CCGs pass first step towards authorisation

CCGs pass first step towards authorisation: The majority of clinical commissioning groups (CCGs) across England have passed the first step towards authorisation, the DH commissioning czar has said. GP Online

Liberating the NHS: developing the healthcare workforce - from design to delivery

Liberating the NHS: developing the healthcare workforce - from design to delivery:

This policy framework sets out a new approach to workforce planning and the education and training of the health workforce. It builds on responses to earlier public consultations and the advice of the NHS Future Forum.

• Policy framework



• Department of Health - publications

NHS Future Forum: responses to second phase reports

NHS Future Forum: responses to second phase reports:

• NHS Confederation



• Nuffield Trust



• Royal College of Nursing

Hospitals feed patients on 90p a meal, official figures show

Hospitals feed patients on 90p a meal, official figures show: Some hospital trusts commit just £2.57 for each patient's daily food and drink, according to the latest statistics, despite growing concern about poor nutrition on wards. The Telegraph

Healthcare assistants 'doing nurses' tasks'

Healthcare assistants 'doing nurses' tasks': Patients are being put at risk by healthcare assistants who have been asked to take on tasks for which they have not been properly trained, nurses have warned. The Telegraph

New Guidelines to Control Group A Streptococcal (GAS) Infections in UK Hospitals Launched

New Guidelines to Control Group A Streptococcal (GAS) Infections in UK Hospitals Launched: The Health Protection Agency (HPA) together with the group A streptococcal (GAS) Working Group* has today launched new guidelines for the investigation, control and prevention of GAS infection in acute healthcare settings, including maternity units, in the UK. Health Protection Agency

NHS Future Forum reports

You can find a summary of the reports here.

Highlights from the Future Forum’s reports include:

Integration

• Integration should be defined around the patient, not the system – outcomes, incentives and system rules (ie. competition and choice) need to be aligned accordingly.
• Health and wellbeing boards should drive local integration – through a whole-population, strategic approach that addresses local priorities.
• Local commissioners and providers should be given freedom and flexibility to ‘get on and do’ – through flexing payment flows and enabling planning over a longer term.
• Download Integration report

Education and training

• The new local education and training boards must have the governance in place to deliver strong partnerships across healthcare providers, academia and education.
• Quality must be at the heart of education and training with systems in place at all levels to reward high quality education and embed continuing professional development.
• There needs to be a review of the principles and aims of the Tooke Report into medical education.
• A properly structured process to support individual nurse and midwife development in post-qualification career pathways should be developed nationally.
• Download Education and training report

Information

• Patients should have access to their online GP-held records by the end of this Parliament.
• The NHS must move to using its IT systems to share data about individual patients and service users electronically in the interests of high quality care.
• The Government should set a clear deadline within the current Parliament by which all information about clinical outcomes is put in the public domain.
• Download Information report

NHS’s role in the public’s health

• The NHS must do more to prevent poor health, so it can reduce health inequalities and continue to provide high quality care for future generations.
• Every healthcare professional should make every contact count – use every contact with the public to help them improve their health. This should be a core staff responsibility in the NHS Constitution.
• The NHS must do more to support the wellbeing of its own staff too, helping a workforce of 1.4 million to live healthily and spread healthy messages with family, friends and patients.
• Download The NHS’s role in the public’s health report

NHS criticised over woman's death

NHS criticised over woman's death: The family of an 87-year-old woman who died after falling and waiting 90 minutes for an ambulance say improvements must be made. BBC News

Nurses 'lacking ability and compassion', warns NHS Future Forum

Nurses 'lacking ability and compassion', warns NHS Future Forum: Nurses in today's NHS too often lack ability, compassion or even the simple desire to work in the profession, a damning new report warns today. The Telegraph

Patients Association responds to GP payments for commissioning work

Patients Association responds to GP payments for commissioning work:
Katherine Murphy, Chief Executive of the Patients Association said,

“From the very start of the NHS reforms the Patients Association has been saying that we were concerned that NHS money would end up in GPs’ pockets. Now it is becoming clear that that is exactly what is going to happen. It is outrageous that so much money is to be spent on sending GPs to meetings on top of their salaries for being a doctor. This money could be more effectively spent on patient care. With parts of the NHS facing deepening financial problems we cannot afford for money to frittered away like this. The Department of Health needs to return GPs to their most important role – the care and treatment of patients – instead of wasting vast sums on a reform programme that nobody agrees with.”

NHS quality accounts 2010/11

NHS quality accounts 2010/11:

The aim of this report is to help providers improve their quality accounts and support auditors in reviewing the arrangements that underpin their production. NHS Networks

VIDEO: Public healthcare "cannot work anymore"

VIDEO: Public healthcare "cannot work anymore": The Indian heart surgeon Devi Shetty tells Stephen Sackur why he believes that taxpayers' money can no longer fund healthcare. BBC News

New 'duty' to promote good health

New 'duty' to promote good health: NHS staff in England must adapt their roles to ensure they promote good health under plans being published. BBC News

QIPP and workforce productivity – new web section

QIPP and workforce productivity – new web section: A new section on our website brings together information and resources from NHS Employers and externally, to help you meet the Quality, Innovation, Productivity and Prevention (QIPP) challenge. NHS Employers

Implementing 7 day working in imaging departments: good practice guidance: a report from the National Imaging Clinical Advisory Group (NICAG)

Implementing 7 day working in imaging departments: good practice guidance: a report from the National Imaging Clinical Advisory Group (NICAG):

The focus of the work programme of NICAG is to improve the quality of services and enhance the patient experience and outcomes. This document aims to contribute towards the wider work around how routine seven day working could be introduced successfully across the NHS.

