This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
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
The article has changed 13 times. There is an RSS feed of changes available.
| Version 4 | Version 5 |
|---|---|
| NHS England says waiting time targets will not be met - live updates | |
| (35 minutes later) | |
| Readers have been in touch to tell us about their experiences and the concerns they have for the future given the funding gap and their views on the tough decisions which have to be made.A 29-year-old nurse working in Cornwall said she doesn’t think everyone realises quite how bad the situation is. | |
| No-one in the NHS wants to ration care when it means putting our patients at risk, but some services are so stretched now that people are already at risk. In the last few weeks I have had genuine fears for the lives of some of my patients in hospital. | |
| It is a terrible decision and one I am glad I don’t have to make, but without more funding it’s just not possible to keep going like this. It comes down to would we rather have half a hospital working safely, or a whole hospital working dangerously? It’s very scary. | |
| One GP in Bromley said the cuts over the last couple of years have affected the way they care for their patients: | |
| I once referred a patient for an urgent appointment and it was made for six months time. Some people can wait a whole year. The situation looks dire. | |
| A 50-year-old emergency physician said in their department there are often ill people in corridors and ambulances “queuing up like a serpent’s tail”. | |
| One of my colleagues collapsed yesterday from exhaustion and refused to go home as she wanted to carry on working! | |
| I worry that unsafe practices will become routine, that we will somehow get ‘used to’ working under such circumstances, and that the morale will break down completely. | |
| There has been a more positive response to the decision to protect planned investment on mental health services (and cancer and primary care services). | |
| Prof Wendy Burn, President of the Royal College of Psychiatrists, said: | |
| Mental health patients and staff across the country can breathe a sigh of relief today. NHS England chief executive Simon Stevens said vital plans to improve mental health services will be kept on track for at least the next financial year. But the promise is to spend an extra £1 billion on frontline mental health services and treat one million more people by 2021 – so we need a commitment to take us beyond 2019. | |
| The next step is to make sure that money gets to patients on the front line. We’re very worried that local healthcare commissioners are being allowed to divert cash intended for mental health services to pay for debts elsewhere. Commissioners must be held properly to account for the decisions that they make. | |
| And Paul Farmer, chief executive of Mind, independent chair of the NHS Mental Health Taskforce and chair of the advisory and oversight board for the delivery of the Five Year Forward View for Mental Health, said: | |
| We are pleased that the NHS has restated its commitments around mental health. The delivery of the Five Year Forward View for Mental Health is essential to bringing mental health services up to a basic standard, to start building the support we have lacked for many, many decades. | |
| We know that the NHS has to make difficult decisions at the moment – it is the right choice to invest in mental health because the sooner people who are struggling get the help they need, the more likely it is that they will avoid needing more intensive and expensive support further down the line. | |
| The Nuffield Trust has also raised concerns about the extent to which waiting lists will grow next year. | |
| Prof John Appleby, the thinktank’s chief economist, said: | |
| It is clear from today’s board meeting that the big question emerging from last week’s budget is how far waiting lists for routine operations like hip and knee replacements are allowed to grow in order to preserve and improve other services like A&E and cancer care. | |
| With the NHS under severe financial pressure – and, as NHS England acknowledges, already spending money it doesn’t have to keep the show on the road – today’s meeting puts down a clear marker that something will have to give. As we and the other health think tanks have warned, the budget settlement fills around just half of the funding gap for next year. | |
| Lots of responses are coming in to the plans for 2018/19. The Lib Dems have homed in on page four of the board paper, which says: | |
| NHS constitution waiting times standards, in the round, will not be fully funded and met next year. | |
| Additionally, on page four, it says: | |
| Factoring in England’s growing and ageing patient population, age-weighted NHS revenue growth per person becomes 0.9% in 2018/19 and -0.4% in 2019/20. | |
