(N.B. This site is not currently being regularly updated. )



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The government's increasingly desperate attempts to defend their record on the NHS have become less and less credible over the last year. This is partly due to in
creasingly effective local and national campaigns and partly to the crisis in hospitals, primary care and social care has forced more and more of those involved to speak out against the damage being caused by austerity. But many of those who are being damaged have no voice. Poor people, disabled people and the chronically ill have fewer opportunities to make their case as their benefit and treatment rights become eroded. NHS staff are generally gagged in one way or another. Exit can be the only escape leaving the NHS still weaker and now less and less able to recruit staff from overseas.

Large national demonstrations and industrial action by junior doctors, nurses and others have made the strength of feeling around the country quite clear, to the extent that even the Conservatives have got worried enough to promise the outlines of a new financial deal this summer. But will it be too late? Certainly it will be insufficient to undo the damage inflicted since 2010. Meanwhile the stress on services which affect the need for healthcare becomes more and more acute. The unspupported costs of Social Care (which is subject to means tested charges) is driving local authorities to bankruptcy.

Another threat is the developing reorganisation into Integrated Care Systems (previously known as Accountable Care Systems) which threaten to become Accountable Care Organisations. In our local area the Integrated Care System covers Barnsley, Rotherham, Doncaster and Bassetlaw as well as Sheffield. (See posts below.) Increasing pressure from campaig
ners and within the Labour Party is deterring local councils to sign up to these in case they become vehicles for further cuts and privatisation.

Across South Yorkshire resistance is building to the threatened implications of the ICS for local services and South Yorkshire Save Our NHS have formed a political party to stand in the Sheffield City Region Mayoral election on May 3rd 2018. See also Barnsley Save Our NHS.

NHS21END_(Small)NOT KILLED OFF YET. Campaigning does work whether on the streets, in the press or, increasingly in the lawcourts. The government's high-handed tactics are being subjected to an increasing number of judicial reviews. At national level these have forced a public consultation on Accountable Care Organisations starting in May 2018.

Cartoons by Samantha Galbraith @sgalbraith47

For more national information see Health Campaigns Together and Keep Our NHS Public


April 14th 2018 11.45 Regional Demonstration to Save the NHS Leeds

April 25th
Soviet Healthcare via Targets: Are Governments Bringing it into the NHS? Roco 2pm or 7pm

April 28th Sheffield Demonstration against proposed closure of the Minor Injuries and Walk-in Centres (see main website for details)

June 27th The NHS is 70 - but what is its life expectancy? Festival of Debate / SSONHS panel discussion and social. Roco 7pm - 11 pm.

June 30th Health Campaigns Together march for the NHS in London See main wesbite for details.

SSONHS planning and information meetings are generally on the first Monday of the month, except for bank holidays. They are usually at 6pm at the United Reform Church. Chapel Walk/Norfolk St S1

To contact us email


In 2016 abnd 2017 we worked with Sheffield Festival of Debate and other colleagues to promote realistic discussion of the issues facing the NHS. On 4th May 2017 we had a lively meeting debating the future of hospitals and in 2016 we mounted an exhibition on NHS privatisation to coincide with a play, A DUTY OF CARE about Labour and the healthcare market. On 22nd November 2016 we held a panel-led debate on the future of the NHS with local NHS leaders, academics and campaigners. We also held a public meeting on 4th July 2016 to celebrate the NHS anniversary, discuss the STPs, the implications for privatisation in South Yorkshire and North Derbyshire and the consequences of the EU referendum result.

In March 2016 we held a successful workshop Taking Back Our NHS

We supported the Junior Doctors throughout their action because we felt they were being unfairly treated and were being treated as the advance guard for Hunt's uncosted, unfunded and misconceived ambition for a 7 day NHS. (For one of our supporter's views at the beginning of the dispute see this column in the Sheffield Star

For our questions to 2017 General Election candidates and canvassers about the NHS see our
website campaign page

2016 8th-22nd November Exhibition on NHS privatisation How come we didn't know by London photographer Marion Macalpine
Theatre Delicatessen, The Moor

22nd November SSONHS Festival of Debate event
Why is the NHS Under so much pressure? How can we save it for future generations?
Speakers included Dr Tim Moorhead, Chair, Sheffield CCG, Kevan Taylor (Sheffield Health and Social Care Trust) and Professor Sarah Salway (University of Sheffield, Public Health) + local campaigners

Taking Back Our NHS SSONHS workshop

Saturday 12th March 2016, 10am - 2pm


Tuesday 22nd September, 7pm screening of Sell Off, attended by well over 100 people.