• Report



• Department of Health - publications

QOF 2013/14 consultation opens

QOF 2013/14 consultation opens: Have your say on 20 potential new QOF indicators NICE

Hospital blamed for death of girl with tooth infection

Hospital blamed for death of girl with tooth infection: A hospital (Kettering General) has been guilty of failing a nine year-old girl who died after being admitted for treatment for a tooth infection. The Telegraph

£1m for NHS manager Elliot Browne who was targeted for his colour

£1m for NHS manager Elliot Browne who was targeted for his colour: A senior NHS manager who suffered a sustained campaign of racial discrimination from hospital colleagues has been awarded nearly £1 million in compensation. The Telegraph

Patients should see medical records by 2015: report

Patients should see medical records by 2015: report: All NHS patients should be able to see their GP medical records by 2015, an influential advisory body has said. The Telegraph

NGH ahead of the game with government plans to improve patient care

NGH ahead of the game with government plans to improve patient care: Care rounds at NGH

Hospital criticised for treatment of disabled patient who later died

Hospital criticised for treatment of disabled patient who later died:

Kettering Hospital says lessons have been learned after a disabled nine-year-old girl died three weeks after being admitted with a tooth infection. Kettering Evening Telegraph

Controversial silicon implants not been used by Northampton General Hospital

Controversial silicon implants not been used by Northampton General Hospital:

SENIOR bosses at Northampton General Hospital have moved to reassure patients who have had breast implants at the hospital that they are not the same as the controversial kind originating from France. Northampton Chronicle and Echo

Behind The Headlines: Good has to come of this...

Behind The Headlines: Good has to come of this...:

IT’S hard to imagine a bleaker story surfacing about our health services in the rest of 2012 than the one involving the tragic death of 87-year-old Phyllis Asten. Northampton Chronicle and Echo

What will 2012 bring in healthcare terms?

What will 2012 bring in healthcare terms?: Stephen Thornton blogs about the year ahead in healthcare terms, and what is in store for the Health Foundation.

AUDIO: 'I'm the nurse I didn't want to be'

AUDIO: 'I'm the nurse I didn't want to be': A mental health nurse talks about the pressures of paperwork, which she says is often duplicated and she is becoming the nurse she didn't want to be. BBC News

Ambulance break talks to continue

Ambulance break talks to continue: Talks aimed at resolving a dispute over payments for ambulance staff having their breaks interrupted by emergency calls are set to resume. BBC News

CCGs 'have to be more inclusive'

CCGs 'have to be more inclusive': GP poll shows most GPs back their CCGs but many cannot vote or influence decisions. Abi Rimmer reports. GP Online

Recognising and approving trainers: a consultation

Recognising and approving trainers: a consultation:

The GMC is proposing new arrangements for recognising and approving trainers. The consultation is seeking feedback on these new proposed arrangements and invites comments on a number of questions arising from those recommendations. The consultation will end on 30th March 2012.

• GMC - further details and documents

More than half of hospital beds cut were for elderly patients

More than half of hospital beds cut were for elderly patients: More than half of hospital beds cut in the past year were for elderly patients as NHS cost-cutting drives take a disproportionate toll on older people, according to new figures. The Telegraph

Drinkers should have two alcohol-free days a week

Drinkers should have two alcohol-free days a week:

Drinkers should give themselves two alcohol-free days a week, a committee of MPs said today. The Independent

NHS PIP breast implants to be removed for free

NHS PIP breast implants to be removed for free:

There is not enough evidence to recommend the routine removal of PIP breast implants, a government expert committee has concluded.

However, the committee said the NHS would remove and replace the implants without charge if patients it had operated on remained concerned. The government said it expected the private sector to follow suit and not to charge for corrective procedures.

The French implants caused global concern after it was revealed they contained industrial silicone rather than medical-grade fillers and that they may be more prone to rupture and leakage. Some 40,000 women in the UK are believed to have had the implants, with 95% of operations done for cosmetic reasons through private clinics.

The expert group recommended that any worried woman should speak to her surgeon or GP.

NHS medical director Professor Sir Bruce Keogh, who led the expert review group, said: “On the basis of the information we have, we do not think it is necessary to recommend the routine removal of these implants.

“But we understand that some women will be very concerned so we support the government’s position that the NHS will support removal of PIP implants if the patient has concerns and, with her doctor, she decides that it is right to do so.”

Andrew Lansley, the health secretary, said he was putting patients' interests first. "We believe that private healthcare providers have a moral duty to offer the same service to their patients that we will offer to NHS patients - free information, consultations, scans, and removal if necessary."

What type of implants are involved?

The implants involved are called Poly Implant Prosthese (PIP) and were made by a French company of the same name. They were pre-filled with a silicone-based gel (the majority of women having breast implants now have silicone implants). However, the marketing, distribution and use of the PIP implants was suspended in March 2010 after regulators found that the manufacturers were using silicone intended for industrial use, and not medical-grade silicone fillers. It is reported that the company used a cheap type of silicone gel intended for making mattresses. They had been manufactured since 2001.

As a result, in March 2010 the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) advised doctors to stop using the implants. The agency then examined evidence on any possible toxic effects of the implants involved, and found that there was no evidence the unapproved filling could cause health problems. Later that year it issued advice to surgeons on how to manage women who already had PIP implants.

In light of the ongoing global concern, the government launched an expert review of the evidence on PIP implants and today released its guidance for patients, the NHS and private cosmetic surgery companies.

What happens if I got a PIP implant through the NHS?

There is no need to remove all PIP implants, but women who received a PIP implant from the NHS will be contacted to let them know they have one. They will be given information and advice. In the meantime, NHS patients can also request information about the make of their implant, which will be provided free of charge.

If you wish to, you will also be able to seek a consultation with your GP or with the surgical team who carried out the original operation. They will offer clinical advice on the best way forward. This could include an examination using scans, such as MRI, to look for any signs that the implant may have ruptured.

The NHS will support removal of PIP implants if a woman and her doctor decide that it is right to do through an assessment of clinical need, risk or the impact of unresolved concerns.

The NHS will replace the implants if the original operation was done by the NHS.

What if I obtained implants privately?

The government is working with the private sector to ensure an equivalent care system is provided to women who obtained implants privately. The government has stated that it does not think it is fair to the taxpayer for the NHS to foot the bill.

