Wednesday, 30 April 2014

Data and patient safety - are we asking the right questions?

Data and patient safety - are we asking the right questions? Publishing data alone won’t improve care, but what just might is using this information to inform operational decisions and making it visible to patients, carers and families when they enter a ward, says John Illingworth. The Health Foundation

Sacking over poor elderly home care

Sacking over poor elderly home care One staff member is sacked and seven suspended from an Essex care home after an undercover Panorama investigation finds poor care. BBC News

Learning Disability Census: new analysis including anti-psychotic medication use and physical 'incidents' for inpatients

Learning Disability Census: new analysis including anti-psychotic medication use and physical 'incidents' for inpatients New analysis of the 2013 Learning Disability Census, commissioned in response to events at Winterbourne View Hospita4 has been published by the Health and Social Care Information Centre. This report provides further information on inpatients with learning disabilities in England, being treated in specialist units, following publication of the initial findings in December 2013.

The census shows that two thirds of these inpatients (68 per cent or 2,220) had been given anti-psychotic medication in the 28 days preceding the census. Of these, 93 per cent (2,064) had been given them on a regular basis.

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Comorbidities: a framework of principles for system-wide action

Comorbidities: a framework of principles for system-wide action This document sets out the current challenges faced in the health and social care system in treating people with 2 or more long term health conditions. It proposes changes to the system to improve care. Department of Health

Ageing alone: loneliness and the oldest old

Ageing alone: loneliness and the oldest old This report argues that loneliness should be a public health priority and explores practical steps that can be taken to reduce levels of loneliness among the oldest old. Addressed to politicians and policy makers in both central and local government, leaders and innovators in the voluntary and community sector, and wider society as a whole, the report urges them to give more priority to the services and support that we know can help older people avoid ageing in loneliness and isolation. CentreForum

How much does high quality care cost?

How much does high quality care cost? This briefing outlines the results of an FTN members' survey and reveals the full scale of extra investment that NHS foundation trusts and trusts are making to improve patient care following the Francis and Keogh reviews and the introduction of the new CQC inspection regime. It calls for a new approach to funding service developments and improved financial risk sharing. Foundation Trust Network

Report helps explain Gulf War illness

Report helps explain Gulf War illness Disorder caused by chemical exposures. OnMedica

6 HUNDRED University of Derby students put at risk of HIV by healthcare worker

6 HUNDRED University of Derby students put at risk of HIV by healthcare worker More than 600 past and present students from the University of Derby have been contacted and advised to attend screening for HIV and hepatitis. The Daily Mail

GP services have reached crisis point warns BMA

GP services have reached crisis point warns BMA Shortage of GPs predicted as large numbers plan to retire while fewer junior doctors are willing to enter general practice, British Medical Association warns. The Daily Telegraph

Doctors who oppose morning-after pill on conscience grounds face qualifications bar

Doctors who oppose morning-after pill on conscience grounds face qualifications bar Guidelines confirm that doctors and nurses who oppose controversial emergency contraception on 'moral or religious' grounds cannot receive key specialist qualifications. The Daily Telegraph

Tuesday, 29 April 2014

Policy paper: Helping people live well for longer

Policy paper: Helping people live well for longer This document will help people understand how the national system as a whole is supporting local action to help people live well for longer. It includes actions already taken in prevention, early diagnosis and treatment.

It focuses on the 5 big killers:
  • cancer
  • stroke
  • heart disease
  • lung disease
  • liver diseases
It includes examples of good practice and help for local commissioning and service delivery. Department of Health

Half with cancer 'live a decade'

Half with cancer 'live a decade' Half of people in England and Wales now being diagnosed with cancer will survive for at least a decade - double the number from the early 1970s, figures show. BBC News

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'Experience dementia via Facebook'

'Experience dementia via Facebook' Facebook users are being invited to experience what it is like to live with dementia in a bid to raise greater awareness about the disease. BBC News

Trust fined £200K for patient death

Trust fined £200K for patient death The health trust which ran Stafford Hospital is fined £200,000 for failing a diabetic patient who died in its care. BBC News

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Non-smokers shunning e-cigarettes

Non-smokers shunning e-cigarettes “E-cigarette users have tripled to 2 million since 2012,” The Guardian reports. This is just one of the findings from a survey by anti-tobacco public health charity Action on Smoking and Health (ASH). It also showed there is little evidence that non-smokers are using e-cigarettes, although this could change in the future.

These headlines are triggered by a new factsheet on the usage of electronic cigarettes (e-cigarettes) published by ASH.

The research has found that non-smokers are not taking up the e-cig habit, although it is too early to be complacent. The data only spans the 2010 to 2014 period, meaning that longer-term smoking trends are unknown. As e-cigarettes are a relatively modern phenomenon, it is impossible to predict with any certainty what long-term effects they may have on smoking habits.

Who are ASH?

Action on Smoking and Health (ASH) was established in 1971 by the Royal College of Physicians. It is a campaigning public health charity that works to eliminate the harm caused by tobacco.

ASH produces a variety of published material for companies and governments, as well as bulletins and newsletters.

Today’s publication on e-cigarettes coincides with the day the Advertising Standards Authority (ASA) consultation on the advertising of electronic cigarettes closes.
The consultation concerned proposals to introduce new rules for the advertising of e-cigarettes, including measures to protect young people, address concerns over the indirect promotion of tobacco products via e-cigarettes and prohibiting health or medical claims.


