Kevin Kelleher – Written evidence (NHS0164)
I enclose a submission in reference to your call for information on the Long Term Sustainability of the NHS and refer to issues, which affect the NHS, Patients, HM Government, Carers etc.
Thought the points maybe already be known and some issues outside the committees remit on Resources, Workforce, Service Delivery, Prevention and Engagement and Digitial Services, it is to try and summarise and support topics of discussion with established findings, data and statics.
1. Choice, Control, Independence and the Law: Through Parliament legalisation, the Law Commission reported on Adult Social Care http://www.lawcom.gov.uk/project/adult-social-care/ , which we have the Care Act 2014, this collated previous Acts of Parliament, e.g. National Assistance Act, the Chronically Sick and Disabled Act, Community (direct payment) Act, some 42 different primary legislations plus any additional regulations. Choice, control, independence comes from both partnership with all, understanding the individual needs, law sets a basic level and aspirations of the individual might differ and is complex for all.
2. Through Parliament and its people scrutiny, investigations, enquiries continue to look at matter effecting it people through the actions, funds, involvement http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news-parliament-2015/improving-access-mental-health-services-report-published-16-17/ to report on the complexity and social return on investment. 21st century living is more complex with higher expectations of what the Laws allow people to access, support needs etc.
3. With division of services through social services, NHS, local commission groups, charities, NGO, forums, PALS etc. I suggest people find it frustrating to challenge the status quo with everyone fighting for the rights and prevaliiages life comes with. Right or Wrong their is a limit which breaks the mind and soul of an individual to take the action.
4. I refer also to previous information, freedom of information requests to support the enclosed information for all to make an informed discussion and discuss the matters, which affects us all living with life and the realities, which united are personal and in depth, monies are spent to support the economy, life choices, options, needs of illness, thats what life is about. Powerful as people are through what we achieve in life, we work to better outcomes, understand what is expected of us and that which Parliament offers in return.
5. Health Inequalities: http://www.kingsfund.org.uk/projects/verdict/has-government-put-mental-health-equal-footing-physical-health and https://www.nice.org.uk/advice/lgb4/chapter/introduction and http://www.lho.org.uk/LHO_Topics/National_Lead_Areas/HealthInequalitiesOverview.aspx
6. Employment and Structure: NHS provides employment, structure, opportunities for those who work, with just under £12bn spent in 2012/13 on Mental Health Services, refer http://www.nuffieldtrust.org.uk/data-and-charts/nhs-spending-top-three-disease-categories-england , 2016 suggest £9.2bn is spent on Mental Health ,refer http://www.wired.co.uk/article/nhs-mental-health-taskforce
7. Funding and Resources: Refer Employment, Local Authorites, Charities, NHS Networks and Partnerships, Employment and Structure and Alternative Community Support Verses Hospitization. A Department of Health budget of around £120bn. Social Services budget, Charitable spend and giving, EU funding equates to a much higher resources spent in services, GDP, Taxes, needs.
8. Alternative Community Support verses Hospitalization: Suggested cost figures, refer https://www.rethink.org/about-us/commissioning-us/alternatives-to-admission and attached. This suggests a cost of £3,832 pounds cost of admission and yet a weekly benefit payment, in arrears can be £182pw, costs for residential care and other places can be cost effective than hospitilization?
9. NHS network and Partnerships: Each of the listed partnerships https://www.england.nhs.uk/ourwork/part-rel/ provide employment, contribute to the UK GDP, taxes etc. Though indirectly not on the front line of services day to day, they contribute in various means?
10. Charities: I have enclosed reference to what UK Mental Health charities spend in the UK, this also provides employment, structure, GDP, Taxes etc. to the economy. (Refer UKCRCHRA2014.pdf)
11. Population: The UK has over 65million people to support through its needs from birth to death, I refer http://www.agediscrimination.info/statistics/Pages/CurrentUKpopulation.aspx
12. Local Authorities: Local authorities have use to the Local Government Finance Settlement which is advised inadvance by the DCLG. Example http://www.southampton.gov.uk/moderngov/mgIssueHistoryHome.aspx?IId=17931 and http://www.publicfinance.co.uk/news/2015/12/local-government-settlement-offers-councils-four-year-funding-deals
13. NHS staff sickness, I refer to for costs of £2.4bn the NHS pays http://www.qualitywatch.org.uk/indicator/nhs-staff-sickness-absence#
14. Lord Carters report into procurement savings, refer https://www.supplychain.nhs.uk/news/company/lord-carters-report/ and https://www.gov.uk/government/news/review-shows-how-nhs-hospitals-can-save-money-and-improve-care
15. NHS Litigation Authority which paid out £1.1bn in 2014/15, refer attached accounts and https://www.evidence.nhs.uk/search?q=litigation+and+financial+cost+to+the+nhs and https://www.themdu.com/press-centre/press-releases/nhs-claims-liabilities-of-22bn-shows-need-for-reform-of-compensation-system
16. Agency and other news related staffing costs, I refer https://www.gov.uk/government/news/clampdown-on-nhs-staffing-agency-costs and http://www.ntda.nhs.uk/blog/2015/09/01/new-rules-launched-to-reduce-agency-spend-in-the-nhs/ and http://www.nhs.uk/NHSEngland/thenhs/about/Pages/authoritiesandtrusts.aspx
17. The DoH and NHS budget 20/21, refer http://www.health.org.uk/chart-breakdown-planned-dh-and-nhs-england-budgets-202021 and https://www.nao.org.uk/report/reports-on-department-of-health-nhs-england-and-nhs-foundation-trusts-consolidated-accounts-2015-16/
18. Personnel Budgets and NHS Continuing Care fund, spent, criteria, refer attached information (file. Pdf and p_h_b...pdf)
19. NHS and Social Care integration, I refer http://www.huffingtonpost.co.uk/dr-louise-irvine/nhs-funding_b_6688632.html
20. Authorities, Trusts and CCG, refer http://www.nhs.uk/NHSEngland/thenhs/about/Pages/authoritiesandtrusts.aspx, should mental health trusts and others be brought under one umbrella enlarging for responsibility, transparency, care instead of affiliated care and responsibilities?
21. NHS and Hospice Care, End of Life options, refer http://www.endoflifecare-intelligence.org.uk/data_sources/place_of_death
22. Junior Doctors strike, rights responsibilities of all
23. Ghost Patients costs https://www.generalandmedical.com/cms/news-media/posts/2016/july/nhs-england-to-remove-ghost-patients-from-gp-registers/
24. NHS Fraud cost's, refer https://www.rt.com/uk/316411-nhs-england-fraud-corruption/ and https://www.nursingtimes.net/roles/nurse-managers/fraud-costs-nhs-7bn-enough-to-pay-for-250000-nurses/5069258.article
25. Discharging, supporting, inpatient care, resources spent refer http://www.bbc.co.uk/news/health-35481849, whilst other means of support limited, suggest management rethink to address the needs of the patients first. Readdress lack of community support by the NHS and Local Authorities, readdress inequalities etc.
26. Drug pricing increases, CMA, SFO and other authorities investigations, refer http://www.cips.org/supply-management/news/2016/august/nhs-failed-to-challenge-125m-drug-price-hike/ and
http://www.bristowsclipboard.com/?tag=/PricingRPM and http://www.pharmatimes.com/news/nhs_drugs_bill_fattened_by_corporate_profiteering,_investigation_claims_1034841
26 September 2016