Thursday 31 October 2013

Kettering Hospital has improved, says new watchdog report

Kettering Hospital has improved, says new watchdog report A report has found significant improvements have been made at Kettering Hospital since a similar inspection earlier this year. Northamptonshire Telegraph

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Residents at Northampton care home had sores so deep “you could feel the bone”, hearing told

Residents at Northampton care home had sores so deep “you could feel the bone”, hearing told Residents at a Northampton care home were found with pressure sores so deep ‘you could feel the bone’, a hearing was told today. Northampton Chronicle and Echo

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Emergency admissions to hospital: managing the demand

Emergency admissions to hospital: managing the demand Many emergency admissions to hospital are avoidable and many patients stay in hospital longer than is necessary, according to a report today by the National Audit Office. Improving the flow of patients through the system will be critical to the NHS’s ability to cope with future winter pressures on urgent and emergency care services.
Today’s report points out that, at a time when NHS budgets are under significant pressure, the number of emergency admissions to hospitals is continuing to rise, albeit at a slower rate than in the past. National Audit Office
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Care leaver strategy

Care leaver strategy This is a cross-departmental strategy document that sets out in one place the steps the government is taking - from housing to health services, from the justice system to educational institutions - to support care leavers to live independently once they have left their placement.
The new strategy includes a wide range of commitments from government to improve the help and support available to young people leaving care across all areas of life. All young people leaving care will be able to see exactly what support is available to them as they take the first steps into adult life. Department of Health

NHS Employers workforce survey results published

NHS Employers workforce survey results published The findings from the workforce survey enable us to share with employers the current reported trends in the labour market across the NHS, nationally and regionally. NHS Employers

Seven-day services in the NHS

Seven-day services in the NHS The BMA has published information about the proposals to make more NHS services available all week round including background, the BMA’s position and evidence about the impact of the plan on hospitals. The BMA

Could the EU Reform the NHS?

Could the EU Reform the NHS? An EU law has just come into force that may shake up the NHS more than any political party has ever been able to do. The Directive on Patients' Rights in Cross-border Healthcare gives the right to any EU citizen to get healthcare in any other EU Member ... The Huffington Post

PIP implant breast cancer link ruled out

PIP implant breast cancer link ruled out Faulty breast implants widely known as PIP (Poly Implant Prosthese) were back in the news today, with the release of a new report that found that women who have the faulty implants are not at higher risk of cancer.

Mental Health Act detentions top 50,000 a year

Mental Health Act detentions top 50,000 a year  Detentions continue to rise while use of place of safety orders fall. Health and Social Care Information Centre

Peer support workers: a practical guide to implementation

Peer support workers: a practical guide to implementation This guide from the Centre for Mental Health sets out four phases for an organisation looking to introduce peer worker posts: preparation; recruitment; employment; and ongoing development. It advises organisations on the key questions they need to ask, addresses common myths and provides sample documents to use.

The national pain audit: third report

The national pain audit: third report This audit from the Healthcare Quality Improvement Partnership (HQIP) has found that safety protocols need to be reviewed in many specialist pain services to ensure that mental health risk assessment and full case reviews of missed diagnoses are routinely performed. It recommended that specialist training is given to staff so they can better identify and manage those at risk.

Less smokers are using NHS help to quit

Less smokers are using NHS help to quit 11% drop in people using NHS Stop Smoking Services last year. OnMedica

Young army recruits at higher risk of mental illness

Young army recruits at higher risk of mental illness
A report by ForcesWatch claims those joining the army under the age of 18 are far more likely to suffer from post-traumatic stress disorder (PTSD) and other mental health problems after leaving the forces. The report looked at over 40 existing studies into mental health problems among armed services personnel, in addition to interviews with veterans. The research also indicated that young recruits from disadvantaged backgrounds were... Healthcare Today

UK warned that youth unemployment is 'public health time bomb waiting to explode'

UK warned that youth unemployment is 'public health time bomb waiting to explode'

Youth unemployment in the UK and throughout Europe is a "public health time bomb waiting to explode" the World Health Organisation has warned. The Independent

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Wednesday 30 October 2013

Securing the future of excellent patient care: final report of the independent review led by Professor David Greenaway

