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Tracking the changes in the NHS
Curated by Mike McNamara
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NHS will need £88bn extra by 2067, says OBR forecast

NHS will need £88bn extra by 2067, says OBR forecast | nhswatch | Scoop.it

The NHS budget will need to increase by £88bn over the next 50 years, meaning governments could have to raise taxes or cut spending in other areas to fund it, the Office for Budget Responsibility (OBR) has said.

The soaring costs threaten to render public finances generally “unsustainable”, according to the OBR’s latest fiscal sustainability report. It says the government could find it hard to deliver on its pledge to balance the budget during the next parliament.

The NHS’s budget will need to increase from £140bn in 2020-21 to about £228bn by 2066-67 in order to keep pace with the rising demand for healthcare, according to the OBR’s projections.

It says the budget will need to rise by an average of 2% each year over that period – much more than the 1% annual rises the NHS has had since the coalition took office in 2010, but barely half the 3.8% annual real-term rises it has seen since 1978-79.

The rising costs of providing healthcare in coming decades could force ministers to increase the proportion of GDP going into health from the 6.9% expected in 2020-21 to 12.6% by 2066-67. That 12.6% would equate to about £228bn in today’s prices, the OBR confirmed.

Norman Lamb, the Liberal Democrats’ health spokesman, said: “This analysis confirms that spending on the NHS and on care services will either have to rise significantly or the system will collapse. We will see an end to the NHS as we know it.

“Current levels of care cannot be sustained with the fall in real-terms spending per person which is currently envisaged.”

The NHS England chief executive, Simon Stevens, has said that under the government’s current spending plans, per capita health funding will fall in real terms in 2018-19, the year the NHS will turn 70.

Last September the OBR set out how the growing number of older people in coming decades would oblige governments to spend more on healthcare, though it did not say how much more.

Its latest figures detail how much will be needed in light of three factors it did not analyse then: the emergence of new technology that will boost patient care, the development of new drugs and a rise in the number of people with chronic long-term conditions, such as diabetes and cancer.

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'Exceptional' NHS Wales winter pressure days

'Exceptional' NHS Wales winter pressure days | nhswatch | Scoop.it

The NHS in Wales has already faced "exceptional" challenges this winter, the head of the organisation has said.

It includes some of the busiest days ever faced by hospital emergency units and the Welsh Ambulance Service.

It comes ahead of December's A&E waiting times being published, which will be the first indication of how Wales is coping with winter pressures.

Dr Andrew Goodall said currently up to 20% of admissions in some A&Es are of patients aged over 85.

How A&E stats take temperature of NHS

"We're used to having a high proportion of over 85s - the normal level is around 10% but we're seeing levels close to 20% over the last two weeks," said Dr Goodall, NHS Wales chief executive.

Dr Goodall added: "We remain a system under a lot of pressure but we've prepared very well for this winter.

"There have been some difficult days. But the fact we've come in to this winter with an ambulance service which is performing much more resiliently has really helped us in our response and that we've kept our social care delays low is a positive issue but there is still more to go at."

BBC Wales has also asked health boards across Wales about pressures so far this winter.

Abertawe Bro Morgannwg - responsible for hospitals in Swansea, Neath and Bridgend - said it had been experiencing an increase in demand, compared to last year.

"In particular, we've seen a 32% increase in the number of ambulances arriving with the most urgent category of patients," said a spokeswoman.

"The number of emergency admissions have also risen by 6% when compared to last year."

More ...

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Brexit trade deal with US puts NHS at risk, Theresa May warned

Brexit trade deal with US puts NHS at risk, Theresa May warned | nhswatch | Scoop.it

Teresa May has been warned by campaigners and politicians that a rushed trade deal with Donald Trump’s US administration puts the NHS, the environment and food safety at risk.

Figures from different political parties, a union and pressure groups united to say an agreement hurriedly arranged to show Ms May’s Brexit strategy is a success, would likely see Britain bowing to Mr Trump’s terms.

Brexiteer hopes of a quick US deal were boosted when Mr Trump used an interview to say his team would look to cement an arrangement with the UK quickly, but shadow health secretary Jon Ashworth demanded “urgent guarantees” the health service would not be carved up by US corporations.

He added: “A rushed trade deal with Trump may give ministers cover for their dangerous Brexit strategy, but it will not hide the risk that this could be a Trojan horse for NHS privatisation.”

Much of the opposition to the EU/US Transatlantic Trade and Investment Partnership, known as TTIP, focussed on whether it would allow the de-facto privatisation of health services.

Unison General Secretary Dave Prentis said a “quick-fix trade deal” with Mr Trump would be as bad for the NHS and the environment as “TTIP threatened to be.”

Joe Carberry, Co-Executive Director of campaign group Open Britain, said: “A quick deal will almost certainly mean the smaller partner acceding to the terms of the larger partner, the US, which in our case could threaten our NHS and high environmental standards.”

Chair of the Environmental Audit Select Committee, Labour MP Mary Creagh, said: “A quick trade deal with Donald Trump runs real risks. “Our food safety and environmental standards could be compromised if we simply open up our domestic markets to US interests without asking questions.

“The Government is chasing positive Brexit headlines but that must not come at the expense of the UK remaining a world-leader on environmental issues.”

Liberal Democrat spokesperson for energy and climate change, Baroness Featherstone, claimed “rushed trade deals” could jeopardise environmental standards and push the UK further away from climate change solutions.

Co-Leader of the Green Party, Caroline Lucas MP, said: “While the EU has shown climate leadership, Donald Trump has appointed at least nine climate-sceptics to his cabinet.

“If the British Government is serious about climate change, we need to keep working closely with European countries who are leading the world in facing up to this challenge.”

Friends of the Earth campaign lead Samuel Lowe argued that the US has long pushed for the removal of the EU ban on hormone treated beef and a “watering down of our precautionary approach to regulating health and the environment”.

He added: “There is a real risk that, in its rush to sign a headline-grabbing UK-Trump deal as quickly as possible, the Government will be forced into concessions it would never normally make.

“Trump knows this; that's why he’s interested. A trade agreement is not a good thing solely by virtue of its own existence. Substance matters. Context matters. Politicians forget that at their peril.”

Downing Street has welcomed Mr Trump’s pledge to work to secure a rapid trade agreement with Britain. In an interview with The Times and German newspaper Bild, the US president-elect said he would be inviting Ms May for early talks in Washington following his inauguration on Friday.

