Daily Insight: Clumsy but (mostly) fair

A trust chief apologised on local radio following media reports he had labelled hospitals “horrible” and unsafe places, which should be avoided “unless you really need to be there”.

East Suffolk and North Essex Foundation Trust boss Nick Hulme told the meeting that NHS leaders had “got to get that message out” to the public – that hospitals were “awful” places to be if you did not need to be there.

Speaking at the Suffolk and North East Essex Integrated Care Board meeting, he also said “the food’s rubbish, we don’t let you sleep, we don’t let you know what’s going on”.

Mr Hulme told HSJ after his comments were reported locally that he had expressed the view because he wanted to move “the debate away from numbers” and on to how patients who do not need to be in hospital in the first place or stay too long after admission “decondition physically [and] suffer psychologically”.

The comment section beneath HSJ’s story was, unsurprisingly, largely supportive. The language was objectively “clumsy”, as the CEO admitted during his apology, but there was largely a consensus that he had raised important issues which would likely benefit from wider debate.

Hospitals are not uniformly “horrible”, but they are certainly not the safest place for patients who do not need to be there, the food is prepared on a modest budget, and few people would describe a hospital stay as enjoyable.

A public campaign on how horrible hospitals are would be a terrible idea, but more candour from senior NHS leaders about quite how “awful” conditions are at times for their patients would be no bad thing.

Hard to swallow

Medicine issues have soared in the past year, with the number of those unavailable nearly doubling from 52 in January 2022 to 97 this month. 

This is based on an analysis by British Generics Manufacturers Association of NHS Specialist Pharmacy Service medicines supply tool data, shared with HSJ. 

Industry leaders have said the growing shortages are largely driven by the cost of selling drugs in the UK – including shipping (increasing sixfold in the last year), active pharmaceutical ingredients (trebling in the last year) and energy (rising by 230 per cent since 2021).

BGMA chief executive Mark Samuels said supply of branded generics was particularly being dented by steep increases in the past year in the government’s voluntary pricing scheme (VPAS) payment rate for manufacturers, linked to high price inflation. 

He said: “Generic and branded generics run on razor-thin margins because once a medicine’s patent expires, competition can take place, which drives down the price.”

SPS data, seen by HSJ, shows several “high impact” shortages, which means they have the potential to change clinical practice or have safety implications.

Among them, Capimune (ciclosporin), which is used to treat arthritis, has been unavailable since November. Senior clinical policy adviser for charity Versus Arthritis Benjamin Ellis warned: “Even a short gap in treatment can cause an agonising flare-up.”