IN AN unprecedented move, NHS hospital trust managers have rejected plans for next year’s NHS payment system, warning that they cannot any longer guarantee ‘safe care’ if the next wave of cuts proceeds.
NHS England had proposed a cut of just under 4% once inflation is taken into account as part of a ‘savings drive’.
NHS England is proposing changes to the funding for 2015-16, so that all patients treated in excess of the numbers of patients treated last year, will only get 50% of the standard tariff.
Much of a hospital’s funding comes from a set of tariffs that rewards them per patient treated.
Chris Hopson, chief executive of NHS Providers, said the decision to reject the proposals had ‘not been taken lightly’, but 80% of hospitals were now in deficit.
‘It is a clear response from the front line that they can no longer guarantee sustainable and safe care,’ he added.
The reduction in the tariff had been proposed to ‘free up more money for services’ outside of hospitals as part of the push to ‘move care into the community’.
Meanwhile, 450 doctors from University Hospitals Birmingham and other specialist hospitals have written in protest to Simon Stevens, head of NHS England about the reduction.
Queen Elizabeth Birmingham, a £545m hospital built in 2010 with 1,213 beds, stands to lose £60m. Over Christmas it had to announce a major incident for lack of capacity.
The chief financial officer of QEH said: ‘We would have to take a lot of staff out of frontline healthcare to deliver that level of savings.’
The letter from Dr David Rosser, medical director of QEH, said: ‘The clinical consequences of these longer waiting times and a lower quality of service to patients with conditions such as heart disease, liver disease, leukaemia, complex cancers etc will be severe.
‘There will also be avoidable deaths as patients die on waiting lists or find their disease has progressed during the wait for treatment to the point that it is no longer curable.’
Meanwhile, doctors have slammed proposals to shorten the time necessary to train to become a qualified doctor warning that such a move will ‘seriously compromise patient care’.
The plans would see the time it takes to reach consultant level cut by two years.
Dr Tom Dolphin, of the British Medical Association’s (BMA) junior doctor’s committee, said: ‘The proposition is going to result in people finishing training and being labelled as a consultant much earlier on, when in fact they have not reached the same standard that patients have come to expect in this country.’
The Royal College of Physicians raised concerns, saying that shortening doctors’ training would ‘compromise both quality of patient care and patient safety’.
Currently, doctors spend the first two years after graduation in rotation between around half a dozen different areas of medicine, such as geriatrics or A&E.
They then specialise and stay within that area until they reach consultant level.
Depending on which area they choose to focus on, that can take between eight to 10 years.
The ‘Shape of Training’ review into specialist doctor training was chaired by Prof Sir David Greenaway of the University of Nottingham. The 2013 report made 19 recommendations for changes to medical training.