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Welfare Reform on the Web (April 2011): National Health Service - funding

Anxiety grows over funding as hospital trusts refuse to sign their budgets

S. Lister

The Times, Mar 7th 2011, p. 12

The majority of hospital trusts in London are refusing to sign their budgets for the 2011/12.financial year.

Commissioning funds siphoned off for basics

S. Gainsbury

Health Service Journal, Mar. 3rd 2011, p. 4-5

An investigation has revealed that GPs have been able to increase their profits by using commissioning funds rather than their contractors' income to buy basic medical equipment and pay for premises refurbishments. The analysis shows that almost 1m of commissioning surpluses generated through practice-based commissioning was spent on basic kit such as stethoscopes. A further 1.6m went on premises refurbishments including new carpets and decorating. Because GPs were able to spend commissioning funds on core equipment, they had less need to draw on the payments they receive as contractors to the NHS, potentially increasing their profits.

Costs of paediatric assessment

R. Jones

British Journal of Healthcare Management, vol. 17, 2011, p. 57-63

Short-stay paediatric assessment units are the preferred environment for the equivalent of adult emergency department activities. These activities, which involve achieving a diagnosis, are currently paid for under the short stay tariff. This is leading to cost distortions because the costs of achieving a diagnosis are not the same as the costs of inpatient care due to a diagnosis. The current short-stay tariff uses a set of assumptions based on length of stay that do not hold for assessment activities.

Cuts put best hospitals and thousands of jobs at risk, says health trust

R. Ramesh and D. Campbell

The Guardian, March 9th 2011, p. 10

The Foundation Trust Network, which represents 136 top hospital groups, has warned in a letter to the deputy chief executive of the NHS that, despite claims that hospitals should expect to make savings of 4% next year, in reality many have been forced to squeeze budgets by an average of 6.3%, with a big teaching hospital such as Sheffield expected to make 50m of cuts next year. For many organisations this will mean the loss of many thousands of jobs and will seriously endanger waiting times and services to vulnerable patients.

Cuts put future of more than 50 hospitals at risk

J. Laurance

The Independent, Mar. 7th 2011, p. 2

The author of the article reports that at least 50 hospitals are at risk of closure because of the reduction in NHS funding. The King's Fund has published a report which states that about 70 hospital trusts in England have not achieved the financial performance and quality of care required to become foundation trusts. A significant number have recurrent deficits. The report warned of 'a downward spiral of falling income, growing deficit and declining quality [which] will cause hospitals to fail.' The article also reports that calculations by Health Service Journal illustrate that at least 58 NHS hospitals will be unable to cover their costs if cuts planned by PCTs to 'low priority' treatments go ahead.

DH 'reneging' on cancer drugs fund pledge

D. Williams

Health Service Journal, Mar. 17th 2011, p. 10-11

The Department of Health stands accused of reneging on a promise to provide extra money for cancer drugs after admitting that the 200m pot will mainly be funded by clawing back primary care trust budgets in 2011/12. It is estimated that the clawback will cost primary care trusts 1m each and it is anticipated that the move will have a material impact on commissioning budgets.

Health reforms could ensnare doctors in an expenses-type scandal, top GP warns

C. Smyth

The Times, Mar 3rd 2011, p. 5

Patients risk losing trust in their doctors as the Government's health reforms open the door to an 'MPs' expenses -type' scandal in the NHS. GPs should not be able to 'pocket' budget savings. The budget must be used exclusively for patient care.

The impact of very old patients in the ED

A. Banerjee, H. Dehnadi and D. Mbamalu

British Journal of Healthcare Management, vol. 17, 2011, p. 72-74

Britain is an ageing society, with increasing demands being placed by the very old on hospital emergency departments. Costly multi-disciplinary input into care is often required. Commissioners should look at improving community care for this segment of the population in order to avoid emergency hospital admissions.

NHS reform could spawn 300,000-a-year GPs - study

R. Ramesh and D. Campbell

The Guardian, Mar. 16th 2011, p. 1

GPs could more than double their income to 300,000 a year under Andrew Lansley's plans for the NHS, according to an analysis conducted by The Guardian, sparking calls from top doctors for the government to reverse controversial policies that would appear to reward physicians who ration care.

(See also The Guardian, Mar. 16th 2011, p. 12-13)

NHS will not face price war says Lansley

C. Smyth

The Times, Mar 4th 2011, p. 24

Hospitals will not be able to undercut each other on price prompting accusations of a U-turn after attacks from health unions and experts. Andrew Lansley has tabled an amendment to his health Bill currently moving through Parliament, in order to rule out competition on price among NHS bodies and private health companies.

(See also Health Service Journal, Mar. 10th 2011, p. 11)

Operations delayed by NHS cuts

M. Beckford

Daily Telegraph, Mar. 30th 2011, p. 2

The Cooperation and Competition Panel is looking into allegations that NHS managers are trying to reduce the amount of business private healthcare providers receive. In a submission to the Panel, the Primary Care Trust Network denied commissioners were discriminating against the private sector, but admitted that managers were rationing treatments to save money. Tactics included increasing waiting times between referral and treatment and increasing the level of pain or illness patients must endure before they qualify for treatment.

Patients at risk as health trusts trim out-of-hours care

J. Kirkup

Daily Telegraph, Mar. 3rd 2011, p. 1 + 2

About 78 of England's 152 primary care trusts released information about their spending on out-of-hours services following freedom of information requests by the magazine GP. Twenty said they had cut their budgets. Across the remaining trusts that released information, total spending on out-of-hours care rose by only 3.6m. The cuts were made before the start of the 2011/12-2014/15 spending round, which will require the NHS to find efficiency savings worth 20bn.

Top GP fears spending scandal after health bill

R. Ramesh and D. Campbell

The Guardian, Mar. 3rd 2011, p. 13

Britain's most senior GP has warned of a potential scandal similar to the row over MPs' expenses after an investigation revealed that GP practices could boost their income by diverting cash meant for patients to pay for surgeries and equipment. The findings highlight a key concern about the government's health bill, which nine out of 10 doctors openly fear will damage the NHS.

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