Category Archives: Nurses

An administration with no direction, no virtue, and no future.

The ministry of health has reversed it’s intention on nurses, and selling it’s outsourcing. Both recruitment and procurement are long term problems that are impossible to solve in a shirt time horizon. However, procurement could be so much more quickly solved. Its just that its politically impossible to outsource… Part of the reason for this is the thoughtless devolution 20 or so years ago. A health mutual is stronger when it is larger, and 4 dispensations rather than one makes for inefficiencies, particularly in procurement.

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The Observer reports Sunday 2nd June: on Plan to hire thousands of foreign nurses for NHS is axed

Target was politically difficult for a government committed to reducing net migration

The Guardian initially reported 2nd June: US wants access to NHS in post-Brexit deal, says Trump ally

Before president’s visit, Woody Johnson says every area of UK economy up for discussion

and then Francis Elliott the Times the following day (June 3rd) reports Jeremy Hunt apparently reversing his successor’s intention : NHS will never be part of US trade deal, says Jeremy Hunt

Jeremy Hunt has warned Donald Trump that the NHS will remain off-limits to American companies, whoever wins the Tory leadership race to become Britain’s next prime minister.

The foreign secretary became the second candidate to rule out allowing US firms access to NHS contracts in a post-Brexit trade deal after Woody Johnson, the US ambassador to the UK, said on Sunday that the “entire economy” would have to be “on the table” in any deal.

Pressed whether that included the NHS he said: “I would think so.” Access to NHS contracts and farming standards are the two most controversial elements of any future deal. Speaking before he left Washington Mr Trump said: “[We’re] going to the UK. I think it’ll be very important. It certainly will be very interesting. There’s a lot going on in the UK. And I’m sure it’s going to work out very well for them.

“As you know, they want to do trade with the United States, and I think there’s an opportunity for a very big trade deal at some point in the near future. And we’ll see how that works out.”

Matt Hancock, the health secretary, became the first of the Tory leadership candidates to insist that the NHS was off-limits yesterday…..

Drug Procurement scandalously profligate and inadequate…

The Health Services Procurement – inefficient and risky… Centralisation and management control is needed

Procurement in the NHS – next stop the courts.

Kimberly Hackett in the Nursing Times 8th May 2019: NHS to step up nurse recruitment overseas, says leaked report

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To paraphrase Spike Milligan: “I told you the Health Services were all ill”.

NHSreality as well as Spike told you it was going to get worse. Is it not ironic that in a country where we have depended on nurses, carers and doctors from overseas (usually less developed countries than ourselves) that we are now threatening not to allow them in, and especially not from Europe and the EEC, which means we may well get staff from less culturally affiliated countries, OR we have to export our elderly, OR we have to look after them with robotics! Personal continuity of care has died in the 4 health services, but many of us, if we can afford it, will pay for it.

In the last few weeks the shortage of GPs and poor access to the health care system applicable in your Post Code has become more evident. Rich areas like Horsham cannot attract GPs, partly because the price of property is so high, and poorer areas of the country cannot attract GPs because of the poor housing and schooling problems. Gainsborough surgery closed suddenly… (Connor Creaghan 29th May 2019 in the Lincolnshire Post)

Don’t believe it when the government says they are learning from their mistakes. They still have no “honest language” and they have no exit interviews. These are their main mistakes….

The whole idea of a mutualised health service is to care for those with the bad luck to have a serious illness or a physical / mental handicap. The latter do not often vote, and numbers don’t influence an election so they have been left behind, to the benefit of voters. Our Minister of health seems more concerned with innovation and Big Pharma than she is in boosting numbers of staff!

In a world market (English speaking) Nurses and Doctors have skills and are people who can move. The best way to keep them is to look after them, and to train a surplus.

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Meanwhile clinical acumen and skills, and organisational issues are in decline. Public health has been underinvested and now people are starting to suffer.

The cost of care is so great that we may end up exporting our elderly….

Nursing crisis extends all the time… Surgery, ICU, intensive care and now oncology and cancer care…

29th May 2019 BBC News: ‘Lessons learned’ over £24m Altrincham health hub failings

Sarah Page in the West Sussex county times 22nd Jan 2019: Shortage of GPs in Mid Sussex

and Martin Bagot on the Mirror 31st May reports that there are over half a million people who have had to change their GP.and Desperation recruitment from abroad (Philippines, India, Ireland and Australia are targets, but Bangladesh and Pakistan may be the reality)

BBC News 21st May: ‘Broken’ care system for most vulnerable

on 21st May ITV reported that there were not enough nurses and doctors to meet demand  and the implication of their report is that there won’t be in the foreseeable future.

