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Inadequate resources in the Health Service
For archive material see:
Resource Shortfall Sources to 2006
- Hospitals told
to delay operations to ease debt. Hospitals have been told not to operate
on patients until they have been on a waiting list for up to 20 weeks in the
latest attempt to deal with the financial crisis in the health service. The
instructions to delay treating people for as long as possible are spelled out
in leaked documents seen by The Daily Telegraph. In one letter, hospital
managers are told to work out how many operations can be put off until after
the new financial year, which starts in April. The documents, which were
leaked to the Conservatives, are the latest evidence of the impact that the
£1.3 billion deficit run up by front-line trusts in England is having on
patient care. The Tories said patients were having their treatment
artificially delayed because trusts were under orders from Patricia Hewitt,
the Health Secretary, to ensure that they break even. The instructions to
delay treatment for as long as possible are made in two separate letters sent
by health managers in the East of England, which has the worst performance in
the NHS. The first letter was sent by the
East of England's strategic
health authority to the chief executives of the region's primary care trusts,
which run GP clinics and pay hospitals if a patient needs treatment. The
letter, written in November by Dr Paul Watson, the strategic health
authority's director of commissioning, underlined the pressing need to get a
grip on budgets. "The current end of year projections for PCTs are simply
unacceptable," he said, before going on to set out his plans to ensure
hospital operations were "restricted to the minimum required to meet required
access targets." There is a similar message in a separate letter sent to the
Queen Elizabeth Hospital in King's Lynn by Hilary Daniels, the chief executive
of the
Norfolk primary care trust. In her letter, she said her PCT was having to
impose limits on the number of patients it could pay to be treated at the
hospital in the final few months of the financial year. Andrew Lansley, the
shadow health secretary, said: "There is no point in paying these NHS staff to
do nothing in the last quarter of the financial year solely because Patricia
Hewitt has put her own job on the line by promising to get the NHS back into
the black by April. Even the Department of Health must realise this is false
economy."
Summary by
Keep our NHS Public of Telegraph
2 January 2007
- NHS trusts
force patients to wait longer for operations. Patients in some parts of
the National Health Service are for the first time facing minimum waits to be
seen and treated as managers attempt to balance their books.
Suffolk,
Hertfordshire,
North Yorkshire and
Kingston are all
imposing various forms of minimum wait, with some primary care trust chiefs
saying their organisations may follow suit as the NHS battles to recover from
last year's £500m-plus overspend. Hospitals treating patients from north, east
and west Hertfordshire have been told not to book them in for non-urgent
operations until the start of the new financial year in April. Similar
restrictions will apply to new outpatient appointments from the end of
January. Patients in Suffolk are having to wait a minimum of 14 weeks for
routine surgery and York NHS Trust has been told by its local primary care
trust not to operate on non-urgent cases until they have waited a minimum of
20 weeks - six weeks short of the government's guarantee that patients will
not wait more than six months for an operation. Kingston primary care trust is
operating a standard 10-week wait for outpatient appointments - three weeks
short of the13-week maximum wait. Patricia Hewitt, the health secretary, has
acknowledged that a slight rise in overall waiting times earlier this
financial year was due to some parts of the NHS setting minimum waits on
"patient referrals, diagnostic tests and treatment" to "negate the financial
deficit". Michael Dixon, chairman of the NHS Alliance, which represents
primary care trusts, said: "This is a direct effect of payment by results. In
the old days of cost and volume contracts it wasn't an issue because hospitals
didn't get paid any more if they treated more patients than planned." Now that
they are paid for each patient they treat, "if a hospital brings its waiting
list down rapidly it will do an awful lot of extra work and blow the primary
care trusts' budget", he said.
Summary by
Keep our NHS Public of Financial
Times 2 January 2007
- Patients kept
waiting in car park as hospital 'too busy to cope'. Patients were left
waiting for up to an hour in ambulances in a car park, being looked after by
paramedics, because a hospital was so busy over New Year. Campaigners said the
Royal
Cornwall Hospital in Truro was swamped with admissions on New Year's Eve
and the early hours of New Year's Day. They pointed out that two wards were
closed last year and hundreds of staffing posts axed under cost cuts. Geoff
Martin, head of campaigns at pressure group Health Emergency, said: "We have
warned that hospital capacity is being cut to dangerous levels in many parts
of the country and that is clearly the case in Cornwall as the hospital comes
under government pressure to balance the books. Having ambulances stacked up
outside A& E departments waiting for
a bed to become available takes vital blue-light capacity off the streets and
puts lives at risk. This is the consequence of Government cuts and closures at
the sharp end of the service and is a bleak New Year reminder of what's at
stake in 2007 for the NHS."
Summary by
Keep our NHS Public of Mail
3 January 2007
- Red tape is
'lowering standards of patient care'. More than half of family doctors in
England are being forced to refer patients to hospital through an extra layer
of red tape and many are prevented from naming a consultant they know and
trust. In some cases the referrals are refused and doctors have to argue the
case for the patient to be seen by a consultant. The effect is to increase the
time that patients have to wait for their operations and the aim is to cut the
number of patients treated in order to save money, the doctors say. Referral
management centres which began to be introduced about a year ago are now
common and have destroyed the direct contact between GPs and hospitals. A
survey by the doctor's magazine Pulse found that 53 per cent of GPs said that
they had to refer patients to one of these centres and 43 per cent said they
were barred from naming the consultant they would like to treat their patient.
Management referral centres increase waiting times by weeks because letters
must pass between the GP and the centre. "The centres are widespread. It is
entirely because they want to save money. They are an unnecessary bureaucratic
layer," said Dr Prit Buttar of the Abingdon Surgery,
Oxon. He
said he could refer a hernia patient and then receive a letter refusing to
accept the referral because he had not said the patient was in pain. He would
then have to refer the patient again with more explanation. "Finally the
patient is phoned by a booking clerk and offered a choice of hospitals. I am
not able to recommend a consultant. I am not able to send a patient to the
consultant they had before," he said. In other cases letters have been lost by
the centre. "The centre has to phone the patient three times and then write
once if they had no reply. With one of my patients all three calls were made
within 15 minutes, recorded on his answer phone," Dr Buttar said.
Summary by
Keep our NHS Public of Telegraph
3 January 2007
- NHS managers
spurn top jobs. NHS managers are shunning the top jobs in the health
service because they fear being vilified and blamed for hospital deficits and
closures. Young directors are reluctant to become chief executives of NHS
trusts because of the way that senior leaders are treated, according to the
NHS Confederation, which represents 93 per cent of health service
organisations. Gill Morgan, head of the confederation, told The Times that the
health service was enduring a "crisis of confidence" among its senior bosses
amid the Government's drive to reconfigure local services and cut costs.
Despite salaries of up to £150,000, the CEOs of the most troubled hospital
trusts spent an average of 22 months in the job, often resigning because of
public persecution and political pressure, she said. "We're finding it very
difficult finding people who want to be chief execs," she said. A fifth of
trust CEOs left their jobs last year, leaving a number of senior vacancies
open for months at a time. This turnover of NHS chief executives is 5 per cent
higher than in the private sector.
Summary by
Keep our NHS Public of Times
3 January 2007
- Operations
cancelled as NHS runs out of money. Patients are being denied basic
operations, including treatments for varicose veins, wisdom teeth and bad
backs, as hospitals try frantically to balance the books by the end of the
financial year. NHS trusts throughout the country are making sweeping cuts to
services and delaying appointments in an attempt to address their debts before
the end of March. Family doctors have been told to send fewer patients to
hospital, A& E departments have been
instructed to turn people away, and a wide range of routine procedures has
been suspended. In one example of the cash-saving strategies a PCT in
Yorkshire has told hospitals that they will not be paid for some
non-essential operations, while patients will not be given a hospital
appointment in under 8 weeks. Similar tactics have emerged at hospitals in
Norfolk and
Surrey,
while dozens of trusts have resorted to closing beds and offering voluntary
redundancy in recent months.
Devon Primary Care Trust has offered voluntary redundancy to all 5,000
staff. The cuts are widespread, although there are no central records to
provide definitive figures. Among the most comprehensive plans are those from
North Yorkshire and York Primary Care Trust, which faces a deficit of £24m
this year. A letter from its chief executive, Janet Soo-Chung, says that all
non-urgent admissions must be approved by an assessment team or they will not
be paid for. A& E departments in
Harrogate, Scarborough, South
Tees and York have been told that they will not be paid for treating
patients with minor ailments who could go elsewhere. No patients will be given
a hospital appointment in less than 8 weeks, and none admitted for elective
surgery unless they have waited a minimum of 12 to 16 weeks. Those treated
quicker will not be paid for. The trust also announced the immediate
suspension of treatments for varicose veins, wisdom teeth, X-rays of the back,
operations for carpal tunnel syndrome, bunions, arthroscopy of the knee, and
grommets for the ear, among others. Norfolk PCT has issued similar
instructions, telling hospitals not to treat patients who have waited less
than 17 weeks - expected to rise to 18 weeks by February. Hilary Daniels, the
interim chief executive, said that the trust would not pay for
elective operations on
smokers until they had attended smoking clinics.
Summary by
Keep our NHS Public of Times
4 January 2007
- NHS
title cost £10k. Health bosses have been attacked for using £10,300 of
taxpayers' cash creating a new name. Image consultants spent a year dreaming
up a title for an NHS trust. Cynergy Healthcare eventually chose one that is
longer than the original.
Doncaster
and
South Humber Healthcare NHS Trust will become Rotherham Doncaster and
South Humber NHS Foundation Trust later this year. Doncaster councillor Martin
Williams said: "It's a scandalous waste. They have replaced a daft name with
an even longer one." The Trust said: "It was to include Rotherham."
