Browse content similar to 16/01/2017. Check below for episodes and series from the same categories and more!
Line | From | To | |
---|---|---|---|
Tonight in a special programme we put the | :00:00. | :00:00. | |
region's health care in the spotlight. | :00:00. | :00:09. | |
As budgets tighten and demand rockets, we meet the patients being | :00:10. | :00:11. | |
On the road with Devon's out of hours GPs. | :00:12. | :00:30. | |
We're seeing a 94-year-old chap living alone who | :00:31. | :00:37. | |
has had multiple medical problems in the | :00:38. | :00:46. | |
past, looking at these notes, and may | :00:47. | :00:47. | |
How one of the South West's busiest A is trying to | :00:48. | :00:52. | |
If we can get them up to the unit before nine | :00:53. | :00:56. | |
o'clock, they will be seen by a | :00:57. | :00:58. | |
saving yourself a 12 hour hospital stay. | :00:59. | :01:00. | |
Tighter budgets, more patients, with more complex needs. | :01:01. | :01:18. | |
That's the challenge the NHS is wrestling with, | :01:19. | :01:22. | |
This is A at the Royal Devon and Exeter. | :01:23. | :01:26. | |
We are tracking what happens here at a time when the system is | :01:27. | :01:29. | |
My name is Adam and I'm one of the consultants here. | :01:30. | :01:43. | |
The battle is on to keep patients safe in one of the busiest winters | :01:44. | :01:46. | |
nobody is waiting too long before | :01:47. | :01:51. | |
The doctors call it exit-block, or bed block | :01:52. | :01:59. | |
when patients in A need to be | :02:00. | :02:04. | |
admitted to the hospital but there are no beds. | :02:05. | :02:07. | |
It makes life difficult for Adam Rubin and his patients. | :02:08. | :02:09. | |
We want the best possible care for all of | :02:10. | :02:11. | |
When we have bed blockage and the Department is full | :02:12. | :02:15. | |
it is very difficult at times to do that. | :02:16. | :02:17. | |
when patients in other departments | :02:18. | :02:19. | |
are well enough to leave hospital | :02:20. | :02:21. | |
but there is nobody to look after them at home. | :02:22. | :02:23. | |
In Devon 600 beds per day are occupied by people without any | :02:24. | :02:26. | |
These are beds Doctor Ruben needs for | :02:27. | :02:29. | |
people arriving in the emergency department. | :02:30. | :02:35. | |
Last week or two have been very busy, with high numbers | :02:36. | :02:38. | |
this department is things can change very quickly. | :02:39. | :02:47. | |
In the space of 15 minutes that picture can change to | :02:48. | :02:49. | |
At the moment we are OK, patients are being | :02:50. | :02:53. | |
seen quickly and beds in a hospital | :02:54. | :02:56. | |
It stands for Rapid Assessment and Trriage. | :02:57. | :03:08. | |
That is where paramedics hand over new patients. | :03:09. | :03:12. | |
Beryl Oak is 95 and has just arrived. | :03:13. | :03:13. | |
a handover and when they do I will put a | :03:14. | :03:26. | |
monitor on you to check your blood | :03:27. | :03:28. | |
Doctor Ruben introduced this way of working | :03:29. | :03:31. | |
in Exeter, meaning consultants see | :03:32. | :03:33. | |
In this process we have an opportunity to | :03:34. | :03:36. | |
welcome the patient, do a meet and | :03:37. | :03:37. | |
greet so they meet a very senior | :03:38. | :03:39. | |
member of the team at an early stage. | :03:40. | :03:43. | |
We can tell the patient, forecast and tell what we think is | :03:44. | :03:46. | |
So, you're likely to stay in hospital, that | :03:47. | :03:49. | |
It is one of the top performing emergency departments in | :03:50. | :03:52. | |
the country but even here patients | :03:53. | :04:05. | |
They have come through one week where | :04:06. | :04:11. | |
they have referred 242 people to | :04:12. | :04:12. | |
medical wards, much higher than normal. | :04:13. | :04:13. | |
The waiting ranges from three minutes up to more than 13 hours. | :04:14. | :04:16. | |
