The number of children and young people self-harming has risen dramatically in the past 10 years, new NHS figures obtained by the Guardian show.
The sharp upward trend in under-18s being admitted to hospital after poisoning, cutting or hanging themselves is more pronounced among girls, though there have been major rises among boys too.
Experts say the rise is shocking confirmation that more young people are experiencing serious psychological distress because they are under unprecedented social pressures.
The number of girls under 18 who have needed hospital treatment after poisoning themselves has gone up from 9,741 in 2005-06 to 13,853 – a rise of 42% – figures collated by NHS Digital show. The numbers of boys ingesting a poisonous substance have stayed almost unchanged; 2,234 did so in 2005-06 and 2,246 did so in 2014-15.
However, the number of girls treated as inpatients after cutting themselves has almost quadrupled over the same period, from 600 to 2,311 – a 385% rise. The number whom A&E teams have treated after hanging themselves has also risen during that decade, from 29 to 125.
While far fewer boys end up in hospital after cutting themselves, the numbers went up from 160 in 2005-06 to 457 in 2014-15 – a rise of 286%. Similarly, the numbers of boys who hanged themselves also doubled from 47 to 95 over the same period, the figures show.
“This is a depressing confirmation of the clinical experience of child and adolescent psychiatrists’ experience on the ground,” said Dr Peter Hindley, chair of the Faculty of Child and Adolescent Psychiatry at the Royal College of Psychiatrists.
“It is also shocking because it appears to confirm our clinical experience that levels of distress are rising, though not all young people who self-harm have mental health problems, and [that] mental health disorders are rising, for both girls and boys,” he said.
Mike McNamara's insight:
What a terrible state, life has become for many young people! How can this have happened and what can be done to change this trend?
“Next to every frail elderly patient’s bed, there should be a framed photograph of them when they were young and beautiful,” says Alison Steadman. “Maybe then they would be treated with something approaching the respect and dignity they deserve.”
The actress, now 70, is speaking in measured tones, but her outrage is perceptible as we discuss the way in which the our healthcare system treats – mistreats – the old and terminally ill.
She is talking about her mother’s last days before she succumbed to the horrors of pancreatic cancer and, after spending time at a Marie Curie hospice, was cared for at home by nurses from the charity.
“The kindness, the gentleness was just what my mum needed,” recalls Steadman. “They managed her pain – and were such a calming presence – I don’t know what we would have done without them.
“By contrast, the geriatric wards I’ve seen have been terrible places, where patients are treated like dirt, like animals,” she says. “There was an attitude that because they were old, they didn’t matter. I remember asking three times if someone could come and see my mother, who was gripped by nausea and in a terrible state. I was met with ‘How dare you try and tell us what to do?’ hostility.”
It’s slightly discomfiting to talk about death with a much-adored national treasure who is powering ahead at full throttle. But Steadman – a handsome woman, with a peaches-and-cream complexion – sweeps my squeamishness aside.
“We’re all going to die, it’s the only certain thing about life, so there’s no point pretending otherwise,” she says, matter-of-factly. “I look back at radio shows I’ve done, and I’m the only cast member still breathing – now that is a bit depressing, which is why I refuse to dwell on it.”
Over the past year, the award-winning actress, who was awarded an OBE in 2000, has shed tears over Victoria Wood, 62, and Alan Rickman, 69. The latter once read Dylan Thomas’s “Do not go gentle into that good night” at a mutual friend’s funeral.
“It was the most compelling thing I had ever heard. His delivery was utterly perfect and the entire congregation strained forward to hear ever syllable,” she remembers. “Afterwards, I thanked him and he displayed such characteristic humility and that elegance of his. I wasn’t at his funeral, but I do hope someone recited something as moving for him.”
The NHS Shelford Group of 10 trusts has inked a deal with software firm Virtualstock to use its supply chain management software.
It’s thought the deal will help the group surpass NHS targets of £5bn in savings by 2020. A February report estimated that £5bn is lost in the NHS through waste and price variations every year.
