the NHS up to the July election, and little

North Central London Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target Break even 11.7 2 38.2 £205.6m This ICB only meets quarterly, next in November (so this report is based on May and July board papers). While the financial outlook for 2024/25 for London and across England is

Bedford, Luton and Milton Keynes Control Total (24/25) Current variance from C Total Month YTD Deficit (£ million) Savings Target Break even 4 9.1 £106m The Integrated Care System (ICS) had submitted a plan to NHS England projecting a balanced budget (break even)for 2024/25 (p21), one of the few systems in the country to do

The views of Irwin Nash on the government’s recently launched NHS consultation Many campaigners will react with despair and disappointment to Wes Streeting’s “consultation” on the future of our NHS. The shadow Health and Social Care Secretary, who studiously avoided any engagement with campaigners or health unions before the election, is unlikely to take any more notice

It’s another autumn, and the private healthcare sector is again attempting to convince journalists and the public that it is booming. The publicists for the private hospitals are keen to take the stigma out of wealthy people paying up to jump lengthy NHS queues for elective treatment: David Hare, who runs the Independent Healthcare Providers Network (IHPN), has

Nottingham University Hospitals Trust have outraged trade unions and campaigners by outsourcing parts of their finance department in the desperate effort to cut spending. The Trust faces a £104m deficit as the inadequate NHS budget has come under pressure. In total, 84 staff, many of whom have been loyal employees for up to 35 years, have had

Comment by Irwin Nash The Health Service Journal has reported that “A hospital chief executive (of East Suffolk and North Essex NHS Foundation Trust (ESNEFT)) has apologised after being filmed telling staff his trust had already decided to outsource its facilities management services”. It is unclear how this apology went down with hundreds of striking

More than 20 radiographers, radiology assistants and associated support staff, members of the GMB employed by Frimley Health have opted to suspend action following their 100% ballot vote to strike. They are fighting Trust plans to outsource the contract for MRI services at the new £25m Community Diagnostics Centre (CDC) in Slough, which is to

Talking therapies services in Derbyshire will move to private providers in 2025, as the current NHS provider, Derbyshire Healthcare NHS Foundation Trust, has decided not to bid for the new contract. As a result around 80 staff will have to leave the NHS whether they want to or not, and into the employ of a

The private equity-owned company, HCRG Care, has been awarded a contract to lead all adult and community services across Bath and North East Somerset, Swindon and Wiltshire (BSW) Integrated Care System, which could be worth up to £1.3bn over nine years. The ICS’s community services are currently split across separate contracts, including the NHS providers,

The notorious Labour Party conference bureaucracy may have successfully shunted a Socialist Health Association motion on Physician Associates off the prioritised agenda last month, but the controversy shows no sign of dying down since the change of government in July. Indeed, so great has been the professional concern at the proposed expansion in numbers of

The long-delayed Midland Metropolitan University Hospital (MMUH) in Smethwick, West Birmingham, is now planned to open on October 6, six years later than planned, and with substantial question marks over the viability of the new hospital once the current A&E departments close permanently.  The hospital, along with the Royal Liverpool Hospital – both signed off

Lord Darzi may be best known as a high-flying surgeon, but he is also quite keen on knocking out reports – especially when the main subject is not the services he is most involved with. And far from there being any continuity, each report shows a fresh change of mind Darzi’s 2007 report for NHS

According to a Lowdown survey of recent board papers, Integrated Care Boards (ICBs) covering the South West of England are cutting spending on workforce and continuing healthcare.  Many of the board papers include optimistic targets for implementing elective care, which can boost the ICS’s income. Three ICS have large deficits and will receive further penalties

Lord Darzi has delivered a stark report on the NHS’s unprecedented problems. The Prime Minister responded with a commitment to producing a new long-term plan for the NHS, but also stated firmly that “no new funding would be available without reform”. With debts mounting this leaves many local NHS leaders with tough choices affecting staff

The second round of strikes in Colchester has at times has seen well over 100 on the picket line. The photo above was taken just before a squad of security staff came along to intimidate, and to demand the UNISON sign van was moved. Hundreds of staff at East Suffolk and North Essex FT are