Links To The Headlines

E-cigarette users have tripled to 2 million since 2012, study finds. The Guardian, April 28 2014

Two million now puff on e-cigarettes: Number using devices trebles in two years. Daily Mail, April 28 2014

E-cigarette users in UK have 'tripled' since 2010. BBC News, April 28 2014

E-cigs ‘cleared of being route into smoking’. Metro, April 27 2014

E-cigarette use 'has tripled in two years'. ITV News, April 28 2014

Outcomes assessment for people with long-term neurological conditions

Outcomes assessment for people with long-term neurological conditions This researched aimed to identify factors that affect integration between health and social care; outcomes important to people with long-term neurological conditions who are clients of an ‘integrated’ service; develop these outcomes into a checklist and understand how different models of integration affect outcomes. National Institute for Health Research

Flu immunisation plan published for 2014/15

Flu immunisation plan published for 2014/15 Public health experts warn against ‘complacency’. OnMedica

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Lethal camel-borne MERS virus death toll reaches 102 in Saudi Arabia

Lethal camel-borne MERS virus death toll reaches 102 in Saudi Arabia

A spike in the number of infections from a deadly virus, which has now killed more than one hundred people in Saudi Arabia, is “concerning” but the risk to the UK remains low, health officials have said. The Indepedent

Superbug NDM could 'change face of healthcare' experts warn

Superbug NDM could 'change face of healthcare' experts warn Cases of a superbug that can break down antibiotics and could 'change the face of healthcare as we know it' have risen exponentially in the last five years, Government experts warn. The Daily Telegraph

Fears over plans to cut emergency admissions

Fears over plans to cut emergency admissions Patients' groups have raised fears that hospitals will be forced to cut services before it is safe to do so. The Daily Telegraph

Monday, 28 April 2014

E-cigarette users reach 2 million

E-cigarette users reach 2 million The number of electronic cigarette users in the UK has tripled over the past two years, says Action on Smoking and Health. BBC News

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New NHS supply list 'to save £500m'

New NHS supply list 'to save £500m' The government claims a new central procurement list for hospitals to buy everyday supplies could save the NHS in England £500m. BBC News

Amputation postcode lottery getting worse

Amputation postcode lottery getting worse The new figures, based on NHS data, show that the overall diabetes-related amputation rate has not improved at all, with 2.6 per thousand people with diabetes per year having a lower limb amputation. And what is more unacceptable is that the gap between the worst and best performing areas has got bigger. Diabetes UK

Upping coffee intake may reduce diabetes risk

Upping coffee intake may reduce diabetes risk Three cups of coffee a day could help keep diabetes away," The Independent reports. A US study has found a link between increased coffee intake and a small – but significant – reduction in type 2 diabetes risk, but not proof that drinking coffee prevents diabetes.

The study found that adults who increased their coffee consumption by more than one cup a day reduced their risk of developing type 2 diabetes by around 11% in the following four years. The reduction in relative risk held for a range of initial coffee consumption levels and appeared to remain up to 16 years later.

Coffee consumption was assessed every four years. It appeared that increasing coffee consumption during this period made a difference to diabetes risk in the subsequent four years and longer.

NHS understaffing may have effect on baby mortality rate, says top doctor

NHS understaffing may have effect on baby mortality rate, says top doctor 'Legitimate to ask' whether number of staff is contributing to death of 300 babies a year, says Dr David Richmond

Britain's leading obstetrician says it is legitimate to ask whether understaffing of maternity care and labour wards is contributing to Britain's stubbornly high rates of baby death and brain damage.

Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists, has voiced alarm that nearly 300 babies a year are dying during or soon after birth with a further 1,200 ending up with brain damage or other serious health problems.Continue reading... The Guardian

‘Depression and burn-out’ at work afflict one-third of employees

‘Depression and burn-out’ at work afflict one-third of employees
Depression at work devastates lives and wipes billions from the European economy, a report finds. The Independent

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Government watchdog 'stuck in time'

Government watchdog 'stuck in time' Poor handling of complaints about public services is 'poisoning' efforts to learn from tragedy, MPs warn. The Daily Telegraph

Patients should get financial advice at GP surgery, watchdog says

Patients should get financial advice at GP surgery, watchdog says Public Health England said financial concerns were "getting in the way" of the good health of many people, and should be tackled in GP surgeries. The Daily Telegraph

Friday, 25 April 2014

“A third” of Northamptonshire`s community mental health nurses at risk of redundancy

“A third” of Northamptonshire`s community mental health nurses at risk of redundancy About a third of community psychiatric nurses in Northamptonshire have been placed at risk of redundancy, patients have claimed.
Northamptonshire Healthcare NHS Foundation Trust, which provides NHS mental health services across the county has confirmed that it has begun several separate staff consultations over job losses, including some of its community psychiatric nurses. Northampton Chronicle and Echo

EXCLUSIVE: Grandmother with fractured pelvis locked in toilet at Northampton General Hospital for an hour

EXCLUSIVE: Grandmother with fractured pelvis locked in toilet at Northampton General Hospital for an hour A faulty emergency cord in a Northampton General Hospital toilet left a great grandmother shocked and distressed when she was locked in there for more 
than an hour. Northampton Chronicle and Echo

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We can learn more from India than how to cut costs

We can learn more from India than how to cut costs Here’s a puzzle for you. You have a population of one million people, three psychiatrists, and no mental health nurses. How do you go about delivering mental health care?

Resource constraints of this order are something we rarely have to contemplate in the UK, but are a daily reality in India and many other countries. Despite the differences in the scale of the resources available, the underlying challenge of improving quality within limited budgets is one shared by health systems across the world, and in the UK there has been increasing interest in the lessons that might be learnt from innovations in lower-income countries.

Health atlas shows risks by area

Health atlas shows risks by area A new online map of England and Wales allows people to enter their postcode and find their community's level of risk of developing 14 conditions, such as heart disease and lung cancer. BBC News

Lung and pancreatic cancers may be on the rise

Lung and pancreatic cancers may be on the rise "Lung cancer will soon become the biggest cancer killer among women," the Mail Online reports, while ITV News reveals that pancreatic cancer "poses [a] growing threat". Both headlines are prompted by a study that has estimated future cancer trends across the EU.

