Thursday, 23 April 2015

Hospitals have been getting busier over the last 5 years - The Kings Fund

Hospital activity levels
Sources: NHS England (2015 ab); Office for National Statistics (2014, 2013 ab)
Hospitals have been getting busier over the past five years, with increased numbers of emergency (non-elective) admissions, elective admissions, and outpatient attendances. Between October and December 2014 there were 1.4 million emergency admissions to hospital; almost 2 million elective admissions; 4.3 million people attended a first outpatient appointment; and 5.5 million people went to A&E. 
Population change is one factor driving increased NHS activity, but between 2009/10 and 2013/14 hospital activity increased at a faster rate than the population grew. Other factors such as the increasing numbers of older people, changes in the way that services are provided and changes in clinical practice have also combined to increase hospital activity.

VIDEO - Privatisation of the NHS: Allyson Pollock at TEDxExeter

Use this link to watch the video clip:

https://www.youtube.com/watch?v=1m8kFIFmUC4


This talk was given at a local TEDx event, produced independently of the TED Conferences. The 1948 Act establishing the NHS gave the Secretary of State for Health the duty to provide universal health care. 

The Health and Social Care Act 2012 removes this duty and introduces a market. Allyson Pollock describes why we need to worry.

Allyson Pollock is Professor of Public Health Research & Policy at Queen Mary, University of London. She is one of the UK's leading medical intellectuals, and undertakes research and teaching intended to assist the realisation of the principles of social justice and public health, with a particular emphasis on health systems research, trade, and pharmaceuticals.

She trained in medicine in Scotland and became a consultant in public health. Among her previous roles she has been director of the Centre for International Public Health Policy at the University of Edinburgh and director of research & development at UCL Hospitals NHS Trust. She is the author of NHS plc and co-author of The New NHS: a guide.

At TEDxExeter 2014 our speakers and performers connected us with other worlds. Our talks exposed corruption in big business, shared effective approaches to tackling social inequality and gave a voice to those whose human rights are under threat. We explored the impact of fast changing technologies on all our lives. We journeyed through fire and forest to frozen landscapes. We were challenged to consider worlds of extremes, cutting edge controversies and risky opportunities.
Video Production Chromatrope (http://chromatrope.co.uk/)
Production Manager Andy Robertson (http://www.youtube.com/familygamertv)

About TEDx, x = independently organized event In the spirit of ideas worth spreading, TEDx is a program of local, self-organized events that bring people together to share a TED-like experience. At a TEDx event, TEDTalks video and live speakers combine to spark deep discussion and connection in a small group. These local, self-organized events are branded TEDx, where x = independently organized TED event. The TED Conference provides general guidance for the TEDx program, but individual TEDx events are self-organized.* (*Subject to certain rules and regulations)

Tuesday, 21 April 2015

Experts Support SAVE OUR HOSPITALS - Plans 'Deeply Flawed'


Paul WilliamsTue, Apr 21, 2015

The Independent Health Commission, set up by four West London boroughs (Hammersmith and Fulham, Ealing, Brent and Hounslow) and chaired by Michael Mansfield QC, has released a preliminary report.

They have concluded that the reorganisation plans, Shaping a Healthier Future, are ‘deeply flawed’ – just what Save Our Hospitals has been saying for more than 2 years.
Campaigners outside Hammersmith in September 2014

Under Shaping a Healthier Future, NW London is to lose 4 A&Es – two have already gone in September 2014, Hammersmith and Central Middlesex. The other two are Charing Cross and Ealing. Charing Cross is to be demolished, 55% of land to be sold to private developers, and a small cottage-type hospital with only 24-64 overnight beds to replace the current 360-bed acute hospital.

SOH campaigners protesting at the closure of Hammersmith Hospital A&E on 10th September 2014

The preliminary report, drawn up by independent consultants Seán Boyle and Roger Steer, provides damning evidence to support SOH’s demands for a stop to the reorganisation plans and for a complete rethink of the proposals.

The main SaHF proposals and rationale are shown to be lacking any supporting evidence and they describe the programme as a ‘preconceived solution’ imposed on local people without there being any clear problem that needed to be solved.

The consultants stress that there has been ‘no proper assessment of the needs of the whole area to which the health and social care system would respond’. They point our clearly that there is still no clear and final business case to support the plans. And state clearly the, with the current estimate of the programme at £1 billion,’ it is unlikely that the SaHF programme as a whole would be affordable or deliverable’.

