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You can find the current article at its original source at https://www.theguardian.com/society/live/2017/nov/30/nhs-leaders-meet-to-discuss-cutting-services-amid-funding-gap-live-updates
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| Row breaks out as Jeremy Hunt says NHS must stick to targets - live updates | |
| (35 minutes later) | |
| Thanks for following the blog today and all your comments. Here is a summary of the day’s events. | |
| Jeremy Hunt has said NHS England (NHSE) must still strive to meet the waiting time targets in its constitution after its leaders said they could not be met, placing him at loggerheads with health service bosses. | |
| Earlier, NHSE bosses said waiting times standards would be neither fully funded nor met next year, at a meeting to discuss their response to the budget settlement. Chief executive Simon Stevens had asked for £4bn for the health service in 2018/19 but was granted only £1.6bn. | |
| Labour, Lib Dems and health experts claimed the move, which they said was a consequence of government underfunding, would lead to long waits for routine operations like hip and knee replacements. | |
| NHSE also warned that guidelines from the health regulator, the National Institute for Health and Care Excellence, on new drugs and treatments may not be implemented in future unless “they are accompanied by a clear and agreed affordability and workforce assessment at the time they are drawn up”. | |
| The decision to protect planned investment in mental health care was welcomed by the Royal College of Psychiatrists (RCPsych) and Mind. However, the RCPsych said a longer-term spending commitment was needed. NHSE chief executive Simon Stevens said as well as mental health services, planned investment in primary care and cancer services would also be protected. | |
| Three heart surgery units have be saved from closure, after NHSE made a U-turn on their future. Units at the Royal Brompton in London, in Leicester and Newcastle had been earmarked for closure as part of plans to consolidate services offering specialist surgery and care for congenital heart disease patients. The decision to keep them open comes after years of campaigning. One, in Manchester, will still close and be consolidated with services offered in Liverpool. | |
| The board recommended that low value treatments, including fish oil, herbal remedies and homeopathy no longer be provided on the NHS. It said it would save the health service hundreds of millions of pounds a year and also free up millions of GP appointments currently taken up with prescribing such medicines. | |
| And with that rejection of what the NHS bosses said that morning, the conference ends not on a note of harmony between health service leaders and politicians, as King’s Fund chief executive Chris Ham earlier said was needed, but with Jeremy Hunt and the NHS board at loggerheads. | |
| A Press Association reporter has asked Hunt about the NHS England board meeting earlier and the fact that health service leaders said that waiting time targets would have to be abandoned next year (which Labour suggested the NHS had been pushed into through insufficient funding but might not be legal under its constitution). | A Press Association reporter has asked Hunt about the NHS England board meeting earlier and the fact that health service leaders said that waiting time targets would have to be abandoned next year (which Labour suggested the NHS had been pushed into through insufficient funding but might not be legal under its constitution). |
| In response the health secretary, reaffirmed his commitment to the constitution and the established targets. | In response the health secretary, reaffirmed his commitment to the constitution and the established targets. |
| Earlier, NHS England was highlighting its productivity increases of 1.7% a year, much better than the wider economy, warning that there was only so much more - if any more at all staff could do. | Earlier, NHS England was highlighting its productivity increases of 1.7% a year, much better than the wider economy, warning that there was only so much more - if any more at all staff could do. |
| Hunt is pointing out where he things the NHS can do better: | Hunt is pointing out where he things the NHS can do better: |
| @Jeremy_Hunt :Things the NHS needs to do better; 1. spread best practice; 2. workforce planning and skill mix (draft workforce plan before end 2017 for consultation); 3. marry tech and safety #KFAnnual2017 | @Jeremy_Hunt :Things the NHS needs to do better; 1. spread best practice; 2. workforce planning and skill mix (draft workforce plan before end 2017 for consultation); 3. marry tech and safety #KFAnnual2017 |
| He moves on to safety: | He moves on to safety: |
| People more often mention workforce constraints rather than financial ones, says Hunt #KFAnnual2017 #NHS Goes on to talk about Mid Staffs scandal | People more often mention workforce constraints rather than financial ones, says Hunt #KFAnnual2017 #NHS Goes on to talk about Mid Staffs scandal |
| Last year we removed ovaries from three patients by mistake, says Hunt #KFAnnual2017 #NHS | Last year we removed ovaries from three patients by mistake, says Hunt #KFAnnual2017 #NHS |
