Tory and Labour migration elections pledges fail to address NHS and social care staffing crisis

A report today by the independent healthcare think tank The Nuffield Trust, highlights the potential staffing risks to healthcare and social care if migration from EU were to fall. Currently, almost 25% of hospital staff and 20% of health and social care staff were born outside the UK. The NHS and social care sectors already have significant staffing shortages and vacancies.  We have highlighted in previous blogs that the demand for  care will increase in the future, and there’s an estimated 100,000 vacancies for staff for the NHS in England alone.

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NHS up for sale… or already sold?

One of the key issues to arise in campaigning for this month’s UK General Election is the future of the NHS and the role that private companies, in particular US-based healthcare companies, might play in that future following Brexit.  Last week, the Labour leader Jeremy Corybn claimed papers he had obtained showed that the NHS was “up for sale”.  This has been denied by the Conservatives.

Figures show that private businesses already have a significant interest in NHS healthcare and services and were awarded almost £15 billion in NHS contracts in the last five years. Additionally, NHS mental health services are dominated by private equity firms which are now estimated to provide nearly 25% of NHS mental health residential places.  The Independent today highlights this issue and in particular the huge financial interests of three private equity firms Acadia, Cygnet and Elysium that have invested significantly in British public healthcare services, in particular in the psychiatric/mental health residential areas.

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On your marks!

Jeremy Hunt, when he held the position of Health & Social Care Secretary, published a letter to independent hospitals on 8 May 2018 urging them to “get their house in order and improve safety.”  One of the triggers for this was the Care Quality Commission (CQC) identifying that a third of independent hospitals “required improvement” as they demonstrated poor practice and unsafe care.

The Independent Healthcare Providers Network (IHPN) has now produced a Medical Practitioners Assurance Framework (2019) which has been described by Chair, Sir Bruce Keogh as the equivalent of firing “a starting gun …to improve care and confidence in the private sector.” A link to this framework is provided here

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Duty of candour prosecutions – is silence golden?

The statutory duty of candour has been hailed the greatest reform in patient rights in the modern era. It was brought in under the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 as amended, in response to the Mid Staffordshire Inquiry.

The regulation 20 duty of candour requirements are detailed and specific.  There is an overriding obligation to be open and transparent, coupled with clear requirements to notify patients and/or their families where there is any unintended or unexpected incident, whether this amounts to an error or not.  This notification must be prompt. Whilst the requirements are dependent upon the level of harm sustained, the underlying principles governing the provisions are focussed on ensuring that patients are kept properly informed and that errors and/or other unintended consequences are not ‘brushed under the carpet’.

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NHS pays firms £181m to care for patients with serious mental illnesses

Due to a severe shortage of NHS mental health beds in England, the NHS has been left with no option but to pay private institutions such as the Priory increased sums to provide residential rehabilitation each year.

“The NHS is paying private firms an “eye-watering” £181m a year to look after people with serious mental health problems in units often hundreds of miles from their homes.” – The Guardian.

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NHS Procurement Rules under attack

An online campaign survey has revealed huge support for an overhaul of the current procurement requirements within the NHS and to free the NHS from overly rigid procurement requirements.

A survey run by 38 Degrees asked “to what extent do you agree that the law should be changed so that contracts to run NHS services no longer have to be put up for auction?” In response to this, 89% expressed that they strongly agreed.

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NHS launches digital capacity tracker for care home places to cut ‘bed blocking’

The NHS has this week launched an online portal to assist NHS hospitals in identifying care home places for patients upon discharge. 

Elderly and infirm patients are often delayed in being discharged from hospital due to the lack of availability of a suitable care home for them to be discharged to.  Often, their care needs will have changed since their admission to hospital.  The fact that patients remain in hospital after they are medically fit for discharge – but cannot return to their previous home – places a strain on the NHS.  In 2018, the NHS estimated around 250,000 hospital beds days were taken up by patients well enough to be discharged but with no care home to go to. 

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