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  • Plan to end Huddersfield A&E gets green light – campaigners see red KONP update on the latest developments in the long-running battle to save Huddersfield Royal Infirmary, and challenge spurious -- and potentially dangerously misleading -- plans which claim to be retaining an A&E but in reality leave only an urgent care centre.

  • Capita failure over cervical screening letters more extensive than thought Guardian reports on the latest updated numbers of women affected by the most recent high profile fiasco by contractors Capita in their 7-year contract for support services to primary care: the company argues that not many of the test results were abnormal so relatively few suffered harm. Lucky, but not convincing.

  • Hospitals 'in red zone' with record numbers of A&E patients Guardian report on latest NHS figures which show:
    "• 87.6% of patients arriving at A&E were treated within four hours, far off the 95% target and the lowest proportion ever for November.
    • 94.2% of hospital beds were full last week, well above the 85% figure that evidence shows is the safe limit for bed occupancy.
    • A&E units had to divert patients to another hospital 25 times last week, of which 11 occurred at the troubled Worcestershire acute hospitals trust.
    • 10,675 patients had to spend at least 30 minutes with ambulance crews before being handed over to A&E staff, in breach of NHS rules which say that should never happen."

  • Pensioner poverty rises as benefits freeze bites More indications that the continued austerity regime is not only making many people's lives miserable but undermining their health and shortening lives.

  • Life expectancy drops for Britain's poor for first time since Second World War Mirror report underlining widespread concerns at a reversal of the previous long term trend towards longer life expectancy.

  • NHS waiting lists for lung and bowel treatments double since Conservative-led government came to power, analysis shows Independent report on new figures clearly lays blame on austerity policies imposed since 2010.

  • Hammond's Budget birthday present is more austerity Tony O'Sullivan analysis the current financial squeeze on the NHS in Public sector Focus

  • 'Patients will be put at risk...' - Anger as 288 hospital jobs will remain UNFILLED to save £10.9m-a-year Stoke Sentinel reports that "Hundreds of vacant positions are no longer being filled at Staffordshire's two biggest hospitals - to save a whopping £10.9 million-a-year.
    "The 'vacancy pause' will affect 288 jobs at the Royal Stoke University Hospital and Stafford's County Hospital.
    "It is the latest money-saving plan by the University Hospitals of North Midlands (UHNM) NHS Trust which remains in financial special measures." Campaigners are unconvinced by claims that the job losses will not affect patient care.

  • Interserve: Major government contractor 'seeks second rescue deal' Yet another weak and wobbly major contractor that is struggling to float on a sea of almost £500m borrowing. How long can they last? will minister bail them out?

  • Hospitals in race to combat ‘toughest ever’ winter crisis for NHS too little, too late? Some remarkably small-scale steps being taken by trusts around the country to fend off the widely-expected deeper winter crisis.

  • Combining Transitional Care and Long-term Self-management Support Interesting study publish by the Journal of the American Medical Association (JAMA) confirming the unsurprising point that lending additional support to patients over and above "usual care" improved results – resulting in fewer COPD-related hospitalizations and emergency department visits. So all we need is more resources to improve outcomes!

  • Patients at risk with doctors at ‘breaking point’ and looking to quit in unprecedented numbers, GMC warns Independent report warns that:
    "Patient safety is being put at risk by doctors on the 'brink of breaking point' thanks to out of control NHS pressures, the UK’s medical regulator has warned.
    "Ministers are running out of time to act as patient numbers continue to rise and staff are forced to make 'risky compromises' to training and care, the General Medical Council (GMC) said.
    "With doctors at the limit of what can be done safely, the GMC warns doctors are looking to quit the health service in 'unprecedented numbers'."

  • Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study The University of Southampton research paper showing the important role of registered nurses in maintaining the safety of patients.

  • Policymakers warned as nursing associates poised to enter NHS (£) HSJ article notes that as the first cohort of nursing associates are due to qualify and join the English NHS next month, "NHS Improvement has developed safe guidance about it and warned that nurses should not be substituted with associate staff."
    It highlights new research that confirms that "a lower level of registered nurse staffing and a higher use of nursing assistants was associated with a higher death rate."
    The new associates need to be used to complement, not replace, the numbers of registered nurses.

  • Pensioners left in pain amid NHS cuts to hip and knee operations Daily Telegraph article highlighting Royal College of Surgeons figures that show a reduction of 7,000 operations to replace hip and knee joints in the last year, as arbitrary rationing and exclusions restrict surgery in some areas to those in the greatest pain (and drive those who can afford to pay to consider going private to escape the pain that is not deemed severe enough).

  • Mental health - The NHS patients who are 'abused and ignored' Useful BBC backgrounder on the latest proposals for reform of the Mental Health Act.

  • Help needed from the North East Thoughtful (£) HSJ article discusses the gathering crisis of mental health services in Lancashire, where there are increasing delays admitting patients in serious need of treatment, and where "A few weeks ago, chief constable Andy Rhodes took the unusual step of publicly criticising the county’s mental health provision, saying his officers are having to pick up the pieces of a system in crisis."

  • Internal incident amid 'unprecedented' demand at top hospital (£) HSJ Short article on the desperate bed shortage at the Royal Free Hospital, before the winter pressures gather force. The HSJ points out that the Free "has missed the national target for processing 95 per cent of emergency attendances in less than four hours for the past two years."

