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the National Health Service, which for decades had management overhead costs of 5%

The additional costs of this market split in England have increased overheads to over 14% of NHS spending – an extra  £10 billion per year .

 In England Independent Sector Treatment Centres set up by Labour to create a new private sector provider network, charge an average 11.2% above the standard NHS cost. But they cherry-picked only the easiest cases  – leaving the rest to the NHS. And they were given generous 5-year contracts, which paid them for a fixed number of operations, regardless of how few patients chose to use the service.

A leaked version of the final draft of a Consortium consultation into pay and conditions for NHS Staff in the South West of England (here) shows that without any consultation, and despite the opposition of all 15 health Trade Union & professional bodies in England, the Department of Health have pushed on with imposed pay and conditions cuts for the NHS in the South West of England. As a matter of fact, these punitive measures will be rolled out across the northern and midland parts of England in time.

over and above the already 2 year pay freeze (to 1%) that has been suffered by NHS staff

28,610 NHS Staff have been sacked with a projected total number of 72,000 NHS job losses on the way

BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i2219 (Published 19 April 2016) Cite this as: BMJ 2016;353:i2219

Jacqui Wise

Public Health England has warned that a strain of gonorrhoea that is resistant to the antibiotic azithromycin has now been found in the West Midlands and the south east, after first emerging in the north of England in November 2014.1Since September 2015, 11 cases of azithromycin resistant gonorrhoea have been confirmed in the West Midlands and the south of England. Five of the …

By Alex Scott-SamuelThe BMJ, August 5, 2016

July 2016 saw the very quiet publication of two key documents charting the route to the privatisation of the NHS in England. Firstly, from NHS England, came Strengthening Financial Performance and Accountability in 2016-17. This is the latest set of instructions on the implementation of NHS chief executive Simon Stevens’s Five Year Forward View (5YFV). The 5YFV is increasingly coming to resemble one of Stalin’s Five Year Plans from the 1950s. As the new guidance makes clear, Stevens’s latest collectivisation strategy, the Sustainability and Transformation Plans (STPs), is being rigidly imposed across England.

BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i2179 (Published 15 April 2016) Cite this as: BMJ 2016;352:i2179

Anne Gulland

Hospital trusts in England have reported their worst waiting times in accident and emergency departments since monthly data began to be collected.Figures published by NHS England on Thursday 14 April showed that 87.8% of patients were seen within four hours in all emergency departments in February: the worst performance since monthly data became available in August 2010. 1 The figure was below the target of 95% and lower than the 92% reached in the same month last year. This was the second month in a row that the proportion has been the lowest ever, with 88.7% …

The bacteria is linked in hospital records to more than 30,000 deaths a year in the United States

William Jarvis, who spent 17 years heading the health care infection division at the U.S. Centers for Disease Control and Prevention. "We know what to do (to lower rates). It's not rocket science. And we know the barrier is cost."

more than 9% of C. diff-related hospitalizations end in death — nearly five times the rate for other hospital stays

In 2012, parliament in England passed a law effectively ending the NHS by abolishing the 60-year duty on the government to secure and provide healthcare for all. From 2013, there will be no National Health Service in England, and tax funding will increasingly flow to global healthcare corporations. In contrast, Scotland and Wales will continue to have a publicly accountable national health service.

NHS hospitals and services are being sold off or incorporated; land and buildings are being turned over to bankers and equity investors. RBS, Assura, Serco and Carillion, to name but a few, are raking in billions in taxpayer funds for leasing out and part-operating PFI hospitals, community clinics and GP surgeries that we once owned.

The great NHS divestiture, which began in 1990 with the introduction of the internal market and accelerated under the PFI programme, now takes the form of franchising, management buyout and corporate takeovers of our public hospitals. Virgin has been awarded £630m to provide services to vulnerable people and children in Surrey and Devon. Circle has been given the franchise for NHS hospital Hinchingbrooke and is now struggling to contain its debts. London teaching hospitals are merging to give them greater leverage for borrowing and cuts.

