Alcohol detox centre saves NHS millions

The NHS could save £27 million a year by changing the way it deals with alcoholic patients.

Alcohol detox centre saves NHS millionsAlcohol abuse costs the NHS £3.8 billion a year, £145 for each UK household. One in three of all A&E admissions are alcohol related- but on a weekend that can rise to 70%.

Dr Chris Daly, the lead consultant at the unit, believes the NHS is wasting money by often treating people for the effects of alcohol problems without dealing with the underlying problem.

“We were very surprised that a significant proportion, maybe as much as 50% of the patients that we see, were not open to any services and some of them had never been seen by alcohol services before, so it’s almost as if we’re dealing with a different sort of population,” he says.

“These are people who are maybe only using their A&E department as their main source of treatment for their alcohol problems.”

The Radar ward at Chapman Barker is the first of its kind in the UK. Set up three years ago it takes alcohol dependent patients directly from 11 A&E departments across Manchester.

Some 75% of the people who come through the unit do not go back to hospital for at least the next three months.

The Radar ward is split with separate eating and living spaces for both sexes. Four in 10 of the places here are taken by women, from teenagers right up to pensioners in their 80s.

Patients are treated with talking therapies, support and counselling, but also specialist medical care they would not always get in a large hospital.

Around half of all alcohol dependent patients can develop clinical symptoms when they try to quit, including seizures, fits and hallucinations.

Without the right support the most severe cases often end up back in hospital.

An independent analysis of the unit by academics at Liverpool John Moores University published in April 2015 found it saves the NHS £1.3 million a year.

If the same approach was taken across the country the researchers say it could save the NHS £27.5 million in England alone.

This unit has secured funding to operate for another year but the future is always uncertain. The people working there say ignoring these patients will cost the NHS more in the long run.

Health Direct repeats numerous research warnings that alcohol is the drug that causes the most damage to the UK population- so anything that curbs preventable crisis is to be welcomed.

GP services face retirement crisis

GP services are facing a crisis- with a third of doctors considering retirement in the next five years a BMA poll suggests.

GP services face retirement crisisThe survey of more than 15,000 UK GPs also found over a quarter were considering working part time and one in 10 said they were thinking about moving abroad.

BMA GP leader Dr Chaand Nagpaul said the findings showed some of the promises being made about doctors by politicians were “absurd”.

Improving GP care has been one of the major themes of debate in the election, with the Conservatives promising seven day access to services and Labour pledging a 48-hour waiting-time guarantee.

The findings are in the second tranche of results from the BMA’s poll of GPs, in which nearly a third of doctors in the UK took part.

Last week the BMA released figures suggesting excessive workloads were harming care. This batch of results focused on the effect those rising demands were having. It suggests:

  • 34% of GPs are considering retiring from general practice in the next five years
  • 28% of those working full-time are thinking about moving to part-time
  • 9% are considering moving abroad
  • 7% are considering quitting medicine altogether

They also cited various factors that had a negative impact on their commitment to being a GP, including:

  • excessive workload – 71%
  • unresourced work being moved into general practice – 54%
  • not enough time with their patients – 43%Dr Nagpaul said: “This poll lays bare the stark reality of the crisis facing the GP workforce.

“It is clear that incredible pressures on GP services are at the heart of this problem, with escalating demand having far outstripped capacity. GPs are overworked and intensely frustrated that they do not have enough time to spend with their patients.”

“In this climate, it is absurd that in the recent leaders’ debate, political parties were attempting to outbid each other on the number of GPs they could magically produce in the next Parliament. Since it takes five to eight years to train a GP, it is not possible to create thousands of GPs in this timeframe.”

Katherine Murphy, of the Patients Association, said: “We know from the many calls to our helpline that patients are not able to access GP services at times when they need to.”

“What patients want is a clear and firm commitment that GPs now and tomorrow will have the resources to meet their needs.”

“Anything less is just not acceptable. We need a 21st Century primary care service with access 24/7.”

There are currently 9,000 GPs in training, although 14,000 doctors – about four in 10 – are over the age of 50.

Hospital charges to rise for non EU patients

Visitors from outside the EU who receive treatment in NHS hospitals in England are now charged 150% of the cost.

Hospital charges to rise for non EU patientsThe charges however only apply to non EU citizens settling in the UK for longer than six months. The new rules from the Department of Health came into force on 6 April.

However primary care and Accident and Emergency treatment will continue to remain free.

Permanent residents of 32 European countries qualify for NHS treatment, which is then billed to their country of residence, but this new ruling applies to foreign migrants or visitors based in other countries, mainly those outside the EU.

These patients can be treated in an NHS hospital but are expected to repay the cost of most procedures afterwards.

But up to now, the DoH has only sought to reclaim the actual costs, without adding any extra charges.  The DoH hopes the changes will help it recoup up to £500 million a year by 2017-18.

The new guidelines do not require patients on trolleys in hospitals to produce passports before getting access to urgent care. Nor do they apply to accident and emergency or a visit to a GP.

What is covered is ongoing treatment on the NHS after an initial diagnosis or referral – for example an outpatient appointment.

