16/01/2017 Inside Out South

Hello. With pushing our health service to the limit and it's

starting to show. Services within the hospital and within our

community are under particular pressure. If it doesn't get more

funding, waiting times are going to get longer.

The quality of patient care is going to stuff. The fact that I've had to

pay for my treatment is criminal. It is absolutely criminal. I'm sorry.

Change is coming. But what's being prescribed? We seeing hospitals

close. We're seeing A emerged. Some of these changes are so

dramatic, people will oppose them to the death. The change is not easy.

Inside Out is back. The doctor will see you now - probably!

Thirsty dart things were addicted to in this country - caffeine and the

NHS. We expected to be there where ever we are and whenever we wanted.

But with more of us living longer, it means that costs are rising at an

alarming rate. And that means NHS bosses here in the south facing some

tough decisions about which services to cut and which services to keep.

The NHS has a huge problem - us. There are more of us, and we are

living longer. The average of 55-year-old costs the health service

twice as much as a 20-year-old. And over 85s cost three times as much

again. Members of the Bournemouth Swimming Club are doing their bit to

stay healthy - even when it's 5 degrees outside. It's amazing. I

cannot feel my body! After you done this, nothing else in the week seems

too bad, really. It gives a real boost the immune system. It's good

for the body. But even hardy folk like these need to call on the NHS

from time to time. I've been diabetic for about 33 years. I am

grateful for the NHS because if it wasn't for them, you know, well, I

wouldn't be here. As an ex-nurse, I've seen it's all. When they come

into hospital with a bag full of pills. You just don't think about

how much it's costing, I guess. But I'm a working man so I guess I'm

entitled to that. Here's the thing. The amount of money the NHS has been

getting has been going up over time. But the amount of money the NHS

actually needs to keep us all fit and healthy has been going up like

this. And by 2020 it is estimated there will be a funding difference

of ?22 billion. Here in the south, our share of the

shortfall adds up to ?2.2 billion a year. In the entire health budget

for the Isle of Wight is only 215 million. The meeting the soaring

costs of health care in the south would require cutting the island's

health services more than ten times over. The island's well aware of the

cost of caring for an ageing population. A quarter of its

residents are pensioners. The NHS here faces a ?52 million shortfall

by 2020. So they're trying to make some radical changes.

We've had the phone call through the 111 service, and they've asked us to

come out and see you. Lousi leads the Isle of Wight crisis

response team. To keep hospital admission down, they're bringing the

NHS to your door. These three are practically dead

now. It started on that hand as well.

90-year-old Joan has severe arthritis, which means caring for

her 94-year-old husband is a struggle. Their house also poses

some risks. Oh, yes. I see. When was the last

fall that your husband had? Actually, he had won about three

days ago. I had to call the neighbour.

Our job is to keep people out of hospital safely and independently in

their rain residence. I'm just going to pop it in your

ear, take your temperature. We have nurses, occupational therapists and

We have the luxury of having more We have the luxury of having more

time in the emergency services and GPs have got, so we can go in and

look at keeping these people at home.

Lousi provides a carer to come and help with the morning and a builder

to sort out the back step. The local council will pick up the tab on the

basis that prevention is better and cheaper than cure.

We can get that all sorted out for you, can't we? Thank you. We can get

people so you're not struggling on your own, all right?

The island's health services reviewing everything it does to be

cost-effective. And you keep people healthy and out of Saint Mary's

Hospital, the only one on the island. Lucy's office as part of the

process. It's now an integrated care hub. It's home to council workers

and charity staff, as well as the NHS.

The 999 and 111 calls coming to this centre here on the island, and we

have generically trained staff who are able to answer both sets of

calls. Have you ever had a leg ulcer?

Solar putting everyone in the same room so they can talk face-to-face?

So they can actually talk to each other.

The district nurse said she is bleeding from her right ear. When

the call comes into here, we decide on what services need to actually

attend that. When you think an ambulance call costs ?202 per call,

here on the island we have saved over 1000 of those Popa. The IM's

NHS says it joined up approach of saving money. But money isn't the

only problem. The hospital is full. Saint Mary's

is on black alert. That means there's no room for new patients.

They're going to tell us he's got increased wounds.

It's a serious incident, and it's worryingly common. Last year, the

alert. alert.

It's a surge of services within the trust, within the hospital and

within our community services. They're under particular pressure.

Hospitals should have enough spare beds to cope.

But in Saint Mary 's, they sometimes don't. Patients who could be at home

get stuck in hospital, because community care services already at

capacity. We are in difficulty. We have had to

slow down access to planned care, so two operations, to enable us to

manage the flow through our emergency department.