One of London’s largest mental health trusts, East London Foundation Trust, is attempting to cut spending by £29m – and putting the quality of services at risk, with the potential loss of up to 365 jobs, including adult and child and adolescent services, according to the largest union in the Trust, Unite. The cutback comes

“Vassal State: How America runs Britain” by Angus Hanton, Swift London 2024 £25.00 Hardback. Review by Roger Steer The book is the result of a quest by the researcher and author to answer the question: how much of the UK is owned by the USA? The answer is difficult to answer (the UK government does

In her first speech to the Commons as Chancellor, Rachel Reeves committed to “reining in” consultancy spending in government departments. Both Labour and Tory campaigns in the general election promised to reduce the public sector’s dependence on external firms, which failed so massively, so expensively and so publicly to deliver functioning test and trace systems as the

A major Australian multinational company is looking to make substantial profits from a new shared pathology network being set up to serve trusts and primary care in Hertfordshire and West Essex Integrated Care System. Health Services Laboratories (HSL) has been appointed as the provider for this service, which is part of a national plan to

https://docs.google.com/document/d/1ZwK_9JcolqAC9nMt5dorsn2ex5mF2C20Fi3yZi6aTcw/mobilebasic FROM KONP NEWS RELEASE NHS Commissioners decided to terminate all of Operose’s GP contracts in Islington and Camden, having previously ended the contract at Operose’s St Ann’s Road GP Surgery in June.  This comes after North Central London Integrated Care Board (NCL ICB) disclosed that they were not informed, nor gave permission for the

Keir Starmer may have rattled a few Tory cages when he ordered a portrait of former Tory PM Margaret Thatcher to be moved out of sight in Downing Street, but it’s Thatcher’s policies and neoliberal approach that most need to be dumped if Labour is to rescue the NHS. The latter part of the summer

Nurses working in the NHS who have trained overseas are struggling to cope with the increases in cost of living and are being “pushed into poverty,” according to a new report from the Royal College of Nursing (RCN), as a result many are planning on leaving for other countries where pay and conditions are better.

A 15 year contract worth around £900 million for pathology services across much of Essex has been awarded to a company that suffered a massive cyber attack in June this year, the consequences of which are still being felt today. The German company Synlab has been given preferred provider status for the contract across Mid

Over the past few years, drug shortages have become a regular reality in the NHS and a significant problem for pharmacists and patients Back in May, a Community Pharmacy England report noted that drug shortages are now at critical levels with patients at risk of immediate harm and even death. “This all causes worrying delays

There is mounting evidence that the Galleri blood test to detect multiple types of cancer from a single blood sample should not be used by the NHS, according to a report in the BMJ, and its selection for large-scale trials by NHS England was based on politics rather than good science.  The investigation led by

Latest performance figures show further decline The latest NHS performance figures are a stark reminder of the scale of the task Keir Starmer’s government faces if it is to implement its manifesto commitment to “Build an NHS fit for the future”. To sum up: there are too few hospital beds, too many patients staying too

Healthcare assistants (HCAs) and other support workers, some of the lowest paid workers in the NHS, have continued their campaign to be properly paid for working beyond their pay grade, with a new wave of strike action through the summer months. At Surrey and Sussex Healthcare Trust more than 350 nursing assistants took part in

The Care Quality Commission (CQC) is “not fit for purpose” and its safety ratings can not be trusted, Wes Streeting, Secretary of State for Health and Social Care has said. His remarks came after the publication of an interim review of the CQC currently being undertaken by Dr Penny Dash, chair of the North West

Public Finance has always tended to be the sort of publication that provides serious, evidence-based analysis of the state of play in public services, linked to the Chartered Institute of Public Finance and Accountancy. So why did it decide to give space on July 22 to Carly Caton, a lawyer specialising in commercial healthcare, to

