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The BBC are reporting: Tough targets to be set for NHS
Quote:
Health Secretary Patricia Hewitt is to order the NHS in England to tighten its belt next year, the BBC has learned.
NHS managers will be told that balancing the books in 2006-07 will not be good enough - the NHS overall will have to run a small surplus.
Last month the government admitted the NHS was on course for a deficit of about £620m for 2005-06.
Meanwhile, troubleshooters are to be sent into the 18 NHS organisations with the biggest financial problems.
Accountancy firm KPMG investigated the finances of 60 NHS organisations with significant financial problems before Christmas.
As a result of that investigation it has been decided to send turnaround directors into nine NHS acute trusts, and nine primary care trusts.
The turnaround directors, who will be based at the strategic health authorities who oversee local NHS trusts, will do their best to try to sort out each of the trust's financial problems.
They will be private sector accountants, financiers or management consultants.
A Department of Health spokesman stressed that only a small minority of NHS organisations had serious problems with deficits.
He said most trusts were managing to improve services while at the same time balancing the books.
Ms Hewitt is set to reveal more plans for controlling NHS spending on Wednesday.
Managers will be given new business rules for the coming financial year.
Treasury officials have made it clear that the NHS is set for a spending squeeze.
Treasury papers have suggested the NHS is likely to see real term growth of less than 4% after 2007-8 - this compares with the 7% increase it has enjoyed since 1999.
A survey by the Health Service Journal published last week found that three-quarters of NHS bosses believe patient care will suffer because of the current cash crisis.
The survey found two-thirds of acute trusts polled had already had to close wards.
The BBC are further reporting: NHS 'tough choices over deficits'
Services will have to be closed or radically overhauled if the NHS is to sort out its finances, managers say.
Quote:
The NHS Confederation poll of 35 trusts facing debts found most thought cash problems would continue unless tough decisions were taken.
These could include shorter hospital stays and consultants seeing patients in community settings.
The warning comes as ministers said hit-squads will be sent into the 18 trusts with the most problematic debts.
Health Secretary Patricia Hewitt said consultants had identified nine hospital trusts and nine primary care trusts which needed expert help to sort out their finances after reviewing over 60 trusts - 10% of the total in England.
The "turnaround teams" will work alongside trust staff, although another 23 trusts will be specially monitored by regional NHS bosses to make sure their deficits are reined in.
Ms Hewitt said health managers should be aiming to operate with surpluses by the end of the 2006-7 financial year.
The NHS is currently predicted to finish this year £620m in deficit, although ministers say the final figure will be much lower.
Ms Hewitt said: "Despite all the talk of a so-called financial crisis, the projected overspend, at the half-year stage, still accounts for less than 1% of the total NHS budget."
The health secretary also unveiled a new rule book for the NHS which has placed financial management as one of seven priorities alongside the likes of cancer care, sexual health services and waiting times.
Patient care
She said achieving financial balance need not harm patient care.
But the NHS Confederation survey of health service bosses revealed they think more tough measures were needed to balance the books
Three quarters said the public had to move away from its obsession with hospitals and accept services may close, hospital stays shorten and more care may be done in community settings in a bid to make the NHS more efficient.
And a third said the solution may also lie in operating with fewer staff.
NHS Confederation chief executive Dr Gill Morgan said: "A fixation with buildings is preventing the development of new and imaginative services and we will have to work hard to convince the public that, with technological advances, the loss of beds does not necessarily equate to a decline in services."
Paul Miller, chairman of the British Medical Association's consultants committee, said: "The measures about redesigning services make a lot of sense and are something consultants have been trying to do for years. The problem is we are not always consulted with.
"Shorter stays in hospital save money, but are also good for the patient as they recuperate better at home."
Shadow Health Secretary Andrew Lansley said ministers had "lost control" of NHS finances, while Liberal Democrat health spokesman Steve Webb said the government was repeating past mistakes by trying to manage the health service from the centre.
