Monday 20 March 2017

NHS services in England are facing a "mission impossible"

NHS facing 'mission impossible next year'

  • 19 March 2017
  •  
  • From the sectionHealth


A hospital wardImage copyrightPA

NHS services in England are facing a "mission impossible" to meet the standards required by the government, health bosses say.
The warning has been made by NHS Providers, which represents hospital, mental health and ambulance trusts.
It said front-line services simply do not have enough money - and predicts longer waits for hospital operations and more delays in A&E as a result.
But ministers said the NHS has been given the money it needs.
The NHS budget is increasing this Parliament, but not by as much as the health service has traditionally got.
NHS Providers predicts its members, which account for nearly two-thirds of health spending, will get £89.1bn in 2017-18 - that is 2.6% more than they got this year, but crucially just half of the 5.2% demand is expected to grow by.

Patient safety 'at risk'

Chief executive Chris Hopson said it was time for the government to "sit up and listen".
He described the goals for next year - to get back to hitting the waiting time targets for A&E and hospital operations, while balancing the budget - as "mission impossible".
"NHS trusts will strain every sinew to deliver the commitments made for the health service. But we now have a body of evidence showing that, with resources available, the NHS can no longer deliver what the NHS constitution requires of it.
"We fear that patient safety is increasingly at risk."
The analysis carried out by NHS Providers predicts that the numbers waiting in A&E longer than the four-hour target will increase by 40% next year to 1.8m, while the numbers waiting beyond the 18-week target for routine treatments, such as knee and hip operations, will go up by 150% to around 100,000.
A Department of Health spokeswoman said extra money was being invested in the NHS and pointed out the Budget had set aside more funding for social care, which would also help relieve the pressures on hospitals in particular.
She added the government had a "strong plan to improve performance" and accused NHS Providers of failing to acknowledge the steps that were being taken.


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Related Topics

Care firms have cancelled contracts with 95 UK councils, saying they cannot deliver services for the amount they are being paid

'Lack of money' prompts care firms to end council contracts

  • 47 minutes ago
  •  
  • From the sectionUK


Carer with womanImage copyrightGETTY IMAGES

Care firms have cancelled contracts with 95 UK councils, saying they cannot deliver services for the amount they are being paid, a BBC Panorama investigation has found.
Some firms said they could not recruit or retain the staff they needed.
The Local Government Association said it was the result of "historic under-funding" and an ageing population.
The government declined an interview but said English councils had received £9.25bn for social care.
The figure for the number of cancelled contracts comes from a Freedom of Information request, which was responded to by 197 of 212 UK councils.
According to the research, carried out for Panorama by Opus Restructuring and Company Watch, 69 home care companies have closed in the last three months and one in four of the UK's 2,500 home care companies is at risk of insolvency.
Councillor Izzi Seccombe from the Local Government Association - which represents councils across England and Wales - said: "We have warned that the combination of the historic under-funding of adult social care, and the significant pressures of an ageing population and the national living wage, are pushing the care provider market to the brink of collapse.
"These figures show the enormous strain providers are under, and emphasises the urgent need for a long-term, sustainable solution to the social care funding crisis."
Many home care companies say their biggest problem is recruitment and retention of carers.
The Centre for Workforce Intelligence estimates at least two million more carers will be needed by 2025 in England alone, in both in-home care and care homes, to cope with growing demand.
Last October, the regulator for England, the Care Quality Commission, warned that adult social care was at a tipping point.


Care worker Amanda Hopewell
Image captionThere are 800,000 home care workers in the UK

One home care company, Cymorth Llaw, which had contracts with three councils in north Wales, told Panorama it had recently stopped working with one - Conwy, which had initially paid £14.20 an hour for care.
It offered to raise that to £15, but the company decided that still wasn't enough and handed back the contract.
Ken Hogg, at Cymorth Llaw, said: "We didn't think we could do it for the money - it was as simple as that.
"We pay as much [in wages] as we possibly can and we've always paid above what was the national minimum wage and the national living wage.
"[Carers] get a mileage allowance, they get paid travelling time between their clients."


Ken Hogg
Image captionKen Hogg says council funding barely covers his care home company's costs

Mr Hogg said the company was legally obliged to pay 1% pension and 13.8% national insurance contributions, along with training and other staff-associated costs, which "doesn't leave a great deal".
Conwy Council said it was committed to supporting vulnerable people in communities, despite the financial challenges.
Home care company Mears used to have a contract with Liverpool City Council but cancelled it in July, saying £13.10 an hour was not enough to cover costs.
Mears said it needed at least £15 an hour, and like other companies across the UK, argued its costs are often greater than what councils pay.
Alan Long, executive director at Mears, said: "That was a terrible thing to do for both service users and for care staff.
"We absolutely did not take that lightly, but frankly what choice did we have?
"We just cannot do the two most basic things that you need to do in home care - pay staff the absolute minimum of a living wage and be able to recruit enough people to deliver the service that Liverpool Council actually expected from us."