Virtualstock – which is backed by Nick Jenkins, founder of personalised greeting cards company Moonpig.com – is also understood to be in advanced talks with three other NHS trusts in England and is expected to close the deals soon.
Virtualstock first launched in the health sector last year, with its software used by Guy’s and St Thomas’ NHS Foundation Trust.
“We wanted to embed best practice by replicating the best in retail. We need to deliver at pace, so we have adopted VS, the same digital platform used by some of the UK’s largest retailers to deliver both a common catalogue solution and a platform for future process improvement,” said David Lawson, chief procurement officer at Guy’s and St Thomas’ NHS Foundation Trust.
The NHS of the future, as envisaged by the government’s five year forward view, will be highly personalised and focused around the needs of each individual patient.
A major part of achieving this goal will be more innovative and effective use of technology across all aspects of health and social care provision – whether that's through better use of analytics to predict patient need, or through sharing information across organisations.
Crucial to this vision of a better connected NHS will be the new network provisions that are due to come into force in less than six months.
And yet there is a worrying lack of awareness among health and social care providers about both the impending deadline and the opportunities for efficiency that the new network could bring about.
With the termination of the N3 (NHS National Network) contract in March 2017, it is time to consider the urgent need for change, how the new world of NHS network connectivity will impact health and social care services and the preparations NHS bodies need to make now in order to build the NHS of tomorrow.
NHS Digital - formerly known as the Health and Social Care Information Centre - manages N3, and has recognised that the requirements for information sharing and network access have transformed dramatically since its inception. It is seeking to address this head-on with the new Health and Social Care Network (HSCN).
No longer fit for purpose
The existing network, is the single-supplier network that allows NHS providers to access national applications and information. It is a national private network, managed centrally and delivered by a single supplier on a long-term contract arrangement.
However, it was designed more than 10 years ago is no longer fit for purpose - it lacks the flexibility and agility to meet the needs of an evolving health and social care service.
One of the limitations of the N3 is the N3SP portal, where customers have to pay a premium for extra bandwidth to meet their particular needs – it is unpopular and an expense users would like to avoid.
The HSCN aims to create an open marketplace of certified service suppliers. It will open up the landscape for more competitive pricing and a diverse supply chain, as well as encouraging innovation.
New operators have emerged with fresh approaches to sourcing network bandwidth and software defined networking, providing the NHS with much more flexible and cost-effective solutions. This open marketplace aims to eliminate one of the most unpopular features of N3 – its lack of flexibility.
The HSCN is designed to offer an interoperable network between health and social care organisations, both within the NHS and outside. It should result in greater integration of health and social care services, flexible and remote working and access to national, regional and locally-hosted applications – while reducing reliance on central infrastructure and services.
A CONTROVERSIAL shake-up of hospital services in Halifax and Huddersfield was approved today as NHS bosses came to a decision after months of deliberations.
Following a 14-week public consultation, health chiefs voted to centralise emergency care in Halifax and downgrade Huddersfield’s A&E to an urgent care centre, treating minor ailments. Under proposals by Calderdale and Greater Huddersfield Clinical Commissioning Groups (CCGs), which control the NHS budget for those areas, Calderdale Royal Hospital would be expanded by up to 300 beds.
But Huddersfield’s existing 400-bed infirmary would be replaced with a smaller 120 hospital nearby, where more planned NHS procedures would be carried out. Both CCGs met at the Cedar Court, Ainley Top, Huddersfield, this afternoon. The proposals, designed to tackle a £280m funding gap, have sparked safety fears over longer journey times to hospital and a campaign to keep both A&E departments open.
Protestors have also claimed the shake-up is driven by the need to cut budgets. Financial pressures include costly repayments for Calderdale Royal Hospital, which is leased back from the private sector under a Private Finance Initiative (PFI) scheme. But the plan would itself require more than £490m if it is to succeed.
Members of the opposing Hands Off HRI campaign group travelled to the capital on October 10 to hand over a petition of around 80,000 signatures to officials at both Downing Street and the Department of Health. Helen Kingston, a member of the group’s steering committee who lives in Rishworth, said: “The community has put up enough of a fight for them to not just breeze [the plans] through. They are hoping it will work on a wing and a prayer.”