| The Lib Dems’ former health minister, Norman Lamb, said: | |
| This is the inevitable consequence of the government’s continued underfunding of our NHS. | |
| Patients will suffer longer waiting times for routine operations, while progress towards improving mental health care risks being reversed. | |
| The public very clearly wants to see more investment in the NHS as a national priority. | |
| The Liberal Democrats have set out a clear plan to raise £6bn for the NHS and care by putting a penny on income tax. | |
| We need to be honest with the British people that securing the best possible standards of care will mean all chipping in a little more. | |
| The board have voted that, subject to certain conditions, heart surgery units at the Royal Brompton, London, and in Leicester and Newcastle will not close as was previously mooted. | The board have voted that, subject to certain conditions, heart surgery units at the Royal Brompton, London, and in Leicester and Newcastle will not close as was previously mooted. |
| A unit at Manchester University NHS Foundation Trust will stop offering specialist surgery and care for congenital heart disease patients but the services previously offered there will be consolidated in Liverpool instead. | A unit at Manchester University NHS Foundation Trust will stop offering specialist surgery and care for congenital heart disease patients but the services previously offered there will be consolidated in Liverpool instead. |
| Keogh has now excused himself from the discussion because he when he leaves the board at the end of this year he is to be chairman of Birmingham women’s and children’s NHS Foundation Trust. | Keogh has now excused himself from the discussion because he when he leaves the board at the end of this year he is to be chairman of Birmingham women’s and children’s NHS Foundation Trust. |
| Four trusts have been identified as not meeting acceptable standards for level 1 services, i.e. providing specialist surgery and care for congenital heart disease patients, the board hears: | Four trusts have been identified as not meeting acceptable standards for level 1 services, i.e. providing specialist surgery and care for congenital heart disease patients, the board hears: |
| Manchester University NHS Foundation Trust (formerly Central Manchester NHS Foundation Trust) | Manchester University NHS Foundation Trust (formerly Central Manchester NHS Foundation Trust) |
| University Hospitals Of Leicester NHS Trust | University Hospitals Of Leicester NHS Trust |
| Royal Brompton & Harefield NHS Foundation Trust | Royal Brompton & Harefield NHS Foundation Trust |
| Newcastle upon Tyne Hospitals NHS Foundation Trust. | Newcastle upon Tyne Hospitals NHS Foundation Trust. |
| All of these level one centres had previously earmarked for closure but the new recommendation is that only Manchester, which only has one surgeon, should do so, with services, in that case, consolidated in Liverpool. | All of these level one centres had previously earmarked for closure but the new recommendation is that only Manchester, which only has one surgeon, should do so, with services, in that case, consolidated in Liverpool. |
| Leicester was said to have presented a “a convincing plan for meeting the co-location standards”, Royal Brompton & Harefield was said to have presented an ambitious plan to collaborate with Guy’s and St Thomas’ and services at Newcastle will also be kept open until at least 2021. | Leicester was said to have presented a “a convincing plan for meeting the co-location standards”, Royal Brompton & Harefield was said to have presented an ambitious plan to collaborate with Guy’s and St Thomas’ and services at Newcastle will also be kept open until at least 2021. |
| This is the reaction from Leicester West MP, Liz Kendall: | This is the reaction from Leicester West MP, Liz Kendall: |
| Fantastic news!!! @NHSEngland decides to keep children’s heart surgery at Glenfield. Huge thanks to all the staff, patients & families, campaigners & MPs who’ve supported our campaign. We couldn’t have done it without you! | Fantastic news!!! @NHSEngland decides to keep children’s heart surgery at Glenfield. Huge thanks to all the staff, patients & families, campaigners & MPs who’ve supported our campaign. We couldn’t have done it without you! |
| They are onto agenda item six now: “Congenital Heart Disease Services for Adults and Children: Future Commissioning Arrangements.” | They are onto agenda item six now: “Congenital Heart Disease Services for Adults and Children: Future Commissioning Arrangements.” |
| Medical director Bruce Keogh is giving some context, namely the deaths in the 1990s of babies at the Bristol Royal Infirmary, whose heart surgeons were not as skilled as others elsewhere. | Medical director Bruce Keogh is giving some context, namely the deaths in the 1990s of babies at the Bristol Royal Infirmary, whose heart surgeons were not as skilled as others elsewhere. |
