Tuesday, 31 January 2012
In December 2011, the Department of Health published the first stage of the assurance framework, which is a mandatory board governance memorandum for all aspirant foundation trusts.
Read the modules and listen to Laura Roberts, head of provider leadership development at DH, on why the new framework will be so valuable for NHS trusts. NHS Networks
British Medical Journal, Health Service Journal and Nursing Times condemn shakeup as a 'damaging … unholy mess'
The coalition's NHS reforms, the biggest shakeup of the health service in 60 years, are a "damaging … unholy mess" that will need overhauling in five years' time, the editors of three leading healthcare publications claim.
In an editorial published simultaneously by the British Medical Journal, Health Service Journal and Nursing Times, their editors say the NHS "is far too important to be left at the mercy of ideological and incompetent intervention" and argue ,"we must make sure that nothing like this ever happens again".
The health secretary, Andrew Lansley, will attempt to soothe the anger of critics, particularly in the House of Lords where the health and social care bill will return next month, by proposing 200 amendments to the legislation later this week. However, the editorial bluntly states that the damage has already been done.
"The government's NHS reforms have proved divisive and destructive. They have slowed the improvement of NHS services and cost the UK money that it can ill afford."
In a second BMJ editorial published on Tuesday, Kieran Walshe, professor of health policy at Manchester Business School, says that abandoning the bill now would save just over £1bn in 2013.
He says there are three clear benefits to dispensing with the bill. First, it would put an end to the damaging period of prolonged organisational uncertainty in the NHS that started when the white paper was published 18 months ago. Second, it would allow NHS organisations to focus on what is the real and urgent problem for the NHS - finding £20bn in efficiency savings.
Finally, Walshe says the savings from the proposals have already been made. "Going ahead with the bill means setting up the NHS Commissioning Board (with an annual running costs of £492m), 260 clinical commissioning groups (with an annual running costs of £1.25bn), and the new economic regulator, Monitor (with its anticipated annual running costs of £82m). Each of these new statutory organisations will have additional set-up costs – perhaps amounting to a one-off spend of £360m. If the bill were stopped now, it would save all those set-up costs, and at least £650m in annual running costs – just over £1bn in 2013."
Labour seized on the analysis. Andy Burnham, the shadow health secretary, said: "The chorus of protest against Andrew Lansley's ill-conceived plans for the NHS grows louder by the day, uniting voices across the health world. This is a powerful and scathing critique of the government's handling of its NHS re-organisation from three of the most respected voices in healthcare.
"It reflects the strength of feeling in the health professions and echoes the widely-held that this bill is unnecessary and a distraction from the financial challenge facing the NHS."
However, it was dismissed by Lansley's aides as "not exactly unexpected".
A Department of Health spokesperson said: "Our reforms are based on what NHS staff themselves have consistently said; they want more freedom from day to day bureaucracy and political interference so they can get on with the job of caring for patients. That is exactly what this bill achieves.
"It's completely untrue to suggest that dropping the bill would save the NHS money. Our plans will reduce needless bureaucracy by a third and save £4.5bn over the course of this parliament and £1.5bn every year afterwards. Every penny saved will be reinvested in frontline care for patients." The Guardian
The Chief Medical Officer, Dame Sally Davies, has written to health professionals, with some more detailed guidance. The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.
This report reveals that this year spending on older people’s social care in England has fallen by £500 million and the funding gap is growing. It projects that by 2012-2013 the Government would need to spend £1 billion more than this year to stop the situation getting any worse.
This paper aims to measure variation in hospital quality using a new, routinely collected dataset on patient‐reported outcome measures (PROMs). It explores hospital performance with respect to self‐reported health outcomes for hip replacement patients at the level of the individual, disaggregated PROM responses.
Monday, 30 January 2012
PATIENTS treated in the new Macmillan Haematology Suite, which opened its doors at Northampton General Hospital today, will have more privacy and dignity, and be more comfortable for patients than the old unit, hospital staff have said. Northampton Chronicle and Echo
According to this research there are over a million people who look after a loved-one with cancer that are potentially missing out on vital support and benefits. The report details the number and profile of the 1.1m people currently caring for someone with cancer in the UK and found that almost none (just 5%) have received a local authority Carers’ Assessment which enables them to access practical, emotional and financial support with their caring role.
NHS 'faces peril' if reform plans are derailed
The British Medical Association, the Royal College of Nurses and the Royal College of Midwives oppose the reform, describing it as a covert privatisation of the NHS. David Cameron agreed to "pause" the reforms last year as a result of the opposition.