| We need to be better at spreading best practice, adds Hunt #KFAnnual2017 #NHS | We need to be better at spreading best practice, adds Hunt #KFAnnual2017 #NHS |
| He suggests that money is not the most important thing holding the NHS back but staffing levels, although many would argue the two are inextricably linked: | He suggests that money is not the most important thing holding the NHS back but staffing levels, although many would argue the two are inextricably linked: |
| People more often mention workforce constraints rather than financial ones, says Hunt #KFAnnual2017 #NHS Goes on to talk about Mid Staffs scandal | People more often mention workforce constraints rather than financial ones, says Hunt #KFAnnual2017 #NHS Goes on to talk about Mid Staffs scandal |
| Hunt is defending the performance of the NHS (and by definition the government) in the face of increasing demand: | Hunt is defending the performance of the NHS (and by definition the government) in the face of increasing demand: |
| .@Jeremy_Hunt “Most of the key safety indicators have gone in the right direction despite the pressures of the past five to seven years” #KFAnnual2017 | .@Jeremy_Hunt “Most of the key safety indicators have gone in the right direction despite the pressures of the past five to seven years” #KFAnnual2017 |
| The health secretary is about to begin. | The health secretary is about to begin. |
| Jeremy Hunt on stage now after cycling to #KFAnnual2017 #NHS | Jeremy Hunt on stage now after cycling to #KFAnnual2017 #NHS |
| Chris Ham, chief Executive of the King’s Fund, where Jeremy Hunt will shortly be speaking, said in response to events earlier today, imploring NHS leaders and politicians to work together: | Chris Ham, chief Executive of the King’s Fund, where Jeremy Hunt will shortly be speaking, said in response to events earlier today, imploring NHS leaders and politicians to work together: |
| Today’s NHS England Board meeting is welcome recognition that we need to begin a discussion with the public about what the NHS can be expected to provide with the funds it has been given. | Today’s NHS England Board meeting is welcome recognition that we need to begin a discussion with the public about what the NHS can be expected to provide with the funds it has been given. |
| The NHS must play its part by continuing to seek and deliver improvements in efficiency but these will not be sufficient to bridge the funding gap. Politicians and NHS leaders need to find common cause in engaging with the public and avoid adopting adversarial positions which will undermine public confidence in their stewardship of the NHS. | The NHS must play its part by continuing to seek and deliver improvements in efficiency but these will not be sufficient to bridge the funding gap. Politicians and NHS leaders need to find common cause in engaging with the public and avoid adopting adversarial positions which will undermine public confidence in their stewardship of the NHS. |
| We’re about 20 minutes away from the health secretary’s speech. While we wait, doctors’ union, the British Medical Association (BMA), has added its voice to those expressing concern at the impact of underfunding. | We’re about 20 minutes away from the health secretary’s speech. While we wait, doctors’ union, the British Medical Association (BMA), has added its voice to those expressing concern at the impact of underfunding. |
| Dr Chaand Nagpaul, BMA council chair, said: “It is deeply worrying that the body with responsibility for running the NHS is warning of the service’s inability to meet national standards of care. Unfortunately, it is patients who are unfairly suffering the consequences of a clearly underfunded service. Waiting time targets for hospital care haven’t been met for years and patients face growing delays to see their GP as general practice struggles to cope with demand. | Dr Chaand Nagpaul, BMA council chair, said: “It is deeply worrying that the body with responsibility for running the NHS is warning of the service’s inability to meet national standards of care. Unfortunately, it is patients who are unfairly suffering the consequences of a clearly underfunded service. Waiting time targets for hospital care haven’t been met for years and patients face growing delays to see their GP as general practice struggles to cope with demand. |
| “Doctors always want to deliver the best possible care for our patients, but we can’t continuously plug gaps by penny pinching and poaching from elsewhere in an overstretched service. Ministers must listen to the warnings of doctors, and to the NHS’ own leaders, and take urgent steps to put the NHS on a sustainable footing.” | “Doctors always want to deliver the best possible care for our patients, but we can’t continuously plug gaps by penny pinching and poaching from elsewhere in an overstretched service. Ministers must listen to the warnings of doctors, and to the NHS’ own leaders, and take urgent steps to put the NHS on a sustainable footing.” |
