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Stories from the Lowdown:

Collapse of private ambulance firm hits NHS 999 care

Faltering promises to support cancer services costs lives

CCG mergers: efficiency drive, or something more sinister?

 

No Deal Brexit: How bad can it be?

Asked to make a cut too far, NHS Trust CEO resigns

Welsh bed closures have left hospitals short of capacity

Curse of PFI strikes again

 

Can trusts continue as a going concern?

Calls for care workers to be given the recognition of their NHS counterparts

Totting up the cost of interest payments

South Tyneside campaigners win right to appeal

 


GPs express concern over new NHS plans which would allow chemists to prescribe statins 

Last week Simon Stevens announced new NHS plans aimed at reducing the number of people dying from heart attacks and strokes, by giving pharmacists new responsibilities.  

If approved, the plans would allow pharmacists to provide an on the spot health check and statins to people suspected of “dangerously high” levels of bad cholesterol.  

NHS England says the move “could prevent thousands more deaths and countless more heart attacks and strokes”. 

However, the Royal College of GPs (RCGP) voiced alarm at the proposed change, saying it could lead to people being misdiagnosed and wrongly treated by pharmacists. 

Full story on The Guardian, 4 September 2019. 

 

East Kent Hospital Trust books hotels for staff and extra ambulances in case of no-deal Brexit 

Hotel rooms have been pre-emptively booked by the Trust in case there is difficulty travelling to work with severe traffic jams if a no-deal Brexit was to happen.  

Two of the trusts main sites are near ports of Folkestone and Dover. If no-deal Brexit was to occur there would be a tailback of lorries awaiting customs declarations at the ports, which would cause major traffic disruption on the Kent roads.  

Extra ambulances and ambulance staff are also being brought in from other areas to support the South East Coast Ambulance Service. 

East Kent Hospitals University NHS Foundation Trust said: “Like the rest of the NHS, East Kent Hospitals is putting preparations in place to ensure essential services for patients would continue to be available if local traffic routes were disrupted […] We have booked a small number of hotel rooms close to our emergency hospitals as a precautionary measure, for an initial two-week period.” 

Full story on BBC News, 5 September 2019. 

 

Hospitals in England are being encouraged to sign up to staff passporting agreements, following successful pilot programmes 

The new scheme would allow healthcare staff to seamlessly move between hospitals to cover staff shortages and improve patient care. Such passporting agreements would remove the need for inductions and other admin processes when staff move between NHS organisations. 

The deployment of staff under this scheme has been successfully trialled at five London hospitals. 

Jeeves Wijesuriya, Chair of the British Medical Association’s (BMA) Junior Doctors Committee admitted the scheme may bring about some positive changes but warned that patient care should not be compromised for convenience. 

Full story on Nursing Notes, 7 September 2019. 

 

Specialist referrals to be restricted under new controversial “rationing” plans in London 

GPs are to be urged against specialist referrals and some outpatient services are to be axed altogether under new plans.  

The plans will affect millions of Londoners. Health chiefs are hoping they can plug the huge hole in their healthcare budgets by saving £60 million in the next few months.  

North West London collaboration of CCGs communicated the changes by letter and will affect around 2 million people. GPs will be urged to find “alternative ways” of dealing with patients in need of hospital care. 

Dr Gary Marlowe, BMA London regional council chair and London GP, said that while the financial pressures that clinical commissioning groups (CCGs) were under was appreciated, “cost-cutting must not come at the expense of quality patient care or increased bureaucracy and workload for doctors”. 

Full story on The Guardian, 8 September 2019. 

 

Unison warns that a No-Deal Brexit will cause chaos for the NHS and push the service over the edge 

Unison warn that the uncertainty and chaos of a no-deal Brexit could cause the NHS to reach breaking point, with patients being the biggest losers.  

Such a situation could lead to severe drug and medical equipment shortages, cancelled operations and increased waiting times.  

There are also concerns about the impact of Brexit on the recruitment and retention of staff in the NHS, exacerbating an already large problem for the health service.  

Unison general secretary Dave Prentis said: “The chaos and uncertainty a no-deal Brexit would bring could push an already under-pressure NHS over the edge. And patients will be the biggest losers.” 

Full story on Huffington Post, 8 September 2019. 

 

Seven in 10 hospital trusts failing to meet safety standards 

Analysis of inspection reports shows that patient safety is at risk, with 70% of hospital trusts failing to meet national safety standards. Staff shortages are cited as the biggest problem.  

The CQC found that managers at one trust failed to act on staff reports of abuse and violence. Another trust had such a shortage of critical beds that three serious incidents occurred, resulting in patient harm. 

Of 148 acute and general hospital trusts, safety standards at 96 are rated as “requires improvement” by the CQC; six are rated inadequate, the lowest category. The others are rated good, with none outstanding. 

Full story on The Guardian, 8 September 2019. 

 

Midwives are calling for the Government to scrap NHS maternity charges for vulnerable migrants 

Midwives are calling for the maternity charges for refugees, migrants or visitors from overseas, which can amount to tens of thousands of pounds, to be scrapped. 

Health workers say that the “hostile environment” is making it more difficult to do their job, putting vulnerable women and their babies at risk.  

Maternity Action and the RCM have called on the government to immediately suspend charges for NHS maternity care and also to stop debt built up from such services from affecting immigration applications. 

Rosalind Bragg, the director of Maternity Action, told the Guardian: “NHS midwives provide brilliant care to the destitute women they see, but the policies of charging for maternity care make it hard for them to do effectively. The charges put them at risk of avoidable harm 

Full story on The Guardian, 9 September 2019. 