Summary by
Keep our NHS Public of Mirror
5 January 2007
-
NHS trusts with
total £186m deficit could get extra funds. Seventeen indebted NHS trusts
whose income was capped under the transition to
payment by results are now
eligible for additional financial support in 2007/
08, the Department of Health has said. The trusts reported a combined
deficit of more than £186m in 2005/
06, with over half forecasting a deficit in 2006/
07, eight of them more than 5% of annual turnover. A further ten trusts
whose income was also capped yet who have not experienced a deficit will also
be eligible for support from their strategic health authorities. Any support
given will have to be approved by the DoH and reported in financial plans.
Potential recipient trusts include
South Warwickshire General Hospitals Trust, which has a £14m deficit,
equivalent to 13% of annual turnover. The trust last year told Public Finance
it would not have a deficit at all if it was not capped. Summary by
Keep our NHS Public of Public
Finance 5 January 2007
- Views sought on
shake-up of mental health.
Mental health services are the latest area to face
cost-cutting in the NHS in
Sheffield,
as plans for the shake-up go out to public consultation. If the changes go
ahead as planned, they are expected to save Sheffield Primary Care Trust 5% on
the cost of that type of care. Savings are being implemented across health
services in Sheffield in the drive to save money to make the accounts balance.
Summary by
Keep our NHS Public of Yorkshire
Post 5 January 2007
- Two-thirds of maternity units understaffed, survey says. Midwives
today blamed the NHS financial crisis for turning maternity care into a
"Cinderella" service. The Royal College of Midwives (RCM) expressed "deep
concern" at the drastic measures being taken by cash-strapped hospitals at a
time when the birthrate was rising in most maternity units. A survey by the
union published today revealed that cuts, job freezes, staff shortages and
financial crises meant two-thirds of maternity units were now understaffed,
and an equal number were struggling with deficits. Hélène Mulholland
Monday January 8, 2007 Guardian Unlimited
- NHS "on track"
to balance books. Health Secretary Patricia Hewitt has insisted that the
NHS is "on target" to achieve balance by the end of the financial year. She
also said that, while there was a projected 18,000 job losses this year, the
final figure could not yet be pinned down. The 18,000 would not all be
redundancies with many vacancies merely not being filled. Ms Hewitt said: "I
have made it clear that we do need to get the NHS back into financial balance
by the end of March. We are on track to do that and I am confident we will."
She said that of the 903 redundancies up to September last year "almost all of
them" were managerial and administrative, and that this would be a trend
across the year in line with the Government's 2005 manifesto pledge to reduce
such overheads.
Summary by
Keep our NHS Public of Birmingham
Post 8 January 2007
- Interpreters
axed in bid to save £40,000. Financially troubled
Cambridgeshire Primary Care Trust has slashed interpreting services to
save £40,000 as part of its attempts to counteract a looming £33million
deficit predicted for April this year. Ethnic minority groups have branded the
decision as discriminatory and health care professionals have said it will
hamper their efforts to provide an equitable service. Councillor Geoff
Heathcock, chairman of Cambridgeshire County Council's health scrutiny
committee, said: "£40,000 doesn't even measure on the Richter scale in terms
of the cash saving it makes compared with the impact this has." The primary
care trust has said that the cut is due to a "significant" increase in use of
the service and thus an overspend that has made the measure necessary. The
trust wrote to GPs last year asking them to use more telephone interpreting
instead of the face to face service. However, a letter from Karen Mason, the
PCT's acting director of communications and public involvement, says that: "We
have to ensure all costs remain within budget and when overspends occur,
expenditure is brought back into line or at very least the position does not
worsen." The PCT has said it will recommence telephone interpreting on April
1st, but that the face to face service will cease completely.
Summary by
Keep our NHS Public of Cambridge
Evening News 8 January 2007
- Health chiefs
face "rationing" claim. Health chiefs at North East
Essex Primary Care
Trust have been accused of rationing treatment to cataract patients. A leaked
memo has revealed a policy supposedly designed to ensure that those with the
most serious conditions get treated quickly. The new system of "affordable eye
care" means people in the Colchester, Clacton and Harwich areas who suffer
from cataracts will be graded on a points system depending how serious their
condition is. Health bosses have claimed it is designed to avoid those with
more advanced conditions being blocked by those with less serious ones.
However North Essex MP Bernard Jenkins has accused the PCT of massaging
figures and covering up the true numbers waiting by not adding many to the
list. The PCT's director of strategic development and commissioning, Matt
Bushell, defended the new system saying: "Patients who need cataract surgery
will receive an operation within three months, which is in accordance with
national guidelines. Patients are assessed as to those who need prompt access
to surgery, those who can wait three months and those that do not need
surgery. People with more advanced cataracts need an operation as soon as
possible and this system means they will not be delayed." He added that the
new system would "ensure that the PCT operates within its means, as there are
limited resources available for elective surgery - across the East of England
PCTs are in overall financial deficit situation."
Summary by
Keep our NHS Public of East
Anglian Daily Times 8 January 2007
- Bidding war
fears for GPs' out-of-hours service. A bidding war is looming over
out-of-hours services in
Norfolk and Waveney, sparked by Norfolk PCT's demands for a cheaper deal
as it battles a £50m deficit. The situation is causing concern over the
quality of the service if a cut-price battle ensues. North Norfolk MP, Norman
Lamb, has voiced concerns over what he says will be a cut in expenditure
between 30% and 40%. He added that providing such a service in rural areas
cost more than less isolated ones and that the service could be a matter of
life and death. Concerns include the fact that doctors in the area, who make
up 90% of those used in the service, may find that massive reductions in the
hourly rate for being available out-of-hours make it an unappealing option.
Summary by
Keep our NHS Public of Eastern
Daily Press 8 January 2007
- Patient, 80,
told to wait a year for heart test. A patient waiting a year for a heart
test received a letter from his consultant blaming hospital bosses. Dr Thomas
Mathew said pleas for more technicians to carry out tests had been ignored.
The City Hospital
specialist wrote: "In spite of repeated requests, we are yet to receive any
response from the management team and as a consequence have been unable to
advertise for replacements. I am sorry that our service has let you down but
you will appreciate this situation is beyond my control." He said patients
were waiting up to 40 weeks for an echocardiogram, even though the Government
is about to introduce a target of less than 18 weeks.
Summary by
Keep our NHS Public of Nottingham
Evening Post 9 January 2007
- Government has one year left to save the NHS, warns BMA chief. Call
to look again at competitive market. Many hospital trusts in 'the worst
of all worlds'. The government has only a year to save the NHS and maintain
its status as a free service funded by taxation, the leader of Britain's
120,000 doctors warned yesterday. James Johnson, chairman of the British
Medical Association, said the period of record growth in the health budget was
due to come to an end next year. If Patricia Hewitt,
the health secretary, did not correct the "idiocy" of the
competitive market she created in
the NHS, there would be overwhelming pressure for fundamental reform. John
Carvel, social affairs editor
Friday
January 12, 2007 The Guardian
- Hospital told
to treat fewer patients. One of
Essex's biggest
hospitals has been ordered to see fewer patients because of the cash crisis in
the NHS. Colchester General Hospital has been told that the North East Essex
Primary Care Trust (PCT) cannot afford to pay for it to continue treating
people at the current rate. More than 1,500 people will now be seen later than
they could have been because the PCT has ruled that non-emergency patients
must wait at least 16 weeks before going to the hospital. This means people
waiting to see a hospital consultant will face the minimum wait even if the
consultant is available for an NHS appointment the following week.
Summary by
Keep our NHS Public of East
Anglian Daily Times 12 January 2007
- We'll get NHS
cash back - eventually. The county's top NHS boss has defended £27.3m
worth of loans from south
Essex health
services to bail out debt-ridden health departments in other counties. Neil
McKay, newly-appointed chief executive of the east of England Strategic Health
Authority, said he has a responsibility to balance the books for the entire
region. But patients fear longer waiting times and fewer services as £18.4m is
taken from the £460m budget of the South West Essex Primary Care Trust. A
further £8.9m has been demanded from the South East Essex Primary Care Trust.
There is no guaranteed date for when the cash will be returned.
Summary by
Keep our NHS Public of Essex
Echo 12 January 2007
- PCT hikes drug
prices. A radical shake-up in prescribing medicine could mean some of the
borough's sickest residents are forced to pay more for their drugs. Since
January, doctors' surgeries in
Sutton and Merton
are being encouraged to prescribe regular medication to last for 28 days,
which the primary care trust (PCT) says will cut wastage and allow for regular
monitoring. But it could mean those on regular medication paying £6.65 a
month, rather than the same charge for a longer-lasting supply. Geoff Martin,
head of campaigns for pressure group, Health Emergency, and a Unison official
said: "It sounds like the PCT is using this to claw back more money." One
Merton resident used to pay £13.30 for a six-month supply of two types of
drugs she has taken regularly since having cancer. She is furious and said:
"I'll now have to pay £159.60 a year. I may have to do without one of the
drugs now if I can't afford it. My GP is extremely angry and is concerned that
residents have not been made aware of the new scheme and will only realise
once they get to the chemists." The PCT insists that '28-prescribing' is a
well-publicised and positive move. Summary by
Keep our NHS Public of Sutton
Guardian 12 January 2007
- A&E success
'not sustainable'. A& E
departments are
struggling to sustain improvements to waiting times because of NHS
deficits, the British Medical Association has
warned. A BMA survey of doctors blamed a lack of inpatient beds, along with
staff shortages and inappropriate demand from people with minor complaints. A
third of doctors surveyed said data was manipulated to ensure government
targets were met. Since 2004, 98% of patients in A&
E should be seen within four hours. Around 500 members of the British
Association of Emergency Medicine responded to the BMA survey to investigate
the impact of the four-hour target, which has been heralded as a success story
by the government. Almost half of respondents reported that their department
was not meeting the target. And doctors raised concerns that even when targets
had been met, departments had needed to use additional funding and agency
staff on short term contracts to make sure patients were seen in time.
