Wednesday, 21 November 2012

NHS Mandate published

NHS Mandate published:
The first Mandate between the Government and the NHS Commissioning Board, setting out the ambitions for the health service for the next two years, is published today.
The Mandate reaffirms the Government’s commitment to an NHS that remains comprehensive and universal – available to all, based on clinical need and not ability to pay – and that is able to meet patients’ needs and expectations now and in the future.
The NHS Mandate is structured around five key areas where the Government expects the NHS Commissioning Board to make improvements:
  • preventing people from dying prematurely
  • enhancing quality of life for people with long-term conditions
  • helping people to recover from episodes of ill health or following injury
  • ensuring that people have a positive experience of care
  • treating and caring for people in a safe environment and protecting them from avoidable harm.
Through the Mandate, the NHS will be measured, for the first time, by how well it achieves the things that really matter to people.The key objectives contained within the Mandate include:
  • improving standards of care and not just treatment, especially for the elderly
  • better diagnosis, treatment and care for people with dementia
  • better care for women during pregnancy, including a named midwife responsible for ensuring personalised, one-to-one care throughout pregnancy, childbirth and the postnatal period
  • every patient will be able to give feedback on the quality of their care through the Friends and Family Test starting from next April – so patients will be able to tell which wards, A&E departments, maternity units and hospitals are providing the best care
  • by 2015 everyone will be able to book their GP appointments online, order a repeat prescription online and talk to their GP online
  • putting mental health on an equal footing with physical health – this means everyone who needs mental health services having timely access to the best available treatment
  • preventing premature deaths from the biggest killers
  • by 2015, everyone should be able to find out how well their local NHS is providing the care they need, with the publication of the results it achieves for all major services.
See NHS Mandate site
The Mandate has been drawn up following consultation with the public, health professionals and key organisations across the health system between July and September 2012.
Read the following documents:
Department of Health

NHS staff need to be creative to hit Qipp targets

NHS staff need to be creative to hit Qipp targets:
The NHS has saved £5.8bn in the last year without compromising quality, but to continue to hit targets clinicians and finance managers must work together
A 75-year-old woman was admitted to a NHS hospital in the north-west with a fractured left ankle that was treated with surgery. But while reaching for her glasses on a side table a day before her discharge date, she fell from her bed causing a hip fracture, which meant a further stay of 14 days.
In the same week, at a London hospital, another elderly woman was ready to be discharged after her treatment for a chest infection, but had to stay an extra two days because of lack of co-ordination in the discharging process.
 In both cases, an effective engagement between the clinical and finance teams were triggered to establish common ground and deal with the problems together.There are many more examples like this available at Nice Qipp evidence case studies, which help to spread best practice around the NHS.
NHS chief executive Sir David Nicholson has outlined a challenge for the NHS to deliver annual efficiency savings of up to £20bn by 2014-15 without compromising quality and safety, while also creating fresh momentum to achieve a fit for purpose health system for the future.
If the NHS is to deliver on this challenge then clinicians and finance managers need to get engaged in the new commissioning and provider world.
There are a number of things happening in the NHS which would help to create better value-based healthcare.
The 2011-12 period was the first full year of the £20bn productivity challenge – Qipp – and national figures showed that the efforts of NHS organisations led to a saving of £5.8bn without any compromise in quality. This is an excellent start but to repeat it in the remaining three years, organisations have to be creative, proactive, show perseverance and harness their expertise to achieve value for patients.
It won't be easy, but late Body Shop founder Anita Roddick put it well: "To succeed you have to believe in something with such a passion that it becomes a reality."
Dr Mahmood Adil is national Qipp adviser for clinical and finance engagement at the Department of Health and visiting professor of value-based healthcare at Manchester Business School.
Guardian Professional.

NHS continuing healthcare

NHS continuing healthcare: This Briefing outlines for commissioners and providers the challenges and opportunities they will need to consider as the responsibilities change for assessing eligibility for and commissioning NHS continuing healthcare. NHS Confederation

Chief Medical Officer publishes her first annual report

Chief Medical Officer publishes her first annual report:
This first of 2 volumes of the Chief Medical Officer Professor Dame Sally Davies’s annual report provides a comprehensive picture of England’s health.
It brings together a number of data sources in one place for the first time and is designed to be used by local authorities and local health professionals as they work together to improve the health of local populations.
Watch Sally Davies talking with report editor Dr Tom Fowler about how her report can be used and particularly how it shows health information at a local level.

Professor Dame Sally Davies said:
“I have undertaken a comprehensive analysis of the state of the public’s health, and found some areas where we are doing really well and others where there is still a lot of improvement needed.
“I strongly believe that data and scientific evidence should be at the heart of policy making and advice to Government and have reflected this in the Annual Report. Data should be used to inform our action on public health and to evaluate the effectiveness of that action.
“I hope the data that I have provided will become a major tool for the Department of Health, Public Health England, health professionals and local authorities as they draw up their strategies for improving public health.”
Read this first volume


The report looks at important areas of health including heart disease, obesity and cancer, and makes a number of recommendations around access to care and how data can be better used. Recommendations include:
  • Giving better access to diabetes care – only half the people registered as diabetic receive the annual checks recommended by NICE.
  • Non-fatal diseases can impose a great burden on both the individual and the NHS. Public Health England should ensure our capacity to capture data on long term conditions such as loss of hearing, back pain, incontinency and dementia is as strong as current surveillance on the causes of early death.
  • Participants in the new health system must work closely together to increase survival and reduce mortality from cancers such as lung and pancreatic cancer.
  • Nearly 70% of us have 2 or more habits or medical risk factors that are linked with life limiting diseases, for example, smoking, harmful alcohol use or not eating enough fruit and vegetables. Health professionals must focus on tackling these together rather than individually.