An urgent review of services for people with severe mental health issues, such as psychosis and paranoid schizophrenia, has been ordered by NHS England, as concern grows over the number of individuals being let-down by services leading to their involvement in serious incidents. All Integrated Care Boards (ICBs) have been told to “review their community

The new Labour government will need to make major decisions on how the current situation in the NHS, in particular record waiting lists, is going to be tackled. Pre-election Labour was reported to be keen to increase the use of the private sector.  The Labour party pledged that the backlog of about 3.2 million people

“The floggings will continue until morale improves” appears to be NHS England’s management approach as they turn up the heat on Integrated Care Boards and NHS trusts in their efforts to squeeze down a collective deficit projected as £3 billion. They will have been encouraged to crack the whip by Health and Social Care Secretary

As Wes Streeting’s review kicks off, there is growing evidence on all sides that Labour’s promise to “bring back the family doctor” is headed for failure unless new resources are injected into GP practices. The BMA is balloting GPs on industrial action to challenge the disastrous below-inflation 1.9% uplift in practice funding for 2024/25, as

Electing a Labour government with its close links to the trade unions raises many expectations. The King’s Speech commitment to legislate policy around workers’ rights includes tackling decades of outsourcing, with the Plan to Make Work Pay proclaiming “Labour will learn the lessons from the collapse of Carillion and bring about the biggest wave of insourcing

When Tony Blair’s government took office in 1997, every one of the newly-appointed health ministers who had worked with campaigners for the previous decade and more, abruptly cut off all contact with them, and found themselves new, more conservative allies and advisors. Keir Starmer’s government is different: the front bench team has never worked with

Skills for Care, the workforce development body for adult social care in England, has published the first ever adult social care sector Workforce Strategy. The previous government had refused to develop a strategy or be involved, so Skills for Care, in collaboration with a number of other organisations, went ahead without government involvement. Now Skills

The first steps to social care workers getting fair pay and conditions were announced in the King’s Speech on the 17th July. A welcome move for a sector with serious workforce issues, but it’s not the reform that those in the sector want and that has been promised for so long. And there is still

Nursing leaders have called for the government to launch an independent investigation into the Nursing and Midwifery Council (NMC), following the release of a damning report by former chief crown prosecutor Nazir Afzal, and Rise Associates. Nursing leaders are concerned that despite promises from the NMC, little will change and public confidence will not be

After 14 long years of real-terms cuts in funding alongside increased pressures on the NHS, its 76th birthday (July 5) saw a change of government, and promises of a change in policy. The first was Labour’s new Health and Social Care Secretary Wes Streeting stating clearly that the NHS has been “broken” – and needs

With 412 Labour MPs and a huge majority in the House of Commons, Keir Starmer’s Labour government clearly now has the power to bring in real change for the NHS. The challenge for campaigners now is to ensure the new government seizes this opportunity to repair and rebuild the NHS, which is facing a long

Few campaigners or union activists appear to have noticed or commented upon Labour’s Manifesto commitment to roll back privatisation in public services. Some of Labour’s manifesto promises go further than many union activists and campaigners have realised. The Manifesto promises (under ‘Kick start economic growth’) to “introduce legislation within 100 days to implement in full”

Active Care Group, a company owned by private equity that cares for hundreds of vulnerable patients for the NHS, has narrowly avoided going out of business. After months of escalating financial difficulties, an administrator was appointed 29 May 2024, who immediately sold the company’s assets in what is known as a ‘pre-packaged sale’ to avoid

The Royal College of Nursing (RCN) is calling for the new government to urgently invest in the nursing workforce and put into law nurse-to-patient ratios, as the current chronic nursing shortage is putting patients’ safety at risk. Investment includes in nursing education as at the moment cuts are taking place to courses and educators, which

The recently aired Channel 4 Dispatches programme, Undercover A&E: NHS in crisis has received widespread coverage due to its exposure of the “suffering and indignity faced by patients on a daily basis” in the the Royal Shrewsbury Hospital’s emergency department, where an undercover reporter worked as a trainee healthcare assistant for two months. The footage

