NHS news

In this feature, we highlight key stories relating to the NHS in the news.  It is intended that this will be updated approximately monthly.

NHS TRACKER 20 July – 25 September 2016

The Bishop’s Castle Patients Group’s ‘NHS Tracker’ is based on newspaper clippings and news sites. Its focus is stories about changes to NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments. From May 2016, news will be divided into local and national news items.

Local NHS news

Shropshire Council has refused to back a campaign to keep A&E services in Shrewsbury and will only object to the reduction of services in the county as a whole. Telford & Wrekin set aside £100,000 at the end of last year, to lobby on behalf of the town keeping its emergency centre. (S Star 22July)

Ambulance staff lost 393 hours in June waiting to transfer patients at the two main hospitals: 278 at RSH; 115 at PRH. Ambulance arrivals have increased year on year (S Star 26 July)

Ambulances have missed the target for responding to the most serious calls in Shropshire. 55.8% of Red One calls (life threatening) were attended within 8 minutes the target being 75%. (S Star 26 July)

Shropdoc is currently recruiting advanced nurse practitioners,advanced paramedics and physician associates.

Five paramedics have left WMAS to work with Shropdoc. New staff are recruited but training takes up to 30 months. (S Star 28 July)

“Shropshire and Staffordshire Blood Bikes” provide a 24/7 voluntary service for delivery of blood and other medical items. Since being founded two and a half years ago, the 100 riders have carried out more than 2,500 deliveries on their specially-equipped motor bikes. It costs around £60,000 a year to keep the charity running. (S Star 29 July)

Shrewsbury Town Councillors agree to fight to save A&E at RSH (S Star 3 August)

142 new junior doctors joined Shrewsbury and Telford Hospital NHS Trust in the last week (Press release from Healthwatch August 5)

Philip Dunne, Minister of State for Health, has assured supporters that Ludlow Hospital will remain a hospital. ( S Star 5 August)

Figures for June 2016 reveal 278 waiting hours for ambulance staff at RSH and 115 hours at Princess Royal   The hospitals, designed to cope with up to 5 ambulances an hour, have been faced with up to 14. SaTH is campaigning for a single, more efficient department to attract skilled staff (S.Star 5 August)

Response target times are not being met -West Midlands Ambulance Service says the trust’s budget was “insufficient to meet the needs of the people of Shropshire” (12 August)

A brief and simple explanation of Future Fit in Shropshire can be seen on You Tube. (NHS Future Fit -You Tube. Released 8 August)

No sugary drinks or confectionery aimed specifically at children will be sold at counters or machines at Princess Royal Hospital Telford. (SaTH Media Release 10 August )

Shropshire CCG, facing a deficit of £14.5 million which could rise to £31m. if nothing is done, is considering disinvesting from 12 of its services in an effort to save £2million. Among those under consideration are: a 3-bed mental health crisis centre in Ludlow; an employment centre for people with mental health problems; a centre for people with profound and multiple disabilities; a Children’s Movement Centre; counselling services based in GP surgeries. (CCG Commissioning Review on line 16 August)

GP extended hours now offered to patients registered in 37 GP practices in the county that are part of the Prime Minister’s GP Access Fund. Depending on availability, patients may book a routine appointment at a convenient time and location at any of the practices. Practices who are part of the Prime Minister’s GP Access Fund may also have access to an Acute Visiting Service delivered by GPs across the locality which provides a rapid response service for patients requiring a visit at home. In all cases the GPs will have access to the patient’s medical history and after consultation will send information back to the patient’s own surgery.   (Printed flyer)                                           3,500 people have used Shropdoc’s GP Extended Opening Hours Service since it was launched as a trial in January 2016.100% of people who have used the service want it to be kept. (S Star 23 August)

Shropshire’s hospitals are reviewing whether orthopaedic services should be provided on 3 hospital sites as part of a bid to save costs.

(S Star 27 August )

Approval is awaited from NHS England who are considering Shropshire’s draft 5 year Sustainability and Transformation Plan which sets out a number of service cuts and changes which would help reduce the predicted financial deficit in health and social care services. (S Star 27 August)

Ward managers at the 2 main hospitals have welcomed a 6 month trial in which two Pharmacy Support Officers have been introduced to act as runners, collecting prescriptions from pharmacy and delivering them to wards. Patients ready for discharge wait a shorter time for prescriptions. Runners also help with delivery of urgent items and paperwork. (S Star 6 September)

Following a CQC inspection of Shropshire Community Health Trust, inspector, Sir Mike Richards, stated “several improvements were needed… but we also observed many areas of good care across several departments. There were insufficient numbers of suitably qualified competent, skilled and experienced staff to meet the needs of people using the service within the children’ and adolescent mental health service’s learning disability team.” (S Star 7 September)

RJAH Orthopaedic Hospital has new blood test machine (Bio-RadIH500) which can analyse up to 10 samples so that staff can group patients by blood type and cross-match blood all at the same time. When a number of patients need blood at the same time the machine is much faster than manual analysis and there is no room for human error. (S Star 8 September)

An audit of Shropshire CCG 2015-16 resulted in an adverse “value for money” rating something only 5% of CCGs receive. £11 million is to be saved by the end of the year. (S Star 17 September)

Shrewsbury MP to advocate keeping A&E in Shrewsbury at Prime Minister’s Question Time in early October. (S Star 20 September)

 

National News

More than 50 hospital trusts will no longer be fined for missing treatment deadlines. Instead they will have to show performance is improving in order to get a share of an extra £1.8billion NHS investment. (Sunday Mirror 24 July)

£56 billion set aside last year to pay compensation for NHS negligence. A member of the Society of Clinical Injury Lawyers said that in most cases the NHS Litigation Authority insists on a full investigation which can take years and is not always needed. (Sunday Mirror 24 July)

A shortage of staff funding means young people with mental health problems may experience a long wait for treatment, the worst wait being 3 years. The government has pledged an extra £1.4 billion investment for children’s mental health.

(Mirror 1 August)

The NHS is spending £2.6 million each day on diabetes drugs as the number of people with the condition soars. (Mirror 8 August)

The target of seeing 95% of patients within 4 hours has not been hit by an A&E at any major hospital since July 2013.The Dept. of Health said that despite shortages in specific A&Es there were 1,250 extra doctors working in emergency departments compared with 2010. (10 August “i”)

13 hospitals have had either to downgrade or close their A&E departments in the last 2 years. BMA chair of council stated that “more will inevitably follow unless the Government agrees to fund public healthcare services to the same level as other European countries.” ( i August 11)

From the end of August, a new mobile app (Doctaly) will allow patients to book and pay £40 for a 15 minute consultation at a local surgery with a GP– who primarily works for the NHS (16 August “i” )

The BMA council rejected the the government’s final offer on the contract with Junior doctors and will commence with a “full withdrawal of labour” between 12 and 16 September, with further dates to be announced. Junior doctors, including those working in emergency departments, will walk out between 8am and 5pm on the days in question. (Guardian 1 September)

The King’s Fund identified official figures showing that district nurse numbers had fallen by 28% in the past five years to just under 6,000, while the wider community nurse workforce had shrunk by 8% to 36,600

It acknowledged some of this was down to services being contracted out to the private and voluntary sectors – nurses working in those sectors are not counted in the official figures. But it said this would not account for the entire drop. Anna Charles, of the King’s Fund, said: “For years health service leaders have talked about the importance of providing more care in the community, but this objective cannot be achieved when district nursing is at breaking point.” ( BBC Website September 1)

The BMA has suggested GP appointments should be lengthened to 15 minutes and limited to 25 a day to stop GPs being”run into the ground” (S Star 9 September)

The Royal College of General Practitioners has warned of a shortfall of almost 10,000 GPs by 2020 as the population grows and ages. The RCGP has launched a video called “Think GP” to try to entice medical and sixth form students into general practice.    (The Mirror 19 September)            I

BMA calls off Junior doctors’ proposed 5 day strike in the interest of patient safety. There is still opposition to the contract imposed by the Health Secretary. (Independent on line 24 September)

Health problems related to diet, drinking and smoking costs Health Service more than £11 billion per year. (BBC news on line 25 September)

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NHS TRACKER 29 May – 20 July 2016

The Bishop’s Castle Patients Group’s ‘NHS Tracker’ is based on newspaper clippings and news sites. Its focus is stories about changes to NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments. From May 2016, news will be divided into local and national news items.

Local NHS news

Shropshire Clinical Commissioning Group (CCG) voted against supporting Future Fit’s Strategic Outline Case which sets out a framework for which services will be retained either at RSH or Princess Royal Hospital; Telford and Wrekin CCG voted for.  David Evans, accountable officer. for both CCGs said that concerns were about transfer of activity from acute care into community and primary care. (Shrop. Star 10 May)

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Shrewsbury and Telford Hospital NHS Trust winners for fourth year running in the top 40 hospitals gaining the CHKS award based on the evaluation of 22 indicators of clinical effectiveness, health outcomes, efficiency, patient experience and quality of care. CHKS- Comparative Health Knowledge System ( Shrop Star May 19)

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Oswestry Orthopaedic Hospital

  • No cases of MRSA since 2006
  • Midland Centre for Spinal Injuries short listed for a Spinal Injuries Association Rebuilding Lives Award
  • A new £15.1million theatres and ward development should be fully operational in November            (S. Star May)

Doctors at the Meadows Medical Practice, which has surgeries in Clun and Knighton, have been unable to replace one of the senior partners this year. A consultation document outlining 4 possible courses of action will be considered at public meetings in Clun and Knighton. (S Star 8 June)

 

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More than 1,000 people have signed a petition to have its own urgent care centre in Oswestry. If Shrewsbury’s emergency centre is closed, the mayor of Oswestry feared patients may travel to Wrexham Maelor Hospital which is “currently oversubscribed.” (10 June S Star)

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Telford & Wrekin Council has launched a campaign dedicated to keeping emergency services in Telford.

David Evans, current accountable officer of Shropshire and Telford CCGs said plans are in place to address Shropshire CCG’s financial problems. With an in year deficit of £14.5m he said that it would take 3 years to get it back into balance. A joint management team is looking at changes that help with money but do not impact adversely on patients e.g. the 2 CCGs working together on specific projects; change in managing outpatient follow- ups; using community beds to prevent people going to the acute sector,

( June 13 S Star)

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A new Point of Care Testing Pack (POCT) means tests formerly done in hospital labs. can be done at home with results shown in minutes.

Led by Dr Simon Chapple of Shropdoc, GP out-of-hours service and SaTH have developed a pilot project to do on-the-spot testing which features blood tests for anaemia, diabetes control,inflammation/infections, kidney function, acute heart disease and Deep Vein Thrombosis.

The trial will be carefully monitored and assessed – SaTh are already supporting the POCT pilot in Telford and Powys – and if successful will be expanded across more areas. ( S. Star 13 June 2016)

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No dedicated rural urgent care centres will be built but extra services will be bolted on to existing GP surgeries or community hospitals. “There will be a rural urgent care service delivered but some of that will be from home or other facilities.” (David Evans) Under new plans the only dedicated urgent care centres will be on the sites of RSH and Princess Royal Hospital. They will offer treatment for patients who do not       need to attend A&E. (S Star 13 June)

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The Dept. of Health is proposing to cut £170million from funding available to community pharmacies in 2016/7. Rural pharmacies are dependent on the grant to survive. Bishop’s Castle and Pontesbury pharmacies cover an area of 200 square miles. NHS England said plans were to do away with clustering of pharmacies and to make greater use of the skills of pharmacists in GP surgeries, A&E and care homes with improved use of technology. (S. Star 14 June)

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One of the county’s four acute stroke specialists in the county will leave this month and the remaining three specialists may all be temporarily based at Princess Royal Hospital, Telford. Stroke patients requiring rehabilitation will be cared for by a general physician at RSH. Owing to a national shortage, it has not been possible to recruit a replacement. (17 June S. Star)

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SaTh has been rated as the third most improved NHS Trust in the country according to a survey of adult inpatients carried out by the Care Quality Commission. ( 20 June s. Star)

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Health officials have started work on proposals that will provide care in outlying areas of the county including Ludlow, Bridgnorth, Bishop’s Castle, Whitchurch and Oswestry.

Dr Stephen James, Shropshire CCG GP board member and clinical director, said: “We know that not enough people can access urgent care close to their home in rural Shropshire and parts of Mid Wales.“We want to enhance the range of services people can get without travelling to a hospital and we also want to make those services more accessible and easier to understand. There will not be a ‘one size fits all’ approach.

(June 29 S Star)

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Shropshire CCG agrees to support the Strategic Outline Case which describes plans to address challenges to sustainability of patient services, specifically in emergency and critical care. The SOC proposes one fully staffed and equipped single emergency unit supported by one diagnostic treatment centre and local planned care on both RSH and Princess Royal sites.

Most people currently treated at A&E will be seen at the same hospital at an urgent care centre. (29 June S. Star)

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Simon Hodson, of Shropshire Local Medical Committee which represents GPs, said there were fears the closure of an A&E department would greatly increase the workload of his members. He said: “There seems to be a predication in the strategic outline case that even more will be done in the community, and there is anxiety that the total resource allocation will be inadequate and specifically the resources in general practice will be inadequate. Especially when it is already under strain.”

He made the comments at an extraordinary meeting of Shropshire Clinical Commissioning Group, called to decide whether to back the latest step of the Future Fit review
( June 30 S. Star)

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SaTH NHS Trust has been working to improve care in patients suffering from sepsis

using techniques learnt from the Virginia Mason Institute in Seattle. A leaflet, designed to make staff more aware of sepsis, has proved successful and the trust has been asked to share it with the UK Sepsis Trust and some other hospital trusts.

(SaTH NHS newsletter July 2016)

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Future emergency care at the county’s two major hospitals and measures to help to support GPs and provide health and social care services in the community have been included in a new sustainability and transformation plan for Shropshire and Telford & Wrekin.
A decision on whether the blueprint will be accepted by NHS England’s is expected in the near future (8 July 2016 S. Star)

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The loss of one more consultant will lead to the immediate closure of one of Shropshire’s two A&E wards. “Remedial action” will have to be taken if staffing levels in the emergency wards are hit any further, David Evans, chief officer for Shropshire and Telford & Wrekin Clinical Commissioning Group has warned.

He said: “We currently have five A&E consultants across two sites. The current on-call rota for them is something like one in four. At Stoke, for instance by comparison, it is something like one in 14 or 15. Mr Evans insisted that, despite the staffing situation, the number of people being seen within four hours or less at A&E was actually improving. (S Star 13 July)

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Councillor Pam Moseley (who represents Monkmoor on Shrewsbury Town Council)has put forward a motion to the local authority, calling on it to protect the town’s health services. She suggests the council “strongly opposes. any proposals which would lead to the diminution of emergency care facilities available to Shropshire residents, through the downgrading of the Royal Shrewsbury Hospital from an emergency care centre to an urgent care centre.”Shropshire Council has so far remained impartial in the debate about which A&E should close, while Telford & Wrekin Council has actively campaigned to keep the unit at PRH open. (16 July S. Star)

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Philip Dunne is to take up a new role as Minister of State for the Department of Health, meaning Shropshire will have its own MP working closely with Secretary of State Jeremy Hunt at a time when health services across the county are facing major changes and uncertainty. (18 July S Star)

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Scam warning. A patient discharged from hospital received a call, said to be from the local medical centre, saying they could deliver medicine and asked for bank details and card number. (19 July S Star)

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National NHS News

The Dept.of Health is proposing to cut £170million from funding available for community pharmacies in 2016/7. NHS England said the plans would do away with the clustering of pharmacies. 40% of pharmacies are in clusters of three or more within 10 minutes of each other – each supported by NHS funds. (Shrop. Star 29 April)

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Figures, released by the regulator NHS Improvement, which cover hospitals, ambulance, mental health and community trusts show an overspend of £2.45bn. last year. (BBC website 20 May)

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Review by the Children’s Commissioner finds more than a quarter of children referred to mental health services in England in 2015 received no help. 13% with life-threatening conditions were not allowed specialist support. NHS England said it was clearly the case that services needed to expand. (BBC website 28 May)

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To adjust to budget cuts the Care Quality Commission will undertake fewer and smaller inspections of hospitals in England and rely more on information provided by patients and NHS Trusts under the watchdog’s new 5-year strategy. Inspectors will concentrate on core services, such as A&E and critical care. Hospitals requiring improvement will face more regular visits, while those rated good or outstanding will be inspected less often than before

(Guardian 24 May)

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HIV and sexual health charities have attacked a decision by NHS England not to fund a treatment method that can reduce transmission risks. NHS England states that preventative services are the responsibility of local authorities. (Guardian 30 May)

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Earlier this year Simon Stevens, NHS Chief Executive, had said that the NHS would need between £8bn and £21bn by 2020 to sustain and improve, the lower amount  would only have been enough if there was sufficient access to social care for the elderly and improvements in prevention of ill-health.

At the June NHS Confederation conference, regarding changes to funding plans for the NHS following the EU Referendum, he said: “ I do not believe that it would be prudent for us to assume any additional funding (to that already requested) over the next several years, not least because I think there is a strong argument that where extra funding is to be available, frankly we should be arguing that it should be going to social care, that is one of the arguments that I have been making publicly and I think social care has a very strong case for that.” ( Telegraph on line June 17)

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Simon Stevens yesterday made the case for the first time that the NHS should receive more money than the extra £10bn ministers have pledged to invest between 2015 -16 and 2020-2021 once David Cameron’s successor is in Downing Street.(Guardian 5 July)

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 NHS junior doctors voted against the government’s final offer on their new contract 58% : 42%. The ballot closed 1st. July.