Cost of NHS reformThe Wiltshire Gazette and Herald
Group of GPs warns of 'peril' if NHS changes failBBC News
NHS 'in peril' if health reforms fail, warn senior GPsTelegraph.co.uk
Huffington Post UK -The Press Association
all 242 news articles »
Threat of Lords revolt compels health secretary to change NHS bill amid claims of 'sheer panic' in government over opposition
The health secretary will perform a dramatic climbdown over his reforms this week in a desperate attempt to prevent a cross-party revolt among peers who fear that the changes would lead to the fragmentation of the NHS.
Amid growing concern in Downing Street that health policy is becoming the government's achilles heel, ministers will table a series of amendments to the health and social care bill that will oblige Andrew Lansley to maintain the NHS as a national public service and, his critics say, limit his ambitions to expand the role of the private sector.
The changes will also spell out the kind of services that must be offered by GPs and will effectively ban them from withholding certain forms of care from patients.
On Saturday Labour's health spokesman in the House of Lords, Baroness Thornton, described the move as a "massive climbdown" by Lansley. But she said the bill still remained deeply flawed and that attention would turn to clauses dealing with plans to increase competition when it returns to the Lords next month.
The peers, led by the Lib Dem, Baroness Williams, and supported by a former Tory lord chancellor, Lord Mackay of Clashfern, have complained that the original bill left serious legal doubt as to whether the secretary of state would any longer be responsible for providing a "comprehensive health service for the people of England free at the point of need".
They feared that the absence of a chain of accountability would allow the service to become fragmented as different groups of doctors adopted different approaches and the role of the private sector expanded.
Lansley's reforms will abolish two major tiers of health service bureaucracy and devolve greater responsibility for commissioning care to GPs – moves the health secretary believes will deliver a more efficient service and a system of care tailored better to patients' needs.
The Department of Health confirmed the changes would be made to the bill but denied they were a panic response following a fortnight in which Lansley's approach has been criticised by a cross-party group of MPs and a growing number of health professionals.
One of the amendments was sparked by concern that the new consortia of local doctors in each part of England would be able to deny patients certain treatments because of their lifestyles. In Hertfordshire, the Herts Valley Clinical Commissioning Group (CCG) has become the first in England to tell obese patients to lose weight or they would not receive gall bladder, hernia or tonsil surgery. The CCG has also told smokers that they have to see a counsellor about trying to quit before they can undergo certain operations.
Although the NHS already imposes conditions on certain patients, there was concern that CCGs would go much further if the health secretary was no long responsible for ensuring they provided a national service.
A letter from the government health minister Lord Howe to a group of peers last week confirmed the changes. It said that "there seems to be an emerging consensus about how the bill can be improved in order to put beyond doubt the secretary of state's accountability for the health service".
Meanwhile, opposition from doctors to the bill appears to be growing. The Royal College of Physicians, which represents hospital doctors, is under pressure from members to hold an emergency general meeting. The members want it to follow the British Medical Association, the Royal College of Nursing and the Royal College of Midwives in calling for the bill to be scrapped.
The body representing NHS radiologists has also voiced "grave concerns" about the bill and said that: "Given our widespread concerns over many serious and as yet unresolved issues, the Royal College of Radiologists cannot support, and must continue to oppose, the passage of the bill in its current form."
The Royal College of Psychiatrists has taken a similarly hard line while the College of Emergency Medicine, which speaks for A&E doctors, has also voiced serious doubts.
Andy Burnham, the shadow health secretary, said on Saturday that there had been "sheer panic" at the Department of Health. "But no amount of pressurising phone calls and desperate concessions will make the bill acceptable," he said. The Guardian
Friday, 27 January 2012
ALMOST two thirds of people who attended A&E at Northampton General Hospital in a 12-month period were not taken by ambulance. Northanpton Chronicle and Echo
The Department of Health has today published the report of the NHS Litigation Authority (NHSLA) Industry Review and the Department’s response.
The Department welcomes the report, which highlights the positive role of the NHSLA and the effective contribution it has made since its establishment in 1995. The Department broadly accepts the report, its conclusions and recommendations.
The Department’s response sets out actions that will be taken forward as a result of the review undertaken by Marsh Ltd between February and April 2011.
A process of engagement will now begin with stakeholders by the NHSLA and the Department to look at how particular recommendations will be implemented or where further policy development needs to be undertaken.
This report aims to provide a starting point to consider factors that may influence the requirements, numbers and proportions of the future medical workforce.
