Stuck at home: the impact of day service cuts on people with a learning disability:
This report finds that nearly a third of local authorities have closed day services in the last three years which results in one in four adults with a learning disability now spending less than one hour a day outside of their home due to these cuts.
Wednesday, 23 May 2012
NICE guideline to standardise opioid use in palliative care and address patient's concerns
NICE guideline to standardise opioid use in palliative care and address patients? concerns: A new clinical guideline published today (23 May) by the National Institute for Health and Clinical Excellence (NICE), will help ensure safe and consistent prescribing of opioids as a first-line treatment option to relieve pain for patients receiving palliative care for chronic or incurable illnesses. NICE
NHS education reforms 'lack detail' - The Press Association
NHS education reforms 'lack detail' - The Press Association:
NHS education reforms 'lack detail' The Press Association The Government's plans to reform education and training in the NHS are unclear and lack detail, MPs have warned. The health select committee said the success of Health Education England (HEE), which will oversee the training across services in England, ... GP training plans lack crucial detail, MPs sayGP online MPs criticise delays in education and training reformHealth Service Journal all 3 news articles » |
Health watchdog: extend IVF treatment to older women
Health watchdog: extend IVF treatment to older women: Sir Andrew Dillon, the CEO of the National Institute for Health and Clinical Excellence (Nice) explains why the NHS should provide IVF to women over 40 and same-sex couples.
The Daily Telegraph
The Daily TelegraphHealth care assistants 'must be registered' say MPs
Health care assistants 'must be registered' say MPs: Patients are being put at risk because health care assistants (HCAs) who make serious mistakes are not banned from the profession, MPs warn today.
The Daily Telegraph
The Daily Telegraph
Diabetes timebomb: Only half of NHS patients receiving acceptable care
Diabetes timebomb: Only half of NHS patients receiving acceptable care:
Sweeping variations in standards of care for diabetic patients is costing thousands of lives and wasting tens of millions of pounds every year, the government’s spending watchdog reveals. The Independent
Sweeping variations in standards of care for diabetic patients is costing thousands of lives and wasting tens of millions of pounds every year, the government’s spending watchdog reveals. The Independent
Patients to get choice of where they have medical tests
Patients to get choice of where they have medical tests:
Patients will be able to choose where they have essential medical tests under a new scheme announced today. The Independent
Patients will be able to choose where they have essential medical tests under a new scheme announced today. The Independent
Tuesday, 22 May 2012
Race equality in mental health
Race equality in mental health:
The report is based on a series of interviews with NHS and local authority leaders.
Ensuring that more people have good mental health, and more people recover, means we must focus on tackling inequalities in access and experience. Some black and minority ethnic (BME) groups, particularly people from black African and black Caribbean backgrounds, have historically experienced poorer outcomes than the rest of the population. Some groups continue to have higher rates of admission to inpatient units and greater rates of detention than the rest of the population.
The report is based on a series of interviews with NHS and local authority leaders.
Ensuring that more people have good mental health, and more people recover, means we must focus on tackling inequalities in access and experience. Some black and minority ethnic (BME) groups, particularly people from black African and black Caribbean backgrounds, have historically experienced poorer outcomes than the rest of the population. Some groups continue to have higher rates of admission to inpatient units and greater rates of detention than the rest of the population.
NHS trust fined for data breach
NHS trust fined for data breach: An NHS trust is fined £90,000 after details of 59 patients were mistakenly sent to a member of the public.BBC News
Patients 'suffer NHS rationing'
Patients 'suffer NHS rationing': Creeping rationing of NHS care is making patients suffer unnecessarily, doctors are warning. BBC News
The power of information: putting all of us in control of the health and care information we need
The power of information: putting all of us in control of the health and care information we need:
This information strategy from the Department of Health sets a ten-year framework for transforming information for the NHS, public health and social care. One of the key commitments is that patients will be able to view their GP record online by 2015.
This information strategy from the Department of Health sets a ten-year framework for transforming information for the NHS, public health and social care. One of the key commitments is that patients will be able to view their GP record online by 2015.
Hospital food will improve
Hospital food will improve:
The Health Secretary has told the BBC that the government is working on improving "buying standards" for hospital food given to patients in the NHS.Andrew Lansley informed the Andrew Marr Show that the government's efforts would mean "better nutrition for patients".He said that during the time the Labour government was in power from 2001 to 2010, the amount of patients who suffered from maln... Healthcare Today
The Health Secretary has told the BBC that the government is working on improving "buying standards" for hospital food given to patients in the NHS.Andrew Lansley informed the Andrew Marr Show that the government's efforts would mean "better nutrition for patients".He said that during the time the Labour government was in power from 2001 to 2010, the amount of patients who suffered from maln... Healthcare Today
King's Fund warns of challenges to new NHS information strategy
King's Fund warns of challenges to new NHS information strategy:
NHS commissioners will find it 'challenging' to invest in IT to meet new government strategy, says think-tank
The King's Fund has warned that implementation of the government's long-awaited NHS information strategy raises technical and financial challenges and will rely on the pace and scale of local take up.
"While we welcome the ambition and direction of the strategy, at a time of unprecedented financial constraint, some commissioners and providers will find it challenging to invest in developing information systems rather than frontline services," said Dr Veena Raleigh, a senior fellow at the health think-tank.
"The goal of linking health and social care records is the right one and is vital for facilitating integrated care to meet the needs of older people and those with chronic conditions. However, while there are some outstanding examples of linking records across services to draw on, implementing this on a national scale raises technical and financial challenges and much will depend on the pace and scale of local take up."
Titled, The power of information: putting all of us in control of the health and care information we need, the document says that the success of the strategy depends as much on a culture shift – in the way patients, users of services and professionals think, work and interact – as it does on data or IT systems.
Intended as a 10-year framework to transform information for health and care, and a response to the consultation on Liberating the NHS: an information revolution, the strategy sets out deadlines for changes.
By 2015, all general practices will be expected to enable patients to book and cancel appointments, order repeat prescriptions, and access their records online.
Currently more then 50% of general practices use IT systems that are capable of providing patients with electronic access to their own records, but less than 1% offer this service.
The document also sets out an aim to develop integrated health and social care networks, when technology is available to enable this. It acknowledges that many health and social care IT systems currently have their own 'standards' and do not work together.
"Using digital and online services can simplify the more routine aspects of care, such as booking appointments, requesting repeat prescriptions, or self-assessment for social care," says health secretary Andrew Lansley in a forward to the document.
"The strategy sets out ways to reduce the frustrations we experience, such as repeating or recording the same information many times for different staff, or travelling long distances for services that could be delivered better in other ways."
The document acknowledges, however, that some GPs may decide that they can only provide online access to records from a specific date onward, rather than access to historical information "which may not have been written with patient access in mind".
By 2014 the Department of Health and NHS Commissioning Board will pilot new ways to promote the use of integrated barcode medication administration systems in care homes. The results will inform the planning of wider implementation.
From 2013 a single portal will bring together information and online services currently provided by NHS Choices, NHS Direct online, NHS 111 online content and Healthspace. The plan is that, together with the 999 and 111 telephone services, it will be one of only three main ways for patients to access help and information about health and social care.
In terms of taking the strategy forward, actions such as setting common standards to allow information to flow effectively around the system, will be led nationally.
More detailed implementation planning will be led by organisations including the NHS Commissioning Board, the NHS Health and Social Care Information Centre, and Public Health England.
"This strategy represents a detailed repudiation of the centralised National Programme for IT," said SA Mathieson, a senior healthcare analyst for market intelligence provider Kable. "In future, except for some national infrastructure, it will be up to individual trusts and surgeries to equip themselves, although there will be some financial help from the department.
"Patients should get a much better service online, but the careful choice of 'digital first' rather than 'digital by default' recognises that many NHS users will want to use offline methods for many years to come."
Guardian Professional.
The King's Fund has warned that implementation of the government's long-awaited NHS information strategy raises technical and financial challenges and will rely on the pace and scale of local take up.
"While we welcome the ambition and direction of the strategy, at a time of unprecedented financial constraint, some commissioners and providers will find it challenging to invest in developing information systems rather than frontline services," said Dr Veena Raleigh, a senior fellow at the health think-tank.
"The goal of linking health and social care records is the right one and is vital for facilitating integrated care to meet the needs of older people and those with chronic conditions. However, while there are some outstanding examples of linking records across services to draw on, implementing this on a national scale raises technical and financial challenges and much will depend on the pace and scale of local take up."
Titled, The power of information: putting all of us in control of the health and care information we need, the document says that the success of the strategy depends as much on a culture shift – in the way patients, users of services and professionals think, work and interact – as it does on data or IT systems.
Intended as a 10-year framework to transform information for health and care, and a response to the consultation on Liberating the NHS: an information revolution, the strategy sets out deadlines for changes.
