National Health Service

[SteveH]

Senior doctors are charging the NHS premium rates for overtime, as pressure to cut waiting lists is allowing some to make more than £200,000 a year from additional work, a BBC News investigation has found.

That is nearly double the average basic pay for a full-time consultant in England.

Many of the consultants earning the most are thought to be part-time, allowing them to work significant amounts of overtime for rates exceeding £200 an hour – more than four times normal pay.

In response, Health Secretary Wes Streeting told the BBC: "I don't think the rates are acceptable. Every penny that goes into the NHS needs to be well spent."

But the British Medical Association (BMA), the doctors' union, pointed out the NHS would not have to rely so much on overtime were it not for staffing shortages...............https://www.bbc.co.uk/news/articles/cy0lkxl7061o

[SteveH]

Failing hospitals will be revealed in league tables and NHS managers sacked if they do not turn things around, the health secretary will tell health leaders at a conference in Liverpool.

Wes Streeting is promising a "no-holds-barred, sweeping review" of NHS performance in England.  Hopefully Wales too......

Hospitals can expect to be ranked on indicators such as care delivery and finances, so patients can see whether they are receiving a good service.

And "turnaround teams" will be sent into struggling trusts, while top performers will have more freedom over spending.

https://www.bbc.co.uk/news/articles/c1kn092rvn3o

[SteveH]

The NHS will receive an extra £22m to tackle waiting lists, the first minister is expected to say on Saturday.
Eluned Morgan will make the announcement at her first Welsh Labour conference as the party's leader.

Prime Minister Sir Keir Starmer will also address delegates in Llandudno, Conwy.

He is expected to defend his government's recent budget, which has attracted criticism from farming unions.

It is Welsh Labour's third attempt at holding its spring conference, which was initially scheduled for March, then pushed to July due to the Covid-19 public inquiry, before being delayed again because of the general election.

It comes at the end of a turbulent year, during which the party has had three leaders........... https://www.bbc.co.uk/news/articles/c39n4mwyx12o


PS
Some surgeries move to England after 'incident'
Some major vascular operations will no longer be going ahead in north Wales, a health board has announced.

Betsi Cadwaladr health board said it was pausing its provision of planned and emergency open abdominal aortic aneurism (AAA) surgery to help improve its other care.

The health board confirmed there had been an “incident”, but said the decision was not based solely on this and other vascular care would continue as normal.

About 10 to 15 patients per year will have to travel across the border to have their surgery in England.... https://www.bbc.co.uk/news/articles/c4gp58z7pr2o

[SteveH]

Letter to the Editor...........

Concerns are mounting over the difficulty many patients and NHS staff have in grasping the role and responsibilities of physician associates (report, November 15). Patients cannot give properly informed consent for treatment unless they understand the practitioner’s professional status.

This valuable group of health care professionals were termed “assistants” until 2003 (as they are elsewhere in the world), but their name was then changed. Physician associates should not be passed off as members of the medical profession.

The General Medical Council, which is shortly to regulate them, is clear that physician associates are not “medical practitioners”, yet it is complicit in the clinical confusion. It should insist that the title reverts to “physician assistant” – a much-respected role. Or will the GMC be renamed the General Medical and Physician Associate Council? If not, why not? Does the GMC, or the Government, intend there to be obfuscation?..................... https://www.telegraph.co.uk/opinion/2024/11/16/nhs-patients-need-clarity-over-role-of-physician-associates/?IYA-reg=49560bcd-5a9c-47f0-8fc5-ba2e71710589

[SteveH]

Prof Sir Stephen Powis said rising rates of flu and the vomiting bug norovirus were putting hospitals under huge strain.

Around 95% of beds are already occupied at the start of December – rates normally only seen in the depths of winter.

The warning comes as the prime minister has identified hitting the 18-week target for non-urgent hospital care as one of his six long-term priorities for government.

That prompted senior doctors to accuse the government of avoiding the immediate "crisis" facing the emergency system............

cont  https://www.bbc.co.uk/news/articles/cd9xnl9nvg3o

[SteveH]

New guidance on use of physician associates

A leading medical royal college says physician associates (PAs) should only be supervised by senior doctors, and not doctors in training, in guidance issued to members.

The Royal College of Physicians' (RCP) announcement follows an acrimonious debate in the medical profession over the use of PAs, who are intended to assist doctors and can perform some health examinations.

There have been claims that the scope of the role is not clear, that patients are not always aware of the status of PAs, and that their differentiation with doctors is becoming blurred...............https://www.bbc.co.uk/news/articles/c5y80528nqlo

[SteveH]

Soft touch Britain............

London hospitals have written off more than £112m in unpaid treatment bills from overseas patients between 2018 and 2023, according to figures obtained by the BBC.

Under current NHS regulations, hospital trusts in England must charge patients who are not "ordinarily resident" in the UK for non-urgent treatment.

Critics argue that the current system for recouping these costs is unfair and ineffective.

The Department of Health and Social Care (DHSC) said it expected all NHS trusts to recover any charges not paid in advance wherever possible.

The BBC contacted all 32 of London's acute hospital trusts about their overseas patient billing.

