Friday 30 June 2017

Will the capped expenditure process help keep a lid on NHS finances?

Will the capped expenditure process help keep a lid on NHS finances? It’s not surprising that NHS finances continue to hit the headlines. NHS providers of hospital, ambulance, community and mental health services ended 2016/17 with a deficit of £791 million and are currently planning for a £500 million deficit in 2017/18. The challenging financial situation is also increasingly spreading to the commissioning sector, with several CCGs expecting to overspend their allocated budgets. The King's Fund

Where’s policy action needed for a healthier population? Learning from international experience

Where’s policy action needed for a healthier population? Learning from international experience If you were to choose a Government department you would run for a day to improve the health of the population, which would it be?

You might instinctively choose the department of health. But since access to healthcare accounts for as little as 10% of a population’s health and wellbeing, it is unlikely to be your best choice. Instead, because it is the conditions in which we are born, grow, live, work and age that contribute in large part to our prospects of a healthy life, you might be better off with HM Treasury, the department for education, or the department for work and pensions, perhaps.

Yet there is a lot less attention on the policy action needed outside the health sector to create better health and wellbeing by influencing the social determinants of health – for example, our access to adequate income, good education and work, decent homes and strong social relationships. The Health Foundation

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A trade in people: the inpatient healthcare economy for people with learning disabilities and/or autism spectrum disorder

A trade in people: the inpatient healthcare economy for people with learning disabilities and/or autism spectrum disorder This report analysis the market for inpatient services for people with learning disabilities in England. The analysis finds that approximately half of these services are run by the independent sector, services which are valued at over a quarter of a billion pounds per year.

The report calls for greater scrutiny and accountability for the independent sector to ensure high quality of care and patient safety. Centre for Disability Research

Air pollution: outdoor air quality and health NICE guideline NG70

Air pollution: outdoor air quality and health NICE guideline NG70 This guideline covers road-traffic-related air pollution and its links to ill health. It aims to improve air quality and so prevent a range of health conditions and deaths.

This guideline recommends taking a number of actions in combination, because multiple interventions, each producing a small benefit, are likely to act cumulatively to produce significant change. National Institute of Health and Clinical Excellence

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No-show women at cervical screening 'unaware of test'

No-show women at cervical screening 'unaware of test' Nearly a quarter of women who don't make cervical screening appointments are unaware that the process even exists, according to a UK survey.

University College London researchers said more creative ways of reaching them were needed, like using social media instead of sending letters.

Women who miss out tend to be younger from poorer families or non-native English speakers, the research found.

Cervical cancer screening has been falling in the UK since 2011. BBC News

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GP pleas to help vulnerable patients ignored by ‘disintegrating’ social services

GP pleas to help vulnerable patients ignored by ‘disintegrating’ social services GPs are referring more vulnerable children and adults than ever for protection against abuse or neglect, but Pulse can reveal that their concerns are often going unheard.

A Pulse investigation reveals a 15% increase in primary care referrals about safeguarding concerns to child and adult social services after new guidance came in following the infamous case of Baby P.

But a Pulse survey of over 800 GP readers found a third say they are unable to access social services support and 42% experience unacceptable delays when referring vulnerable adults and children. GPs told Pulse that they were unable to get hold of social workers and this is leaving vulnerable members of society at risk.

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Taking a child away from their mother isn't easy – but sometimes it's necessary

Taking a child away from their mother isn't easy – but sometimes it's necessary As a nurse, sometimes I have to confront the fact that parents can do terrible things to their children

I watch as my staff nurse colleague hands a two-year-old child into the waiting arms of the social worker who has just returned from court. He’s being taken into temporary foster care under an interim care order. It’s a decision we’ve been working towards for months, which I believe to be right. It should feel like a victory but it really doesn’t.

I’m on the children’s ward surrounded by carrier bags containing this boy’s belongings. I’m hoping his mother has left him some familiar item of comfort for later on tonight; a cuddly toy or a special blanket, perhaps. He’s been on the ward for weeks and the staff have grown fond of him. We’re sorry to see him go, but hoping that it’ll be for the best. Continue reading... The Guardian

NHS chiefs soften 'brutal' cost-cutting plan after huge backlash

NHS chiefs soften 'brutal' cost-cutting plan after huge backlash Health service’s financial regulator waters down proposal for 14 areas in England after warnings that patient care would suffer

NHS bosses have been forced to backtrack on controversial plans to impose “brutal” cost-cutting measures that involved delaying operations, denying patients treatment and closing hospital wards.

NHS Improvement (NHSI), the service’s financial regulator, has watered down proposals it drew up alongside NHS England after doctors, health charities and senior NHS staff in the 14 affected areas of England reacted with anger, amazement and warnings that patients would suffer. Continue reading... The Guardian

NHS prescribed record number of antidepressants last year

NHS prescribed record number of antidepressants last year Data prompts debate about whether rise shows drugs are handed out too freely or whether more people are getting help

The NHS prescribed a record number of antidepressants last year, fuelling an upward trend that has seen the number of pills given to patients more than double over the last decade.

The figures raised questions over whether the rise shows doctors are handing out the drugs out too freely or whether it means more people are getting help to tackle their anxiety, depression and panic attacks. Continue reading... The Guardian

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More than 50,000 Britons with 'metal on metal' hips recalled for X-rays and blood tests over toxic fears 

More than 50,000 Britons with 'metal on metal' hips recalled for X-rays and blood tests over toxic fears More than 50,000 patients with “metal on metal” hips are being told to undergo X-rays and blood tests after watchdogs found they are far more toxic than was thought.

Every person fitted with the devices is being advised to have checks, in a safety alert issued by the Medicines and Healthcare products Regulatory Agency.

Concerns have been repeatedly raised about the devices, with watchdogs previously recommending patients with particular types of implant, or troublesome symptoms, to undergo tests. The Daily Telegraph

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Thursday 29 June 2017

Kettering General Hospital 'filtered' data to remove waiting list patients

Kettering General Hospital 'filtered' data to remove waiting list patients A hospital accused of "fiddling" its waiting lists to meet targets has admitted it "filtered data".

Whistleblower David Phelan claimed patients were removed from lists at Kettering General Hospital because national targets were being missed.

The hospital said it used data filtering to get a "true picture of the size of its waiting list" but the practice had stopped in December 2015.

It said its data management had been "well intended, if misguided". BBC Northampton

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KGH buildings deemed safe after post-Grenfell Tower check

KGH buildings deemed safe after post-Grenfell Tower check All clinical and non-clinical buildings at KGH have been found to be safe after a review of potential fire risks.

