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

4.7bn on digital medical records 'will benefit no one'

S. Adams and M. Beckford

Daily Telegraph, May 18th 2011, p. 14

Digitising the medical records of the country's 62m people was the core objective of the National Programme for IT in the NHS, accounting for 7bn of the 11.4bn estimated cost. However the National Audit Office has warned that the 2.3bn spent on computerising patient records so far does not represent value for money and that there are no grounds for confidence that the remaining 4.7bn will make a difference. There are now serious doubts that the computerisation of medical records will benefit patients or doctors.

At the sharp end of NHS history

M. Britnell

Health Service Journal, May 12th 2011, p. 16-17

It appears that countries that have a mix of public and private health service provision, co-payment and social insurance are the most resilient. The author presents a case study of Singapore which uses individual savings accounts within its central provident fund to enable citizens to pay for their own housing, pensions and healthcare. Market-based mechanisms promote competition between providers while tiered insurance covers all citizens. A more sophisticated debate about price competition could better serve the long-term interests of the NHS.

Dentists 'overcharging' for NHS care

S. Adams

Daily Telegraph, May 23rd 2011, p. 10

An undercover reporter for Channel 4's Despatches programme has found that some dentists are overcharging patients for NHS treatment. Patients are being quoted up to 725.00 for work that should cost 198.00 under the NHS three-tiered system of payment for procedures. Dentists are also neglecting to offer a scale and polish, which should be included in most basic tier work alongside a check-up, and are instead selling it as a private add-on.

Europe flies the flag for new ideas

J.-L. Spencer

Health Service Journal, May 19th 2011, p. 28-29

The European Union has ambitions for Europe to become a global leader in research and development. The NHS's approach to innovation through partnership working has attracted its favourable interest. The European Commission is now considering how to shape future EU funding programmes to support cross-sector initiatives at the local and pan-European level. The revision of EU funding programmes is an opportunity to develop a more simplified, inclusive and less bureaucratic framework, which may enable more NHS trusts to access European funding for innovation.

General practitioner commissioning consortia and budgetary risk: evidence from the modelling of 'fair share' practice budgets for mental health

S. Asthana and others

Journal of Health Services Research and Policy, vol.16, 2011, p. 95-101

The Coalition government plans to devolve control of NHS commissioning budgets to consortia of GP practices. At present, the number and size of future consortia are unknown. There is also a relative lack of empirical evidence on the nature and scale of risk associated with setting and managing devolved budgets for relatively small populations. This paper aims to help fill the gap in the evidence by quantifying the level of budgetary risk likely to be experienced by GP consortia of different sizes using the methodology currently employed by the Department of Health to set practice-level mental health budgets. It is concluded that unless steps are taken to mitigate budgetary risk, the devolution of decision-making and introduction of fixed budgets is likely to result in significant financial instability. It will be difficult to reconcile the policy objectives of devolved commissioning, best met through relatively small and fully accountable consortia, with the need for financial stability, which is best met by pooling risk across larger populations.

Hospitals lose thousands of beds in NHS cuts

S. Adams

Daily Telegraph, May 31st 2011, p. 4

Some of England's largest hospitals are cutting up to 10% of their beds and reducing staff to decrease wage bills in order to meet government targets for efficiency savings. The Royal College of Nursing has warned that moves risk adversely affecting the quality of care, a claim rejected by the hospitals.

NHS chiefs' pay up by 2.5% despite cuts

D. Campbell

The Guardian, May 10th 2011, p. 13

NHS bosses' pay is increasing despite the health service's years of flat budgets, a 20bn efficiency drive and growing cuts, a report by Income Data Services has revealed. The average pay for a trust chief executive in England increased by 2.5%, from 155,000 in 2009 to 158,000 last year.

(See also Daily Telegraph, May 10th 2011, p. 6)

Patients with leukaemia denied 'costly' treatment

M. Beckford

Daily Telegraph, May 6th 2011, p. 14

The National Institute for Health and Clinical Excellence has ruled that three drugs used to treat chronic myeloid leukaemia in patients who do not respond to the standard medication are not effective enough, considering that they cost 40,000 per year. Campaigners point out that the drugs are available on the NHS in Scotland and in 29 European countries plus Australia, the USA and Canada. There is growing evidence that NHS managers are restricting access to treatments to cut costs.

Providers warn of dangers of PCT 'war chest'

D. West, C. Dowler and B. Clover

Health Service Journal, May 19th 2011, p. 4-5

Calculations show that about 2.25bn of primary care trusts' 2011/12 budgets is being held back from routine spending on hospital and community services in order to fund service reconfiguration and deal with financial emergencies. Provider trusts are arguing that money should be released and spent immediately as they are facing financial shortfalls and having to make large staff reductions.

Squeezed trusts owe DH quarter of a billion in bailout cash

B. Clover

Health Service Journal, May 26th 2011, p. 4-5

Figures released under the Freedom of information Act show that hospital trusts were given 778m in working capital loans by the Department of Health in 2006/07 and 247m since then. At the end of 2010/11 trusts owed a total of 269m and 11 trusts had more than 10m outstanding. Loan repayments place an additional burden on non-foundation trusts that are looking to be authorised by Monitor before the deadline of April 2014.

Trusts reveal extent of cuts to paybill

D. Williams

Health Service Journal, May 12th 2011, p. 4-5

A survey of Foundation Trust Network members has shown that provider trusts are planning to cut pay budgets by 1.9bn in 2011/12. There have been warnings that trusts will be unable to make such large savings without opting out of national pay structures.

Trusts warned of hike in savings target

B. Clover

Health Service Journal, May 5th 2011, p. 8-9

A document sent out by Monitor said that a worst case scenario could require foundation trusts to achieve in-year efficiency savings of 6.5% in 2011/12. The predictions for the four subsequent years range from 6% to 7.1%. The more optimistic scenario sees efficiency savings of 4.6% or 4.7% for each of the next five years from 2011/12. This is still higher than the combined inflation and tariff reduction figure of 4% set out by the Department of Health in the operating framework.

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