Government figures show that in 2005-06, 98.2% of patients were seen,
diagnosed and treated within four hours of their arrival at A&
E, the first full financial year in which this has happened. However,
the BMA survey suggested that data could not be relied upon, due to
manipulation of the figures. Mr Don MacKechnie, chairman of the BMA's
Emergency Medicine Committee said: "Many hospitals have cut bed numbers as
part of their financial recovery plans and attempts to balance their books.
This means that there are fewer available beds for patients coming through A&
E who need to be transferred within four hours to a hospital ward from
the emergency department to meet the Government's access target." Doctors also
raised concerns about the effects of the target on clinical care with
two-thirds saying that some patients are moved to inappropriate areas or wards
and over half reporting that patients may be discharged before they had been
adequately assessed or stabilised. Previous surveys by the BMA have shown that
many believe the target is set too high and that a lower goal of 95% of
patients being seen within four hours would be more realistic.
Summary by
Keep our NHS Public of BBC
Online 19 January 2007
- Ward shuts at
new hospital. Bosses at
Coventry's new
University Hospital have announced plans to close a ward and axe 24 beds -
just six months after it opened. Ward 33a is to close down under the plans,
which will save the hospital trust about £400,000, and the staff and patients
will be spread around other wards. But staff and union officials have accused
hospital management of failing to think through the plans, which could come in
to force as early as February 1. And they say mixing the wards is a potential
disaster, as it could see cases of superbug MRSA rocket at University
Hospital, which has until now had a good record for the bug. Charlie Sarrell,
regional officer for Unison, said: "They're closing ward 33a and shunting
everybody to 22 and 32, and one of our main concerns is that services will be
lumped in together, and this could be dangerous. This is not good clinical
practice. Management are taking the view that there can be fewer beds if
there's a faster throughput of surgical patients, but surgical beds are used
when there is an over-flow of clinical patients, so where will they go
? There are no redundancies indicated but we are concerned about the
disruption to staff and the fact that the management seem to be rushing this
through. There will be more pressure on staff, consultants will be expected to
be more available and nurses could end up discharging patients, which is not
their job." One nurse affected by the closure, who asked not to be named, said
she was worried that nurses were being asked to reapply for their jobs. She
said: " We've been told we have to reapply for our own jobs within a week.
They told us there were going to be bed closures and it was for economic
reasons." Acting director of nursing Dr Ann-Marie Cannaby said: "We are not
making any nurses redundant. A small number of nurses will have to work on a
different ward but they are being asked for their preference as to where they
would like to work."
Summary by
Keep our NHS Public of Coventry
Evening Telegraph 19 January 2007
- Health trust
under attack for cutting services. Patients may be forced to wait a
minimum of 12 weeks for routine surgery, as health chiefs order cuts in
services. It comes as the
East Riding of Yorkshire Primary Care Trust (PCT) attempts to tackle a
shortfall of £20m. Patients due an outpatient appointment will also have to
wait at least six weeks, the PCT said. And, under the proposals, people making
a normal recovery after an operation will also be referred to their GP rather
than a consultant. The PCT announced it is taking urgent action "to ensure the
expenditure in the remaining months of this financial year is brought back
into line with original financial forecasts". GPs and local trusts have been
told to "ensure restricted treatment guidelines are strictly adhered to".
These limit access to certain treatments including liposuction, varicose vein
removal and the removal and revision of breast implants. In Withernsea,
campaigners have been told the hospital's 12 beds could be leased to the
private sector. Mayor of Withernsea Stuart Woodruff said the latest proposals
are an "absolute disgrace". He said: "The PCT are in the headlines for all the
wrong reasons at the moment. These latest proposals are just another erosion
of services."
Summary by
Keep our NHS Public of East
Riding Mail 19 January 2007
- NHS boss shock
resignation: MPs predict 'slashing cuts'. The chairman of
Epsom and St Helier
NHS Hospitals Trust has announced his resignation, leaving the crumbling
healthcare provider in "total crisis". News of Michael Doherty's departure -
which comes just weeks after the sudden exit of its chief executive Lorraine
Clifton - has led to increased fears that more cuts to health services are on
the way. Sutton and Cheam MP Paul Burstow said: "To lose one NHS boss may seem
a misfortune, to lose another NHS boss so soon looks more like a crisis. Staff
morale at St Helier must be in free fall. Frontline staff - already concerned
for their future after the trust announced that 470 jobs would go - now see
the trust's senior managers departing on an almost weekly basis. Staff cannot
be blamed for wondering just what sort of ship they are working on." Head of
Campaigns at London Health Emergency Geoff Martin added: "Epsom and St Helier
is a Trust in total crisis. It's a scandal that it's been allowed to descend
into this level of chaos and clearly the strings are being pulled right at the
top. We can now expect a wave of slash-and-burn panic cuts over the coming
months with severe consequences for staff and patients."
Summary by
Keep our NHS Public of Sutton
Guardian 19 January 2007
- Diabetics' limb
risk. Thousands of
diabetic children risk losing limbs because of the
NHS cash crisis, according to the charity Diabetes UK. It says that four
out of five diabetic children have poor glucose control, putting them at risk
of complications including ulcers that will not heal and could eventually lead
to amputation.
Summary by
Keep our NHS Public of Times
24 January 2007
- Cash crisis
warning to NHS staff in the Isles. A report from the finance director of
Western Isles NHS has revealed it is facing losses
of £3.2m and has warned that the failure of staff to "engage" with the
financial position of the trust - and efforts to tackle it - could lead to
further problems in the future. The news comes as local man John Angus Mackay
was appointed chairman of the trust's board. Finance director Marion Fordham
said the report shows that for this current year, the board is expected to be
in the red by £813,000 which, added to its rolling deficit, gives a total loss
of £3.231million. She said: "The board cannot be given assurance that in-year
break-even will be achieved." She added that a range of measures had been
implemented to tackle the deficit and that staff have been asked to make
economies to slash costs, implement cutbacks and find further savings.
Summary by
Keep our NHS Public of Aberdeen
Press & Journal 25 January 2007
- Campaigners condemn plea for nurses to work unpaid. Health
campaigners today condemned an NHS trust for asking its staff to resign, work
for no pay or take unpaid leave in order to reduce its multimillion-pound
deficit.
Maidstone and Tunbridge Wells NHS Trust, which reported a £16.7m deficit
last year, has sent staff a letter asking them to work unpaid for a day, take
six months unpaid leave, take voluntary redundancy or defer taking five days
of their holiday until next year to help balance its books. Staff and agencies
Friday
January 26, 2007 Guardian Unlimited
- Trust tells its
nurses to save £2.50 a day. Staff at a cash-strapped NHS trust have been
ordered to make an extraordinary series of penny-pinching cutbacks. Doctors
and nurses have been told they each must save £2.50 a day by measures such as
prescribing cheaper medicines, reducing the number of sterile packs used,
cutting hospital tests and asking patients to bring drugs in from home. The
astonishing edict was sent by e-mail to around 3,600 staff working in the West
Hertfordshire Hospitals NHS Trust by chief executive David Law. The leaked
e-mail, entitled Saving £2.50, contains 13 suggestions to cut costs. Other
measures include switching off lights and asking patients to pay for a taxi
home instead of using ambulances. West Hertfordshire Hospitals NHS Trust,
which serves around half a million people, posted a £27m deficit last year -
bringing its total debt to £41m. One of its flagship hospitals, Hemel
Hempstead General, is facing closure and 750 job cuts have already been
announced in the area. Mr Law's email says: "If everybody in the trust saves
£2.50 a day until the end of March, we will achieve our financial target for
the year." NHS trusts across the country are facing the threat of hospital
closures, job losses and cutbacks to services after the Health Service
finished the year more than £500m in debt.
Summary by
Keep our NHS Public of Mail
26 January 2007
- Hospital
'hell-hole' needs positive action, trust says. "Hell-hole" staff
accommodation at North
Devon District Hospital could be demolished and land sold off to help
balance the books. Northern Devon Healthcare NHS Trust, which runs the
hospital, has drawn up plans to rebuild staff housing on the lower end of the
hospital site. If the relocation goes ahead it could raise up to £5m of
badly-needed cash for the trust. The estates plan is part of a full-scale
review of the hospital and acute services in North Devon following a report by
Durrow Consultants last autumn. The hospital was facing debts of £14m but Mrs
Kelly, who took over as interim chief executive in October, told councillors
that it would achieve its financial target of lowering debt to £7.5m this
year. She said the trust was expected by the Government to have generated a
cash surplus and achieve financial balance by April.
Summary by
Keep our NHS Public of North
Devon Journal 26 January 2007
- Interest will
cost NHS £1m. Oxfordshire's largest hospital trust will pay out £1m in
interest next year after NHS managers were forced to convert its debt into a
£20m loan at commercial rates.
Oxford
Radcliffe Hospitals NHS Trust finance director Chris Hurst has admitted that
the five per cent annual interest will be an "added pressure" on the
cash-strapped organisation. The trust has a £19.5m deficit from the last
financial year, and is expected to incur a further £9m debt by the end of
March this year. The NHS policy forcing trusts to take out loans comes at the
end of a year when Oxford Radcliffe Hospital managers have had to take drastic
measures to reduce costs, and has been criticised by MPs and health watchdogs.
