More from Scotland.

 

A couple of days ago I was Blogging about Scotland so I thought I’d re-publish this very helpful BBC Scotland article setting out the Emergency waiting times for Scotland so that us Sassenachs can see how they are doing compared to us.

Once again, the Scots are showing us the way. We used to have a 98% target but the ConDem coalition government reduced it to 95% for England;

 

Almost 95% of accident and emergency patients in Scotland are being treated within four hours of waiting, according to newly-released figures.

 

The figure is up from the average of 91.9% recorded in March, but below the 98% national standard set in 2007.

 

The Scottish government said it wanted to see all A&Es reach a target milestone of 95% by September 2014.

 

Health Secretary Alex Neil said his plan to reduce waiting was continuing with a further £6.8m investment.

 

He explained: "There is no doubt that unscheduled care continues to be a priority. As we continue to deal with the requirements of an ageing population, we are seeing an increasing requirement for more effective unscheduled care.

 

"That is why we continue our actions to improve unscheduled care in Scotland and this latest funding will help to ensure people are seen quickly and treated effectively."

 

In June 2013, six NHS Boards achieved the waiting time standard of 98% of patients admitted, transferred or discharged from A&E within four hours. The remaining eight NHS Boards recorded more than 91%.

 

In June, Greater Glasgow and Clyde recorded the lowest figure of 91.7% and Tayside recorded the highest at 99.2%.

 

The total number of people attending accident and emergency departments increased from 1.60 million in 2008/09 to 1.62 million in 2012/13.

 

Source: The General Register Office for Scotland

 

Four-hour A&E waiting target
Health board	March 13	April 13	May 13	June 13
Source: The General Register Office for Scotland
Ayrshire & Arran	89.6%	88.8%	92.2%	92.8%
Borders	97.0%	96.3%	99.1%	99.3%
Dumfries & Galloway	94.0%	94.5%	94.7%	96.3%
Fife	96.9%	93.5%	96.6%	96.5%
Forth Valley	87.6%	87.0%	96.2%	94.6%
Grampian	95.2%	94.8%	97.2%	98.3%
Greater Glasgow & Clyde	89.6%	91.1%	92.4%	91.7%
Highland	97.5%	97.6%	97.4%	98.0%
Lanarkshire	91.8%	87.9%	91.6%	92.6%
Lothian	88.1%	88.6%	94.9%	94.6%
Orkney	98.6%	98.0%	97.9%	98.2%
Shetland	99.5%	99.5%	97.7%	99.1%
Tayside	98.7%	98.8%	99.4%	99.2%
Western Isles	98.9%	98.1%	99.4%	97.9%
SCOTLAND	91.9%	91.6%	94.6%	94.6%

 

 

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

More benefits of contracting out.

Here’s another good example of what good value contracting out services to private companies can be.

SERCO is a massive multinational, one of its contracts is taking prisoners from police stations to courts to prisons.

If they miss a targeted delivery, if they aren’t making enough revenue – what do they do?

They fiddle the figures.

m

It’s Ok, Boss -

I’ll Cooka Da books

Do you think I’m worried about being sued?

Oh no, I don’t think so – because they called the Feds in.

Have a look at this article from The Independent, I think the confusing reference to £40 million is to the profits made from the contract;

Fraud alleged in Serco prisoner escort contracts

Services giant agrees to repay past profits from its £40m-a-year contract and forgo all future earnings

Cahal Milmo   

Wednesday 28 August 2013

 

Serco, one of Britain's largest companies, is to be investigated for fraud after the Government and the services giant called in police to examine irregularities in records kept for its £285m prisoner escorting contract.

Justice Secretary Chris Grayling announced that the company has agreed to repay past profits from its £40m-a-year contract and forgo all future earnings after an investigation suggested records relating to the delivery of prisoners to courts had been falsified by members of its staff.

 

Mr Grayling said the review by Ministry of Justice (MoJ) officials had not found evidence that knowledge of the alleged malpractice reached the boardroom of the company, which last year had revenues of £4.8bn, but warned Serco that it faces being frozen out of all future public contracts.

 

Serco is one of two companies, along with G4S, which are also being investigated for allegedly over-charging the taxpayer in the “low tens of millions” to monitor non-existent electronic tags on prisoners, some of which had been assigned to dead detainees.

 

The Prisoner Escort and Custodial Services (PECS) contract is one of a gamut of public sector deals held in Britain by Serco, which earns hundreds of millions of pounds a year for providing services ranging from border controls to managing London's cycle hire scheme.

 

The MoJ said an audit of Serco's contract for transporting prisoners between court and jails in London and East Anglia had found “evidence of potentially fraudulent behaviour” by employees. The alleged fraud concerns the recording of prisoners having been delivered to courts when they had not - a key measure of performance for the contract. An audit is understood to have produced evidence that the figures may have been manipulated to enhance performance and earnings.

