Saturday, 24 January 2015

Seema Malhotra MP: Urgent measures are needed to save the NHS

 Recent crises in the local NHS are the results of decisions in Westminster, argues Feltham and Heston Labour MP Seema Malhotra in her latest column.
Feltham & Heston MP Seema Malhotra

Few will have missed that the last few weeks has seen a crisis in the NHS .
This has also been the subject of debates in Parliament in which I have asked questions of the Secretary of State (for Health) on the issues and on GP appointments, which local residents continue to raise with me.
I was saddened that Ashford and St Peters had to declare a major incident, and I think we should all acknowledge the staff for what they achieved in bringing the situation back under control in a week following a difficult New Year. Their website still reads 'We are currently under severe pressure - please don't come to A&E unless you are a real emergency. Non-emergency patients are likely to have an extremely long wait and could be taking staff away from caring for patients who need emergency or life-saving care.'
Other hospitals in our area including Ealing and Hillingdon continue to suffer huge pressures.
This week the House of Commons in an opposition day also debated the way the NHS is under unprecedented pressure, how attendances at A&E departments have increased by 60,000 in the last four years of the current Government, and believe that this is linked to decisions taken by David Cameron, including cuts to adult social care, the abolition of NHS direct, the closure of almost one in four walk-in centres and the removal of the GP access guarantee.
Labour called on the Government to raise an extra £2.5bn for the NHS, which Labour will fund from a tax on high value homes. We desperately need measures to ease the current pressure.
The NHS changes that Labour has been concerned about and much of which we would seek to reverse have led to an unfortunate fragmentation of health services. The Government took away the ratio that Labour brought in of GPs to patients. This means GP practices can accept as many patients as they wish without needing to get another GP on the team if they go over a certain limit. This means it can contribute to revenues coming in to the GP services, but patients waiting longer for an appointment.
The inflexibility of some GPs in how you can fix an appointment is also a matter of concern. The need to call on the day at a certain time e.g. 8am, and then with so many calling it can be pot luck if you get through or if you have to try again tomorrow. That isn’t the way to plan healthcare. Statistics from the Health and Social Care Information Centre in spring last year suggested there are 2,003 registered patients per GP in the borough, higher than anywhere but Swale, in Kent.
Labour's 48 hour GP appointment guarantee means you would be able to get an appointment within 48 hours if you want and need it. But of course you should also be able to plan ahead and book on a date in the future convenient for you and for your work. We need to think holistically about how GP appointments and our health services tie in with people's lives.
I spent some time with our community health care trust this week, as part of my Parliamentary work, also to understand more about how strategies to help identify and tackle violence against women and girls are being embedded in our community. Our community nurses, midwives and school nurses do an outstanding job, and we are incredibly fortunate that we have a local community health trust that has a green rating both on finances and quality - a rare combination. They work closely with Richmond and Hounslow local authorities and hospitals on most aspects of care in the community.
So whilst we thank and appreciate what all those who work in our health services are doing for our families and communities, it’s time also to make the connection between what is happening on the ground and the political decisions being made in Westminster.



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Wednesday, 21 January 2015

Health meeting 20/01/2014 at Hammersmith Town Hall















Check the video clips here:

Is Charing Cross Hospital going to be downgraded? Andy Slaughter MP for Hammersmith 
https://www.youtube.com/watch?v=E_1qDVRLCoc

Best Stroke Unit in the country at Charing Cross Hospital - Dr William Oldfield 
https://www.youtube.com/watch?v=WH8ypWgJphU

We praise the staff, but not the management decisions - Cllr Stephen Cowan , Leader of H&F Council 
https://www.youtube.com/watch?v=dMVJw0vbJ-k

Council wants to know the steps taken by Imperial T. to solve crisis in the NHS - Cllr Rory Vaughan 
https://www.youtube.com/watch?v=byRN67CbCAs

Is Imperial NHS Trust going to withdraw the foundation bid? Cllr Stephen Cowan , H&F Council 

Imperial Trust NHS answers questions about the A&Es crisis - Stephen Cowan, leader of H&F Council 

Should Imperial NHS Trust closed Hammersmith A&E in a middle of an A&E crisis? 

"We didn't get it right, the figures show..." Steve MacManus, Imperial NHS Trust 

Are patients been transferred because of bed shortages? Steve McManus , Dr Willian Oldfield 

Imperial NHS Trust provided data during crisis to NHS England - Steve MacManus, deputy chief exec. 

