Is more outsourcing the remedy for NHS delays? | Letters

I cannot have been the only person staggered by the figure – £16bn – that the government is proposing to pay to the private sector in its attempts to reduce waiting lists for planned care (Private sector’s role in cutting NHS waiting lists in England to rise by 20%, 6 January).

Your report and the response to the proposal from Keep Our NHS Public raise the issues that everyone should be concerned about, ie how the private sector proposes to staff their treatment facilities, and what the effects on an already demoralised and stretched NHS will be.

Have Starmer, Streeting and their advisers not seen the figures that show significant reductions in people taking up university training places for nursing? Hardly surprising when they are landed with debts of tens of thousands. It is surely time to remedy this ludicrous situation and provide grants for the training of nurses and other medical skills. Set against the billions that government bungs to those corporates who voraciously digest any treatment category they can (mostly with staff who have gained experience and training through NHS resources), this would be a bargain, and put future NHS staff on a much more positive course.
John Newman
Golcar, West Yorkshire

The government has made reducing elective waiting times its top NHS priority. While this is very welcome, the NHS has not met its elective waiting time targets for a decade. Achieving these goals requires a step-change in how the health service delivers elective surgery and diagnostic appointments. In particular, the availability of staff is a hard constraint on the NHS (despite increases in staffing since Covid‑19) and is usually the primary constraint to increasing activity.

The system needs to use digital technology to help staff deliver more care, more productively. Historically, emergency pressures have crowded out elective procedures, leading to cancellations – and so any new capacity needs to be ringfenced, or delivered in separate centres, to ensure it is available. Properly managing services to be available more than 12 hours a day, seven days a week, will be a big change for non-emergency healthcare, requiring a step-change in service management.
Stephen Farrington-Bell
Healthcare expert, PA Consulting

Many emergency admissions could be avoided (Hospital admissions for flu quadruple in England as NHS bosses warn of ‘huge’ strain, 3 January). People from care homes are frequently admitted to hospital as they require intravenous antibiotic treatment and oxygen. Nurses working in nursing homes have the training to provide this treatment, but, in many homes, do not have the agreement and authority to use their expertise. For residential care homes where nursing care is not provided, district nurses could provide and supervise this.

The 2019 NHS 10-year long-term plan and hospital at home initiatives aspire to prevent emergency admissions, but practical solutions to achieve this now in care homes are for the most part ignored. The benefits are compelling: easing pressure on ambulances and A&E departments, preventing the distress of hospital admission on frail, vulnerable people and, for some, preventing a very traumatic end-of-life.
Bernadette Roden
Enfield, London