Care at home? “Care homes could become most common place to die by 2040”

Care homes could overtake hospitals as the most common place for people to die, according to new research.

Just over a fifth of annual deaths in England and Wales currently occur in care homes, but experts predict the number will more than double by 2040.

Experts from King’s College London analysed data for deaths from 2004 to 2014.

Over that period, the proportion of deaths that occurred in care homes increased from 17% to 21%, with the number of fatalities rising from 85,000 to 106,000 a year. Calculations suggest this figure could rise to nearly 230,000 a year by 2040.

Meanwhile, the number of deaths in hospitals fell between 2004 and 2014 to 241,335, and this trend is expected to continue.

The researchers said most people prefer to die in the place they are usually cared for, including home, rather than in hospital. But they warned that hospital deaths could rise again unless capacity continues to increase in care homes.

They said: “Our projections show that if current trends continue, the need for end-of-life care will rise substantially over the next 25 years, particularly at home and in care homes.

“If current trends continue, deaths in care homes, homes and hospices will almost double by 2040, which will account for 76% of all deaths.

“Care home deaths are projected to become the most common place of death by 2040.

“However, if care home capacity does not increase and these additional deaths instead occur in hospital, the decline in hospital deaths will reverse by 2023, rising to 40.5% of all deaths by 2040.” …

https://www.theguardian.com/society/2017/oct/11/care-homes-could-become-most-common-place-to-die-by-2040

When is enough, enough?

Owl says: “social care beds” … what exactly are they? Residential homes? Nursing homes? Community hospital beds? Whatever they are – Cornwall doesn’t have enough of them.

So, how do they measure “enough”? Certainly in Devon our Clinical Commissioning Group doesn’t do numbers, so we will be hard-pressed to know if Devon has too much, enough, not quite enough, critically few or “disastrously dangerous” levels of anything measurable.

“The Care Quality Commission’s (CQC) calling on Cornwall’s health and social care managers to have “courage” to radically overhaul services.

The CQC points to the county having less social care beds than other comparable parts of the country.

In its annual report, the CQC says the system is “straining at the seams” because of increasing numbers of frailer pensioners and people with long term complex conditions.”

http://www.bbc.co.uk/news/live/uk-england-devon-41509465

“Too late for cash injection to save NHS from a winter crisis”

But Diviani and Randall-Johnson have decided there is no crisis in Devon, so that’s ok …

“It is too late for a cash injection to save the NHS from a winter crisis, according to a senior health official.

A poll of healthcare leaders found that 92 per cent are concerned about their ability to cope as the colder months arrive.

Niall Dickson, chief executive of the NHS Confederation which represents all health service organisations, said that there was “an even greater sense of foreboding” this year than last.

Writing in The Times today, Mr Dickson warns: “It is becoming hard to overstate the perilous state of the health and care system in England.”

His comments came as figures revealed that the number of the most critically ill patients waiting more than an hour for an ambulance has doubled in a year.

A separate report also suggested that 25,000 operations were cancelled last year because of a lack of beds.

Mr Dickson writes: “A cash injection at this stage is unlikely to solve the winter pressures, but the chancellor must revisit the pencilled in figures for 2018-19 and 2019-20, which if left as they are, would guarantee more crises and further delays to the reforms that are needed.”

He highlighted issues in A&Es last winter when there were ten hospitals in which less than 70 per cent of patients were seen within the four-hour target.

“Emergency departments are seen as a litmus test for the rest of the system. If the health service cannot cope at its front door, what lies behind it will also be struggling,” he says.

There has not been enough investment in community health and social care services, he adds, and draws attention to problems with staff recruitment and retention.

Figures released in July showed that the number of nurses and midwives fell by 1,783 to 690,773 in the financial year 2016-17 as 20 per cent more people left the profession than joined it.

Mr Dickson writes: “Emergency admissions are continuing to rise — in the first quarter of this year there was a 25.9 per cent jump in responses to life-threatening ambulance calls — so the ambulance service too is under increasing strain.”

