1766 York patients denied surgery because they are overweight?

A report to a council meeting next week reveal how many patients in York have had elective surgery delayed because they’re overweight.

The Vale of York CCG’s “Health Optimisation policy” started in February 2017. Patients seeking operations but who had a Body Mass Index (BMI) of over 30 faced possible delays.

There was a long list of procedures that were not affected by the policy.

The CCG said it had learned from elsewhere that implementation of this policy could contribute to confined financial management while providing the opportunity for improving the health of the population.

Other claimed that the policy was driven by cost cutting rather than patient welfare.

The criteria used was If a patient’s BMI>=30 their surgery if delayed/deferred until the following was achieved:

  1. Their BMI is <30
  2. They’ve lost 10% of their weight
  3. They’ve not achieved a or b but have waited 12 months since initial assessment.

Since its inception of Health Optimisation in February 2017 the Referral Support Service have sent out 1,766 letters for patients that exceed BMI criteria. Not all of these had to wait before joining the a waiting list.

The CCG has claimed some anecdotal evidence that patients have reported to their GPs that as a result of losing weight, in accordance with the policy, the pain they were previously suffering from had dissipated. Some patients did not therefore require surgery.

Bootham Park Hospital

The future of the 240-year-old former mental hospital is under the spotlight as Ministers consider its future.

The building was taken out of service 4 years ago when a catalogue of defects were found by quality inspectors. These included rat infested cellars and collapsing ceilings.

The hospital was ordered to be closed in September 2015 when it was declared “unfit for purpose” A modern replacement facility is being provided.

The events surrounding the closure were heavily criticised in a York Council report which concluded that NHS Property Services “significantly underestimated the logistic and practical challenges of upgrading a Grade I listed building where shortcomings had been identified over many years”

Running costs on a building of this age are huge.  Energy and repair costs represent a constant drain on owners.

Now the local MP says the building should reopen as an NHS facility. She says “key workers in the health health sector” should be accommodated there.

Really? Offering valued employees pre-Victorian housing standards will move us forward in some way?There is only very limited scope to build on other brownfield sections of the site

No costings for the “plan” are offered much less any source of funding. We are assured though that the open space on the site will be retained as an additional public “park”.

Converting the listed building into residential accommodation would be very expensive even if it was in sound structure condition.

It isn’t.

Costs would be measured in  tens of millions. If such funding is available, then it is desperately needed to provide modern buildings for our ailing NHS.

Bootham Park is a valuable part of the heritage of the City. It’s Listed status means that it can’t be demolished. Planners could ensure that the parkland surrounding it is respected (although, in recent years, urban green space conservation hasn’t been the strong point of the York Council).

It is by no means certain that the private sector would want to acquire the hospital. The high modernisation costs would be the same for them as would ongoing running costs. Grade 1 listing means that only very limited physical changes could be undertaken.

But all options should be put on the table.

In the end, if a different use for the building is found, and this produces a substantial capital receipt for health providers in York, then this could most effectively be invested in modern facilities for patients and staff in the NHS.

And the local MP should stop posturing. She is too quick to blame developers of “luxury homes”, student flats and hotels for every challenge that faces the City.

Indeed, we would be in a pickle if developers did not want to invest in York.

Inspection report boost for York Hospital

Services at York Hospital ‘most improved’ after recent CQC inspection

York Hospital has seen its service rating upgraded to ‘Good’ after a recent a team of CQC inspectors visited York, Scarborough, and Bridlington Hospitals to check on the quality of core services.

Previously, The York Hospital was adjudged to ‘Require Improvement’ by the CQC and over Winter period, was adversely affected by the Winter crisis. In response, the Liberal Democrats made significant investments in York’s Adult Social Care system, through the 2018/19 Council Budget, to alleviate pressure on The York Hospital and reduce York’s Delayed Transfers of Care.

The York Hospital has now been found to be the most improved hospital in the York Teaching Hospital Trust and more specifically, has improved considerably in responding to the needs of people in York.

The York Teaching Hospital Trust as a whole, still ‘Requires Improvement’ and more work is needed to achieve widespread progress and maintain improvements.  The Liberal Democrats will continue to work and assist The York Hospital, where possible, to ensure quality services are provided to all residents.

Cllr Carol Runciman, Liberal Democrat Executive Member for Adult Social Care, said:

“Over recent months, a significant amount of effort has been made to improve services at The York Hospital and ensure residents receive quality care when they need too.

