NHS Scotland compensating for serious bed shortages in England

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We hear, often headlined, the single cases of NHS Scotland patients travelling to London for specialist care, such as for Ebola, not available in Scotland or for access to expensive drugs not approved here.

Far more significant, but rarely reported in our Nomedia, are examples of large numbers being transferred from a system ten times its size, into NHS Scotland, because of shortages in NHS England.

In the Guardian yesterday:

At least 154 vulnerable patients, mainly women and some teenagers, had to travel hundreds of miles from their homes in order to receive residential care in Glasgow and Edinburgh, costing the NHS millions of pounds annually. The data, obtained under freedom of information from NHS England, is the first of its kind to be revealed. Official figures showed that in 2017-18, caring for English eating disorder patients in Scotland cost £5.1m, compared with £4.5m the year before and £2.2m in 2014-15. Mental health experts expressed alarm and blamed the NHS’s use of cross-border care on an acute lack of both beds in mental health units and specialist staff to look after patients. They said care further from home could damage patients’ chances of recovery, increase their sense of isolation through the separation from their families and even raise their risk of dying.’

https://www.theguardian.com/society/2018/oct/16/nhs-england-eating-disorder-scotland-treatment

See this from only one English Board in July 2017:

‘Mental health patients in Oxfordshire have been wrenched from their families and forced to travel as far as Scotland to receive care and treatment. As many as 478 residents with mental health problems have been sent out of the county in the past three years, with the furthest travelling 532 miles to New Craigs Hospital in Inverness. The British Medical Association (BMA) found that patients of Oxford Health NHS Foundation Trust had to travel some of the greatest distances of anyone in the country.’

https://www.oxfordtimes.co.uk/news/15383748.Bed_closures_force_mental_health_patients_to_travel_as_far_as_Scotland_for_treatment/

These are very large numbers being supported by NHS Scotland and, all things being fair, headline stories for our Nomedia.

It is inevitable that any small country such as Scotland, Belgium or Denmark will find itself sending patients with rare conditions to specialist facilities in larger countries such as England, France or Germany. It’s one of the things the EU was built to do efficiently but the proportionately heavy traffic of regular cases from England to Scotland suggest the smaller country is, in this case, subsidising the larger one.

 

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12 thoughts on “NHS Scotland compensating for serious bed shortages in England

  1. gavin October 17, 2018 / 12:02 pm

    The “invisible” news—at least to BBC @Branch Office.cringe.

    Liked by 1 person

  2. Alasdair Macdonald October 17, 2018 / 12:16 pm

    The last time that Good Morning Scotland and allied programmes did a feature on cross border transfers for specialist treatment was about a fortnight ago and related to a young man with a severe autistic condition who was being moved to a unit in the north of England – Hull, I think. There was a long interview with his mother, who was very articulate and spoke fluently, probably having developed her competence over many years of advocacy for her son.

    She was seeking a provision closer to his home in Scotland, as had been the case for some time.

    The programme implied that there had been some sort of bureaucratic or administrative foul up, although it did not state this explicitly. There was a statement from the relevant section of NHS Scotland and the caring organisation that the case had been reviewed. As with most of these case there are complex, specific and sometimes unique circumstances. There was little contextual information other than that provided by the mother.

    The programme made no attempt to talk about how very rare conditions are dealt with, such as by single specialist units somewhere within the UK.

    It was a ‘dogwhistling’piece, as was the mention, when interviewing the Chief Medical Officer about the flu vaccination programme, that ‘Some pharmacies were reported to have run out of supplies of the vaccine for private patients’. The ‘excess deaths’ last winter was dropped in to the piece. There was no accusatory questioning of hostile tone or interruption: just innuendo. I know of two people of my age who are muttering that they want the vaccine that they have heard some English Health Boards are using but which is available in Scotland only to over 75s ( I have four years to go. I get my ‘normal’ flu jag next week.)

