Useful links:


Paramedics not sent to a quarter

Ways to raise the money the NHS needs

Radiotherapy before surgery

Clarks not so cunning plan

Virtual wards

PFI Still paying

Mount Vernon neglected:Should be closed

First CEO on £300k

Long cancer waits ICB

Long cancer waits

Virtual wards risk
The funding crisis and how to solve it

NHS funding: how to solve it

Trust underplayed IT outage

Half of directors leave Trust

Hospitals at home no substitute

Beds and ambulances, no staff

Virtual wards plan

Shopping habits: ovarian cancer

Should you pay for GP

No plan for NHS


Government delays pension reform

Delayed pension reform

Berkshire low staff mental unit

Elderly in home virtual wards

More at home care

Coroner: risk of future deaths

NHS black hole devouring country

Repercussions for whistlblowers


January media

£3m on B&B rooms

Trust names new medic CEO

A & E target unambitious

New hospital delays £13 million a month

What a 13 hour paramedic shift...

Royal Free 27 hour wait

Hospital under pressure...

Integrated model scrapped...

Holding back recovery

National safety review

Births suspended Somerset

Harlow nitrous oxide

Redundancy scheme unfit

Third strike ambulance

Nurse paramedic pay fact

Tecnology can help

Gordon Brown on charges

Private boom fear two tier

84% care private

SaraGorton warning

Two hundred k to whistleblower


The government announcement of an extra £200 million to move patients fit to discharge from NHS beds to care homes, and other settings, has received a mixed reception – NHS leaders say they need the money as soon as possible to begin freeing up beds and are concerned there will be delays, in contrast social care leaders warn that the pressure to discharge patients fast has already led to inappropriate placements and the scheme is just another “sticking plaster” that doesn’t address the long-term problems.
There are an estimated 13,000 people in NHS hospitals that are fit to discharge and the scheme, announced by Health and Social Care secretary Steve Barclay, aims to free-up around 2,500 beds by funding “maximum stays of up to four weeks per patient” in care homes or other settings. The scheme runs for just three months to the end of March 2023.
The scheme is similar to the national discharge scheme begun in 2020 as the NHS needed beds for Covid patients, which led to thousands of patients moving out into care homes. Funding for this scheme ended in April 2022.
This £200m is in addition to the £500m adult social care discharge fund(ASCDF), announced in September 2022. However, Barclay claims that the extra £200m means the NHS will be able to “immediately buy up beds in the community.”
NHS leaders fear, however, that the distribution of the money will be as slow as the £500m ASCDF; it took many weeks to distribute the first £200m of the ASCDF, and the final £300m is only now being distributed to organisations .
One national NHS leader told HSJ: “If this announcement is to be anything more than politically-driven theatre and have an impact before the start of spring, then the money needs to be in place in the next week to 10 days.”
In contrast, The British Geriatrics Association (BGA), the Association of Directors of Adult Social Services (ADASS), the Local Government Alliance (LGA), and charities that work with the elderly, fear that the rapid discharge of people from hospital means they could end up in care homes or hotels which are totally unsuitable for their needs. The BGA noted:
“In order for this to have the intended impact, care homes must be able to provide the necessary rehabilitation to help older people recover. This requires expert input from nurses, therapists and medical staff. If this expertise is not in place to aid recovery, then older people’s health will continue to decline and hospital readmission becomes more likely.”
The ADASS is also concerned about the focus on care homes, when if the right care package is in place, home is the best place. Chief executive Sheila Norris noted:
“Use of the funding should be guided by the ‘home first’ principle, rather than the default being that people are discharged into care homes. Otherwise we run the risk of people being inappropriately placed and then remaining in residential provision indefinitely. Legally, and morally, it is right that they have a choice about where they live.”
Hospitals in Devon, Cornwall and Dorset are already discharging patients into hotels. With beds booked in hotels in Plymouth and Bournemouth for what are described as “medically fit guests” with social care needs.
Louise Jackson, health and care manager for Age UK, told the BBC that care hotels were “unlikely to be appropriate settings” and added that “this is another sticking plaster, whereas what we need is sustained core investment.”
This constant reliance on short-term funding schemes, means that nothing has been done to tackle the root problems of why so many people are ending up in hospital. David Fothergill, chairman of the LGA community wellbeing board told CommunityCare:
“A decade of consistent underfunding of social care and underinvestment in community health services has led us into this crisis and it will not be fixed through tacked-on funding that fails to address any of the root causes of this situation.”
Fothergill added:
“Until the government presents social care as an essential service in its own right – valued equally highly as the NHS – we will continue to lurch from one sticking plaster to the next”.
Jane Townson, Chief executive of the Homecare Association, the membership body for home care providers, highlighted that the 13,000 people waiting to be discharged from hospital was a small fraction of the approximately 500,000 awaiting a social care assessment or service, according to ADASS data.
“We need to fix the problem at both ends,” she said, “buying up care home beds is a necessary sticking plaster for this winter but does not address underlying causes, so people will continue to be left waiting for care at home.”
It is clear that these short-term funding schemes also do not address one of the major issues in social care, the workforce crisis.
Home care providers can not provide the capacity needed to meet demand, according to Townson, as they were unable to recruit and retain staff, with vacancy rates of 14.1% as of October 2022. Overall, there were 165,000 vacancies in social care, up 52% over the previous year. With the median hourly rate of a care worker listed as just £9.50 and with an HCA with two years experience getting only £11.30, it is clear that pay is an issue. Supermarkets and other retail outlets pay more.
Without a plan for long-term funding increases, however, neither homecare companies nor care homes can invest in new staff or increase pay rates. Martin Green of Care England, which represents the largest private care home providers, has said it wants the government to pay them £1,500 a week per person, citing the need to pay care workers more and hire rehabilitation specialists. The current rate of pay is described by Green as “inadequate”.
More than anything, however, the industry would like a long-term plan, as the chief executive of the National Care Forum Vic Rayner told Community Care:
“There may not be enough money, but make a plan, provide some certainty to enable organisations to take on new staff, to invest in new facilities and to develop their in-house rehabilitative resources. Without this long term vision, all of this money will be swallowed into short term fixes such as over reliance on agency staff, or the prioritisation of hospital patients over those with urgent needs in the community.”
And as the BGA notes what happens after the three months of funding ends, it will be the same problems just in a few weeks time:
“There is a risk that discharging older people to care homes will simply move the problem down the line and we will be in the same crisis situation in two to three weeks as older people come to the end of the funding period and have ongoing health and social care needs.”

