UK end of life care- best in world

End of life care in the UK has been ranked as the best in the world with a study praising the quality and availability of services.

End of life care in the UK has been ranked as the best in the world with a study praising the quality and availability of servicesThe study of 80 countries said thanks to the NHS and hospice movement the care provided was “second to none”.

Rich nations tended to perform the best – with Australia and New Zealand ranked second and third respectively.

But the report by the Economist Intelligence Unit praised progress made in some of the poorest countries.

For example Mongolia – ranked 28th – has invested in hospice facilities, while Uganda – 35th – has managed to improve access to pain control through a public-private partnership.

The rankings were worked out following assessments for the quality of the hospitals and hospice environments, staffing numbers and skills, affordability of care and quality of care.

Just 34 out of 80 countries provided what could be classed as good end-of-life care – and these accounted for just 15% of the adult population.

The report said the quality of end-of-life care was becoming increasingly important with the ageing population, meaning people were increasingly facing “drawn-out” deaths.

It’s no major surprise that richer countries, with stronger health systems, provide some of the world’s best palliative care. But a few poorer nations are bucking the trend, and it’s often down to the efforts of individuals campaigning for everyone to be allowed a dignified and pain-free death. Panama, Chile, Mongolia and Uganda are singled out for praise, whereas the situation in India and China is described as “worrying”.

India ranked 67th in the index, and China was in the bottom 10 at 71. Both have huge populations and have experienced rapid economic growth, but care for people at the end of their lives has not kept up. The report warns further improvements are needed across all countries to cope with the future demands of an aging population, increasingly facing drawn-out illnesses such as cancer, heart disease and dementia.

The UK received top marks for affordability – as would be expected for a service that is provided free at the point of need – but also got a perfect score for quality of care.

Overall it was given 93.9 out of 100, but the report still said there was room for improvement – as there was with all the top-performing nations.

Services in England have recently been criticised by the Parliamentary and Health Service Ombudsman.

The UK also came top the last time this report was produced in 2010. Also in the top 10 this time were the Irish Republic, France, Germany and the US.

Iraq and Bangladesh finished bottom of the ranking, while China was in the worst 10.

Fraud could be costing NHS in England £5.7 billion a year

The NHS in England could be losing up to £5.7 billion a year to fraud from its £100bn budget, a new report suggests.

The NHS in England could be losing up to £5.7 billion a year to fraud from its £100bn budget, a new report suggests.A review – led by former NHS anti-fraud boss Jim Gee – highlighted fraud by pharmacists, dentists, GPs and patients.

Among the areas it found to be affected were procurement, prescriptions, registration of patients and payroll.

To work out how much fraud is being committed, the review had to rely on estimates as well as detected fraud. It said the level of fraud was likely to be between £3.7 billion and £5.7 billion a year- out of a budget of more than £110 billion.

Among the scams highlighted were dentists claiming money for NHS care they did not carry out and GPs falsifying records for extra payments.

To illustrate the scale of some of these cases, it highlighted the jailing of a Birmingham dentist in 2012 after she stole £1.4m from the NHS.
The biggest sources of fraud in the NHS
Area                                                     Scams used                                                          Estimated value per year
Payroll                  False allowance claims and incorrect qualifications used                   £555m – £1.49bn
Procurement          Overcharging for goods and services or under-delivery                      £1bn – £1.27bn
General practice     Claims for services not provided and for ghost patients                          £348m
Patients       Claim for free prescriptions, dental care and optician services they are not entitled to     £304m
Dentistry                 Claims for dental work not carried out                                                        £121m – £137m
Pharmacy     Staff claiming for more drugs than actually dispensed or for services not provided     £83m – £96m

Patient fraud identified included wrongful claims for free prescriptions, dental and optician care.

But the biggest area of fraud was estimated to be payroll, at between £555m and £1.49bn – although the report said this mainly consisted of lots of small-scale cases.

Mr Gee, who carried out his work for PFK Littlejohn accountants, said: “There is a vast, honest majority who find fraud against the NHS to be completely unacceptable. However, there is also a dishonest minority who can cause significant financial damage.

“The best way of stopping this is not to wait for fraud to happen and then act after losses have been incurred, but to proactively deter and prevent them. Fraud is a cost to be measured, managed and minimised like any other.”

There is nothing new about fraud in the NHS. The scams are all too familiar – whether it’s health service managers purchasing hospital supplies and taking backhanders or corrupt GPs claiming they have patients who don’t actually exist.

But the report’s authors argue that, even though the NHS’s fraud problem is no worse than in other healthcare systems, the need for a crackdown is as urgent as ever because of the intense financial pressure on the NHS and the need to make efficiency savings.

They accuse the government of failing to carry out a detailed audit of the extent of health service fraud. The Department of Health said it didn’t recognise the figures, but there has been no official denial that there is a problem that needs fixing.

Fraud officers work in each local area while at a national level, fraud work is co-ordinated by NHS Protect.

Target of four week cancer diagnosis plan

More details of plans to improve cancer care in England have been revealed.

Target of four week cancer diagnosis plan They include a target that 95% of people should be given a diagnosis or the all-clear within 28 days of being referred by a GP, by 2020. Implementing it will cost £300 million a year until then.

The target – recommended by the Independent Cancer Taskforce – will be trialled in five hospitals before being rolled out nationwide if successful.

Faster cancer diagnosis could save 11,000 lives a year, the taskforce said.

Health Secretary Jeremy Hunt said the UK lagged behind other western European countries in cancer survival rates and the new measures would help “close the gap”.

“We know that the biggest single factor that means that our cancer survival rates lag those of France, Germany and other European countries is the fact that we have too much late diagnosis; we don’t get an answer to people quickly enough,” he said.

Mr Hunt said he was making “a very simple promise to all NHS patients” that by 2020 they would have a cancer diagnosis or an all-clear within 28 days.

However, the Department of Health later clarified that while it hoped to achieve the Independent Cancer Taskforce target of 95% by 2020, it would only be clear once trials were completed whether that was achievable.

Speeding up diagnosis would require more cancer consultants, specialist nurses, staff trained in endoscopies and diagnostic tests, Mr Hunt added.

Currently 280,000 people in England are diagnosed with cancer each year – with half surviving for at least 10 years.

Patients are meant to see a specialist within two weeks of a GP referral under existing targets but may then face a long wait for test results, meaning a growing number of patients do not get their treatment started within the recommended 62 days.

Cancer patients will also get online access to their test results if they choose, under the new measures.

Harpal Kumar, chief executive of Cancer Research UK and chairman of the Independent Cancer Taskforce, said services for diagnosing cancer were under immense pressure, which is why increased investment and extra staff were so important.

“Introducing the 28-day ambition for patients to receive a diagnosis will maximise the impact of this investment which, together with making results available online, will spare people unnecessary added anxiety and help cancer patients to begin treatment sooner,” he said.

The announcement comes after a cross-party group of MPs warned that cancer services had “lost momentum” in the past two years.

The health service has been struggling to meet waiting times and seen resources reduced, the Public Accounts Committee warned.