Securing the future of excellent patient care: final report of the independent review led by Professor David Greenaway This report is the result of an independent review which examined postgraduate medical education and training in the UK to ensure that doctors now and in the future are able to meet the changing needs of patients, society and health services. It recommends that a new way of training doctors is needed for a changing healthcare landscape; arguing that patients and the public will need doctors who are able to provide general care in broad speciality areas across a range of different settings.
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Hunt loses Lewisham Hospital appeal

Hunt loses Lewisham Hospital appeal The Court of Appeal rules Health Secretary Jeremy Hunt did not have power to implement cuts at Lewisham Hospital in London. BBC News

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Sickness absence figures released

Sickness absence figures released The Health and Social Care Informatics Centre (HSCIC) has released the report on NHS staff sickness absence figures, for the period of April to June 2013. NHS Employers

Swaddling may damage babies' hips, expert warns

Swaddling may damage babies' hips, expert warns Swaddling may have come back into fashion, particularly after speculation about how Prince George appeared to be wrapped as he left hospital. But the centuries-old practice could damage babies' hips is the warning carried by most media outlets today after the issue was highlighted by a British surgeon.

New data from the Summary Hospital-level Mortality Indicator

New data from the Summary Hospital-level Mortality Indicator The publication shows mortality from hospitalisation in England where the patient either died in hospital or died within 30-days post discharge from hospital, during the reporting period April 2012 to March 2013. Health and Social Care Information Centre

Interim gender dysphoria protocol and service guideline 2013/14

Interim gender dysphoria protocol and service guideline 2013/14 This guidance aims to address the significant variations in equity of access currently experienced by patients using gender identity services across England. It aims to achieve national consistency in the commissioning of these services, and is the culmination of extensive work to adapt the NHS Scotland protocol, ensuring that it meets the needs of patients; provides for the safe delivery of services, and reflects NHS England structures.

Cancer imaging centres to receive funding

Cancer imaging centres to receive funding
Four cancer imaging centres across the UK are to receive £35m funding to develop imaging technologies for cancer research.The money which comes as part of a new initiative by Cancer Research UK and the Engineering and Physical Sciences Research Council will be spread over five years and will benefit the University of Oxford; the Institute of Cancer Research in London; a centre run jointly by King’s College, London ... Healthcare Today

Cancer survival rates up - but UK still lags behind other countries

Cancer survival rates up - but UK still lags behind other countries

Survival rates for cancer patients in England continue to improve, but leading charities have warned that treatments for some types of cancer are still “lagging behind” others. The Independent
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Tuesday 29 October 2013

A review of the NHS hospitals complaints system: putting patients back in the picture

A review of the NHS hospitals complaints system: putting patients back in the picture This report looks at how complaints about care in NHS hospitals made by patients, their carers and representatives are listened to and acted on by hospitals. The review received 2,500 responses, the majority describing problems with the quality of treatment or care in NHS hospitals. The review panel also heard from people who had not complained because they felt the process was too confusing or they feared for their future care. The recommendations cover improving quality of care; improving the way complaints are handled; ensuring independence in the complaints procedures; and whistleblowing.
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A summit for safer care

A summit for safer care Measuring safety rather than harm requires us to engage with information that will give us insight into what is currently happening and what is likely to happen. Only when we have this knowledge can we respond effectively to prevent patients from being harmed in our care, says Jo Bibby. The Health Foundation

A good day to bury a significant piece of legislation?

A good day to bury a significant piece of legislation? Amid the furore (at least in health policy circles) of the Competition Commission’s decision to refuse themerger of trusts in Bournemouth and Poole, it may have passed people by that some potentially very significant changes to the current failure regime have been approved as part of the Care Bill.

VIDEO: Students tackle mental health stigma

VIDEO: Students tackle mental health stigma A scheme in the West Midlands, which has been successfully trying to combat the stigma that surrounds mental health, is about to be extended. BBC News

2015 records access promise scaled back

2015 records access promise scaled back The government's pledge for patients to have online access to their GP record by March 2015 will only require access to the brief information held on their Summary Care Record. E-Health Insider

More gene changes have role in Alzheimer's disease

More gene changes have role in Alzheimer's disease BBC News reports that there has been "Alzheimer's insight from DNA study". The BBC says that a clearer picture of what causes Alzheimer's disease is emerging after the largest-ever analysis of patients' DNA.

It's not just Mid Staffordshire. Private hospitals fail, too

It's not just Mid Staffordshire. Private hospitals fail, too For-profit healthcare groups depend on NHS contracts for their revenue, yet they are not forced to be transparent.