Nearly half (48 percent) of the 100,000 hospitalizations occurred among adults 80 and up, according to the study, published in the Nov. 24 issue of the New England Journal of Medicine. Nearly two-thirds (66 percent) were the result of unintentional overdoses.The four medications, used alone or together, most often cited:The blood thinning medication warfarin (Coumadin, Jantoven), which is used to treat blood clots, was involved in 33 percent of emergency hospitalizations.Insulin, used to control blood sugar in diabetes patients, was involved in 14 percent of cases.Antiplatelet drugs such as aspirin and clopidogrel (Plavix), which are used to prevent blood clots, were involved in 13 percent of cases.Oral hypoglycemic agents -- diabetes medications taken by mouth -- were involved in 11 percent of cases.With antiplatelet or blood thinning drugs, bleeding was the main problem. For insulin and other diabetes medications, about two-thirds of cases involved changes in mental status such as confusion, loss of consciousness or seizures.

by BMJ

31 Mar, 14

England is not alone in facing the implications of an ageing population with changing patterns of illness. To inform the work of the independent commission on the future of health and social care in England, I have spent the past few months looking at how other countries are responding to these challenges. By comparison with other OECD countries, two features of the English system stand out. First, we have an unusually defined split between our health and social care systems. By comparison, many countries have developed a funding system for social care that complements their funding for health. For example, Germany, France, Korea, and Japan have all introduced insurance for social care to complement their systems of health insurance. Second, we are at the lower end of the range for public spending on social care, although it is difficult to establish direct comparisons as we do not report on social care funding to the OECD. The UK spent 1.2 per cent of GDP on long term care in 2012/13, while the highest figure reported to the OECD was 3.7 per cent (in the Netherlands).

2015; 350 doi: http://dx.doi.org/10.1136/bmj.h3421 (Published 23 June 2015) Cite this as: 2015;350:h3421

Zosia Kmietowicz

Capita, one of the biggest outsourcing companies in the United Kingdom, has been announced as the “preferred provider” of a £400m (€560m; $630m) contract to provide back-office administrative support services to the NHS in England.Anglian Community Enterprise, a social enterprise that currently provides community services in northeast Essex, supported Capita’s bid and will act as a “subcontractor” to the company, NHS England has said.The contract is for primary care support services, including the management of medical records, prescription payments, and administrative support to GPs, dentists, opticians, and pharmacists.The contract will run for 7-10 …

2015; 350 doi: http://dx.doi.org/10.1136/bmj.h3253 (Published 12 June 2015) Cite this as: 2015;350:h3253

Caroline White

England has seen an “unprecedented” fall over the past five years in the number of people aged 65 or over who receive social care packages, despite a rise in the need for such services, delegates to a seminar on the care of older people heard on 9 June.Speaking at the Westminster Health Forum’s keynote seminar on improving care for older people in London, José-Luis Fernández, principal research fellow and deputy director of the Personal Social Services Research Unit at the London School of Economics and Political Science, said that care packages funded by local authorities in England for people aged 65 or over had plummeted since 2009-10.“There has been a very steep decrease in the absolute numbers of people receiving services over the past five years,” he said. “When you control for the demographic effect, where more people are in …

The democratic and legal basis for the NHS in England was abolished by the Health and Social Care Act 2012. The impact of this fundamental change is already being felt, ahead of the shift to the new market system in April 2013.  

The Act ended the Secretary of State’s duty to secure or provide health services throughout the country, a duty that had been in force since 1948.

The Act breaks up the universal system that has served us for over sixty years, and reduces the NHS to a stream of taxpayer funds and a logo for the use of a range of public and corporate providers of services.

The democratic and legal basis for the NHS in England was abolished by the Health and Social Care Act 2012. The impact of this fundamental change is already being felt, ahead of the shift to the new market system in April 2013. 

