Tag Archives: NHS trust

NHS shoots itself in foot – again

English: NHS logo








My Heart Surgeon leant over the desk: “now I have to tell you the risks”.   (Having just been told I needed a 7-hour heart operation, surely I was savvy enough to realise that carried a huge risk?)

“If anything happens, will I know anything about it?”

“No – you will be under anaesthetic” he told me.

“Right – then it’s your problem”, was my reply, and we went on to more sensible questions.

What Doctors are For

Drugs had produced my heart problems, and I relied on my doctor to choose the best person to operate and repair the damage.  I SO did not need ‘Choose and Book’;  faced with a list of possible surgeons, I wouldn’t have had a clue whom to choose;  but a sensible doctor would know which surgeons had a good record for survival, because they had accepted ‘last hope’ cases whom no-one else would help.

NHS Interferes

 LaLaLite (the new Health Minister, Jeremy Hunt) is showing  just as much grasp of essentials as his predecessor,   LaLa Lansley.  Latest dictat info from Richmond Towers says “surgeons will be ranked by how many people die in their operating theatres”. 

This means a junior doctor, newly qualified and only trusted with the most basic procedures, will be top of the tables;  an experienced surgeon with patients queueing up from around the world, who will operate on many ‘no hopers’, will probably be way down the bottom of these silly, time and money-wasting statistical tables.

Can we please get back to sensible health care, where one’s GP is trusted to do their best for their patients, not waste valuable time and money having to compare paper statistics?

 Does anyone listen?

After shooting itself in the foot, today’s dictat is called

 Everyone Counts.

Well, if the bean counters in Richmond Towers haven’t noticed, is there any hospital really operating ‘7  DAYS A WEEK’?

LaLaLite obviously inhabits the same Alice in Wonderland country as his predecessor.

Wonder how much this latest exercise cost us? 

Has anyone thought if they got down to actual work, instead of writing Fairy Stories (even though it is Christmas) they could go a long way to saving the money the NHS needs.

But I suppose this will mean a lot of ‘Consultants’ will be out of work.  Well, if this is the standard of their work, a good thing too.

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Understanding NHS language

Nurses need Degrees


to understand NHS jargon

English: East Midlands Ambulance Service NHS Trust

NHS jargon needs its own Ambulance Service (Photo credit: Wikipedia)


We may not be able to understand what doctors tell us – but spare a thought for NHS staff, who have to content with providing a ‘spectrum of adequacy’, when treating patients.

NHS Trusts are asking medics to provide this – but would you know what it is?

 The Plain English Campaign is gunning for the NHS, and its latest examples of mindless ‘officialese’.  In the running for ironic Awards is this gem from North Staffordshire, rejecting an application for a new pharmacy…..

There was not currently a gap on the spectrum of adequacy sufficient to conclude that the provision of pharmaceutical services is not currently secured to the standard of adequacy’.

 Er – wonder what that meant.

The invaluable website www.nhsmanagement.net  comments on the newly revised SHA guidance entitled ’12 hour trolley breach protocol, Version 3.0 updated November 2012′. 

 It contained the usual strong language and nonsensical directives to make hourly phone calls to on-call commissioning directors (they must love receiving these – provided they can get through).

 A full root cause analysis should be undertaken for all 12 hr trolley waits these should be submitted to the Commissioner and LAT within 72 hours of the incident. Any 12 hour trolley wait is not acceptable under any circumstances and CCG’s are expected to use whatever mechanisms are appropriate to penalise Trusts who allow such waits to happen.

 Does anyone in the NHS think that perhaps the medics looking after patients are looking for the best solution?  Reminds me of the time I visited Brasov Hospital in Romania, where a tin of baby powder was so precious it was kept under lock and key.  There, they really have to play ‘box and cox’ with patients, and no stupid directives to stop them from doing the best under trying circumstances.

But so far the top contenders in the Plain English Golden Bull Awards contain four ‘entries’ from NHS Trusts.  Seems patients are not the only ones who can’t understand what medics are saying.

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When will NHS recommend exercise?

Year 4~Day 342 +313/365 AND Day 1438: Water Ae...

Water Aerobics Class


‘wonder drug’


which can make all the difference to recovery.”  Accoerding to Susan Morris, general manager for Macmillan in Wales.

She says new research showed that the message was still not being passed on to cancer patients about just how important it is for them to keep active.

