DH reveals details of CCG share of NHS funding

DH reveals details of CCG share of NHS funding: The DH has published details of how NHS funding currently managed by PCTs will be split between clinical commissioning groups (CCGs) and the NHS Commissioning Board (NCB).

New apprenticeship guidance launched

New apprenticeship guidance launched: New guidance has been launched which aims to ensure employers ‘get full benefits’ from apprenticeship schemes NHS Employers

Learning disability reports

Learning disability reports:

The CQC has published a further 20 reports from a targeted programme of 150 unannounced inspections of hospitals and care homes that care for people with learning disabilities.

• Reports


• CQC - press release

MPs call for joint commissioning of health and social care - Public Finance

MPs call for joint commissioning of health and social care - Public Finance:

The Guardian

MPs call for joint commissioning of health and social care Public Finance Jo Webber, deputy policy director at the NHS Confederation, also added her support to the calls for better integration. 'The starting point must be to find a long-term solution to social care funding as, without reform, the system is on the brink of ... Health select committee to say government's health reforms have failed to ...The Guardian (blog) Government details structural breakdown of new health funding plansZenopa Health committee recommends joined-up social care commissioningCivil Society Media Yorkshire Post -OnMedica -Huffington Post UK all 249 news articles »

Why the NHS must embrace telehealth on a larger scale

Why the NHS must embrace telehealth on a larger scale:

There is a more efficient and cost-effective way to treat long-term conditions that also benefits the patient

A target of delivering between £15bn and £20bn in efficiency savings over the next four years has been set by the new operating framework for the NHS.

The announcement of the Whole System Demonstrator (WSD) results in early December 2011 highlighted that telehealth provides a unique opportunity to make significant financial savings when implemented for patients suffering with long-term conditions.

The report provides robust evidence in support of changing the way healthcare is delivered and accessed and, in particular, the way that the NHS manages the growing problem of long-term conditions. The government's recent drive to boost private sector funding of infrastructure projects is also a timely catalyst to help deliver telehealth systems in the UK.

Patients who suffer from long-term conditions make up 31% of the population, but approximately 69% of all primary and acute care budgets in England are spent on them. They account for more than half of GP appointments and nearly two-thirds of all outpatient appointments. The 5% of patients who have one or more long-term conditions account for 49% of all inpatient bed days.

One particular long-term condition, chronic obstructive pulmonary disease, is the second most common cause of emergency admissions, the largest cause of hospital readmission and is one of the most costly diseases in terms of hospital care.

So, looking at different ways of delivering care to patients who suffer from these long-term conditions is a key priority for an NHS facing challenging efficiency targets. The delivery of those targets will require the NHS to challenge the current methods of service delivery and the boundaries that are often placed on the provision of acute, community and social care.

Telehealth and telecare have been shown to provide opportunities for delivering care more efficiently. There is national and international evidence that demonstrates the delivery of both cost savings and improved care to patients with long-term conditions. The benefits have primarily been in preventing unplanned hospital admissions and facilitating early discharge.

It also provides a mechanism through which selected patients with long-term conditions can remotely monitor a range of daily vital signs such as blood pressure, oxygen saturation, pulse rate, temperature and weight. This also provides trend data for clinical teams.

Additionally, it has been demonstrated that the act of taking their own readings can provide patients with a greater understanding of their own condition thereby promoting improved self-management and they often highlight a renewed independence from a normal daily life.

Recent Department of Health research highlighted that over 90% of people with long-term conditions say they want to be more active self-carers and over 75% would be confident in being a self-carer if they had support and assistance.

The WSD projects figures show a 20% reduction in emergency admissions and a 14% reduction in elective admissions. Telehealth also leads to significant reductions in the number of A&E visits, increased levels of patient satisfaction and a 45% reduction in mortality.

Even greater benefits can be realised when the NHS works collaboratively with colleagues in adult social care to develop integrated telehealth care pathways.

This kind of integrated approach can deliver reductions in the amount of domiciliary care needed, as well as a 17% reduction in the number of people needing residential or nursing care over a 12-month period. Equally, in groups of frail elderly people who were provided with telecare, there is a reduction in the number of hospital admissions following falls.

While the evidence for telehealth is clear, to date, telehealth procurements have usually been on a small scale. They have not been fully implemented and have not led to substantive changes in the way services are delivered or in the patient experience of those services.

The NHSis currently missing the opportunity for significant financial benefits and improved patient care and urgently needs to look at implementing telehealth on a larger scale.

