United Kingdom: National Health Service (NHS) news

It remains to be seen of course what Wessely's influence will be but the Board isn't a place where the specifics of individual diseases are discussed - the Board meeting are viewable online https://www.england.nhs.uk/about/nhs-england-board/meetings/ and the Minutes are public: https://www.england.nhs.uk/publicat...rd-meeting-agenda-and-papers-1-december-2022/ it's all pretty turgid stuff

 

I agree with this. NHS England generally have been quite bad throughout the pandemic anyway, and SW has been carrying on behind the scenes without any semblance of transparency whatsoever.

 

https://www.networks.nhs.uk/news/transfer-of-primary-care-contracts

Presumab1y this wi11 mean that 1oca1 ICBs wi11 be taking over the responsibi1ity to dea1 with comp1aints about primary care services, a1though it doesn't cover when this wi11 be (I'd expect some de1ay).

 

He's probably there to help with the privatisation
I just saw this and felt sick too. And the ' long covid (and ME) is fnd' article he tweeted from the republic.
Just when you could just about feel attitudes might finally be starting to turn in our favour and something positive might emerge from the pandemic.
This will kill any hope of new NICE guidelines for ME making a jot of difference or getting the inadequate services overhauled into something semi useful and removed from the grip of psychiatry.
I despair. Why couldn't he just retire gracefully or continue to treat cancer patients and stay away. The only chink of light is that he's sufficiently embarrassed of PACE that's it been omitted from his bio's.

 

Walport has seemed less than awesome in some ways too.

eg I noted this when the PACE TSC minutes were not released:

Now they have been, it seems that what Walport said in defence of PACE's was overly generous to them.

 

https://archive.ph/KrVt0

The Times has a detailed interview (depaywalled above) with Wes Streeting. He floats two very interesting ideas for the NHS under Labour: self-referral to consultants, and forcing GPs onto salaried contracts.

Both seem eminently sensible to me as a patient in non-ME contexts, although I wonder what would happen to GPs who have bought into a partnership and taken on the mortgage on their surgery: compulsory purchases?

More complex for pwME, especially if specialist care ends up being represented mainly by predatory services specialising in MUS/IAPT. In my case, a GP with a staunch belief that ME is real was a very helpful gatekeeper indeed. Self-referral could eliminate checks and balances on dodgy fatigue clinics.

 

This works in other countries. For example, I think France and Greece allow people to make appointments with any doctors they choose. I'm sure there are others.

I do wonder who would be responsible for collating and keeping medical records if making my own appointments was possible. I'd love to be able to keep my own which might reduce the number of doctors writing nasty letters to each other about me, but the private sector wants our records so I doubt that would ever happen.

 

I have booked a couple of private appointments with consultants through the insurer’s “doctor at hand” service, where a frazzled locum refers you on demand, and I still only get the consultant’s notes as a cc when they write to my GP saying “thank you for referring me to this delightful gentleman” (which presumably is a viciously apposite insult according to some secret physicians’ code), so I guess that the GP’s position as medical correspondence owner may well be safe, even under the Streeting reforms.

 

Not sure this deserves it's own thread: Virtual wards and Covid-19: An explainer

"What are virtual wards?
Virtual wards are remote services which help patients to manage their health and care at home.

Patients and carers are asked to take health readings (e.g. blood oxygen levels, blood pressure, temperature) in a location convenient for them, such as their home. They can submit these to health care providers either via telephone or digitally (e.g. using an app). The readings may then be reviewed and responded to by professionals elsewhere, or patients may be asked to seek further help, for example if their readings are of particular concern. Remote monitoring models have been previously used for a range of chronic health conditions (e.g. Peretz and others, 2018; Castelyn and others, 2021; Jonker and others, 2021).

There is currently a national policy push in England towards virtual wards being developed for a range of conditions, such as COPD and urinary tract infections. The ambition is for the NHS to have 40–50 ‘virtual ward beds’ per 100,000 population by December 2023. Some of these services already exist, while others will develop from Covid-19 virtual wards. There are a number of lessons from the experience of the latter – see the final section of this explainer for more detail."

More at link: https://www.nuffieldtrust.org.uk/resource/virtual-wards-and-covid-19-an-explainer

 

I paid to see a gastroenterologist a few years ago. He never even bothered to write to me afterwards. The next time I saw my NHS GP she told me that she had received a letter from the man I'd seen. She printed it out and gave it to me without comment. My mistake appears to have been that I told him what I wanted, and as a result he described me as "demanding".

I seem to rub all doctors up the wrong way just by being alive and breathing. My suspicion is that my GP told the gastroenterologist how many warning flags there are on my NHS records (or he looked me up himself if that is possible), just so that he was on his guard and ready to tar me with any number of insults.

 

If he works occasionally at a hospital trust where you have been treated, he’d have access to all records generated within the trust. I don’t think that GP records are visible in secondary care settings, or that consultants and GPs ever have the opportunity or the inclination to confer behind a patient’s back - although consultants within trusts definitely do.

But yeah, insulting you and then “forgetting” to cc you with the letter is outrageous, especially when you’re a paying customer.