If a clinic that implanted PIP implants no longer exists or refuses to care for their patient, then, so long as that patient is entitled to NHS services, the NHS will cover the cost of the removal of PIP implants in line with the guidance.

Any NHS service in these circumstances would not include the replacement of private cosmetic implants. The government says that it will pursue private clinics with all means at its disposal to avoid the need for the taxpayer to pick up the bill.

Are the implants safe?

During December 2011 UK media had originally focused on a possible link between PIP implants and a rare type of cancer called anaplastic large cell lymphoma (ALCL). This arose after a French woman with PIP implants developed the cancer and died. However, after reviewing the evidence, the expert group conducting the review agreed that there was no link with cancer. Other sources have highlighted the large number of women around the world with PIP implants and the tiny number of ALCL cases.

More recently, attention has focused on the rupture rate of the implants, and whether the unapproved gel filling of PIP implants could have a toxic affect. The review has specifically looked at these issues, and found:

• The data provided by industry has been “patchy”, and that good data is necessary to ensure that problems are discovered when they arise


• From the data available, the review panel was not able to tell whether the rupture rate for PIPs is higher than for other types of implant


• From the implants that have been tested there appears to be no risk of dangerous toxic effects in the event of a rupture


• The review group said it could not be certain that the manufacturer did not change the content of the implants, so could not completely rule out the possibility that some might contain toxic substances.

The group also highlighted the need to ensure the safety of people having cosmetic surgery. In response Sir Bruce Keogh’s Expert Group will examine the wider issues around quality of data monitoring and the way the wider sector is regulated. The Care Quality Commission is also reviewing the evidence of providers' compliance with registration requirements and is considering a fuller programme of inspections based on that.

What is a rupture and what are the signs?

A rupture is a split that occurs in the implant’s casing. A rupture can be caused if:

• the implant’s shell (that holds the silicone or saline) gets weaker over time


• the implant is damaged during the operation


• there is a flaw in the implant


• the breast is injured

When implants were first developed, they had very thin walls and rupturing was a common problem. However, modern implants that have been used in the UK since the 1990s rupture much less frequently. If an implant ruptures, it is recommended that it be removed and replaced with a new one. If it is a saline implant, any leakage from the implant is not expected to cause problems as saline is a sterile, saltwater solution that the body is able to safely absorb. However, with silicone implants, silicone that leaks out of a ruptured implant may cause problems, such as siliconomas or a gel bleed.

Siliconoma

A siliconoma is a small lump formed of silicone that has spread outside of the scar capsule and into the breast. Siliconomas can be tender to touch and if they are causing significant pain they may need to be removed. In rare cases, the silicone can spread to the muscles under the breast, armpit or around the nerves to the arm.

Gel bleeds

Gel bleeds are where tiny particles of silicone are released from the surface of a silicone breast implant. This can occur when the breast implant ruptures, or sometimes it can happen when there is no rupture. If silicone particles get into the lymphatic system (the network of vessels that help the body to fight infection) they can be transported to nearby lymph nodes (glands), such as those in the armpit. This may cause the lymph nodes to become slightly swollen. This is usually a minor problem, although in some cases the enlarged lymph nodes may become uncomfortable.

MRI scanning is considered to be the most effective method of detecting “silent rupture” of silicone gel-filled breast implants. In the US the FDA recommends that women with silicone gel-filled breast implants receive MRI screening for silent rupture three years after receiving their implant, and then every two years. In the UK women can get specific advice from their implanting surgeon.

Who has produced the faulty breast implants?

The implants that are being examined were made by the now defunct French company Poly Implants Prothèses (PIP). Its former owner, Jean Claude-Mas, is facing investigation by French police, according to the Daily Mail. The Guardian has said French papers claim Mr Mas was aware that the wrong type of silicone was being used for 13 years without problems and that it was seven times cheaper than medical-grade silicon.

Several newspapers have reported that in police interviews from 2010 - quoted in French newspapers - Mr Mas had nothing to say to people affected. He is also reported as confirming that he had had confidence in his products and that he had no knowledge that they would rupture.

Links To The Headlines

No Routine Removal For PIP Breast Implants, Sky News, January 6 2012

NHS will remove implants free of charge for their patients but private clinics must pay for operations themselves, Government says, Daily Mail, January 6 2012

Government will pay for women who had breast implants on NHS to have them removed, The Daily Telegraph, January 6 2012

Clinics 'should remove implants', BBC News, January 6 2012

NHS Choices

Northampton General Hospital pledges inquiry into death

Northampton General Hospital pledges inquiry into death:

EAST Midlands Ambulance Service (EMAS) chief executive Phil Milligan has offered his sincere condolences to Mrs Asten’s family and friends. Northampton Chronicle and Echo

Family calls for investigation after ‘fit and healthy’ pensioner dies waiting for treatment at Northampton A&E

Family calls for investigation after ‘fit and healthy’ pensioner dies waiting for treatment at Northampton A&E:

AN investigation has been launched into the standard of care provided to an elderly woman who died in hospital shortly after she had been forced to wait nearly an hour-and-a-half for an ambulance to arrive to provide treatment for her broken hip. Northampton Chronicle & Echo

Improving dementia services

Improving dementia services:

Watch the latest video blog by David Behan on the importance of improving dementia care services. Department of Health

Report on clinical coding and improving clinical records from the Audit Commission

Report on clinical coding and improving clinical records from the Audit Commission: A new study has made key recommendations into improving clinical records and clinical coding.The study, by the Audit Commission and the Royal College ...

