Northamptonshire Healthcare investigates 26 incidents
Health Service Journal
Advertise with HSJ, the UK's leading health service management and policy title and reach an audience of senior health service management professionals via a variety of media solutions. We provide a range of online advertising opportunities.
Availbe via the Library Service
Friday, 24 February 2012
Dame Fiona Caldicott has agreed to lead an independent from Government review of the balance between protecting patient information and its sharing, to improve patient care.
The Department expects to respond to the panel’s recommendations when the review publishes during 2012.
The recommendation for a review of the balance between protecting patient information and its sharing, to improve patient care was part of the Future Forum’s recommendations to Government on the modernisation of health and care.
Set up as an independent group in order to ‘pause, listen and reflect’ on the Health and Social Care Bill, the Forum made 16 key recommendations in total.
Dame Fiona is known across the NHS as the originator of ‘Caldicott Guardians’, the individuals responsible in every NHS and local authority organisation for making decisions about sharing identifiable information. This requires balancing the public interest of protecting confidential information with the public interest for sharing the information. She will be calling on an expert panel made up of clinical, social care, research and other professionals, as well as patients and service users. The panel will determine the detailed scope and priorities for the review.
Dame Fiona Caldicott said:
“It is timely to reconsider the principles of information protection and sharing. Since the original working group’s report on the security of patients’ information in 1997, it has become clear that there is sometimes a lack of understanding about the rules and this can act as a barrier to exchanging information that would benefit the patient. On other occasions, this has resulted in too much information being disclosed. These are issues of importance to everyone who uses health or social care services and our review will look across both sectors. We need to examine when and how to seek and record consent, to support the flow of information to enhance patient and citizen care.”
”Ensuring that information is shared for best care and to promote excellent research is central to the Government’s vision for the new health and care system, as is protecting confidential information. This is a complex issue and I am most grateful that Dame Fiona has accepted the challenge – I can think of no better person to complete the review.” Department of Health
Launch of single operating model: part 1 - SHA development and FT assurance for NHS trusts in the pipeline
Between February and May 2012, SHA clusters will be introducing a single operating model to support and assure NHS trusts through their FT applications. The Department of Health has published documents outlining the details about the new SOM.
Specially trained paramedics to assess whether they can treat patients out of hospital in plan to improve 999 response rates
East Midlands ambulance service trust is piloting a new project that allows specially trained paramedics to decide whether patients should be treated at home, or referred to a GP or walk-in centre.
The trial is part of the trust's plans to keep people out of hospital where possible in an effort to cut the strain on A&E, and help improve ambulance response rates to emergency calls.
If rolled out fully, emergency care practitioners – paramedics with an extended set of university qualifications – would view 999 calls on a computer-aided dispatch system at the trust's emergency operation centre in Lincoln, and select the jobs that they believe would normally result in an ambulance taking the patient to accident and emergency.
They would then respond to the call and decide whether the patient needed to be taken to hospital, or if an alternative option was appropriate, such as being treated on the spot or referred elsewhere, for example as an out-of-hours GP. Under normal circumstances, the trust would respond to a job with an ambulance crew, which would probably take a person to A&E straight away without any other considerations.
Pete Jones, the assistant director of operations in Lincolnshire for the trust, told the Guardian that automatically taking people to hospital could no longer be the default option, due to unprecedented pressures on A&E departments.
"The future is not bright in terms of commissioning and extra money. We can't just keep adding to the bill in terms of resources. What we've got to start doing is taking patients off the front end of that list, and start treating them in the community and keep them away from the hospitals if possible," he said.
Around 20 ECPs are taking part in the trust's pilot, which is being funded by NHS Lincolnshire. Jones said meeting response time targets for 999 calls was also an important consideration when launching the scheme.
"The government sets these targets and we have to reach them, and that's what we have to aspire to, but from our point of view what we're trying to do is concentrate on the quality of care and patient safety. But these targets do have to be achieved. It's a by-product, and I don't like it, but it's there and we've got to do it," he explained.
Ambulances are expected to respond to life-threatening emergencies within eight minutes under the government's current rules. This is an area the trust is trying to improve after councillors in Lincolnshire expressed concerns about East Midlands ambulance service's response times at a recent cabinet meeting.
Jones stressed that the trust was doing its best in this area, but said it faces the additional burden of around 4.5 million tourists visiting the area each year.
"We're not funded for that in any big way. The emergency ambulance cost adjustment payment that is made to the division is about £700,000 each year and that doesn't even begin to bridge that gap," said Jones.
"These people bring with them their requirements for pharmacies. In the summer, particularly when it's busy out in the east coast, we set up triage centres on weekends just to try and alleviate the necessity to trundle up and down the road to hospital."
Jones is hopeful that the new system could help the trust become more efficient, and plans to show the benefits of the project to clinical commissioning groups and service providers once the scheme finishes at the end of March. If successful, the pilot could be rolled out across Lincolnshire, with ECPs potentially gaining additional responsibilities, such as giving out antibiotics for chest infections.
"If we've got a framework around this concept of clinicians going out into the community … and they're keeping patients in the community and treating them at home or in their workplace, that's where we want to go with this," he added. Guardian Professional.
Community providers are being pushed aside as commissioners recognise only those with money, not their track record
In any economy, let alone one in recession, capital is king, so it is a primary consideration when contemplating reform of public services.