Organisations up and down the country have been checking their buildings after the Grenfell Tower disaster, which claimed the lives of at least 80 people.

KGH says all clinical and non-clinical buildings have passed the review, although one staff building was found to have potentially flammable insulation. That building will no longer be used - although a KGH spokesman stressed that the decision was not because of the fire risk. Northamptonshire Telegraph

Best of Both Worlds campaign to get doctors and nurses to work in Northamptonshire

Best of Both Worlds campaign to get doctors and nurses to work in Northamptonshire Four Northamptonshire-based NHS healthcare providers and the University of Northampton have joined forces to launch a recruitment campaign.

The campaign is aimed at enticing doctors and nurses to relocate and work in the county. Recruiter

A Mile in My Shoes

A Mile in My Shoes In 2016, the Health Foundation teamed up with the Empathy Museum to develop a collection of stories from people working in, and using, health and social care in the UK. A Mile in My Shoes, invites you to step into someone else’s shoes and embark on a mile-long physical, emotional and imaginative journey to see the world through their eyes. This collection of stories showcases the remarkable contribution and challenges faced by those working in, and using, our health and social care system.

Report on transition of care between childhood and adulthood for people with diabetes

Report on transition of care between childhood and adulthood for people with diabetes A new report that charts the care of young people with Type-1 diabetes as they move from paediatric to adult services has been published for the first time today by NHS Digital.

The National Diabetes Transition Audit (NDTA) links datasets from the adult and paediatric national diabetes audits and examines whether the transition between childhood and adulthood has an effect on care.

The report includes figures on the percentage of people who are receiving the nine NICE recommended care processes, as well as the percentage of people who have met the NICE treatment targets for diabetes care.

The defibrillator drone that can beat ambulance times

The defibrillator drone that can beat ambulance times A drone which could deliver a defibrillator to a person suffering from a cardiac arrest is being tested by the Karolinska Institute in Sweden.

Trial flights have the shown the drones can arrive at a destination four times faster than an ambulance.

After cardiac arrest, the chances of survival decrease by 10% for every minute that an individual goes without cardiopulmonary resuscitation (CPR) or defibrillation. BBC News

Government fails to track mental health in UK prisons amid soaring suicide and self-harm rates, finds report

Government fails to track mental health in UK prisons amid soaring suicide and self-harm rates, finds report The Government does not know how many people in prisons have a mental health illness, a report has warned, prompting calls for “urgent” action amid soaring suicide rates and self-harm incidents among inmates.

Prison authorities’ response to rising suicide and self-harming rates in British jails has been “poor”, according to research by the National Audit Office (NAO).

Her Majesty’s Prisons and Probation Service (HMPPS), NHS England and Public Health England have set ambitious objectives for providing mental health services, but they are failing to collect enough data on inmate’s wellbeing, the report states. The Independent

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'Without this, I would have killed myself': gardening helps heal refugees' trauma

'Without this, I would have killed myself': gardening helps heal refugees' trauma An NHS-run therapeutic gardening project in London is helping to alleviate symptoms of severe mental health problems

It was around a year after Fatu Mangeh* arrived in the UK that she considered taking her own life.

In 2002 she fled the civil war in Sierra Leone where she had been raped and tortured – scars are still visible on her hands 15 years later. Her parents were killed and the only family she had left was her two-year-old daughter. She was lured to the UK by a man who promised to marry her but abandoned her, leaving her destitute and with no support. Wandering the streets, she came across a woman from Sierra Leone who offered to help; she took her to the Home Office to claim asylum and registered her with a GP. Continue reading... The Guardian

NHS staff taking more sick days than ever

NHS staff taking more sick days than ever As the NHS comes under increasing strain, the number of staff taking time off has risen, with mental health conditions among the main reasons

NHS staff are taking more time off work because of illness, with the total now close to 17m days a year. Continue reading... The Guardian

Thousands with long-term conditions skipping treatments

Thousands with long-term conditions skipping treatments Thousands of people with long-term health conditions are skipping medications because of prescription costs, charities have claimed.

Research for the Prescription Charges Coalition suggests 30 per cent of people who have conditions such as asthma and arthritis, and are not eligible for free prescriptions, sometimes skip their drugs or reduce their dose because of cost.

Of those, 43 per cent cite the cost of their prescription as a reason for doing so, and 59 per cent admit skipping doses has had a negative impact on their health.

Some 34 per cent of those who have missed or reduced their dose have required extra medical treatment - such as GP or hospital appointments - as a result. The Daily Mail

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GPs allowed to close their doors when they get busy

GPs allowed to close their doors when they get busy Up to 250 doctors voted in favour of the policy, similar to that of a 'black alert' used by hospitals, at the British Medical Association's annual conference in Bournemouth. The Daily Mail

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Scotland to introduce 'soft' opt-out organ donation system

Scotland to introduce 'soft' opt-out organ donation system Scots will have to actively opt out of donating their organs after death under a controversial new system that aims to increase donation rates.

Aileen Campbell, the Scottish Public Health Minister, said legislation would be tabled to introduce a “soft” opt-out system whereby people will have deemed to have consented to the removal of their organs unless they say otherwise. The Daily Telegraph

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Wednesday 28 June 2017

Senior KGH midwife struck off for series of serious failings

Senior KGH midwife struck off for series of serious failings A senior midwife who put the health of mothers and babies at KGH at risk through a series of failings has been banned from the profession. Northamptonshire Telegraph

Northamptonshire's patient transport service handed to company lambasted in every area by latest inspection

Northamptonshire's patient transport service handed to company lambasted in every area by latest inspection A service that transports Northamptonshire's sick and elderly patients to appointments has been given to an organisation that inspectors recently found operated with dirty ambulances with "poor infection control". Northamptonshire Telegraph

Championing quality and seizing improvement opportunities – are we getting it right?

Championing quality and seizing improvement opportunities – are we getting it right? Our new report on the Getting It Right First Time (GIRFT) programme describes the efforts that leading orthopaedic surgeons made to improve care in their specialty – with impressive results. It reminds me of an early clinical encounter that shaped my own interest in health and care improvement. The King's Fund

Winter warning: managing risk in health and care this winter

Winter warning: managing risk in health and care this winter This report highlights concerns from NHS leaders around the ability of the health system to respond to mounting pressures next winter. It argues that the extra £1bn social care funding committed to easing delayed transfers of care will not be sufficient with 91 per cent of trusts reporting a lack of capacity in social care. The report calls for a funding injection of £350m to ensure that there is enough capacity across the system and to ensure adequate resourcing. NHS Providers

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News story: Secondary school staff get mental health 'first aid' training

News story: Secondary school staff get mental health 'first aid' training From June 2017, teachers in secondary schools around the country will take part in a new training programme to help them identify and respond to early signs of mental health issues in children.

