Friday, 5 April 2013

First paperless NHS trust helps GP practices go digital

First paperless NHS trust helps GP practices go digital:
The NHS trust which claimed to be the first to become paperless a year ago is now helping GP practices to do the same.
St Helens and Knowsley teaching hospitals NHS trust in the north-west is offering family doctors in England what it claims to be the first service of its kind to digitise, store and give GPs immediate desktop access to their Lloyd George paper patient records.
So far the Electronic Lloyd George Records Service (e-LGS) has been contracted by the trust's three local clinical commissioning groups in Halton, Knowsley and St Helens to rid its 85 GP practices of their 500,000 patient paper records. But the trust says it has the capacity to offer e-LGS to any practice in the country.
Dr David Wilson is one of the first GPs to use the e-LGS system which he says is transforming administration and saving money at his Grove House practice in Runcorn where he is senior partner. Digitising all its 11,000 Lloyd George records is, he estimates, reducing admin costs by the equivalent of about one person a day each week. The practice is as paperless as it is possible to be in the current NHS system where trusts still send some paper correspondence. "We are paper light plus because we still receive paper from trusts although we immediately scan the paper into the system," Wilson said. "We are as advanced as GPs can be."
Practice staff in the past would often spend up to two or three hours manually searching the paper records for specific past referral letters, test results or details of a GP's written account of a previous consultation. With the new system they can remotely access a digital database that contains all the material previously held in the Lloyd George by clicking an icon on a computer screen and logging on to a secure site. The move to e-LGS has also freed up more than 20 sq metres of space in the practice as it no longer needed its Lloyd George library.
Wilson said: "The Lloyd George is the only part of my patient record that still remains on paper and has been a huge burden to maintain administratively. I absolutely love the new system."
The e-LGS system was created by St Helens and Knowsley health informatics service at the trust, which developed its own paperless patient records system a year ago. The trust's IT experts created a similar electronic system for GPs that allows them to access a digital database of the practices' paper records, which have previously been scanned and stored. All the paper records held in the Lloyd George are destroyed – only the covering brown envelope is retained by the practice in case a patient registers with a new GP and a paper copy of their original record needs to be created.
Neil Darvill, director of informatics at the health informatics service said: "I don't think that any other organisation is offering this end-to-end service although some commercial companies will offer archiving and scanning of paper records and provide practices a backup with a DVD. Where we are different is that we take the paper records away, scan them and then provide online access with no data stored in the practice."
Signing up to e-LGS for five years costs a practice £3 for each Lloyd George record, or 60p a record a year. There is a 10% discount for individual clinical commissioning groups. Any profit made is ploughed back into the trust's health informatics service.
The national launch of e-LGS comes three months after Jeremy Hunt, the health secretary, set the NHS a challenge to become paperless by 2018. All NHS trusts are already expected to have their patient records online by 2014.
Guardian Professional. 

NICE publish first guideline for conduct disorders and antisocial behaviour in children and young people

NICE publish first guideline for conduct disorders and antisocial behaviour in children and young people: Conduct disorders are the most common reason why children are referred to mental health services and it’s estimated that around 5% of all UK children aged 5-16 have a diagnosis of the condition. Around half of the young people affected by conduct disorders go on to have a serious mental health problem as an adult. [read the full story...] The Mental Elf

Halve our salt intake and save millions of lives, says new report

Halve our salt intake and save millions of lives, says new report:
If we could end our love affair with salt we would save tens of thousands of lives in Britain and millions around the world, researchers claim today. Independent

Nursing and Midwifery Council resumes overseas registration

Nursing and Midwifery Council resumes overseas registration: The NMC has resumed overseas registration from 2 April 2013 following an review of its policies. NHS Employers News

Putting patients first: government publishes response to Francis Report

Putting patients first: government publishes response to Francis Report:
Health secretary Jeremy Hunt has announced how a culture of compassion will be a key marker of success, spelling an end to the distorting impact of targets and box ticking which led to the failings at Stafford Hospital.
Radical new measures will be introduced to achieve this including Ofsted-style ratings for hospitals and care homes, a statutory duty of candour for organisations which provide care and are registered with the Care Quality Commission, and a pilot programme which will see nurses working for up to a year as a healthcare assistant as a prerequisite for receiving funding for their degree. NHS Networks

Smoking and Mental Health

Smoking and Mental Health: This report examines the issue of smoking in people with mental health conditions. It argues that much of the lower life expectancy of people with mental disorders can be attributed to smoking which is overlooked and neglected by the NHS. However, there is a moral duty to provide this group with the same health interventions. 20 % of the general population are smokers compared to 40% of those with a mental disorder. The report states that there is a general acceptance of smoking of people with mental disorders by health professionals and it is often engrained in the culture of the institutions who provide care for these populations. Key recommendations include quickly identifying smokers and providing appropriate support, mental health settings to be smoke free and mandatory training for professionals in the awareness of smoking issues. CASH News