Liberal Democrat Dr Evan Harris, MP for Oxford West and Abingdon, said: "The
Government's insistence that the top priority for trusts is financial balance
on commercial terms before the next General Election means that £1m which
should be spent on patients will now be spent paying banks. Given it was the
Government's obsession with forcing trusts to meet political targets at all
costs that caused the deficit in the first place, it's the Department of
Health that should be paying the interest not doctors and nurses here in
Oxford." Dr Peter Skolar, chairman of the Oxfordshire Health Overview and
Scrutiny Committee, said: "This is what happens when you get people to balance
their books by the end of the financial year. It's incomprehensible to me how
anyone who wants to improve the NHS can lumber it with the targets and
structures at its centre. The problem is that ministers think they're running
a business. I'm sorry, the NHS is not there to make a profit. It's there to
provide a service." Oxford Radcliffe Hospitals NHS Trust finance director
Chris Hurst said the debt had to be turned into a loan in line with the
Government's wish for all hospital trusts to take on foundation status -
making them more commercially viable and in charge of their own finances. He
added: "We've managed to get it down to about £20m, but it means we will have
to operate at a surplus next year because we will need the cash to pay it off.
The interest is an added pressure for us. Next year we will have to pay £1m in
interest."
Summary by
Keep our NHS Public of Oxford
Mail 26 January 2007
- Leeds health
services face financial crisis. Health services across Leeds are facing a
major financial crisis. The city's hospitals are trying desperately to cut
spending and on the streets ambulances across
West
Yorkshire have driven into their own cash crisis. Yorkshire Ambulance
Service NHS Trust is projecting a £5m debt by the end of March. The West
Yorkshire region of the trust already has the worst response times in the
region, according to a report to Yorkshire Ambulance Service's board meeting,
and needs to make savings. Cost-cutting at Yorkshire Ambulance Service NHS
Trust has shrunk their projected deficit from £6.5m two months ago to £5m now.
Leeds Teaching Hospitals NHS Trust, which runs Leeds General Infirmary and St
James's, has put in place cost-cutting measures to get its predicted deficit
at the end of the financial year down to £11m. The trust has also started an
action plan to cut that even further with a freeze on recruiting external
staff and strict controls on using bank and agency nurses. Other cutbacks have
included the closure of 12 neurosurgery beds out of 48 at LGI and the planned
closure of a ward for the elderly at Wharfedale Hospital in Otley. Debt
problems have also surfaced for Leeds Primary Care Trust (PCT). A spokesman
said there was a risk of not breaking even by April unless cash was saved.
Summary by
Keep our NHS Public of Yorkshire
Evening Post 26 January 2007
- Trust in debt
asks staff to work for no wages. A health trust is asking doctors and
nurses to work without pay because it is millions of pounds in debt. Managers
at Maidstone and Tunbridge Wells NHS Trust have written to workers at its
three hospitals to see if they will put in a day's work as "a voluntary
contribution". The trust, which has cut services because of a £16m deficit
last year, is also encouraging staff to postpone taking a week's holiday to
"help avoid additional costs". Health campaigners have been angered by the
move because the letter suggests that one reason was to enable the trust to
build a hospital and mental health unit at Tunbridge Wells, under the private
finance initiative (PFI). Geoff Martin, a director of NHS campaign group
Health Emergency, said: "The same trust is employing management consultants at
huge fees. Are they going to ask them to give their services for free
? Nurses and other members of the health care team are called on to
work for nothing so that speculators and banks can cream off another fat
profit from a PFI scheme. This is robbing the poor to fill the pockets of the
rich." One nurse said: "Nurses are pushed to the limit. I don't see too many
administrators offering their services for free."
Summary by
Keep our NHS Public of Telegraph
27 January 2007
- More problems
for health trust.
Norfolk's troubled health trust was rocked over the weekend by the second
sudden departure of a senior executive within days. Now MPs and doctors'
leaders fear it could cause serious instability in an organisation that is
fighting to head off debts of £42m and looking to implement radical changes to
the health system in the county. It has emerged that director of commissioning
Audrey Bradford is leaving Norfolk Primary Care Trust, days after it was
announced that interim chief executive Hilary Daniels was stepping down. The
trust stressed that the two women were only ever temporary appointments but
what has caused concern is their departure at such a critical stage. Norfolk
PCT is struggling to balance its books, has set up radical cuts of some
services and is about to move into a crucial stage of plans to change
intermediate care provision in the county, which could see up to 70 community
beds axed and some cottage hospitals closed. A large number of rank and file
staff are unsettled by looming redundancies following the fall-out from the
merger of five former PCTs into the larger organisation.
Summary by
Keep our NHS Public of Eastern
Daily Press 29 January 2007
- Health boss in
pledge on patient care. Radical plans to treat more people near home
rather than in hospital have been welcomed by watchdogs.
Leicester City Council's health scrutiny committee wanted reassurance that
the quality of patient care would not be compromised as trust bosses battled
to balance their books. However, Tim Rideout, chief executive of Leicester
City Primary Care Trust (PCT), which is facing an £11m deficit, vowed that the
bulk of new NHS funding would be used to improve patient care and not to pay
off debt.
Summary by
Keep our NHS Public of Leicester
Mercury 29 January 2007
- Cash help for
health trust. Councillors have agreed to
help out a struggling health trust with its finances.
Leicester City Council is going to give the city primary care trust more
than £1 million in return for services in the future. The primary care trust
is currently expecting a deficit of £10.9 million at the end of this financial
year. There have been assurances there will be no cost to the council or the
tax-payer as a result of the arrangement. Cabinet member for finance,
Councillor Peter Coley, said: "If we were not to do this, it could lead to
cuts in health services across the city. There is no good reason not to go
ahead with this."
Summary by
Keep our NHS Public of Leicester
Mercury 29 January 2007
-
Hospital refuses to
cut cleaning costs. Executives at a debt-ridden
hospital have gone against the team brought into overhaul their finances
by refusing
to cut cleaning costs. The "turnaround team" sent to
Southport and Ormskirk Hospital to sort out its ailing finances told it to
reduce the amount spent on the vital service to help wipe out its £15m debt.
But management refused, insisting the cleaning team was crucial to patients'
health by keeping superbugs such as MRSA at bay. Summary by
Keep our NHS Public of Liverpool
Daily Post 29 January 2007
-
Diabetes treatment
'may bankrupt NHS'. The NHS must improve the treatment of diabetes in
England and Wales or risk being made bankrupt by the spiralling number of
sufferers. The number of patients is expected to top three million by 2010,
creating a "funding timebomb", Stephen Gough, Professor of Medicine at the
University of Birmingham, said. He told a panel in London that the Scottish
system was more effective, allocating set funding for treatment rather than
dividing it between hospitals and local services.
Summary by
Keep our NHS Public of Times
31 January 2007
-
More patients wait
longer for NHS care. More patients are waiting longer for National Health
Service treatment in what may be early evidence of primary care trusts trying to
slow down hospital activity in an attempt to balance their books. The overall
numbers waiting for an operation in England rose by only 5,000 in December to
just over 761,000, figures released by the Department of Health show. But the
number of patients waiting more than 13 weeks increased by almost 16,000 to
181,321. The number waiting more than four weeks for an outpatient appointment
rose by 10%, up almost 50,000, to 5.25m. Hospitals in some parts of the country
are being told not to see or treat patients until they have waited a set period
- in some cases 10 weeks for an outpatient appointment and six months for
surgery. The Department of Health dismissed the December rise in longer waiting
times as a purely seasonal effect. But John Appleby, chief economist at the
King's Fund health think-tank, said the increase in waiting times for
outpatients and for in-patient admission "could well be early signs of the
effect of primary care trusts telling hospitals not to see or treat patients
ahead of waiting time limits that they have themselves set locally in order to
control activity and save money". Average waiting times for inpatient admission
rose last month from 6.9 to 7.4 weeks. For inpatients, "the NHS appears to have
lost in one month much of the gains it had made in shorter waiting times over
the previous year", Professor Appleby said.
Summary by
Keep our NHS Public of Financial
Times 3 February 2007
-
NHS trust slips
further into the red. South
Staffordshire Primary Care Trust had intended to reduce its debt to £8.7m by
the end of the financial year but instead looks set to finish a further £2.4m in
the red. The worsening bank balance comes despite tough cost-cutting measures
being implemented. Helen Simpson, financial director for the PCT, warned the
organisation would be £13.5m in debt by April if current trends continued.
Summary by
Keep our NHS Public of Derby
Evening Telegraph 5 February 2007
-
Surgery slashed to
claw back cash. The amount of elective surgery in hospitals will be reduced
by 6% next year under Kingston Primary Care Trust's plans to balance its books.
Healthcare bosses have drawn up a plan to claw back £12m of debt next year, and
cutting non-essential surgery in hospitals will help them do it. But they admit
they have no idea how to deal with the rest of the £22.5m debt they expect to
have incurred by April. Kingston Primary Care Trust (PCT), which pays for
healthcare commissioning for Kingston's patients, has run up the debt over a
number of years. This financial year to April it will overspend its budget by
£11.9m, due in part to a £4m overspend by hospitals on patient treatment
compared to agreed levels of care. The PCT hopes to record a surplus of £300,000
and that will leave only a historic debt of £10m. Bosses hope
NHS London will
allow that to be set aside for now.