The programme, backed by £200,000 government funding, and delivered by the charity Mental Health First Aid, will eventually cover every secondary school in England, as part of a government commitment to improve support for children and young people.

Teachers and other school staff will receive practical advice on how to recognise issues including depression and anxiety, self-harm, and eating disorders.

They will also be invited to become ‘first aid champions’, sharing their knowledge and experiences across schools and communities to raise awareness and break down stigma and discrimination. Department of Health

A&E cuts will hit 23m people, British Medical Association says

A&E cuts will hit 23m people, British Medical Association says Nearly 23 million people in England - more than 40% of the population - could be affected by proposed cuts to A&E departments, doctors are warning.

The analysis of NHS plans by the British Medical Association also warned the changes were being rushed through without the evidence they will work.

The proposals have been put forward by local managers seeking to make savings under the direction of NHS England.

Bosses have argued services in the community will be boosted in return. BBC News

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Vulnerable told to expect cuts to council care

Vulnerable told to expect cuts to council care The elderly and disabled in England are being told to expect cuts to care services and rises in charges after council chiefs unveiled spending plans.

The Association of Directors of Adult Social Services said £20.8bn was expected to be spent on care this year, a cash rise of 5% since last year.

It follows a £1bn cash injection announced in the Budget which ministers said would relieve the pressures.

But ADASS said £824m of savings were still having to be made.

The group, which represents social care directors, said rising demand meant cuts were inevitable given the current funding levels. BBC News

Charlie Gard parents lose court appeal

Charlie Gard parents lose court appeal Judges at the European Court of Human Rights have rejected a plea from the parents of terminally-ill baby Charlie Gard to intervene in his case.

Chris Gard and Connie Yates lost their final legal bid to take their son to the US for treatment.

Specialists at Great Ormond Street Hospital believe Charlie has no chance of survival.

The court agreed, concluding that further treatment would "continue to cause Charlie significant harm".

Charlie is thought to be one of 16 children in the world to have mitochondrial depletion syndrome, a condition which causes progressive muscle weakness and brain damage. BBC News

Abortion should not be crime, says doctors' union

Abortion should not be crime, says doctors' union Doctors have backed decriminalising abortion, as momentum gathers to overhaul the 1967 Abortion Act.

Currently women in England and Wales have to prove to a doctor that carrying on with the pregnancy is detrimental to health or wellbeing to get permission for a termination.

Without permission, abortion is a criminal offence.

But medics at the British Medical Association's annual conference voted to scrap that rule. BBC News

NHS staff and teachers could receive pay rise as MPs vote on public sector pay cap

NHS staff and teachers could receive pay rise as MPs vote on public sector pay cap A cap on public sector pay that has frozen salaries below inflation for seven years could be lifted as MPs vote on the policy during the Queen’s Speech debate.

Parliament will vote on whether to end the austerity policy, introduced in 2010 by George Osborne, on Wednesday following a debate about health, security and social care.

The amendment to the Queen’s Speech, tabled by Labour's front bench, calls for a "fair pay rise" for emergency and public sector workers including teachers, doctors and police officers. The Independent

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Jeremy Hunt accused of 'sleeping at the wheel' during NHS data loss scandal

Jeremy Hunt accused of 'sleeping at the wheel' during NHS data loss scandal Health secretary forced to respond to urgent Commons question after withering NAO report on loss of 700,000 health documents

Jeremy Hunt has been accused of being “asleep at the wheel” while a private firm co-owned by the Department of Health built up a backlog of over 700,000 pieces of medical correspondence it never delivered to GPs.

The health secretary was summoned to the House of Commons to answer questions from MPs after a damning National Audit Office report found that the scandal may have harmed the health of at least 1,788 patients and had so far cost £6.6m. Continue reading... The Guardian

Give the NHS more money – or it will face trouble this winter

Give the NHS more money – or it will face trouble this winter Without investment, there is a serious possibility of wider failures than last winter with the safety of more patients at risk

It may seem odd to issue a winter warning when we have just been through an early summer heatwave. But the forecast from the NHS frontline is clear: unless we do something now to manage the risk for winter, there is trouble ahead.

Last winter, NHS staff responded heroically to extraordinary pressures. But safety and standards of care were compromised in too many places. As demand increased, so did pressure on beds, staff and the whole health and care sector. That meant delays in A&E and more patients waiting on trolleys for a bed. This had knock-on effects for ambulance response times and there were similar pressures in mental health and community services. Continue reading... The Guardian

Video link GP service deemed UNSAFE by inspectors

Video link GP service deemed UNSAFE by inspectors The first digital GP service allowing patients to have private appointments via video link has been deemed unsafe by inspectors.

Push Doctor, which charges users £25 for a ten-minute webcam consultation with a doctor, received a scolding Care Quality Commission (CQC) report.

Its seven day a week service, reliant on NHS doctors keen to earn some extra money, was found to not be safe, effective, or well-led.

Patients were being dangerously prescribed drugs they may not have needed due to a lack of essential tests, a damning report said. The Daily Mail

Heart disease deaths drop by 20% since indoor smoking ban

Heart disease deaths drop by 20% since indoor smoking ban Public Health England statistics show the number of smokers dying from heart attacks has dropped by over 20 per cent since the 2007 ban, while deaths from stroke have dropped by 14 per cent. The Daily Mail

NHS alert as fire chiefs warn 38 hospitals are 'as dangerous as Grenfell Tower'

NHS alert as fire chiefs warn 38 hospitals are 'as dangerous as Grenfell Tower' Up to 38 hospital sites may be as dangerous as Grenfell Tower, with nine identified as at greatest risk, fire chiefs have warned.

The alert came as more than 17,000 care homes and private hospitals were ordered to undertake their own safety reviews, in the wake of the disaster.

Theresa May has ordered a major national investigation into the use of potentially flammable cladding on high-rise towers across the country.

It follows checks on cladding from residential tower blocks, with all 95 samples submitted by councils so far failing fire safety tests. The Daily Telegraph

NHS 'lost sight that GP was a human being' before she committed suicide

NHS 'lost sight that GP was a human being' before she committed suicide The NHS has been criticised for suspending a GP with bipolar disorder by a coroner who warned that services “lost sight she was a human being”.

