The real NHS Cuts behind the Tory figures.

This article has been ignored by the British press during the election campaign; it was published on the RT website but it’s a Reuters article.

The two main health service unions have commissioned a study into what the NHS pays hospitals for the operations they carry out (that’s where most of their income comes from).

When the Tories tell us how well off the NHS is – well this tells a different story; hidden cuts that hurt:

Stealth cuts of £2 billion cripple NHS - report — RT UK 

 Stealth cuts of £2 billion cripple NHS - report

 April 26, 2015 

 

 

Reuters / Toby Melville

 

  

Hospitals in England are being hit by “stealth cuts” of more than £2 billion

($3.03 billion) since 2010 according to new research, blaming the cuts for

"rapidly deteriorating" hospitals’ finances.

 

Tariffs – hospital price payments per procedure, fixed by the National Health

Service (NHS) – have been massively reduced in the past five years according to

research carried out by the False Economy think tank, which was commissioned by the TUC and Unison. And those tariffs are where two-thirds of English hospitals' income comes from, the study adds.

 

The research found that one of four elective procedures, such as treatment for blood poisoning or diabetes, have had their tariffs slashed by more than 40 percent since 2010.

 

By examining 138 NHS procedures, the researchers found that between 2010 and 2015 hospitals suffered an income loss amounting to £70 million ($106).

 

Some treatments suffered cuts of 85 percent, including leukemia, asthma and sickle cell anemia, while cash for conditions like tuberculosis and glaucoma had been reduced by more than 70 percent and conditions like septicemia and kidney stones have had the amount given to them reduced by more than half.

 

When applied across all 4,500 tariffs, which make up most of the funding given to hospitals, the cuts amounted to more than £2 billion ($3.03 billion) over five years, making a mockery of the government’s claim that funding for the NHS has been ring fenced.

 

“These stealth cuts may have been largely hidden from the public eye, but the effects are grave. The NHS is in a rapidly deteriorating financial position, with hospital finances in steep decline,” said Frances O’Grady, TUC general secretary, in a statement.

 

Dr. Mark Porter, the head of the British Medical Association, said that the reductions in tariffs are part of a wider problem of cost cutting in the NHS.

 

“Cutting hospital tariffs causes real hardship for NHS services which are already struggling under rising patient demand, especially from an ageing population. This will push NHS organizations further into deficit, making a mockery of claims to have protected the NHS from cuts,” he told the Independent.

 

However, the NHS insisted that funding is going up rather than down.

 

“Rather than being cut, hospital funding in England has gone up, rising over the past three years from £49 billion to over £56 billion, a real terms increase of 9 percent,” said an NHS spokesman in a statement.

 

A spokesman for the Conservatives also insisted that hospitals had seen an increase in their budgets.

“Getting efficiency from the tariff is an important part of driving better value for taxpayers from the NHS, which is why it has been the policy of successive governments. Hospitals have seen real-terms increases in their budgets this Parliament, and unlike Ed Miliband, we’re committing to the £8 billion the NHS says it needs to transform community care,” he said.

 

However, NHS providers, like organizations providing mental health and ambulance services, are opposed to the cuts in tariffs.

“It is now widely accepted that 2015/16 will be the most difficult financial year for the NHS in its recent history,” they warned in January, according to the Independent.

I suppose the greatest scandal in all this is the 85% reduction in rates for the treatment of Sickle cell anaemia, which is a disease specific to African and afro-Caribbean people and has never been properly addressed in this country.

You only have to work for the NHS or be a patient to know that the Tory figures don’t add up.

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

Contact me: neilwithpromisestokeep@gmail.co.uk

Bart's Health trust - told you so!

I'm reprinting an article from September 2013. As you can see, it wasn't the first time that I'd warned about the scandal at Bart's Health Trust.

It's quite simple; I looked at the extraordinary number of 'never happen' events that were taking place at the trust.

It's not the only measure of what's going wrong at a hospital. It's just one of many.

Two years down the line and Bart's Health trust has been taken into special measures.

It's about time....time for managers and senior health professionals at the trust to resign. We'll see if that happens.

