This paper discusses the views of GPs and specialists on current policy on specialists in Clinical Commissioning Groups. It calls for policy to be more inclusive and flexible to allow both groups of doctors to develop positive relationships to enable integrated care across the primary-secondary healthcare boundaries.
Tuesday, 17 January 2012
Specialists in commissioning: looking beyond current policy
Specialists in commissioning: looking beyond current policy:
After the event: getting care right for patients after a heart attack
After the event: getting care right for patients after a heart attack:
This report calls on all NHS Trusts to offer cardiac rehabilitation services to heart attack patients after finding that 2,100 patients across England are not being offered rehabilitation despite the clear benefits of the service in improving patient experience and outcomes from the disease.
NHS warned of 'neurology timebomb'
NHS warned of 'neurology timebomb':
Call for 'neurology tsar' as growing numbers are diagnosed with Parkinson's, motor neurone disease and multiple sclerosis
The NHS is facing a "neurology timebomb" as the number of people with conditions such as Parkinson's and motor neurone disease (MND) increases, an umbrella organisation for charities in the field has said.
The Neurological Alliance, which represents more than 70 charities and organisations, said the NHS will be caught unawares unless urgent action is taken and accused the government of having its "head in the sand".
Figures from Parkinson's UK suggest that by 2020 will be 162,000 people with Parkinson's disease – which affects actor Michael J Fox and boxing legend Muhammad Ali – 28% more that the 127,000 now diagnosed.
The number with MND is set to rise by 27% in the same period and 50 people are newly diagnosed with multiple sclerosis (MS) every week.
The alliance argues that services are being run in a "haphazard way" with no clear strategy, potentially wasting billions of pounds of taxpayers' money.
It follows a damning report in December from the National Audit Office (NAO), which found that emergency hospital admissions for people with neurological conditions have risen by almost a third despite a government financial investment in services.
While access to services has improved and waiting times have fallen, the study found, key areas of care have got worse.
In 2009-10, 14% of people with Parkinson's, MS and MND who were discharged from hospital after an overnight stay were readmitted within 28 days as an emergency. People admitted as an emergency are also often treated by doctors and nurses with no neurological training, with evidence suggesting this worsens outcomes for patients. Furthermore, the report found delays in diagnosis and treatment.
Steve Ford, the chair of the Neurological Alliance and chief executive of Parkinson's UK, said: "A crisis is looming but the government has its head in the sand. When it comes to helping vulnerable people with a neurological condition, the government is floundering around in a fog of its own making.
"We need a leader to champion improvements – a neurology tsar, if you like, backed up with a plan and a strategy. "When diabetes, cancer and stroke were assigned tsars, things really started to happen. People affected by neurological conditions are fed up with being at the bottom of the government's 'to do' list.
"It is time the Department of Health sorted out this mess. It's not about spending more money: it's about getting good value and quality services."
Ford will give evidence to the Commons public accounts committee on Wednesday in light of the NAO report.
Simon Gillespie, the chief executive of the MS Society, added: "The government now needs to send a clear message to everyone living with a neurological condition that these services are a priority."
The estimated number of people who have MND in the UK is 4,200, but this is predicted to rise to 5,330 by 2020. About 100,000 people in the UK have MS.
The Liberal Democrat minister of state for care services, Paul Burstow, said: "We know that care for people with neurological conditions is not good enough and we must do more. It is clear that too many people are not getting personalised support to suit their needs.
"This is exactly why we need to reform the NHS so we give people with long-term health conditions more control over their care and support, in consultation with clinicians. That is why we are developing a new outcomes strategy, piloting personal health budgets, and rolling out tele-health to deliver better results for people and make sound use of NHS resources." The Guardian
Nurses call for Care Quality Commission to be strengthened
Nurses call for Care Quality Commission to be strengthened: A new survey has shown that nurses believe the Care Quality Commission (CQC) needs to improve to become truly effective. Royal College of Nursing
Integrated Care: Its clinicians that make the difference
Integrated Care: Its clinicians that make the difference:
As clinicians we want to work in the health service to provide better care for our patients. The only way we can do this is by being part of a team. The same is true for our social care colleagues. The relationships we have with other clinicians, managers and health and social care partners are absolutely vital if a community is going to meet the difficult financial challenges ahead and yet deliver the highest possible quality of care.