The researchers estimate there will be approximately 1.32 million deaths from the eight most common cancers in 2014. They predict that in women, deaths from breast and colorectal cancers will decrease, but lung cancer rates are expected to increase by 8%.

The generation strain: collective solutions to care in an ageing society

The generation strain: collective solutions to care in an ageing society The number of older people in need of care is expected to outstrip the number of family members able to provide informal care for the first time in 2017, according to a report by IPPR. It shows that the average annual cost for an older person who pays for a typical package of care has increased to £7,900 a year, an average £25,000 for home care and an average £36,000 for a nursing home.By 2030, an estimated 230,000 older people in England who need care of more than twenty hours a week could be left without family to help, according to IPPR. The report says that the number of people aged 65 and over without children to care for them will almost double before the end of the next decade and that by 2030, there will be more than 2 million people in England without a child to care for them if needed. Institute for Public Policy Research

11% rise in women overdue for cervical screening

11% rise in women overdue for cervical screening There has been a substantial rise in the number of women who are overdue for screening for cervical cancer, with 11% more now overdue, compared to three years ago, data from the Health and Social Care Information Centre shows. OnMedica

GPs face growing pressure on child mental health referrals as CCGs impose further cuts

GPs face growing pressure on child mental health referrals as CCGs impose further cuts Exclusive CCGs are making cuts to the funding of child and adolescent mental health services, despite concerns from GPs that services are already overstretched, an  investigation has revealed. Pulse

Are clinical commissioning groups coping with the changes in the NHS?

Are clinical commissioning groups coping with the changes in the NHS? With CCGs just over a year old, do they have the ability to provide the bold leadership needed to make the necessary changes to local healthcare?

Are clinical commissioning groups coping with the changes in the NHS? The answer is very mixed. CCGs are still relatively young organisations. They have just completed their first year as commissioning bodies responsible for setting strategic priorities for their patch and commissioning care for secondary (acute and mental health) and community care, and for co-ordinating closely with public health and social care.

This is no small task. There are many cultural, organisational, budgetary and policy boundaries that divide and disintegrate care for patients and for populations. It is really too early to tell whether CCGs will have the ability to provide the bold local leadership to make the changes necessary to integrate care seamlessly for their population. The goal must be to manage the care landscape so that individuals can navigate the different sectors without encountering barriers or boundaries.Continue reading... The Guardian

Foreign doctors are vital to the NHS

Foreign doctors are vital to the NHS Recent reports risk creating a wave of distrust among patients, which could lead to future recruitment problems

From its inception, the NHS was built with the help of foreign workers and professionals from across the world. Thousands of doctors emigrated from the Indian subcontinent, Africa and Caribbean islands, recruited by a health service afflicted by an acute post-war shortage of medical staff.

Recent reports on foreign doctors have given adverse publicity, which is a matter of grave concern. Two issues are the pass rates of international medical graduates (IMGs) in GP exams as well as the rates of suspensions and erasures from the General Medical Council register which are in danger of creating sensationalism and marginalising dedicated NHS doctors.Continue reading... The Guardian

Thursday, 24 April 2014

Pensioner killer released early from secure unit

Pensioner killer released early from secure unit A man killed a pensioner after being released ‘prematurely’ from a secure psychiatric unit. Northamptonshire Telegraph

Troubled Northampton nursing homes to defer closure plan

Troubled Northampton nursing homes to defer closure plan  Almost 70 nursing home residents could be allowed to remain at two at-risk care homes in Northampton for the time being, if a last -minute
 intervention by council officers is successful. Northampton Chronicle and Echo

Care needs to 'outstrip' family help

Care needs to 'outstrip' family help The number of older people in England needing care will "outstrip" the number of family members able to provide it by 2017, a think tank warns. BBC News

Anatomy of the cost of a new drug

Anatomy of the cost of a new drug Why do new treatments costs so much? BBC News

A&E performance: England 2013/14

A&E performance: England 2013/14 It looks at the number of people who have attended A&E, the pattern of A&E attendance over the year and how different NHS trusts compare on waiting times. House of Commons Briefing Paper

Kidney injuries 'killing thousands,' study claims

Kidney injuries 'killing thousands,' study claims “Failures in basic hospital care are resulting in more than 1,000 deaths a month from … acute kidney injury,” The Independent reports. A study commissioned by the NHS estimates that up to 40,000 people may be dying from this preventable condition.

The study aimed to discover the prevalence of acute kidney injury (AKI – previously called acute kidney failure) among adult inpatients in NHS hospitals.

AKI is characterised by a rapid decline in kidney function, which can have many underlying causes. The condition can have a high risk of multiple organ failure and death.

The management of waste from health, social and personal care

The management of waste from health, social and personal care The guide was developed with RCN members and waste management experts from across the UK. It was co-authored by WSP, the professional consultancy which also helped produce the Department of Health’s revised guidance on the safe management of health care waste. It aims to supporting health care workers to classify waste appropriately in order to bring benefits to health organisations as well as the environment. Royal College of Nursing

Sexual and reproductive health evidence summaries

Sexual and reproductive health evidence summaries This package of new resources providing the latest evidence on the impact and economics of opportunistic chlamydia screening, and HIV screening and testing. The topics were selected given their priority as key sexual health indicators within the ‘Public Health Outcomes Framework’, which local areas are now delivering against. For both of these topics, PHE have produced evidence summaries and leaders' briefings which aim to inform the planning and commissioning of these services. Public Health England

First reports from new-style inspections of mental health services and community health services

First reports from new-style inspections of mental health services and community health services These are the first reports from the new CQC programme of mental health and community health services inspections. Reports have been published on Coventry and Warwickshire Partnership NHS Trust; Devon Partnership NHS Trust; Bridgewater Community Healthcare NHS Trust; and Central Essex Community Services. Care Quality Commission

The dos and don'ts of NHS reconfiguration

The dos and don'ts of NHS reconfiguration Many of the proposed changes to health services are hugely controversial. How can NHS bodies ensure a legal challenge doesn't stop a reorganisation in its tracks?