Meanwhile you read it here first, two years ago; 

 

 

Tuesday, 10 September 2013

More questions about Barts health NHS Trust.

O.K.

I’m getting seriously worried about Bart’s Health NHS Trust which is in fact a large grouping of East End Hospitals, swallowed up by inappropriate mergers over the years. This is what I wrote in May of this year after I analysed the ‘Bottom 21’ Trusts for ‘Never Events’, things that should never happen because they are completely preventable:

My own ‘Lantern Rouge’ (that’s the Tour de France prize for finishing last) is because I’ve picked out the two separate entries for ‘Bart’s’;

Bart’s& The London NHS Trust 8

              Retained foreign object post-operation 4

              Wrong site surgery 2

              Misplaced naso-or oro-gastric tubes 2

Bart’s Health NHS Trust 11

               Retained foreign object post-operation 4

               Wrong site surgery 3

               Misplaced naso-or oro-gastric tubes 2

               Wrong implant/prosthesis 1

               Air Embolism 1

and I did so because Barts Health was formed on 1 April 2012 by the merger of Barts and the London NHS Trust, Newham University Hospital NHS Trust and Whipps Cross University Hospital NHS Trust.

For starters that means that St Bartholomew’s may have had its figures split in two and actually had 19 ‘never happen’ incidents over that four year period which is seriously worrying. Even more worrying is that the newly combined Trust – the four hospitals together- seems to have had 11 incidents in just under a year (2012/13).

If you want to get really frightened, add up the number of incidents over the four hospitals for those four years – it’s a total of 27. Or is there duplication in these figures? Have they tried to separate the new from the old, producing double counting? I hope so – mind you where the NHS is concerned the problem is usually undercounting problems.

Either way, it’s not what I would call a centre of excellence.

So if Barts it isn’t being investigated right now, it’s time it was.”

I didn’t believe my eyes, so I left it as a question.

Then I got my answer in The London Standard two months later:

“An inquiry was ordered today at Britain’s biggest health trust in response to the deaths of 28 patients due to medical blunders last year.

 Barts health trust — which runs six London hospitals — was declared at “high risk” of failing patients, with major concerns about delays in cancer care and hundreds of emergency cases readmitted for further treatment.

The inquiry was ordered by England’s new Chief Inspector of Hospitals, Professor Sir Mike Richards, in his first day in the job. It comes after Barts last night said it was calling in financial trouble-shooters to address a £93 million debt.

Sir Mike was alerted by whistle-blowers, patient complaints and key measures indicating the performance at Barts was markedly worse than the national average. This included 10 “never events” — things that should never happen in surgery — involving seven cases where swabs were left inside patients, two cases where the wrong teeth were removed and one where the wrong eye implant was inserted.

 

Barts also admitted 348 serious incidents in 2012/13, including 129 at The Royal London Hospital in Whitechapel, and 105 at Whipps Cross in Leytonstone. Of these, 28 resulted in death.”

 

Now I am really concerned. Yesterday I posted the Freedom of Information responses from 101 NHS Trusts – replies to requests for Information made by the BBC News team about the number of unfilled vacancies at Accident and Emergency departments.

I went back to the figures to find out what has been going on down at Bart’s Health NHS Trust and the answer is……nothing…..nadda….nowt…zilch.

They didn’t provide the information.

So, of course, the only explanation is that the management, after failing to sort out its fairly serious problems has responded by hiding the result of the problems under the carpet. Given the extent of their troubles it would be no surprise to discover that staff are leaving and aren’t replaced and we have a right to know.

Its bad when there are problems, it’s much worse when you cover them up.

What else are they hiding?

Neil Harris

(a don't stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com

Contact me: neilwithpromisestokeep@gmail.com

 

 

Morecombe Bay NHS Trust, 12 avoidable deaths in maternity.

This is another very long awaited report.

Morecombe Bay Hospital suffered a series of deaths of babies and mothers at its maternity unit – a number far higher than this report accepts.

There followed a similar pattern; denial by the hospital and the professionals involved, the deaths rising to a level where local patients start campaigning, staff move on, there is an investigation and…….everything is fine.

It isn’t.

