Diagnostic tests and outpatient appointments will also be delayed, but hospitals insist emergency and critical care will not be affected.

Managers say they are preparing as they would for Christmas or bank holidays.

An estimated 400,000 nurses and healthcare assistants, as well as paramedics, physiotherapists, and support staff like cleaners and administrators have said they will join the action on 30 November over changes to public sector pensions.

However, the main medical unions – the Royal College of Nursing, the Royal College of Midwives and the British Medical Association are not taking part.

The Department of Health in England said it was expecting at least 5,500 non-emergency procedures like hip and knee operations to be rearranged.

More than 12,000 patients are likely to have diagnostic tests postponed, and 40,000 outpatient appointments are expected to be rescheduled.

On an average day, 28,000 patients have planned treatments or operations in England and there are 60,000 diagnostic tests.

However, managers say they are putting plans in place to make sure people can still get emergency or urgent care, in the way they do on bank holidays or at Christmas.
999 calls

Patients needing urgent treatment like chemotherapy and kidney dialysis will still be able to get it, and maternity units will remain open.

Calls to 999 will still be answered, but patients are being urged to think hard and only call if it is a genuine emergency.

The Health Secretary, Andrew Lansley, said health service workers should not take action that harms the interests of patients.

“I would ask staff to consider carefully whether going on strike is the right thing to do,” he said.

Three out of four nurses lack the time to talk to patients, a major survey of NHS trusts has revealed.

A quarter admit they are too busy to administer drugs on time and more than 40 per cent said at least one patient under their care had suffered a serious fall in the last month.

The findings were based on unannounced inspections at 100 hospitals to check elderly patients were given enough to eat and drink and were treated with dignity.

In some instances, watchdog’s inspectors saw patients rattling bedrails or banging on water jugs in an effort to attract the attention of nurses.

The report also claimed that some hospitals were “putting paperwork over people” with patients being left for more than ten hours without a drink.

The latest study involving 2,943 nurses looked at 31 NHS trusts across England. Researchers found there was an absence of humanity as without regularly talking to their patients nurses had no way of knowing their needs.

The survey revealed that 76 per cent of nurses did not have enough time to talk to or comfort patients and 40 per cent of staff were too busy to carry out necessary checks such as taking their temperature.

Thirty-nine per cent admitted they did not have enough time to record details about patient care such as whether they had been given anything to eat or drink.

Twenty-six per cent said they were too busy to administer drugs on time and 24 per cent had not been able to check skin for signs of pressure sores.

A further 44 per cent admitted that in the past month at least one patient under their care had suffered a serious fall.

And 26 per cent said that at least one patient in the same period had been given the wrong dose of drugs or developed bed sores.

Professor Peter Griffiths, of the national nursing research unit at King’s College London, told the Daily Mail: “Talking and comforting patients is very important as nurses need to know how they are and how they feel.

“It’s about having humanity, having a relationship with people. It’s important to understand what patients need. Sometimes staff feel that paperwork has to come first.”

The Royal College of Nursing admitted it was “not surprised” that so many nurses lacked the time to talk to patients.

Janet Davies, its executive director of nursing and service delivery, said: “We know many nurses are wilting under the strain of longer working hours, taking on the burden on unfilled vacancies and reduced staffing levels.”

FroM: http://www.telegraph.co.uk/Three-in-four-nurses-dont-have-time-to-talk-to-patients

Nurses and midwives are being urged to get their flu jabs after figures reveal less than a third did last year.

Last year only 30% of hospital nursing staff in England got immunised compared with 43% of GP practice nurses, 38% of GPs and 37% of other doctors.

Nursing and midwifery groups say having the jab is a “professional duty”.

This is the first time the figures have given broken down by occupation.

The number of healthcare workers getting the vaccine had increased from 26.4% in the 2009 winter to 34.7% in 2010.

However, the majority of nurses who work with the most critically ill over the winter months and midwives who work with pregnant women, were left vulnerable to flu, its potentially life-threatening complications and passing it on to patients and family, says the Department of Health which released the figures.

The data also shows that only 25.2% of youngsters aged six months to two years in at-risk groups were vaccinated last winter, compared with 51.7% of those aged 16 to 65.

Those at risk include people with conditions such as asthma, diabetes, heart disease and liver disease, as well as the over-65s and pregnant women.

Last winter people in at-risk groups were 11 times more likely to die from seasonal flu than people with no underlying health problems.

Chief Medical Officer Dame Sally Davies said: “It is never too early to start thinking about flu. So as NHS staff return from their holidays, I urge them to plan ahead and get vaccinated.”

Dr Peter Carter, of the Royal College of Nursing, said while NHS staff should not be forced to get immunised, they had a professional duty to do so: “Patients and healthcare staff suffer when nurses are off sick.

“It is vital that nurses do all they can to take responsibility for their own health and of those around them. The RCN will be working with our members to ensure they have access to all of the relevant information to enable them to make the right decision about the uptake of the vaccine.”

Louise Silverton, of the Royal College of Midwives, said: “Midwives are strongly advised to encourage all pregnant women to be vaccinated against seasonal flu.

“In addition midwives as key health workers should themselves seriously consider being vaccinated to prevent transmission of influenza to the women for whom they care and also to their own families.”