“It’s hard to encourage people to think about keeping active during and after gruelling cancer treatment but, increasingly, many patients will need our help to bust the myth that resting up is always the right thing to do, ” said Ms Morris.


Macmillan backing scheme

According to a BBC report, in Hydrotherapy session at a swimming pool,  Patients are encouraged to take more exercise such as hydrotherapy.

Yet Chelsea and Westminster Hospital has just closed their Hydrotherapy pool;  excuse is that pool floor is breaking up, even though it is less than a year since a new lining was installed.  When patients complained at yet another closure, they are being kept in the dark and don’t know when it will re-open.

However, in Wales Cancer patients are being encouraged to take more exercise in a pilot scheme aimed at boosting their quality of life and independence.

Single cancer diagnosis patients in north Wales, Cardiff and Swansea will be assessed by a “physical activity champion” under the year-long scheme.

Macmillan Cancer Support said research showed greater fitness reduces stress, fatigue and clinical dependency.  Exercise could make all the difference to recovery.

The scheme is being trialed by Betsi Cadwaladr University Health Board, Abertawe Bro Morgannwg University Health Board and Velindre NHS Trust.

As Susan Morris Macmillan Cancer Suppor says, “tIt’s hard to encourage people to think about keeping active during and after gruelling cancer treatment but, increasingly, many patients will need our help ”

Among those taking part is Fiona Lamb, 80, of Blackpill in Swansea.  Diagnosed with inoperable ovarian cancer last year, she has been attending hydrotherapy and gym exercise sessions at the Wales National Pool.

“The hydrotherapy programme includes a series of muscle-strengthening exercises and keeps me exercising every Wednesday,” she said.

“I enjoy it as I used to do a lot of swimming and it gives me the chance to meet other people in the same boat and have a good laugh with them.”

Miss Lamb said prior to her diagnosis she had always kept herself fit.

“My cancer is inoperable, although I have been extremely lucky as I’ve had no real pain,” she said.


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Who gives NHS staff permission to call us by our first names?

Cameron highlights


bad treatment for elderly



But it’s not only the elderly who are subjected to rudeness and bad treatment by some NHS staff.  The NHS needs to put itself into a patient’s shoes, and work out what is best for THEM – NOT the hospital.

And remember that the NHS is funded by the patient – NOT out of a bottomless purse.  So make sure the patient gets value for money.

Somehow, treating patients with dignity and courtesy seems to have two meanings:

1.  Staff meaning might be :  “you are ONLY a patient”, and may give no thought to what patients are actually feeling.

2.  Official attitude might be:  we say we care for out patients (to stop them complaining).

This was amply demonstrated in the TV Junior Doctors programme, when ‘caring’ doctor Lucy was shown spending a great deal of time looking after one elderly patient, and even asking about her arrangements for when she got home.  Those who care for elderly relatives who were in the same ward know full well that the reality can be very different – when cameras aren’t around to record what actually can happen.

The same hospital has a £600 banner waving above its Atrium, proclaiming that it won a PEAT Award for ‘Dignity’  i.e. treating patients with courtesy.

What’s a PEAT Award?  Er – something awarded by the hospital to itself.

So you guess that dignity and courtesy can be lacking.

Name calling

I went to see Mrs. M in hospital – a very old friend and employee.  Asking a nurse where I could find her, and was there anything I could do to help, the nurse said it would be helpful if I could remember to shout.  Shout?  Her hearing was razor-sharp.

Talking to her (in a normal voice) she said that she didn’t answer if they called her Joan.  Only if they addressed her as Mrs. M.

One feisty old lady’s solution to bad manners;  a pity nurses don’t ask patients how they want to be called as a courtesy.

Good things

Having a Colonoscopy probably isn’t high on most patients wish list, but this hospital has a department run by Sue, where the staff are unfailingly polite.  They work in a cramped corridor (called a ‘ward’), yet Sue’s staff are the type of nurses you just have to hug – they are so helpful and courteous.  So if Sue can give dignity, kindness and courtesy to patients on her ward – why not others?


The Receptionists who snarl “what’s your date of birth?”  (what’s dignified about that?) try to tell you that this is the way their IT system works.  Obviously this has been set up by someone with not an ounce of courtesy in their veins.