The trusts getting hit-squads are: Hammersmith Hospitals, Barnet and Chase Farm, Mid Yorkshire, Royal West Sussex, Surrey and Sussex, Brighton and Sussex University Hospitals, University Hospitals North Staffordshire, Shrewsbury and Telford, George Eliot Hospital, Hillingdon PCT, Selby and York PCT, Cheshire West PCT, West Wiltshire PCT, Kennet and North Wiltshire PCT, Kennet and North Wiltshire PCT and the four Sheffield PCTs.
NHS Confederation chief executive Dr Gill Morgan said: "A fixation with buildings is preventing the development of new and imaginative services and we will have to work hard to convince the public that, with technological advances, the loss of beds does not necessarily equate to a decline in services."
You couldn't make this **** up! Oh, of course they just did....
More from the BBC Pay rises blamed for NHS deficits
Quote:
The government has been accused by the Tories of mismanaging the NHS finances by underestimating the cost of new staff contracts.
Shadow Health Secretary Andrew Lansley said the cost of pay rises for GPs, consultants and other NHS workers had caused the financial crisis.
The health service is facing a £620m deficit this year - three times higher than in 2004-5.
But ministers said the situation would be reversed in coming years.
The government is sending teams of accountants into the 18 worst-hit trusts to help them turnaround their finances.
Some of these contracts have cost more than expected
Patricia Hewitt, health secretary
But the effects of the deficits are already beginning to hit.
Some trusts have been forced to delay operations, close wards and impose recruitment freezes.
The latest to come to light is in Kent where local health bosses at South West Kent and Maidstone Weald primary care trusts have told doctors not to carry out any new elective operations or outpatient appointments apart from in the most urgent cases until the next financial year.
Mr Lansley said: "There is a systematic problem going on here. It is not just poor financial management by individual trusts, although that may be the case for some.
"Most of it has come from the Department of Health which has imposed substantial additional costs."
In recent years, new deals have been agreed for GPs, hospital consultants and other workers such as nurses and non-clinical staff, significantly boosting their pay.
Cost
Mr Lansley said the government had underestimated the cost of the GP contract by £1.5bn, consultants by £400m and had no idea about the deal for other NHS staff.
He said the contracts had meant that up to three-quarters of the extra money being pumped in to the health service had gone on pay rises and he also called for NHS trusts to be given more freedom from central control.
Health Secretary Patricia Hewitt said she did not recognise the figures, adding the extra funding had paid for more staff.
"Some of these contracts have cost more than expected. But the important thing is that the health service is improving and will get better. It is all about creating a more patient-led NHS."
She said in coming years no-one would have to wait longer than 18 weeks for an operation and patients would get more choice over where they were treated.
She also promised the financial crisis would be solved with help from the teams of accountants and by 2006-7 the NHS would be back in balance.
"It is important to remember the vast majority of trusts are operating within budget."
But the naming of the trusts with the most problematic debts has angered doctors.
Jonathan Fielden, deputy chairman of the British Medical Association' consultants committee, said it created a "blame culture" which made staff fear for their jobs.
More from the BBC: Health trust debts more than £1bn
Quote:
Health trusts in England are more than £1bn in debt, a major investigation by the BBC News website has revealed.
Every NHS trust or primary care trust in England was asked for its current financial situation, whether it was in debt or had money in the bank.
The total for the whole country showed a debt of £1.087bn - despite the NHS receiving record funding of £76.4bn for the financial year 2005-2006.
It has led to patient services being affected as trusts try to cut spending.
Some trusts revealed they had closed beds, wards or entire hospitals, others had cancelled operations and many said they had cut staff levels.
The government has forecast the NHS as a whole in England will be £620m in debt by the end of the financial year in March.
Health Secretary Patricia Hewitt told BBC News: "Three quarters of local NHS organisations are balancing the books or in surplus."
But in the BBC survey more than half the trusts indicated they were in debt, although some of those did forecast they would break even by the end of the financial year.
Some of those who said they would cut or eliminate their debts by the end of March said their cuts would have no impact on patients.
'Decisive action' :
But others did reveal more drastic action, such as closures, redundancies or cancelled surgery.
Ms Hewitt announced on Wednesday 18 trusts with financial problems would be given "turnaround support" - help from financial experts to help them tackle their problems.
Another 23 organisations will be monitored by regional NHS management to make sure their deficits are eased.
