Instead of talking therapies, lets shock them: Rise in electric therapy for treating mentally ill – Driving staff away.

The Health Services of the UK are understaffed in many (all?) areas. Nurses, Psychologists, Counsellors, Radiographers are considering their positions… Some may move abroad.. Rationing by deliberate undercapacity and restricting their income drives staff into the private world, or abroad.

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Kat Kay reports in The Times 19th April 2017: Rise in electric therapy for treating mentally ill

The NHS is increasingly turning to electroconvulsive therapy to treat patients with serious mental health problems.

In 2015-16, 22,600 ECT treatments were carried out, a rise of 11 per cent from the 20,400 in 2012-13. The number of patients treated also rose — to more than 2,200 — as did the average number of treatments per patient, from 9.6 in 2012-13 to 10.1 in 2015-16. The data, obtained by The Guardian, covers 44 NHS health trusts in England.

“I think [ECT] should be on the increase because it has been underused for years,” Tim Oakley, of the ECT Accreditation Service and a clinical director at the Northumberland, Tyne and Wear NHS trust, told the newspaper. “There are some patients who would respond very well to ECT who perhaps don’t get it as quickly as they should or don’t get it at all for various reasons. In terms of getting people better, particularly for depression where everything else fails, it is still the best treatment.”

A 2014/15 survey of patients found that 91.5 per cent improved after treatment and 1.7 per cent became worse. However, Mind, the mental health charity, warns that the therapy, which involves passing electricity through the brain, can have side effects including memory loss, poor concentration and dizziness. The National Institute for Health and Care Excellence advises that it should be used as a last resort.

Nurses vote on strike action after NHS pay cuts leave staff ‘struggling to make ends meet’ – The Independent

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Vaccine credited with HPV virus reduction in Scotland

Without vaccinating boys there is not enough herd immunity. Somehow I feel this report may be rubbish, but on the surface it seems good news. We have made the same mistake as for rubella (German measles) and tried to save money by only vaccinating females.

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BBC News reports good news from Scotland 5th April 2017?: Vaccine credited with HPV virus reduction in Scotland

A campaign to vaccinate girls against a cancer-causing sexually transmitted infection has led to a dramatic drop in reported cases.

Researchers have found a 90% fall in levels of the human papilloma virus (HPV) in Scottish women since the vaccine was made available in 2008.

HPV virus types are thought to account for about 90% of cervical cancers.

Scientists hope the drop in HPV cases will lead to a significant drop in future cervical cancer cases.

The researchers, led by senior epidemiologist Dr Kevin Pollock at Health Protection Scotland, said they hoped to see a decrease in new diagnoses within a year.

He told BBC Radio Scotland: “The two HPV types we were vaccinating against – HPV 16 and HPV 18 – cause about 70% to 80% of cervical cancers within Scotland but the vaccine has exceeded our expectations because it appears to have knocked out another three high-risk HPV types which cause about 10% of cervical cancers.

“So we do forecast within the next few years a 90% reduction in cervical cancer within Scotland.”

Researchers compared the cervical screening and vaccination records of women born in 1995, who had been vaccinated as teenagers, with those from unvaccinated women born between 1989 and 1990.

They found just 0.5% of women from the 1995 group tested positive for the virus, compared with 21.4% of women born before 1990.

The study also showed evidence that the vaccine protected against three other high-risk HPV genotypes involved in the development of cervical cancer.

‘Significant impact’

The research will be presented to the Microbiology Society’s annual conference in Edinburgh on Wednesday by Dr Kate Cuschieri, director of the Scottish HPV Reference Lab.

She said: “These new findings indicate that the positive impact of the HPV vaccine may be even greater than we initially thought.

“Collectively, these data demonstrate the significant and continued benefits of the HPV vaccination programme in Scotland, which has achieved a consistent and high uptake of around 90% in 12 to 13-year-old girls.”

Dr Pollock added: “The very high uptake of the HPV vaccine is strongly associated with these massive reductions in high-risk HPV types that are known to cause approximately 90% of cervical cancer in Scottish women.”

He said the virus was also known to cause a number of other cancers, including vulvovaginal, anal and a subset of head and neck cancers.

“These results suggest that this vaccine will also have a significant impact on these cancers in the years ahead”, he said.

The research, which was funded by the Scottish government, looked at samples from more than 20,000 women, making it one of the largest population-based studies on the impact of the vaccine.

There were 388 new cases of cervical cancer in Scotland in 2014.