In Northamptonshire we formed our Integrated Care Partnership (NICP) in 2009. We invited senior clinicians and front line workers from all major providers (including the LMC as the provider arm of primary care), as well as patients, carers, social care and the voluntary sector to come together with the aim of providing better integrated care to our mutual patients. Our ambition was to use this partnership to break down and resolve all organisational barriers and interface issues. We identified a series of quick wins that quickly established the value of the partnership, which still commands the attendance of all organisations 31 monthly meetings later!
We agreed a set of shared markers of success: decrease in emergency admissions and readmissions, decrease in length of stay, decrease in admissions to care homes, and ensure that we are able to honour the wishes of more patients in terms of their preferred place of death. Who could argue or put organisational barriers in the way of these markers? We agreed that we would use the partnership to ensure that the right clinical leaders come together in the right meetings at the right time to make all of the important decisions.
We have already seen a 17% (440 patients) reduction in deaths in hospitals compared to last year following the introduction of new end of life service. However, the most successful and ambitious scheme has been our £3 million Community Elderly Care Service. This all started when a Consultant Geriatrician asked me for 20 minutes on one of our agendas to present the concept. We quickly harnessed the collective enthusiasm around the table and ensured that doors of organisations on which we previously had to pound on heavily to find a solution were flung open due to the collaborative bottom up approach. The business case was quickly developed, piloted and approved.
We are never going to agree on everything. What we have developed over time are strong personal, as well as organisational, relationships that enable us to tackle differences of opinion in an open and constructive manner. For example, we continue to reconcile our ideological differences of the most appropriate place of care for patients by working our way through our Consultant to Consultant referral policy to agree exactly which patients should be seen where. Because we have the right senior clinical leaders in place we can openly discuss and resolve all issues within the NICP. We do not need to escalate to any higher authority, and in fact we would see this as a failure of our partnership.
Once we agree a collective course of action, each clinical leader takes this back to their organisations and ensures the appropriate changes are made. Where change is not delivered and there are further obstacles to be overcome we bring this back to the partnership and work together to resolve them. The hearts and minds battle is so much more easily won when clinicians are leading and driving the change. Nene Commissioning
Monday, 16 January 2012
Hospital’s staff claim £300,000
Hospital’s staff claim £300,000:
A hospital trust has revealed it has spent more than £300,000 on compensation payouts to staff following workplace accidents over the past five years. Northamptonshire Evening Telegraph
Elective surgery – low value?
Elective surgery – low value?:
The aim of this report has been to make recommendations for consideration by the NHS Operations Board with regard to effective commissioning of elective surgical procedures. The work was commissioned by Professor Sir Bruce Keogh, NHS medical director, following widespread expressions of concern from professional bodies that approaches based on lists of procedures deemed to be of “limited effectiveness”, “low value” or requiring a “threshold” result in inequitable patterns of service delivery. The evidence base for such approaches is not thought to be sufficiently robust, and in many cases procedures with well-established evidence of effectiveness, such as cataracts or arthroplasty, have been included. NHS Networks
New objectives set to reduce MRSA and C Difficile
New objectives set to reduce MRSA and C Difficile:
New ambitions have been set for the NHS which build on the progress made on infections last year. The NHS is being asked to collectively reduce the numbers of infections in 2012-13 on MRSA by a further 29 per cent and Clostridium difficile (C. difficile) by 17 per cent. If delivered it would bring annual numbers of MRSA bloodstream infections down to 880 and reduce C difficile infections from 19,754 to 16,100.
The latest monthly statistics show that, for the first time since mandatory surveillance began in 2001, MRSA bloodstream infections across the NHS have been sustained at under 100 reported cases per month for the last six months.
Health Minister Simon Burns said:
‘There has been great progress in reducing MRSA bloodstream and Clostridium difficile infections in some parts of the NHS, but we want everyone at the level of the best.
That is why we have set each Trust their own objective – to drive further improvements, particularly in the organisations with the highest rates of MRSA bloodstream and C. difficile infections.’