A National NHS Staff Seasonal Flu Vaccination Campaign launches later this month and will use resources like Twitter and Facebook, as well as leaflets, to encourage more healthcare professionals to get vaccinated.

From: http://www.bbc.co.uk/news/health-14792570

NHS managers are trying to restrict access to crucial tests and scans in a move that could mean diseases being diagnosed later. 

An investigation has found that a quarter of Primary Care Trusts are either investigating how many patients individual GP practices send for examinations or looking for ways to reduce the numbers.

In addition, a handful are identifying “excessive” use of the tests or setting upper targets while others have completely stopped letting doctors have direct access to the scans.

Experts said the tactics could lead to patients being diagnosed later with diseases such as cancer, which research shows lowers survival chances.

Dr Clare Gerada, head of the Royal College of GPs, said: “This is about money and finances driving behaviour by the PCT – not about putting patients first.”

Cancer Research UK’s director of policy, Sarah Woolnough, added: “It is very worrying to hear of PCTs setting referral targets and decommissioning direct access to tests that could speed up a cancer diagnosis.”

Meanwhile, official figures show that even patients who are being referred to hospitals for tests are being forced to wait longer than a year ago.

Department of Health statistics show that 10,700 patients were waiting more than six weeks for any one of 15 key diagnostic tests at the end of July, a rise of 7,000 on the figure for the previous year.

The Government has told health service managers to improve direct access to diagnostic scans such as MRI, CT and ultrasound in order to improve early diagnosis of cancer and heart disease.

But an investigation by GP magazine suggests that many trusts want to reduce the number of patients sent directly to tests at specialist centres in order to save money.

Of the 116 Primary Care Trusts contacted, 28 per cent said they had either started looking into how many referrals GPs carried out across their area, or were planning to do so. A quarter are helping practices reduce inappropriate access.

Nine trusts said they had found surgeries that either sent too many or too few patients for tests while two are considering introducing upper and lower targets.

Five PCTs have scrapped direct access altogether to at least one type of test.

Dr Chaand Nagpaul, a leading member of the British Medical Association, said restricting access to scans risks “turning back the clock” on plans to diagnose disease early.

“An intelligent approach would be to have guidelines for appropriate use of diagnostics and incorporate them into the pathway.”

The moves are the latest example of how managers are rationing patient care in an attempt to make unprecedented efficiency savings totalling £20billion across the NHS by 2015.

From: http://www.telegraph.co.uk/NHS-managers-restricting-access-to-crucial-scans-and-tests

In particular, it said there was a risk the lines between personal and professional lives could be blurred.

It comes after a series of cases in which NHS staff and other public sector workers have got into trouble through their use of social media.

In 2009, a group of doctors and nurses were suspended for posting pictures of themselves on Facebook lying down in unusual places, including a hospital helipad.

And last year a civil servant found herself in the newspapers after using her Twitter account to make political points and saying she was struggling with a hangover.

Dr Tony Calland, chairman of the BMA’s medical ethics committee, said: “Medical professionals should be wary of who could access their personal material online, how widely it could be shared and how it could be perceived by their patients and colleagues.”

The guidance advises both doctors and medical students to adopt conservative privacy settings where they are available.

It also warns them against making informal or derogatory comments about patients or colleagues as well as not accepting current or past patients as friends on Facebook.

The message was echoed by the Nursing and Midwifery Council (NMC), which has also issued its own guidance this week.

NMC official Andy Jaeger said: “What you regard as just an amusing story could end up causing serious offence more easily than you think.”

From: http://www.searchclinic.org/doctors-warned-over-facebook-risks.htm

They believe the plan would help staff set a healthy example to patients and argued that there are more checks on wheelchairs than NHS staff.

Claire Topham-Brown, a critical care nurse from Peterborough, said: “There is no denying that nursing is a physically demanding job. You do need a certain level of physical fitness.”

She told delegates during a discussion on the issue that one activist had “observed that we take better care of wheelchairs than we do of the staff.

“Bizarre but true – we now risk-assess everything, yearly, monthly, weekly and sometimes daily. But when do we ever assess that vital, delicate and most valuable part of the machine – namely me and you?”

She said it was not just about the physical and psychological nature of nursing work but also the culture and environment in which they operated.

“Don’t we deserve an annual MoT?” she said. “It would allow our employers to be more proactive and supportive instead of reactive.”

Ms Topham-Brown was supported by other nurses, including Karen Webb, the RCN’s director of the eastern region of England.

She suggested support was even more important given the expansion in nurses in training in recent years, which could lead to an increase in the numbers not fit for a career in nursing.

She said students had a health check before joining a course but their psychological suitability was not tested.

“It is about making sure people have the right attributes,” she added.

In her local area, screening had been launched to “make sure that the people coming in have the right attitude to what is essentially customer care”.

She said nurses also had a duty to deal with public health issues, such as obesity and well-being.

And those nurses who were overweight themselves could be supported.

“It would be about supporting those people in that position to help them lose the weight.”

The Government’s NHS Health and Wellbeing report, published a year ago, said the NHS needed to do more to improve the health of staff.

NHS staff take an average of 10.7 days off work a year – more than the public sector average and nearly double the 6.4 figure for the private sector. Staff sickness is thought to cost the NHS £1.7 billion a year.