37,000, or 68% , of the 54,000 eligible to vote took part. (Guardian 5 July)

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Jeremy Hunt has said he will impose a new contract on the 54,000 junior doctors in England. He rejected holding any further talks with the BMA, pointing out that 3 years talks on new terms and conditions had failed to produce a final agreement. (6 July Guardian)

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The government’s scheme to store patients’ medical information in a singe database is to be scrapped. Reviews by the national data guardian (Dame Fiona Caldicott) and Care Quality Commission recommended tougher measures to keep people’s medical information secure and confidential. Responding to Caldicott’s proposals on data security and a new consent/opt-out model, the government minister for life sciences said, “It is vital that a full consultation and dialogue with the public and professionals takes place before any implementation of the recommendations can take place.”

(Guardian 6 July)

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Nearly 55,000 of the 1.2 million staff in the NHS are citizens of other European countries. (Source: Health and Social Care Information Centre) These include doctors, nurses, paramedics, pharmacists, support workers and administrative staff.

(Guardian 6 July)

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1 in 10 nurse posts in England are unfilled.

29% of nurses are over 50

13% of nurses come from overseas

(Source: Institute for Employment Studies)   (BBC website 7 July)

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Two of 13 hospitals met most or all of the standards set by NHS England that children’s heart surgery units must meet in order to be commissioned and paid to do the work; the 2 were Birmingham Children’s Hospital and Great Ormond Street. Crucially, every surgeon has to carry out at least 125 operations a year to ensure that they remain sufficiently skilled and each hospital team must have at least 4 surgeons on the rota.

13 level 1 centres that perform surgery will be cut to 10, and nine level 2 specialist cardiac centres will be cut to four. Officials at NHS England believe that while units in England are safe, not all are providing excellent care.

They hope that by centralising services, outcomes for patients will continue to improve, with more patients surviving and those children born with congenital heart defects living longer into adulthood.(Guardian, Daily Mail July 8)

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The number of days patients remain in hospital because of bed blocking has risen since 2011/2012 according to a GMB Union study and is costing the NHS more than £800 million a year.( S Star 9 July)
                                                                                                                                                                                                                                    

 Jeremy Hunt has broken his pledges on NHS funding and is misleading the public about health service reforms, a committee of MPs has found.The House of Commons select committee, which is formed of MPs from across different parties, has made the claims in a highly critical report of the Health Secretary’s controversial reforms. The report finds contrary to government claims to be injecting an extra £8.4bn into the NHS on top of inflation by 2020/21, the real figure was more likely to be £4.5bn.The committee has claimed the Government has used a different definition of spending to calculate the figures which made it appear that a larger increase in spending had occurred than was actually they case. (19 July Independent)

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Philip Dunne is to take up a new role as Minister of State for the Department of Health, meaning Shropshire will have its own MP working closely with Secretary of State Jeremy Hunt at a time when health services across the county are facing major changes and uncertainty. (18 July S Star)

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Patients in England who have not been to see their GP for five years face being deregistered as the NHS prepares to get tough on “ghost patients”. NHS England said new rules would be brought in next month and see patients removed from GP lists unless they responded to warning letters. The move is aimed at stopping GPs being paid for patients who have died, moved practices or left the country – up to 5% of practice lists could be wrong. (20 July BBC website)

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More than 50 hospitals in England have been given the green light to miss key waiting time targets this year to help ease their financial problems.The move is part of a package of measures taken by NHS bosses after hospitals exceeded their budgets by a record amount last year.

Fines for missing targets in A&E, cancer and routine operations have been scrapped altogether. Hospitals have been struggling to hit their targets for some time and will now no longer be fined for missing the four-hour A&E target, the 62-day target to get cancer treatment and the 18-week goal for routine operations, such as hip and knee replacements.

Instead, they will have to simply improve on their current performance to get their slice of the extra money being invested in the NHS this year. ( 21 July BBC website)

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NHS TRACKER February – April 2016

The Bishop’s Castle Patients Group’s ‘NHS Tracker’ is based on newspaper clippings and news sites. Its focus is stories about changes to NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments.

DECISION re PREFERRED SITE FOR SINGLE EMERGENCY UNIT PUT BACK

until summer 2016 owing to none of options suitable to tackle £23m. deficit of health economy. Pricewaterhousecoopers asked to provide an income and expenditure account up to 2020/21 that provides a consolidated assessment of the financial deficit that needs to be addressed. ( 3 Feb Shropshire Star)

JUNIOR DOCTORS WILL PROVIDE EMERGENCY COVER ONLY from 8 am

Wednesday 10 February to 8am Thursday after failing to reach an agreement with Government over contract and pay. (Shropshire Star 4 February )

SaTH NHS TRUST ON TRACK TO REDUCE DEFICIT BY £3m BY END OF FINANCIAL YEAR through reduction in using agency nurses and other cost-cutting measures. Nurses are being recruited from the Philippines (Shropshire Star 5 Feb.)

NHS £4.4billion TECHNOLOGY OVERHAUL PLANS UNVEILED to ensure one in four patients with long-term conditions can access health records remotely by 2020. Patients will be able to use apps and speak to doctors by video link. Electronic records will be shared securely across the NHS (People 7 February)

SHROPDOC WILL CONTINUE TO RUN THE OUT OF HOURS GP SERVICE UNTIL 2018 when the contract will go out to tender. (Shropshire Star 11 February)

A&E SEES SURGE IN PATIENT NUMBERS. An 8% year on year increase in attendances at major units, many of whom could have used an alternative local service: GP ;minor injuries unit; NHS111; pharmacy (Shropshire Star 12 February)

SIMON WRIGHT, CHIEF EXECUTIVE SaTH, “WE WANT TO BE THE SAFEST HEALTH CARE PROVIDER IN THE NHS” Staff are currently being mentored by the Virginia Mason Institute in Seattle, a 336 bed acute hospital regarded as the safest in the world and known for its programmes in reducing healthcare costs. (Shropshire Star February)

MORE THAN 33,000 APPOINTMENTS MISSED EVERY YEAR in the Shrewsbury and Telford Hospital NHS Trust. Every missed appointment costs between £108 and £160. (Shropshire Star 23 February)

JUNIOR DOCTORS PLANNING 3 48 HOUR STRIKES OVER NEXT 2 MONTHS

British Medical Association is preparing legal action against Health Secretary’s decision to impose a new trainee contract. (Daily Mirror February24)

WEST MIDLANDS AMBULANCE SERVICE COMMITTED TO HAVE AT LEAST ONE PARAMEDIC ON EVERY FRONTLINE VEHICLE. Currently the front line workforce has the highest ratio of paramedics anywhere in the country. (Shropshire Star 24 February)

HUNDREDS SIGN PETITION TO SAVE SHROPDOC FROM BEING REPLACED BY NHS 111 amid fears that, despite putting off an immediate move to put Shropdoc out to tender for 2 years, it could be switched off at any time depending on the success of 111 in Shropshire. (Shropshire Journal February 26)

176 NURSE POSITIONS and 63 DOCTOR JOBS UNFILLED AT SHROPSHIRE’S MAIN HOSPITALS.  60 more nurses from the Philippines are being recruited to work in Shrewsbury and Telford to join a smaller number currently working in Shrewsbury and Telford. (Shropshire Star March 1 )

SaTH JUDGED AS HAVING A POOR REPORTING CULTURE. In a review of openness and transparency SaTH ranked 214 out of 230 Trusts.

SHROPSHIRE COMMUNITY HEALTH TRUST RANKED AS ONE OF THE TOP ORGANISATIONS for being open and transparent. (Shropshire Star 10 March)

LONG-TERM LEASE FOR LUDLOW HOSPITAL STILL NOT SIGNED

Community Health Trust still working with NHS Property Services to finalise details.(Shropshire Star March11)

19 of 136 ACUTE TRUSTS MET THE TARGET TO TREAT 95% of A&E PATIENTS WITHIN 4 HOURS. Shrewsbury and Telford in bottom 30. (People March 13)

A quarter of people attending the 2 hospitals have to wait 4 hours or more to be dealt with. (Shropshire Star March 18)

HALF OF ALL AMBULANCES ARRIVING AT SHROPSHIRE’ S TWO MAIN HOSPITALS FORCED TO WAIT OUTSIDE FOR MORE THAN 30 MINUTES IN JANUARY AND FEBRUARY.

The Trust is working with the national Emergency Care Improvement Programme and West Midlands Ambulance Service to make improvements. (Shropshire Star March 21)

SHROPSHIRE AMBULANCE SERVICE MISSING COUNTY RESPONSE TARGETS. With the target of reaching 75% of the most serious calls in 8 minutes, the trust has answered 65.6% of the 1,256 Shropshire calls answered in time. (Shropshire Star March 22)

CQC REPORT OF OSWESTRY ORTHOPAEDIC HOSPITAL states care of patients is good   but overall improvement is needed in learning and feedback from incidents, inconsistent compliance with hand hygiene standards and out-of-hours paediatric medical cover. (Shropshire Star March 24)

TELFORD AND WREKIN CCG LAUNCH 24 HOUR MENTAL HEALTH CRISIS HELPLINE. An action plan has been drawn up and a mental health forum set up

to oversee development of future services and consideration of a hub, providing a place where people can feel accepted and safe and get advice and information. (Shropshire Star March 24)

MP PHILIP DUNNE SAYS LUDLOW HOSPITAL IS SAFE, respondingto campaigners’ fears for the future of the hospital since a lease from NHS Property Services still has not been signed on the building a year after the drawing-up of terms. (Shropshire Star March 25)
SHREWSBURY and TELFORD HOSPITAL NHS TRUST RECEIVES
REPORT AND AGREES IMPLEMENTATION PLAN FROM ROYAL COLLEGE OF OPHTHAMOLOGY
following investigation last year of a series of serious incidents in the eye care service. (Shropshire Star March 25)

UP to 300 PARAMEDICS TO BE RECRUITED BY WMAS to meet increasing demands on the service. (Shropshire Star March 26)

 LUDLOW HOSPITAL TO GET ULTRA-SOUND SCANNER. Ludlow League of Friends has bought a scanner, used to detect problems in the liver, heart, kidney and abdomen. It should be operational in April. (Shropshire Star March 28)

LUDLOW MP ASKS HEALTH SECRETARY TO INTERVENE TO SECURE HOSPITAL LEASE. At the request of the Ludlow Hospital League of Friends, Philip Dunne has asked the Dept. of Health to see if he could get NHS Property Services Ltd to restore the lease to Shropshire Community Health NHS Trust. The League Chair states that current lease terms proposed by NHS Property Services “would hurt the hospital as it would cost too much to run facilities there in the future” (Shropshire Star March29)

NHS ENGLAND TODAY LAUNCHED A NEW IMPRROVEMENT AND ASSESSMENT FRAMEWORK FOR CLINICAL COMMISSIONING GROUPS which will include ratings published on line to show patients how their local health service is performing in 6 areas. From June an initial assessment of CCG performance will be available on line in the areas of: cancer, dementia, diabetes, mental health, learning disabilities, maternity care. (NHS England website 31 March)

SHROPSHIRE SINGLE EMERGENCY UNIT LOCATION DECISION SCHEDULED FOR 30 JUNE 2017. Public consultation to begin 1st. December, ending 12 March 2017. London- based AHR Architects to start drawing plans.

If based at Telford the unit will take 3years 6 months to complete; if at Shrewsbury 5 years and nine months to opening date. (Shropshire Star 31 March)

CCG INSIST NO DECISION HAS BEEN MADE ON COMMUNITY BEDS AND CONSULTATION WOULD BE CARRIED OUT BEFORE ANY RULING MADE

Intermediate care has been delivered principally through community hospitals.

Now ICS (Integrated Care Services) has been fully established – a team of specialists who support people discharged from acute hospitals in their own homes (Shropshire Star 1 April)

SENIOR DOCTORS CONCERN FOR THE IMPACT CAUSED BY THE OF IMPOSITION OF JUNIOR DOCTORS’ CONTRACT ON NHS AND FUTURE PATIENT CARE.

Chairs of 22 Medical Colleges have written to Prime Minister and 1000 doctors have signed a letter to the PM asking that the imposition of the contract be halted and renegotiations commence.

The British Medical Association, representing doctors at all levels and in different specialities, has called a meeting to talk about the low morale leading young doctors to leave the country and older doctors to take retirement. (Shropshire Star 2 April)

3 YEAR RECRUITMENT DRIVE GAINS ONLY 1 A&E CONSULTANT. Chief Executive of SaTH, Simon Wright, says 2 A&E sites cannot be sustained. The Royal College of Emergency Medicine guidelines say a minimum of 10 consultants should be working everyday on each of the two sites. The two A&Es are currently operating with 5. (Shropshire Star 4 April)

HEALTH SERVICES IN SHROPSHIRE HAVE BEEN PLACED IN FORMAL DIRECTIONS BY NHS ENGLAND

SHROPSHIRE CCG must appoint a turnaround director to implement an improvement plan and produce a financial recovery plan to deal with its deficit of £14.5m. David Evans, current leader of Telford and Wrekin, has now been asked to develop a joint management team to support both Shropshire and Telford and Wrekin. (Shropshire Star 5 April)

JUNIOR DOCTORS STAGE FOURTH STRIKE . Emergency care only will be covered but 5,000 operations and procedures postponed. The latest action means the total number of treatments now delayed has hit 24,500 during the dispute. The all-out stoppages will take place from 08:00 to 17:00 BST on both 26 and 27 April and will see junior doctors refuse to staff A&E departments as well as emergency surgery and intensive care (Guardian 6 April)

NHS CONSIDERING BRINGING GPS FRON INDIA TO INCREASE THE NUMBER OF DOCTORS IN ENGLAND. Researchers have warned that the 16% increase in GP workloads over the past 7 years is unsustainable. (Mirror 8 April)

EAST AND WEST MIDLANDS AMBULANCE SERVICES DISCUSS POSSIBLE MERGER. EMAS,struggling financially and with low response times, approached WMAS to explore how WMAS may help them. Nothing has been agreed. A combined service would cover a population of 10.4 million people and 11,500 sq miles. (Shropshire Star 8 April)

COMMUNITY NURSES CALLED IN TO HELP COPE WITH DEMANDS OF PATIENTS COMING INTO A&E. The move will ensure both Shropshire departments stay open 24 hours. (Shropshire Star 8 April)

HEALTH CHIEFS DEFER DECISION ON A&E CLOSURE PLAN

Board members of Telford and Wrekin CCG said they feel uneasy about plans for a single emergency centre to cover all of Shropshire and part of Mid-Wales and voted to defer a decision on the proposals to allow for more consideration. (Shropshire Star 13 April)

SHROPSHIRE CCG DEFERS DECISION ONPLAN TO CLOSE ONE OF COUNTY’S A&E DEPARTMENTS. David Evans, Chief Officer of Shropshire CCG, said that there are many factors to consider and financial weighing is less than the non-financial. Neil Nisbit, assistant chief executive and finance director of SaTH said the strategic outline case would solve A&E but only if supported by primary care. A decision was deferred while more work is carried out. (15 April Shropshire Star)

_________________________________________________

Key stories in AUGUST -SEPTEMBER:

  • The realism of 7-day week GP surgeries;
  • GP pressures and staff numbers;
  • Shropshire Hospitals financial health; and
  • NHS Future Fit options.

National news

SOCIAL CARE CHIEF SAVAGES FAILING SYSTEM FOR ELDERLY (OBERVER 09 AUGUST)

The chief inspector of adult social care at the Care Quality Commission has issued a damning judgment on standards in England, warning that a broken system is turning good people into bad carers. The warning comes on the back of more than 150 allegations of the abuse of the frail and elderly every day. The inspector said that huge cuts in funding in recent years, a lack of political leadership in dealing with the realities of an ageing population have left the social care sector under stress and strain.

NHS DATA PUBLICATION (DAILY MIRROR 13 AUGUST)

From today all NHS performance data is to be published on a monthly rather than weekly basis and across all performance areas. NHS England justified the decision as an attempt to bring together uncoordinated data, others criticised the move as an attempt to hide information.

CANCELLED NHS OPERATIONS REACH RECORD HIGH (DAILY MIRROR 16 AUGUST)

NHS England data reveals a total of 16,180 operations were cancelled in the three months to June, up from 15,650 in the same period last year. The total is now at its highest three month figure since 2002.

LEGAL COVER FEARS OVER GP HOURS (SHROPSHIRE STAR 21 AUGUST)

Urgent Health UK, a federation of 26 social enterprises providing out-of-hospital urgent care, has said that its survey of GPs found that four out of five said that high clinical indemnity premiums are stopping them from taking on out-of-hours shifts.

NEW DOCTORS OPTING TO WORK ABROAD (OBSERVER 23 AUGUST)

General Medical Council data show that an average of 2,852 certificates enabling British doctors to work abroad was issued annually between 2008-2014. So far this year the Council has issued 2,008 certificates. This compares with the number of new graduates from medical schools of 2,500 doctors. Anecdotally, the evidence suggests that a very high proportion of newly qualified doctors are seeking work abroad.