Cameron: There is a real problem with nursing in our hospitals

Cameron: There is a real problem with nursing in our hospitals: There is a "real problem" with the standard of nursing in British hospitals, David Cameron has said, as he today calls on nurses to make hourly rounds to ensure patients are comfortable. The Telegraph

David Cameron unveils hospital care revamp

David Cameron unveils hospital care revamp:

Nurses will be told to undertake hourly ward rounds while members of the public will be allowed to inspect hospitals, under plans announced by the Prime Minister. The Independent

Implants review to give findings

Implants review to give findings: Some 40,000 British women with banned PIP breast implants should find out later whether the government believes they should be removed. BBC News

5,000 more British women had PIP implants

5,000 more British women had PIP implants: Implants produced by French company Poly Implant Prothese were rebranded by Dutch supplier Rofil. Public Service

PM tells trusts to publish patient views

PM tells trusts to publish patient views: The government is to formally require NHS organisations to publicly publish new data on performance and patient and staff views on their service. E-health Insider

Integration will be good for patients but requires social care reform fist

Integration will be good for patients but requires social care reform fist: Commenting on a recent report on integrating care from the King's Fund and the Nuffield Trust NHS Confederation deputy policy director Jo Webber said integration was the right way to go but requires social care funding reform first. NHS Confederation

The Commission on Assisted Dying

The Commission on Assisted Dying:

This report concludes that the current legal status of assisted suicide is inadequate and incoherent. It finds that while the current legal regime can be distressing for the people affected and their families, it is also unclear for health and social care staff, and lays a burden on police and prosecutors, which could be eased by a new statutory framework. A proposed legal framework for assisted dying is laid out in detail, including strict criteria to define who might be eligible to receive assistance and robust safeguards to prevent abuse of any new law.

• Report



• Demos - publications

Warning of sustained industrial action

Warning of sustained industrial action: Unions warn members to prepare for sustained industrial action if government's latest offer on NHS pension scheme is rejected. Healthcare Today

Unite rejects NHS pensions offer - Public Finance

Unite rejects NHS pensions offer - Public Finance:

Money Marketing

Unite rejects NHS pensions offer Public Finance By Richard Johnstone 5 January 2012 Trade union Unite has today refused to sign up to the government's reform plan for the NHS pension scheme, saying that the offer late last year was not satisfactory. The union's health sector national industrial ... Public sector pensions offer rejected by Unite health workersThe Guardian Unite rejects NHS pensions dealMoney Marketing Unite rejects 'politically motivated' NHS pension dealCitywire.co.uk Press TV -Health Service Journal all 204 news articles »

Unite rejects pensions offer to health workers

Unite rejects pensions offer to health workers:

Britain's biggest union rejected last night the Government's final offer to health service workers in the public sector pensions dispute, raising the prospect of fresh industrial action. The Independent

Staffing key to PM’s quality drive, says RCN

Staffing key to PM’s quality drive, says RCN: The Royal College of Nursing has backed David Cameron’s moves to free up nurses to put care first, but has warned that achieving the improvements suggested by the Prime Minister will depend on staffing levels and skill mix.

Whooping cough cases increase

Whooping cough cases increase: Cases of whooping cough (pertussis) reported to the Health Protection Agency (HPA) in England and Wales have more than doubled from 421 cases in 2010 to 1040 in 2011. Increases in levels of whooping cough are seen every three to four years and figures in 2011 are in line with cases reported in the last peak year of 2008.

Clinical commissioning groups: Does size matter?

Clinical commissioning groups: Does size matter?: Paul Zollinger-Read considers whether it's the size of clinical commissioning groups that counts, or their ability to collaborate. (Blog, 3 Jan 2012) Kings Fund

Common and complex: commissioning effective dementia services in the new world

Common and complex: commissioning effective dementia services in the new world:

It outlines recommendations for health and wellbeing boards and the role that they have to play in improving dementia care. NHS Networks

VIDEO: Santorum: 'NHS devastated Britain'

VIDEO: Santorum: 'NHS devastated Britain': Newsnight's Peter Marshall challenges Republican presidential hopeful Rick Santorum on what he meant when he said that healthcare policies had brought down the British Empire. BBC News

'Strong case' for assisted dying

'Strong case' for assisted dying: There is a "strong case" for allowing assisted suicide for people who are terminally ill in England and Wales, a group of experts says. BBC News

Extra funding for PCTs to help discharge patients from hospital

Extra funding for PCTs to help discharge patients from hospital: Source: Department of Health (DH)

Area: News

The Department of Health has announced the availability of an additional £150m fund to be allocated to Primary Care Trusts in England, for immediate transfer to local authorities for investment in social care services which also benefit the health system.

This additional investment is aimed to reduce the pressure on health services by discharging patients from hospital more quickly and provide effective ongoing support for people in their own homes.

An additional £20 million will be allocated to the Disabled Facilities Grant for 2011/12, to help more people with a disability to access the aids and adaptations they require to live independently at home, saving them from an unnecessary stay in hospital or going into residential care.

Integration should be given same priority as reducing waiting times, says report

Integration should be given same priority as reducing waiting times, says report: Integration should be given the same priority over the next decade as reducing waiting times was given over the past 10 years, the King's Fund and Nuffield Trust have recommended. GP Online

Elderly care reforms could get cross-party agreement, says Andrew Dilnot

Elderly care reforms could get cross-party agreement, says Andrew Dilnot: Andrew Dilnot, the architect of proposed reforms to long-term elderly care, said there is a "real chance" of a cross-party agreement between the Coalition and Labour on improving the system. The Telegraph

Implementing the Equality Act 2010: interim guidance for the NHS

Implementing the Equality Act 2010: interim guidance for the NHS:

The Equality Act includes specific deadlines that all public bodies are legally required to meet. NHS Employers has published interim guidance to support NHS organisations with this. The guidance signposts the best advice and answers the most popular questions asked in relation to employer responsibilities.

• Guidance



• NHS Employers - news

Joint plan to foster a healthy and vibrant healthcare IT market

Joint plan to foster a healthy and vibrant healthcare IT market: The draft plan focuses on improving the perception of healthcare IT. Connecting for Health

Using resources efficiently

Using resources efficiently: NICE has identified recommendations that could help the NHS save millions of pounds, whilst maintaining or improving the quality of care.

David Cameron orders merging of health and social care

David Cameron orders merging of health and social care:

Integration of services will save money says prime minister as NHS warns changes will lead to hospital closures

David Cameron has ordered health and social care services to be brought together in order to benefit patients in a move which government advisers are calling the NHS's most urgent overhaul.