By 2015, all general practices will be expected to enable patients to book and cancel appointments, order repeat prescriptions, and access their records online.
Currently more then 50% of general practices use IT systems that are capable of providing patients with electronic access to their own records, but less than 1% offer this service.
The document also sets out an aim to develop integrated health and social care networks, when technology is available to enable this. It acknowledges that many health and social care IT systems currently have their own 'standards' and do not work together.
"Using digital and online services can simplify the more routine aspects of care, such as booking appointments, requesting repeat prescriptions, or self-assessment for social care," says health secretary Andrew Lansley in a forward to the document.
"The strategy sets out ways to reduce the frustrations we experience, such as repeating or recording the same information many times for different staff, or travelling long distances for services that could be delivered better in other ways."
The document acknowledges, however, that some GPs may decide that they can only provide online access to records from a specific date onward, rather than access to historical information "which may not have been written with patient access in mind".
By 2014 the Department of Health and NHS Commissioning Board will pilot new ways to promote the use of integrated barcode medication administration systems in care homes. The results will inform the planning of wider implementation.
From 2013 a single portal will bring together information and online services currently provided by NHS Choices, NHS Direct online, NHS 111 online content and Healthspace. The plan is that, together with the 999 and 111 telephone services, it will be one of only three main ways for patients to access help and information about health and social care.
In terms of taking the strategy forward, actions such as setting common standards to allow information to flow effectively around the system, will be led nationally.
More detailed implementation planning will be led by organisations including the NHS Commissioning Board, the NHS Health and Social Care Information Centre, and Public Health England.
"This strategy represents a detailed repudiation of the centralised National Programme for IT," said SA Mathieson, a senior healthcare analyst for market intelligence provider Kable. "In future, except for some national infrastructure, it will be up to individual trusts and surgeries to equip themselves, although there will be some financial help from the department.
"Patients should get a much better service online, but the careful choice of 'digital first' rather than 'digital by default' recognises that many NHS users will want to use offline methods for many years to come."
Guardian Professional.
Growing number of hospital patients are malnourished when they die
Growing number of hospital patients are malnourished when they die: The number of people dying in hospital while malnourished has risen by half in 10 years, affecting more than 2,500 people in a decade, official figures have shown.
The Daily Telegraph
The Daily TelegraphJobseekers NHS patient care scheme 'health care on the cheap'
Jobseekers NHS patient care scheme 'health care on the cheap': A scheme in which unpaid jobseekers help deliver patient care on NHS hospital wards was attacked last night as being akin to health care "on the cheap".
The Daily Telegraph
The Daily TelegraphPatients able to compare treatment by GPs online
Patients able to compare treatment by GPs online:
Patients will be able to compare the performance of their local family doctors and nearby hospitals on a single website, under plans to bring the NHS into the information age. The Independent
Patients will be able to compare the performance of their local family doctors and nearby hospitals on a single website, under plans to bring the NHS into the information age. The Independent
Budget cuts may hit free IVF treatment
Budget cuts may hit free IVF treatment:
Tens of thousands more infertile couples could be entitled to free IVF treatment on the NHS from later this year, but budget shortfalls mean many are likely to find themselves excluded. The Independent
Tens of thousands more infertile couples could be entitled to free IVF treatment on the NHS from later this year, but budget shortfalls mean many are likely to find themselves excluded. The Independent
New website to help clinicians integrate physical and mental healthcare
New website to help clinicians integrate physical and mental healthcare:
Four medical royal colleges have launched a new website giving health professionals easy access to clinical resources to support the provision of integrated physical and mental health care.
A strong body of evidence shows that mental illness is associated with poor physical health. People with mental illness die on average 5-10 years younger than the general population, and people with medical unexplained symptoms account for around 20% of new presentations in primary care. Yet it can be hard for clinicians to find the right information to help them address these issues.
read more
Four medical royal colleges have launched a new website giving health professionals easy access to clinical resources to support the provision of integrated physical and mental health care.
A strong body of evidence shows that mental illness is associated with poor physical health. People with mental illness die on average 5-10 years younger than the general population, and people with medical unexplained symptoms account for around 20% of new presentations in primary care. Yet it can be hard for clinicians to find the right information to help them address these issues.
read more
Monday, 21 May 2012
Change of telephone number at Isebrook Library
Change of telephone number at Isebrook Library:
The Library at Isebrook Hospital now has a new phone number. You can call us on 01933 235862 from an outside phone.
If you are calling us from Highfield, Francis Crick, Bevan House, Danetre and Isebrook Hospital just dial extension 3562.
 |
| Nene House |
If you are calling us from Highfield, Francis Crick, Bevan House, Danetre and Isebrook Hospital just dial extension 3562.
Work to raise care standard
Work to raise care standard:
ERRORS by hospitals are putting the lives of patients with diabetes in danger, according to research. Evening Telegraph
ERRORS by hospitals are putting the lives of patients with diabetes in danger, according to research. Evening Telegraph
Heatwave Plan for England 2012 published
Heatwave Plan for England 2012 published:
The Heatwave Plan and accompanying guidance is intended to raise public and professional awareness on how to prepare in case of severe hot weather and potential heatwaves this summer.
The Plan has been developed in partnership with the Health Protection Agency, and is supported by the Met Office. It sets out the risks to health of exposure from severe heat, and the steps people can take to protect their own health, and to reduce the risks of illness and death in the most vulnerable people.
This year there is a specific focus on large scale public events in light of the events and celebrations planned this summer, and to provide advice during Ramadan, which this year falls over the summer period.
The accompanying guidance published alongside the Heatwave Plan includes:
Download Heatwave plan for England 2012 and accompanying documents
Department of Health
The Heatwave Plan and accompanying guidance is intended to raise public and professional awareness on how to prepare in case of severe hot weather and potential heatwaves this summer.
The Plan has been developed in partnership with the Health Protection Agency, and is supported by the Met Office. It sets out the risks to health of exposure from severe heat, and the steps people can take to protect their own health, and to reduce the risks of illness and death in the most vulnerable people.
This year there is a specific focus on large scale public events in light of the events and celebrations planned this summer, and to provide advice during Ramadan, which this year falls over the summer period.
The accompanying guidance published alongside the Heatwave Plan includes:
- an Equality Analysis
- a ‘Making the Case’ document which outlines the impacts of heat on health
- Heatwave: looking after yourself and others during hot weather (2011) – a public information factsheet
- Heatwave: supporting vulnerable people before and during a heatwave – advice for health and social care professionals (2012)
- Heatwave: supporting vulnerable people before and during a heatwave – advice for care home managers (2012)
Download Heatwave plan for England 2012 and accompanying documents
Department of Health
NHS hospital food 'will improve'
NHS hospital food 'will improve': Health Secretary Andrew Lansley insists the quality of hospital food in England will improve, after criticism of the nutritional value of meals currently offered. BBC News
Calls to mental health lines rise
Calls to mental health lines rise: Mental health charities say they have seen a surge in calls to their helplines since the start of the recession. BBC News
New NHS Information strategy unveiled
New NHS Information strategy unveiled: The new NHS Information strategy, published today, says patients will be able to book doctors' appointments and check test results online, and access their GP records online and by smart phone within three years. E-Health Insider
GMC publish report on implementing revalidation
GMC publish report on implementing revalidation: The General Medical Council (GMC) has published a report on the implementation of revalidation, subject to legislation being agreed by the Secretary of State for Health. NHS Employers
Alive and clicking: information that benefits all
Alive and clicking: information that benefits all:
This paper explores the potential for using and sharing information in the NHS. It looks at the costs and benefits of informing and communicating with patients through web and social media platforms versus the costs of not doing so effectively.
This paper explores the potential for using and sharing information in the NHS. It looks at the costs and benefits of informing and communicating with patients through web and social media platforms versus the costs of not doing so effectively.
Debt 'putting off' medical students, BMA warns - BBC News
Debt 'putting off' medical students, BMA warns - BBC News:
 BBC News | Debt 'putting off' medical students, BMA warns BBC News He urged delegates to fight government plans to change the NHS pension scheme. Health minister Simon Burns said pension reform was "necessary". Ballot papers are being sent to 103000 BMA members. It is the first time doctors have been balloted for ... and more » |
Up to 1,000 new doctors could face unemployment
Up to 1,000 new doctors could face unemployment: Up to 1,000 new doctors will face unemployment next year as there are too few training places available, it has been warned.
The Daily Telegraph
The Daily TelegraphGPs go online to end '8am rush'
GPs go online to end '8am rush': Patients are to be allowed to book GP appointments online as part of an attempt by ministers to make the NHS more "customer friendly".
