Appalling Admission of Failure by NHS North West London (NWL) as Final Anticipated Deficit Figure for 2019\/20 is \u00a3112 Million<\/b><\/p>\n
\u2018Unscheduled Care\u2019 is the reason given by NHS NWL bosses for an anticipated annual deficit at the end of this financial year of \u00a3112 million. Unscheduled care equates to poor planning. A deficit equates to underfunding.<\/span><\/p>\n The blood on the carpet here must be attributed to the disastrous \u00a31.3 billion \u2018Shaping a Healthier Future\u2019 (SaHF) plan. SaHF, launched in 2012 and ignominiously abandoned in March 2019, tragically closed two hospital A&Es in September 2014. This has caused rises in unscheduled care at the remaining seven Major Hospital A&Es ever since. For over six years Ealing and Charing Cross Hospitals were threatened with downgrading (loss of A&Es). NHS NWL closed down Maternity and then Paediatrics at Ealing Hospital. At Ealing and Charing Cross Hospitals \u2013 loudly earmarked for possible complete closure as \u2018Major Hospitals\u2019- hiring new permanent staff has been difficult and expensive. So temporary, Agency, \u2018Bank\u2019 and locum staff costs have been enormous.<\/span><\/p>\n Patients at all seven Major Hospitals will no doubt now suffer from service cutbacks, closures, more pain and possible death in order to reduce this deficit. It\u2019s hard to forget that expert analysis of SaHF pegged the cost of the failed initiative at \u00a3235.55 million by 31 March 2018. Separate research has revealed that management consultants\u2019 fees incurred by NHS NWL on service transformation 2009\/10 to 2018\/19 now total over \u00a376 million. The \u2018Sunday Times\u2019 on 10 February 2019 revealed that the maintenance backlog at just four of the nine NHS NWL Major Hospitals stood at \u00a3729 million.<\/span><\/p>\n When will anyone in authority take responsibility for this NHS NWL financial, management, planning, commissioning and service delivery debacle and do the honourable thing by resigning?<\/span><\/p>\n <\/p>\n NHS NWL Hopes That Reducing the Number of Referrals to Hospital Consultants Will Cut Costs by \u00a360 Million<\/b><\/p>\n NHS North West London (NWL) has decreed that GPs will have to restrict the number of patient referrals to hospital\/Secondary Care consultants they initiate. This is to cut costs. NHS NWL\u2019s cost cutting record is not good. The NHS NWL 2012 \u2018Shaping a Healthier Future\u2019 (SaHF) programme planned to achieve cuts of \u00a34 million every year. No achieved SaHF cuts were ever announced during the programme\u2019s 2012-2019 existence.<\/span><\/p>\n Presumably with fewer referrals to consultants, fewer consultants will be needed so salary costs will be saved. \u2018Alternative ways\u2019 must be sought by GPs whose opinion is that a patient needs hospital treatment. What alternatives might these be?\u00a0<\/span><\/p>\n Maybe contacting the hospital consultant in a private capacity and paying for the consultation and the treatment? The patient having to put up with the pain by constant use of painkillers perhaps? Or if it\u2019s someone with mental health problems, suggesting to the patient that they get a book from the library (or search the online world) and attempt to consult those resources for clues on how one might \u2019get better\u2019.<\/span><\/p>\n The London North West University Healthcare NHS Trust LNWH) has been singled out by NHS NWL for cuts to its Acute costs, improvements in patient flow and reductions in Delayed Transfers of Care. For its two Hospital A&E units at Ealing and Northwick Park the 95% four hour waiting time target was breached to a level of just under 85% in December 2018. By March 2109 it had only improved to just over 88%. In a surprise revelation in September 2019 Dame Jacqueline Docherty, Chief Executive of LNWH, is seemingly stepping down from her role on 31 March 2020. A seven month notice period seems very protracted. In 2018\/19 she earned \u00a3230,000.<\/span><\/p>\n Ealing\u2019s Referral Facilitation Service Bites the Dust<\/b><\/p>\n Ealing GPs are soon to now \u2018audit\u2019 their own consultant referrals. Ealing CCG has decided to discontinue its Referral Facilitation Service (RFS) in November 2019. RFS is provide by US healthcare giant UnitedHealth at no small cost. The service was clearly aimed at reducing referrals by refusing some of them. The service has cost over \u00a32 million over three years. Apparently very few referrals were refused and the service was correctly deemed to be a complete waste of money.<\/span><\/p>\n NHS NWL makes it clear that the hospitals which face the biggest financial challenges are those in the London North West University Healthcare NHS Trust. These, of course, are the Major Hospitals at Northwick Park, Ealing and Central Middlesex.