Ms Hewitt said: "I have announced decisive action to turn around the minority of NHS organisations which have significantly overspent their budgets.
"This government will have trebled the investment in the NHS - and we are ensuring that every penny of extra cash is spent wisely for the benefit of patients.
"Throughout the country people can see that our investment means extra doctors and nurses, quality treatment and faster access to health services."
Much of the debt is centred on London and the Home Counties, with deficits in the capital alone accounting for almost a quarter of the total across England.
The largest single reported debt for any one health trust was for the Hammersmith Hospitals NHS Trust in London.
It has a debt of £16.2m, but also runs Ravenscroft Hospital for the Department of Health, which has a debt of £19.1m - making a total deficit for the trust of £35.3m.
Management said they had taken a wide range of steps to reduce the debt - including cutting 300 jobs.
The John Radcliffe Hospital in Oxford announced in December that many patients would not be able to have the same heart therapy received by Prime Minister Tony Blair, with only life-threatening conditions still being treated.
'Detrimental effect' :
The withdrawal for up to 100 patients of cardiac ablation therapy, to control an irregular heartbeat, was blamed on the need to cut the local NHS trust's £15.1m deficit.
Ms Hewitt criticised the trust's bosses for failing to manage their budget effectively - and the trust is not one of the 18 to be given turnaround support.
Ms Hewitt told the BBC: "Improving financial management does not mean compromising services for patients.
"Any action that the NHS takes to reduce deficits should not lower the quality of care provided to patients."
Several organisations have expressed their concern at the level of debt in the NHS, or the way it was being dealt with.
Michael Summers, chairman of The Patients Association, said: "Those that have very large deficits do affect patient care, it's very clear.
"It is very worrying at the moment.
"Looking at it optimistically, in the new financial year hopefully things will get better, but it is not going to happen overnight."
The Royal College of Nursing said earlier this month it feared more than 3,000 health service jobs could be lost through cost-cutting efforts which were having a "direct and detrimental" effect on patients.
Unison, the trade union which represents many nurses, said newly-qualified staff were struggling to find jobs because posts were being left unfilled.
And the NHS Confederation, which represents more than 90% of NHS organisations, said trusts were under too much pressure to cut deficits quickly and needed to be given "space" to deal with debt in a way which did not have patients care at heart.
The BBC are reporting: Caution urged over NHS spending
Quote:
The government must be clear about what would be gained from further investment in the NHS before it commits any more funding, a think tank warns.
The King's Fund says there has not been a detailed review of the benefits and costs of bringing in existing policies.
Without this, the fund says, it is hard to know if patients are seeing value for money.
The government said extra investment went hand-in-hand with reform to ensure "every penny" benefited patients.
The report comes as many parts of the NHS face financial deficits.
Over the last six years, there has been a significant increase in annual spending on the NHS.
The next comprehensive review of public spending is due next year, but it is projected that one in four hospitals will be in deficit by the end of the 2005-06 financial year.
'Inevitable decisions'
The King's Fund report says only some new policies - such as the patient choice pilot in London - have been properly evaluated.
But the authors say many major policies have not been comprehensively assessed.
The report suggests the rate of improvement in the benefits from health spending may be declining as more money flows into the NHS.
And it points to evidence showing pressures to spend more are rising as a result of government policies fuelling demand in the health service.
King's Fund chief economist John Appleby said: "As the UK moves into the big league of healthcare spenders - but with unabated pressures to spend more - it will become increasingly important to consider in a rational and transparent way how much more we want to spend."
Reform
He added: "We are nearing the end of a period of planned high growth in health care investment and we soon face inevitable decisions about how to arrive at limits to funding.
"This does not necessarily mean no future growth in spending.
"But it does mean that a more sophisticated case needs to be made to justify devoting society's scarce resources to healthcare rather than other things."
The report recommends ways of obtaining better evidence, using researchers and the National Institute for Health and Clinical Excellence to form the basis for decisions on NHS investment.
Niall Dickson, chief executive of the King's Fund, said: "With the comprehensive spending review looming, we now hope that the government will be very clear not only about the way the NHS budget is determined, but on the benefits that can be expected from specific policies and investment."