 

Mr Grayling said: “It has become very clear there has been a culture within parts of Serco that has been totally unacceptable, and actions which need to be investigated by the police.

 

”We have not seen evidence of systemic malpractice up to board level, but we have been clear with the company - unless it undertakes a rapid process of major change... then it will not win public contracts in the future”.

 

Did you notice the reference to G4S?

This is SERCO’s rival in the provision of contracted out services to the government. Their ‘tagging’ department is being investigated for making up figures when they were claiming for work for installing electronic tags on sentenced criminals – they were making things up too.

But it’s OK, it’s only in ‘the low tens of millions’.

Neil Harris

(a don’t stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com

The economics of contracting out NHS services to the private sector.

The cat is out of the bag. Here’s the perceived wisdom;

The NHS is a bad thing, it’s the ‘Big State’, its inefficient and it costs too much.

Private healthcare providers could do it all much better and cheaper.

Instead of the NHS/the State providing healthcare it should be commissioning private care providers to do it on their behalf instead.

Here’s the reality;

The Competition Commission (CC) believes that the main private healthcare providers (BMI Healthcare, HCA International and Spire Healthcare) have been overcharging their private patients by between £173 million to £193 million a year between 2009 and 2011.

These three companies dominate the market and as a result have bumped up their charges, or as the Competition Commission puts it they have; “been earning returns substantially and persistently in excess of the cost of capital” over those three years.

The overcharging is estimated to be around 10% to 11% of their private revenue although the Commission thinks that this may be an under estimate.

All three companies deny the allegations but an investigation will follow and is likely to throw up some more interesting figures.

This all came about because a smaller company, Circle which isn’t part of ‘The Club’, made a complaint to the Commission which blew the gaff on the ‘big three’

Chief financial officer Paolo Pieri said: “We are delighted that we have been vindicated by the Competition Commission and believe more patients will now be able to access our state-of-the-art facilities as a result of this ruling…..This report is clear that patients across the country have suffered higher prices and poorer care because of the monopolistic behaviour of private hospital providers. We now look forward to the Competition Commission pushing through these remedies with haste – including pursuing the maximum financial penalties – to finally ensure a fair deal for patients across the country.”

 

What all this exposes is that the private healthcare providers are ripping off their private patients and there is absolutely no reason to believe that they aren’t ripping off the taxpayer/NHS in the contracts they carve up between themselves when they do work for us.

So much for more efficient, cheaper, better.

Neil Harris

(a don’t stop till you drop production)     

Home: helpmesortoutthenhs.blogspot.com

They do things differently in Scotland.

They do things differently in Scotland – it’s a devolved government with limited powers to decide how to spend revenue that we don’t have down here in the soft south.

There’s a whole different attitude to the NHS too – much more proactive, much more successful in keeping down mortality rates – a target to work towards and action taken when there are problems.

Above all, they aren’t waiting for a long drawn out public campaign, to be ignored for a decade before they do something.

There also questions I’d raise, it’s an area I knew well, lots of deprivation and health problems arising from them which can make a difference to mortality rates.

But what looks like a bad news article is actually the right way of going about things.

Take a look at this article

 

 

 

By Lindsey Archibald

Investigation launched after mortality rates at three Lanarkshire hospitals were found to be above average

27 Aug 2013

Monklands Hospital, Wishaw General and Hairmyres Hospital are all under review after official figures showed higher than normal mortality rates.

 

PATIENT safety is to be assessed at three Lanarkshire hospitals after above average mortality rates were recorded.

 

Healthcare Improvement Scotland (HIS) will carry out an assessment of the approach towards patient safety after figures from the last quarter showed the hospital standardised mortality ratios (HSMR) to be high at two locations.

Monklands Hospital in Airdrie and Wishaw General Hospital were identified as having an above average HSMR rate in the latest figures published by ISD Scotland today.

As part of the HIS assessment, the other NHS Lanarkshire hospital, Hairmyres Hospital in East Kilbride, will also be reviewed.

Dr Iain Wallace, medical director for NHS Lanarkshire, said: "Our priority is for patients to receive the highest quality of care every time and we have a clear focus on the provision of safe and effective patient care.

"We very much welcome the support and involvement of HIS to undertake an assessment of the local action plans we are progressing, along with their detailed review to identify any further improvement measures that can be implemented."

The results for NHS Lanarkshire show a break in trend as during the last five years, since the last quarter of 2007 to the first quarter of this year, hospital mortality in Scotland has decreased by 11.6%.

Between 2009 and 2011 there was a sustained drop in HSMR rates across Scotland and in recent years figures have been more constant, according to ISD Scotland.