<\/span><\/p>\n The Collaboration of NHS NWL CCGs, who collectively \u2018boss\u2019 the purchasing of all healthcare services for 2.2 million people in north west London were quoted in \u2018The Guardian\u2019 9 September 2019:<\/span><\/p>\n \u2018<\/span>The safety of our patients and the quality of our services will always come first\u2019.<\/b><\/p>\n Given that the collaboration is a non-statutory purchasing body and not a clinical services delivery body, this aspiration is in many ways quite offensive. Four of the eight local CCG bosses in this collaboration signed their names to the shambolic SaHF Acute reconfiguration programme and have drawn their not ungenerous stipends for over six years. NHSE has clearly demanded that quantity of service and cost cutting are very high priorities.<\/span><\/p>\n It also appears that even if you are referred to one consultant, you will then be prevented contemporaneously being referred to a second consultant (of another discipline). To employ another mental health example there is plenty of data which confirms that those with mental health problems use more physical healthcare services than those without. (Colorado Access insurance system data puts the percentage at 60%). So chances are if a consultation with a psychologist and a urologist are needed, the GP must choose between say, a 20 week wait to see a urologist or a 40 week wait to see a psychologist.\u00a0 More stress for the GP, the patients and his\/her loved ones \u2013 whichever choice the GP makes.<\/span><\/p>\n <\/p>\n Yet Another Attempt at Acute Reconfiguration Transformation<\/b><\/p>\n Language and strategy very similar to that used in the failed SaHF is employed to instruct GPs to send fewer patients into Acute care. All attempts in NHS NWL in recent years to reduce Acute admissions (so called Non-Elective Admissions \u2013 NELs) and treat more patients in GP surgeries, GP hubs and at home mostly ended in failure – failure to cut costs and sustain bed number reductions. It will be interesting to see if West London NHS Trust\u2019s (WLNT\u2019s) 10 year Ealing Out Of Hospital services approach (branded Ealing Community Partners – ECP) can both save on costs and suffer no reduction in service quality. However, and somewhat surprisingly, at the 11 September 2019 WLNT Board meeting, there was no sign of cost cutting \u2013 more the opposite with lots of new hires planned. Clearly there are parts of NHS NWL not required to help reduce the enormous deficit.<\/span><\/p>\n The latest released monthly figures for July 2019 show little improvement with aspirations of further action on managing urgent care and limiting the growth of elective and outpatient care.<\/span><\/p>\n <\/p>\n New Regional NHS NWL Clinical Commissioning Group (CCG) Start Date Delayed till April 2021<\/b><\/p>\n Lots of loud voices offered the opinion that the NHS NWL rush to eliminate eight local CCGs and \u2018replace\u2019 them with one new regional CCG in April 2020 was a bad idea. Many thought the whole process had not been adequately thought through. No doubt some (all?) of the eight existing local CCG bosses were less than impressed by the prospect of losing their remuneration in six months\u2019 time. NHS NWL has announced that the start date will now be 1 April 2021.<\/span><\/p>\n <\/p>\n Should the BMA Boss Be Paid More than Seven Times The Salary of a First Year Junior Doctor?<\/b><\/p>\n Union bosses do themselves no favours when their take home pay completely dwarfs the workers they are attempting to represent. \u2018The Times\u2019 of 9 September 2019 revealed that the salary of Chaand Nagpaul, Chairman and General Secretary of the British Medical Association (BMA) is \u00a3193,000\/year. A first year Junior Doctor earns \u00a327,100\/year. One wonders whether Mr Nagpaul is worth seven first year Junior Doctors?<\/span><\/p>\n <\/p>\n GP Locums Are Now Eligible for Holiday Pay \u2013 Backdated for Six Years<\/b><\/p>\n GP locums, who allegedly earn on average \u00a3140,000\/year, can now enjoy holiday pay back datedfor\u00a0 up to six years. This is the outcome of a Court case in Gateshead. Not only could this cost an estimated \u00a3250 million a year, that figure does not include any back payments. The General Medical Council reckons there are 20,000 locum GPs in England, some of whom can command \u00a31,000\/day.<\/span><\/p>\n Surely this eligibility will encourage more GPs to become locums rather than become dedicated to one practice? Does this matter? Well the growth in locums will increase the running costs for Primary Care and will slowly eat away at the number of salaried and permanent partnership roles in GP practices. It will also degrade continuity of care, which is highly valued by most patients, especially elderly patients.\u00a0<\/span><\/p>\n <\/p>\n \u00a0<\/span>A&E Waiting Times Throughout England are the Worst for 10 Years<\/b><\/p>\n In 2008, 93% of patients were seen in NHA hospital A&E units within four hours. In 2018 it was 88%. Separate figures show that August 2019 was the busiest August month ever.