A spokeswoman for the Department of Health said: "We have always been clear that increased investment will go hand in hand with reforms to ensure every penny of extra cash is spent wisely for the benefit of patients."
She said the government was halfway through a 10-year reform plan for the NHS.
But Liberal Democrat health spokesman Steve Webb said: "At a time when some NHS trusts are being visited by bailiffs or borrowing money to pay staff wages, this report highlights the importance of ensuring efficiency within the health service."
I think there is in this Government the biggest bunch of con. merchants I've ever come across! I wonder how long it will be before they suggest patients sharing beds so they can increase or double the turn over of patients!
I am getting patients who used to get their nails cut over the years at the NHS. Clinics. Now they are been told as they limp into the Clinics that their feet are normal and they can file their own nails down from now on.
Upset and worried as they limp back out again with their semi-permanent very painful corn! It looks like they are trying to close Podiatry down if I did not know better!!!
Talk about cutting off your nose to spite your face or something like that?
Doctors refusing to turn out on a night? Dentist heading for the hills in private practice! I heard a radio report this week that if a dentist scales his NHS. practice down to 2,300 from 9,000 patients, he will earn the same wages and not die from a heart attack trying to reach a probably impossible NHS. Gov. yearly patient work-units target if he signs his new contract!
Are the NHS. Podiatry Dept. numbers beginning to fall also in the effort to reduce costs I wonder? First get rid of the patients by declassifying them as non-medical, then remove the Podiatrist's the real target I suspect. Labour costs always the most expensive in manufacture and service industries are they not??? How about NHS. Podiatrists doing two or three patients at a time, like the barbers used to do? Private Podiatrists used to run something similar years ago?
Regards,
Colin.
PS. added! My son had a tooth out as I sat in my dentists waiting room! Instead of him sitting in the dental chair as per-usual he was put in the waiting room for the anaesthetic to work with a lot of others the dentist has already tripled his capacity of working it seems!!!
The NHS is a monster but it is the only source of Health Care Free at the point of delivery.
So how would we change the NHS.
The NHS cant do today what it is trying to do.
Trouble is new T/t come along and new expensive drugs come along and pts want these as well.
Herceptin is many thousands of pounds per pt per year.
That is why in many areas this is not available on the NHS. But in some areas it is.
GO FIGURE.
The NHS is anything BUT NATIONAL.
Back to Pod provision.
in my area we have a population of 125 thousand .
We have 6 staff.
So how would you decide to allocate your resources??????
So we have decided that only certain medical conditions will be able to access our service.
Others eg Ortopaedic referrral will receive a course of tt leading to discharge.
We no longer accept new pt referrals for nail care unless they are identified as at risk and in receipt of a tt plan.
We are providing health education to pts, carers (all 120 have now had nail care training). soon nursing staff on wards and district and practice.
we will hopefully be doing this for relatives also.
It is not possible to provide regular nail cuts when you are trying to see weekly ulcer pts and high dependency high risk pts who will be at great risk if the NHS did not see them.
Many people pay large sums of money for their hair but will not pay a sou for thier nails to be expertly dealt with by a competent private practitioner.
many pts would rather invest a fortune in smoking related diseases obesity alcohol disease and drug damage than in caring for their own social medical needs.
This week i saw a 31 year old female iddm who has lost one leg and is currently awaiting amputation of her other leg. Needles to say she wishes to keep this damged leg for as long as possible hence the frequency of her care with us and the practice nurses.
This is what i and my colleagues trained for.
I could safely cut nails before i got to college so i did not train for 3 years to cut healthy nails and mild pathology of nails.
This is different in pp as people pay for services that they wish to have.
look at the ,millions spent on cosmetic surgery!!!!!
people must get their priorities right
The NHS is their to treat Medical Conditions that compromise the lower limb.
PERIOD
so tomorrow i will be giving a Health Education lecture to a local Pensioners Clb at the request of the Club.
This is an intelligent thing to do. I will also be doing another pensioners club soon after as this has got around and there is a demand for this education for the public.I and my colleagues are very pleased to provide this.
NHS ordered to run at profit
You couldn't make this **** up! Oh, of course they just did.... 
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