At the moment, health and social care – the help given mainly to old or disabled patients to help them continue to live at home rather than in hospital or nursing homes – are different systems in England. NHS medical treatment and domiciliary support, which is provided mainly by local councils, are usually not joined-up.

But Cameron has told the health secretary, Andrew Lansley, to drive through changes that health policy experts claim will make life more convenient for patients, improve care and save the NHS money.

The changes will lead to some hospitals closing, warned the pro-integration NHS Confederation, which represents hospitals and other major NHS employers.

The prime minister has been persuaded by senior doctors and Downing Street health advisers that, without integration, the NHS could become unsustainable due to rises in the number of patients with long-term health conditions such as obesity, diabetes and breathing problems.

The first move towards creating joined-up services is likely to see Lansley tell the NHS that it has to give integration the same priority that keeping waiting lists under control has had for the last decade.

That new target is the key recommendation of a new report on integrating care by the King's Fund and Nuffield Trust health thinktanks, whose chief executives both advise Downing Street.

They want the introduction of "a clear, ambitious and measurable goal to improve the experience of patients and service users, and to be delivered by a defined date.

This goal would serve a similar purpose to the aim of delivering a maximum waiting time of 18 weeks for patients receiving hospital care."

The new duty would oblige providers of medical care to start working closely with social care providers in order to streamline the care patients receive, ensure they have to deal with fewer organisations and departments and deliver more care in community settings rather than hospitals.

Cameron is also keen on the other suggestions in the report, according to well-placed NHS sources. They include new guarantees that patients will receive an agreed care plan and a named case manager responsible for co-ordinating care for all their needs, and changes to the existing "tariff" system – where hospitals are paid for providing episodes of care – to favour the planning and delivery of ongoing programmes of joined-up care for people with complex health and welfare needs.

The confederation's deputy policy director, Jo Webber, said: "Integrating care will improve services, particularly for people who are frail and those with long term conditions. But it will also involve making some really difficult decisions as hospital activity is reduced and moved into the community."

"Integration will take a long time to bed down and start improving the quality of care patients receive. Integration will produce more sustainable models of care in the long term but many local initiatives could mean new services being run in tandem while old ones are shut, which could be more expensive in the short term."

In addition, "fundamental reform of social care" – which the charity Age UK said was "an absolute disaster" – was vital, otherwise integration would not work, Webber said. Achieveing joined-up services "will require significant political courage and leadership."

Health and social care is already integrated in Northern Ireland and a few parts of England, such as Torbay in Devon, and patients generally report greater happiness with their care where it exists.

Cameron made integration one of his five "personal NHS guarantees" last year.

The care services minister Paul Burstow said: "Integrated care should be the norm. That's why we asked the NHS Future Forum to specifically work on the issue. Our ambition for the NHS and social care is a simple one – to achieve better results for people and carers. So our priority is to orientate the whole system around patients, service users and carers through our Outcomes Framework."

Andy Burnham MP, the shadow health secretary, backed the report and said it was further proof that the government should drop its health and social care bill, which would set back the cause of integration by 10 years. The Guardian

Risk from breast implants cannot be judged

Risk from breast implants cannot be judged:

The safety of breast implants inserted into tens of thousands of British women is impossible to judge, the body responsible for regulating them has admitted, because an accurate record of the number of procedures has not been kept. The Independent

RCN ‘appalled’ at attacks on lone working nursing staff

RCN ‘appalled’ at attacks on lone working nursing staff: The Royal College of Nursing has said that assaults on nursing staff are completely unacceptable, as new survey findings show that over 60 per cent of nurses working in the community have been subjected to abuse in the past two years.

'Concealed' drug trial data putting lives at risk

'Concealed' drug trial data putting lives at risk:

Patients' lives are being put at risk and public money wasted on ineffective medicines because researchers are concealing the results of clinical trials amid a "culture of haphazard publication and incomplete data disclosure". The Independent

New start date and more funding announced for local HealthWatch bodies

New start date and more funding announced for local HealthWatch bodies:

Further details on the establishment of local HealthWatch bodies, including a new start date and extra funding, have been set out by Health Minister Andrew Lansley.

Following feedback from local authorities and Local Involvement Networks, they now have until April 2013 to work with local health experts and volunteers to establish the local HealthWatch. The new local health bodies are set to replace Local Involvement Networks and will be the local consumer champion for patients, service users and the public.

From next year, an additional £3.2m will also be made available to local authorities to establish local HealthWatch.

In addition, more than £370,000 will also be made available until the end of the 2011/12 financial year for 75 HealthWatch pathfinders, who are pioneering and testing out plans ahead of the full establishment of local HealthWatch across the country.

This money can be used in any part of their development, including spreading best practice, engaging more in the community, and financially supporting volunteers.

Andrew Lansley said:

‘Local HealthWatch is a vital part of our plans to give people a stronger voice and drive improvements in health and social care services across the NHS.

‘Today’s announcement is a further sign of our commitment to support the dedicated staff and volunteers who are driving this forward. It gives them the support necessary to carry out their important work in shaping the future of local healthcare.’

Becky Shaw, Chief Executive of East Sussex County Council and a member of the HealthWatch Programme Board, said:

‘Ensuring the voices of patients and the public are heard in the health and social system is a vital ingredient for future success. It is a complex task and extra resources to support councils in this task at a local level are very welcome.’

The new date for establishing Local HealthWatch supports the need to align this closer to the establishment of other new bodies such as the health and wellbeing boards. The extended deadline will also support preparations for implementation and enable HealthWatch England – which will be established in October 2012 – to provide the leadership and support to local HealthWatch organisations.

See letter from David Behan, Director General for Social Care, Local Government and Care Partnerships, on the launch and funding arrangements for local Healthwatch and Healthwatch pathfinders.

See press release

See more information on HealthWatch

Extra money to help people leaving hospital

Extra money to help people leaving hospital:

£150m additional support funding for social care

A one-off additional £150m will be allocated to Primary Care Trusts in England, for immediate transfer to local authorities for investment in social care services which also benefit the health system.