Jeremy Hunt takes Lewisham hospital reform battle to court of appeal

Jeremy Hunt takes Lewisham hospital reform battle to court of appeal Health secretary challenges previous ruling that he is not empowered to downgrade A&E and maternity services.

Monday 28 October 2013

Six accused of care home 'failings'

Six accused of care home 'failings' Six people are to appear before a Nursing and Midwifery panel accused of care failings at a nursing home. BBC Northamptonshire

Hospital ‘is tackling risks’ highlighted by watchdog

Hospital ‘is tackling risks’ highlighted by watchdog Kettering Hospital says it is working to eliminate risks highlighted in a report by a national watchdog. Northamptonshire Telegraph

Bullied KGH nurse forced to quit

Bullied KGH nurse forced to quit A senior nurse with 46 years of experience has won a constructive dismissal case against Kettering General Hospital. Northamptonshire Telegraph

Most cancer patients who die in Northamptonshire hospitals wanted to spend last days at home

Most cancer patients who die in Northamptonshire hospitals wanted to spend last days at home About three quarters of cancer patients in Northamptonshire who die in hospital beds wanted to die at home, Macmillan Cancer Support has said. Northampton Chronicle and Echo

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Project to help stop ‘horrific practice’ of female mutilation in Northamptonshire

Project to help stop ‘horrific practice’ of female mutilation in Northamptonshire A project has been launched to protect girls in Northamptonshire from female mutilation as the county is in the top 10 places in the UK where the practice is carried out. Northampton Chronicle and Echo

Policy paper: Mental Health Act 2007: response to Commons Health Committee

Policy paper: Mental Health Act 2007: response to Commons Health Committee The Department of Health responds to the 11 Health Select Committee recommendations following the Mental Health Act 2007. The response covers:
  • independent mental health advocate services
  • supervised community treatment and places of safety
  • deprivation of liberty safeguards
The department’s response will be of particular interest to mental health and learning disability professionals and to those with a personal or family involvement with mental health services.

NHS complaints review set to report

NHS complaints review set to report The conclusions of a government review into the way the NHS in England handles complaints will be published on Monday. BBC News

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Emergency care: an accident waiting to happen?

Emergency care: an accident waiting to happen? This briefing aims to debunk some of the myths around A&E care and provides a snapshot of what our members are experiencing across the country. NHS Employers

NHS support organisations – new infographic published

NHS support organisations – new infographic published NHS Employers has produced a new infographic showing the organisations that support the new NHS and what they do.

Compulsory 'Care Certificate' to be introduced for support workers

Compulsory 'Care Certificate' to be introduced for support workers Health Minister Lord Howe has announced this week that a new national certificate for care will be introduced to ensure healthcare assistants and social care support workers receive high quality induction in the fundamentals of caring. NHS Employers

Cold weather plan for England 2013: protecting health and reducing harm from cold weather

Cold weather plan for England 2013: protecting health and reducing harm from cold weather The cold weather plan from Public Health England aims to prevent avoidable harm to health, by alerting people to the negative health effects of cold weather, and enabling them to prepare and respond appropriately. The emphasis of this year’s plan is on long term planning and winter action and preparedness.

Measuring and monitoring safety: an acute care perspective

Measuring and monitoring safety: an acute care perspective This thought paper offers reflections on the measurement and monitoring of safety from the perspective of a practising clinician based at a busy district general hospital. The Health Foundation

Doctors back seven-day NHS service plan

Doctors back seven-day NHS service plan Apparent U-turn by British Medical Association could pave the way for routine procedures being offered at weekends.

Simon Stevens' switch to NHS 'is like Arsenal signing Mesut Özil'

Simon Stevens' switch to NHS 'is like Arsenal signing Mesut Özil' he man who helped orchestrate New Labour's massive NHS investment is seen by many as the right choice for the job.