NHS Scotland clinical director Professor Jason Leitch said: "We expect all health boards to ensure patient safety is their top priority and the Scottish Patient Safety Programme (SPSP) has been working for over five years to deliver ways to make healthcare safer.

"Although a high hospital standardised mortality rate (HSMR) is not by itself a definitive measure of the quality and safety of care, it serves as an important prompt for further investigation.

"Where HSMR suggests a potential issue, a health board must be able to demonstrate that it is taking appropriate action to investigate and resolve any problems found to be causing a higher than expected HSMR, and it is reassuring that NHS Lanarkshire is already working on an action plan to address this.

"That is why I have also commissioned Healthcare Improvement Scotland (HIS) to undertake a rapid assessment, in partnership with NHS Lanarkshire, of the reasons behind the HSMR figures in Lanarkshire and to see if the improvement measures in place can be strengthened and accelerated."

 

Robbie Pearson, director of scrutiny and assurance for HIS, said: "We will carry out a rigorous and independent review of NHS Lanarkshire.

"Our work will be driven and underpinned by a commitment to improving the safety and quality of care for patients, and patient interests will be placed first at all times.

"We have today published the terms of reference and review plan. In due course, our final review report will also be made public."

 

There are 31 hospitals taking part in the SPSP and 28 (90%) have shown a reduction in HSMR since the last quarter of 2007, with seven (22.6%) reaching the target decrease of 15%.The SPSP aim was to reduce HSMR by 15% by December 2012, although this has now been revised to a 20% decrease by December 2015.

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

Redundancy costs.

This is a Daily Telegraph article, which I’ve edited, dealing with the cost of making NHS managers redundant. There are a couple of points – I don’t think these figures for the last three years (£1.4 Billion) are up to date – I don’t think they fully reflect the enormous cost of shutting all the Primary care trusts.

The last paragraph says it all, really, a high proportion of those made redundant simply walk into similar jobs somewhere else in the NHS.

Failing to plan is expensive, allowing the managers to manage their own redundancies is even more expensive;

By Robert Watts

 25 Aug 2013

Nearly 1,000 health workers have received six-figure exit deals in the past year, with 157 managers and other senior staff receiving more than £200,000 — a 50 per cent rise on the previous year.

 

Some officials have received golden goodbyes of £600,000 as part of the Government’s ongoing restructuring of the NHS.

 

Campaigners said the figures provided further evidence that the coalition was wrong to protect the health service from the austerity programme imposed on almost all other areas of public spending.

 

Labour blamed the heavy redundancy costs on the “unnecessary reorganisation” of the NHS carried out by Andrew Lansley, the former health secretary.

 

The NHS executives who received the largest severance packages include Nicholas Hicks, the director of public health at Milton Keynes Primary Care Trust.

 

Mr Hick was handed redundancy pay of around £600,000 when he left the trust four months ago.

 

While in opposition David Cameron pledged that the Conservatives would impose “no more pointless and disruptive reorganisations” on health service.

 

Andy Burnham, the shadow health secretary, said: “Billions have been siphoned out of the NHS front-line to pay for an unnecessary re-structuring no-one voted for and David Cameron personally promised would not happen.

 

“At a time when the NHS needs every penny it can get, we have a Prime Minister handing out gold-plated, six-figure pay-offs to hundreds of managers and P45s to thousands of nurses.”

 

Details of the NHS’ spending on redundancy packages are laid bare in the Department of Health recently-published annual report.

 

NHS workers typically receive redundancy of one month per full year of service, with the amount usually capped at 24 months’ pay. However, executives sometimes manage to negotiate better deals.

 

Between April 2010 and the end of March 2013, the NHS spent a total of £1.4billion on redundancy payments for 32,089 staff. The average package is more than £43,000.

 

During 2012/13, 958 health officials received payoffs of more than £100,000 — up from 628 the year before.

 

Last year, the Telegraph revealed that Sir Neil McKay, the chief executive of the Midlands and the East strategic health authority, was able to take a £1.1million lump sum when his job was made redundant as part of the Government’s NHS reforms.

 

The eye-watering figure included a £465,000 redundancy cheque and a £549,000 tax-free lump sum from his £2.4million pension pot.

 

……However, a National Audit Office (NAO) report last month found that more one in five of NHS staff made redundant as part of the Government’s reforms had been re-employed by the health service.”

 

Neil Harris

(a don’t stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com

Barts health trust, again.

This is the end of a long and sad tale, which I’ve Blogged about before – it’s disgraceful abuse of elderly patients at Whipps Cross Hospital, part of the failing Bart’s Health trust. I pointed out the worrying developments at that trust, which is now being investigated. This bad treatment is an example of bullying and laziness (they are related) and demonstrates the culture on some wards at that hospital. Bad outcomes may well be related to that kind of treatment, among other things.