From: http://www.independent.co.uk/call-for-annual-health-check-for-nurses

During the meeting he hinted that when the Government outlined its concessions to the Health and Social Care Bill in June, nurses would be given a greater role, particularly in deciding where NHS funds are spent. Nurses are likely to be given a statutory role on the new GPs’ commissioning boards, ensuring that at least one nurse is represented. The boards are also likely to be renamed to show that they represent other healthcare workers.

Mr Lansley tried to reassure the 60 RCN representatives who had been chosen to meet him that he did care about the NHS. He ruled out accepting any other job in Government, suggesting he would resign rather than be moved in any cabinet reshuffle.

“I believe in the NHS,” he said. “I am in politics for that. I am not here to do some other job. If there is an ideology behind what I am doing it is a belief in the NHS and a desire to protect it and make it stronger.”

Asked how he felt about being the only health secretary to receive a vote of no-confidence from nurses, he said: “It’s not something I sought out.

“I think it’s a rebuke and from my point of view I take it as a rebuke and I think listening to nurses this afternoon it was very clear some of the reasons why that happened is because they thought I was too focused on general practitioners when I was taking about clinical commissioning, GP commissioning.

“I know that nurses are not only the largest healthcare profession but are responsible for the delivery of most healthcare, and are often in the best place to be able to see the whole of care.

“From that point of view is it a rebuke in the sense that I didn’t get to the right place? Absolutely.”

Many nurses appeared partially mollified by Mr Lansley’s approach. But they all said they would wait to see how his “listening” materialised into concessions.

One of the problems Mr Lansley faces, however, is that it is not just the contents of his contentious Bill that the nurses object to. In the earlier no-confidence debate most were angered at cuts to frontline services as a result of the Government’s plans to try to make £20bn worth of efficiency savings over the next four years.

This is not something Mr Lansley has much control over as an ageing population means that the NHS will have to do “more for less” and savings will have to be found.

Earlier in the day delegates in Liverpool had voted 99 per cent in favour of the no-confidence motion, to 1 per cent against.

The RCN’s leadership had attempted to amend the motion to delay any no-confidence vote until after the conclusion of the Government’s listening exercise. But amid angry and passionate scenes on the conference floor the amendment was dropped when nurse after nurse took to the stage to condemn the Government.

“What this is about is how Andrew Lansley has introduced these reforms,” said Geoff Earl. “They are being driven by ideological dogma, not by what is best for our patients. This [vote] is about our patients, not about us.”

Another nurse went on to the platform and played a tape of David Cameron’s promise in 2010 to “stop the pointless reorganisation of the NHS”. Birmingham nurse Bethann Siviter added: “If these reforms go through, the NHS is dying.”

Andrew Frazer, an emergency care nurse, said: “When Andrew Lansley addressed us last year we listened to him politely and decided to adopt a wait-and-see policy. Well, we’ve waited and we’ve seen, and I for one don’t like what I’ve seen.

“We’ve been trimmed to the bone for years. Trying our damnest to deliver excellent care with limited resources. Here’s a message for Mr Lansley: if you cut frontline services, in the short-term care may be a little cheaper, but in the long-term care will be poorer and people will die.”

From: http://www.independent.co.uk/im-sorry-lansley-tells-nurses-afternoconfidence-vote

The Government’s plans for the NHS were denounced by six health service unions – including the British Medical Association and the Royal College of Nursing – as “potentially disastrous”.

But Mr Cameron insisted that change was essential.

“Every year without modernisation the costs of our public services escalate. Demand rises, the chains of commands can grow, costs may go up, inefficiencies become more entrenched.

“Pretending that there is some ‘easy option’ of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction.

“We need modernisation, on both sides of the equation. Modernisation to do something about the demand for healthcare, which is about public health. And modernisation to make the supply of healthcare more efficient, which is about opening up the system, being competitive and cutting out waste and bureaucracy.

“Put another way: it’s not that we can’t afford to modernise; it’s that we can’t afford not to modernise.”

With the Government also set to publish details of its school reforms next week, Mr Cameron cited the experience of Tony Blair, who found that delaying public service reform simply resulted in “institutional inertia” against change.

He acknowledged that in the past the Conservatives had not always shown sufficient respect for those who worked in public services, but insisted he would “revere, cherish and reward” an ethos of public service.

“I believe previous Conservative governments had some really good ideas about introducing choice and competition to health and education – so people were in the driving seat. But there was insufficient respect for the ethos of public services – and public service,” he said.

“The impression was given that there was a clear dividing line running through our economy, with the wealth creators of the private sector on one side paying for the wealth consumers of the public sector on the other.

“This analysis was – and still is – much too simplistic. Public sector employees don’t just provide a great public service – they contribute directly to wealth creation.”

He denied he was planning “a kind of public service version of a laissez-faire economic policy” with the Government’s reforms for schools and hospitals, “where winners are created at the expense of those who get left behind”.

“The state has a hugely important responsibility to ensure clear, basic standards are met, the rights of users are maintained and independent inspection is carried out in our public services and we are in no way abrogating that,” he said.

The Prime Minister also rejected suggestions that the Government was trying to do “too much at once” in pushing through change.