Close A&Es to save lives, doctors urge Jeremy Hunt

Close A&Es to save lives, doctors urge Jeremy Hunt Senior doctors have called on Jeremy Hunt to authorise mass closures of A&E departments, saying it will prevent needless deaths. The Daily Telegraph

Doctors to face regular competence tests following Harold Shipman murders

Doctors to face regular competence tests following Harold Shipman murders All doctors in the UK to be subject to tests originally recommended in the wake of the Harold Shipman scandal. The Daily Telegraph

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Friday 25 October 2013

NGH to receive CQC inspection

NGH to receive CQC inspection
Northampton General Hospital NHS Trust is included in the next 19 acute and specialist trusts that will be inspected as part of the CQC's new hospital inspection programme under the direction of the new Chief Inspector of Hospitals, Sir Mike Richards.
Dr Sonia Swart, Chief Executive of NGH, said 'We welcome the opportunities that the CQC inspection will give us to make further improvements to the services we provide.  Feedback from our patients and our staff, along with our own internal inspection processes, scrutiny and constructive challenge from regulators enables us to provide even better care for our patients.
'We know there are areas where we need to take action to ensure our services are of a consistently high quality and there is an enormous amount of work already underway.  The CQC inspection will complement this work and help us to improve patient care even further.'  NGH News

Poor care risk 'at 1 in 4 hospitals'

Poor care risk 'at 1 in 4 hospitals'
Northampton and Kettering hospitals are at raised risk of providing poor care, a review by the regulator shows.  BBC Health News

NHS Trusts put in risk categories - full list

NHS Trusts put in risk categories - full list
Here is a list of the trusts in the risk categories identified by the Care Quality Commission (CQC). Band 1 is considered the highest risk and band 6 the lowest.  Independent

Hospital intelligent monitoring: October 2013

Hospital intelligent monitoring: October 2013
Care Quality Commission -
Intelligent monitoring looks at 150 different indicators covering a range of information including patient and staff experience and statistical measures of performance, with the aim of giving inspectors a clear picture of the areas of care that need to be looked at in NHS acute trusts. Together with local information from partners and the public, this monitoring helps the Care Quality Commission to decide when, where and what to inspect. A further 19 NHS trusts will be inspected from January 2014.

Daily aspirin 'risky' for healthy

Daily aspirin 'risky' for healthy
Healthy people should not take aspirin to ward off heart attacks and cancer, according to the most comprehensive review of the risks and benefits.  BBC News

Co-ordinated care for people with complex chronic conditions: key lessons and markers for success

Co-ordinated care for people with complex chronic conditions: key lessons and markers for success
The King's Fund -
This report presents the findings from a two-year research project funded by Aetna and the Aetna Foundation, which aimed to understand the key components of effective strategies employed by studying five UK-based programmes to deliver co-ordinated care for people with long-term and complex needs. It elicits some key lessons and markers for success to help identify how care co-ordination might be transferred from the UK to the US context.

Medical tourism generates millions for NHS and wider economy, finds study

Medical tourism generates millions for NHS and wider economy, finds study
'Foreigners abusing system' claim contradicted by research that also shows more people go overseas for treatment than arrive
Medical tourism is a lucrative source of income for the NHS, according to a major new study that contradicts many of the assumptions behind the government's announcement that it will clamp down on foreigners abusing the health service.
Eighteen hospitals – those deemed most likely to be making money from overseas patients – earned £42m in 2010, according to researchers from the London School of Hygiene and Tropical Medicine and York University. Medical tourists spent an estimated £219m on hotels, restaurants, shopping and transport in the UK.
The researchers also found that more people leave the UK seeking medical treatment abroad than arrive in this country for care: about 63,000 people from the country travelled to hospitals and clinics abroad in 2010, while considerably fewer, about 52,000 people, came here.

Our response to the appointment of Simon Stevens as the new Chief Executive of NHS England

Our response to the appointment of Simon Stevens as the new Chief Executive of NHS England
Commenting on the appointment of Simon Stevens as Chief Executive of NHS England, Chris Ham, Chief Executive of The King's Fund said:
'Simon Stevens will take up a very different role to the one David Nicholson was appointed to in 2006. Although still the most senior leader in the national health system, he will not be the Chief Executive of the NHS.
'This will mean treading a careful line between responding to the priorities of ministers on the one hand and, on the other, working collaboratively with colleagues from the other main national bodies to provide strong collective leadership for the NHS.
'He will arrive in post at a time when the NHS is facing unprecedented financial and service pressures and its most significant challenges in a generation – meeting these challenges will require leadership skills of the highest order.
'Simon brings exceptional knowledge of working at the highest level of government, a strong commitment to the NHS and significant international experience. He will also have a keen appetite for addressing the challenges facing the NHS – as such I can't think of anyone better qualified for the role.' Kings Fund

Integrated health & social care — exploring how people’s care and support needs change and how the workforce has to adapt to meet the...

