Tuesday, 31 December 2013

Liver disease deaths: areas with highest levels 'most starved of NHS funds'

Liver disease deaths: areas with highest levels 'most starved of NHS funds' British Liver Trust slates funding policy giving areas with lowest fatalities 10% more in GP budgets than areas with most deaths.
Health reforms have ensured that the areas with the greatest number of deaths from liver disease are being "starved of NHS funds", a leading charity has warned.
According to an analysis by the British Liver Trust, areas with the lowest numbers of deaths will on average get funding increases worth 10% more than those areas with the highest number.
Despite a personal commitment from the prime minister for liver disease to be tackled as a priority, charities said that no real action had been taken and that a promised strategy was now two years overdue.
Campaigners also said also that the money to tackle the disease was slowly being reduced. Just before Christmas NHS England unveiled how much local groups of GPs would be able to spend on their patients.
When the figures, which represent £100bn of health spending, were analysed a widening gap was revealed between the apparent needs of local populations – especially when it came to so-called preventable lifestyle diseases – and the cash available to them.
The British Liver Trust compared the latest death rate from liver disease with the NHS funding growth that each area of Britain would receive following the government's decision in December on cash settlements for family doctors' clinical commissioning groups (CCGs).
The results of the research were stark: areas with fewer than five deaths from liver disease per 100,000 people would receive a budget growth in 2014-15 of 10% more than those areas that had more than 35 deaths per 100,000.
In north Manchester death rates from liver disease run at 35 per 100,000 people, more than double the national rate. However in this region GPs are to receive NHS funding rises in 2014-15 of just 2.14%.
Meanwhile in south Norfolk, where the deaths from liver disease are a third of those in Manchester, and stand well below the national average, GPs will get a funding boost of 4.92%.
The trend becomes more pronounced for later years. Across two years' of data, on average CCGs get 4.74% funding increases. However, those areas with above-average rates of deaths due to liver disease get a fifth less than this amount.
The lower funding for some areas appears at odds with warnings that excessive drinking is a growing problem in England.
A year ago the chief medical officer, Dame Sally Davies, said deaths from chronic liver disease had increased by about 20% in the past 10 years in England while they fell by the same amount in most EU countries.
The trust claims that the government has ignored campaigners who have warned of the downgrading, under the coalition, of diseases that can be attributed to personal decisions.
Liver disease, the only leading cause of death still increasing year on year in the UK, is largely due to lifestyle issues such as alcohol, drugs, and obesity, factors viewed by doctors as preventable.
The British Liver Trust's chief executive, Andrew Langford, said: "These findings confirm our worst fears. We warned the government back in November not to change NHS funding until its impact on liver disease was better understood, but they ploughed on regardless.
"From April, the poorest areas will be starved of the funds to tackle liver disease even though they need the money the most."
Langford said that ministers needed to "make good" on the prime minister's promise to publish a strategy to tackle liver disease, "with investment to match".
He added: "The government has not only broken its promise to produce a strategy to tackle liver disease, but now they have taken away the money too. The progress we have seen in recent years is more at risk than ever before."
Driving the change in allocations is the government's decision to force NHS England not just to flatten health inequalities but also to allocate funds on the basis of whether every patient can "access" services.
This, in effect, forces the NHS to skew funding to the elderly who live in richer areas and more frequently complain that they cannot get to see a doctor.
In 2012 Andrew Lansley, then the health secretary, caused outrage by stating that age not poverty was going to determine the amount of cash GPs would get in the new NHS.
The shadow health secretary, Andy Burnham, said: "Ministers must intervene and ensure areas with the greatest health challenges are not stripped of crucial NHS funds."
In a statement Paul Baumann, chief financial officer for NHS England, said: "We must ensure funding is equitable and fair and we have used … [last year's] review period to ensure that funding is based on up-to-date and detailed information and takes into account the three main factors in healthcare needs: population growth, deprivation and the impact of an ageing population.
"What is clear is that doing nothing is not an option. Some areas have not had the funding per head that they need, particularly where population has grown quickly and funding has remained relatively static.
"These areas are now at risk of not being able to provide the services needed by their population, so we need to tackle these differences in funding as a matter of urgency." The Guardian

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