NHS Direct ran the predecessor service to the 111 helpline before it was broken up and put out to tender. Photograph: AlamyWelcome to our weekly roundup of healthcare news from around the web.
This week started with claims that the NHS 111 non-emergency helpline is failing patients. An investigation by Channel 4's Dispatches revealed concerns about staff shortages, poor training and unnecessary ambulance callouts.
The Guardian explained the helpline and listed the problems it faced as it emerged that NHS Direct, the biggest single provider of NHS 111, announced it wanted to pull out of its contracts to provide the service.
Meanwhile, this video shows Dame Barbara Hakin from NHS England admitting that the 111 helpline has failed patients. Criticising NHS Direct, which withdrew from providing services, she said: "I would not deny that in March and April patients were getting a really poor service." She said other providers will take over.
The Telegraph catalogued the failings which blighted the non-emergency number, while the Guardian's data blog looked at the evidence on what happened next to callers.
The paper also reported that NHS Direct's withdrawal has left the 111 helpline on life support amid fears that chaos will lead to "tragic consequences for patients".
Michele Hanson wrote for the Guardian that "the health service's non-emergency helpline has never been much help to the people I know who've called it". She wrote:
NHS Direct wants to withdraw from its "financially unsustainable" contracts to run NHS 111, the service for urgent-but-not-urgent-enough-for-999 health concerns. About time too. It promises to "provide a safe and reliable … service until alternative arrangements can be made". How? It hasn't managed so far.
And, Felicity Lawrence wrote that critics said the 111 helpline has a fundamental flaw. She wrote that any money saved in using lay call handlers is simply added to the bill in more expensive care elsewhere. She wrote:
Critics believe it is built on a fundamental flaw. Instead of using expensive nurses and GPs to assess patients, lay call handlers, who are cheaper, follow a script of questions that leads them to a decision about where to send the caller. handlers have no clinical experience, the system has to default to the least risky option – which means sending people to A&E or calling an ambulance if there is any doubt. Any money saved is simply added to the bill in more expensive care elsewhere.
The Telegraph also ran an editorial saying that the NHS cannot go back – it must reform. It said that the basic idea of the 111 service – of remote triage to ease the pressure on A&E departments – is a good one but it was introduced in haste.
And, Dr Kailash Chand wrote for the Manchester Evening News that the 111 debacle must never happen again. He said that the past few days have shown that the implementation of NHS 111 has been an abysmal failure.
The Daily Mail reported that Sir Bruce Keogh told the NHS to adopt the attitude of high street giants like Dixons or PC World if it wants to survive. He said the health service had to accept a "more-for-less" philosophy and ditch the "inbuilt mindset that better quality costs more".
Melissa Kite wrote for Comment is free saying we won't need a PC World NHS if more of us go private. She said that those who can should unburden the health service, so it can act as the good, basic provider that Beveridge intended.
Perhaps we should ask how the founders of the NHS would respond to the fact that the service has deteriorated to a point where making it "more like PC World" seems, to its current director, a reasonable ambition. Certainly, the original aims of the Beveridge report make fascinating reading in the current context of a worsening service under increasing strain.
Sir William Beveridge said that: "The state, in organising security, should not stifle incentive, opportunity, responsibility; in establishing a national minimum, it should leave room and encouragement for voluntary action by each individual to provide more than that minimum for himself and his family." Specifically, he felt that state provision should not take the burden off personal insurance.
In other words, you could argue that those of us who pay for private medical care are the ones being true to the original aims of Beveridge, while those who say we are undermining the NHS by "running it down", are the ones who are missing the point. Those who aspire to instant, tailor-made or niche medical services – the ultimate in consumer care – should be congratulated for paying for them and taking the weight off the state system.
Kailash Chand wrote for the network responding to Keogh's comments. He argued that healthcare cannot be sold like an iPad. He wrote that it is time to reject the market ideology that has plagued the NHS for more than 30 years and wasted billions.
There are no evidence-based examples of successful healthcare relying on the principles of the free market. People, like Sir Bruce, who say that the market is the answer to achieving better outcomes for health are flying in the face of both theory and overwhelming evidence.
The Guardian reported that Jeremy Hunt's plan to reduce A&E and maternity services at London hospital was overturned at high court.
Sarah Boseley wrote for the paper that Stafford and Lewisham had been reprieved, but that more NHS closures are inevitable. She said to expect further bloodshed as A&E reorganisation leads to departments being replaced with low-key urgent care centres. She wrote:
Reorganisation of NHS care is essential and becoming more urgent as the population ages and the costs of caring for all of us rise. Where it has been allowed, it has been incredibly successful. Stroke patients are rushed past their local hospital these days to one further away with a specialist stroke unit. The same happens with trauma patients. Lives are saved as a result.
And Colin Leys wrote for Comment is free that we all would have suffered from Lewisham hospital cuts. He said that Jeremy Hunt's unlawful decision to close hospital services was commercially driven. The government must rethink its PFI policy.
The Guardian ran a story that said thirty-six NHS wards failed the 'friends and family' test. The Telegraph said the test was 'at best meaningless' at worst misleading" as critics warned the system is "open to gaming".
And, the Guardian ran an editorial about NHS privatisation. It said that coalition ministers justify privatisation as a response to failure, but over-ambitious bids have led to under-fulfilled contracts.
Meanwhile, the Nuffield Trust put together a package of content on the state of the NHS at 65. The resources in this update provide commentary and analysis from leaders, including Stephen Dorrell, Alan Milburn, Clare Gerada and Tim Kelsey, on how they think the NHS should respond to the challenges that lie ahead.
Here's a run through some of the other healthcare stories from around the web this week:
• BBC: 'Boarding' increases hospital stays and spreads infections, researchers say
• BBC: Mid Staffordshire NHS Trust 'should be dissolved'
• Telegraph: Hospital doctors should wear airline-style uniforms to make them easily identifiable
• Telegraph: Dozens of NHS hospitals allow 'no-win, no-fee' firms to advertise
• Pulse: GPs begin legal battle to force reversal of CQC closure notices
• HSJ (subscription): Trust teams up with Capita and Circle in £1bn contract bid
• HSJ (subscription): NHS England chief executive job description
• Independent: NHS helpline has 3,000-strong backlog of complaints about GPs and dentists
• Independent: Privately-run hospital taken over by NHS after patient deaths following routine surgery
Our most read pieces on the network this week have been:
• Dr Na'eem Ahmed wrote that "we should listen to our frontline staff - they know the patients". He said the Keogh review highlighted that frontline healthcare staff have the most interaction with a patient.
• Ray Johannssen-Chapman advised on how to improve patient engagement in mental health and said that service users have a valuable contribution to make to service development and training.
• Pam Lewis explained how charities can become serious players in the NHS. She wrote that now patients can choose 'any qualified provider', a range of organisations can compete in a new market.
• Five top tips on nurturing innovation put together by Dr Peter Thomond, co-founder and managing director of Clever Together, an organisation that helps leaders empower people using crowdsourcing
We'll bring you a roundup every Friday over the summer, but if there's something you particularly enjoyed reading this week, please add a comment below or tweet us @GdnHealthcare.
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