UK Hospitals Breach Drug Storage Security
A third of NHS trusts surveyed had audits showing that either medicines were not locked away; missing drugs were unaccounted for or medications were administered by unauthorised staff. They research uncovered that on a ward in Mid-Essex, ...
The health service needs to take a new approach – retailers are wary of boring their customers, so hospitals should be too
From in-store questionnaires to online surveys, giving feedback is an accepted part of our high street shopping experience. Retailers dedicate a huge amount of effort and money towards finding out our views on every aspect of a visit to their stores because it provides managers with crucial information to make improvements that keep them ahead of their competitors.
But in the NHS there is a public and clinical suspicion that answering patient surveys is a fast-track way to file unread feedback into a hospital cabinet; this perception needs to change.
The government's focus on patient choice means that hospitals have to check whether patients are satisfied with the quality of their service as much as retailers do. Otherwise we risk missing out on the patient feedback-led improvements that help prevent serious breakdowns in clinical care.
I work for a company that provides feedback solutions to both hospitals and the high street. This organisation takes customer experience models it has developed from longstanding relationships with multimillion pound businesses, such as Argos, and applies them to the health sector.
This work is supported by my four years' experience as a mental health nurse in the NHS where I saw first-hand how hard it is to implement new ways of doing things onto a ward from a management directive. But some of the greatest mistakes made by hospitals happen even before a response is collected.
Too often, hospitals create questionnaires that capture information that is useless in driving service improvements. The retail sector, on the other hand, is fully aware that to gather feedback it is asking customers to donate their own time. So realises that every second should be put to best use.
Demographic questions are a prime example of poor questioning in the NHS. It seems natural to ask identifiers such as age or gender, but I often challenge hospitals whether this will yield any useful data. Unless you can identify a clear reason to identify a certain group for the sample there may be little or no point. Especially when this information may be available through other hospital data systems.
Instead, questions must be geared towards the things that matter most to customers (or in this case patients) and to areas that can actually be improved upon, if and when shortcomings are identified. There is no magic formula, nor a perfect set of questions for every hospital. But if the answers cannot feed directly into an action plan for improvements then they may not be worth asking.
In his article on the Guardian Healthcare Network, Stephen Dunn advocates the power of the of the "net-promoter" question: "Would you recommend us to friends and family?" He makes a good case, but I would argue that there is a healthy middle ground between this simple, but limited, litmus test and the plethora of questions we see in many NHS surveys.
Retailers are wary of boring their customers, so hospitals should be too. Even if feedback is being given in the middle of a four-hour wait in A&E, patients' time should never be taken for granted.
Once the right type and number of questions are in place, the real work begins. As information streams in from the wards the biggest challenge is turning the data into meaningful actions. For this to happen hospitals need to encourage two fundamental changes to their cultures.
First, patients' experiences need to be treated as real-time data not as material for a retrospective evaluation. News that there's been a sudden dip in standards of care in a certain ward, for instance, should not be filed away until the next board meeting. Second, this information needs to be acted upon immediately.
In our work with Argos we collect and process over 150,000 pieces of individual feedback a week. This is useful for understanding long-term trends, but at its most powerful when treated as a stream of information that staff react to continuously. For example, an Argos store tracking its daily feedback realised that satisfaction levels dropped between 1pm and 2pm, identified that this was when managers tended to take their lunch break and was promptly able to increase staffing levels at this time.
This first cultural change for the NHS will take time, but can only emerge in conjunction with the second. Staff at all levels need to be engaged with the feedback process, not just management. Nurses, healthcare assistants and doctors should know how to check how satisfied patients were in a particular shift, for example. This is a tool for ward and board.
There is much for the NHS to learn about patient experience, but though it currently lags behind other sectors, there should also be a great deal of optimism. While people might not have a vested interest in the success of one private retailer over another, people genuinely care about making the NHS better. Hospitals that use handheld feedback devices, kiosks and online surveys will attest that there is no shortage of opinions on wards and in waiting rooms. There is a wealth of useful patient data ready to be collected for those who ask the right questions and make the most of the answers.
Andrew Lansley upped the stakes in his increasingly acrimonious dispute with the medical profession over the Health and Social Care Bill yesterday, accusing the British Medical Association (BMA) of having opposed "every important reform" back to the founding of the NHS more than 60 years ago. The Independent
More than half of A&E attendances stay for longer than two hours, say new figures from the NHS Information Centre
Thursday, 26 January 2012
NHS data shows mortality rate at half the 2002 level, with fewer people smoking and better NHS care contributing factors
The number of people dying from a heart attack has halved in the last decade, with falling rates of smoking, greater use of statins to lower cholesterol, and better NHS care thought to be behind the fall.
