Monday, 11 June 2012

Emergency calls rise over Jubilee

Emergency calls rise over Jubilee: Ambulance crews in Northamptonshire experienced a 25% increase in emergency call-outs over the Jubilee weekend, figures show. Evening Telegraph

Concern that rise in child neglect cases could cripple services in Northamptonshire

Concern that rise in child neglect cases could cripple services in Northamptonshire:
The NSPCC is warning that a sharp increase in reports of neglect cases will place additional pressure on already stretched children’s services across Northamptonshire.Northampton Chronicle & Echo

Small rise in Legionnaires' cases

Small rise in Legionnaires' cases: The number of confirmed and suspected cases of Legionnaires' disease in the Edinburgh outbreak rises slightly to 82. BBC News

Doctors' tribunal service begins

Doctors' tribunal service begins: Doctors will be referred to a new independent tribunal service if they are involved in fitness to practise hearings, as part of reforms by the General Medical Council. BBC News

Health visitor employment: from training to practice – new briefing

Health visitor employment: from training to practice – new briefing: NHS Employers has published a briefing outlining an employment model to help meet the required increase of health visitor training places.

Guidance on the appointment and employment of locum doctors

Guidance on the appointment and employment of locum doctors: The NHS Employers organisation has published guidelines and standards for the appointment and employment of NHS locum doctors in order to safeguard the quality of patient care.

Low cost and high quality integrated care: what can we learn from Japan?

Low cost and high quality integrated care: what can we learn from Japan?:
Natasha Curry, of the Nuffield Trust, explores Japan's long-term care insurance system and the lessons we can learn about caring for an ageing population
While changing demographics are putting considerable pressures on health and care systems in all Western countries, nowhere is it more acute than in Japan. A baby girl born today in Japan can expect to live to 86 and a baby boy to 79. By 2030, almost one in three people will be 65 or older.
Meeting the needs of an ageing population, against a backdrop of a diminishing total population, presents an enormous challenge for its Government. Yet Japan manages to provide universal health care coverage for its population (albeit with some co-payments) while spending around 8.5% of GDP – lower than the UK, Germany, New Zealand and a whole host of other OECD countries.
Just how is Japan managing to do it? To explore this question (among others) the Nuffield Trust organised a study visit to Japan with the generous support of the Great Britain Sasakawa Foundation.
Part of the answer to Japan's relatively low expenditure lies in its tight grip on costs. It operates a fee for service system but, instead of restricting access, it uses the fee schedule – which is revised every two years – to keep prices under control.
Another key part of the answer lies in Japan's long term care insurance system (LTCI). Established in 2000, LTCI was designed to socialise the care of older people, shifting responsibility away from family and into the public domain.
In so doing, the scheme sought to lift the burden of care from families (particularly women), enabling them to enter the workforce, and to relieve pressure on the health system.
Introduction of the scheme entailed significant cultural and systemic change and was not without controversy. Historically, there was stigma attached to putting your elderly parents in a care home yet there was no stigma attached to admitting them to hospital as it was seen to be a medical issue.
Lengths of stay grew and the number of institutional beds used for long-term care expanded rapidly. The trend towards older people living alone was also putting increasing pressure on health services.
Twelve years on, the scheme is embedded, well-established and widely considered a success. As such, it provides an interesting model for us as we grapple with the thorny issue of social care funding.
Part insurance-based and part tax-funded, the scheme operates alongside the existing health system, which is similarly part insurance-based and part tax funded. When people turn 40, they are required to start contributing to LTCI. Contributions vary according to locality but are typically around £30-40 per month.
Interestingly, debates at the time of its introduction focused on the possible erosion of traditional family values, and less on the extra financial burden on top of existing compulsory health insurance premia.
On turning 65, people become entitled to wide-ranging social care support, from home-based help with cooking and dressing to residential respite, intermediate and permanent care. Unlike our narrow definition of social care, long-term care in Japan includes some nursing and medical care for long-term conditions.
An individual's needs are assessed and they are assigned a care level which determines their entitlement. Individuals are required to pay some co-payments and 'hotel costs' for residential services (means-tested). The oil in the machine is the care manager who holds the budget and puts together a package of care.
Long-term care services have developed to wrap around mainstream health services. A competitive market of provision has emerged and many thousands of providers offer services. Many established hospitals have branched out into social care provision, extending their services to include home-based support and residential homes for those with dementia.
Of course, it's not perfect and growing financial pressures are giving rise to debates about eligibility and access. Before advocating for such a scheme to be introduced here, we must consider the context.
The Japanese scheme was introduced at a time of relative financial and political stability and in a very different cultural setting. In addition, the very limited system of provider regulation and quality assessment are elements that few here would find acceptable.
However, as the debate rages in England about how we might tackle the same issues, Japan offers one example of how wide-ranging reform can be achieved.
And, with 12 years of experience under their belts, we have the luxury of being able to observe and learn about what works and what doesn't and just how a parallel system of care can work and take the pressure off an overloaded health service.
Natasha Curry is senior fellow in health policy at the Nuffield Trust. Guardian Professional.

Handling concerns about a practitioner's behaviour and conduct: an NCAS good practice guide

Handling concerns about a practitioner's behaviour and conduct: an NCAS good practice guide:
This guidance sets out principles and practical steps for handling concerns regarding poor professional behaviour and conduct within the NHS.

Quality, innovation and value in cardiac rehabilitation: commissioning for improvement

Quality, innovation and value in cardiac rehabilitation: commissioning for improvement:
This interactive digital resource captures all the learning from the development, roll out and implementation of the DH Commissioning Pack for Cardiac Rehabilitation (2010) together with other leading NHS Improvement work driving up quality and efficiency in cardiac rehabilitation services.

A glossary for NHS finance and governance

A glossary for NHS finance and governance:
This briefing covers a variety of terms regularly used by both commissioners and healthcare providers when discussing the key areas of NHS finance and governance.

Red Cross warns of 'false economy' of 'dangerous' social care cuts

Red Cross warns of 'false economy' of 'dangerous' social care cuts: Elderly people are being put in jeopardy by "dangerous" cuts to basic home care which will end up costing the taxpayer thousands of pounds, GPs today warn. The Daily Telegraph

Doctors issue new warning on legal highs

Doctors issue new warning on legal highs: Doctors and police have issued a warning over a 'legal high' called Benzo Fury after a man died and two people were taken to hospital at a music festival. The Daily Telegraph

10-year low for cervical cancer tests

10-year low for cervical cancer tests:
Cervical cancer testing among women in England is at a 10-year low, with 20 per cent not being screened. The Independent

Update 8 June: Increase in cases of cryptosporidiosis

Update 8 June: Increase in cases of cryptosporidiosis: The Health Protection Agency (HPA) continues to lead a multi-agency investigation to determine whether recent cases of cryptosporidiosis are linked to a common source.