The NHS should take inspiration from Rolls-royce’s purge of managers

SIR – The chief executive of Rollsroyce has identified 4,600 jobs, described largely as “middlemanagement fat” (by the BBC), to be removed from the company. Could he be asked to look at the NHS next, please? John Newbury

Warminster, Wiltshire

SIR – It’s encouraging to see that new NHS figures show a decrease compared to last year in the number of patients occupying hospital beds and delayed in their transfer to care. Coupled with Tuesday’s announcement that NHS chiefs are taking a strong stance against delayed transfers of care by pledging to end the health service’s “long-stay” culture, we’re moving in the right direction.

But for too long people have suffered unnecessarily as they find themselves trapped in hospital beds through no fault of their own. Historically, there have been solutions on offer that have not been taken up on a wider scale. Anchor has run successful trials offering “reablement” beds at a care home in Birmingham, for example.

Better alignment of healthcare and social care can improve lives and save the NHS hundreds of thousands of pounds. Jane Ashcroft

Chief Executive, Anchor London WC1

SIR – It was great to read your report (June 13) that the NHS has pledged to cut long stays in hospital and send patients home sooner to make sure they are treated with dignity and looked after in the right setting for them.

However, without the right services in place in the community, people will continue to end up in hospital, or be unable to leave at all. This is certainly true of people at the end of life.

In 2016, there were more than

1.6 million emergency hospital admissions for people in the last year of life, amounting to around 11 million days in hospital. Unless we ensure there is sufficient support in the community, the system will be stuck in a vicious cycle where, although the dying patient no longer needs to be in hospital, they are unable to leave because the support they need to get home isn’t available.

In the region I oversee at Marie Curie, we have already begun to work with local trusts to see how we can help with winter pressure planning. Joanne Stradling

Divisional General Manager Marie Curie Hertford

SIR – You report (June 14) that a poll has recommended fining people who fail to attend GP appointments.

Any “free” service is treated with contempt by a significant percentage of its users. Are those individuals likely to pay up meekly when they abuse it? Then there is the cost of administering such a scheme.

Think again, I would suggest.

Ceri Twiston Davies FRCS

St Lawrence, Jersey