SOH has consistently said that Out of Hospital services, however good, are not yet in place and nor are they likely to compensate for the loss of hospital beds. The consultants agree with us and add ‘ the evidence on the impact of better primary care and OOH services on demand for A&E services is flawed’.

Merril Hammer, chair of Save Our Hospitals, welcomes the interim report. ‘Plans for closures and cuts to health services in NW London should be withdrawn immediately and a proper assessment of local health needs needs to undertaken. This interim report is entirely damning of the SaHF proposals. Local health bodies need to respond by withdrawing the current proposals.’

Chiswick Herald.co.uk

PRESS RELEASE – 20th APRIL 2015

EXPERTS SUPPORT SAVE OUR HOSPITALS 
- PLANS ‘DEEPLY FLAWED’

The Independent Health Commission, set up by four West London boroughs (Hammersmith and Fulham, Ealing, Brent and Hounslow) and chaired by Michael Mansfield QC, has released a preliminary report. They have concluded that the reorganisation plans, Shaping a Healthier Future, are ‘deeply flawed’ – just what Save Our Hospitals has been saying for more than 2 years.

Under Shaping a Healthier Future, NW London is to lose 4 A&Es – two have already gone in September 2014, Hammersmith and Central Middlesex. The other two are Charing Cross and Ealing. Charing Cross is to be demolished, 55% of land to be sold to private developers, and a small cottage-type hospital with only 24-64 overnight beds to replace the current 360-bed acute hospital.

The preliminary report, drawn up by independent consultants Seán Boyle and Roger Steer, provides damning evidence to support SOH’s demands for a stop to the reorganisation plans and for a complete rethink of the proposals.

The main SaHF proposals and rationale are shown to be lacking any supporting evidence and they describe the programme as a ‘preconceived solution’ imposed on local people without there being any clear problem that needed to be solved.

The consultants stress that there has been ‘no proper assessment of the needs of the whole area to which the health and social care system would respond’. They point our clearly that there is still no clear and final business case to support the plans. And state clearly the, with the current estimate of the programme at £1 billion,’ it is unlikely that the SaHF programme as a whole would be affordable or deliverable’.

SOH has consistently said that Out of Hospital services, however good, are not yet in place and nor are they likely to compensate for the loss of hospital beds. The consultants agree with us and add ‘ the evidence on the impact of better primary care and OOH services on demand for A&E services is flawed’.

Merril Hammer, chair of Save Our Hospitals, welcomes the interim report. ‘Plans for closures and cuts to health services in NW London should be withdrawn immediately and a proper assessment of local health needs needs to undertaken. This interim report is entirely damning of the SaHF proposals. Local health bodies need to respond by withdrawing the current proposals.’

Merril Hammer, Chair, Save Our Hospitals



Monday, 20 April 2015

Why £8bn is a zombie figure that won't save the NHS

As the former boss of the NHS slams politicians for not addressing the financial 'black hole', will the pledged £8bn merely be used to pump prime further privatisation and cuts? The introduction to a series examining the parties' NHS manifesto pledges.

