NHS chiefs order hospitals to begin urgent overhaul of A&E care

NHS chiefs have ordered hospitals to push through an urgent overhaul of A&E care, with GPs assessing every patient when they turn up to help the health service avoid another winter crisis.

The move comes as the NHS in England disclosed that it recorded its worst performance to date in January, missing vital treatment targets covering A&E, cancer and planned hospital care. The number of patients stuck in hospitals due to inadequate social care, such as a shortage of care home places, also hit an all-time high.

In a speech on Thursday, Jeremy Hunt, the health secretary, added to the pressure on hospitals by telling them to get back to meeting the target of treating 95% of A&E patients within four hours. That fell to 77.6% in January as hospitals buckled under unprecedented demand for emergency care.

However, hospital chiefs immediately criticised Hunt’s edict as “unrealistic” and demanded much more money to improve A&E care than the £100m in Wednesday’s budget.

NHS groups have voiced serious doubts as to whether there are enough GPs in England to work at every A&E unit. Dr Helen Stokes-Lampard, the chair of the Royal College of GPs, said: “We feel that the best place for GPs is working with patients in their communities and the money just announced for new triage systems in emergency departments would achieve more if most was spent shoring up general practice.”

The NHS England chief executive, Simon Stevens, and his counterpart at NHS Improvement, Jim Mackey, have written to all parts of the health service outlining “concrete changes” they must make to prevent next winter from overwhelming hospitals.

Over the previous winter, pictures of patients lying on trolleys in hospital corridors and countless stories about waiting many hours for ambulances caused major embarrassment to ministers and NHS chiefs.

Under the changes set out on Thursday:

• Ambulance crews will treat many more sick people where they find them, rather than bringing patients to hospital. In future, paramedics should be “conveying patients to hospital only when this is clinically necessary”, the letter says.
  


• Every hospital will have put in place “comprehensive front door streaming” by October, under which family doctors and nurses will assess how unwell patients are to reduce the risk of A&E units becoming overloaded by the 1.5 million to 3 million people who turn up unnecessarily every year.
  


• GP surgeries will have to offer many more appointments at weekends and in evenings, ultimately providing these to everyone in England by 2020.
  


• Doctors and nurses will have to provide better medical care to the 400,000 older people living in care homes, to stop them becoming so unwell that they need to be admitted to hospital.
  


• NHS bodies will work much more closely with local councils to reduce so-called bedblocking in hospitals. Councils will use the £1bn extra for social care in 2017-18 announced in Wednesday’s budget to provide more at-home care services and places in care homes.
  


• The NHS 111 telephone advice service will be overhauled to enable many more callers to speak to a doctor, nurse, mental health specialist or other type of health professional, as the Guardian reported on Wednesday.

Stevens and Mackey made it clear in their letter, published on Thursday, that NHS hospital trusts that do not implement every element of the plan will in effect be fined, by being denied money from the service’s £1.8bn-a-year sustainability and transformation hospital bailout fund.

Prof John Appleby, the chief economist at the Nuffield Trust health thinktank, said the latest performance figures “make dismal reading for the NHS and patients”.

“The number of patients stuck on a trolley waiting for a hospital bed has gone through the roof, with more than 80,000 patients waiting for four hours or more in January, and a staggering 988 of them waiting longer than 12 hours,” he said. “These are vulnerable people with acute medical needs. Corridors, it seems, have become the new emergency wards.”

Cancer charities criticised ministers over the NHS again missing the target for treating cancer patients referred for urgent treatment within 62 days.

Emma Greenwood, the director of policy at Cancer Research UK, said: “Today’s figures for January are the worst ever performance against this crucial cancer target, which has now been missed annually for three years. This is completely unacceptable.

“Cancer targets exist to ensure quick diagnosis and access to treatment, and provide a snapshot of how the NHS is performing for patients. The government and NHS England have committed to improving early diagnosis of cancer, including increasing investment, but it’s clear that this is yet to have an impact.

