BMJ summaries

A member of Leeds KONP has contributed the following which will feature more regularly on the blog in the future:

  • The NHS 111 urgent care telephone service increased the use of ambulances in England during its first year of
    operation—contrary to what it was designed to do—shows an evaluation of pilot sites published in BMJ Open. The researchers said that their findings reflected the inherent character of NHS Pathways. They pointed out that a triage system designed to be used by handlers without clinical expertise would inevitably err on the side of caution and offer less flexibility than one designed for clinicians.
  • How private providers are feeling the pinch.The entire privately funded healthcare market in the UK is worth £6.4bn (€7.5bn; $10.5bn), with around one in eight people belonging to a scheme. However, this is still small fry compared
    with public provision. The NHS is a major client for many private healthcare providers, especially the five main hospital
    groups (HCA, Spire, BMI Healthcare, Ramsay, and Nuffield Health).Insured patients accounted for just over half (59%) of overall revenue generated by independent hospitals in 2010 compared with nearly two thirds (65%) in 2005. As numbers go down, so the marketing goes up, with companies trying to exploit negative stories about the NHS. To get a better deal for patients, the Competition Commission has recommended the radical measure of selling off just under 20 hospitals owned by three companies: BMI Healthcare, Spire and HCA.
  • Cuts to the Office for National Statistics. We stand to lose essential healthcare data. Without statistics we have no compass, no anchor, and no oars.  The losses could include data on health inequalities, alcohol and tobacco consumption, deaths amenable to healthcare, cancer survival, weekly death registration, and childhood and infant is a fact that the ONS has been provided with £2m a yearfor four years to pursue a project dear to the heart of the prime minister, the measurement of national wellbeing. This double the amount the ONS is trying to save by reducing outputs, but it is far from clear that the measurements of wellbeing will prove twice as valuable as the datasets it is planning to jettison.
  • Private surgeon jailed for manslaughter after postponing surgery on man with perforated bowel. A senior surgeon at a private hospital, Clementine Churchill Hospital in Harrow,  has been jailed for two-and-a-half years for causing the death of a patient  through gross negligence. The surgeon suspected a perforated bowel, but failed to act with the urgency the case required. The court at the Old Bailey heard that he inexplicably delayed operating.
  • NHS doesn’t know how many managers were made redundant and rehired after coalition’s changes. David Nicholson admitted that no one would know exactly how many people had been made redundant and then rehired somewhere in the NHS as a result of the reorganisation instigated by the previous health secretary.“There was a system set up by the government (not by me), signed off by ministers, which appraised every job through an external evaluation and put a salary against it—and that’s what people have got. We should not be surprised by the salaries that people have got.”
  • NHS  “pays twice” for patients at walk-in centres NHS commissioners in England believe that they are paying twice for patients who attend walk-in centres, as most are already registered with a general practice elsewhere that is getting paid for their care. The report, commissioned after claims that the centres were being closed purely on cost grounds, includes results from a survey of almost 2000 patients who used walk-in centres, together with interviews with walk-in centre providers and
    commissioners. The nurse led centres were mostly commissioned by GP commissioning groups, but the GP led centres were commissioned by NHS England.
  • Population ageing: the timebomb that isn’t? We should not assume that population ageing itself will strain health and social care systems. Demand for services will rise but continue to be driven by other factors, chiefly progress in medical knowledge and technology, but also the increasing complexity of comorbid age related conditions.Medical staff will need to stay alert to the changing relation between “old” and “age” as life expectancy continues to increase and the typical onset of senescence and its associated morbidities is delayed.

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