"Without any plan to tackle the financial crisis in the social care system, it’s hard to see how the vision in this 10 year NHS plan can be achieved." - Entrepreneur Generations

The arguments locally over community hospitals have been going on for some time:
Futures Forum: Health and politics in East Devon
Futures Forum: The future of community hospitals in East Devon
Futures Forum: County Council rejects Devon Health Scrutiny report >>> "The care at home (Rapid Response) service is very stretched, especially since community hospital beds were closed."

And they continue:
EDDC says community hospitals do not contribute to social well-being | East Devon Watch
Ottery Community Hospital – a campaigner speaks on council in-fighting | East Devon Watch
Just three Ottery Town Councillors back a working group to protect Ottery Hospital ... - Claire WrightWhy has EDDC refused to list Seaton and other community hospitals as ‘assets of community value’, when other Devon districts have done so? Jack Rowland will ask at the EDDC on Wednesday « SEATON & COLYTON matters

Beyond these 'political points', there are still general points to be made about 'community hospitals':

The value of ‘cottage’ hospitals has been debated from the Victorian period to the present day. Aneurin Bevan, who presided over the birth of the NHS, said: ‘Although I am not a devotee of bigness for bigness’s sake, I would rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of warm sympathy in a small one.’

Counterintuitively there is contemporary evidence to suggest that mortality after surgery is proportionate to the size of the hospital. This may reflect reduced rates of infection. Although difficult to quantify, the ‘homely’ feeling, the quiet environment and the ease with which relatives and friends can visit must all contribute to a patient’s well- being.

Futures Forum: A history of Sidmouth's cottage hospitals

The government has just published its plans for the NHS - and there is not much to be said about the 'cottage hospital': 

Medical professionals left ‘staggered’ as new NHS plan reveals focus on ‘prevention’ over hospital care

Amy Hunt

7 January 2019 12:00 pm

A new, 10-year plan for the future of the NHS has today been unveiled, revealing that the focus will be on 'preventing' medical conditions. According to the BBC, the areas which will see the biggest funding increases will be mental health, community care, and GPs, in order to help save ‘500,000 lives’, including everyone from babies, to those in old age.

These areas will be receiving a third of the extra £20billion that will be given to the NHS in upcoming years, with NHS England chief executive Simon Stevens claiming it is a “practical route map” for the next decade of care. However, it means that hospitals and urgent care will not be receiving as much money, despite the fact that they currently use up about half of the £114 billion budget.

The aim of the new plan is to reduce the reliance on hospitals and emergency departments. Currently, these areas are some of the most over-stretched and under-resourced of the entire NHS. There is currently a huge staffing crisis within the health service. And in fact, many trusts across the country are consistently missing their targets for timely care – e.g, patients receiving cancer care within 62 days – due to the issues.

Medical professionals have voiced concerns that the lack of funding could be even more harmful to hospital care in the NHS, particularly during the difficult winter. Dr Nick Scriven, president of the Society of Acute Medicine, said in a statement yesterday: ‘While any plans to improve services across the NHS are always welcome, I am staggered that the key priorities released a day early by the Prime Minister overlooked acute and emergency care and hospital capacity.

‘The full plan to be released tomorrow will come on the day many health systems will be on black alert – the highest level of pressure on hospitals – so here’s hoping all will change. The harsh reality right now is that the NHS is at least 3,100 beds short of what it required last winter, more than 45% of consultant posts are unfilled along with 11.6% of nursing posts and the proposed green paper on social care is nowhere to be seen.”

Dr Jennifer Dixon, chief executive of the Health Foundation thinktank, also said that while the plans were “ambitious”, they will be difficult to implement. She told The Guardian, “This is a pragmatic plan with an ambitious vision to improve NHS care, but making it a reality will be extremely tough given growing pressures on services, widespread staff shortages and continued cuts to other parts of the health and care system.”