Dr Wendy Potts was suspended by her surgery, after a patient read her blog about her mental health condition and complained about her fitness to work.

Weeks later the mother of two, 46, was found hanged at her home after telling her partner "How can I have been so stupid?"

Derbyshire's Assistant Coroner James Newman concluded that Mrs Potts committed suicide on November 24, 2015. He criticised the way the matter was handled and the manner in which the NHS deals with doctors suffering mental health issues. The Daily Telegraph

Tuesday 27 June 2017

Major review finds failings at Northampton hospital caused woman to die from un-diagnosed broken back

Major review finds failings at Northampton hospital caused woman to die from un-diagnosed broken back A major review enacted after a 57-year-old woman's broken back went unnoticed has called for raft of improvements to be made to a Northampton hospital ward branded as 'medieval' by a grieving family. Northampton Chronicle and Echo

Corby MP to keep ‘close eye’ on Urgent Care Centre tender process

Corby MP to keep ‘close eye’ on Urgent Care Centre tender process The newly-elected MP for Corby says he will be keeping close tabs on the tender process at the town’s Urgent Care Centre. Northamptonshire Telegraph

Investigation: clinical correspondence handling at NHS Shared Business Services

Investigation: clinical correspondence handling at NHS Shared Business Services  The findings from an investigation into how NHS Shared Business Services (NHS SBS) handled unprocessed clinical correspondence. In March 2016 NHS SBS informed NHS England and the Department of Health (the Department) that it had discovered a backlog of approximately 435,000 items of unprocessed clinical and other correspondence. NHS SBS accepts it had a contractual responsibility to process misdirected clinical and other correspondence. National Audit Office

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Far from home, far from hope

Far from home, far from hope An investigation has discovered a rise in the number of adult mental health patients placed in out-of-area beds. Keith Cooper examines the impact on patients, their families and the doctors who care for them. British Medical Association

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Government ‘reneging on promise to fund 10,000 extra nursing places’

Government ‘reneging on promise to fund 10,000 extra nursing places’ Scrapping nursing bursaries was supposed to expand training places – but that pledge has been quietly dropped, universities say

Universities are warning that the government is quietly reneging on its promise to provide 10,000 new nursing degree places, intended to relieve pressure on the NHS.

Student nurses must spend 50% of their degree working under supervision, usually in a hospital. But universities have told Education Guardian that not a single extra nursing training place has been funded or allocated for the future. It would cost £15m over five years to fund training placements for 10,000 new nurses, according to the Council of Deans of Health, the body that represents university faculties of nursing. Continue reading... The Guardian

£1bn bedblocking fund not being spent properly, say 40% of hospitals

£1bn bedblocking fund not being spent properly, say 40% of hospitals Hospital bosses say local councils are failing to properly boost social care provision so that more patients can be discharged

More than 40% of British hospitals say they cannot guarantee patients will receive safe care next winter because a sum of £1bn earmarked to reduce “bedblocking” is not being spent properly.

Hospital bosses claim that many local councils are failing to put the emergency funding into schemes to help patients get home quicker by improving social care support for them. Continue reading... The Guardian

Millions wasted on 'rubbish' homeopathic remedies on NHS

Millions wasted on 'rubbish' homeopathic remedies on NHS Homeopathic therapies have costed the NHS £577,529 in the last five years. But the true bill could be ten times more. England's chief medical officer says they're no better than placebos. The Daily Mail

Patients are being 'belittled and bewildered' by the NHS

Patients are being 'belittled and bewildered' by the NHS Mark Porter, chair of the British Medical Association, said that 'too many' patients are being failed by the NHS 'too often' at its annual conference in Bournemouth. The Daily Mail

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Government is deliberately creating a health crisis to privatise the NHS, doctors claim

Government is deliberately creating a health crisis to privatise the NHS, doctors claim Doctors leaders have accused the Government of a conspiracy to create a crisis in hospitals in order to usher in the back-door privatisation of the NHS.

The British Medical Association passed a motion claiming ministers are using plans launched last year, ostensibly as a means to reform over-spending facilities, as a front for selling off the health service.

They fuelled the row by also accusing political leaders of “scapegoating” doctors as a means of “distracting the public from and under-funded service”.  The Daily Telegraph

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Too many children are sun tanned because parents are increasingly abandoning sun cream, NHS England warns

Too many children are sun tanned because parents are increasingly abandoning sun cream, NHS England warns The image of a sun-kissed child on a summer's day may strike most parents as the picture of health.

But health experts claim that a golden glow may be more harmful than it appears as they warn that too many children are becoming sun tanned because parents are increasingly abandoning sun cream.

The warning comes as research from NHS England and the Met Office found almost two fifths of parents mistakenly believe that suntans are a sign of good health.

NHS England said the findings showed a "worryingly relaxed attitude" towards sun care among the parents of young children, highlighting the fact that one in ten parents of children aged 2-7 admitting they have encouraged them to sunbathe.

The study, of 1,000 parents with children aged 11 and under, found that more than a fifth do not apply any sunscreen on their child until they are visibly starting to burn. The Daily Telegraph

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Monday 26 June 2017

'This will be the final straw': Northampton General Hospital volunteers asked to pay to park

'This will be the final straw': Northampton General Hospital volunteers asked to pay to park A number of NGH volunteers are considering resigning as a result of an 'unwarranted' parking charge at the hospital. Northampton Chronicle and Echo

Corby Urgent Care Centre operators say they won’t bid for new contract

Corby Urgent Care Centre operators say they won’t bid for new contract The operators of Corby’s Urgent Care Centre say they will not bid for a new contract to run the service unless they are given more money.

Lakeside+ Limited has run the centre since 2012 but became embroiled in a funding row in March, which led to fears over the centre’s future.

Corby CCG insisted that the centre would remain open and a tender process has opened for a new one-year contract, which would begin on October 1.

But Lakeside+ says it will not bid to run the centre unless the CCG meets NHS national tariffs and stops capping the sums it will pay. Northamptonshire Telegraph

NHS England announces new sites to redesign mental health services and cut out of area placements

NHS England announces new sites to redesign mental health services and cut out of area placements NHS England has announced a new tranche of sites to test new approaches to delivering mental health services – cutting the number of people travelling long distances for care.

Eleven new sites will be tasked with bringing down the number of people who receive in-patient hospital treatment and for those who do need more intensive care, that this is available closer to home.

