Backlog blues
In May 2021 NHS England’s elective accelerator programme disbursed £160m to 12 local health systems to help develop new care models and increase clinical activity. None of the 12 systems has managed to outperform their pre-Covid levels of clinical activity. Some had pledged to achieve 120% of pre-Covid activity, making their failure spectacular.
This matters. If hospitals can maintain activity levels 5 per cent above pre-pandemic levels, it will take until 2033 to clear the cancer treatment backlog caused by the pandemic. However, if activity levels can be increased to 15 per cent above pre-pandemic levels, backlogs across the cancer care pathway could be cleared by next year.
Source: Daily briefing Accelerators stuck in reverse HSJ 23/11/21
Climate change, catastrophism and mental health
Much has been written about rising levels of anxiety and depression in young adults, and their connection with the climate emergency. According to a study published by the Lancet, over half of young people think humanity is doomed. The study involved 10,000 16- to 25-year-olds in 10 countries.
Three-quarters said the future was frightening; 55% said they would have less opportunities than their parents; 52% said family security would be threatened; and 39% were hesitant to have children as a result. These attitudes were consistent across countries from the United States and the United Kingdom to Brazil, the Philippines, India, and Nigeria.
Climate change is a big problem but is telling our children that the world will soon end good for their mental health?
Sources: Hannah Ritchie Stop Telling Kids They’ll Die from Climate Change Wired 11/11/2021 & Young People’s Voices on Climate Anxiety, Government Betrayal and Moral Injury: A Global Phenomenon. Posted as a pre-print by The Lancet on 7th Sept 2021
Resolving contradictions
Defend our NHS Wirral continues to muddle along in its inimitable way. In its recent bulletin (Friday 12th November 2021) it tells readers that the coming Integrated Care System (ICS) is a set of emperor’s new clothes, but also an ideological tsunami…which will kill some of us. Confused? You should be.
The emperor’s new clothes don’t exist and tsunamis are giant waves –in this case made up of political theorising, not water. Can an ICS be both these things?
Invisible clothes and a wave of ideas may not sound dangerous but we are assured that some Wirral residents will die because of them. Worse, if you don’t oppose the ICS with actions, you are supporting it.
The last claim helps clarify the rest. In political communication, the phrase “you are either with us or against us” is used to depict polarised situations and to force witnesses, bystanders, or others not aligned with some form of pre-existing conflict to either become allies of the speaking party or suffer the consequence of being deemed an enemy.
This is a threat straight from the Bible (Matthew 12.30 He who is not with me is against me) but also an identifying feature of the sectarian Left.
In this context the statement “you are either with us or against us” is a form of splitting. Splitting (also called black-and-white thinking or all-or-nothing thinking) is the failure in an individual’s thinking to bring together the positive and negative qualities of the self, of others or of situations into a cohesive, realistic whole. The individual tends to think in extremes (i.e., actions and motivations are all good or all bad with no middle ground).
Splitting is a common defence mechanism, but a poor lever for change. As the Wirral bulletin points out, despite all the warnings, councillors – with a few honourable exceptions – continue to refuse a black-and-white explanation of events.
The bulletin ends with this fear: This may be our final message before the NHS is consigned to history.
Source: defendournhswirral@gmail.com
Health Inequalities
NHS England is responding to widening health inequalities through the Core20PLUS5 programme.
The ‘Core’ is the most deprived one-fifth (20%) of the population. ‘Plus’ includes ethnic minority communities, coastal communities, people with multi-morbidities, people experiencing homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system, victims of modern slavery and other socially excluded groups.
‘Five’ is the part of the formula where the Public Health approach starts to fall down. The programme identifies five (in our view rather modest) clinical priorities:
1. Maternity: ensuring continuity of care for 75% of women from BAME communities and from the most deprived groups.
2. Severe Mental Illness (SMI): ensuring annual health checks for 60% of those living with SMI.
3. Chronic Respiratory Disease: a clear focus on driving up uptake of Covid, Flu and Pneumonia vaccines.
4. Early Cancer Diagnosis: 75% of cases diagnosed at stage 1 or 2 by 2028.
5. Hypertension Case-Finding: to allow for interventions to optimise BP and minimise the risk of myocardial infarction and stroke.
The problem with focusing ICS minds on five clinical priorities is that it presents a transactional, medical model (full of tests, jabs and drugs) when what is needed is for the NHS to promote health creation as a social process.
The achievement of specific clinical goals will once again trump taking a long-term approach to health inequalities. Knowledge of how to address health inequalities is lacking in the NHS and this approach doesn’t help to address the lack of know-how. NfN moles agree with this criticism and are underwhelmed by the Core 20PLUS5 programme.
Sources: https://www.engage.england.nhs.uk/survey/core20plus5/ and the Health Creation Alliance’s Submission to NHS England and NHS Improvement on Core20Plus5.
https://thehealthcreationalliance.org/wp-content/uploads/2021/11/THCA-INTERIM-response-to-Core20Plus5-consultation_12-Nov-2021.pdf
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/
In May 2021 NHS England’s elective accelerator programme disbursed £160m to 12 local health systems to help develop new care models and increase clinical activity. None of the 12 systems has managed to outperform their pre-Covid levels of clinical activity. Some had pledged to achieve 120% of pre-Covid activity, making their failure spectacular.