The Daily Telegraph
The Daily TelegraphMost GPs can't recognise signs of Alzheimer's
Most GPs can't recognise signs of Alzheimer's:
Dementia will kill one in three people over 65, but a survey of GPs reveals that almost two-thirds admit they are not properly taught to recognise the signs of it. The Independent
Dementia will kill one in three people over 65, but a survey of GPs reveals that almost two-thirds admit they are not properly taught to recognise the signs of it. The Independent
Friday, 18 May 2012
Alliance aims to deal with dementia
Alliance aims to deal with dementia:
GROUPS and organisations are set to come together to try and improve life for thousands of people living with dementia in Northamptonshire. Evening Telegraph
GROUPS and organisations are set to come together to try and improve life for thousands of people living with dementia in Northamptonshire. Evening Telegraph
Digital service launched for new parents
Digital service launched for new parents:
The NHS Information Service for Parents, launched today by the Prime Minister, will give new parents information and advice they can trust covering a wide range of issues related to staying healthy in pregnancy, preparing for birth and looking after their baby.
By signing up to the service, parents-to-be and new parents will receive regular emails and text messages containing relevant and timely NHS approved advice as their pregnancy develops and as their child grows.
Links to videos showing midwives demonstrating practical advice such as bathing your baby, and parents discussing issues that affected them and how they supported each other, will also be sent at appropriate times.
The care and attention a child receives when young will affect their health, behaviour and ability to learn throughout their lives. A recent survey suggests that 85% of parents want more practical help on caring for their baby to provide the best possible start for their children.
Parents will be invited to sign up to the new service at booking appointments with midwives, and organisations where parents already go for advice and support will have the option of including a sign-up facility directly on their own websites.
Prime Minister David Cameron said:
The National Childbirth Trust, Coram, Save the Children, and the Fatherhood Institute are among those who are delivering the classes.
Up to £5m has been made available for the trial which runs until March 2014. This includes funding for redemption of parenting class vouchers and an independent evaluation.
The trial will help government understand how classes could be made available to every parent. Decisions on national roll out will be informed by the independent evaluation.
Research shows that the birth of a new child can be a stress point for couples. A trial starting in July will offer subsidised relationship support sessions for all expectant mothers and fathers and those with children up to the age of 2 in the trial areas:
Parents will have the choice of face to face and/or online support and the trial will be managed and promoted by the National Childbirth Trust.
The aim is to encourage couples to feel that it is normal to access relationship support in the first few years of their child’s life – just as they would go to an antenatal class.
The offer will be distributed by professionals working in the early years – for example, from nurseries, children’s centres, midwives and health visitors.
Up to £1m has been made available for the trial, which will run until March 2014. Department of Health
The NHS Information Service for Parents, launched today by the Prime Minister, will give new parents information and advice they can trust covering a wide range of issues related to staying healthy in pregnancy, preparing for birth and looking after their baby.
By signing up to the service, parents-to-be and new parents will receive regular emails and text messages containing relevant and timely NHS approved advice as their pregnancy develops and as their child grows.
Links to videos showing midwives demonstrating practical advice such as bathing your baby, and parents discussing issues that affected them and how they supported each other, will also be sent at appropriate times.
The care and attention a child receives when young will affect their health, behaviour and ability to learn throughout their lives. A recent survey suggests that 85% of parents want more practical help on caring for their baby to provide the best possible start for their children.
Parents will be invited to sign up to the new service at booking appointments with midwives, and organisations where parents already go for advice and support will have the option of including a sign-up facility directly on their own websites.
Prime Minister David Cameron said:
“Parents are nation-builders. It’s through love and sheer hard work that we raise the next generation with the right values. That’s why this government is doing everything possible to support parents.Health Secretary Andrew Lansley said:
“We’re focused on making life easier for parents day-to-day, from extending childcare to increasing the number of health visitors. The parenting classes and films we’re launching this week are an important part of that, providing clear, professionally-led advice on everything from teething to tantrums.”
“We all want to give our children the best start in life. But sometimes, particularly for first-time parents, bringing a new baby home can be a daunting as well as a happy experience.Visit www.nhs.uk/parents to sign up to the service or to find out more.
“That is why we are determined to help people become more confident in becoming a parent – from pregnancy to the start of their children’s lives.
“From now on, this new information service will be at parents’ sides to support them in the first stage of their child’s journey, guiding them with relevant information and first-hand experience from other parents.”
Free parenting classes
Free parenting classes are also being made available for all parents of children aged 5 years and under in 3 trial areas:- Middlesbrough
- High Peak in Derbyshire
- Camden in London
The National Childbirth Trust, Coram, Save the Children, and the Fatherhood Institute are among those who are delivering the classes.
Up to £5m has been made available for the trial which runs until March 2014. This includes funding for redemption of parenting class vouchers and an independent evaluation.
The trial will help government understand how classes could be made available to every parent. Decisions on national roll out will be informed by the independent evaluation.
Relationship support for first-time parents
To support first-time parents with the transition to parenthood, expert organisations will deliver relationship support sessions in 4 trial areas of the country from this summer.Research shows that the birth of a new child can be a stress point for couples. A trial starting in July will offer subsidised relationship support sessions for all expectant mothers and fathers and those with children up to the age of 2 in the trial areas:
- York and Leeds
- North Essex
- Hackney and City of London
- Islington and Westminster
Parents will have the choice of face to face and/or online support and the trial will be managed and promoted by the National Childbirth Trust.
The aim is to encourage couples to feel that it is normal to access relationship support in the first few years of their child’s life – just as they would go to an antenatal class.
The offer will be distributed by professionals working in the early years – for example, from nurseries, children’s centres, midwives and health visitors.
Up to £1m has been made available for the trial, which will run until March 2014. Department of Health
Why we should talk more about death
Why we should talk more about death: Why doctors should talk more about death BBC News
Health secretary says GPs have 'ethical duty' to save NHS costs
Health secretary says GPs have 'ethical duty' to save NHS costs: GPs have an 'ethical duty' to save NHS costs and must be transparent about how they are spending taxpayers' money, health secretary Andrew Lansley has said. GP Online
''50,000 fewer patients wait over 18 weeks''
''50,000 fewer patients wait over 18 weeks'': New stats show an average wait for admitted patients of 8.1 weeks, lower than it was in May 2010 Public Service
Mortality among inpatients with diabetes: key findings for England
Mortality among inpatients with diabetes: key findings for England:
This analysis of mortality among inpatients with diabetes used data on over 13 million hospital admissions to assess case-mix and risk factors for inpatient mortality and identify trust level variation in the risk of an inpatient with diabetes dying.The key finding of this analysis was that inpatients with diabetes are 10% more likely to die than those without the condition.
This analysis of mortality among inpatients with diabetes used data on over 13 million hospital admissions to assess case-mix and risk factors for inpatient mortality and identify trust level variation in the risk of an inpatient with diabetes dying.The key finding of this analysis was that inpatients with diabetes are 10% more likely to die than those without the condition.
More help for women with postnatal depression
More help for women with postnatal depression:
The NHS is set to offer more support to women who have postnatal depression or who have suffered a miscarriage, stillbirth or the death of a baby.
The government has announced that it will recruit an extra 4,200 health visitors, who will be given enhanced training to help them spot the early signs of postnatal depression.
The health visitors, who provide services for expectant and new parents after they... Healthcare Today
The NHS is set to offer more support to women who have postnatal depression or who have suffered a miscarriage, stillbirth or the death of a baby.
The government has announced that it will recruit an extra 4,200 health visitors, who will be given enhanced training to help them spot the early signs of postnatal depression.
The health visitors, who provide services for expectant and new parents after they... Healthcare Today
Half of hospital costs are on over-60s
Half of hospital costs are on over-60s:
Analysis of the Hospital Episode Statistics payment by results (PbR) data has revealed that the over-60s account for nearly half of hospital admissions in England and more than half of hospital income from admissions.
Figures show that 43% of all hospital admissions paid under mandatory PbR were of people aged over 60 and accounted for £10.9bn, or 51% of hospitals’ income from admissions that attracted a manda... Healthcare Today
Analysis of the Hospital Episode Statistics payment by results (PbR) data has revealed that the over-60s account for nearly half of hospital admissions in England and more than half of hospital income from admissions.
Figures show that 43% of all hospital admissions paid under mandatory PbR were of people aged over 60 and accounted for £10.9bn, or 51% of hospitals’ income from admissions that attracted a manda... Healthcare Today
What does the abandonment of two commissioning support services mean for the NHS reforms?
What does the abandonment of two commissioning support services mean for the NHS reforms?:
Richard Vize explores the development of the commissioning support services and the wider implications for the health sector. Are cracks beginning to show?
Just weeks after the health reforms passed into law, serious cracks have emerged in the new system that could derail both the quality and financial stability of NHS services.
