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Results of the annual health check in 2005/2006 [pdf]
Results of the annual health check in 2006/2007
John Carvel, social affairs editor
Tuesday
October 19, 2004 The Guardian
Q&A: Cancelled operations. This week a row has developed over the case of
Margaret Dixon, who claims she has had her shoulder operation cancelled seven
times. David Batty explains the background and the circumstances of cancelled
NHS operations.
Friday March 4, 2005
Enfield is just about the last place Labour's high command would choose for
an assessment of whether the government has delivered improvements in the health
service over the past four years. It is home to one of the few zero-star NHS
trusts in England. Chase Farm hospital has persistently struggled to meet the
targets for shorter waiting times and stay within budget. John Carvel
Thursday March 31, 2005 The Guardian
Caesarean births are up again, new government figures revealed yesterday,
suggesting that last year's halt in the rise was just a blip in a long-term
trend of increasing medical intervention in childbirth. Sarah Boseley, health
editor
Friday April 1, 2005 The Guardian
Labour's record on cutting hospital waiting lists in England was put in
doubt yesterday by figures showing the government struggling to meet targets.
The health secretary, John Reid, promised to cut the number of patients waiting
more than six months for hospital treatment in England from 79,950 in March 2004
to 46,666 by the end of last month. Figures from the Department of Health
yesterday showed that the number had fallen to 60,400 by the end of February -
13,734 above the target. With Easter falling in March, that left only 21 working
days for trusts to catch up with the backlog and rush the remaining patients
through the operating theatre.John Carvel, social affairs editor
Saturday April 9, 2005 The Guardian
The number of patients waiting for an NHS operation in England has increased
by nearly 6,000, the government admitted today. A total of 827,300 patients were
on the waiting list at the end of April - up by 5,700 since the end of March.
Although there are 72,700 fewer patients waiting for operations than in April
last year, the monthly rise poses questions as to whether the government can
meet its targets to reduce waiting times. The number of patients waiting more
than six months for treatment also increased. At the end of April there were
45,400 people waiting over six months for an operation - up by 4,600 since March
but a reduction of 38,600 since April, 2004.
Friday June 3, 2005
More is being spent on Britain's health than at any time before, but are the
government's ambitious reforms working? Jo Revill reports.
Sunday
June 19, 2005 The Observer
Hospitals are still missing a key government target on waiting times,
according to new figures published today. The latest NHS waiting list figures
show the number of patients waiting over six months for treatment at the end of
May has risen by 9.3% to 49,600 since April, despite a key promise made by the
former health secretary John Reid to cut six-month waits to 46,666 by the end of
March 2005. Hélène Mulholland
Friday July 1, 2005
The government today announced sanctions to cut "intolerable" NHS waiting
lists in Northern Ireland, where hundreds of patients are waiting for more than
18 months for treatment. Trusts unable to provide treatment within 12 months
will be forced to offer patients a fully funded "second offer" at another
hospital, in line with a similar scheme in Wales. The move is part of NHS
reforms being planned for the province, where concerns are growing over the wide
variation in service delivery across the 19 Northern Ireland health trusts.
Hélène Mulholland
Monday July 4, 2005
The NHS must provide better care for those with incurable illnesses. Tom
Hughes-Hallet
Thursday
July 7, 2005 The Guardian
The NHS is meeting its targets, but failing to treat patients as customers
entitled to good service, the health inspectorate said yesterday in its annual
report for England and Wales. The Healthcare Commission found nearly a quarter
of patients are deterred from going to the GP by inconvenient opening hours.
Only half the people with depression get treatment for it - usually drugs and
rarely psychological therapy. John Carvel, social affairs editor
Tuesday
July 19, 2005 The Guardian
GPs are set to receive a major cash boost following publication today of
performance figures under their new contracts. Hélène Mulholland and agencies
Wednesday
August 31, 2005
High scores net doctors £200m windfall from incentive scheme. The first
ranking of GP practices in England showing the relative breadth and efficiency
of the services each offers was published yesterday by the Department of
Health.John Carvel, social affairs editor
Thursday
September 1, 2005 The Guardian
For patients at the Walnut Lodge surgery in Torquay in Devon, the bonus
scheme to reward GPs providing a better service brought tangible benefits. The
practice responded by offering an annual "health MoT" to patients with long-term
conditions such as diabetes and asthma. John Carvel
Thursday
September 1, 2005 The Guardian
NHS set to miss
patient waiting times target. An analysis of Department of Health data by
the Financial Times suggests that the NHS will miss its target to cut waiting
times for treatment to a maximum of 18 weeks by 2008 without either an
unprecedented increase in productivity, or more work contracted out to the
private sector, or both. The 18-week target encompasses referral, diagnosis and
treatment. There are no comprehensive statistics on current waits for diagnostic
scans, but there are fears that increased capacity may be met with increased
demand. Figures show that the average wait for operations has actually been
rising, not falling, as a consequence of eliminating long-term waits over six
months - it is up by 20 per cent to 7.4 weeks since 2000. Alan Maynard,
professor of health economics at York University, said: "Of the three elements
needed to get to an overall 18-week target, one [the outpatient wait] is falling
far too slowly, one [the wait for diagnostics] may well rise before it falls,
and the third [the time spent on the waiting list before an operation] is going
in the wrong direction." Summary by
Keep our NHS Public
of Financial Times 4 January 2006
Patricia Hewitt faced widespread criticism yesterday after
claiming that the NHS had just had "its best
year ever". Speaking on BBC Radio Five Live's weekend news, Ms Hewitt said:
"Despite the headlines, actually the NHS has just had its best year ever. We
have just come through one of the coldest winters for decades and we haven't had
any of the winter bed crises. We got the waiting times down to the lowest level
ever." But nursing and opposition leaders pointed to the service's
estimated debts of more than £600m and the possibility of swingeing job
cuts. Sam Jones
Monday April 24, 2006 The Guardian
Children with cancer and leukaemia are among the frontline victims of
sweeping cuts being forced through to contain the health service's ballooning
financial deficits, nurses' leaders warned last night. The
elderly and those with
mental health problems
are also suffering, with the closure of beds in
community hospitals and
the reduction in numbers of
specialist
nurses needed to treat them. Nurses' leaders yesterday published a dossier
of examples to back their claims and said their research disproved ministers'
assertions that trusts are seeking to balance their books without any detriment
to patient care. The warning came as Patricia Hewitt, the health secretary, came
under widespread attack for claiming
yesterday that the NHS had just enjoyed its "best year ever". In a speech to
Unison's health conference in Gateshead today, Ms Hewitt is expected to offer a
stark message that the NHS must "modernise
or die". As part of a coordinated fightback she will say that, after the
additional resources put into the service by Labour over the past few years, the
NHS was now "back in business". Beverly Malone, general secretary of the Royal
College of Nursing, roundly denounced Ms Hewitt, saying that if this was the
best year for the NHS she dreaded to think what a worse one could be like.