“Every year we delay, every year without improving our schools is another year of children let down, another year our health outcomes lag behind the rest of Europe, another year that trust and confidence in law and order erodes,” he said.

“These reforms aren’t about theory or ideology – they are about people’s lives. Your lives, the lives of the people you and I care most about – our children, our families and our friends. So I have to say to people: if not now, then when? We should not put this off any longer.”

Mr Cameron also explained comments in which he appeared to describe the NHS as a second rate National Health Service as a slip of the tongue.

His slip-up came during a radio interview this morning on BBC Radio 4′s Today programme.

Asked if he would apologise for using the term, Mr Cameron said: “I think if you listen to the interview, I immediately said we shouldn’t settle for second best and that is exactly what I meant to say.

“I speak often quickly, I don’t just have a pre-arranged order of saying things and sometimes you can get a little word out of place and I immediately said, if you listen to the clip, we shouldn’t settle for second best, that was the point I was making.”

To widespread guffaws from the assembled media, he added: “We shouldn’t settle for second best is what I meant, it’s largely what I said, if you skip over a quick word in the middle.”

In a letter to The Times today ahead of Wednesday’s publication of the Health and Social Care Bill, the heads of six health unions expressed their “extreme concerns” about plans to create greater commercial competition between the NHS and private companies within the health service.

The signatories, including BMA chairman Hamish Meldrum, RCN chief executive Peter Carter and the heads of health for the Unison and Unite unions, said: “There is clear evidence that price competition in healthcare is damaging.”

It follows a report by the NHS Confederation which acknowledged the potential benefits of the changes, which will give GPs power over commissioning treatment, but warned they were “extraordinarily risky” at a time when the NHS is facing its toughest financial constraints for a decade.

From: http://www.independent.co.uk/we-cannot-afford-not-to-reform-nhs-says-david-cameron

It said it had been inundated with similar stories.

The Patients Association acknowledged that most patients do get good treatment, but said some were still being denied the essentials of nursing care, even though it highlighted serious problems last year.

A national survey of hospital experiences in England suggests that nearly half of all patients rate their care as excellent, and just 2% said it was “poor”.

The Patients Association said the 17 cases highlighted wider failings in NHS nursing care.

It is calling for the introduction of independent “patient safeguarding champions” at every hospital to check that nursing standards are maintained. It also wants the NHS complaints process to be overhauled.

“Surely the essentials of nursing care are what every patient deserves and should get?” said Chief Executive, Katherine Murphy.

“It’s a scandal, and it’s outrageous that it has been persisting for years.”

The family of former Patients Association president, Claire Rayner, who died in October, is backing the calls for change.

“If she were here today she would have been hollering from the roof tops about it,” said Claire Rayner’s son Jay.  “Any health system is only as good as its failings, and those detailed in these pages are truly dismal.”

The Royal College of Nursing said there was no excuse for poor care.

General Secretary Peter Carter said: “Neither the RCN nor the overwhelming majority of committed and caring nurses can possibly condone the neglect, rudeness and in some cases outright cruelty outlined in this report.”

However, he said problems often arise when staffing levels are cut.

Care Services Minister, Paul Burstow said the report painted a disturbing picture.

“It is an unacceptable legacy that this government is committed to tackling. The NHS must become much more tuned into patient views and experience.”

He said that was why the government would soon start publishing details about complaints.

From: http://www.bbc.co.uk/news/health-11889342

The Department of Health has published the results of two simultaneous reviews of the SCR, covering the content of the record and the information patients receive before their record is uploaded.

The reviews were set up by the coalition government this summer, following concerns about patients’ awareness of the SCR and the kind of information added to it. This had led to the suspension of further patient information programmes.

The review of the content of the record, led by NHS medical director Sir Bruce Keogh, concluded that the core record should only contain a patient’s demographic details, medications, allergies and adverse reactions, and that these should continue to be copied from the GP’s medical record.

The review group said the DH should only consider expanding the content of the record “when we have built trust in the system and when patients request that we should do so.”

Sir Bruce said: “In an advanced national health system, it is reasonable for citizens to expect that when they arrive in accident and emergency or require treatment out of hours, the clinicians treating them have access to enough basic medical information to prevent anyone making wrong or even dangerous decisions.”

The separate Patient Information and Preference Review group, led by national director of patient and public affairs Joan Saddler, concluded that an opt-out form should be included in the patient information packs, and that these should also be simplified.

It said services such as HealthSpace should also continue to provide access to SCRs.

Almost 30m patients have already received information about the SCR but the review concluded that there should be no requirement to send another letter to those patients.

However, it said but there should be awareness raising campaigns at local, regional and national levels to ensure patients realise that an SCR is being created for them unless they choose to opt out.

Health minister Simon Burns said he was pleased that a consensus had emerged about the importance of the SCR in supporting safe patient care, so long as the content of the record was limited to core information.

He added: “Coupled with improvements to communication with patients which reinforce their right to opt out, we believe this draws a line under the controversies that the SCR has generated up to now.

“We see this review as having taking a significant step towards the goal of patients owning their records and using them to share decision-making with healthcare professionals.”

A BMA spokesperson said: “We welcome the progress that has been made towards an emergency electronic record that supports urgent care, yet recognises many of the understandable concerns of patients and clinicians.

