Analysis from NHS England reveals how fast the health service is changing, and how much there is to do. The narrative needs to be reset, in this highly political phase. Labour will say the NHS is broken and it’s the Tories fault. The Tories will say the NHS is broken and it’s the NHS’s fault.
There are some signs of recovery. Waiting lists are down, the number of long waiters is declining, and A&E performance has improved. There have been 50 million extra appointments in General Practice with 34,000 more roles added plus more digital telephony. This winter hasn’t been as bad as last and diagnostic activity is up 14% compared with pre pandemic levels.
There are 50,000 more nurses mainly from overseas, but retention remains a problem, of course. Rising demand - ageing, chronic conditions and an increase in mental health problems – means that NHS performance as seen by the public as not good enough.
The four key priorities for the NHS are: recoveries in emergency care, waiting list and cancer diagnostics, and access to general practice. Dentistry, mental health and maternity safety are areas of focus. There will be an emphasis on productivity following growth in staff numbers without increases in patient outcomes. Then there all the concerns about transformation - digital, data, personalised medicine, care closer to home, and so on.
There is no more Revenue money - growth will be 0.02% in 24-25 so controlling costs (for example, by not hiring agency staff) and by reducing the workforce will have to happen. Getting Capital is a problem but it may be easier to get than Revenue. Even if Labour forms a government, there will probably be no more money, initially, making a “left shift” a distant prospect (see below). And industrial action needs to be sorted ……
Sources: NfN moles
What’s a “left shift” when it’s at home?
Is it this? “Left shift” describes when immature neutrophils are released from the bone marrow due to an outpouring of cells, typically due to infection”. https://en.wikipedia.org/wiki/Left_shift_(medicine)
Or this? “Left Shift is a term that has been part of the arsenal of NHS-Newspeak for 15 years- the concept that healthcare activity can be 'shifted' from expensive hospitals to cheaper community settings” https://www.linkedin.com/posts/profrishabhprasad_left-shift-is-a-term-that-has-been-part-activity-7124298421225574400-j4i4?trk=public_profile_like_view
“Left shift” will probably only happen with growth money.
Associate troubles
Our prediction in NfN 131 (March 2024) that the debate about Physicians Assistants would turn nasty proved correct. The argument at the Royal College of Physicians on March 13th was vitriolic, claims were made that data presented was biased, if not fraudulent, and senior staff members resigned.
Of course some of the problems of the Physicians’ Associate’s role should have been sorted out years ago – like defined scope of practice, supervision, requirement for CPD, regulation, clear information for patients. The RCP has been home for the Faculty of Physician Associates for 10 years, so why all the fireworks now?
It’s partly because of the juniors pay dispute, as PAs are paid more when they start out than early career junior doctors. The juniors are also very dissatisfied with the organisation of their training - endless rotations, lots of paperwork - and that’s got mixed into the PA argument. And of course there’s job protectionism and the usual sense of medical entitlement.
It’s not a good look. The NHS will press on with the training and employment of Physicians’ Associates, saying that doctors can’t complain about how overworked they are and then object to the help being put in place to support them…(Who says they can’t?).
Sources: various NfN moles.
Scandilight (Have we been here before?)
Norwegian private healthcare provider Dr.Dropin has launched its first UK clinic in Fulham. The team plans to open a further 3 clinics in London over the course of 2024. Established in 2017, Dr.Dropin has 30 clinics providing healthcare to over 1.5 million patients in Norway and Sweden.
With Dr.Dropin, patients get access to same-day appointments at a local clinic or online, and there is a one-stop shop for frequent patient needs. There is a patient portal with access to medical records, test results, treatment plans etc, and transparent pricing with no surprises or hidden costs.
Dr Dropin is aiming for the middle ground between what the NHS offers and expensive, private medical services for the very affluent. A virtual appointment with a Dr. Dropin GP costs £59, in-person consultation £79, preventative health assessments cost £199, initial dermatology consultation costs £249, and £199 for a follow-up appointment.
Source: www.drdropin.uk
Private hospital sector surge
Analysis of the latest quarterly Private Healthcare Information Network (PHIN) data by Broadstone, the leading independent pensions, investment, and employee benefits consultancy, finds that private healthcare admissions could exceed 900,000 a year by the end of 2024. Insured admissions increased to 458,000 through the first three quarters of the year, an 11% rise from the 412,000 recorded in 2022. It means insured admissions are likely to surpass 610,000 through FY 2023, a record annual level.
Growth has been driven by surging corporate demand for private healthcare solutions from employers who no longer trust the NHS to secure the health of their employees, with the UK’s public healthcare crisis driving increased sickness absence, low productivity and economic inactivity due to ill health.
In comparison, self-pay admissions are plateauing due to a natural limit on the amount of people able to self-fund.
Source: PHIN, Private Market Update: March 2024: https://www.phin.org.uk/news/phin-private-market-update-march-2024
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