Drawing from RCN research, she gave examples of how patient care was being
affected in second tier services for the vulnerable. Among the examples were:
- Children with cancer and leukaemia in Taunton,
Somerset, are no longer being treated by a community nurse because the
local primary care trust withdrew funding it had promised to the
cancer charity CLIC. The children now have to make long journeys for
treatment, wrecking their chances of continuing a normal life in their own
community.
-
Avon and Wiltshire mental health trust has cut the number of beds by more
than 65 to less than 40. The frail and vulnerable have to go further afield
for treatment.
- In the
Cotswolds, 80 community beds have been closed within the last three months
to reduce deficits. A similar number have been lost in
Felixstowe.
- Ward closures in
Skegness has led to patients having to travel 40 miles to Lincoln.
- Minor injuries units are being closed and opening hours reduced.
Dr Malone said: "NHS deficits are hitting patient services; to claim
otherwise is simply wrong. These are real services for real people with real
illnesses, and we have got to stop treating them as statistics on a balance
sheet." Yesterday it emerged that Downing Street received a report from his
delivery unit last week pointing out that prospects for reaching 11 of the
government's 28
health targets by 2008 were poor. The Department of Health declined to
name the 11 targets that received "red traffic lights", but it was understood
they included
public health objectives such as improved sexual health and reduced
children's obesity. John Carvel and Tania Branigan
Monday
April 24, 2006 The Guardian
The frontline is hurting. Leader
Tuesday April 25, 2006 The Guardian
Second opinions on the best-ever NHS. Letters
Thursday
April 27, 2006 The Guardian
Thousands of cancer patients are waiting
longer than two months before they can begin treatment, according to new figures
that reveal a crucial health target has been missed. The government had promised
that 95 per cent of patients would start treatment for cancer within 62 days of
being referred by their GP. But figures to be released in June will show that 9
per cent of all patients had to spend longer in the queue, equating to around
12,000 people a year. The main delays happen in the wait for a diagnosis, where
there is still a shortfall of both staff and equipment to carry out the tests
needed to assess the nature and severity of a cancer. The biggest waits are for
bowel cancer, the third most common form of cancer in Britain affecting 34,000
people a year, where patients need a colonoscopy, an internal probe to find the
tumour, for their diagnosis. ... The figures came as new pressures emerged over
the
deficits facing the NHS. A rally took place yesterday in Stoke-on-Trent
where up to 1,000 jobs could be lost as the NHS trust, the University Hospital
of North
Staffordshire, faces debts of up to £15m. Managers have launched a 90-day
consultation on the plans, which have been greeted with dismay by staff there.
The actual deficit in the NHS could be as high as £1.2bn with 58 per cent of
hospital trusts facing deficits. Many of them now have to repay loans to the NHS
Bank, which has traditionally lent money and allowed deficits to be carried
over. Niall Dixon, the fund's chief executive, said further cuts in services
were almost inevitable because of the pressure to meet targets on cancer and
waiting lists. 'It's clear that these financial problems threaten to derail the
reform agenda,' he told the Health Service Journal. 'Hospitals will be left with
too little cash to fund policies which would improve patient care.' One leading
economist called last week for the government to acknowledge that there would be
a huge funding gap for the NHS by 2009, when the large year-on-year increases in
funding dry up. Oxford economist Andrew Dilnot, former head of the Institute of
Fiscal Studies, said the government should contemplate a system of 'co-payments'
so that those able to afford it could pay towards routine care, and the NHS
would be safeguarded. ...· Have you or your relatives had to endure a long wait
for cancer radiotherapy? If you want to tell us about it, please email
jo.revill@observer.co.uk Jo
Revill, health editor
Sunday April 30, 2006 The Observer
Concerns about
Britain's contaminated blood scandal escalated yesterday after it emerged that
thousands of people who were infected with hepatitis C have still not been
informed. Lorna Martin, Scotland editor
Sunday
April 30, 2006 The Observer
Job cuts point to
further NHS ills. The latest waiting list figures show the numbers have
barely moved over the past four months as hospitals struggle to achieve balance.
As a result there has been little progress towards the target to cut the maximum
wait from seeing a GP to surgery to 18 weeks by 2008.
Summary by
Keep our NHS Public
of
Financial Times 6 May 2006
Many to miss PBC
milestone. GPs around the country reported massive delays in agreeing plans
for practice based commissioning with primary care trusts. Some 70% of GPs said
they did not have a locally agreed plan in place. Nearly two-thirds of those
without a plan did not expect to have agreed one by the end of June the point at
which ministers had hoped all plans would be in.
Summary by
Keep our NHS Public
of Pulse 9 June 2006
NHS workers in
Yorkshire rubbish their own hospitals. An official survey carried out by
the Healthcare Commission, asking NHS staff their opinion of the services they
work in, has produced damning results. When asked whether they would be happy as
a patient with the standard of care provided; ten Yorkshire trusts had more
staff unhappy about the treatment they would receive. Beverley and Holderness MP
Graham Stewart said the survey showed NHS staff "who aspire to high standards
but feel they're not being allowed to deliver."