The NHS Commissioning Board has revealed that as a result of its "Checkpoint 2" tests for the viability of the plans for 25 regional commissioning support services, two have had to be abandoned: West Mercia and Peninsula (Devon and Cornwall). A further nine require "more rapid management" to stop them from failing.
The support services are often wrongly described as providing "administrative functions" for clinical commissioning groups. This does not begin to articulate the breadth of their work and their importance in determining whether the reforms succeed or fail.
They will lead change and service redesign, identify gaps in services, spot and manage risks, identify service providers, manage tendering, negotiate contracts and do much else besides.
Getting the support services off the ground would be difficult enough if they were just run of the mill public sector bodies. But they will eventually be "free standing", selling their services into the NHS. So the commissioning board has been charged with setting them up not only to help CCGs reform the health service but to then blossom into commercial, independent organisations. It takes a fertile imagination to see how a board steeped in a culture of central control can be an incubator for business start-ups.
Any weaknesses in the operation of the support services will be exposed in both service quality and financial stability. The turbulence in the NHS as real-term funding cuts collide with the reforms means there is a serious risk of a financial failure or a local deterioration in quality that goes unspotted or unchecked. The cuts alone increase this risk substantially; support organisations teetering on the brink of failure are unlikely to identify problems and work with providers to address them in time.
The Treasury has been worried about handing over £60bn of public money to new and unaccountable organisations. With the dire verdict of the NHS Commissioning Board on the state of the nascent commissioning support services they now have reason to be terrified.
No-one has ever claimed that GPs' skills lie in managing NHS finances – their strength is in understanding patient needs and clinical pathways. The support services are vital for effective financial control.
The commissioning board now has to fill the gap left by the abandoned services. The strategic health authorities are moving quickly, and neighbouring services whose preparations are going well could be asked to take over. While expansion has its advantages, changing boundaries and taking on new CCGs and populations will make the further development of their existing operation more complex.
The board also announced it has abandoned plans for a national communications and engagement service for CCGs. The service would have had the advantage of keeping costs down but looked suspiciously like a Ministry of Information for the board, which would have undermined the notion of a locally accountable NHS. Noises are still being made about a nationally co-ordinated communications service, but the hope must be that CCGs will now have more freedom to develop an approach to communications and engagement tailored to their own area – albeit made out of cheap cloth.
But even this is symptomatic of how desperately difficult it is for managers, GPs and the national board to stop the reforms from toppling over. Overlay the problems in support services with the setbacks and difficulties CCGs are experiencing as they struggle to establish themselves, and the wealth of management talent leaving the service, and you have a national picture of growing uncertainty and risk. Staff across the system are fighting to make it all work, but the chances of something going badly wrong are escalating.
Guardian Professional.
Just weeks after the health reforms passed into law, serious cracks have emerged in the new system that could derail both the quality and financial stability of NHS services.
The NHS Commissioning Board has revealed that as a result of its "Checkpoint 2" tests for the viability of the plans for 25 regional commissioning support services, two have had to be abandoned: West Mercia and Peninsula (Devon and Cornwall). A further nine require "more rapid management" to stop them from failing.
The support services are often wrongly described as providing "administrative functions" for clinical commissioning groups. This does not begin to articulate the breadth of their work and their importance in determining whether the reforms succeed or fail.
They will lead change and service redesign, identify gaps in services, spot and manage risks, identify service providers, manage tendering, negotiate contracts and do much else besides.
Getting the support services off the ground would be difficult enough if they were just run of the mill public sector bodies. But they will eventually be "free standing", selling their services into the NHS. So the commissioning board has been charged with setting them up not only to help CCGs reform the health service but to then blossom into commercial, independent organisations. It takes a fertile imagination to see how a board steeped in a culture of central control can be an incubator for business start-ups.
Any weaknesses in the operation of the support services will be exposed in both service quality and financial stability. The turbulence in the NHS as real-term funding cuts collide with the reforms means there is a serious risk of a financial failure or a local deterioration in quality that goes unspotted or unchecked. The cuts alone increase this risk substantially; support organisations teetering on the brink of failure are unlikely to identify problems and work with providers to address them in time.
The Treasury has been worried about handing over £60bn of public money to new and unaccountable organisations. With the dire verdict of the NHS Commissioning Board on the state of the nascent commissioning support services they now have reason to be terrified.
No-one has ever claimed that GPs' skills lie in managing NHS finances – their strength is in understanding patient needs and clinical pathways. The support services are vital for effective financial control.
The commissioning board now has to fill the gap left by the abandoned services. The strategic health authorities are moving quickly, and neighbouring services whose preparations are going well could be asked to take over. While expansion has its advantages, changing boundaries and taking on new CCGs and populations will make the further development of their existing operation more complex.
The board also announced it has abandoned plans for a national communications and engagement service for CCGs. The service would have had the advantage of keeping costs down but looked suspiciously like a Ministry of Information for the board, which would have undermined the notion of a locally accountable NHS. Noises are still being made about a nationally co-ordinated communications service, but the hope must be that CCGs will now have more freedom to develop an approach to communications and engagement tailored to their own area – albeit made out of cheap cloth.
But even this is symptomatic of how desperately difficult it is for managers, GPs and the national board to stop the reforms from toppling over. Overlay the problems in support services with the setbacks and difficulties CCGs are experiencing as they struggle to establish themselves, and the wealth of management talent leaving the service, and you have a national picture of growing uncertainty and risk. Staff across the system are fighting to make it all work, but the chances of something going badly wrong are escalating.
Guardian Professional.
Heart services face closure or merger
Heart services face closure or merger: Heart services treating hundreds of thousands of patients face being closed or merged with others over fears they are too small, it has emerged.
The Daily Telegraph
The Daily TelegraphRise seen in mixed-sex NHS ward breaches
Rise seen in mixed-sex NHS ward breaches:
The number of breaches of rules on mixed-sex NHS wards rose by nearly 100 last month, according to new figures. The Independent
The number of breaches of rules on mixed-sex NHS wards rose by nearly 100 last month, according to new figures. The Independent
Statins 'may even help healthy over-50s'
Statins 'may even help healthy over-50s':
Everyone over the age of 50 should be given statins because the “cholesterol-busting” drugs reduce the risk of a heart attack even in healthy people, according to the Daily Telegraph and many other papers today.
The story is based on a systematic review of 27 studies looking at the effect of lowering low-density lipoprotein cholesterol (LDL, the “bad” cholesterol) using statin therapy in 175,000 individuals. It found that for every 1.0 mmol/L reduction in cholesterol, taking statins reduced the risk of heart attacks, strokes and other “major vascular events” by about a fifth (21%), even among those without existing vascular disease or at low risk of developing it.
Current guidelines recommend prescribing statins for people who have at least a 20% chance of developing cardiovascular disease within 10 years. Doctors normally calculate this risk by looking at a range of factors including the patient’s age, blood pressure, cholesterol levels, whether they smoke and whether they have diabetes.
This large review of studies suggests the cholesterol-lowering drugs are suitable for those without existing heart or vascular disease and those who are not considered at high risk of developing it. The 21% reduction in risk of heart disease and stroke sounds impressive.
However, it’s worth noting that the number of people who stand to benefit from statins gets smaller as the risk threshold for treatment is reduced. For example, one thousand people at low risk would need to be treated (have a 1 mmol/L reduction in bad cholesterol) for five years in order for 11 of them to benefit. This suggests that someone at low risk may wish to consider whether the possible benefit of taking statins would outweigh the inconvenience.
An accompanying editorial argues that the current guidelines should be revised to use age as an indicator for statins (over 50 years old), rather than expensive screening tests. The commentary forms part of a running debate as to whether middle-aged people without any known risk of cardiovascular disease should be “medicated”, and if so, how much (whether with statins, aspirin or a “polypill”, as previously suggested).
The study was published in the peer-reviewed medical journal, The Lancet.
The study – in particular the commentary arguing for all over 50s to take statins - was covered widely and accurately in most of the media.
The authors pointed out that their previous analysis of studies suggested that statin therapy to reduce LDL cholesterol in people without a history of vascular disease ultimately reduced their risk of heart attacks and strokes by about a fifth. However, uncertainty remains as to whether statins have an overall “net benefit” in this group, given that they are at low risk to begin with. The authors said that at least half of all heart attacks and strokes (vascular events) occur among individuals without previous disease.
The authors said they have now taken individual patient data from each trial within the database, allowing a more complete assessment of the effects of lowering LDL cholesterol in low-risk individuals.
They grouped the participants into five categories depending on their risk of a vascular event within five years and compared those taking a statin with control groups or with group taking a lower-dose statin. The risk categories were:
They also pointed out that, under present guidelines, such individuals would typically not be regarded as suitable for statin therapy.