The NHS electioneering has so far been dominated by arguments about whether the Tories 'unfunded' £8bn pledge is better than Labour's 'funded' £2.5bn pledge.
But this morning David Nicholson – the old boss of the NHS – weighed into the argument with a bombshell.
He told the BBC that in any case £8bn won’t be nearly enough to save the NHS from entering a period of “managed decline” with ever-lengthening waiting lists.
Nicholson is not alone – the Health Foundation said much the same earlier this month. And the British Medical Association has just warned that unless the funding gap is filled, a "pay NHS" could be on the way.
Nicholson has now joined the fray, criticising politicians for making election pledges of a 24/7 NHS (Tories) and more staff (Labour) and “talking about extra services” but refusing to talk about the “financial hole”.
Nicholson calls for politicians to be more honest with the public about what “big decisions” might be in the pipeline (of which more in a moment). But he himself is only pointing out the basic arithmetic. Most experts – including the NHS’s new boss, Simon Stevens – have said the projected NHS funding shortfall is more like £30bn a year by 2020. So even £8bn of new money leaves £22bn a year still to be found from somewhere.
There is considerable evidence to suggest that getting the expensive market out of the NHS could save a large chunk - maybe even all - of this cash.
But that's not on Simon Stevens' agenda. 
Stevens pledged last year that he could instead make £22bn of “efficiency savings” – a commitment hailed by politicians from all sides.
It’s time to examine the Stevens’ £22bn savings pledge in a bit more detail. What kind of ‘tough decisions’ might the unelected heads of the NHS have up their sleeves ready for politicians to rubber stamp?
Stevens - who used to work for United Health, has laid his ideas out in his ‘Five Year Plan’, though you need to dig deep behind the jargon, and listen closely to his other pronouncements, to identify what's really being put forward.
For starters, the Five Year Plan talks about "unlocking assets". Stevens suggested to the Independent last month that possibly as much as £7.5bn will be “saved” by selling off many more hospitals and clinics to property developers, adding "this is obviously just the beginning”.
Quite how such a mass sell-off will solve waiting list crises, when we havealready lost half our hospital beds in the last 30 years, is unclear. We now haveamongst the lowest level of beds in Europe.
But there are worrying signs that many more closures and sell-offs are planned for after the election, with a law passed in the dying days of this parliament that will help sell-offs of NHS buildings including those currently in use.
Stevens says this will lead to “fundamental changes” in how the NHS is delivered, though is always keen to tell us that these will be ‘local decisions’ – that favourite politician’s trick.
Already, ‘local plans’ almost inevitably turn out to be written by the same narrow cohort of management consultants who have close working relationships with private healthcare, insurance, pharma and technology companies.
You’ve probably got at least one such plan in your area, though if it is explicit about bed, hospital and ward closures, you may, like the citizens of Staffordshire, struggle to see it before the election.
The public facing plans typically use Stevens’ language of “right care, right place, right time”, heavy on appealing talk of “care closer to home” and in particular more “self-care”, "integration", and “demand management”.
The respected Health Services Journal calls such talk “Messiah concepts” and “magical thinking”. The  Nuffield Trust says that to suggest we’ll get “better services outside hospital that can either prevent the need for hospital admission or offer the same care but in different settings…is a common theme in initiatives…But there is little evidence that this can be achieved”.
Local scrutiny of these re-organisation and closure plans has been blunted in many cases as councillors are tempted by the prospect of nabbing a bit of NHS cash to fill the gaping hole in their social care budgets, under the familiar rhetoric of ‘integration’. To see this prospect writ large, see Manchester’s ‘DevoManc’ plans, breezily waved through by George Osborne just before the start of election purdah, even as Manchester’s smaller hospitals face an uncertain future.
And there’s more up Stevens’ sleeve. He used his first speech as NHS boss to announce a huge roll-out of personal healthcare budgets, to cover the 5 million most sick people in the NHS over the next 3 years. The roll-out of the scheme is already underway, with people receiving a capped ‘entitlement’ for planned (though not emergency) healthcare. If your needs change and you need a bit more healthcare, NHS England have admitted patients will have to individually ‘negotiate’ that with bureaucrats. This is hardly a reassuring prospect – socialcare users with personal budgets have already found they face delays of up to 6 months for such renegotiations, which are not always successful.