An MP is demanding the health secretary investigates how a private firm running dozens of GP surgeries and NHS walk-in centres is handling its finances.
Integral Medical Holdings (IMH), which controls 50 NHS sites, swapped its debts for loan notes to its parent company, which is based in The Bahamas.
It essentially means taxpayers' money given to IMH ends up paying off interest of 20%.
IMH said the system allowed flexibility over when debts were repaid. 'High interest rate'
A loan note is essentially a document which has evidence of a promise to repay an amount to a lender.
The company obtained most of its NHS contracts when it bought Manchester-based Malling Heath Limited in February 2015 for £6.21m.
It operates 12 surgeries and walk-in centres in the West Midlands, seven in Kent, five in London and others in Essex, Cambridgeshire, the East Midlands and Dorset.
Loans totalling about £4m to Santander and Lloyds, and which had an interest rate of 3.5%, were paid off in November 2015 and other debts exchanged for loan notes from IMH's parent company Butterfly Ventures. Image copyright Getty Images Image caption Butterfly Ventures, IMH's parent company, is based in The Bahamas
A document seen by the BBC shows David Hudaly, a multi-millionaire domiciled in Israel, as the note holder for at least one of the loans, for £2.4m.
Labour MP Emma Reynolds, who represents Wolverhampton North East, said she would write to Health Secretary Jeremy Hunt urging him to investigate private NHS contractors with off-shore tax havens.
"I would like to know why this private company has taken a loan at such a high interest rate and I would like to know if the NHS and Department of Health and government is looking into this practice and whether it's widespread," she said.
The figures, published by the NHS Litigation Authority, also show a rise in the number of claims against the region’s six acute hospitals since 2007 - which one expert attributed to more public awareness of their legal rights.
Meanwhile the government yesterday announced plans for a new voluntary compensation scheme which it hopes will help end what it sees as a “litigation culture”.
However those plans were slammed by Sandra Patton, a medical injury lawyer based in Thetford, who accused the government of “squeezing the rights of patients from every angle”.
Figures from the 2015/16 financial year shows nearly £17m was paid out on behalf of the region’s acute hospitals to claimants who have experienced negligence in obstetrics (maternity).
This amount includes damages plus the legal costs of dealing with claims and includes regular payments made due to previous years’ settlements.
Jeremy Hunt, the health secretary, yesterday said the new compensation scheme would work out far cheaper from the NHS and rejected claims that it would remove people’s rights.
The NHS has slashed more than £600m from the billions it pays every year for temporary doctors and nurses by cracking down on fees paid to “rip-off” staffing agencies, new figures reveal.
Gaps in hospital rotas sent the bill for temporary staff soaring from £2.2bn in 2009-10 to £3.6bn last year. But hospitals have halted the relentless increase in recent years of the rates for stand-in personnel needed to ease chronic understaffing and ensure patient safety on wards.
Data compiled by NHS Improvement, which regulates the health service in England, shows that hospitals spent £613m less since the blitz on agency staff began on 15 October last year, compared to the 12 months before caps on hourly rates were brought in. The stories you need to read, in one handy email Read more
In August, for example, NHS trusts spent £252m on agency staff – £61m (19.5%) less than the £313m they paid out in the same month the year before. Similarly, in July they spent £256m compared to their £331m outlay in July 2015.
If maintained, the NHS stands to meet its target of spending £1bn less a year on temporary staff, which would be key to its ambition to reduce hospitals’ collective overspend of £2.5bn last year to £580m. Hospitals are now paying 18% less on average for nurses whom they hire through agencies which NHS England boss Simon Stevens last year criticised for “ripping off the NHS”. The limits on fees for stand-ins have also succeeded in reducing the cost of locum doctors, but only by 13%.
Parts of the NHS “will implode” this winter, an expert has warned, as new figures show falling A&E performance over the past few months.
Dr Mark Holland, the president of the Society for Acute Medicine, said the days when summer used to provide a respite for busy emergency departments had gone, and instead the NHS faced an “eternal winter”.