Lack of beds meant 400 cancelled operations last year. The hospital

was ?4 million overspend. Tough times for chief executive Karen

Baker. You've innovated, you're trying

different things, and here we are on black alert. Absolutely we are. And

I guess that's the pressure - that's the pressure in the system. We know

at the moment that we're not looking after people in the community as

well as we could be. When there was people are not accessing different

going to see their pharmacist, being going to see their pharmacist, being

cared for by the community teams. All of those things are available

and we need to make sure people are unaware and ultimately that will

save money in the system. But the worry is the pressures are

increasing faster than the solutions that can be found for it. They're

still a queue at both doors. You're absolutely right. The answer is we

continue to work on those solution. Pub managers here believe it of

working methods can bridge the financial gap. But across the whole

of the self, ?2.2 billion needs to be found by 2020. -- health managers

here. Some health analysts like Roy Lilley, himself a former Trust

chairman, so the changes needed will be radical and unpopular.

If we want to save 2.2 billion, with God to stop doing things. We will

seem hospitals closed, we will see A merged. GPs surgeries will have

to be merged and put together. The Public were like that. The real

solutions are the ones that are really painful. -- the public won't

like that. The Isle of Wight faces a challenge

because of its older proportion of older residents, but it's a crystal

ball for the rest of the South. In ball for the rest of the South. In

the rapidly ageing population, in 20 years' time the region's age profile

is set to match the island's. So to help the NHS, we all need to do our

bit. If I had a message for the public,

it would be there's a lot. If you smoke, that they daft idea because

that costs the NHS a fortune. If you're overweight, lose weight

because that leads to obesity and cardiac problems. But we know these

messages. I'm not telling you anything that we all don't know. How

do we make people do? I don't know, but we really have got to take

better care of ourselves. Back in Bournemouth, the Spartan

swimmers are doing just that. A year ago, I was crippled with

depression. And in the last six or seven weeks I've made leaps and

bounds. And a lot of it is in part of this. There were fireworks going

off in your brain. It makes you feel amazing, it really does. It makes

you feel alive. You know, and I you feel alive. You know, and I

encourage anybody to give it a try. Still to come, how we can help get

the NHS back on its feet. Walking is the single most important

thing that everyone can do for their health.

As ever, I'd love to hear what you think. You can always drop me an

e-mail at the below address. Next, does where you live matter more than

ever now when it comes to the provision of health care? Chris

Jackson has been investigating. The NHS is facing the most

significant financial challenge in its history. There are fears the

service were growing up with is beginning to fragment.

It's not a National Service. Absolutely, there is a postcode

lottery. It's criminal. It is absolutely

criminal. This is the start. It's going to get

worse. So, it is the NHS in danger of

ceasing to be a National Service where everyone is entitled to the

same care? It is treating more patients, but is it becoming a

postcode lottery where access can depend on where you live? Were going

to put that to the test. On a bad day, it ruins your life.

The muscle pain, it feels like my bones are screaming at me at times.

33-year-old Ben Franklin has Hepatitis C.

The virus can cause life-threatening liver damage.

I'm about to lose my job. I haven't been at work since April, I've been

off sick. And I could possibly lose my flat.

There are new drugs that could potentially cure Ben's Hepatitis,

All I got was, you have two worried - basically because my liver wasn't

bad enough. That made me want to go out and get absolutely wasted and

when my brother just so that they would treat me. I wouldn't do that,

but I wouldn't be surprised if nobody else would.

The money is there for just over 10,000 treatments.

It's claimed that means there are no queues in parts

of the North ? and long waits in places like London.

Two people will exactly the same state of liver damage could present

themselves in different parts of the country, and in one watt able to

walk in, get hepatitis C treatment immediately, get to it. In another

part of the country they will be told, I'm sorry, you're going to

have to do it. This is inherently unfair.

NHS England told us it was regularly reallocating unused Hepatitis C

treatments to places with waiting lists.

The number of patients treated will increase by 25% next year.

The fact that it's down to money, that upsets me the most. It's just

money. So Ben is taking the risk

of treating himself with cheaper How much have you spent on that box?

?1300. ?1300 but I don't really have. The fact that I've had to pay

for my treatment, it's criminal. It is absolutely criminal. I'm sorry.

I'm just tired of being tired. Ben is hoping the generic drugs will

cure him within a matter of weeks, and he's not alone. The hepatitis C

Trust estimates around 1000 people in Britain may have bought the drugs

abroad. If you go outside, there's halos

around the lights. Lights and around the lights. Lights and

shadows. It's often hard to see things, they're a bit distorted.

