LETTERS
Email your views to
opinion@nationalhealthexecutive.com
to be managed but not over- managed, which I suspect is half the problem within the NHS – we have Government; local authori- ties; the public; non-execs and chief execs all managing in their own style, nil is joined up, now we have a new style of commissioning – what will this bring.
From: Siobhain O’Donnell Topic: Care Quality Commission (CQC)
The CQC is damned if it does and damned if it does not (in- spect!). However, it has respond- ed positively to criticism recently by recruiting more inspectors and, according to local intelli- gence, inspections (both planned and unannounced) have also in- creased.
I think it is important to keep in mind though, that CQC inspec- tions are just one way of check- ing that health and social care providers are fulfilling their legal responsibilities. It is ultimately the trust boards who must en- sure that quality, effectiveness and user experience are central to everyone’s work right across the organisation at all times.
Equally, commissioners have a responsibility via contracts to en- sure that providers are delivering services that meet user require- ments.
From: Valerie John-Charles, City & Hackney Teaching PCT Topic: Hinchingbrooke Hospital and Circle
I believe that a change in over- all management of the hospi- tal should be watched closely. Despite all the new management structures in the NHS, this has not delivered the savings that were expected. We have seen a change in the quality of managers with CEs; directors and a whole host of consultants who have drained the NHS of funds, but not delivered.
Of course the services will need From: Lorrie Farrall, East
Kent Hospitals University NHS Foundation Trust Subject: Equipment efficiency
A friend of ours went private but saw the rheumatologist specialist in a clinic within the local NHS hospital. He was told that he need- ed a MRI scan and that if he would like to wait up to half an hour then he could have it done.
He did this and when he voiced his surprise about being put through so quickly he was told that they just slotted the ‘paying’ patients ahead of NHS ones by using the gaps in the times between outpa- tient appointments reserved for possible inpatient requirements for private use.
When he queried what happened to inpatients if they could not be allocated another gap he was in- formed that they would have to go on the list again the next day. Maybe this is part of the problem?
From: Terry Leigh, Mediation Consultant Topic: NHS complaint handling
I would like to provide some feed- back on your recent report regard- ing complaint handling in the NHS (‘GPs criticised for complaint handling’, October 18).
I have provided health media- tion (NHS Conciliation) services to more than 30 NHS organisa- tions over the last 10 years.
I think it would be of interest to re- port that there is a really effective dispute resolution process already established as part of the NHS
national health executive Nov/Dec 11 | 17
Complaints Process. Unfortunately it is not well promoted and there- fore under-utilised.
The main advantages of this pro- cess are: 1) It is independent and impartial. 2) It reduces the time, energy and costs associated with complaint handling. 3) It shows that the NHS organisation is com- mitted to resolving the complaint fairly. 4) It has been cited in the literature as very effective in re- solving complaints. 5) It aims to promote early resolution by effec- tive, facilitated communication.
From: Dr David Cochrane, direc- tor of Conrane Consulting Topic: PFI
The NHS has over-planned acute hospital capacity for over 30 years now. Most of the PFI acute schemes were based on a set of ca- pacity modelling assumptions set by the DoH in 2000 (the National Beds Inquiry) and were never planned, paying only lip service to whole-systems care. However, giv- en that closure or even downsizing of these gleaming new hospitals would be politically as well as fi- nancially challenging, the local commissioners and trusts do have an option for internal re-design as single site integrated delivery sys- tems. They key here is the staffing and financial models, which need to show a significant differen-
tial between acute care and other levels of care – in turn reflecting the differential in intensive of the service (in the US it’s a factor of 3:1). This can be achieved either by unbundling the tariffs or, more radically and simply, by capitat- ing the provider, say for unsched- uled care, so there is an incentive for the provider to re-design and release resources from within a more clinically appropriate path- way of care.
CORRECTION
In the September/October 2011 edition of NHE, we wrote that ‘Epsom hospital announced a £38m budget deficit in May’.
In fact, Epsom Hospital does not have a deficit of £38m, but Epsom and St Helier University Hospitals NHS Trust, which runs both Epsom and St Helier, did in May have a predicted gap between its income and expenditure of £38m. It has plans in place to save £18.7m, and is now forecasting a deficit of £19.3m.
The trust said it has met the vast majority of key standards for hospitals over the past four years while balancing the books and that its clinical and operational perfor- mance is sound, but acknowledges it is not financially viable in the long term.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100