    Liked by 1 person

    • Legerwood October 17, 2018 / 2:48 pm

      If you look at the statistics for the increase in deaths you will find, if I have remembered correctly, that the highest rate for deaths from flu was in the over 75s there for makes sense to target them with the additional vaccine. But of course you will never get the No media to point that out. They would rather spin it as SG not ordering enough vaccine.

      Liked by 1 person

      • Alasdair Macdonald October 17, 2018 / 3:58 pm

        Re Nomedia: Mr Tom Gordon in today’s Herod states baldly: NHS Scotland did not order enough (of the vaccine being given to over 75s) in time.

        Liked by 1 person

      • johnrobertson834 October 17, 2018 / 6:45 pm

        Did I get the rubbish one for the only over65s? Aren’t those dastardly over 75s mostly No voters?

        Like

  3. bigjon999 October 17, 2018 / 2:39 pm

    I spotted that Guardian article and hoped you’d do a check on it. Seems like the English NHS is relying on Scottish NHS to cover for its (major?) weaknesses. Can’t wait till this is highlighted by BBC Scotland or Radio Scotland…

    Liked by 1 person

  4. Ludo Thierry October 17, 2018 / 4:25 pm

    Hi Alasdair and Legerwood – Couldn’t agree more with your comments. The National Registers of Scotland figures do indeed identify that:

    Around 80% of additional deaths (3,860) last winter were among people aged 75 and older.

    The underlying causes of most of the “additional” deaths included respiratory diseases, heart disease, stroke and dementia.

    Very few deaths were caused by hypothermia and only a small proportion directly by influenza.

    The beeb Scotland website article actually contained the relevant info but the author appeared mightily confused and the piece was certainly fixated on ‘flu.

    My instinct is that Dr. Calderwod (Scotland’s Chief Medical Officer) and the Scottish Govt were fairly sanguine about the high confusion in the (fairly lengthy) article as the beeb was doing good work by stealth by reminding readers and viewers/listeners that there is a major ‘flu vaccine programme being rolled out right now – and the principal focus is to encourage as many of the target populations to get themselves along (nice and quickly) to one of the many vaccination clinics operating throughout Scotland.

    A case of employing the beeb’s confused shrieking to actually get the ‘desired’ message out there. Well done beeb Scotland – Keep up the good work.

    As an asthmatic I was contacted directly by post and, by a simple phonecall, arranged my own jag. It was a very minor lump for approx. 24hrs. If anyone reading this post is in the target groups or has friends/family in the target groups please do take advantage of this brilliant service organised by NHS Scotland. Scotland needs us all (and our YES votes at the Indyref).

    Liked by 1 person

    • Legerwood October 17, 2018 / 7:24 pm

      The BBC article also mentioned that the figures were the highest since the 1950s. In fact from the graph they helpfully provided the winter deaths in 2018 were 52% of the deaths in the 1950s. There has been an overall downward trend over that time – improvement in treatments, generally healthier population and more effective vaccination programme may be factors in that.

      With regards to the shortage of the trivalent vaccine, it would appear that there were other parts of the UK affected by the shortage as this article from Pulse points out:
      http://www.pulsetoday.co.uk/clinical/immunisation/gps-told-to-only-give-new-flu-vaccine-to-over-75s-as-scotland-fails-to-secure-stock/20037560.article

      The advice about the new vaccine came late in the day and the company producing it in the UK had a race to increase their output. Preparation of the flu vaccine takes 6-8 months. In October/November 2017 the WHO issued its recommendations for the composition of flu vaccine for the Northern Hemisphere flu season for 2018-19.
      Worldwide a total of 1.5 Billion doses can be prepared. The vaccines are prepared in chicken eggs and each dose requires 3-4 eggs – you do the arithmetic. New, quicker methods are being researched but for now it is chicken eggs and 6-8 months to grow the vaccines. The flu virus has one of the highest mutation rates of any of the human viruses. HIV is the only one that comes close in terms of mutation rate. This mutation rate can cause problems during the lengthy preparation because mutations can arise that render the vaccine less effective. They think that is what happened last season’s vaccine making it less effective against one of the circulating strains.

