Wednesday, 25 January 2012

East Midlands Ambulance Service has worst sickness rate in NHS

East Midlands Ambulance Service has worst sickness rate in NHS:

SICKNESS absence rates at East Midlands Ambulance Service (EMAS) are the worst in the NHS, according to latest figures. Northampton Chronicle and Echo

Running the NHS: if you get the small things right, will the big things follow? Lara Sonola

Running the NHS: if you get the small things right, will the big things follow? Lara Sonola: Lara Sonola asks if clinicians used data to improve clinical practice and drive efficiency, could a little change help the NHS in a big way? Kings Fund

Department of Health staff survey 2011

Department of Health staff survey 2011:

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.

Standards for members of NHS boards and governing bodies in England

Standards for members of NHS boards and governing bodies in England:

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.

Better governance key to making NHS reforms work

Better governance key to making NHS reforms work:

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

This article is published by Guardian Professional.

NHS reforms: Lansley defends shakeup after scathing report from MPs

NHS reforms: Lansley defends shakeup after scathing report from MPs:

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

The perfect storm that threatens the NHS

The perfect storm that threatens the NHS: The NHS is facing an enormous funding crisis. To avert it, we must be more innovative in integrating our health and social services, says Chris Skidmore. The Daily Telegraph

End-of-life plans halve unplanned hospitalisations

End-of-life plans halve unplanned hospitalisations: Asking people to draw up plans for how they want to be treated in their final days can halve the number of unplanned hospital admissions, according to a study. The Daily Telegraph

Lansley defends NHS reforms after scathing report from MPs

Lansley defends NHS reforms after scathing report from MPs:

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

Public consultation launched to help develop Mental Health Act statistics

Public consultation launched to help develop Mental Health Act statistics: The NHS Information Centre (NHS IC) has launched a public consultation on how one of its major mental health statistical reports should be further dev... NHS Information Centre