The NHS Operating Framework 2012-13, published 24 November 2011, prioritises the achievement of the MRSA and C. difficile objectives. The technical guidance lists all the indicators against which the NHS will be accountable nationally during 2012/13. Department of Health
Read the New Year ambitions to reduce healthcare associated infections press release
Planning guide for public health transition published
Planning guide for public health transition published:
Download Public health workforce issues: Local government transition guidance
Department of Health
To help the process of local decision-making around the public health transition, the Department and the Local Government Association have today published a planning guide for local authorities and primary care trusts.
Public Health Transition Planning Support for Primary Care Trusts and Local Authorities, which as been co-produced with the NHS and local government, aims to support PCTs and LAs as they develop transition plans for the transformation of the local public health system, including how transfer of accountability from the NHS to local government will be enacted during the transition year.
The Local Government Association has published transition guidance on public health workforce matters. The guidance builds on the earlier Public Health HR Concordat, which set out general principles for dealing with staffing issues.Download Public health workforce issues: Local government transition guidance
Department of Health
Advice on PiP implants
Advice on PiP implants:
The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.
There is no link to cancer and there is no clear evidence of an increased risk of harm compared to other brands of breast implants.
The Government is advising women to take three steps to reassure themselves:
• Find out if you have PiP implants by checking your medical notes. You can get this information for free from your clinic or through your GP. If you had PiP implants on the NHS, you will receive a letter in the next few weeks.
• Speak to your specialist or GP, if you had them done on the NHS, or your clinic if you had them done privately.
• Agree what’s best for you. Get advice on whether or not you need a scan, then discuss appropriate action with your doctor.
If a private clinic no longer exists or refuses to remove the PiP implants, the Government is advising women to speak to their GP. The NHS will remove the implants if the doctor agrees, but the NHS will not replace implants unless it is clinically necessary.
Dental body's complaints backlog
Dental body's complaints backlog: The body which investigates dangerous or incompetent dentists has been battling a backlog of serious complaints, the BBC has learned. BBC News
Social care talks due this week
Social care talks due this week: Cross-party talks about overhauling care and support for the elderly and disabled in England are due to begin this week. BBC News
NHS Safety Thermometer
NHS Safety Thermometer
The NHS Safety Thermometer is a local improvement tool for measuring, monitoring and analysing patient harms and harm free care that can be used to measure and monitor local improvement over time.
From April 2012, it is the recommended tool for measuring pressure ulcers as part of the Commissioning for Quality and Innovation (CQUIN) payment programme. Please see the link below for details. NHS Information Centre
The NHS Safety Thermometer is a local improvement tool for measuring, monitoring and analysing patient harms and harm free care that can be used to measure and monitor local improvement over time.
From April 2012, it is the recommended tool for measuring pressure ulcers as part of the Commissioning for Quality and Innovation (CQUIN) payment programme. Please see the link below for details. NHS Information Centre
NHS efficiency: closing the gap - Public Finance
NHS efficiency: closing the gap - Public Finance:
NHS efficiency: closing the gap Public Finance A set of recommendations for policy-makers is laid out alongside the advice to practitioners, and these are targeted at the NHS Commissioning Board and Monitor in particular. The suggestions include providing direction to commissioners and providers ... and more » |
Deaths and serious injuries involving medical devices up 29%
Deaths and serious injuries involving medical devices up 29%: The number of patients killed or seriously injured by medical devices rose by almost a third last year, according to official figures.
The Daily Telegraph
The Daily TelegraphNo-show patients should be charged, says Clegg adviser
No-show patients should be charged, says Clegg adviser: Patients who fail to turn up for hospital appointments should be charged, a Coalition adviser has suggested.
The Daily Telegraph
The Daily TelegraphWarning over speech therapy cuts
Warning over speech therapy cuts:
Cuts to speech therapy services could force thousands of children with problems to wait for months for support, the Government’s communication champion warns ministers today. The Independent
Four Health Care Organizations' Efforts to Improve Patient Care and Reduce Costs
Four Health Care Organizations' Efforts to Improve Patient Care and Reduce Costs: This report synthesizes findings and lessons from case studies of four diverse health care organizations participating in the Brookings–Dartmouth ACO Pilot Program, launched in 2009 to support selected provider groups that are collaborating with private payers to form accountable care organizations (ACOs).
The Commonwealth Fund
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