Yesterday figures released to the Sunday Mirror under freedom of information laws showed that paramedics had taken more than an hour to reach 6,096 people requiring urgent treatment for conditions such as cardiac arrest in 2016-17. The total of “red” calls, which should be reached in eight minutes, waiting more than an hour was up from 2,746 in 2015-16.

Mr Dickson says that concerns have been heightened by fears of a flu epidemic. Simon Stevens, chief executive of NHS England, said last month that hospitals in Australia and New Zealand had struggled to cope with “a heavy flu season”, with the likelihood that the same strains of flu will head west and north.

Mr Stevens reiterated calls for “a comprehensive review looking at the funding of health and social care across the UK”.

A Department of Health spokesman said: “ The NHS has record funding and more doctors and nurses on our wards. The NHS planned for winter earlier this year than ever before and has robust plans in place, supported by an extra £100 million for A&E departments and £2 billion for the social care system to help improve discharging and free up beds in hospitals.”

Source: Times (pay wall)

Cap on care home fees scrapped

Something that wasn’t announced at their conference. But with a membership with an average age of 72, hardly surprising.

All those rich pensioners in PegasusLife flats will have to keep chipping in to their savings!

“The Tories’ pledge to introduce a cap on social care costs by 2020 has been officially abandoned.

David Cameron promised to bring in an upper limit of about £75,000 on the amount people must pay towards their own care.
But a senior Government source has said the cap will not be introduced until well into the next decade at the earliest.”

http://www.dailymail.co.uk/news/article-4961110/Tories-ditch-plan-cap-care-home-fees-2020.html

Does Jacob Rees-Mogg contribute to his local food bank? They need it

“After Jacob Rees-Mogg said he found the huge rise in food banks “uplifting” in a live interview on LBC, we went to find out how many people in his constituency use this service.

According to the manager of the Somer Valley Food bank Paul Woodward, over 1,500 people used the food bank last year. Since April, in just over six months, almost 700 people have come to collect food already. This is added to numbers from Bath, where local food banks can see over 20 people a day.

While Jacob Rees-Mogg said food banks are a good thing as they show what a “good compassionate country” the UK is, the numbers paint a different picture.

According to data by the Trussel Trust, which accounts for about half the food banks in the UK, the number of emergency food packs given out has risen from 61,468 in 2010/2011 to 1,182,954 last year.

The Somer Valley Food Bank stated they currently have more stock going out than going in. There are collection boxes at local churches and supermarkets. Mr Woodward said they need the usual long-life food such as tinned meat, fish and vegetables, but also UHT milk and sponge pudding.”

http://www.somersetlive.co.uk/news/somerset-news/surprising-number-people-who-need-588920

Cancer survival poorer for rural patients – travel time may be a factor in decisions

One-year survival rates are lower for those who live in rural areas, found a study by the University of Aberdeen. They say longer travel distance limits treatment choices and follow-up care

“… It could be that living in rural areas where you have to travel further to receive treatment might limit treatment choices once a diagnosis has been made.

‘There is evidence that when faced with two treatment options, patients might weigh the costs in terms of time, expense and inconvenience of travel against the perceived benefits, for example, choosing surgery over chemotherapy to limit time in hospital.

Lengthy or difficult travel to a cancer centre or hospital could also result in less limit engagement with post-primary treatment follow-up, with consequent implications for the effective management of treatment effects and the identification of other follow-up needs.’ …”

http://www.dailymail.co.uk/health/article-4955794/Low-survival-cancer-patients-living-far-hospital.html

DCC Tories torpedo Devon NHS

“PRESS RELEASE
Yesterday the Conservative Party machine defeated my final attempt to get Devon County Council to take action over the closure of community hospitals beds. My motion, seconded by Claire Wright, asked the Health Scrutiny Committee to look again at the issues it failed to scrutinise properly in July, and asked the Council to write to the Secretary of State for Health to alert him to our concern about hospital beds. I highlighted widespread NHS concern that there will be too few beds if there is a flu epidemic this winter. My speech is available here and you can watch it and the debate in the webcast (beginning at 2.18).