Summary by
Keep our NHS Public
of
Yorkshire Post 13 June 2006
Patients facing
long test waits. Patients are facing six-month waits for some diagnostic
tests, statistics show. It is the first time the so-called hidden waits have
been published - to date hospital waits have been measured from diagnosis to
treatment. The figures, for 15 of the most common diagnostic tests, mean that
for many patients the wait for diagnosis is as long as the wait for treatment.
It has left many to predict the government faces a tough challenge meeting its
18-week target. The current average is seven weeks, but many are facing longer
waits for key tests such as CT and MRI scans and endoscopies. Summary by
Keep our NHS Public
of BBC Online 12
July 2006
Some NHS patients in England are still waiting up to two years for an
operation, the government admitted yesterday in the first official analysis of
hidden delays in the health service. John Carvel, social affairs editor
Thursday
July 13, 2006 The Guardian
Damning NHS
report "will cause collapse in morale". The most comprehensive assessment
yet of NHS performance is likely to be highly critical, and medical
organisations are warning that it could sap morale and damage patient care.
Officials at the Healthcare Commission, the watchdog responsible for the report,
have argued that it would be pointless introducing new measures to raise
standards if "everyone passed it". Many NHS trusts self-assessments have already
been quite damning. However the new ratings, to replace the previous star
system, will "feel tougher to trusts, particularly in the first year", according
to the commission. The report is also likely to embarrass ministers who continue
to claim that the NHS deficit has had no effect on patient care.
Summary by
Keep our NHS Public
of Independent
9 October 2006
'Weak' hospitals
are failing to care for patients. A hardcore group of debt-ridden hospitals
are offering poor-quality patient care, Patricia Hewitt said. In response to the
Healthcare Commission report, Hewitt said that trusts that were running up debts
were also likely to be mismanaging parients and have worse waiting times,
cleanliness and MRSA infections. "I'm afraid that a lot of the trusts with the
worst financial records are also weak on quality of care," she said. "They are
not making the best use of their resources, not working through the processes of
making sure everybody is paying attention to hygiene and cleanliness, and if
they're not doing that, they're probably not going through the processes of
making sure everything else is being done properly." Hewitt will ask failing
trusts to propose and implement an action or improvement plan within a month, if
measures are not in place.
Summary by
Keep our NHS Public
of Times
11 October 2006 [In fact financial problems are much more widespread than
poor patient care]
Health inspectors demanded urgent action last night to remedy failings at 50
NHS trusts across England that scored the worst marks in a new tougher system of
measuring the quality of patient care. The Healthcare Commission confirmed a
report in the Guardian yesterday that it has graded nearly half the country's
hospitals and other healthcare organisations as "weak" in the NHS's first annual
health check published today. John Carvel, social affairs editor
Thursday
October 12, 2006 The Guardian
Ratings cannot hide worrying prognosis. In
Norfolk and Suffolk, every PCT received a "weak" rating for its use of
resources, which are primarily related to financial performance. For Norfolk PCT
- which brings together the former West Norfolk, Broadland, North Norfolk,
Southern Norfolk and Norwich PCTs - the deficit is between £30-£50m. For the
patient, that means cuts to services. All of which places the new PCTs in a
difficult position. They are being pressured to balance the books and cut the
deficit but the only way they can do that is to axe services, which will mean
their rating of "fair" for the "quality of services" component is already
threatened for next year.
Summary by
Keep our NHS Public
of Eastern Daily Press 12 October 2006
Hospital finances slammed in report.
Hinchingbrooke hospital has been given the worst possible rating for
managing its finances by the healthcare watchdog. The trust, which could face a
deficit of £24m by the end of the year, was assessed as "weak" in the Healthcare
Commission's new annual performance review. The hospital's quality of services
achieved a "fair" grade. The trust's dire performance marks a dramatic fall from
grace in the last year. Under the old system, Hinchingbrooke was told it was
performing well and was awarded two stars last July. Geoff Reason, Unison's
regional head for health, said: "I do not think these results represent the
facts. The march on Saturday showed the hospital is a highly valued local
hospital by the people of Huntingdonshire. These results will probably be used
to support what ever they are planning to do to the hospital." The serious
financial plight of the hospital has led to fears Hinchingbrooke could close.
While the hospital will not close as of yet, A& E and maternity services will be
slashed. The new £22m treatment centre could be sold to the private sector.
Andrew Lansley, shadow health secretary and South Cambridgeshire MP said: "We
know there have been severe financial control failures at Hinchingbrooke. The
question now is quality of service. I think that 'fair', just on the edge of
adequate, in some respects might be understandable. There are difficulties about
the cover at A& E because of the availability of staff. In other areas like
maternity services there are not, I believe, any underlying serious questions
about the quality and safety of what they are doing. It would be disgraceful if
maternity services were closed because they were unsafe, because I don't think
that is true. Considering 51% of other NHS trust's ratings were 'fair', I do not
see how that could be used as a reason to close or cut services. What they need
to do is look at how services can be improved and make them financially viable."
Summary by
Keep our NHS Public
of Cambridge
Evening News 13 October 2006
Finding
NHS reforms difficult to trust…
In a letter to the Guardian consultant anaesthetist Dr. Katherine Teale writes:
"I am puzzled why there is no mention of the latest nail in the NHS's coffin -
the rolling out of the "integrated
clinical assessment and treatment service" centres across the
north-west. These privately run clinics are going to take most of the
outpatient services out of our NHS hospitals, which are quite lucrative and
easily run. Just as many hospitals achieve foundation status, and have to
balance their books as well as taking on PFI loans, the government has removed a
considerable chunk of their income. This has been done without any public
consultation, and will undoubtedly lead to the closure of many local
departments." Meanwhile an anonymous letter from a nurse says: "Polly Toynbee
argues that the government needs to "win back trust" of the doctors and nurses
so that they "make the case and take the strain for these reconfigurations"
(i.e. yet more changes to the health service). Has she ever stopped to wonder
why nurses and doctors do not support the government's plans ? It is nothing to
do with "trust" but everything to do with deep worry that these "reconfigurations"
will not lead to better care and in some cases worse patient care. I have yet to
meet a practising doctor or nurse who supports these measures. We are not in
nursing to make money. We are in the profession to help sick and ill people, and
what really upsets us most is that so much extra money has been spent on the NHS
with so little to show for it in terms of better patient care. Even the
much-heralded improvement in waiting times is on the whole
not a real improvement: at my hospital
patients are frequently given numerous irrelevant interim appointments before
the final appointment for treatment, and what is measured statistically is the
waiting time between each of these interim appointments. Patients are often not
getting actual treatment any quicker than they were 10 years ago. Trust or
otherwise in the government is not the issue for nurses and doctors. Sensible
health policies in practice are the issue."