Fewer people in England are suffering a heart attack, and fewer of those who do are dying as a result, according to research by Oxford University reported in Thursday's British Medical Journal.
They used official NHS data on hospital admissions and mortality to study 840,175 men and women who between them had 861,134 heart attacks between 2002 and 2010.
Overall, mortality rates among men fell by 50% and among women by 53%.
The steepest falls in heart attacks were noted among middle-aged people. Rising rates of diabetes and obesity among younger people is thought to lie behind their not seeing the same dramatic drop.
Professor Peter Weissberg, medical director of the British Heart Foundation, which funded the study, said: "This impressive fall in death rates is due partly to prevention of heart attacks by better management of risk factors such as smoking, high blood pressure and cholesterol and due partly to better treatment of heart attack patients when they reach hospital."
Despite the welcome downward trend, "far too many heart attack victims still die from a cardiac arrest before medical help arrives. Many of these deaths could be prevented by rapid cardiopulmonary resuscitation," added Weissberg.
Improvements in the NHS's ability to prevent heart attacks, and better treatment of those who have one, were identified as key factors by the researchers. The Guardian
Government ministers yesterday promised to put the NHS at the forefront of the revolution in genetic medicine and perhaps eventually see everyone having the three billion letters of their genome fully sequenced. The Independent
Vitamin D was in the headlines today, with many papers reporting that a quarter of all toddlers are deficient in the nutrient and that childhood rickets is on the rise. The vitamin plays several important roles in the body, including regulating the balance of nutrients needed for strong, healthy bones.
The vitamin has fallen under the spotlight as Chief Medical Officer for England, Professor Dame Sally Davies, is reportedly contacting health professionals to highlight the need to prescribe vitamin D supplements to at-risk groups. There are already extensive guidelines on circumstances where people should take vitamin D supplements, but the move seems designed to increase use of the pills, which are available on prescription, or even free to individuals with a raised risk of deficiency.
An independent advisory committee is also researching and reviewing current recommendations on vitamin D, but the results of this extensive analysis are not expected until early 2014.
While vitamin D deficiency may have increased in recent years, rickets is still a rare condition. That said, it is entirely preventable and vitamin D supplementation can be of great importance to at-risk groups such as toddlers and young children.
What is vitamin D and why do we need it?
Vitamin D plays an essential role in maintaining good health. It has several important functions, including helping to regulate the amount of calcium and phosphate in the body. These substances are needed to keep bones and teeth healthy.
Without adequate vitamin D, bones can become thin, brittle and misshapen. In extreme cases this can lead to rickets in children, a condition involving a softening of the bones that can lead to fractures and deformity. In adults softening of the bones is usually called osteomalacia, and may cause pain and muscle weakness.
Vitamin D has many other important roles in the body including regulating cell growth, neuromuscular and immune function, and reduction of inflammation. Even years after its discovery, there is still ongoing research examining the various other functions vitamin D might perform in the body.
According to the Scientific Advisory Committee on Nutrition (SACN), a group of experts that advises the government about all aspects of nutrition, some evidence suggests that vitamin D may be important in preventing other diseases including cancer, cardiovascular disease and multiple sclerosis, although it points out further research is needed before any definite conclusions can be drawn.
How can I get vitamin D?
The best source of vitamin D is sunlight on the skin. The vitamin forms under the skin in reaction to a type of ultraviolet ray called UVB. UVB rays are more powerful in the summer, and experts advise exposing the skin to regular, short periods of sun during the summer months, without sunscreen, which blocks UVB rays. However, it is important to ensure that the skin does not burn.
Vitamin D is also found in a small number of foods but it is difficult to obtain enough vitamin D from diet alone. Good sources of vitamin D include oily fish (such as salmon and sardines), eggs, cheese and meat. In the UK, all margarines and infant formula milks are fortified with vitamin D. It is also added to other foods such as breakfast cereals, soya and some dairy products, but usually only in small amounts.
Breastfed babies get their vitamin D from their mother’s breastmilk, which makes it especially important that breastfeeding women have adequate vitamin D levels of their own.
Vitamin D is also available in supplement form. Women and children participating in Healthy Start can get free supplements containing vitamin D. Some doctors sell vitamin D supplements or supply them free of charge to those not eligible for Healthy Start.