New Single drug fund list to bring fairer system for cancer patients

New Single drug fund list to bring fairer system for cancer patients:
NHS England is today (Thursday) taking action to end regional variation of access to the Cancer Drugs Fund. There will be one national list of approved fast-track drugs giving uniform access to treatment across the country.
From 1 April, NHS England took on responsibility for the operational management of the Cancer Drugs Fund, creating for the first time a single national system for deciding which drugs are available and for which conditions. The Cancer Drugs Fund provides an additional £200m each year to enable patients with cancer in England to access drugs that are not routinely funded by their local NHS. It was established in 2010 and will continue to run until the end of March 2014.
Sean Duffy, National Clinical Director for Cancer at NHS England said,
“This is a national levelling up of the number of approved treatments that are available under the Cancer Drugs Fund. This means more people will benefit. It is really important that we stretch every penny of the Cancer Drugs Fund so we get maximum benefit to the most people we possibly can.
“This is a step forward for the Cancer Drugs Fund.  In recent weeks cancer specialists from across the country have been working together to agree one national list of approved fast-track drugs for the Cancer Drugs Fund, which will then allow more uniform access to treatment and reduce variation of prescribing across the country.  Having one consistent method for consideration of overall clinical benefit and funding means that all applications will be assessed by the same criteria. Regional variation of the past is clearly not acceptable for patients. Clinicians can still apply for drugs to join the national list of approved fast-track cancer drugs. Clinicians can also continue to make individual funding requests for cancer drugs on behalf of their patients. Doctors will still be able to apply for any cancer drug through the Cancer Drugs Fund on behalf of their patients.”
Doctors will still be able to apply for any cancer drug through the Cancer Drug’s Fund on behalf of their patients. The single national list of approved fast-track drugs will contain 28 drugs which will treat approximately 70 different cancer conditions. A small number of drugs which were previously on local lists are now available more widely to patients through normal hospital treatment with no special application needing to be made.
NHS England stresses that any patient who is already receiving funding for a cancer drug, or has received confirmation that they will receive funding as part an agreed treatment plan, will continue to receive treatment, despite any changes made to the national list, as long as they and their clinicians consider it clinically appropriate. Any changes to the treatment plan for individual patients will be made as part of the regular clinical reviews of care and this will include any drugs that were prescribed on a time limited basis.
Until now, the Cancer Drugs Fund has comprised ten regional areas each with different regionally approved lists of fast-track drugs and the cancers they can be used to treat.There has also been a variety of processes for managing their availability to patients. This has led to differential access to drugs and different processes for reviewing patient’s requests. Clearly this is not acceptable. In anticipation of a single clear national approach to the Cancer Drugs Fund, the regional clinical leads for the ten areas worked with the National Cancer Action Team during the early part of 2013 to draft the single, national list of approved fast track drugs and the cancers they can be used to treat.
NHS England has established a national Clinical Reference Group for Chemotherapy which has approved the proposed list. This strong, clinically-led process ensures that access to the Cancer Drugs Fund is based on the best available trial data – ensuring swift access to innovative therapies but importantly ensuring that patient safety and quality of life are central to the process. View the Standard Operating Procedures document
The Cancer Drugs Fund Standard Operating Procedures document and the national list of drugs and indications that will be routinely funded from the Cancer Drugs Fund are published on the dedicated webpage.
Additionally, NHS England will consider applications for cancer medicines made by clinicians to treat individuals with rarer types of cancers including those affecting children. More details on how to make Individual CDF Requests (ICDFRs) are set out on the Cancer Drugs Fund webpage. NHS England

NHS England publishes clinical access policies for specialised services

NHS England publishes clinical access policies for specialised services:
NHS England is today publishing an agreed set of clinical access policies for specialised commissioning. For the first time ever, specialised services will be commissioned using a nationally consistent approach, meaning that patients will have equal access to high quality services, regardless of where they live.
The policies, along with a number of specialised services specifications, were the subject of a short public consultation between December 2012 and February 2013. The consultation attracted more than 3,500 web and email responses from patients, carers, the general public and wider stakeholders, all of which have been used to inform the final versions of the policies.
The consultation covered a total of 135 service specifications and 44 clinical access policies. The draft service specifications will be subject to a period of further engagement with stakeholders during the coming months. A full consultation report, outlining all feedback, will be published by NHS England in due course.
In addition to publishing clinical commissioning policies, NHS England is also developing a new approach for widening access to some services that are not routinely commissioned by the NHS.
‘Commissioning through Evaluation’ enables treatments or procedures to be commissioned initially on a limited basis whilst further evaluation is carried out to determine whether a substantive commissioning policy should be developed for future use.
NHS England is considering a number of treatments and medical devices as potential subjects for the ‘Commissioning through Evaluation’ approach. These include deep brain stimulation for the treatment of epilepsy; Mitraclip – a device used in the repair of heart valves; renal denervation for the treatment of chronic high blood pressure, and selective dorsal rhizotomy, a treatment aimed at reducing  spasticity in children with cerebral palsy.
Patients, carers and wider stakeholders will continue to help NHS England in the development of evaluation criteria for ‘Commissioning through Evaluation’. Patient and carer members of the 74 specialised services Clinical Reference Groups (CRGs) will play a vital role in this work. The recruitment of patient and carer members to CRGs is now open. NHS England

NHS England publishes generic commissioning policies

NHS England publishes generic commissioning policies:
NHS England has published a number of interim generic policies, ensuring fair and consistent decision-making across its direct commissioning function.
The 14 policies cover all aspects of NHS England’s direct commissioning responsibilities including specialised services, primary care, screening, military and offender health.
The policies, agreed by the Clinical Priorities Advisory Group (CPAG), set out NHS England’s approach on a variety of funding issues including Individual Funding Requests; access to treatments for patients moving between different sets of commissioners and services providers, and the process that NHS England will adopt for implementing guidance produced by the National Institute of Clinical Excellence (NICE).
Other policies include the Ethical Framework for Priority Setting and Resource Allocation which sets out a fair and consistent approach to decision-making.
The policies are being adopted on an interim basis to enable NHS England to carry out further engagement with patients, carers and the public over the next 6-12 months in refining and agreeing final versions.
NHS England plans to bring together a steering group which will lead development of the policies, working in partnership with a range of stakeholders. This group will test the principles on which the policies are based and will revise them, where appropriate, in order to make them more accessible. This transparent approach to policy development reinforces NHS England’s commitment to ensuring that patients and carers are at the heart of the planning and development of NHS services. NHS England
Access the individual policies.