\u00a0<\/span><\/p>\n <\/p>\n The UK Spends Less on Healthcare Than USA, France, Germany, Japan and Canada<\/b><\/p>\n The Office of National Statistics (ONS) has published data collected for 2017 on percentage of Gross National Product (GDP) spent on healthcare. Here are the top seven:<\/span><\/p>\n USA\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 17.1<\/span><\/p>\n France \u00a0 \u00a0 \u00a0 11.3<\/span><\/p>\n Germany \u00a0 11,2<\/span><\/p>\n Japan\u00a0 \u00a0 \u00a0 \u00a0 10.9<\/span><\/p>\n Canada \u00a0 \u00a0 10.7<\/span><\/p>\n UK\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 9.6<\/b><\/p>\n Italy\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 8.8<\/span><\/p>\n","protected":false},"excerpt":{"rendered":" Appalling Admission of Failure by NHS North West London (NWL) as Final Anticipated Deficit Figure for 2019\/20 is \u00a3112 Million \u2018Unscheduled Care\u2019 is the reason given by NHS NWL bosses for an anticipated annual deficit at the end of this financial year of \u00a3112 million. Unscheduled care equates to poor planning. A deficit equates to […]<\/p>\n","protected":false},"author":2,"featured_media":1260,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[],"tags":[],"class_list":["post-1892","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png","uagb_featured_image_src":{"full":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",1024,512,false],"thumbnail":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3-150x150.png",150,150,true],"medium":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3-300x150.png",300,150,true],"medium_large":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3-768x384.png",640,320,true],"large":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3-1024x512.png",640,320,true],"1536x1536":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",1024,512,false],"2048x2048":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",1024,512,false],"td_0x420":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",840,420,false],"td_80x60":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",80,40,false],"td_100x75":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",100,50,false],"td_180x135":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",180,90,false],"td_238x178":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",238,119,false],"td_265x198":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",265,133,false],"td_300x160":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",300,150,false],"td_300x194":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",300,150,false],"td_300x350":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",300,150,false],"td_341x220":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",341,171,false],"td_341x400":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",341,171,false],"td_511x400":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",511,256,false],"td_537x360":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",537,269,false],"td_640x0":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",640,320,false],"td_640x350":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",640,320,false],"td_681x0":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",681,341,false],"td_681x400":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",681,341,false],"td_741x486":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",741,371,false],"td_1021x580":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",1021,511,false],"mailpoet_newsletter_max":["https:\/\/ealingsaveournhs.org.uk\/wp-content\/uploads\/2018\/03\/Traveling-in-London-3.png",1024,512,false]},"uagb_author_info":{"display_name":"Eric Leach","author_link":"https:\/\/ealingsaveournhs.org.uk\/?author=2"},"uagb_comment_info":0,"uagb_excerpt":"Appalling Admission of Failure by NHS North West London (NWL) as Final Anticipated Deficit Figure for 2019\/20 is \u00a3112 Million \u2018Unscheduled Care\u2019 is the reason given by NHS NWL bosses for an anticipated annual deficit at the end of this financial year of \u00a3112 million. Unscheduled care equates to poor planning. A deficit equates to…","jetpack-related-posts":[],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts\/1892","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1892"}],"version-history":[{"count":1,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts\/1892\/revisions"}],"predecessor-version":[{"id":1894,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/posts\/1892\/revisions\/1894"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=\/wp\/v2\/media\/1260"}],"wp:attachment":[{"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1892"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1892"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ealingsaveournhs.org.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1892"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}