Tuesday, 13 October 2015

NHS deficits hit 'massive' £930m

NHS deficits hit 'massive' £930m

  • 9 October 2015
  •  
  • From the sectionHealth
StretcherImage copyrightThinkstock
NHS trusts in England have racked up a £930m deficit in the first three months of the financial year - that is more than the entire overspend last year.
Regulators said the problems were the "worst for a generation" and demanded immediate action be taken.
The scale of the deficits - eight in 10 trusts are in the red - also prompted warnings that care would suffer.
The accounts cover hospital, mental health, ambulance and some community services.
Between them they account for about two-thirds of the NHS's £116bn budget - with the rest going on other areas including GPs, drug prescribing and training.
Last year, NHS trusts overspent by £822m - with the health service as a whole balancing the books only after a cash injection from the Treasury and by raiding the capital budget earmarked for buildings.

NHS deficit

£930m
NHS trusts deficit for April to June 2015
  • £451m deficit for same period last year
  • £822m total overspend for the whole of last year
  • £2bn estimated deficit for the 2015/16 financial year
But it is thought unlikely there will be the money in the system to plug the shortfall if the financial situation continues to deteriorate in this way.
It has been suggested the deficit among the 237 NHS trusts could top £2bn this year.
The figures released by the two regulators - Monitor and the Trust Development Authority - show the NHS is on track for that as spending pressures do tend to ease as the financial year goes on.
Nonetheless, trusts - and in particular hospitals - are now under pressure from regulators to make savings.
Spending on agency staff has been highlighted as one of the biggest potential savings, but the accounts also show that rising demands year-on-year have been gradually making it harder for trust to break even.
David Bennett, chief executive of Monitor, said: "Today figures reiterate the sector is under massive pressure and must change to counter it.
"The NHS simply can no longer afford operationally and financially to operate in the way it has been and must act now to deliver the substantial efficiency gains required."
However, most experts believe the NHS has little wriggle room to improve its performance.
Chancellor George Osborne said: "More than £2bn extra are going into our health service this year with more to come.
"Clearly the NHS has to spend that money well and deal with things like rip-off nursing agencies and management consultancies that charge too much.
"We want the money going to the frontline."

'Challenging'

Nigel Edwards, chief executive of the Nuffield Trust think-tank, said: "Financial problems on this scale cannot be explained by individual pockets of mismanagement - we are looking at a systematic problem across the health service.
"It is becoming increasingly impossible to provide quality standards, timely access to care and financial control at the same time."
NHS finances chart
Paul Healy, from the NHS Confederation, which represents trusts, said: "Hospitals and other front-line organisations have all-but exhausted their options for becoming more efficient."
He said it was important that the extra money being promised to the NHS this Parliament was front-loaded so that most of it came in the first few years.
But the Department of Health said there were still savings that could be made - and it expected performance would improve as the year goes on.

Analysis: Do deficits matter?

It is easy to be blase about NHS deficits and think the money will always be found to bail out the health service. That is the case - but only to a certain extent.
While there are a number of trusts that have been overspending for years and have been kept afloat by the wider system, the support is not endless.
Three years ago, South London Healthcare, which ran three hospitals, was allowed to go under after racking up large deficits.
Howhe problem this year goes beyond individual NHS trusts and to the very heart of government.
A deficit on the scale of £2bn among trusts will make it incredibly difficult for the Department of Health to balance the books overall.
If that happens, it will have to go cap in hand to the Treasury. For a service that is being protected from cuts to have to do this raises some very difficult questions all round.

Alongside the financial data, the regulators have also warned about worsening waiting times for hospital treatment.
Latest figures show:
  • The number waiting for non-emergency operations, such as knee and hip replacements, is 3.3 million - the highest level since early 2008
  • The 62-day cancer waiting time target has been missed for the past 16 months
  • The four-hour A&E target has been missed for 11 of the past 12 months
Newcastle upon Tyne Hospitals NHS Foundation Trust chief executive Sir Len Fenwick, the longest-serving hospitals boss in the health service, told the BBC the pressures were likely to mean winter would be extremely difficult.
He predicted non-emergency operations would need to be delayed to help hospitals cope.
"In the coming winter, we do believe there will be greater pressures than ever before," he added.
ever, t

Bowel cancer is four distinct diseases

Bowel cancer is four distinct diseases

  • 3 hours ago
  •  
  • From the sectionHealth
bowel cancer cellsImage copyrightSCIENCE PHOTO LIBRARY
Bowel cancer is four distinct diseases, each with a different prognosis, scientists have discovered.
Armed with this new knowledge, doctors might better determine which patients need the most aggressive treatment, the Institute of Cancer Research team say.
They looked at laboratory and clinical data from more than 3,000 patients with bowel cancer to see if they could better classify the disease.
Nearly all of the tumours could be sorted into the four groups.
The groups focus on the genes a tumour contains, rather than just the type of bowel tissue that it affects or how far it has spread - although those factors are important too.

Grouped by genes

Cancers that fit the four consensus molecular subtypes (CMS1, CMS2, CMS3 and CMS4) share genes that dictate their behaviour and might also make them more or less vulnerable to certain treatments, Nature Medicine reports.
Patients with CMS4 tend to have the worst prognosis and might need more extensive treatment, for example, while those with CMS2 have much better survival rates, even if the cancer returns.
bowel x-rayImage copyrightThinkstock
Researcher Dr Ganiraju Manyam said the discovery was important for knowing how best to treat patients.
"The next step is to match existing therapies with these groups so that we can begin to personalise treatment.
"Some of these patients might be undergoing chemotherapy when they do not need it and could be spared it."
Lucy Holmes, Cancer Research UK's science information manager, said: "Each patient's cancer is unique and we need to tailor treatments and move away from a 'one size fits all' approach. Studies like this showing different types of a certain cancer are helping us get there."