“Much will depend on the way the amended scheme is put into practice, and the BMA looks forward to continuing our work with government on its implementation. It is essential that patients have genuine control over who has access to their records, and when changes are made to them.”

The review groups concluded that patients should play a key role in deciding the evolution of the record and that new arrangements should be introduced to define responsibility for decisions about the introduction of any new content to the record.

They said the principle should be that any change to the scope of the record should be driven by citizens and patients with appropriate advice from professional bodies and in line with the IT capability.

Saddler said the availability of core information when patients need care was essential if patients were to be at the heart of care but it should also be easy for patients to opt-out.

She added:”Patients must be the ones who decide if any additional information should be included in their SCR, supported by appropriate professionals. This is the only way we will build trust in the SCR and its use.”

The SCR Content Review group said standards should be defined to support a patient’s wish to add information to their SCR such as end of life preferences, a care plan for patients with long term conditions or the inclusion of a patient’s significant medical history.

The review groups, which between them took evidence from almost 50 bodies, said it had heard strong opinions that the use of smartcards was not universal within GP practices which had implications for accurate updating of the SCR.

The reviews said use of smartcards was outside their remit but recommended that further options were investigated to mitigate the risk of practices not using smartcards.

The review group on Patient information and Preferences also recommended that the outer envelope that patients receive should have clear emphasis that the information contained in the envelope is about “Your health records, you need to make a choice.”

John Heyworth, president of the College of Emergency Medicine, said the college welcomed the decision to proceed with the SCR.

He added: “Clinicians working in emergency departments are currently often deprived of key background and patient information, particularly during the initial phase of time critical treatment and this may significantly compromise the quality and safety of care provided.

“Immediate access to such records will lead to better and safer care for our emergency patients.”

The review’s conclusions were backed by a range of bodies including the Patients’ Assocation, The Royal College of Nursing, Asthma UK and Sue Ryder Care.

From: http://www.e-health-insider.com/summary_care_record_given_go-ahead

The charity’s poll of more than 1,200 first time mothers found 59 per cent did not get the “emotional support” they felt they needed after giving birth – compared with 51 per cent in a similar survey a decade ago.

Women who had undergone a caesarean section were the least happy about their experience.

Asked about the 24 hours following birth, 66 per cent said they had not received enough support, compared to 57 per cent of those who had a natural labour in hospital, and 24 per cent of those who gave birth at home.

Mothers who had gone through traumatic labours said they had been left to cry themselves to sleep, while others said overstretched midwives had no time to offer a kind word of reassurance.

In total, 42 per cent said there were not enough midwives to care for them, compared with 33 per cent, when the question was posed in 2000.

Those who gave birth at home, or in a midwife-led birth centre, were less likely to describe shortages of midwives.

The NCT findings show that despite a large investment in maternity services, and pledges from the last Government to make care “woman-centred” with a choice of where to give birth, many women are being denied even basic care.

Among the poll of 1260 first time mothers, 44 per cent said they did not even get the physical help they needed, while 55 per cent said they did not get enough information or advice in the weeks after having their first child.

Anne Fox, the head of campaigns and public policy for the NCT, said; “It’s clear postnatal care urgently needs improvement – our report paints a dreadful, shocking picture of care in the UK – we’re letting women and their babies down.

“Many of the problems these women highlight seem to be due to staff shortages or lack of visits once they had left hospital – and this issue needs to be addressed if the quality of postnatal care is to be improved, particularly for vulnerable women.

In the report, new mothers describe being “absolutely terrified” and alone during their first night in hospital, frightened to ask for help from staff who responded to them rudely.

One mother said: “As soon as the baby was born, I felt I was on my own. I spent the first night after the birth of my son in floods of tears and unable to sleep as every time I closed my eyes the nightmare of my birth experience came flooding back.

“Nobody came to check on me to see if I was OK, even though I know I was sobbing loudly and uncontrollably.”

Louise Silverton, Deputy General Secretary of the Royal College of Midwives, described the report’s findings as “disappointing,” but said the study sent a compelling message to those in charge of NHS budgets, about the need to keep investing in maternity services.

From: http://www.telegraph.co.uk/Midwives-have-no-time-to-care-for-new-mums-report-warns

“I have not announced plans to scrap NHS Direct. I have announced plans to phase out the NHS Direct number,” the health secretary said in a letter.

This appears to contradict statements from the Department of Health last month, including to the BBC, that said the service would be scrapped. The new 111 helpline is already being piloted in the north-east of England.

However, there are concerns that fewer medical staff will be employed by the new service. NHS Direct employs 3,400 people, 40% of whom are trained nurses. It was reported that the ratio for the new helpline would be lower.

The threat to the telephone service, which costs £123m a year to run, provoked an immediate backlash. In the fortnight since the story broke, more than 16,000 people have signed a petition to save NHS Direct, which provides general health advice and information about out-of-hours GPs, walk-in centres, emergency dentists and 24-hour chemists.

Lord Prescott, the former deputy prime minister, played an active role in the campaign – including changing his Twitter picture to a “Save NHS Direct” badge.