Campaigning for GP practices at risk of closure

2nd July Successful SSONHS public meeting addressed by Ray Tallis and speakers from Devonshire Green and Unison.

2nd May SSONHS stall in city centre from 11.30 Come and see us.

The 38 degrees ambulance will also be in Surrey Street at 12pm and conveying the 38 degrees petitions to local Hallam candidates at Wesley Hall in Crookes for 3pm.

25th April - March through Sheffield Hallam, with the People's NHS and 38 degrees

28th February 38 degrees petitioning around Sheffield

22nd November Leafleting in Sheffield City Centre from 12.00 pm in support of the NHS strikers. For A5 and A4 copies of the leaflet which has more information on it see the Campaigns Page at our website

24th November NHS picket lines from 7am to 11am. Rallies at the Hallamshire and Northern General (Herries Road) at 10 am.

We were proud to support the Jarrow to London march for the NHS, organised by Darlington Mums passing through Sheffield on August Bank Holiday Monday. Thanks to everyone for helping and joining in.

24th JULY 2014 Public Meeting jointly with Sheffield Medsin

Is our NHS really in crisis? Behind the headlines and soundbites
Panel discussion led by GPs and health experts from the NHS and universities.

For past activities see our website

Thursday, 27 October 2016

Sustainability and Transformation Plan update

The STPs look like being neither sustainable nor transforming, except for introducing cuts. They're more like castles in the air. At the time of writing the STPs are still mostly secret despite having been submitted on 21st October. Some details of the Sheffield Place Plan were published at the Sheffield CCG meeting on 6th October here.  NHS England have instructed that all local communication about the STPs must be processed through their central communications team.

Some call the STPs the least bad option (Chris Ham here) but campaigners like John Lister of London Health Emergency and Keep Our NHS Public are more scathing.  Campaigners are pushing local Councils not to sign up to the STPs if they involve cuts. Two London Councils decided to publish the STPs anyway in order to bring them into the public domain and, because they involve disputed hospital closures, to seek a judicial review.

Opposing STPs does put cash-strapped councillors in a dilemma because the STPs are a potential source of funds for social care. But to accept this is just making matters worse. The plans need to be part of a proper public debate which must surely but back pressure on Hunt and May to recognise they can't go on pretending that the NHS is managing.  Cracks are appearing all over.  The Chancellor's neglect of the NHS and social care in his Autumn Statement was quite shocking.

Update 28th November

The South Yorkshire and Bassetlaw STP has been published on the website of South and Mid Yorkshire Commissioners Working Together, the group which is providing administrative support for the STP.  Here you can also find consultation proposals about the reconfiguration of Hyper acute stroke services and children's surgery. (Scroll down for the link to the STP page).

The STP does not involve any immediate cuts in Sheffield but significant changes are hinted at.  The financial strategy is not yet written or agreed.

We have attended a number of local events to challenge assumptions in the STP process but both the STP and the Sheffield Plan are up for approval at Sheffield CCG on 1st December.

Update 10th December

Sheffield Clinical Commissioning Group agreed the Direction of Travel of the STP and also approved the outline of the Sheffield Plan.  However at the full meeting of Sheffield Council on 7th December Cllr Cate Macdonald, Cabinet Member for Health and Social Care, said that it was not currently the intention of the Council to approve the STP because of the implications of agreeing the cuts which it implies, both at local and national level.  Hostility has also been expressed within Barnsley Council.  Other Councils up and down the country (including Tory controlled Devon) have also refused to agree their STPs.  The NHS leadership is showing signs that it recognises the process is in trouble, but for the moment it remains the only game in town.  There is likely to be more consultation and wooing of Councils and other organisations but the press seems clear that Theresa May is adamant in her refusal of more money for the NHS despite its increasing desperation.  Expect more trouble and confrontation from many quarters, not excluding staff groups as things become more and more stretched.