The Government is in denial and Nicola Blackwood in a speech to the ABPI opined: “We are going to have one of the most exciting health innovation systems in the world.” It certainly will be different for those who fall foul of it…

Thank Goodness one health Trust has agreed to actually pay nursing trainees! Cornwall’s Megan Ford on 14th May in The Nursing Times.

The Yorkshire Post: Scandal of the growing wait for a GP appointment. (YP 11th May 2019)

Meka Beresford and Ollie Cole in Human Rights News report 21st March 2019: NHS staff shortages could double without radical action.

Nick Triggle admits through the BBC news 21st March that there is “No chance of training enough staff”.

BBC News 29th May: Glan Clwyd Hospital told to improve orthopaedic care by coroner

BBC News 31st May 2019: Llwynhendy TB outbreak: Family ‘disgusted’ after death

And Matthew Parris in 2018 asked “How does anyone know how to navigate the maze of our second-rate NHS: ( You can download the whole article below)

The Maze of the NHS – Matthew Parris

Just cry at the bribery, and the Death of the Goose that used to lay the golden eggs that used to make the Health Service(s) so efficient, and the envy of the world.

Say goodbye to continuity of care.

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Nursing crisis extends all the time… Surgery, ICU, intensive care and now oncology and cancer care…

We have as a nation, rationed the training numbers of nurses for decades. Now that Brexit means more are leaving than joining the profession, and we are obviously reluctant to accept more overseas staff, the crisis is on us, and the dissonances of the politicians, who want both Brexit and more Health Service staff are apparent. Export our elderly for their cancer and other care?

Dennis Campbell in The Guardian 19th February 2019 reports: Record numbers of NHS staff quitting due to long hours  – Number of nurses leaving the service almost triples – at a time of more than 40,000 nursing vacancies

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Today 19th May 2019 Andrew Gregory in the Sunday Times reports: SOS call for 1,500 cancer nurses – A shortage of specialist hospital staff is having a ‘devastating’ effect, including cancellation of life-saving chemotherapy

Cancer patients face “life-threatening” delays to treatment because of a shortage of specialist nurses.

Some are told on the morning of hospital appointments not to attend because there are not enough staff. Others have chemotherapy cancelled repeatedly.

The NHS has begun a global recruitment drive for tens of thousands of nurses, but the shortages are having a devastating impact, Britain’s most senior nurse and cancer charities say.

NHS providers needed 1,411 specialist cancer nurses in the six months to September 2018, an analysis by the Royal College of Nursing shows. That figure was up 16% on the 1,213 vacancies for the same six-month period the year before.

The statistics, from NHS Digital, count advertised posts. NHS Digital says they are likely to understate the shortage because one advert can be used to fill many vacancies and not all hospitals advertise on the NHS Jobs website.

Nurses breaking – NHS spends millions on agency staff because nursing is an increasingly unrewarding job

The richer areas of the country, with good schools, are the areas most doctors want to work in. Now the bill for locums will be much higher in the unpopular areas than the popular (wealthy) ones. So a perverse outcome of the mismanagement of manpower, people, and politics, is that those areas which need the most have to spend more of their emergency budgets on locums. Jenni Russell needs to be reminded that there is no NHS, and that devolution has failed.

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Jenni Russell opines in the Times 9th May 2019: We’ve pushed our nurses to breaking point. NHS spends millions on agency staff because nursing is an increasingly unrewarding job

ike many others, I’ve had a recent and alarming encounter with the NHS’s critical shortage of nurses. A relation came out of hospital with a serious condition which required constant monitoring by the hospital team.

Inside, their care had been exemplary. Once outside, and with worrying symptoms, it was as if a steel door had been slammed. No amount of hammering on it made any difference. Every number given for nursing or follow-up advice rang out. Nobody responded to the voice messages we were told to leave. The switchboard said it wasn’t their responsibility to find an actual human being, and put us through to more machines.

It took 11 days of calling, and the intervention of the chief executive’s office, before anyone rang back to advise. In between, quite apart from the absence of a nurse to offer guidance, everything had indeed fallen into a hole, with none of the critical tests or appointments listed on the discharge letter scheduled. “We don’t have time to listen to the messages. Phones ring out on the wards all over this hospital,” one staff member told me, apologetically. Efficiency can’t be assumed in an overloaded system. England’s nursing crisis, with 42,000 unfilled posts, hospitals desperate for staff, and hundreds of millions being spent on expensive agency nurses instead, is neither unpredictable nor an accident. It is entirely the government’s fault.

