Friday, 30 March 2012

Health and Social Care Act 2012 now available online

You can now find the full text of the Act on the government legislation website.

Immigration changes pose threat to nursing numbers, says RCN

Immigration changes pose threat to nursing numbers, says RCN: The Royal College of Nursing has expressed grave concerns about changes to UK immigration policy, which will see nursing staff from overseas being forced to leave Britain unless they’re earning more than £35,000 per year.

The Month: Special Issue 52, March 2012

The Month: Special Issue 52, March 2012:
This special issue of ‘the month’ carries a detailed letter from NHS Chief Executive Sir David Nicholson on the passing of the Health and Social Care Bill and what the new Act  means to the NHS now and from 2013/14. Department of Health
Read the Special Issue of ‘the month’ – 29 March 2012 (PDF, 190KB)

the week: issue 241

the week: issue 241:
On the agenda this week: the Secretary of State writes to all NHS staff following the Royal Assent of the Health and Social Care Bill this week, the Prime Minister announces a new challenge on dementia and the NHS Institute for Innovation and Improvement introduces the NHS Patient Feedback Challenge. Department of Health
Download ‘the week’: issue 241, 23-29 March 2012 (RTF, 535KB)

Transplant fluid 'contaminated'

Transplant fluid 'contaminated': The solution used to preserve some donor organs could be contaminated with bacteria, the government says. BBC News

CCGs face tough challenge despite PCT savings

CCGs face tough challenge despite PCT savings: Clinical commissioning groups (CCGs) stand to inherit a grim financial legacy from PCTs despite a report showing they are on track for efficiency savings worth £5.8bn in 2011/12, GP leaders have warned. GP Online

Obesity fuelling kidney cancer rise

Obesity fuelling kidney cancer rise: The number of kidney cancer cases diagnosed in Britain has risen sharply with obesity highlighted as a key factor.
Figures from Cancer Research UK have found that cases rose from about 2,300 in 1975 to almost 9,000 in 2009 and it is now the eighth most common cancer in this country.
With obesity increasing kidney cancer risk by about 70% - compared to smoking which increased it by about 50% - the charit... Healthcare Today

Doctors face pension reforms ballot within weeks

Doctors face pension reforms ballot within weeks:
The first ballot of doctors on industrial action since 1975 will go ahead within weeks if the Government does not rethink the major changes it is making to NHS pensions, it has been warned. The Independent

Letter from Secretary of State to NHS staff on Health and Social Care Act

Letter from Secretary of State to NHS staff on Health and Social Care Act:
Health Secretary Andrew Lansley has thanked NHS staff for their work over the last year and reassured them the Health and Social Care Act 'explicitly supports the core principles of the NHS'. These are: care provided free at the point of use, funded from general taxation, and based on need, not ability to pay.

Improving safety in maternity services: a toolkit for teams

Improving safety in maternity services: a toolkit for teams:
This toolkit is organised around five key areas for improvement in maternity care: teamworking; communication; training; information and guidance; and staffing and leadership. Each section begins with a brief explanation on how focusing on improvements in each area can contribute to improved safety. It then highlights some of the experiences of the maternity teams who focused on this issue and their key learning points. There are also short summaries of tools that can be used to improve safety.

Solution to preserve donor organs 'contaminated'

Solution to preserve donor organs 'contaminated': A major alert has been issued over the solution used to preserve some donor organs for transplant.
The government has said the solution used to preserve some donor organs - viaspan - could be contaminated with the bacteria Bacillus cereus.
Tests have found it in the solution that is used to test the sterility of viaspan and further investigations are now being carried out to see if viaspan is also conta... Healthcare Today