Summary by
Keep our NHS Public
of Guardian
23 November 2006
Patients wait
year for hip surgery. Almost a quarter of patients needing operations such
as hip or knee replacements wait between one and two years for surgery and a
small number wait more than this, new calculations of the real waiting times
showed. Across all the specialities the real waiting time from seeing a GP to
treatment shows that one patient in seven waits more than a year. The figures
emerged as the Department of Health published a different way of measuring the
waiting time in which the clock starts ticking when the GP first refers the
patient to a hospital. By the end of 2008 the maximum waiting time should be 18
weeks from the GP consultation to the start of hospital treatment. This is the
"referral to treatment" time. At present, waiting times are measured from when a
consultant decides the patient needs an operation. The target that has been met
is that patients should not wait more than six months for their operation. In
orthopaedics 16 per cent of patients were treated within 18 weeks, 58 per cent
within 18 to 52 weeks, 23 per cent between one and two years and three per cent
waited more than two years. This compares with totals across all main
specialities of 35 per cent waiting up to 18 weeks, 49 per cent waiting 18 to 52
weeks, 14 per cent waiting more than a year and two per cent waiting even
longer. Dr Jonathan Fielden, the chairman of the BMA consultants' committee,
said: "The NHS has already proven that it can deliver innovative approaches to
health-care. The Government must now focus on developing long-term solutions to
increase capacity within the NHS rather than turning to the private sector which
so often undermines and destabilises the local health economy."
Summary by
Keep our NHS Public
of Telegraph
20 December 2006
Ops cancelled
amid hospital beds crisis.
Ipswich Hospital is "managing well" despite being on "black alert"
intermittently this week and having two outbreaks of the winter vomiting virus.
The hospital was on black alert - meaning there are no ordinary beds available -
during periods this week. Some routine, elective operations have been cancelled
and clinical areas not usually used during weekends and in the evenings have
been opened up as the hospital activated its contingency plans to deal with the
surge in demand.
Summary by
Keep our NHS Public of East
Anglian Daily Times 5 January 2007
Are maternity
services delivering? Maternity services offered across
Scotland have been scrutinised to check how they perform against national
standards. NHS Quality Improvement Scotland, the health service's own watchdog,
said it was impressed by the dedication of the staff and their efforts to
provide high quality care despite limited resources. However, there were also
deficiencies. Only one health board, NHS Ayrshire and Arran, gave the inspectors
an up-to-date strategy on how they planned to develop their maternity service
and meet changing guidelines and needs. Gaps in staff training were also
identified. Furthermore, half of Scotland's health authorities said they could
not meet national guidelines for staffing their neonatal intensive care units
because of shortages of qualified nursing staff. In some areas this had resulted
in cots not being used.
Summary by
Keep our NHS Public of Herald
26 January 2007
Notts operation
waits too long. Patients in
Notts are still waiting too long for hip and knee ops. Now the private
sector is set to get more of the work. By the end of March, the Government wants
no patient to wait more than 20 weeks and trusts have been set monthly targets.
But Notts County Teaching Primary Care Trust says that not enough of its
patients are being treated on time. In December, 281 patients waited more than
20 weeks - 51 for ops at Sherwood Forest Hospitals NHS Trust and 182 at
Nottingham University Hospitals NHS Trust.
Summary by
Keep our NHS Public of Nottingham
Evening Post 23 February 2007
NHS walk-in
centres do not cut GP waiting times. There is no evidence that walk-in
centres shorten waiting times to see a general practitioner. NHS walk-in centres
are primarily nurse-led, have wide opening hours and provide information and
treatment for minor conditions without the need for appointments. One of their
aims is to relieve the pressure on access to primary care by freeing up time
during normal practice surgery hours for patients who need to see their GP.
There are concerns that they increase demand rather than reduce the workload for
primary care, but the evidence to date is inconclusive. The study took place
from April 2003 to December 2004 and involved 2,509 general practices in 56
primary care trusts in England, and 32 walk-in centres within 3km of at least
one of these practices. There was a clear increase in the percentage of
practices achieving the target waiting time of less than 48 hours to see a GP
over the 21 month study period, but there was no evidence that walk-in centres
contributed to shorter waiting times. Waiting times were longer in more deprived
areas and shorter in larger practices. These results are consistent with a
previous study that found no effect of a single walk-in centre on workload or
waiting times in nearby practices, say the authors. There are a number of
possible explanations for this apparent lack of effect. Walk-in centres may have
created more demand by seeing patients who would otherwise not have attended for
health care. Alternatively, duplication of services could have arisen due to
patients being referred back to their GPs. Walk-in centres are part of an
increasingly complex network of primary care and first contact services for
health care and may extend and at times potentially duplicate rather than offer
an alternative for care provided by GPs, they say.
Summary by
Keep our NHS Public of British
Medical Journal 9 March 2007
NHS investment
achieves 'limited' success. Retired health minister Lord Warner has said
that the government's massive investment in the NHS hasn't delivered all the
improvements hoped for. He blamed a smaller than expected benefit from the
increased work force on "productivity" issues. He also attacked staff for
resisting change. "If you say 'have [staff] delivered all that you would have
liked them to deliver for that extra investment' then the frank answer for me is
'not as much as I would like to have seen'," he told Parliamentary Monitor
magazine. "They have done a lot of good things, but some of the productivity
issues which have been around in the NHS for such a long time need more work."