The Shaping Sheffield event held on 8th December was notable for avoiding the phrase STP wherever possible (though it was raised by the SSONHS speaker) and it seems likely that the Sheffield Plan (which predates the STP though is based on similar principles) will carry on edging forward under its own branding. 

Sunday, 25 September 2016

Sheffield's "Place Plan" - part of the South Yorkshire and Bassetlaw STP

The NHS was instructed early this year to prepare Sustainability and Transformation Plans for 44 NHS Footprint areas. Ours is South Yorkshire and Bassetlaw and it is founded on so-called Place Plans for each of the CCG areas involved. The foundation for Sheffield's Place Plan is the Out of Hospital Strategy previously adopted by the CCG.

The STPs are unequivocally about getting the NHS to make local decisions about how to manage within the very tight and effectively reducing Government budget for the NHS. Nervous about this, NHS England placed a ban on public involvement during the preparation of the plans. In many areas (including West Yorkshire) they involve hospital closures. Some London Councils have refused to sign up to STPs where they involve the closure of popular facilities and the organisation Health Campaigns Together is calling on all Councils to refuse to sign up to STPs where they involve significant closures.

Some details of the Sheffield Plan will be made available on 29th Sept but local statements suggest that the process is currently more fluid than the early proclamations from NHS England anticipated. Although the plans are scheduled for implementation from April 2017 there will have to be formal public consultation from October. In Sheffield this will include sub-regional consultation on new proposals for hyper-acute stroke and paediatric surgery services - separate from but linked to the STP - and any changes deemed 'significant' by Sheffield CCG on Urgent and Emergency Care. the changes to stroke and paediatric services will involve some services ceasing in some centres (e.g. Barnsley and Rotherham) in order to reinforce/improve the regional services from the centres regarded as stronger (including Sheffield. This will have implications for income, viability and capacity in all local hospitals and the consultation will need to be vigorously addressed.

The Sheffield Plan is due to be approved by the Clinical Commissioning Group on 1st December and will be the subject of a citywide workshop on 8th December, hosted by Sheffield Health and Wellbeing Board and Sheffield Healthwatch.

Wednesday, 29 June 2016

So after the Brexit vote, what next?

Whatever you make of the Brexit vote, the ensuing chaos must be laid firmly at the door of the Conservative Party which forced the idea of the referendum, organised it (if that's the right word), failed to be honest about the issues (on either side), alienated the public and failed also to plan for an unexpected result.

The EU Leave campaign made a deliberate point of promising extra money for the NHS. The extent of the pledge was quickly revealed to be a lie and, indeed, post referendum, has already been retreated from by the likes of Nigel Farage. Nevertheless comments from the public both before and after referendum day suggested that it stuck in the memory and influenced people’s votes.

Whatever happens to the UK’s relationship with the EU after the vote in favour of Leave, the current government's austerity programme has placed the NHS in dire trouble and it is now issuing new threats to public spending. Goerge Osborne warned that even his so-called protection for the NHS budget was unlikely to be guaranteed. Starved of resources, haemorrhaging clinical staff, and facing continually rising expectations, the NHS faces new threats of further cuts because of growing economic weakness, rising inflation as a result of currency fluctuation and the likely diminution of the 52000 EU immigrant staff who help to keep services meeting patient need. As budgets get tighter national and local NHS leaders are being forced into ever more contortions to keep the service going - the latest being so-called Sustainability and Transformation Plans, in our case covering the whole of South Yorkshire and Bassetlaw. In many parts of the country these plans introduce cuts and closures and are already subject to challenge.

In the General Election our area voted overwhelmingly for pro-NHS candidates but in the referendum it voted narrowly for Leave. Few in Sheffield want to see the NHS collapse so we have a collective responsibility to ensure that what we value about our system lives on. We, the public, NHS patients and NHS staff, whether we are Remainers or Brexiters, need to care for the NHS both in the demands we must make of decision makers in all parts of the political spectrum and in the way in which we use it. Otherwise. before very long, we will find ourselves faced with an increasing spread of charges and the collapse of many parts of the system into private hands with no sense of responsibility to society at large. We've already seen the mess which has been left in places like Nottingham, Cambridgeshire and Cornwall when that happens. Sheffield Save Our NHS will be continuing to campaign both locally and in partnership with others in Yorkshire and the rest of the country to keep the NHS as a public provider of quality universal health care.