“Specifically, we have yet to see any significant progress to address huge staff shortages in the diagnostic workforce, especially for radiologists, pathologists, endoscopists and radiographers.”

NHS chiefs order hospitals to begin urgent overhaul of A&E care

Most Still Don’t Know ObamaCare Penalties Waived by Trump Executive Order

The I.R.S has been instructed by the Trump Administration via Executive Order  not to collect ObamaCare Penalties. Giving millions of Americans and small businesses a huge break and boosting the economy. Ordering the I.R.S. not or ask about your healthcare situation makes sure no further penalties can be assessed. Effectively throwing a monkey wrench into the ObamaCare tax and penalty system that has wrecked the American economy. As Congress sits on their hands and does nothing this one act alone has given millions of families much needed help. Millennials who don’t get ObamaCare will actually get a tax return this year. Small business can expand not having to worry about the mandates. Majorly boosting the consumer confidence and adding to the stock market rally. Trump can do this because the President has the responsibility to direct all employees of the federal government. Congress may wait and try to introduce ObamaCare Lite but Trump has beat them to the punch back on January 20th.

Why is this not more widely reported on mainstream fake news? Nothing on nightly news. A couple begrudging mentions in the national papers. Local or city newspapers and television? Forget about it. Alternative sources and conservative economic media have reported on it. The answer is obvious. It is not politically convenient.

This is such cause for celebration for all Americans yet almost nothing is being done by the 5th column to advertise the fact to the people. This is important. A lot senior citizens who rely on these “news sources” are not even aware of this. Lower income people and even low information consumers are still making financial and healthcare decisions based on old information.

Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

Section 2 of the Executive Order of Jan 20th reads.

Sec. 2.  To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.

Small businesses over 50 people that don’t comply with the Obamacare can pay as much as $ 5000 per employee as places like Macdonalds get waivers. The penalty to an individual can be as high as $ 2800 in the higher tax brackets. Even at the lower end even $ 600 can be be a low income earner’s entire tax return. The effect goes far beyond that.

Now families and individuals can effectively ignore the disastrous law all together. No longer saddled with having to get useless health insurance with high premiums. Saving many hundreds of dollars a month for an average family. Choosing alternative means of healthcare not prescribed under the draconian ObamaCare. If they know about it.

Sources:

RaptormanReports

https://www.whitehouse.gov/the-press-office/2017/01/2/executive-order-minimizing-economic-burden-patient-protection-and

https://www.forbes.com/sites/kellyphillipserb/2017/01/20/trump-signs-executive-order-to-roll-back-obamacare/#7858a7643eeb

Most Still Don’t Know ObamaCare Penalties Waived by Trump Executive Order

Presidential Order to End School Segregation Now

Proposed Presidential Order

The Constitution guarantees that all children have a right to go to school, regardless of medical history or vaccination status.  In order to protect the right to go to school, a California mom, Sharon Brown, has proposed a presidential order that will establish the fundamental privacy of children’s medical records, which in turn, will end segregation by schools that discriminate against children – based only on the child’s medical history or vaccination status.

Regardless of whether you love or hate him, when Donald Trump signs this proposed executive order, it will essentially halt mandatory vaccination in American schools – because schools won’t be allowed to ask about the child’s medical history or vaccination status – because under our proposed order – the child’s medical history and vaccination status will be deemed “private.”

Origins

I was recently contacted by a registered nurse who wanted to see Trump issue a presidential order guaranteeing the parents’ right to opt-out of school vaccine programs.  “Great idea!” thought I!  I then contacted Sharon Brown, who said, “Great idea, but…”  So now, instead of a presidential order that merely guarantees the right to opt-out of vaccination programs, we decided to propose a broader order – to prohibit schools from even asking about the children’s medical history in the first place!

As Sharon Brown explains: “The schools have no right to ask about a child’s medical history because it’s none of their business—it’s private!  Just like in the workplace—the worker’s medical history is nobody’s business—it’s private!”