Sustainability action: top 10 tips for NHS trusts

Sustainability action: top 10 tips for NHS trusts:
To mark the first annual day of action for sustainability on 28 March we asked readers to let us know what their trusts are doing to contribute. Here are some of their best tips,
Raising patient awareness: We are getting members of the public to jump on a rower and bike machine in the entrance of our new Royal London Hospital to see how much energy it takes to power up an iPod for the day of action on sustainability. Hope the volunteers ate a good breakfast this morning! — Barts and the London NHS trust
Alice the Harris Hawk: Alice is a majestic bird with a wingspan of more than a metre. She's our secret weapon in the fight against pigeons as we were keen not to use harmful pesticides and chemicals. Patients love to see her in flight, and children on the Starlight ward look out for her. She's become a really important member of the UHSM team – Paul Featherstone, director of estates, University Hospital of South Manchester NHS foundation trust
Good work down the drain: Our food digesters use a bio-enzymatic formula to break food down into grey water, which then passes harmlessly through the system's filter and into the drainage system. This is much better for the environment than throwing food away, and will save us nearly £100,000 in water and electricity costs over the next five years — David Moss, deputy director of estates, Tameside and Glossop PCT
Food sourcing: All of our meat, milk and seasonal vegetables come from local farms within the East Midlands, reducing the carbon footprint of every meal we produce for our patients. We've also done this at no extra cost to the hospital — Nottingham Hospitals
Video conferencing: At NHS Medway video conferencing is just one of ways that the trust is reducing emissions. To celebrate NHS Sustainability Day of Action we have launched a video about how NHS Kent and Medway is helping to create a green and sustainable healthcare system. – NHS Medway
Savings can be made with water too: A tap dripping 2 drops of water per second would waste £7.50 per year. A 2mm drip stream costs £115 per year, and a 5mm drip stream costs £415 per year. Don't flush toilets unnecessarily, a single flush can use nine litres of water, and when boiling a kettle only fill with the amount of water needed – Martin Aizlewood, estates officer, energy and special Projects, Rotherham NHS foundation trust
Staff challenges: We can measure our electricity usage hour by hour. So we've set up an energy challenge for our staff. We've heavily promoted how they can help, with five simple top tips and encouraged engagement with a little competitive spirit – Barnsley Hospital
Loving cycling: The sustainability team has recently relaunched an "I Heart Cycling" free bike loan scheme with folding bicycles for staff to try cycling as part of their commute. We will soon launch an "I Heart Walking" pedometer loan scheme to encourage 2,012 staff to become more active in the runup to the Olympics – Rebecca Hall, sustainability co-ordinator, Imperial College Healthcare NHS Trust
Cake incentives: I work for a five-partner GP practice in Brighton. To mark sustainability day we permanently swapped to a green energy supplier, asked staff to come to work without using a car (with the incentive of homemade carrot cake for those that did!) and planted a plum tree which we registered with NHS forests — Comment from Mungomorris
Large-scale campaigns: We have an ongoing ecosmart energy and environment campaign to help staff save energy and money at work and at home. Every day is Sustainability Day in NHS Greater Glasgow and Clyde! – NHS Greater Glasgow and Clyde
• You can read the full comment thread online here. Guardian Professional. 

NHS reforms: what now for health service managers?

NHS reforms: what now for health service managers?:
NHS managers now have the task of implementing Andrew Lansley's reforms
The passing of the health and social care bill was trumpeted in some quarters (including, apparently, the Cabinet room) as a hard-won victory for Andrew Lansley and his plans to "liberate the NHS".
For the battalion of health service managers, however, the campaign has now begun in earnest. It is they who have to take the legislation, translate its complex clauses into practical plans, and determine how far Lansley's hopes will be realised and the fears of his detractors proven or not.
NHS managers have been here before. Reorganising the service forms a core part of the person specification for any NHS management post, because every four years or so, they can be pretty sure to find themselves charged with implementing the latest grand plan of their political masters.
However, the latest reforms are of a different order, entailing change at every level: Department of Health (splits to form a new NHS commissioning board); strategic health authorities (to be abolished in 2013); primary care trusts (again, abolished in 2013); hospitals (if not already a foundation trust, must be by 2016); public health (off into local government); and general practice (to be organised into 250 clinical commissioning groups by 2013).
The managers responsible for all this could be forgiven for feeling beleaguered. While waiting nearly two years to find out if the NHS white paper would be passed into legislation, they were instructed by the Department of Health to get on with implementing the reforms, which is why primary care trusts are already a thing of the past, clinical commissioning groups are up and running, the NHS commissioning board has a top team in place, and strategic health authorities are down from 10 to four.
What is more, managers have obeyed orders, knowing that cuts to the administrative budget of 45% over four years are coming in the name of cutting bureaucracy, although the NHS is one of the most lightly managed – some would say under-managed – health systems in the world.
This structural change is, however, a sideshow. The biggest challenge is not the implementation of these legislative changes. What keeps senior NHS managers awake at night is how on earth they are going to make 4% efficiency savings each year until 2015 (and probably for several years beyond that) and make sure that local services stay safe and viable.
They know they need to make radical changes to how hospitals and general practice work in the future, and that mergers and other difficult decisions will be required. Managers are also painfully aware of the signs of strain in the NHS, as witnessed by reports of shockingly awful care of older people, cancelled operations and sub-optimal maternity and other services.
What managers want more than anything is for politicians to provide them with the equipment (ie, political leadership and support) with which to fight the most important battle facing the NHS: that of doing more with less.
The main salvo of 2012 has yet to be fired into the NHS. Robert Francis QC is busy writing his report of the public inquiry into the scandal of Stafford hospital. This is likely to provide shock and awe for NHS managers, doctors and nurses, asking how the NHS allowed itself to become enmeshed in such a complicated system of oversight and performance management that it could not see what mattered most: the suffering of frail and vulnerable patients.
As NHS managers concentrate on implementing this latest, and most complicated, reorganisation, they need to think hard about how the new system they create will look when the Francis report casts its piercing light over the service. Most critically, who will notice if there is a serious failing in a hospital or practice, and who will be responsible for taking action?
Judith Smith is head of policy at the Nuffield Trust, a healthcare thinktank Guardian Professional.