This consultant Lewis Jones is chairing the midday handover. | :04:17. | :04:18. | |
Next we have got a plan, spinal, rest of | :04:19. | :04:23. | |
Let's have a quick look at the waiting room as well, Andy. | :04:24. | :04:30. | |
Many of Dr Jones's patients are elderly. | :04:31. | :04:33. | |
I think we have one of the highest rates in all | :04:34. | :04:38. | |
the country, you have a higher volume of patients. | :04:39. | :04:41. | |
Historically would not get that many in an emergency | :04:42. | :04:43. | |
department but then we regularly | :04:44. | :04:49. | |
We try as hard as we can, even to the point | :04:50. | :04:57. | |
of receiving a patient the minutes | :04:58. | :04:58. | |
We can get them up to the medical unit before | :04:59. | :05:02. | |
nine o'clock, they will be seen by | :05:03. | :05:04. | |
tomorrow morning, you are then | :05:05. | :05:06. | |
saving yourself a 12 hour hospital stay. | :05:07. | :05:08. | |
older patients experience a long | :05:09. | :05:13. | |
We discovered 36,000 patients over 80 spent more | :05:14. | :05:18. | |
than 12 hours in A departments this year. | :05:19. | :05:20. | |
That figure has gone up by over 280% in five years. | :05:21. | :05:22. | |
Coming down the stairs and when I came right down | :05:23. | :05:29. | |
And I didn't realise that I had hurt myself. | :05:30. | :05:45. | |
Well, if any of these collapses are the same as the | :05:46. | :05:48. | |
previous ones, I don't think we are | :05:49. | :05:53. | |
going to be of any benefit bringing her in. | :05:54. | :05:58. | |
what value are we going to add to | :05:59. | :06:01. | |
If there is something specific we can do and she | :06:02. | :06:05. | |
The risk of bringing her in and getting a | :06:06. | :06:09. | |
hospital acquired infection and | :06:10. | :06:10. | |
reducing muscle power probably | :06:11. | :06:14. | |
They will do something to it in a moment. | :06:15. | :06:20. | |
Wrap it all up and everything, and | :06:21. | :06:22. | |
then I shall go home to my daughters again. | :06:23. | :06:25. | |
It is what mum wants and I think it is better, for | :06:26. | :06:28. | |
anybody that can stay out of | :06:29. | :06:30. | |
hospital, it is better to be in your | :06:31. | :06:32. | |
One way to take the pressure off A might be | :06:33. | :06:41. | |
to get more people treated closer to home. | :06:42. | :06:43. | |
injuries unit at Homerton Ben Harris | :06:44. | :06:46. | |
is here because he has hurt his hand | :06:47. | :06:48. | |
The role played by small hospitals like this is under | :06:49. | :06:52. | |
review as part of proposed NHS | :06:53. | :06:53. | |
In the minor injuries department they are trying | :06:54. | :06:57. | |
Patients like Ben will be treated by nurses, but what | :06:58. | :07:03. | |
is unusual is that they have the | :07:04. | :07:04. | |
back-up from the emergency department. | :07:05. | :07:10. | |
Doctor Ruben without his scrubs is over from Exeter for the morning. | :07:11. | :07:13. | |
I think that looks like an undisclosed fracture. | :07:14. | :07:14. | |
What do you think we should do with that? | :07:15. | :07:22. | |
Probably strapping again, give it some support. | :07:23. | :07:24. | |
If this facility was not here you would have | :07:25. | :07:45. | |
queue in the emergency department, | :07:46. | :07:49. | |
which for an x-ray, wait to be managed. | :07:50. | :07:51. | |
doorstep, he has the treatment | :07:52. | :07:54. | |
sorted out and all the prep | :07:55. | :07:56. | |
follow-up in place within half an | :07:57. | :07:57. | |
We had quite an influx of sick patients. | :07:58. | :08:05. | |
We now have six patients needing | :08:06. | :08:10. | |
One of the new patients is retired doctor, Judy Daws. | :08:11. | :08:16. | |
What they will do is put two electrodes or my chest. | :08:17. | :08:25. | |
They will give me a brief anaesthetic so | :08:26. | :08:30. | |
I will be unconscious and a current | :08:31. | :08:34. | |