He also highlighted a lack of enthusiasm for the £12bn NHS computer upgrade.
"The idea that we could carry on with a paper-based NHS forever is nonsense, but
a lot of the staff have been very slow to embrace the idea that you could have
an electronic patient record and that you could move information about people
faster," he said. He insisted that the government's reforms were necessary and
would continue. "I can't tell you how many meetings I have been to with NHS
staff when they say 'why can't you ministers just stop this change and let us
get on with this perfect path ?' Well,
the truth is there has never been one of these perfect paths because health has
always continued to change and evolve as new treatments arrive and new demands
are made," he said. "One of the great frustrations has been trying to explain to
people the inevitability of change."
Summary by
Keep our NHS Public of Guardian
24 April 2007
Healthcare Commission completes
independent review of the 2006 performance ratings for NHS trusts in England.
The
University Hospitals Coventry and Warwickshire NHS Trust is now considered
to have met all of the core standards and its score for quality of services has
been changed from “good” to “excellent”. The Trust’s score for use of resources
remains “fair”.
Bassetlaw Primary Care Trust requested a review of the Commission’s
assessment of core standard C4c: ”All reusable medical devices are properly
decontaminated prior to use and that the risks associated with decontamination
facilities and processes are well managed.” The Commission concluded that,
despite some identified lapses, they were not significant lapses and the request
for review was upheld. This had no effect on the Trust’s final rating, which
remains at “good” but it is now considered to have met all of the core
standards. Care
and Health 10 May 2007
NHS inpatient and outpatient
waiting times figures. Care
and Health 10 May 2007
Final Fitness for
purpose results name at risk PCTs.
Cumbria and Western
Cheshire PCTs are at the greatest risk of not meeting baseline performance
goals in the next six to twelve months, according to the final wave of PCT
fitness for purpose results. Cumbria PCT corporate affairs director Ross Forbes
said the news was unsurprising as the trust had not been fully formed when the
process began. "We had to merge three PCTs and we were brand new and still in
the process of looking at the structure. If we were to go through it again in a
couple of months we would come out a great deal higher," he said. "The process
is not something that judges, it's a helpful diagnostic tool. We are going to
use it to set up the best possible organisation to deliver what we need to."
Western Cheshire PCT chief executive Helen Bellairs, who worked on the
development of fitness for purpose with the Department of Health, said: "Our
organisation had been running for three weeks when the process was carried out
in October but I wanted to get in there in the beginning to help inform our
development plan. We were £42m in debt and we knew the previous organisations
were not fit for purpose. The process showed what was wrong with previous
organisations so we could make it better." Simon Morritt, chief executive of
Bradford and Airedale teaching PCT - which came out top of the third and final
wave of reports - said: "We made an early decision that if fitness for purpose
was going to work for us we would need to take the process seriously and prepare
well. We were able to use the process to help build the new organisation and
ensure our energies are focused on commissioning." Fitness for purpose was
measured on finance, governance, strategy, external relations and emergency
planning. The commissioning diagnostic assessment looked at strategic planning,
care pathway management, provider management and monitoring.
Summary by
Keep our NHS Public of Health
Service Journal 10 May 2007
Brown 'bounce'
helps boost public confidence. Public confidence in the state of the economy
and public services have received a fillip with Tony Blair's departure, an Ipsos-Mori
poll has found. The chancellor's "bounce" has had the greatest impact on
perceptions of the National Health Service where there has been a 16 point
improvement between March and May this year. Even so, a net figure of 14 per
cent believe NHS services will deteriorate further, and they are more sceptical
about it improving than they are about education, policing, public transport or
the environment.
Summary by
Keep our NHS Public of Financial
Times 28 May 2007
NHS back in the
black, but 17 trusts in dire straits. The Health Secretary has announced
that the NHS has finished the year with a £510m surplus, however she admitted
that one in five were still in the red. Patricia Hewitt confirmed that last
year's £547m NHS budget deficit had been turned into a surplus after the drastic
cuts ordered by the government. "If we hadn't taken decisive action to deal with
the overspending, the NHS deficit would have doubled again this year. The
minority of over-spenders know they have to put their own house in order instead
of expecting strategic health authority trusts to bail them out," she said. "I
want to thank NHS staff, who have worked incredibly hard to turn the NHS around
while minimising the impact on patients and cutting waiting lists to their
lowest level ever." 17 trusts are still categorised as "financially challenged"
and 22 per cent of NHS organisations ended the year with gross deficits. Andrew
Lansley, the Shadow Health Secretary, said: "Cutting education and training and
plundering public health budgets is not the way to manage the future of our NHS.
No other business would be run on boom and bust and neither should the health
service." A leaked email seen by The Times has shown that the government is
worried that cuts have hindered the flagship waiting times policy. The email
said that over half of those waiting did so for over the 18-week target and some
were still waiting "in excess of one year". However, Ms Hewitt denied there was
a waiting list crisis. "There is some leaked email about the figures for one
part of the country. The fact is, that last December when we first saw baseline
data, only about one third of patients were going from GP referral right through
to the operating table in less than 18 weeks," she told BBC Radio 4. "What we
now have is nearly half of patients getting from the GP to the operating table
within 18 weeks, and by the end of next year it will be true across the NHS. The
media should be congratulating the NHS on this achievement, not trying to
belittle it." Jonathan Fielden, chairman of the British Medical Association's
consultants' committee, said: "It takes weeks to cut, it takes years to rebuild
trust. Morale is at an all-time low." The accounts show that those NHS trusts
which failed to break even last financial year had debts totalling £911m, down
from the £1,312m total from the previous financial year. The Liberal Democrats
said the figures did not reveal a £135m cut in training budgets. Norman Lamb,
the party's health spokesman, said: "The NHS has clawed its way out of overall
debt, but at what cost ? Over the past
year, trusts have made harsh cuts to staff and services and raided training and
mental health budgets to meet the Government's political deadline of breaking
even this year. This problem is far from over."
Summary by
Keep our NHS Public of Times
6 June 2007
One in eight patients waiting over a year for treatment, admits minister.