Ms May’s official spokeswoman said: “We welcome the commitment from the President-elect to engage with the UK on this, to work together to agree a deal quickly. That highlights one of the opportunities of the UK leaving the EU.”

The spokeswoman said that Ms May's expected visit to Washington in the spring would provide an opportunity for “early discussions” on a UK-US deal, but stressed that Britain will respect EU rules which bar it from signing agreements with third parties so long as it remains a member.

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You can see the cuts in the NHS but the cuts in schools are as dire

You can see the cuts in the NHS but the cuts in schools are as dire | nhswatch | Scoop.it

As recent weeks have shown, hospitals are in crisis, with ill people lying in corridors, in pain, as treatment is held back for hours. Those images are why the public worries about the NHS and almost always supports extra cash for it.

School crises are less visual. No one photographs the child with learning difficulty, sobbing as the teaching assistant they worked with for the past three years is booted out. No one sees the cuts in music lessons, the special needs children who are told to go somewhere else because the school cannot afford to take them, the extra pupils in a class – or 10.

But make no mistake: schools really are heading for a budget crisis. Last year, more than half of secondary schools overspent. The average secondary academy that is in the red has a bank balance of minus £363,000. The situation is so dire the National Audit Office has warned that by 2020 schools will be worse funded than at any time since the mid-90s.

Luckily, the Department for Education has everything under control. It told the NAO that mainstream schools can cut their “workforce” (read: teachers) by £1.7bn over the next three years. Plus £1.3bn of savings in “procurement spending” are possible (everything else).

There’s just one catch. When the NAO asked the DfE how these savings were possible, it couldn’t give any detail. No tests have been done to see if schools can run at lower costs. The government failed to cut back procurement spending by just £1bn over the last parliament (costs actually went up by half a billion), so £1.3bn in the next three years seems like a finger-in-the-air plan. What it all adds up to is this: schools are heading towards mass bankruptcy and the only government plan for solving it is optimism.

Theresa May did a similar thing with the police. In 2015, as home secretary, she told the Police Federation they were “crying wolf” over budget cuts given crime was falling. Less cash did not necessarily mean a poorer quality service, seemingly. There is not going to be a similar fall in demand in schools. If anything, May’s new plan to make schools a key figure in identifying mental health problems in children means their responsibilities are only likely to grow.

Headteachers, pressured to keep academic results high, will scramble to save pounds while fighting tooth and nail to keep delivering a quality education. But, as head Lorraine Heath wrote recently, things are getting raw: “There is nowhere else to cut. It will hurt and it will fester, and it will infect and contaminate everything that we do. It’s easy to lead when things are going well and we have been very lucky. And I also know that it is in times of adversity when leaders really have to step up and show their worth. I’m just not sure that I want to.” As the demands on schools grow, people like her will become so demoralised they start to think about walking away – along with many other teachers already flocking overseas.

Here’s a question, though. Let’s imagine it is 2020 and almost all schools in England are in deficit, with no plan for improving. What then? Will the government close them all? Will it sack every head who fails to adhere?

The DfE does not have a plan. It would be a brave headteacher who refused to make the cuts but, if it comes to it, there may be merit in calling the DfE’s bluff, at least until the brains who said the savings were possible come up with a strategy for delivering them.

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Breast cancer patients' distress at withdrawal of Kadcyla

Breast cancer patients' distress at withdrawal of Kadcyla | nhswatch | Scoop.it

Terminal breast cancer patients have spoken of their distress after learning that a life-extending drug they had been told would be available to them looks set to be withdrawn.

Advisory body NICE is reviewing drugs made available through the old cancer drugs fund, and has rejected Kadcyla for use on the NHS in England.

It believes the price per patient set by manufacturer Roche is too expensive. Roche says discussions are continuing.

One patient said the move felt "cruel".

In clinical trials, Kadcyla - £90,000 at full cost per patient - was shown to extend terminal breast cancer patients' lives by an average of six months, and to dramatically improve quality of life when compared with other treatments.

It is used to treat people with HER2-positive breast cancer that has spread to other parts of the body and cannot be surgically removed.

Bonnie Fox, who is 39 and from Croydon, south London, told the BBC's Victoria Derbyshire programme that she had been informed by her oncologist that the drug would be available to her when her current drug became ineffective.

She said when she had discovered the drug was no longer routinely available on the NHS, she had been "completely devastated".

"I'm really dependent on those extra years... they could [help me achieve] extra milestones with my son, help me see him get to school," she said.

"To have that suddenly taken away feels so cruel. You know that drug is there, and you know that drug is good."

Patient Gill Smith said had been assured by her oncologist that Kadcyla would be available when she needed it.

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Health tourism warning as NHS chases £350,000 bill from Nigerian woman who gave birth in a British hospital

Health tourism warning as NHS chases £350,000 bill from Nigerian woman who gave birth in a British hospital | nhswatch | Scoop.it

The Government has been urged to crack down on health tourism after it emerged that a Nigerian woman cost the NHS £350,000 by flying to Britain to give birth to twins.

Luton and Dunstable University Hospital is said to be chasing payment for the caesarean section the unidentified woman had, followed by intensive care treatment for the two babies.

The incident was disclosed by the hospital following a freedom of information request by the Daily Mail.
Pregnant woman
Maternity wards are under pressure Credit: Katie Collins /PA

The woman gave birth in 2015, and the hospital confirmed it was still owed £348,683 for the treatment.

The hospital, which has one of just three paediatric intensive care units in the East of England region, said it could not refuse treatment if there was a "danger to life".

The cost of health tourism is believed to add up to £280m each year.

There were 13,077 overseas patients given treatment in the UK in 2015-16, according to data from the 90 hospitals who responded to the freedom of information requests. Of those, over 3,000 were mothers who arrived in the country to give birth.

A woman who gave birth to triplets has an outstanding bill of £319,895 to Imperial College Hospitals London.

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Hospitals across England declare 'black alert' as NHS crisis worsens

Hospitals across England declare 'black alert' as NHS crisis worsens | nhswatch | Scoop.it

More than 20 hospitals in England have been forced to declare a black alert as the NHS crisis deepens.

According to figures obtained by the Guardian, at least 23 hospitals had to issue the warning declaring that they cannot cope with increasingly overwhelming patient numbers.