Who needs vitamin D supplements?
The current advice is that most people should be able to get all the vitamin D they need by getting enough sun and eating a healthy balanced diet. However, the Department of Health says the following people may be at risk of vitamin D deficiency and recommends they take daily vitamin supplements:
- all pregnant and breastfeeding women
- all children aged six months to five years old
- all people aged 65 or over
- people who are not exposed to much sun – for example people who are housebound and those who cover up their skin for cultural reasons
- People who have darker skin, such as people of African Caribbean and south Asian origin. Their bodies are unable to produce vitamin D as easily.
You can buy single vitamin D supplements at most pharmacies and supermarkets. Pregnant women who take vitamin D as part of a multivitamin should avoid supplements containing vitamin A (retinol), which can be harmful in pregnancy.
Can too much vitamin D be harmful?
The Department of Health says that taking 25 micrograms (0.025mg) or less a day of vitamin D supplements is unlikely to cause any harm. But taking high doses of vitamin D over a long period could weaken your bones.
Is rickets really on the rise?
Yes. In 2007 SACN published an update paper on vitamin D which, it said, highlighted “the prevalence of low vitamin D status throughout the UK population and the re-emergence of rickets in certain subgroups”.
However, while it would appear that a relatively high proportion of children do not get enough vitamin D, rickets is still a rare disease in the UK and there is certainly not an epidemic of the condition, as might be supposed by reading some news articles. That said, the condition is entirely preventable, and so there is a need to ensure parents and children have access to vitamin D supplements wherever appropriate, such as through the Healthy Start scheme.
What will happen next?
Last year the government launched a review of vitamin D supplementation, which is due to report in the next few years. In the meantime, Dame Sally is reportedly contacting health professionals to ensure they offer advice on vitamin D supplementation to those at risk, so that they can avoid health problems associated with deficiencies of this important nutrient.
Links To The Headlines
Experts review vitamin D advice. BBC News, January 25 2012
Vitamin D awareness in decline, say doctors. The Guardian, January 25 2012
A quarter of UK toddlers are lacking Vitamin D. The Independent, January 25 2012
Rickets returns as 1 in 4 toddlers found to be lacking in vitamin D. Daily Mirror, January 25 2012
Vitamin D deficiency in UK a 'major problem'. The Daily Telegraph, January 25 2012
Wednesday, 25 January 2012
SICKNESS absence rates at East Midlands Ambulance Service (EMAS) are the worst in the NHS, according to latest figures. Northampton Chronicle and Echo
This survey took place in October 2011 and involved 97 organisations across the Civil Service. A key element of the survey is the ‘Employee Engagement Index’. This is based on evidence of a link between highly-engaged staff, high levels of health and well-being and organisational performance. A total of 73 per cent of Department of Health staff took part in the survey in 2011, an increase of 6 per cent compared with 2010. The Employee Engagement Index was calculated at 53 percent in 2011 which is 2 percent lower than 2010 and two percent lower than the Civil Service average for 2011.
The CHRE are now consulting on draft Standards for members of NHS boards and governing bodies in England. They cover three domains: technical competence and ability to carry out the job; personal behaviours and accountability; and business practices including financial probity. The consultation ends on 10 April 2012.
Boards should strive to do the right thing and explain any variance from the rules, rather than just slavishly comply
The transition from Primary Care Trusts (PCTs) to GP-led Clinical Commissioning Groups (CCGs) envisaged in the white paper, Equality and excellence: liberating the NHS is attracting a lot of press, much of this negative.
But good things have been happening too. CCGs already demonstrate a very different risk appetite to the PCTs they will replace and we are seeing involvement of a wide range of stakeholders. We see a focus and obvious passion for commissioning integrated pathways of care closer to patients in these new devolved commissioners. Will they be allowed the freedom to get on with this? The Department of Health said so in the first consultation on the white paper
'We will not fall into the trap of prescribing top-down processes or governance requirements': many may feel this is being forgotten in the erratic passage of the government's plans, but it is an important guiding principle for devolved bodies to have the authority and responsibility to build their own structures locally that are fit for purpose.
This is consistent with modern views of good governance promoted by professor Mervyn King (the South African judge, not the chair of the Bank of England) in his King III report published by the Institute of Directors Southern Africa.
King suggests an approach to governance of "apply and explain", rather than "comply or explain". Cynics will tell you the NHS model is "comply or else" – in King's approach boards should do the right thing and explain any variance from the rules rather than slavishly comply.