The pilot sites, made up of NHS mental health trusts, independent sector and charitable organisations will work together, sharing a local budget, to effectively reorganise services in their area to provide the best care for patients.

Local managers and clinicians will take charge of managing budgets and providing inpatient and specialised mental health services, tailoring them to their area’s individual needs.

Enabling change through communities of practice

Enabling change through communities of practice In June 2014, National Voices set out to explore and test how communities of practice could facilitate the spread of large-scale change across England’s voluntary sector working for health and wellbeing. This report shares reflections on this project, and in the spirit of communities of practice, aims to share reflections in order that others can use the learning. National Voices

A Mental Health Act fit for tomorrow

A Mental Health Act fit for tomorrow Last summer, Rethink Mental Illness, along with members of the Mental Health Alliance, conducted the largest survey into the 34 year old Act. The message from the research was clear: the Act is no longer fit for purpose and there is a growing need for it to be reformed.

The research, the first of its kind, includes the views of over 8000 people who use mental health services, carers, and professionals working in the field. Half of those who responded did not think that people are treated with dignity and respect under the Mental Health Act.

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BMA chief: NHS is 'running on fumes'

BMA chief: NHS is 'running on fumes' The NHS in England is "running on fumes", the leader of the British Medical Association is warning.

Dr Mark Porter hit out at the government at the start of the union's annual conference.

He accused ministers of putting patients at risk and "picking the pockets" of NHS staff because of the squeeze on wages.

But ministers rejected the criticisms, saying they were putting more money into the health service. BBC News

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Wait for justice

Wait for justice Patients taking out private health insurance expect to get the best treatment, but what happens if things go wrong? While the NHS has paid out millions to the patients of disgraced breast surgeon Ian Paterson, his private patients are still seeking compensation. Why? BBC News

NHS hernia mesh repairs 'leaving patients in chronic pain'

NHS hernia mesh repairs 'leaving patients in chronic pain' NHS England is using mesh to repair hernias which leaves many patients in chronic pain, surgeons have told the BBC's Victoria Derbyshire programme.

The concerns come after it emerged that more than 800 women are taking legal action against the NHS over the use of vaginal mesh implants.

One woman said she was left "screaming on all fours from the agonising pain".

NHS England said mesh implants had been successfully used to treat hernias for several decades.

The material is its "recommended method" for treating the condition. It is used on tens of thousands of patients every year. BBC News

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NHS doctors turning to substance abuse amid rising levels of stress and burnout

NHS doctors turning to substance abuse amid rising levels of stress and burnout The number of GPs seeking specialist help for substance abuse and mental health problems is “increasing day on day”, the medical director of a new NHS support service for doctors has warned.

Referrals to the GP Health Service have surpassed expectations since its launch in late January, while medics in all fields are seeking help “in escalating numbers”, said Clare Gerada, former chair of the Royal College of GPs. Dr Gerada told The Independent stress and burn-out faced by family doctors with increasingly heavy workloads is contributing to the number of GPs developing severe depression and anxiety, with some turning to alcohol and substance misuse to cope with the pressure. The Independent

Difficulty of NHS language test ‘worsens nurse crisis’, say recruiters

Difficulty of NHS language test ‘worsens nurse crisis’, say recruiters Even native English speakers with degrees struggle to pass exams, as number of applicants from EU falls to 46 in April from 1,304 last July

Language tests introduced by the government to restrict immigration are stopping the NHS from recruiting foreign nurses – including highly qualified native English speakers.

Growing nursing shortages mean that the NHS has major gaps in its workforce, but this is being added to by Australians and other English-speaking nurses being turned down because they cannot pass the English tests. Continue reading... The Guardian

NHS and police failings led to brutal murder of grandmother – report

NHS and police failings led to brutal murder of grandmother – report Nicola Edgington, who had previously murdered her own mother, killed Sally Hodkin after series of failings

A series of failings by the NHS and police led to a psychiatric patient brutally murdering a grandmother, a report has concluded.

Nicola Edgington almost decapitated Sally Hodkin, 58, with a butcher’s knife in Bexleyheath, south-east London, in 2011, six years after killing her own mother. Continue reading... The Guardian

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Soaring obesity could see millenials die at younger age than their parents 

Soaring obesity could see millenials die at younger age than their parents Four in ten young adults in Britain are overweight or obese, according to new figures released by the NHS.

Nearly three million 16- to 24-year-olds weigh too much - a million more than two decades ago, the statistics reveal.

Doctors said the generation risked dying at a younger age than their parents, despite a host of medical breakthroughs in recent decades.

The figures from NHS Digital, show 39 per cent of 16- to 24-year-olds are overweight or obese, up from 27 per cent in 1993.

Soaring numbers have dangerously large waist sizes, the statistics reveal.

In total, 17 per cent of young men have a waist of at least 40 inches, compared with 4 per cent in 1993. The Daily Telegraph

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1,000 more psychiatrists needed to tackle 'unacceptable failings' in care 

1,000 more psychiatrists needed to tackle 'unacceptable failings' in care At least 1,000 more psychiatrists are needed to tackle “unacceptable” failings in treatment of the mentally ill, the head of the profession has said.

Sir Simon Wessely, president of the Royal College of Psychiatrists, called for urgent action to tackle widespread shortages of doctors, warning that he was “absolutely terrified” that the crisis would deepen as a result of Brexit.

Too many vulnerable patients were being sent for treatment hundreds of miles from home, because of shortages of specialists he said, with “scandalous” failings in some services.

In his final interview as president, he called for an overhaul of medical training, to plug widespread shortages of doctors which he fears will worsen if the supply of medics from Europe falls. The Daily Telegraph

Radical plans to ease NHS 999 targets amid mounting pressures 

Radical plans to ease NHS 999 targets amid mounting pressures Ambulances are set to be given far longer to reach 999 calls in a controversial bid to ease spiralling pressures on emergency services.

Handlers could be given four times as long to assess calls after a study of 10 million calls found too many cases being counted as hitting official targets, without patients getting the help they need.

Current rules state that 75 per cent of calls classed as life-threatening are supposed to receive a response within eight minutes. Before the clock starts, handlers have just 60 seconds to gather information - meaning they often send a response before crucial details have been established. The Daily Telegraph

Friday 23 June 2017

Careless smoker causes fire at Corby Urgent Care Centre

Careless smoker causes fire at Corby Urgent Care Centre Firefighters were called to Corby's Urgent Care Centre on Wednesday after a careless smoker set a plant alight. The incident took place outside the health centre in Cottingham Road at about 4.15am.

