Fallen campaigner
Indefatigable campaigner for the NHS Steve Carne died in a road traffic accident in the USA, in January. He had been the moving force behind Wirral ‘Defend our NHS’ and proudly claimed a 30 year history of militant defence of the health service. Cynical moles wondered how much attack the NHS had actually been under if it had lasted so long.
Another surprise was the view that the NHS no longer existed, having been broken up into Integrated Care Systems. An actor by trade he illustrated Rudolf Klein’s view that NHS politics can be strong on drama. He will be a hard act to follow.
Source: DONHS defendournhswirral@gmail.com
Who would have known?
A local Conservative Party chairman stood down after going on a rant against feckless women and children. In his New Year’s Eve message on Twitter, Gareth Baines suggested that A&E departments were full of fat mums in Pot Noodle-stained leggings with their snot-covered Asbo children. He also said that many parents were taking their children to hospital just so that they could gain sympathetic likes on Facebook. Mr Baines apologised and stood down as chairman of the Clwyd South Conservative Association.
Prior warnings in 2022: a selection
Early in 2022 members of the Commons Health and Social Care select committee warned that the NHS was facing “the greatest workforce crisis” in its history, which was putting patients at serious risk of harm.
A report from the Royal College of Emergency Medicine made clear to the government that the loss of 25,000 NHS beds over the past 12 years had led to “real patient harm and a serious patient safety crisis”
An Imperial College Business School study argued that patient safety benefits depended on rostering experienced, well-qualified, permanent nursing staff.
Latest data on GP-patient ratios from the Office for National Statistics show that GPs’ workload has increased by 18 % while the FTE workforce has fallen by nearly 700.
The National State of Patient Safety 2022 report identified an under-resourced and over-stretched workforce as a risk to patient safety, and called for a robust workforce plan.
Source: The Lowdown
Expertise up front
All paramedics in the Welsh ambulance service have access to advice from senior hospital specialists to help them decide what to do with patients. The Welsh Government uses ‘Consultant Connect’ to provide immediate advice from senior doctors. Paramedics make over 2,500 calls to the advice service per month and are connected to specialists in an average of 30 seconds. About a third of patients avoid an unnecessary trip to hospital, releasing space and resource to deal with surges in demand. If it can be done in Wales, why not in England?
Source: https://www.consultantconnect.org.uk/
Wes is right, but why is he right?
Wes Streeting has let the reform cat loose amongst the primary care pigeons with his talk about reform of the NHS. In 1948 the BMA supported a tacit pact between Medicine and the State against medical consumerism. This pact no longer functions, for a number of reasons.
First, in an ageing society health and social care costs have to increase to support people with slowly progressing and overlapping but incurable conditions – dementia, depression, disability and frailty. These conditions are endemic - spread across the population – and synergistic – worsening one worsens the others.
Second, the rising health literacy of the younger population challenges professional authority and competence. GP gatekeepers -who are now working harder than ever - rely on probabilistic reasoning plus some low performance diagnostic tools that may not convince consumers. This explains the rising referral rates across the disciplines before 2019 and makes the possibility of self-referral to experts so attractive to some.
Third, the Covid-19 pandemic has used up the slack in all health services in advanced societies, leaving professionals to run on empty.
Wes Streeting is right to highlight the need for change in general practice, even if his suggestions – like choice of consultation format – are hardly innovative. He has made provocative claims that gained him airtime and print coverage, and once the dust has settled he will be able to say what he really means.
Source: assorted moles
Lists within lists
Patients struggling with their mental health may be left stuck in limbo on "hidden" NHS waiting lists. New analysis by UK charity, Future Care Capital (FCC), reveals that 1 in 4 patients (24%) are waiting more than 90 days between their first and second appointments for NHS Talking Therapy treatment (previously known as IAPT).
Source: https://futurecarecapital.org.uk/digital-mental-health-tools-guide
Steady as you go
Catastrophism is running riot in the NHS and the advocates of switching to a health insurance system are increasingly vocal. Consider a headline from Bloomberg UK : Britain’s NHS Black Hole is Devouring the Whole Country. This is nonsense – health insurance systems are wasteful and bureaucratic. For some in-depth analysis of health insurance’s failings read Hugh Alderwick’s Health Foundation blog and Sam Friedman ‘s article in Prospect magazine (see below).
Sources:
Philip Aldrick Britain’s NHS Black Hole is Devouring the Whole Country Bloomberg UK Jan 24th 2023
Sam Freedman How the NHS crisis epitomises everything wrong with the UK’s political system Prospect magazine, January 25th 2023
Hugh Alderwick Rhetoric about NHS reform is misplaced Health Foundation 23rd January 2023
Read more News from Nowhere and articles on the NHS in ERA 3 at http://www.healthmatters.org.uk/