The Tory response was an amendment, moved by the leader, John Hart, which took the guts out of the motion. Despite all the evidence to the contrary, it said that Health Scrutiny had ‘extensively considered the issues and concerns from members of the public, elected members and others, including medical professionals, all matters relating to the closure of some community hospital beds in Honiton, Okehampton, Seaton and Whipton.’

Instead of my proposal to write to the Secretary about the beds closures, the amendment proposed to write ‘seeking reassurance that appropriate funding is provided by government to deliver the necessary health and social care services in Devon’. Not a dicky bird to the minister about community hospital beds, the whole point of the debate.

In reply I told the Council (at 3.10) that if they passed this amendment, they would be ignoring East Devon opinion just like Kensington & Chelsea Council ignored the residents of Grenfell Tower; and the Conservative Group as a whole would have made itself responsible for the failure to properly scrutinise the hospital bed closures.

The result

Although they were not formally whipped, 40 Tories fell dutifully in line to support the amendment. There were 16 votes against (these were Liberal Democrat, Labour, Independent and Green members, together with only one Conservative, Ian Hall of Axminster).

Claire made a valiant attempt to put some guts back into the motion, with another amendment – but the Tory machine squashed that too.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton

DCC Tories fail, yet again, to do the right thing on our NHS

“Martin Shaw and Claire Wright were voted down… [at today’s health scrutiny committee, see below] shame on Devon County Council! Every single Tory Councillor with the exception of one voted against Martin’s motion – they put party politics above their communities interests once again.
People need to know what they did.”

Patients discharged in dressing gowns and with no home care plans

Patients are being discharged from hospitals in dressing gowns to empty homes and without medication or support, according to a new report.

Healthwatch England also expressed concerns over the level of bed-blocking in the NHS, with patients fit to go home but staying in hospital.

The watchdog talked to more than 2,000 people about their experiences in the past two years. In a report in 2015 it had criticised “shocking” cases and “common basic failings” leading to emergency readmissions and deaths.

While hospitals are doing better overall, Healthwatch said that people “still don’t feel involved in decisions or that they have been given the information they need” and that they continue to experience delays and a lack of co-ordination between services.

In July an average of 5,861 beds a day were occupied by patients fit to go home, up 23.4 per cent on the same month in 2015, although down slightly year on year. The majority of delays were caused by the NHS, but the number attributed to social care services rose to 37 per cent from 30 per cent two years ago. The watchdog said that patients sometimes had to stay in hospital because non-emergency transport was not available to take them home.

Healthwatch warned that people felt they did not have access to the services and support they needed after being discharged. A patient who spoke to a Healthwatch branch in Berkshire said: “Discharged without support, with low blood pressure, very weak and unsteady on my feet, and diarrhoea.”

A patient in Richmond upon Thames, southwest London, said: “I was discharged in a dressing gown and had to get my own taxi home as transport was not available.”

Imelda Redmond, national director of Healthwatch England, said: “Getting people out of hospital and safely home is . . . an ongoing process that requires thought, planning and support before, during and after the moment someone is actually discharged. Things work best when all services work together.”

NHS England said: “This report provides further support for the intensive focus the NHS is giving to safe and speedy hospital discharge, and the related importance of local councils’ actions to ensure proper home care and care home places for frail older people.”

Source: Times, pay wall

Ind. East Devon Alliance Councillor Martin Shaw’s speech to DCC committee today

“Speech by County Councillor Martin Shaw (Independent East Devon Alliance, Seaton and Colyton), moving to send the issue back to Health Scrutiny, at Devon County Council, 5 October 2017:

“I represent a large division in East Devon. 2 years ago Seaton, Axminster and Honiton hospitals had in-patient beds, universally appreciated by patients & doctors, and supported by local communities. Today large parts of each hospital lie empty – nurses and other staff are dispersed – volunteers have been told they are no longer needed. We don’t even know whether the buildings will survive as centres of health services or be sold off.

This is the biggest crisis East Devon & Okehampton have faced in many years. Local communities have been united in their opposition; councillors of all parties have opposed the decisions.

