LATEST ARTICLES
NHS urgently needs a workforce plan
21 September 2018
As the NHS leadership develops its 10-year plan, the service is trapped in a
vice of eroding performance and rising vacancies.
The latest quarterly performance statistics from NHS Improvement revealed
that, up to the end of June, delivery in five key maximum waiting time
targets – four hours in A&E; an 18-week referral-to-treatment time; six
weeks for diagnostic tests; 62-day urgent GP referral to treatment for
cancer; 52 weeks for treatment – were all worse than the same period last
year. The deficit also worsened by £78m, to £814m.
A reduction in delayed discharges from acute beds was one of the few
pieces of good news, but there were still almost 275,000 bed days.
Meanwhile nursing vacancies were close to 42,000 – an increase of more
than 3,000 since last year. We are short of more than 11,500 doctors, which
is also worse than a year ago.
Alongside the 10-year plan, Health Education England is finalising the
workforce strategy following the launch of its consultation document last
December. It includes one killer fact: if no action is taken to reduce demand,
the NHS will need an additional 190,000 clinicians by 2027.
Read the full article at Guardian Society
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Hancock makes big healthtech promises
7 September 2018
Passing chatbots for dementia patients and tools for manipulating big data
as he entered the annual NHS Health and Care Innovation Expo in
Manchester on Thursday, the health secretary, Matt Hancock, could have
been forgiven for thinking the health service is well on the way to exploiting
the potential of digital technology.
But visits to see hospital and ambulance services in action as he gets to
grips with his new post have left him horrified at the pervasive and lethal
weaknesses in NHS technology, and he has wasted no time in giving vent to
his feelings.
Hancock loves tech. He used to work for his family’s software business, was
the first MP to launch his own app and was responsible for digital policy as a
minister for two years in the Department for Digital, Culture, Media and
Sport.
Since being appointed health secretary two months ago, he has made three
big calls. He has scrapped the famous Monday morning meetings in which
his predecessor Jeremy Hunt brought together system leaders and delved
deep into operational detail. He has used his first appearance in front of the
health and social care select committee to attack the “very, very old school”
NHS management culture, and he has declared that his mission is to sort
out NHS technology.
Read the full article at Guardian Society
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Sexual health services need an overhaul
24 August 2018
The health and social care select committee has launched an inquiry into
sexual health. The move comes as serious infections are rising and funding
is falling, hitting services of vital importance to young people and many
others.
Demand for services has been rising relentlessly. Between 2013 and 2017,
total attendances at sexual health services in England rose 13% to more
than 3.3 million. New diagnoses for gonorrhoea increased 66% between
2012 and 2017, while syphilis jumped 136%. Chlamydia infections fell by
3.5%, but infections are still diagnosed in more than 200,000 people each
year. Chlamydia testing has been falling, while drug resistant strains of
gonorrhoea have emerged.
The news on HIV is more encouraging, with Public Health England reporting
a UK-wide 18% decline in diagnoses between 2015 and 2016. The power of
good sexual health services was underlined by a 29% decrease in London,
with the largest declines seen in boroughs with the highest testing rates and
prompt access to treatment.
According to the select committee, the impact of sexually transmitted
infections remains greatest in heterosexuals aged 15 to 24 years, black
ethnic minorities and gay, bisexual and other men who have sex with men.
Read the full article at Guardian Society
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Healing the scars of the Bosnian War
10 July 2018
More than two decades after the Bosnian war, memories of the conflict and
caring for the living—and the dead—still define many lives in the Balkan
state.
Ilijaz Pilav was a doctor in the mining town of Srebrenica, close to the
Serbian border, when Serb forces encircled the largely Muslim population in
1992. Like many Bosnian towns it is surrounded by hills, an easy target for
artillery and mortars.
The 1992-95 war followed the breakup of the former Yugoslavia. After the
republic of Bosnia and Herzegovina voted for independence Serb forces
mobilised to secure continuous territory across a swathe of the country,
forcing out inhabitants through its policy of ethnic cleansing.
Most doctors in Srebrenica fled. That left five—including Pilav and one
trapped there while visiting after graduating medical school—for a
population swelled to 40 000 by refugees.
“The city was under siege from the beginning—no electricity, no medicines,
no sanitation materials, and for a couple of months no food. We five doctors
with humble experience of medicine had to solve every problem,” Pilav says.
Until the Serbs advanced on Srebrenica three years later and massacred
Muslim men and boys, in what the International Criminal Tribunal in The
Hague described as genocide, “there were bombardments every night,” says
Pilav, who as a Muslim was at risk himself. “From the beginning the number
wounded was huge.”
Read the full article at the BMJ
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NHS won’t be saved by reorganisation
5 July 2018
The seven-decade history of the National Health Service is littered with
organisations which have come and gone. Regional health authorities,
primary care trusts, strategic health authorities, the NHS University, the
Health Education Authority, the Health Development Agency, the NHS
Modernisation Agency, the Commission for Healthcare Improvement, the
Trust Development Authority – all bodies scrapped in what Nuffield Trust
chief executive Nigel Edwards has described as “major extinction events”.
Politically driven re-engineering has tended to focus on intermediate
management structures such as regional layers, commissioning and
regulatory bodies, and agencies designed to drive system changes such as
clinical improvement.
The UK’s predilection for reorganising its health system is unusual by
international standards, according to Mark Britnell, former director general
for NHS commissioning and now global chair of healthcare, government and
infrastructure for KPMG. “That doesn’t mean to say that systems don’t
change. For example, in the Nordics there has been a greater push towards
regionalisation while Australia and Canada have pushed for larger hospital
and health board areas to facilitate integration, but my impression is that
the NHS goes through reorganisation convulsions whereas other systems try
to manage change more organically.”
Read the full article at Civil Service World
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Public Policy Media
Richard Vize
July to September 2018