Don’t say inconvenient things
The Health Service Journal has pointed out that repeated Covid19 waves are undermining attempts to restore elective care activity to above pre-Covid19 levels. NHS elective activity in the first quarter of 2022-23 has been significantly below pre-Covid19 levels, and a mile away from NHS England’s aspirations. “Getting the maximum wait down to 78 weeks by the end of the financial year looks a very stiff task indeed”.
An anonymous commentator adds: I think the elective target has had it - sorry. I have empty beds this morning and patients who need admitting. Can I admit them? - no I can't - because despite moving cohorts of patients around and changing bays and areas to Red and Green - I cannot get it to all match up. In my system, this means that medical outliers will be in surgical beds now. But at least we are following NHSE Infection Control guidance. Perhaps NHSE could decide whether it wants to protect people from Covid,or have their delayed operation. Have to be anonymous, because the "don't say inconvenient things" and "resubmit your data" narratives have now re-emerged very strongly.
Source: Anonymous comment on The stubbornness of Covid leaves the NHS with brutal choices to make by Alastair McLellan Health Services Journal 4 July 2022
Tony returns to the fray
Tony Blair’s Institute for Global Change has joined the great NHS debate. It has published a report by Axel Heitmueller, a visiting professor at Imperial College London’s Institute of Global Health Innovation. The report starts from the assumption that the NHS as currently constituted cannot meet the nation’s needs. Heitmueller argues that the NHS should concentrate on five policy principles.
1. The NHS centre should introduce • a full national interoperable public-health data infrastructure • electronic personal or health records for all patients with patients given the right to have all their information stored and available to any health-care professional they want anywhere in the NHS system • a revamped NICE, giving guidance on new treatments and drugs • a process for enabling new learning and sharing of innovation across the service and • of course, the power of intervention in the case of a failing or mismanaged service.
2. Other than for these capabilities, the new integrated care boards, in partnership with clinicians and NHS staff, should have the freedom from central control genuinely to innovate, run the service and manage the budget in the way they see fit to meet the needs of their local patients, which they know best. Going further and faster on devolution is therefore essential.
3. These freedoms should include the ability to enter into partnerships with the private or voluntary sectors, to embrace new methods of treatment and prevention, to create the workforce they believe is best suited to the care they want to provide and to raise money locally through social impact bonds – not as a substitute for taxpayer funding but as a source of better community engagement.
4. In place of a system of accountability based purely on the centre, there should be full transparency and publication of health data, nationally and locally, available to the patient and to the broader public.
5. The NHS should make available – on an anonymised basis – all the data held by the service for the encouragement of research and the development of the British life-sciences sector.
News from Nowhere’s veterans are scratching their heads at this. The Heitmueller report seems - how should we say this without being unkind? – unoriginal and overstated. Decentralisation debates go back to the foundation of the NHS; the question is how to achieve decentralisation. Information technology companies have been yapping round the ankles of the NHS for decades and have produced mixed results. Artificial Intelligence is overrated, with lots of magical thinking about its curative powers and much boosterism about the value of its data. But we may be wrong, and Heitmueller might just hit the button. Thoughts from NfN readers would be especially welcome.
Source: Axel Heitmueller The NHS Refounded: Delivering a Health Service Fit for the Future
https://institute.global/policy/nhs-refoundeddelivering-health-service-fit-future on June 29 2022
A tale of two pressure groups
In the April ’22 edition of News from Nowhere we commented on a new political player within BMA politics, a junior doctors’ Broad Left. Quite what this new Broad Left (The Young Turks) would do, given there was already an established Old Broad Left in the BMA (The Old Guard), was not clear. We anticipated that for a while the Young Turks might move fast and break things, and then be incorporated into the BMA’s apparatus.
The first stage has now happened. The Young Turks took advantage of the BMA’s transferable vote system to reject the Old Guard’s candidate for Chair, Dr David Wrigley, a veteran campaigner for the NHS and long-time supporter of junior doctors. He had served as Deputy Chair of BMA Council for three years and was seen by his supporters as “ideally placed” for the top job (it looked like a shoo-in to outsiders).
The Old Guard are understandably peeved. One put it this way: “Years of work to get our candidate elected as chair of Council down the drain”. NfN moles are reminded of the old leftist slogan about the NHS, Collaboration not Competition, and wonder where it went.
Source: Doctors in Unite
Approaching the Titanic Moment
In our June ‘22 edition of News from Nowhere we noted the prediction that West Midlands Ambulance Service would collapse on or around August 17th 2022. WMAS’ Nursing director Mark Docherty, who made the original prediction, recently added that serious incidents causing patient harm had increased steeply compared to previous years.
Much of the increase was attributable to worsening hospital handover delays. From April-June this year, 262 harm incidents were logged – a 240 per cent increase in the same period in 2019 and a 71 per cent increase compared with last year. On one very bad day there were over 700 people waiting for ambulances that were unavailable because they were standing outside A&E.
WMAS chief executive Anthony Marsh told Staffordshire’s health and scrutiny committee “I will not allow this service to collapse.”.
Source: Emily Townsend Exclusive: Ambulance serious incidents triple. Health Service Journal 15th July 2022
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/