Gloria McShane has cataracts in both eyes.

I can't take stairs, go up or down stairs with any kind of confidence.

Cataracts are supposed to be treated within four

Gloria, who lives in the North East, says she's been waiting seven.

It's too long because there is such potential for accidents, and there

is such a change in a person's mood. If Gloria had lived in Luton,

her wait could have been Absolutely, there is a postcode

lottery. It's not about the clinical need. It's about some places in

England having poor systems, having budget pressures, and deep

prioritising cataract surgery. That doesn't feel too national to me.

Gloria expects to get her operation later this month.

It really makes me angry because I think it's almost like survival of

the fittest. Clinical Commissioning Groups,

or CCGs, control health budgets. It's claimed some are delaying

treatments like cataract surgery Others are requiring patients

to lose weight before getting Postponing an operation in these

circumstances can save money in the short term. And most of the CCG say

can be clinically justified, the Royal College of surgeons say it

can't. There is a vague evidence that

people are now not getting elective operations, which they desperately

sometimes require. -- there is very good evidence. Simply because the

financial restrictions. It is up to the clinicians to decide who should

have what treatments, and therefore a bureaucratic system which produces

a blanket ban, we think, is morally wrong.

It's also claimed new systems for vetting appointments

with specialists are another form of rationing.

Why are they treating their patients with such contempt?

Last month, MPs complained about a private company

being paid ?10 for every GP referral they stopped.

This is rationing by the back door. And it has the potential to patient

safety. The same private company oversees

referrals in North Tyneside. We've spoken to doctors who say the

system is putting patients at risk. The GPs, who fear speaking out, have

told us that cancer diagnosis are being held up.

In a statement, North Tyneside CCG said there was no evidence the

system course additional risk or delay. Cancer referrals do not go

through the system and are made directly to hospital. The number of

referrals knocked back to GPs in England has risen by about 30% in

the last two years. You can see the details

of our research online. Shortage and regional difference

have always been part of the NHS. Today, the differences

could get much worse. The NHS is under an unprecedented

level of pressure at the moment. If it doesn't get more funding, waiting

times will get longer and the quality of patient care is going to

suffer. So we will see different decisions taken in different parts

of the country, and different of the country, and different

services being available to patients.

So, is the NHS still a national service?

One of our most prominent medics is clear.

No, it's not a National Service. It is now a local health service. It

matters because it leads to an inequality in health care. Somebody

will get health care for free, and others won't.

In a statement, the Department of Health told us that far from

getting prompt treatment. 3261 more getting prompt treatment. 3261 more

cancer patients are being seen every day, and standards of care an

improving. We asked the Health Secretary and NHS England for an

interview. Both declined. The people actually paying for NHS

the clinical commissioners, did the clinical commissioners, did

agree to speak. It's a National Service with local

variation based on the need of the population. Demographically, the

populations vary quite significantly from town, to rubble, to county.

It's really important that we respond to that population on a

local basis. -- from town, to rural. We don't want to squander any money.

We have limited resources. It's really important that we most

effectively and get the best value for our population.

For those forced to take their own action, rationing appears all too

real. Chris Jackson reporting. Don't

forget, where one Twitter. You can find out more about the show and see

behind the scenes - Paul Dunne - at...

-- hold on. Now, it's not all doom and gloom. There are some things we

can do to help the NHS. One of them doesn't cost a penny and involves

the ancient art of putting this foot in front of this foot.

Human beings were designed to sit down all day. We evolved to walk.

But modern life means few of us are working enough, and it's making us

all. Everyone at South Central Ambulance Service is in the business

of saving lives. Tanya speaking, how can I help quiz? I name is Tanya and

I been with the service for ten years. I've save five lives. My name

is David. I'm 25 years old. I been working here for two years.

Whether the patient live? Sitting down a day, like so many of

us too, means Tanya and Dave are putting their own health at risk.

You get half an hour meal break, but we are supposed to leave the screen

every hour for five minutes. But I don't.

Walking is the single most important thing everyone can do for their

health. Both in the short term and long term. I believe health care is

what we do for ourselves, and what I'm prescribing doesn't cost a

penny. Sitting at work means you lose fitness, strength, stamina,

suppleness and skill. So you've got to build walking into the working

day. Have you got your patient's NHS

number? It is a secret that many of our

health problems are caused by not doing enough exercise.