Come to our meeting on 4th July at the United Reform Church (6.30 for 7pm) to celebrate the 68th anniversary of the NHS, to hear about developments across Yorkshire, and to plan how best to campaign for the NHS in the future.

Sunday, 19 June 2016

The EU Leave campaign has no right to claim the NHS logo

SSONHS isn't taking a stance on whether the UK should or shouldn't remain in the EU. However we decided to circulate a comment to our email list on the unjustified use of the NHS logo on Leave publicity material including bus advertising. We thought that NHS England had not challenged this but a reply told us that apparently government lawyers did request them to stop in March but the Leave campaign refused accusing the government of 'bully-boy tactics' and no further action was taken. It says a lot about the debasement of the logo through its regular licensing to private firms that NHS England went no further than a threat and that the Leave campaign was so shameless.

Whatever side you are on in the referendum debate the NHS should not in itself be a crunch issue although broader health considerations may be. The NHS is not directly relevant to the basic arguments for or against EU membership especially as the debate becomes increasingly polarised between those who consider they have a lot to lose and those voters who feel they have very little left to lose.

The basic trope of the Leave campaign in relation to the NHS is that more money will be available for the NHS if we leave and that pressure on services will be reduced because there will be less immigration. Two Tories have commented on the finance issue: Dr Sarah Wollaston the GP who was part of the Leave campaign, has changed sides because she could not justify the claim that £350billion is paid to the EU, let alone that a significant part of this would be available for the NHS. Also speaking about the NHS last week, John Major, ex Tory PM, told Andrew Marr on the BBC that "Michael Gove wanted to privatise it, Boris wanted to charge people for using it and Iain Duncan Smith wanted a social insurance system. The NHS is about as safe with them as a pet hamster would be with a hungry python". As for immigration, yes there are pressures on the NHS just as there are pressures on the Spanish health service because of elderly Brit expatriates. These might change slightly if Brexit secured some change in migration rules but would not necessarily be hugely different especially if we remained in the single market. The threat to the many non UK nationals working in the NHS would be significantly undermining and an extension to the threats faced by non-UK NHS staff earning under £18000 under the current Tory system. We have also been told about the importance of EU membership for collaboration on medical and public health research.

The Remain campaign claim that the Brexit would lead to economic difficulties and confusion for the economy as a whole and this, as Simon Stevens (head of NHS England) has warned, could seriously affect the NHS both short and long term. The NHS is highly vulnerable right now and the head of NHS Improvement has already said that the NHS will be unable to meet its national undertaking to break even this financial year. However the dire general warnings being uttered by lead Remain campaigners and European leaders seem much too catastrophic. Faced with Brexit more bilateral or alternative agreements could and would be drawn up to cover such issues as EHIC although some of the arrangements for elective treatment in EU countries currently available for NHS patients are likely to become unavailable and this would create more demand on UK services. Nevertheless Brexit supporters who are concerned for the NHS have to weigh up whether the longish period of serious economic and political uncertainty which will follow any vote, together with the consequent high level of threat to public sector spending and an NHS which is already over-stretched, is worth the risk against whatever they think will be gained. It is quite possible that the administrative strain of leaving the EU could be at least as stressful for the NHS as Lansley's Act.

Broader health issues and the consequent effects on the NHS are also relevant. We already have austerity and further economic uncertainty will, in the short term at any rate, affect jobs and the national income. Some of the issues are listed in a BMJ article but the links are behind a pay wall. Some medical opinion is summarised by The Independent here. Most medical opinion is in the Remain camp. The EU has taken significant public health initiatives although these are constrained by the lumbering nature of the way in which decisions are taken. Would the sort of UK government or regime which might follow a Brexit vote be likely to give equal support to public health issues, environmental considerations or even human rights given that a prime argument for leaving is deregulation?

