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Surprised? Rich and poor in England receive different levels of service from the NHS

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Frequently reported differences in health outcomes are generally ascribed to factors beyond the control of the health service, such as unhealthy lifestyles or poor living conditions. However, research has disclosed that there is a difference in the level of service received by poorer communities.

Though the NHS’s funding formula is designed to provide more money to the neediest areas, an FT article reported last week that – according to data analysed by the Nuffield Trust for the Financial Timessome poorer communities being “left behind” when accessing GP services.

Sarah Neville, Global Pharmaceuticals Editor, summarising the data, reports that rich and poor people in England receive different standards of care from the UK’s universal free health service.

Despite the higher burden of ill health in lower socio-economic groups, there are markedly fewer GPs per head in poorer areas of England than in richer areas

There was an average of 1,869 patients on GP lists for each doctor in the most affluent clinical commissioning groups, compared with 2,125 in the most deprived, according to Nuffield researchers. One in seven people in the poorest areas was unable to get a GP appointment, compared with one in 10 in the richest areas.

As GPs act as the crucial “gatekeeper” to other health services, a delay in seeing a doctor can lead to delays in securing other appropriate treatment. Emergency admissions were nearly 30% higher in the most deprived fifth of CCGs, compared with the least deprived fifth, which could point to delays in securing — or seeking — the right treatment. (See references to Sandwell here)

Nigel Edwards, chief executive of the Nuffield Trust, said that the new analysis showed there were “concerning discrepancies between the standards of care rich and poor receive from some NHS services”.

NHS England, “more medical treatment isn’t by itself the only answer”:

“ (T)he NHS long-term plan will be setting out new action to tackle inequalities including in access to primary care. But with the root cause of ill health lying in factors such as diet, smoking and exercise, income security, housing, air pollution and social connection, more medical treatment isn’t by itself the only answer.”

Ms Neville concludes that the findings raise questions about how well the 70-year-old National Health Service is meeting its founding principles of equity. They increase pressure on the NHS to outline plans to reduce health inequalities when it publishes its long-awaited spending plan next month.

 

 

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Private hospital profits boosted as NHS struggles

A Solihull reader draws attention to a major investigation by Pulse, the leading publication for GPs in the UK, which has revealed that private companies are boosting their profits by up to 100% as the health service struggles to cope.

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An analysis of company reports and statements from all the major private hospital chains that make their figures available shows all have boosted their revenues this year. They say they are gaining from the plight of the NHS, with patients more likely to pay for their care to avoid lengthening NHS waiting lists, which have led to 3.7 million NHS patients wait for treatment – the most since December 2007.

Commissioners pay millions to private hospitals

The investigation – the most comprehensive since the introduction of the Health and Social Care in 2012 – also shows that local commissioners are paying hundreds of millions to private hospitals and that hospitals have also boosted their income from private work.

GP visit for £120 fee

It comes as Pulse yesterday reported that one private GP firm is expanding its service which promises to deliver a GP to patients’ doorsteps in 90 minutes for £120 – one of a number of companies taking advantage of long waiting times for GP appointments.

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General Practitioners Committee (GPC) leaders say the Government is undermining the NHS in favour of the private sector through ‘scandalous’ underfunding, and ‘sleepwalking’ us towards a US-style health insurance system.

The Pulse investigation found that companies are looking to expand services to take advantage of waiting lists. News concerning the following providers may be read here:

  • BMI Healthcare
  • Spire
  • Nuffield Health
  • Circle
  • BMI
  • CareUK

David Hare, chief executive of NHS Partners Network – which represents private health companies – said: ’Independent hospitals play a vital role in keeping NHS waiting times low during a time of huge service pressures. NHS patients are also increasingly choosing to be treated at private hospitals, paid for at NHS prices, to NHS standards and free at the point-of-use.’

But GPC chair Dr Chaand Nagpaul says the rise in private use ‘represents a clear diversion of funds out of the NHS and into the private sector’: “In many cases private providers will cherry-pick low-risk patients, adding further strain onto impoverished NHS hospitals caring for patients with greater morbidity. This is unfairly undermining the NHS in favour of the private sector”.

 

 

NHS Sustainability and Transformation Plans under the spotlight

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Dr Carl Walker (5th from left above), a member of the NHA party’s executive committee, is scrutinising the press reporting of the new mass cuts regime currently being implemented across the NHS:

He sees, on one side the government and their appointed spokespeople, scrambling to assuage a newly anxious population with the soothing language of consolidation, reconfiguration, efficiency, and modernisation masking service cuts, lost beds and staff lay-offs and on the other, a variety of campaigning groups, doctors and politicians, “using an array of evidence to carefully unpack these reconfiguration fantasies”.

Reduced provision will lead to better provision – really?

The scale and imminence of cuts advocated and the PR, which has ‘critically departed from reality’ is shocking health professionals. It is reported that, in Dorset, the new Sustainability and Transformation Plan (STP) suggests that a ‘reduction in the number of sites’ would lead to a better provision of services ‘for more hours of the day and days of the week’. Dr Walker continues: “In Hampshire and Isle of Wight, commissioners are planning to make general practice more sustainable by cutting GP workload by almost a third, while also significantly reducing patients’ face-to-face contact with primary care . . .

“No amount of PR window dressing and STP gobbledegook will ever convince anyone that removing beds, services, A&E units and GP surgeries is going to lead to better patient care. Indeed the way in which STP plans are wrapping the extraordinary shrinking of our NHS in the language of better patient care has now stretched incredulity to a truly insulting level.

“Thus far, those who resist these cuts publicly have made salient points about poor public consultation and lack of democratic accountability, about GPs being excluded from the STP planning process . . .”

Read Dr Walker’s article here: http://nhap.org/friday-surgery-21/ and consider taking the recommended action.

Next: NHA news about the ‘revolving door’ at work in shaping the future of the NHS.