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When will public anger over the NHS reach a political tipping point? More NHS mental health patients treated privately…

It seems we are a long way from the tipping point whilst “most” services are up and running for the articulate and coherent. NHSreality has opined that “civil unrest” is not far below the surface, but whilst the Regional Health services can hoodwink their populations, and whilst citizens (mainly healthy) can remain in denial as their elderly and mentally infirm get a “rough deal”, and whilst the media and press, including Toynbee, fail to grasp that “overt rationing” is a pragmatic necessity, post coded and covert rationing will drive more and more into private care, and result in a two tier service. Harry may have had “counselling” but I expect it was private, unlimited, and done by a fully trained psychology counsellor. In the Health service it would be limited to six sessions, provided by a Nurse Counsellor who has done an extra short course, and terminated when the allowed sessions expired.

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Polly Toynbee in the Guardian 13th April asks: When will public anger over the NHS reach a political tipping point?

here is an ebb and flow in reporting on the NHS as Trump, Syria and Brexit dominate front pages. But the pressure-cooker state of the entire service still worsens. This morning’s latest figures are just a snapshot of deterioration – but every target is missed: for A&E, ambulance response times, for treating psychosis within a week, for cancer waiting times, blocked beds and diagnostic tests.

“Demand” is rising, the government says, as if serious illness were a choice, though the pressure comes from well-predicted, rapidly increasing numbers of old, sick people: this February’s A&E figures are, as ever, better than deepest winter January, but worse than February last year, as this crisis ratchets up.

Major A&E centres are treating 81.2% of patients within four hours, against a target of 95%, which used to be hit before 2010. The government likes to blame frivolous users of A&E, but those are easily triaged to on-site GPs. Serious delays are because of very ill people needing to be admitted with no empty beds: bed occupancy is at dangerous levels, as Chris Hopson of NHS providers warns, where doctors often have to decide “one in, one out”, discharging those who still need more care too early.

Take the temperature in virtually every part of the NHS and the wonder is how the heroically overstretched staff keep the wheels on the trolley. Take this week alone: the Royal College of Physicians says 84% of doctors have to cope with staff shortages and gaps in rotas.

GPs? Two years after a government promise of 5,000 more GPs, numbers are still falling. They dropped by 400 just in the last three months of last year: as doctors find the workload unmanageable some escape abroad, take earlier retirement or become locums. Too few new doctors want the burden of running a GP partnership, so 92 practices closed last year, tipping hundreds of thousands more patients on to already overloaded neighbouring GP lists.

Today the Royal College of Nursing, traditionally most reluctant of unions to take action, starts consulting its members on whether to hold a strike ballot. But with public sector pay frozen yet again at 1%, when inflation will shortly hit 3%, nurses are departing – as are doctors – for less stressful, better-paid work. Recruitment from the EU is plummeting, as predicted…..

…This is the dismal background to the reorganisation that the head of NHS England, Simon Stevens, is attempting, almost undercover. His state-of-play review of his five-year forward plan passed hardly noticed, announcing a first tranche of England’s 44 STPs, (sustainability and transformation plans) to reconnect local services fragmented by the Lansley 2012 act.

Most observers think it the right way to go, putting the NHS and social care under a united structure with one finance hub, ending destructive and expensive competition and tendering of services. But hardly anyone thinks this can be done with no new money: every STP calls for capital for new beds and units. Virtually all involve closures and mergers stirring a local political outcry.

Jeremy Hunt, who always presented himself as the patient’s ally, rooting out poor quality, wallowing in the Labour disaster at Mid-Staffs, has fallen uncharacteristically quiet. He has nothing much to say about patient safety in A&Es or elderly patients turned out of beds too soon. Not even deaths on trolleys in A&E corridors in Worcester roused his usual righteous ire.

Concern about the NHS has risen high in recent polling: what no one knows is when public anger will reach a political tipping point. Theresa May and Philip Hammond stay iron-clad adamant: all this is NHS shroud-waving and there will be no more money. Lack of any opposition helps, but can they really tough it out where Margaret Thatcher, John Major and Tony Blair all bent in the face of NHS crises?

Chris Smyth in the Times 18th April reports: Sick children ‘denied drugs to save money’ and Spendthrift NHS regions face big cuts. This is the reality of todays health services, and which/what quality of service depends on which. post-code you live in. You cannot plan for the deficit, because the “priorities” change from year to year.

George Greenwood for BBC 18th April: More NHS mental health patients treated privately

 

Nurses consider whether to strike over low pay – if all nurses joined an agency on striking what could happen?

