The NHS crisis: A spotter’s guide

Pastygate, Leveson and the local election results have kept the NHS out of the headlines. For now.

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With the Health and Social Care Bill limping over the finishing line to enter the statute book, “Pastygate”, Leveson and local election results have kept the NHS out of the headlines. For now.

patient-in-hospitalYet, look closer and in places, the strain is showing. Not everywhere, not to the same extent. But the impact of public sector austerity, and the financial squeeze on both NHS and local authority budgets, is already feeling its way through to services.

Inflation undermined the Tory claim of a real terms increase in NHS budgets, with £500 million of NHS funding recently clawed back by the Treasury.

Locally though, financial squeeze is concentrated in two areas. The first is staff wages, with most staff looking at 2-3 years wage freeze, probably longer. The second is hospital Trusts, through cuts to patient treatment payments.

Another pressure is the selective but growing influence of the private sector in running hitherto NHS services, in which price is a key factor in awarding the tender. Two major community services tenders, in Norfolk and Surrey have been won by Serco and Virgin respectively.

 


See also:

The two graphs that show why the Tories are not trusted on the NHS 12 Jun 2012

Cameron’s vetoing of NHS Risk Register release “a desperate act which will backfire badly” 8 May 2012

Regional pay is “Tory code” for slashing pay of the poorest NHS workers 24 Apr 2012


 

In Surrey, Virgin beat off the Tories’ poster-boy for NHS social enterprise, Surrey Community Health, whose chief executive previously graced the Tory conference platform with Andrew Lansley.

The financial terms of these tenders are usually kept secret – but one recently uncovered (discovered by a journalist in the Commons’ library) is the franchise deal for a private health company, Circle, to run Hinchinbrook Hospital in Cambridgeshire. Circle’s reward will be £30 million of public money if it eliminates the hospital’s debt of £40 million.

For many hospitals however, making ends meet is a struggle: the government has been busy doling out subsidies for a growing list of hospitals – over 31 shared over £400 million in 2011/12.

So what might be the main “crisis” signs in your local NHS services? Here are five things to look out for:

Long trolley waits in A&E. Long trolley waits for A&E treatment were a familiar story in the Major years. Labour set a target of 98% of patients to be seen and moved on from A&Es within 4 hours. This standard has a strong safety angle: in essence, overcrowded accident departments mean things are missed. Andrew Lansley reduced this to 95% but there is growing evidence that Trusts are struggling to meet this, and, as nursing unions highlighted recently, excessive trolley waits are on the rise to reach an 8 year high.

Waiting times increasing. Waiting times went up by an average of 6 per cent from 2010 to 2011, with patients requiring a new knee having to wait 99.2 days, the Patients Association report found.

Savings programmes dominate. Savings programmes are driving the hospital’s priorities to unprecedented degree. This will get worse next year, with Foundation Trust regulator Monitor setting an eye-watering 5% “downside“ cuts requirements for hospitals over the next three years, acknowledging these “will have to be delivered on an even more ambitious scale going forward”.

Nurse staffing levels being cut. A consequence of tough savings programmes is that nurse staffing, as the biggest single expense, is being gradually targeted in many places, with less frontline staff and senior grades stripped out. Though no central figures are kept, the Royal College of Nursing estimates that 26,000 posts were lost from frontline services over the last two years.

NHS impact of local authority cuts. The NHS relies on local authority social services to help discharge its elderly patients in particular. Under Labour these discharge delays fell rapidly, but they are creeping back. A joint survey carried between Nursing Times and charity Age UK found 85% of respondents believed more patients had experienced delayed discharge from hospital compared to the previous year. The majority, 82%, said cuts to council social services had contributed. With local authority cuts of around 28% over the next few years, NHS and local authority staff know this will only get worse.

The NHS has just wasted two years dealing with an ever changing top down reorganisation that many experienced NHS staff are grappling to understand fully – at a cost of between £2-3 billion. But these early warning signs are alarming, given we almost certainly face another 4-5 years of austerity, courtesy of their Spending Reviews.

Meanwhile, the fightback continues: The Reclaiming Our NHS conference on June 23rd will look at how to continue the campaign to protect the NHS and its principles; for tickets, click here.

 


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47 Responses to “The NHS crisis: A spotter’s guide”

  1. F. Bouchiba

    RT @leftfootfwd: The NHS crisis, the strain is blatently showing: A spotter’s guide //t.co/TNZiGXxX

  2. Grahame Morris

    The NHS crisis: A spotter’s guide: //t.co/SLAaHjGH by Trevor Cheeseman via @leftfootfwd #SaveOurNHS

  3. NewsatLeft

    The NHS crisis: A spotter’s guide //t.co/OgTBTZjX #PublicServicesforAll #NHS

  4. NewsatLeft

    The NHS crisis: A spotter’s guide //t.co/6kIZwGeu #PublicServicesforAll #NHS

  5. Val Hudson

    RT @leftfootfwd: The NHS crisis: A spotter’s guide //t.co/azFAgIL0

  6. Hurstingstone

    RT @leftfootfwd: The NHS crisis: A spotter’s guide //t.co/azFAgIL0

  7. BevR

    RT @leftfootfwd: The NHS crisis: A spotter’s guide //t.co/Dws7On3P

  8. Political Planet

    The NHS crisis: A spotter’s guide: Pastygate, Leveson and the local election results have kept the NHS out of th… //t.co/1VrgR9QM

  9. Pulp Ark

    The NHS crisis: A spotter’s guide //t.co/MPShTLtJ #PublicServicesforAll #NHS #muslim #tcot #sioa