Furness General Hospital and it’s trust has had problems in a number of areas – for example I’ve catalogued it’s poor record in ‘Never happen Events’.

In this case there seems t have been a climate of incompetence, bullying and a very real cover up.

Preparing answers for everyone to follow at an inquest is the offence of ‘perverting the course of justice; prosecutions should follow.

This report is from ‘The Independent’ newspaper today;

Morecambe Bay hospital report finds 'lethal mix' of failures led to 11 baby deaths

 

The investigation has recommended a national review of NHS maternity services

 

Charlie Cooper

Health Correspondent 

Tuesday 03 March 2015

 

A “lethal mix” of incompetence, cover-up and failure to learn from mistakes led to the preventable deaths of 11 babies and one mother at a rural NHS hospital in Cumbria, a long-awaited report has said.

 

The inquiry into maternity services at Furness General Hospital between 2004 and 2013 found “failures at almost every level”, from the maternity ward to national NHS regulators and the Department of Health, who missed opportunities to investigate a series of serious incidents.

 

The investigation, led by Dr Bill Kirkup, has recommended a national review of NHS maternity services and care for children in rural areas.

 

In total the inquiry uncovered 20 instances of significant or major care failures at Furness General, part of the University Hospitals of Morecambe Bay (UHMB) NHS Foundation Trust. Failures occurred in the run-up to the deaths of 16 babies at or shortly after birth, as well as the deaths of three mothers.

 

Better care could have saved the lives of 11 of the babies and one of the mothers, the report said.

 

Staff on the unit in Barrow-in-Furness lacked essential “skills and knowledge” and working relationships between doctors and midwives were “extremely poor” with a “them and us” mentality that prevented safe working.

 

Midwives failed to keep up with the latest national standards of care and were heavily influenced by a small group of “dominant” midwives who pursued normal childbirth “at any cost”, the report said, leading to avoidable mortality rates that were four times higher than neighbouring hospitals.

 

A “strong group mentality” among midwives known as “the musketeers” hindered investigations into the incidents. The inquiry found “clear evidence of distortion of the truth” in responses to investigation. In preparation for an inquest into one of the incidents, "model answers" to difficult questions were circulated among midwives, the report said.

 

However, the UHMB Trust, as well as regional and national authorities, were slow to investigate and between them missed seven opportunities to intervene in the three years from 2008, when five serious incidents occurred within a short space of time.

 

Proper investigations as far back as 2004 would have raised the alarm, the report said.

 

The report added that without the efforts of bereaved families, the scale of the failings would never have been brought to light.

 

The report makes 44 recommendations for the Trust and for the wider NHS.

 

Investigation chairman Dr Bill Kirkup said: “All healthcare – everywhere – includes the possibility of error. The great majority of NHS staff know this and work hard to avoid it. They should not be blamed or criticised when errors occur despite their efforts.

 

"But in return, all of us who work for the NHS owe the public a duty to be open and honest when things go wrong, most of all to those affected, and to learn from what has happened. This is the contract that was broken in Morecambe Bay.”

 

He added: “There was a disturbing catalogue of missed opportunities, initially and most significantly by the Trust but subsequently involving the North West Strategic Health Authority, the Care Quality Commission, Monitor, the Parliamentary and Health Service Ombudsman and the Department of Health.”

 

The report also recommended that the General Medical Council and the Nursing and Midwifery Council should consider investigating the conduct of those involved in patient care during the incidents investigated.

 

The Trust has undergone changes in management since 2012, and the report said there were now “welcome signs of significant recent improvement” including in maternity services.

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

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Hips; saving money costs lives yet again.

For the last 20 years, it has been a given in the NHS that patients need to be sent home as soon as possible after an operation or treatment; ‘it’s in the patient’s best interests’.

Ask any patient and they will tell you they were sent home too early – I certainly was. In my case one extra day would have made all the difference.

In fact it’s all aimed at reducing the number of occupied beds and thereby reducing costs.

The assumption that the ‘community’ or ‘family’ will help out just leaves a lot of vulnerable people at risk.

The problem is that there aren’t the medical facilities and knowledge available at home. Often there isn’t a family or a community to help out.