| Referring to the 2001 Kennedy review into the tragedy, he says one of the recommendations was to rationalise services to safeguard standards. | Referring to the 2001 Kennedy review into the tragedy, he says one of the recommendations was to rationalise services to safeguard standards. |
| He says: | He says: |
| We are reaching crunch time, this has been going on since 2001, we need a decision... The uncertainty that has surrounded the past 17 years has been highly counterproductive for people working in this speciality. | We are reaching crunch time, this has been going on since 2001, we need a decision... The uncertainty that has surrounded the past 17 years has been highly counterproductive for people working in this speciality. |
| This is what the shadow health secretary thinks of the discussion on planning for next year (Jeremy Hunt is giving a speech at the King’s Fund health charity this afternoon): | This is what the shadow health secretary thinks of the discussion on planning for next year (Jeremy Hunt is giving a speech at the King’s Fund health charity this afternoon): |
| NHS bosses just effectively conceded 18 week target won’t be met because of Tory underfunding. But this breaches the legal duty in NHS constitution. At Kings Fund later Jeremy Hunt must tell us if he now intends to legislate to amend NHS constitution | NHS bosses just effectively conceded 18 week target won’t be met because of Tory underfunding. But this breaches the legal duty in NHS constitution. At Kings Fund later Jeremy Hunt must tell us if he now intends to legislate to amend NHS constitution |
| Sir Malcolm Grant CBE, @NHSEngland Chairman, continuing discussions around budget related planning matters. The #NHSEnglandBoard meeting can be viewed live via: https://t.co/fFWiXjLYsP pic.twitter.com/4cEFSEjeh9 | Sir Malcolm Grant CBE, @NHSEngland Chairman, continuing discussions around budget related planning matters. The #NHSEnglandBoard meeting can be viewed live via: https://t.co/fFWiXjLYsP pic.twitter.com/4cEFSEjeh9 |
| Medical director Bruce Keogh makes clear that the guidance on “items which should not be routinely prescribed in primary care” is just that, i.e. it is not a ban but about “judicious” prescribing. | Medical director Bruce Keogh makes clear that the guidance on “items which should not be routinely prescribed in primary care” is just that, i.e. it is not a ban but about “judicious” prescribing. |
| A consultation between July and October received more than 5,000 responses online and more than 200 through the post. | A consultation between July and October received more than 5,000 responses online and more than 200 through the post. |
| Keogh says the guidance, previewed earlier this year, remains largely unchanged. | Keogh says the guidance, previewed earlier this year, remains largely unchanged. |
| He says there was no evidence to support the prescribing of homeopathic remedies on the NHS. | He says there was no evidence to support the prescribing of homeopathic remedies on the NHS. |
| They have identified 26 conditions where over the counter medicine is sufficient, says Keogh. | They have identified 26 conditions where over the counter medicine is sufficient, says Keogh. |
| Non-exec director Lord Victor Adebowale CBE asks “how we will monitor for unintended consequences?” | Non-exec director Lord Victor Adebowale CBE asks “how we will monitor for unintended consequences?” |
| Keogh says they will consider that. | Keogh says they will consider that. |
| The recommendations are passed. | The recommendations are passed. |
| Treatments to b cut off routine prescriptions list in full attached: inc. homeopathy, herbal treatments, fish oils, co-proxamol #NHSBoardMeeting pic.twitter.com/PeI8BIRO82 | Treatments to b cut off routine prescriptions list in full attached: inc. homeopathy, herbal treatments, fish oils, co-proxamol #NHSBoardMeeting pic.twitter.com/PeI8BIRO82 |
| Dame Moira Gibb, another non-executive director, says the public must understand that not everything can be done, staff can’t be continually pushed to do more and more. | Dame Moira Gibb, another non-executive director, says the public must understand that not everything can be done, staff can’t be continually pushed to do more and more. |
| Her view is echoed by NHS England chair Prof Sir Malcolm Grant, who says: | Her view is echoed by NHS England chair Prof Sir Malcolm Grant, who says: |
| We should not set out blindly imagining that our staff can do everything. | We should not set out blindly imagining that our staff can do everything. |
| He says chief executive Simon Stevens needs to carry out a “rigorous process” reflecting the discussion. | He says chief executive Simon Stevens needs to carry out a “rigorous process” reflecting the discussion. |