Lorna Garner, general manager at Lakeside Plus which runs the centre, says it could have been a lot worse and urged people not to smoke outside. Northamptonshire Telegraph

What should the new government prioritise for health and social care?

What should the new government prioritise for health and social care? The new government’s in tray is unusually full of pressing challenges, but what should it do on health and social care in England in this parliament?

No surprise that health didn’t feature prominently in today’s Queen Speech. Commitments were made to reform mental health legislation, as well as a framework to help improve patient safety. And the government is to press ahead with at least a consultation on improving social care.

Clearly preparations for Brexit and the cooling economic situation are rightly major preoccupations, and the legislative schedule will be pretty jammed with the former. In the meantime, the NHS has a Five Year Forward View and needs to get on with it without new priorities or distracting political interventions. The Health Foundation

Adult weight management: guidance for commissioners and providers

Adult weight management: guidance for commissioners and providers This collection of guidance, interventions and datasets aims to support commissioners and providers of tier two adult weight management services. The guidance outlines findings from qualitiative research providing insight into patient experience of weight management services, evidence to support commissioning, and further information on evidence-based behaviour change techniques. Public Health England

Review of two decades of social care policy

Review of two decades of social care policy This House of Commons Library briefing considers the policy proposals of successive Governments since 1997 for how individuals should pay for their social care.

What on earth is a vanguard?

What on earth is a vanguard? Cutting through modern-day NHS jargon is no mean feat, but one up-and-coming TV broadcaster has succeeded where the Jeremy Paxmans of this world have failed… meet Healthwatch Harriet. The tenacious 10-year-old has turned her sights on the NHS England new care models programme. NHS England

'Remarkable' drop in new HIV cases among men

'Remarkable' drop in new HIV cases among men For the first time, new diagnoses of HIV have fallen among men who have sex with men in England, according to data from Public Health England.

They have decreased from 2,060 in 2014-15 to 1,700 in 2015-16, while in London there was an even steeper drop.

PHE said increased testing, fast treatment with HIV therapy and the use of preventative drug Prep have all contributed to the trend.

New HIV diagnoses among heterosexuals have remained stable.

While huge advances have been made in treating HIV/Aids, there has been frustration at a lack of progress in reducing the number of men being diagnosed each year.

New infections in the UK had been stuck at about 3,000 every year in the five years up to 2015. BBC News

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Danger map reveals health threat zone

Danger map reveals health threat zone South America is a hotbed of potential viruses that could be the next major threat to the world's health, according to "danger maps".

The EcoHealth Alliance in New York looked at mammals, the viruses they harbour and how they come into contact with people.

It revealed bats carry more potential threats than other mammals.

The researchers hope the knowledge could be used to prevent the next HIV, Ebola or flu.

Some of the most worrying infections have made the jump from animals to people - the world's largest Ebola outbreak seemed to start in bats, while HIV came from chimpanzees. BBC News

Cost of NHS negligence claims likely to double by 2023, says study

Cost of NHS negligence claims likely to double by 2023, says study Medical society calls for legal changes, saying spiralling £1.5bn annual bill diverts significant funding from frontline care.

The annual cost to the NHS in England of settling clinical negligence claims is equivalent to training 6,500 doctors and is expected to double by 2023, according to the Medical Protection Society.

Further increases in the £1.5bn bill will render such payments unsustainable and divert significant amounts of funding away from frontline patient care, the organisation has warned in a report. Continue reading... The Guardian

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My friend's suicide, bureaucracy and cuts: why I quit as an NHS manager

My friend's suicide, bureaucracy and cuts: why I quit as an NHS manager I was driven to the brink by the poor care my friend received. I finally left over pointless tasks

The first time I thought I should leave the NHS and never return was at my friend’s inquest. After struggling with mental health issues for many years he had taken his own life. At his inquest, I learnt that in the period leading up to his suicide his mental health appointments had all been with support workers and he had not once seen a qualified mental health nurse. I also discovered that his last five appointments had been with four different members of staff. The coroner asked about the level of the service he had received. The manager of the service cited difficulties with a large geographical patch and described the service he received as usual practice. As an NHS manager myself, I could see it may have been usual practice, but it was far from good enough.

As I drove home from the inquest my head was spinning with dissonant thoughts and questions. I was angry and upset. I was concerned for the service manager. I was furious with government cuts. I was worrying about the service I managed. I needed the noise in my head to stop. I found myself contemplating killing myself. I did not sleep that night. I knew I was unwell and so the next day I saw my GP. I needed three months off work for severe depression and anxiety. I had excellent talking therapy via my GP surgery and my counsellor continued to support me through and beyond my return to work. Continue reading... The Guardian

Award for mental health professional who shared her own struggle with depression

Award for mental health professional who shared her own struggle with depression A former NHS mental health director has won an award for speaking out about her own breakdown.

Mandy Stevens told her story to Bryony Gordon on the Telegraph’s Mad World podcast, recalling a bout of depression so severe that she spent three months being treated as an in-patient.

She has received the Special Achievement Award from the Cavell Nurses’ Trust in recognition of her work de-stigmatising mental health. The Daily Telegraph

Thursday 22 June 2017

Kettering General Hospital whistleblower resigns as governor

Kettering General Hospital whistleblower resigns as governor A whistleblower who alleged that patients were removed from a hospital's waiting lists to "fiddle" the system has resigned as a governor.

David Phelan, a Kettering General Hospital Trust governor, said patients were removed from lists because national targets were being missed.

The governors were due to look at a resolution claiming his behaviour had breached its code of conduct.

But Mr Phelan decided to resign from his position as a governor.

The governors had stressed the decision to take action against him was not connected to his whistleblowing. BBC Northampton

Share your experiences with Northamptonshire's maternity services and reshape pregnancy care

Share your experiences with Northamptonshire's maternity services and reshape pregnancy care A survey has been opened to gather feedback on Northamptonshire's childbirth services for a national review to make pregnancy and labour a "personalised, kinder, professional and family friendly" experience.

Anyone or their partner who is pregnant or has recently given birth has been invited to complete the survey and share their experiences. Northampton Chronicle and Echo

You can find the survey here: https://www.surveymonkey.com/r/JR9V2R2 

Corby survey finds majority of people are unaware of planned NHS changes

Corby survey finds majority of people are unaware of planned NHS changes Fewer than one in five people in Corby have heard of a major plan which could radically change local health services, according to a survey.

NHS Corby Clinical Commissioning Group carried out its healthcare survey across the population it commissions health services for. It found that just 16 per cent of respondents had heard of the county’s Sustainability and Transformation Plan (STP).