After a biased consultation and flawed, unjust decisions, we looked to the Health Scrutiny Committee to hold NEW Devon CCG to account, and they have failed us. My proposal today is not a motion of NO confidence in any councillor or party. It is a motion to RESTORE confidence in this Council’s ability to represent Devon communities and stand up for their interests.

The tragedy is that Health Scrutiny started sensibly by asking the CCG 14 questions, in order to decide whether it should use its legal power to refer their decision. This proposal had cross-party backing, with the support of more Conservatives than members of any other party. A minority of the committee were, however, determined from the beginning to disregard public concern and voted not even to ask the questions.

The CCG replied to the questions but the Committee found their answers inadequate and wrote back detailing areas of concern. So far so good – a model of scrutiny. But things started to go wrong when the issue came to the new Health & Adult Care committee in June. The new Chair argued that members were insufficiently experienced to decide the issue and recommended delaying a decision until September 21st. It escaped no one’s notice that this was after the date given for permanent closure of the beds. It was seen as an attempt to prevent effective scrutiny.

Fortunately, the Committee agreed instead to a special meeting in July. For this meeting, the County Solicitor prepared a guidance paper outlining 6 issues outstanding with the CCG. Councillor Ian Hall, Councillor Mike Allen who is a Conservative District councillor, and others joined me in pressed the local communities’ case.

However the CCG gave a long powerpoint presentation which simply did not address most of the 6 issues, and before any debate could take place, Councillor Gilbert proposed there be no referral. In case anyone believed that he still wanted to scrutinise the issues, he made a point of emphasising that not referring would ‘save the committee a huge amount of work ’.

Councillor Diviani then told the committee that referral would be a waste of time, because ‘attempting to browbeat the Secretary of State to overturn his own policies is counter-intuitive’.

The Committee never discussed most of the remaining issues that the guidance paper had identified. By my reckoning, only 1 out of 6 was more or less satisfactorily addressed. Let me mention just one that wasn’t, the surprise decision to close Seaton’s beds, removing all provision from the Axe Valley. Neither the CCG nor any member gave any reason for believing this decision was justified – yet the committee voted for it anyway and the empty wards of Seaton hospital are the consequence.

There was no broad support for the anti-scrutiny motion: it was supported only by 7-6 ; 4 members abstained or were absent. The meeting was widely seen as an abdication of scrutiny. The Standards Committee says it ‘may not reflect well on the Council as a whole’. I would go further: it did not reflect well on this Council.

Since then, new evidence has shown that cutting beds to the bone brings great risks. The Head of the NHS, Simon Stevens, has called for more beds to be urgently made available this winter in face of a possible flu epidemic. Expert bodies like the Kings Fund, the College of Emergency Medicine and NHS Providers have backed the judgement that the NHS is cutting too far, too fast. These are new reasons to question the CCG’s plans.

This motion therefore proposes that

The Scrutiny Committee should look again at the issues which were not satisfactorily addressed.
The Council should tell the Secretary of State that the CCG’s decisions and the wider STP process have aroused great feeling in Devon, that people are not happy with either the decisions or the way they were made , and we are worried that we simply won’t have enough beds for the coming winter.
Finally, following a more constructive Health Scrutiny meeting on 21st September, this motion welcomes the Committee’s help in securing community hospital buildings.
Some of you may still wonder if Cllr Diviani was right, and all these proposals will be a waste of time. The answer to this is given in a recent letter from the Secretary’s own office: ‘As you may know,’ it says, ‘contested service changes can be referred to the Secretary of State, who then takes advice from the Independent Reconfiguration Panel.’ So a referral is not something the minister deals with personally; it is a legally defined procedure.

The letter continues, ‘However, as you are aware, Devon’s Health Scrutiny Committee … passed a motion … in favour of not referring the CCG’s decision to the Secretary of State.’ Cllr Diviani suggested that referral was pointless because of the minister’s opinions: the minister’s office implies it WOULD be meaningful, if only Devon would take action.

I ask you to restore this Council’s reputation and take the action which it is within your power to take, even at this late date, to save our community hospital beds.”