King also promotes a focus on organisations explicitly defining their risk appetite to better control risk and a move to integrated reporting, all ideas being considered by the more thoughtful NHS trusts and the new CCGs.
As part of this evolution to good governance, some new CCGs are seeking to design systems built around purpose and task rather than adopting traditional NHS committee and reporting systems. We applaud this approach.
The Good Governance Institute recently identified the cycle of business requirements for PCT clusters, the newly agglomerated bodies that will see commissioning through to 2013. We identified the "must dos" and set the scene for a second piece of work for CCGs which encourages a challenge to determine locally what they should focus on and an understanding of the rhythm of board activity.
For example, May is a quieter month when contracts are signed and performance returns have not yet come in, and therefore one of those few gaps in the year to do some strategic thinking.
Miss this opportunity and the routine firefighting will soon soak up available thinking time before the summer is over. CCGs should be encouraged to use the existing cycle of business as a starting rather than end point for determining their way of working. GGI are working with CCGs in Wandsworth, Hounslow (GWCC) and elsewhere encouraging the GPs leaders to examine the tasks their predecessors have pursued and to challenge and refine their own cycle of business.
This will help create the form of good governance they need to deliver their potential.
Dr John Bullivant is the chair of the Good Governance Institute, an independent organisation supporting better governance practice. He is co-author of a guidance paper for PCTs on managing the transition to CCGs, commissioned by Allocate Software
Health select committee says hospitals are resorting to 'salami slicing' as they try to find £20bn in efficiency savings
Andrew Lansley, the health secretary, has defended his NHS shakeup in the face of a scathing report from MPs which said the overhaul was undermining efforts to cut spending and make the health service more efficient.
In its highly critical report, published on Tuesday, the health select committee said hospitals were resorting to short-term "salami slicing" as they tried to find £20bn in efficiency savings by 2014-15.
"The reorganisation process continues to complicate the push for efficiency gains," the report said. "Although it may have facilitated savings in some cases, we heard that it more often creates disruption and distraction that hinders the ability of organisations to consider truly effective ways of reforming service delivery and releasing savings."
The committee's report also noted a "marked disconnect between the concerns expressed by those responsible for delivering services and the relative optimism of the government" when it comes to achieving the cuts.
The attack is especially wounding because the committee is chaired by one of Lansley's Tory predecessors, Stephen Dorrell, and is dominated by Conservative and Liberal Democrat MPs.
During a round of interviews aimed at fending off the criticism, the health secretary dismissed the report as "Westminster nonsense".
"I think the select committee's report is not only out of date but it is also, I think, unfair to the NHS – because people in the NHS, in hospitals and in the community services are very focused on ensuring that they deliver the best care to patients and that they live within the financial challenges that clearly all of us have at the moment," he told ITV Daybreak.
"I am afraid the evidence points to the fact that they are doing that extremely well."
Lansley said the NHS was being managed well and insisted the focus remained on improving performance. "There are things happening across the NHS that are really doing well," he told Sky News.
"I think, frankly, people working in the NHS … instead of seeing this kind of Westminster nonsense, what they want to see is that people are recognising that they are working very hard, they are saving resources and reinvesting them for the benefit of patients.
"On most of the measures of performance, they are improving that performance."
The health secretary accused the committee of failing to substantiate its claims, telling BBC Radio 4's Today programme: "Clearly someone can go around the country and say someone's made the wrong decision … frankly, sometimes, they make the wrong decisions.
"But of course we have 150 different places across the country where they have to make decisions about local priorities and it's not my job to try and second-guess all of those."
The report comes days after all the major health unions – representing doctors, nurses and midwives – stated their "outright opposition" to the health and social care bill, which is being debated by parliament.
However, Lansley said the bill was backed by many NHS professionals, telling Today: "Where we are is there has been support for the principles of what we are doing, including from many of the professional organisations."
The report also rebukes Lansley's department for giving NHS bodies only weeks to prepare bids for £300m of capital funding over the Christmas period.
"At a time when all NHS bodies are being required to make efficiencies and need to plan strategically to reshape services, it is unhelpful for the Department of Health to require them to make bids for capital funding to short deadlines and without adequate preparation," the document says.
As part of an examination of the state of social care, the committee says there is "precious little evidence of the urgency" required being given to integrating health and care services.
It expresses "deep concern" that £116m of £648m earmarked to improving the link between the two had been spent simply "sustaining existing eligibility criteria".
It also calls for urgent investigation of the possibility of "passporting" more NHS funds directly to the sector, and warns that more vulnerable people are losing out on state-funded help.
