My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

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Further evidence of post election changes from today’s Times

Filed Under (Conservative party, Election campaign, Health Policy, Labour Party, Liberal Democrat Party) by Paul on 04-05-2010

The Times on May 4th picks up on the big issue of post election NHS politics by highlighting the coming significant changes in hospital services. As with my own posts of last week they recognise the significance of the advice from patients’ groups and doctors to bring about improvement and value for money.

The NHS is facing significant cuts in services across England and Wales despite election pledges from the main parties to protect health spending.

Analysis by The Times has revealed that the number of health bodies preparing the ground for possible closures has increased. Those seeking advice on big changes to NHS services, including shutting down hospital units, has doubled over the past year.

A total of 26 organisations across England approached the Independent Reconfiguration Panel (IRP), the group of experts consulted on service changes, over the past financial year about restructuring care in their area — up from 13 in 2008-09. Requests for informal advice, which normally involve NHS reconfigurations that may attract controversy, cover reforms to maternity, paediatric, cancer and emergency care services.

The approaches illustrate a dramatic shift in attitude to the great NHS taboo of reducing the number of hospitals and beds.

In recent weeks doctors, managers, patient groups and health service researchers have all advocated the strategy as a means of maintaining and enhancing healthcare in the current economic climate. It comes after warnings that the NHS needs to find £20 billion of savings in coming years.

A senior government health adviser told the Times that the NHS was “still in the foothills” of service reconfiguration, with a “maximum amount of change” to be expected over the next two to three years. He added that the message needed to be put out that the Department of Health “would back changes where there is a strong evidence base”. Andy Burnham, the Health Secretary, has also spoken of tough decisions in the near future.

The programme is seen as a flashpoint in the next Parliament and a challenging, but essential, agenda for the incoming government.

Experts suggest that the NHS will be structured around fewer, larger hubs of specialist services, many more “outreach” units in local communities and less hospital-based care. The future of many medium-sized facilities, such as the traditional district general hospital, remains uncertain.

A review of child heart surgery in England, disclosed last week in the Times, is seen by some as a model for safer and more cost-effective specialist services. The report sets out plans to have fewer centres, with more staff and facilities, by merging and relocating smaller units.

Patients such as heart attack victims or pregnant women with labour complications could benefit from treatment at specialist regional centres rather than their local hospital, experts suggest.

Last month Reform, a free-market think-tank, called for some regions to cut more than a quarter of their hospital beds.

It argued that the reduction in beds in English hospitals over the past 20 years, from 270,000 to 160,000, must continue and a further 30,000 beds should go.

A recent report commissioned by the Department of Health from McKinsey, the management consultancy, concluded that up to £700 million is spent annually on hospital procedures with limited clinical benefit, and about 40 per cent of patients in hospital at any one time do not need to be there.

Recent attempts to cut or relocate services have been opposed vociferously by patients’ groups and local MPs. Currently, patients are opposing the merging of paediatric units in the West Midlands and the consolidation of maternity units in Manchester and emergency services in London.

Last week Mr Burnham pledged not to close the emergency department at the Whittington Hospital, in North London, after months of public protest. He said, however, that this did not rule out future reconfiguration.

Doctors and medical royal colleges have argued that many hospital services are located too close together or do not see enough patients. Writing in a letter to the Times last month, a coalition of more than 40 national healthcare charities said that cuts to some services could free money to help to care for the long-term sick at home.

These developments provide the local and national leadership of the NHS with the possibilities of a step change in delivering value for money in the NHS.

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