One hospital trust was under so much pressure on Tuesday that it had to declare a ‘system critical incident’ – even higher than a black alert.

Staff at University Hospitals of Leicester NHS trust were reportedly forced to make patients wait in ambulances before they could be offloaded into A&E.

As hospitals struggle to manage a surge in the demand for care, they have been forced to take unprecedented actions – such as treating adults in children’s wards, cancelling cancer operations, and even closing a birthing centre.
What is a 'black alert'?

Last October, in anticipation of a winter crisis, NHS England issued guidance to NHS acute trusts telling them to declare a ‘black alert’ if they become ‘unable to deliver comprehensive care’, and if there is ‘increased potential for patient care and safety to be compromised’.

The document outlined a system hospital trusts could use – the operational pressures escalation levels (Opel) scale.

A black alert is around Opel 4 – which means that ‘decisive action must be taken… to recover capacity and ensure patient safety’ as they experience ‘rising system pressure’.

After running out of beds, staff working at Lewisham hospital in south London received an email describing the situation as ‘critical’ and ‘not safe’.

These stark cases showing the extent of the crisis came to light just one day after the Prime Minister dismissed the Red Cross’s warnings about the NHS as ‘overblown’.

Addressing the Commons at PMQs, Theresa May attacked the Red Cross for calling the situation a ‘humanitarian crisis’, admonishing them for what she said was an ‘irresponsible and overblown’ statement.

However, the Royal College of Physicians, the Royal College of Emergency Medicine and the British Medical Association have all also issued warnings about the NHS crisis.

And the trusts declaring black alerts could be just the tip of the iceberg.

One doctor at Maidstone and Tunbridge Wells NHS trust in Kent told the Guardian it hadn’t declared an internal emergency because trust bosses didn’t want the negative publicity.

But the situation is no less dire. The doctor apparently described how a patient with urinary problems was given a bed bath in the middle of a corridor, with nothing to shield her but a plastic sheet.

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Hundreds of NHS staff face being assaulted at work – but few assaults lead to criminal convictions

Hundreds of NHS staff face being assaulted at work – but few assaults lead to criminal convictions | nhswatch | Scoop.it
Avon and Wiltshire Mental Health Partnership (AWP) and the South Western Ambulance Service NHS Foundation Trust (SWASFT) saw a rise in the number of assaults against their staff in 2015/16, compared to 2014/15.

In 2015/16, 160 assaults against SWASFT staff led to 38 criminal sanctions but just one of 1,003 assaults against AWP staff led to a prosecution.

This could be because many assaults are due to medical factors – where a person is either confused or unable to control their actions.

A spokesman from AWP said it takes all assaults ‘very seriously’ and added: “We have a positive reporting culture and processes in place to review all incidents and learn from them.

“All clinical staff are trained in conflict resolution and de-escalation techniques.

“We involve the police as required and the Crown Prosecution Service decides if a prosecution is in the public interest.”

An SWASFT spokesman said it takes a ‘zero tolerance’ approach to abuse against its staff, and added: “All reports of violence and aggression are taken very seriously.

“Every member of trust staff plays a vital role in serving the community by helping to deliver the right care in the right place at the right time and staff should be able to fulfill their life-saving role without fear of abuse or assault.”

SWASFT also has a ‘staying well’ service which provides counselling and physiotherapy for staff affected by assault.

Weston General Hospital has bucked the trend to see a reduction in the number of assaults against its staff, and the hospital says it is working closer than ever before with police.

Bronwen Bishop, the hospital’s director of strategic development, said: “We understand visiting hospital can be a stressful experience for people. However, no-one should feel threatened or intimidated while they are here. It is really important our staff feel safe.

“We are currently working with our local partners, including police, on various initiatives to ensure we are providing the safest environment for staff to do their job and for patients to be treated.

“Assaults can also occur when treating people who become confused as part of their illness, so we’re continually examining different ways we can create the right, calm environment in which those patients can be treated.”
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London’s NHS hospitals face extra £16m-a-year business rates bill

London’s NHS hospitals face extra £16m-a-year business rates bill | nhswatch | Scoop.it

NHS hospitals in London will have to pay an extra £16m a year in business rates after a revaluation that comes into force from April, putting them under further financial pressure.

According to calculations for the FT by CVS, a group of business rates consultants, bills for NHS hospitals in London will rise by a quarter.

Business rates are calculated on the rental value of a property and are being updated in April for the first time in seven years. Because rents in London have accelerated faster than the rest of the country, bills for the capital will rise rapidly.

The worst affected hospital is the 17-floor Royal London, halfway between the City and Canary Wharf in the east of the city. Its bill will rise from £6.3m to £9m in April, said CVS.

Royal London is part of Barts Health NHS Trust, the biggest in the country, which operates five hospitals and whose rates bill could rise by as much as 40 per cent.

The trust had a budget deficit of £135m in 2015-16 and was placed in “financial special measures” by NHS Improvement, the regulator, in September.

“Like every Trust in London, we have been aware of the coming changes in business rates and we have plans in place to meet our financial obligations,” it said.

Imperial College Healthcare NHS Trust, which runs five hospitals including St Mary’s in Paddington, said its bill would rise by 25-30 per cent and “we have factored the rise into our financial planning”. It recorded a £48m deficit for last year and had a rates bill of £4.7m.

Last year 80 NHS trusts, represented by consultancy Bilfinger GVA, launched a campaign to claim eligibility for an 80 per cent discount on business rates, backdated for six years, because they were charities. The move was criticised at the time as one part of the public sector taking money from another.

The Local Government Association said on Wednesday the dispute had not been resolved. “We remain of the view that NHS Trusts and Foundation Trusts are not charities and therefore not eligible,” it said. “Following legal advice, affected councils have responded to further letters from GVA setting out that their arguments for relief remain unfounded.”

Some private hospital groups, such as Nuffield Health, are charities and thus eligible for the discount. Business rate valuations are carried out by a government agency in a way mandated by law, and the tax is collected by local councils. The Treasury redistributes the tax revenue raised among councils nationwide according to need.

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NHS to recruit hundreds of GPs from Poland, Lithuania and Greece

NHS to recruit hundreds of GPs from Poland, Lithuania and Greece | nhswatch | Scoop.it

The health service is to recruit hundreds of GPs from countries such as Poland, Lithuania, Greece with promises of £90,000 salaries and “generous relocation packages” in a bid to tackle a spiralling NHS crisis.