Summary by
Keep our NHS Public of Wimbledon
Guardian 5 February 2007
-
Hospitals cut 200
beds in savings. The three main hospitals in
Leicester are to close up to eight wards and cut 900 jobs over two years to
make savings of £90m, bosses have announced. The chief executive of University
Hospitals of Leicester Trust said cuts would mainly affect office staff, but 200
compulsory job cuts were expected. Peter Reading said the cuts would see more
services moved into the community. But union officials said strike action could
be a possibility as future care proposals had not been made clear. "The primary
care trust during the course of this year has cut staffing numbers," said Nick
Holden from workers' union Unison. "There are no announcements from the primary
care trusts in Leicestershire about additional resources, additional staff or
additional services over the next two years". Peter Reading, UHL's chief
executive, said savings were necessary to tackle a predicted deficit of £32m
across health organisations in Leicestershire and further savings beyond this
figure were required. The trust runs Leicester Royal Infirmary, Leicester
General Hospital and Glenfield Hospital. Wholesale closure of wards would take
place.
Summary by
Keep our NHS Public of BBC
Online 7 February 2007
- Patients face freeze on NHS dental care until April. Thousands of
patients are likely to be refused
dental
treatment until the start of the new financial year in April due to a
cash crisis in the health service. Dentists in
England were given new contracts last year which mean they are paid an annual
income for an agreed number of check-ups and treatments. Those who were
heading to complete their quota ahead of schedule expected to be able to
negotiate payment for extra work, but they are now being told that there is no
more money in the budget. If they treat any more NHS patients before the end
of March, they will not be paid, which means thousands might be turned away.
The problem was exposed by Health Service Journal, which today publishes
details of a Department of Health memo telling trusts to have "clear lines
ready" to respond to media reports about the problem. The trusts should
"ensure patients know how to access urgent care, and publicise spare capacity
in other practices." Pressure on dental budgets was exacerbated by inaccurate
forecasting by the department of the number of patients who would be exempt
from charges. A memo leaked last week showed the government expected £630m in
income from charges, but less money was coming in. Exempt patients include
children and pregnant women, people on benefits, some war pensioners and some
on low incomes. Under the contract, dentists provide an agreed number of
"units of activity" (UDAs) at an agreed price over the year. A dentist earns
one point for investigative work, three points for fillings and 12 points for
treatment involving laboratory work. Peter Ward, chief executive of the
British Dental Association, said: "Three quarters of dentists don't believe
the UDA target reflects the amount of treatment they are able to give. John
Carvel, social affairs editor
Thursday February 8, 2007 The Guardian
- Government
blamed as hospitals shed staff.
Leicestershire's Tory MPs have blamed the government for cuts hitting the
county's hospitals, accusing them of wasting investment on a decade of
organisational change. Yesterday it was announced that 900 jobs and 200 beds
are to be lost at the University of Leicester NHS Trust over the next two
years. Edward Garnier, Conservative MP for Harborough, said: "There are good
scientific and medical reasons for wanting to have people treated closer to
home and we have to get them through hospital quickly and safely. These good
reasons have been overshadowed by the appalling management by this
Government." His colleagues echoed support for trust staff and continued to
blame central control for the health service's ills. Patricia Hewitt, Health
Secretary and Leicester West MP, defended changes arguing that they were not
"financially driven" and expressed delight at the progress in modernisation.
She also attributed the lack of a health crisis - such as a pandemic - in the
last few years to the work of the NHS. A spokeswoman for the Department of
Health also defended the changes. "We have always said there will be a number
of redundancies with the new health service. The majority of these are going
to be management and 'back room' staff, not clinical staff," she said.
Summary by
Keep our NHS Public of Leicester
Mercury 8 February 2007
- Exclusive:
'closing NHS beds is a sign of success' - is this the most extraordinary
statement ever made by a Labour health minister? Patricia Hewitt has
incredibly declared that NHS bed closures are a sign of success - because it
means fewer people need care. The Health Secretary's astonishing claim came as
it was announced 900 jobs are being axed at hospitals in and around her
constituency to save local health chiefs £90million. Despite many NHS trusts
facing financial collapse, ward closures and thousands of staff being given
the boot, Ms Hewitt insisted Labour's controversial reforms will save lives.
Launching her defence of the changes, she said: "More money will be going into
nurses in all fields to transform the quality of life and care for people in
their home or closer to home. "That will mean fewer emergency admissions, so
you need fewer beds. Fewer beds are a sign of success - not a sign of
failure." It is the most blunt admission yet by a Cabinet figure that
traditional hospitals will no longer be the core of the health service. Ms
Hewitt - who last year was heckled and jeered by angry NHS workers at a speech
as the crisis began to bite - said about 80 new or refurbished hospitals have
opened, as well as new walk-in diagnostic and treatment centres. The
Government also wants fewer people using A&
E and more day surgery which dramatically slashes the need for acute
beds. But as she spoke, furious staff at hospitals in her Leicester
constituency were reeling from news they face the axe with the closure of up
to 200 beds. Of the 900 posts going at the University Hospitals of Leicester
Trust, 200 will be redundancies. Campaign group Health Emergency said more
than 24,000 job losses had been announced in the NHS since last year.
Spokesman Geoff Martin added: "This nails the lie there has only been a tiny
effect on posts."
Summary by
Keep our NHS Public of Mirror
8 February 2007
- A healthy
suspicion. A Mirror leader says: "Labour risks losing the next General
Election if it fails to persuade voters that the National Health Service is
getting better. Health Secretary Patricia Hewitt faces an uphill battle
despite waiting lists at a record low and treatment improving, particularly
for cancer and heart conditions. Few patients will agree with her that the
loss of hospital beds is a "sign of success", seeing it as a most peculiar
measure of progress… Ms Hewitt must review the closure of wards, accident
units and, in a few cases entire hospitals, that would force the sick to
travel farther. The Labour government has a proud record on the NHS, yet it is
losing the political battle because of unpopular reforms."
Summary by
Keep our NHS Public of Mirror
8 February 2007
- Bed closures
healthy sign for NHS, says Hewitt. Patricia Hewitt, the Health Secretary,
has been criticised for claiming bed closures were a sign of "success" as new
figures showed NHS trusts will end the year more than £1bn in the red. The
scale of the health service's financial crisis emerged as Miss Hewitt
delivered a presentation to the Cabinet on NHS "reconfiguration" - plans which
will lead to the closure of dozens of maternity units, casualty departments
and community hospitals. Tony Blair tried to rally support for his embattled
Health Secretary during yesterday's meeting by hailing her proposals as the
"biggest change in the NHS since its foundation". He added that better care
and value for money could go "hand-in-hand". But the Prime Minister's
spokesman admitted later that ministers were free to oppose proposals to close
hospitals or cut services in their own constituencies. His comments came as
research showed that frontline NHS trusts which run hospitals and GP clinics
across England are on course to finish the year £1.05bn in the red - only a
fraction below last year's record deficit. The figure is drawn from a
Conservative analysis of the deficits being forecast by each of England's 10
strategic health authorities. While front line trusts are deep in the red, the
strategic health authorities themselves are on course to end the year with a
huge £920m surplus - almost twice last year's figure. This allows ministers to
say the overall deficit across the whole NHS is only £132m. However, the
Tories claimed that health authorities have only been able to produce such a
big surplus by slashing the amount they spend on crucial services, including
training for doctors and nurses. The figures were released as Miss Hewitt was
accused of living on a "fantasy planet" after defending the proposals to
overhaul services across the country. She claimed the planned changes would
allow more people to be treated closer to home by their family doctor or local
health centre, rather than having to go into hospital. Andrew Lansley, the
shadow health secretary, said Miss Hewitt's remarks would be greeted with
incredulity at a time when many trusts were struggling to cope with huge
deficits. "Despite this year's savage job losses, bed cuts and service
closures, the NHS organisations providing front-line care are no less in the
red than they were last year." The Patients Association said it did not see
bed closures as a sign of success. "What we hear about from patients is
inappropriate discharges with patients being sent home too soon," said
Katherine Murphy, a spokesman for the association. "We heard from one patient
due to be discharged on a Wednesday who was away from her bed for 50 minutes,
the night before to take a bath. When she went back to the ward someone was in
her bed. Beds are being closed because of financial deficits. I would not call
this a mark of success." Summary by
Keep our NHS Public of Telegraph
9 February 2007
- 600 more NHS
jobs could go. Health bosses are to cut up to 600 more hospital jobs over
the next five years. The news comes just days after staff were told 900 posts
were to go and 200 beds would be lost by 2009. Now, the University Hospitals
of
Leicester Trust (UHL) says 100 to 200 full-time jobs a year could be at
risk between 2009 and 2012 as part of a £90m savings package. The move has
been condemned by union representatives, who say they have been kept in the
dark about any cuts beyond the next two years. Trust bosses said the plans are
part of "further efficiency related reductions" rather than job losses. David
Morgan, chairman of Staff Side, which represents 10 accredited unions at
Leicester's hospitals, said: "It's news to us. Efficiencies will mean job
cuts. Once it is said they could happen there is a 50/
50 chance they will. We realise the trust is having to cut its cloth to
fit plans put forward by primary care trusts. We are massively disappointed at
the number of job losses announced earlier this week. We had no idea that the
trust was planning further ahead than 2009." Staff Side has called on the
trust board to throw out the plans to axe 900 jobs and cut 200 beds. A UHL
spokeswoman said the staff reductions reflected the "annual national
efficiency requirement" on NHS trusts. She said: "The numbers are based on the
fact we will treat fewer patients and employ fewer staff after 2007." The
latest round of cuts are contained in a business plan approved by the trust
board. The plan, which will be submitted as part of its foundation trust
application next week, sets out the trust's business plan for the next 10
years. Angus Maitland, the trust's operations director, outlined the predicted
drop in patient numbers at Leicester's hospitals as care moved closer to home.
Mr Maitland said the trust was also looking to work more efficiently so that
people did not have to stay in hospital so long. Summary by
Keep our NHS Public of Leicester
Mercury 9 February 2007
- Government
blamed as hospitals shed staff.