The importance of this study is that it uses survival rates after hip injuries which are one of a number of international standard for hospital outcomes. The results for one country are relevant to another; in this case our results would be worse than Sweden as our community facilities are worse than theirs.

The fact is that sending patients home too early may save money but it costs lives.

The answer may well be to have wards with reduced medical cover for those who are recuperating rather than being actively treated;

Short hospital stays after hip fracture 'may increase risk of death'

Medical News Today

 

Wednesday 25 February 2015

 

A new study published in The BMJ finds that adults aged 50 and older who are subject to short-term hospital stays after admission for hip fractures may be at higher risk of death than those who have longer hospital stays.

 

Researchers found that hospital stays lasting less than 10 days after hip fracture was associated with increased risk of death.

 

Hip fractures are an increasingly common problem among older adults, with more than 95% of cases being caused by falls.

 

In 2010, there were around 258,000 hospital admissions in the US for hip fractures among adults aged 65 and older. And according to the Centers for Disease Control and Prevention (CDC), the number of hip fracture-related hospital admissions is expected to rise in coming years along with the aging population.

 

These admissions put an enormous strain on health care services and costs.

One-way health care systems have attempted to reduce this burden is by reducing the length of hospital stays for patients, referring them to home- or community-based care instead.

 

However, the researchers of this latest study - from Umeå University in Sweden - note that there are fewer sufficiently educated staff outside of hospital settings, and shorter hospital stays may mean the patient has less time for satisfactory rehabilitation.

 

These points raise the question: does early hospital discharge increase patients' risk of complications and death?

 

Patients at twice the risk of death with short-term hospital stays;

To find out, the team assessed 116,111 Swedish patients aged 50 and older who had been admitted to the hospital for hip fractures between 2006 and 2012.

 

The researchers analyzed how long the patients stayed in hospital and calculated their risk of dying within 30 days after being discharged.

 

Between 2006 and 2012, the team found that the average length of stay in the hospital for hip fracture patients fell by around 20%, from 14.2 days to 11.6 days.

 

Compared with patients who stayed in the hospital for at least 15 days, those who stayed in the hospital for 5 days or less were twice as likely to die within 30 days of being discharged, according to the researchers.

 

In addition, the researchers found that for patients whose hospital stay lasted less than 10 days, each 1-day reduction in length of stay was associated with an 8% increased risk of death in the 30 days following discharge.

 

Male patients and those with pre-existing heart, lung or kidney disease were found to be at highest risk of death in the 30 days after discharge following short-term hospital stays. Commenting on their findings, the researchers say:

"Our results suggest that the continuous efforts to decrease length of stay after major surgery in many countries is associated with higher mortality after hospital discharge.

 

In addition to evaluation of other diagnoses than hip fractures, further research should seek to gain a better understanding of the underlying cause of the increased risk of death after discharge in surgical patients, and evaluate whether early discharge to rehabilitation centers or nursing homes is associated with a worse outcome."

 

The researchers admit their findings are subject to some limitations. For example, following a hip fracture, risk of death is highest early on. This means that if a patient's length of hospital stay is reduced, they will automatically be at increased risk of death. "In the present study, this could bias the association between length of stay and death during follow-up as length of stay decreased," the authors note.

 

In addition, the researchers say they were unable to assess whether subjects received home- or community-based care following discharge, noting that it would be interesting to see whether one or the other may lead to a more positive outcome.

 

In an editorial linked to the study, Peter Cram and Raphael Philip Rush - both of the University of Toronto in Canada - say these study results may "serve as further warning to those who seek to discharge patients as quickly as possible."

 

"As clinicians we should be aware that, although hospitals are scarce resources, rapid discharge of patients should be considered carefully," they add. "For some patients, early discharge is likely beneficial and for others perhaps not. As policy makers, we should be aware that, while we have the tools to reduce length of stay, the potential for unintended consequences should not be forgotten."

 

In February 2014, Medical News Today reported on a study published in JAMA suggesting that home-based exercise programs may improve recovery for patients following hip fracture.