One in eight NHS hospital patients still has to wait more than a year for
treatment, the government acknowledged yesterday in its first attempt to tell
the full truth about health service queues in England. A Department of Health
analysis of 208,000 people admitted to hospital in March showed 48% were wheeled
into the operating theatre within 18 weeks of a GP sending them for hospital
diagnosis. But 30% waited more than 30 weeks and 12.4% more than a year. In a
key manifesto pledge at the 2005 general election, the government promised that
by December next year all patients would be treated within 18 weeks. John
Carvel, social affairs editor
Friday
June 8, 2007 The Guardian
NHS swamped by an epidemic of allergies. The NHS is failing to keep
up with the growing number of allergy sufferers, with new figures today showing
that only a handful of specialist doctors across the country are running clinics
for them. One in three people in Britain can expect to suffer from some form of
allergy during their lifetime - including 2 million people in the UK thought to
have some allergy to food - but there has been barely any increase in NHS
services to cope with this. Experts will warn this week that demand for care is
outstripping the NHS's ability to cope, and many patients go to private clinics
or dieticians that may offer unconventional diets. Jo Revill, Whitehall editor
Sunday
June 10, 2007 The Observer
Expert patients failing to relieve NHS burden, report says. The
government's £18m attempt to keep the long-term sick out of hospitals is failing
to reduce admissions, according to evidence in this week's British Medical
Journal. So-called "expert patients", who are trained to coach people with
illnesses including asthma, diabetes and pulmonary diseases, are giving patients
confidence but are not reducing the strain on the NHS, the report says. The
expert patients programme is key to the government's plan to reduce reliance on
hospital care for people with chronic illnesses. Launched in 2001, it has had
£18m in funding and will involve 100,000 people by 2012. Polly Curtis, health
correspondent
Friday
June 15, 2007 SocietyGuardian.co.uk
Quarter of NHS trusts miss targets for superbug. One in four NHS trusts
in England admit they are failing to comply with hygiene regulations introduced
last year to halt the spread of MRSA and other hospital superbugs, health
inspectors disclose today. The Healthcare Commission said 99 of the 394 trusts
confessed to not meeting all the standards included in a compulsory hygiene code
introduced by health ministers last October. Self-assessments by the trusts show
widespread hygiene problems, including failure to decontaminate reusable medical
equipment. Hygiene failings were admitted by 38 hospital trusts, the ambulance
service in
Yorkshire,
Staffordshire and the
South-East Coast areas, mental health organisations and primary care trusts.
John Carvel, social affairs editor
Monday
June 18, 2007 The Guardian. Link to the
Healthcare Commission, including an Excel workbook with detail of self
assessments.
NHS urged to cut carbon emissions. The NHS - one of the world's largest
public bodies - has been urged to cut its greenhouse gas emissions. Each year,
the UK's health service spends £400m on energy and emits about one million
tonnes of carbon, think tank New Economics Foundation said. Its NHS
Confederation-commissioned report said 5% of UK road transport emissions were
from NHS-related trips. The authors also warned that a more variable climate
could see an increase in heat-related deaths and diseases. The report, Taking
the Temperature: Towards an NHS Response to Global Warming, says staff, patients
and visitors travelled almost 25 billion passenger miles in 2001, predominately
by cars and vans. Waste was also an area for concern: "One in every 100 tonnes
of domestic waste generated in the UK comes from the NHS, with the vast majority
going to landfill."
BBC 22 June 2007
Doctors' survey finds public unhappy with NHS reforms. Doctors'
leaders yesterday said the public was as disenchanted with NHS reforms as the
medical profession, releasing a survey showing that only a third of patients
were happy with the changes of the last 10 years. On the eve of its annual
meeting in Torquay, Devon, the British Medical Association released a study
suggesting that only 34% of the public thought a decade of reform had made the
NHS any better, while 42% thought there had been no improvement. Against this
background of apparent public discontent, doctors will today mount a full-scale
attack on NHS reforms, accusing the government of "contemptuous disregard" for
the views of the profession and of introducing changes "that are not fit for
purpose and are damaging to medicine and healthcare in the UK". The Archdeacon
of Totnes, John Rawlings, giving the sermon at the BMA's traditional
pre-conference service last night, said the debacle over jobs for junior doctors
"has brought heartache of immeasurable proportions". Earlier Sam Everington,
acting chair of the BMA, said he thought the survey of public opinion gave "a
very stark message, but I think it is very clear". The survey results run
counter to most of those commissioned by the government and the official
watchdog, the Healthcare Commission, which have traditionally found most
patients are happy with their doctors and the treatment they receive on the NHS.
Vivienne Nathanson, head of science and ethics at the BMA, said the survey
"reflects a big difference of opinion between the government, patients and
doctors". The findings of the survey of around 1,000 members of the public in
England, questioned on the street, generally reinforced the views of doctors -
but there was divergence on the issue of charges in the NHS. The BMA is
adamantly opposed to any charges, but 53% of the public thought there was a case
for a small charge for some services where resources are limited. Sarah Boseley,
health editor
Monday
June 25, 2007 The Guardian
"the year." NHS Chief Executive's
annual report.
Care & Health 25 June 2007
Patient survey
unfit to publish, claims Johnson. Health secretary Alan Johnson has promised
the Government will publish the results of its £11m Patient Experience Survey
later this month, after coming under growing pressure from GPs and opposition
MPs to explain its delay. The Department of Health has been sitting on details
of its survey into access to surgeries and GP opening hours for almost two
months. This week he told the Commons the report had been delayed because in its
original form it was unfit to publish. GPs have become increasingly angry that
the Government is still refusing to allow them to reveal details from the
survey. Practices were told how they had performed in most elements of the
controversial survey weeks ago but have been gagged by strict embargoes imposed
by their PCTs on the Government's instruction. Pulse revealed last month that
MORI had been instructed by then health minister Andy Burnham to carry out more
work on the presentation of the findings, which are thought to have shown up
widespread local variations on feelings about opening hours. However, GPs are
believed to have performed strongly in most of the questions included in the
survey and Pulse understands many scored more than 90% satisfaction levels from
patients over access to surgeries, scores which will be directly related to GPs'
directed enhanced service payments. But whereas the Government has been accused
of using several reports in the past as a basis with which to bash GPs,
practices claim they have been denied the right to spread the good news. Dr John
Givans, secretary of both North Yorkshire and Bradford LMCs, said: 'The
understanding in our area is that the Government is "working" on the overall
results to spin them.' Dr Hamish Meldrum, BMA chair, has repeatedly challenged
the Government to release the results of the survey and has also expressed fear
that it will be subjected to spin.
