The BMJ Today: No cash in the attic

finance_abyss• Politics of desperation
In the latest of his regular column, Nigel Hawkes comments on the impossible situation the NHS finds itself in: as prey to an austerity hungry government convinced that more efficiencies can be squeezed out of the service. Hawkes despairs at various improvement initiatives designed to wring extra savings out of the service. The stubborn mantra at the heart of government is that “more money is not the answer,” but nobody actually believes this.
“Hasn’t the government already promised £8bn? Isn’t that enough? Not unless another £22bn can be saved by 2020 from budgets that are already bust, and nobody actually believes that this is likely.”
“Like a drowning man grasping at a straw, the NHS in England is currently prey to the politics of desperation. The financial regulators apparently believe that the total deficit in acute care trusts—£2bn this year and rising—is the result of trusts not trying hard enough, while the trusts say that they can do no more without affecting services,” writes Hawkes.

addenbrooke• Addenbrooke’s woes
So are the current woes facing one of the NHS’s best known hospitals a result of it “not trying hard enough”? Addenbrooke’s Hospital is now in special measures after inspectors found serious staff shortages, cancelled operations, and long waits for surgery and outpatient appointments. Matthew Limb’s news story on the Care Quality Commission’s report includes a comment from the regulator Monitor, which said the trust was overspending to the tune of £1.2bn a week and lacked “adequate financial control.”
However, despite serious staff shortages, inspectors did praise the “outstanding” quality of care given by staff. Keith McNeil, the popular chief executive, who was forced to step down last week in the face of the CQC’s report, countered by highlighting the “very serious challenges” facing the hospital. He thought the word “inadequate” used by inspectors to describe the trust’s services was wrong.

gp_appointment• Reducing the risk of diabetes
A new 10 minute consultation has been published on how to reduce the risk of diabetes. Consultant Tahseen Ahmad Chowdhury and GP Rupal Shah set out what a doctor should do if faced with, for example, a 45 year old white man at high risk of developing diabetes.


Rebecca Coombes is head of investigations and features.