The NHS was “on its knees” and a major increase in hospital admissions due to flu or the sickness bug norovirus could lead to collapse, he added.
Holland spoke out as new figures show that waiting times in A&E units in England this summer have been worse than for most winters stretching back more than a decade.
One in 10 patients waited more than four hours in A&E during June, July and August – worse than any winter in the past 12 years bar one, analysis by the BBC showed. Only last winter marked a worse performance since the target was launched in 2004.
Data from NHS England for the summer also showed hospitals are missing key targets for cancer cases, routine operations and ambulance response times. Delayed discharges – where patients are stuck in hospital despite being medically fit to leave – continued to rise, with a record high during August.
The Local Government Association has said a funding gap of at least £2.6bn is opening up for providing social care in the community. This affects discharges because care packages are not always in place for those leaving hospital.
Holland said: “The NHS is on its knees and, this winter, areas will implode around the country. There is no reserve left. We coined the phrase ‘eternal winter’ months ago in relation to increasingly poor performance and this data is clear evidence that is what we are now dealing with.
In response to a written question from Labour MP Steve McCabe, health minister David Mowat said NHS England would set out on 18 October 'which practices would be included in the first cohort to receive support' through the Practice Resilience Programme.
An initial deadline of 30 September was pushed back 'to allow greater opportunity for practices to self-refer for assessment', Mr Mowat said.
GPC deputy chairman Dr Richard Vautrey told GPonline that the limited funding 'must be used wisely' and that it was inevitable some struggling practices would miss out. He warned that practices must be reassured that asking for support under the programme would not open them up to a 'punitive' process. GP funding
It remains unclear how many practices will benefit as part of the first wave of support from the Practice Resilience Programme, through which NHS England has pledged to deliver £40m over four years - £16m in 2016/17 and £8m in subsequent years.
GPonline reported earlier this year that as many as 20% of GP practices in some parts of England had been declared vulnerable by NHS officials, and a BMA poll found that one in 10 were financially unsustainable.
Mr Mowat's written answer earlier this week said the government could not estimate how many practices needed support until NHS England reported back on 18 October.
But he pointed out that NHS England's earlier Vulnerable Practice Programme had identified around '900 practices as potentially vulnerable and in need of support'. Across these 900 practices, the £16m available in the current financial year amounts to around £18,000 each.
Speaking at the RCGP annual conference in Harrogate earlier this month, NHS England head of primary care commissioning Dr David Geddes said the health service needed to 'triangulate' different sources of information better to identify struggling practices early. He warned that even high-performing practices could become vulnerable quickly and risk triggering a 'domino effect' locally if they collapsed.
WARRINGTON North MP Helen Jones has reiterated fears that essential health services in the town could be axed after NHS bosses refused to give details of planned shake-ups.
Concerns have been expressed by Mrs Jones over the NHS’ sustainability and transformation plans, with the MP earlier accusing health officials of being ‘up to no good’.
She now says that NHS England has refused to release details of what the plans will mean for Warrington after she submitted a Freedom of Information request to the organisation.
Mrs Jones said: “A brick wall seems to have been erected around the plans for Warrington.
“My Freedom of Information request to NHS England asking for details of their discussions with trusts and their meetings on this matter has been refused on the grounds of cost.
“It would appear that they are hiding behind every bureaucratic trick in the book and are putting every obstacle possible in the way of disclosing what their plans are.”
Mrs Jones feared that primary care services and provisions for trauma and strokes could be among those facing the chop.
She added: “It is clear from a letter I have seen that the NHS in Cheshire and Merseyside are looking at specific services such as strokes, primary care and trauma.
“Alarm bells start to ring when both Cheshire and Merseyside NHS and NHS England are being so deliberately secretive.
“I remain fearful that there could be plans to close essential services in Warrington, that the decision is being made behind closed doors and that it will be presented as a fait accompli with little time allowed for public consultation.
“It’s time for them to come clean and let us all know what they have planned in this review for our services here in Warrington.”
