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

5% of England's NHS nurses 'fear for their jobs'

D. Campbell

The Guardian, Oct. 3rd 2011, p. 4

Almost 75,000 nurses expect to lose their jobs, have their hours cut or see their roles downgraded in the next year, according to a survey that highlights the growing impact of the NHS's financial squeeze. Five per cent of the NHS in England's 410,000 nurses - some 20,500 in all - believe their posts will disappear in the next 12 months. Another 24,600 anticipate a cut in hours, while another 28,700 expect to have their jobs reassessed as involving fewer responsibilities. The findings, extrapolated from a Royal College of Nursing (RCN) poll of 8,000 of its members, have prompted renewed claims that the coalition is not honouring repeated promises to protect the NHS frontline from cuts.

Achievement of Foundation Trust status by NHS hospital trusts

National Audit Office

London: TSO, 2011 (House of Commons papers, session 2010/12; HC 1516) This report looked at all 113 NHS trusts that had not achieved foundation status. Of these, it was estimated that 48 would need 'additional work' to balance their books, which could take the form of significant loans. Twenty were deemed 'not financially viable and/or clinically viable' in their present form. Seventeen of the most challenged trusts were seeking takeovers by other hospitals or private firms but six trusts with the heaviest PFI debts were considered 'not viable under any of the tested scenarios' and were likely to need significant Treasury funding. In total, 80% of the 113 non-foundation trusts were judged to be in financial trouble, while 65% had 'quality and performance problems' and 39% needed improvements in governance and leadership.

Bail-outs to help NHS trusts balance books

R. Winnett

Daily Telegraph, Oct. 11th 2011, p.1

This article reports that up to 20 NHS trusts had approached the Department of Health for financial help due to 'cash flow shortages' and 'high levels of debt'. The Department was warned that patient care in many areas would suffer unless ministers intervened.

Fix the system to find the finances

J. Barlow, C. Gray and S. Wright

Health Service Journal, Oct. 6th 2011, p. 18-19

The payment by results tariff, derived from healthcare resource group prices which incorporate average historical costs, does not allow for the expenses of new capital, whether these are charges for PFI deals or depreciation of public dividend capital. This inadequate payment mechanism is damaging planning for appropriate NHS capacity. The authors argue that to solve immediate problems either commissioners should offer a tariff uplift that makes allowances for capital charges, or there should be an injection of public dividend capital into financially challenged trusts.

NHS hospitals drain money from elderly care, says peer

J. Kirkup

Daily Telegraph, Oct. 18th 2011, p.1

Lord Warner, a former Labour health minister, warned that care services for older people were being denied funding because under-performing NHS hospitals were soaking up public money. He called for some failing NHS hospitals to be closed to cut spending and release money to pay for care for older people as proposed by the Dilnot Commission.

NHS pays millions of pounds more than it needs to for drugs

M. Newman and O. Wright

The Independent, Oct. 5th 2011, p. 1

An investigation by the Bureau of Investigative Journalism reveals that the NHS might be spending more than needed in order to prescribe a newer, more expensive antidepressant instead of an older out-of-patent version which, according to the investigation, is just as effective. A single clinical study suggests the newer Cipralex (Lexapro in the US) is more effective; the finding is disputed by the investigation.

NHS will not fund some operations, patients told

R. Ramesh

The Guardian, Oct. 7th 2011, p. 14

GPs at a health centre in York have written to patients saying the NHS will no longer fund minor operations and instead offering to carry out the procedures for a fee. In a letter obtained by the website nhsmanagers.net, patients are advised that for a number of minor surgical procedures, such as ingrowing toenails, mole removal and chopping out warts and cysts, they would have to go private. The letter from John McEvoy, managing partner at Haxby and Wigginton health centre, which serves more than 20,000 patients, claims the NHS will no longer fund some operations. "As a result I am writing to make you aware of some of the options that you have to have the procedure completed as a private patient."

(See also Daily Telegraph, Oct. 5th 2011, p. 1+2; Times, Oct. 5th 2011, p. 13)

One in four dentists earns more than 100,000 a year

M. Beckford

Daily Telegraph, Oct. 6th 2011, p. 18

Statistics from the NHS Information Centre revealed that the average taxable income for all primary care dentists, based on their NHS and private work, was 84,900 in 2009/10. This represented a 5% fall on the 89,600 recorded the previous year. It was thought that fewer patients were having their teeth checked or having expensive work carried out due to the economic downturn and rising inflation. Dentists said that their income was falling because their overheads were rising. They blamed rising equipment costs, staff costs and the burden of regulation.

Outlook worsens for challenged acute trusts

C. Dowler and B. Clover

Health Service Journal, Oct. 6th 2011, p. 4-5

At the end of June 2011, six acute NHS trusts - all in London and the South East - forecast that they would finish the year in the red, three times the number forecasting a deficit in June 2010. At the same time foundation trust regulator Monitor also reported that the number of trusts in the highest category of financial risk had doubled from three to six in the first three months of 2011/12.

Revealed: toll of cuts across NHS services

D. Campbell and J. Meikle

The Guardian, Oct. 18th 2011, p. 1

Birth centres are closing, patients are being denied pain-relieving drugs and leaflets advising parents how to prevent cot death have been scrapped because of NHS cuts which are increasingly restricting services to patients, evidence gathered by the Guardian reveals. The NHS's 20bn savings drive also means new mothers receive fewer visits from health visitors, support for problem drinkers is being reduced and families are no longer being given an NHS advice book on bringing up their baby. The disclosure that the savings drive is affecting so many different areas of NHS care has prompted claims that pledges by the prime minister and the health secretary, Andrew Lansley, that the frontline would be protected despite the NHS's tightening financial squeeze cannot be trusted. One of David Cameron's election pledges was: "I'll cut the deficit, not the NHS."

Trusts demand 350m to stay in FT pipeline

B. Clover

Health Service Journal, Oct. 27th 2011, p. 4-5

A quarter of trusts aspiring to attain foundation status have asked for at least 352m in transitional support in 2011/12 from the Department of Health, strategic health authorities and commissioners to help them meet Monitor's financial requirements for foundation trust authorisation. The figure rises to 476m when the need to plug the predicted year end deficits of aspiring foundation trusts is taken into account. Further funding will be needed in subsequent years.

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