Halting Medical Tyranny

Sharon Brown knows about fighting medical tyranny – my office represents her and seven other brave parents who are now suing the State of California to halt mandatory vaccination of schoolchildren.  [More info: RevoltRevokeRestore.com]  And the first step in halting medical tyranny is making the government recognize that the individual’s medical history is fundamentally private and beyond the scope of governmental inquiry!

Medical Record Are Private

Please read our proposed presidential order – it’s just 64 words long, (I counted!).  Our goal is clear – medical records must be regarded as private!  So, whether you’re conservative or liberal, please defend the right to privacy!  All parents, regardless of politics, should support the right to privacy for their children’s medical records.  Please sign ‘n share!

https://www.change.org/p/sharon-brown-presidential-executive-order-to-end-school-segregation?source_location=minibar

T. Matthew Phillips
Attorney-at-Law

 

Presidential Order to End School Segregation Now

Patient who spent two years in hospital evicted under court order

A patient who was evicted from a hospital under a court order after spending more than two years in a bed has insisted that he did not want to stay there.

Adriano Guedes was removed from the James Paget hospital in Gorleston, Norfolk, which said the 63-year-old was occupying the bed “unnecessarily” and was fit to be discharged.

Guedes, who came to the UK from Portugal 15 years ago seeking work and suffers paralysis following a stroke in 2008, said he “didn’t want to stay” but “they forced me to stay”.

He told the BBC: “It’s very bad to occupy a place which should be used by someone in need, but I didn’t cause the situation; on the contrary, I tried to get out of there.”

The hospital obtained a possession order from the court to remove Guedes and it was granted on 1 December and enforced on 10 January.

Guedes said he had asked to be moved from the hospital to a “wheelchair-friendly place” and said he had been on hunger strike since his removal, with his last meal on 10 January.

He said he was initially admitted to hospital in 2014 on mental health grounds and not because of his physical condition.

His request to see a spinal specialist in London for his injuries was ignored, he said, adding: “I wanted to leave, but they always offered what they knew I would refuse.”

Guedes, whose hospital stay is estimated to have cost around £340,000, is now living in a council flat in Suffolk.

The Department of Health says the average daily cost of a hospital bed is about £400.

Director of governance at the hospital, Anna Hills, said Guedes had “repeatedly refused all offers of appropriate accommodation organised by our local authority and social care partners, despite being fit for discharge”.

The hospital said it had worked “in partnership with a range of agencies to achieve a safe discharge from the hospital” for Guedes.

It said “detailed planning” had taken place which “led to a successful discharge in this complex case”.

Guedes has been described as a so-called “bed blocker”, but the NHS Confederation’s director of police, Johnny Marshall, told the Guardian last year that the term was an inappropriate description of people staying in hospital when they did not need to be there.

He said: “These ‘blockers’ are often older people who are frail and vulnerable and who would like nothing more than to return home to their families. The phrase ‘bed blocker’ puts all the emphasis, and blame, on the individual.

“The reality is that it is the system that has failed to move quickly enough to put together the right package of care to enable the person in the bed to return home.”

Patient who spent two years in hospital evicted under court order

Alcohol companies funding charities in order to obtain political influence, claims review

5 alcohol charities have acquired donations of up to £1m each and every in latest years from the drinks sector, says the review led by Dr Jim McCambridge. Photograph: David Jones/PA

Alcohol firms are adopting contentious tactics pioneered by the tobacco business by funding charities in order to gain influence within government, researchers declare in a new study published on Tuesday.

Drink makers, merchants and grant-generating trusts have given five alcohol charities donations of up to £1m each and every in recent many years as they have deliberately “used corporate philanthropy as a political device”, according to analysis by academics at the London College of Hygiene and Tropical Medication.

Addaction, which works with folks addicted to drink and medication, has acquired £1.56m in the course of the previous 3 years. That involves £1m from Asda to perform with youthful individuals aroundon damaging alcohol consumption and £560,000 from Heineken for a variety of tasks.