So what happens in the private sector?  They know that to ask this question in front of a packed waiting room is a security risk;  in fact Scotland Yard frowns on the practice, and says no-one should give out personal information in front of strangers.  So in the private sector, if a Receptionist has to ask for a DOB, they push paper and pen across the desk and politely ask if you will write this down.

I now ask for pen and paper every time an NHS receptionist asks for this – and surprise, surprise – they are perfectly happy to comply, making me think that they must have been warned to do it this way, but have ‘forgotten’ until a patient reminds them.


Watching patients arrive at A & E, it is obvious that some are in pain.  They may not be very polite;  understandable when every step is painful, yet one frequently hears receptionists snap “I don’t have to listen to your rudeness”.

It’s NOT being rude, and they should realise that the person shouting at them would probably be horrified if they knew how they were behaving.  But when you can’t think for pain, your manners go out the window. The receptionist is NOT in pain and they should be trained that part of their job is to make allowances.

Being drunk is NOT an excuse for bad manners, and if a receptionist snaps at an abusive drunk they should be applauded.  But training should tell them the difference.

Another local hospital has some horrors as Outpatient Receptionists.  Check in, and although they know the Consultant hasn’t even come down from the operating threatre, they say nuffin.  After an hour or so, you meekly ask if someone has forgotten you exist?  Visible sneers, and you are told Consultant is still upstairs/is running an hour late, etc.

Another hospital has installed an expensive LED screen to alert patients.  Only problem is, Receptionists can’t be bothered to up-date it.

Perhaps best system would be for Patients to ask when checking in, “how late is so-and-so running?”  Last time I did this Receptionist was very happy to tell me “he’s running an hour late”.  So I told her I would be back in one hour, and went off to see a friend.

Lost notes

For patients to be told that a Clinic has lost their notes can be devastating.  You have been waiting for months to see the Consultant, and then realise you are expected to make another appointment weeks down the line.

Last time this happened to Bettina, she said “I smiled sweetly and said I quite understood this must be a problem for them, but I would wait whilst they looked for the notes.  My appointment had been for 3 pm – the notes were ‘found’ at 4.55.  But at least I got information I needed on that day and didn’t have to wait weeks for another appointment”.

Another friend had the same thing happen to her.  Her consultant said she would see her, they talked, and consultant said she would email the test results when they turned up.  Results turned up in her inbox two days later;  on the same day that a letter arrived from the hospital saying ‘as you didn’t turn up for your appointment you are off the list.  If you wish to re-book you will have to get a referral from your GP’.  That is really polite!


Figures get bandied about regarding the cost of the NHS computer system (did I hear £60 billion?).  What seems extraordinary is that in a system where various hospitals can belong to the same trust, they can’t work out a way of checking if a patient has already got an appointment booked when they confirm a date.

Imperial NHS Trust ‘owns’ several hospitals.  Patients can be booked into one for an appointment, but need to have another appointment – so you can guess what happens.  The two appointments can invariably be scheduled for same day with not enough time for a patient to travel between hospitals – especially if their first appointment is running late.

It would be courteous and helpful if

  • Every appointment letter gave out a dedicated number so a patient could phone straight through to change times/dates, rather than the general number which can see patients waiting up to 30 minutes to be answered.
  • If an appointment is running late, Receptionists did everything possible either to ‘insert’ a patient in next, or to help the patient by phoning through to the next clinic, explain what is happening, and work out with that receptionist if the doctor can see them later.

 What to do

LISTEN to patients.  The NHS is a National Health SERVICE, and as such is there to serve contributors i.e. the general public.

And imagine every patient is a friend of your mother/father.  Treat them the same.

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Has NHS scared off James Martin?

James Martin, British celebrity chef

NHS patients

throw away




We’ve all seen attempts before to change NHS culture, notably when Gerry Robinson came in and demanded to know why hospital operating theatres close at mid-day on a Friday.

But although Robinson’s TV programme asked many questions, and suggested excellent solutions, the NHS still carry on wasting OUR money, and nothing changed.

Same seems to have happened to the excellent work done by TV Chef James Martin.  After having produced an enjoyable and thought-provoking TV series on food at Scarborough  hospital – he’s disappeared.

Emails arrive, asking me how people can contact James as they want to see if their hospital could hire him – but no reply from him, his PR company or the production company.

NHS Waste

Now comes a report saying one in twelve hospital meals is returned uneaten.

According to NHS Trusts, this is costing over £22 million a year.