The new scheme run by NHS England will see doctors from across the EU undergoing 12 weeks training in Poland before they start work in Britain.

Health officials are trawling EU countries for medical staff in a bid to plug shortages of family doctors, amid warnings that long waits to see GPs are fuelling the Accident & Emergency (A&E) crisis.

Medics from Croatia, Lithuania, Greece, Spain and Poland have now been recruited, as part of plans which aim to bring 500 doctors in from the EU ahead of Brexit.

Last night patients groups said the measures were “desperate” and said the NHS had “taken a wrong turn” in failing to attract enough home-grown doctors.

On Wednesday a report by the National Audit Office warned that poor access to GPs during the working day could be fuelling Britain’s A&E crisis.

The watchdog said almost half of practices had closures during office hours, with one fifth regularly closing their doors by 3pm.

It followed warnings that rising numbers of patients are being forced to wait a month to see a family doctor, with estimates of a shortage of up to 10,000 GPs by 2020.

The new scheme, being piloted in Lincolnshire by local medical committees and NHS England, is being used as a blueprint for national plans to hire 500 GPs from overseas.

Doctors will be promised a guaranteed annual salary of £90,000 and a “generous relocation package” to move to England.

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The NHS is a national disgrace - here's my 10-point plan to save it

The NHS is a national disgrace - here's my 10-point plan to save it | nhswatch | Scoop.it

For just £2 a month this winter, you can help someone like Elsie.

Eighty-seven-year-old Elsie nearly died when she fell near her West Country home and was left freezing by the side of the road after it took an ambulance over two hours to reach her.

Elsie is just one of thousands of Britons being “forgotten-to-death” in an ailing, third-world medical system where besieged A&E departments shut their doors 42 times in a single week, and patients in so-called “care homes” are regularly deprived of food and water. Please give generously to a desperate country at this time of crisis…

Can you imagine such a charity ad ever being placed? And yet, here we are, in denial about the scale of the unfolding catastrophe with our National Health Service.

On the same day that the British Red Cross warned it faced a “humanitarian crisis”, a message popped up in my Twitter feed from something calling itself NHS Million. “We’re searching for a million people who love the NHS and think it’s worth celebrating,” it cooed. “Please retweet if you agree.”

Do you love the NHS? Do you really?

Do you love the fact that at least two Britons a day are dying of thirst or starvation in hospitals and care homes, a situation which Age UK calls “horrifying”? Do you love the fact that an overstretched NHS has set aside £56 billion (yes, billion…) for compensation payouts? Do you love that our cancer survival rates lag well behind other countries?

Read much more ...

Mike McNamara's insight:
An interesting article that really brings out some valid points that need to be addressed by this government.
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NHS cuts plan will hit Cheshire couples desperate for a baby

NHS cuts plan will hit Cheshire couples desperate for a baby | nhswatch | Scoop.it

Cash-strapped NHS bosses in Cheshire and Wirral are looking to slash free fertility treatment for couples desperate to have a baby.

Under the plans, five Clinical Commissioning Groups (CCGs) are proposing to reduce the number of IVF cycles being offered as health bosses attempt to plug a £13m budget shortfall in West Cheshire alone.

The move has been slammed as ‘short sighted’ by fertility experts and a leading charity warned it would exacerbate the ‘postcode lottery’ of fertility services.

Currently, would-be parents are offered three cycles of IVF, which is in line with guidelines set out by the best practice body NICE.
A pregnant woman. Photo: Andrew Matthews/PA Wire

But if the proposals are given the go-ahead, this will be slashed to either two cycles or one cycle for women between the ages of 23 and 39.

The plans could also see the use of donor eggs and sperm banned unless the patient has a genetic condition.

CCGs are also considering making couples try for three years before they are entitled to help, one year longer than at present.

And one option suggests introducing restrictions within the policy around body mass index and smoking thresholds for both the female and male partner

In a consultation document considering a raft of NHS cut-backs, health bosses acknowledge the impact for couples unable to conceive ‘may be significant’.

According to NICE, the typical success rate for each cycle is 20 to 35 per cent. The cumulative effect of three cycles increase the chances of getting pregnant to around 45 to 53 per cent.

Nationally, IVF on the NHS has hit a record low. Charity Fertility Fairness say less than one in five (17 per cent) of CCGs offer three full cycles of NHS-funded IVF to eligible couples.
Dr Luciano Nardo, of Daresbury-based Reproductive Health Group.

Dr Luciano Nardo, clinical director at Daresbury-based Reproductive Health Group, said: “One in seven couples will experience difficulty conceiving and embarking on fertility treatment is an important decision which will rarely be taken lightly.

“Couples who face restrictions with regard to what they are entitled to on the NHS face even more stress and uncertainty.

“Guidelines from NICE are clear, and are there for a reason. Ignoring these recommendations is not only short-sighted, but it is devastating for those couples desperate to achieve their dreams of having a child.

“We regularly see couples who have had one failed cycle on the NHS, only to conceive through fertility treatment with us, proving additional cycles are clinically effective.

“Using donor eggs and sperm can also be the only way in which some people can have a baby. Taking this option away on the NHS will be incredibly difficult for many to take.”
A pregnant woman having a scan.

Other fertility treatments being targeted under the proposed plans include scrapping funding for intrauterine insemination, which involves sperm being placed into the womb using a plastic tube, surgical sperm retrieval, and all male and female sterilisation.

Susan Seenan, joint chair of charity Fertility Fairness, said: “Infertility is a disease as recognised by the World Health Organisation and, as with any other medical condition, it is deserving of treatment.

“Based on the NICE guidelines, it is unequivocally clear that three full cycles of IVF or ICSI should be provided to those in need.

“Reducing access to IVF treatment and introducing restrictive access criteria would mark a drastic departure from these guidelines, and further exacerbate the postcode lottery of fertility services.”

Dr Chris Ritchieson, chair of NHS West Cheshire Clinical Commissioning Group, said: “Fertility treatment, including IVF, is just one area which is currently being consulted on – and we welcome people’s views.

“The consultation is being conducted in partnership with Clinical Commissioning Groups across Cheshire and Wirral to ensure that similar treatments and procedures are provided against the same criteria.