Written by Honor Whiteman

References;

Length of hospital stay after hip fracture and short term risk of death after discharge: a total cohort study in Sweden, Peter Nordström, et al.,  BMJ, doi: 10.1136/bmj.h696, published online 24 February 2015.

 

  Length of hospital stay after hip fracture: how low can we go before patients are at risk?, Peter Cram, Raphael Philip Rush, BMJ, doi: 10.1136/bmj.h823,   editorial.

 

  Additional source: CDC, Hip fractures among older adults, accessed 23 February 2015.

 

  Please use one of the following formats to cite this article in your essay, paper or report:

  Whiteman, Honor. "Short hospital stays after hip fracture 'may increase risk of death'." Medical News Today. MediLexicon, Intl., 25 Feb. 2015.

Medical News Today is concerned about it's copyrite; in this case this article is really an abstract of a British medical Journal article and therefore (with the correct attributions) I am reproducing it.

Neil Harris

(a don’t stop till you drop production)

Home: helpmesortoutthenhs.blogspot.com

Contact me: neilwithpromisestokeep@gmail.com

Privatisation hits the most vulnerable and we pick up the tab: Vista Independant healthcare.

I've tried to chronicle the failure of privatising NHS services to profit making entities, this is just the latest.

A contract is awarded because the private supplier undercuts the NHS in the tendering process.

Then after a while the level of care collapses as they try to make a profit out of the contract.

Then the tax payer has to pick up the pieces, once again.

This is from today's BBC News site; 

16 February 2015

Vista Independent Hospital: Patients moved after violence concerns 

Patients have been moved out of a mental health hospital that was criticised over a "disturbing" number of violent attacks.

A Care Quality Commission (CQC) report said Vista Independent Hospital at Winchfield, Hampshire, recorded more than 300 violent incidents.

NHS England said its decision to move patients was to ensure they were "safe and well cared for".

Hospital owner Vista Healthcare has not yet commented on the move.

A second CQC inspection was carried out earlier this month.

A spokesman for NHS England said Vista Healthcare has "failed to maintain safe standards of care and treatment for the vulnerable patients in its care".
'Considering further enforcement'
"Commissioners, working with the Care Quality Commission have acted promptly and already begun the process of transferring these patients, some with complex needs, to centres that can provide care to the appropriate standards," he said.

CQC inspectors - whose initial unannounced visit in November was made after concerns were raised - found multiple breaches of care, safety and health regulations.

It recorded 334 incidents of physical abuse or violence involving patients in seven months. There were 272 incidents of physical assaults on staff reported, with some needing hospital treatment.

The CQC said police had been involved in 22 incidents. The regulator formally warned Vista Healthcare, owned by Fairhome Care Group, to make urgent improvements.

The inspection also raised concerns over staff numbers, training and leadership.

A second inspection was carried out by a team of eight inspectors over three days from 3 February.

A CQC statement following that inspection, said: "We have discussed our findings with the provider and commissioners, and we are now considering whether further enforcement action is appropriate."

The hospital is registered for up to 69 patients with mental health needs or learning disabilities.

Neil Harris
(a don't stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com

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The price of being a courageous Whistle Blower.

Here is another disgraceful story of how NHS whistle blowers are treated; when will they learn that hiding problems under the carpet cures nothing.

Complainers and whistle blowers should be welcomed - it's the people who keep quiet about problems whjo are dangerous;

BBC News
15 January 2015
A whistleblower paramedic has been banned from two hospitals after he spoke out
about overcrowding in A&E.
Stuart Gardner, of West Midlands Ambulance Service, received the ban after
telling the BBC under-pressure emergency units were "not safe".
He said the chief operating officer (COO) of Worcestershire Acute Hospitals NHS
Trust has told him he was "not welcome" on either of its sites.
The trust said the ban was imposed as Mr Gardner's comments had upset staff.
It said its conversations with him were related to "personal upset" his comments
had caused among some A&E staff.