The plan sounds suspiciously like the old Thatcherite ‘vouchers’ plan. Effectively state subsidised insurance, topped up from your own pocket if you want more than the bare minimum of healthcare – just as we already have in social care. 
Vouchers were favoured (but never delivered) by the Thatcherites as a key way of funnelling state subsidy (and increasingly, personal contribution) to private health firms.
We should never forget that Stevens – in his pre-United Health role as health advisor to Tony Blair and Alan Milburn – was described by the Financial Times as the “key architect…of the reforms that for the first time broke up the NHS monolith, introducing privately run treatment centres”.
And he’s still at it. His Five Year Plan said we need more “new provider networks” from the private sector, though – as usual - this was disguised in lots of talk of partnership and ‘GP leadership’.
It’s another politician’s trick from the unelected head of the NHS. The Health & Social Care Act was sold to us as ‘GP leadership’ too. But the reality has been a few entrepreneurial GPs providing political cover to service cuts, whilst the majority of GPs are left struggling to get on with the job – or leaving. Many areas now have fewer than half the GPs they need, says the Royal College of GPs.
Stevens’ 5 year plan is vague on any commitment to patients being able to access sufficient skilled healthcare professionals in a timely fashion – surely the bedrock of what a health service should be about. Instead it is full of hints that in future an increasing number of services will be delivered, not by face to face contact with doctors and nurses, but by telephone and internet contact, mobile phone apps and “remote monitoring” gadgets. “Innovators from the UK and internationally will be able to bid to have their proposed discovery or innovation deployed and tested”, we are told. There will also be “an expanding set of NHS accredited health apps that patients will be able to use to organise and manage their own health and care and the development of partnerships with the voluntary sector and industry”.
Such 'apps' are dismissed in an article in this week's British Medical Journal as "likely useless" and possibly worsening the anxiety of the "worried well". But there’ll be no shortage of bidders – PWC says the ‘mhealth’ (mobile health) market will be worth $23bn by 2017, and whilst the UK is at the vanguard, the opportunities for roll out to expanding economies like India are huge. Ali Parsa - the man who duped the political class into believing his private company could do a good job of running Hinchingbrooke hospital - is now selling us just such an 'app' to replace doctors. Called 'Babylon', it is accredited by the NHS - and available for a monthly fee. 
Noting that it takes a long time to train medical staff, Stevens also suggests greater reliance on privatised care home staff to provide ‘shared models’ of medical care, and lauds the increasing reliance on volunteers and non-medically qualified staff nudging us towards more ‘self-care’ (whilst not, of course, addressing the structural issues of poverty that make poor lifestyle choices the easiest choice for many).
Stevens also suggested in 2010 that a good model for primary care might be ‘Michael Gove-style free schools’ (ie cheaper, unqualified teachers) – and refused to rule this out when challenged in 2014.
Staff make up over 70% of NHS costs – so fewer, cheaper, less skilled staff is the main way that the increasingly involved private sector cuts corners to make their profits.  
As both insurance companies and providers in America know, the really fat profits aren’t in providing health care, as much as in purchasing it – and somehow weeding out those people, and treatments, it isn’t profitable to provide for. The kind of thing that Kaiser Permanente does in the US – a model cited approvingly in Stevens report.
Alarmingly, a subsidiary of Stevens' old employer United Health - Optum Health - has just won (alongside Capita) the contract to control £5bn of NHS ‘purchasing decisions’. Already we see attempts to weed out undesirable patients – whilst the ‘local decision’ in Devon to refuse all routine surgery to smokers and obese people was overturned after an outcry, there are currently no legal obstacles to cash strapped local health bosses taking the same decision elsewhere in future.
Stevens 5 Year Plan even hints at the plans announced this week by the Tories - to cut the benefits of those who don’t consent to unspecified ‘treatment’ by saying “we will seek to test a win-win opportunity of improving access to NHS services for at-risk individuals while saving ‘downstream’ costs at the Department for Work and Pensions, if money can be reinvested across programmes”.
So that’s what the new boss – and the old boss – have up their sleeve.
And where are the parties on these plans? Over the next week OurNHS will examine the extent to which the major parties have signed up to Stevens’carefully crafted consensus in favour of service cuts, hospital closures, self-care and conditionality – and whether any of them have committed to taking the truly bold decision, to get the hugely expensive market out of the NHS altogether, to plug the funding gap that we know still looms.
CAROLINE MOLLOY 16 April 2015