 

Private provider of autism services in South Staffordshire cancelling services amid a dispute with the CCG 

Midland Psychology, who provide children’s autism services, have begun cancelling appointments and drawing back their services ahead of their contract ending at the end of September. 

This move comes as the CCG made the decision to re-tender the services following an external review that was critical of autism and child and adolescent mental health services in the area. The procurement process is ongoing and due to end in January 2020.  

The CCG argue that Midland Psychology are contractually obliged to continue their full services until the end of the month, when the CCG then plan to have an interim provider in place. However, the provider argues it is impossible to carry on ‘business as usual’ by continuing to see new patients when the service will not continue past September 30th.  

Children in crisis appointments will continue to be provided up till this date. However, the CCG have not responded to HSJ questions regarding the specific timescale of the procurement process. This leaves children with autism in limbo as services are disrupted before an interim provider has even been established. 

Full story on HSJ, 10 September 2019. 

 

Discussions continue surrounding NHS pension ‘tax trap’ that is contributing to the staffing crisis 

Earlier this year it was reported that medics have had to turn down extra hours in fear of falling into a ‘tax trap’ that could leave them with bills as high as £100,000. This has led to operations being cancelled, sometimes at the last minute, and cancer scans piling up unread for weeks.  

The Department of Health and Social Care estimate that the current rules are leading to as many as 1 in 3 GPs and consultants turning down extra hours, in fear of their pension pot increasing too much in one year and leading to a large bill. 

The Government has announced plans of a pension shake up in the hope of finding a solution to the problem. However, groups representing doctors affected have said the reforms need to go much further. There are also concerns that the current plans will make the already complicated pension arrangements even more complex. 

Full story on The Guardian, 11 September 2019. 

 

Hospice forced to close due to staff shortage 

The St Mary’s hospice in Ulverston, Cumbria has been unable to find a doctor to oversee its services and will now have to close its doors to new patients. 

Its senior doctor is due to leave, but after months of trying, the hospice has been unable to find a replacement. From mid-October dying patients will have to be cared for elsewhere and some inpatients may have to be moved. The nearest alternative is St John’s 39 miles or an hour’s drive away in Lancaster. 

St Mary’s hopes that this closure will be temporary. The hospice cares for 1,350 people a year either as inpatients or via the hospice at home team.  

Full story in The Guardian, 11 September 2019 

 

NHS England makes partial U-turn on cancer scanning plans 

The controversial decision by NHS England to award the PET-CT scanning contract for the Thames Valley to the private company InHealth has been partially reversed. The Oxford University Hospitals Foundation Trust, which lost the contract following a procurement process, will now continue to run the services at the Churchill Hospital after a partnership agreement was reached with InHealth.  

The awarding of the contract to InHealth would have meant the service at the Churchill site closing and being relocated. The Churchill Hospital is a specialist cancer care centre. InHealth will now provide a mobile scanning service to the wider area in at Milton Keynes University Hospital, Royal Berkshire FT and Great Western Hospitals FT. 

The decision to award the contract to InHealth resulted in an avalanche of complaints from councillors, politicians and the public. Concerns revolved around the break-up of the world-class scanning department at the Churchill Hospital and that patients at the hospital would have to be transported to a scanner elsewhere. HSJ reports that, co-chair of the Socialist Health Association Oxfordshire and member of the Oxfordshire Health Overview and Scrutiny Committee, Nadine Bely-Summers welcomed the partial u-turn but said the “fight will continue” for the rest of the Thames Valley. 

Full story in the HSJ, 12 September 2019 

 

The Scottish government agreed deal for Orkambi for cystic fibrosis patients  

The Scottish government has come to a deal with Vertex, the makers of Orkambi for the treatment of cystic fibrosis. The price that the government has agreed to has not been disclosed, but 350 patients eligible for the drug will now receive the drug paid for by the Scottish NHS. 

The deal, which is for five years, also includes access to the follow-up drug Symkevi. Vertex will collect data from patients to monitor its efficacy in a real-world situation outside of clinical trials. 

In England no deal has been reached and patients and relatives continue to campaign for access. NHS England has offered £500m over five years for Orkambi and other upcoming cystic fibrosis drugs, but the manufacturer, Vertex, turned that down. 

Full story in The Guardian, 12 September 2019 

 

Government’s Operation Yellowhammer document confirms medicine delays 

The leaked Operation Yellowhammer documents, which outline the ‘reasonable worst case’ scenario if the UK crashes out of the EU without a deal include delays to a large number of medical supplies, both human and veterinary. The Government has also acknowledged that this will have a particularly bad impact at a time of year when flu rates are increasing.  

The document states that medicine supplies would be ‘particularly vulnerable to severe extended delays.’ Stockpiling may also not be possible due to the short shelf lives of many products. 

Full story in GPonline12 September 2019 

 

The rise in patient numbers has not been matched by a rise in nurses  

Research conducted by the Royal College of Nursing shows that the nurse workforce has increased by 4.6% in five years, however this has been eclipsed by the 12.3% rise in hospital admissions 

The RCN notes that this highlights that more needs to be done to ensure safe staffing. According to the government the rising NHS budget will ensure high-quality care. 

The shortage of nurses is well established, with latest figures suggesting one in nine posts is vacant. The government often counters this fact by pointing out the number of nurses working in the NHS is increasing. 

Full story on The BBC, 17 September 2019 

 

 

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