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Politics Amp Policy
Cameron fixers oversee NHS winter planning
From the Financial Times of Tue, 23 Dec 2014 17:22:50 GMT
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Two of David Cameron’s most trusted fixers have been drafted in to oversee winter planning in Britain’s health service, indicating the prime minister’s determination to avoid a pre-election crisis.

Sir Jeremy Heywood, the UK’s most senior civil servant, and Oliver Letwin, minister for government policy, have been spending large amounts of time liaising with health department and NHS leaders to ensure that hospitals and doctors can cope with the additional pressures of winter, according to Whitehall sources.

The prime minister, who throughout his premiership has turned to both men to defuse difficult issues, is being regularly briefed on conditions in accident and emergency departments.

Winter is always a difficult time for the health service, with cold weather exacerbating existing conditions, adding to the burdens on stretched staff. This year the number of patients visiting A&E departments is higher than ever. There appear to be several reasons for this, including rising numbers of elderly people and difficulty in securing an appointment with a GP which is leading patients to treat emergency departments as a first, rather than a last, resort.

Planning for winter began earlier this year than ever, with an extra £700m allocated for thousands more doctors, nurses and beds. But figures last week showed just under 90 per cent of patients were seen within four hours at A&E in the seven days to December 14, the worst performance since records began in 2010.

Part of the cause is, paradoxically, a sustained drive to raise the quality of NHS care, following an inquiry into hundreds of unnecessary deaths at Mid Staffordshire NHS Trust. Its disclosures of cruel and substandard treatment led to a series of recommendations including a requirement to raise nursing levels substantially.

Chris Hopson, the chief executive of NHS Providers, said that rather than sacrifice standards, hospitals had opted to overspend and health service performance was dependent “to a worrying degree” on weather and the extent of illness. “If we have good weather and no flu outbreak we would be relatively confident but if we have prolonged bad weather and flu the NHS will struggle to cope,” he said.

Insiders say that the prime minister, having endured one of the most bruising episodes of his premiership when a big NHS reorganisation split the coalition and sparked a backlash from medical professionals, is now determined the reformed health service be seen to cope with the demands on it.

In a sign of the urgent need to bring down waiting lists for treatment, NHS England last week set aside £30m to buy an estimated 30,000 operations from private hospital groups between now and the end of March.

However, private providers have say the NHS has been too slow to take advantage of the additional capacity it can offer

It is understood that the providers have been in talks with NHS England and Monitor, the regulator, for close to nine months about the part they could play in supplementing overstretched NHS facilities. They have told NHS leaders they could offer 50,000 operations and 50,000 diagnostic tests by the end of March.

David Hare, chief executive of the NHS Partners Network which represents independent providers said that while he welcomed the additional £30m, “engagement with the independent sector has been extremely erratic”.

Separately, the FT has learnt that representatives of the biggest care home providers, along with Care England, an umbrella body, wrote to the health department four weeks ago, urging both the government and NHS England to show “leadership” by using the sector to ease pressure on hospital beds.

Ian Smith, who chairs Four Seasons, the biggest care home provider, said that although the health department had been very positive about the idea, and there had been some progress, “it is slow and the sector would like to see more pace”.



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