Against this it is perfectly possible to argue that taking back responsibility for decision making into UK hands would mean that credit or blame for outcomes, for instance on the NHS, could be squarely put where it belongs instead of using the EU as scapegoat or smokescreen. Some financiers fear that Brexit could give space for 'madcap left ideas' if EU restrictions on state aid to industries are withdrawn (although other EU countries seem to have found ways to provide state support where necessary/desired). One positive outcome of the referendum arguments is the present government's agreement to formally exclude the NHS from TTIP - though the real worth of this assurance is still be tested. Brexit may of course eventually exempt the UK from EU competition laws (though these might still apply, at least partially, in a single market) but what would be the likelihood of a UK government taking an even more pro-competition stance? Business leaders who favour Brexit are overwhelmingly taking a neoliberal free market line.

If this piece is read as being pro-Remain, it is largely because of the misleading claims about the NHS being made by the Leave campaign and the distrust this generates. Campaigners report doorstep opinion that the Brexit campaign is more pro NHS which, as the quotes above suggest, is absolutely untrue.

If we remain in the EU, we know what the general climate is. If we leave then we will have to fight even harder to try and retain the public services we value. For some this may in the long term be a more attractive scenario because it can be argued to favour self-organisation. For others it can only create serious alarm.

Sunday, 24 April 2016

Treat our doctors fairly Mr Hunt, so that they can treat us safely

Update 18th June
As the Junior Doctors begin to vote on the contract offer, opinion remains split. There are plenty of reasons for rejecting the offer but many doctors feel they have gone as far as they can and want to get on with their training/careers. Another result for Hunt - divide the opposition. Most are agreed that the current offer is a massive improvement on the original proposals and also on the March offer. There are some significant concessions by the junior doctors (for example the loss of increments) and other technical worries remain partly because of Hunt's insistence on the 7 day concept and his neutral cost envelope. But the main concern is the effect on staffing and recruitment as well as the loss of momentum in the huge wave of public support to preserve the NHS. The rejecters say "The contract on offer will not fix the recruitment and retention crisis. It is not going to help trainees on rotas with less than 50% fill rates such as GP and Core Medical Training. It is not going to help with the cost of living crisis as inflation continues to outstrip pay. It is not going to attract trainees back from abroad and encourage people to stay as a doctor in the NHS. It will drive LTFT [doctors in less than full-time training] out of medical and surgical specialties and possibly out of medicine as a career, despite the best efforts of our negotiators to prevent that. It will require a constant fight with management in order to be paid for the work we do, with no independent oversight, without concrete safeguards that a hospital has any legal duty to honour." See here

We were asked by the Sheffield Star to submit a short article for possible publication in a feature on the strikes on 26th April. This is what we wrote.

"Talk to almost any junior doctor and you’ll immediately sense their anxiety not just about their own future but about the whole NHS. Jeremy Hunt’s insistence on trying to stretch the NHS while cutting its funding is squeezing staff at all levels beyond endurance. As numbers fall, junior doctors find themselves rostered to provide more and more extra cover with less help, often in unfamiliar surroundings and knowing that any mistake will be jumped on. In the 2015 NHS Staff Survey only 31% of staff agreed that there are enough staff for them to do their job properly.

We already have fewer doctors per head than most other European countries. 80% of junior doctors work unpaid overtime, often 11 hours a week. In 2008, 22% of doctors using the official ‘sick doctor service’ were aged under 35 but by 2015 that number was 54%. In 5 years newly qualified doctors joining NHS training schemes have reduced from 71% to 52%. Many trainees are planning gap years from this August because the proposed contract is the last straw. It also discriminates against women doctors.

Hunt’s 7 day service plan is based on misleading statistics and an ill-thought-out manifesto commitment totally derailed by his government’s austerity programme. The NHS will be less safe and possibly not even sustainable. Despite considerable progress in negotiations, the disagreement about Saturday working is less about pay than about clinical staff being able to retain enough control over their working lives to ensure they can make decisions and carry out treatments safely. If the doctors lose, nurses and other clinical staff will be next. We call on Sir Andrew Cash at STHFT not to implement the contract locally.