Wednesday, 15 April 2015

BMA backs principles of NHS Reinstatement Bill to save NHS from destruction by market forces

As politicians squabble over NHS funding figures, the British Medical Association's Council has backed the principles of radical legislation which would get the costly 'market' out of the NHS.

Professor Allyson Pollock, member of the BMA Council and their working group examining neccessary legal changes.

The stated policies of the British Medical Association are to end the market in health care, oppose the purchaser provider split, and to reinstate the Secretary of State’s duty to provide universal health care throughout England. 
The BMA has made its position clear - not only in its general election briefingsbut in full page advertisements where it has declared that its doctors support a “publicly funded, publicly provided” NHS.
The BMA has now gone as far as setting out the principles of the legislation it would expect to see after the election.
 On 11th March 2015, the BMA’s Council completed its examination of two sets of legislative proposals on the NHS set out in Private Member’s Bills laid before the House of Commons. 
The purpose of its examination was to analyse two bills - the NHS (Amended Duties and Powers) Bill, presented by Labour MP Clive Efford and supported by 11 Labour MPs; and the proposed NHS Reinstatement Bill subsequently presented – on 11th March 2015 – as the NHS Bill 2015 by Green MP Caroline Lucas and supported by 11 Liberal Democrat, Labour, SNP and Plaid Cymru MPs.
The BMA Council established a large working group, of which I was a member, to identify which proposals in the Bills were in line with and would further BMA policies.
In response to the reports of that working group the Council unanimously agreed to support legislation which furthers implementation of strong and clear policies of the Association concerning:
• restoration of the Secretary of State’s duty:
o to provide and secure provision of services in accordance with the National Health Service Act 2006 for the purpose of the comprehensive health service that it is his or her duty to promote, and
o to provide listed services throughout England under section 3 of that Act,
• limits on the Secretary of State’s powers over operational matters and day-to-day running of the health service,
• abolition of the purchaser-provider split, the internal and external market and competition,
• the ending of PFI in the NHS,
• the exemption of the NHS from TTIP, and
• the moral unacceptability of the Immigration Health Charge,
• ensuring public accountability
• supporting national terms and conditions.
BMA Council also unanimously insisted that where legislation to abolish the purchaser-provider split, the internal and external market and competition involves structural changes the legislation must be implemented in a flexible and devolved way in order to minimize concerns about potential disruption that might result from implementation of those policies.
BMA policy is made by the annual representatives at its Annual Representative Meeting. 
The BMA is not alone. The King’s Fund has recognised the ‘disastrous’ impact of the Health & Social Care Act, reporting recently that services are deteriorating faster than at any time since the early 90s, with waiting lists at a record high, morale low, and GP and mental health services under severe strain.
Another Kings Fund report released in the last month has also set out howwithout a re-organisation that scraps the autonomous nature of Foundation Trusts, it will be impossible for the NHS to avoid EU competition law (even without TTIP).
There is growing concern too over Osborne’s surprise announcement which would shift £6bn of NHS and social care funding and decision making to the yet to be elected Manchester mayor. Responding to that announcement, Dr Mark Porter, Chair of the British Medical Association, said:
 “We need assurances on who is responsible if these changes go wrong. Doctors believe the Secretary of State for health should have the duty to provide a universal and comprehensive health service.”
Only legislation will do this. And the principles of what is needed is set out in the NHS Bill 2015, which is the product of over two years work by the Campaign for NHS Reinstatement.
It is highly significant that the BMA has said it will support legislation to support its policies. Now it is up to voters to demand that their candidates support the NHS Bill 2015 and the legislation required to restore the duty to provide in the first Queen’s Speech of a new parliament. There is very little time left.
To contact your parliamentary candidates please visit www.nhsbill2015.org and TAKE ACTION. 
ALLYSON POLLOCK 14 April 2015
About the author
Allyson Pollock is professor of public health policy and research at Queen Mary, University of London and was previously Director of the Centre for International Public Health Policy at the University of Edinburgh. She is a leading authority on public health and the implications of privatisation for public services, and the author of NHS plc, on the privatisation of our health care under New Labour.

Tuesday, 14 April 2015

Experts slam West London closure plan...



VIDEOS - People's Convention for the NHS 11/04/2015

We've seem the destruction of the NHS - Steve Sweeney 
https://www.youtube.com/watch?v=yaU2dlNzwOw

STOP the closures, loud and clear message to all politicians - Merril Hammer, SOH chair 
https://www.youtube.com/watch?v=w_XHdrdxJxc

Is David Cameron PM telling the truth about the NHS? Prof Sue Richards, KONP 
https://www.youtube.com/watch?v=kqjoq1rxu8c

NHS contracts are been given to the private sector! 
https://www.youtube.com/watch?v=xM6jp3f0aIs

We fight against TTIP to protect the NHS - John Hilary - Director, War on Want 
https://www.youtube.com/watch?v=X3rJnB5ZQoA

What is PFI in the NHS? Dr John Lister 
https://www.youtube.com/watch?v=XK3UqDoFjDI

The NHS downgrading plans for London could happen around the Country - Anne Drinkell, SOH secretary 
https://www.youtube.com/watch?v=dv9xiBakhBY

Unions should put pressure on the Labour party! 
https://www.youtube.com/watch?v=W1SOnweuoaA

The demands of the NHS campaigners... 
https://www.youtube.com/watch?v=m0afuDFnyWE