The five-year STP contains proposals for a joining of health and social care in the county, but there has been criticism of a lack of transparency surrounding the drawing up of the plans.

The CCG says that although this is a small proportion, it is still notably higher than that indicated in national polls. Northamptonshire Telegraph

The hidden half: Bringing postnatal mental illness out of hiding

The hidden half: Bringing postnatal mental illness out of hiding It’s time to get postnatal mental illness out of hiding.

It’s common for new mothers to suffer from postnatal mental illness, but only half receive the treatment they need. This can be fixed with some simple and low-cost changes to our health system.

We surveyed 1,000 women who had recently had a baby and found that half had had a mental health or emotional problem postnatally or during pregnancy.

Read the full report here.

Of these women, nearly half hadn’t had their problem identified by a health professional and hadn’t received any help or treatment.

Many of these new mothers said they were too embarrassed or afraid of judgement to seek help.

95% of mothers who had a mental health problem said that this had an impact on their ability to cope as a mother or on their family. National Childbirth Trust

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Queen's speech 2017

Queen's speech 2017 A summary of the areas that impact on the NHS workforce, from the Queen's speech at the state opening of parliament. NHS Employers

A healthy state of mind: improving young people's mental fitness

A healthy state of mind: improving young people's mental fitness This report argues for reform of the mental health system to provide greater support for the majority of young people who will not receive treatment from specialist child and adolescent mental health services (CAMHS) whilst ensuring that those in desperate need of clinical intervention receive immediate help. Localis

First NHS proton beam machine arrives at Christie hospital

First NHS proton beam machine arrives at Christie hospital The machine that will enable the NHS's first proton beam therapy (PBT) unit to treat cancer patients will arrive later.

Manchester's Christie hospital will be the first NHS unit to provide the treatment, meaning patients needing PBT will no longer have to go abroad.

Up to 750 patients will use the new unit due to open in August 2018.

University College London Hospital (UCLH) is due to open its own PBT centre in 2020.

The government has invested £250m into building the two new NHS centres. Currently, only low-energy treatment is available in the UK for rare eye cancers.

Last year, the NHS sent 210 patients abroad for PBT - mostly to the US and Switzerland - at a cost of about £114,000 each. BBC News

Ninth avoidable baby death at NHS trust

Ninth avoidable baby death at NHS trust A ninth avoidable baby death has been uncovered by BBC News at a troubled NHS trust.

Maddison Dawn Wilkins Jackson died in 2013 after staff at the Royal Shrewsbury Hospital could not find her mother a bed on the labour ward.

The health secretary ordered an investigation into maternity services at the Shrewsbury and Telford Hospital NHS Trust in April.

The trust says it has apologised to Maddison's family for her death.

A new report from the Royal College of Obstetricians and Gynaecologists says that poor care was responsible for hundreds of babies across the UK either dying in labour or suffering severe brain injuries.

The report's conclusions appear to chime with the experience of Maddison's parents. BBC News

GP recruitment is rising and more on track to hit target levels, says HEE

GP recruitment is rising and more on track to hit target levels, says HEE 'Good progress' has been made on GP recruitment, with more than 100 additional places filled compared to last year, Health Education England (HEE) has said. GPonline

Britain's unregulated plastic surgery industry 'targeting children and causing mental health problems'

Britain's unregulated plastic surgery industry 'targeting children and causing mental health problems' The largely unregulated British cosmetic surgery industry is a “cause for serious concern”, especially for children targeted by advertising and online plastic surgery games, health experts have warned.

A new report from the Nuffield Council of Bioethics highlights increasing concerns over anxiety related to unachievable appearance ideals – with young people said to be “bombarded” by promotion of breast implants, nose jobs, and non-surgical procedures such as botox and laser hair removal.

The think tank called for all cosmetic surgeons to be properly trained and certified, for a ban on non-medical invasive procedures for patients under 18, and for evidence of safety and effectiveness to be required for dermal fillers and implants. The Independent

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Cheshire cancer patients 'could die sooner' if NHS cuts are forced through

Cheshire cancer patients 'could die sooner' if NHS cuts are forced through Cost-cutting plans could see waiting times shoot up and risk patients’ chance of survival, doctors and charities warn

Cancer patients in Cheshire could die sooner because they will end up waiting longer for urgent hospital treatment if NHS regulators push through controversial cost-cutting plans, it has been claimed.

Doctors and cancer charities have criticised recommendations by NHS England and NHS Improvement that hospitals in the county cut the amount of endoscopies – internal examinations used to diagnose illness – they undertake by 25%. Continue reading... The Guardian

I’m at the sharp end of A&E. The recent attacks make it like working in a war zone | Saleyha Ahsan

I’m at the sharp end of A&E. The recent attacks make it like working in a war zone | Saleyha Ahsan In the emergency services we’re constantly braced for the next big disaster. Everyone has to pull together against the odds – but we need more support

You can’t move for breaking news headlines these days and within the emergency services we brace ourselves for what it might be. It’s not just news for us – we could end up being directly involved.

This week we woke to news of the attack in Finsbury Park. The result – one death and 10 injured, all distributed to major trauma centres within London. One trauma call will need manpower of up to 10 people around the bed, then you’ve got those needed for the CT scans to run, the urgent blood tests, blood supplies and the labs urgently cross matching samples. It can, in those early hours, take at least 20 people. And that’s without including the surgical and intensive therapy unit (ITU) teams needed for poly-trauma patients, typical from a major incident, so multiply that number by 10. But we don’t have 200 people in one place to do all that. So things get shared, redistributed and there’s plenty of concurrent activity. It’s an exercise of open communications, thinking on your feet and leadership. Sadly, the teams are getting used to it. Continue reading... The Guardian

Draconian NHS plans to save £200 million

Draconian NHS plans to save £200 million The plans have been drawn up by managers running the 'North Central London' area which serves the London boroughs of Camden, Islington, Barnet, Enfield and Haringey. The Daily Mail

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Wednesday 21 June 2017

Teamwork in maternity units key to reducing baby deaths and brain injuries during childbirth

Teamwork in maternity units key to reducing baby deaths and brain injuries during childbirth Adherence to best practice on fetal monitoring and neonatal care also identified as crucial to improving outcomes.

A detailed analysis of all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015 has identified key clinical actions needed to improve the quality of care and prevent future cases, reveals a summary report from the Each Baby Counts initiative.