Imperial NHS Trust adds consultants to help solving the A&E crisis - Steve MacManus 

More consultants are available at Charing Cross and St Mary's Hospitals during crises 


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Location: Hammersmith Town Hall, London W6, UK

Monday, 19 January 2015

Huge rise in patients ‘stacked’ in ambulances outside A&E as hospitals run out of space

Malcolm Alexander, chairman of the Patients’ Forum for the London Ambulance Service, called the situation “intolerable”.
No room: Patients waited between 30 and 59 minutes for transfer to A&E cubicle in December 2014

Patients were stuck in ambulances for more than half an hour on over 4,400 occasions in London last month because hospitals had run out of space.
Figures passed to the Standard show a 66 per cent rise in the number of emergency vehicles “stacking” outside hospitals.
A total of 4,407 patients waited between 30 and 59 minutes to be transferred to an A&E cubicle last month — up from 2,655 in November, according to NHS England statistics. The NHS target is for patients to be offloaded within 15 minutes.
Campaigners have written to the Department of Health calling for more beds to be opened, and warning of a “crisis” if temperatures plummet.
Malcolm Alexander, chairman of the Patients’ Forum for the London Ambulance Service, called the situation “in-tolerable”, saying: “Ambulance staff are under 100 per cent pressure, with long shifts, staff shortages, no lunchbreaks.
"They are at the edge of a precipice. Staff are being recruited from Australia but this is a short-term solution.”
Dr Onkar Sahota, Labour chairman of the London Assembly health committee, said: “Rising waiting times, ambulances queuing and patients waiting on trolleys are symptoms of a system which has reached crisis point.
"There are simply not enough beds. Lives are being put at risk.”
Number of patients waiting between 30 and 59 minutes for transfer to A&E cubicle in December 2014. Source: LAS Patients' Forum/LAS Commissioners
Last month the capital saw more people attend A&E than ever, including a record high of 77,199 in the week before Christmas. NHS England’s London director, Dr Anne Rainsberry, has launched an investigation into the causes of the unprecedented “spike”.

The greatest number of queues was at Queen’s Hospital in Romford — 636 waits of between 30 to 59 minutes, followed by St George’s in Tooting (531), Northwick Park in Harrow (475), and North Middlesex in Edmonton (454).
Next month London Ambulance Service will begin a pilot scheme giving call-handlers an extra two minutes — on top of the one minute allowed — to quiz people who ring 999 before they decide whether to dispatch an ambulance. It will not apply to cases where the patient is not breathing and without a pulse.
Professor Keith Willett, director of acute care at NHS England, said he wanted to prevent ambulances from being dispatched before the full extent of a problem had been determined.
He added that the trial would also stop multiple ambulances being dispatched to the same call.

 http://www.standard.co.uk/news/health/huge-rise-in-patients-stacked-in-ambulances-outside-ae-as-hospitals-run-out-of-space-9987901.html
 Ross Lydall,Health Editor
Published: 19 January 2015
Updated: 14:35, 19 January 2015
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Saturday, 17 January 2015

