Unite-funded research outlines a further unravelling of services as the NHS becomes more fragmented and financially squeezed
London’s NHS – into the unknown outlines a further unravelling of services as the NHS becomes more fragmented and financially squeezed, which is coupled with a continued management vacuum at the strategic level – with the public still having no real voice in decisions that affect them.
The report is a follow-up to London’s NHS at the crossroads which was unveiled in March last year. Both reports, which gathered evidence from interested parties, were funded by Unite.
Roy Lilley , chair of the inquiries that formed the basis of the reports,said: “We would have liked to report that the picture had improved over the last 12 months – however, the situation has moved from serious to being in intensive care.
“Again, we have prepared a template for action to ameliorate the growing demands that threaten to overwhelm increasingly stretched services. We call on ministers to give the crisis facing the NHS in London the urgent attention and resources it needs.”
The key findings:
- divisions within the NHS in London have never been deeper, and decisions by local GP-led commissioning groups are putting the future of frontline hospital services at risk. Almost all of London’s 32 clinical commissioning groups (CCGs), which hold the purse strings for the capital’s health services, are comfortably in surplus, and predicting a total of over £150 million underspend by the end of March.
Meanwhile, almost all of London’s 19 acute hospital trusts are deep ‘in the red’ and braced for an end of year deficit of almost £270 million.
- the situation is set to worsen. While CCGs group together in five collaborative organisations and draw up strategic plans to tackle an estimated £4 billion gap between service needs and NHS resources by 2019, almost all of the savings and ‘efficiencies’ they propose will be dumped onto the hospitals, mental health and community health services trusts.
- most of the planned ‘savings’ centre on unproven plans to reduce numbers of patients treated as emergencies, as waiting list patients or as outpatients – all of which would drain vital funding from hospital budgets and put services and whole hospitals at risk.
- to make matters worse, the plans to reduce access to hospital care are not matched by equivalent investment in services outside hospital – community health services, district nurses, or GPs and primary care.
- the funding gap between resources and demand for social care, provided by local boroughs in London, is growing rapidly; councils warned that the gap by 2017/18 in London alone could be more £900 million.
The 10 key recommendations include:
- a renewed call for a review of funding in London, given the increasing population.
- the creation of a new type of London strategic health authority with democratic involvement – at present, commissioning is fragmented across the clinical commissioning groups (CCGs).
- a swift reversal of the worst aspects of the Health and Social Care Act which has led to a wasted of £3 billion reorganisation, fragmenting NHS services.
- further investment in ambulance services, which are losing 26 paramedics-a-week and struggling to fill 400 vacancies from as far afield as Australia.
- the closing down of Healthwatch England and that patients’ interests are represented by new bodies fashioned in the style of the former community health councils.
- adequate protection for whistleblowers.
Unite regional secretary for the London region Pete Kavanagh said: “This second report brings a detailed, but disturbing, analysis of how the Health and Social Care Act has caused havoc to NHS services in London.
“Some clear strategic thinking is desperately needed before the service implodes under the mounting pressures.”
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