Each Baby Counts is a national quality improvement programme, launched in October 2014, aiming to halve the number of babies who die or are left severely disabled as a result of preventable incidents occurring during term labour (after 37 weeks) by 2020.

The investigation team has now conducted 2,500 expert assessments of the local reviews into the care of 1,136 babies born in the UK in 2015 – 126 who were stillborn, 156 who died within the first seven days after birth and 854 babies who met the eligibility criteria for severe brain injury*.

The reviewers concluded that three quarters of these babies - 76% - might have had a different outcome with different care. This finding was based on 727 babies where the local investigation provided sufficient information to draw conclusions about the quality of care. A quarter of the local investigations were not thorough enough to allow full assessment. Royal College of Obstetricians and Gynaecologists

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Getting the dementia pathway right

Getting the dementia pathway right In this scenario – using a fictional patient, Tom – we examine a dementia care pathway, comparing a sub-optimal but not atypical scenario against an ideal pathway. At each stage we have modelled the costs of care, to the commissioner and the impact on the person and their family’s outcomes and experience. NHS RightCare

Juniors doctor morale: Understanding best practice working environments

Juniors doctor morale: Understanding best practice working environments As part of the work to enhance junior doctors’ working lives, Health Education England undertook a listening exercise to gather together the themes affecting junior doctors’ morale and to understand their experiences of the best training environments.

The report highlights the work taking place across the NHS to address these themes, and suggests ways for health organisations to move forward. In so doing, it seeks to move the conversation forwards towards tangible changes for doctors in training. There is also an accompanying case study.

Experts write manifesto for evidence-based medicine

Experts write manifesto for evidence-based medicine Experts have produced their ‘manifesto for evidence-based medicine’ in response to what they say is the systematic bias, wastage, error, and fraud in the research that underpins patient care. They lament the questionable integrity of much of today’s evidence, the lack of research answering questions that matter to patients, and the lack of relevant evidence to inform patients’ and clinicians’ shared decision-making, and have called for a series of measures to help rectify the situation.

The authors of the editorial, in The BMJ, from the Centre for Evidence Based Medicine at the University of Oxford and The BMJ itself, argue that too many research studies are poorly designed or executed, and too much of the resulting research evidence is withheld or disseminated piecemeal. OnMedica

Number of GP practices drops by more than 650 in four years

Number of GP practices drops by more than 650 in four years The number of GP practices in England has dropped by more than 650 in the four years since NHS England was founded, while average list sizes have risen by around 900 patients, official data suggest. GPonline

The NHS must act to tackle its looming workforce crisis

The NHS must act to tackle its looming workforce crisis Vacancies, an increase in demand for services, workplace pressure and low morale could be worse than funding issues

The workforce crisis enveloping the NHS could soon eclipse funding as the most serious problem.

There are tens of thousands of vacancies, far too few new staff are coming through; the pressure on those in post is relentless and morale is dangerously low. Continue reading... The Guardian

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Funding alone won’t fix the social care system

Funding alone won’t fix the social care system Alzheimer’s Society is investing in three new research centres of excellence that aim to find ways to improve quality of life and care

The election campaign led the public to the misconception that the “dementia tax” is a new issue. The reality is that decades of squeezed government funding have left people with dementia and their families enduring inadequate care, crippling costs and impossible choices. The Queen’s speech on Wednesday will hopefully promise to create a long-term, sustainable system for funding dementia care that doesn’t leave the burden of cost on individuals.

But fixing the system goes beyond funding. The government needs to adopt a more cost-effective approach that starts with preventing or slowing the rate that people need to access services. Investing money in ways to improve quality of life – and the quality of support people affected by dementia receive from the start of the care pathway – will alleviate the demand and reduce the costs incurred at a later stage. Continue reading... The Guardian

Pets should be allowed to visit their owners in hospital, senior nurses say

Pets should be allowed to visit their owners in hospital, senior nurses say Pets should be allowed to visit owners in hospital, and animal therapy offered to patients to boost mental and physical health, the Royal College of Nurses says.

New guidance will for the first time encourage hospitals to be more welcoming to four-legged friends, and to introduce “animal-assisted therapy” to calm the nerves of anxious patients.

A survey of 750 nurses found almost half had worked with animals - including ponies and chipmunks, as well as cats and dogs - at some point in their careers. In total, 82 per cent said that animals – dogs in particular – encouraged patients to be more physically active, while nearly 60 per cent said their presence appeared to speed physical recovery. The Daily Telegraph

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Tuesday 20 June 2017

Sustainability and Transformation Plans: How serious are the proposals? A critical review

Sustainability and Transformation Plans: How serious are the proposals? A critical review This report critically reviews each of the 44 STPs in terms of how they stand as serious, coherent and achievable plans. Each was subject to the levels of rigorous appraisal you would expect for ant set of NHS planning documents. The researchers were looking for clear expert evidence, how the plans matched population needs, the resources required, the key assumptions in the overall approach, and how local accountability operates across the footprint. Overall the report finds that the STPs are not ready for implementation, with the plans lacking a secure grounding in the current situation, and a robust evidence base to the changes proposed. Significant developments in the relationship between the NHS and Local Government are required and this will take time. The emphasis on reducing acute beds and A&E attendance will require local consultation. Legislative change is also required to free health and care from the constraints of the market to provide integrated quality care for local populations. Finally there is a significant funding shortfall, and a need for clear and robust workforce plans. London Southbank University

Action needed to prevent confusion over medicines

Action needed to prevent confusion over medicines Only about a third (37%) of the public trust evidence from medical research, compared to approximately two-thirds (65%) who trust the experiences of their friends and family*, according to a report launched today.

The new report highlights the significant difficulties patients and some healthcare professionals face in using evidence from research to judge the benefits and harms of medicines, and calls for concerted action to improve the information patients receive.

The report was instigated following public debate around the benefits and harms of treatments such as statins, hormone replacement therapy and Tamiflu. It calls for a range of actions including significant improvements to patient information leaflets, better use of medical appointments and a bigger role for NHS Choices as the ‘go to’ source of trusted information online for patients and carers, as well as healthcare professionals. The Academy of Medical Sciences

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Where next for commissioning?

Where next for commissioning? This report is the first in a series which promotes the views of leaders from a range of trusts and other parts of the service on some of the key issues facing the NHS today. The report includes eight interviews that address concerns including the role of STPs and accountable care systems, the challenge of integrating health and care commissioning, and the future of the purchaser-provider split. Contributors include leaders of hospital, mental health and community trusts and ambulance services, with additional perspectives from a CCG and local government. NHS Providers