passes through my heart and hopefully that | :08:35. | :08:35. | |
will shock my heart back into a normal rhythm. | :08:36. | :08:37. | |
Then they usually hang onto me for a little while to | :08:38. | :08:40. | |
make sure everything is all right, | :08:41. | :08:41. | |
give me something to eat and drink | :08:42. | :08:43. | |
and then I call a taxi and go home. | :08:44. | :08:45. | |
It is the kind of procedure which | :08:46. | :08:47. | |
used to need an overnight hospital stay. | :08:48. | :08:49. | |
are saving her a hospital admission, | :08:50. | :08:52. | |
so it is good for the patient and | :08:53. | :08:54. | |
also good for the trust, because | :08:55. | :08:56. | |
that is one bed available for | :08:57. | :08:58. | |
It has been a good day, but there are likely | :08:59. | :09:04. | |
In truth we do not know what the answers are. | :09:05. | :09:11. | |
But we have a very good system here and an excellent department. | :09:12. | :09:14. | |
We have good support services in | :09:15. | :09:16. | |
place and it combines to work very | :09:17. | :09:19. | |
well for us for the majority of the time. | :09:20. | :09:21. | |
The emergency team will be hoping the changes deliver on their promise | :09:22. | :09:31. | |
to relieve some of the pressure on places like this one. | :09:32. | :09:37. | |
It's not just hospital patients feeling the strain. | :09:38. | :09:39. | |
In Devon, where there's a huge health funding | :09:40. | :09:40. | |
shortfall, a third out of hours GP surgeries have been shut. | :09:41. | :09:43. | |
Saturday morning in North Devon. | :09:44. | :09:53. | |
On his way to his first appointment | :09:54. | :09:57. | |
We will go on to the moors and see what happens on this beautiful day. | :09:58. | :10:09. | |
Doctor Hughes runs Devon Doctors, the GPs you call | :10:10. | :10:11. | |
We're going to see this 90-year-old chap who lives alone and may | :10:12. | :10:23. | |
This is one of the largest and most rural counties | :10:24. | :10:26. | |
Just finding the patients can prove tricky. | :10:27. | :10:36. | |
That is not where it is. I'm just going to check. I'm going round the | :10:37. | :10:42. | |
front. I do not think there is any entrance there. I'm going to give | :10:43. | :10:46. | |
not look right. That is Mrs Thorne. not look right. That is Mrs Thorne. | :10:47. | :10:54. | |
It is like keystone cops. I cannot find it. The sign says somewhere | :10:55. | :10:57. | |
else. I will have a little luck. Oh, else. I will have a little luck. Oh, | :10:58. | :11:04. | |
it is down here. We were totally confused by the sign. Hello. Good | :11:05. | :11:09. | |
morning. 94-year-old Herbert Symons | :11:10. | :11:12. | |
has had a rough night. Grandad had a bad night. Last night | :11:13. | :11:23. | |
he hardly slept. He has swollen legs. He is complaining about | :11:24. | :11:29. | |
feeling dizzy. Your grandson said you do not like to make a pass. You | :11:30. | :11:30. | |
had some pains in your back keeping had some pains in your back keeping | :11:31. | :11:35. | |
you awake, is that right? I want to see what you are like on your pins | :11:36. | :11:43. | |
in a second. That is not bad, is it? I think you probably have some | :11:44. | :11:47. | |
anaemia. That is why you are not so well in yourself and probably why | :11:48. | :11:48. | |
your ankles are swelling up. Dr Hughes thinks Herbert | :11:49. | :11:53. | |
is OK to stay at home. Visits like this help | :11:54. | :11:55. | |
reassure relatives and I live up in London but try to come | :11:56. | :11:57. | |
down each year for Remembrance Day. We do won three times a day and get | :11:58. | :12:14. | |
started straightaway with plenty of water and a lot of fluid. Check the | :12:15. | :12:18. | |
sugars again at lunchtime. Any changes over the time he is here, | :12:19. | :12:22. | |
call 111 or encouraging to press his buzzer. Thanks for your help. | :12:23. | :12:29. | |
Cheers. Cheers. We probably have doubled the average number of | :12:30. | :12:31. | |