COMPETITION LAW ‘RISKS BIG LEGAL BILLS FOR NHS’ (GUARDIAN 24 AUGUST)

Care UK, the UK’s largest private provider of health and social care, has said that four London area’ CCG’s applied the wrong criteria in the letting of a contract to a local health trust. The regulator, Monitor, is to investigate the complaint in the context of mounting concern by the British Medical Association and others about the rising legal costs of operating the NHS.

LACK OF SCHOOL NURSES (GUARDIAN 24 AUGUST)

The Royal College of Nursing has said there is an escalating crisis in school nursing. Despite a steadily growing number of school pupils the number of school nurses has decreased in the past five years.

CRITICISM OF 7-DAY WEEK PLAN (DAILY MIRROR 05 SEPTEMBER/ SUNDAY MIRROR 06 SEPTEMBER)

The Royal College of GPs has said that the plan for a 7-day week service by 2020 is unrealistic. This requires tackling the current 10% vacancy rate in the NHS and amongst GPs as well as additional 5,000 doctors.

The British Medical Association has criticised Government plans for a full 7-day service in hospitals and GP surgeries. It argues that there is insufficient staff numbers and the proposal means a thinner service throughout the week.

BURNED OUT DOCTORS READY TO QUIT NHS (GUARDIAN 11 SEPTEMBER)

In a survey of 817 experienced hospital doctors by the Hospital Consultants and Specialists Association, 81% said they had thought about retiring earlier than planned as a direct result of work pressures. Prof Bruce Keogh, the NHS’s medical director said: “This survey illustrates how hard people are working across the NHS. We need to get on with redesigning our NHS to make it easier for doctors, nurses and other NHS staff to provide the care their patients deserve – including at weekends.”

HOSPITALS CAUGHT IN STAFFING TRAP (INDEPENDENT 23 SEPTEMEBER)

An analysis of Care Quality Commission inspection reports of acute hospitals in 2014 and 2015 found that of 89 hospitals, 68 had issues raised about short staffing on one or more wards.

MEDICAL SCHOOL WITH NO UK STUDENTS (INDEPENDENT 23 SEPTEMEBER)

The University of Central Lancashire has launched a medical degree that is open only to overseas students. The University said that it is unable to invite British students because of limits on the numbers allowed to study medicine.

NHS WILL CREATE HOSPITAL CHAINS TO IMPROVE FINANCES AND CARE (GUARDIAN 25 SEPTEMBER)

The NHS has approved the creation of chains of hospitals for the first time in a bid to tackle its deep financial problems. Simon Stevens, head of the NHS England, is set to announce 13 ‘new hospital vanguards”, nine of them chains which will work together to an unprecedented degree. The plan is to benefit patients by offering the best NHS specialist services over much wider geographical areas.

JUNIOR DOCTORS TO BE BALLOTED ON STRIKE ACTION (DAILY MIRROR 27 SEPTEMBER)

The British Medical Association has said that junior doctors in England are to be balloted on strike action following the Government’s plans to introduce new terms and conditions which it is claimed will mean longer hour working and a pay cut.

‘HALF OF SEVEN-DAY SURGERIES REDUCE HOURS’ (GUARDIAN 29 SEPTEMBER)

Pulse, the magazine for family doctors, reports that almost half the GP surgeries that began opening at weekends and in evenings have reduced their hours because so few patients came. Eight of the 18 pilot GP surgeries are reported to have scaled back opening times.

SURGERIES CLOSE TO COLLAPSE (SHROPSHIRE STAR 29 SEPTEMBER)

The Chair of the BMA General Practitioners Committee has claimed that general practice in England and Wales is close to collapse as more GPs retire and the funding per patient (£140 per year) is insufficient to meet costs particularly the use of locum doctors.

TWO THIRDS OF NHS STAFF WANTS TO QUIT (DAILY MIRROR 30 SEPTEMBER)

According to a report by Unison based on a survey of 10,500 workers, two in three are seriously considering resigning from their job. A third of respondents said that they believed patient safety is being put at risk

Local News

MPs ON THE FUTURE OF A&E (SHROPSHIRE STAR 01/15AUGUST)

Glyn Davies, MP, said that A&E services would most likely remain at one of the two major hospitals in Shropshire instead of a new site although he favours a new build next to the Shrewsbury by-pass. Mr Davies was supported by the Shrewsbury and Atcham MP but opposed by the MPs for Telford and Wrekin.

LUDLOW HOSPITAL (SHROPSHIRE STAR 01/14/28 AUGUST, 17 SEPTEMBER)

A fresh petition has been launched calling for the retention of Ludlow Community Hospital and the development of a rural urgent care centre. The League of Friends is pushing for an unequivocal pledge on the future of the hospital. The local health forum has met to discuss ideas.

LUDLOW HOSPITAL LEASE (SOUTH SHROPSHIRE JOURNAL 03 AUGUST)

Ludlow Town Council has called for the 25-year lease to be finalised between NHS property services and the Shropshire Community Health Trust. The Council believe this will help to protect the sites future.

POWYS HEALTH BOARD SUCCESS (SOUTH SHROPSHIRE JOURNAL 03 AUGUST)

Powys Teaching Health Board has won the ‘Outstanding Innovation in Care’ award at the NHS Wales awards for its service that allows frail patients to receive care from the same nurse or specialist.

A&E TARGETS NOT MET (SHROPSHIRE STAR 05 AUGUST/ 09 SEPTEMBER)

88.25% of A&E patients at SaTH were admitted or discharged within four hours during June. The Government target is 95%. Performance so far in 2015-16 is 5% below the same period in the year previous. Under performance is in part attributed to a 3.66% increase in the number of emergencies and more late evening presentations when fewer staff is at work. A recovery plan is being drawn up.

12-HOUR SURGERY IN LUDLOW (SHROPSHIRE STAR 05 AUGUST).

Ludlow’s Station Drive medical practice is to open 12 hours every weekday (8a.m to 8p.m).

120 DOCTORS JOIN SaTH (SHROPSHIRE STAR 07 AUGUST)

120 new doctors joined SaTH in the last week of July, including 100 junior doctors.

SaTH £17.2 M DEFICIT (SHROPSHIRE STAR 07 AUGUST, 25 SEPTEMBER)

SaTH is currently forecasting a £17.2 million deficit, maybe £19.2 million, in 2015-16 but it has been asked by the Trust Development Authority to work to a stretched target of a £15.2million deficit. Cost cutting measures will include reducing agency nursing staff and the number of patients who occupy beds who are ‘medically fit’ to leave hospital. SaTH has said that closing one of its two A&E departments will not wipe out the debt.

WEST MIDLANDS AMBULANCE BOSS (SHROPSHIRE STAR 11 AUGUST)

WMAS boss, who also led the East of England Ambulance Service amidst much criticism over his salary and doing two jobs, has resigned from the East of England job.

POLITICIAN BACKS HOSPITAL STAFFING FIGHT (SHROPSHIRE STAR 12/15 AUGUST, 02/ 09 SEPTEMBER)

The Welsh Assembly member for Mid Wales is pressing the Home Secretary to rescind the decision not to allow 68 nurses from the Philippines to work at SaTH. On 15 August it was announced that 21 of the nurses have been given clearance to work for SaTH. SaTH has also written to the Home Secretary about the remaining 47 nurses. The Health Secretary has placed a cap on all hospital trusts on how much they can spend on agency staff after it was revealed that total expenditure in England was £3.3bn per year.

MONTGOMERYSHIRE PATIENTS SUPPORT SHREWSBURY A&E (SHROPSHIRE STAR 13/26 AUGUST)

Patients in mid Wales have expressed worries if A&E services are removed from Shrewsbury as part of the Future Fit programme. Welshpool Town Council and the Montgomeryshire Welsh Assembly member support them.

MID WALES URGENT CARE CENTRE PETITION (SHROPSHIRE STAR 22 AUGUST).

A petition has been launched calling upon the Welsh Government to open an urgent care centre in Montgomeryshire.

SUPER HOSPITAL OFF/ ON/OFF AGENDA (SHROPSHIRE STAR 23/29 AUGUST, 09/14/15/29 SEPTEMBER)

Having dismissed the idea of one single hospital for Shropshire and Telford and Wrekin it is reported that the idea is could be brought back to the table. Telford and Wrekin CCG support this. Others fear it will lead to the closure of Shrewsbury Hospital. Health chiefs dropped the idea at the end of September.

WELSH AMBULANCE SERVICE TARGETS MISSED (SHROPSHIRE STAR 02 SEPTEMBER).

The Welsh Ambulance Service only reached 57.6% of Category A emergencies in Powys in the eight minute target (65%) during July.

CANCER WAITING TIMES IN SHROPSHIRE (SHROPSHIRE STAR 14/15 SEPTEMBER)

The latest figures for July show that SaTH is exceeding the national targets for the commencement of treatment of cancer patients. From 2020 the government has set a new target of a definitive cancer diagnosis or the all clear within 28 days of being referred by a GP.

MORE WELSH AMBULANCES (SHROPSHIRE STAR 16 SEPTEMBER)

The Welsh ambulance fleet of 700 vehicles is to be strengthened by 35 standard ambulances and six non-emergency patient transport vehicles.

WELSH GPS OFFERED SUPPORT PACKAGE (SHROPSHIRE STAR 28 SEPTEMBER)

The Welsh Government has agreed a special support package to assist vulnerable GP surgeries.

COMPLAINTS DOWN AT SHROPSHIRE’S TWO HEALTH BODIES (SHROPSHIRE STAR 29 SEPTEMBER)

The number of complaints to SaTH and Shropshire Community Health Trust are down by 25% so far this year.

WINTER HEALTH WARNING (SHROPSHIRE STAR 29 SEPTEMBER)

The new chief of SaTH has called for all health bodies in the county to agree a combined plan to tackle demands on the health service, particularly A&E.

FUTURE FIT IGNORES RURAL AREAS (SHROPSHIRE STAR 29 SEPTEMBER)

A Shropshire Councillor has claimed that Future Fit is ignoring the needs of rural areas.

111 HEALTH LINE PREFORMANCE (SHROPSHIRE STAR 30 SEPTEMBER)

Almost nine out-of- ten calls to the West Midlands, including Shropshire, 11 helpline were answered within the national target of 60 seconds during the first week of the new operator, the West Midlands Doctors Urgent Care.

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NHS TRACKER April–June 2015

The Bishop’s Castle Patients Group’s ‘NHS Tracker’ is based on newspaper clippings and news sites. Its focus is stories about changes to the NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments.

Key stories in April – June (excluding the extensive media coverage on healthcare matters as part of the General Election campaign):

  • ‘7 day GPs’ and a ‘New Deal’ for GPs to boost recruitment and tackle appointment waiting times;
  • Cost of, and recruitment difficulties of overseas nurses and locums;
  • Government direct intervention in three ‘failing’ health regions; and
  • NHS deficit in 2014-15 and long-term financial pressures.

National news

NHS CASH NEEDED (DAILY MIRROR 26 MARCH)

The Kings Fund chief economist’s report on the NHS says that the NHS has deteriorated badly: waiting times for A&E and cancer treatment are getting longer; GPs are under huge pressure; 40% of NHS staff felt ‘unwell’ at work during 2014 due to stress and NHS debt is £800M in 2014

GP APPOINTMENTS (DAILY MIRROR 01 APRIL)

A British Medical Journal survey states that only 88.8% of patients were able to book an appointment with a GP.

AGENCY STAFF COSTS (GUARDIAN & SHROPSHIRE STAR 02 APRIL)

Civitas, the cross-party think tank says the NHS is spending £2.5BN on locum doctors and agency nurses. Its report said that agency nurses cost in the region of £24 to £29 per hour, equivalent to between £47,000 to £56,000 a year, while the salary of an NHS Band 5 nurse is between £21,478 and £27,901. The typical charge for a consultant from an agency is £1,760 a day, equivalent to a pro-rata salary of £459,000

‘PAY – NHS ‘ IS COMING SAY BMA (GUARDIAN 04 APRIL)

The chair of the British Medical Association has said that patients could face paying charges to use basic NHS services such as visiting a GP, because the health service’s s finances have become so dire.

OVERSEAS NURSE RECRUITMENT (OBSERVER 05 APRIL & SHROPSHIRE STAR 08 & 14 APRIL)

New figures from the Nursing and Midwifery Council reveal that one in four nurses recruited in 2014 were from abroad. In 2009-10 11% of nurses were recruited from abroad and this had risen to 29% in 2014-15. A Royal College of Nursing survey estimated that there are 54,000 home-grown applicants a year seeking training places. However, in 2010-11 there were only 20,092 nurse training commissions in the UK.

A Freedom of Information figure for SATH revealed that it paid £2,200 for an agency nurse to cover a temporary shift. In December there were 47 agency nurses at SATH. By end March 80 staff nurses and health assistants had been recruited from abroad out of a total of 150 new staff.

COMMUNITY NURSING CARE REPORT (OBSEVER 12 APRIL)

The Royal College of Nursing has published a review of community nursing. It says there has been a 28% cut in community nurses, down by 3,300, including 2,000 district nurses. In 2011 the Government launched the health-visiting programme, aimed at increasing the number of health visitors to over 12,200 by 2015. There has been an increase of 2,691 health visitors since May 2010, bringing the total to 10,783 in December 2014.

THIRD OF GPS CONSIDERING RETIREMENT (SHROPSHIRE STAR 15 APRIL)

A British Medical Association poll (15,560 took part) of GPs reveals that a third are considering retirement in the next five years. When asked to rank the top factors that most impact on their personal commitment to their roles, 71% cited an excessive workload, 54% said un-resourced work being moved to the GP and 43% said not being able to spend enough time with patients.

NHS RATIONING (GUARDIAN 22 APRIL)

Almost two in five of England’s 211 CCGs are considering imposing new limits this year on eligibility for services including IVF, foot care, and hip and knee replacements.

GP WAITING TIME FEAR (SHROPSHIRE STAR 07 MAY)

One in four family doctors surveyed by the GP magazine Pulse said the current wait for an appointment at their Practice was two weeks. When asked what it could be in 12 months time 22% said less than one week, 33% said one to two weeks, 26 % up to three weeks and one on five said it could increase to longer than this.

CHILD HOSPTIAL VISITS INCREASE AFTER GP REFORM (SHROPSHIRE STAR 13 MAY)

Imperial College London research has found that reforms to GPs’ working practices in 2004 corresponded with a 8% rise in potentially avoidable emergency admissions for children with chronic conditions such as diabetes and asthma. This was the equivalent to 8,500additional admissions a year and above the overall trend increase for admissions of 3%.

TEN YEAR LOW FOR OPERATIONS CANCELLED (DAILY MIRROR 16 MAY)

NHS England data for Januarys – March 2015 shows that 20,464 operations were cancelled at the last minute for non-clinical reasons – up from 17,868 in the corresponding period in 2014.

CALL FOR NHS CASH INJECTION (GUARDIAN & SHROPSHIRE STAR 23 MAY)

NHS providers of care in England ended the 2014-15 financial year with a deficit of £821.6M. This was more than seven times the shortfall of £107M in 2013-15. The Kings Fund said plugging the hole was an urgent priority for the Government. The DHS spokesperson said, “We know the NHS is busier than ever and trusts are facing challenges. However, we expect them to show tight financial grip and live within their means”.

NEW LIST OF PRIVATE SERVICE PROVIDERS (OBSERVER 24 MAY)

The nine regional consortia of CCGs have published their lists of preferred suppliers of non-clinical services. Capita, KPMG, PwC and USA firm United Health dominate the lists.

PM’S SEVEN-DAY NHS (SHROPSHIRE 18 MAY, DAILY MIRROR 19 MAY)

The Prime Minster’s first major speech since the General Election focused on the creation of ‘seven-day service’. The SHROPSHIRE STAR reported that Shropshire health experts are sceptical about the need for and the possibility of delivering a seven per week GP service following the Prime Minister’s promise to recruit an additional 5,000 new GPs by 2020. There was widespread criticism of the announcements from nursing and GP professional bodies.

THIRD OF PATIENTS STRUGGLE FOR GP APPOINTMENT (GUARDIAN 01 JUNE)

Monitor, the NHS’s financial regulator has conducted a survey of 3,315 patients in England. Over 90% said their surgery was easy to get to and near a pharmacy, with male and female GPs available and enjoyed a good reputation. It reports that 1 in 10 people are dissatisfied with their GP surgery, with accessing services the main frustration. 30 % of respondents said it was not easy to get an appointment. 35% said they could not see the same doctor on each visit and 34% said the surgery do not offer on-line appointments.

160,000 LOSE THIER GP (DAILY MIRROR 01 JUNE)

Pulse, the GPs weekly magazine, reports data that the closure of 61 practices since April 2013 means people are having to look for other GPs to take them on.

PATIENTS PREFER A&E TO DOCTOR (SHROPSHIRE STAR 03 JUNE)

A joint report by the Royal College of Emergency Medicine and Patients Association says that many people are attending A&E despite being offered a same-day appointment at their GP. Many patients are reluctant to wait as little as three hours to see their family doctors if they think their needs are urgent. Substantial numbers also go to A&E because they are advised to do so by other healthcare providers.

GP RECRUITMENT A CHALLENGE (GUARDIAN 03 JUNE)

The Chief Executive of Health Education England, the government appointed body responsible for the recruitment and retention of staff, with an annual budget of £5.0BN says that GP recruitment is what ‘keeps him awake at night’. Although the number of GP training places has been increased, 20-25% of them are not being filled. The situation is much worse in regions away from London.