What is worse, seven Trusts admit that one in five meals is returned – so WHY haven’t they called in Martin?  What is this waste food costing the NHS, let alone the patients’ health?

And the Care Quality Commission are about to issue a report warning of poor NHS practice over nutrition for the elderly.

James Martin’s excellent series made many sensible points, from nutrition to pricing – but the NHS tends to aim for the lowest common denominator – rather than aiming for excellence  (it’s easier).


In the TV series, Pat Ball, Sharon and their team at Scarborough Hospital were right behind James, showing that patients can be given tasty, nutritious food – but to pay for this James had set up a restaurant aiming to make a profit which will be ploughed back into hospital food.


The scary thing is, when the financial administration look at the books at the end of the year, Pat is going to have to fight very, very hard to keep any profit for the catering dept.


We all wish her luck.  She is going to need it to fight off greedy financial gurus wanting to get their hands on any profit.

Bringing in meals

Currently statistics say that 2/3rds of patients will have a meal bought in for them; a very sorry state, but something that happens all round the country.

Even the Doctors at our local hospital (Chelsea and Westminster – supposedly NHS flagship) queue up every lunchtime at Tray Gourmet, a privately-run caterer opposite the hospital,  to buy their baguettes because they are tastier.    Even Michael Winner sent out for their baguettes when he was a patient earlier this year.

But when I approached I.S.S (the hospital caterers) to ask why they couldn’t bring in a private firm that was offering fresh fruit nicely packaged, from a stall outside the hospital’s area – a very dismissive email zinged back, saying I.S.S. supplied fruit.

Yes – they do.  French apples and other fruit from abroad.  But if patients choose a piece of fruit, they can’t have a pudding as well.  And elderly people don’t have the teeth to bite into those hard, sour French apples.

Hospitals should lead the way

Following on from James Martin’s plea to get people eating local produce, why not get NHS hospitals to host Farmers’ markets  on their forecourts, in car parks, atriums, parks, gardens or other areas?  These could not only bring in extra income, but would also show patients and visitors the way to buy healthier food and support British farming.

And echo what Martin was trying to put across in his programme, when he took Scarborough Hospital’s catering staff out to meet local producers.

Royal Brompton Hospital

Again and again this hospital is singled out for excellence in food.  Yet somehow I don’t see a queue of hospital administrators following.

Those of us who have been lucky enough to be patients at the Brompton (lauded in the TV programme) know that their policy of buying free range, local and where possible organic produce pays dividends.  I still lick my lips when I remember their signature liver dish – scrummy!  And I wouldn’t have minded eating it again, if menus are on a weekly cycle.  As one patient remarked when asked if he minded dishes being repeated;  he couldn’t even remember what he ate yesterday – let alone a week before.

Soil Association encouraging better nutrition

The Soil Association (SA) say “We think that good food should always be on the menu in hospitals – to help people get better and improve staff morale”.

“In 2010, a survey revealed that nearly two thirds of people have bought in food from outside hospitals because the meals on offer were so unappetising”.

The association’s  Catering Mark offers patients a guarantee that what’s on the menu is free from controversial e-numbers including aspartame, tartrazine and MSG. Meals are freshly prepared and do not contain artificial trans fats or GM ingredients.  James was very keen that Scarborough Hospital aspire to the SA’s  Bronze Award – and we have to wait to see if Pat and her team achieve this.

Over 10,000 meals which have received Soil Association ‘Food for Life Catering Mark’ bronze award are already being served in hospitals every day. ”

The Soil Association lay down a challenge:

“We know there are many more hospitals serving freshly prepared, locally sourced and organic food. Could your hospital be the first to receive a silver or gold award?”

So get YOUR hospital involved.

“If you are concerned that changing food is too complicated, applying for the Catering Mark can help to make it simpler. We will advise you on the most effective changes to make to your menus and help you overcome any challenges”.

Switching to healthy, sustainable food doesn’t always cost more. One hospital saved £6 million a year by cooking with fresh, local ingredients; another sources yoghurt from a local supplier for two thirds of the price of the nationally approved supplier.

The SA believe that the best hospital food

  • is good for patients
  • good for NHS staff
  • good for British farmers and food businesses
  • good for Britain.

If you agree, why not get your hospital to apply for the Catering Mark and reassure patients that you care about food?