Doctors are giving too many patients tests and drugs they do not need, senior medics have warned, as they published a list of 40 treatments which should no longer be in routine use.
The unprecedented intervention by the Academy of Medical Royal Colleges (AMRC) follows research which found doctors commonly ordering X-ray, scans and drugs, in cases they believed to be pointless.
More than six in 10 medics said their decisions had been driven by a fear of litigation, with just as many saying they ordered interventions because they felt under pressure from patients.
The Academy – which represents all 21 medical royal colleges in the UK – has today drawn up a list of 40 treatments and procedures which it says are of little or no benefit to patients.
Prof Dame Sue Bailey, AMRC chairman, said doctors and patients should question whether interventions were “really necessary” before embarking on tests and treatments. statins
It came as Simon Stevens, head of the NHS, said GPs were being driven by “box ticking” systems – which link their pay to treatment targets – which would now be phased out.
The list drawn up by medics includes a string of investigative procedures which it says are of little or no benefit. For example, patients with lower back pain should not be offered X-rays, unless there are other concerning symptoms, the report says, while children suffering “buckle” fractures do not need plaster casts.
In other cases, it says patients should be told more about the side-effects they may face before deciding whether to embark on treatment.
Most controversially, it suggests chemotherapy for advanced cancer should be carefully considered, as “benefit is likely to be small, and the harm may be great,” the report says.
The NHS is “failing” and it is time to "debunk the myth" that it is the best healthcare system in the world, a Conservative MP is due to say on Monday night.
Owen Paterson believes the UK lags far behind comparable countries in terms of health outcomes.
The former environment secretary will warn that Britain must confront problems within the NHS and open the debate on healthcare in order to make improvements.
He is due to speak on the issue in light of a report commissioned by the UK 2020 think-tank he founded which suggested the number of annual avoidable deaths from common serious diseases in the UK is thousands higher than many other places across the globe.
Speaking in London on Monday evening, he is expected to call on people to take a more critical approach to the NHS, and look to explore other options.
He will say: "It is clear that possibly the most unquestioned consensus in politics today concerns the National Health Service. It is an area of public policy that, like no other, a politician dare not touch.
"The NHS towers above all else as the one common cultural unifier that we hold on to. To take a critical tone toward the NHS is considered almost unpatriotic.
"We simply do not have the best healthcare system in the world and the sooner we debunk the myth... the sooner we can square up to the reality and start improving our healthcare system."
Dozens of MPs have signed a joint letter, organised by a group that aims to hold leave campaigners to their pre-referendum promises, which calls on the government to uphold the most infamous Brexit promise of all – £350m more a week to be spent on the NHS.
The letter, signed by 41 MPs, mainly from Labour but also some Liberal Democrats and Caroline Lucas of the Greens, demands that the chancellor, Philip Hammond, make the pledge in his autumn statement a month from now.
The £350m pledge was a key element of the Vote Leave campaign’s promise to voters, billed as money that would be saved after leaving the EU which could instead go to health spending.
In the wake of the 23 June referendum many leading pro-Brexit figures began to distance themselves from the idea, a process highlighted in a new Vote Leave Watch video to accompany the letter.
Last month it emerged that a successor group to Vote Leave, Change Britain, had not included the pledge among its aims.
The letter, addressed to Hammond, noted that the chancellor’s speech to the Conservative party conference earlier this month said that “the message of the referendum result had been ‘received, loud and clear’ by the government”.
The letter continued: “We accept the verdict of the British people. Yet it is clear that, if this mandate is to mean anything, it must include the single most visible promise of the leave campaign – spending £350m more a week on the NHS.
“In just under a month you will present your first autumn statement. We are calling on you to commit to increase national NHS spending by £350m a week – that is £18.2bn a year – as soon as this money becomes available by leaving the European Union. This additional funding must be over and above the amount that is currently planned to be spent on the National Health Service.
The NHS is the second biggest area of public spending behind welfare. Last year, the Treasury handed over £118bn to the Department of Health in England - that is enough to buy more than 1,200 Paul Pogbas, the most expensive football player on the planet.