elderly people in Devon compared to most counties. There is a big thrust | :12:32. | :12:37. | |
to not send people to hospital who do not need to be there. But you had | :12:38. | :12:41. | |
to pick the right people to go in and the right people to stay at | :12:42. | :12:42. | |
home. Devon Doctors has been | :12:43. | :12:45. | |
running out of hours care But this year they have | :12:46. | :12:47. | |
to deliver the face-to-face part of the service for around | :12:48. | :12:50. | |
20%, ?2 million, less. More money is going instead | :12:51. | :12:52. | |
to the NHS 111 helpline. Dr Hughes thinks the changes | :12:53. | :12:57. | |
could benefit patients. On the face of it I think patients | :12:58. | :13:09. | |
should get an improved service. I do not think they should experience any | :13:10. | :13:15. | |
reduction in service in terms of reviving a home visit. The really | :13:16. | :13:16. | |
needing it. Devon Doctors also runs the county's | :13:17. | :13:20. | |
out of hours clinics There used to be 15 but one third | :13:21. | :13:23. | |
of them have now been shut. In North Devon the only | :13:24. | :13:29. | |
treatment centre now is in It has taken an hour | :13:30. | :13:31. | |
Kelly Joanna Mitchell and her son They used to be a clinic ten | :13:32. | :13:39. | |
miles away from their home but it was shut | :13:40. | :13:42. | |
as part of the changes. He's like an ox, so it takes a lot | :13:43. | :13:45. | |
to bring him down but we just He has been on high temperatures | :13:46. | :14:00. | |
before and he has been a fine. The doctor is one of four on duty. It | :14:01. | :14:10. | |
has definitely got worse. That has been spreading? Yes, it has got | :14:11. | :14:16. | |
darker. I will call paediatrics and see what they say. OK? OK. I will | :14:17. | :14:22. | |
see you in a minute. The demand for the service has not reduced. Around | :14:23. | :14:28. | |
5000 patients pass through the out of hours surgery doors in Devon | :14:29. | :14:30. | |
every month. As a group of GPs in every month. As a group of GPs in | :14:31. | :14:35. | |
the local area we are very nervous about the changes. There is nothing | :14:36. | :14:41. | |
quite as local for the patients as there was before. OK, thank you. | :14:42. | :14:51. | |
Goodbye. That is Doctor Hughes. The treatment centre keeps in constant | :14:52. | :14:58. | |
contact with GPs on the road. Doctor Hughes is close to his next | :14:59. | :15:01. | |
appointment but transport links in Devon can cause delays. This is what | :15:02. | :15:05. | |
it is like in the summertime with holiday season. I'm not sure what | :15:06. | :15:09. | |
the event is today. It is a massive challenge. When funding formulas are | :15:10. | :15:14. | |
worked out essentially I think it is worked out based on cities like | :15:15. | :15:18. | |
London and Birmingham and do not take into account a 45 minute travel | :15:19. | :15:21. | |
time and getting caught behind a herd of sheep. Another challenge is | :15:22. | :15:27. | |
rising numbers of elderly patients with conjugated health needs. He has | :15:28. | :15:33. | |
a virus, a stiff neck, catheter, bladder cancer and he is not passing | :15:34. | :15:45. | |
much fluid any more. Good morning! Doctor Hughes. You have a lot of | :15:46. | :15:51. | |
horseshoes, haven't you? Geoffrey Barker has been housebound for over | :15:52. | :15:59. | |
one week. Hello. Mr Barker? Hello, Jeffrey. How are you doing? I feel | :16:00. | :16:06. | |
like I want to be sick. I keep bringing up a lot of mucus. From | :16:07. | :16:14. | |
your chest? From my chest. Jeffrey's wife is his sole carer. When he is | :16:15. | :16:21. | |
not well he takes to his bed the stop he will be their two or three | :16:22. | :16:28. | |
days. -- takes to his bed. He was walking like this with his head and | :16:29. | :16:31. | |
he would not move it. It has continued from there. If I cannot | :16:32. | :16:43. | |