Six reasons A&Es are struggling

By Nick TriggleHealth correspondent, BBC News
A&E waits in England are at their worst level for a decade with the four-hour target now being missed - as it is elsewhere in the UK.
Pressures have become so great that a number of hospitals have had to declare major incidents, calling in extra staff, cancelling operations and - in extreme cases - diverting ambulances away from A&E units.
It has led to reports of patients queuing in corridors, being treated in side-rooms and ambulances struggling to drop patients off.
But what is behind these problems? The truth is there isn't one simple answer, but rather a multitude of factors behind the difficulties being seen across the health service.
line
Lack of staff
Healthcare team of nurses and doctors
It has been known for some time that A&E units are struggling to recruit and retain staff.
The College of Emergency Medicines says each unit should have 10 consultants with the largest trusts needing up to 16. But the average number stands at just over seven. There are also said to be shortages of A&E nurses.
Hospitals have reported problems both recruiting and retaining staff withreports emerging of emergency care doctors emigrating abroad.
The college said the "relentless" pressures on A&E units make it unattractive.
line
111 Helpline
111 logo
The 111 helpline was launched in the spring of 2013 to replace NHS Direct. The idea was to create a system that was integrated better with local health services enabling appointments to be booked.
But it was beset by problems from the start. One of the biggest criticisms has been the fact that it has fewer clinically trained staff than its predecessor.
This, critics say, has led to increases in the number of patients being referred to A&E or an ambulance being called.
Over one in 10 calls end in an ambulance being sent, while one in 13 lead to a patient being sent to A&E. Although, interestingly, in the lead up to the festive period, when calls reached a peak, those figures actually fell.
line
Cuts to social care
Helping hand on a walking stick
While the NHS budget has been rising, the opposite has happened for council-run social care services.
A total of £17.23bn was spent on services for the elderly and disabled last year - down by 3% in five years. It has meant the numbers getting help have been falling - down by 29% to 1.27m during the same period.
This, remember, is at a time when you would expect it to be increasing in light of the ageing population and the fact that people with disabilities are living for longer.
If there is not good access to social care, hospitals can struggle to discharge patients - something that seems to be happening with delays higher in the lead up to Christmas than they were in previous years.
line
GP access getting more difficult
Stethoscope
Unlike A&E, waiting times to see a GP are not routinely collected, although there is evidence to suggest it is getting more difficult to see a doctor.
The most recent national GP patient survey found that in the last two years the proportion saying it was not easy to get through on the phone had risen from 18% to 24%. When they did get through 11% were unable to get an appointment.
It comes as both the Royal College of GPs and British Medical Association have been vocal about the workload their members are facing. A recent BMA survey found three quarters of doctors said their caseload was "unsustainable".
The most obvious place patients go if they can't get to see a GP is, of course, A&E.
line
Ageing population
Elderly patient
The fact that people live longer has rightly been widely celebrated. One in five people alive today will live to see their 100th birthday.
Over the next two decades the number of over 65s will rise by 50% and the number of over 85s will double.
But this means there are a growing number of frail and elderly people who have complex conditions that take longer to treat.
This is acknowledged to be one of the major causes behind the rise in numbers attending A&E units - and in particular those that needed to be then admitted into hospital for further treatment. Two thirds of emergency admissions are among the over 65s age group.
line
Money is tight
Money
While the NHS budget has been increased - 0.7% a year in real terms on average during this Parliament - money is still short because of the rising demands.
Half-way through the 2014-15 financial year, the NHS in England had racked up a deficit of £630m, with the biggest problems concentrated in hospitals.
A&E units are particularly susceptible when money is tight. Under the funding rules, they can actually be paid less per patient the more they see.
Attempts have been made to correct this anomaly But hospitals still claim it is hampering their ability to cope.
To help A&E units during winter, ministers have released an extra £700m. But £300m of that came in the autumn, which some said was too late to make much of a difference.
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More than 400,000 extra A&E visits

By James Gallagher & Nick TriggleBBC News
Ambulance, LiverpoolJunior and overseas doctors will help bolster A&E units over the winter, the Department of Health said.

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The number of A&E visits in England soared by more than 400,000 in 2014, figures show.
The College of Emergency Medicine said that was the equivalent of filling an extra nine emergency departments.
The Health Select Committee has been taking evidence after the worst waiting times in A&E for a decade and many hospitals declaring "major incidents".
Doctors said it was "absurd" to blame patients, who were advised to go to A&E by services including NHS 111.
The committee heard the reasons for the surge in demand were "many, varied and complex", but staff were doing a "heroic" job.

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Figures for England showed 92.6% of patients had been seen within four hours during the October-to-December quarter. The target is 95%.
Then, last week, data for the start of the new year showed the proportion had dropped to a new weekly low of 86.7%.
The figures include walk-in centres and minor injury units. Once you strip them out, just one in seven major A&E units are hitting the target.
More people
Data from NHS England shows there were over 14.6m visits to A&E in 2014 - an increase of 446,049 on 2013.
Dr Clifford Mann, the president of the College of Emergency Medicine, told the committee: "Now the interesting thing about that is many people would describe that as only a 3% increase in attendances.
"That's certainly true, but the other way of describing it is to say that's equivalent to eight or nine extra emergency departments and of course we haven't built or staffed eight or nine extra emergency departments in the last 12 months."
Graph
Other parts of the UK are also missing the four-hour target with waits in Northern Ireland and Wales even worse than in England.
The four-hour target measures the point from when the patient arrives to when they are treated and discharged, admitted to hospital or transferred to another part of the NHS.
Prof Chris Ham, from The King's Fund health think tank, said there was no simple explanation for the extra pressures on A&E.
He said: "The causes are many, varied and complex. We think the most important causes are outside hospital."
He cited under-investment in GP services and a lack of community services to support people being discharged from hospital.
'Don't blame patients'
Dr Mann said it was not the fault of patients, who were often told to go to A&E, including through the helpline service, NHS 111.
He said: "I don't think you should blame people for attending an emergency department when we've told them to go there, it's absurd."
The pressures being felt in A&E are also affecting other parts of the hospital system.
line
AnalysisBy Hugh Pym, BBC Health Editor
The Government has made much of the £700m of extra funding made available to the NHS in England to cope with winter pressures. But has it all reached the frontline?
Doubt was cast on that by Dr Cliff Mann of the College of Emergency Medicine. He told MPs that investment of the money was "geographically patchy".
Chris Ham of the King's Fund ventured that some of the money might be "papering over the cracks" of trusts struggling with deficits.
Dale Bywater of the Trust Development Authority argued that the money had been pledged early and was being closely tracked through the system.
Just how the extra cash for the NHS has been used will continue to be an issue as the debate over the intense pressures on A&E continues.
line
Delays are also being seen when ambulances hand over patients and inside the hospital when patients need to be found beds and when they are ready to be discharged.
The problems have even led to a number of hospitals declaring major incidents, which means they take steps such as calling in extra staff and cancelling routine operations, such as knee and hip operations.
The committee heard that pressures on A&E would have a knock-on effect on the rest of the health service as priorities shifted to target the four-hour wait.
Prof Ham warned other targets were likely to slip later in the year.
Prof Keith Willett, the director of acute care for NHS England, said: "We have to do a transformation of the whole system with a particular focus on out-of-hospital services being the way to both reduce demand and also alleviate the issues of congestion within the hospital.
"It isn't going to be a quick fix. We have said it will be three to five years to get all of these things in place."

