Hospitals Could 'Grind To Halt' In Shake-Up

Health experts have warned that the NHS is "not ready" for the raft of changes being implemented under controversial health reforms which come into effect today.

The Health and Social Care Act, which became law after a tortuous passage through Parliament, is expected to cost the taxpayer between £1.5bn and £1.6bn to implement.

Nick Black, professor of health service research at the London School of Hygiene and Tropical Medicine, said that he did not believe the health service was prepared for such a huge structural change.

He warned that hospitals could "grind to a halt" as cuts to social care budgets mean that doctors are unable to discharge patients who do not need to be on the wards.

And Labour said that the reforms have exposed the health service to risk because they have been implemented during a time of huge financial pressure.

When asked whether the NHS is ready for such a big change, Professor Black said: "Not really no. It could really do without this.

"What we have got at the moment is a perfect storm with three major things happening - the changes in the structure, the fall out from Francis (a review into failures at Mid Staffordshire NHS Trust) and the Nicholson challenge (where the NHS has been tasked with making £20bn in efficiency savings during the four years to 2015).

"At one level patients won't notice anything dramatic on Monday morning. But the biggest thing that patients will notice will be the knock-on effect from the cuts in social care funding.

"It is clear that our hospitals are already struggling to discharge patients. One manager who I spoke to last week said that 100 beds in his hospitals could be discharged if there was the care in the community.

"Hospitals could cease to function and the system could grind to a halt because of people who do not need to be there."

The main aim of the health reforms is to make the NHS more accountable to patients and to release frontline staff from excessive bureaucracy and top-down control.

One of the biggest changes is the move from primary care trusts (PCTs) to clinical commissioning groups (CCGs), which will be led by GPs and other clinicians who will take on responsibility for commissioning care. The move will see 211 CCGs replace 151 PCTs across England.

But last week it was announced that only half of of the new CCGs will be fully ready to start work when the changes come into effect .

However, the Department of Health said that for the first time health and social care services will be "designed around the needs of the local community".

Health Minister Lord Howe said: "From April 1 local nurses and doctors, who best know what their patients need will have the power, freedom and budget to decide what care and services are best for their local communities and how taxpayers' money is spent.

"Patients will be able to choose who provides their care so everyday health checks like hearing and blood tests can be carried out at a time and place convenient for them, such as at a pharmacy on the high street instead of a hospital.

"Health and care services will be better joined up by bringing together the NHS, local councils and patients. Patients will have a greater influence in changes to their local health and care services through the patient led inspections and the friends and family test.

"Through these changes, the health service will improve, work smarter and, importantly, build an NHS that delivers high quality, compassionate care for patients."