Care Quality Commission considering transferring control of its Clinical Commissioning Group to Cornwall Council

AND

“On the same day as the Royal Cornwall Hospitals Trust has been placed in special measures, the CQC has also highlighted problems with the wider health and social care system in Cornwall.

It said too many patients were stuck in hospital waiting for the support they needed to live at home, or be placed in residential care, and managers had lost sight of the needs of people using services.

Its review calls for “urgent and significant change to improve” to ensure people move through the system more effectively.

NHS England said it was considering transferring the management of the county’s Clinical Commissioning Group to the council. A director of adult social services and health integration could also be appointed.”

http://www.bbc.co.uk/news/live/uk-england-devon-41434125

Another south-west hospital buckles under the strain

Which pushes the falling domino to Plymouth … which pushes it to Exeter … which pushes it to … us.

“The Royal Cornwall Hospitals Trust has been placed in special measures following a damning report from health watchdog the Care Quality Commission.

Inspectors visited the trust in July and raised concerns about patient safety in surgery, the maternity unit and the paediatric emergency department, as well as long delays in cardiology and ophthalmology.

Chief Inspector of Hospitals Professor Ted Baker said patients had been “let down” with some “placed at risk” and the people of Cornwall “deserved better”.

Speaking on BBC Radio Cornwall, the trust’s chief executive Kathy Byrne (pictured) apologised unreservedly for the trust’s failings.

She said patients should “not be worried” and the trust had taken action on all the areas of concerns raised by the CQC’s warning notice.”

http://www.bbc.co.uk/news/live/uk-england-devon-41434125

DCC Ind. East Devon Alliance Councillor Martin Shaw will try again to get DCC to see sense on bed closures

“PRESS RELEASE
Tomorrow (Thursday) Devon County Council will discuss a new call to review the controversial closure of beds in community hospitals in Honiton, Okehampton, Seaton and Whipton.

I have been told my motion will be discussed, rather than referred to Cabinet as is normal with most motions.

The motion proposes to redress the widely perceived failure of the Health Scrutiny Committee to properly scrutinise NEW Devon CCG’s decisions, which has allowed the CCG to go ahead with the closures.

The motion asks Health Scrutiny, which alone has legal power to refer the decision, to look again the outstanding issues, while at the same time committing the Council to alerting the Secretary of State to the disquiet in the County over the issue.

The motion also highlights the urgent call by Simon Stevens, Head of the NHS in England, to free up more hospital beds in view of the danger of an extreme flu season this winter.

I will issue the text of my speech tomorrow morning.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

Devon to be one of worst-hit areas for inability to cope with ageing population

Devon will have largest shortage in number of beds, with a projected 1,921 short by 2022

“… Izzi Seccombe, from the Local Government Association, said: ‘These findings reinforce our warning about the urgent need to reform adult social care and deliver a long-term sustainable solution that delivers a range of high-quality care and support for the growing numbers of people who will need it.

‘It is absolutely critical that the Government uses the Autumn Budget to bring forward its consultation for social care announced in the Queen’s Speech, and that it works with local government leaders in delivering a long-term sustainable solution for social care.

‘To tackle the problems we face tomorrow, we must start planning today.’

http://www.dailymail.co.uk/news/article-4946632/Nine-10-areas-run-care-home-places.html

A Tory council leader pleads for cross-party initiatives and unitisation to cut costs

Owl sats: One has to wonder if he would be putting out the same message if his party had a majority.

Austerity means careful, selective investment is needed in core services, says Martin Tett, the Conservative leader of Buckinghamshire council

“… Less than a fortnight ago, the LGA sent chancellor Philip Hammond a 40-page submission ahead of the autumn budget which warned that services in England were at “tipping point” as a result of significant funding gaps, pointing to children’s services, adult social care and homelessness. By the end of this decade, English town halls will have seen £16bn of reductions to government grant funding – and from April 2019, 168 councils will not receive any funding for day-to-day expenditure.