S.A. Award holders


* North Bristol NHS Trust
* Nottingham University Hospitals Trust

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Back stabbing at Dept Health

The Mad Hatter, illustration by John Tenniel

Image via Wikipedia

Long knives are out – this time aimed at LaLa Lansley’s back

The Health Bill is causing major ructions behind the scenes.

Having promised Labour a punch up over health during the pre-election campaigning, Cameron recently took a beating from Ed Miliband in House of Commons.  During his punishment there was no sign of Lansley – where was he skulking?  He would have been told Milliband would be asking a question on health, so surely should have been there ?

Or had Cameron told him to stay out of it?

Take Advantage

Before the election, Cameron promised Labour a bare-knuckled fight over the health service; now he’s got one, thanks to the controversial Health and Social Care Bill, which has shaken the NHS to its foundations.

If anyone in London is free on Monday and wants to know what is going on, The Guardian is offering readers a one-off opportunity to improve the coalition government’s controversial health bill.

In a unique event the chairman of Andrew Lansley‘s listening panel, Prof.  Steve Field, will host a department of health “listening event” at the Guardian’s offices.

It’s a chance to put your case to the coalition government’s point man on the bill. The session will take place at the paper’s offices at Kings Place, London N1 9GUon Monday 16 May from 1-3pm. If you’d like a ticket to attend email ruth.kiveal@guardian.co.uk. Space is tight and places are offered on a first come first served basis. It’s a ticket only event.

The event is meant as a service to readers who wanted to tackle Prof.  Field in the flesh. He’s one of the prime movers behind this controversial bill – so session should be very lively.

Getting you up-to-date

On July 12th last year, Minister of Health Andrew Lansley came out with the spin doctor phrase, “No decisions about me without me”;  promising patients that at last they would be listened to.   It hasn’t taken long for this to be forgotten, in the usual way of today’s politicians.

Then came the announcement from Richmond House, HQ of the Mad Hatters Tea Party (a.k.a Dept. Health (DH) when La La announced

“Patients will get more choice and control, backed by an information revolution, so that services are more responsive to patients and designed around them, rather than patients having to fit around services”.

Cumbria took it softly-softly

Several years ago the country of Cumbria decided that something should be done, and went about co-operating with the medical professions and patients, to instigate many of the reforms in La La’s Bill.  But they took things slowly, in a small way – something the Coalition seems incapable of mastering.

Currently Lansley is trying to curry favour to get his unpopular Health Bill back on track, having disrupted the NHS to such an extent that waiting times are getting longer, patients are being fobbed off when they need operations, and cutbacks are promised for everything from elderly care to drugs.

I reckon he should slip opposite tothe  Home Office and borrow a stab proof vest – although probably no back-stabbing is planned at the moment as  no-one dares do the actual deed, suspecting he is sitting on a can of worms that will escape if he is forced to quit.

Press Office jumpy

At Mad Hatter HQ all is not well. Phoning the DH Press Office has become a sorry exercise:  staff are jumpy and on the defensive before you have even asked your question (always a sign that resignations are on the way in Whitehall).  They are desperate to get rid of you, sending you off chasing red herrings (or does the Coalition have a fetching combination of blue and yellow fish?)

And every time LaLa opens his mouth to make a statement, you can feel the shudder going through the DH accolites.

The DH has been reduced to asking 42 major GPs to sign a letter backing Lansley and his Bill.  Unfortunately the Press Office didn’t think this spin doctoring exercise through to its inevitable conclusion.  It didn’t take long for journalists to do their sums, and wonder why all the thousands of GPs who belong to the Royal College of GPs had come out against it.

Listening Exercise

Last month La La rushed through a face-saving exercise, promising to send a Minister to  “listen” to patients, in consultation across England.  Sadly for him, patients can do their sums too, and when they went on to the DH’s website to get an invite to one of these meetings, they were surprised and bemused when going through the specially set-up website for these events, www.healthandcare.dh.gov.uk

There was a page headed Listening Events for Patients and Service Users  – but don’t all rush – try as I can, and after numerous phone calls to the Fluffy Bunnies in the DH Press office, the only events I can find are:

1.  Regional Events – which are “aimed primarily at Voluntary and Community Services”, and instructions talk about groups getting together to organise their approach.  So lone patients, if they actually manage to get past the selection process, won’t have much of a chance of being able to ask a question.

2.  Or the website advises you can contact your Strategic Health Authority.

So I did – or at least the first six.  Each expressed astonishment – first they had heard of this – no-one had told them anything – they didn’t know about these.