Cold weather heart attacks

Mixed reception discharge scheme

Trapped in hosp for months

Imprison CEO chiefs

Inferior pensions

Barclay Unaffordable

Nurses on Downing Street

Wales 26 hour wait

NHS contingency

Drag back to pre War

Nurses work one day free

The first duty of a doctor is to his patient
The first duty of a Foundation Trust frontline worker is to the Trust-any criticism, whistleblowing is rewarded by bullying, refer to GMC, no employment/labelled as troublemaker…
The first duty of a private corporation is to generate the highest profit for its executives and shareholders

Staff shortages caused by Treasury result in Agency locus-£4500 or £2500 for a single shift: bonkers
Frontline staff often leave direct employment for “ bank” work

Private companies, outsourcing, often have poor results- Capita, Carillon, Serco
Firms like United Health and Centene often pull out of contracts if the profit is too low…

I am sure it would be far better, and less expensive to improve the existing model of tax funded public NHS, and supervise S C ; privatisation gives far worse, more expensive results
Where rich patients demand better care from a fragmented service
Real integration, as pre Lansley- gives far better service- with all staff feeling pride at the NHS
Or cut corners- like many ANPs, locums, trainees rather than supervising GPS
And cut clerical data records staff to increase profits
Sent from my iPad

GPS were urged by CCGs not to refer patients for tests, in hospital, to save money
While Hunt urged GPS to refer more for tests, for better, earlier diagnosis

In 1948 the state were given all the hospitals
Foundation Trusts we’re small non profit businesses asked to make a profit
With PFI, the consortium of builders, banks and hedge funds now own the hospitals-not the state, not the taxpayers

Crews physically sick

Hosp video

Self referal Good idea?

