Orthopaedics at Stanmore under threat. Managed decline… A Two tier system seems inevitable now..

Progression towards “Meltdown” is going well. Faster and faster as more hamster doctors on their wheels break down or escape. Even Orthopaedics at Stanmore under threat. A Two or three tier system seems inevitable now…. either by default (Private “selective” or State “Universal”) or by design (Wales). That is now the choice for politicians..

Dennis Campbell in The Guardian reports 9th October 2015: NHS hospitals’ £930m overspend prompts calls for urgent funding

Fears grow that hospitals will run out of money and care standards will deteriorate unless chancellor injects more cash

Richard Vise on the same day opines: New NHS regulator has impossible task in face of spiralling funding crisis

James Meikle on 29th October reports: NHS orthopaedic hospitals warn of funding crisis due to payment changes

Royal National Orthopaedic hospital says it could face 25% drop in income, with other hospitals fearing impact on patient care

Specialist NHS orthopaedic hospitals in England fear huge drops in funding because of changes to the payments they receive for treating patients.

The Royal National Orthopaedic hospital (RNOH) in Stanmore, north London, has warned that it will lose £15.2m in income during 2016-17 under draft proposals, more than a quarter of what it received last year for inpatients on the tariffs then in force.

The changes would also mean an 11% fall in the hospital’s overall turnover, leading its financial experts to warn of an impending deficit at the flagship hospital, where one in five of the UK’s orthopaedic surgeons are trained.

The Robert Jones and Agnes Hunt Orthopaedic hospital (RJAH) in Oswestry, Shropshire, has calculated it will lose £8m, or 16% of its expected tariff-related income this year. The hospital’s entire budget last year was £94m.

Although the Royal Orthopaedic hospital in Birmingham has not published any estimates on how the changes will affect its operations, it is concerned by the impact they could have on patient care.

The hospitals are among the big losers from the proposed new system, because many trusts with a broader mix of patients can balance significant reductions in payments for orthopaedics by increasing numbers of patients whose treatment attracts higher fees.

Private hospitals that perform many planned hip and knee operations for the NHS will also see their state-funded income fall.

NHS hospitals specialising in women’s health will be among those to benefit.

Monitor, the NHS financial regulator, insists the proposed tariffs are not intended to be final prices, saying they may rise by as much as 30%.

The changes across all NHS payments are said to be necessary “to incentivise best practice (and) efficient and accessible delivery of care to make sure that NHS funding goes as far as it can for patients”.

John Grinnell, the acting chief executive at the RJAH, said: “Monitor’s own impact assessment indicates that RJAH and other standalone orthopaedic hospitals stand to suffer the greatest impact of the tariff proposals.

“Whilst this is clearly of concern, we continue to work with Monitor and NHS England with a view to finding a long-term and sustainable solution to the funding of orthopaedic care.”

Dr Victor Chua of healthcare analysts Mansfield Advisers said the figures at RNOH exceeded even his forecasts. “If this happens, RNOH as an independent trust is probably finished. They would have to merge with another trust, probably Imperial. But these orthopaedic hospitals have been centres of excellence for 50 years,” he said.

“They have a long proud history of independence and innovation. They have great training programmes, attracting fellowship doctors from all over the world.

“For the NHS, this is the lesser of two evils. It needs to save money. It will be saving money on the NHS activity it contracts to the private sector, mainly for hip and knee surgery. But for the private hospitals it will be incremental revenue and it will be very hard for them to give it up.”

Chua added: “In general the NHS has managed to achieve a price cut and overall not caused too many problems for NHS contractors.”

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This entry was posted in A Personal View, Commissioning, Political Representatives and activists, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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