Summary by Keep our NHS Public of Pulse
13 July 2007
Man who helped
NHS to £46bn says it wasted the money and needs more. The NHS has failed to
become more efficient or reduce unhealthy lifestyles, despite record levels of
funding, and more money will be needed in the future, according to Sir Derek
Wanless' latest review. The report, commissioned by health think-tank the Kings
Fund, comes five years after his work for the treasury which led to the extra
£43.2bn since spent on the health service. Sir Derek highlights some
improvements, but criticises mismanaged structural changes and pay deals, and a
neglect of public health. He said that the extra money had improved patient care
but, "what is equally clear from this review is that we are not on course to
deliver the sustainable and world-class healthcare system, and ultimately the
healthier nation, that we all desire". He states that more money is required
unless pressing concerns are dealt with, and that such financial demands might
"raise questions about [the NHS's] long-term future". The report points out that
£18.9bn of the £43bn spent has been taken up by inflation and wages. Of the new
contracts for consultants, GPs and other staff, Sir Derek says that: "there is
very little robust evidence so far to demonstrate significant benefits arising
from the new pay deals." Staff numbers have risen above targets set in 2000, by
up to 166% for GPs and 272% for nurses. According to the report, NHS activity
has seen the biggest increase in A& E
attendances, though this is hard to explain. Sir Derek said that there were
"lots of positives" in his report, and that the government should stick to its
current framework for the near future to further minimise disruption. The report
says that restructuring so far has been costly and has distracted managers.
Norman Lamb, the Liberal Democrat health spokesman, said: "This report is a
damning critique of the Government's failure to get value for money out of all
the extra investment in the NHS. Ministers cannot ignore these recommendations
as they did with last year's report by Sir Derek into social care."
Andrew Lansley, the Shadow Health Secretary, said: "Even Gordon Brown's own
adviser thinks he has mismanaged the NHS. Labour have invested lots and achieved
too little. Gordon Brown is obsessed with pursuing top-down reorganisation
instead of delivering genuine reform, which gives power to professionals and
better healthcare to patients." He added: "Public health budgets have been
robbed to pay off huge deficits despite warnings about the strain that
spiralling obesity levels will have on the NHS. Labour's ignorance belies their
arrogance." A spokeswoman for the Department of Health said: "We welcome this
report and its recognition that the Government's investment and reform have
improved patient care. We agree that more has to be done to improve NHS
productivity and to tackle some lifestyle issues like obesity. We also agree
that spending on healthcare will need to continue to grow above inflation if we
are to meet patients' growing expectations. These issues will be central to
decisions made in the next few weeks as part of the Government's Comprehensive
Spending Review and the long-term review of the health service being conducted
by Lord Darzi."
Summary by
Keep our NHS Public of Times
12 September 2007
More, not less.
An editorial in the Financial Times reads: Sir Derek Wanless's report this week
for the King's Fund health think-tank delivered some sobering reading for the
government, seven years into its great decade-long plan to turn the National
Health Service into a "world-class" health service. Waiting times are shorter.
Cardiac, cancer, mental health and other services have all improved. But access
and, on some evidence, quite possibly outcomes, do not yet match the best in
Europe. Productivity - perhaps unsurprisingly given the scale and speed of the
spending increase - appears to have declined. Big pay rises for staff, and
bigger increases in their numbers, have not been matched by commensurate
increases in treatments. Meanwhile, government policy has lurched from the most
fierce form of centralised command and control ever seen in the service's
60-year history to - belatedly under the government of Tony Blair - a
reintroduction of a more sophisticated form of the internal market for
healthcare that the Conservatives tried in the 1990s. Under Gordon Brown's
administration, it is still unclear how firmly the government remains committed
to reform. These reforms - the introduction of a degree of more competition and
choice, along with greater use of the private sector's skills in both
commissioning and provision - remain deeply unpopular with many in the health
service. But now is not the time to back off. The reforms need completing and
driving through. No one can be sure how well they will work, and they will
doubtless need amendment as they go along. But the government has no coherent
alternative to put in their place. Labour's more market-like reforms are
currently at about the stage that the Tories had reached in 1992 when they took
fright at the implications and backed off full implementation. If Labour does
the same now, it will be guilty not of five, but of 15 wasted years. It will
risk leaving itself with a health service that costs around the European average
without delivering a commensurate quality of service. That, in turn, would call
into question the very existence of the NHS model - not a happy way to celebrate
the service's 60th anniversary next year. The conclusion the government should
draw from Sir Derek's review is that it needs more of the current reform, not
less.
Summary by
Keep our NHS Public of Financial
Times 13 September 2007
A foreigner’s view of the NHS in
Wales. The Welsh Assembly Government wants
Wales to have a world class health service. But how does the rest of the
world regard NHS Wales?
Care & Health 14 September 2007
Financial targets
no excuse for poor service, NHS trusts told. Anna Walker, chief executive of
the Healthcare Commission, has told NHS trusts that they must stop using
financial targets as a "facile" excuse for inadequate services. Following the
publication of the commission's annual NHS performance ratings on October 18,
Walker told the boards of underperforming trusts that she wouldn't accept
financial targets as an excuse for such poor services. "Targets, financial or
otherwise, are no excuse for trusts not addressing themselves to quality-of-care
issues. We've got to move on from that debate," she said. "Any organisation has
a budget and has to live within that budget - that is just a fact of life. The
point is that boards need to look at their business, which is to treat people
who are ill. Issues of budgets and targets are not an excuse for not keeping
patients safe." Her comments follow accusations from staff at Maidstone and
Tunbridge Wells NHS Trust that the recent C-diff outbreak was caused partly by
officials being distracted, and resources being diverted, by financial targets.