The Act ended the Secretary of State’s duty to secure or provide health services throughout the country, a duty that had been in force since 1948.

This briefing explains what the government is doing and why an urgent bill to reinstate the NHS in England is required. 

Ontario pays for most of its hospital care using the same global budget “lump sum” approach it has used since the late 1960s. Meanwhile, the rest of the industrialized world has spent the last thirty years moving to funding models that pay hospitals based on the types and quantities of patients they treat. Forward-thinking countries are already shifting to the next generation in health care funding: paying for care that stretches beyond the walls of the hospital.

These sorts of issues have pushed countries like Sweden and England to move from global budgets to a per-patient funding approach that pays hospitals through fixed prices for each type of patient based on the complexity of treatment required. Per-patient funding motivates hospitals to treat each case more efficiently and to increase the number of cases they treat in order to increase their revenue.Under this approach, hospitals begin to admit more patients and discharge them more quickly. More patients are treated for the same number of beds.

Elsewhere, countries that have used per-patient funding for years, like the United States and England, are now wondering if it’s time to move on. Traditional hospital-focused patient funding does a good job of buying more surgeries, but it doesn't do much to address the challenge of co-ordinating care across health care providers.

The respected economist Andrew Dilnot, chairman of the Commission on Funding of Care and Support—the body that recently reviewed the funding system for care and support in England—emphasised that the current system was in dire need of an overhaul

The Dilnot inquiry, which reported in July (BMJ 2011;343:d4261, doi:10.1136/bmj.d4261), recommended a cap on individuals’ personal contributions to the costs of social care of around £35 000 (€41 000; $55 000) over their lifetime. When that cap was reached, people would be eligible for full state support.

At the moment, the means tested threshold at which point people are required to fund the full costs of their care is £23 250, but the commission recommends increasing this to £100 000.

A coalition of experts has called on politicians of all parties to agree urgent reforms of adult social care in England

have written to the Daily Telegraph urging “fundamental and lasting reform” of a system that they say harms society, the economy, and the dignity of elderly and disabled people (http://tgr.ph/tIkRRk).

The signatories warn that an estimated 800 000 elderly people are being left without basic care and as a result are “lonely, isolated and at risk.” Others face losing their homes and savings because of soaring care bills, while disabled people are deprived of the support they need to live independently.

The public inquiry into the high number of deaths at Mid Staffordshire NHS Foundation Trust is expected to recommend that minimum staffing ratios be set for total numbers and the skills mix of doctors and nurses in accident and emergency and elderly care wards in England to ensure the safety of care.

counsel to the inquiry, Tom Kark QC, said “that consideration should be given to the production of model staffing guidelines for certain types of wards and departments against which the Care Quality Commission should assess the acceptability of staffing.”

Mr Kark pointed out that the real danger in accident and emergency services at Mid Staffordshire was understaffing, inadequate training, and poor governance.

Changes to the NHS in England have created an "unholy mess", the editors of three leading journals have said.

suggests an independent commission be set up to oversee changes in the future

the major NHS unions have called for the bill underpinning the changes to be scrapped

The Conservative-led government in the United Kingdom is embarking on massive changes to the National Health Service in England. These changes will create a competitive market in both purchasing and provision. Although the opposition Labour Party has stated its intention to repeal the legislation when it regains power, this may be difficult because of provisions of competition law derived from international treaties. Yet there is an alternative, illustrated by the decision of the devolved Scottish government to rejectcompetitive markets in health care.

By Andy Lines 15 Comments Controversial American health firm that donates to Tories handed huge NHS contract 3 Sep 2013 00:00 It is already at the centre of a massive row after being accused of overcharging the NHS by millions of pounds in a damning report // Vital skill; Brain surgeon at work Getty A contract to treat NHS patients with brain tumours has been awarded to a controversial American healthcare firm that is a donor to the Tory party.

Hospital Corporation of America

HCA has given the Tories at least £17,000 since they came to power.