NHS news review:
Speculation concerning the future of the Destroy the NHS bill and the coalition government.
The King’s Fund response to the Destroy the NHS Bill proposes greater intergation and collaboration to improve services.
Further health funding cuts in Manchester.
Waiting times rise.
NHS Central Lancashire is considering making GPs redundant.
Lansley admits that the NHS Bill may be delayed by further scrutiny by MPs.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
The Lib Dems have a lot to answer for when it comes to the deeply unpopular Health and Social Care Bill. The Orange Book wing of the Lib Dems, of which Nick Clegg is a key member, actually supports the idea of a social insurance scheme with private providers to replace the NHS, which is a key objective of the current bill.
The Lib Dem election manifesto promoted the idea of a market-based healthcare system and abolition of SHAs. The coalition agreement on health reform was signed by Nick Clegg and reviewed by Danny Alexander. The final page of the Bill itself (p367) has the Lib Dem names of Nick Clegg, Vince Cable, Danny Alexander and Paul Burstow as supporters the Bill.
Finally, Lib Dem MPs have fully supported the Bill through its first two readings in Parliament.
However, the political landscape changed when the scale of the public and professional opposition became clear. The Lib Dem’s Spring conference, along with other factors such as the Royal College of Nursing vote of no confidence in health secretary Andrew Lansley, was crucial in terms of changing Nick Clegg’s stance on the reforms and gaining a natural “pause” in the Bill.
The King’s Fund has called for significant changes to the government’s health reforms to enable the NHS to provide a ‘new model’ of care that meets the challenges of the future.
In its response to the government’s listening exercise on the Health and Social Care Bill, the Fund says it supports the need for reform but argues that it must be based on a clear diagnosis of NHS performance and the challenges it faces. It calls for the NHS to be re-orientated to deliver a new model of ‘integrated’ care, based on stronger collaboration between health professionals and more effective co-ordination of services.
The response argues that integrated care offers the best prospect of improving services for patients and addressing the key challenge facing the NHS – demographic change and the increasing number of people with long-term conditions such as diabetes, asthma and dementia. It draws on evidence from the NHS and the United States showing that integrated care delivers better outcomes for patients with long-term conditions and improves the quality of specialist services such as cardiac, cancer and stroke care.
The Fund calls for a number of significant changes to the Health and Social Care Bill and wider health policy to deliver integrated care.
The NHS is under-managed but over-administered, a report from the King’s Fund finds.
It calls for a new style of leadership to overcome unprecedented financial pressures and adapt to future challenges.
High-quality, stable management is be key to high-performing health services, it finds. Yet across the NHS, the average chief executive spends just 700 days in post. In part, this reflects a culture where ‘heroic’ leaders grapple with problems only from the top of the organisation, or are ‘parachuted in’ to replace individual managers and ‘turn around’ troubled NHS services. The report advocates a new type of ‘shared leadership’ involving leaders at different levels of the workforce working collaboratively with all those involved in patient care to lead change and improve services, rather than only tackling problems inside specific institutions.
The report criticises the government for not assessing the future needs of the NHS before imposing a 45% cut in NHS management posts and 33% cut in administration costs.
It says: “There is no persuasive evidence that the NHS is over-managed, and a good deal of evidence that it may be under-managed. While administration and management costs will have to take at least their fair share of the pain as real-terms growth in NHS spending ceases, a more sophisticated approach to the reduction in both is needed.”
Health chiefs say they will have to save more than £20m from Manchester’s NHS budget this year. It comes after £30m in cuts in spending last year.
NHS Manchester is now drawing up plans including slashing management costs by £3.7m and cutting £2m by rationing treatment.
A new system for GPs’ referrals is being credited with helping make savings last year.
All treatment apart from mental health, obstetrics and urgent care, now has to go through a ‘referral gateway’ before being approved.
The number of patients waiting more than 18 weeks from referral to treatment is greater than at any time since mid-2008, the latest NHS statistics for England reveal.
More than 35,000 patients waited more than 18 weeks for treatment in March, breaking the NHS constitution-enshrined right for 18 week waits for the second month running.
The figures show that 10.4% of patients waited for more than 18 weeks from referral to treatment in March, up from 10.2% in February.
The numbers of patients waiting for more than 18 weeks has increased steadily since ministers removed the formal target of admitting 90% of patients within 18-weeks last summer. The target had been strictly enforced until last June but still remains a patient right under the NHS Constitution.
Figures for non-admitted patients showed the numbers being treated within 18 weeks had stayed stable on around 97% since the beginning of the year. Some 25,578 non-admitted patients waited for longer than 18 weeks in March.
Exclusive: Salaried GPs employed by a PCT face being made redundant as NHS managers charged with cutting costs turn their attention to general practice.
NHS Central Lancashire has placed a series of salaried GP positions under review as the PCT looks to restructure the organisation and realign costs.
Dr Edoardo Cervoni, a full-time permanent salaried GP employed by the PCT to work in practices in Preston and Ormskirk, is one of several GPs to be told their contracts are due to be terminated by the trust.
Dr Cervoni was informed in April that salaried GP positions had been placed under review and has now been told to expect to be made redundant at the end of July.
‘I was told that the PCT was going to stop providing clinical services and it had been planned that salaried GP positions “had to go”,’ said Dr Cervoni, a GP specialist in ENT medicine with 17 years’ experience.
‘Being made redundant is not nice and it has a negative impact on your career and particularly on your family life. I hope I may remain one of the very few GPs to have to experience the feeling, but it really seems that the process of dismantling the NHS is well on the go.’
The changes to the government’s flagship NHS bill could be so substantial that it has to undergo fresh scrutiny by MPs – delaying its passage through the Commons, the health secretary said on Monday.
The bill has already passed through the committee stage, where it was scrutinised line by line by MPs, but the proposals have been paused for a “listening exercise” with NHS staff and the public. A panel of experts, known as the Future Forum, was tasked with hearing concerns about the bill – a process that ends next week.
In an online question and answer session with Guardian readers, the health secretary, Andrew Lansley, answered a post about “recommitting” the bill to the house. “We won’t decide that until we have received the NHS Future Forum report and have responded to that. I told the House of Commons on 4 April that we would ensure proper scrutiny of the bill – we have done that so far and we will continue to do so,” he wrote.