It takes a lot to make the nurses even think of striking. However there is a solution: they ALL join the agencies!  NHSreality believes that if this happened reality would come home to the politicians and the UK citizens. Nurses are underpaid…

James Gallagher for BBC news reports 14th April 2017: Nurses consider whether to strike over low pay

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Appalling and shameful: Huddersfield and Cumbria Trusts in disgrace..

This exposes inappropriate and immoral rationing. If true, it is appalling and shameful: Huddersfield and Cumbria Trusts are in disgrace..

Sophie Borland and Rosie Taylor report 17th April for the Mail: GPs ‘bribed’ to NOT send patients for cancer tests: NHS pays millions for rationing hip ops, heart checks and even tumour scans

  • GPs are being paid millions to not refer patients for a variety of important tests
  • In a bid to reduce patient numbers doctors are being deterred from referals
  • The incentives mostly cover non-urgent referrals but some include cancer tests
  • Patient groups have deemed the payments ‘profoundly wrong’ 
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Doctors warn NHS is rationing best drugs to cut costs

Far better to have fairness in rationing so that all of us know what is excluded, wherever we live. Devolution and GP Commissioning have ensured inequality, and covert rationing of fearful conditions. Remember, drugs do not improve the health of populations… This is an issue for public health consultants, but are there any left?

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Jon Ungoed-Thomas in the Sunday Times 16th April reports: Doctors warn NHS is rationing best drugs to cut costs

Hospital doctors have revealed how some of the best available medicines are being rationed by the NHS in a cost-cutting drive.

Doctors including gastroenterologists, rheumatologists and dermatologists say they are being prevented from prescribing the most appropriate drugs by their local clinical commissioning groups (CCGs).

CCGs are already reducing the number of hip and knee operations by using pain thresholds to ration procedures.

Now a survey of 200 clinicians, commissioned by the drugs company UCB and conducted by ComRes, has found that seven out of 10 clinicians claim NHS funding pressures have restricted their ability to prescribe approved medications.

The Breast Cancer Now charity revealed last year that some women were missing out on a potentially life-saving drug that costs 43p a day. Bisphosphonates cut the risk of cancer spreading to the bone, but many CCGs have blocked their use.

Dr Thomas Sheeran, a consultant rheumatologist at the Royal Wolverhampton NHS Trust, said bureaucratic hurdles and financial restrictions were hampering clinicians. “It’s frustrating that the people we have to try to persuade are accountants and the CCGs,” he said.

In one case last year he said a woman at risk of going blind was turned down by her local CCG for £2,000 of drugs to save her sight. The woman was admitted as an emergency patient so the trust could pay for treatment.

The drug in question, infliximab, is approved for use by the National Institute for Health and Care Excellence (Nice) for some conditions, but the treatment for this patient was considered experimental.

Sheeran said another drug used to treat arthritis and approved by Nice, abatacept, was not being permitted by Wolverhampton CCG for some patients.

He said there were concerns that patients who were not given the most suitable drug were more likely to be readmitted to hospital, so the drive to cut the drugs budget was in fact not cost effective.

Patients are entitled to drugs approved by Nice for specific conditions, but there is often no national guidance and CCGs make their own funding decisions.

A spokesman for NHS England said: “As the NHS goes into the most financially challenging few years in its history, it is right that we strive to ensure maximum value for patients from every penny available, but ultimately these are legally decisions for clinical commissioning groups, informed by best evidence and national guidance where appropriate.”

A spokesman for Wolverhampton CCG said that although it could not comment on individual cases, “a number of individual funding requests have been approved for the prescribing of abatacept”.

NHS managers still growing as GP posts fall

The Observer reports 15th April 2017: Number of NHS managers still growing as GP posts fall again – Doctors say ministers’ ‘bureaucracy busting’ shakeup has failed to switch resources and manpower to the front line

The number of NHS managers has grown by almost 18% in the four years since the government introduced a “bureaucracy-busting” shakeup of the health service, according to the latest official data.

The rise of about 4,650 in total management posts since April 2013, when the controversial Health and Social Care Act came into force, contrasts with an alarming fall in the number of GPs over recent months at a time of unprecedented demand for health care. The figures have drawn criticism from the British Medical Association (BMA), who say ministers are failing in their central objective of shifting more resources and manpower from back-office posts to the front line….

Managers are at odds over rationing, and management recognises the case, but the “rules” don’t allow them to speak out.