NHS campaigners must put pressure on political parties to change policies 
https://www.youtube.com/watch?v=LjWhMaw2a8s

TTIP is so bad in so many directions... John Hilary - Director, War on Want 
https://www.youtube.com/watch?v=er7vs60h_SQ

We must STOP the closures in West London! Dr John Lister 
https://www.youtube.com/watch?v=TH-iCD_nW4g

Coalition Government decided to close Hospitals and A&Es in the poor areas 
https://www.youtube.com/watch?v=Pfamw14TZj8

The NHS campaigners will be on the streets - Lewisham campaigner 
https://www.youtube.com/watch?v=17RuqzsKWAA

Close or not to close Hospitals? St Helier Campaigner 
https://www.youtube.com/watch?v=0SQNsYCOXC8

We've been told lies all the time about the NHS! 8 billion a year for the NHS? 
https://www.youtube.com/watch?v=Q8t1NslM4TQ

Nursing is in a state of crises across the NHS! 
https://www.youtube.com/watch?v=Qgdun76aSuw

We have a crises of A&Es around the Country - Jim Grealy, SOH campaigner 
https://www.youtube.com/watch?v=rD1y8_bdIO4

TTIP demonstration on the 18/04/2015 at Shepherds Bush Green, 12pm 
https://www.youtube.com/watch?v=Q59j8biyOzk

Demonstration in Staffordshire on the 02/05/2015 - Walk for Life 
https://www.youtube.com/watch?v=xtoTbQWWH4Y

Clinical Commissions Groups (CCGs) are a disaster! Dr John Lister 
https://www.youtube.com/watch?v=tcnn1WIXb2A





Wednesday, 8 April 2015

West London NHS trusts miss A&E waiting time targets

All NHS trusts across west London fell short of the target of 95% of patients waiting less than four hours to be seen in A&E.


All of west London's hospital trusts missed A&E waiting time targets last month.
Just 89.2% of patients at London North West Healthcare NHS Trust waited less than four hours from arrival to being admitted, discharged or transferred in the week ending March 29.
The target is at least 95% of patients waiting less than four hours.
The trust, responsible for Ealing Hospital, Northwick Park and Central Middlesex hospitals, has not hit the 95% target since it was created at the start of October.
Isleworth's West Middlesex Hospital, where 92.8% of patients waited less than four hours, has missed the target for six weeks running.
Imperial College Hospital, 89.8%, has missed the target for four weeks; Pennine Acute, 93.4%, for 22 weeks; and University Hospitals of South Manchester, 93.1%, for five weeks, while Chelsea and Westminster, 92.8%, and The Hillingdon Hospitals, 94.4%, just dipped below the target in the last weeks of March.
Across England, A&Es have missed the waiting time targets every week for the last six months.
The latest figures, from NHS England, show in the week to March 29, 92% of people attending A&E waited less than four hours before being admitted, discharged or transferred. The target is at least 95% waiting less than four hours.
The figures for the last week of March mean that the target has been missed every week for two quarters, with the last time English A&Es managed to hit the target in the week ending September 28.
Across the whole of the January to March quarter, just 91.8% of people attending A&E waited less than four hours, the worst performance across a quarter in the 10 years the figures go back.
For the whole of 2014/15, English A&Es missed the 95% target, with an overall performance for the year of 93.6%, the lowest performance since 91% in 2003/04, when targets were first introduced. In 2014/15, the 95% target was missed in 37 out of 52 weeks.
The worst performing trust in England in the week to March 29 was Hull and East Yorkshire Hospitals, with 71.4% of patients waiting less than four hours. More than a fifth of patients had to wait longer than four hours in 13 other A&Es across England.

Fifth west London hospital criticised by NHS watchdog – will problems worsen under A&E and maternity shake-up?