Without junior doctors our health service will collapse. Nobody wants these strikes but any short term safety risks are outweighed by the longer term danger of system collapse. Not all doctors’ strikes have been for the NHS but this one definitely is. They need our support."

Although several of us are away during the week, we shall be supporting the pickets at the major hospitals and the rally in Barkers Pool at 1pm on 27th April.

Thursday, 18 February 2016

Taking Back Our NHS SSONHS Saturday Workshop 12th March

Update 21 March. The workshop went well and generated a lot of information sharing, comment and suggestions. We will be discussing future plans, together with updates on local and national issues at our monthly meeting on 4th April.
Sheffield Save Our NHS will be hosting a half day event of information, discussion and campaign planning.

Taking Back Our NHS

Saturday 12th March 2016, 10am - 2pm
The Roco, 342 Glossop Road, Sheffield. S10 2HW

Keynote speaker Dr David Wrigley, Carnforth GP, Member of BMA Council and GP Committee and longstanding KONP activist. Plus regional and local speakers, who will cover the situation in Sheffield, the parliamentary NHS Bill to reinstate the NHS, and the Junior Doctors' dispute; followed by guided discussion and action planning.

The NHS is reeling under the pressure of the new market structures and the financial restrictions introduced by the 2010-15 Coalition government and reinforced by the current Conservative government. What is the impact in Sheffield and what can we do about it?

The Junior Doctors dispute has shone a light on the discontent felt about the government's agenda by many NHS staff and provided a focus for showing support for the NHS. Find out the latest in the dispute and what can be done to build solidarity.

This event is part of national action called by Keep our NHS Public to mark the second Parliamentary reading on March 11th of the National Health Service Bill, introduced by Caroline Lucas MP (Green Party) and co-sponsored by the Labour leader Jeremy Corbyn MP.

All welcome to come along and contribute Refreshments and low cost lunch available.

Accessible venue.

Register for the event at,
or email
Pre-registration would be helpful to us but you can just turn up on the day

Wednesday, 10 February 2016

Junior Doctors strike - Hunt must take the blame

Update Sept 2016
After many false hopes of potential settlement (including Hunt's potential departure following the Brexit vote)the junior doctors voted not to accept the new deal and eventually decided that escalating the dispute would be the only way forward. Reluctantly they posted notice of a rolling programme of 5 day strikes (daytime only) starting in September, but feedback from members and senior doctors soon revealed that the NHS would be too fragile to cope and patient safety might well be compromised. The first strike was called off and on 24th Sept a newly elected junior doctors leadership (including several radical names) decided to suspend the proposed actions entirely while not accepting imposition of the document. This will cause difficulties for junior doctors as new rotas are introduced next month and the JD leadership is likely to propose a different series of actions. A High Court judgement on the junior doctor's challenge to the new contract as the result of Hunt acting beyond his remit and irrationally is expected on the 28th Sept. The Junior Doctors' statement is on the BMA website.

Update 18/02/16 Following the strike on 10th February Hunt announced that he would be imposing the contract. In a typical NHS management muddle a number of leading NHS Trust executives including Sir Andrew Cash from Sheffield Teaching Hospitals were cited as supporting Hunt. However many of them, including Sir Andrew, notified that while they regarded the revised contract as fair and reasonable they did not support its imposition. Following reports that the imposition was not binding on Trusts, Health Education England which is now in charge of national training schemes announced that Trusts which did not impose the contract could be fined. Junior doctors are considering their positions while senior doctors have rallied to their support. This is a huge crisis for the NHS.

10/02/16 Both the Independent and the Guardian have reported that a provisional agreement between NHS Employers and the BMA has been personally vetoed by Jeremy Hunt. The crux seems to be around the description of Saturdays. Jeremy Hunt did not turn up to Parliament on Monday to answer an urgent health question, leaving it to his sidekick Ben Gummer. The interesting parliamentary exchanges can be read here.

The new chief negotiator's letters to junior doctors and to Jeremy Hunt can be accessed here. Note David Dalton's references to the crisis in morale among junior doctors (not to mention other NHS staff groups) and figures published today suggesting that fewer and fewer doctors finishing training will stay in the NHS.

