System shift
Waiting lists will continue to grow despite the injection of an extra £12 billion as part of a ‘waiting list recovery plan’. NHS management views the aims of increasing elective activity to 130 per cent over the next three years and ensuring that waiting lists are shrinking by March 2024 as “very stretching”. The right-wing press, including The Daily Mail, the Telegraph and the Times, is unimpressed. Likewise, Covid Recovery Group MPs note that waiting times seem to be lengthening across the NHS. Watch out for arguments about the system-wide failures of the health service, and the advantages of European health insurance systems.
Source: James Illman Recovery Watch: Mackey’s blunt message Health Services Journal 16 February 2022
Long waiting
Maidstone and Tunbridge Wells NHS Trust recently had a solitary patient who had waited 52 weeks or more, compared with a high of 976 in April 2021. This individual had chosen to delay treatment. Success in tackling long waiters was attributed by NHS managers to “attention to detail” in tracking each patient, and not expecting staff to run too many extra sessions.
The Trust had been helped by the local private sector which had some spare capacity – but not much because the area is affluent and private medicine is busy. The scale of the ‘long wait’ problem varies a lot within the NHS. For example, University Hospitals Birmingham NHS Foundation Trust had 17% of its elective surgery list waiting 52 weeks or more. That adds up to 31,530 people.
Source: Alison Moore ‘Don’t overwork staff’, says trust with just one 52-week waiter
Health Service Journal 16 February 2022
The Long March through the courts.
Pharmaceutical price regulation is a tricky topic. Big Pharma doesn’t like it because it suppresses profits. Some in the NHS think it is too friendly to industry. Whatever your view, be prepared for a long haul. In a major victory for the NHS, the High Court in London has ruled against attempts by French pharmaceutical giant Servier to limit damages it owes the NHS for serious infringements of competition law in the supply of the blood pressure drug perindopril (brand name ‘Coversyl’).The dispute between Servier and the NHS has been going on for 11 years.
Servier has already been found by the European Commission to have committed a very serious breach of competition law. The company had agreed with providers of generic alternatives to delay entering the market with cheaper generic versions of the drug. This forced the NHS to pay the full costs of the branded version, adding up to £250m to the price of the drug.
The final judgment in the European proceedings is expected later this year. A full trial to decide the full level of losses suffered by the NHS will follow. Nine lawyers have been mobilised for the NHS, three being QCs. It is not over yet.
Source: Matthew Grundy at Farrar Kane The Secretary of State for Health and Another -v – Servier Laboratories Limited and Others
Numbers count
Data analysed by QualityWatch, a joint programme between the Nuffield Trust and the Health Foundation, reveals an unprecedented increase in demand for mental health services for children and young people, particularly those with eating disorders. The report, published on February 18th, states that in England the number of children and young people waiting to start treatment for a suspected eating disorder quadrupled from pre-pandemic levels to 2,083 by September 202. During the pandemic, the number of children and young people (under 19 years) attending A&E primarily for an eating disorder rose from 107 in October 2019 to 214 in October 2021.
There is no doubt that Child & Adolescent Mental Health Services are struggling, and had long waiting times before the pandemic, which has made the situation worse. The situation for children and young people with eating disorders is perhaps not as problematic as the graphs of percentages suggest, because the actual numbers are small.
Source: Jessica Morris & Elizabeth Fisher The impact of Covid-19 on health care for children and young people in England Nuffield Trust 18th February 2022
Poisoned Chalice
Baroness Cavendish was tasked by Matt Hancock (remember him?) in June 2020 “to make recommendations for social care reform and integration with health in the wake of the covid-19 pandemic….”
The good Baroness duly reported and rejected the idea of the NHS taking over social care because the health service is too “hierarchical” and “centralised” whilst social care is “more innovative, more responsive and human”. NfN moles were deafened by cries of “you could have fooled me” coming from both sides of the Great Health and Social Care Divide, but as the hubbub faded one critique stood out in the HSJ’s comments page.
Joe Mccrea said: With all due respect to Camilla Cavendish, the Tory, Oxbridge former Murdoch journalist, wife of a merchant banker and with no experience whatsoever of ever having spent a day working in the NHS, this fairly blatant hatchet job on the NHS is total garbage.
This review is a smokescreen to draw attention away from - and provide political cover for - power politics in Whitehall by the local government lobby, determined to retain the profile and funding that comes with social care (despite the challenges it faces).... the NHS and social care should be merged - straight and simple”.
Source: Hayley Kirton NHS not ‘human’ enough to get greater role in social care, says government review Health Service Journal 23 February 2022
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/