Across the country, commissioners and providers face escalating demand for services, increasing scrutiny of quality and flatlining funding. From root-and-branch reviews of acute, community and mental health services to proposals to relocate or close a single service, clinical commissioning groups, trusts and foundation trusts are making daily decisions that will shape the services available to their communities.

Many of these changes can be hugely controversial. It takes only one determined individual or a small number forming a campaign group to bring a legal challenge. Whatever the outcome of that challenge, it can stop a reconfiguration in its tracks, leading to months of delay and significant legal costs.Continue reading... The Guardian

Hospital chiefs 'ignoring midwives shortage rather than paying to fill gaps'

Hospital chiefs 'ignoring midwives shortage rather than paying to fill gaps' Royal College of Midwives claims senior staff avoiding assessment of workforce because they know they could not afford to plug any gaps it would expose. The Daily Telegraph

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Warning over 'unacceptable' lottery in care of the dying

Warning over 'unacceptable' lottery in care of the dying Review of end-of-life care as NHS inspector warns of 'huge inequalities' in treatment of the dying. The Daily Telegraph

Wednesday, 23 April 2014

Fergie, football and the NHS: building a leadership team for the future

Fergie, football and the NHS: building a leadership team for the future Several national reviews have emphasised the need to cultivate future clinical leaders, yet opportunities to do so remain one-dimensional, says Na'eem Ahmed. The Health Foundation

Breast cancer drug price cut urged

Breast cancer drug price cut urged Campaigners urge pharmaceutical giant Roche to lower the cost of a pioneering breast cancer drug as the NHS prepares to rejects its use on price grounds. BBC News

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'A third' can't afford healthy food

'A third' can't afford healthy food High food prices mean a third of UK adults are struggling to afford to eat healthily, a survey by the British Heart Foundation suggests. BBC News

500 GP practices to pilot care.data

500 GP practices to pilot care.data Up to 500 GP practices will trial care.data in a phased roll out beginning this autumn, NHS England has announced. E-Health Insider

DH rolls back GP records access promise

DH rolls back GP records access promise The government's pledge to give patients online access to their GP records by March 2015 has been scaled back again, with practices now only required to have a plan to provide access by the deadline. E-Health Insider

Learning for care homes from alternative residential care settings

Learning for care homes from alternative residential care settings This review explores the learning from delivery of care in residential services for children and young people, residential services and supported housing for people with learning disabilities and hospice care, and considers how this can be applied in care homes for older people. Joseph Rowntree Trust

Cheap holidays 'increased' melanoma rates

Cheap holidays 'increased' melanoma rates “Skin cancer rates ‘surge since 1970s’,” reports the BBC.

The news is based on a press release from Cancer Research UK after the release of new figures for the number of people diagnosed with malignant melanoma, the most serious form of skin cancer. The statistics show that the number of people being diagnosed with malignant melanoma is five times higher than it was 40 years ago.

The press release argues that the rise can be explained, at least partially, by the growth of cheap package beach holidays since the late 1960s.

The rise in popularity of sunbeds and sunlamps may have also contributed to the increased rates.

Doctors facing more patient complaints online

Doctors facing more patient complaints online Growing trend to raise concerns on social media instead of official channels. OnMedica

Norman Lamb rattled by 'zombie' attack on health and care policy | David Brindle

Norman Lamb rattled by 'zombie' attack on health and care policy | David Brindle The care minister's plan for a £5bn joint NHS and social care fund to be used for personal budgets is doomed unless thinking changes

You never know where you are with zombies. So care and support minister Norman Lamb might have thought twice when it was put to him that doctors were likening his pet policy to an animated corpse. That he didn't, but chose instead to let rip, speaks volumes about the tension surrounding the health and social care interface.

Lamb was speaking at the annual conference of the School for Social Care Research and had said he wanted to see "great chunks" of NHS funds turned over to personal health budgets for people living with long-term conditions. A questioner told him that at another event, packed with health professionals, a show of hands had gone overwhelmingly against the idea of patients using budgets to arrange their own care. One eminent medic at the event had described the policy as an "intellectual zombie", an "ideologically driven dead idea still moving" that needed putting out of its misery.Continue reading... The Guardian

Illegal abortion doctors face no action

Illegal abortion doctors face no action Doctors who illegally signed dozens of abortion consent forms will not be disciplined, as MPs say this is evidence of the UK's 'abortion on demand' culture. The Daily Telegraph

Tuesday, 22 April 2014

Appeal for St Andrew Hospital deaths’ report to be public

Appeal for St Andrew Hospital deaths’ report to be public A health watchdog has called for an independent inquiry into four deaths on the same ward, after claiming a lack of transparency from the Northampton hospital involved. Northampton Chronicle and Echo

Two Northampton care homes likely to close after going into administration

Two Northampton care homes likely to close after going into administration Almost 70 elderly people could be forced to move to new accommodation after two Northampton care homes went into administration. Northampton Chronicle and Echo

New CQC inspection framework: what does a 'well-led' organisation look like?

New CQC inspection framework: what does a 'well-led' organisation look like? Last week the Care Quality Commission (CQC) launched a consultation giving more detail on proposed changes to the way it regulates, inspects and rates health and social care providers, building on the new vision and direction that it set out last year.

The new inspection framework sets out five ‘domains’, assessing providers on whether they are: safe; effective; caring; responsive to people’s needs; and well-led.