Beyond Brexit, three key decisions over the past nine years have worsened the current and future shortfalls. The most recent, misguided and blithely foolish of these was the decision by Jeremy Hunt and George Osborne in 2015 to remove bursaries and free tuition for nursing students and replace them with loans from 2017.

They were widely warned not to do anything so stupid. The NHS pay review board, the Royal College of Nursing, and the Labour Party were all aghast, pointing out that forcing low-paid nurses into about £50,000 of student debt would be a huge disincentive. Far from it, the government insisted. The £1 billion saved by the Treasury would fund more training, and produce more nurses.

Two years in and the proof is there: the critics were right and the government wrong. Applications for nursing have fallen off a cliff, down a third since 2016. The fall is steepest among mature students, traditionally the majority of new nurses; women with families or life experience who want a new career. Those are down 40 per cent.

The numbers accepted on nursing courses have also gone into reverse, spinning down from a peak of 22,000 to just over 20,000 in 2018. It means the shortage will only worsen in the future. The government’s strategy has been a disaster.

Whatever the arguments for fees and loans in principle, it makes no sense to apply these to nurses. University students have short terms and predictable schedules, allowing them part-time jobs. Nursing students work for 45 weeks, and spend half their course contributing to the NHS by working in hospitals or the community, often in long, unsocial shifts. They can’t cut their debt by working on the side. Nor do they have the earning potential of other graduates. For the vast majority, nursing will be a steady job but not a lucrative one.

This makes the debt both a real burden to nurses and an illusory saving to the Treasury. Official figures show that eventually 45 per cent of nurses’ loans will be written off. Almost half the claimed savings from the change are in fact a pretence.

Bursary abolition compounded two other major errors. In 2010 one of the first coalition decisions was to cut university nurse training places by 12 per cent within two years. Had they retained Labour’s quota, thousands more nurses would be available now. In 2013 they cut the potential supply further by deciding nursing should be graduate-only. That has eliminated swathes of caring people who are less academic. The belated attempts to make up for that by creating nursing apprenticeships and associates have been pitiful and little-noticed; last year, fewer than a thousand were taken on.

This is a crisis that will hit every one of us when we or our families need care. The sticking-plaster solution, increasing our raids on other nations’ nurses by another 5,000 a year, will only meet part of the shortage, and raises the question of how we can defend making other countries pay for the training we refuse to fund ourselves.

The government has to change tack. Its new NHS long-term plan relies on nurses it doesn’t have. A third are due to retire within five years. Meanwhile, staff gaps are creating a vicious circle where exhausted nurses quit the NHS, forcing hospitals to fill rotas with agency staff. These are inevitably less efficient, and less committed, as they aren’t familiar with the computers, systems or patients. The cost is another ludicrous burden. Last year the Open University reported that replacing agency nurses with full-time ones would save £560 million a year.

The Royal College of Nursing has a practical solution to increase numbers sharply, with the government either paying nurses’ fees and giving means-tested grants, or writing off loans in return for ten years’ work in the NHS. Either gives a net saving of almost £1 billion per year group once the cost of agency nursing and existing loan write-offs are added in. Without action, the staffing gap will be 48,000 by 2023. The government must listen, learn and reverse its policy, now.

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Wales is bust, and cannot pay for its citizens care. Devolution has failed. This is the thin end of a very large wedge..

The service quality is falling, and staff are leaving

Across the four health services staff are demoralised and leaving. Bullying is endemic, and Scotland and its midwives are at least is trying to address this more actively.  Staff numbers are at their lowest, and Brexit will only make this worse. Most pregnancies are now to women over 30, and such a large proportion are “high risk” that midwifery led units are probably destined for extinction…. The NHS England site mouths platitudes like “participation is important”… for NHS staff, but those employed no longer believe it.

Bullying and Maternity Care Plans in Scotland (Nursing Times 15th April)

Laura Donnelly in in the Telegraph 27th March 2019: The number of NHS staff quitting over long hours trebles in the last 6 years.

Jane Dalton reports for the Independent today : One in four wards has dangerously low numbers of nurses..

Meka Beresford and Oli Cole report in RightsInfo: NHS Staff Shortages Could Double Without ‘Radical Action’

The NHS in England could be short of 70,000 nurses and 7,000 GPs within five years unless urgent action is taken to address a growing staffing crisis, according to analysis by three leading health think tanks.

