More than 10 avoidable deaths a day linked to A&E overcrowding : Express.

Problems can occur in any organisations and situations and if they are not attended to outcomes will be affected. In some instances the problems will create blockages in processes thereby, more than likely, the outcomes will related to shortages. In others the problems could produce outcomes relating to over supply.

In manufacturing and industry these outcomes could be dealt with by changing production systems, reallocating employees, increasing or decreasing production and even stop production over a period. All these can be considered as the products being produced are inanimate objects. But when the outcomes, as in health and social care are relative to human life other methods need to be considered and implemented.

More money being available is one such consideration and for a time this may solve the problem, but if the root cause or causes are not being identified, then the problems will continue to reappear and more often with a greater intensity.

The problems could be not having the right staff in the right place at the right time, system deficiencies, lack of effective management or supervision or the wrong type. In time all of the these problems can be overcome, but the biggest problem is identifying the problem or problems in the first place. In this does the system even allow for this identification to take place and if it does do those in power or control of the system consider the findings and or act accordingly.

For in health and social care much of what is brought to bear on both health and social care is governed by political motives.

Funding for both is mainly in the hands of who is in power at any particular time and what is their own political outcomes, which may or may not be beneficial to health, social care and those in receipt of the services.

All that being said there are some savings or changes which could be found, however, these will most likely not be sufficient to solve the problems.

What should solve the problems is that all persons, organisations and political masters to work together to formulate a common aim that everyone could take ownership of, in other words ‘co-production’.

Unfortunately, those in power do not care for co-production as the resultant aim is owned by the co-production team and not those with the purse strings.

New NHS Alliance calls for community pharmacy ‘forward view’ – NHS Alliance : NHS Alliance

A new paper, published today by New NHS Alliance: “Supporting the Development of Community Pharmacy Practice within Primary Care” argues that community pharmacy in England, with approaching 11,700 pharmacies, represents health on the high street and within our communities. The NHS needs clinical pharmacists within general practice, urgent care and out of hours, nursing homes… Read More

Source: New NHS Alliance calls for community pharmacy ‘forward view’ – NHS Alliance : NHS Alliance

NHS Alliance publishes new report, Making Time in General Practice

Original post from NHS Alliance


NHSA Catalyst

NHS Alliance launches delivery arm

NHS Alliance provides a unique service for members, NHSA Catalyst. Building on its considerable experience and expertise in delivering project work for policy makers, and developing cutting edge thinking and analysis on the national stage, as well as for local health and social care, it is now taking this a stage further. NHS Alliance has always been about thinking, but its priority now is to help its members translate ideas into best practice on the ground. Recognising the lack of time and space to work ideas through coupled with a reluctance to bring in external consultants who may lack the practical experience of working on the front line, NHSA Catalyst will provide thinking and doing teams at an affordable price.

NHSA Catalyst will build on the Alliance’s strong local and national networks to build teams that can work with its members to develop and implement solutions that transform care for patients.  It will source bespoke clinical and managerial leaders, working both within the NHS and independently, who can deliver expertise and offer a fresh perspective on the problems they face in their own day-to-day work.

NHSA Catalyst has teamed up with a number of delivery partners to broaden its offering and enable it to scale up if necessary. Specialist health communications consultancy, Salix & Co, will provide strategic and tactical communications delivery, while an emerging strategic partnership between NHS Alliance and Capita, means Catalyst can draw upon the resources of the largest and best outsourcing and consultancy when necessary.


The NHSA Catalyst offering:

  • Supporting practices to work together and exploring the benefits of working at scale, from simply managing office functions in a more efficient way, through to new ways of delivering services, rising to the challenge of extended hours care, and building new relationships across an extended primary care team and the wider community.
  • Building relationships between primary care practitioners and the CCG – with a particular focus on general practice and community pharmacy. Supporting CCGs to manage their local market for care by enabling local primary care to rise to the new challenges of delivering care in better ways.
  • Building collaborations between local NHS and community-based providers of wellbeing services to reduce the demand on the NHS. In every locality there are community-based organisations such as housing providers that have an ambition to keep people healthy, promote recovery, support those with LTCs to live well in the community and reduce demand on GPs and A&E. NHS Alliance has knowledge of the types of work they’re doing and can support your efforts to collaborate with local partners to build healthy communities.
  • Ensuring that the patient’s voice is central to the way we change and develop health and social care. Our Patient Powered Improvement (PPI) Network connects a wide range of practitioners who are at the forefront of creating care where decisions between the patient and the clinician are shared, and patients are supported to identify what they need to improve their lives rather that moves way beyond a medical intervention.
  • Sourcing the best clinical experts to support local changes.  NHS Alliance is a network of clinical leaders, both experienced and emerging, who are interested in taking time out to understand key challenges and share their expertise.
  • Thinking through problems with you and highlighting the best of local practice. NHS Alliance is regularly asked to work with others to explore how primary care can change and develop as part of an evolving health and social care system – transforming care at a time of increasing demands and standstill budgets.
  • Development of strategic and tactical communications strategies. Whether to facilitate internal engagement or develop behavioural change campaigns, insight, intelligence and sound thinking will support programmes of work to help its members reach the right people with the right message at the right time through the right channel.


Examples of recent project work includes:

  • Creating a team of facilitators to support practices to work together across London: Eg, a team of NHS Alliance leaders with different expertise and experience are working with groups of practices and their CCGs to develop their capacity to work together as providers of extended primary care.  It is working with the Office of London CCGs to support pilot demonstration projects in a number of areas across London.
  • Supporting innovation in primary care – PM Challenge Fund bids: Eg, it worked with and supported a number of members in developing their bids for the PM’s Challenge Fund and is now a direct partner in two of the selected projects.
  • Running workshops across healthcare systems to develop primary care: Eg, it is supporting a CCG and its practices to develop a collective view about how to work together, agreeing the shape and scope for new practices to work together across local natural communities.
  • Sourcing clinical leaders to act as independent experts on tendering or procurement exercises: Eg, we identified a medical director of an out of hours organisation to support a tender exercise in another part of the Country, reviewing applications remotely over the internet as well as joining others in the local team to review tenders face to face.
  • Understanding the impact of digital exclusion: Eg, supporting NHS England to help them understand what the impact might be for the losers in the new digital world and identify areas of best practice.

 The Report  ……………………’


NHS funding: will patients be forced to pay for some care?

Original post from The Guardian


With a predicted deficit of around £2bn, if we want to preserve a health service free at the point of need, we must accept radical thinking on funding

A less politically toxic alternative than charging for services would be for Jeremy Hunt to reverse his previous opposition to a tax on sugary drinks. Photograph: Alamy
A less politically toxic alternative than charging for services would be for Jeremy Hunt to reverse his previous opposition to a tax on sugary drinks. Photograph: Alamy

With NHS providers on track to run up deficits in the region of £2bn this year, the spectre of patients paying for more services again looms over the NHS.

Last year’s combined deficit of £822m across the provider sector hid an even more serious truth: add in the extra £250m from the Treasury and another £650m transferred from capital budgets and the underlying deficit was nearer £1.7bn.

With little prospect of finding the required £22bn of efficiencies, and the Health Foundation and King’s Fund pressing for even more money on top of the additional £8bn already promised by the chancellor, George Osborne, one way or another we are going to have to find other ways to pay.

We can thank the Germans for all but killing off one idea that used to be touted – paying to see your GP. In 2004 Germany introduced a €10 quarterly payment but the Bundestag unanimously scrapped it eight years later. Predictably, the cost of administration almost outweighed the money collected, and there is some evidence that it deterred people on low incomes from seeing their doctor. The strongest argument against charging to see a GP here is that it would destroy the best thing about the NHS – that it is free at the point of need. But there are other ways the edges of that principle could be blurred.

The room for manoeuvre comes at the intersection of three healthcare trends – integration of health and social care budgets, greater use of personal health budgets, and the shift of care from hospitals to homes.

Eight areas, such as Barnsley and Luton, are in the first wave of the integrated personal commissioning programme, leading the way towards integrated health and social care personal budgets. Personal budgets in social care have demonstrated their power to build services round the client, give people more control over their lives and save money. Their use for NHS services has huge potential to drive new care pathways while reducing emergency admissions and keeping patients at home. But care at home also provides room to start charging for services at the boundary between health and social care.

A more radical plan, with the Dilnot reforms aimed at capping care costs now stalled following the government’s postponement of the promised changes, would be for ministers to rethink the whole proposal and look at compulsory insurance for social care, similar to that introduced in Japan. Labour leadership candidate Andy Burnham has tentatively backed the idea.