Bed shortages

The industry's trade body, the United Kingdom Homecare Association, said many companies were really struggling.
Colin Angel, its policy and campaigns director, said some care providers are "really desperate" and "really do not know whether they're going to be able to continue in business, beyond the next year".
He added: "That means they're really having to make some hard commercial decisions, whether they might need to cease trading or indeed just hand back work to local councils."
The nationwide shortage of carers is leaving many elderly people stuck in NHS wards, which results in bed blocking.
Government figures show there are more than 6,500 people across Britain stuck in an acute hospital bed, despite being well enough to leave.
In England, a third of these are waiting for a home care package.


Colin Angel
Image captionColin Angel has concerns that more care home companies may close in the coming months

Mike Furlong, manager of the Granby Rehabilitation Unit in Liverpool, told Panorama that while on average people spend 28 days at the care facility, "some patients have been with us 12 and 14 weeks because all the therapy is complete, but unfortunately there's no care package available at the end of it".
Liverpool City Council said that, over the last seven years, its budget had been cut by £330m and it now needed to find a further £90m over the next three years.
Samih Kalakeche, Liverpool's director of adult social services, said: "Is there a crisis in the home care services? I'll say yes, there is - and it's not just money, it's the sheer volume of demographics.
"We've got an ageing population which we welcome, but we don't have enough people coming into the industry."

'£2bn extra'

Earlier this month, Chancellor Philip Hammond announced £2bn extra for social care for English councils over the next three years.
Scotland, Northern Ireland, and Wales will decide how they spend their extra funding.
But the industry says that with an increasingly ageing population, it's just not enough to keep pace with demand.
The government has said it will be bringing forward more proposals later this year, to ensure a financially sustainable social care system.
Panorama: Britain's Home Care Crisis - Monday, 20 March, 20:30 GMT, BBC One

Monday 5 September 2016

The General Medical Council





ThThe General Medical Council said the scale of the action, planned at such short notice, could not be justified.Junior doctors on strike

The first of four five-day walkouts is due to begin from 12 to 16 September, with the last being in mid-December.
Junior doctors are striking over a new contract which is being imposed.
The GMC has set out advice to doctors before next week's series of one-day strikes and voiced a stronger warning than previously about the possible impact of the strike action.
GMC chair Prof Terrence Stephenson, said doctors have a right to strike but they must consider whether it will cause significant harm to patients.
The GMC will investigate any case where a patient has come to significant harm because of actions by a doctor.
Prof Stephenson told the BBC's Today Programme: "The idea that you can take a third of the workforce out of a busy emergency service for five days and have no consequences seems to me unlikely.
"We are quite clear in our guidance that every single individual doctor most put their patients first. And we make it clear that they are personally accountable for their actions and must be able to justify what they did afterwards if allegations our made against them."
He urged every doctor in training to "pause and consider the implications for patients."
Meanwhile, Chris Hopson, of NHS Providers, said: "The GMC is right to be 'extremely concerned' about the impact the series of strikes by junior doctors will have on patients.
"We share the GMC's view that the scale of action planned at such short notice cannot be justified."
Consultants will cover junior doctors in providing emergency care, as they did during two days of walkouts in April.
Hospitals will see junior doctors stage walkouts from 08:00 to 17:00 from:
  • Monday 12 September to Friday 16 September
  • Wednesday 5 October to Tuesday 11 October (although the weekend will be covered)
  • Monday 14 November to Friday 18 November
  • Monday 5 December to Friday 9 December


Junior doctors on strikeImage copyrightPA

The warning from the GMC comes after senior doctors last week urged the government and junior doctors to restart negotiations to avoid the series of strikes.
While some medical colleges have said the planned strikes are disproportionate, others say they support the junior doctors' stance.
The row over their pay and conditions has escalated into the worst industrial relations dispute in the history of the NHS.
The BMA has said the government could stop the strikes by calling off the imposition of the contract, which is due to be rolled out from October.
A spokesman said: "Patient safety remains doctors' priority and, since the announcement last week of further action, the BMA has been liaising with NHS leaders so that plans can be put in place swiftly to minimise disruption for patients."
But Prime Minister Theresa May last week told doctors to stop "playing politics" in the dispute and urged the union to cancel the strikes.