The Department of Health is incentivising hospitals to be more vigilant in checking patient credentials by allowing them to charge more for treatment of people “not ordinarily resident” in the UK.

The department can recoup those costs from the patient’s member state if they are from the European Economic Area.

In the paperwork filled in by the patient before the appointment they will be asked for proof they are “ordinarily resident”.

This could be a utility bill, national insurance number or passport details. Some hospitals were doing this already but many were not.

The guidelines are designed to increase the chances that the treatment costs for a non UK resident can be recovered. Critics may ask why it has taken so long for the initiative to be launched.

The charges are based on the standard tariff for a range of procedures, ranging from about £1,860 for cataract surgery to about £8,570 for a hip replacement.

Similar charges can be imposed by the NHS in Northern Ireland, Scotland and Wales for hospital care received by non-EU residents.

Patients using hospital services have been required to show their passports and other immigration documents if their UK residence status was in doubt.

The “health surcharge” on visa applications for non-EU citizens comprises an annual fee of £200-a-year, which is reduced to £150 for students.

Certain individuals, such as Australian and New Zealand nationals, are exempt from the surcharge.

And non-EU citizens who are lawfully entitled to reside in the UK and usually live in the country will be entitled to free NHS care as they are now.

New government should boost nurse numbers

Immediate action must be taken by the next government to increase the number of NHS nurses, a report has warned.

New government should boost nurse numbersThe Royal College of Nursing (RCN) said there were fewer nurses now than in 2010 if midwives, health visitors and school nurses were not included.

It said government cuts to nurse training places in 2010 were a significant factor in the shortage.

The Conservatives and Liberal Democrats said they were committed to investing £8 billion each year in the NHS.

The RCN said that while the government claimed the number of nursing posts has increased the actual headcount figure for nurses fell from 317,370 in May 2010 to 315,525 in December 2014.

It described this as “remarkable” given the continued increase in demand for the NHS.

While 50,000 people applied to become nurses last year, there were only 21,000 places – meaning there is no shortage of people wanting to do the job, the RCN said in its report.

It said cuts the coalition government made to student nursing commissions in 2010 led to a reduction of 3,375 places.

The report said that as it takes three years for student nurses to qualify, these cuts are impacting on the supply of nurses right now.

Dr Peter Carter, chief executive and general secretary of the RCN, said: “We warned that cutting the workforce numbers to fund the NHS reorganisation and to find the efficiency savings was the wrong course to take.

“The cuts were so severe that we are only just catching up with where we were five years ago.  Many areas, like district nursing and mental health, are even worse off. While the health service has spent the last five years running on the spot, demand has continued to increase.”

“Whoever forms the next government must learn from this report and take immediate action to grow the nursing workforce, and ensure it can keep up with demand with a sustainable and long term plan.”

The report also said the community nursing workforce had been cut by more than 3,300, despite NHS plans to move care from hospitals to the community.

From May 2010 to December 2014 there has been a 28% reduction in the number of specialist district nurses, a loss of 2,168 posts across England.

A reliance on using agency nurses means that the NHS would have spent an estimated £980 million on them by the end of the 2014/15 financial year, the RCN said.

As with GPs, the nursing workforce is ageing, with around 45% being over 45, the RCN added.

Skin cancer linked to package holiday boom

A boom in cheap package holidays in the 1960s is partly behind the “worrying rise” in skin cancers in pensioners, Cancer Research UK suggests.

Skin cancer linked to package holiday boomThe charity says that although all ages are at risk, many older people would not have been aware of how to protect themselves four decades ago.

Figures show that 5,700 over 65s are diagnosed with the condition each year, compared to just 600 in the mid-1970s.

The condition can often be prevented by covering up and avoiding sunburn.

Around 13,300 people are diagnosed with malignant melanoma – the most serious form of skin cancer – each year in the UK. And 2,100 lives are lost to the disease annually.

Numbers are increasing across all age groups but the steepest rise is seen in over-65s.

The charity said all ages are benefitting from public health messages explaining the dangers of holiday sun.

Professor Richard Marais of Cancer Research UK (CRUK), said: “It is worrying to see melanoma rates increasing at such a fast pace, and across all age groups.”

“It is important people keep an eye on their skin and seek medical opinion if they see any changes to their moles or even to normal areas of skin.”

Research suggests that getting sunburnt just once every two years can increase the odds of developing malignant melanoma.

Dr Julie Sharp, head of health information at CRUK, said: “You can burn at home just as easily as you can on holiday, so remember to spend time in the shade, wear a T-shirt and a hat to protect your skin and regularly apply sunscreen that is at least factor 15 and has four stars.”

Johnathon Major, from the British Association of Dermatologists, said: “The increasing incidence of skin cancer within the UK is alarming.

“As people are living longer, more people are reaching an age where they are at a higher risk. Interest in package holidays and in fashion tanning are among the reasons that more people are developing skin cancer.”

“But it’s crucial to remember that you don’t have to go on holiday or use a sun bed to heighten your risk. Skin cancers can develop as a result of both short term and long term overexposure to the sun’s rays within the UK.”