Significantly, the Royal College of Nursing said it would be “shortsighted” of ministers to axe a service that had saved the NHS more than £200 million by dispensing advice over the phone.

Labour attacked Lansley for a “significant U-turn” that had seen the health secretary “rowing back” from previous statements. “It’s an incredible victory for the campaign to save NHS Direct,” said Andy Burnham, Labour’s leadership contender and spokesman for health.

A series of letters between Lansley and Burnham, the previous health secretary, reveals a combative exchange. Burnham accused his Tory counterpart of “misrepresenting his position” as Lansley claimed that the 111 number was Labour’s idea and he was “getting on with what you failed to do”.

In a statement the health secretary said: “This is the latest political stunt from [Burnham]. He seems more concerned with trying to boost his leadership campaign than discussing our policies accurately.”

Unions warned that the future of medical staffing levels in the new service would remain an issue. Dave Prentis, general secretary of Unison, said: “Staff will still be confused and worried the government may have another change of heart. I would like a guarantee from the health minister that the 1,300 nurses working for NHS Direct will still have a job there this time next year.”

Despite its popularity, the medical establishment has been divided over the benefits of phone line. Earlier this summer British Medical Association chairman Dr Laurence Buckman said that getting rid of NHS Direct could be one way of cutting back on spending — adding that the “expensive” phoneline delayed healthcare reaching patients.

From: http://www.guardian.co.uk/nhs-direct-closure-Andrew Lansley backtracks

Unions criticised the plan saying it was privatisation and that NHS Professionals was set up to stop the NHS being ripped off by private agencies charging large sums for staff to work unfilled shifts.

NHS Professionals has 50,000 staff on its books who cover around two million shifts in 77 organisations around England.

Karen Jennings, head of health at Unison, said: “The whole reason that NHS Professionals was set up, was because private agencies were ripping off hospitals by charging them outrageous fees for recruiting or finding staff for shifts. It makes no sense at all to bring back private companies who will want their slice of the action in return.

“This proposal is purely about Tory plans to promote privatisation and hive off parts of the NHS to private companies, regardless of the consequences on patient care.”

A Department of Health spokesman said: “This is about exploring ways that the commercial skills of the independent sector can make NHS Professionals Ltd a more efficient business and save the NHS money.

“NHS Professionals Ltd is a business, not a public service, and like any business it must ensure its services are as efficient and effective as possible. We want to discuss options with potential independent sector investors that could help to achieve this, and ultimately improve services outcomes for patients.”

It comes as the Royal Berkshire Hospital Trust announced up to 600 jobs will be cut to make £60 million worth of savings in the next few years, pledging that frontline staff would not be affected.

The Royal College of Nursing said last month that thousands of NHS jobs were being cut despite Government promises to protect frontline services.

The nurses’ group said it was aware of almost 10,000 posts lost through recruitment freezes, redundancies and people not replaced when they retired, or which face cuts in the future.

From http://www.telegraph.co.uk/Ministers-accused-of-privatising-NHS-nursing-agency

The Department of Health has spent almost £500 million on management consultants, including deals with firms which have hired senior Labour figures and high ranking civil servants.

Among those recruited by the favoured firms are a former health minister, an ex-adviser to the health secretary and a senior Whitehall official responsible for encouraging private sector involvement in the NHS.

Doctors’ and nurses’ leaders expressed concern over the use of resources which could have paid for more than 60,000 hip operations, or the annual salary of 22,000 nurses.

Critics also said the revelations indicated that the “revolving door” between the labour Government and its favourite consultant firms was spinning ever more quickly, with former senior politicians, officials and advisers linked to companies profiting directly from the policies they had introduced.

Lord Warner, a Labour peer, who was a health minister until December 2006, now acts as an adviser to PA Consulting group, which received £4.9 million from the Department of Health (DoH) in 2007/8.

Until last December he also advised Deloitte, which received almost £3 million in the same year.

Since resigning as a minister in 2006, the peer has also registered interests working for six other health care, technology and IT firms.

Matthew Swindells, policy adviser to then health secretary Patricia Hewitt between 2005 and 2007, who was earning £195,000 at the DoH, is now group managing director for health at Tribal, which earned more than £2 million from the department in 2007/8.

KPMG, the finance firm, secured £4.9 million in the same year. Last month the firm announced the appointment of Mark Britnell, currently on gardening leave from his £235,000 role as DoH director general for commissioning.

The civil servant was responsible for a policy to encourage more private sector involvement in the health service. He drew up plans which allowed a shortlist of firms – including KMPG – preferential access to lucrative NHS contracts.

Under rules intended to reduce conflicts of interests, Mr Britnell has been told that he cannot lobby the Government for his first nine months in his new job.

Other figures to have crossed from Government to private sector firms which won the management consultancy contracts include Sir Michael Barber, who was Tony Blair’s chief adviser on delivery – focusing on education and health – from 2001 to 2005.

Since September 2005 Sir Michael has been a partner at McKinsey, which was paid £9 million for management consultancy services to the DoH in 2007/8.

Lord Birt, the former BBC director general, was Tony Blair’s strategy adviser from 2000 to 2005. In 2006 he was appointed as an adviser to Capgemini UK, the British arm of the global outsourcing giant.

