Unanimous support for services to stay at Charing Cross and Ealing Hospitals - Hounslow Council

Paul Williams  Fri, Nov 25, 2016 - Chiswick Herald
At the Borough Council meeting held on Tuesday 22nd November 2016, Hounslow Council passed a motion tabled by the Labour administration to reaffirm the Council’s support for acute services including A&E to remain at both Ealing Hospital and Charing Cross Hospital.

The motion, seconded by the Leader of the Council, Cllr Steve Curran, was fully supported by the Tory group and refers to a statement recently released by five west London borough councils (Ealing, Hammersmith and Fulham, Hounslow, Harrow and Brent) acknowledging the serious concerns raised by Ealing Council and Hammersmith and Fulham Council with regard to the threat of closure of their A&Es.

Reacting after the meeting, the Leader of the Council, Cllr Steve Curran, said: “I am delighted that the Tory opposition group fully supported our motion and it will send out a clear message of solidarity with our neighbouring boroughs.

It is essential that both local government and the NHS work together collaboratively, especially at a time of financial cuts imposed by the Tory government, to ensure that we provide the best possible service for our residents, particularly those groups more at risk, such as the elderly.”

Hospital bed squeeze is being miscounted and causing congestion


11 October 2016 - The Nuffield Trust


With performance falling below targets and winter approaching, a Nuffield Trust briefing today warns the NHS can no longer find enough bed space to move patients through hospitals quickly and meet key A&E targets – and that its practice of counting patients at midnight means we are missing the true scale of the squeeze.

Understanding patient flow in hospitals, a briefing for NHS managers, estimates that 5.5% of beds need to be free for cleaning and preparation if patients are to be moved through quickly enough to meet the high-profile commitment to admit or transfer emergency patients within four hours. Yet many hospitals are unable to provide this much of the time, making target breaches inevitable. With a growing number of patients coming and going during the day, counting bed occupancy at midnight means that crunch times are often invisible.

The authors, Sasha Karakusevic and Nigel Edwards, show how space has been squeezed over the last five years as the number of hospital beds has flat-lined even as thousands more have been needed. The NHS is now so far from the 85% occupancy rate once considered ideal that 12,000 extra beds would be needed to return to it. They expect pressure to continue due to rising number of patients with multiple conditions, and a predicted rise in the death rate from 600,000 each year to 800,000 by 2050.

The report finds that the 10% of patients who stay for more than a week account for 65% of bed use, and concludes that a strong focus on earlier discharge for these people may help to free up space.

It tracks how bed use changes through the day, with the most beds full in the morning, and the highest rate of patient movements seen in the afternoon. The authors argue that IT systems and management must adapt to tracking how beds are used on a minute by minute basis, so that hospitals can react when staff and space are under most pressure.


NHS trusts overshoot maximum annual deficit in just six months

Regulator says English trusts set for £648m first-half deficit after £580m was forecast as most that could be overspent this year

NHS trusts in England have overshot their maximum deficit permissible for the financial year after just six months despite a £900m emergency cash injection from the government.

NHS Improvement (NHSI) said financial performance information from providers show they are on track to record a year-to-date deficit of £648m in the first half of the year.

The financial regulator described the figures, published on Friday [18th November], as “just £22m worse than planned” but they are some way off what health leaders have defined as an acceptable overspend for 2016-17, even by the most generous interpretation.

NHS England’s chief executive, Simon Stevens, and Jeremy Hunt, the health secretary, have pledged to ensure that trusts end the year no more than £250m in the red, while other NHS leaders have said the service can afford to record a figure of £580m without risking major financial problems.

Trusts are forecasting a deficit of £669m for the year, although that is after the £1.8bn sustainability and transformation funding, £900m of which was paid out in the first six months.

Sally Gainsbury, senior policy analyst at think tank the Nuffield Trust, said: “More and more people need healthcare, yet the money available to provide it is tightly squeezed.

NHSI’s report shows hospitals and other services are now forecasting a deficit of around £670m by the end of this financial year. That looks like a huge turnaround from last year’s deficit, yet is in fact flattered by the inclusion of an extra £1.8bn of emergency support pumped into the hospital sector, making the real forecast more like £2.5bn.”

NHSI said the deficit could be limited to £580m “if providers met their savings targets in full over the remaining half of the year”, but analysts and trusts expressed doubts.