The pace and intensity of the row over the role and regulation of Physicians Associates (PAs) and Anaesthesia Associates (AAs) have both rapidly increased in this pre-election period, forcing a major climbdown and apology in Bradford, a Royal College President to stand down, another Royal College to change course, and two separate legal challenges to

The BMA has just identified another growing problem that will face the next government, the chronic underfunding of GP practices, and is urging patients to advocate for better support during the election. The campaign, called ‘GPs are on your side’, warns that general practice is ‘collapsing’, and that ‘every practice across England is struggling to

The publication of the manifestos of the three major parties has been followed by a barrage of useful information on the state of the NHS, from the Guardian and the Nuffield Trust, and a new Dashboard on GP services from the Health Foundation. The common message is that after 14 years of under-funding and under-investment,

Almost casually, and with no real coverage in the mainstream national news media, the Labour Party has abandoned its previous reluctance to commit to spending, and its caution on promising new hospital projects – and committed to delivering the new hospital projects notoriously promised by Boris Johnson. A patchily-covered series of statements targeted at areas

NHS England published a new plan in May, aimed at speeding up the response of A&E services and reducing waiting times, setting a new target of 78% of A&E patients to be seen within four hours – way short of the 95% target that was being regularly achieved prior to 2010. On the same day

While Rishi Sunak flies around the country claiming to be spending ‘record amounts’ on the NHS, NHS England has been increasingly cracking the whip over Integrated Care Boards (ICBs) and trusts, seeking to squeeze down the estimated £3bn deficit for 2024/25. The underlying problem is that this financial year real terms funding for England’s NHS,

East Suffolk and North Essex Foundation Trust seems determined to outsource nonclinical support services at Colchester Hospital, 12 years after boasting of the Colchester trust’s success at bringing them back in-house.  But why they have chosen to do so, and why they have not considered any other options remains a mystery, since the Trust has

The public wants the next government to shift funding to GP and community services and away from hospital services, according to a new report from the health think-tank The Health Foundation, and is willing to pay more taxes to improve services. The results of polling, carried out in Autumn 2023 by Ipsos on behalf of

The harm from alcohol costs society in England £27.44 billion a year, according to a new analysis by the Institute of Alcohol Studies. The cost of alcohol to society has risen 37% in just over 20 years since 2003, which was when the last comparable research was carried out by The Cabinet Office, which then

A private equity-owned company that holds contracts for almost 50 GP surgeries in London has been found to be in “serious breach” of its contracts by local commissioners, something which was highlighted by Campaigners from North East London Save Our NHS in April this year. The company Operose, once a subsidiary of US corporation Centene,

John Lister begins what we hope will be regular Lowdown coverage of the NHS in Scotland, with an overview of current key issues and an interview with UNISON’s Scottish Head of Health Matt McLaughlin. The news media in England carries little information on the NHS in Scotland, which is controlled by the Scottish government, which

Survey of 19 Integrated Care Boards (part 2 of 2), Key points: (West Midlands, South East and South West of the country – 19 ICBs) Workforce pressure continues to push “trust leaders to the limit” with difficult choices. Pressure on leaders to avoid deficits is stalling progress and leading to discussions about cuts. ICBs are

A bizarre experiment is being acted out in North West London. Its Integrated Care Board, covering the third largest population of all 42 ICBs in England was discovered at the end of January to be embarking on a scheme to fundamentally change primary care services by April 1 – with no plan for consultation with

The Lowdown survey of 23 ICBs has revealed interesting new information on the extent of local dependence upon private sector clinical services, and the extent to which ICBs and trusts view the private contracts to be a liability rather than an asset. Thirteen ICBs from the sample of 23 refer to the use of private

Survey of Integrated Care Boards, Key points: (East of England, London, East Midlands, North East and Yorkshire and North West regions – part 1 of 2) 18 out of the 23 ICBs surveyed finished the financial year in deficit. and 10 already forecast bigger deficits for 2024-25. Greater Manchester: “the ICS finds itself starting from

Big privateers, like Virgin and Operose, may have abandoned their interests in NHS contracts – facing shifts in government policy and elusive profits. The private equity investor though is gaining a stronger foothold. Involved in the care and education sectors for many years,  private equity has added to their interests in mental health and elective