Integrated health & social care — exploring how people’s care and support needs change and how the workforce has to adapt to meet the... Skills for Care -
This review explores how people's care and support needs change and how the workforce has to adapt to meet the challenges that change can present. It has sought to understand the characteristics of effective workforce practice in integrated health and social care services with a particular focus on avoiding hospital admissions, improving reablement services, and speeding up and improving hospital discharge services and transfers between residential and nursing homes.  NHS Evidence

NHS 111 service is stable and improving, says NHS England

NHS 111 service is stable and improving, says NHS England
The NHS 111 service is stable and improving, NHS England said today.
It issued an update on the organisations that are to replace NHS Direct, currently one of the providers of NHS 111 services.
NHS Direct has had some difficulties in providing these services and decided in agreement with NHS England that it would withdraw from the market.  The NHS 111 service in England is divided into 44 areas, nine of which are currently provided by NHS Direct.

NHS Direct to close in 2014

NHS Direct to close in 2014  Telephone advice service set up in 1998 was forced to withdraw from new NHS 111 service owing to its slashed budget
NHS Direct, the telephone advice service that many GPs refer patients to after-hours, is to close at the end of the financial year, putting more than 700 jobs at risk.
NHS Direct, which has been running for 15 years, has been effectively superseded by the NHS 111 scheme, which was introduced in some areas earlier this year to cope with people who felt they needed care but were not a 999 emergency.
NHS Direct was set up by the Labour government and had continued to operate. It took on some of the 111 contracts around the country, but was forced to withdraw from them earlier this year. Five ambulance trusts have taken on the staff and call centres from NHS Direct, but other redundancy costs could rise to £15m.
In the end, it came down to money. NHS Direct could not provide the 111 services at a financially sustainable cost and commissioners could not afford to pay for the former's services separately from the latter's.
Joanne Shaw, chair of NHS Direct, said: "The closure of NHS Direct marks the end of its 15 years of continuous innovation, during which time it has led the world in remote health assessment, advice and information. It is an enormous privilege to have been part of this journey, and I look back over my 10 years with NHS Direct with gratitude and respect for the staff who have created this exceptional service.
"I look forward to seeing other organisations take forward a number of the services developed by NHS Direct, and I wish them well as they exploit the ever-growing reach and power of technology, to provide value to patients and the NHS."
NHS England says that 93% of the population now has access to NHS 111 and that 92% of people who call up are satisfied with the service.  Guardian

Thursday 24 October 2013

Officers back hospital replacement

Officers back hospital replacement Plans for a development to replace a Northamptonshire hospital in Brackley are expected to be approved. BBC News

Nurse struck off after pain relief dispute

Nurse struck off after pain relief dispute A nurse who refused to give pain relief to a patient at Kettering General Hospital has been struck off. Northamptonshire Telegraph

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Hospital plans £45 million unit in Northampton to help children with autism

Hospital plans £45 million unit in Northampton to help children with autism A new £45 million unit to help children with autism and learning difficulties is to be built in Northampton. Northampton Chronicle and Echo

Ex-Blair adviser linked to US healthcare giant is new NHS boss

Ex-Blair adviser linked to US healthcare giant is new NHS boss

A former adviser to Tony Blair who has spent a decade at the top of an American private healthcare giant has been appointed to run the NHS in England. The Independent
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If care planning is so good, why aren’t more people doing it? asks Jeremy Taylor

If care planning is so good, why aren’t more people doing it? asks Jeremy Taylor “I’ve been a doctor for ten years and I have no idea what a care plan is or looks like.” This refreshingly honest admission, heard at a recent conference, perfectly illustrates the continuing gap between rhetoric and reality when it comes to person-centred care. National Voices is working to narrow that gap. Policy makers, progressive … Continue reading » NHS Choices

Saturated fat link with heart disease questioned

Saturated fat link with heart disease questioned "The risk from saturated fat in foods such as butter, cakes and fatty meat is being overstated and demonised, according to a cardiologist," BBC News reports.
In an opinion piece, a doctor specialising in heart disease writes that warnings over saturated fats are misguided.

Proposed changes to EU data protection rules "would erode UK healthcare and research"

Proposed changes to EU data protection rules "would erode UK healthcare and research" Changing data protection rules could lead to less effective NHS, warn NHS Confederation and Royal College of Physicians. 