A report by The Nuffield Trust, Health Foundation and King’s Fund warns that existing nursing shortages could double and the shortfall of family doctors treble, without radical action.

The analysis says that urgent measures must be adopted in a new NHS workforce strategy to prevent the shortages from worsening, with a combination of international recruitment, student grants and innovation needed…..

The NHSExecutive website reports 8th April: Widening pay gap between private and NHS staff ‘risks damaging the health service beyond repair’

how long to numbers recovery? Much longer for morale recovery!

The health services are all broken. The exodus of staff when the opportunity arises and the cynical disillusion with system and management is evident. The doctors who “go over to the dark side” (management) are looked on with suspicion by colleagues. GP commissioners are derided, ad they have to ration health care without using the word. Taxpayers in poorer regions (such as Wales) get inferior care, lack of choice and poorer outcomes….. It is getting to the point where two tiers of health service are available: National or Private. A few more exit interviews would help…

Peter Russell for Medscape reports 12th Feb 2019: NHS Staffing Shortfalls ‘Threaten Long-Term Plan’

NHS staff numbers in England have failed to keep pace with demand, according to a report by an independent health charity.

In its third annual review of staffing levels, the Health Foundation highlighted specific problems in primary and community care, nursing, and mental health….

This is not the first time: Nicky Broyd on the 15th November 2018: Staff Shortages Threaten NHS Long-term Plan: Report – Medscape

According to the first of two reports by The King’s Fund, the Health Foundation and the Nuffield Trust, staff shortages in the NHS in England now present a greater threat to health services than funding.

The group of leading health thinktank experts predicts an increase in NHS staff shortages from over 100,000 at present to almost 250,000 by 2030 and warns the figure could be over 350,000 if the NHS continues to lose staff, fails to adequately fund training places and can’t attract workers from abroad.

and 4 days ago Peter Russell: NHS Staffing ‘a Make-or-Break’ Issue, Says Report – Medscape

Sign the Brexit petition – and have more wealth for better health

The Stop Brexit petition

The 4 UK health services need more staff: not less. The 4 UK health services need more money and new infrastructure, not less. Health is so closely related to wealth that in population terms they are virtually indistinguishable. There are only a few poor countries whose life expectancy has exceeded the richer countries, but this is mainly due to politics, warmongering, and subject populations in the richer ones. (Nepal has a better life expectancy than Russia, Venezuela and Zimbabwe, despite no natural resources, and with only tourism to bring in foreign currency). The threat from Brexit is closing fast, and the indicative voting from most recent polls is that there could well be a majority for remaining in the EU now. We will have fewer people, especially carers, less money, and poorer health after Brexit.

Informed consent is better than uninformed consent. The opinions of rich, self employed businessmen, and media owning magnates, are not important except that they have informed the first vote with false assertions. People are wiser now and more informed, which makes the peoples vote petition that much more important. This may be our last chance….

We all know that many elderly people are not “on line” and will not write. We all know the petition is self selecting for those with e ability. BUT this does not negate the need for another vote. Those of us who voted to remain will be much more accepting of another Brexit vote and the country will unite whatever the result. If Brexiteers ask for a third, fourth and fifth referendum, then this is the price we have to pay for Mr Cameron’s idiotic decision to replace representative democracy with a peoples democracy for a single issue. We can all make mistakes…

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The Stop Brexit petition is at

https://petition.parliament.uk/petitions/226509

27th November 2018: Seeking informed consent on Brexit

26 Jan 2019 On the Brexit slipway…. There is a problem: there may be too many to save, all at once.

23 December 2018: The Brexit deadline and the Health Services planning – standards and services are going to get worse..

8th December 2018: BREXIT will negatively impact the NHS and health services regardless of a deal, a new report has revealed, with devolved nations set to suffer the most.

August 2018: Patients should not be looking forward to a “hard” Brexit. Make sure you have a good stock of medications..

and Successive increases in the health budgets in Wales have not helped….. Brexit will make it worse… We all seem agreed, so why not change direction?

and Doctors warn “Brexit bad for health”, as calls grow for new EU vote.

Beware the tyranny of the mob. Brexit will harm those suffering from rare diseases.

The Commonwealth Fund compares health systems. Unreality of MPs. ..

Health is closely correlated to Wealth – If you are poor you get no choice (Wales), and live a shorter life, but if you are rich, or born abroad, you live longer and you do get choice! So much for equity…

Just for Health – “MPs must be brave and tell us we were wrong” December 29 2018

This made me laugh, but its sick.

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