Ivan McConnell is a telehealthcare expert at PA Consulting Guardian Professional.

The NHS is a professional service ripe for re-engineering | Ali Parsa

The NHS is a professional service ripe for re-engineering | Ali Parsa:

Our healthcare system will only survive if it allows private companies and others to innovate, increase quality and drive down costs

The health and social care bill will be the subject of heated debate at its report stage in the House of Lords today. Yet the real healthcare issue should be less about the NHS landscape in the next three years, and more about the survival of our universal and equitable healthcare system for the next three decades.

The £20bn deficit facing the NHS in the next three years is undoubtedly important, but the elephant in the room is the sustainability of the sector.

In Britain, we spent about £40bn on healthcare in 2000. Around 10 years later, we are spending near to £120bn. Economic value is defined as quality divided by price. We have tripled the denominator of the value equation. Yet it is hard to claim the nominator – defined as clinical results and patient experience in healthcare – has kept pace.

We have been here before in Britain. When any sector has become unsustainable, we have brought down barriers to entry, stopped artificially pumping up the outdated, and allowed new entrants to come up with new solutions and flourish ahead of our global competitors. As a result, we have in our small country of 60 million people some of the world's most successful telecommunication, retail, financial, creative and professional services.

The NHS, too, is a professional service now ripe for re-engineering. By contrast, manufacturing teaches us a salutary lesson. When we protect our old industries with subsidies and inflexible legislation, we risk losing all. British factories are now predominantly foreign-owned.

When innovation is needed in a sector, it is understandable that those involved in the current system feel insecure about their future. Yet neither incumbent organisations nor employees should fear the opening up of their sector to new ideas, because both tend to do better in sectors where Britain stays ahead of the global rejuvenation curve. Just contrast the fate of the British telecommunications industry and its participants with that of the once-mighty British Leyland.

Liberating a sector is simply about giving professionals the liberty to create a new chapter in their profession. In healthcare, the future will be created by people who are delivering the services today. We should therefore spend less energy safeguarding existing structures and institutions and focus more on freeing their participants to create the new.

Of course, with freedom comes responsibility. Concerns over independent companies competing with the public sector often centre on accountability and profit. It is true that some lost their way in recent years in the quest for profit. Profit for an enterprise is like oxygen, food and water for the body: necessary to sustain life, but not the point of life. Just as the entire public sector can not be condemned for the failure at Mid Staffordshire hospital, it is wrong to judge every non-state operator according to the actions of a guilty few. The key here is the accountability of all operators to public scrutiny.

In fact, the search for new solutions in healthcare gives us a great opportunity to create a fairer society. At the moment, two single square miles – the City and Whitehall – control over 90% of our productive assets. This concentration of ownership is unique among developed countries, and has produced unacceptable consequences. For instance, the richest region in Germany is two times more prosperous than the poorest; in France this ratio is four times; in the United States five times; in Britain it is a shameful 10 times.

Healthcare professionals must be empowered to set up their own alternatives. GPs provide a great example of how healthcare professionals can be freed to own and deliver their own services. They set up and own their practices, and sell their services back to the NHS as single-handed practitioners or small partnerships. This model could be expanded to nurses, midwives, hospital consultants and countless others, so that many more professionals could come up with new solutions that they control for their patients.

Our healthcare system is on an unsustainable trajectory. The solution is fundamental innovation that increases quality and reduces costs. We need charities, mutuals, private companies and public sector organisations all to participate to give us the greatest chance of rejuvinating our NHS for future generations. The country that pioneered the first antibiotic, the first blood transfusion and the first universal health service should still be a place where the brightest minds can create the boldest solutions. The Guardian

No alternative to NHS reforms, say coalition

No alternative to NHS reforms, say coalition:

David Cameron and Nick Clegg admit it could take until election to persuade voters their fears are unfounded

David Cameron and Nick Clegg have agreed they have no alternative but to push ahead with the planned reforms to the NHS, even though they admit they are in "a rubbish place politically" and it could take three years until the general election to persuade voters that fears about the reforms are unfounded.

Cameron endured a mauling over the issue at prime minister's questions , and afterwards one senior minister involved in deciding how to proceed with the bill admitted: "This is a politically rubbish place to be. We can either go back, sideways or forward." Ministers have argued there was no alternative but to plough on.

Liberal Democrats, including Baroness Williams, are in no mood to abandon the bill, even though many health professionals – at one time reconciled to the bill – have now defected.

On the day that health visitors and the Faculty of Public Health joined the long list of those deserting the bill, Labour leader Labour leader Ed Miliband accused Cameron of presiding over a "complete disaster" with the bill.