But, of course, not all of that goes to the front line. An organisation the size of the NHS - it is the fifth biggest employer in the world and sees a million patients every 36 hours - needs some form of management, administration and regulation.
So how much goes on that sort of stuff? Well, if you look at the £118bn, £17bn was sliced off by the Department of Health with the rest handed down to bosses at NHS England to distribute across the health service.
They gave more than £90bn to hospitals, GPs, mental health services and ambulance trusts.
Theresa May has told Simon Stevens, chief executive of NHS England, that the health service will get no extra money, despite rapidly escalating problems that have led to warnings from the British Medical Association that hospitals are close to breaking point.
The NHS is now at a more pivotal stage than it has ever been since I became a GP more than 30 years ago. The financial squeeze on health services will get much tighter over the next five years, with spending per person on the NHS falling by 9% (pdf).
In 2014, the Institute for Fiscal Studies predicted that even if the NHS budget remained protected from cuts, the growth in population would lead to big real terms cuts. The myth that the NHS budget is protected is over. Even if health spending continued to rise with inflation, as it has since 2010, age-adjusted spending per person would be 9% lower in 2018 (pdf) than in 2010. On top of this, Jeremy Hunt wants the NHS to save £22bn by 2020.
These “efficiency savings” are unfeasible and dangerous and will push an NHS already teetering on the brink right over the cliff edge. If Hunt wants to save money, abolishing wasteful internal/external health markets and renegotiating private finance initiatives would be a good start.
The NHS has not faced this level of challenge in its history. The universal care it provides is in danger of becoming unsustainable. The dire prospect is that the NHS will have to ration treatment, shut hospital units, close GP surgeries and cut staff if it gets no extra money soon.
Already, one in five patients are waiting a week or more to see their GP, or not getting an appointment at all, and thousands of patients wait hours in A&E and on hospital trolleys. The answer to the funding crisis would be a firm commitment to get funding levels back to the EU average on health spending. The prime minister might say it depends on a strong economy, but I would say it depends on your commitment to the NHS.
By reappointing Hunt as health secretary, May has signalled that she endorses the imposition of an unsafe junior doctors’ contract, an unaffordable seven-day service, rock bottom staff morale, a decline in general practice and the ideologically driven privatisation of the NHS.
Meanwhile, May is the architect of the minimum salary for immigrants who have lived in the UK for less than 10 years (the threshold is at least £35,000), if they want to continue to stay. The points-based immigration system she advocates would mean the low-skilled migrant workers who form the backbone of the care sector would be denied entry to Britain. Bad IT, grazed knees and bureaucracy: NHS staff share their frustrations Read more
This would hugely impact on the recruitment of nurses and para-medical staff in the NHS. If she means what she says, that she loves the NHS, May needs to wake up to the crisis in the NHS. A failing NHS will only help to boost private healthcare insurance for those who can afford it, signalling the death knell for a universal healthcare service, free at the point of use.
A mental health trust underestimated the risk posed by its patients and sometimes did not act on threats to kill, a review of 10 killings over eight years has found.
The review examined deaths linked to Sussex Partnership NHS Foundation Trust patients between 2007 and 2015.
It found killings by Kayden Smith in 2012 and Roger Goswell in 2007 had been "preventable" and "predictable".
The trust has apologised and offered its condolences to families.
'They could have saved my mother's life'
The review of what is one of England's largest mental health trusts was launched following the stabbing to death of Donald Lock, 79, by Matthew Daley in 2015.
Daley, who had been under the care of the trust at the time, was convicted of manslaughter on the grounds of diminished responsibility after stabbing Mr Lock 39 times following a collision between two cars on the A24 in Findon, West Sussex.
During the trial, jurors were told Daley's mother had pleaded with mental health experts to have her son sectioned.
The review looked at nine killings committed by patients of the trust and the case of one patient who was killed while under the care of the trust.
Smith killed Danish tourist Jan Jansen at his flat in Hassocks, while Goswell, who was also a patient, killed his wife Susan in West Chiltington before taking his own life. Image caption Retired solicitor Donald Lock was stabbed 39 times
The independent review commissioned by the trust and NHS England found that, in several cases, the process to assess patients was "inadequate" and "the risk posed by the service user went unrecognised or was severely underestimated".