Similarly, the researchers’ trawl of Charity Commission data showed that Mentor United kingdom, which seeks to prevent alcohol-related harm amid children, took £421,000 between 2008-09 and 2012-13. It has also accepted a even more £100,000 because. That incorporated £371,000 from the drinks company Diageo and £100,000 from two trusts funded by earnings from sales of alcohol.

The revelations have caused concern since the two charities are the only wellness groups that continue to be involved in the coalition’s public health responsibility deal, which tries to reach voluntary agreements with meals and drink firms on how to tackle the large harms associated with obesity and alcohol misuse. They have continued to participate in spite of all other alcohol charities and medical groups that initially took element pulling out owing to worries that the approach – organised by the Division of Well being, which lauds it as a essential contribution to solving public wellness problems – was also dominated by representatives of the alcohol market.

“The reality that the only folks left within the responsibility deal procedure who are advocating for wellness are each market-funded is a result in of excellent concern, due to the fact absolutely everyone else who was representing well being walked out as they had no self-confidence in it,” explained Dr Jim McCambridge, lead author of the paper, which appears in the European Journal of Public Wellness.

Alcohol sector funding for the two charities confers a legitimacy on the obligation deal which it does not deserve, he added. “This [funding] is an instance of the business sowing division in the public well being neighborhood. It keeps alive the accountability deal, which otherwise may be dead.”

Katherine Brown, director of the Institute of Alcohol Scientific studies, an independent, thinktank not funded by the sector, said Whitehall civil servants she had spoken to were unaware that the two groups received income from industry bodies.

“Funding NGOs is a longstanding tactic utilised by tobacco and alcohol firms. It can help bolster corporate reputations, but, far more importantly, it can provide better access to government officials with the possible to influence public policy,” mentioned Brown. She called for greater transparency about the backers of organisations lobbying government on alcohol.

Addaction stated its receipt of this kind of funding had not influenced its aims, policies or positions, citing its help for minimal unit pricing of alcohol, which the coalition pledged to significantly contemplate introducing, but then rejected last 12 months and the alcohol market is strongly opposed to.

Provided its work with individuals whose lives have been wrecked by alcohol “it may look incongruous – or even compromising – that the charity will take cash from the United kingdom alcohol market”.

But it insisted that its partnerships had assisted adjust the market for the greater.

“In 2008 Heineken senior management visited an Addaction services and realized that their substantial-strength white cider brand names had been overly prevalent amid those looking for assist for alcohol troubles. Subsequently they delisted White Lightning and Strongbow Black and no longer promote any similar super-strength products.”

Mentor Uk said it had not obtained any money from the alcohol market because 2012 and denied that the Robertson Trust and Gannochy Believe in, themselves charities, were industry bodies.

Robertson has a near relationship with the Edrington Group, which tends to make well-acknowledged whisky brand names including Popular Grouse. Gannochy is funded by the profits from product sales of Bell’s whisky. The two trusts jointly fund Mentor UK’s perform in Polmont youthful offenders institution in Scotland.

Henry Ashworth, chief executive of the Portman Group, which speaks for the alcohol industry, staunchly defended back links in between companies and charities and the tasks they lead to. “This campaign by the London School of Hygiene &amp Tropical Medicine does wonderful disservice to thousands of charities that have created private sector funding partnerships to aid them achieve their charitable goals and it is outrageous to recommend they have a conflict of interest when they are transparent about their funding sources and have rigorous protocols in area to safeguard their independence,” he said.

“A lot crucial investigation and numerous charitable services would not exist without corporate assistance.”

Prof John Ashton, president of the Uk Faculty of Public Wellness, stated: “The wellness messages and policies that the alcohol industry favours are frequently without having an proof base. Such policies are unlikely to have any true effect on the tens of thousands of deaths, or hundreds of thousands of hospital admissions, that alcohol causes ever year.”

The study also uncovered that three other charities active in the United kingdom alcohol policy method – Drinkaware, the Robertson Believe in and British Institute of Innkeeping – “get virtually all their revenue from the alcohol business or from people working in the market”. None, though, is involved in the duty deal.

Alcohol companies funding charities in order to obtain political influence, claims review