One charming person said they were “not holding any events for Listening Exercise”.  With over 100 promised events spread amongst 12 authorities, this seems funny.

Another said that hot on the heels of the announcement had come the request that they tie these up with previously planned events for NHS staff – so patients not welcome.

And another sent me this:

For the most part, health organisations in xxxxxxxxxxx are not holding separate, specific Listening Events but are using their current planned events and meetings to engage with staff and stakeholders – not patients.

Members of the public who wish to find out more about events in their area can do so by contacting their local NHS Trusts.  (Er – I did.  They didn’t know anything either).

And as one member of a SHA said, with feeling, “you are not the only person to ask why patients and the public aren’t being consulted about how the NHS is spending your money”.


London cancer hospitals get 'Red Card'

Liam Trotter Gets the Red Card

Liam Trotter gets Red Card Flickr

Eight of the ten NHS Trusts that came bottom of a hospital league table are from London – so they have been given a ‘Red Card’.

The table measured patient experience across England, in the latest Patient Experience Survey

It does not cover the medical treatments patients received, such as standards of chemotherapy or surgery.  But if patients are worried about their care, they aren’t going to be in the right frame of mind to take advantage of treatment.

The league measures patients’ experiences while being treated at hospital, for example:

  • if there were enough nurses on duty
  • whether they were given enough support from health and social services when they left hospital
  • whether they were given the right emotional support or told about financial information.

Ciarán Devane, Chief Executive of Macmillan Cancer Support says:

‘Cancer patients are being let down by many Trusts that are failing to give adequate levels of care.

The experiences you have whilst in hospital can have a massive impact on your health and wellbeing, and how well you cope once you leave hospital.

We hope that the Trusts given a ‘red card’ will work with community services and take urgent action to improve the care they offer cancer patients.’

According to the research, breast cancer patients in England have the best patient experience, while sarcoma patients have the poorest.

Trusts in the bottom 10 (from worst to best):

1) Imperial College Healthcare NHS Trust

2=) Royal Free Hampstead NHS Trust, 2=) The Whittington Hospital NHS Trust

4) Barts and the London NHS Trust

5=) Royal National Orthopaedic Hospital NHS Trust, 5=) The Princess Alexandra Hospital NHS Trust

7) Newham University Hospital NHS Trust

8) Croydon Healthcare NHS Trust (formerly Mayday)

9) Ealing Hospital NHS Trust

10) Portsmouth Hospitals NHS Trust.

What do you do if ‘caught’ in one of these hospitals?

Macmillan is calling for the Government to put more focus on improving cancer patient experiences and to provide urgent support to the Trusts with the worst results in its league.  However, as a petition elsewhere on this website says,  Breast Care Nurses are being moved to other departments – so first thing is to sign www.breastcancercare.org.uk/keepourbreastcarenurses

Through over 5,000 Macmillan professionals and over 100 information centres in the UK, Macmillan has a presence at all of the hospitals that came bottom in the league and will be working with them to improve patient experience.

So get in touch with the Macmillan Nurses – ASK what you can do to help.  Often it can be just writing or even phoning a Department to ask them not to close down a service.

If we don’t do anything – why should hospitals think they need to ?

Eight out of the top 10 Trusts, including Harrogate and District NHS Foundation Trust, and Barnsley Hospital NHS Foundation Trust are in the North of England.

According to the Dept. Health, there are 12 Trusts which never appear in the bottom 20% of Trusts on any question in the survey, as follows:

•        Airedale
•        Barnsley
•        East Cheshire
•        East Sussex
•        Gateshead
•        Harrogate
•        Northumbria
•        Poole
•        Royal Devon and Exeter
•        Sheffield
•        South Tees

You can view the full report for each of the trusts by scrolling down to the relevant trust on this link: http://www.quality-health.co.uk/cancer-reports

And well done to them!

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Here's where the NHS can save money

NHS Overspends £500 million on basic supplies

Now if you or I overspent by even £500 – we’d know about it.

There are precious few companies today that would allow employees to overspend by even £50

But it seems the NHS can throw £500 million around with gay abandon – and no-one seems to worry about checking the bills.

For ages I have been saying that if each Trust appointed one genuine business man or woman to oversee budgets, they would be able to show them how to save money – without all the cuts needed.

