The NHS has wasted more than £11m using ambulances as “waiting rooms” to get around Labour’s target that patients should be treated within four hours of entering casualty.

New figures reveal the time spent by crews waiting outside hospitals for their patients to be admitted last year was the equivalent to funding 31 fully staffed ambulances to do nothing for 24 hours a day.

The statistics released by NHS ambulance trusts show the amount of time ambulances are forced to remain idle is increasing each year. In the first nine months of 2009 the total so-called “dead time” in England reached 284,000 hours — more than the whole of 2007.

The four hour target was introduced in 2004 in an effort to end the scandal of patients left on trolleys overnight waiting to be seen by doctors.

However, it has led to hard-pressed casualty departments refusing to admit patients until they can be sure they can be seen within the four hour limit. Waits of more than two hours occur in hundreds of cases each year.

Mike Penning, a shadow health minister, said: “It is a scandal that desperately needed frontline paramedics are trapped at hospitals around the country because of Labour’s fixation with the target culture.

“It can’t be right that bureaucracy has taken over from clinicians being able to put patients first, rather than watching the clock. Millions of pounds are being wasted and patients are suffering.”

The Conservatives have promised to slash the number of NHS targets and hand more power to doctors.

From: http://www.timesonline.co.uk/tol/news/politics/article7078867.ece

A woman has been denied an operation on the NHS after paying for a private consultation to deal with her severe back pain after cancer.

Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.

She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine.

“When I paid £250 to see the specialist privately I had no idea I would be sacrificing my right to surgery on the NHS. I feel victimised,” she said.

The case will reopen the debate over NHS policy towards patients who pay for some of their care privately. Following a Sunday Times campaign in 2008, the government ordered the NHS to stop withdrawing care from patients who received additional private treatment or drugs.

Cancer sufferers were being barred from further NHS treatment after buying potentially life saving medicines not offered by the health service.

Whitehead’s case, which has shocked her local Labour MP, reveals that patients who go private in despair at long waiting lists still risk jeopardising their NHS treatment. Department of Health officials admit it remains official policy.

Whitehead, 64, a former museum assistant from Yorkshire who works as a volunteer at a hospice, went to her GP in December for back pain. Because of her breast cancer history, she was immediately offered an MRI scan to check the disease had not returned. It revealed a cyst on her spine, pressing against her sciatic nerve. Her GP referred her to a consultant at Airedale NHS hospital.

She was told the next available NHS appointment was in May, so she accepted the offer of a private slot to see him the following week.

“My husband and I are retired and don’t have a lot of money, but I am in intense pain and couldn’t face the thought of waiting months just for an initial consultation,” she said.

The specialist promised to add her to his NHS waiting list for surgery. After two months, however, hospital managers told her she had been barred from the waiting list because she had seen the surgeon privately.

Now her only alternative to paying £10,000 privately is to go back to her GP, seek another referral to the same specialist, this time on the NHS, and face another 18-week wait.

“We will scratch together the money if we absolutely have to, but I feel it’s incredibly unfair,” said Whitehead. “I’ve paid full National Insurance contributions all my working life and feel I should get this operation on the NHS.”

Ann Cryer, who is standing down as Labour MP for Keighley, has written to the hospital urging it to reconsider. She told Whitehead that she had been “badly let down and ill advised”.

Bradford and Airedale NHS trust said it was looking into the case “as a matter of urgency” but added: “Anyone who chooses to pay for a private outpatient consultation cannot receive NHS treatment unless they are then referred on to an NHS pathway by their consultant.”

From:http://www.timesonline.co.uk/tol/life_and_style/health/article7100968.ece

Doctors say a key NHS target – to treat people visiting accident and emergency units within four hours – is compromising care and patient safety.

The College of Emergency Medicine says the target, at English hospitals, puts staff under “incredible pressure”.

It says it supports having a target in principle, but that doctors sometimes need time to make the right decision.

The government says safety and good quality care should always take priority over targets.

The NHS target in England to deal with patients in A&E within four hours has been highly controversial. Critics say it forces clinical staff to put deadlines before quality of care.

The chairman of the College of Emergency Medicine, Dr John Heyworth, says the target has helped to make emergency care a priority for the NHS. But he says staff are being forced to meet it at almost any cost.

“We’ve had nurses reduced to tears. We’ve had very senior consultants in emergency medicine threatened with a disciplinary process.
 
Patient safety and good quality care should always take priority over administrative targets where a doctor believes that is necessary
Department of Health spokeswoman

“This is an outrageous misuse of the standard.

“It’s not what the clinicians are in the emergency departments for. But it’s representative of the immense pressure being put on chief executives and all managers downwards from there to comply with the target.”

The four-hour target is just one of a range of centrally imposed standards, most of them designed to speed up treatment.

They have been used in other parts of the UK but have been much more heavily enforced in England.

Politicians now dislike the language of centrally-imposed targets in the NHS.

The Conservatives and Liberal Democrats say they will scrap them. Labour now prefers to talk about “standards”, “entitlements” and “guarantees”. The issue promises to be an important dividing line in the general election.

Professor Julian Le Grand, who was senior policy adviser to Tony Blair between 2003 and 2005, says many patients did benefit from targets – but he recalls that the then-PM was troubled by complaints from doctors about the targets regime.
 
“I remember sitting in a meeting once where the prime minister said ‘do we have to just keep beating up on the consultants – in A&E for instance – endlessly to achieve this? Or is there some way we can think of building in incentives within the system so that we’ll get these quality improvements on their own, without always having to crack the whip?’”

That led to a shift towards encouraging more patient choice and competition between hospitals, rather than relying on targets to improve standards.

The trust’s director, Dr Jennifer Dixon, says they are a potent way of achieving quick results.

“I think there’s widespread consensus that targets have resulted in immediate benefits, for example in reduction in waiting times.

“It’s highly unlikely that those other reforms could have had that impact so quickly and so precisely on the waiting times. So it’s really ministerial “diktat” almost that’s produced the goods.”

The Department of Health said that, in England at the beginning of 2003, almost a quarter of patients spent more than four hours in Accident and Emergency. It argued that since then there has been a “revolution in patient care”, reducing that figure to less than 2%.

A spokeswoman said: “The funding for hospitals has risen dramatically and targets are minimum standards which taxpayers have a right to expect from NHS hospitals.

“Patient safety and good quality care should always take priority over administrative targets where a doctor believes that is necessary.

“Despite his concerns over the four-hour standard, Dr John Heyworth from the College of Emergency Medicine said he had nothing against targets in principle. But he said he wanted a more sophisticated measure that accounts for quality of care, as well as speed.

From: http://news.bbc.co.uk/1/hi/health/8580761.stm