Policy paper: Progress on improving nursing for people with learning disabilities

Policy paper: Progress on improving nursing for people with learning disabilities This report sets out the progress made in England during the past year against the 17 recommendations set out in ‘Strengthening the Commitment: The report of the UK Modernising Learning Disability Nursing Review (2012)’.

It shows how the recommendations have been turned into good practice to achieve better health and wellbeing for people with learning disabilities.

It fulfils the commitment we made in ‘Transforming Care: A national response to Winterbourne View Hospital’. Department of Health

Staggering Trainee Doctor Changeover

Staggering Trainee Doctor Changeover. There is a clear need for change in the process of trainee doctor changeover (the time when junior doctors rotate their position). The beginning of August brings an apparent increase in patient morbidity and evidence suggesting increased mortality. It is a time that trainee doctors find stressful and difficult. Royal Colleges, Deans and employers all say that greater uniformity at the time of changeover would enhance service organisation and would be welcomed by trainers. This paper explores the need for variation in the current system for trainee doctor changeover dates. Academy of Medical Royal Colleges

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NHS data-sharing scheme 'mishandled'

NHS data-sharing scheme 'mishandled' The chair of the panel set up to advise ministers on the governance of NHS data tells the BBC the Care.data programme was "mishandled". BBC News

Foreign doctors 'need tougher tests'

Foreign doctors 'need tougher tests' Tests taken by foreign doctors who want to work in the NHS should be made harder to pass to bring them in line with UK standards, a study says. BBC News

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Apathy unproven as early warning sign of dementia

Apathy unproven as early warning sign of dementia “Elderly who lose interest in pastimes could be at risk of Alzheimer's,” reports The Daily Telegraph, with other papers reporting similar headlines.

These incorrect headlines are based on the results of a study that looked for a link between symptoms of apathy and structural brain changes (on brain scans) in over 4,000 older adults who did not have dementia.

Leading doctor calls for inquiry into NHS treatment of whistle-blowers

Leading doctor calls for inquiry into NHS treatment of whistle-blowers

The treatment of NHS whistle-blowers must be subject to a public inquiry, a leading doctor and patient safety pioneer has said, after a heart surgeon who raised the alarm about poor care was found to have been wrongly dismissed by his hospital. The Independent

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Thousands die of thirst and poor care in NHS

Thousands die of thirst and poor care in NHS Up to 40,000 patients die annually because hospital staff fail to diagnose a treatable kidney problem, a figure that dwarfs the death toll from superbugs like MRSA. The Daily Telegraph

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Opportunity for Regional Improvement: Three Case Studies of Local Health System Performance

Opportunity for Regional Improvement: Three Case Studies of Local Health System Performance Case studies of three U.S. regions that ranked relatively high on the Commonwealth Fund’s Scorecard on Local Health System Performance, 2012, despite greater poverty compared with peers, revealed several common themes. In these communities, multistakeholder collaboration was an important factor in achieving community health or health system goals. There were also mutually reinforcing efforts by health care providers and health plans to improve the quality and efficiency of care, regional investment and cooperation to apply information technology and engage in community outreach, and a shared commitment to improve the accessibility of care for underserved populations. The Commonwealth Fund

Thursday, 17 April 2014

Transforming primary care

Transforming primary care The new Department of Health document, Transforming primary care, mostly looks to improve services for those with the most complex needs. While the focus on this group is no doubt right, what does it tell us about transforming primary care for the rest of the population?

We’ve discovered a shortcut to innovation…go outside the box

We’ve discovered a shortcut to innovation…go outside the box Ask people if they think they are innovative. Go on, see what they say. The reality is that we are very competent using innovations but not very innovative ourselves, says Peter Chamberlain. The Health Foundation

Hospital infections 'still too high'

Hospital infections 'still too high' Doctors and nurses should do more to stop hospital patients developing infections, an NHS watchdog says. BBC News

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Should drug firms make payments to doctors?

Should drug firms make payments to doctors? Does it matter that drug firms give doctors money and gifts? BBC News

70 percent of nurses and midwives are missing out on over £170 a year

70 percent of nurses and midwives are missing out on over £170 a year Nurses and midwives who do not claim tax relief on their annual NMC registration fee, subscription to their union or professional body, laundering of their uniform or for tights and shoes are missing out on over £170 a year the Nursing and Midwifery Council (NMC) has found.

Cannabis linked to brain differences in the young

Cannabis linked to brain differences in the young “Using cannabis just once a week harms young brains,” the Daily Mail reports.

The newspaper reports on an US study that took one-off brain MRI scans of a group of 20 young adult recreational cannabis users, and a comparison group of 20 non-users. They compared their brain structure, focusing on regions that are believed to be involved in addiction.

They found differences between users and non-users in shape and volume of the nucleus accumbens and amygdala; areas of the brain involved in reward and pleasure responses, emotions, memory, learning, and decision making.

However, a case could be made that the media has overstated the implications of the research.

Operating theatre safety warning

Operating theatre safety warning Six serious incidents due to residual anaesthetic drugs in cannulae or IV lines OnMedica

Mobile technology will nurse the NHS back to health

Mobile technology will nurse the NHS back to health Smartphone technology could help nurses spend more time with patients and improve the quality of healthcare on the NHS

Overhauls, strategic changes, new objectives: the NHS is no stranger to grand claims and plans about the future of healthcare. However, all too often these plans are political footballs, doing little to improve day-to-day patient care or the working lives of frontline healthcare professionals. Continue reading... The Guardian

How text messages can eradicate waiting times

How text messages can eradicate waiting times An automated text messaging system can save time for staff and makes access to appointments easier for patients.

Has there ever been a more explosive issue in the NHS than waiting times?