| We have to find an accommodation of all of these conflicts ...to ensure that when we enter the financial year 2018/19, we are confident of our ability to deliver. | We have to find an accommodation of all of these conflicts ...to ensure that when we enter the financial year 2018/19, we are confident of our ability to deliver. |
| That is the end of that agenda item and there was not the detail that many anticipated after the post-budget warnings. There was detail of the services to be prioritised but no flesh on the bones about those that will be cut. | That is the end of that agenda item and there was not the detail that many anticipated after the post-budget warnings. There was detail of the services to be prioritised but no flesh on the bones about those that will be cut. |
| Next up is “Items which should not be routinely prescribed in primary care”, which should reach concrete conclusions. | Next up is “Items which should not be routinely prescribed in primary care”, which should reach concrete conclusions. |
| Non-exec director Lord Victor Adebowale CBE refers to the amount allocated in the budget as a “tough settlement” and seeks extra reassurance from chief executive Simon Stevens that mental health will be protected, as he suggested it should be, given that historically it has been underfunded. | Non-exec director Lord Victor Adebowale CBE refers to the amount allocated in the budget as a “tough settlement” and seeks extra reassurance from chief executive Simon Stevens that mental health will be protected, as he suggested it should be, given that historically it has been underfunded. |
| Another non-exec director Prof John Burn says it’s “enlightened self-interest” to put money into mental health and primary care. | Another non-exec director Prof John Burn says it’s “enlightened self-interest” to put money into mental health and primary care. |
| Simon Stevens, @NHSEngland Chief Executive, at today's #NHSEnglandBoard meeting, discussing budget related planning matters. The meeting can be viewed live via: https://t.co/fFWiXjLYsP pic.twitter.com/L17xnCguu7 | Simon Stevens, @NHSEngland Chief Executive, at today's #NHSEnglandBoard meeting, discussing budget related planning matters. The meeting can be viewed live via: https://t.co/fFWiXjLYsP pic.twitter.com/L17xnCguu7 |
| We’d like to hear from NHS staff about how you have been affected by cuts. How has funding helped in the past and what will the proposed changes mean?You can share your views and experiences with our journalists by filling in our encrypted form here. Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous. | We’d like to hear from NHS staff about how you have been affected by cuts. How has funding helped in the past and what will the proposed changes mean?You can share your views and experiences with our journalists by filling in our encrypted form here. Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous. |
| Your stories will help our journalists have a more complete picture of these events and we will use some of them in our reporting. | Your stories will help our journalists have a more complete picture of these events and we will use some of them in our reporting. |
| Stevens is asked about how the public and patients will be involved in discussions. | Stevens is asked about how the public and patients will be involved in discussions. |
| He says patient groups have already been engaged when coming up with priorities over the next two years. Healthwatch is also being engaged. | He says patient groups have already been engaged when coming up with priorities over the next two years. Healthwatch is also being engaged. |
| There will be public consultation by NHS England as well as a formal public consultation ultimately by the Department of Health, he adds. | There will be public consultation by NHS England as well as a formal public consultation ultimately by the Department of Health, he adds. |
| Matthew Swindells, national director – operations and information, says: | Matthew Swindells, national director – operations and information, says: |
| There are going to be some really difficult decisions that we need to make. | There are going to be some really difficult decisions that we need to make. |
| Chief executive Simon Stevens said the recommendation is to uphold the planned investment in mental health, cancer care and primary care next year. | Chief executive Simon Stevens said the recommendation is to uphold the planned investment in mental health, cancer care and primary care next year. |
| He says the working principle is to be as “stretching but realistic” about what can be achieved in other areas so that frontline staff already under pressure are not overwhelmed. | He says the working principle is to be as “stretching but realistic” about what can be achieved in other areas so that frontline staff already under pressure are not overwhelmed. |
| We have until March 31st to get this combination of judgements right. | We have until March 31st to get this combination of judgements right. |