get some care for him today, that will not meet his needs, then he has | :16:44. | :16:46. | |
to go to hospital. Ideal for you, I think. He arranges a care package. | :16:47. | :16:53. | |
Good news. I think they can help. They will telephone you. It is | :16:54. | :16:57. | |
somebody called the rapid response team and they will bring some help | :16:58. | :17:04. | |
in. We have got a 50% hit rate this morning of arriving at the right | :17:05. | :17:09. | |
place. So if we get this one, we are on 66%. What do you think? Do we | :17:10. | :17:17. | |
know where this one is? Hello, Devon Doctors. Back at the treatment | :17:18. | :17:24. | |
centre, the patients are coming in thick and fast. Most are here for | :17:25. | :17:27. | |
minor problems but clearly this is a service in demand. I slipped down | :17:28. | :17:31. | |
the stairs last night and did something to my coccyx. Ulcers on | :17:32. | :17:39. | |
the tongue. Take a deep breath in. He has had this for Sundays. We've | :17:40. | :17:42. | |
had a rough night and I think it is a chest infection. We will have a | :17:43. | :17:48. | |
look. Here we go. Good boy. I have injured my shoulder. Agony through | :17:49. | :17:53. | |
the night. Most of what I have done is just reassuring people and giving | :17:54. | :17:57. | |
advice as to when to seek help if they get worse. Feeling a bit rough, | :17:58. | :18:00. | |
isn't he? Changes to the out of isn't he? Changes to the out of | :18:01. | :18:05. | |
hours service are part of a trial until March. At that stage the | :18:06. | :18:09. | |
number of GPs on the road could be reduced to one. The concern is if it | :18:10. | :18:19. | |
goes down to one, we may be delaying treatment to the sickest of our | :18:20. | :18:24. | |
patients and they are the people we're busting housebound when they | :18:25. | :18:28. | |
are unable to come in. He heads back to base. Five visits this morning in | :18:29. | :18:34. | |
total. Which for Saturday morning is about average. A good morning's | :18:35. | :18:41. | |
work. Out of hours care is just one service having to change in the face | :18:42. | :18:46. | |
of an unprecedented NHS overspent. Those on the front line are trying | :18:47. | :18:49. | |
to adapt but they are feeling the pressure. The workload is through | :18:50. | :18:53. | |
the roof. The workforce is disappearing in droves. People are | :18:54. | :18:58. | |
finding maybe Australia, Canada, New Zealand, offer a better work and | :18:59. | :19:00. | |
life balance for them. Literally this morning I had an e-mail from | :19:01. | :19:05. | |
somebody wanting me to come and work in Canada. Are you tempted? I looked | :19:06. | :19:12. | |
up exactly what they are offering and it looks like tundra and polar | :19:13. | :19:15. | |
bears, so I think not for the moment! | :19:16. | :19:21. | |
new concerns around the so-called postcode lottery | :19:22. | :19:24. | |
Does where you live now matter more than ever when it comes | :19:25. | :19:28. | |
Chris Jackson has been investigating. | :19:29. | :19:34. | |
The NHS is facing the most significant financial challenge | :19:35. | :19:36. | |
There are fears the service we have grown up with is | :19:37. | :19:42. | |
Absolutely there is a postcode lottery. | :19:43. | :19:50. | |
So is the NHS in danger of ceasing to be a National | :19:51. | :20:06. | |
Where everyone is entitled to the same care? | :20:07. | :20:11. | |
It's treating more patients but is it becoming a | :20:12. | :20:13. | |
postcode lottery, where access can depend on where you live? | :20:14. | :20:15. | |
It feels like my bones are actually screaming | :20:16. | :20:36. | |
33-year-old Ben Franklin has hepatitis C. | :20:37. | :20:38. | |
The virus can cause life-threatening liver damage. | :20:39. | :20:40. | |
I've been off sick and could possibly lose the flat over my head. | :20:41. | :20:50. | |