  • 'Gross insult' NHS fee rise for overseas nurses gets go-ahead Free access article from Nursing Times on the latest shot fired by ministers into their own feet, with the tightening of the "hostile environment" for nurse recruitment and training. Parliament has just agreed to double the annual fee overseas nurses must pay to use the NHS from £200 to £400, despite strong opposition.
    The "immigration health surcharge" has to be paid by temporary migrants from outside the European Economic Area (EEA) .
    The policy has raised more than £600m "for the NHS", and the rise is expected to bring in an additional £220m a year -- but as yet there is no estimate of the numbers of nurses who might have been deterred from applying as they get the message from a hostile government that they are not welcome.

  • GP seven-day access programme did not reduce A&E attendance, study finds A further Pulse article following up on previous critical reports highlighting the waste of time energy and staff resources delivering "7-day" GP appointments that almost nobody with health needs really wanted.

  • Council quits leading ICS due to 'lack of democratic oversight' (£) HSJ report on decision of Nottingham City Council to pull out of so-called "Integrated Care System" -- an important if belated step that points the way for other councils that don't want to get dragged into rubber stamping cuts, closures and potential privatisation.

  • Health visitors warn of 'child tragedy' fears as caseloads rise Alarming article in Children and Young People Now warns that:
    "More than four in every 10 health visitors in England feel so stretched they "fear a tragedy" at some point, research has found.
    "Nearly half (44 per cent) of health visitors said they are now working with caseloads of more than 400 children.
    "A survey of more than 1,200 health visitors found that 43 per cent believed they may not recognise a child in need until it's too late as a result of rising demands in recent years."

  • ‘The biggest disgrace at mental health trust is that people were warned, and failed to act’ Local mental health campaigner Emma Corlett writes in the Eastern Daily Press on the chronic crisis if the Norfolk & Suffolk NHS Foundation Trust which is supposed to deliver mental health services. Instead the picture is:
    "A perfect storm of cuts, incompetence and stigma has seen services unravel, with people struggling to access services, being discharged too soon, and staff under intolerable pressure with unmanageable caseloads.
    "Following a savage real-terms budget cut, the number of doctors has been reduced by 51 (around 25pc) and the number of nurses by 163 (1 in 8) compared to when the trust was formed in 2012, while referrals have rocketed.
    "The number of patients referred but still awaiting their first contact is 2,732 (as of October 12).
    "That’s a lot of people in distress, without support."

  • One in three GPs likely to quit within five years, warns RCGP GP Online reports a ‘gravely concerning’ RCGP survey of over 1,000 GPs.
    It "found that nearly a third (31%) of respondents said they were likely to leave the general practice workforce within the next five years - citing stress and retirement as the main reasons.
    "Nearly one in four (37%) GPs responding to the survey said there were GP vacancies in the practice where they work, while 5% said their practice will probably close in the next year."

  • Items which should not routinely be prescribed in primary care: an update and a consultation on further guidance for CCGs New consultation document, published in late November, outlining further restrictions and exclusions from NHS services, with consultation running into 2019.

  • Why general practice is bracing itself for a fresh winter crisis Pulse analysis of the likely impact of the winter crisis on primary care services

  • MP welcomes local trust being put into special measures There was discussion in parliament of the decision to halt the planned closure of A&E services at Telford Hospital as a result of the recruitment of locum medical staff at premium rates.
    Responding to the earlier news of the Shrewsbury & Telford Hospitals Trust being put into special measures, local Ludlow MP Philip Dunn said:
    "It should be regarded as support for the trust and the staff who are working tirelessly to provide the best care for all the people of Shropshire.
    "People need to see what is happening here, rather than just believe everything that is being said by campaigners who might have an agenda."
    Mr Dunne's agenda has not been made clear: however from his recent statements and silences we can assume it does not include consistent defence of local health services in his constituency.

  • Changing the face of Health Services in Oxfordshire – what is going on? Oxfordshire KONP newsletter notes and analyses the latest changes, notably:

    "An even more significant and worrying development is the creation of a new body, the Integrated System Delivery Board (ISDB). The terms of reference of the ISDB were presented and approved at the November 2018 meeting of the Health & Wellbeing Board without even a murmur of dissent. Briefly, this board is made up entirely of executive officers (CEOs). It meets in secret every month and its minutes or documents are not published. The public is excluded from meetings. Not a single elected official sits on this board."
    This is the body drawing up plans for an "Integrated Care System" in Oxfordshire by the spring of 2019.

  • Former NHS England and hospital boss to lead integration firm (£) HSJ reports that Samantha Jones, a former hospital boss and NHS England director has been appointed the chief executive of the UK arm of American insurance firm Centene.
    Centene, which owns half of the Ribera Salud company embroiled in the Alzira style hospitals in Valencia, Spain, has been advising "integrated care" vanguard projects in Nottinghamshire. It is also one of 78 companies and consultancies on a government-approved list to contract for a role £300m of new NHS spending on digital technology.

  • Revealed: STP leader’s damning assessment of local commissioners Evidence of the ineffectiveness of STPs is widely available, but in this case the criticism comes from a man heading all of the CCGs in the patch.
    (£) HSJ reports on "A candid assessment of the health system across Kent and Medway," which "has concluded the sustainability and transformation programme has not unified the system, is dominated by providers and little significant action has been taken on improving commissioning.
    "The comments were made in Glenn Douglas’ report to a clinical commissioning group governing body meeting this month, despite himself being the accountable officer of all eight CCGs in the Kent and Medway STP.
    "He has since distanced himself from the remarks, saying they reflected a “moment in time” and the system had moved on."

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