Leicestershire's Tory MPs today blamed Government mishandling of the NHS
for the swathe of cuts hitting Leicester's hospitals. They say money pumped
into the county's health services has been wasted on a decade of
organisational change. Health Secretary - and Leicester West MP - Patricia
Hewitt said the changes were not "financially driven" but the result of
listening to patients and staff. She said she realised the difficult time
facing staff but was delighted at the progress in modernising services. Summary by
Keep our NHS Public of Leicester
Mercury 9 February 2007
- Job losses
won't affect patient care - claim. Health bosses pledged that patient care
will not be affected by huge job losses and bed closures at
Leicester's three hospitals. There was cold comfort for staff facing
redundancy, as primary care trust bosses said it was unlikely they would
create many vacancies. It follows University Hospitals of Leicester's
announcement it is to cut 900 jobs and close 200 beds over the next two years.
Primary care trust chiefs said although they would be spending less at the
hospitals, patients would have good care closer to home. This will be provided
at community hospitals, GP surgeries and by community health teams.
Leicestershire County and Rutland Primary Care Trust (PCT) will be spending
£20m less on emergency care at UHL this year. Instead, care will be provided
through its out of hours service and schemes like its "clinical navigator"
which helps prevent emergency hospital admissions by finding alternative care
in the community. Leicester City PCT will spend about £8m, but it intends to
spend £14m less with UHL by providing services elsewhere for its patients.
Catherine Griffiths, chief executive of the Leicestershire County and Rutland
Primary Care Trust (PCT), said there would be few vacancies at the PCT as four
organisations were still being merged into one. Summary by
Keep our NHS Public of Leicester
Mercury 9 February 2007
- NHS trusts
'delaying treatment to save money'. One in four NHS trusts have admitted
forcing patients to wait longer for treatment in a bid to save money and
reduce their deficits, a survey has revealed. Some trusts have introduced
minimum waiting times to put off admitting patients for as long as possible.
Others have said they will not treat patients until the new financial year in
April. In some cases, trusts have even told patients that certain treatments
are no longer available with NHS funding, according to a BBC survey of
England's 152 primary care trusts or PCTs. The Conservatives said the delays
being imposed on treatment underlined the scale of the financial crisis in the
NHS. Andrew Lansley, the shadow health secretary, said: "Patients are being
deliberately obstructed in accessing the treatment they need, despite
hospitals having paid for the consultants and other NHS staff who can treat
them. There is no point in paying NHS staff to do nothing in the last quarter
of the financial year solely because Patricia Hewitt has put her own job on
the line by promising to get the NHS back into the black by April. The
Department should encourage health authorities in financial difficulty to
maximise the number of patients treated from within available resources."
However, Caroline Flint, the health minister, rejected the criticism and said
it was vital that all trusts made sure that their finances were in good order.
Summary by
Keep our NHS Public of Telegraph
10 February 2007
- Younger women denied IVF. Young women are being denied test tube
baby treatment until their late thirties under NHS rationing plans, even
though age sharply reduces their chances of conceiving a child. The move means
even couples diagnosed early with fertility problems are being told to wait
years before they can have IVF. A 39-year-old's chances of conceiving through
the treatment are only half those of a woman under 35. While cash-strapped
health authorities have long restricted treatment for older women on the
grounds that over-forties have little practical chance of success they have
not previously set lower age limits in the same way. The moves to introduce
lower age limits was revealed after MPs raised the issue in the Commons last
week. Women in
Thames
Valley must be at least 36 to get IVF, while
North Yorkshire and York Primary Care Trust has suspended provision of
fertility treatment except for cases 'where the female partner is nearing 40'
- the age over which the authority will not fund treatment. Dari Taylor, chair
of the all-party Commons infertility group, who herself adopted children after
struggling to get treatment, has uncovered other examples nationwide with a
lower age limit of 34 or 36. Gaby Hinsliff, political editor
Sunday
February 11, 2007 The Observer
- Hospital tells
staff not to order pens and pencils. Hospital staff have been told to stop
ordering pens and pencils to save money. Health workers at the Queen Elizabeth
Hospital in King's Lynn,
Norfolk, were told in a newsletter that new stationery orders can only be
approved as a last resort. A hospital spokesman said the restriction would be
in place until the end of the financial year because of debts of £11m. 'We are
asking staff to share or borrow stationery where possible,' he said. Summary by
Keep our NHS Public of Observer
11 February 2007
- NHS 'cutting
chaplain services'. Hundreds of hospital chaplains face the sack or a
reduction in their hours as a result of the NHS cash crisis. The College of
Health Care Chaplains says up to 40% of the 850 hospital chaplaincy posts in
England are at risk, and that -thousands of dying patients and bereaved
relatives will lose out on vital support. Some chaplains have already been
made redundant and others have been made part-time or moved to administrative
roles. Many have had on-call pay cut and vacant posts are routinely "frozen".
In
Worcester, the salaries of chaplains are coming from the proceeds of
jumble sales and coffee mornings. The college claims hospital managers,
fighting to reduce an NHS deficit predicted by the Department of Health to
reach £94m by the end of the financial year, see chaplaincies as a "soft
target". Chaplains are full-time employees of hospital trusts and are
recruited to represent the local population. Their wage bill accounts for
0.05% of hospital trusts' budgets. Summary by
Keep our NHS Public of Telegraph
11 February 2007
- Health reforms cause financial disarray at top eye hospital. An NHS
hospital with an international reputation for medical excellence has been
thrown into financial disarray by the government's
health service reforms. After
overspending by about £900,000 in the first half of the year, Moorfields eye
hospital in London
got a risk alert from the regulator and had its borrowing limits halved. The
hospital is recognised as one of the world's premier centres of ophthalmic
expertise. Last week it opened a new children's complex, the largest in the
world for paediatric eye care. John Carvel, social affairs editor
Monday
February 12, 2007 The Guardian
- Maternity wards
set for crisis over bed shortages. Doctors believe
Scotland's biggest city is set to face a shortage of maternity beds as the
birth rate continues to defy forecasts of sharp decline. One of Glasgow's
three maternity hospitals, the Queen Mother's, Yorkhill, is scheduled to close
at some point between this year and 2009, leaving the city with capacity to
deliver just 12,000 babies a year. Yet the city is currently handling more
than 11,800 births a year and even traditionally pessimistic NHS planners
believe the figure will hold up for years to come. Current levels of
deliveries would mean Glasgow's two surviving maternities, at the Princess
Royal and Southern General hospitals, will have to work at 99% capacity. Some
obstetricians believe that is completely unrealistic. "We keep telling them
that there isn't enough room," said one senior clinician, "But the board is
not listening." NHS Greater Glasgow and Clyde yesterday insisted it was
unaware of such concerns. A spokeswoman said: "Our assumptions for the number
of deliveries per bed sit comfortably within the range of births per bed
experienced elsewhere. These assumptions have been tested fully with clinical
colleagues and no concerns have been raised about future capacity. It is
anticipated that births for Glasgow will remain at 2005 levels. We are
confident, however, that we have the flexibility to respond to an increase in
birth rates, if required." Pauline McNeill, a Glasgow Labour MSP with close
links to clinicians, was not convinced yesterday. "Having looked at the
figures recently, it looks exceptionally tight to me," she said. "And if
births increase, there will need to be some decision about how they are going
to deal with that." Birth episodes at the three Glasgow hospitals were
officially measured at 11,858 in 2005-2006 and 11,881 in 2004-2005. Glasgow's
population has bounced back far faster than anybody anticipated, not least NHS
officials previously planning for continuing decline. Glasgow City Council now
expects births to outstrip deaths by 2014. Maternity hospitals in Glasgow, of
course, also cater for pregnant women from outwith the city. NHS Greater
Glasgow and Clyde is currently finalising an outline business case for a new
children's hospital to replace Yorkhill. Concerns, as revealed in The Herald
last week, are mounting over the size of the new hospital and the way it will
be financed. Internal NHS documents suggest a joint PFI will be proposed for
the new Yorkhill and a new adult hospital for the Southern. Doctors, however,
remain worried about the size and quality of the Southern's existing maternity
unit, one of the few parts of the existing hospital campus to survive a
massive rebuilding programme. NHS Greater Glasgow and Clyde has declined to
comment on the Southern maternity until its business case for the new
children's hospital is approved. Summary by
Keep our NHS Public of Herald
12 February 2007
- Buy your own
stationary, hospital staff are told. A newsletter to health workers at the
Queen Elizabeth Hospital in
Kings Lynn has has told staff to stop ordering pens and pencils in order
to help meet the hospitals saving target of £7m . The letter says: "A
restriction on all new stationery orders was imposed by our turnaround team,
following the news in the chief executive's staff briefing that we had missed
our cost savings target last month." Last month the target was missed because
there was a reduction in the number of people requiring operations and
emergency treatment meaning the hospital will receive less funding from the
government. Last night a hospital spokesman said: "A lot of staff are already
buying their own stationery because they know the trust is in financial
difficulty, so they buy their own pens and notebooks. This is happening right
across the hospital. People are doing a lot to help by subsidising the
hospital out of their own pockets" Summary by
Keep our NHS Public of Eastern
Daily Press 13 February 2007
- NHS paying
bills late in struggle to balance books, say suppliers. The NHS is
delaying bill payment and cutting supply orders as it tries to balance its
books, according to those who supply it. Ray Hodgkinson, director-general of
the British Healthcare Trades Association, said that while the picture was
highly variable "some of our members are having real trouble getting money out
of NHS trusts." Most NHS trusts have standing orders to pay bills within 30
days, however "some are not paying for 60 or 90 days and even longer…for a lot
of our members who are small businesses this is creating problems with cash
flow. There is no doubt there is slow payment on a significant scale," said Mr
Hodgkinson. He added: "NHS chief executives are telling us that they must
balance their books at all costs". Other suppliers have noticed a cost-cutting
trend towards the end of the financial year. Doris-Ann Williams,
director-general of the British In-Vitro Diagnostics Association, whose
members provide diagnostics supplies and tests, said: "We did a survey of our
members in September and things had got much better than at this time last
year. But the reports we are getting now is that the problem is recurring."