“Cheshire and Wirral benchmarks highly on IVF provision compared to other parts of the country and currently offers three cycles as per national NICE guidelines. Most Clinical Commissioning Groups fund one cycle of IVF on the NHS, while others have stopped funding IVF altogether.

“We understand that fertility treatment is an important and emotive issue. That’s why we want to listen to people’s views and understand how any change in policy may affect them.”

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Lancashire Care NHS Trust has improved

Lancashire Care NHS Trust has improved | nhswatch | Scoop.it

Lancashire Care NHS Foundation Trust has been rated good after its latest inspection.

During their last one the rating was 'requires improvement.'

A team of 80 inspectors from the Care Quality Commission spent a week with the Trust in September to look at their services.

Six of them got a rating of good across all domains:

- Forensic inpatient wards
- Wards for older people with mental health problems
- Community based mental health services for older people
- CAMHS Tier 4 (The Junction and The Platform)
- Mental health crisis services and places of safety
- Community sexual health services

A rating of good was given to mental health services overall

Heather Tierney Moore, Chief Executive at Lancashire Care NHS Foundation Trust said:

"This is a fantastic achievement and is solely down to the hard work and effort that the Trust has put into making improvements following the first initial inspection. Our staff provide the best possible experience to the people that use our services. There are a number of times when the reports refer to teams and individuals that go the extra mile to support people.

"The CQC reports also highlight the positive interactions between our staff and patients and comment on our employees' kindness and caring nature. This fills us with pride and shows that we are a truly compassionate organisation. Comments from the people that use our service were also positive, with people saying that they were treated with dignity and respect also being a theme across the reports. It is heartening to know that people are being treated in line with our values. It also shows that we are making steps in the right direction towards achieving our vision of high quality care, in the right place, at the right time, every time."

In summary, some of the positive aspects within the reports include:

- Most care plans were of good quality with evidence of patient involvement
- Services are delivered in line with national guidance and good practice
- Arrangements for children and young people transitioning to adult mental health services had improved since the last inspection
- Each clinical network had a clear and effective governance structure 'from board to ward'
- The Trust has a clear vision and values, and there is evidence that the Trust's strategy meets the needs of the population and is embedded across the clinical networks
- Evidence that the Trust's strategy had been developed to meet the needs of the local population and the Trust is actively involved in the Lancashire and South Cumbria Change

There are some areas that the CQC require them to focus on.

On the whole, these include issues that are already known to the Trust and that are in the process of being addressed, with some aspects such as staffing that will require on-going attention.

In summary, those areas requiring focus are:

- Ensuring that all staff receive regular supervision and appraisals
- Continuing to implement the recruitment and retention drive to ensure there are enough staff to meet patients' needs
- Ensuring that the seclusion policy is updated in line with the - Mental Health Act Code of Practice
- Ensuring that staff who require essential training receive it in line with trust policy
- Notifying the CQC of all Deprivation of Liberty Safeguards applications
- Relocating Hurstwood Ward (formerly ward 22) from Burnley to Blackburn, which has now been completed.

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How this charity bus is helping the isolated AND the NHS together

How this charity bus is helping the isolated AND the NHS together | nhswatch | Scoop.it
solated residents in rural parts of Holderness will be taken to doctors appointments and helped home from hospital after a charity bus service won an NHS contract.

Holderness Area Rural Transport (HART) is a vital service in the area, which has a high population of elderly people who are dependent on public transport to make their appointments.

HART has secured the contract, which was put out to tender, and hopes not only will it help isolated residents but take some of the pressure off the NHS.

Charity trustee Nigel Lowe said: "We're very pleased the bid's been accepted. We've shown that we can undertake this kind of work, and hopefully we'll be taking some pressure off the NHS."

Among the issues facing the NHS is so-called "bed-blocking", where patients are well enough to go home but because they are vulnerable, the care outside of hospital, like getting home, is not there.

Read more: Tragedy of 'strong, determined' dad Mike, 29, who won't live to see his children grow up

They also believe by HART taking on the non-emergency journeys, it will freeing up medical professionals to handle emergency situations.

"We hear a lot about issues of bed blocking causing problems for hospitals, so that's something we'll be able to help with," said Mr Lowe.

"It will give the ambulance service more resources for them to use and it will fill in a bit of flat time for us."

The move comes after HART teamed up with similar organisations in Beverley and Goole. The three teams put the bid together and will work across the region, meaning a wide reach for patients.

"It's important to be clear that this was a teaming up of three groups, so all parts of the region will be served," added Mr Lowe.

HART was set up in 2003 to help cater for those who can't drive and struggle with the cost and frequency of public transport in some areas in Holderness.
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More than 7,000 nurses could face axe under secret NHS plans 

More than 7,000 nurses could face axe under secret NHS plans  | nhswatch | Scoop.it

More than 7,000 nurse posts could be axed from NHS hospitals across the country despite a mounting Accident & Emergency crisis, new plans reveal.

Every area has been ordered to draw up meaures to save £22bn and reorganise health services in order to meet rising demand from an ageing population.

But new documents suggest that the proposals could result in the loss of more than 17,000 staff by 2020 - including 7,300 nurses and midwives.

Last night senior nurses said the implications for safety were “truly frightening” with widespread shortages of staff already in overstretched hospitals.

The forecasts, seen by Health Service Journal, also reveal that the plans rely on a dramatic reversal in trends which have seen casualty units under unprecedented pressure.

While A&E attendances across England have risen by 4.5 per cent and emergency admissions by 3.5 per cent in the past 12 months, the plans rely on a 4.2 per cent fall in attendances, and a 0.8 per cent drop in admissions.

Health authorities across England have been ordered to draw up 44 “sustainability and transformation plans” (STPs) to tackle rising pressures on the health service.

The controversial measures will see swingeing bed cuts in many parts of the country, and widespread closures of Accident & Emergency departments.

Officials insist that the changes will improve patient care, by shifting investment into GP and community services.

The analysis by HSJ examined finance, workforce and efficiency forecasts supplied alongside the STPs.

The data - from a sample of one in four STPs - suggests that savings rely heavily on job cuts, with a 2.3 per cent fall in registered nurses, and a 1.6 per cent reduction in all jobs.

Applied across England, it would mean reducations of around 17,300 staff in total, including 7,300 nurses, midwives and health visitors.

While the forecasts set out plans to boost GP numbers, the time taken to train such staff mean a time lag between cuts to hospital staff, and any significant increase in family doctors.