A chain of GP surgeries in London run by a private company has been operating “without permission” from NHS commissioners since December 2023, according to campaigners from North East London Save Our NHS – in a “serious contract breach”  The 49 surgeries were originally owned by US corporation Centene, via its UK subsidiary Operose, but

UNISON’s Pay Fair for Patient Care campaign continues across the country, with new strikes in Leicestershire, strikes continuing in Teesside, and the threat of strikes in Surrey. Hundreds of healthcare assistants at the University Hospitals of Leicester NHS Trust (Leicester General Hospital, Glenfield Hospital, and Leicester Royal Infirmary) began strike action 11 April in a

The latest raft of performance figures have shown that the NHS is still mired in a chronic capacity problem and hamstrung by the lack of adequate provision of community health and social care to support patients ready for discharge. The Royal College of Emergency Medicine (RCEM) notes that the final weekly winter ‘situation report’ figures released

New research commissioned by the NHS Confederation’s Mental Health Network shows the cost of mental ill health for England was a staggering £300 billion in 2022. The study, conducted by the Centre for Mental Health, shows that the £300bn figure breaks down into: £110bn – economic costs such as sickness absence, ‘presenteeism’, staff turnover and unemployment £130bn –

(adapted from an article for Labour Outlook) Wes Streeting has been winding up health workers, campaigners and Labour activists once again, with more loose talk about turning to the private sector rather than investing in expanded NHS services to reduce waiting lists. It follows his promise last November to “hold the door wide open” for

Press reports of the wafer-thin reduction in the NHS waiting list in England were divided, with some reports buying the NHS England interpretation that the numbers had reduced for the “fifth month in a row.” However others were more nuanced. Business news from Bloomberg reported “NHS Waiting Lists Decline, But Still Fall Short of Sunak

Doctors were shocked to discover the latest cash-saving wheeze from NHS England to axe the dedicated mental health support for hospital doctors offered by the Practitioner Health Programme (PHP), but after an outcry from across the medical profession, the scheme was given a last-minute reprieve. The service – the largest publicly-funded mental health staff treatment

With an election looming, on past form NHS chiefs might have been expected to hold back on driving through ‘unpalatable’ measures to cut spending this year, partly because ministers would not normally want to see unpopular cuts in the run up to polling, and partly in the hope of some relief to come if there

But while hospital beds clog up with thousands of patients who cannot be discharged for lack of services to support them, and the queues for beds back up into Emergency Departments, NHS England has resorted to desperate tactics in their efforts to force an apparent improvement in A&E performance. The HSJ revealed that on the

The British Social Attitudes (BSA) survey shows just how far satisfaction in the NHS has fallen – it is now at an all-time low of just 24%; in 2010 it stood at 70%. Figures for social care services were even worse – just 13% of respondents were satisfied with social care and 57% were very

The business press and private sector spin doctors are doing their best to talk up the growth of the private hospital sector despite increasing signs that the prices of private care are unaffordable. The most recent flurry of puff came as a result of analysis by independent consultancy Broadstone, which showed admissions using private medical insurance increased to

There have been many calls for better access to GPs, but no clamour at all from patients to be able to get an appointment with a Physician Associate: yet that may be all that is on offer to 2.4 million patients in nine North West London boroughs if plans to reshape primary care services are

The battle over the proper delineation of the role of Physician Associates (PAs) in particular has been taken in to the once prestigious Royal College of Physicians (RCP), which in recent years has strongly embraced the idea of PAs. Unlike the Royal College of Anaesthetists, which last October convened an extraordinary general meeting at which over 90%

Tackling poverty and its negative effects on health should be as high a priority as addressing the NHS waiting lists, according to a new report by The Kings Fund and the Joseph Rowntree Foundation.  The report – Illustrating the Relationship Between Poverty and NHS Services – found that despite poverty being very bad for your