Monday, 12 October 2015

Family of Ebola nurse Pauline Cafferkey says she was 'let down'

Family of Ebola nurse Pauline Cafferkey says she was 'let down'

  • 11 October 2015
  •  
  • From the sectionScotland
Pauline Cafferkey
Image captionPauline Cafferkey previously spent a month in the specialist isolation unit at the Royal Free Hospital in London
The family of nurse Pauline Cafferkey says doctors "missed a big opportunity" to spot she had fallen ill again.
Ms Cafferkey is in an isolation unit in London after tests indicated the Ebola virus is still present in her body.
The health board confirmed she was sent home by an out-of-hours doctor in Glasgow earlier this week.
In an interview with the Sunday Mail newspaper, her sister Toni Cafferkey said it was "absolutely diabolical" the way the nurse had been treated.
Ms Cafferkey, from Cambuslang in South Lanarkshire, spent almost a month in isolation at the beginning of the year after contracting the virus in December 2014.
Bodily tissues can harbour the Ebola infection months after the person appears to have fully recovered.
Media captionBBC News looks at why some Ebola survivors suffer a flare up of symptoms
On Tuesday, the 39-year-old was admitted to the Queen Elizabeth University Hospital in Glasgow after feeling unwell.
She was later flown to the Royal Free Hospital in London where she remains in a serious condition in an isolation unit. She is not thought to be contagious.
Toni Cafferkey told the Sunday Mail that her sister had gone to a GP out-of-hours clinic at the Victoria Hospital in Glasgow on Monday night but the doctor who assessed her diagnosed a virus and sent her home.
She said: "At that point me and my family believe they missed a big opportunity to give the right diagnosis and we feel she was let down. Instead of being taken into hospital, she spent the whole of Tuesday very ill.
"I think it is absolutely diabolical the way she has been treated... We don't know if the delays diagnosing Pauline have had an adverse effect on her health, but we intend to find out.
"It has not been good enough. We think there have been major failings and we just want her to pull through. This kind of recurrence seems to be rare but we don't yet know enough about it."
NHS Greater Glasgow and Clyde confirmed that Ms Cafferkey did attend the New Victoria Hospital GP out-of-hours service on Monday.
A spokesman said: "Her management and the clinical decisions taken based on the symptoms she was displaying at the time were entirely appropriate.
"All appropriate infection control procedures were carried out as part of this episode of care."
Ebola isolation unit
On Friday, a statement from the Royal Free Hospital confirmed Ms Cafferkey had been transferred to the hospital "due to an unusual late complication of her previous infection by the Ebola virus".
It added: "The Ebola virus can only be transmitted by direct contact with the blood or bodily fluids of an infected person while they are symptomatic, so the risk to the general public remains low and the NHS has well-established and practised infection control procedures in place."

Tuesday, 6 October 2015

New GP contract for seven-day service

 New GP contract for seven-day service


  • From the sectio
A close-up shot of a doctor writing a prescriptionImage copyrightScience Photo Library
GPs in England are to be offered a voluntary contract to provide seven-day-a-week cover for patients, David Cameron has announced.
Seven-day hospital services will also be extended to "half the country" by 2018 and the whole of England by 2020.
Mr Cameron made the announcement as the Conservatives gathered in Manchester for their annual conference.
The Royal College of GPs has warned a recruitment crisis was making plans for seven-day working "unrealistic".
Mr Cameron's comments came as the government denied pressuring officials behind the scenes to delay the publication of figures which show the financial performance of the NHS.
A report in the Observer claimed officials at Monitor and another NHS regulator were leaned on to delay financial and other performance figures such as treatment waiting times in order to avoid embarrassment at the Conservative conference, which is taking place this week.
Health officials have said the data will be published shortly.

'Clear goals'

On the BBC's Andrew Marr Show, Mr Cameron insisted a seven-day-a-week NHS was "a really exciting prospect".
He said: "We said that we are going to have to make difficult decisions elsewhere, but the NHS will not just be protected.
"It's getting an extra £10bn of money during this Parliament, over and above inflation, and that enables us to meet some really clear goals.
"Parents and people in our country want to access the NHS on a seven-day basis.
"Let me be clear, this doesn't mean that all staff in the NHS have to work every seven days, it just means the services are available.
"So, I can announce today that we will be publishing a new GP contract to get rid of the box-ticking and the form-filling."

NHS weekend: Want to know more?

SignImage copyrightOther

The new contract for GPs will be voluntary, with family doctors able to decide whether they want to join forces with neighbouring GPs to form federations and networks of practices delivering seven-day care to populations of at least 30,000 patients.
Grouping GPs together in federations or networks will allow them to deliver better integrated care, the prime minister argues.
They will also be able to work more closely with community nurses, hospital specialists, pharmacists and other health and care professionals, he added.

Destabilising care

Trials of seven-day GP access have already begun, with 18 million patients getting extended availability by March this year.
But a recent survey found practices in some areas had scaled back weekend opening due to limited demand.
The Royal College of General Practitioners has warned that seven day opening in England is unachievable in this Parliament and risks destabilising care.
Conservative sources said the voluntary GPs contract will be funded from the additional £10bn of NHS investment promised by the prime minister over the course of the Parliament.
Labour's Jonathan Ashworth said: "You can't trust [David Cameron's] promises on a seven day NHS - he has made them before but hasn't delivered.
"What the Tories have done is take the health service backwards - under them it is harder to see your GP and waiting lists are higher."

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