The documents also set out plans to increase the number of GP “support staff.” Health officials said this might include some nurses.
Simon Stevens
Simon Stevens has warned that the NHS trails other countries for funding Credit: PA

Senior doctors have warned that the NHS is currently battling the worst winter crisis in its history.

Latest figures show that in the first week of January, almost half of NHS trusts declared major alerts, with fears that the situation may worsen, amid rising levels of flu.

Tom Sandford, Royal College of Nursing drector of England, said reductions in nursing posts would have “truly frightening” implications for patient safety.

“Nursing staff make up the biggest proportion of the NHS workforce. There are already 24,000 vacant nursing posts across the UK,” he said.

“We have been hearing from members how the current situation is the worst that many have ever experienced. The situation cannot be allowed to worsen.”

Nigel Edwards, chief executive of think tank the Nuffield trust, suggested the plans were an unrealistic attempt to balance the books.

“Demand has been going up by around four per cent a year for around two decades and the demography of the next three to five years is characterised by the population ageing rapidly and growing - with a bulge in the group that uses healthcare most,” he said.

“These are very bold, if not heroic assumptions,” he said. “The question is whether this is achievable - and if it was, would it really be palatable?”

An NHS England spokesman said the planning process was still ongoing.

He said health officials expected to see a rise in the total number of nurses employed, with an expansion in the numbers employed in community and primary services.

“We are confident that a growing NHS will see more qualified nurses employed across England,” the spokesman said.

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Toll of hospital ‘bed blocking’ rockets to 7,000

Toll of hospital ‘bed blocking’ rockets to 7,000 | nhswatch | Scoop.it

Around 7,000 of England’s 137,000 hospital beds are filled each day by patients who should be discharged. The latest figures are 52 per cent up on five years ago.

One in three fit enough to leave are hit by delays in arranging home care or nursing home places.Social care budgets have been slashed by around a third in real terms since 2011. But each night in hospital costs around £298, compared with about £80 in a care home.

Other reasons for bed blocking may include family disputes or patients awaiting assessment. It has been blamed for partially causing the winter NHS crisis because the shortage of beds means A&E patients cannot be moved on to wards.

It also leads to muscle wastage in frail patients, who remain in bed without moving. Lib Dem health spokesman Norman Lamb said last night: “The crisis facing social care is turning our hospitals into ludicrously expensive care homes. “It’s a lose-lose situation.

“Forcing people to remain in hospital when they could be cared for at home makes thousands of beds needlessly unavailable for those who desperately need them. “Every day an elderly person stays unnecessarily in hospital, they lose more muscle strength and become more dependent.

“The Government must address this intolerable situation and invest more in social care to relive pressure on the NHS.” There were 6,825 bed blockers on the last Thursday of November, the last period for which figures are available.

A report by the National Audit Office published earlier this year questioned the accuracy of the official data and said the true number of blocked “bed days” could be underestimated.

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NHS Grampian funding could be chopped - amid growing concern over cancelled operations and staff recruitment

NHS Grampian funding could be chopped - amid growing concern over cancelled operations and staff recruitment | nhswatch | Scoop.it
NHS Grampian faces the prospect of being short-changed by the Scottish Government again next year – despite growing concern about cancelled operations and staff recruitment.

The health board is poised to receive as much as £15.1million less in 2017-18 than analysts believe it should, despite sky-high agency staff bills and reports that services are overstretched.

Last year, NHS Grampian was underfunded by £12.2million, which prompted criticism from any in the north east.

The revelation, which comes amid claims the health board has failed to act on a “damning report” into its services, has drawn outrage from local politicians, who said such a move would “beggar belief”.

Yesterday, the Press and Journal revealed a nursing staff crisis had led to the health board cancelling 160 operations in the past two months, including at least 13 since the beginning of January.

The Scottish Government said last night it had an additional £50million to distribute across Scotland’s health boards – which they insisted would bring NHS Grampian more closely in line with recommended funding levels.
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UK's largest NHS trust launches probe after recent cyberattack forced systems to go offline

Barts Health Trust, the UK's largest NHS trust, was reportedly hit by hackers recently. The trust, which runs The Royal London, St Bartholomew's, Whipps Cross, Mile End and Newham hospitals, has launched an investigation into the cyberattack that forced systems to be briefly taken offline.

The trust has ruled out a ransomware attack and added that patient data was not accessed by the hackers. However, the nature of the attacks and how many systems were affected still remain unclear.

"We are urgently investigating this matter and have taken a number of drives offline as a precautionary measure," The trust said, BBC reported. "We have tried and tested contingency plans in place and are making every effort to ensure that patient care will not be affected."

Security consultant Jamie Moles of malware detection firm Lastline told IBTimes UK, "There are a number of trusts in deficit and spending on the NHS has dropped in real terms since the recession. Priorities for all NHS trusts are unsurprisingly targeted at medical needs over and above admin and operational needs, but of course this includes IT Security.

"While security remains a low priority for NHS management, they will increasingly fall victim to these kinds of threats, which wouldn't be a serious problem except it has previously resulted in cancellation of treatments whilst the affected systems are investigated and cleaned up."

The recent cyberattack follows a similar attack in November 2016, which saw 3 hospitals run by the Lincolnshire and Google trust forced to cancel patient appointments and shut down systems while security experts worked to mitigate the impact of the attack.

A previous report highlighted that several NHS trusts spent little to nothing on cybersecurity, leaving sensitive patient data vulnerable and exposed to cybercriminals.

Moles said, "Moving forward if we are to prevent these issues causing delays to treatment and potentially deaths, NHS trusts are going to have to invest in technology to deal with Ransomware and other targeted malware based threats. There are plenty of good technologies available to assist in this issue and they can be scaled effectively and cost efficiently to cope with massive organisations like the NHS. Unfortunately, Antivirus is not one of them."

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Referral centres cause 'dangerous' NHS delays, BMA warns

Referral centres cause 'dangerous' NHS delays, BMA warns | nhswatch | Scoop.it
NHS patients face "dangerous" treatment delays due to a 10-fold increase in "crude, expensive" referral management centres, doctors have warned.

The centres, sometimes run by private firms, vet GP referrals and decide if patients should receive hospital care.

The British Medical Association (BMA) called them "inefficient" and a "block between the GP and patient treatment".

NHS Clinical Commissioners said "in many cases" the centres "provide a useful and effective role".