Medical professionals left 'staggered' as new NHS plan reveals focus on prevention over hospital care

If patients are either not treated in hospital or discharged at the earliest possible moment, there needs to be a better care system - which is not yet forthcoming:
Futures Forum: Doctors object to retirement village plans > they can't cope with the pressure of extra elderly residents
Futures Forum: Ensuring a sustainable future for social care > disrupt the market, and deliver greater supply, sustainability and fairness
Futures Forum: "Put more money into care services to help overflowing hospitals"
Futures Forum: "The loss of community hospital beds was intended to be offset by increasing the capacity of community care... Unfortunately there is not sufficient capacity in the home care services to do this job."
Futures Forum: Care Closer to Home: It's Not Working > new video from Save Our Hospital Services Devon
Futures Forum: By 2022, Devon will have the largest shortage in number of care homes places

With further comment today from ITV: 

Big questions left unanswered in long-term strategy for NHS

7 January 2019 at 11:10am
EMILY MORGAN HEALTH CORRESPONDENT

An extra £20 billion has been promised to the NHS over the next five years. Credit: PA

Today at last the long-term strategy for the NHS in England will be published. So long-term, it will take the health service right through the next decade, which is no mean feat.

NHS England’s Chief Executive, Simon Stevens, has written the plan at the request of the prime minister. He says it can save up to half a million lives by focusing on killer conditions and getting people to live healthier lifestyles. An extra £20 billion promised to the NHS over the next five years will be used to help achieve this. But how?

Well, we’re told diagnosis of major diseases will be made easier and quicker with technology, mental health provision will increase and patients will be looked after better in the community - keeping them out of hospital, ensuring they live longer and healthier lifestyles. This all sounds plausible when you take into account that GPs, local community and mental health will get a third of the extra funding.

So, less money you might say, going straight to hospitals.

The buzzword today is integration. Few really know what that means, but in essence it’s about the NHS working better with local authorities who control social care in the community. It might seem crazy that this isn’t joined up already, but it’s not, and while local authority funding has decreased, care in the community has had to be scaled back, putting huge pressure on hospitals.

That will change we’re told. It’ll all be joined up, hospitals will be able to discharge elderly patients more freely and community care will take over.

That’s all well and good but there remain some big unanswered questions. We’ve been waiting two years for a Social Care green paper, which will consult on the best way to fund and manage social care in England.

Without any plan to tackle the financial crisis in that system, it’s hard to see how the vision in this 10 year NHS plan can be achieved.

Health secretary Matthew Hancock. Credit: PA

That, along with dwindling local authority budgets, seems right now a fantasy. The health secretary Matt Hancock has promised the Social Care green paper will be published in the coming weeks so all eyes will be on whether it can deliver what the NHS needs.

It is also admirable to encourage healthier lifestyles and to offer healthy living programmes to those most at need, but that pledge is at odds with the massive cuts to public health budgets. 

Local authorities, in charge of those finances, have had to cut back on key services which ultimately help those with drink problems, drug problems and weight problems. How will the government achieve this pledge if councils aren’t given extra money to keep vital service?

My last point is who will deliver this? The staffing crisis in the NHS is not a joke. Around 100,000 doctors and nurses are needed and unions have warned that this figure will just keep rising. If there are no medics to deliver this, the plan is pretty much pointless. The government has promised to tackle staffing in the service at a later date, but until that happens there will always be a fear this plan can’t be delivered in full.

There is a lot of good in this plan. Of course there is. But until these questions are answered there will, I think, always be doubters.

NHS 10-year plan launched in bid to save 500,000 lives

Last updated Mon 7 Jan 2019

Big questions left unanswered in long-term strategy for NHS - ITV News

.
.
.

from Futures Forum http://bit.ly/2AAXHg6 "Without any plan to tackle the financial crisis in the social care system, it’s hard to see how the vision in this 10 year NHS plan can be achieved." - Entrepreneur Generations

Posted by Entrepreneur Generations

Tweet