NHS ‘TAKES OVER ‘ THREE FAILING REGIONS (DAILY MIRROR 04 JUNE & GUARDIAN 09, 15 JUNE)

In an unprecedented move the Government has asked health sector regulators to take over the running of health services in three regions were seen to be failing.

NHS STAFFING GUIDELINES SCRAPPED (GUARDIAN 05 JUNE)

The National Institute for Health and Clinical Excellence (NICE) has unexpectedly scrapped guidelines on safe staffing levels, introduced after the Mid-Staffs hospital problems. NICE said that it stopped devising a set of patient to staff ratios intended to help guarantee patient safety in A&E units and mental health settings at the request of NHS England which is to take over the work.

HOME CARE STAFF CRISIS (DAILY MIRROR & SHROPSHIRE STAR 16 JUNE)

A survey by trade union, Unison, of 1000 home care workers found that six out of ten are on zero hour contracts; for many travel time is unpaid and many do not have the training to carry out effective homecare.

NEW DEAL FOR GP WORKLOAD (GUARDIAN, SHROPSHIRE STAR & DAILY MIRROR 19 JUNE)

The health secretary has unveiled a ‘new deal’ for GP’s, promising measures to ease the workload and to make the profession more attractive to new recruits and to boost retention, including:

  • Recruit 1000 “physician associates ‘ by 2020. They will have less medical training than doctors but help them to diagnose patients and to relieve the administration burden;
  • Recruit 5000 clinical staff for England’s 8,500 surgeries;
  • 5000 more nurses, physiotherapists and other staff;
  • More money for GPs which has seen its share of the NHS budget fall to 8.3% if the sector embraces 7 day access; and
  • Cash incentives for GPs to work in certain areas.

OVERSEAS NURSES RULES CHANGE (SHROPSHIRE STAR & DAILY MIRROR 22 & 26 JUNE)

The Royal College of Nursing has said that many nurses will be forced to return home if they are from outside the European Economic Area because of a new government rule that migrants must earn at least £35,000 a year after five years in UK. The rule is due to come into effect next year. It is estimated that 3,365 nurses are impacted and maybe as many as 30,000 and it could cost the NHS £20.19M to recruit replacements.

MEDICS TO APOLOGISE FOR BLUNDERS (GUARDIAN 29 JUNE)

New NHS rules for doctors, nurses and midwives mean they must offer a prompt and heartfelt apology and explanation to the patient when things go wrong.

Local News

NHS CROSS BORDER COSTS (SHROPSHIRE STAR 23&31 MARCH)

Councillor Karen Calder, cabinet member for health and chairwoman of the Shropshire Council’s Health and Wellbeing Board has claimed that £700K per annum is being spent on patients resident in Wales which cannot be claimed back from Welsh local government. Welsh Government Health Minister responded by saying that every Welsh patient who has planned care in Shropshire is fully paid for. Emergency Care is provided on a ‘knock for knock’ basis. If a patient registered in England presents at a Welsh A&E /MIU there is now charge back to England.

OSWESTRY ORTHOPAEDIC HOSPITAL PRAISED (SHROPSHIRE STAR 27 MARCH)

Three independent surveys have praised the quality of care. 93% of staff said they would recommend the hospital to friends and family. The highest score in the country. A patient survey also gave it top marks. The one major concern was admission rates, with one in four appointments having to be changed.

SHROPSHIRE HOSPITALS OVERSPEND (SHROPSHIRE STAR 27 MARCH)

The Shropshire and Telford Hospital NHS Trust has forecast that the two hospitals are expecting to overspend by £18.2 M over the 2015-16 financial year. Total income is forecast at £314.859M. Cost improvement programmes will save £12.3M.

A&E TARGETS (SHROPSHIRE STAR Various, DAILY MIRROR & GUARDIAN 05 JUNE)

National target = 95% within 4 hours

SATH 1503 = 88.8%

SATH 2203 = 87.8%

SATH 0504 = 87.9% (2,137 attended the two A&E departments of which 455 were emergency admissions).

SATH 1204 = 81.8%

SATH 1904 = 83.9%

SATH 2604 = 90.1%

NHS England has decided to stop publishing weekly A&E data and to move to monthly publication.

SHAKE UP IN WAY COUNTY GP’S WORK (SHROPSHIRE STAR 28 MARCH, 2 APRIL & SOUTH SHROPSHIRE JOURNAL 10 APRIL)

A £4.2M grant to Shropshire and Telford and Wrekin, funded by the Prime Minister’s Challenge Fund, will pay for a 12 month project to extend on-line GP booking services, a 24/7 telephone hub, more consultations options for patients including email, phone and Skype and new ways of sharing clinical records across all sites.

WHITCHURCH GP’S MERGE AT HOSPITAL SITE (SHROPSHIRE STAR 31 MARCH)

The Government has set aside £25M to pay for building, modernising and expanding 141 GP practices in the West Midlands. This includes £2M to refurbish Whitchurch Community Hospital to merge two existing GP practices.

MANY A&E VISITS ‘NOT NECESSARY’ (SHROPSHIRE STAR 07 APRIL)

In March 2015 1,703 patients who visited SATH A&E departments were discharged without the need for any follow-up treatment (February 1,414). Research suggests that up to one in four people who visit A&E could have either treated themselves or used an alternative local provider.

GPS FEAR 7-DAY COVER PLAN (SHROPSHIRE STAR 11 APRIL)

The British Medical Association says that only 51% of GPs felt their practices should offer some form of extended hours and most are against having to open everyday.

WELSH NHS WAITING FIGURES (SHROPSHIRE STAR 17 APRIL)

NHS Wales’s data shows that at the end of February 23,238 patients in Wales were waiting more than 36 weeks to be seen for treatment against a zero target. In total 415,737 were waiting for treatment. In England in the same period just over 13,000 people have been waiting more than 26 weeks.

MISSED APPOINTMENTS AT GPS (SHROPSHIRE STAR 18 APRIL)

Medical staffs have warned that a huge strain is being put on doctor’s surgeries across Shropshire because of patients who fail to turn up and cancel appointments.

TWO NEW WARDS TO HELP A&E (SHROPSHIRE STAR 01 MAY)

SATH wants to open two ‘fit for transfer’ wards with 25 beds each in advance of winter 2015-16 to relieve ‘bed blocking’.

BEST AMBULANCE SERVICE (SHROPSHIRE STAR 02 MAY)

The West Midlands Ambulance Service has been named as the best performing in England. Its paramedics responded to heart attack patients faster than anywhere else and control rooms staffs were quickest to answer 999 calls.

MORE INTERMEDIATE CARE IN WALES (SHROPSHIRE STAR 04 MAY)

The Welsh Government’s Intermediate Care Fund is designed to help older and vulnerable people in Powys to have care closer to home instead of having to travel to hospital in Shrewsbury or other parts of Wales.

MONTGOMERY NEEDS AN URGENT CARE CENTRE (SHROPSHIRE STAR 06 MAY)

William Powell, LibDem AM for Mid and West Wales has said that he wants to see an urgent care centre in Montgomeryshire to help with the demand for cross-border treatment.

NEW SATH CEO ANNOUNCED (14 MAY)

Simon wright has been appointed the CEO of SATH and commences work later this summer. Mr Wright is currently deputy chief executive and chief operating officer at Warrington and Halton Hospitals NHS Foundation Trust.

POWYS HEALTH IMPROVEMENTS (SHROPSHIRE STAR 16 MAY)

Powys County Council and the Powys Health Board have pledged to work more closely together on community and social care issues through joint service delivery.

FUTURE FIT (SHROPSHIRE STAR 16 MAY, 12 & 20 JUNE)

North Shropshire MP, Owen Paterson MP, has said that Shropshire should have one main A&E unit on a new site and a number of urgent care centres.

Telford and Wrekin Council has launched a campaign to retain A&E services at Telford.

SHROPDOC SERVICE AWARDS (SHROPSHIRE STAR 21 MAY)

The out-of –hours GP service for Shropshire has received the prestigious customer service excellence award.

SATH ‘ONE OF THE BEST’ (SHROPSHIRE STAR 23 MAY)

SATH has been named as a CHKS Top 40 Hospitals for 2015, an accolade awarded to the 40 top performing CHKS client trusts.

RURAL URGENT CARE CENTRES (SHROPSHIRE STAR 27 MAY)

More public meetings will be held to help decide where urgent care centres are needed in outlying areas of Shropshire.

HEALTHWATCH SHROPSHIRE REPORT PUBLISHED (SHROPSHIRE STAR 25 MAY)

Between October 2014 and March 2015 Healthwatch Shropshire received 363 comments about experiences and opinions of health and care services.

OSWESTRY ORTHOPAEDIC HOSPITAL INVESTIGATED (SHROPHIRE STAR 03 & 05 JUNE)

Monitor, the NHS watchdog, has commenced an investigation into Oswestry Hospital because patients appear to have to wait too long for their operation. It also fears that the Trust, which runs the Hospital, has been inaccurately reporting waiting times.

Meanwhile, the Trust is paying its medics £40 per hour to clear the backlog.

SATH OVERSPEND FORECAST (SHROPSHIRE STAR 03 JUNE)

SATH expects to overspend by £18.3 M this financial year and will borrow £17M that it will have to pay back in the following two years at an interest rate of 3.5%.

OVERSEAS NURSE RECRUITMENT DELAYS (SHROPSHIRE STAR 26 JUNE)

68 nurses recruited by SATH from the Philippines are experiencing delayed entry to the UK by the Home Office. In May SATH spent £1.246m on agency nurses.

WORTHEN VILLAGE SURGERY (SHROPSHIRE STAR 26 JUNE)

Plans for a new £1.5m surgery for Worthen are to re-ignited by the MP after a delay caused by the Shropshire CCG wanting a 25 year lease.

SATH PATIENT SATISFACTION (SHROPSHIRE STAR 27 JUNE)

The Care Quality Commission’s National Inpatient Survey for the NHS of patient satisfaction at SATH has shown steady improvement since 2012.The survey was sent out in July 2014 and 436 completed forms were returned (52% response rate cf. 60% in 2013; 47% national response rate).

POWYS GP WAIT (COUNTY TIMES 26 JUNE)

Powys patients have to wait up to 50 days to see their regular GP because of a shortage of GPs.

SATH IDENTIFIES NEW RISKS (SHROPSHIRE STAR 27 JUNE)

The health watchdog the Care Quality Commission assesses SATH on a range of indicators. It has not placed SATH in a high-risk category but identified some areas for concern including the trend in mortality not being as expected. It highlighted improved staff satisfaction.

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NHS Tracker March 2015

Key stories in March:

  • The pressures on A&E and the importance of ‘bed-blocking’ as cause;
  • GP numbers and patient access and
  • Views on Future Fit from around the county.

National news

BED-BLOCKING (DAILY MIRROR 24 FEBRUARY)

A Royal Voluntary Service report says that almost 70% of hospital nurse surveyed admitted they were ‘frequently’ delaying discharging older patients because there was no one to care for them in the community. Nearly 50% of them described it has a serious problem and 82% said it had got worse in the past year.

NHS STAFF VIEW (DAILY MIRROR 28 FEBRUARY)

An on-line poll by 38 Degrees campaign group of NHS staff states that 50% think the NHS has got worse over the past two years, whilst 6% think it has improved. 91% think staff issues have become bigger issue since 2012.

GP RETIREMENT PLANS (DAILY MIRROR 02 MARCH, SHROPSHIRE STAR 03 MARCH)

A BMA survey of 1,004 GPs across the UK found that 56% said they expect to retire or leave before they are 60. The Secretary of State responded: “The centre of gravity in the NHS for 66years has been the big hospitals. We have to change that to make the centre of gravity general practice and out-of-hospital care.”

CHILDREN’S MENTAL HEALTH (DAILY MIRROR 02 MARCH)

NHS England revealed in a Parliamentary Answer that spending on children’s mental health has dropped by more than 6% in real terms since 2010 to £717million.

PATIENT ACCESS TO GENERAL PRACTICE (KING’S FUND 03 MARCH)

A paper from the Royal College of General Practitioners explores some of the initiatives being tested and looks at what solutions and challenges are emerging to improve ‘patient access’ to GPs. GP access is a popular topic in public debate about the NHS – with politicians and the media often quick to call for initiatives to “improve” access for patients. However, there is little agreement about what ‘good’ access to general practice looks like, and the term is often used to describe a range of quite diverse projects – from offering consultations via skype to providing extended practice opening hours. With some exceptions, there is a lack of evidence around what does and doesn’t ‘work’ in terms of improving access for patients in general practice and how this relates to the outcomes they experience.

The starting point for this paper is that there is no single definition of good access to general practice, and no one-size-fits-all solution that all practices should implement. In fact, access can mean very different things to different people, depending on an individual patient’s priorities. Many practices are already closely monitoring how patients access their services:

  1. Availability and proximity of care. Some patients would prioritise being able to access general practice in the right location to suit their needs. For example, people with reduced mobility need their local practice to be physically accessible.
  2. Timeliness of care. Some patients would prefer to prioritise accessing GP services quickly or at a time most convenient to them, and would prioritise this over (for example) seeing a particular GP.
  3. Ability to see a preferred GP or nurse. For some patients, being able to see a GP or nurse of their choice takes priority over fast access (this may apply in particular to those with long term conditions for whom continuity of care is an important factor).

This paper explores current initiatives focusing on each of these aspects of access to general practice, before considering what systems and processes underpin effective approaches to improving access for patients. It focuses largely on in-hours access to general practice, and should be read alongside the RCGP’s recent paper on out of hours GP care.

NHS SHAKE-UP DAMAGING (GUARDIAN 06 MARCH)

The King’s Fund assessment of the government’s NHS record says that the 2011 reforms were “damaging and distracting’:

  • The structure of the NHS is now “complex, confusing and bureaucratic’ and the organisation is “not fit for purpose”;
  • Senior staff time was diverted away from the real clinical issues;
  • Led to a loss of talented individuals.

GPS TO OPEN OVER EASTER (DAILY MIRROR 07 MARCH)

NHS England has written to all NHS Trusts and GPs saying that surgeries must be open on the Saturday morning of the Easter break to maintain ‘continuing operational resilience’. The letter calls for extra staff to cope with surges in demand for the 111 phoneline and GP out-of hour’s services.

WHAT’S BEHIND THE A&E ‘CRISIS’ (KING’S FUND 10 MARCH)

This report by the Nuffield Trust examines the latest problems in A&E, which are part of a well-established decline since 2012. It says the picture is not straightforward and there has been a tendency among commentators to confuse long-term trends and the immediate causes. A&E attendance at major units has not risen much beyond what we would expect because of population change, and simple explanations such as the impact of NHS 111, cuts to social care, or changes to the GP contract in 2004 do not fully explain pressures on A&E or performance problems. There has been little change in the median time people wait at A&E or in the proportion re-attending within seven days, and patient satisfaction remains high.

The report argues that the most significant issue is not the numbers of people presenting at A&E, but the ability to discharge patients safely and quickly from the hospital as a whole. Many answers to the problems facing urgent care already exist. But the complexity of the system and the highly politicised nature of A&E have impeded progress. Problems will not be solved if policy-makers, political leaders and regulators continue to micro-manage A&E. With change so urgently needed, it is imperative that there is a cross-party consensus on how to move forward and that action is not postponed or delayed for political reasons. Solutions need to:

  • Focus on getting things right in primary care to enable prevention to work – but be realistic about how much can be achieved. Policy-makers can help to boost primary care through supporting moves to build up the skills and capacity of health care professionals to provide high-quality urgent care services outside hospital.
  • Remove some of the complexity of different services that has been built into the system, and which confuses the public and NHS staff. Creating a single point of access to community services for patients and GPs would be one way to achieve this.
  • Focus on the way patients move through hospital – and be realistic about what policy-makers can and can’t do. Policy-makers can help by investing in care outside hospital, but they must let providers find solutions that work for their patients.
  • Foster a better understanding of the way that local systems work. Promoting better data outside hospital and encouraging the development of systems modelling in individual trusts would be an important start.
  • Take a longer-term and broader view of performance in A&E – and consider clustered randomised controlled trials of alternative performance measures. Policy-makers should encourage the adoption of a set of richer performance indicators to sit alongside the four-hour target, which could be trialled in certain areas.

OAP’S FLOOD A&E (DAILY MIRROR 11 MARCH)

The charity, Age UK, says that the cut in the number of district nurses by 27.5% since 2010 has forced more OAPs into using A&E services.

PROGRESS ON NHS REFORM (KING’S FUND 15 MARCH)

Reform, an independent think tank whose mission is to set out a better way to deliver public services has looked at the evidence on the progress of the “NHS Five year Forward View’. It notes that the NHS has made improvements and managed under the pressure of a flat-lined budget and rising demand; patient satisfaction is at an all-time high; the NHS has become more efficient and patient choice has been extended. However, the report concludes that the balance of evidence suggest a less positive picture. Savings have been made through short term efficiencies and are not sustainable.

PLACE PHARMACIES IN GPS (SHROPSHIRE STAR 17 AND 18 MARCH)

The Royal College of General Practitioners, backed by the Royal Pharmaceutical Society, has said that stationing pharmacists in surgeries to resolve day-day medicine issues could ease the pressure on GP practices.