All but 12 of the 209 Clinical Commissioning Groups (CCGs) in England responded to a BBC Freedom of Information (FoI) request. Sixty-one of them said they used some form of referral management centre.

These centres were introduced in about 2003 and were designed to reduce NHS spending by limiting unnecessary referrals to hospital. However, one GP claimed cancer diagnoses were being delayed because of the extra bureaucracy.

Since 2005 there has been a 10-fold increase in the use of referral centres.

A BBC investigation revealed there had been a rise in referrals being rejected for administrative, rather than clinical reasons, with delays due to administration queries rising from 28% in 2013-14 to 41% last year.
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How the ‘humanitarian’ crisis in the NHS is paving the way for private health insurance

How the ‘humanitarian’ crisis in the NHS is paving the way for private health insurance | nhswatch | Scoop.it

It has been a calamitous winter inside the NHS. Last week, three people tragically died at Worcestershire Royal hospital with a women dying of a heart attack after waiting for 35 hours on a trolley. A similar picture has developed across the country with patients on trolleys due to lack of beds, many hospital trusts on red alert and ambulances missing targets for life-threatening emergencies. The British Red Cross declared a humanitarian crisis in the NHS.

The return of the Red Cross to Europe, over the last few years, for the first time since the Second World War is a terrible indicator of the toll austerity is taking. Wall-to-wall coverage and acres of column inches have generally failed to examine the root causes. Health journalists and correspondents seem perfectly content to recycle the crisis mantra. This is extremely convenient for the government and vested interests. What is missing from this picture is that the NHS crisis is manufactured by deliberate policies of cuts and privatisation.

The NHS will have endured an unprecedented nearly £40bn in cuts by 2020. Prime Minister Theresa May’s response – notably in last Sunday’s interview with Sophy Ridge on Sky News – has been to downplay the crisis. Hunt followed suit and his statement to the Commons on Monday was a typical masterclass in deflecting the blame. The initial response in the government playbook was to change the subject to mental health. Hunt also raised the possibility of axing the 4-hour A&E waiting target.

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NHS bed-blocking rises 42% in a year, new figures show

NHS bed-blocking rises 42% in a year, new figures show | nhswatch | Scoop.it

Bed-blocking has risen more than 40 per cent in a year as hospitals continue to be overwhelmed with people needing care, figures showed on Thursday.

New data from November shows a health system under strain as it got ready to enter its busiest time ever over Christmas.

It follows warnings from the Royal College of Physicians and the Royal College of Nursing that the NHS is now experiencing its worst ever winter crisis.

The research for England highlights acute problems with delayed discharges - where patients are medically fit to leave hospital but are stuck in beds due to problems arranging care in the community.

It follows calls from the head of the NHS for extra funding for social care.

This impacts on A&E as hospitals struggle to find beds for incoming patients.

Days lost to delayed transfers of care totalled 193,680 in November. This is the third highest number on record, and 26 per cent higher than the figure for November 2015.

Matthew Swindells, NHS England's national director for operations and information, said: "This month's figures show a 42 per cent annual increase in delays in being able to discharge patients as a result of pressures in social care.

"Hospitals report this affects their ability to quickly admit emergency A&E patients, so the NHS is working closely with local councils and community health services to enable older patients to get the support they need after a hospital stay, back at home"Matthew Swindells, NHS England

"Hospitals report this affects their ability to quickly admit emergency A&E patients, so the NHS is working closely with local councils and community health services to enable older patients to get the support they need after a hospital stay, back at home."

The figures also show trolley waits of over four hours after a decision has been made to admit the patient totalled 52,769, the second highest figure on record, and 54 per cent higher than November 2015.

Trolley waits of over 12 hours totalled 456 - again, the second highest figure on record.

This is 16 times higher than the number for November 2015.

The proportion of people seen at A&E within four hours in November was 88.4 per cent, against a 95 per cent target. Last November it was 91.3 per cent. November's figure of 88.4 per cent is the lowest since March 2016, when it was 87.3 per cent.

Some 88 per cent of calls to NHS 111 were answered within 60 seconds - down from 90 per cent in November 2015.

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Hospital review – shining a light on an NHS at breaking point

Hospital review – shining a light on an NHS at breaking point | nhswatch | Scoop.it
Morning at St Mary’s hospital, London; who’s for a game of musical beds? There is no flu epidemic, no norovirus, it’s not midwinter, just an average Monday last October. But the hospital is on red alert, meaning parts of it are full to capacity. Such as intensive care, where there is only one bed left.

Prof George Hanna will need it after an operation to remove a cancerous tumour from the oesophagus of his patient, Simon, 67. Simon has already had one operation cancelled because of a red-bed situation, and the operating window after his chemo isn’t going to stay open for long. The trouble is that 78-year-old Janice, being blue-lighted down from Norwich for an emergency op on a ruptured aneurysm in her aorta, will also need the bed if she survives the touch-and-go journey, and if vascular surgeon Richard Gibbs operates successfully. If Simon’s wife looks as if she’s not entirely wishing Janice a safe arrival, then it’s understandable. Is via Buckingham Palace really the quickest route from Norfolk to Paddington, though? Maybe the satnav says it is. Unless Janice isn’t really in that ambulance and it’s just library footage.
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Oh, and then another trauma comes in, an attempted hanging. He may need the bed as well. It could be a three-into-one-doesn’t-go problem for Simon Ashworth, the consultant in charge of the ICU and whose difficult decision it is. “It does feel to me like the elastic is a bit nearer to breaking now than perhaps it ever was,” he says, gloomily.

Former nurse, now site manager Lesley Powls has the job of trying to ensure the entire hospital doesn’t grind to a halt. She tries to keep her teams motivated, uses appropriate management speak such as “going forward” and could be played by Joanna Scanlan if she wasn’t playing herself.
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The lies we tell ourselves about the NHS | The Spectator

The lies we tell ourselves about the NHS | The Spectator | nhswatch | Scoop.it

The language of the left is a truly transformative grammar, so I suppose Noam Chomsky would heartily approve. There are words which, when uttered by a leftie, lose all sense of themselves — such as ‘diverse’ and ‘vibrant’ and ‘racist’. It is not simply that these words can mean different things to different people — it is that when the left uses them they are at best a euphemism and at worst a downright lie. And from that you have to draw the conclusion that their whole political edifice is built upon a perpetually shifting succession of imaginative falsehoods. Such as when they tell you you’re a ‘denier’ of something — child sexual abuse or climate change, for example. They are attempting to lump you in with maniacs who think that the Holocaust didn’t take place. Denier! It has the whiff of Salem about it, that particular accusation, and flung about simply because some people doubt the efficacy of wind farms or think we might be overdoing the old Operation Yewtree stuff.