 

Time I think to invoke that excellent critic of things medical, Spike Milligan

Spoiler: Maveric

Maveric Prowles
Had Rumbling Bowles
That thundered in the night.
It shook the bedrooms all around
And gave the folks a fright.
The doctor called;
He was appalled
When through his stethoscope
He heard the sound of a baying hound,
And the acrid smell of smoke.
Was there a cure?
'The higher the fewer'
The learned doctor said,
Then turned poor Maveric inside out
And stood him on his head.
'Just as I though
You've been and caught
An Asiatic flu -
You musn't go near dogs I fear
Unless they come near you.'
Poor Maveric cried.
He went cross-eyed,
His legs went green and blue.
The doctor hit him with a club
And charged him one and two.
And so my friend
This is the end,
A warning to the few:
Stay clear of doctors to the end
Or they'll get rid of you.

 

Posts moved from:
UK Government ME/CFS Delivery Plan (includes Attitudes and Education Working Group and Living with ME Working Group) and consultation


Health Education England (HEE)
https://www.hee.nhs.uk/

'Health Education England (HEE) exists for one reason only: to support the delivery of excellent healthcare and health improvement to the patients and public of England by ensuring that the workforce of today and tomorrow has the right numbers, skills, values and behaviours, at the right time and in the right place.'


My emphasis

https://www.hee.nhs.uk/about/work-us/recovery-delivery-hee-business-plan-202122/introduction-context


Introduction and context


Health Education England (HEE) is a non-departmental public body accountable to the Secretary of State and Parliament. We are part of the NHS and work with partners to plan, recruit, educate and train the health workforce.


We serve the people of England by educating, training and developing healthcare professionals. We oversee undergraduate and postgraduate health education and training for around 240,000 students and trainees across 350 different roles, including doctors, nurses, midwives, paramedics, healthcare scientists, pharmacists, and physiotherapists. We also provide planning, transformation and development support to the NHS workforce, for now and the future.

We collaborate with others at global, national, regional, system and local levels over the short, medium, and long term. In particular we partner with NHS England and NHS Improvement (NHSE/I) and support both Regional and System People Boards. These boards currently carry out Local Education and Training Board (LETB) functions and bring together stakeholders around workforce, education, leadership and organisational development.

The COVID-19 pandemic fundamentally changed how the NHS operated last year and will continue to have consequences for years, with 2020/21 focussed on recovery and developing a ‘new different’ operating model. We all came together to face the pandemic and our relationships with trusts, universities, trades unions, professional bodies and regulators strengthened as a result.

The pandemic continues as we plan to deliver the Government’s proposed workforce expansion and support record numbers of applications for clinical courses. Our delivery of core education and training this year will be impacted both by catching up for learners and ongoing service demands (including new testing and vaccination). The availability of service staff to support our work will be impacted by their health and wellbeing due to increased absence rates, mental health risks and burnout.

ICSs will be vital partners and we will support their transition into statutory bodies and subsequent development, as well as NHSE/I’s Operating Model review, developing approach to improvement and emerging System Oversight Framework and planning processes as we learn lessons from the pandemic.

Over 90% of our budget is allocated to educating and training the future workforce through universities and health providers. Over the next 12 months the ongoing impact of the pandemic on the NHS, the nation and the globe will be a factor in how we budget, plan and deliver our priorities. Closer working with social care, cooperation and collaboration with stakeholders and looking after our people and learners will be vital to how we deliver our objectives, including the proposed workforce growth.

 

https://www.gilliankenny.com/blog/how-does-nhs-england-work/

How does NHS England work?
NHS England leads the National Health Service in England. It’s an independent body whose main role is to set the priorities and direction of the NHS, whilst at the same time improving health and care across England.

NHS England was created in 2013 as part of sweeping reforms aimed at improving services by increasing competition, cutting red tape and keeping the government out of the day-to-day running of the NHS.

The duties and responsibilities of NHS England
NHS England is responsible for commissioning NHS primary services such as GPs, pharmacists and dentists, including military health services as well as some specialised services. It also sets a lot of strategies and acts like something of an NHS headquarters. NHS England manages about £100 billion of the overall NHS budget and ensures that organisations are spending these funds effectively.

Other roles and responsibilities of NHS England include commissioning services at a national level, such as specialised services, offender healthcare, and some services for the armed forces. As a single organisation, NHS England has 27 Area Teams across England, which serve as kind of regional offices that work to ensure the overall system of NHS-funded services works well. NHS England also devises plans to keep improving the commissioning for specific conditions or patient groups, such as children’s services.

 

NHS England- I rest my case ........
This is where the road block is!
AND NHSE has shifted much of Specialisted Service decisions to new ICS's and regional consortium of ICSs.

 

New Secretary of State for Health and Social Care Ministerial appointments: November 2023 > Victoria Atkins

This is 7th person to hold the role in five years, this high level of 'churn' has become a feature of UK Government across all departments in the last 8 years: Is this the age of churn in UK politics? leading to concern that Ministers don't have time to ensure developments are seen to conclusion. With a mandatory General Election due within 13 months, and a change in Party of Government widely predicted, Victoria Atkins may not be around any longer than her immediate predecessors.

 

Merged
"The chairman of NHS England has announced he is resigning, saying it was a “very difficult decision”. Richard Meddings, who has been in the role for almost three years, said he had notified Health Secretary Wes Streeting that he would stand down as chairman at the end of March.

It comes after reports that Labour was planning on asking Mr Meddings to leave after the election, possibly to be replaced by former health secretary Alan Milburn or ex-home secretary Jacqui Smith."


NHS England chairman Richard Meddings resigns (msn.com)

 

With luck they will realise that appointing Milburn would make it apparent just how little grasp Streeting has of anything and make Streeting look and feel like the junior partner. For all I know Jacqui Smith might actually be quite sensible.

 

Milburn is definitely an older experienced head.