St Helens Clinical Commissioning Group Could Suspend Non-Vital Operations in Winter

An NHS commissioning group has proposed a temporary ban on non-vital operations in a bid to tackle funding problems.

St Helens Clinical Commissioning Group (CCG) in Merseyside could suspend all non-essential hospital referrals for four months during the winter.

The CCG’s lay chair, Geoffrey Appleton, said the group recognises the move “won’t be popular” but is facing a funding gap of £12.5m this year.

Appleton stated that the plan would “support hospitals during the busy winter period and allow them to concentrate on the sickest patients.”

Explaining the group’s situation in its Financial Recovery Plan, Appleton commented thus:

“Imagine our NHS budget is your household budget and every year the cost of living goes up but your salary doesn’t increase; the result is money becomes tighter and tighter. Now imagine another relative comes to live with you and because of their health needs are unable to work and cannot contribute financially. How would you manage?”

The CCG, which was recently rated “inadequate” by NHS England, is also suggesting a two-year suspension of IVF services for people aged under 37 and stopping provision of gluten free foods and some over-the-counter medicines.

The CCG said it hopes to save at least £2.5m by pausing non-urgent referrals to hospital, and claims that it is “under-funded” compared with other areas in Cheshire and Merseyside.

Dr Richard Vautrey, deputy chair of the BMA’s GP committee, asserted that the move “highlights the incredible financial pressure facing general practice and its impact on patient care. It cannot be right that the public will be effectively denied access to healthcare because the local CCG has run out of money.”

Vautrey also called on government ministers to “step up their commitment to resolving this crisis”.

“The cost to the health service of delaying referrals could ultimately be much greater in the long term as more complex and costly problems develop as a result,” Vautrey suggested.

The NHS England regional office will review the proposals before a decision is made because of the CCG’s inadequate rating.

An NHS spokeswoman indicated that deciding how to prioritise resources is “very difficult for commissioners, but CCGs must plan and manage demand over winter. St Helens CCG is actively engaging with its local population on the best way to ensure patients have their care prioritised over the busy months for the NHS.”

The proposals are under public consultation until 5 October, but will undoubtedly be controversial, as they effectively represent the rationing of NHS services which until now have been taken for granted.

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Smoking Ban Having Positive Impact on Cancer Deaths According to Study

Evidence suggests that the public ban on smoking indoors has helped save the lives of many passive smokers.

A study assessed the effects of smoking bans across 21 countries, including England and Scotland, and found fewer admissions to hospital for heart attacks and strokes following smoking bans.

On the other hand, it was notable that the bans in question didn’t result in many people stopping smoking.

The assertion is based on the fact that the study included in the review found a larger reduction in heart attacks and strokes among non-smokers.

It thus concluded that the fact that people who do not smoke are no longer exposed to passive smoking is having a positive influence over the health of the population as a whole.

The problem with the research in question is that carrying out a randomised controlled trial of any merit over such a complicated subject is simply impossible.

Although the observational evidence in this particular case has some credibility, it is difficult to entirely cite causality considering that this is based on data alone.

There could be numerous factors contributing to this phenomenon, but it is nonetheless encouraging, and it seems reasonable to assert that the smoking ban has indeed had some influence.

Research was carried out by researchers from the Cochrane Tobacco Addiction Group, which is part of the Cochrane Collaboration of international healthcare researchers, and funded by the Health Research Board Ireland and University College Dublin.

The study was published in the peer-reviewed Cochrane Database of Systematic Reviews on an open-access basis, so it is free to read online.

Researchers found 77 studies and looked at the effects of a smoking ban on:

– cardiovascular health (mainly heart attacks and strokes)

– respiratory health (mainly asthma and chronic obstructive pulmonary disease, or COPD)

– the health of newborn babies

– numbers of deaths from smoking-related diseases

– numbers of people who smoked, plus quit rates and tobacco consumption

In 33 out of the 43 studies included in the research, there was persuasive evidence that fewer people were admitted to hospital with heart attacks and unstable angina.

However, the evidence was unclear about the effect smoking bans had on how much people smoked, and how many smoked.

While some studies showed a dip in smoking and an increase in attempts to quit just before and shortly after a smoking ban was introduced, these reductions didn’t last.

What can be reasonably concluded from the evidence is that the smoking ban is having influence in some areas of public health, but not significantly impacting upon the tendency of people to stop smoking.

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