The King’s Fund’s director of policy, Richard Murray, praised the trusts’ hard work on deficit reduction but warned “the second half of the year is likely to prove more challenging than the first”.

Anita Charlesworth, director of research and economics at the Health Foundation, said: “NHS trusts will have a mountain to climb if they are not to breach the end of year deficit target.”

Chris Hopson, chief executive of NHS Providers, which represents trusts, said its members were already “straining every sinew” to deliver savings.

“Significant risk remains as NHS trusts will have to increase their rate of savings in the third and fourth quarters to enable the sector to meet the target year-end position of a £580m deficit,” he said.

Hopson stressed that given the deficit reduction plan had been significantly aided by sustainability and transformation plan funding, action was needed in the medium and long term to address the “clear and widening gap between what’s being asked of the service and the funding available”.

NHSI lauded a second successive quarter in which fewer trusts reported a deficit against a backdrop of “unprecedented growth in demand”.

The chief executive, Jim Mackey, said: “No one should underestimate the challenge of turning around a very difficult financial position for the NHS. But, thanks to a phenomenal effort by staff across the NHS, we’re one-nil up at half time.”


NHS hospitals suffer from chronic bed shortage, surgeons say

Royal College of Surgeons calls for rethink after figures show 89% of beds are full overnight for fourth quarter in a row

The Royal College of Surgeons has warned of a chronic shortage of NHS hospital beds in England, after occupancy rates for overnight stays topped 89% for a fourth successive quarter.

The maximum occupancy rate for ensuring patients are well looked after and not exposed to health risks is considered to be 85%, a figure that has not been achieved since NHS England began publishing statistics in 2010.

From July to September this year the percentage of beds occupied in wards open overnight was 89.1%, compared with 87% in the same period last year. That was the last time it was below 89%.

The RCS said the figures, published on Thursday, made for alarming reading and indicated a failure to cope with the increasing number of older patients in hospital.

Ian Eardley, a consultant urological surgeon and vice-president of the RCS, said: “The NHS has been able to reduce bed numbers as medical advances mean more modern surgery can take place without an overnight stay. However, these figures suggest bed reductions have now gone too far in the absence of sufficient social care or community care alternatives.

“We are now seeing increasing numbers of frail older patients in hospital because they have nowhere else to go. The lack of additional money in the autumn statement for social care and the NHS is only going to make this even harder.”

The chancellor, Philip Hammond, had been urged to increase funding for social care in the autumn statement, amid warnings that it was in a critical condition, and to help plug shortfalls at NHS trusts, but health providers were left disappointed. NHS Confederation, which represents 85% of providers and commissioners, described it a “missed opportunity to ease the strain on the NHS”.

The high occupancy rates have coincided with record delayed transfers of care, whereby patients are medically fit to leave hospital but unable to be safely discharged, costing the NHS £800m a year. There were 6,777 patients delayed from being transferred out of hospital on the last Thursday of September, up 29% on the equivalent figure a year ago and the sixth month in a row in which a new high was recorded.

The number of delayed days in September – 196,246 – was also the highest number since monthly data was first collected in August 2010, and up one-third on a year ago. Four in five UK local authorities have insufficient care for older people in their area, according to research published on Monday.

The occupancy situation is forecast to deteriorate further with more beds expected to disappear under local sustainability and transformation plans designed to improve NHS services and ensure their viability.  [Many campaign groups, including ours, dispute this claim by NHS directors]

Among the acute service beds at general hospitals in line to be cut are 535 in Derbyshire, 400 each in Devon and West Yorkshire, and 30% of all beds in hospitals in Bristol, North Somerset and South Gloucestershire.

Eardley said: “NHS leaders need to think carefully about whether this is a good idea without first putting in place better care in the community.”

Last month the Nuffield trust warned that the statistics underestimated the problem because they took a snapshot of occupancy at midnight, so did not capture squeezes in availability of beds during the day.

Eardley said: “I and too many of my colleagues all around the country are regularly having to cancel patients’ operations due to a lack of beds and delays in transferring patients back into the community.”

Caroline Abrahams, Age UK’s charity director, said: “The professional consensus, based on experience across the country, is that the shortage of social care for frail elderly people is a big part of the problem. This is what Age UK hears from older people and families too, through our advice line and local Age UKs too.

“Unless and until there is additional government investment in social care we can only see these difficulties getting worse.”