There are new drugs that could potentially cure Ben's hepatitis. | :20:51. | :20:52. | |
All I got was "Wait", basically, because my | :20:53. | :20:59. | |
That made me want to go out and just get | :21:00. | :21:07. | |
absolutely wasted and ruin my liver just so they would treat me. | :21:08. | :21:11. | |
But I wouldn't be surprised if anybody else wouldn't. | :21:12. | :21:21. | |
The money is there for just over 10,000 treatments. | :21:22. | :21:23. | |
It is claimed that means there are no queues in parts | :21:24. | :21:28. | |
of the North and long waits in places like London. | :21:29. | :21:30. | |
Two people with exactly the same state of liver | :21:31. | :21:32. | |
damage could present themselves in different | :21:33. | :21:34. | |
in one they'll be able to walk in and get hepatitis C treatment | :21:35. | :21:38. | |
In another part of the country they may | :21:39. | :21:41. | |
go there and be told, "Sorry, you're going to have to wait." | :21:42. | :21:44. | |
NHS England told us it was regularly reallocating | :21:45. | :21:49. | |
unused hepatitis C treatments to places with waiting lists. | :21:50. | :21:57. | |
The number of patients treated will increase by 25% next year. | :21:58. | :22:00. | |
The fact that it's down to money, that upsets | :22:01. | :22:03. | |
So Ben is taking the risk of treating | :22:04. | :22:11. | |
himself with cheaper copies of the new drug. | :22:12. | :22:18. | |
The fact that I've had to pay for my treatment, it's | :22:19. | :22:29. | |
I'm just tired of being tired, basically. | :22:30. | :22:46. | |
Ben is hoping the generic drugs will cure | :22:47. | :22:48. | |
The hepatitis C trust estimates around 1,000 people in | :22:49. | :22:56. | |
Britain may have bought the drugs abroad. | :22:57. | :23:02. | |
If you go outside there are halos around light. | :23:03. | :23:04. | |
Gloria MacShane has cataracts in both eyes. | :23:05. | :23:13. | |
Go up or down stairs with any kind of confidence. | :23:14. | :23:24. | |
Cataracts are supposed to be treated within 4.5 months of referral. | :23:25. | :23:27. | |
Gloria lives in the north-east and says she has been waiting seven. | :23:28. | :23:30. | |
Because there's such potential for accidents and there is | :23:31. | :23:34. | |
If Gloria had lived in Luton her wait | :23:35. | :23:44. | |
could have been as little as 15 days. | :23:45. | :23:46. | |
Absolutely, there is a postcode lottery. | :23:47. | :23:48. | |
It is not about clinical need, it is about | :23:49. | :23:50. | |
some places in England having poor systems, | :23:51. | :23:53. | |
budget pressures and de-prioritising cataract surgery. | :23:54. | :23:58. | |
That doesn't feel too national to me. | :23:59. | :24:02. | |
Gloria expects to get her operation later this month. | :24:03. | :24:09. | |
It really makes me angry because I think that it's | :24:10. | :24:11. | |
Clinical Commissioning Groups, or CCGs, control health budgets. | :24:12. | :24:18. | |
It is claimed some are delaying treatments | :24:19. | :24:20. | |
like cataract surgery by slowing down referrals. | :24:21. | :24:23. | |
Others are requiring patients to lose weight before | :24:24. | :24:25. | |
getting operations like hip replacements. | :24:26. | :24:32. | |
Postponing an operation in these circumstances can | :24:33. | :24:34. | |
Whilst the CCGs say it can be clinically | :24:35. | :24:48. | |
justified, the Royal College of Surgeons says it can't. | :24:49. | :24:50. | |
There is very good evidence people are now | :24:51. | :24:52. | |
not getting elective operations, which they desperately sometimes | :24:53. | :24:54. | |
require simply because of financial restrictions. | :24:55. | :24:56. | |
It is up to the clinicians to decide who should have | :24:57. | :24:58. | |
Therefore a bureaucratic system producing a | :24:59. | :25:01. | |
blanket ban we think is morally wrong. | :25:02. | :25:08. | |
It is also claimed new systems for vetting appointments | :25:09. | :25:10. | |
