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  1. NHS cash boost will shore up current services - colleges

    Cuts in public health budgets will increase the pressures on the NHS at a time when demand is at an all-time high, according to the heads of two medical royal colleges.

    The Royal College of Physicians and the Royal College of Surgeons have team up to give a mixed welcome to the government's plans for health spending.

    They gave a "strong welcome" to a £3.8 billion increase in next year's NHS budget - adjusted for inflation.

    But they warned the money may mostly be eaten up tackling the current pressures on the service. Recent projections have suggested a £2 billion deficit in NHS budgets this year - and finance directors have suggested this could be "optimistic".

    They also express concern about the fate of medical education budgets - which could become part of a multi-billion pounds savings drive in the Department of Health.

    The statement was issued in the names of Miss Clare Marx, president of the Royal College of Surgeons, and Professor Jane Dacre, president of the Royal College of Physicians.

    They warned: "The NHS deficit is worsening by the day, and we need to be realistic about how much of this money will be spent shoring up current services this winter.

    "The NHS is reaching a crucial point in its history. Demand is at an all-time high, the care needs of patients are becoming increasingly complex and the NHS is struggling to provide the standard of care patients deserve."

    They go on: "We must also reduce the number of patients requiring care which can only be done through investment in prevention. Although there was no clear update in the Comprehensive Spending Review on public health budgets, we remain concerned that any cuts will only increase the pressures facing the NHS and significantly undermine any initial potential savings."

    [Earlier report on this on news]

  2. Weekend effect in paediatrics may be positive

    Paediatric care in hospitals may be better at weekends than mid-week, according to a study in Scotland.

    Researchers said there were several indicators that children admitted to hospital at the weekend fared better than those admitted mid-week.

    The findings were reported to a conference of the Scottish Paediatric Society yesterday.

    They follow an analysis earlier this week showing a slight increase in mortality rates for babies born in English hospitals at weekends.

    The Scottish researchers say they undertook their analysis after the English medical director Sir Bruce Keogh cited a range of evidence about outcomes for adult patients admitted at weekends.

    The analysis, conducted over a 14 year period, found 251 deaths on weekdays in Scotland - an average of about 50 a day - and 84 over the two days of the weekend.

    The analysis involved some 574,403 hospital admissions.

    Researchers found that 7.8% of patients admitted between Monday and Friday needed readmission compared with 7.3% of those admitted at weekends.

    Fridays were the days when patients were most likely to be discharged on the same day - some 44% - while Mondays were the busiest days, representing 16% of admissions.

    In contrast Saturdays had the least admissions and children admitted on Sundays were least likely to be discharged the same day.

    Yet the number of patients needing intensive or high dependency care was 20% greater on the days of the weekend than on weekdays.

    Researcher Dr Steve Turner said: “Although the numbers are mercifully small, our research shows there were no more deaths over weekends than during week days. Our results also suggest that extrapolating evidence from adult care to the paediatric setting is not always accurate.

    “There are increasing pressures on hospital services but relatively little is known about the numbers of paediatric admissions. This study aimed to help plug this gap in knowledge and help us identify how any increase in demand on paediatric services might be managed in future."

    [Earlier report on this on news]

  3. London Ambulance Service "inadequate"

    Britain's busiest ambulance service - in London - is "inadequate" and its staff are ill-prepared for major incidents, inspectors say today.

    The London Ambulance Service is now set to be placed in special measures in a bid to improve its services.

    Inspectors found shortfalls in safety, effectiveness, responsiveness and leadership. They praised the service for being "caring."

    Some 54 Care Quality Commission inspectors spent three weeks at the trust in June.

    Inspectors reported complaints of harassment and bullying and found there "just weren't enough properly trained staff."

    They also found staff were unaware of procedures for major incidents and that crews had not undergone training in this since the 2012 London Olympics.

    London Ambulance Service is responsible for emergency transport for 8.6 million people in London.

    Hospitals chief inspector Professor Sir Mike Richards said: "The Trust has been performing poorly on response times since March 2014. This is a very serious problem, which the trust clearly isn't able to address alone, and which needs action to put right."

    Rehana Azam, from the GMB union, said: "The underlying problem is a shortage of staff. There is a seriously high vacancy rate in the London Ambulance Service and other ambulance services for some time."

  4. Junior dispute talks continue

    Talks which could avert junior doctor industrial action were resuming today.

    Negotiators from the British Medical Association and the NHS Employers successfully completed a full day of talks yesterday at the conciliation service Acas.

    The talks began after an about-turn by Health Secretary Jeremy Hunt on Wednesday - six days after he rejected a BMA offer to use Acas following the 98% junior doctor vote for strike action.

    The first industrial action is due on Tuesday when participating junior doctors are set to refuse to undertake non-emergency work.

    The BMA has said it will not suspend the action unless the government withdraws its threat to impose a new junior doctors' contract next year.

    And NHS organisations are continuing to plan for disruption to services on Tuesday.

    Yesterday's talks were overseen by Acas chief conciliator David Prince with help from an Acas regional director, Rob Johnson.

    A spokesperson for Acas said last night: "Talks under the auspices of Acas between NHS Employers, the Department of Health and the BMA have adjourned for the day and will resume tomorrow."

    * In Northamptonshire, GPs urged the public to help reduce the pressure on the NHS on Tuesday.

    Local hospitals have already begun contacting patients to postpone appointments and procedures, the local NHS said.

    Dr Miten Ruparelia, clinical leader for NHS Corby Clinical Commissioning Group, said: “For vulnerable groups – such as the elderly, children and people with long-term conditions – steps should be taken to ensure they, or those caring for them, know what to do if they need medical care. If they have regular medication – please make sure they collect any prescriptions from the GP and have been to the pharmacist to collect it, and have it to hand.

    "Most importantly A&E is only for people who have life threatening emergencies.”

    [Earlier report on this on news]


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