Among its many appeals, the umbrella body urged the government to meet a £5.8bn funding gap facing existing local services by 2019/2020, of which £2.3bn is identified in adult social care. This figure includes £1.3bn that the LGA says is needed immediately to stabilise the adult social care market. This is despite an additional £2bn announced by Hammond in his spring budget to help councils cope over the next three years.

It also reiterated its call for greater financial flexibility and powers to allow town halls to build new homes in large numbers once more. …

… Alongside its urgent plea for cash for adult social care, the LGA has called for cross-party talks at national level to find a long-term solution to the social care funding crisis. The move echoes a call made by the Commons select committee for communities and local government in March that concluded that inadequate funding was having a serious impact on both the quality and level of care, and said a long-term fix was urgently necessary. Earlier this year, former Lib Dem social care minister Norman Lamb and a small group of cross-party MPs urged the prime minister to set up an NHS and Care convention to work on a sustainable settlement. A recent poll by the charity Independent Age showed that 86% of MPs believe a cross-party consensus is needed. The LGA has even offered to host the first round of discussions. …

… One way to save significant money would be to replace the two-tier system of one county and four district councils with one unitary authority. Having responsibilities split across two tiers of local government is crazy, says Tett. Districts, for example, are responsible for housing, counties for infrastructure – yet they are “two bits of the same jigsaw”. It would speed up decision-making, end the confusion about who is responsible for which services and allow a more holistic approach, such as joint commissioning across housing, health and care, he says.

The business case for unitary authority status has been in communities secretary Sajid Javid’s in-tray since last September. Tett is waiting to see if the reasoned argument will be heard.”

https://www.theguardian.com/society/2017/oct/03/martin-tett-social-care-decent-housing-austerity-neglect-investment

Rise in hospital deaths coincides with bed-blocking

Owl isn’t sure if The Times or the British Medical Journal realise that what they are saying is:

Sick people should have been turfed out of hospitals (where they died in the charge of nurses and doctors)and should instead have been sent to die at home (with carers).

One gets included with mortality statistics, the other doesn’t … Hhhmmm!

A sharp rise in deaths in England and Wales could be down to an increase in bed-blocking in the NHS.

Between July 2014 and June 2015 there were an additional 39,074 deaths compared with the year before. For England it represented the largest rise in nearly 50 years. The higher rate of mortality has continued since, with most of the deaths in older, frail people.

About a fifth of the increased deaths may have been caused by heightened levels of delayed discharge from hospitals, a study has concluded.

While the study itself can prove only a correlation, rather than causation, the researchers said that their findings required “urgent attention”, adding: “Greater investment in the NHS and adult social care to address the rising levels of delayed discharges may be needed to tackle the rapid rise in mortality rates.”

In February, a study published by the Royal Society of Medicine concluded that cuts to health and social care were “implicated” in the deaths.

The research team from the universities of Liverpool, Oxford, Glasgow and York found that while the total number of days beds were blocked increased from 2011, the rate of change increased from 2014, with the number of affected patients also rising rapidly. For each additional acute patient delayed, the number of deaths went up 7.32.

Mark Green, lecturer in health geography at the University of Liverpool, who led the research, said: “Since 2014, the number of patients admitted for acute conditions who were delayed being discharged from hospital has almost increased by 50 per cent. This creates blockages in the NHS where beds are not available for new patients.

“We detect an association only for acute patients and not non-acute patients. Acute patients require urgent medical care and therefore may be more susceptible to any delays.”

Hospitals have laid much of the blame on social care services, with patients waiting in hospital beds for the services they need to go home.

Saffron Cordery, director of policy and strategy at NHS Providers, representing hospitals, said: “We cannot say with any certainty how much delayed transfers of care are to blame for rising death rates. However, it is clear that they are bad for patients.”

The research is published in the Journal of Epidemiology and Community Health, a BMJ title.

Source: Times, pay wall

The NHS: one doctor’s story

“An open letter to Prof Ted Baker, following his attack on the NHS
Dear Professor Baker,

It seems like only yesterday that another Professor – Stephen Hawking – felt compelled to raise concerns in the press about the current state of the NHS. If you recall, Hawking’s critique of Jeremy Hunt’s predilection for statistical cherry-picking prompted an extraordinary barrage of tweets from the Health Secretary, admonishing one of the world’s greatest scientists for his cluelessness on the matter of, well, scientific methodology.