This additional investment will enable local services to discharge patients from hospital more quickly and provide effective ongoing support for people in their own homes.

The aim is to reduce the pressure on health services, and particularly hospitals during the winter period.

£20m additional Disabled Facilities Grant funding

An additional £20 million will be allocated to the Disabled Facilities Grant for 2011/12, to help more people with a disability to access the aids and adaptations they require to live independently at home, saving them from an unnecessary stay in hospital or going into residential care. Allocations will be confirmed shortly by the Department for Communities and Local Government.

As part of the package of measures in the spending review, the Government is providing an extra £7.2 billion over the next four years to local councils so that they can protect services that support vulnerable people.

See more information on the allocation of funds

Warning over social care costs

Warning over social care costs: Individuals will still face significant social care costs even if politicians reach agreement on reform in England, experts say. BBC News

Three million patients to get telecare, DH pledges

Three million patients to get telecare, DH pledges: The DH will roll out telehealth and telecare services to three million people with long-term conditions by 2016, care services minister Paul Burstow has said. GP Online

Mental Health Act annual report 2010/11

Mental Health Act annual report 2010/11:

This is the Care Quality Commission’s second annual report on the use of the Mental Health Act, covering findings from April 2010 to March 2011.

• Full report


• Summary report


• Care Quality Commission - publications

Interactive slide pack on the NHS pension scheme

Interactive slide pack on the NHS pension scheme:

An interactive slide pack published in response to the Heads of Agreement on the proposed scheme design for the NHS Pension Scheme has been made available. It aims to provide staff with guidance on the NHS pension scheme proposals.

• Slide pack


• Department of Health - news

Data briefing: emergency bed use - what the numbers tell us

Data briefing: emergency bed use - what the numbers tell us:

This briefing examines why we need to understand more about bed use for emergency admissions; what progress has been made in reducing bed use; how reducing bed use can lead to improved quality of care and patient experience; and what the next steps should be.

• Briefing


• The King's Fund - publications

Implementing the Government ICT strategy: six-month review of progress

Implementing the Government ICT strategy: six-month review of progress: This report commends the early progress being made by the Government in implementing its ICT strategy but has identified areas where progress has not kept pace with the Government’s ambitions. Healthcare Today

China calls for calm after bird flu death

China calls for calm after bird flu death: Beijing health officials say the virus was not transmitted from human to human, making it less likely to form a pandemic strain. Healthcare Today

NHS trust plans alternative to 'outdated hospital model'

NHS trust plans alternative to 'outdated hospital model':

Has North Bristol NHS trust found the answer to providing efficient health and social care after hospital closures?

NNot everyone is happy about North Bristol NHS trust's proposal to close one of its hospitals as part of a reconfiguration of health services, admits its chief executive, Ruth Brunt. The changes will affect around 500,000 people living in Bristol and south Gloucester. "Understandably, if you have to travel four miles rather than half a mile to get to your acute hospital in the future, there are some people who will be anxious, and feel they have lost something," she says.

The trust recently published a document detailing its planned alternative to the hospital at Frenchay: a "health and social care campus" with a community hospital and nursing home owned by the private sector, a new GP surgery, "extra care" housing, and outpatient services for people with long-term conditions.

Mike Farrar, head of the NHS Confederation, which represents health service managers, last week said that at least one in four patients in hospital beds could be better looked after in the community, or at home, rather than in the "outdated hospital model of care … Hospitals play a vital role, but we do rely on them for some services that could be provided elsewhere. We should be concentrating on ... shifting resources into community services."

Brunt couldn't agree more. "Twenty seven per cent of the patients sitting in my acute hospitals don't need to be there," she points out. "Acute hospital care is extraordinarily expensive, and despite what patients think, acute hospitals are fantastic if you really need hi-tech acute specialist care but they are not that great if you're getting better, or you're waiting well."

Before moving to Bristol Brunt worked in Devon, which has a network of community hospitals that treat patients near their homes for less serious conditions. "I was horrified coming to Bristol that there was such a poor level of community provision," she says. "It felt like you either had to be well enough to receive your care at home, or you were in hospital. There was very little provision in between."

The Bristol health services plan was developed over several years by the city's three primary care trusts, three acute hospital trusts, its mental health trust, ambulance services and other public sector organisations. It aims to provide, by 2014, a £22m 68-bed community hospital located in the same building as a nursing home. The building will be owned and operated by a third party, probably a consortium of a construction company and a care provider, which the trust hopes to choose by the end of this year. It expects to lease the hospital area, with the ability to vary the number of beds used to cope with extra demand, at an annual cost of around £3.5m. Unlike a private finance initiative (PFI) deal, ownership of the building will remain in the hands of the private sector.

GPs may also lease beds in the community hospital, as an alternative to sending patients to a "superhospital" that is scheduled to open in 2014 on the trust's other site some 6km (4 miles) away in Southmead.

The plans for the health and social campus include extra care housing, where people can move to in order to continue living in their homes while receiving enhanced health and social care, and outpatient clinics for older people and those with long-term conditions, such as diabetes and illnesses that require respiratory medicine. The trust's plans for the Southmead hospital include the assumption that 40% of outpatient activity will move to community facilities.

The community hospital will have diagnostic facilities that will provide blood tests, x-rays, scans and echocardiograms, and physiotherapy, dietetics and occupational therapy. A section of the site will be reserved for a new GP surgery, and an existing brain injury rehabilitation unit.

"We were tantalised by the possibility of developing a whole health and social care campus at Frenchay, which was focused around reablement and rehabilitation, not just maintenance care but actively focused on returning people to independent living," says Brunt.

Frenchay will also improve North Bristol trust's finances, with part of the site being sold for residential housing. Proceeds from the sale of homes will reduce the PFI debt from building the new £430m hospital at Southmead and boost the trust's planned application for foundation trust status, which requires evidence of financial stability. Selling land at Frenchay will reduce the PFI cost to around 7% of the trust's annual income. As a result, Brunt says: "We can make our long-term financial plan stack up." she addssays Brunt

Conservative councillor Trevor Jones, who sits on South Gloucestershire council's health select and development control committees thinks the trust has done a good job of engaging with opponents of the hospital's closure. Campaigners from the Save Frenchay Hospital group joined a Frenchay Project Board, which asked the trust for changes to its plans – most of which were agreed. "The big one for local residents is the capacity for a new GP surgery," says Jones, as the area will get several thousand new homes. The plans for intermediate care for older people are also popular. "They can see a way of staying in their own homes, or moving into the care village," he says.