As both the chief executive of Social Enterprise London and chair of the Transition Institute, which supports public services, I am an advocate of those independent providers who offer affordable, quality services with social impact and real accountability.
Today we are being asked how we stand on NHS reforms. Through the work we have done in public services and, in particular, health, we have seen some wonderful organisations offer innovative, patient-centred services on reduced budgets. To achieve this does mean acknowledging competition in the NHS.
But here is where I have a problem: almost without exception, the procurement processes that have come from government in the last 18 months have been large – and are getting larger. They have increasingly favoured those applicants with capital, lots of it. In some bidding rounds, applicants have been required to prove the existence of large capital sums or capital bonds as an essential part of the process, which excludes most if not all community-driven providers.
The innovators I refer to offer extraordinary opportunity to link motivated staff with happy patients, such as those treated by City Health Care Partnership CIC in Hull. City Health is an employee-owned service, like Central Surrey Health, that provides award-winning, community-based healthcare. I have to say both these organisations do not have the look or feel of a privatised company, but a new generation of public service, with the strongest possible public service ethic.
I read with interest Sir Stephen Bubb, chief executive of Acevo, the Association of Chief Executives of Voluntary Organisations, and a board member of the Transition Institute, whose article in the Times on Wednesday considered the NHS reforms. Bubb was a member of the Future Forum that reviewed the reforms over the summer and he attended the No 10 NHS summit on Monday.
As someone at the heart of the debate, Bubb tells us: "Almost everyone agrees we have a problem when over 70% of NHS funding is spent on treating long-term conditions, usually in the most inefficient way there is: in hospital.
"And almost everyone agrees that if the NHS is to cope with these pressures, it must shift resources towards preventative, patient-led, community-based services which treat chronic conditions far more effectively and which act to pre-empt acute crises of ill health."
He goes on to say: "Might I also suggest that the majority of observers agree that to carry out this change effectively, the NHS must allow new providers with new ideas to break the bureaucratic stranglehold on service delivery … What frustrates many of my members, the leaders of the country's charities and social enterprises, is that, despite the consensus on both problems and solutions, the debate over reform focuses on the phantom of 'privatisation'."
All of us on the front lines of community service share Bubb's belief that, with a fair crack at the whip, we could make a real contribution, but to do that a number of things have to change.
I don't think this is a debate about whether to privatise or not: the NHS has always been a mixed model and will continue to be so. No, this is about big versus small or, more specifically and sadly, this is about financial versus social capital.
Most of the members Bubb is referring to have a great track record but limited access to capital. Like Social Enterprise London members and those approaching the Transition Institute, they are finding it harder and harder to succeed in a commissioning process that pits them against companies which don't have the track record but do have the cash.
The principle of this debate is clear: everyone wants universal, quality healthcare, free at the point of use, but the means to achieving that are bound to be complex, even if money wasn't so tight. The Transition Institute thinks it has part of the answer in that we can supply willing providers of quality, community-driven service solutions. All government has to do is procure those services and look for capital elsewhere.
Allison Ogden Newton is chief executive of Social Enterprise London
The number of clinically obese people in England is following a worrying trend the NHS report today. We check the latest statstics to see what this means
• Get the data
26.2% of the male population in England to said to be clinically obese according to the lastest Obesity, Physical Activity and Diet report published today by the National Health Service (NHS).
That's over 26% of men in England whose body mass index is greater than 30 kg/m2, and an increase of 13 percentage points in 17 years.
Obesity has been increasing, not only for men, but for women too. Here's the data for the whole adult population of England:
We can see an 11.2 percentage point increase from 1993 to 2010.
The effects of this change are many and varied. Today the Press Association reported that weight loss operations have risen:
In 2010/11, there were 8,087 weight-loss stomach operations in England's hospitals, up from 7,214 in 2009/10, according to data from the NHS Information Centre.
The report highlights around a 30-fold increase in the number of people going under the knife in the last decade, from just 261 weight loss operations in 2000/01.
Recent figures include operations to adjust an existing gastric band rather than fit a new one. Of the 8,087 procedures in 2010/11, 1,444 were for maintenance of an existing band.
The report shows the number of hospital admissions with primary diagnosis of obesity has also risen really quite dramatically too. Here's the data:
But perhaps the most concerning part of the report is the data on children. The chart shows the percentage of children (aged between 2 and 15) who are overweight and obese:
Although there has been a decrease in overweight and obese children from 2004 levels, we can still see that the percentages are higher than in 1995. Here are some more detailed facts about boys and girls in 2010 compared to 1995:
• In 2010, 17% of boys and 15% of girls (aged 2 to 15) were classed as obese, an increase from 11% and 12% respectively since 1995.
• In 2010, around three in ten boys and girls (aged 2 to 15) were classed as either overweight or obese (31% and 29% respectively).
• In 2010/11, the around one in ten pupils in Reception class (aged 4-5 years) were classified as obese (9.4%) which compares to around a fifth of pupils in Year 6 (aged 10-11 years) (19.0%).
Are we doing enough to provide young people with good food and an active lifestyle? This data suggests the answer is no when compared to 17 years ago.
We've included in the spreadsheet of the key data sets from the Obesity, Physical Activity and Diet report. What can you do with them?