A hospital facing an increased number of emergency patients and births under a controversial shake-up of A&Es and maternity departments was today criticised by the NHS watchdog.
West Middlesex hospital, in Isleworth, became the fifth west London NHS trust in a year to have its failings exposed by the Care Quality Commission – even before it has to deal with an influx of patients under the Shaping A Healthier Future plans.
Inspectors gave it a rating of “requires improvement” and said inadequate numbers of nurses and A&E consultants posed a risk to patient safety. 
But they found “good” care in a number of areas. The A&E department had a “calm and well-managed response to very heavy emergency demand”. The A&E and urgent care centre treat 137,000 patients a year.
The Chief Inspector of Hospitals, Professor Sir Mike Richards, said of the inspection, carried out last November and December: “We found that, while staff were caring and compassionate – and some were going the extra mile for patients, some of the services we looked at required improvement.
“Our overall findings highlight the level of variation that can be found within the same organisation.”
A shortage of more than 17 midwives and nine maternity assistants meant there was one midwife for every 36 births, compared to the national target of one for every 28.
Patients requiring admission from A&E to specialist wards waited an average of four hours 50 minutes – more than double the national average of two hours 20 minutes.
The hospital, which serves Richmond and Hounslow, is due to merge this summer with Chelsea and Westminster hospital and undergo a major rebuild in 2017/18 to cope with extra patients diverted as a result of the closure of neighbouring units under Shaping A Healthier Future.
West Middlesex chief executive Jacqueline Totterdell said: “Despite our obvious strengths and caring attitudes of staff, there are some areas requiring improvement. The report made clear the issues we must focus on and we have been working collaboratively with our health and social care colleagues to address some of these.”
Posted by  in HealthPolitics

Finding the political will to maintain the health of the NHS

Doctor checks patient's blood pressure
'NHS GPs are now managing 150,000 more consultations every day than five years ago.' Photograph: Anthony Devlin/PA


The NHS is one of the country’s most treasured institutions. It represented a real advance for the health of the nation and its provision of free, universal healthcare for all is admired throughout the world. But its future is under serious threat. There have been many local campaigns established to defend services threatened with privatisation or closure. But there must be a response on a national level. Starting last month with the relaunch of the People’s March for the NHS, there have been a series of events that will culminate in a People’s Convention for the NHS on 11 April.
The aim is to unite the broadest coalition possible, bringing together health workers, campaign groups, trade unions, health activists, pensioners groups and others with one common aim – to save our NHS.


The convention is being organised around five key demands. 1) Repeal the Health and Social Care Act to halt and roll back the privatisation of the NHS. No to TTIP. 2) End the NHS funding freeze: increase spending to meet growing need for healthcare. 3) No more unsafe cuts and closures to save money. 4) Don’t let PFI costs kill off local services – renegotiate on the basis of fair value. 5) A fair deal and fair pay for NHS staff. 

Steve Sweeney Founder, People’s Convention for the NHS
David Babbs 38 degrees
Ken Loach Film director
Rufus Hound Actor/comedian
Michael Sheen Actor
Stephen Mangan Actor
Lord David Owen
Frances O’GradGeneral secretary, TUC 
Dave Prentis General secretary, Unison
Len McCluskey General secretary, Unite
Paul Kenny General secretary, GMB
Sam Fairbairn National secretary, People’s Assembly Against Austerity 
Dot Gibson General secretary, National Pensioners Convention
Moz Greenshields TUC trade union councils committee
Professor Clare Gerada Former chair of the council of the Royal College of General Practitioners
Dr Jacky Davis BMA Council
Dr David Wrigley GP, Carnforth
Dr Kailash Chand 
Dr Clive Peedell Co-leader, National Health Action party/consultant oncologist
Grahame Morris Labour PPC, Easington
Rehana Azam GMB national officer/co-founder, People’s March/Vote for the NHS
Jos Bell Chair, London Socialist Health Association
Dr John Lister Director, London Health Emergency
Professor Sue Richards Co-chair, Keep Our NHS Public
Dr Aysha Raza Organiser, Ealing Save Our Hospitals
Dr Richard Taylor President, Independent Community and Health Concern party
Carolyn Jones Institute of Employment Rights 
Dr Helen McArdle GP
Dr Alex Scott-Samuel Senior clinical lecturer in public health, University of Liverpool
Rob Griffiths General secretary, Communist Party of Britain
Martin Quinn Tavistock Keep Our NHS Public
Ben Chacko Acting editor, Morning Star
Dr Ray Tallis
Romayne Phoenix Co-chair, People’s Assembly Against Austerity
Ann Leonard York Save Our Hospitals
Martin Booth Stop the NHS Sell-Off in Cambridgeshire
Professor Wendy Savage
Merril Hammer Chair, Hammersmith and Charing Cross Save Our Hospitals
Bill Greenshields The People’s Charter
Dr Tricia Barnett Islington Keep Our NHS Public
Anita Wright National Assembly of Women
Harsev Bains National secretary, Association of Indian Communists GB
Dyal Bagri National president Indian Workers’ Association GB