      Sorry, went on a bit there.

      Liked by 1 person

    • Alasdair Macdonald October 18, 2018 / 9:05 am

      Thierry, Like you, I felt that there was an attempt to encourage people in the identified group to avail themselves of the opportunity to receive the flu vaccination. I felt that the CMO’s reply was certainly focussed on that. Extending the principle of charity, it is plausible that the ‘project fear’ approach was being used to try to ‘motivate’ more people to get vaccinated. Perhaps my perception of the BBC interview and website was coloured by having read previously the Herod’s outright blaming of NHS Scotland.

      Like you, I have had a letter and a text reminding me that the vaccination was available. I usually get it during the week of the school holiday in October, but this year, because I have another routine screening to take, I deferred for a fortnight until the first available time to do both at the one appointment. My experience of the jag has varied. Mostly, I have had no ill-effects. On one occasion I had a slight respiratory infection for a few days after. On the other, I had a really sore arm, but I put that down to the fact that it was my GP who did the injection rather than the nurse!!!

      PS I see that the BBC is having another kick at the baby boxes. Again they are quoting ‘experts’, but, the issue is about POSSIBLE risks if it is used for an extended period for sleeping. There are no cases of SIDS associated. The ‘experts’ were, again, ‘The Lullaby Trust’ whom Kaye ‘Rosa Klebb’ Adams used to kick the boxes apart. As far as I know the Trust does not operate in Scotland. I see that some Health Boards in England now issue baby boxes.

      Like

      • Alasdair Macdonald October 18, 2018 / 3:53 pm

        Apologies, Ludo. I have a neighbour called Thierry!

        Like

  5. Ludo Thierry October 17, 2018 / 4:52 pm

    Since beeb Scotland are getting confused between all respiratory illness and ‘flu I thought I’d do an edit of a wee piece from news.gov.scot which I’ve not noticed elsewhere. The official stats for Scottish emissions of air pollutants during 2016 have been published. The figures are good and the figures over the period since 1990 are very impressive (the period of the SNP Scottish Govt covers a decent chunk of that period – so fair to assume that well-considered SNP Govt public policy is having at least some impact on this encouraging progress):

    https://news.gov.scot/news/scottish-emissions-of-air-pollutants-2016-results

    Scottish emissions of air pollutants – 2016 results

    An Official Statistics Publication for Scotland.

    Scotland’s Chief Statistician today announces the release of a report on Scottish emissions of ammonia, sub-10 micron particulate matter (PM10), sub- 2.5 micron particulate matter (PM2.5), nitrogen oxides, non-methane volatile organic compounds (NMVOCs), carbon monoxide, sulphur dioxide and lead on the National Atmospheric Emissions Inventory (NAEI) website.

    The main findings are:

    • Over the long term there have been reductions in emissions for all the pollutants. Since 1990, there have been decreases of:
    12 per cent for ammonia,
    64 per cent for PM10,
    65 per cent for NMVOCs,
    67 per cent for PM2.5,
    72 per cent for nitrogen oxides,
    84 per cent for carbon monoxide,
    94 per cent for sulphur dioxide
    and 98 per cent for lead.

    Between 2015 and 2016, there were reductions in emissions for 6 of the 8 pollutants (sulphur dioxide 34 per cent, nitrogen oxides 12 per cent). There were small increases in emissions of ammonia (+3 per cent) and NMVOCs (+1 per cent).

    The report notes: “There are uncertainties associated with all estimates of pollutant emissions … However, although for any given year considerable uncertainties may surround the emission estimates, it should be noted that trends over time are likely to be more reliable. “

    Those darned EsssseNnnnPeee types are doing it again – they’re insisting on operating policies that benefit ALL of Scotland – and – what’s worse – they’re doing it DELIBERATELY.

    Liked by 1 person

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