They concluded: "The present report shows that statins are indeed both effective and safe for people with a five-year risk of major vascular events lower than 10% who would typically not be judged suitable for statin treatment … and, therefore, suggests that treatment guidelines might need to be reconsidered."
Although the study looked at whether statins increased the risk of cancer and death from other causes, it did not include possible adverse effects. Statins are safe drugs that have been associated with a small risk of side effects. As the authors stated, the risk of side effects when giving statins to everyone over the age of 50 would have to be taken into account when calculating the overall benefit.
The current guidelines on statin therapy from the National Institute of Health and Clinical Excellence (NICE) are reportedly to be updated soon, at which point NICE will take this and any other new evidence into account.
There is good existing evidence that a healthy lifestyle (including regular exercise, stopping smoking and a healthy diet) are also important factors in cardiovascular health. This study helps to answer previous uncertainty about which apparently healthy individuals could benefit from taking statins.
NHS 'should consider giving statins to healthy people'. BBC News, May 17 2012
Statins could benefit health of millions. The Guardian, May 17 2012
All over 50s should be taking statins. The Daily Telegraph, May 17 2012
Statins 'could benefit the healthy'. The Independent, May 17 2012
Why EVERYONE over 50 needs to be taking statins: Cholesterol-busting pills cut risk of heart attack or stroke. Daily Mail, May 17 2012
The story is based on a systematic review of 27 studies looking at the effect of lowering low-density lipoprotein cholesterol (LDL, the “bad” cholesterol) using statin therapy in 175,000 individuals. It found that for every 1.0 mmol/L reduction in cholesterol, taking statins reduced the risk of heart attacks, strokes and other “major vascular events” by about a fifth (21%), even among those without existing vascular disease or at low risk of developing it.
Current guidelines recommend prescribing statins for people who have at least a 20% chance of developing cardiovascular disease within 10 years. Doctors normally calculate this risk by looking at a range of factors including the patient’s age, blood pressure, cholesterol levels, whether they smoke and whether they have diabetes.
This large review of studies suggests the cholesterol-lowering drugs are suitable for those without existing heart or vascular disease and those who are not considered at high risk of developing it. The 21% reduction in risk of heart disease and stroke sounds impressive.
However, it’s worth noting that the number of people who stand to benefit from statins gets smaller as the risk threshold for treatment is reduced. For example, one thousand people at low risk would need to be treated (have a 1 mmol/L reduction in bad cholesterol) for five years in order for 11 of them to benefit. This suggests that someone at low risk may wish to consider whether the possible benefit of taking statins would outweigh the inconvenience.
An accompanying editorial argues that the current guidelines should be revised to use age as an indicator for statins (over 50 years old), rather than expensive screening tests. The commentary forms part of a running debate as to whether middle-aged people without any known risk of cardiovascular disease should be “medicated”, and if so, how much (whether with statins, aspirin or a “polypill”, as previously suggested).
Where did the story come from?
The study was carried out by researchers from Oxford University and the University of Sydney. It was funded by several institutions including the British Heart Foundation, the UK Medical Research Council and Cancer Research UK.The study was published in the peer-reviewed medical journal, The Lancet.
The study – in particular the commentary arguing for all over 50s to take statins - was covered widely and accurately in most of the media.
What kind of research was this?
This was a meta-analysis of individual patient data from 27 trials looking at the effects of lowering LDL cholesterol with statin therapy, including trials of those without vascular disease or at low risk of cardiovascular disease.The authors pointed out that their previous analysis of studies suggested that statin therapy to reduce LDL cholesterol in people without a history of vascular disease ultimately reduced their risk of heart attacks and strokes by about a fifth. However, uncertainty remains as to whether statins have an overall “net benefit” in this group, given that they are at low risk to begin with. The authors said that at least half of all heart attacks and strokes (vascular events) occur among individuals without previous disease.
The authors said they have now taken individual patient data from each trial within the database, allowing a more complete assessment of the effects of lowering LDL cholesterol in low-risk individuals.
What did the research involve?
The researchers conducted a meta-analysis of data from 175,000 participants in 27 randomised trials, to explore the effects of lowering LDL cholesterol with statin therapy. Trials were included if:- They included at least one treatment where the main effect was to lower LDL cholesterol.
- There were no other differences in treating risk factors.
- At least 1,000 participants were recruited for a duration of at least two years’ treatment.
They grouped the participants into five categories depending on their risk of a vascular event within five years and compared those taking a statin with control groups or with group taking a lower-dose statin. The risk categories were:
- less than 5%
- 5% to less than 10%
- 10% to less than 20%
- 20% to less than 30%
- 30% or more
What were the basic results?
The researchers found that:- Reducing LDL cholesterol with a statin reduced the risk of major vascular events (relative risk 0.79, 95% confidence interval 0.77 to 0.81 per 1.0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular mortality and all-cause mortality.
- The reduction in major vascular events was at least as big in people in the two lowest risk categories as those in the higher risk categories.
- For stroke, the reduction in risk in participants with a 5-year risk of major vascular events lower than 10% (relative risk per 1.0 mmol/L LDL cholesterol reduction 0.76, 99% confidence interval 0.61 to 0.95) was also similar to that seen in higher-risk categories.
- In participants without a history of vascular disease, statins reduced the risks of deaths from vascular disease and any other cause (relative risk 0.91, 95% confidence interval 0.85 to 0.97).
How did the researchers interpret the results?
The researchers calculated that in individuals with a five-year risk of major vascular events lower than 10%, each 1 mmol/L reduction in LDL cholesterol produced an absolute reduction in major vascular events of about 11 per 1,000 over five years. They said this benefit “greatly exceeds any known hazards of statin therapy”.They also pointed out that, under present guidelines, such individuals would typically not be regarded as suitable for statin therapy.
They concluded: "The present report shows that statins are indeed both effective and safe for people with a five-year risk of major vascular events lower than 10% who would typically not be judged suitable for statin treatment … and, therefore, suggests that treatment guidelines might need to be reconsidered."
Conclusion
Current guidelines recommend statins for people who have a 20% or greater chance of developing cardiovascular disease within 10 years. This large review of studies, which is a further assessment of previous research, suggests they may also benefit those without existing cardiovascular disease and those who are not considered at high risk of developing it. However, the individual benefit for those at low risk may be small.Although the study looked at whether statins increased the risk of cancer and death from other causes, it did not include possible adverse effects. Statins are safe drugs that have been associated with a small risk of side effects. As the authors stated, the risk of side effects when giving statins to everyone over the age of 50 would have to be taken into account when calculating the overall benefit.
The current guidelines on statin therapy from the National Institute of Health and Clinical Excellence (NICE) are reportedly to be updated soon, at which point NICE will take this and any other new evidence into account.
There is good existing evidence that a healthy lifestyle (including regular exercise, stopping smoking and a healthy diet) are also important factors in cardiovascular health. This study helps to answer previous uncertainty about which apparently healthy individuals could benefit from taking statins.
Links To The Headlines
Give statins to everyone over 50. Daily Express, May 17 2012NHS 'should consider giving statins to healthy people'. BBC News, May 17 2012
Statins could benefit health of millions. The Guardian, May 17 2012
All over 50s should be taking statins. The Daily Telegraph, May 17 2012
Statins 'could benefit the healthy'. The Independent, May 17 2012
Why EVERYONE over 50 needs to be taking statins: Cholesterol-busting pills cut risk of heart attack or stroke. Daily Mail, May 17 2012
Links To Science
Cholesterol Treatment Trialists' Collaborators. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. The Lancet. Published online May 17 2012 NHS ChoicesThursday, 17 May 2012
Northamptonshire doctor banned from working for the NHS over deadly spider venom probe
Northamptonshire doctor banned from working for the NHS over deadly spider venom probe:
A GP from Northamptonshire who was banned from working for the NHS after trying to buy deadly venom from the black widow spider and death stalker scorpion insists she is the victim of a ‘set-up’. Northampton Chronicle and Echo
A GP from Northamptonshire who was banned from working for the NHS after trying to buy deadly venom from the black widow spider and death stalker scorpion insists she is the victim of a ‘set-up’. Northampton Chronicle and Echo
Integrated care and why the NHS needs more deviant leaders | Chris Ham
Integrated care and why the NHS needs more deviant leaders | Chris Ham: If integrated care is to emerge at scale and pace, the NHS needs more positive deviants. (15 May 2012) Kings Fund
Preparation for commissioning picks up pace – Barbara Hakin
The pace is picking up now in terms of establishing CCGs, with less than ten months left until the new system goes live in April 2013.
Across the country, groups of practices have been coming together and identifying the shape and configuration of their CCG. It is a fantastic achievement that these geographies are now sorted and we have emerging CCGs covering the whole of England coming forward for authorisation.