FROM HOSPITALS TO HEALTH SYSTEMS (KINGS FUND 20 MARCH)

A core part of the vision laid out in the NHS five year forward view (Forward View) involves acute hospitals becoming more closely integrated with other forms of care. This report argues that if the health and social care system is to respond to the changing needs of the population, and also address the financial challenges it faces, acute hospitals will need to play a fundamentally different role within local health economies. This will involve:

  • Moving from an organisational focus to a system-wide perspective
  • Working more closely with local partners, including primary care, social care and community services
  • Developing integrated service models that span organisational boundaries
  • Providing services through horizontal networks with other acute hospitals.

This report explores the role that acute hospitals can play in integrated care, drawing on learning from five case study sites in England where acute hospital providers have engaged actively with the integration agenda.

HEALTHWATCH REVIEW (KING’S FUND 20 MARCH)

This report was commissioned by DofH to review the first 18-21 months of local Healthwatch. Broadly, local HW’s are positive about their progress but they vary widely in how they are organised and how they interact with the rest of the health and care system and their levels of influence. The main challenge identified is their ability to define a distinctive local role and to build strong relationships with local system leaders and to bring an independent voice.

BETTER CARE CALL FOR LONG-TERM SICK (SHROPSHIRE STAR 21 MARCH)

A Richmond Group – a coalition of 10 leading health and social care charities – report says that £7 in every £10 of NHS spending goes on treating people with long-term conditions. An ONS report has said that one in three adults had a long-term illness or disability in 2013. The report calls for better early diagnosis.

GP NUMBERS (PULSE 25 MARCH)

Statistics from the Health and Social Care Information Centre reveal that the number of GP partners and principals is continuing to decrease whilst the number of full-time equivalent GPs in the UK has increased by 1.7% since 2013. There were 40,184 GPs in the UK in 2014 and the number of FTE GPs grew to 32,628. The statistics also reveal:

  • In 2013 the number of female GPs exceeded the number of male GPs;
  • Female GPs continue to increase steadily whilst male GPs continue a long term decline;
  • There are more GPs per 100,000 population now -66.5 – than there were in 2004 (62.9); and
  • A continuation the trend to work in a GP practice for a salary rather than as a principal or partner.

NHS PERFORMANCE REVIEW (KING’S FUND 26 MARCH)

The King’s Fund report examines NHS performance in England. It says that the NHS has held up well during the coalition government first three years but has deteriorated since with waiting times at their highest levels , operations being cancelled, 62 days wait for cancer consultations and a £2bn deficit.

Local News

ONE OR MORE EMERGENCY HOSPITALS and UCCS –POLITICIANS AND CLINICIANS START TO SPEAK OUT

  • Telford Council leader has called for a fight to retain all PRH services (Shropshire Star 07 March).
  • 2,000 sign a petition for a minor injuries unit in Newtown (County Times 20 February).
  • Glyn Davies, Montgomeryshire MP, has said that the costs of treating patients across the border are unsustainable because not enough funding is being transferred from Wales to England. The number of Welsh patients attending Shrewsbury A&E has risen by 9% in the past two years (Shropshire Star 18, 21 March).

PRESSURE ON A&E HITS OPERATIONS (SHROPSHIRE STAR 28 FEBRUARY)

In the period October to January 561 operations at the two main hospitals were cancelled compared with 158 operations in the same period 12 months ago. This is attributed largely to bed demand from A&E patients.

GP FUNDING TRANSFERRED TO CCG (SHROPSHIRE STAR 02 MARCH)

NHS England has agreed to transfer the responsibility to allocate GP funding to the two Shropshire CCGs.

AMBULANCE SERVICES DELAYED AT A&E (SHROPSHIRE STAR 03 MARCH)

The West Midland’s Ambulance Service reports that in four-week period mid December –mid January ambulances spent the equivalent of more than one year waiting outside West Midland hospitals.

COUNTY SHOULD CONTROL HEALTH CASH (SHROPSHIRE STAR 06 MARCH)

Following the Government’s decision to delegate all health and social care spending to Greater Manchester local authorities an all-party group of MP’s has called for similar arrangements to be given to Shropshire and said the case was stronger in rural counties.

SHROPSHIRE HOSPITALS A&E TARGETS (SHROPSHIRE STAR 07, 10, 21 MARCH)

89.1% and 90.1% of A&E patients were seen within four hours at Shropshire’s two main hospitals during the weeks ending 01 and 08 March respectively compared to the Government target of 95%. It is the 24-week in a row that the target has been missed but a much better performance than in January and February. In the week ending March 15 performance had slipped back again to 88.8%.

LUDLOW HOSPITAL IMPROVEMENTS (SHOPSHIRE STAR 10 MARCH)

£160,000 has been invested in the Ludlow hospital to improve flooring, electrics and plumbing, new shower and toilet rooms and a refurbished café. The previously mixed sex wards are now single sex only.

FLYING DOCTORS SERVICE LAUNCHED IN WALES (GUARDIAN 14 MARCH)

Three Wales Air Ambulances will carry a full critical care team. One helicopter is based at Welshpool.

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Key stories in January and February:

  • New fund for GPs to improve their surgeries;
  • Expanding role of GPs;
  • A&E demand and NHS11 referrals;
  • ‘Bed blocking’;
  • Shropshire hospitals fail to meet A&E targets;
  • Children’s mental health services under pressure;
  • NHS budget to be devolved to Greater Manchester; and
  • Views on Future Fit from around the county.

National news

POLICE CALL OUTS TO HOSPITALS (DAILY MIRROR 03 JANUARY)

Sky News, has obtained figures under the Freedom of Information Act , from 30 police forces on hospital related incidents. Police attended 64,278 incidents at NHS premises in 2014, up from 1,700 in 2013. Assaults account for most ‘callouts’ and the Association of Chief Police Officers said that many were alcohol related.

WORST WEEK FOR A&E (GUARDIAN 07 JANUARY, DAILY MIRROR 15 JANUARY)

Eight more hospitals, bringing the total to 15 for this winter, declared a major incident. Between 15 and 21 December, the NHS treated and either admitted or discharged 88.8% (target 95%) of patients seeking care at all types of urgent and emergency care units within four hours. Emergency departments treated just 83.1% of those arriving at so-called type1 A&E units. Professor Keith Willett, NHS England director of acute care, said the A&E system is “running hot”. The causes are attributed staff recruitment issues, failings in the NHS111 service, changing behaviour patterns of younger people, shortage of District Nurses.

In the week 05 to 11 January not a single hospital trust ( excluding foundation trusts) met the 95%target.

NHS BEDS TAKEN UP BY ‘BEDBLOCKERS’ (GUARDIAN 08 JANUARY)

A Guardian survey of 50 NHS trust chief executives, reported that over one half of hospitals report at least 10% of beds are taken up by so-called ‘bed blockers’. NHS figures for November showed that 5,026 patients in English hospitals were ready to leave but no arrangements existed for aftercare. Two thirds of all beds lost were down to the NHS, 25% to social care and the rest attributable to both sectors.

CHILDREN’S MENTAL HEALTH (DAILY MIRROR 10 JANUARY)

NHS England revealed in a Parliamentary Answer that spending on children’s mental health has dropped by more than 6% in real terms since 2010 to £717million.

NEW £1BN FUND FOR GPs GUARDIAN 15 JANUARY)

NHS England has written to all 8,500 GP practices with details of the money to be made available to improve GP practice buildings. The Government announced the money, which is funded by fines imposed on banks for their role in the Libor scandal, in December. £250million is to be made available annually, subject to certain conditions. The practice must do much more to keep patients at home, offer increased appointment and patient contact time, and or a reduction in emergency attendance at hospital of over -75s. Surgeries are expected to make better use of technology to monitor patients’ well-being.

A&E FIGHTING FOR ITS LIFE (GUARDIAN 15 JANUARY)

Allyson Pollock. Professor of Public Health Research and Policy, Queen Mary, University of London commented that emergency medicine is a tiny speciality with fewer than 4,000 doctors in contrast to 32,000 GPs but that it is ‘the canary in the mine’. The cuts / closures of A&E have not been a result of changing patient need but often because of expensive PFI projects. Likewise the reduction in NHS beds to 135,000 in 2013/14 from 297,000 in 1987/88 is being driven by Government attempts to shift patients to the private / paid for sector. Britain now has one of the lowest number of hospital beds per head of population in Europe but the highest occupancy at 100%. Pollock argues that without beds, the closure of NHS ‘walk in’ centres and the changes to GP services the pressure has built on A&E even though the overall numbers visiting A&E has not changed. The area of growth has been in minor injuries. The problem has been compounded by the Health and Social Care Act which has removed the duty on Government to offer universal care and consequently Pollock argues that because A&E is expensive it is being cut back even further driven by the new NHS pricing model.

GP TRUST BEING UNDERMINED (GUARDIAN 17 JANUARY)

Guardian poll of 1,008 GPs of UK 40,000 found 83% agreed that “Jeremy Hunt is seeking to undermine public trust in GPs”. 94% agreed that “GPs are being unfairly criticised for political purposes”. The poll was strongly criticised by DoH for asking loaded questions.

NHS 111 HOSPITAL REFERRALS (SUNDAY PEOPLE 18 JANUARY)

Government data reveals that the NHS 111 phone helpline referred 526,500 people to A&E in the 2013-14 financial year and in the eight month April – November 2014 the total was 515,500 and increase of an average of 6,00 people each week.

NHS FAILING DEPRESSED PATIENTS (OBSERVER 19 JANUARY)

The first annual report of by the NHS’s Health and Social Care Information Centre into the ‘Improving Access to Psychological Therapies scheme’ found that in 2012-13 GP s made 883,968 referrals for psychological support of which only 49% of them led to someone suffering from mental health problems to starting treatment. 166,458 were still awaiting treatment to start after 12 months. In all 274,975 (63%) who did get a first treatment were seen within 28 days. One third dropped out altogether after GP referral mainly citing the reason of ‘lack of choice’.

CALL FOR SHIFT OF RESOURCES TO GPS (GUARDIAN 20 JANUARY)

Professor Sir Bruce Keogh, medical director of NHS England, has said that without massive changes to the way the NHS treats patients, including far less reliance on hospitals, the service risks becoming unaffordable and the model of delivery and service that we have at the moment is not fit for the future. He has called for a massive shift of resources and care into GP surgeries. He envisages hospital consultants being required to visit patients in their GP surgery, patients being given more time to discus their ailments and treatments with GPs and more services being provided under a ‘single roof’.

HOSPITALS TO GET MORE MONEY FOR SEEING A&E CASES (GUARDIAN 21 JANUARY)

Hospitals are to receive more money for treating patients admitted as emergencies. This is in response to emergency departments only receiving 30% of the cost of treating any patient admitted as an emergency over and above the number of patients treated in 2008-09. The remaining 70% was held back and supposed to be spent on initiatives to reduce avoidable trips to

PHARMACIES TO HOLD KEY TO SOLVING A&E CRISIS (GUARDIAN 21 JANUARY)

Pharmacy Voice, the trade body for pharmacists, reports that just one in 100 calls to NHS 111 is referred to their local pharmacy, yet studies show that 20% of a GPs time could be treated by a pharmacist. There are more than 11,000 community pharmacists in England and it is estimated that 96% of the population live within a 20-minute drive.

A&E DELAYS HARMING OTHER AREAS OF NHS (GUARDIAN AND DAILY MIRROR, 22 JANUARY)

 A Kings Fund report ‘s analysis of the decline in the ability of the NHS to meet key waiting time targets and its worsening financial state during the last three months of 2014 concludes that the delays are hitting also aspects of NHS services from GP referrals to major operations. The report also found that the NHS received just 0.8% more money in real terms year-on-year but was seeing bigger rises in the number of patients at A&E (up1.8%), having planned care (up2.8%) and being admitted as an emergency (up 1.8%).

PROPOSAL FOR SINGLE CONSULTANT FOR ALL CARE (GUARDIAN 23 JANUARY)

NHS SofS Jeremy Hunt has called for patients in hospital to be put under the charge of a single consultant accountable for all the care they receive. They would be responsible for a “proper handover to an accountable GP”. The SofS proposes also to limit the number of times a patient can be moved from one ward to another.

THREE GPs’ SURGERIES PLACED IN SPECIAL MEASURES (GUARDIAN 23 JANUARY)

The Care Quality Commission has for the first time put three GP surgeries into special measures because of major concerns about the quality of care. The surgeries now have six months to overhaul how they operate or face closure. Special measures means they will be put under strict supervision and offered a package of help to improve provided by NHS England and the Royal College of GPs.

NHS WILL NEED EXTRA £65 BN BY 20230 (GUARDIAN 23 JANAUARY)

The Health Foundation has said that the NHS will end up with a £30billion black hole unless Ministers plug the gap or allow the quality or availability of care to slip. It says that the NHS needs its budget to rise by 2.9% a year above inflation each year if it is to maintain the standard of services and avoid rationing of treatment and the pursuit of unrealistic productivity improvements.

FOREIGN NATIONALS IN BRITAIN’S HEALTHCARE (GUARDIAN 27 JANUARY)

The Health and Social Care Information centre show that 11% of all staff who work for the NHS and community health services in England are ‘non-British’. For professional staff it is an average of 14% and for doctors 26%.

63.4% of doctors are UK trained.

9.7% are trained in India.3.6 % and from Pakistan.

HOSPITALS VETO NHS BUDGET (GUARDIAN 30 JANAURY)

In an unprecedented move, hospitals that provide 75% of all NHS care have vetoed plans drawn up by Monitor, the NHS financial regulator, to reduce their income to help the service balance its accounts. NHS Providers, which represents 94% of hospitals, said its members could ‘no longer achieved the impossible’. Under the rules governing tariffs, Monitor can be forced to rethink its proposals if objections are raised by more than 51% of Trusts.

7-DAY GP OPENING CUTS USE OF A&E BY UP TO 25% (OBSERVER 01 FEBRUARY)

The first data from 20 pilot schemes which have been running for up to 10 months, suggest GP surgeries that are open longer hours and seven days a week have seen an average fall in A&E attendances by 10-15%.

PATIENTS CAN SAVE NHS £32BN BY 2020’ (SHROPSHIRE STAR 10 FEBRUARY)

A report by Reform claims the NHS can save £2billion by 2020 by getting people more involved in their own healthcare by using new technology and the private sector.

PATIENTS FEAR MAKING NHS COMPLAINTS (SHROPSHIRE STAR 11 FEBRUARY)

The Patients Association says the NHS complaints system is too bureaucratic and deters complaints. It is estimated that only 40% who wish to complain do so. And there are 70 different complaint systems.

SURGE IN CHILDRENS MENTAL HEALTH CASES AT A&E (DAILY MIRROR 14 FEBRUARY)

In a Parliamentary response it was revealed that the number of children attending A&E with mental health problems has increased by 85% in the past four years.

GREATER MANCHESTER TO CONTROL HEALTH AND SOCIAL CARE BUDGETS (GUARDIAN 26 FEBRUARY)

Greater Manchester is to become the first English region to be entrusted with spending its own £6bn health and social care budget. Currently, these services are run separately and there is no democratic control of NHS spending.

OVERSEAS GP RECRUITMENT QUESTIONED (GUARDIAN 26 FEBRUARY)

The Home Secretary’s Migrations Advisory Panel has reported that a shortage of general practitioners in Britain does need to be met by further overseas recruitment.

Local News

ONE OR MORE EMERGENCY HOSPITALS and UCCs – POLITICIANS AND CLINICIANS START TO SPEAK OUT

  • North Shropshire MP, Owen Paterson, calls for ‘super hospital to serve all Shropshire’(Shropshire Star 02 and 09 January).
  • Jane Dodds, LibDem candidate for Montgomeryshire, has called for keeping A&E at Shrewsbury and a UCC in Montgomeryshire Shropshire Star 10 January).
  • Glyn Davies, Montgomeryshire MP, has said that the birder should not become a barrier preventing patients receiving the best health care and cross-border cooperation is vital (12 January).
  • Civic leaders in Wem, Whitchurch and Ellesmere have called for a UCC (23 January).
  • Bridgnorth mayor has called for a UCC in the town (Shropshire Star 30 January).
  • Leader of Telford and Wrekin disappointed that the Princes Royal Hospital, Telford is still not guaranteed its future (Shropshire Star 31 January).
  • Clinicians say that the new Emergency department must be co-located with children’s and women departments ( Shropshire Star 07 February).

AMBULANCE SERVICE PERFORMANCE (SHROPSHIRE STAR 06 JANUARY)

Shropshire’s ambulance service is still failing to hit response time’s targets despite being considered one of the best in the UK (70.6% against target of 75% within eight minutes).

SHROPSHIRE HOSPITALS MISS A&E TARGETS (SHROPSHIRE STAR 07,12,17,31 JANUARY AND 7, 14 FEBRUARY)

Only 86% of A&E patients were seen within four hours at Shropshire’s two main hospitals between October and December 2014, which is nearly 10% below the Government target.

In the first week of January performance dropped to 76.1%. The following week performance improved to 80.5%. In the week ending 18 January performance was 79.9%.

During the first week of February performance was 83 % and 815 in the second week.

SHROPSHIRE HOSPITALS MUST IMPROVE (SHROPSHIRE STAR 20 JANUARY)

The Care Quality Commission has reported that Shropshire’s two hospitals need to improve on 4 of 5 key measures. This follows an inspection in October. The report commented adversely on the excess use of agency staff and the relationship between management and staff.