Opposition MPs have warned that financial targets have led to service cuts and
thus understaffed and dirty wards. The commission's latest ratings reveal that
services, in particular hygiene, are often weak. However financial management
has improved slightly. Walker urged trust executives struggling to balance
resource management with adequate patient safety to contact the commission as
targets could be relaxed to enable them to focus on safety. Summary by
Keep our NHS Public of Public
Finance 19 October 2007
University Of Kent Research Shows That Many People Mistrust The NHS Even
Though It Is Improving. Research carried out by Professor Peter
Taylor-Gooby and Dr Andrew Wallace at the Department of Social Policy, Sociology
and Social Research, University of Kent, shows that many people mistrust the NHS
even though spending has increased hugely, waiting lists have fallen rapidly and
death rates in the priority areas (heart disease and cancer) have improved
sharply. Funded by the Economic and Social Research Council (ESRC), Professor
Taylor-Gooby's and Dr Wallace's research also shows that most people think that
recent NHS reforms are at best irrelevant and at worst damaging.
Care
& Health 27 November 2007
NHS greatly improved - but not for all · Basic standards still not
guaranteed, report says. The NHS has improved dramatically over the
last few years, but still cannot guarantee that basic minimum standards are
being met for patients throughout England and Wales, the government's health
watchdog said yesterday. More than a quarter of NHS hospitals failed to provide
adequate emergency services for children and 48% could not provide children with
a satisfactory service in outpatient clinics, the Healthcare Commission said in
its annual report on the state of the nation's healthcare. It found specialist
paediatric units were good. "But in a substantial minority of hospitals, levels
of activity, training and emergency cover are so low as to put children at
unnecessary risk." In the weak hospitals, surgeons did not do enough work with
children to maintain their skills. In 18% of trusts, paediatric life support was
not available to deal with serious emergencies at night. One in 20 trusts did
not comply with the child protection standards introduced after an official
inquiry into the death in 2000 of Victoria Climbié, an abuse victim. In 62% of
trusts, none of the general surgeons were trained in basic child protection,
including methods to detect the signs of abuse. In almost half of trusts none of
the anaesthetists were trained in it, and across the NHS 17% of paediatric staff
who took the lead on child protection issues did not have more than basic
training in this area. Anna Walker, the commission's chief executive, said:
"This is of serious concern. We are systematically following up progress in
every trust where there was a problem." Professor Sir Ian Kennedy, the chairman,
added: "Let's be clear that healthcare has improved. Cuts in waiting times have
been genuinely dramatic and millions more people are seeing their doctors sooner
... We are close to being able to offer all patients a minimum guarantee on
standards - in the NHS and private sector - but we are not there yet. Safety is
being taken more seriously, but we need leadership from trusts' boards to drive
this through." The report included the first analysis of how private hospitals
and clinics performed in 2006-07. It said 5% of independent establishments
failed five or more quality standards, compared with 6% in the NHS. The most
common faults were in monitoring the quality of treatment, providing properly
trained staff and taking account of patients' views. The worst performers were
mental health units working under contract to the NHS. About 17% failed to meet
the standard for restraining patients safely. Other common faults included poor
premises and inadequate resuscitation facilities. The commission said the skin
clinic at the David Lloyd leisure club in Moortown,
Leeds, was the worst independent healthcare establishment in 2006-07,
failing to meet 32 of the core standards. Most of the poorest performers were
laser and light clinics, but the bottom 10 also included the Willows independent
mental health hospital in Keighley, West Yorkshire, and the Phineas Gage mental
health unit at St Mary's hospital in
Warrington. The commission identified eight improvements in healthcare, but
said they were all accompanied by problems. For example, men were living more
than four years longer than 20 years ago, and women three years longer. But
poorer areas had lower life expectancy and fewer GPs. There had been dramatic
cuts in waiting times for most treatments, but people in some areas could still
wait two years for psychological therapy or a hearing aid. Hospital trusts were
improving, with 46% rated excellent or good in 2006-07, compared with 40% in
2005-06. But the performance of primary care trusts deteriorated. Walker said
more than half the PCTs did not keep up-to-date registers of patients diagnosed
by GPs with conditions such as diabetes and heart disease. They could not
explain why GPs failed to record the body mass index of an estimated 2.3 million
patients with weight problems. "The registers are not being updated and
[patients] are not regularly called back to have their cholesterol or diabetes
checked. That means there's a real risk that the person appears as an emergency
in the hospital, or appears in the surgery fairly ill." Niall Dickson, chief
executive of the King's Fund, a health thinktank, said the report showed too
many healthcare organisations were failing to deliver the basics. "It is
unacceptable in the 21st century that patients are receiving care that does not
meet minimum standards ... This report once more suggests that too many of the
organisations responsible for commissioning do not fully understand the health
needs of local people." John Carvel, social affairs editor
The
Guardian, Wednesday December 5 2007.
387,000 wait more
than a year for surgery. Right-wing thinktank Civitas has claimed that
government figures showing an increase in the number of patients admitted within
18 weeks of referral conceal the number of those forced to wait longer. It said
that almost one in five patients wait longer than 36 weeks for elective surgery,
with almost half of those waiting more than a year. Current rates mean the
government will miss its target for all patients to be treated within 18 weeks
by the end of this year. Civitas also warned of a continuing postcode lottery
for waiting times. James Gubb, of the health unit at Civitas, said: "Instead of
political targets, performance should be driven by choice and competition - a
much more positive mechanism." Summary by
Keep our NHS Public of Telegraph
11 January 2008
See also
Clinical Outcomes , where some material
has been moved in March 2006.
See Society Guardian index on
NHS Performance.
See
Society Guardian index on
Local Case Studies.
See
Society Guardian index on Cancer.
See Society Guardian index on
Drugs and Alcohol.
See Society Guardian index on
Mental Health.
See Society Guardian index on
Primary Care.
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