The reforms are based very firmly on three key principles; that patients in their communities should be at the heart of everything we do; that clinicians should be in the driving seat in shaping services; and that we should focus on outcomes based on sound evidence. CCGs are the cornerstone of delivering these aspirations. GP practices know their patients and largely serve specific communities with whom the practice has had a relationship for many years. They already act as the hub of care for their patients; linking patients with other clinicians and ensuring that, through the registered list and the single lifelong record, all the care patients receive is coordinated in one place. This model is envied around the world and is key to delivering better care, better experience, better outcomes and improved safety. So it is only logical that these practices should be at the heart of determining how the range of local services can best meet their patients’ needs.But good commissioning is mainly about bringing together all those with expertise and an interest in care in order to arrange the services which can deliver these quality outcomes. So the responsibility on the CCG to involve patients and the public, and the full range of health and social care colleagues, is huge.
There is also lots going on to shape the rest of the commissioning system. This means putting in place all the elements of the NHS CB’s own architecture, the national support office, regional teams and local area teams. The NHS CB will be responsible for ensuring the whole commissioning system works well together and that the £80bn of taxpayers’ money is turned into the best possible outcomes for patients. It will support and oversee CCGs who will have the majority of this resource, as well as commissioning specialised services, primary care, prison and military health services, as well as many public health services on behalf of Public Health England.
Another key plank of the systems will be dedicated commissioning support units. While CCGs will be able to buy their support services from whoever they choose, we need to ensure they have the full range available to them from day one. Many independent and third sector organisations can offer fantastic niche commissioning support or highly sophisticated tools and products to aid commissioners. But the capacity and capability to deliver the full range of commissioning support sits with high experienced individuals currently in PCTs, and we must ensure this expertise is supported to deliver the best range of services from which CCGs can choose.
In the final analysis, our success will be predicated on whether healthcare services deliver better outcomes which meet local needs, whether these services deliver integrated care, and whether local communities feel they have a real voice in shaping services which suite them. The key vehicle in ensuring this happens will be the local health and wellbeing board. These vital structures are still in their early development but need to be the focal point for communities, bringing together patient and public representatives, alongside all the players who commission or provide care in the locality, in one place in order to ascertain the needs of the population and outline the overarching strategic plan on which individual components will be based.
There is still much to do in a relatively short space of time. But much is already in place, and we should be optimistic that this greater clinical and patient engagement will bring about the changes we need to see in order to keep improving the quality of care in this difficult economic environment.
GPs and their practices have been placed centre stage in this arena in a way we have never seen previously. CCGs will only be successful if the majority of practices seize this opportunity and make the CCG their own. Their leaders are already emerging, trusted to oversee much of the day to day aspects of clinical commissioning. But without the support of the majority of their practice colleagues their task will be too great. It is the action of all GPs and their practice teams through their connection with their patients, and all others who care for them, which will create a wealth of collective experience which will make the difference. NHS Commissioning Board
Ambulance changes ''may save 150 lives''
Ambulance changes ''may save 150 lives'': A new way that 999 calls are received will prioritise call-outs to the most critically ill patients Public Service
Nurses fear spending cuts will put people with learning disabilities at risk
Nurses fear spending cuts will put people with learning disabilities at risk: Three in four nurses have seen cuts to services in their area in the past year, survey revealsNurses who work with people with learning disabilities have "real concerns" about the safety of their clients because of cuts in services, according to a study published on Wednesday.A survey of 500 nurses revealed that three out of four saw spending cuts to services in their area in the past year. The Royal College of Nursing (RCN) said its survey also uncovered cuts in the range of services offered, such ...
Race equality in mental health
Race equality in mental health: This Briefing summarises the findings and recommendations from a recent report, commissioned by the Department of Health, into race equality in mental health. The report is based on a series of interviews with NHS and local authority leaders. NHS Confederation
Smart guides to engagement
Smart guides to engagement:
The next set of guides in this series of 10 have been published. This set covers practices and patient engagement; listening, learning and responding; and community development and population health.
The next set of guides in this series of 10 have been published. This set covers practices and patient engagement; listening, learning and responding; and community development and population health.
NHS 'should consider giving statins to healthy people' - BBC News
NHS 'should consider giving statins to healthy people' - BBC News:
 BBC News | NHS 'should consider giving statins to healthy people' BBC News The Oxford researchers says the NHS should consider giving statins to healthy people. The NHS drugs watchdog, NICE, is reviewing the evidence. However, statins have been linked to side-effects such as kidney failure. They are among the most widely ... Statins could benefit health of millionsThe Guardian All over 50s should be taking statinsTelegraph.co.uk all 16 news articles » |
Why today's NHS leaders need to be more engaging
Why today's NHS leaders need to be more engaging:
High quality leadership is more important than ever, a King's Fund report has judged. It recommends a shift away from traditional 'heroic' leadership towards a more engaging style
The NHS is facing some of its biggest financial and quality challenges since its inception. An ageing population poses significant challenges to our health care system. The increase in demand means that the NHS needs to make efficiency savings worth £20bn by 2015. Older people are more likely to have complex conditions, requiring better co-ordination and integration of care. Never before has effective leadership and management been so vital for our healthcare system.
In May last year, the King's Fund published a report, called No More Heroes, into the future of leadership. It found that, contrary to prevailing assumptions, the NHS was not over-managed. Cuts in management will result in the loss of thousands of experienced leaders at a time when their expertise is most needed to secure essential productivity gains.
The report also found that a shift away from the strong heroic leader model relied upon to meet targets was needed. It judged that leaders are far more likely to meet today's challenges, and deliver better results financially and in terms of quality of care, by engaging populations, patients, carers and staff. More engaging leadership styles will also be important in enabling patients and their families to receive better co-ordinated care across systems.
This approach to leadership was also explored by the NHS Institute of Innovation and Improvement and the Academy of Medical Royal Colleges, which used a medical scale to measure levels of engagement amongst clinicians. Initially working with 30 hospitals, the study concluded that there was a very strong association between medical engagement and clinical and financial performance, as assessed by the Care Quality Commission.
The new national structures, such as the NHS Commissioning Board and Leadership Academy, will have a key role to play in developing leadership across the systems but, importantly, local NHS bodies and local authorities will be instrumental in embedding it throughout the system.
There are already some exciting programmes working on real challenges within communities. In Surrey, clinicians are focusing on optimising the care of the frail elderly, working with the King's Fund on a whole system leadership programme.
The work has encompassed social care, community providers, GPs, mental health and acute care along with nursing homes. This is just one example where openness and communication amongst a multitude of players is at the core of effective and sustainable change in pursuit of delivering high value care.
The challenges for the NHS and local government to continue to enhance the range and quality of services within a very challenging fiscal environment requires the very highest quality of leadership. The case for a more distributed and engaging style of leadership is compelling and needs to be the norm now more than ever before.
The King's Fund is holding its second annual summit on leadership and management on 23 May and will be publishing a follow-up to the No More Heroes report at the event.
Guardian Professional.
The NHS is facing some of its biggest financial and quality challenges since its inception. An ageing population poses significant challenges to our health care system. The increase in demand means that the NHS needs to make efficiency savings worth £20bn by 2015. Older people are more likely to have complex conditions, requiring better co-ordination and integration of care. Never before has effective leadership and management been so vital for our healthcare system.
In May last year, the King's Fund published a report, called No More Heroes, into the future of leadership. It found that, contrary to prevailing assumptions, the NHS was not over-managed. Cuts in management will result in the loss of thousands of experienced leaders at a time when their expertise is most needed to secure essential productivity gains.
The report also found that a shift away from the strong heroic leader model relied upon to meet targets was needed. It judged that leaders are far more likely to meet today's challenges, and deliver better results financially and in terms of quality of care, by engaging populations, patients, carers and staff. More engaging leadership styles will also be important in enabling patients and their families to receive better co-ordinated care across systems.
This approach to leadership was also explored by the NHS Institute of Innovation and Improvement and the Academy of Medical Royal Colleges, which used a medical scale to measure levels of engagement amongst clinicians. Initially working with 30 hospitals, the study concluded that there was a very strong association between medical engagement and clinical and financial performance, as assessed by the Care Quality Commission.
The new national structures, such as the NHS Commissioning Board and Leadership Academy, will have a key role to play in developing leadership across the systems but, importantly, local NHS bodies and local authorities will be instrumental in embedding it throughout the system.
There are already some exciting programmes working on real challenges within communities. In Surrey, clinicians are focusing on optimising the care of the frail elderly, working with the King's Fund on a whole system leadership programme.
The work has encompassed social care, community providers, GPs, mental health and acute care along with nursing homes. This is just one example where openness and communication amongst a multitude of players is at the core of effective and sustainable change in pursuit of delivering high value care.
The challenges for the NHS and local government to continue to enhance the range and quality of services within a very challenging fiscal environment requires the very highest quality of leadership. The case for a more distributed and engaging style of leadership is compelling and needs to be the norm now more than ever before.