This matters. If hospitals can maintain activity levels 5 per cent above pre-pandemic levels, it will take until 2033 to clear the cancer treatment backlog caused by the pandemic. However, if activity levels can be increased to 15 per cent above pre-pandemic levels, backlogs across the cancer care pathway could be cleared by next year.
Source: Daily briefing Accelerators stuck in reverse HSJ 23/11/21
Climate change, catastrophism and mental health
Much has been written about rising levels of anxiety and depression in young adults, and their connection with the climate emergency. According to a study published by the Lancet, over half of young people think humanity is doomed. The study involved 10,000 16- to 25-year-olds in 10 countries.
Three-quarters said the future was frightening; 55% said they would have less opportunities than their parents; 52% said family security would be threatened; and 39% were hesitant to have children as a result. These attitudes were consistent across countries from the United States and the United Kingdom to Brazil, the Philippines, India, and Nigeria.
Climate change is a big problem but is telling our children that the world will soon end good for their mental health?
Sources: Hannah Ritchie Stop Telling Kids They’ll Die from Climate Change Wired 11/11/2021 & Young People’s Voices on Climate Anxiety, Government Betrayal and Moral Injury: A Global Phenomenon. Posted as a pre-print by The Lancet on 7th Sept 2021
Resolving contradictions
Defend our NHS Wirral continues to muddle along in its inimitable way. In its recent bulletin (Friday 12th November 2021) it tells readers that the coming Integrated Care System (ICS) is a set of emperor’s new clothes, but also an ideological tsunami…which will kill some of us. Confused? You should be.
The emperor’s new clothes don’t exist and tsunamis are giant waves –in this case made up of political theorising, not water. Can an ICS be both these things?
Invisible clothes and a wave of ideas may not sound dangerous but we are assured that some Wirral residents will die because of them. Worse, if you don’t oppose the ICS with actions, you are supporting it.
The last claim helps clarify the rest. In political communication, the phrase “you are either with us or against us” is used to depict polarised situations and to force witnesses, bystanders, or others not aligned with some form of pre-existing conflict to either become allies of the speaking party or suffer the consequence of being deemed an enemy.
This is a threat straight from the Bible (Matthew 12.30 He who is not with me is against me) but also an identifying feature of the sectarian Left.
In this context the statement “you are either with us or against us” is a form of splitting. Splitting (also called black-and-white thinking or all-or-nothing thinking) is the failure in an individual’s thinking to bring together the positive and negative qualities of the self, of others or of situations into a cohesive, realistic whole. The individual tends to think in extremes (i.e., actions and motivations are all good or all bad with no middle ground).
Splitting is a common defence mechanism, but a poor lever for change. As the Wirral bulletin points out, despite all the warnings, councillors – with a few honourable exceptions – continue to refuse a black-and-white explanation of events.
The bulletin ends with this fear: This may be our final message before the NHS is consigned to history.
Source: defendournhswirral@gmail.com
Health Inequalities
NHS England is responding to widening health inequalities through the Core20PLUS5 programme.
The ‘Core’ is the most deprived one-fifth (20%) of the population. ‘Plus’ includes ethnic minority communities, coastal communities, people with multi-morbidities, people experiencing homelessness, drug and alcohol dependence, vulnerable migrants, Gypsy, Roma and Traveller communities, sex workers, people in contact with the justice system, victims of modern slavery and other socially excluded groups.
‘Five’ is the part of the formula where the Public Health approach starts to fall down. The programme identifies five (in our view rather modest) clinical priorities:
1. Maternity: ensuring continuity of care for 75% of women from BAME communities and from the most deprived groups.
2. Severe Mental Illness (SMI): ensuring annual health checks for 60% of those living with SMI.
3. Chronic Respiratory Disease: a clear focus on driving up uptake of Covid, Flu and Pneumonia vaccines.
4. Early Cancer Diagnosis: 75% of cases diagnosed at stage 1 or 2 by 2028.
5. Hypertension Case-Finding: to allow for interventions to optimise BP and minimise the risk of myocardial infarction and stroke.
The problem with focusing ICS minds on five clinical priorities is that it presents a transactional, medical model (full of tests, jabs and drugs) when what is needed is for the NHS to promote health creation as a social process.
The achievement of specific clinical goals will once again trump taking a long-term approach to health inequalities. Knowledge of how to address health inequalities is lacking in the NHS and this approach doesn’t help to address the lack of know-how. NfN moles agree with this criticism and are underwhelmed by the Core 20PLUS5 programme.
Sources: https://www.engage.england.nhs.uk/survey/core20plus5/ and the Health Creation Alliance’s Submission to NHS England and NHS Improvement on Core20Plus5.
https://thehealthcreationalliance.org/wp-content/uploads/2021/11/THCA-INTERIM-response-to-Core20Plus5-consultation_12-Nov-2021.pdf
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/