While government proposals for anything that smacked of a new tax would face substantial opposition from its backbenchers, the haemorrhaging of money from social care itself carries big political risks. How long before nursing homes are hit by their own Winterbourne View-type scandal? And the “national living wage” plan seriously exacerbates the funding pressures.

A less politically toxic alternative would be for Jeremy Hunt to reverse his previous opposition to a tax on sugary drinks. Last year Mexico – which has one of the highest obesity rates in the world – became the first country to impose such a tax, and in May the life sciences minister, George Freeman, became the first member of the government to back a tax on sugar. Public Health England is looking at the issue.

With rotten teeth being the most common reason for young children to be admitted to hospital, a sugar tax could cut demand for NHS services quickly as well as provide potential revenue. With a radical chancellor winning plaudits for bold moves, perhaps a sugar tax could be seen in the same context as the increase in the minimum wage announced in the emergency budget; bringing about change by shifting costs away from government.

Something has to give. The present financial targets are a fantasy. Either through taxes or charges we will have to pay more in this parliament.  ………………’


High rate of healthcare visits before suicide attempts

Original post from Medical News Today 


Most people who attempt suicide make some type of healthcare visit in the weeks or months before the attempt, reports a study in the May issue of Medical Care, published by Wolters Kluwer.

The study also identifies racial/ethnic differences that may help to target suicide prevention efforts in the doctor’s office and other health care settings. The lead author was Brian K. Ahmedani, PhD, LMSW, of Henry Ford Health System, Detroit, Mich.

Health Visits May Provide Chances for Suicide Prevention

Using data from the NIMH-funded Mental Health Research Network, the researchers identified nearly 22,400 individuals who made suicide attempts between 2009 and 2011. They analyzed healthcare visits before the attempt, with an eye on the possibilities for identifying people at risk for suicide.

The study focused on racial/ethnic differences in the types and timing of visits, including any documented mental health issues or substance abuse. Information on race/ethnicity was available for 78 percent of patients.

Overall, 38 percent of patients made some type of healthcare visit within a week before attempting suicide. The visit came within a month before the suicide attempt in 64 percent of patients, and within a year in nearly 95 percent. The percentage of visits with mental health or substance abuse diagnoses was about 25 percent within a week, 44 percent within a month, and 73 percent within a year before the attempt.

The study found significant racial/ethnic differences: 41 percent of white patients made any type of health visit within a week before the suicide attempt, compared to 35 percent for those in other groups. Nearly 27 percent of white patients made a mental health visit in the preceding week, compared to less than 20 percent for most other racial/ethnic groups.

Asian-Americans were the least likely to make any type of visit within a year before attempting suicide. Hawaiian/Pacific Islanders had the highest rate of hospital admissions and emergency department visits before a suicide attempt, but the lowest rate of mental health or substance abuse diagnoses.

“Overall, visits were most common in primary care and outpatient general medical settings,” Dr. Ahmedani and coauthors write. Rates of visits for mental health specialty care ranged from nearly 60 percent for white to 40 percent for Asian patients.

More than one million people attempt suicide each year in the United States. The recently published National Strategy for Suicide Prevention concluded that healthcare is one of the best places to prevent suicide.

“This research provides essential information to aid suicide prevention efforts in health care systems,” according to Dr. Ahmedani and coauthors. They discuss the implications for targeting suicide prevention efforts by race/ethnicity – including the need for “culturally competent mental illness detection and treatment” in minority groups.

Most previous prevention efforts have focused on emergency and mental health settings, rather than doctor’s offices and other primary care settings, the researchers note. They conclude, “This study supports the promotion of suicide prevention within general outpatient settings, where most people visit before suicide attempt.”


Article: “Racial/Ethnic Differences in Health Care Visits Made Before Suicide Attempt Across the United States” (doi: 10.1097/MLR.0000000000000335)

Wolters Kluwer Health  ……….’

Affordable How?

An interesting post.

Here in the UK our NHS is free at point of delivery for those eligible , with costs being borne from Central Government funds from various forms of taxation from the UK population and businesses.

However, due to the ever increasing costs required by the NHS, some, over the years, have suggested that some treatments should be paid directly by the recipients who would, most likely, have to obtain forms of medical insurance to cover their costs.
By viewing this post, it is more evident that our current means of funding the NHS needs to be maintained.