with specialists are another form of rationing. | :25:11. | :25:12. | |
Why are they treating their patients with such contempt? | :25:13. | :25:18. | |
Last month MPs complained about a private company being paid ?10 for | :25:19. | :25:21. | |
This is rationing by the back door and | :25:22. | :25:25. | |
has the potential to compromise safety. | :25:26. | :25:31. | |
The same private company overseas referrals in North Tyneside. | :25:32. | :25:34. | |
We spoken to doctors who say the system is putting patients | :25:35. | :25:36. | |
The GPs, who fear speaking out, have told us that cancer | :25:37. | :25:41. | |
I tried to get a patient referred to a dermatologist. | :25:42. | :25:49. | |
The referral Management service said it was a | :25:50. | :25:50. | |
It was a nasty, invasive skin cancer. | :25:51. | :25:57. | |
They are putting up barriers, using delaying tactics. | :25:58. | :26:03. | |
It is getting between the doctor and the specialist. | :26:04. | :26:08. | |
In a statement North Tyneside CCG said there was no | :26:09. | :26:11. | |
evidence the system caused additional risk or delay. | :26:12. | :26:16. | |
the system and made directly to hospital. | :26:17. | :26:24. | |
The number of referrals back the GPs in England has risen by | :26:25. | :26:27. | |
You can see the details of our research online. | :26:28. | :26:36. | |
Shortage and regional difference were always part of the NHS. | :26:37. | :26:39. | |
Today the differences could get much worse. | :26:40. | :26:40. | |
The NHS is under an unprecedented level of pressure at | :26:41. | :26:43. | |
If it does not get more funding waiting times are going to | :26:44. | :26:47. | |
get longer, the quality of patient care is going to suffer. | :26:48. | :26:49. | |
We will see different decisions taken in | :26:50. | :26:52. | |
different parts of the country and different services being available | :26:53. | :26:54. | |
One of our most prominent medics is clear. | :26:55. | :27:02. | |
I think it matters because it leads to | :27:03. | :27:08. | |
inequality in health care, that is the problem. | :27:09. | :27:12. | |
Some people will get health care for free and others will not. | :27:13. | :27:17. | |
In a statement the Department of Health told us that | :27:18. | :27:20. | |
far from rationing more people than ever are getting prompt treatment | :27:21. | :27:24. | |
and more cancer patients are being seen every day and that | :27:25. | :27:27. | |
We asked the Health Secretary and NHS England for | :27:28. | :27:35. | |
The people actually paying for NHS services, the clinical | :27:36. | :27:40. | |
It is a National Service with local variation based | :27:41. | :27:47. | |
Demographically populations vary significantly from | :27:48. | :27:50. | |
town to rural, from county to county. | :27:51. | :27:51. | |
It is very important we commission and respond to the needs | :27:52. | :27:54. | |
It is about making sure the pathway is correct. | :27:55. | :27:59. | |
We do not want to squander any money. | :28:00. | :28:01. | |
We have limited resources so it is really important | :28:02. | :28:07. | |
we spend most effectively and get the best value for our population. | :28:08. | :28:10. | |
For those forced to take their own action, | :28:11. | :28:12. | |
rationing appears all too real. | :28:13. | :28:19. | |
That's all for this week, but do join me next Monday, when Nick | :28:20. | :28:25. | |
Baker's all sea having a whale of a time with these fellows. | :28:26. | :28:30. | |
This is what it is all about. We have got a pod of dolphins right | :28:31. | :28:42. | |
underneath the bowel. What I love watching, it doesn't get any better | :28:43. | :28:43. | |
than this. That is next week. I will than this. That is next week. I will | :28:44. | :28:52. | |
see you then. Hello, I'm Louisa Preston | :28:53. | :29:06. | |
with your 90 second update. 30 British tourists shot | :29:07. | :29:09. | |
dead in Tunisia in 2015. | :29:10. | :29:12. |