LUDLOW HOSPITAL LEASE DEAL (SHOPSHIRE STAR 07 FEBRUARY)

A new 10-year lease deal for the Ludlow Hospital site, rolling there afterwards but with a break clause has ben welcomed in the town.

WHITCHURCH DOCTORS CUT TIES WITH COMMUNITY HOSPTIAL (SHROPSHIRE STAR 16 FEBRUARY)

Local doctors have withdrawn form supply medical care at the Whitchurch Community Hospital.

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December 2014

The Bishop’s Castle Patients Group’s ‘NHS Tracker’ is based on newspaper clippings and news sites. Its focus is stories about changes to the NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments.

Key stories in December continue the themes of Autumn:

  • Staffing sickness and shortage of nurses;
  • A&E demand;
  • 999 call volume record;
  • ‘Bed blocking’;
  • Shropshire Hospitals budget deficits.

New items include:

  • Government guidance for NHS England 2015-16;
  • Mental health provision:
  • GP Practice report and flaws;
  • Changes to Ambulance response times; and
  • Operations cancelled.

 

National news

MENTAL HEALTH DEMAND UP, JOBS DOWN (Sunday Mirror 23/Daily Mirror 24 November)

A Royal College of Nursing report states says the demand for mental health treatment has increased by 30% in the past four years, with a 13% rise in the number of people detained under the Mental Health Act.   In the same period there has been a reduction in the number of dedicated mental health beds of 1,500 and a reduction of 3.300 mental health jobs.

The Government has responded with the promise of a task force to tackle the growing concerns on mental health care.

CARE QUALITY SYSTEM BANDING OF GP PRACTICES (Shropshire Star 24 November, 01 and 06 December: BBC 06 December)

Under the CQC’s new banding of doctor’s medical practices which prioritises those practices to be inspected eight out the Shropshire /Telford and Wrekin total of 66 have been placed in Band 1 and three in Band 2 for urgent inspection.

The BMA GP Committee attacked the new system saying that the Banding is based on limited, skewed and irrelevant information and that the simplistic targets take no account of the enormous pressures GP practices are under from falling funding, rising patient demand, a shortage of GPs and the fact that GP practice buildings haven’t had any investment in decades.

On 06 December the CQC withdrew the published information because of data errors and a failure to assess the full system. However, it defended its decision to introduce Bands because of the need for transparency and to help it to prioritise its inspections.

HOSPITAL BED BLOCKING CONCERN (Shropshire Star 29 November)

NHS England stated that in October 96,564 “bed days’’ were wasted on patients who should have been discharged. Reasons given include overdue patient assessments, long waits for social care arrangements and funding disputes.

NEW MODELS OF OUT OF HOURS GP CARE (Monitor 4 December)

Pressure on over-crowded A&E departments could be reduced if patients requiring out-of-hours urgent care were encouraged to see a GP based in or near the hospital first, according to Monitor (Government regulator).

The regulator believes the NHS may be able to reduce attendances at A&E and provide better services for patients if it was able to adapt aspects of the model of out-of-hours emergency care used successfully by the Dutch public health service.

NURSING CRISIS (Sunday People 7 December)

The Government’s Health and Social information Centre has published data, which shows that Britain’s total nursing staff decreased from 280,765 staff in June to 278,924 in August. The data also showed that the number of matrons has decreased from 6,399 in 2010 to 5,154 in 2014 and senior nurse from 66,832 to 63,458 in the same period.

NHS COMPLAINTS (Sunday People 7 December)

The Care Quality Commission has received 15,200 complaints from across the NHS England in the period April–November 2014. This compares with a total of 18,500 complaints in the full year 2013-14.

NHS USE OF MANAGEMENT CONSULTANTS DOUBLES (Daily Mirror 10 December)

The Department for Health has stated that NHS spending on management consultants has doubled fro £313 million in 2010 to £640 million per year.

A&E VISITS BOOM (Daily Mirror 13 December)

In the week ending 06 December A&E visits topped 436,000, nearly 30,000 more than the same week the year before. 35,373 patients waited more than four hours for treatment, 66% higher than the same period a year ago.

YOUNG BRITONS TURN BACK ON FAMILY DOCTORS (Observer 14 December)

A report by the Citizens Advice Bureau based on 900,000 responses from across England finds that people aged 18-34 are more than twice as likely to attend A&E or walk–in-centres as those aged 55 and over and they are far less likely than older people to be able to see a GP when they need one. The study also found that 30% of young adult respondents had found their experience of GPs to be “very good”, compared with 64% of those aged 75 and over. One in seven people (14%) aged 18-34 could not see a GP the last time they tried to make an appointment compared with one in 17(6%) aged 55 or over. One in eight (13%) of younger people did not get any professional help for a health problem after failing to see their GP.

GP BURNOUT (Observer 14 December)

The medical trade journal, Pulse, published on 1312, survey found that four in 10 GPs have taken or expect to take time-off because of burnout as a result of increasing workloads and intense scrutiny. The stains on GPs are being blamed in part for a 15% fall in the number of graduates applying for GP training roles this year, compered with 2013.

NHS CONTRACTS (Daily Mirror 15 December)

The BMA has calculated that a third of the 3,494 NHS contracts in England have been allocated to private sector firms.

THE KEOGH REVIEW (Shropshire Star and Daily Mirror 17 December)

Sir Bruce Keogh, the medical director of the NHS, has said that the accident and emergency services are “creaking, it is under pressure at the moment”. Sir Bruce, in The Keogh Review, published in November, advocated the concentrating of accident and emergency services into a few specialist hospitals and to overhaul the health system to create ”supercentre” specialist A&E departments.

PLANS FOR SLOWER AMBULANCE RESPONSE TIMES PUT ON HOLD (Guardian and Daily Mirror 22 December)

A leaked Department of Health document reveals that the Secretary of State approved that the ambulance response time for some ‘Red 2’ patients – those with serious but not life threatening conditions – could be extended from eight from to 19 minutes. The change was due to be implemented on 01 January. Following the leak, and opposition by the Association of Ambulance Chief Executives, the government has said the plans would be introduced on a less ambitious timetable.

PUBLIC HEALTH FUND QUESTIONED (Shropshire Star 15 December)

The National Audit Office has questioned the correct usage of the £2.7billion fund to improve public health. Also the NAO said some records on how the fund is allocated are inaccurate.

COMMUNITY HEALTHCARE (Guardian Health Newsletter18 December) Society’s dependence on acute-care hospitals, which are often not the best places for healthcare issues to be dealt with, must be reduced dramatically over the next few years. That was the general agreement at a recent Guardian roundtable, sponsored by Optum, that looked at the role community services will play in the future of the NHS. The direction for the NHS is towards devolved services, and there are a host of positive reasons for developing them in that way, experts from NHS England, healthcare providers and charities were told at the event.

The problem with hospitals is that they are geared up for acute care and tend to follow narrow pathways focusing in on a particular problem, the roundtable heard, when a more holistic approach to health is what is needed.

Properly thought-out community services – which covers all medical services delivered in the community, from GPs’ surgeries to district nurses and midwifery services to procedures in community hospitals – would take a more personalised, and a longer-term, prevention-orientated view of healthcare and could transform current provision, the roundtable was told.

GOVERNMENT MANDATE AND OUTCOMES FRAMEWORK FOR NHSENGLAND – April 2015 to March 2016 (Department for Health, December)

The NHS mandate for 2015 to 2016 carries forward all existing objectives

from the mandate for 2014 to 2015. There are two updates to existing

objectives where NHS England are expected to make further progress:

to join up health and social care services through the Better Care Fund and

to introduce access and waiting time standards in important areas of mental

health services by March 2016. It is structured around five main areas where

the government expects NHS England to make improvements including

preventing people from dying prematurely and enhancing quality of life for

people with long-term conditions.

The NHS outcomes framework sets out the outcomes and corresponding

Indicators that will be used to hold NHS England to account for improvements

in health outcomes.

Local News

SHROPSHIRE HOSPITAL STAFF SICKNESS (Shropshire Star 21 November and South Shropshire Journal 28 November)

The Shropshire Community Health Trust Board said that staff numbers in Community Hospitals are being maintained by use of agency workers to cover for staff sickness, mainly of a long-term nature. Ludlow Hospital is a “particular concern”.

SHROPSHIRE‘S MAIN HOSPITALS GIVEN EXTRA CASH (Shropshire Star 26 November)

The Trust Board has revealed that it forecasts to be £12.2 million overspent by the end of the 2014/15 financial year, £4million above target. The Telford and Wrekin Clinical Commissioning Group that is responsible for buying health services has agreed an additional £750,000 payment.

HOSPITAL COMPLAINTS DOWN (Shropshire Star 27 November)

SATH Trust Board report that for April-September formal complaints totalled 191 compared with 242 in the same period in2013/14.

NEW SCANNERS (Shropshire Star 27 and 29 November)

Two new scanners at a cost of £1.2m are to be bought for Shrewsbury and Telford Hospital according to the SATH Trust Board.

CROSS –BORDER TREATMENT ISSUES (Shropshire Star 29 November and 4 December)

The Welsh Affairs Committee, a Commons Select Committee made up of 12 cross-party Welsh MPs is collecting views and statistics evidence on cross-border health issues. It will make recommendations in 2015.

The Shropshire Clinical Commissioning Group in its evidence stated that patients living on the Powys/Shropshire border face longer waits if they go to a hospital in Wales.

MINISTER REFUSES TO INTERVENE ON FUTURE FIT (Shropshire Star 29 November)

Health Secretary, Jeremy Hunt, said in a letter to Telford and Wrekin Council “the reconfiguration of health services is a matter for the local NHS. Any changes to local services should be led by clinicians and patients and not from the top down. It is NHS commissioners and providers to work together, with local authorities, patients and the public, in bringing forward proposals that will improve the quality and sustainability of health care services.

999 SERVICES STRETCHED (Shropshire Star 13 December)

West Midlands Ambulance Service has said that on Saturday 06 December 3,500 ‘999’ calls were logged, the fourth busiest day ever. The three previous highest number of calls have been on 01 January in 2011(3,822)/13/14.

NEW WALK-IN CENTRE OPENS (Shropshire Star 15 December)

Shropshire’s NHS Walk-in Centre which allows people to see a GP or nurse without an appointment, opened adjacent to the Royal Shrewsbury Hospital on 15 December. There will usually be one GP, two nurses and a junior doctor who will staff the centre.

SATH A&E HANDLES 2,000 CASES IN ONE WEEK (Shropshire Star 16 December)

Shrewsbury and Telford Hospitals handled more than 2,000 patients in the week ending 12 December. Doctors said that a quarter of these could have gone to minor injury units or seen their GP.

SHROPSHIRE COUNCIL RESPONSE TO FUTURE FIT (Shropshire Star 18 and 19 December)

Shropshire Council debated the Future Fit proposals with a mix views on the need for a single Emergency Centre. The Council decided not to reach any conclusion at this time until all evidence is available but said that retaining A&E in Shrewsbury was “essential’’ because of its wide catchment area.

SHROPDOC UNDER PRESSSURE (Shropshire Star 22,24 and 29 December)

Out of hours health service provider, Shropdoc, says it is busier than ever because A&E departments are urging people to use their non-emergency phone lines before visiting A&E. In the week ending 18 December Shropdoc received more than 2,000 calls and saw about 800 patients either in their own homes or in clinics. Shropdoc aims to answer phone calls within 30 seconds, call routine patients back within an hour and urgent patients within 20 minutes.

On Saturday 27 December Shropdoc received 600 calls in 24 hours as many calls as it would normally receive over a full weekend. Many calls were for advice o a common cold or for a repeat prescription.

FOUR OUT OF FIVE NURSES FROM OVERSEAS (Shropshire Star 18 December and South Shropshire Journal 26 December)

Between September 2013 and September 2014 75% of all 140 acute hospitals in England filled a shortfall in registered nurses with 5,778 foreign staff.

OPERATIONS CANCELLED (Shropshire Star 20 December and South Shropshire Journal 26 December)

Operations and appointments have been cancelled at Shrewsbury Hospital because of the spiralling number of emergency patients. More than 30 operations were cancelled in two days.

SHROPSHIRE A&E UNITS MISS TARGETS (Shropshire Star 20 December and Daily Mirror 22 December)

Shropshire’s two A&E units are failing to meet national targets for seeing patients within four hours. The Government’s target is 96% but in the week ending 14 December the national average was 90% and in Shropshire it was 86%. At Wrexham it was 76%.

INCREASE IN AMBULANCE STAFF (South Shropshire Journal 26 December)

West Midlands Ambulance service has recruited an extra 326 front-line staff in 2014 and 30 extra control room staff to meet a sharp increase in call-outs.

WELSHPOOL AIR AMBULANCE SERVICE (Shropshire Star 29 December)

A visitor suite has been opened by the wales Air ambulance Service at Welshpool Airport.

NHS TRACKER October and November 2014

The Bishop’s Castle Patients Group’s ‘NHS Tracker’ is based on newspaper clippings and news sites. Its focus is stories about changes to the NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments.

Key stories in this period partly continue the theme of early autumn:

  • Five year plan published for NHS England and how to fund it;
  • Staffing shortage of nurses and GPs;
  • A&E swamped;
  • Concerns about 999 calls;
  • ‘Bed blocking’
  • Shropshire Hospitals budget deficits; and
  • MPs and Parliamentary candidates enter the Future Fit public debate.

National news

DOCTORS BID TO QUIT BRITAIN (Sunday Mirror 21 September)

General Medical Council figures show that 4,700 doctors applied for Certificates of Good Practice, which enables them to practice abroad, in the past year. Figures from the Nursing and Midwifery Council show the number of nurses coming from the rest of Europe to the UK has doubled in the past four years to 21,000.

MORE DOCTORS AND NURSES (Sunday Mirror 28 September)

Health Secretary says the NHS has hired 6,300 extra nurses and 6,500 doctors since 2010; every year compared to 2010 there are 850,000 more operations, 3.6 million more diagnostic tests and 450,000 more cancer referrals.

7-DAY GP PROMISE (Daily Mirror 30 September, Shropshire Star 01 October)

The Prime Minister has announced an expansion of ‘seven-days-a-week surgeries’. Two schemes are running twelve months after the initial pilot. The Prime Minster says £400million will be invested over the next five years to recruit an extra 5,000 GPs.

The Shropshire Star reported that patients and practitioners across Shropshire said the idea was unworkable because of current staffing shortages.

RISK OF SURGERY CLOSURES (Guardian and Daily Mirror 02 October, Observer 23 November)

The Royal College of GPs has said that up to 600 GP surgeries could close over the next year because family doctors are due to retire and a recruitment crisis means there is no one to replace them. The RCGP has identified 600 practices where more than 90% of the GPs are aged 60 or over, many who will retire over the next 12 months. Family doctors retire on average at age 59.

VOTERS PREPARED TO PAY MORE FOR NHS (Sunday Mirror 28 September)

A poll for the Sunday Mirror (no research details given) reveals:

  • 75% still trust the NHS;
  • 63% think the NHS has deteriorated over the past decade;
  • 82% said health workers were being pushed to the brink;
  • 80% felt nurse efforts were underrated;
  • Just over 50% felt doctors deserved more public praise; and
  • 79% would pay £5per month extra in national insurance for the NHS.

STUDENT NURSES PLAN TO WORK ABROAD (Daily Mirror 08 October)

A Royal College of Nursing Survey says 64% of nursing undergraduates are considering a nursing career abroad.

NHS NURSING SHORTFALL (Sunday Mirror 12 October)

The House of Commons Library research service has calculated that in 2010 there were 5,364 qualified nurses per 1,000,000 people. If this ratio were maintained then it suggests there is shortfall of 9,700 nurses.

VARAIBLE CARE (Guardian 17 October)

The NHS care watchdog, the Care Quality Council, says in its annual report for 2013/14 “while much care is excellent the variation in the quality and safety of care in England is too wide and is unacceptable.”

NHS FACING PERFECT STORM (Guardian 1 October)

The NHS economic regulator, Monitor, has said that giving the NHS “flat-real” budget increases is no longer sufficient because of growing demand.

CARE QUALITY COUNCIL REPORT (Daily Mirror 17 October)

The CQC has given hospitals, care homes and GP surgeries Ofsted –style ratings for the first time and found that 65 out of 82 hospitals it inspected inadequate or needing improvement on safety. Three hospitals were rated ‘good’ and only one ‘outstanding’.

NHS REFORM (Guardian 22 and 23 October)

The NHS Five Year Forward plan sets out the service’s own views on the radical action it, the government, local councils, employers, staff and the public need to take in order to ensure that it can survive growing pressures.

(A synopsis of the Plan appears at the end of Tracker)

JOINED UP HEATH AND SOCIAL CARE (Daily Mirror 30 October)

The Government has launched a £5billion scheme to join up health and social care services.

NHS FACES CHALLENGING WINTER (Shropshire Star 31 October)

The Kings Fund report that in the period June-September 2014 91% of NHS finance directors were either “very” or “fairly pessimistic” about the health of the hospital sector. This is highest recorded level since the quarterly survey began in 2011. 47% reported “low morale” as their greatest cause for concern.

500 DOCTORS SURGERIES COULD CLOSE IN NEXT SIX MONTHS (Daily Mirror 04 November)

Doctor’s magazine ‘Pulse’ survey reveals that family doctors are considering shutting 500 surgeries, or 1 in 20.