Trade union Unison is concerned that the community hospital will not be run by the trust and that staff will not be NHS employees. "The new build at Frenchay takes the NHS further into the hands of private health companies," says Simon Newell, Unison's south-west regional head of health. He adds that there was no prior consultation with staff or unions before the tender document was published. "With all staff being employed by a contractor, they will have no access to NHS pay and terms and conditions, and we would have serious concerns about training and quality of care."

In response, a spokeswoman for the trust says a nursing home site alongside NHS beds would "offer an opportunity for an integrated approach to patient care with possibly the third-party partner providing nursing care for the NHS beds and staff employed by North Bristol trust providing rehabilitation support. However, we shall need to carefully explore this in conjunction with potential third party partners and no decisions have yet been made," she adds.

Providing intermediate – and cheaper – alternatives to acute hospitals fits well with the government's attempt to increase efficiency in the NHS without increasing funding. So could North Bristol's plans provide a blueprint for other trusts? Candace Imison, deputy director of policy of the King's Fund health thinktank, believes the trust has a good chance of success because its reconfiguration involves just two sites, and that it could work in other areas.

For Brunt, reconfigurations can work when all the organisations with a stake in health and social care in an area co-operate. The difficult part is convincing the public that the loss of acute hospital beds is a price worth paying – but this is something the NHS has to do. She says: "This is about services, not just about facilities."

• SA Mathieson is a journalist and a senior healthcare analyst for Kable, the public services market intelligence specialist. The Guardian

Fillers could prove next cosmetic surgery scandal, experts warn

Fillers could prove next cosmetic surgery scandal, experts warn: Patients who use anti-ageing injections could be putting themselves at risk in a market that is largely unregulated in Britain, experts have warned. The Telegraph

Elderly care reforms could get cross-party agreement, says Andrew Dilnot

Elderly care reforms could get cross-party agreement, says Andrew Dilnot: Andrew Dilnot, the architect of proposed reforms to long-term elderly care, said there is a "real chance" of a cross-party agreement between the Coalition and Labour on improving the system. The Telegraph

Cheap healthy food scheme begins

Cheap healthy food scheme begins: A new effort to convince families in England that they can eat healthily on a budget is beginning. BBC News

NHS accused over deaths of disabled patients

NHS accused over deaths of disabled patients: Mencap inquiry finds institutional discrimination against people with learning disabilities led to at least 74 deathsThe NHS is accused of causing or contributing to the deaths of at least 74 patients with a learning disability because of poor care that reveals enduring "institutional discrimination" among doctors and nurses.The 74 vulnerable patients' deaths over the past decade were either caused or complicated by mistakes in hospitals and decisions by staff who failed to treat them properly and ... Kings Fund Health News

NHS accused over deaths of disabled patients

NHS accused over deaths of disabled patients: Mencap inquiry finds institutional discrimination against people with learning disabilities led to at least 74 deathsThe NHS is accused of causing or contributing to the deaths of at least 74 patients with a learning disability because of poor care that reveals enduring "institutional discrimination" among doctors and nurses.The 74 vulnerable patients' deaths over the past decade were either caused or complicated by mistakes in hospitals and decisions by staff who failed to treat them properly and ... Kings Fund Health News

Government creates £170m fund to help older patients leave NHS hospitals

Government creates £170m fund to help older patients leave NHS hospitals:

Councils will get £1m each to spend on social care to reduce the number of elderly patients occupying beds longer than needed. The government will announce a further £170m funding for councils on Monday, to help them improve care and support for elderly people coming out of hospital. Of the £170m total, £150m will be divided among the 152 councils with social care responsibilities and will be allocated through NHS primary care trusts, which must agree how the money should best be spent to ease pressure on hospitals. The remaining £20m will be used to top up local funding pots for the disabled facilities grant, a means-tested award administered by councils to help with the cost of adaptations to enable people to continue living at home. Guardian

Private clinics must pick up £150 million cost of removing faulty breast implants

Private clinics must pick up £150 million cost of removing faulty breast implants: All 40,000 British women who received faulty implants should have them removed if they are leaking as badly as evidence suggests, in a move which could cost £150 million. Telegraph

Norovirus outbreaks rise

Norovirus outbreaks rise: Hospital outbreaks of norovirus have increased by a third while enquiries from worried patients are up 60 per cent, official figures have revealed. Telegraph

Silicone secrets: Britain's £100m implants industry

Silicone secrets: Britain's £100m implants industry:

Surgeons yesterday called for a national register of breast implants with mandatory reporting of cases of rupture to identify faulty devices that could pose health risks to women. Patients should also be issued with an "implant passport" recording details of the operation and device used in case of problems later, they said. Independent

Bird-flu victim 'had no direct contact with poultry'

Bird-flu victim 'had no direct contact with poultry':

A Chinese bus driver who tested positive for the H5N1 bird flu virus died yesterday, a week after being admitted to hospital with a fever. He was the country's first reported case of the disease in humans in 18 months, and the circumstances in which he contracted the disease are worryingly uncertain. Independent

Drop perilous NHS reforms, say leading health professionals

Drop perilous NHS reforms, say leading health professionals:

David Cameron faces fresh calls to abandon his NHS reforms, as a group of leading public-health experts predicts that the changes will "exacerbate inequalities" in the health of the nation. Independent

NHS Standard Contract 2012/13

NHS Standard Contract 2012/13: The Department of Health has published the NHS Standard Contract for 2012/13 which brings together the previous four core contracts into a single restructured contract. The contract is for use by commissioners when commissioning NHS funded acute, ambulance, community and mental health and learning disability services from all types of providers. This contract reflects the requirements set out in the 2012/13 NHS Operating Framework.

