Sir Bruce Keogh - could do better.

Some of you will realise that compared to the truly dreadful Sir David Nicholson (Chief executive NHS England) so often described as ‘The Man with no Shame’ I hold Sir Bruce Keogh in some regard. He’s the NHS England Medical Director and has different priorities.

He’s just issued a report on Accident and Emergency treatment and it’s quite good. ‘Quite’ because I have some issues, good because it is at least intended to improve things.

1) Reduce the number of A and E’s dealing with Strokes, Heart Attacks and Trauma.

Great idea – in London the number of Stroke units were reduced from over 20 to 8 with the result that the death rate fell dramatically and outcomes improved.

For these three areas specialising works really well, getting early, good treatment is vital.

Before stroke victims waited all weekend for someone to turn up – by then it was too late. Heart Attacks are not the killers they were because of specialisation. Complex trauma needs highly skilled surgeons.

2) A revamped and improved 111 service – with more clinicians and Nurses available on the phone to reduce the number of A and E admissions. Great idea – that’s what we were arguing for when NHS England closed down NHS direct which did that.

Sir David Nicholson – well done again. You just finished off NHS Direct and still have time to watch the failing 111 service being turned back into a pale shadow of NHS Direct at enormous public expense to try and put right another mistake of yours.

3) Improved paramedics, dealing with more cases at home rather than taking them to A and E – who could object to that.

Problems;

1) Where I have a real problem was watching Sir Bruce on a ‘Newsnight’ interview last night. He repeated the nonsense that 40% attending A and E do not need to do so.

It’s nonsense because no one knows that until after the event. The 40% includes all who attend with suspected broken bones for an X-Ray, the abdominal pains, the suspected thrombosis etc. All require tests no Doctor does or paramedic can do. Failing to send those people in for the tests is just negligent; no Doctor would take the risk. So the 40 % includes those who needed a test but luckily they then didn’t need treatment.

2) Keogh expects to downgrade 70 out of 170 A and E’s.

The problem with that is that we have a pretend market not planning. It won’t be the best A and E’s that survive it will be the pushiest, grabbiest Foundation trusts. The others will lose the revenue from admitted patients and decline further.

Losing Cardiology, Stroke and Trauma will remove a massive proportion of any hospitals revenue and that means more closures.

No planning means no concern for local communities and no real search for expertise.

PFI contracts are so binding (an act of parliament could easily unbind them) that being lumbered with a catastrophic PFI is likely to safeguard a poor and inefficient hospital rather than ensure that quality survives.

So Sir Bruce, this paper doesn’t get full marks from me, which is a shame. You were doing quite well up till now. Don’t forget that while you may be thinking about best practise, the managers are only thinking about money.

Neil Harris

(a don’t stop till you drop production)

If you also look at helpmesortoutstpeters.blogspot.com I warn you that tomorrow this article will be repeated - I'm not so well at the moment and the Doctors seem to be out for revenge! Normal service will soon be resumed.

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Private healthcare, the solution to all our problems I don't think.

This is a disgrace. It’s from a report from The Independent, 2^nd August 2013.

I’ll need to translate the article to explain the horror of it all.

Clinicentre/Carillion are given a private, profit making contract to build a hospital and supply operations to the NHS for decades. In other words, NHS jobs are lost and we had to pay for it all.

Instead of being a centre of excellence it turns out to have been messing up, killing patients, losing records. It was a disaster.

The Care Quality Commission starts to take its licence away.

What happens? The taxpayer has to come in and give these idiots £54 million to go away.

We have to compensate them?

That’s what happens when you sign a contract without reading the small print;

 

“Privately-run hospital taken over by NHS after patient deaths following routine surgery

Commissioning Support Unit confirm services currently provided by Clinicenta will transfer to East and North Hertfordshire NHS Trust

Charlie Cooper 

Thursday 01 August 2013

A privately-run hospital has been taken over by the NHS amid patient safety fears following the deaths of three people after routine surgery.

 The Lister Surgicentre in Stevenage has been signed over to the local NHS trust, after the Care Quality Commission began the process of suspending its licence last month.

Local MP Stephen McPartland said the unit had been bought by the Government from Clinicenta Ltd, part of British construction multinational Carillion, for a sum in excess of £54m.

There have been concerns over patient safety at the unit. Mr McPartland said confidence in it was so low that GPs were refusing to refer patients.

“At least three people died, 8,500 patient records were lost and a whole host of serious failings led to the Care Quality Commission beginning proceedings to suspend Clinicenta-Carillion's licence to operate at the Surgicentre because of serious concerns for patients' safety,” he said.

The centre, which opened only 18 months ago, provides routine head and neck surgery as well as orthopaedics, gynaecology and eye services. It has six operating theatres, 26 beds and an urgent eye clinic.

 

The NHS Central Eastern Commissioning Support Unit (CSU) confirmed that services currently provided by Clinicenta will transfer to East and North Hertfordshire NHS Trust. Services will not be interrupted and the transfer will take place over the next few weeks, according to the CSU. The transfer of services had been mutually agreed by the Department of Health, East and North Hertfordshire Clinical Commissioning Group (CCG), NHS England and Clinicenta.

Mr McPartland said that Carillion “should never be allowed to manage another hospital facility in the UK” and criticised the former Labour government for putting “a building company in charge of highly sensitive and complex surgical procedures”.

A representative for Carillion could not be reached for comment.

Mr McPartland added: “I am delighted that the Lister Surgicentre will now be managed by the Lister Hospital which is a centre of clinical excellence. We can now begin the job of rebuilding trust and this facility with state of the art equipment can be managed properly inside our NHS, where it should have been from day one.”

Of course, this is the dreadful Private Finance Initiative which is bleeding the NHS dry of money. Strangely, when the private hospital is about to lose its licence due to incompetence, we are allowed to buy it out. When PFI’s are making exorbitant profits we are not allowed to buy them out.

Nationalise the lot.

Neil Harris

(a don’t stop till you drop production)

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