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The National Health Service in the UK faces many challenges. Some are just an ageing population, a diversity of patients in the 21st Century, the availability of more treatments and modern day expectations. Then there is money. Yes that old chestnut.

The UK Coalition government has proposed reform of the NHS which will see funding reverting back to General Practitioners. This was the way of the NHS sometime ago. It will be a costly exercise to implement such changes. It always is. This means that money which could be better spent on patient care will end up being used for administration and planning. New posts will be created to implement the changes and they will not come cheaply.

Whether the changes will benefit patients or make real savings we will find out in the future. If they don't then it could be another costly exercise to change things once more. And so on it goes.

Already most hospital trusts are having to cut their work forces. Wards have been closed, staff numbers reduced and some services shifted into the private sector. This means that in an emergency situation many cannot cope. They are already working under pressure so an outbreak of the winter vomiting bug, which is ongoing now, can tip services over the edge.

Today there is news once more that the NHS is failing the elderly.

There have been many stories regarding poor health care of the elderly in the UK and the latest is with regard to cancer treatements.  The report follows a poll by British cancer charity Macmillan Cancer Support. SkyNews reports that:

 45% of 155 GPs, oncologists and specialist cancer nurses surveyed said they have dealt with a cancer patient who has been refused treatment on the grounds that they were too old.

Macmillan said the UK has some of the worst cancer survival rates in Europe for older people.

Ciaran Devane, chief executive at Macmillan Cancer Support, said: "Health professionals' concerns about the prevalence of age discrimination in cancer care mustn't be ignored.

"Unless staff are given the time and training to carry out a proper assessment of a patient's overall physical and mental wellbeing, some patients will be unfairly written-off as 'too old' for treatment.

"The number of older people (aged 65 and over) living with cancer in the UK is set to rocket in the next 20 years from 1.3 million to 4.1 million.

"Unless the barriers to timely treatment are tackled now, many older people could die unnecessarily from cancer and services will become unaffordable."

Government Health Secretary Jeremy Hunt claims that the government is working with the Macmillan charity in order to address these issues. He accepts that there is still a great deal of work to be done to ensure that tose aged over 70 receive appropriate care. Look online though and you will see stories relating to this have been around for at least a year. That means that whilst Ministers procrastinate lives are lost.

Opinion
13 years of working in the NHS has shown this blogger that if you work there long enough you will see all reforms come around again. The if it is not broke why fix it scenario never applies. Then when it is broken change is a long time coming.

Elederly patients with cancer tend to end up on Medical Elderly Wards rather than on the modern oncology wards. This is sometimes true of other specialities such as heart failure patients. When there is a bed shortage being moved is acceptable when it is due to an emergency situation. When it is normal practice something must be done.

There may be nothing wrong with a ward you are admitted to but if it does not have the level of care or facilities you need your prognosis will be poor.

Time to cut the management tier at the top of the NHS and reopen wards which are needed with the right staff.

The current government in wanting to move services away from the NHS into the private sector must take responsibility.
 
 
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The UK government is investigating claims that some hospital patients are being discharged overnight. Guidelines are in place to prevent the transport of patients from hospital to hospital overnight, unless there is a clinical need, and likewise discharges home are time sensitive.

As a rule of thumb patients should not be discharged home between the hours of 11pm and 6am. Hospitals have gone a long way to stooping such practices. Sadly they still happen. This is said not simply because of today's news but after more than 12 years working in an NHS hospital.

Problems occur when bed shortages happen. As NHS trusts cut the number of beds available to meet the new budget restrictions it may be a hard thing to prevent. If an emergency admission is in dire need of a bed the alternatives available are numbered.

Elderly and vulnerable patients obviously need careful consideration before discharge but so do many others. It could simply be the area where you live that makes a night discharge not advisable. It does not take much to think of potential problems. It is after all not rocket science.

The Times newspaper has reported on overnight hospital discharges, which in turn has instigated this investigation. As allowed under the Freedom of Information requests in the UK, The Times contacted 170 NHS trusts, but only 100 in England replied. The 100 though had some staggering figures. 239,233 patients were discharged home by these trusts, in 2011, between the hours of 11pm and 6am.

Whilst the government is investigating the claims made by the Times, it is hard to believe that such practices were not known by the government. With a decrease in funding, a decrease in beds and a decrease in staff, inner city hospitals in particular will continue to fail in their bed management.

Tags: NHS trusts, UK health care, overnight hospital discharges