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There are those who know just how valuable the NHS is and those who believe they will live healthily for ever. It is this latter group that inhibits the government from raising the cost of providing adequate funding for the NHS. I suggest a hypothecated tax along the lines of Germany’s reunification tax, raised to help with the enormous cost of bringing two countries together. This is a small supplement to income tax and collected with income tax. For the NHS such a tax, called perhaps the NHS rehabilitation fund or something similar, would signify both need and approval. Talking to people on the street in Ipswich, I was left in no doubt of the belief that the NHS is a vital and noble institution and of the desire to see that it is adequately funded. 

Richard Payne
Ipswich

 Almost one in five (3.7m) visits to A&E a year are for minor ailments, such as coughs, colds, muscular pain or allergies, that could be managed safely and effectively at home or with advice from a pharmacist. It is estimated these visits cost the NHS £290m a year. This is on top of the 57m GP appointments every year for similar conditions, costing an additional £2bn and diverting care away from the people who really need it.
There has been a huge increase in demand for A&E services over the past decade, and GPs are now managing 150,000 more consultations every day than five years ago. This pressure on overstretched GPs and A&E departments is having a negative impact on patient outcomes, increasing waiting times and creating workforce problems. With an ageing population, growing numbers of people with long-term conditions and an increase in lifestyle-related diseases, this pressure on the health system will only become more intense.
We are, therefore, calling on the next government to work with the NHS to empower people to take better care of themselves. To do this, we need national leadership to co-ordinate selfcare policy across the NHS and medicines regulation that is people-centred. In addition to this, there should be renewed efforts to make sure the NHS directs people towards the most appropriate clinical setting and investment in campaigns to raise people’s awareness of the option to self-treat. Making these important changes will result in a healthier population, a stronger workforce and a more sustainable NHS.

Matthew Speers Chief executive, Proprietary Association of Great Britain
Professor John Ashton President, UK Faculty of Public Health
Ash Soni President, Royal Pharmaceutical Society
Dr Peter Smith Vice president, National Association of Primary Care
Sue Farrington Chair, Patient Information Forum
Professor Ian Banks President, European Men’s Health Forum
Dr Patricia Wilkie Patient advocate
Sara Richards Practice nurse educator
Dr Knut Schroeder Bristol GP
Dr Selwyn Hodge Former chair, Royal Society for Public Health



 The idea of patients paying charges to use basic NHS services (Warning: ‘Pay-NHS is coming’, 4 April) assumes continuation of existing NHS parameters. However in March the King’s Fund revealed the scandal that UK funding of the NHS had fallen to 7.3% of GDP. In 2002 the Wanless report recommended that the then expenditure of 7.7% should rise to 9.4% in 2007-08, 10.5% in 2012-13 and 10.9% in 2017-18.
Germany and France spent respectively 11.3 and 11.7% of GDP on health in 2012. The projected UK GDP for 2015 is £2 trillion. An increase of 2.7% of GDP to bring NHS expenditure from 7.3 to 10% would provide an extra £54bn per annum. If austerity limited the increase from 7.3 to 9%, which is the level many had assumed was current, there would be an extra £34bn a year. Both figures more than meet the projected shortfall of £30bn by 2020.

Morris Bernadt
London

 How is it possible for anyone to be taken in by the government’s desire to increase the role of private businesses in the provision of healthcare? Yourcomparison of healthcare spending (30 June 2012) shows the UK spent 9.6% of GNP, the US 17.9%. The UK spent $3,480 a head, the US $8,362.
At today’s exchange rate, a family of three would have to find, whether through taxes or insurance premiums, an additional £9,000 a year. More assiduous readers will no doubt find more recent figures. Doctors (or businesses) may find this appealing. Patients should not. Incidentally, the government of the US seems to have spent $4,437 a head; would that ours did, rather than the 2012 figure of $2,919.

Nicholas Hampson
Richmond, Surrey

 ‘Pay-NHS is coming’ is what I and the National Health Action party and others have been warning for some time. I’d like to say more, but must get out leafletting.

David Murray
Wallington, Surrey

 This article was amended on 7 February 2015 to correct the spelling of Dr Clive Peedell’s name and to clarify the description of him.

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