NICE funds subscription to the online version of the Lancet

NICE funds subscription to the online version of the Lancet: It has been announced that as part of the drive to provide open access to high quality evidence, the National Institute for Health and Clinical Excellence (NICE) has signed a 3 year agreement to provide staff with access to The Lancet via NHS Evidence (www.evidence.nhs.uk) - the service provided by NICE. From 3 January 2012, every member of staff who is eligible for an NHS Athens password can access the latest online editions of The Lancet, as well as back copies from the last 4 years, removing the need for NHS library services and individual members of staff to subscribe to access The Lancet online - a move which will save time and money and which will provide NHS-wide access to this valued resource. The agreement will also cover healthcare students from an NHS-commissioned education programme involving practice and placement within NHS services across England.

Health Visitor Implementation Progress Report

Health Visitor Implementation Progress Report:

The Health Visitor Implementation report published today, sets out progress on key areas of the Health Visitor Implementation programme, which began in February 2011.

The Health Visitor Implementation progress report provides the latest summary of progress against the Government’s commitment. Summary progress reports will be published every quarter until 2015.

Department of Health

New NHS whistleblowers helpline

New NHS whistleblowers helpline: A free helpline for whistleblowers in the NHS and social services is to be launched, the government says. BBC News

GPs reveal IT concerns for 2012

GPs reveal IT concerns for 2012: GPs leading the move towards clinical commissioning have expressed concern that the authorisation process for clinical commissioning groups is becoming rigid and bureaucratic. EHI News

Critical care bed statistics

Critical care bed statistics: The Department of Health has published the following statistics 'Monthly critical care beds, cancelled urgent operations and delayed transfers of care, England, November 2011'. Some of the main findings for November 2011 were that there were 3,702 adult critical care beds available and 3,121 occupied giving an occupancy rate of 84.3%. This is the highest occupancy rate since January 2010, but is lower than November 2011, where the figure was 86.1%. Adult critical care bed occupancy tends to be higher in winter months.

Atlas of variation

Atlas of variation: The NHS Atlas of Variation has been published by the Department of Health to highlight the amount each Primary Care Trust (PCT) spends on clinical services and links this with the health outcomes patients see. Consisting of 71 maps, the Atlas will help commissioners learn from one other, consider the appropriateness of a service, and investigate when clinical health outcomes are not reflecting the financial investment that has been made.
DH press release: http://nds.coi.gov.uk/clientmicrosite/Content/Detail.aspx?ClientId=46&NewsAreaId=2&ReleaseID=422439&SubjectId=36
Atlas: http://www.rightcare.nhs.uk/index.php/atlas/atlas-of-variation-2011/

National audit of dementia

National audit of dementia: The Royal College of Psychiatrists has published the first full report of the National Audit of Dementia which identifies a need for significant improvements in hospital ward environments, staff training and the overall approach to care delivery for patients with dementia. The main audit looked at data collected from 210 hospitals across England and Wales. Ward level data was collected from a sample of 145 wards across 55 hospitals. This included 2,211 staff questionnaires, and 105 observations of care on the ward, carried out by hospital staff.
BBC News report: http://www.bbc.co.uk/news/health-16206169
Report: http://www.rcpsych.ac.uk/press/pressreleases2011/nationalauditofdementia.aspx

Patients will be able to register with any GP: ministers

Patients will be able to register with any GP: ministers: Patients will be able to register with a GP miles away from where they live under Coalition plans to give them greater choice, it has been announced.
Telegraph

Scandal of NHS 'production line'

Scandal of NHS 'production line': The number of NHS patients who have to undergo emergency readmission to hospital within a month of being discharged has increased by more than three quarters in the last decade, the Daily Telegraph can disclose. Telegraph

Escalating depression crisis is costing Britain £11bn a year

Escalating depression crisis is costing Britain £11bn a year: High levels of depression are costing the country almost £11bn a year in lost earnings, in demands on the health service and in prescribing drugs to tackle the problem. Independent

Helicopter flies to rescue 100 times

Helicopter flies to rescue 100 times:

This year has been another busy one for the county’s air ambulance, which flew out to more than 100 incidents in the county. Evening Telegraph

Why 2012 is big year for the NHS

Why 2012 is big year for the NHS: A look at the challenges that lie ahead for the NHS over the next 12 months. BBC News

Political and Healthcare leaders must in 2012 persuade public to let go of "hospital-or-bust"model of care, says NHS Confederation chief

Political and Healthcare leaders must in 2012 persuade public to let go of "hospital-or-bust"model of care, says NHS Confederation chief: The head of the NHS Confederation today warns of a potential loss of confidence in the NHS unless political and healthcare leaders make a compelling case to the public for changes to the delivery of services.

NHS computer system firm in £1bn climbdown

NHS computer system firm in £1bn climbdown:

Computer Sciences Corporation admits it may have to write off entire value of its investment in the delayed Lorenzo system for health service. Computer Sciences Corporation has admitted that eight years of delays and setbacks on its disastrous NHS contract have left little or no value for shareholders, as the company prepares to write off almost £1bn.

CSC's bold writedown this week echoes similar move by fellow regional contractor BT, which is responsible for installing NHS IT systems across London. Its Global Service division wrote down £1.3bn two years ago in relation to two of its most troublesome contracts — though it never revealed how much related to its NHS work. Guardian

Record number of patients catch infections in hospitals

Record number of patients catch infections in hospitals: The number of patients who contracted life-threatening infections in NHS hospitals has almost doubled in two years to a record level, official figures have shown. Telegraph

A quarter of hospital patients 'should be discharged'

A quarter of hospital patients 'should be discharged':

One in four NHS hospital patients would be better off treated at home, the head of the NHS trusts organisation has said. Independent

Doctors sued for creating 'Valium addicts'

Doctors sued for creating 'Valium addicts':

Doctors are being sued for creating prescription drug addicts amid claims they have failed to follow safety guidelines published more than 20 years ago. Independent