Tuesday 7 February 2012

Implementing what works: the impact of the individual placement and support regional trainer

Implementing what works: the impact of the individual placement and support regional trainer:

This briefing describes a pilot in Sussex which found that this approach could achieve a 50%-60% employment rate for those with serious mental health problems. NHS Networks

AUDIO: Have views on NHS reform shifted?

AUDIO: Have views on NHS reform shifted?: Dr Michael Dixon, chair of the NHS Alliance, who supports the governments proposed reforms of the NHS and Dr John Lister, director of the Health Emergency campaign group, who opposes them, debate the Health Bill. BBC News

GMC guidance on assisted suicide

GMC guidance on assisted suicide: The General Medical Council launches guidelines on assisted suicide to help it decide if doctors should face a disciplinary panel on the issue. BBC News

Health and Social Care Bill: Lords report stage briefing

Health and Social Care Bill: Lords report stage briefing:

In this briefing to peers, the BMA acknowledges that the Government has made some effort to try to address some of the association’s concerns, but says the Bill remains fundamentally flawed and should be withdrawn.

Northants picks Civica to inform CCGs

Northants picks Civica to inform CCGs: NHS Northamptonshire has selected software from Civica to help it supply information to its clinical commissioning groups. E-Health Insider

Structural reform plan progress reports

Structural reform plan progress reports:

The Government has published January progress updates for each department’s Structural Reform Plans.

Lost in translation: how much is translation costing the NHS, and how can we both cut costs and improve service provision?

Lost in translation: how much is translation costing the NHS, and how can we both cut costs and improve service provision?:

This report investigates NHS spend on translation services, the overall costs, as well as the individual areas of spend.

Backers of NHS shake-up turn against Andrew Lansley's plans

Backers of NHS shake-up turn against Andrew Lansley's plans:

Leading doctors voice concerns that reforms will suffocate GPs and jeopardise promised freedom to commission care

Two prominent backers of the coalition's NHS shake-up have joined the growing chorus of critics by claiming that GPs will be "suffocated rather than liberated" by the planned changes.

Dr Charles Alessi and Dr Michael Dixon have helped Andrew Lansley claim credibility for his plans among doctors over the past 18 months by strongly supporting his radical restructuring. They are leading lights in the NHS Alliance and the National Association of Primary Care, two key pro-reform organisations.

But they now fear that the new consortiums of local doctors, which will start commissioning healthcare for patients in England from next year, will not have the freedom that the health secretary has repeatedly pledged. Lansley has attempted to persuade sceptics that his reorganisation will put family doctors in charge of healthcare.

NHS primary care trusts (PCTs) and strategic health authorities (SHAs) are due to be abolished next year.

But the doctors are worried that the GP-led clinical commissioning groups (CCGs), which will replace PCTs, will find themselves unexpectedly under the control of another organisation, the NHA National Commissioning Board (NCB).

In July the NHS chief executive, Sir David Nicholson, said "CCGs will be the engine of the new system" and that the reformed NHS "gives pride of place to clinical leaders". But the reality is that primary care doctors and clinical commissioners will not have the promised ability to make key decisions because the current bureaucracy is simply being replaced by another that is growing up around the NCB, the pair claim.

The Department of Health's latest document about the design of the new board involves "layers of bureaucracy and management, with complex guidelines. The old 'footprint' [of the PCTs and SHAs], ie 50 local offices, remains there, plus four sector outposts, all using a single operating model," the two organisations said in a joint statement .

The fact that many of the staff of the new NCB will simply be staff who have joined from PCTs and SHAs "adds to clinical commissioners' concerns and perceptions that they will be suffocated, instead of liberated, which in our view is fundamental to the success of clinically-led commissioning", they added.

"What we are hearing and seeing are the same old messages and the same old structures, albeit with new nomenclatures", said Alessi, a key figure in a CCG in south-west London.

"If we put the same ingredients into the mix, the likelihood is that we shall deliver the same inefficient environment and outcomes. This is insupportable in an economy of tight financial restraint."

Most CCGs now see the new board as the greatest threat to their effective functioning, added Dixon, a GP in Devon and chair of the NHS Alliance.

The pair's comments are another blow to the health secretary as his health and social care bill prepares to undergo its report stage in the House of Lords, when peers will seek to force the government to accept further amendments to its plans. Labour seized on the men's remarks as further evidence of the growing concerns the bill is causing.

"Things are going from bad to worse for Andrew Lansley. In the last fortnight there has been a deepening crisis of professional confidence in the government's health bill, but until now the health secretary could rely on the support of the NHS Alliance and the National Association of Primary Care," said Andy Burnham, the shadow health secretary.

"Yet the bill's biggest cheerleaders are now lambasting the increasing layers of bureaucracy. Even the health bill's greatest supporters are now concerned that Lansley's plans are so complex and full of worrying uncertainties that they risk thwarting the principle of true clinician-led commissioning."

The British Medical Association also fears CCGs' freedom will be curtailed. "There are significant concerns that CCGs will not have genuine freedoms and sufficient independence to make locally sensitive, locally accountable, patient-focussed decisions," it said.

In a briefing to peers ahead of the report stage it says that, despite ministers agreeing to amend several aspects of the bill, the legislation should still be dropped because it involves too much use of "market forces", and could also affect doctors' relationship with their patients through financial incentives for CCGs.

The Department of Health said: "By handing power and responsibility for choosing and purchasing services to doctors and nurses on the ground, we are shifting the decision making closer to patients and building on the trusted role that GPs and other front line professionals already play throughout the NHS.

"The NHS commissioning Board will provide national standards, but doctors and nurses will have the freedom to make decisions about their patients and their organisations." The Guardian

NHS facing £15.7bn for rising number of clinical negligence claims

NHS facing £15.7bn for rising number of clinical negligence claims: The NHS faces a £15.7 billion bill to settle a rising number of clinical negligence claims, a report by MPs disclosed last night. The Daily Telegraph

Force NHS trusts to admit mistakes to patients, urge groups

Force NHS trusts to admit mistakes to patients, urge groups: NHS trusts should be forced to tell patients when they make errors and cause harm, patients groups have said in a letter to The Daily Telegraph.