Stop digging

GP closer to collapse

Government compromise

Clark thumbs down

13 hour strike

Half million missed statins

Online braces damage



This government has intentionally disintegrated our NHS and S C into a thousand particles-with the aim that no one can ever reassemble into one coherent NHS as existed up to 2010 and Lansley’s unwanted, unnecessary dividing Monster bill.

If the government can assemble a coherent single insurance policy that can provide ALL cancer diagnosis, scanning, treatment including all required cancer drugs, for, say £100 a month-then trial that system before destroying the existing NHS system.


33 hours inside A & E

13 hours inside A&E

36 hour wait A & E

nurse miscarriage

Our A & E visit

Private companies

Scotland Ops cancelled

Rishi is NHS GP now

Ambulance service misused

Is the Pay Review body independent?

PreAssembled module hospitals

Slight waiting fall

More strike dates

Could not get ambulance: died

How your Trust performing

sell off

Errors in A & E

Pancreas sensor

Government anti strike bill

Artificial pancreas

Union response to strike bill

Long cancer waits record

NNW failing hospital

One off payment for nurses

One off payment to end strikes

Tearing up the GP model

Patient safety and outcomes

Patient safety and outcomes pdf

Sweeping social care can wait

84% of care homes private













Climate of fear:Whistleblowers

Cost of living careworkers

Exploited foreign doctors

Back to the 19 century

John Lister-the Lowdown

brilliant analysis of Coffey...

Kingsfund paper

Crowd Justice

Questions before 2nd reading

The HSC Act Wrong proposals

RCGPs comment

Cygnus reports: Doublespeak

Optum: How we "help"

The HSC Bill Actual

NHS For Sale

Centene gets a foothold

More flaws in "integrated care"

Integrated care Imperialism

Allyson Pollock

Health Diktat?

GP died lack of beds, consultants

Why we must oppose the HSC bill

Health campaigns together

Aco's in US

Alarm bells HSC Act

Health Campaigns Together

HCT Bulletin 13

Hunt should consult

Unison fights new Sub Co plan

Guardian:NHS bill is dynamite

Healthcare in Canada Wiki

health and social care bill 2021 Google search

Nuffied HSC bill

Allyson Pollock First article to MPs

Article to MPs

Labour hub: Wrong proposals

BMJ blogs opinion

Cygnus Doublespeak guide

RCGP opinion

Optum Health: How cwe v"help"...

Reinstatement bill

Private Eye Whistleblowing

Parliament whistleblower...

How GPs are paid

US Healthcare salaries

Health Imperialism?

NHS for sale

More flaws in ICSs

Centene gets a foothold


Allyson Pollock art

Deadly debt

Submission to HSC committee

The Kings Fund

NHS Support Federation, Community Base, 113 Queens Road, BN1 3XG

NHS Support Federation

Prostate scan

BBC News Health

Prostate messaging wrong

No NHS solutions

Social care needs cash

Critics press reforms

BBC News Wales


Inside the NHS dentistry crisis

Patients resort to diy dentistry

Areas with fewest GPs

Violent incidents at GPs

Lowdon precis

Nurses shortage

N I hospitalvunerable patients

Nurses use foodbanks

Javid Plans-no!

Leadership report

Crumbling concrete

Hospitals with aerated autoclave concrete planks, collapsing and help up with hundreds of Acrow props should have a larger new hospital built properly on adjacent land-if it has not been sold off already to balance the underfunded books…

Dismantling the NHS in England

Obesity rules to be scrapped

Air polution cause of cancer

Profiteers in the NHS

Crumbling concrete

Cornwall hospital a disgrace

Tories no plan

Fixing the NHS nigh impossible after decade of Toriesi

Coffey's plan unimpressive

Funding to discharge quicker

We need another hospital already

Future bed needs

Risk to patient safety

Discharge quicker

motor neurone hop

Mothers uncovering big maternity scandal

Maternity units unsafe

How to avoid A&E waits

Scotland A & E waits worst

Irregular heartbeat deaths

List of posts on Lowdown