Professor Baker, your interestingly-timed intervention today has prompted quite the barrage of headlines itself, hasn’t it? An NHS ‘unfit for the 21st century’, indeed? And that picture you paint of A&E departments’ disgraceful ‘unsafe practices’ – our ‘wholly unsatisfactory’ arrangements that ‘endanger patients, as well as denying them basic privacy and dignity’. It’s almost as if you think we’re somehow choosing to ‘keep piling patients into corridors where staff cannot even see them’ or to force patients to queue, hour upon hour, in ambulances outside log-jammed hospitals. Actually, you go further, don’t you? You directly blame us for the hellish conditions that patients and staff alike endured last winter, condemning our culture of ‘learned helplessness’ that leaves our patients abandoned, unmonitored, without even essentials like oxygen.

There’s just so much blame in your interview, isn’t there? Previous NHS staff, current NHS staff, ‘archaic’ NHS systems, bad managers, bad previous governments. Blimey. No-one, it seems, is immune from your blame. Except, that is, the one glaring exception. The one cherry you chose not to pick, so to speak.

Nowhere in your remarkable blame riff is there any mention of the funding climate in which frontline staff and managers alike are struggling – fighting tooth and nail, frankly – to keep on delivering a halfway decent standard of care for our patients. We are trying so unbelievably hard, Professor Baker. But we already have one of the lowest numbers of beds per capita of any country in Europe, as well as being one of the most under-doctored. And, of course, we have a government, currently, who has chosen to subject the NHS to the most draconian and sustained funding squeeze in NHS history. Right now, the NHS in my region is having to cut even more beds, hundreds of them. It simply cannot afford to do otherwise – like every acute Trust in the country. That’s not really going to help the patients stranded, bedless, in corridors about which you care so deeply, is it?

Of course NHS reform is needed. Of course we need greater community capacity and better integration between hospitals and primary care. But in omitting to mention the political context to your argument – the political choice to provide the NHS with inadequate resources safely to manage not only winter, but all-year-round rising demand – you come across, I’m afraid, as an oddly partisan chief inspector of hospitals. Why the omission, Professor Baker? Why blame the NHS and its dog, yet fall so shy and silent when it comes to acknowledging the political choices to underfund and understaff the NHS into a skeleton service in place of excellence?

Do you really think your admonishing letter to Trust CEOs, telling them to jolly well stop leaving patients in corridors, is going to do anything other than incense us all? Where else would you suggest we put them? Toilets? Broom cupboards? I believe Jeremy Hunt’s new toilet is rather lavish – perhaps we could squeeze one or two in there?

Anyone would think you were giving the Department of Health comms team a helping hand in the pre-emptive deflection of blame for the looming winter crisis away from the government and onto anyone else but Theresa and Jeremy. I thought nothing could surpass for sheer stupidity last week’s news that NHS staff were forced by NHS bosses to chant “we can do it” as an approach to managing ED winter pressures. But you, Professor Baker, have managed to out-Brent even that David Brent of a spectacle: instead of empty exhortation, you have apparently plumped for his more bullying style of management, through the medium of tetchy, head-masterly letters saying ‘you can and will pull your socks up – or else’. In all those years you’ve worked in the NHS since 1972, have you never noticed that nothing good ever comes from a caning?

Let me remind you what blame culture achieves, Professor Baker. First, it demoralises and undermines frontline staff. Then, it makes us feel hopeless and impotent. We stop trying to speak out, we become cowed and silent. And now, all that bullying and blame has managed to make the NHS less safe, not more, by allowing a culture to flourish in which no-one feels they can change anything, let alone risk speaking out for the sake of our patients.

In your interview, you’ve just achieved all of the above. I’m a hard-working NHS hospital doctor, and you’ve made me feel angry, demoralised, hopeless and incredulous – all in the same moment. That is not leadership, Professor Baker, and it is certainly not conducive to high standards of patient care. It serves only to present you to the public and NHS staff alike as a hospital chief inspector who seems to care more about playing a political game than the vital matter of patient safety.