"In spite of government assurances, local authorities are having to raise eligibility criteria in order to maintain social care services to those in greatest need," it adds. The Guardian
Health Secretary Andrew Lansley has defended his reorganisation of the NHS, describing a highly critical report by MPs as “out of date” and “unfair” to the health service. The Independent
Tuesday, 24 January 2012
The "never events" list has been updated with minor amendments to two of the "never event" definitions. The changes are to "never event" number 18, 'Transplantation of ABO incompatible organs as a result of error' and "never event" number 23, 'Misidentification of patients'. This paper sets out the revised list and definitions for use in the NHS in 2012/13.
The Good Governance Institute has collaborated with the Healthcare Quality Improvement Partnership to produce this report into the foundation principles of good governance. Drawn from academic study, the various governance codes and law and established better governance practice, it identifies nine foundation principles. This report explains how to apply these within health and social care organisations.
Senior MPs, including a former Tory Health Secretary, today cast doubt on the Government's ability to save £20bn across the NHS without rationing important services. The Independent
Monday, 23 January 2012
A GROUP of breastfeeding mums have started a Facebook campaign to find funding for a support project which is on the brink of closure. Northampton Chronicle and Echo
Providing a one-stop shop for all Department of Health public health campaign information and resources for anyone who works directly with the public, the online Campaign Resource Centre was launched this week.
If you want to start conversations with families and adults about healthier lifestyles, stopping smoking, the signs and symptoms of cancer or stroke, or you need trustworthy advice about the issues that affect young people, the Campaign Resource Centre can help.
Keeping you up to date with the latest campaign news, the Campaign Resource Centre will also give you access to the leaflets, posters, ads and toolkits available to support the campaigns.
About DH public health campaigns
Department of Health public health campaigns aim to help people:
- become engaged with their own health and well-being
- understand how their lifestyle choices impact on their current and future health outcomes (and, in the case of parents, their children’s health outcomes)
- obtain sound advice about what constitutes a healthy lifestyle
- access appropriate services, products and tools to help them change their behaviour
Each campaign section offers a summary of the public health campaign together with all the resources available to support it.
Visit www.campaigns.dh.gov.uk to find out more or subscribe and receive regular updates.
This report is the result of an all party parliamentary group inquiry into the necessity of the NHS reforms and the introduction of the Health and Social Care Bill. It argues that the NHS was not in need of overall restructuring and highlights concerns about the cost of the reforms, at a time when the NHS has been required to make efficiency savings. It also makes recommendations on how to minimise disruption for patients and maintain quality of care over the course of the NHS reforms.
The Department of Health and the NHS Commissioning Board Authority have jointly signed a framework agreement that sets out the relationship between the two organisations. The agreement covers roles and responsibilities and lines of accountability, and describes how the Department and the Authority will work together.
- Framework agreement
- Annex A: wider guidance
- Annex B: finance and accounting
- Annex C: public and parliamentary accountability
- Annex D: communications
- Department of Health - publications
Helping health and care workers understand one another's roles in a positive spirit has inspired more focus on patient outcomes
New governments always believe that integration of health and social care will solve all the problems of underfunding of care for older people, continuing health care and blocked hospital beds.
Earlier this month, David Cameron echoed Frank Dobson's rallying cry in the 1990s to "bring down the Berlin walls" between us.
Do ministers think we want a system which has so many perverse incentives in it, so many changing policies and so many different funding routes?
What really lies behind their real frustration with the system is that social care is not part of the same command and control structure as the NHS, so we cannot be directed in the same way as our health colleagues, although there are many attempts to do so.
The statement by the Association of Directors of Adult Social Services and the NHS Confederation was spot on - it's all about relationships, co-working, shared caseloads, but most importantly it's about individual clinicians and managers understanding the whole system – and not just their bit of it – on both sides of the house.
We have done some work recently in our area which has been very intensive and very illuminating.
At one of our hospitals, we gathered some key people: GPs, consultants, nurses, social workers, community health and mental health colleagues. The task was to "sort out" the elderly frail care pathway, but it was done in such a way that it challenged us all to work differently, using trust exercises, team games and lots of honest discussions.
Some found it hard and felt there was too much navel gazing, but the results speak for themselves. The way we work together has been transformed: the consultant and the social care team leader are now working together closely ("It's not social services' fault," he has been heard to say), daily multi-disciplinary team meetings are held with our social workers via laptops to enable them to be part of the team working 8am to 8pm and every weekend.