  10. leftlinks

    Left Foot Forward – The NHS crisis: A spotter’s guide //t.co/UJQ3zoel

  11. Live News Updates

    The NHS crisis: A spotter's guide – Left Foot Forward //t.co/noN2PXfb #nhs

  12. Harry Hook

    The NHS crisis: A spotter’s guide: //t.co/eDxt0AjO by Trevor Cheeseman

  13. Authority Watcher

    The NHS crisis: A spotter’s guide: //t.co/SLAaHjGH by Trevor Cheeseman via @leftfootfwd #SaveOurNHS

  14. Hugh Mouser

    The NHS crisis: A spotter’s guide: //t.co/eDxt0AjO by Trevor Cheeseman

  15. Kevin

    They are OUR services and this unmandated shower cannot sell them off. As soon as they are thrown out of office thenall contracts must be declared null and void as the owners (us) did not authorise them.

  16. Dee Speers

    //t.co/Hhn7WWQ4
    The NHS crisis: A spotter’s guide
    HT @grahammorris

  17. bethan.lant

    The NHS crisis: A spotter’s guide: //t.co/eDxt0AjO by Trevor Cheeseman

  18. golightmyway

    The NHS crisis: A spotter’s guide: //t.co/eDxt0AjO by Trevor Cheeseman

  19. Carl

    RT @grahamemorris The NHS crisis: A spotter’s guide: //t.co/SyV4VcRB by Trevor Cheeseman via @leftfootfwd #SaveOurNHS @antonylittle

  20. Michael

    The #NHS crisis I Left Foot Forward – //t.co/BM58J1s8

  21. John Dyer

    The #NHS crisis I Left Foot Forward – //t.co/BM58J1s8

  22. Anonymous

    Or we do as Balls indicated, we have to accept these cuts and if labour gets back in we will carry on with Austerity, the problem is we are stuffed for money even in Wales where the NHS is being kept out of the Private sector, we are being told of a massive closure program , with at least four major hospital closing down completely so money can be used to pay for the other hospitals, and some money can be used to help other sections which are struggling.

  23. T

    The #NHS crisis I Left Foot Forward – //t.co/BM58J1s8

  24. Katherine Smith

    The #NHS crisis I Left Foot Forward – //t.co/BM58J1s8

  25. Alex Braithwaite

    RT @leftfootfwd: The NHS crisis: A spotter’s guide //t.co/Rqdebw8K

  26. ElizaBeta

    The NHS crisis: A spotter’s guide: //t.co/SLAaHjGH by Trevor Cheeseman via @leftfootfwd #SaveOurNHS

  27. nellie_boy

    “@leftfootfwd: The NHS crisis: A spotter’s guide: //t.co/EUylP5ib by Trevor Cheeseman” thank the Lord health is devolved

  28. BevR

    RT @leftfootfwd: The NHS crisis: A spotter’s guide //t.co/Dws7On3P

  29. Brian Tomkinson

    RT @leftfootfwd: The NHS crisis: A spotter’s guide //t.co/Dws7On3P

  30. Lord Blagger

    Good idea.

    We can extend that across the board.

    For example, we haven’t authorised any debts that don’t appear on the government accounts. For example – PFI. Lets repudiate those too.

    Then we can repudiate the civil service pensions. That isn’t on the books too. 1,400 bn to be saved there.

    State pension, not on the books, so that hasn’t been mandated. That has to go. 2,400 bn saved.

    State second pension, after all that has to be fat cats. Mind you that is going. That’s going to be taken. Lib Dem and tory policy being put through now.

    Then guarantees. We can get back at the bankers by removing the guarantees. Mind you HBOS and Lloyds go bust, but what the heck, its only rich people who have bank accounts.

    Post office workers. Their pension assets have been taken and have already been spent. It’s the deficit. However, their pensions aren’t on the books and we weren’t told about it. If its a secret, there is no mandate, so their pension has to be null and void.

    Job solved. No payments on the debts. That’s 30% of the deficit wiped out. Now who is going to pay the other 100 bn a year?

  31. Blarg1987

    To throw a psanner in the works, post office pensions are being guarenteed by the tax payer, just as utility pensions are, so they are not technically off the books as like BT which had a pension problem but is addressing it by investing money in to pay it back, does not mean it is a debt.

  32. Anonymous

    That’s right, whatever the situation you want older people to starve in the street.
    Let’s asset strip you for trying to kill people. That’s a start.

    MURDER DEATH KILL, your default setting.

    (And answer, in your world nobody, since the UK would collapse entirely)

  33. Anonymous

    Of course he can, parliamentary sovereignty.

    Shame there’s not a left-wing party to properly oppose them. Or a sane voting system rather than FPTP. Or…

  34. Axe The Act!

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  35. Axe The Act!

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  36. Marcus Chown

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  37. Marcus Chown

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  38. Axe The Act!

    The NHS crisis: A spotter’s guide: //t.co/SLAaHjGH by Trevor Cheeseman via @leftfootfwd #SaveOurNHS

  39. Kim Blake

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  40. Chebella Phoenix

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  41. Alistair Sinclair

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  42. MrspOppins2012

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  43. Rob Crosbie

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  44. Rachael Chrisp

    What to expect later this year as the crisis in the NHS spreads… //t.co/anLcSeZA #saveourNHS #PMQs

  45. kyrsty winch

    The NHS crisis: A spotter’s guide //t.co/RDmZOcWA

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