Or there’s ‘you’re on the wrong side of history’, as if history was a living and deeply moral entity, a bit like God, except more understanding about transgenderism, and He definitely hates you for your views. And so you come to spot the leftie by these chimeric and virtually meaningless terms and, as they are speaking, you begin to tune out, turn off the radio or TV or leave the room as they witter on and on, having excreted one of these noisome linguistic turds somewhere in their rambling analysis of why Brexit, Farage, Trump and Theresa May are evil — an immediate indicator of their idiocy or dishonesty, or both.

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NHS Lincolnshire East: ‘Keep A&E for medical emergencies’

NHS Lincolnshire East: ‘Keep A&E for medical emergencies’ | nhswatch | Scoop.it

NHS Lincolnshire East CCG is urging people to make sure they choose the most appropriate care for their ailments this winter. Despite a relatively mild winter so far, local NHS services are facing increased demand, particularly from elderly and vulnerable patients, and the weather is forecast to get significantly colder towards the end of the week.

Tracy Pilcher, Chief Nurse, Lincolnshire East CCG, said: “Even without severe weather, such as snow or prolonged sub-zero temperatures, the arrival of winter invariably means the NHS as a whole faces considerable challenges in dealing with greater numbers of patients. “Whilst the NHS plans for increased demand, we need help from people which they can give by using the most appropriate way to treat their ailments.” Colder weather and viruses lead to an increase in the number of people being admitted to hospital as an emergency, particularly those with a respiratory condition.

Lincolnshire East CCG has produced a list of tips to help people plan and ensure they receive the most appropriate and timely treatment during winter: • Ensure you have sufficient over the counter medicines to treat minor ailments, such as coughs, colds, cuts and scratches. The NHS Choices website has further information about sensible items to keep in your medicine cabinet at home • If you feel unwell, particularly if you are elderly, seeking early advice from your GP or pharmacist could prevent a minor ailment becoming more serious.

The NHS Feeling Under the Weather campaign is aimed at people over 60 or anyone aged over 45 looking after elderly relatives or neighbours, encouraging them to get early health advice

• If you have an ongoing medical condition requiring repeat prescriptions, ensure you have sufficient supplied to avoid running out when your GP surgery is closed • Your local pharmacist is a good source of information, advice and treatment for a wide range of minor ailments

• For urgent medical needs that are not emergencies, NHS 111 is a free national phone number able to provide advice at any time on where and how to receive the most appropriate treatment

• This year’s NHS Flu campaign is encouraging all those who are eligible for the free flu vaccination to take up the offer. It is targeted at those with long-term health conditions, pregnant women and parents of children aged two-four. Lincolnshire East CCG is supporting the campaign by providing background advice and guidance on who is eligible for a free flu jab and the importance of getting one

• Keep a look out for elderly or vulnerable neighbours to ensure they are staying safe and well

• If you have symptoms of vomiting or diarrhoea, stay away from hospitals including visiting friends or relatives. Norovirus, often called the winter vomiting bug, is highly contagious and can spread quickly in hospitals

• Don’t go to a hospital A&E department or dial 999 for an ambulance unless it is for a serious or life-threatening emergency.

Tracy added: “Clearly there are times when attending A&E or dialing 999 is the right thing to do. However, using these services for less serious conditions does not mean a patient will receive quicker treatment, and may result in a delay for someone else whose condition is serious or even life threatening. “Taking a few easy and sensible precautions now, along with using the best way to receive treatment if needed, can help ensure the NHS continues to provide high quality, appropriate care for everyone needing it this winter.”

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Review shows limited progress in digitizing NHS records

Review shows limited progress in digitizing NHS records | nhswatch | Scoop.it
Health scientists at the University of York have shown that in the 25 years since the NHS was tasked with digitising patient records there has been limited progress made.

The review, the first of its kind to address progress of electronic record implementation in NHS secondary care organisations, showed that limited guidance on IT implementation and underestimating the level of change to the working lives of staff members, were some of the reasons why little progress has been made towards becoming a fully digitised NHS.

Researchers argued that the high number of challenges that were uncovered, which also included confusion over how policy ambitions would be funded, highlighted the scale of the complexity in implementing technology in healthcare systems.

Dr Arabella Scantlebury, research fellow at the University's Department of Health Sciences, said: "It is difficult for those outside of the NHS system to visualise the scale of this project; there are hundreds of departments and healthcare organisations, using different IT systems, trying to share important information about a patient.

"One way of understanding the complexity, is if we imagine inviting a number of friends to an event using one system, a text message for example, only for them to post their answers back on several different portals, Facebook, voicemail, and so on; this would become a difficult communications exercise.

"And what if one of the portals used was a portal you didn't have? Add in the fact that permission might be needed before you share your response and it starts to get very complicated. If we scale this problem up significantly, then we get some insight into the digital communications challenges faced by the NHS."

The team reviewed policy documents and evaluations of policy to explore the extent of progress that has been made and to try and understand whether common mistakes were being repeated.

The review showed that progress was limited to the introduction of IT infrastructure, such as NHS Spine, which provides network support for electronic records, allowing information to be shared across the many different systems used by NHS departments.

Dr Scantlebury said: "There have been attempts to implement electronic records since 1992, but as so many have failed, it is time to ask why? Hospitals need to make informed decisions about introducing new systems, but guidance, underpinned by research into the pros and cons of such systems, is lacking.

"Previous attempts to implement electronic records have involved decision making at either a central NHS level or a local one, but there is also an argument for decisions to be controlled at both levels.

"Our review, however, suggests that we cannot recommend one approach or produce guidance because there is no real understanding or robust evidence into the pros and cons, as well as cost, of different implementation processes. Rigorous analysis of future policies is needed and should be conducted in a timely way to ensure the results are valuable.

"It costs money every time a policy fails to achieve its purpose, so it is essential that going forward the same mistakes are not made. The more information and guidance on IT implementation there is available, the more likely hospitals can start to make progress in digitising patient records to improve healthcare provision."
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