Last week’s budget gave the NHS’s capital budget, used for infrastructure, a boost of £3.4 billion, but there is a catch. It is all earmarked for technology, digital and AI projects and is dependent on productivity increases – that are almost double anything asked for previously. Meanwhile, parts of NHS buildings are falling on patients

Private health bosses have again been pumping out press releases to give the impression that private hospitals and insurers across the UK are booming as a spin-off from bloated NHS waiting lists. Aviva has reported sales of health insurance were up by 41% in 2023 compared with the previous year, with more businesses and individual

The Spring Budget delivered by Chancellor Jeremy Hunt last week contained little for the NHS, and what was given is largely dependent on huge productivity increases being achieved. Money for Tech and Digital The main funding pledge was £3.4 billion of capital investment primarily for technology and digital transformation, which the Chancellor claimed doubles the

Privatisation of healthcare results in a reduction in quality of care according to a review paper published this week (1 March 2024) in The Lancet. The study’s authors from the University of Oxford, concluded that:  “At the very least, health-care privatisation has almost never had a positive effect on the quality of care.” Adding that

Proposals put forward by the Labour Party to develop a national network of ‘neighbourhood health centers’- should they win the next election, have raised big questions about how the idea would work and what it might cost Impressed by the Australian model of polyclinics, Labour health spokesman Wes Streeting has announced his intention to replicate

In the run-up to the election, The Lowdown is inviting a range of NHS commentators, staff and campaigners to give us their policy priorities for the NHS. Here Tony O’Sullivan, co-chair of Keep Our NHS Public, outlines the arguments and principles behind the call to restore a people’s NHS In the countdown to this year’s

The Urgent and Emergency Care Situation Reports (Sitreps) published by NHS England show that for the week 12-18 February the average daily acute bed occupancy stood at 95.5%. This is a further increase from the average 94.7% occupancy a week earlier, and higher than the highest suggested target level of occupancy. The Royal College of Emergency

The scale and weight of GP antagonism towards plans in North West London  to roll out a system of “same day access hubs” that would make minimal use of GPs (see Lowdown February 15) has forced the Integrated Care Board (ICB) into a limited retreat. A letter to GPs from ‘NW London Primary Care’  dated

John Hutton signed off thirteen NHS Private Finance Initiative (PFI) building projects as a Labour health minister in 2002 (see footnote). Last month he was appointed to speak up for private sector investors ahead of likely disputes as some of the earliest PFI contracts draw to a close. (Now Lord) John Hutton has been installed

The Chancellor’s Spring budget is imminent and the message from the public health and health sectors is that poverty is a public health crisis, which he would be wise to target if the economy is to improve. A letter signed by 60 organisations and individuals, including the Association of Public Health Directors (APHD), leaders of

King’s College Hospital Foundation Trust has been chronically financially challenged for many years now. So seriously challenged we might have expected it to be included amongst the most troubled group of trusts in in NHS England’s ‘System Oversight Framework’ (SOF). (See our recent article on SOF and the latest NHSE ratings of trusts and ICBs). But in

According to NHS England, more than half (23) of the 42 Integrated Care Systems (ICSs) in charge of commissioning services have “Significant support needs” as they struggle to meet financial, operational, or strategic targets. They fall into Segment 3 of NHSE’s NHS Oversight Framework, effectively the NHS ‘naughty step’. Only one ICS – Frimley –

Hammersmith & Fulham Save Our NHS (HAFSON) campaigners in North West London have told The Lowdown of a brewing row over leaked plans to force through a wholesale reorganisation of primary care services that would exclude GPs from almost all provision of ‘same day’ GP care for over 2 million people across the Integrated Care

The NW London row has broken as tensions rise across the NHS over perceived efforts by government and NHS England to squeeze out fully qualified GPs and consultants and replace them with much less well qualified Physician Associates and equivalents. The Lowdown reported on this brewing controversy at the end of November, but since then

Many people may have been unaware of the existence of the British Medical Journal’s Commission on the Future of the NHS: but most will welcome its first report, which combines full support for the founding principles of the NHS with the call for the next government after the general election to declare a “national health