“I am pleased that this has now been recognised by the CQC and that The York Hospital itself is now operating well.”

“The Liberal Democrats have recognised the detrimental affect of the Winter Crisis on the York Hospital and in turn, have secured over £3 million to invest in Adult Social Care and relieve pressure on the hospital.”

“Of course, there is still work to be done, but it is now recognised that The York Hospital is responsive to the needs of people using their services and it can lead improvement in our region.”

 

As part of the CQC review into York Teaching Hospital Trust, a team of inspectors visited York, Scarborough, and Bridlington Hospitals to review their core services

York delays in treating ambulance patients revealed

On New Years Eve 47 patients had to wait for over an hour in ambulances as they waiting for treatment at York Hospital.

The full figures can be viewed by clicking here 

The statistics mirror problems at other hospitals across the region and country generally

As December went on delays gradually increased.

York had suffered earlier in the month with an outbreak of norovirus. At its peak 47 beds were closed.

By the end of the year 834 beds (90%) were occupied at the hospital.

The government has been criticised for failing to anticipate the heavy demands for care that arise over each festive period.

 

 

 

York praised for improvements in adult social care outcomes

Data released by NHS England has shown significant improvements in the performance rating of adult social care outcomes in York in the past year.

York is now ranked as 42nd of the 152 local authorities in England, a rise of 81 places from last year when the city was ranked 123rd, with York the most improved nationally.

York was considered a top performer in areas including:

  • Social care quality of life
  • People getting self-directed support
  • Carer-reported quality of life
  • Social care users having as much contact as they would like
  • Carers having as much contact as they would like
  • Carers reporting that they involved in discussions about those cared-for
  • Carers finding it easy to find information and advice
  • Social care users feeling safe and secure as a result of services provided

The Adult Social Care Outcomes Framework report also suggested areas for further improvements including direct payments and people being offered reablement services after leaving hospital.

Councillor Carol Runciman, executive member for health and adult social care said: “It is pleasing that these figures have acknowledged the considerable work done over the past year to improve adult social care outcomes for our residents.

“Whilst these figures are positive we still recognise there is more to be done, but the news shows that we are heading in the right direction.

“Thanks to all our incredible staff and support from partners, who have worked hard to make this progress possible.”

Bed blocking – Care Quality Commission to probe failings in York

The probe comes in the wake of figures that reveal that the total number of days that patients have were delayed during the year to May 2017 was 10,436.

The Care Quality Commission (CQC) is reviewing the York health and social care system and delayed transfers of care.

In a report to be considered later this week, the York Council says, “The review will highlight what is working well and where there are opportunities for improving how the system works”

This equates to, on average, 28.6 beds each day being occupied because of delayed discharges, although, during the most recent three-month period, this figure was 24.5.

A delayed transfer of care occurs when a hospital patient is deemed medically fit to be discharged, but cannot be released from hospital because they are awaiting a package of care from either the NHS and/or a local authority

There continues to be a downward trend in the number of days that patients are delayed leaving hospital that are attributable to adult social care.

In 2016/17, on average, patients were delayed for 3.73 days in hospital due to adult social care services.

The Better Care Fund provided the Council and hospitals with finances to work together on a range of measures, including delayed transfer of care, aimed at improving outcomes for NHS and adult social care users in the City of York area.

Healthwatch York under review by York Council

The Healthwatch organisation will be reporting to a York Council meeting on Wednesday about their role.

The report comes a few months after the local NHS Vale of York CCG asked the organisation to leave the health bodies governing board.

This led some to wonder whether the “voice of patients” was being properly heeded by the health commissioning body.

Other wondered whether Healthwatch had sufficient gravitas to be effective?

No doubt more will become clearer on Wednesday

The latest contract for Healthwatch was issued by the York Council as recently as April. The contracts value is £575,000 over 5 years. It was let via York CVS

The contract states, “Healthwatch York is for anyone who uses or who wishes to use adult and children’s health, social care and public health services in York – or anyone who cares for or represents individuals who have access to health, social care and public health services in York.

Healthwatch York has a duty to assist local health, social care and public health commissioners and providers, and other community stakeholders, by advising on and helping design engagement activity, and by providing feedback, research and information on local people’s views and experiences of health, social care and public health, in order to drive up standards of service provision.

Healthwatch York must also be able to signpost local people with any complaints they may wish to progress in relation to NHS service provision to the York Independent NHS Complaints Advocacy Service which has been procured by the Council under a separate contract with a provider (in a simultaneous procurement exercise) expressly for these purposes”.