I've got to have a flutter, which I got on the 18th of March 20 13. --

arterial flutter. The first one happened here. I was diagnosed as a

diabetic. Type II. It's quite good at the moment. I'm

keeping in check with good eating, as much exercise as I can. I've got

a few problems with my back. It's manageable if I try not to think

about! One in four women and one in

men do less than half an hour of men do less than half an hour of

even moderate activity in whole week. We start ageing from the age

of 20. So keeping moving is crucial. Whatever your lifestyle, whether

it's 2000 steps a day or 10,000 steps a day, if you walk 3000 extra

vital steps a day, you'll transform the way you feel now and reduce your

risk of death, disease, disability and dementia. So I've set Tanya and

Dave a challenge. Record their daily step count and then up it.

So far today I've done... 1065 steps. The time is just after ten.

Just after 10:10. On this one, I've done 1470 steps.

It took me an hour just to get into work this morning, so that was a lot

of it. At this rate, they're going to struggle to clock up the extra

3000 steps which I call my Walking Cure. 3000 sounds a lot. It's 30

minutes. But we now know it's just as good as three ten minute 1000

steps episode. So on the way to work, get off the bus early.

Lunchtime, got to get out and do 1000. Then on the way home, do

another 1000. That's the way to build it into your lifestyle. Before

I challenge Tanya to walk more, lunchtime often involves no more

than a few steps to the call centre's kitchen. Those also, like

many others, would simply eat a sandwich at his desk. But today he

spends of his break out walking. Good on you, Dave. That's perfect.

As well as the ten minute additions, in your working day there are things

you can do. Obviously, Tanya and David can't stand and walk about.

Although I will be speaking to the call standing desks. -- I'll be

speaking to the call centres about standing desks. How is this likely

to revolutionise - one meetings work very well, particularly if you have

something tough to say. I blew to eyeball is not necessarily as good

as shoulder to shoulder. -- working meetings. Research things that in an

hour, fit for no more than 20 minutes. Stand for eight. And

walkabout for two. So if you're busy and have a telephone call to make,

why not make it while walking? Hi, I've got ten minutes, so we can

catch up. Really nice to speak to you. Where are you? Walking, I hope.

I'm convinced there's no easy way to improve our general health than

through this. The simplest of activities. OK, that's it. Ten

minutes on the phone, ten minutes walking. That's 1000 steps. That's a

kilometre. And we're both better off for it. Back at the call centre,

after sitting down for almost seven hours solid, it's clocking off time.

So how many steps have Tanya and Dave clocked up? Today's abysmal.

2186. That is dismal. 2186. That is dismal.

3275 steps. I didn't like the 2000 steps.

Especially if you're supposed to 10,000 a day, I'm way behind.

one of us making the effort with one of us making the effort with

more active day to day life, and losing our terrible habit of sitting

for long periods of time. Obviously, if you've a heart condition or other

underlying health conditions and check with your doctor first before

stepping up the pace. I suppose stepping up the pace. I suppose

you've got lots of things wrong with you, but if you can do 100 steps

more to start wrong with you, start with that. You'll feel better and

reduce your risk of disease, disability and dementia. That's the

bottom line. When we first met Tanya and Dave at

the call centre, they were doing just 3000 or so steps a day. How are

they doing now? It's been two weeks since the challenge. My best score

is just over 6000 but through the day. I have to go by what my

daughter once, because I've got no one else there helping me as a

single dad. It can be difficult, but it's good fun as well.

I've opted mainly at the weekends. Not while I'm working because of

having to sit down and answer the telephone. -- I have upped it. The

last few days have been in the seven thousands. I would like to be in the

10,000, but I will get there slowly. Here is the bottom line - no matter

your age, no matter what long-term condition or disease you've got,

walking more is the single best thing that you can do. And talking

of bottom lines, Tanya and Dave, and little Edie, are at the foot of

of Winchester, contemplating whether of Winchester, contemplating whether

to take their step count to new heights. I could give some of it a

go, yeah. Coming down will be easy! Go through the gate first. This is a

steep bit. Oh, I'll wait here. Tanya gets most of the way and vows

to return to Congress Saint Catherine's another day. But Dave's

pushing on. -- return to conquer Saint Catherine's.

top! Yay! I could quite happily top! Yay! I could quite happily

liver pate, e.g.. Couldn't you? -- I could quite happily live up here.

Well done, Dave and Tanya. Good effort. That's it for now. Don't

forget the e-mail. I'd better get walking, see you.

Next week... They just moved out onto the right,

and she's almost overcompensating. The junior doctors at risk driving

home after their night shifts. She getting quite bad now. That's

terrifying. That's really, really scary.

Hello, I'm Louisa Preston with your 90 second update.

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