About the CMO’s annual report

Each year the Chief Medical Officer plans to produce 2 volumes of her report.
The first, Volume One 2011, is designed to be a surveillance report, bringing together a large amount of data and information about the public’s health. The  second volume, Volume 2, is designed to concentrate on one specific health issue or area in detail.
The  Chief Medical Officer’s annual report Volume Two, 2011, due to be published early next year, will look at infections and infectious diseases.
  •  Read the CMO’s report

Microsoft launches Identity Agent

Microsoft launches Identity Agent: Microsoft has launched software to enable NHS staff using modern versions of its Windows operating system to connect to the NHS Spine using NHS smartcards. EHI NEWS

Warning over liver disease rates

Warning over liver disease rates: Drinking and obesity levels mean England is one of Europe's few countries still seeing a rise in liver disease deaths, the chief medical officer warns. BBC News

Developing integrated care at scale and pace: time to make it happen

Developing integrated care at scale and pace: time to make it happen:

At the request of Norman Lamb, the Care and Support Minister, The King’s Fund hosted a roundtable discussion with key stakeholders early in November to consider what needs to be done to make a reality of integrated care.

Participants at the discussion were clear that an immediate priority is to promote the widespread adoption of best practice. Examples include the use of care planning and case managers to help people with complex needs navigate their way around health and social care services, and provide a single point of access to these services. Increased take up of personal health budgets in appropriate cases will also help people to take more control over their lives, for example by accessing the support they need to live independently.
Another priority, already recognised by the government, is to develop ways of measuring the experience of patients and service users in order to assess whether care is co-ordinated around their needs. A person-centred measure of integrated care is urgently needed to understand how well services perform and identify priorities for action. Agreement is now needed on the survey questions that should be used to derive such a measure and how the results will be used to support improvements in performance.
It is essential that organisations at a national level work together to support integrated care. There are encouraging signs in this regard in the work being done by the NHS Commissioning Board, Monitor and the Care Quality Commission to work towards a common approach and to engage with the Local Government Association and Public Health England in the process. The national policy framework on integrated care expected in the spring will provide a clear indication of how these organisations will work with each other and the Department of Health to turn the commitments on integrated care included in the Mandate into benefits for patients and users on the ground.
Participants at the discussion were clear that there is no one best way of developing integrated care and the emphasis should be placed on discovery and not design in taking forward policy in this area. There was strong support for the suggestion that integrated care should be developed at scale and pace by enabling a number of areas of the country to test out different approaches. These areas would be encouraged to innovate in the use of payment systems and contracting mechanisms, and they would be allowed to suspend rules that get in the way of progress.

Public Health Outcomes Framework gets technical refresh

Public Health Outcomes Framework gets technical refresh:
The technical refresh of the ‘Public Health Outcomes Framework’, which is published today, is the fulfillment of the promise to continue improving the range and quality of information in the framework.
Working with Public Health Observatories, local authorities and the NHS, the Department has now produced an update to: ‘Improving outcomes and supporting transparency’.
The commitment to produce policy updates setting out more detail on what we want to achieve in a new and reformed public health system was made in ‘Healthy Lives, Healthy People: Update and way forward’.
Originally published in January, the ‘Public Health Outcomes Framework’ covers a period of 3 years and sets out the desired outcomes for public health and how these will be measured. It concentrates on increased healthy life expectancy, and reduced differences in life expectancy and healthy life expectancy between communities.
Also being published is the first set of baselines on an interactive Public Health Outcomes Framework Data Tool,  which will allow local authorities to assess their own outcomes against the various indicators.
The intention is to expand the number of indicators and range of equalities breakdowns that are presented as and when the data becomes available.
Details of what has been updated
Updated versions of the following are being published: the summary technical specifications in Part 2 and the following 3 Appendixes in Part 1:
  • Appendix A: ‘Overview of outcomes and indicators’
  • Appendix C: ‘Breakdown of indicators: local disaggregation, inequalities and equalities characteristics’
  • Appendix D: ‘Readiness of indicators’
Read the documents:
Useful links:
If you have any questions about these publications, you can contact the policy team:
 Department of Health

New Cochrane review says that vitamin E should not be used to treat dementia

New Cochrane review says that vitamin E should not be used to treat dementia: It was relatively recently that every Tom, Dick and Harry in the scientific community was popping vitamin E supplements in the hope that this antioxidant would help protect them from the damaging effects of free radicals. Us elves get our vitamin E from the vegetables, fruits and whole grains that make up our naturally healthy diet. Many single [read the full story...] Mental Elf

Scientists urge ministers: tell truth on 'over-hyped' flu vaccine

Scientists urge ministers: tell truth on 'over-hyped' flu vaccine:
The flu vaccine given to millions of people each year in Britain is “over-promoted” and “over-hyped” and the protection it offers against the seasonal illness has been exaggerated, scientists claim. Independent

1,300 defibrillators at risk as fault drains batteries

1,300 defibrillators at risk as fault drains batteries:
More than 1,300 life-saving defibrillators may not work when needed because of a battery fault, the health regulator said today. Independent

MHRA issues guidance on self-test kits

MHRA issues guidance on self-test kits: Source: MHRA

The Medicines and Healthcare products Regulatory Agency (MHRA) has issued a fact sheet with guidance on the use of self-test kits.
Self-test kits are available for a variety of conditions including fertility, sexually transmitted infections and cancer and can have an important role to play in healthcare. The new guidance provides advice on what to consider before using a self-test kit with a reminder to read the instructions carefully, know how the kit can be stored and know how to read the results. Consumers are also reminded that no test kit is 100% reliable and should never replace a doctor's diagnosis or a result from a national screening programme. NeLM News