These kind of criminal offences are notoriouslu difficult to prove – the witnesses have real problems in communicating and often die before the trial happens. It calls out for secret videoing with mini cameras to keep an eye on the quality of care.

The whistleblower, a student nurse, did a very fine thing in exposing this behaviour when it is so much easier to just go along with the way things are done, when you are new to a job;

‘The Independent’ published this on 23/8/13, it’s a Press Association article.

 

Two healthcare assistants who abused elderly female patients on the geriatric ward of an under-fire hospital were jailed today.

 

Akousa Sakyiwaa, 38, was convicted of four counts of ill-treatment and neglect of patients on Beech Ward at Whipps Cross University Hospital in Leytonstone, east London, between February and April last year.

Sharmila Gunda, 36, was found guilty of one count of neglect and one count of assault by beating an elderly patient in her care following a trial in June.

Sakyiwaa, of Leytonstone, was jailed for 12 months and Gunda, of Ilford, given a five-month prison sentence at London's Snaresbrook Crown Court.

Fellow healthcare assistant Annette Jackson, 33, of Hounslow, west London, was given a two-month suspended sentence and ordered to complete 100 hours unpaid work after being convicted of one count of ill-treatment or neglect.

 

The three women were charged following a Metropolitan Police inquiry into the hospital after a student nurse acted as a whistleblower.

Delivering his sentence, Judge Timothy Lamb QC said the women's actions had "damaged patient trust" in the NHS.

The three women were responsible for looking after elderly female patients with various physical and mental conditions, including dementia, prosecutor John McNally said.

"An entitlement to proper care should not be a matter of chance or be given at the whim of the carer. The conduct complained of simply had no place on any ward," he told the jury.

The women would physically and verbally abuse patients, often telling them to shut up, as well as handling them in a rough and aggressive manner, police said.

Sakyiwaa was found guilty of four counts of neglect against three patients, including holding a bed sheet over 87-year-old Joan Massett's head and telling her she was dead, the court heard.

She pushed Ms Massett's breasts in another incident and forcefully twisted her mouth which was both "demeaning and completely unnecessary", Mr McNally said.

Sakyiwaa shouted at 88-year-old patient Elizabeth Toussaint to force her to sit in a chair and slapped Louise Hodges, 92, after cleaning her, the hearing was told.

Jackson was found guilty of one count of neglecting patient Barbara Jones, while Gunda was found guilty of one charge of neglect and one charge of assault by beating June Evans.

Addressing the defendants, Mr Lamb said: "In short, by your offending you have let down your colleagues, you have damaged patient trust and you have undermined the quality of care for the elderly and vulnerable at Whipps Cross."

Barts Health NHS Trust, which runs the hospital, has apologised to patients and stressed it has a "zero tolerance approach" to any form of neglect or ill-treatment.

In a statement issued following the verdicts, the trust said: "We apologise unreservedly to the patients of Beech Ward and their families for the indefensible failings in their treatment during their time in our care.

"There can be no place under any circumstances for such behaviour in our trust or in the wider NHS."

The trust said that following an internal disciplinary investigation, all three women had their contracts of employment terminated.

It added: "We take a zero tolerance approach to any form of neglect or ill-treatment of our patients and applaud the student nurses who showed courage and integrity in raising the alarm.

"It is the duty of every member of staff to report such behaviour and we will actively encourage and support this through our whistleblowing policy which is made clear to all staff on day one of their employment with the Trust, with ongoing reminders to existing staff during regular statutory and mandatory training.

"Moreover, we will take action against any member of staff who turns a blind eye, or fails to take immediate and appropriate action, if they witness any form of abuse or negligence."

Barts Health NHS Trust was issued with three formal warnings last week after inspectors found "unsafe" conditions at Whipps Cross including  filthy maternity wards and water placed out of the reach of elderly patients.

The trust had "failed to protect the safety and welfare of patients" and must now make "urgent improvements" following unannounced inspections in May and June, the Care Quality Commission (CQC) said.

The judge labelled Gunda "spiteful" before telling Sakyiwaa: "Maybe this offending showed a sign of your character that you and other people didn't know about."

Mr Lamb acknowledged that Jackson, who broke down in tears in court, was the sole guardian of her young son in handing her a suspended sentence.

Only one of the elderly victims, June Evans, was able to give evidence during the trial.

In a statement read to the court, she said: "Since the incident that took place last year I have completely lost trust in the health service.

"I lost faith in my GP, the ambulance service and hospitals in general."

Ms Evans discharged herself from the hospital following the assault and was in a state of distress when she had to return to Whipps Cross for further treatment.

"I wanted to die," she said.

 

"I thought why couldn't I have a heart attack and end it"

 

A number of further charges of neglect, assault and fraud related to the women were ordered to remain on file.

 

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com