Sunday, 28 March 2010

Is this what you really want?

Patients' groups expressed horror at the "sick experiment" in which NHS managers have agreed to pay £38 for every casualty that ambulance staff "keep out of Accident and Emergency" (A&E) departments after a 999 call has been made.

The tactic is part of an attempt to manage increasing demand for emergency care amid failings in the GP out-of-hours system.

Documents seen by The Sunday Telegraph disclose that staff at Britain's largest ambulance service have been encouraged to maximise the organisation's income, by securing payments for diverting patients to telephone helplines.

The bonuses are among dozens of schemes being tried out by ambulance trusts across the country as they attempt to improve their emergency response times and help A&E departments meet controversial targets to treat all patients within four hours of arrival.

Another plan uncovered would see thousands of 999 calls currently classed as urgent downgraded so that callers receive telephone advice instead of an ambulance response.

The changes were due to be introduced across the country this week, but the Government committee governing ambulances has delayed its decision amid safety concerns.

Last week, an investigation was launched at the ambulance trust piloting the scheme following the death on Thursday of a man whose case was referred for telephone advice when an ambulance should have been immediately dispatched.

Sunday, 7 March 2010

Coming to a hospital near you

The catastrophe of Stafford Hospital, where hundreds of patients needlessly died, was an entirely predictable result of this governments target driven obsessions.

Much of what happened at Stafford happened, and continues to happen, elsewhere, perhaps in diluted form (think, perhaps of Stoke mandeville and Maidstone).

It was headline news for 24 hours, but how have we allowed it to slip away. When are senior members of the SHA,, of the Department of Health and health ministers going to be held to account?

Monday, 1 March 2010

You have been warned

"Transforming" & "Vertical Integration".

As in "Transforming" Community Services.

Every PCT in the land has been ordered by the DoH to complete the purchaser-provider split within the next 8 months, by divesting itself of all its community services. These must either be set up as independently-contracting cooperatives ("Social enterprises"), or handed over in their entirety to an alternative contractor.

Such organisations will inevitably be too small to be financially viable, so the preferred solution, & inevitable doom, is for "Vertical Integration" - in plain English, a hostile takeover by the local Acute Trusts.

The Trusts, of course, have perverse incentives NOT to provide community service, but to get everyting transferred to in-patient care, especially as non-elective emergencies to get the massively increased PBR tariffs.

So, in translation, "Transforming" means utterly destroying.

As a means of providing care, or saving money, it is barking mad.

But as a means of fattening up the acute trusts for eventual privatising, it is a brilliant way to give them abusable & highly desirable monopolies.

And in the meantime, as a side-effect, the eligibility of the employees of the divested services for the NHS pension is already being questioned with a view to being cancelled - potentially setting a dangerous precedent for existing GPs & future employees of privatised trusts.

So be advised, this is not going to go away, with or without a change of geovernment. It is civil service policy & not open to democratic debate.