Progress has been made in more recent times, but figures published by the government in March for the January period show a reversal of these hard-won improvements. Around 2.9 million people were waiting for treatment in the first month of 2014, up by 362,000 from January 2013. Continue reading... The Guardian

NHS patients face charges for walking sticks, crutches and braces

NHS patients face charges for walking sticks, crutches and braces Patients could be charged for walking sticks, crutches, neck braces and other equipment, according to plans drawn up for an NHS body. The Independent

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Cancer drugs targeted to patient's own genetics to be offered in new NHS trial

Wednesday, 16 April 2014

Nurse struck off after taking £30

Nurse struck off after taking £30 A senior nurse who was working at St Andrews Hospital is struck off after taking £30 from his employee. BBC Northamptonshire

MPs meet new KGH chief executive

MPs meet new KGH chief executive The area’s three MPs have said a meeting with Kettering General Hospital’s new chief executive last week went well. Northamptonshire Telegraph

How is the NHS performing? April 2014

How is the NHS performing? April 2014 This is the eleventh in a series of quarterly monitoring reports which aims to provide a regular update on how the NHS is coping as it grapples with the evolving reform agenda and the more significant challenge of making radical improvements in productivity. It highlights that the NHS has had no real rise in spending between 2010/11 and 2013/14, yet despite this, in broad terms the NHS has continued to provide services to a growing population and to maintain the quality of those services. However, our survey finds that there is deepening pessimism about the ability of the NHS to make ends meet financially, particularly in 2015/16. The King's Fund

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Two sides of the same coin: Balancing quality and finance to deliver greater

Two sides of the same coin: Balancing quality and finance to deliver greater A crucial issue facing the NHS today is how the health service can balance the imperative to provide better care with the need to reduce costs overall. NHS Confederation

Under 16s 'shut out of safe havens'

Under 16s 'shut out of safe havens' Children suffering a mental health crisis in England are being forced into police custody because 35% of NHS "places of safety" ban under 16s, figures suggest. BBC News

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Warning over bowel cancer screening

Warning over bowel cancer screening Bowel cancer screening uptake needs to improve, campaigners say, after figures showed just half of people eligible in England come forward for the test. BBC News

Pay, conditions and care quality in residential, nursing and domiciliary services

Pay, conditions and care quality in residential, nursing and domiciliary services How do pay and conditions for workers in residential, nursing and domiciliary care services relate to the quality of care they provide? Care workers do demanding work for low pay, and social care services are being delivered in an increasingly challenging environment, yet service users, their carers and families have increasing expectations about service quality and care workers’ skills and attributes. Joseph Rowntree Trust

Barely half of those eligible for NHS Health Check actually getting it

Barely half of those eligible for NHS Health Check actually getting it Only eight local authorities have met the targets set by Public Health England. OnMedica

Four lessons for the NHS on how to manage an ageing workforce

Four lessons for the NHS on how to manage an ageing workforce With plans to raise the state pension age to 70, the health service has to tackle a variety of challenges

In his Autumn statement last year, the chancellor of the exchequer set in motion plans to raise the state pension age to 70 for today's young people, on course to be the highest in the world. The question of whether people will need to work longer in the future is pretty much settled but there is still a lack of clarity about what work will be like for older workers of the future and how managers will oversee increasingly ageing workforces.

Answering the question of how to extend working life made a significant advance when the NHS Working Longer Review group reported the preliminary findings of its investigation into the impact of higher pension ages on the delivery of health services. This is the largest review of working practices in relation to age undertaken in the UK.Continue reading... The Guardian

NHS faces strike threat as 500,000 healthcare staff to be balloted

NHS faces strike threat as 500,000 healthcare staff to be balloted Unison and Unite confirm staff ballot over possible strike action following Jeremy Hunt's decision to axe 1% pay rise

The NHS is bracing itself for a strike after its largest union voted to ballot its members over industrial action to protest against the axing of health staff's planned 1% pay rise.

Unison, which represents 400,000 NHS personnel including about 100,000 nurses, decided on Tuesday to ballot over strike action or action short of a strike.Continue reading... The Guardian

Hospital bed shortage exposed

Hospital bed shortage exposed UK has second lowest number of beds per person in Europe, report shows, as NHS overcrowding breaches safety limit and raises risk of superbugs. The Daily Telegraph

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Tuesday, 15 April 2014

Northampton General to extend accident and emergency

Northampton General to extend accident and emergency Northampton General Hospital has submitted plans to ease pressure on its emergency department with a new building for GPs and consultants. Northampton Chronicle and Echo

Signing up to safety – lessons from Virginia Mason

Signing up to safety – lessons from Virginia Mason Virginia Mason Medical Centre in Seattle provide a route map for the journey to safe, effective, patient-centred and efficient health care, says Professor Stephen Singleton in this blog. He welcomes Jeremy Hunt's invitation to the English NHS to 'sign up to safety' and get going on this journey, and discusses some of the barriers and pitfalls that must be dealt with along the way. The Health Foundation

Transforming primary care: safe, proactive, personalised care for those who need it the most

Transforming primary care: safe, proactive, personalised care for those who need it the most This guidance sets out plans for more proactive, personalised and joined up care, including the Proactive Care Programme, providing the 800,000 patients with the most complex health and care needs with a personal care and support plan; a named accountable GP; a professional to coordinate their care; and same-day telephone consultations. The plan builds on the role of primary care in keeping patients well and independent. It explains how professionals across the healthcare system can work together to transform care to become more proactive and tailored to patients’ individual need. Department of Health

Routine operations: Is a crisis brewing?

Routine operations: Is a crisis brewing? Concern over rise in waits for hospital operations. BBC News

CQC publishes GP inspection handbooks

CQC publishes GP inspection handbooks The CQC has already begun to test this new approach in GP out-of-hours inspections and between April and June 2014 will be testing wave one of the new model by inspecting 200 GP practices within 12 CCG areas. More.....