The imposed contract



DoctorImage copyrightPA

  • Basic pay to rise between 10% and 11% on average
  • Supplements paid for frequent weekend working - those working one in two will get 10% on top of basic salary
  • Nights to attract an enhanced rate of 37% above normal time
  • Replaces old system whereby weekend or night work can attract up to double time
  • First doctors to go on new terms in October with much of the rest of the workforce to follow by next summer
  • The British Medical Association says it is not fair on those who work the most weekends or part-timers

Junior doctors have already taken part in six strikes this year, including two all-out stoppages.
Industrial action was put on hold in May when the two sides got back round the table at conciliation service Acas.
That resulted in the agreement of a new contract, which BMA leaders encouraged members to accept.
But when it was put to the vote, 58% of medics rejected it, prompting the resignation of the BMA junior doctor leader Johann Malawana and causing ministers to announce once again that they would impose the new terms and conditions.

Sunday 29 November 2015

London Ambulance Service rated 'inadequate' by inspectors

London Ambulance Service rated 'inadequate' by inspectors

  • on
London ambulanceImage copyrightPA
Image captionInspectors rated the trust as good for caring but inadequate for meeting target response times
London's Ambulance Service (LAS) NHS Trust has become the first to be put into special measures after a recommendation by inspectors.
The NHS trust serves an estimated 8.6m people in the capital and has been performing "poorly" since March 2014.
Slow response times were highlighted as a major concern, along with a high number of unfilled vacancies.
The Trust said it had taken action to address its failings.
More on this story and updates from London.
Fionna Moore
Image captionThe cost of housing in London was possibly making it harder to recruit paramedics, London Ambulance Service chief executive Fionna Moore said
Prof Sir Mike Richards, chief inspector of hospitals, said: "I am recommending that London Ambulance Service be placed into special measures, because I believe that this is the step necessary to ensure this vital service gets the support it needs to improve.
"The trust has been performing poorly on response times since March 2014. This is a very serious problem, which the trust clearly isn't able to address alone, and which needs action to put right."
A Care Quality Commission (CQC) inspection, which took place in June, found poorly trained staff, a lack of equipment and a reported culture of harassment and bullying.
Trust chief executive Dr Fionna Moore said: "We would like to apologise to Londoners and say how sorry we are that we haven't come up to the standards they should expect of us and we are working really hard to address those issues."
She said problems in recruiting staff were partly due to the high cost of living in London and a shortage of housing.
Despite this, she added, the trust had managed to recruit 167 new members of staff and more than 200 others were in training.
Until 2014 the trust was ranked as the best performing service in the country for dealing with emergency category A calls - requiring attendance within eight minutes - but was now only hitting that target 25% of the time.
Professor Sir Mike Richards
Image captionOnce an ambulance arrived, patients could be assured of a good service, Professor Sir Mike Richards said
GMB union national officer Rehana Azam said: "The underlying problem is a shortage of staff. There is a seriously high vacancy rate in the LAS and other ambulance services.
"We are pleased the CQC identified this and perhaps now it can be addressed in full.
"As a result of staff shortages, existing staff have had to shoulder more responsibility."

Analysis by BBC London political correspondent Karl Mercer

It was not the news they had hoped for, but it is perhaps no surprise that London's ambulance service has become the first to be put into special measures.
For more than a year it has struggled to meet response times and to find enough paramedics to work on the frontline.
Its well publicised search for staff has seen it recruit in Australia and New Zealand as it competes against an ever rising tide of calls.
This year will be its busiest ever with 1.9 million calls. That is more than 5,000 a day. But it knows it has to do better.
It is filling more of those vacancies and there is a new chief executive in place, but being put in special measures means they will get more help.
A new improvement director and experts from the Association of Ambulance Chief Executives will help. But here is the thing. Does being in Special Measures mean it will be harder to recruit new staff?
Being labelled as "inadequate" is hardly a great sales pitch to would-be paramedics. The LAS is not alone in London though.
It now sits with BartsHealth and Barking Havering and Redbridge hospitals as trusts wearing the unwanted tag of being in special measures.

The report identified the following problems at the trust:
  • A high number of frontline vacancies
  • Inappropriate staff training, exacerbated by low staffing levels
  • Demoralised and stressed staff some of whom reported issues with bullying and harassment without any resolution
  • Lack of senior staff supervision
  • Failure to meet response target times

'Shocking'

Trusts like the London Ambulance Service are overseen by the NHS Trust Development Authority (TDA), whose associate director for London, Andrew Hines, acknowledged "significant improvements are required".
He said the TDA was making sure the Trust "has access to the best expertise available to help them to deliver their ambitious improvement plan".
"Londoners should feel confident that it is safe to call the ambulance service and that care is of good quality," he added.
Labour candidate for mayor Sadiq Khan described the report as "shocking" and joined calls from both the Lib Dems and Greens for the service to be devolved to City Hall.

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