The DoH figures show that Capgemini UK was paid £3.2 million in 2007/8 for management consultancy to the DoH and the agency running the NHS IT programme.

Information released under the Freedom of Information Act discloses for the first time the details of 111 management consultancy contracts held by the DoH and two of its central agencies.

In total, the DoH, its IT programme Connecting for Health and the NHS Purchasing and Supplies Agency spent £470 million on management consultants in the three years from 2005/6 to 2007/8.

It came after the department had made hundreds of its own staff redundant via an “efficiency programme” intended to save money.

The spending came in addition to an estimated £350 million spent annually on consultants by 150 primary care trusts. Research has shown consultants in the NHS earning up to £2,000 a day for project work.

Matthew Sinclair, from the TaxPayers’ Alliance, said: “It is particularly alarming that many of these management consultants are political cronies or have only recently finished working for the Department of Health.”

Dr Mark Porter, deputy chairman of the BMA’s consultants committee, said: “These consultants aren’t just taking money from the front line, they are often drawing up policies which in themselves damage patient care.”

Dr Peter Carter, general secretary of the Royal College of Nursing, said: “We are unable to find any evidence about whether this represents good value.”

Andrew Lansley, the health secretary, said: “This lays bare the hypocrisy of Labour’s claims to have cut back on Government administration costs.”

PA Consulting group said Lord Warner’s advisory work for them did not relate to any contracts held with the DoH. Deloitte said the peer’s role as a strategic adviser ran from March to December last year.

Lord Warner said he only began advising PA Consulting in Autumn 2008, and was no longer advising four of the eight companies he has worked for since stepping down as a minister.

He added: “Provided people leave a decent period after they are in office before they take up such posts – which I did – provided they clear it with the Advisory Committee on Business Appointments, which I did, and provided they register the interest in a public document – which again I did, I don’t think it is right to stop people who were involved in Government forever from working elsewhere. I would defend to the death the right to have a free flow of labour.”

From: http://www.telegraph.co.uk/Millions-spent-on-NHS-management-consultants-with-Labour-links

The NHS is suffering potentially devastating cuts to jobs and patient services as the Government’s austerity drive hits the health service, doctors’ leaders have warned.

Despite ministers’ assurances that the health service would not face the same cuts as other departments, many hospitals are feeling the strain, according to the BMA.

Andrew Lansley, the Health Secretary, has boasted that frontline services would be protected. But it emerged yesterday that in his Cambridge constituency, Addenbrooke’s Hospital is planning to sack 170 nurses and up to 500 staff in total over the next year.

A survey for the BMA asked 361 doctors, who between them represent committees at all of Britain’s hospital trusts and some larger primary care trusts, how the NHS was being affected by the demand to make £20billion of cuts.

It comes as the Coalition faces political pressure to reverse its pledge to ring-fence health spending.

The BMA found that 43 per cent of those who responded said there was a freeze on recruiting doctors and nurses at their trust. Almost as many, 40 per cent, said that patient treatments, including varicose vein operations and blood tests, were being rationed.

GPs in Bedfordshire said they had been told not to refer patients with certain conditions, such as skin lesions and cysts, to hospitals except in exceptional circumstances.

Nearly a quarter of those who responded said that their trust was planning to make workers redundant. Although the majority of these would not affect frontline staff, the union warned that cuts to administrative workers could force doctors and nurses to spend more time on these duties and less time with patients.

The poll – to which 92 doctors responded – represents the first real evidence of how the NHS has been hit by the cuts. It found trusts were trying to make annual savings of six per cent on average. The Government has promised to guarantee NHS spending growth in real terms but the BMA says this will be “minimal”. The association called the cuts potentially “devastating”.

Dr Hamish Meldrum, the chairman of the BMA, said: “Whilst we accept that difficult decisions need to be taken in this tight financial climate, there is a real danger that cutting back on health now will have a long-lasting impact on our ability to maintain high-quality, comprehensive and universal care in the future.”

The warning came as senior Tories broke ranks to object to plans to protect health service funding.

Lord Lawson, the former Chancellor, and Nadine Dorries, a Tory member of the Commons health select committee, said that health funding should not be ring-fenced.

Ms Dorries told the BBC’s Politics Show: “I think we need to find the political courage to accept that there is excessive waste in the NHS and that it’s unfair to expect other departments to take all the hits.”

The Royal College of Nursing said earlier this year that about 5,600 jobs were under threat across 26 hospital trusts. In a “worst case scenario”, the true figure could be as high as 30,000, it said.

A spokesman for the Department of Health said: “Alongside all the public services, the NHS will need to deliver significant savings over the coming years.

“The department is very clear that savings should be implemented in a way that does not affect the quality of services and the Secretary of State has been very clear that every penny saved will be reinvested back into patient care.”

From: http://www.telegraph.co.uk/NHS-suffering-devastating-cuts-to-jobs-and-services-warns-BMA

Peter Carter, the general secretary of the Royal College of Nursing (RCN), also said he was in favour of “drug consumption rooms” to enable addicts to take drugs safely under medical supervision, and to cut rates of drug-related crime.Nurses gathering at the RCN’s annual congress in Bournemouth had earlier discussed providing heroin to addicts where other attempts at treatment have failed.