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David Cameron isn't listening - The NHS is NOT for sale

The NHS is not for sale. Let me repeat that because David Cameron doesn’t seem to be listening. The NHS is NOT for sale.
His latest wheeze is to back an EU trade deal which threatens our health service and everything it stands for.
The Transatlantic Trade and Investment Partnership (TTIP) has been described by War on Want as an ‘assault’ on society.
This potential treaty with the US could essentially mean more NHS privatisation. It would allow American health giants to bid for NHS contracts then sue for millions if the government tries to ditch them.
And it’s yet another example that we can’t trust Cameron to tell us the truth. No mention was made by him of the sell-off when he was out begging for votes during the 2010 general election.
The election that got him into bed with the equally untrustworthy Nick Clegg.
News of these behind-doors talks have leaked out and people around the country are outraged. In Chelmsford, hundreds have put signs in their windows demanding ‘Cameron & Hunt Estate Agents’ stop the sale.
They want the prime minister to protect the NHS by using his veto. Fat chance. Instead, we’ve got weasel words and empty assurances from the health secretary.
Of course, we already know that the coalition wants to flog off the NHS- and this deal will make it easier. Take their social care reforms.
The 2012 Health and Social Care Act came with the promise that local people would have the final say in who ran their services.
Instead, it allowed a huge increase in NHS privatisation . A staggering number of NHS contracts have gone to the private sector since the Act was introduced.
Nearly seven out of ten according to campaign group the NHS Support Federation. But the Tories aren’t going to stop there. They may deny they want a US-style system where those that can afford it get the best care through private insurance and those who can’t put up with long waits and are denied life-saving treatments. A two-tier system is what we’re heading for though under Cameron.
PAJeremy Hunt and Andrew Lansley
Former health secretary Andrew Lansley (right) and his successor Jeremy Hunt

Lansley’s changes to the NHS have already left no control. The money goes in but no one is in charge of it. Instead, we’ve handed over the money to doctors and left them to get on with it.
The result is a care ‘lottery.’ Any chance of getting the best treatment is down to luck and where you happen to live.
For the NHS to be reformed we need to take back the power- the clue is in the title ‘National’. But they’ve broken it up into tiny parts.
There’s this myth that a US-style healthcare system is more efficient. It isn’t. The US shows the private sector doesn’t necessarily deliver more for less or is more efficient.
Instead, it spends comparatively more on hospital admin costs than other countries including England and Scotland. 
And the vicious response to President Obama’s healthcare reforms tells you everything to know about the culture of private healthcare.
America’s healthcare industry spent millions of dollars to block the introduction of public health insurance and protect their financial interests.
You’d have expected the health service to be on Cameron’s list of six election priorities for Britain.
But no, saving lives wasn’t important enough. Funny that because in 2010 he said the NHS would be his number one priority.
It’s yet more evidence that he lies- not that we need any.
Labour is going to make the NHS a priority. We’ve fought to protect our health service for nearly 70 years so we’re not going to let Cameron flog off our most precious asset now.
We’re going to campaign on every doorstep for what matters. An NHS that gives everyone access to the treatments and services they need.

Tom Watson, the Labour MP on our Politics Panel says the Transatlantic Trade and Investment Partnership will lead to even more NHS privatisation

Because we know that matters to the people of Britain.

Should private companies be allowed to run parts of the NHS?

  • YES
    6%
  • NO
    94%
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