John Wilkinson, director-general of the Association of British Healthcare
Industries, said the biggest fall had been in capital spending on equipment, a
worrying trend given the impending 18 week target for GP referral to surgery
and the restructuring that will go with it, much of which will - according to
Mr Wilkinson - involve capital spending. One supplier who wished not to be
named said: "We're expecting a flood of orders next month since payment will
then fall in the next financial year." Summary by
Keep our NHS Public of Financial
Times 13 February 2007
- This is how NHS
cash crisis is biting. Cash-strapped hospitals have been ordered to remove
light bulbs in a desperate bid to save money. Secretaries may also be drafted
in to weigh babies at one NHS trust, while newly-qualified nurses are so
desperate for a job they are reportedly working for free or below the minimum
wage. In another sign of the NHS financial crisis, it emerged that some
hospitals are saving money by not paying bills for healthcare supplies. Ray
Hodgkinson, the director general of the British Healthcare Trades Association
which represents 400 medical supply firms, said: "I have been in this industry
since 1960 and this is probably the worst it has ever been. It's very, very
worrying." Within the past two weeks, the St Helier general hospital on the
outskirts of London
and the Epsom district hospital, in Surrey, have been removing light bulbs to
help cut a £3 million annual electricity bill. The Epsom and St Helier
University Hospitals NHS Trust said: "We can confirm that maintenance staff
have removed some light bulbs from the main corridors and some communal areas
in the trust, as part of our financial recovery plan." A spokesman defended
the move, saying "no clinical areas" - such as operating theatres and wards -
were affected. She admitted the savings would only be a tiny part of cost
savings, with plans to discharge patients earlier and improve operating
theatre "productivity" likely to yield much more. But Tom Brake, the Liberal
Democrat MP for Carshalton and Wallington, said: "This is bonkers. You could
not make this up." It also emerged that the Bexley Care Trust in Kent, which
wants to save £12.3 million this year, is considering training up "a range of
staff" to help with weighing babies. The Amicus union expressed fears that the
plan would involve secretaries. The Community Practitioners and Health
Visitors' Association warned that it could leave a health visitor liable to
court action or being struck off the Nursing Midwifery Council register if
something went wrong. The plan came to light as the Royal College of Nursing
raised the alarm over newly-qualified nurses having to work for free or for
below the minimum wage. The RCN said that the
Co Durham and Darlington NHS Foundation Trust as well as the North Tees
and Hartlepool NHS Trust were offering "honorary" preceptorship contracts to
some nurses unable to secure other employment with them. The Co Durham scheme
comes with a training allowance of £480 - an estimated hourly rate of £2.60
compared with the minimum wage of £4.45 for 18-to-21-year-olds and £5.35 for
those aged 22 and over. There is no guarantee of a job at the end of the
contract. Summary by
Keep our NHS Public of Telegraph
14 February 2007
- NHS trusts 'using sexual health funds to balance books'. England
could suffer worryingly high levels of infertility and HIV infection unless
NHS trusts stop misspending money meant to tackle the country's sexual health
crisis, health experts warned today. Cash-strapped trusts have used much of
the £300m government funding meant to combat the country's sexual health
crisis to balance their books, according to the Terrence Higgins Trust (THT).
Staff at almost two-thirds (59%) of primary care trusts - the bodies that
commission and provide local NHS services - told the charity that either all
or part of the money allocated for sexual health had been diverted elsewhere.
Many trusts have changed access to testing and treatment services, while more
than one third of doctors reported that restrictions for HIV drugs were either
in place or under discussion. Lisa Power, the THT head of policy, warned that
the NHS was storing up "a vast increase in costs" for the future if trusts
failed to take prompt action on already record levels of sexually transmitted
infections. David Batty and agencies
Thursday February 15, 2007 Guardian Unlimited
- Light bulb
hospital 'is meanest'.
St Helier Hospital
has been dubbed "the meanest in Britain" by NHS campaigners after a number of
measures including taking down light bulbs. Epsom and St Helier NHS Trust
needs to save £24m and defended the light bulb step as a finance recovery
move. However Health Emergency has claimed that management consultants are
still receiving a "fat fee" while staff morale is "rock bottom". Geoff Martin,
spokesman of the NHS pressure group Health Emergency, said: "St Helier is the
meanest hospital in Britain and is an example of everything that is wrong in
the NHS. Staff morale is at rock bottom and the trust is being run by
management consultants getting paid a fat fee for dreaming up the most
outrageous penny-pinching cuts." And Kevin O'Brien, spokesman for Unison, the
union which represents health workers, said: "Staff are furious at the way
their services are being ripped apart by wave after wave of cuts and threats
of redundancy." The trust is aiming to cut 480 posts and close 200 beds over
18 months under savings plans. Summary by
Keep our NHS Public of BBC
Online 15 February 2007
- Trusts poach
sexual health funding. Funds which should have gone to sexual health have
been diverted elsewhere in almost two thirds of primary care trusts, according
to a survey by the Terrence Higgins Trust. The sexual health charity's survey
of PCT sexual health leads and clinicians in genito-urinary medicine (GUM)
clinics found that 59 per cent of PCTs had had all or part of their Choosing
Health money diverted away from sexual health. The Disturbing Symptoms survey,
carried out annually, also showed that more than two thirds of PCTs had not
done a specific needs assessment for sexual health and HIV in the previous
year - a dramatic decline on figures from two years earlier which showed that
51 per cent of PCTs had carried out a needs assessment in 2003. Nearly half of
PCT respondents called for more cash for sexual health and 26 per cent said
they wanted sexual health funding ringfenced. Asked how payment by results
would affect the ability to provide GUM and HIV services, 24 per cent of GUM
clinicians said it would have a negative impact while nearly a third said they
did not yet know what the impact would be. Summary by
Keep our NHS Public of Health
Service Journal 15 February 2007
- Ops face axe to
cut NHS costs. Patients waiting for a range of routine operations could
find their surgery axed to help the NHS save money.
Oxfordshire
NHS Primary Care Trust managers are looking at five treatments to decide
whether to cut the number of operations they commission. A similar review in
2005 saw hernia, cardiac ablations and varicose vein patients removed from
waiting lists. This time, the PCT is reviewing hysterectomies and dilatation
and curettage, along with lower back surgery, tonsillectomy and myringotomy.
The latter two operations are mainly done on children. The PCT wants to save
£18m this financial year and keep a tight rein on spending next year. When
contacted managers first tried to deny they were considering the move, before
claiming the review was in line with Department of Health guidance - ministers
say decisions on treatments are a PCT matter. The PCT finally admitted it
could not guarantee patients already referred for one of the five treatments
would stay on the waiting list, if it was decided to make the cuts. Oxford
West and Abingdon MP Dr Evan Harris, who raised the issue in the House of
Commons, said that although many operations might not be clinically essential,
they made a difference to patients. He added: "I'm concerned that when the
Oxford Mail approached the PCT initially, they denied they were doing
anything. Only on further questioning have they admitted that this is on the
agenda. If they're going to do this, they must be transparent about it." The
PCT has issued guidelines to GPs not to prescribe more than 28 days'
medication at a time in a bid to cut wastage of drugs. Doctors say the move is
inconvenient and will be expensive for patients who rely on long-term
medication and will have to pay a fee for each new prescription. Summary by
Keep our NHS Public of Oxford
Mail 16 February 2007
- Turnaround
specialist recruited by London NHS.
London's strategic
health authority announced this week that Hillingdon Primary Care Trust
interim chief executive Anthony Sumara would take the role of turnaround
director. According to the latest figures, NHS organisations in London were
forecasting the second biggest aggregate deficit in England - £135m against a
planned deficit for this year of £90m. The biggest deficit was forecast by
East of England SHA (£151m). NHS London chief executive Ruth Carnall said
Sumara's experience in turning around the financial fortunes of NHS
organisations would be invaluable. Summary by
Keep our NHS Public of Public
Finance 16 February 2007
- Hospital drops
four-day week. A Hospital has abandoned controversial plans to close its
huge outpatients department on one day a week. The climb-down at the
University Hospital of North
Staffordshire comes after staff warned their bosses it could lead to
patients being hit by longer delays to see specialists. Now the trust is
investigating closing individual clinics for periods each day instead of
moving the whole central outpatients unit from five to four-day working. The
proposal went out to consultation with staff last November as a way of making
savings needed to tackle the hospital's £15m debt. But it would have meant
some of the 200 staff either losing their jobs, being re-deployed or having
their hours reduced. At least 18 nursing jobs would have gone under the move -
although some were already vacant. The trust confirmed today there had been so
much "staff feedback" on the move - which was part of wider changes across the
site - that the consultation period had been extended by two months. The plan
had also angered some patients, who said they already faced long waits to go
in to see the specialist at clinics operating for the full week. Summary by
Keep our NHS Public of Stoke
Sentinel 16 February 2007
- Hospital debts
spark jobs fear. A further 2,000 West Midland nurses could face
unemployment when they qualify in April because of hospital debts, a leading
nursing body has warned. The region's Strategic Health Authority has insisted
its NHS Trusts are on course to break even this year, but latest reports claim
that West Midland hospitals are £73m in the red. The problem was highlighted
when it was revealed that huge NHS trust debts could leave nearly 5,000
newly-qualified nurses with no jobs to go to. Ann Leedham Smith, West Midlands
Director of the Royal College of Nursing, said: "A further 2,000 nurses will
qualify in eight weeks' time and there are no jobs for them to go to. Most
hospitals have put a freeze on their recruitment budgets to try to manage
their debts. There are not enough jobs to go round. Many of the trusts are
still deeply in debt, although they claim they will break even by the end of
the financial year." An SHA report reveals the two Midland trusts with the
heaviest debts are South
Warwickshire General Hospital NHS Trust (£10.8m) and Coventry Primary Care
Trust (£10.5m). An authority spokesman said it hoped to avert any nursing
recruitment crisis if new nurses were "flexible" about the location of their
new posts.