The King's Fund is holding its second annual summit on leadership and management on 23 May and will be publishing a follow-up to the No More Heroes report at the event.
Guardian Professional.
Number of elderly receiving free home care falls by 11 per cent
Number of elderly receiving free home care falls by 11 per cent: Cuts to social care budgets have been blamed for an 11 per cent fall in the number of vulnerable people who have their care services paid for by their local authority, it was reported.
The Daily Telegraph
The Daily Telegraph
Giving patients choice 'will drive hospital closures'
Giving patients choice 'will drive hospital closures': Hospitals will close under Government plans to give patients more choice about where they are treated in a drive to push up NHS standards, senior health figures have admitted.
The Daily Telegraph
The Daily Telegraph
'No excuse' for diabetes errors
'No excuse' for diabetes errors:
Almost one in three diabetic hospital patients are victims of medication errors that can cause dangerous blood glucose levels, a report has found. The Independent
Almost one in three diabetic hospital patients are victims of medication errors that can cause dangerous blood glucose levels, a report has found. The Independent
Wednesday, 16 May 2012
Care home given formal warning over standards
Care home given formal warning over standards:
A WELLINGBOROUGH care home has been issued with a formal warning by the Care Quality Commission for failing to meet the needs of the people in its care. Evening Telegraph
A WELLINGBOROUGH care home has been issued with a formal warning by the Care Quality Commission for failing to meet the needs of the people in its care. Evening Telegraph
The secret of their success | Vijaya Nath
The secret of their success | Vijaya Nath: What did the participants who ventured to Kaiser in our recent study tour learn from the experience? And what is the value of taking NHS leaders out of their own system to learn from another? Kings Fund
Nursing 'needs more compassion'
Nursing 'needs more compassion': New nurses should be judged on their compassion not just their skills, the NHS Confederation chairman is to say. BBC News
State-funded elderly care 'drop'
State-funded elderly care 'drop': The number of elderly people in England getting council-funded care has fallen by 11% in the last two years and looks like it will fall further, figures obtained by Labour suggest. BBC News
Poly Implant Prothèse (PIP) silicone breast implants
Poly Implant Prothèse (PIP) silicone breast implants:
A review into PiP breast implants has found that, although the regulator acted appropriately and followed scientific and clinical advice, there is room for improvement and lessons to be learned.
A review into PiP breast implants has found that, although the regulator acted appropriately and followed scientific and clinical advice, there is room for improvement and lessons to be learned.
Use of non-geographic telephone numbers (e.g. 0845) by the NHS and GPs’ practices
Use of non-geographic telephone numbers (e.g. 0845) by the NHS and GPs’ practices:
This briefing provides an overview of current Department of Health guidance on NHS and general practice use of non-geographic phone numbers.
This briefing provides an overview of current Department of Health guidance on NHS and general practice use of non-geographic phone numbers.
Cancer death rates drop
Cancer death rates drop:
According to research published by Cancer Research UK, the number of people dying from cancer in the UK is at its lowest in 40 years.The charity's data showed that for people diagnosed with cancer from the ages of 50-59, death rates have decreased 40%.This drop means that 310 in 100,000 people diagnosed with cancer died in 1971 compared to 185 per 100,000 in 2010. There were over 21,000 deaths in th... Healthcare Today
According to research published by Cancer Research UK, the number of people dying from cancer in the UK is at its lowest in 40 years.The charity's data showed that for people diagnosed with cancer from the ages of 50-59, death rates have decreased 40%.This drop means that 310 in 100,000 people diagnosed with cancer died in 1971 compared to 185 per 100,000 in 2010. There were over 21,000 deaths in th... Healthcare Today
Risk register veto 'wrong'
Risk register veto 'wrong':
A report by Christopher Graham, the Information Commissioner, has deemed the government veto on the publication of the NHS risk register to be "unjustified".The Health Secretary Andrew Lansley vetoed the publication of the register because he said it was "in the public interest".He said last week that they had exercised the right to legally veto publication because of the need for a "sa... Healthcare Today
A report by Christopher Graham, the Information Commissioner, has deemed the government veto on the publication of the NHS risk register to be "unjustified".The Health Secretary Andrew Lansley vetoed the publication of the register because he said it was "in the public interest".He said last week that they had exercised the right to legally veto publication because of the need for a "sa... Healthcare Today
Warning that patients are suffering due to medicine shortages - The Independent
Warning that patients are suffering due to medicine shortages - The Independent:
 Daily Mail | Warning that patients are suffering due to medicine shortages The Independent Medicine shortages are having an “adverse” impact on patients, including vulnerable groups such as those with mental health problems, the All-Party Pharmacy Group said. In a report detailing its inquiry into medicine shortages, the group said the ... Patients suffering from medicine shortageITN Exporting medicines for profit puts British patients at risk, say MPsThe Guardian (blog) NHS Patients Face Prescription Shortages Parliamentary Group WarnsHuffington Post UK Netdoctor -Financial Times all 38 news articles » |
Patients 'waiting up to nine years' for NICE to approve drugs
Patients 'waiting up to nine years' for NICE to approve drugs: Patients are waiting up to nine years for drugs to treat life-threatening conditions to become available through the NHS due to delays in approving them, a study claims.
The Daily Telegraph
The Daily TelegraphA quarter of all deaths could be avoided with better healthcare: report
A quarter of all deaths could be avoided with better healthcare: report: A quarter of all deaths could be prevented with timely healthcare and better prevention, official figures show.
The Daily Telegraph
The Daily Telegraph
Nice approves prostate cancer drug
Nice approves prostate cancer drug:
A drug to treat advanced prostate cancer should be given to patients on the NHS, a health watchdog has said. The Independent
A drug to treat advanced prostate cancer should be given to patients on the NHS, a health watchdog has said. The Independent
Cuts to services hitting people with learning disabilities
Cuts to services hitting people with learning disabilities: Specialist nurses fear that people with learning disabilities are missing out or facing a reduced service as demands increase, but resources are not being made available, says the Royal College of Nursing. RCN
Tuesday, 15 May 2012
Trial of mental health, learning disabilities and social care electronic journals
Trial of mental health, learning disabilities and social care electronic journals:
 |
| E-Journals |
We are running a three-month trial of the Emerald Health and Social Care e-journals collection. This collection includes 22 journals covering the fields of mental health, learning disabilities, forensic psychology and vulnerable groups, with titles including:
- Advances in Mental Health and Intellectual Disabilities
- Ethnicity and Inequality in Health and Social Care
- Journal of Adult Protection
- Journal of Criminal Psychology
- Journal of Mental Health Training, Education and Practice
- Mental Health and Social Inclusion
- Quality in Ageing and Older Adults
- Tizard Learning Disability Review
A complete list of titles included is available via the Emerald website.
The journals are available for you to access now via our Emerald page. You will need an Athens username and password – click on “Login” on the top left of the screen, and then click on “Athens login”. Once you are logged in you will see a complete list of our subscriptions including the Health and Social Care Collection at the end of the list.
As well as being accessible via Emerald, you will also find these journals when you search My Journals or the healthcare databases via NHS Evidence (again, you will need an Athens account for this).
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MPs warning of medicine shortages
MPs warning of medicine shortages: Patients in England are suffering from shortages in the supply of some medicines, an all party group of MPs says. BBC News
Half a million could lose disability benefits
Half a million could lose disability benefits: The £13bn-a-year disability benefits bill needs to be cut by around 20 per cent, says Iain Duncan Smith Public Service
New Medicine Service guidance available
New Medicine Service guidance available: The NHS Employers organisation and the Pharmaceutical Services Negotiating Committee (PSNC) have jointly published a comprehensive guidance document for the New Medicine Service (NMS).
NHS Confederation responds to RCN figures on community nursing
NHS Confederation responds to RCN figures on community nursing: David Stout, says community services play an important role in keeping patients out of hospital and it is essential to plan safe and appropriate staffing numbers to meet the needs of patients.
Health regulator must learn lessons of breast implant scandal, report warns
Health regulator must learn lessons of breast implant scandal, report warns:
Health minister Earl Howe finds MHRA acted appropriately in PIP scandal but needs to improve its communication with public
A government report on the actions of a regulator and the Department of Health during the PIP breast implant scandal has concluded that serious lessons must be learned from the affair, which affected as many as 47,000 women in Britain.
The health minister Earl Howe concluded that the Medicines and Healthcare Products Regulatory Authority (MHRA) acted "appropriately" before and after the scandal, but needed to improve in key respects in order to better identify problems early and communicate with the public.
He put the blame for the health scare on the "deliberate fraud" of the now defunct French company Poly Implant Prothèse, whose owner is in prison awaiting trial.