The responding NHS trusts invoiced a total of £223m for such treatments over the five-year period, but £112m was subsequently written off as bad debt.............https://www.bbc.co.uk/news/articles/c77j1x0n54po

[SteveH]

I agree, I personally like to deal with the same Doctor, but needs must etc. and an additional cost of £869million seems ridiculous 

Patients most "in need" should be able to see the same doctor at every appointment in their local GP surgery, the government says.

GPs will be rewarded financially if they do this and if they go "above and beyond" preventing common killers like heart disease or treating high blood pressure early, it says.

The measures are included in proposed changes to the GP contract in England - the government says it will add an extra £889m to the existing budget.

The doctors' union, the BMA, which will now consult its members on the proposals, says GP practices have been worried about finances but this could provide "an important lifeline"............. https://www.bbc.co.uk/news/articles/c047gpgydreo

[SteveH]

Plans for an upgraded NHS App to allow more patients in England to book treatments and appointments will be part of a package of measures unveiled by the government on Monday.

The changes will allow patients who need non-emergency elective treatment to choose from a range of providers, including those in the private sector.

But the British Medical Association (BMA) said there was a risk the policy would "discriminate or alienate" patients who did not have access to digital technology.

Asked about NHS reform, Health Secretary Wes Streeting told the BBC on Sunday that "it is going to take time to turn the NHS around".

The plan will set out how the government intends to meet one of its key election pledges – for more than nine in 10 patients to have their treatment or be signed off within 18 weeks of a referral by the end of this parliament..... https://www.bbc.co.uk/news/articles/ce8nr1936zyo

[SteveH]

LIVE
Flu numbers rise and A&E performance slips, as you share stories of NHS pressures........
Summary
As winter pressures mount on the NHS, we're telling your stories of long waiting times in A&E - get in touch here

A&E and ambulance service performance slipped in December in England, new figures show; meanwhile, senior health bosses are deeply concerned about rising numbers in hospital with flu

A nurse tells us about her "worst night ever" in A&E, while patients recall spending 30 hours waiting - we're hearing your stories as part of our Your Voice, Your BBC News project.............. https://www.bbc.co.uk/news/live/cvgxg7kd6p4t

PS
'Patients are collapsing in the waiting room': A&E nurses speak out ... https://www.bbc.co.uk/news/articles/cy9q9lz887xo

Streeting says he is ashamed of NHS winter problems...............https://www.bbc.co.uk/news/articles/c0ewv2ydgwyo

[Ian]

I've had 'flu twice; the first was the so-called 'Asian 'flu' - 57-58 - and it was extremely unpleasant, as I remember, despite only being a youngster at the time.

But I don't seem to recall many going to hospital. People just deemed to 'get on with it' and I wonder if we've all started expecting more and more from  our NHS.

[SteveH]

A Welsh health board may ask the NHS in England to delay the care it gives to patients living in Wales to save money.

It means hospital waiting times could be extended by up to 11 weeks or longer for people in Powys, where some patients receive treatment from NHS England, because the county is close to the border between the two countries.

Powys Teaching Health Board said if the changes happened, they would not breach NHS Wales waiting times standards and "exceptional action is needed" to deliver savings.

The Welsh government wants all patients to be seen within 104 weeks by March 2025.........

Plus 12 comments ......https://www.bbc.co.uk/news/articles/c4gzgygxd5no

PS
BBC goes inside hospital battling unprecedented winter pressures..............https://www.bbc.co.uk/news/articles/c2kxk791kd5o

[SteveH]

Thousands of NHS beds have been lost under the Welsh Labour government, the shadow health minister has claimed. James Evans MS criticised the Welsh Government for “allowing a significant reduction in the number of NHS beds in Wales”.

He said that since 1999, there has been a reduction of 4,277 in the average daily available beds in the Welsh NHS, from 14,723 to10,446. Average percentage occupancies have also risen considerably, he added......... https://www.walesonline.co.uk/news/health/thousands-nhs-hospital-beds-been-30762047?IYA-reg=49560bcd-5a9c-47f0-8fc5-ba2e71710589

[SteveH]

The level of bureaucracy involved in referring patients to specialist care in England "is too much to deal with", doctors say.

Politicians in Westminster are exploring the state of border healthcare between England and Wales to see if lessons can be learned on both sides.

Last year the Secretary of State for Wales, Jo Stevens, and Wales' First Minister Eluned Morgan announced plans for greater NHS co-operation to bring down waiting times.

Written evidence from the British Medical Association (BMA) in Wales to the Welsh Affairs Select Committee highlighted the frustrations and difficulties consultants experience when referring their patients to services over the border.

The doctors' body said Wales "lacks many specialist services which can be accessed in England, but the ease of such access can be hugely variable"................ https://www.bbc.co.uk/news/articles/cn4zjn2p2keo

[SteveH]

The longest hospital waiting lists are continuing to rise in Wales.

There were 24,361 patient pathways at the end of November, an increase for a second month in a row after the Welsh government sets health boards a target to cut that figure to 8,000 by March.

The overall waiting list rose to 802,268 - setting a record for a 10th month in a row.

Meanwhile, the numbers waiting in A&E for 12 hours or more hit more than 10,800 - the second highest on record.

The health secretary said the NHS was facing "challenging circumstances" and the figures don't yet reflect the investment it was making to reduce the longest waits............

cont https://www.bbc.co.uk/news/articles/c70k6r0rg03o?IYA-reg=49560bcd-5a9c-47f0-8fc5-ba2e71710589