In some cases, "risk assessments were not completed or were completed incorrectly".
The report said: "Some diagnoses are incorrect and remained unchanged in the face of the service user's behaviour.
More than a third of people do not trust the NHS with their personal information, new research has found.
Fears it could be lost, stolen or passed on to private companies topped the reasons why people were reluctant.
While 21 per cent of respondents believe their personal data has already been shared without their apparent consent, a survey revealed.
And shockingly, 56 per cent of adults would stand in the way of medical breakthroughs by not sharing their data for scientific research. More than a third of people do not trust the NHS with their personal information, new research has found. While 56 per cent of adults wouldn't let their data be used for scientific studies +2
More than a third of people do not trust the NHS with their personal information, new research has found. While 56 per cent of adults wouldn't let their data be used for scientific studies
More than 2,000 adults were surveyed in the first ever National Personal Data in Research Survey.
It was commissioned by a European-wide campaign called eTRIKS - which tries to increase the sharing of patient data among studies.
Short for the European Translational Information and Knowledge Management Services, it is a collaboration between 17 partners, including pharmaceutical companies, research organisations and a handful of universities.
Spending by hospital trusts on agency staff is to be published in annual league tables under plans issued by NHS Improvement today.
The watchdog published an update on the effectiveness of the cap on agency spending following its first year of operation. This found that overall spending had been slashed, saving the NHS more than £600m, and three quarters (73%) of trusts had reduced their agency spend.
Jim Mackey, NHS Improvement chief executive, said: “The progress we have made in a single year is really promising and trusts have responded well to the caps. They’ve worked hard to cut these bills and, in many cases, improved the way they manage their workforce.”
However, the regulator also issued new plans to ensure agency spending remained under control.
These include: the publication of league tables of agency spending on best and worst performing trusts; collecting anonymised information on the 20 highest earning agency staff per trust and any long-standing agency staff; and additional reporting requirements, including any shifts that cost more than £120 an hour.
NHS Improvement is also planning to introduce an approval process for the appointment of any senior interim manager costing more than £750 a day.
Mackey said: “We need everybody to pile in, and patients deserve that effort from us to make sure they’re getting the right care, from the right staff, at the right time. We’re committed to making sure hospitals can spend their money on their care and not on excessive agency fees.”
Medical agency fees are a particular concern, he suggested, with a third of the agency paying for interim doctors. “We need to ensure agencies and doctors do their bit to make sure they’re not overcharging.”
According to the regulator’s analysis, a further £102m could be saved if wage rates above the cap were brought down by just £10 an hour.
Scotland's auditor general has criticised NHS 24 for overspending on its revised telehealth system, finding that current development costs are 73 per cent higher than originally budgeted.
The system, which is designed to handle communications and online services for NHS 24, was shut down shortly after going live last year due to fears around patient safety, and a lack of adequate staff training.
A phased relaunch programme is under way, with six care services having recently gone live on the system.
Audit Scotland said in a report released this month that despite six years of significant investment, the protected costs climbed by just under three quarters, partly as a result of the failed initial launch.
"NHS 24 has invested significantly in implementing a new IT system over the past six years. The delays in implementing this system have led to additional costs and risks to NHS 24's ability to meet its financial targets in future years," writes Audit Scotland in its report.
The project was initially postponed in July 2013 for three months. In October 2013 the decision was taken to postpone it indefinitely, due to its failure to meet critical patient safety measures, including the ability to function with multiple users at an acceptable speed.
Lead outsourcing partner Capgemini claimed at the time that the system was meeting the targets set out in the contract.
"It subsequently became apparent that there were flaws within the contract documentation," wrote Audit Scotland. "NHS 24's contractual arrangements with Capgemini and BT were found to be flawed and needed to be substantially revised to provide all parties with clarity on relative roles, responsibilities and commercial liabilities."
In response, NHS 24 chief executive Angiolina Foster admitted that her organisation acknowledged the failings.
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