From innovation to adoption: successfully spreading surgical innovation

From innovation to adoption: successfully spreading surgical innovation Failure to adopt new surgical techniques quickly into everyday clinical practice means NHS patients are missing out on ground-breaking new procedures. This report sets out the factors that have helped and hindered the adoption of new surgical techniques in England and seeks to address how to progress the uptake of surgical innovations in a practical way, eradicating delay to ensure their benefits are realised by patients as quickly as possible. Royal College of Surgeons

Exclusive: NHS faces financial disaster in 2015 as politicians urged to find radical solution

Exclusive: NHS faces financial disaster in 2015 as politicians urged to find radical solution
The NHS faces a “financial crisis” next year as a budget freeze imposed by the Coalition risks pushing most hospital trusts into deficit, a leading think-tank has warned. The Independent

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Is the NHS institutionally racist?

Is the NHS institutionally racist? A new report highlights that there are very few senior healthcare professionals from BME backgrounds

I have bookshelves of reports detailing the unfair treatment many NHS Black and Minority Ethnic (BME) staff receive in recruitment, promotion, training, discipline and pay. The Snowy White Peaks of the NHS suggests such unfair treatment extends to every level of leadership and governance of the NHS, with important adverse consequences for patients.

Latest statistics show that 20% of nurses and 37% of doctors in the NHS are from BME backgrounds. Yet just 6% of senior and very senior managers in the NHS are from a BME background and just over 7% (and falling) of NHS trust board members are in this category. Continue reading... The Guardian

Global Drug Survey 2014: UK has the most delusional drinkers

Global Drug Survey 2014: UK has the most delusional drinkers
The UK has the most delusional drinkers, drug-takers and ‘reckless youths’ than any other country in the world, according to a survey. The Independent

Newly blind left to cope alone, research finds

Newly blind left to cope alone, research finds Thousands of NHS patients 'abandoned' after being told they are going blind. The Daily Telegraph

Half of nurses work through breaks or beyond their shift

Half of nurses work through breaks or beyond their shift Nurses are working through breaks and beyond their hours, but still do not feel they have enough time for patients, Unison survey reveals. The Daily Telegraph

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Monday, 14 April 2014

Health regulator agrees urgent improvement plan with Kettering General Hospital

Health regulator agrees urgent improvement plan with Kettering General Hospital Kettering General Hospital has agreed a set of urgent improvements to A&E arrangements at the trust to improve care for patients. Northamptonshire Telegraph

Robber jailed after knife attacks at KGH

Robber jailed after knife attacks at KGH A heroin addict who stabbed a Kettering Hospital doctor during a terrifying robbery has been sent to jail. Northamptonshire Telegraph

E-cigarettes banned in pubs across Northampton

E-cigarettes banned in pubs across Northampton A debate is gathering steam as more people are being shown the door for ‘vaping’ in public places across Northampton. Northampton Chronicle and Echo

MPs urge shift in complaint culture

MPs urge shift in complaint culture Public services still need to learn lessons from the Stafford Hospital scandal on how to handle complaints, says a committee of MPs. BBC News

No way to reliably identify low-risk prostate cancer

No way to reliably identify low-risk prostate cancer “Men with prostate cancer being given 'false hope',” The Daily Telegraph reports.

UK researchers have examined the accuracy of different methods that have sometimes been used (mostly outside the UK) to identify “clinically insignificant” prostate cancers – those that would not be expected to affect a man during his lifetime (meaning he is likely to die of something else).

The NHS is overlooking charities

The NHS is overlooking charities The health service is not ready to listen to charities on the role they can play in improving health and social care integration

Integration is often held out as the solution to many of the problems in the health sector. It's a great idea, but not everyone's sure what it is and what it might feel like if we achieve it.

We have an ageing population and those living with long-term health conditions and co-morbidities will become more numerous. We understand the theory that more joined-up services help keep people well and out of hospital. This is good for them and because these patient groups account for 70% of the NHS budget, it's also good for the taxpayer.Continue reading... The Guardian

Drug giant faces bribery claims

Drug giant faces bribery claims GlaxoSmithKline accused of corruption for alleged asthma drug promotion in Poland. The Daily Telegraph

Ministers tell GPs to open all hours

Ministers tell GPs to open all hours Doctors will receive £50 million of funding so they can see patients seven days a week, under plans to be launched on Monday. The Daily Telegraph

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Friday, 11 April 2014

KGH ward closure will save £800,000

KGH ward closure will save £800,000 A ward at Kettering General Hospital is to close in June because of new arrangements in the way medical patients are looked after. Northamptonshire Telegraph

Labour candidate calls on Northamptonshire healthcare trust to withdraw plans to cut dementia care services

Labour candidate calls on Northamptonshire healthcare trust to withdraw plans to cut dementia care services Sally Keeble calls on Northamptonshire Healthcare NHS Foundation Trust to withdraw the plans pending consultations on the way forward for services for a condition that affects thousands of people across the county. Northampton Chronicle and Echo

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The four health systems of the UK: How do they compare?

The four health systems of the UK: How do they compare? Since political devolution in 1999, there has been increasing policy divergence between the health systems of the four countries of the United Kingdom (UK). This report attempts to update earlier comparisons of the publicly financed health systems of England, Scotland, Wales and Northern Ireland in terms of funding, inputs and performance before and since devolution.

The report finds that variations in the running of the NHS across the four countries, including greater or lesser involvement of the private sector, has made little difference to outcomes. The Nuffield Trust and The Health Foundation

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The future provider landscape: are foundation trusts taking us down a dead end?

