NHS Transformation: Beware snake oil salesmen!
Cameron and Osborne are imposing NHS Transformation carnage on the health service, with active, even enthusiastic, support from local political leaders, both Labour and Tory. The brains behind this is Simon Stevens, head of NHS England (NHSE). Transformation will see NHS budgets slashed, even though NHS budgets are already way below those of our European neighbours. Dozens of NHS hospitals and services will be scrapped, replaced by corporate-run and non-evidence-based (snake-oil) services, rhapsodically named Hospital at Home or the like, as set out in NHSE’s Five Year Forward View (5YFV).
In March 2016, NHSE reorganised all NHS bodies into 44 area based Transformation Footprints across England, in partnership with local authorities, with no new legislation and virtual absence of publicity. By the end of June 2016, these 44 bodies must each have formulated a five year Sustainability and Transformation Plan (STP) including proposals to:
bring their budget into financial balance within 2016-17 – eliminating at a stroke NHS England’s £2.3bn deficit;
implement the Five Year Forward View untested and potentially dangerous models of care
demonstrate how their plans will improve clinical outcomes and patient satisfaction.
If the Sustainability and Transformation Plan does not achieve all these aims, they will not qualify for a share of critical £1.8bn Transformation Funding and new leaders may be imposed.
The Five Year Forward View proposes reducing demand for beds by substituting digital monitoring and healthcare visits at home. Never mind that England has fewer beds than any comparable economy: Germany has nine hospital beds per 1,000 population compared with just three in England. Never mind the absence of any valid clinical evidence for this model, or that it means thousands of carers– predominantly women having to care for very sick children and family members at home with occasional visits from a nurse or healthcare assistant. Contracts for this type of care will be highly attractive to the corporate sector.
In another ‘new model’, we can expect ‘urgent and emergency care’ centres to replace full Accident and Emergency (A&E). This will lead to reductions in back-up diagnostic and treatment services required for a full A&E, with consequent loss of routine services at the hospital and reduced doctor training opportunities. Patients will have to travel much further to reach A&E and other services.
Transformation will open up opportunities for a single corporate to deliver the entire complex of health and social care services in one locality. This model might well be particularly attractive to giant US healthcare corporations which already deliver these services in the US.