Results of pilot studies in London, Brighton and Darlington suggest that allowing users to inject themselves with the Class A drug under medical supervision can cut local crime rates by two thirds over six months.

Aberdeen has been considered as a potential future pilot location in Scotland.

But some experts are concerned at the prospect of providing legitimate “shooting galleries” in publically-funded clinics, despite the increasing use of methadone, the heroin-subsitute, and a lack of abstinence-based programmes.

Amid controversy over how to treat chronic drug users, members of the RCN, the country’s largest nursing union, discussed the possibility of providing heroin on the NHS today but did not hold a vote for or against the move.

Speaking in a personal capacity after the debate, Dr Carter, the former head of Central and North West London Mental Health NHS Trust, said that he believed in providing drugs, needle exchanges and locations for users to inject substances safely.

“The fact is heroin is very addictive,” he said. “People who are addicted so often resort to crime, to steal to buy the heroin. It obviates the need for them to steal.

“It might take a few years but I think people will understand that if you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.” Dr Carter added that more research was needed into consumption rooms, which have been tested in Sydney and Amsterdam.

Experts found the programme stopped users injecting in school playgrounds and stairwells.

“Critics say you are encouraging drug addiction but the reality is that these people are addicts and they are going to do it anyway,” he added.

Radical proposals for the most chronic drug users were first advocated in 2002 by the then Home Secretary David Blunkett. The gave rise to pilot programmes in England in which users inject themselves with pharmaceutical diamorphine imported from Switzerland, under medical supervision.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article7108342.ece

Health trusts are planning to cut thousands of staff “by stealth” to deliver £20bn of “NHS efficiencies”, according to a survey by the Royal College of Nursing. Labour reacted by promising that there would be more jobs in the health service at the end of the next Brown administration if it wins the election.

The move comes as Gordon Brown addresses the RCN’s four-day annual conference today. More than 4,000 nurses have gathered in Bournemouth for the event, which is expected to be dominated by NHS finances.

The nurses’ union has been riled by a warning from Sir David Nicholson, the chief executive of the health service, that up to £20bn of savings will have to be found by 2014.

A survey by the RCN of 26 of the 168 English health trusts revealed that 5,600 jobs were already earmarked for cuts in an attempt to slash costs. That figure could rise to more than 36,000 in a “worst-case scenario” if the trend was replicated across all hospital trusts, said Howard Catton, head of policy at the Royal College of Nursing. The loss of posts – including redundancies and staff not being replaced if they leave or retire – could happen over the next three years, he added.

In an online survey of 287 nurses earlier this month, the RCN said hospital wards were already operating with an average of 13% fewer staff than officially needed. Nine out 10 nurses said that patient care was being compromised by short staffing.

There is little doubt that the nurses’ union, which has 400,000 members, has political clout. Last year Brown became the first prime minister to speak at the conference in its 93-year history – to a warm reception by delegates.

Although health has not been a major focus of this election campaign, the issue of NHS job cuts is an explosive one for Labour. In 2006 the then health secretary Patricia Hewitt was jeered and slow-hand-clapped by nurses as she tried to address their fears about NHS deficits.

Andrew Burnham, the health secretary, told the Guardian that savings would come from wage restraint, cutting management costs by a third, and asking “some nurses and doctors to take on different roles in different locations outside of hospitals”.

“It is unlikely that we would need fewer people in five years in the health service. Labour will ensure sufficient funding to frontline NHS services so that they do not need to make any compulsory clinical redundancies and we will ask the NHS to co-operate across organisational boundaries and work towards ensuring this basic guarantee,” he went on. “Cutting doctors, nurses and frontline staff would be costly, counterproductive and would risk a return to the kind of NHS we saw under the Tories.”

The problem for Labour is that decisions on savings are being made at a local level. The RCN points out that managers at some trusts are already openly equating efficiency savings with job cuts.

In an open letter to staff, the chief executive at Salford Royal, a foundation hospital, said: “We are about to enter a financial crisis that could ruin all that we have achieved … this means reducing costs by about £16m a year [and] providing safe standards of service with about 250 fewer people for each of the next three years.”

The market reforms that Labour implemented have made it possible for hospitals to identify savings easily. Dorset county hospital, which made 28 posts redundant in March, admitted that its strategy to “attract more patients” with 300 new staff had failed, leaving a putative black hole of £11m in next year’s budget. The hospital issued a blunt press release: “These extra patients never came and so we are left with rising costs but without the income to cover them.” .

The Conservatives say that their promise to outspend Labour on the NHS insulates them against the charge that the health service is not “safe in their hands”. They say that thousands of NHS medics will lose their jobs over the next five years under Labour’s “secret” cost-cutting plans, which would see 651 fewer doctors and 2,050 fewer nurses across England.

Disclosures made under the Freedom of Information Act at the request of the Tories show half of NHS trusts that responded were planning reductions in the numbers of full-time equivalent doctors and nurses.

The shadow health secretary, Andrew Lansley, said: “We will back the NHS. Conservatives will increase funding for the NHS each year in real terms. So instead of Labour’s cuts to doctors and nurses, we will support the recruitment of staff we need, like specialist nurses, midwives and health visitors.”

From: http://www.guardian.co.uk/politics/2010/apr/26/health-trusts-planning-job-cuts