The future provider landscape: are foundation trusts taking us down a dead end? A year ago NHS commissioning was ripped up by its roots, divided up and then pushed back into the soil. Like the plants in my garden that get such rough treatment, commissioners are struggling to flourish. The NHS provider architecture has, so far, had more gentle treatment, and the journey towards ‘liberalisation’, that started in 2004 with the establishment of the first foundation trusts, continues. The King's Fund

Patient engagement – we need to live it, not talk it

Patient engagement – we need to live it, not talk it Without insight into, and measurement of what our patients are really thinking and capable of, and helping them set expectations, we’re firing blanks at the ‘self-management’ target with our eyes closed, says Mark Duman. The Health Foundation

Updated guidance published for avoiding unplanned admissions

Updated guidance published for avoiding unplanned admissions NHS Employers, GPC and NHS England have today published an updated version of the enhanced service Avoiding unplanned admissions: proactive case finding and care review for vulnerable people. NHS Employers

Surveillance of infectious disease

Surveillance of infectious disease This briefing describes current surveillance efforts and examines new technological developments and their likely impacts on UK and international public health. The Parliamentary Office of Science and Technology

Bupa's £2,000 'bribes' for members to use the NHS

Bupa's £2,000 'bribes' for members to use the NHS Bupa has been accused of dumping patients on NHS for most expensive procedures, meaning that they can increase their profits. The Daily Mail

Information governance in the NHS: the challenges and the future

Information governance in the NHS: the challenges and the future Information governance has had a difficult history in the NHS but it's time that the health service embraced it

When it comes to information governance, the NHS has experienced a few catastrophes. Take for example, the misdemeanour that saw hard drives containing the records of patients go up for sale on eBay.

Lapses like this can be attributed to the NHS contracting out its IT service to external companies rather than investing in IT professionals of its own. Dawn Monaghan, strategic liaison group manager at the Information Commissioner's Office (ICO) explains: "They have a service level agreement [with external companies] and don't consider that for data protection purposes they can't contract out the information governance, they still have responsibility to comply with the Data Protection Act." Continue reading...  The Guardian

High Court: GP exam for trainee doctors must not discriminate against minorities

High Court: GP exam for trainee doctors must not discriminate against minorities A High Court judge has ruled that the exam trainee doctors must take to become a GP does not unlawfully discriminate against candidates from ethnic minorities. The Independent

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Abortions are not for minor disabilities, says minister

Abortions are not for minor disabilities, says minister A minor disability such as a club foot or cleft palate should not be basis for abortion, says Jane Ellison, public health minister. The Daily Telegraph

Tamiflu: Government 'must listen' to findings

Tamiflu: Government 'must listen' to findings Dr Fiona Godlee, editor in chief of the British Medical Journal, says the system for drug regulation is "clearly flawed", while Dr Daniel Thurley, UK medical director of Roche, says he disagrees with the findings of a report questioning the efficacy of Tamiflu. The Daily Telegraph

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Thursday, 10 April 2014

CQC says improvements still needed in East Midlands Ambulance Service

CQC says improvements still needed in East Midlands Ambulance Service East Midlands Ambulance Service still needs to improve in a number of areas, according to a report released by the Care Quality Commission. Northamptonshire Telegraph

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Improving results from adult inpatient survey at Northampton General Hospital

Improving results from adult inpatient survey at Northampton General Hospital The Care Quality Commission (CQC) has published the results of the 2013 survey of adult inpatients, which includes a random sample of Northampton General Hospital (NGH) inpatients discharged during June 2013. Northampton Chronicle and Echo

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Government response to the House of Commons Health Select Committee report into public expenditure on health and social care

Government response to the House of Commons Health Select Committee report into public expenditure on health and social care This paper sets out the government’s response to the 18 conclusions and recommendations made in the House of Commons Health Select Committee report. Department of Health

Mental health cuts cost NHS millions

Mental health cuts cost NHS millions Mental health cuts are costing the NHS millions long-term as reduced preventive measures mean more people are ending up in hospital, a report says. BBC News

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'Millions wasted' on flu drug

'Millions wasted' on flu drug Hundreds of millions of pounds have been wasted on Tamiflu, a drug for flu that may work no better than paracetamol, a landmark analysis says. BBC News

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Prescription cost analysis, England, 2013

Prescription cost analysis, England, 2013 Prescription cost analysis provides details of the number of items and the net ingredient cost of all prescriptions dispensed in the community in England. Health & Social Care Information Centre

Painkiller use linked to irregular heartbeat

Painkiller use linked to irregular heartbeat “Painkillers used by millions of Britons have been linked to higher risk of an irregular heartbeat that could trigger a stroke,” the Mail Online reports.

This headline follows the publication of a long-term study that aimed to find out whether older adults developed atrial fibrillation. The researchers looked at whether adults who had developed the condition had used non-steroidal anti-inflammatory drugs (NSAIDs) recently, previously or not at all.

Health and social care to share £5bn integration funding

Health and social care to share £5bn integration funding Councils and NHS commissioners are set to share a pooled budget of more than £5bn to deliver integrated health and social care services, a government minister has confirmed. Continue reading... The Guardian

NHS spending doubles on private ambulances used for 999 calls

NHS spending doubles on private ambulances used for 999 calls Senior medics and safety campaigners fear patient safety is being jeopardised by relying on private firms to answer emergency calls as expenditure doubles in three years. The Daily Telegraph

Wednesday, 9 April 2014

An alternative guide to the urgent and emergency care system in England

An alternative guide to the urgent and emergency care system in England A&E is often seen as a service in crisis and is the focus of much media and political interest. But A&E is just the tip of the iceberg – the whole urgent and emergency care system is complex, and surrounded by myth and confusion. Our brand new animation gives a whistle-stop tour of how the system fits together and busts some myths about what’s really going on – explaining that the underlying causes go much deeper than just A&E and demand a joined-up response across all services. King's Fund

Sharp increase in steroid users

Sharp increase in steroid users A leading drugs charity says it has seen a 645% increase in the number of steroid users at needle exchanges. BBC News

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