Summary by
Keep our NHS Public of Birmingham
Mail 19 February 2007
- Health trust
'on target' to break even this year.
Winchester hospital trust has "a good chance" of balancing the books in
three months, although costs still need to be cut. In December the trust,
which runs the Royal Hampshire County Hospital and Andover War Memorial
Hospital, managed to control running costs for the first time in nine months.
The trust has an accumulative overspend of £653,000 and is £500,000 adrift of
its financial recovery plan. The trust ended the financial year 2005/
06 £3m overspent. A large charitable donation and a "war chest" of past
savings could help plug the estimated £1m black hole in its budget this
spring, the board heard. Up to 125 beds and 310 jobs are to be axed over three
years as part of a plan to turn around debts and get back in the black. Other
cost-cutting measures included asking office staff to empty their own bins and
reducing the number of delayed discharges.
Summary by
Keep our NHS Public of Hampshire
News 19 February 2007
- Many NHS trusts
face growing debt. One in three hospitals and primary care trusts are not
expected to balance their books this year. However the Health Secretary
Patricia Hewitt appears to be on course to deliver her promise as the health
service overall is predicted to break even. Contingency funds have been built
by saving money from training and public health budgets and withholding money
that was due for the NHS this year. Three-quarter year forecasts show that the
health service will finish £13m in surplus. This however masks the increasing
deficits of some hospitals and PCTs, up from £1.2bn to £1.3bn in three months.
Financial balance can only be achieved by using small surpluses from some
trusts and taking money from elsewhere. The NHS budget grew by £5.4 billion to
£75 billion in 2006-07. But nearly £2 billion of this has not been passed on
to trusts as expected. Some £698 million was used to pay off deficits from
previous years. Added to this is the £450 million contingency fund and nearly
£200m in surpluses some trusts are amassing. Andrew Lansley, Shadow Health
Secretary, said: "We have to ensure that those organistions in difficulties
are being turned around, because otherwise we're just storing up problems for
next year or the year after that." Norman Lamb, for the Liberal Democrats,
drew attention to the tough measures some trusts were being forced to make to
achieve balance. "The impact on patient care around the country could be very
damaging," he said.
Summary by
Keep our NHS Public of BBC
Online 20 February 2007
- Winter squeeze rescues health service. £13m surplus will save
Hewitt's political skin. Price of equilibrium paid by patients and
staff. A winter squeeze on NHS services across England will be enough to pull
the health service out of financial deficit by the end of March, forecasts
from the Department of Health indicated yesterday. They showed 132 NHS trusts
are heading to overspend by £1,318m in 2006-07 - slightly more than the
overspend that played havoc with NHS finances last year. But this time the
deficits of the overspenders will be cancelled out by underspending in other
parts of the NHS. John Carvel, social affairs editor
Wednesday February 21, 2007 The Guardian
- Health budget
'fiddled to save Hewitt's skin'. Hospitals are forcing patients to wait
longer for operations because of a desperate attempt by Patricia Hewitt, the
Health Secretary, to balance the NHS budget, it has been claimed. The
accusations came after Miss Hewitt, who has staked her Cabinet future on
ending the NHS financial crisis, produced new figures suggesting it was
heading for a financial surplus this year. Experts poured scorn on the
figures, saying the prediction of a £13 million surplus - out of a £75 billion
NHS budget - had only been achieved by cutting services, slashing jobs and
reducing training nurses and doctors. The Tories described the latest
quarterly accounts as a "sham" which masked a rapidly escalating debt
mountain. Dr Peter Carter, general secretary of the Royal College of Nursing,
said: "Ministers today might try to claim a small NHS surplus but this smoke
and mirrors figure has only been achieved by raiding essential NHS training
budgets, freezing posts, shedding jobs and cutting services." A total of 1,446
compulsory redundancies had been ordered as trusts fought to limit their
deficits. Andrew Lansley, the shadow health secretary said: "There are more
NHS organisations, saddled with worse deficits, than there were last year.
Patricia Hewitt's skin is being saved only by savage cuts to centrally-held
budgets." Geoff Martin, head of campaigns at Health Emergency, an NHS pressure
group, warned: "2006 was a grim year for the NHS and 2007 looks like being
even worse. 23,000 staff posts have been axed and nearly 3,000 beds closed in
an effort to balance the books. Despite all the financial chicanery on offer,
services at the sharp end are deeper in the red than ever."
Summary by
Keep our NHS Public of Telegraph
21 February 2007
- Legal warning
over referrals. The risk of legal action by patients has risen
significantly since the introduction of referral management centres (RMCs),
medical defence experts have warned. GPs have been urged to make letters to
RMCs as clear as possible to avoid claims from patients who feel their
diagnosis has been delayed because of faults in the system. Dr Nicholas
Norwell, a medico-legal adviser with the Medical Defence Union, said it was
'quite possible that legal action would happen'. The warning came as more
examples came to light of cash-strapped PCTs restricting or even banning GPs
from making low-priority referrals. GPs covered by two Hertfordshire PCTs have
been warned to 'keep referrals to an absolute minimum', in a letter sent out
to practices. 'Failure to do so will mean we will face another year of extreme
financial difficulty and uncertainty,' it threatens.
Summary by
Keep our NHS Public of Doctor
Update 21 February 2007
- NHS sees £13m
surplus, but trusts expect deficits. Patricia Hewitt's job as secretary of
state for health looks safer as the National Health Service forecast a tiny
overall surplus for the current financial year despite more trusts projecting
a bigger gross deficit than last year. The health secretary has said she will
take personal responsibility for the NHS achieving financial balance this
year. The health department published figures suggesting that by the end of
next month there will be a £13m surplus in England on a £75bn turnover. But 35
per cent of organisations - 2 percentage points up on last year - are
forecasting a gross deficit that almost exactly matches last year's £1.3bn.
Those deficits are off-set by surpluses elsewhere and a £450m contingency
reserve. But strategic health authorities are also holding back more than
£1.1bn top-sliced from the budgets of primary care trusts. A minority of NHS
organisations remain in deep financial trouble. Around 30, or 8 per cent, are
forecasting deficits of more than 5 per cent of turnover, with some projecting
10 per cent. In one or two cases, the deficit will be 30 per cent or more. But
the underlying performance of the whole system, including foundation trusts,
shows it is running at a small in-year surplus after allowing for a £450m
reserve created for this year, and once the £700m of previous overspends dealt
with this year, are knocked off. The improvement, however, has come at a
price. Around a quarter of primary care trusts are setting minimum waiting
times for patients or otherwise slowing treatment, at least until the start of
the new financial year. Hundreds of millions of pounds have been taken from
training and other budgets. Some organisations are pushing orders for supplies
and planned developments into April and beyond - the start of the new
financial year.
Summary by
Keep our NHS Public of Financial
Times 21 February 2007
- City hospitals
are 'too good'. Derby's
hospitals are treating patients so quickly that its neighbour,
Leicestershire County and Rutland Primary Care Trust, has asked them to
slow down because it can't afford to pay for the number of patients it refers
to them. The trust stopped referring patients in January but will resume
referrals in March as it won't have to pay for such procedures until the new
financial year in April. The trust has now asked the hospital to meet
government targets instead of exceeding them. The trust's spokeswoman said:
"Some hospitals such as Derby are able to offer waits shorter than national
waiting times but we do not have the resources to fund these. We have
therefore asked the hospital to match waiting times to the national targets
for non-urgent treatment as planned at the beginning of the year. Referrals to
Derby have temporarily been removed from the system to ensure that all of our
patients experience similar waiting times." A spokeswoman for Derby Hospitals
Trust said in response to the request: "No decision about the action to be
taken has been made." Summary by
Keep our NHS Public of Derbyshire
Evening Telegraph 22 February 2007
- Critics claim
money is the force behind demand management. The Department of Health
would have us believe that demand management is a straightforward and
egalitarian system of getting the best for patients. But is 'care and resource
utilisation' really just about balancing the books
? CRU - as demand management appears to have been rebranded - is 'all
about giving the patient the right treatment in the right place at the right
time,' says the Department of Health. Its document, Care and Resource
Utilisation: ensuring appropriateness of care was published alongside the
2007-08 operating framework before Christmas. In the real world many primary
care trusts have implemented a range of demand management schemes,
unilaterally issuing lists of routine procedures that they will not fund
without prior approval, setting up referral management centres, attempting to
place primary care staff in accident and emergency and halting
consultant-to-consultant referrals. With a few exceptions, these have pitched
acute trusts against PCTs, doctors against managers and sent the British
Medical Association and MPs shouting 'foul' to the media. Among acute trusts
and the clinical establishment, the feeling is that these schemes are simply a
cover for financial cutbacks and have very little to do with improving patient
care. The BMA is against prior approval, for example arguing that all GP
referrals are, de facto, appropriate. More specifically, the BMA has set
itself up in opposition to independent clinical assessment, treatment and
support centres, currently in the negotiation stage in NHS
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