From a situation which was in escalation most weeks during the winter last year, we now have a completely different approach, and it is entirely down to taking the time out to understand each other's responsibilities and pressures and be challenged about the way we talk to each other.
It is time we need to build relationships, understand each other's roles and manage the work together, not hand off and blame each other.
The system needs strong, inspirational leadership which is focused on outcomes for patients – not targets and tariffs – to enable different professionals to work together in a complex system, leadership which sees the need for people to have the time to invest in getting this right. It's not done in a day at a "whole system workshop".
We don't need organisational change to achieve this. It saddens me to see social care being transferred into the NHS as part of a care trust. The role of social care is to be the voice of a vulnerable person when they cannot make themselves heard – for example, when they might be medically fit but not fit for discharge as arrangements are not in place. Independence and integrity are key if we are to ensure a social model of disability is maintained in such disabling environments.
So let's have another pause and take the time to think what is it we are trying to achieve between health and social care professionals and whether it will be delivered by "integration" or by simply good, empowered leadership and effective, multi-disciplinary working.
Let's also make sure integration is not a way of making the latest health reforms affordable by giving the NHS responsibility for social care.
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Local authorities to get cash to promote breastfeeding and action on tooth decay
Councils will be able to get extra funding to encourage breast-feeding and combat child tooth decay as part of a government plan for local authorities to take a greater role in improving public health.
In a public health framework to be outlined on Monday by the health secretary, Andrew Lansley, local authorities will be alloted more than £2bn for the role. Councils that get the best results across 60 factors influencing health will be awarded extra funds under a so-called "health premium" incentive scheme.
Along with breast-feeding and tooth decay, they will be expected to tackle homelessness and the number of young people in the criminal justice system. A figure of £5.2bn will be spent on public health next year while the budget will increase in real terms each year after that, Lansley will say in a speech in London to the Faculty of Public Health.
"We all want to be healthy. No one wants an unhealthy existence," he will say. "And the job of the government – and my responsibility – is to help people live healthier lives. A failure to recognise that meant 2000-2010 was a decade in which public health was seen as relatively unimportant, something to be sidelined.
"Obesity rates from 2000-2010 rose from 21.2% to 26.1% so now over a quarter of adults are obese. Sexually transmitted infections, after the steep declines in the 80s to 90s, doubled in the subsequent decade.
"And health inequalities persist, with gaps in life expectancy of over a decade between people born in the richest areas and people born in the poorest." The Guardian
Hospitals and GPs have been quietly offered an extra £200m in an attempt to hold down waiting times this winter. With little fanfare, the four new regional bodies that now oversee the NHS in England have been told they can each spend up to £50m in the next month to treat patients more quickly. The Independent
Britain's royal medical colleges will come under intense pressure this week to join the growing clamour from doctors, nurses and MPs for the Government to drop its NHS reforms. The Independent
Friday, 20 January 2012
The series provides easily accessible summaries of the latest guidance and research evidence relating to specific key topics of relevance to healthcare professionals and the diabetes community.
The guide includes a brief summary introduction to each topic, followed by a synthesis of latest key policy papers, national body statements, clinical or care guidelines and the latest key research and evaluation papers. NHS Networks
In this week’s edition, read the latest advice on PIP implants. Views are sought on draft statutory guidance on JSNAs and joint health and wellbeing strategies and Minister Paul Burstow has reaffirmed his commitment to 3millionlives at an event today. Department of Health
A consultation document on low secure services and psychiatric intensive care is being issued today for a three month consultation by stakeholders.
The purpose of this consultation is to invite the views of stakeholders on how new guidance will operate by explaining the rationale behind the strategic approach and raising questions which cover a broad range of issues.
Subject to Parliamentary approval, the NHS will undergo a period of substantial change in how it commissions health services. The planned changes will introduce a new commissioning architecture, formally establishing a new NHS Commissioning Board and clinical commissioning groups.
Over the course of transition to the new system, the responsibilities of Strategic Health Authorities, regional specialised commissioning groups and primary care trusts will largely transfer to the NHS Commissioning Board and to clinical commissioning groups.
Under the proposed commissioning arrangements, the NHS Commissioning Board will commission services to include primary care, veterans and offender health services and those services that fall into the national specialised services definition set, for example secure services. Clinical commissioning groups will commission local health services including community and non-specialised inpatient mental health services.
In order to issue guidance by middle of 2012 it would be helpful for responses to be received in advance of 19 April 2012 deadline. Department of Health