This is clearly a strike which did not need to happen and the fault appears to lie firmly with the Government. As well as failing with this particular contract negotiation, they continue to undermine the NHS as a whole.

Finally a report just out from the National Audit Office, the independent spending watchdog, firmly criticises NHS workforce planning and says it is often driven by the need to make cash savings rather than clinical need. It says:
there is a 5.9% reported staffing shortfall in 2014, equating to some 50,000 clinical staff.
Across the health system as a whole, there are shortcomings in how the supply of clinical staff is managed, in terms of both planning the future workforce and meeting the current demand for staff.

"Trusts’ workforce plans appear to be influenced as much by meeting efficiency targets as by staffing need. Our evidence indicates that trusts’ workforce plans are often driven by the financial plans that they prepare for the NHS Trust Development Authority or Monitor. These plans envisage significant recurrent pay savings. Between 2012-13 and 2015-16, trusts planned to make recurrent pay savings of around £1 billion each year, although actual savings consistently fell well short of this amount. By focusing on efficiency targets when balancing financial sustainability and service requirements, trusts risk understating their true staff needs. This in turn could result in Health Education England commissioning too few places to train new staff. At trust level, it may also lead to gaps in staffing or additional costs from using more expensive temporary staff to address shortfalls.

All key health policies and guidance should explicitly consider the workforce implications. Past developments have not fully assessed how the necessary staff will be made available and funded. When major changes to services are proposed, such as the ‘7-day NHS’, the various national oversight bodies – including the Department, NHS England, NHS Improvement, the Care Quality Commission and the National Institute for Health and Care Excellence – need to work together to understand the staffing implications and financial impact.

The Department and Health Education England should review the funding arrangements for training clinical staff. The review should involve evaluating the effect of current and planned funding arrangements for higher education institutions, clinical placements and students. Specifically, they should ensure that the right incentives, including financial reimbursements, are in place to supply sufficient staff with the right skills in the right locations."

In these circumstances - more and more responsibility, stretched out over more and more time, and with less and less help - is it any wonder that Junior Doctors feel that they are being "hung out to dry"?

Monday, 11 January 2016

Junior Doctors forced to strike by Hunt's intransigence

Junior doctors will face their new assignments on the picket line with strong resolve but with heavy hearts. They did not want this strike but the NHS Employers, dancing to the tune of Jeremy Hunt and the Conservative Cabinet, have failed to recognise that this is a protest against the persistent and continuous squeeze on the NHS, the brunt of which is borne by front line staff, including junior doctors as they try to maintain a good service to patients. Already over 80% of doctors work unpaid overtime as they try to complete their rostered tasks and deal with emergencies. 30% report workplace stress and the main organisation providing counselling support for doctors says that their clientele is getting younger and younger. Doctors, both in hospital and in general practice, are getting driven away from the NHS - and it can't exist without them. The leakage of nursing and medical staff into agency and locum work is a warning symptom of how further privatisation could happen.

Hunt is trying to introduce a 7 day NHS on the basis of ropey evidence and within a tight financial envelope which will not bear the strain. The 7 day NHS may be a manifesto pledge but even manifestos have to be treated with realism. The public does want proper safeguarding of their health, both within hospital and outside, but there are few signs that it wants or expects the NHS as a whole to function fully for 7 days, especially if this eventually means a dilution of services during the week.

Hunt wants to put doctors working conditions firmly in the grasp of the management of hospital Trusts, many of which are either in desperate financial straits or retain control only by squeezing their staff till they have no energy left. Doctors want to retain some control over their own conditions and not find that they are being used as elastoplast to cover up management inadequacies, shortages of staff, and financial crises. While it is reasonable to ask staff help organisations adapt to new conditions, it is not reasonable to force staff on whose decisions lives depend, to become overstretched and undervalued. Doctors are striking against what for many would be a cut in pay and a worsening in conditions. They are also striking because the government position on safety both for patients and practitioners lacks both detail and conviction.

Any inconvenience to patients is outweighed by the overall consequences for the NHS if the doctors lose their action and Hunt imposes a new contract. It is vital that the public speaks out in favour of the doctors and rejects the smears and insinuations being peddled by the government and much of the right wing press.