Many eyes are on NHS performance these days.

Healthwatch contract

One area for improvement would involve Healthwatch pulling together each month some key performance stats. They are already available but are difficult for the average resident to find. Area to be covered might include:

  • A & E speed and quality
  • Ambulance speed and quality
  • Waiting times
  • Delayed discharges
  • GP patient volumes and appointment waiting times
  • NHS dentists waiting lists

 

Probe into NHS service quality in York

York Councillors will be given an insight into the several problems faced by the NHS in York over the winter period.

They will be told that the number of patients increased with GP to hospital referrals up by as much as 19%.

NHS managers say that nationally it was one of the most challenging winters with the “lowest national performance since reporting began in 2004”.

There was  a “surge pressure” from Christmas Day to the New Year (footfall increase of 14% +522; ambulance increase 9% +123, compared to same period in 2015 -16).

Staff sickness, in particular on bank holidays, limited the options for additional cover

Emergency Care Standards (4 hour waits) targets in A & E were not met. They hit a record low point in January but performance had improved by March.

Hospital report on A & E performance

Lack of hospital beds continues to be blamed on delayed discharges (bed blocking) with over 5000 bed days being lost.

The report  is bound to fuel demands for higher investment in NHS services. It has emerged as a key issue in the current General Election campaign

All eyes on investment in health budget as York NHS hits crisis

UPDATE – So not much hope for the NHS in todays budget announcement. There will be a scheme to put a supplementary GP workforce into some A & E departments next winter and there is more for social care. But Councils face a further dramatic reduction in government grants with a likely knock on effect on crisis management by either the NHS or emergency services.. 

EARLIER: Whether the Chancellor will do anything in today’s budget to help York’s cash strapped NHS services remains to be seen.

A report, being considered by the York Council today, reveals the extent of the problems facing local health services.

Currently cuts of around £45 million are expected placing additional pressures on a service which is already facing a crisis.

NHS York started off with the lowest funding per head of population across the whole region. Cuts are now expected to fall on:

  • outpatients
  • continuing healthcare
  • prescribing
  • high-cost drugs
  • elective orthopaedics (e.g. hip, knee replacement)
  • out of hospital facilities

The local LibDem health spokesperson said, “Cuts in services such as continuing healthcare and out of hospital care are not welcome news”.

“Liberal Democrats will continue to call for the Government to acknowledge the growing pressures on health services and give York a fair funding deal.”

Meanwhile the scale of the centralisation of GP surgery facilities has become clearer. Many are set to become localised mini hospitals with several in Acomb – including the now huge Priory Group which has premises on Cornlands Road – now the largest in the City.

In the Westfield Ward a “Local Area Coordinator” is being appointed by the Council to support people who may “feel vulnerable due to age, frailty, disability or mental health needs”

Interviews are currently taking place and the successful applicant is expected to start work later in the Spring.

York Police scam alert

TAX REBATE FRAUD ALERT

The police have issued the following warning, ”

NHS members are being targeted by tax rebate companies, purporting to offer services whereby they obtain a tax rebate on the victim’s behalf. However, the company obtains the refund but does not provide any of the funds to their customer, leaving victims over £34,000 out of pocket.

Information suggests that the companies have managed to infiltrate NHS practices/hospitals as part of training/open days and in lunchtime meeting sessions for staff. They also advertise their services to staff members and have been known to set up stands in the reception or restaurant areas.

The companies request the victim sign forms which give them permission to liaise with HMRC on their behalf, stating their fee will be charged to the rebate received. HMRC have confirmed that they have issued refunds to the companies in relation to requests received and authorised by the staff member. Once the refund is obtained all contact with the companies are broken and the victim does not receive their rebate.

Tax rebate fraud does not only affect NHS staff but can also affect Police Officers, airline staff and teachers. However this list of professions is not exclusive and anyone can be targeted.

Crime Prevention Advice
  • · Do research online to ensure the company is reputable by checking the registration details are correct and by viewing feedback online.
  • · Do not feel pressured to sign documentation without doing some basic checks.
  • · Do not respond to unsolicited emails, texts or calls offering rebate services.
  • · Make sure that you are aware and agree to the commission that will be paid to a rebate company prior to signing any documents.

· If you have been affected by this, or any other fraud, report it to Action Fraud by calling 0300 123 2040, or visiting www.actionfraud.police.uk.