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In the NHS, if 2005 is as interesting as 2004 we are in for a treat, and the fun has already started. It appears, according to a Health Service Journal report, that the NHS is currently some half a billion pounds in the red. As with many NHS affairs, some of the details seem surreal. One SHA, South London, was unable to supply financial data, and the report talks of the possibility of multi-million pound deficits being removed by finance directors working long hours and having late nights. What are they doing, printing money?
| the report talks of multi-million pound deficits being removed by finance directors working long hours. What are they doing, printing money? |
If a few accountants moving figures from one column to the next can solve the problem, then it can’t be concerned with real money. If the advent of Agenda for Change and the consultants contract are major contributory factors, why weren’t they part of the financial plan? If the NHS is having more money spent on it than ever before, where is the extra going? Why are hospitals closing wards and freezing vacant consultant posts, when the independent sector is setting up treatment centres like there’s no tomorrow? While we are on the subject, why are so-called “perverse incentives” allowed to exist? Isn’t it management’s job to get rid of such things? We are aware that part of the reason that the independent sector is allowed to run treatment centres is to “shake up” the NHS. However, could you believe that there is a master plan in Whitehall to drastically cut the provision of hospital services in favour of community- based care, which, if it were made public would be political suicide for the government? Rather they will simply let market forces mould the system, so that they are not to blame if hospitals have to close.
Answers on a postcard please, and . . . did you know what an “exemplar” was before the DoH used the word to describe a “patient journey” for a young person with chronic fatigue syndrome? We suspect that 99.9% of people (at a rough guess) would have had no idea that it was “an example to be followed” and many would have little idea why the Minister was talking about a “patient journey.” So why use unfriendly language? Is it because there are people employed in the NHS who, if they didn’t spend their time writing such stuff, would be out of a job. The Tories apparently want to sack some 30,000 managers, and it is sometimes difficult not to sympathise with them. What happened in December?
- Agenda for Change was, at last, rolled out
- More treatment centres were opened and five flagship surgical ones got £1.4 million a year to act as models of good practice.
- A review was published on how five-years-worth of the National Service Framework had affected the treatment of mental health and it concluded that, by-andlarge, things have improved, but there is still more to be done.
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| cdm Monitor Informing the NHS about key resource developments for the management of chronic disease |
| The NHIS Update (cont.) |
- Guidance was issued on practice-led commissioning
- A Hepatitis C awareness campaign was launched.
- £3 million more was allocated to fight obesity
- Cash was allocated to improve the regulation of complementary medicine
- The Chief Executive’s report said what you would have expected it to say
- Guides and Frameworks, included: – HIV and AIDs in the African Community – Cutting heart disease among South Asians
- The 2003 Health Survey for England was published
| The Tories want to sack 30,000 managers, and it is sometimes difficult not to sympathise with them. |
Probably the biggest surprise in December in the chronic disease management sector was the sudden emergence into the limelight of a homegrown competitor to the Evercare and Kaiser systems. Apparently there has been a system in use in Castleford for years, but no one seemed to notice. Now we know that it is called the Unique System, we can all talk about it. Early in January an NHS and Social Care Model to Support Local Innovation and Integration, entitled Supporting People with Long Term Conditions was published, as the start of a major overhaul of the way health and social services work together, with Community Matrons at the heart of the system. Since home-based patients will need innovative technical support and especially IT support, a research proposal concerning the Role of Technology in Supporting Chronic Disease management was a very logical move.
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