How incredibly, bitterly disappointing.

Incidentally, please consider this letter my raising of safety concerns on behalf of NHS patients nationwide, as my duty of candour demands me to do.

Dr Rachel Clarke

Oxford”

An open letter to Prof Ted Baker, following his attack on the NHS

Playing politics with peoples’ lives

“Labour has called for an inquiry after the collapse of a private ambulance firm that has contracts with the NHS and other private health organisations.

Private Ambulance Service, which the trade union Unison described as running an “abysmal” operation, was issued a winding-up notice by the Inland Revenue on Friday. The firm is expected to stop trading on 9 October.

The company has been employed in Bedfordshire and Hertfordshire as non-urgent patient transport service. It worked for hospitals including Watford General and Bedford hospital.

Labour MP Justin Madders, the shadow health minister, said: “It is still staggering that under the Tories so many parts of the NHS are being packaged up and sold off to companies who are unable to run the services properly.

“Several hundreds of staff and thousands of patients are now faced with huge uncertainty because of the failings of another private ambulance firm, and it’s not the first time this has happened.”

Madders called for an inquiry into what went wrong, saying the government should place “an immediate halt” on issuing other patient transport contracts until “lessons have been learned”. …”

https://www.theguardian.com/society/2017/oct/02/labour-calls-for-inquiry-after-private-ambulance-firm-folds

Jeremy Hunt – drinking for US (that’s for the United States, not us the people)

Not at an NHS meeting, not at a social care meeting – special guest at a Boeing “drink tank”.

“Jeremy Hunt faced a torrent of criticism after it emerged he will be at a Boeing-sponsored “drink tank” while more than 4,000 UK jobs at rival firm Bombardier “hang by a thread”.

Theresa May has hinted that the UK Government could boycott Boeing after a trade dispute over aggressive tariffs broke out – a dispute which could ultimately see 4,500 workers at Bombardier’s Belfast factory made jobless. …”

Huffington Post UK
https://t.co/C3R5WiAPm5

“NHS ‘not fit for 21st Century’, says chief hospital inspector”

And not a word about austerity, cuts or underfunding!

“The NHS is not fit for the 21st Century, the new chief inspector of hospitals in England has said.

Professor Ted Baker, who started the role last month, said the system had not adapted to deal with the growth in the population.

In an interview with the Daily Telegraph, he said: “The model of care we have got is still the model we had in the 1960s and 70s.”

The Department of Health is yet to respond to his views.

Prof Baker succeeded Sir Mike Richards overseeing the hospital division of the Care Quality Commission (CQC), having been his deputy since 2014.
The former hospital medical director said the NHS had not modernised because of a historic lack of investment.

He said: “One of the things I regret is that 15 or 20 years ago, when we could see the change in the population, the NHS did not change its model of care.

“It should have done it then – there was a lot more money coming in but we didn’t spend it all on the right things. We didn’t spend it on transformation of the model of care.”

The number of pensioners has increased by a third in the last 30 years and he said the system had not been able to deal with the increase in the number of elderly people in particular.

He also criticised accident and emergency wards and has written to all hospital chief executives calling for action to improve safety.

Too many hospitals had “wholly unsatisfactory arrangements”, he said, such as letting ambulances queue up at the entrance or leaving patients in corridors.

The CQC is expected to highlight increasing pressures on hospitals, who are in danger running out of beds and staff, in a report next month on the state of the health and care services.

That was an issue that Prof Baker touched on in the interview, saying: “Capacity is being squeezed all the time. That is a real concern going forward – because there comes a point at which the capacity isn’t there”.

The BBC’s health editor Hugh Pym said Prof Baker’s comments come after predictions of a difficult winter for the service, with the chief executive of NHS England warning of the possibility of a serious flu outbreak.
NHS Providers, representing trusts, has said that without an emergency cash bailout the service faces the worst winter in recent history, our correspondent added.”

http://www.bbc.co.uk/news/uk-41451162