NHS CASH CRISIS IS UNSUSTAINABLE (Daily Mirror, Shropshire Star, Guardian 07 November)

The National Audit Office, the Government’s spending watchdog, in a report forecasts a NHS £500million loss in 2014/15 that it says is unsustainable and “we cannot be confident value for money will be achieved over the next five years”.

£1bn NHS SAVINGS PLAN UNREALISTIC (Guardian 11 November)

The National Audit Office says that the setting up of the Better Care Fund which aims to integrate local health and social services, will achieve at best one third of the projected savings. The shortfall is due to over ambitious targets and plans for saving money. The NAO is highly critical with how the new Fund has been project managed.

NHS FOCUS ON OUT-OF-HOURS SERVICES CRITICISED (Shropshire Star 12 November)

The Commons Public Accounts Committee has described NHS England’s oversight of out-of-hours GP services as “inadequate”, contributing to wide variations in quality and cost. It found that not enough was done to prevent conflicts of interest between the bodies commissioning out-of-hours services and the GPs providing the coverage.

GP APPOINTMENT PERFORMANCE (Shropshire Star and Guardian 17 November)

The Care Quality Commission reports that out of 336 GP practices inspected one in six surgeries had problems booking appointments.

Local News

A MONTGOMERYSHIRE – NEWTOWN VIEW OF FUTURE FIT (Shropshire Star 26 August)

Joy Jones, leader for Newtown Health Forum and Powys Councillor calls for ‘A&E’ to remain at Shrewsbury to main accessibility for Powys patients.

WELSHPOOL TOWN COUNCIL VIEW OF FUTURE FIT (Shropshire Star 01 September)

The Mid Wales Health Study, compiled by Welshpool Town Council and the North Montgomeryshire Local Council Forum say that A&E must remain at the RSH until there is proper provision for patients in Wales.

SHROPSHIRE HOSPITALS OVERSPENT (Shropshire Star 24 September)

In the five months April–August SATH reports that pay exceeded budgets by £2.75million contributing to a £6.1 million overspend. The extra pay was attributed to agency nurses to cover for vacancies and staff being on sick leave.

A&E SWAMPED BY GP-RELATED ISSUES (Shropshire Star 24 September)

Healthwatch Shropshire has published a research report that says the steady increase in attendance at the two A&E units has risen from 108,554 in 2010/11 to 116,236 in 2013/14. The report concludes that the evidence suggest gaps in knowledge of the range of services available and that many patients did not need to go to A&E.

BURNHAM’S FEARS OVER A&E DEBATE (Shropshire Star 26 September)

Shadow health secretary Andy Burnham told BBC Radio Shropshire that concentrating A&E services in Shropshire on one site could be ‘dangerous’. He spoke about potential long journeys for patients.

ALTERNATIVE TO FUTURE FIT PROPOSALS (Shropshire Star 01 October)

As an alternative to the Future Fit preferred proposal for a single Emergency Centre, David Sandbach, former CEO of Shrewsbury and Telford Hospitals as proposed Telford’s PRH being a centre of excellence for surgery and the RSH being used as a base for the county’s only fully blown accident and emergency centre.

SOUTH SHROPSHIRE MP ON FUTURE FIT (Shropshire Journal 03 October)

Philip Dunne MP says he “will be firmly arguing for Urgent Care Centres for both Ludlow and Bridgnorth. There may also be a case to be made for Bishop’s Castle if sufficient demand can be shown that it would attract enough patients from Mid Wales where there is limited cover.”

SHARED AMBULANCE SERVICE FEARS (Shropshire Star 03 October)

The Oswestry Health Group has raised concerns that the two Oswestry based ambulances are used frequently for the transfer of non-urgent patients to Chester and Wrexham hospitals.

MID WALES MUST HAVE NEW HOSPITAL (County Times 10 October)

Glyn Davies MP for Montgomeryshire says the Powys Local health Board must follow the Shropshire model, if adopted, and have an Urgent Care Centre in the county.

FUND BOOST FOR 999 MEDICS (Shropshire Star)

The West Midlands Ambulance Service has received an extra 162 calls everyday in 2014 compared with 2013.This is a 5% increase reflecting the long term trend. 100 calls are received every hour. £2million extra is being given to the service through the Sandwell and Dudley Clinical Commissioning Group, which commissions the service for all West Midlands CCGs, including Shropshire.

WELSH AIR AMBULANCE BOOST (Shropshire Star)

The Welsh Assembly has announced that the air ambulance service at Welshpool airport will now have a consultant level doctor on board in addition to a paramedic.

AMBULANCE STAFF ABUSE (Shropshire Star 20 October)

West Midlands Ambulance Service reports that in 2013/14 there were more than 200 recorded incidents of staff abuse and a spokesperson said that a large number of cases had been reported in Shropshire.

NO-SHOWS AT HOSPITALS (Shropshire Star 21 October)

Around 80 patients a day are failing to turn up for appointments at Shropshire’s two hospitals according to Freedom of information data obtained by the Star. The figure excludes cancelled appointments. Since 2010 the data is:

  • PRH: 960,833 attended, 73,625 missed appointments.
  • RSH: 1,464,674 attended, 71,601 missed appointments.

CROSS BORDER HEALTH CARE (Shropshire Star 22 October)

Figures from the NHS show that 31,000 Welsh patients are travelling annually to England for treatment. There is no local data for Powys –Shropshire travel.

URGENT CARE CENTRE FOR MONTGOMERYSHIRE (Shropshire Star 24 October)

Montgomeryshire Welsh Assembly member Russell George said he has been told Welsh Government ministers are looking into a proposal for an Urgent Care Centre in Montgomeryshire.

WEST MIDLANDS AMBULANCE SERVICE PERFORMANCE NEEDS EXTRA RESOURCE TO MEET TARGET (Shropshire Star 25 October)

Shropshire CCG has said that WMAS has failed to reach 75% of serious emergencies in the target time of eight minutes in the past two years and that it would take 510 extra staff and almost 40 ambulances to achieve national guidelines. For Shropshire, that would mean doubling present ambulance staff to 400. The CCG revealed that in 2012/13 the target time achieved was at 67.2% and in 2013/14 is 63.2% and current year performance is 60.9%. Also the red target for urgent calls was met 72% of the time in 2012/13 and 68% in 2013/14 with 65.2% for this year so far.

HOSPITALS IN RED (Shropshire Star 31 October)

SATH report that they are on course “for significantly worse than hoped for” £12million overspend. They had planned to be overspent by £6.2million to end September to meet a revised end of year target of an £8.8 million overspend. But after six months the trust is already £8.7 million overspent. This is attributed to rising demand in A&E and the cost of temporary nurses.

OVERSEAS TARGETED FOR NURSES (Shropshire Star 31 October)

SATH is hoping its overseas recruitment drive will help the to fill up to 30 vacant nursing posts. Interviews are taking place in Portugal, Spain and the Philippines.

BED –BLOCKING CRISIS (Shropshire Star 04 November)

People who do not need to be there are taking up one in four beds at Shropshire’s two hospitals. SATH has a target of no more than 30 beds being occupied by’ fit to release ‘patients but the figure rose to just over 100 in October.

PHARMACIES OFFER FREE FLU VACCINES (Shropshire Star 04 November)

As part of a pilot scheme in Shropshire and Staffordshire Pharmacies can now give the flu jab to those eligible to receive it free of charge. Also school children in years seven and eight are to receive a single nose spray to help prevent flu.

MORE AMBULANCE STAFF AND AMBULANCES NEEDED (Shropshire star 05 November)

WMAS Chief is reported to have slammed Shropshire Clinical Commissioning Group plans’

to “opt out” of national targets because of a lack of resource as unacceptable. He said that WAS has always been concerned about resource levels in Shropshire and he did not support the assertion that the CCG can simply opt out of NHS England and Care Quality Commission targets.

CONSULTANTS TO JOIN MEDICS IN AIR AMBULANCE (Shropshire Star 06 November)

The Welsh Government has said that it will employ up to eight emergency consultants to provide a new flying doctor service in Wales. The £3million scheme will see patients given doctor-led care within 30 minutes wherever they are in Wales. Welshpool is on of three bases for the charity.

CCG PLEDGE ON HOSPTIAL SERVICES (Shropshire Star 07 November)

The Chief Operating Officer of the Shropshire CCG has insisted Shropshire will not lose any of the health services its hospitals currently provide, irrespective of the re-organisation proposed by Future Fit. He said, “Some major trauma will go to Stoke, Birmingham or Wolverhampton as they do now but these are very small numbers”.

NON-EMERGENCY AMBULANCE DELAYS (Shropshire Star 10 November)

Medical Services Ltd took over the contract for providing non-emergency health transport on 01 November. In its first week of delivery it is reported that it has been beset with teething problems.

CCG DENIES OPT OUT FROM AMBULANCE EMERGENCY CALL TARGETS (Shropshire Star 11 November)

Shropshire CCG has denied the claim by the head of the West Midlands Ambulance Service that it is to “opt out” of national targets. The CCG said “National targets are rarely met in rural counties across England. The challenges of rurality make meeting these targets far more challenging than in urban areas”.

PATIENTS SATISFIED WITH 111 NHS HELPLINE (Shropshire Star 13 November)

111 was first introduced in April 2013, replacing the former NHS Direct. The non-emergency helpline was broken up into 46 different contracts across England. In Shropshire the West Midlands Ambulance Service took the contract over from November 2013. A WMAS patient survey shows 91.3 % were satisfied with the service received, 77.1% were very satisfied.

MONTGOMERYSHIRE MP ENTERS DEBATE ON HEALTH SERVICES (Shropshire Star 17 November)

Glyn Davies MP Montgomeryshire says a green field emergency centre east of Shrewsbury and a network of new Urgent care centres, including one in Mid Wales, is the best future model for health care in the region.

NEW QUALITY REGIME FOR SURGERIES (Shropshire Star 19 November)

The Care Quality Commission has introduced a new inspection regime for GP surgeries. It has divided the surgeries into six categories using information such as the results from patients’ surveys 1=highest perceived concern to 6=lowest perceived concern). The categories are used to determine the priority for GP Inspections.

TACKLING RURAL GP SHORTAGE (Shropshire Star 20 November)

Powys Teaching Local Health Board has drawn up plans to tackle the problem of a shortage of GPs, including raising the profile of the county as somewhere to live.

Footnote (Guardian extract)

NHS Five Year Forward View –this new document will set the framework for NHS changes over the next few years and much of the context for the work of BCPG. Key items of interest for BCPG are highlighted in bold.

Introduction

  1. The NHS Five Year Forward View (known as the Stephens review) sets out the service’s own views on the radical action it, the government, local councils, employers and the public need to take in order to ensure that it can survive the growing pressures.
  2. It is a blueprint for whoever ends up in government after next May’s general election, setting out what ought to be done between 2015 and 2020 to improve the NHS by transforming how it works and interacts with patients.

3.The document’s 39 pages are a response to the widespread concern that, with demand for healthcare rising just when the NHS is experiencing an unprecedented financial squeeze, the health service is in danger of soon becoming “unsustainable”.

Reforming the whole

  1. The Forward View says that the NHS has been getting better in the last 15 years, despite its tight budgets, as illustrated by much-improved outcomes for people who get cancer or heart problems. However, it warns, “quality of care can be variable, preventable illness is widespread, health inequalities deep-rooted. Our patients’ needs are changing, new treatment options are emerging and we face particular challenges in areas such as mental health, cancer and support for frail older persons. Service pressures are building.”

The NHS needs to change significantly in order to have “a better future” it concludes. While the service itself can make some of those changes, “some critical decisions – for example on investment, on various public health measures, and on local service changes – will need explicit support from the next government”.

Public health

  1. Health problems associated with obesity, smoking and drinking are growing, and the NHS is facing a rising financial burden from dealing with them. “The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.” As a result, “the NHS will now back hard-hitting national action on obesity, smoking, alcohol and other major health risks”. Mayors and local councils, who regained responsibility for public health last year, should get greater powers to tackle such problems.
  2. England’s 1.4 million full-time unpaid carers will get new support, and those who volunteer in the NHS could receive a £200 council-tax discount the document proposes.

Hospital reforms

  1. Unhelpful divisions in the NHS – between the different places care is delivered, such as hospitals and GP surgeries, for example, need to be dissolved, to improve care. “The NHS will take decisive steps to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care.
  2. The Forward View envisages much less healthcare being provided in hospitals and much more in community settings. “The future will see far more care delivered locally but with some services in specialist centres, organised to support people with multiple health conditions, not just single diseases.”
  3. NHS England will expect, embrace and fund “new models of care” to look after specific groups of patients, such as diabetics or the frail elderly. One option could see the creation of a so called “multispecialty community provider” in which GPs could come together with nurses, hospital specialists and potentially also mental health and social care services to provide integrated care outside of hospitals.
  4. Urgent and emergency care services, which look after patients when GP surgeries are shut, will be redesigned so that the array of different services are integrated. That will see A&E units, out-of-hours GP services, urgent-care centres, walk-in centres, the NHS 111 telephone advice line and ambulance service work together better.
  5. Smaller hospitals, which some fear have a very uncertain future, are promised “new options to help them remain viable, including partnerships with other hospitals further afield”. Some acute hospitals could share their “back-office” functions with another, which may not be nearby.

New deal for GPs

  1. For GPs there needs to be a “new deal” because many are struggling to cope with growing demands from patients, many of whom are more medically challenging than before. The service will tackle the recent shift in NHS funding away from family doctor services; “the NHS will invest more in primary care”. New incentive schemes will try and boost the number of GPs, especially those prepared to work in deprived areas.

Financing the future

  1. Under the proposals the NHS will try to close the £30bn gap between its available resources and demand for care that is predicted to open up by 2020/21 by making annual productivity and efficiency gains of 2%-3%. It has averaged 0.8% historically. Further restraint of NHS staff’s pay, through wage freezes and 1% rises, is deemed unsustainable in the long-term.
  2. If those productivity gains materialise, and new ways of looking after patients bear fruit, and demand can be reduced, the government would need to give the NHS an annual budget increase to cover inflation, plus some money to bankroll its metamorphosis into a new-look service, and also another £1.5bn a year of extra funding in order to ensure the £30bn gap is closed.

 _____________________________________________________________

August –September 2014 Tracker

NHS Tracker is based on newspaper clippings and news sites. Its focus is stories about changes to the NHS structures, systems and performance, developments in Shropshire and local news. It does not cover news about particular types of treatments.

Key stories in this period:

  • Waiting times at GPs and A&E;
  • Hospitals running budget deficits; and
  • Future Fit public debate.

 National news

CHILDREN’S MENTAL HEALTH SERVICES (Daily Mirror 21 August)

Norman Lamb, Care Minister, has established a task group to improve children’s mental health. He said, “I don’t think that children’s mental health services, the way they’re organised, the way they are commissioned, are fit for purpose.”

PHYSICIAN ASSOCIATES (Daily Mirror 23 August)

The Health Secretary has introduced ‘physician associates’, graduates with two years training, five years shorter than the usual seven years. They will perform many junior doctor roles to “give busy doctors more time to care for patients”. The British Medical Association has attacked the proposal as “doctors on the cheap” and it highlighted the increased risk of errors.

OVERSEAS NURSES (Daily Mirror 27 August)

NHS data shows that the total number of foreign nurses coming to Britain has more than doubled since 201, reaching 6,228 in 2013. Foreign nurses must apply to the Nursing and Midwifery Council to become a registered nurse before they can work legally in the UK. At the moment, every nurse from outside the EU must complete the Overseas Nurses Programme this involves a supervised work placement in a specialist nursing field for a period of 3 to 12 months. They must complete 20 days of study at an approved education institution in the UK. The NMC has introduced new rules from October that require nurses from outside the EU to only take an on-line multiple choice test and exam.

ELDERLY BED BLOCKERS (Daily Mirror 3 September)

Age UK charity has published a report ‘Housing in later Life’ states that delayed discharges from hospital are occurring because of delays in the adaption of homes. It assesses this has resulted in 40.000 wasted days in hospital in 2013 at a cost to the NHS of £11m.

A&E BLOCKING (Daily Mirror 10 September)

The College of emergency medicine has said that 500,000 patients a year are put at risk because of the shortage of hospital beds. The delay can harm their chances of survival and means others queuing to be seen in A&E wait longer.

OBESITY Guardian 11 September)

The chief executive of NHS England has warned that obesity is a major problem for health services with one in five secondary school children and a quarter of adults – up from 15%, 20 years ago – now classified as obese leading to the risk of Type 2 diabetes. His proposals to tackle this problem will be published in October.

A&E TARGETS MISSED (Shropshire Star 13 September)

NHS England shows that the national target of seeing and treating, transferring or admitting 95 per cent of patients in four hours was missed for the first two weeks of September, It dipped to 93.8 %.

7-DAY GP SERVICE PILOT (Daily Mirror 13 September)

The GP’s magazine ‘Pulse’ reports on the £50M scheme for seven-days a week (8 until 8) GP surgeries to be piloted in 20 projects to benefit 7.5 million patients in more than 1000 surgeries. One year after the pilot’s introduction Pulse found only two schemes operational.