But Howe stressed that the scandal had revealed ways in which both the MHRA and the Department of Health should improve. They should work to improve their communications, he said, and ensure that full and accurate information was made available as early as possible.
Last month a report by MPs said the action taken to communicate with the public as the scandal broke in December was inadequate.
Howe said: "It must be emphasised that this case was one of deliberate fraud by the PIP manufacturer which purposefully misled European regulators. Regulation alone cannot prevent fraudulent activity such as this. But serious lessons must be learned from this scandal. The MHRA needs to look at how it gathers evidence so it is able to identify problems early. It needs to better analyse reports about higher risk medical devices. And it needs to improve the way it communicates with the public."
He added: "It is clear that problems occurred that weren't reported to the regulator. A vigilance system is only as good as the information that is reported to it. More needs to be done to ensure that problems with medical devices are reported, so problems can be identified and action taken to address them."
The review found that the MHRA began to receive reports of potential problems with PIP implants in 2002, almost a decade before the scandal broke in December. It also says that a director's post at the MHRA, whose occupant would have had strategic oversight of medical devices such as implants, was vacant from September 2010 until February 2012.
Shadow public health minister Diane Abbott said these and other findings contributed to a "damning indictment" of the health secretary, Andrew Lansley, and the relevant authorities.
"Their handling of the issue has caused confusion and anxiety to thousands of women," she said, adding: "The review doesn't really explain the gap between the French authorities deciding to recall all silicone PIP implants and the British authorities taking action.
As many as 47,000 women in Britain are estimated to have been given substandard PIP implants, the vast majority of them – at least 37,000 – in private clinics. According to the latest government figures, 6,632 of them have been formally referred to the NHS. Of that total, 3,865 have already had scans and more than 400 have decided to have their implants removed.
Last month's report by the Commons health select committee said most women learned of the potential problems with their implants in December, 21 months after the MHRA became aware of the fact that the silicon in them was substandard. As well as the clinics themselves, the regulator was criticised for not having done more to warn people.
Howe said the MHRA had fulfilled its role of monitoring all incidents reported to it, making sure that those incidents were investigated fully and that necessary action was taken. He said the MHRA needed to "review and develop" its communications capability, and obtain evidence from a "wider and more detailed set of sources".
The regulator must also be able to routinely review information about potential risks in order to identify any problems early. Howe also called for improved coordination between the European regulators.
He said: "This report won't repair the distress caused to women who have PIP implants, but it should give them and the public reassurance that we have identified the lessons; that we will take all steps to act on them; and that, should something like this happen again, our systems for dealing with it will be stronger."
Professor Sir Kent Woods, the MHRA chief executive, welcomed the report. "We will act quickly to implement the recommendations and use the lessons learned from this episode to improve the regulatory system for medical devices in the UK and Europe," he said.
Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said: "Poor post-marketing surveillance of medical devices lies at the root of the PIP crisis. At the BAAPS we feel there needs to be significantly more stringent monitoring of all medical devices including breast implants and all cosmetic injectables, via compulsory, regular reporting of adverse effects and mystery shopping which are all part of our regulation proposals.
"This is an opportunity for the Department of Health to get it right, and put the necessary systems and checks in place to avoid a repeat fiasco. Clearly changes are also needed at European level of the CE marking process."
Rajiv Grover, BAAPS president-elect, said a compulsory implant register should be reinstated, a proposal that is being examined by Sir Bruce Keogh, the NHS medical director, in a separate review of the wider system of cosmetic surgery regulation in the wake of the PIP scandal. The Guardian
A government report on the actions of a regulator and the Department of Health during the PIP breast implant scandal has concluded that serious lessons must be learned from the affair, which affected as many as 47,000 women in Britain.
The health minister Earl Howe concluded that the Medicines and Healthcare Products Regulatory Authority (MHRA) acted "appropriately" before and after the scandal, but needed to improve in key respects in order to better identify problems early and communicate with the public.
He put the blame for the health scare on the "deliberate fraud" of the now defunct French company Poly Implant Prothèse, whose owner is in prison awaiting trial.
But Howe stressed that the scandal had revealed ways in which both the MHRA and the Department of Health should improve. They should work to improve their communications, he said, and ensure that full and accurate information was made available as early as possible.
Last month a report by MPs said the action taken to communicate with the public as the scandal broke in December was inadequate.
Howe said: "It must be emphasised that this case was one of deliberate fraud by the PIP manufacturer which purposefully misled European regulators. Regulation alone cannot prevent fraudulent activity such as this. But serious lessons must be learned from this scandal. The MHRA needs to look at how it gathers evidence so it is able to identify problems early. It needs to better analyse reports about higher risk medical devices. And it needs to improve the way it communicates with the public."
He added: "It is clear that problems occurred that weren't reported to the regulator. A vigilance system is only as good as the information that is reported to it. More needs to be done to ensure that problems with medical devices are reported, so problems can be identified and action taken to address them."
The review found that the MHRA began to receive reports of potential problems with PIP implants in 2002, almost a decade before the scandal broke in December. It also says that a director's post at the MHRA, whose occupant would have had strategic oversight of medical devices such as implants, was vacant from September 2010 until February 2012.
Shadow public health minister Diane Abbott said these and other findings contributed to a "damning indictment" of the health secretary, Andrew Lansley, and the relevant authorities.
"Their handling of the issue has caused confusion and anxiety to thousands of women," she said, adding: "The review doesn't really explain the gap between the French authorities deciding to recall all silicone PIP implants and the British authorities taking action.
As many as 47,000 women in Britain are estimated to have been given substandard PIP implants, the vast majority of them – at least 37,000 – in private clinics. According to the latest government figures, 6,632 of them have been formally referred to the NHS. Of that total, 3,865 have already had scans and more than 400 have decided to have their implants removed.
Last month's report by the Commons health select committee said most women learned of the potential problems with their implants in December, 21 months after the MHRA became aware of the fact that the silicon in them was substandard. As well as the clinics themselves, the regulator was criticised for not having done more to warn people.
Howe said the MHRA had fulfilled its role of monitoring all incidents reported to it, making sure that those incidents were investigated fully and that necessary action was taken. He said the MHRA needed to "review and develop" its communications capability, and obtain evidence from a "wider and more detailed set of sources".
The regulator must also be able to routinely review information about potential risks in order to identify any problems early. Howe also called for improved coordination between the European regulators.
He said: "This report won't repair the distress caused to women who have PIP implants, but it should give them and the public reassurance that we have identified the lessons; that we will take all steps to act on them; and that, should something like this happen again, our systems for dealing with it will be stronger."
Professor Sir Kent Woods, the MHRA chief executive, welcomed the report. "We will act quickly to implement the recommendations and use the lessons learned from this episode to improve the regulatory system for medical devices in the UK and Europe," he said.
Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said: "Poor post-marketing surveillance of medical devices lies at the root of the PIP crisis. At the BAAPS we feel there needs to be significantly more stringent monitoring of all medical devices including breast implants and all cosmetic injectables, via compulsory, regular reporting of adverse effects and mystery shopping which are all part of our regulation proposals.
"This is an opportunity for the Department of Health to get it right, and put the necessary systems and checks in place to avoid a repeat fiasco. Clearly changes are also needed at European level of the CE marking process."
Rajiv Grover, BAAPS president-elect, said a compulsory implant register should be reinstated, a proposal that is being examined by Sir Bruce Keogh, the NHS medical director, in a separate review of the wider system of cosmetic surgery regulation in the wake of the PIP scandal. The Guardian
Nurses stretched to 'breaking point' as 60,000 frontline health service posts under threat, says RCN
Nurses stretched to 'breaking point' as 60,000 frontline health service posts under threat, says RCN: Overworked nurses are being stretched to "breaking point" amid spending cuts that have placed more than 60,000 frontline jobs in the NHS at risk, it was claimed today.
The Daily Telegraph
The Daily TelegraphHealth Minister Simon Burns: 'GPs strike would put patients at risk'
Health Minister Simon Burns: 'GPs strike would put patients at risk': Health Minister Simon Burns says GPs should think "long and hard before casting a vote for a strike that can only harm their own patients".
The Daily Telegraph
The Daily TelegraphLansley jeered as angry nurses attack cuts to frontline NHS staff
Lansley jeered as angry nurses attack cuts to frontline NHS staff:
The Labour Party leader, Ed Miliband, will today accuse the Government of acting like masters rather than servants of the NHS in a speech to hundreds of disgruntled nurses, who yesterday jeered the Tory Health Secretary after he claimed frontline staffing levels had increased under his watch. The Independent
The Labour Party leader, Ed Miliband, will today accuse the Government of acting like masters rather than servants of the NHS in a speech to hundreds of disgruntled nurses, who yesterday jeered the Tory Health Secretary after he claimed frontline staffing levels had increased under his watch. The Independent
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