NHS watchdog not ready for new responsibilities, say MPs

NHS watchdog not ready for new responsibilities, say MPs:
Public accounts committee reports that Care Quality Commission is 'poorly governed and led' as shakeup looms
England's NHS regulator should not be allowed to take on new responsibilities planned under the government's health reforms, according to a damning report by MPs.
The Care Quality Commission (CQC) was described as "poorly governed and led" and is not ready for the challenges of the coalition's health bill or to take on the functions of the Human Fertilisation and Embryology Authority (HFEA), according to the public accounts committee.
The CQC has focused on administration whilst neglecting to inspect the level of care and failing to act on information from whistleblowers, MPs concluded.
Plans for the CQC to take over the functions of watchdogs which regulate fertility treatment and human tissue should not go ahead in 2015 as planned, said the cross-party committee.
Margaret Hodge, chair of the committee, said the commission has been struggling for some time while the Department for Health has not got to grips with a failing institution.
"We are far from convinced that the CQC is up to the major challenge of registering and assessing 10,000 GP practices this year.
"Registration will now be decided on the basis of information from GPs themselves and there is a risk that the CQC will simply become a postbox. Unless the assessment of GP practices is meaningful and robust the commission cannot be sure that basic standards of quality and safety are being met," she said.
The DH, which oversees the commission, was criticised for failing to take action quickly.
The report will be a further blow for Andrew Lansley, the health secretary, who inherited a failing commission but wanted it to take a leading role in assessing GP practices and take over the functions of the soon-to-be-abolished HFEA.
The report welcomed the DH's announcement of a "pause" for consultation on the proposed transfer of the responsibilities of the HFEA and the Human Tissue Authority to the commission.
It warned that plans to register 10,000 GP practices between September 2012 and April 2013 may reduce the watchdog to little more than a "postbox" role, as surgeries were being asked to assess for themselves whether they were compliant with quality and safety standards.
The MPs said it was "astonishing" that – almost three years after its creation in 2009 – the CQC had not even developed measures by which to judge quality.
It had carried out "far fewer" inspections than planned and the information it provided to the public on the quality of care was "inadequate and does not engender confidence in the care system", said the report.
There were "serious concerns about the leadership, governance and culture of the commission", which had given incorrect information to Parliament, claiming to have completed twice as many inspections and reviews as it really had.
The committee raised concerns about the commission's use of "gagging clauses" in severance deals with staff, which prevent them from speaking out in public. One former board member said she had been "ostracised and vilified" after challenging the commission's leadership.
The MPs called on the commission to re-establish a dedicated whistleblowers' hotline for staff to report concerns about standards in care homes and hospitals.
However the report has not called for Cynthia Bower, head of the CQC, to stand down from her post before her expected leaving date in the autumn.
Bower resigned last month in expectation of the report and two other major inquiries which are also expected to criticise her and the commission.
The DoH is reviewing how the commission handled the scandal of Winterbourne View, a private hospital near Bristol for people with learning disabilities.
But the most serious criticism of the CQC and Bower is likely to come from a public inquiry into how NHS bodies failed to prevent between 400 and 1,200 patient deaths due to poor care at Stafford hospital.
A CQC spokesman said that the MPs' report had failed to take on board recent improvements in performance, an increase in the number of inspections and a tightening of its whistleblowing policy.
"These improvements were noted in the Performance and Capability Review published by the DoH in February, which referred to CQC's 'considerable' achievements in setting the essential platform from which tougher regulatory action can be taken when needed," he said.
A source close to Lansley said that the failings of the CQC had developed under the last government, but are being dealt with by the current administration. "We are addressing a difficult legacy," he said. The Guardian

Health regulator 'still failing' in duty to protect patients

Health regulator 'still failing' in duty to protect patients: A senior board member at the health and social care watchdog has warned that despite a series of damning reports the regulator is still failing to protect patients from poor treatment in hospitals and care homes. The Daily Telegraph

International Perspectives on Patient Engagement: Results from the 2011 Commonwealth Fund Survey

International Perspectives on Patient Engagement: Results from the 2011 Commonwealth Fund Survey: An international survey of adults with complex health care needs found wide variations in the degree to which patients are engaged in their own care, from self-managing a health condition to actively participating in treatment decisions. The Commonwealth Fund