Now here comes proof:  National Audit Office (NAO) says “hospitals could be saving half a billion pounds a year if they reconsidered the way in which they purchase basic supplies”.

Why Hospitals need business-trained executives to oversee budgets

Can’t you just imagine what would happen if Alan Sugar, Nicola Horlicks, Gerry Robinson etc. cast their eyes over a hospital’s accounts?  They would soon come up with questions:  why are Trusts being allowed to order basics such as gloves, paper, etc. from different suppliers?

The NAO report “The procurement of consumables by NHS acute and Foundation Trusts” has revealed a lack of information and the fragmented purchasing attitude of Trusts. The severity of the problem is directly linked to the lack of central control over procurement. With the Health and Social Care Bill proposing that all hospital Trusts become Foundation Trusts, there are concerns this trend will accelerate.

Translation:  someone who understands accounts and purchasing should take the NHS by the throat and teach it good basic business principles.  Otherwise money is going to continue to pour down the drain.

Overspend by nearly £1 million per Trust

According to the report, the average trust could save £900,000

  • if they bought the same type and volume of products
  • and paid the lowest available price.

Could you imagine M & S or Tesco allowing each store to buy overalls, floor cleaning equipment, or any other basics from different companies?  No, a central office negotiates the price with a major supplier – and they award the contract to the company that provides the best overall product at a reasonable price.

But the NAO said “great variation in the range of basic supplies purchased by different trusts was also discovered. Trusts that NAO examined bought “

  • 21 different types of A4 paper
  • 652 different types of surgical and examination glove
  • 1,751 different cannulas
  • 260 different administration sets

Some variations were particularly striking. For example, the purchase numbers of hospital gloves varied significantly. While one trust operated with 13 different types of glove, another needed 177.

NAO concluded that “if hospital trusts were to amalgamate small, ad-hoc orders into larger, less frequent ones, rationalise and standardise product choices and strike committed volume deals across multiple trusts, they could make overall savings of at least £500 million, around 10 per cent of the total NHS consumables expenditure of £4.6 billion”.

So what is La La Lansley doing?

His office loves sending out press release after press release – but so far – NOTHING.

The head of the National Audit Office, Amyas Morse, says  “In the new NHS of constrained budgets, Trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”

Er – sorry.  La La has announced the Government were considering the launch of a review “to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”

Now why do stables and bolted doors come to my suspicious mind?

So should the companies making millions out of NHS be quaking in their shoes?  Er – not exactly.  According to La La Lansley, “We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the advice of government advisers,” he said.

So that’s all right then.  CEOs of companies that supply rubber gloves, canulas, gowns etc. can get back on the golf course – knowing full well by the time the review comes out, the next Government will be in.

What can you do?

Have a look at the names of the non-executive Trust officials of your local hospital.  Is there a noted businessman amongst them?  If so, ask them what they are doing to scrutinise bills.

If not – suggest that a noted local businessman be asked to run their eyes over the accounts – and say where they think savings could be made.

But this will be difficult.  Contracts for services from cleaning to lift maintenance are awarded to certain companies – and they won’t want to be moved.  We have been trying to find out how our local hospitals can have allowed the firm that put in the telephone system to get away with it – last time I wanted Pysiotherapy the phone rang and rang;  eventually a voice said “Accident and Emergency”.

So far letters to the Chief Executive go unanswered.

To download the report “The procurement of consumables by NHS acute and Foundation trusts”, follow the link: http://www.nao.org.uk/publications/1011/nhs_procurement.aspx
The Guardian article: http://www.guardian.co.uk/society/2011/feb/02/hospitals-waste-money-says-nao-report

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Ways to save NHS money

The biggest change I would make if I could would be the scrapping of “the internal market”.

A report from an anonymous mole says :

This you may or may not have heard of, but basically this means that each NHS trust is competing financially against every other trust.

Also it means that each trust bills other trusts for the work it undertakes for them. For example an Ambulance Trust is paid for every patient that it takes to hospital.

Now this may seem all well and good, but none of this money actually exists. It is figures on balance sheets that armies of accountants are being paid to move around.

Also, if an ambulance is held at hospital for more than fifteen minutes waiting to unload a patient, then the ambulance service fines the hospital two pounds fifty pence per minute per patient.

All this money is not being spent on patients, it is being spent on admin.

At the moment we don’t have a national health service, we have a loose alliance of competing businesses”.

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