Lessons from Europe: the value of tariff redesign

Lessons from Europe: the value of tariff redesign With responsibility for pricing structures being shifted to NHS England and the pricing function moving to Monitor, this briefing reviews the European experience of paying for specialist health services and examines whether it is time to redesign the NHS tariff in England to facilitate the development of new models of care.
Lessons from Europe: assuring quality through regulation
This briefing highlights approaches to quality assurance taken in Germany and the Netherlands. It identifies lessons for NHS leaders and policymakers in England on how to approach the challenge of regulating effectively for quality as the current regulatory system is being reconsidered.

Feel better outside, feel better inside: ecotherapy for mental wellbeing, resilience and recovery

Feel better outside, feel better inside: ecotherapy for mental wellbeing, resilience and recovery This report includes new findings from the University of Essex showing the many benefits of ecotherapy for mental wellbeing. It finds that ecotherapy has been proven to improve mental health, boost self esteem, help people with mental health problems return to work, improve physical health, and reduce social isolation.

We must not ignore people's wishes as they approach death

We must not ignore people's wishes as they approach death An end-of-life self assessment tool can be used to ensure care is tailored to patients' needs.

Most GPs back Government plans to charge foreign patients

Most GPs back Government plans to charge foreign patients A poll finds most family doctors support Government plans to charge migrants to access the NHS, despite strong opposition from GP leaders and their unions. The Daily Telegraph

Chief Medical Officer ‘ashamed’ as rickets makes a comeback

Chief Medical Officer ‘ashamed’ as rickets makes a comeback

The Victorian-era disease rickets has returned to England, the country’s Chief Medical Officer has said, and should be fought off through a universal handout of vitamin supplements to all children under five. The Independent

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Wednesday 23 October 2013

Specialist healthcare provider in Northampton reports 5.5 percent increase in income

Specialist healthcare provider in Northampton reports 5.5 percent increase in income St Andrew’s Healthcare in Northampton has reported a growth in income of 5.5 percent for 2012-13 with a turnover of £178 million. Northampton Chronicle and Echo

What are we spending on the English NHS?

What are we spending on the English NHS? The Chief Executive of the English NHS, Sir David Nicholson, recently called for politicians to be '…completely transparent about the consequences of the financial settlements…' for the NHS. His point was that, although politicians say the NHS has been protected financially, this is only relative to real cuts in other areas of government and, crucially, not in terms of the demands on health care.

Five ways to deliver high quality care at low cost

Five ways to deliver high quality care at low cost What would you do to deliver the highest quality care at the lowest possible cost? Jo Bibby gives her top five ideas following a study tour to innovative healthcare centres in India. The Health Foundation

Overseas visitors and migrant use of the NHS: extent and costs

Overseas visitors and migrant use of the NHS: extent and costs These two reports, commissioned by the Department of Health, provide evidence of the impact overseas visitors and migrants are having in GP practices and NHS hospitals. They give a first set of estimates for the number and costs of that care.
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'Breakthrough' trial brings baldness cure closer

'Breakthrough' trial brings baldness cure closer "Scientists say they have moved a step closer to banishing bald spots," BBC News reveals. While the research only involved mice, it did provide 'proof of concept' that it is possible to reprogramme human cells to grow hair.

Healthcare systems: Sweden & localism - an example for the UK?

Healthcare systems: Sweden & localism - an example for the UK? This briefing provides an overview of the Swedish healthcare system and highlights their de-centralised model as an example of best practice for the coalition government's localism agenda. 

Improvement of care for the physical health of patients with severe mental illness

Improvement of care for the physical health of patients with severe mental illness "Three major themes emerged: needs of patients with severe mental illness differ from the general population; professional roles and collaboration; and health monitoring and supporting a healthy lifestyle." BMC Health Services Research

Why mental health bed cuts make me ashamed to work for the NHS | Alex Langford

Why mental health bed cuts make me ashamed to work for the NHS | Alex Langford As doctors, we are crossing our fingers that a bed is available when a patient with a mental illness arrives at A&E.

Doctors have a duty to help ensure migrants pay for NHS care, say No 10

Doctors have a duty to help ensure migrants pay for NHS care, say No 10 Downing Street says there is an obligation on GPs to ensure the taxpayer gets a good deal from the health service.