| I’m going to put the blog on hold now until 4.50pm when Jeremy Hunt is giving a speech at the King’s Fund annual conference, in which he will have the chance to respond to what NHS England leaders said this morning. | I’m going to put the blog on hold now until 4.50pm when Jeremy Hunt is giving a speech at the King’s Fund annual conference, in which he will have the chance to respond to what NHS England leaders said this morning. |
| In the meantime, you can read the news story by my colleague, Denis Campbell, on today’s developments so far: | In the meantime, you can read the news story by my colleague, Denis Campbell, on today’s developments so far: |
| Unite, which has 100,000 members in the NHS has complained bitterly about the impact of government funding on its members. | Unite, which has 100,000 members in the NHS has complained bitterly about the impact of government funding on its members. |
| The union’s head of health, Sarah Carpenter, said: | The union’s head of health, Sarah Carpenter, said: |
| We should not have to be juggling, as the world’s sixth largest economy, between lengthening waiting lists or whether to direct resources to A&E departments. | We should not have to be juggling, as the world’s sixth largest economy, between lengthening waiting lists or whether to direct resources to A&E departments. |
| Staff morale is on the ropes as they are asked to do more with fewer resources – and there is only so much extra that you can ask dedicated professionals to do. ‘Recruitment and retention’ is now a major problem for NHS trusts. | Staff morale is on the ropes as they are asked to do more with fewer resources – and there is only so much extra that you can ask dedicated professionals to do. ‘Recruitment and retention’ is now a major problem for NHS trusts. |
| The pay austerity that NHS staff have endured since 2010 needs to be addressed and, as yet, it is not clear how this will play out. The next stage after the budget announcement is for the NHS unions to explore what this actually means and what such a deal could look like. | The pay austerity that NHS staff have endured since 2010 needs to be addressed and, as yet, it is not clear how this will play out. The next stage after the budget announcement is for the NHS unions to explore what this actually means and what such a deal could look like. |
| Philip Hammond’s budget has not solved the cash crisis facing the NHS – the same set of stark challenges still remain and they need to be tackled urgently. | Philip Hammond’s budget has not solved the cash crisis facing the NHS – the same set of stark challenges still remain and they need to be tackled urgently. |
| The Royal College of Surgeons, in this case jointly with the Society for Cardiothoracic Surgery, has also responded to the reconfiguration of congenital heart disease services in England, announced at this morning’s meeting, bemoaning how long it took to happen. | The Royal College of Surgeons, in this case jointly with the Society for Cardiothoracic Surgery, has also responded to the reconfiguration of congenital heart disease services in England, announced at this morning’s meeting, bemoaning how long it took to happen. |
| Services at the Royal Brompton in London, and in Leicester and Newcastle, which have been under threat for some time won a reprieve but a heart surgery unit in Manchester will close. | Services at the Royal Brompton in London, and in Leicester and Newcastle, which have been under threat for some time won a reprieve but a heart surgery unit in Manchester will close. |
| In a joint statement, the college and society said: | In a joint statement, the college and society said: |
| These changes should have happened decades ago. The endless delays to a decision being made on this reconfiguration has caused great uncertainty to all of the hospitals involved, their staff and the children they care for. | These changes should have happened decades ago. The endless delays to a decision being made on this reconfiguration has caused great uncertainty to all of the hospitals involved, their staff and the children they care for. |
| Currently, some smaller teams are very stretched in their ability to provide a comprehensive 24/7 service and to develop sustainably. It is fundamentally important that specialist surgical centres are large enough and treat patients regularly enough to develop full expertise to treat all conditions. It is vital that centres have adequate resources to support patients with increasingly complex needs, especially access to paediatric intensive care beds.” | Currently, some smaller teams are very stretched in their ability to provide a comprehensive 24/7 service and to develop sustainably. It is fundamentally important that specialist surgical centres are large enough and treat patients regularly enough to develop full expertise to treat all conditions. It is vital that centres have adequate resources to support patients with increasingly complex needs, especially access to paediatric intensive care beds.” |
| It’s vital centres are properly staffed to provide on-call rotas and teams have the time to create a supportive environment where new techniques are shared and future specialists can learn. | It’s vital centres are properly staffed to provide on-call rotas and teams have the time to create a supportive environment where new techniques are shared and future specialists can learn. |