Union bosses are now considering taking legal action in the case.
Mr Gardner told reporters last week that he had seen patients being treated in
corridors at the Worcester Royal Hospital.
He said all he did was "raise concerns" about the location of treatment, and had
not criticised the behaviour of doctors or nurses.
"I was highlighting that issue and saying [patients] should have been on the
wards," he said.
 Mr Gardner said he had seen patients treated in corridors at Worcestershire
Royal Hospital
In light of his comments, Mr Gardner said COO Stewart Messer had banned him from
entering the hospital in Worcester and the Redditch Alexandra Hospital.
Mr Messer e-mailed the ambulance service the night before Mr Gardner appeared on
TV, and warned he would "not be welcome" on trust property if he was "critical
of managers or emergency department staff".
After the broadcast, Mr Messer e-mailed again and wrote: "[Mr Gardner] is no
longer welcome on either of our hospital sites, so can you please ensure that he
does not attend."
Ray Salmon, Unison area manager, said the union was threatening legal action
against the trust.
"Stuart informed the hospital he was going to blow the whistle, they threatened
him, he blew the whistle, they've now excluded him from site," he said.
"It's clear victimisation of a whistleblower."
The trust said it "actively encouraged" whistleblowing and it was "critical" to
preserve good relations with the ambulance service.
"[But] in response to this isolated incident, we have suggested it would be
appropriate for Mr Gardner to address the upset he has caused amongst A&E staff
who are working tirelessly under... extreme pressure," it said.
West Midlands Ambulance Service said it did not wish to comment.
However, the BBC understands it wrote to the trust to inform it Mr Gardner would
continue to be deployed in the same way.
Correction: This story was amended on 16 January 2015 in light of updated
information.
We should all be supporting Mr Gardner in this dispute, his cause is just.

Neil Harris
(a don't stop till you drop production)

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111 Emergency - still an emergency.

This is an article from The Daily Telegraph today – figures are now coming through which prove what this Blog has been saying for over a year.

The old ‘NHS Direct’ phone line was a real help to patients; it offered quick access to experienced nurses who could confidently divert patients away from Accident and Emergency.

The new ‘111’ line is staffed by unqualified staff who use a computer programme to advise patients.

If in doubt? Send them to A and E because you can’t go wrong.

It’s not the whole answer, of course. The real delays are because too many Nursing jobs have been lost, too many beds are empty and too many wards have shut.

The effect of this is that when patients are treated in A and E but need in patient time – there aren’t the beds.

Every one waits, operations are cancelled, simple problems become emergencies.

By  Laura Donnelly, Health Editor

Daily Telegraph.

14 Jan 2015

NHS 111 is to blame for almost all of the last year's rise in Accident & Emergency admissions, one of the country's most senior medics has said.

 

Dr Cliff Mann, president of the College of Emergency Medicine, said it was "absurd" to suggest patients were wrong to go to casualty units, when large numbers were being directed there by the telephone service.

 

Speaking at a session of the Commons health select committee on Wednesday, he said the NHS needed to change its systems so they work better for patients.

 

 

He told MPs that the 111 phoneline, which was supposed to help patients and relieve pressures on hospitals has had the opposite effect.

 

 

"The reason these people are attending these emergency departments is because we told them to," he said.

 

"Of the 450,000 extra attendances in the system in the last year, 220,000 were advised by NHS 111 to come to the emergency department and another 220,000 had an ambulance despatched to them by NHS 111.

 

"If you put those figures together you have more than 95 per cent of the rise in type 1 [major A&E unit] attendances. I don't think we should blame people for attending the emergency department when we've told them to go there. It's absurd."

 

Earlier this month, emergency medicine experts said that when nurses handled calls on the helpline's predecessor, NHS Direct, they had the experience to know when an A&E visit was not appropriate.

 

It came as figures emerged showing that NHS 111 sends an extra 50 per cent more patients to A&E at the weekend, when GP surgeries and other clinics are shut - increasing the strain on already stretched hospitals.

 

Latest figures show A&E waiting times in England are now at their worst levels in more than a decade.

 

Suzanne Mason, professor of emergency medicine at the University of Sheffield said the numbers of patients being sent to A&E after calling 111 was a huge problem.

 

She said ambulance services in some parts of the country had been "brought to their knees" by call handlers, who follow a risk-averse computer symptom checker, that defaults to A&E as a safety-first option.

Neil Harris

(a don’t stop till you drop production)

 

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