EU-US TRADE DEAL AND THE NHS (Daily Mirror 14 September)

The EU and USA are currently negotiating the Transatlantic Trade and Investment Partnership agreement. UK Ministers believe the removal of trade barriers would boost the UK economy and that NHS services should be included fin the trade deal. Others are arguing against the inclusion of the NHS.

NHS DEFICIT (Guardian 16 September)

NHS performance data for April–June shows a sudden and sharp deterioration in its financial health compared with the previous quarter. It is attributed to rising demand and the extra labour costs. It affects both Foundation Trusts and NHS acute hospital trusts.

HEALTH WORKERS TO STRIKE (Guardian 24 September)

The NHS is to be hit by strike action over pay for the first time in 32 years on Monday 13 October between 7-11am. Up to 9 unions representing 500,000 staff are set to take part in coordinated action. The NHS Pay Review Body recommended last year that all the NHS’s 1.3 million workforce should receive a 1% pay rise for 2014-15. The Health Secretary declined this recommendation.

NEW CAR PARKING AT HOSPITAL GUIDELINES (Shropshire Star 25 August)

The Health Secretary has drawn up new guidelines to introduce pay on exit and to allow refunds for those patients and visitors who are detained in the hospital.

GP WAITING TIMES (Guardian 26 September)

The Royal College of GPs has said that waiting times at GPs is a national disgrace. NHS data shows that 58.9 M patients in England waited one week or more to see their GP in 2014, up from 40M during 2012. It notes that GP share of NHS spending in England fell from 10.95% in 2005-06 to 8.39%in 2012-13 despite GP surgeries’ treating 40M more patients during this period. The average number of consultations undertaken by each GP has also risen over this period, from 9,264 to 10,714.

Local News

LUDLOW MINOR INJURIES UNIT (Shropshire Star 19 August, South Shropshire Journal 12 September)

NHS ‘s Future Fit proposals include the closure of Minor Injury Units (Ludlow, Oswestry, Bridgnorth and Whitchurch) to be replaced by Urgent Care Centres. In Ludlow concern has been expressed that there is no guarantee that Ludlow will get a UCC.

NEW NON-999 FLEET (Shropshire Star 29 August)

The Shropshire and Telford and Wrekin CCGs have awarded the contract for non-999 ambulance services to Medical Services Ltd.

In Wales, the Welsh Government has authorised the purchase of 41 new ambulances.

NEW WOMEN AND CHILDRENS UNIT (Shropshire Star 6 September)

A new main facility providing care for women and children opens at the princes Royal Hospital, Telford at end of September. Shrewsbury Hospital retains many day services

FUTURE FIT: CALL FOR CROSS-PARTY TALKS (Shropshire Star 10 September)

MP for Shrewsbury and Atcham wants MPs from across the region to sit down and take the best advice from clinicians, assess all options and then reach some form of consensus on Future Fit proposals. This follows some MPs arguing in favour of their particular locality.

HUNT URGED TO ACT OVER THREAT TO A&E IN TELFORD (Shropshire Star 12 September)

Wrekin Council has called upon the Health Secretary to intervene over the Future Fit proposals to have only one A&E facility in the region to end uncertainty.

NHS DEBATE RAGES (Shropshire Star 19 September)

D Bill Gowan, who led the Future Fit clinical service review, which has proposed a single A&E facility for Shropshire and Telford, and Montgomeryshire, has called upon the debate to be not so much about buildings but on patients and their care.

MID WALES HEALTH STUDY (Shropshire Star)

The Mid wales health study, complied by Welshpool Town Council and the North Montgomeryshire Local Council Forum, says that A&E services should be retained at Shrewsbury hospital.

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NHS TRACKER JULY AND AUGUST 2014

NHS Tracker is based on newspaper clippings and news sites. Its focus is stories about changes to the NHS structures, systems and performance. It does not cover news about particular types of treatments. New this month is a specific section of Shropshire and local news.

Key stories in July and August:

  • Pressure of demand on A&E described as the’ Anything & Everything’ service;
  • Private contractors and private income at hospitals;
  • Future funding prospects for the NHS; and
  • High GP patient satisfaction survey results.

National news

STRAINED A&E    (Shropshire Star 30 June).

Research published in the British Journal of General Practice by Imperial College London concludes that for every 100 patients trying to get a GP appointment 1.7 resorts to attending A&E. For 2012/13 this figure equates to 5.77 million A&E visits or 26.5% of unplanned attendances during this period.

END OF LIFE SERVICES (Shropshire Star 4 July).

Macmillan Cancer Support says 36,400 patients who died in hospital in 2012 would have preferred to be in their own homes thus releasing expensive hospital beds, which are in short supply.

ELDERLY FORCED TO USE A&E (Daily Mirror July).

Health and Social Care information Centre report that over half of all hospital beds are used by over-65s and 1 in 5 people aged over 85 had to use A&E, inpatient or outpatient services in 2013.

60 DOCTOR SURGERIES FACING AXE (Daily Mirror 6 July).

A survey by Medical Journal, Pulse, estimates that 60 GP surgeries are about to close in England because of cash and staff problems.

PATIENTS HANDED MONEY FROM NHS TO FUND TREATMENTS (Guardian 9 July).

CEO of NHS England has announced that from April 2015 the most vulnerable patients 9about 5 million patients) will be allocated a pot of money from the NHS budget and Local Government care budgets to purchase health and social care services in the community. They will still receive free GP and hospital care. Patients will not receive cash but will control a budget allocated to them, from as little as £200 per year to over £1000. The budgets will only made available where local councils and NHS clinical commissioning groups agree to work together and fund them.

Age UK charity and the Local Government Association welcomed the proposals in principle.

NHS BOSSES PREDICT PATIENTS WILL PAY BY 2024 (Guardian and Shropshire Star 10 July)

In a survey of 78 senior NHS leaders by Nuffield Trust health think-tank:

  • 47% said it was quite (33%) or very (14%) unlikely that comprehensive healthcare would still be provided free at the point of use in England in a decade’s time;
  • 48% thought the NHS would be operating along similar lines as today;
  • 63% said that taxes should rise to fund the NHS, although 29% disagreed;
  • 55% opposed introducing charges for services such as visiting a GP but 35% backed the idea; and
  • 76% believe the service could be become more efficient and caring.

The report, Into the red, identifies a £1bn turn around in the finances of the hospital sector between 2012-13 and 2013-14 which saw the number of hospital trusts in deficit rise from 45 to 66 and a £383m surplus become a £100m deficit in2013-14even after the government pumped in an extra £100m.

ARBITRARY RUES FOR ACCESS TO OPERATIONS (Guardian 15 July).

A Royal College of Surgeons report, ‘Is Access to Surgery a Post Code Lottery’, says that 73% of CCGs do not follow rules set down by the National Institute for Health and Care Excellence on referral for hip replacement and 44% of CCGs require patients to be in varying degrees of pain before surgery. Only 27% had policies, which complied with NICE or surgical guidance.

SPECIAL MEASURES FOR FAILING GPS AND CARE HOMES (Guardian 15 July).

The Secretary of State for Health has announced that the Care Quality Commission will be adopting tougher measures for care homes and GPs. It will start with care Homes which could see those considered unsafe or inadequate being closed or handed to another operator. How the system will work for GPs has yet to be worked out.

The Care Quality Commission is to give Ofsted style ratings to GPs from October.

GP SERVICES OUT OF HOURS SERVICESSHOULD BE LOCATED AT HOSPITALS (Shropshire star 16 July).

New recommendations by the College of Emergency medicine, Royal college of Paediatrics and child Health, the Royal College of Surgeons state that every emergency department should have a co-located GP primary care out-of-hours facility and other health and social workers. This proposal is aimed to relieve the strain on A&E and to provide a better-integrated service for vulnerable patients.

MORE HOSPITALS WITH SERIOUS CASH CONCERNS (Daily Mirror 24 July).

19 hospitals were referred to the Secretary of State because of financial problems in 2013/14, up from 5 in 2012/13. (See Local News section)

PATIENTS ‘NEED OWN GP’ (Daily Mirror 25 July).

Researchers at Bristol, Manchester and Oxford Universities have established that patients who always see the same GP are less likely to end up in A&E.

MENTAL HEALTH PATIENTS FACE POST CODE LOTTERY (Guardian25 July).

Freedom of Information requests to England’s 211 GP–led Clinical Commissioning Groups shows that 72 of the142 (67%) spend lees than 10% of their budget on mental health services. Spending ranged from 6.55% to 18.02% whereas conditions such as anxiety and depression make up 23% of the services overall burden of illness.

NHS EQUIPMENT FAILURES (Daily Mirror 25 July).

In total, 1,409 patients have died because of faulty equipment since 2009accprding to data by the Medicine and healthcare products regulatory Agency.

NHS TRUSTS SHOULD THINK ABOUT BECOMING MUTUALS (Guardian 29 July).

Francis Maude, Cabinet Office Minister, has floated the idea of NHS Hospitals being taken out of public ownership and converted to mutual status. He quotes expert estimates that one million of the six million NHS employees could end up working in mutuals. He has written to al NHS Trusts encouraging them to consider mutualisation.

PRIVATISATION OF CARE HOME SECTOR (Observer 10 August).

A report by Laing and Bulsson on the ‘Role of private equity in UK Health And Care Services and the Public interest’ states that:

  • 200,000 people are being cared for in homes run by a dozen private equity companies;
  • Annual turn over rate for care workers is 19%;
  • Average pay in adult residential care homes in England is £6.45 an hour and £7 an hour for a care worker providing domiciliary care service;
  • Independent sector providers are substantially more competitive than public sector providers because of pay rates and terms and conditions of employment; and
  • There is no legal requirement for care workers to have qualifications. Less than a half have completed an NVQ Level 2 qualification (GCSE equivalent).

RED TAPE FUELLING GP CRISIS (Daily Mirror 14 August).

The Royal College of GPs has said that as many as 5,000 family doctors, including those who have taken career breaks and extended maternity leave, are being prevented from working again in UK surgeries. This is because the NHS requires that they re-sit exams, attend interviews and work for no or little money during supervision periods.

PRIVATE PATIENT INCOME AT NHS TRUSTS (Guardian 19 August)

The Health and Social Care Act 2012 removed the 2% cap on income earned by NHS Hospital Trusts from the private treatment of patients which can now generate up to 49% of their income from private patients New information released under the Freedom of Information Act shows some trusts increasing their private income by up to 40% since the cap was lifted.

Local news

HUGE INCREASE IN A&E ADMISSIONS (Shropshire Star 27 June).

In April and May A&E staff at Shrewsbury and Telford’s Princess Royal hospitals dealt with an average of 281 patients per day, significantly more than normal resulting in a £1million overspend for the period (largely on recruitment of temporary staff).

Total overspend in April and May was £4million, £864,000 over budget. The Hospital Trusts are trying to keep 2014-14 losses to no more than £8.2 million, to be covered by loans.

999 CREWS FAIL TO MEET TARGETS (Shropshire Star 30 June).

In May paramedics in Shropshire met 64 per cent of the highest priority emergency calls within the 8-minute deadline. This was an improvement on April when performance was 61%. In May the overall demand for the service ambulance was 7.6% higher than in the previous year.

MEDICS SUPPORT HOSPITAL SHAKE-UP (Shropshire Star 2 July).

The lead doctors from the Shropshire and Telford and Wrekin Clinical Commissioning Group have defended their proposals to suggesting only one specialised emergency centre for the region including Powys and the development of more community-based provision. Campaign group ‘Shropshire Defend Our NHS’ is objecting to the proposals.

PATIENTS GIVE CLEAN BILL OF HEALTH TO GPS (Shropshire Star 5 July).

On behalf of NHS England, IPSOS Mori carry out an independent survey of patient views on GP services. In Staffordshire and Shropshire they distributed 75,000 forms and received 28,344 responses (38%):

  • 88% said their overall experience of GP services was good;
  • 93% said they were given an appointment at a time that was convenient for them;
  • 915 booked their appointment by phone; and
  • I in 20 booked appointments on-line.

MID WALES MINOR INJURY TARGET IMPROVEMENTS (Shropshire Star 22 July).

In June, of the 1,726 people who attended minor injury units in Powys 99.8% were seen within the four-hour target.

FUTURE OF SHROPSHIRE WALK IN CENTRE (Shropshire Star 15,18 and 24 July).

Public meetings are being held to discuss the proposal by the Shropshire CCG to close the ‘walk-in‘ centre in Monkmoor, Shrewsbury and relocate it to the Royal Shrewsbury Hospital. The proposal has been put forward to try to reduce the number of people attending A&E. 34,000 people used the centre in 2013.

SHREWSBURY AND TELFORD NHS TRUSTS UNDER FINANCIAL SCRUTINY (Shropshire Star 24 and 25 July).

Shrewsbury and Telford Hospitals NHS Trust is one of 19 Trusts in England identified has giving cause for financial concern by the Audit Commission. The Trust achieved a small surplus in 2013/14 but it has not achieved its statutory duty of breaking even over a five-year period.

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NHS Tracker May and June 2014

Key issues in past two months:

  • International assessment ranks NHS as best in the world;
  • Various reports that the NHS is ‘fraying at the edges’;
  • Delayed introduction to the Better Care Fund which is aimed at bringing together health and social care services with a view to relieving pressure on the NHS;
  • Pressure on A&E units and general practitioners: and
  • Continuing coverage of the depth of the NHS funding ‘black hole’ and how to fill it including charging for services accompanied by increasing rhetoric.

EXPERT PANEL RATES NHS WORLD’S BEST HEALTHCARE SYSTEM (Guardian 18 June).
A report by the Commonwealth Fund, a Washington based foundation, examined the performance of 11 different health care systems around the world using a variety of performance data. The UK was ranked first overall, scoring highest on quality, access and efficiency although it spends the second-lowest amount on healthcare among the 11- £2,008 per head, less than the US at £5,017. On keeping people alive, the UK was ranked 10th.

 £3.8BN SCHEME TO EASE STRAIN ON NHS HALTED (Guardian, 7 May).
The Better Care Fund was supposed to be introduced in April 2015. It has been delayed following a Cabinet Office review which expressed disquiet about its viability and how the expected savings were to be realised. The Fund is to be partly funded by a Department of Health contribution of £1.9bn taken from the £40bn hospital budget. It is reported that many NHS chief executives fear the money will be used by local government to prop up adult social care services which have been subject to deep cuts.

NHS FUNDING REVIEW (Guardian, 4 June).
Simon Stevens, NHS England chief executive has announced a major internal review of NHS funding. The report will be produced before the next autumn budget statement by the Chancellor.

ADDRESSING THE HUGE CHALLENGES FACING THE NHS (Guardian Letters, 4 June).
This open letter, by NHS leaders including the chief executive of the NHS Confederation, argues that the NHS is at ‘at the most challenged time in its history. Rising demand means that the cost of providing the health service rises every year by about 4% above inflation. At the same time the services we commission and run are not designed to cope with the care needs of the 21st century’. The letter went on to call for all ‘party leaders to recognise the challenges facing health and their manifestos are written to support how we will address them’.

 SUMMER CRISIS IN CASUALTY UNITS (Guardian, 11 June).
NHS data shows for the last week of May a record number of patients attending hospital A&E departments and a record number then admitted to hospital wards. A total of 296,667 patients visited A&E in the last week of May. For the four week period during May those waiting more than four hours ranged from 22,231 a week to 24,503. This compares with November 2013 range of 13,938 a week to 17,372.
The Government subsequently announced a £650million cash injection for A&E. £440m came from money diverted from other NHS projects.

GP NUMBERS FALLING AND RECRUITMENT CRISIS BITES (The Observer 15 June)
House of Commons library data shows that the number of GPs in 2013 has dropped by 356 compared with its level of 35,917 in 2009/10 (27,811 in 1997). The proportion of family doctors serving every 100,000 people has also dropped from 70 in 2009/10 to 66.5 now.
Health Education England data that in August 2013 2,564 GP training places were taken up compared with 2,764 a year ago. In the East Midlands the take up was 62% of the available places

WE NEED COTTAGE HOSPITALS (Daily Mirror, 31 May)
The chief executive of NHS England has said “mass centralisation” means many patients are being robbed of “dignity and care”. He said other Western European nations were able to provide excellent treatment without cutting back on local care. He sees local hospitals taking over some GP services and closer ties between specialist and community care.

ACCESS TO GPs IS HIT BY ‘POSTCODE LOTTERY’ (Shropshire Star, June).
A Royal College of General Practitioners study shows a post code lottery for patients trying to book an appointment with their GP. In Telford and Wrekin, 12 per cent of patients said they were unable to get a GP appointment compared with 6.9 per cent in the rest of Shropshire. Both areas are shown to perform quite well in the number of GPs per head of population, with 48.3 doctors per 100,000 patients in Shropshire and 41.1 GPs in Telford and Wrekin.

NHS IS FRAYING AT THE EDGES, WARNS DOCTORS’ LEADER (Guardian, 30 June).
A research study for the National Institute for Health Research shows that of 5.77million attendances at A&E units in England in 2012-13 – 26.5% of the total occurred after patients had tried to get a timely consultation with a GP.
GP organisations did not dispute the finding that delays to appointments add to the A&E caseload and said ‘this research is further evidence of the crisis in general practice’ and noted that the general practice share of NHS funding has fallen from 11% to 8.4% in recent years. The leader of Britain’s doctors said the ‘NHS is fraying at the edges’ and forecast that some practices could close as some doctors have to see 60 patients per day.

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