He said the prime minister had broken a pre-election promise not to have any "top-down re-organisation of the NHS" and told him: "Every day he fights for this bill, every day trust in him on the NHS ebbs away, every day it becomes clearer the NHS is not safe in his hands."

But Cameron said Labour had previously supported NHS reform – and would not match government commitments on NHS spending: "They are not in favour of the money. They are not in favour of the reform. They are just a bunch of opportunists."

He criticised Labour's record on the NHS in Wales – where the party controls the Welsh Assembly – and said the coalition was cutting bureaucracy and ploughing money back into patient care.

He said of Miliband: "This is not a campaign to save the NHS. This is a campaign to try and save his leadership. I make this prediction, the NHS will go on getting better and his prospects will go on getting worse."

Cameron also backed his health secretary Andrew Lansley, saying he would survive a lot longer in office than Miliband.

It is understood that Lansley put in angry performance at cabinet this week defending his reforms, saying they were in line with government public services reform. He has been infuriated by leaks form Downing Street blaming him for mis-selling the reforms.

Although a Downing Street source has suggested Alan Milburn, the former Labour health secretary could be drafted into Lansley's role, Milburn himself dismissed the suggestion.

He criticised Lansley's handling saying: "This bill has ended up as a – to be frank – a patchwork quilt of complexity and compromise and confusion. They will get the measure through in my view, they will probably win the day in parliament, but at a terrible cost. The NHS will not have either the clarity or the direction that is necessary in a period of considerable challenge where it is being asked to make unprecedented efficiency savings."

In a sign that the government will face a tough month as the bill enters the Lords report stage, peers inflicted an early defeat over the issue of social care. By a margin of four votes, peers demanded mental health be made a higher priority. The amendment creates a duty for the health secretary to promote a health service that deals with "mental and physical illness", rather then the original draft of just "illness". The government described issue as largely symbolic.

All but three Lib Dem peers voted with the government, suggesting that on most issues Labour will rely on cross bench support to further amend the bill that has already been heavily altered by government to take on concerns of health professionals.

Meanwhile there was a fresh embarrassment to the reforms after part of a major risk assessment into the bill was published on the internet, suggesting that changes could lead to the financial "failure" of some NHS organisations, worse care for patients, and threats to maternity services, children's safety and public health.

Most worryingly for the coalition the "risk register" for the London NHS suggested that problems with implementing the new system could delay improvements to patients' health – even after a host of proposed "mitigation" measures to ensure a smooth transition.

The document, dated October 2011, was published by NHS London on their website, according to the Labour-supporting blogger Dr Eoin Clarke, who has waged a campaign to get the full national risk register published. At least nine Lib Dem MPs have also signed an early day motion organised by Labour MP and health select committee member Grahame Morris calling on the health secretary to publish the document.

Health officials have pointed out that such a risk assessment would be carried out for any major changes, but added that during the transition there was "more of a risk because of the uncertainty".

In a statement to the Guardian, an NHS London spokesperson said: "It is our job to identify and manage potential risks to deliver safe services for patients. We are duty bound to publish this information quarterly on our website and have done since our formation." These risks cover a wide range of services and issues, including how we manage the transition to 2013 appropriately. The more we plan for and pre-empt issues, the less of a risk they become." The Guardian

Senior Tories begin to get cold feet as health Bill is defeated in Lords

Senior Tories begin to get cold feet as health Bill is defeated in Lords:

David Cameron has been urged to abandon the Government's controversial Health and Social Care Bill by at least one senior Cabinet minister in the face of widespread public hostility. The Independent

Booze problems getting worse - Northamptonshire Evening Telegraph

Booze problems getting worse - Northamptonshire Evening Telegraph:

Northamptonshire Evening Telegraph

Booze problems getting worse Northamptonshire Evening Telegraph The Evening Telegraph can reveal that between 2007 and 2011 a total of 7157 patients were seen at Northampton General Hospital and a further 5649 treated at Kettering General Hospital. Across the county's medical services, alcohol-related admissions ...

A&E patients at ‘urged to complain’ by staff at Northampton General Hospital

A&E patients at ‘urged to complain’ by staff at Northampton General Hospital:

NURSES encouraged emergency patients at Northampton General Hospital to complain in order to escalate the issue of overcrowding in A&E, a patient has claimed. Northampton Chronicle and Echo

Estimating the prevalence of autism spectrum conditions in adults

Estimating the prevalence of autism spectrum conditions in adults:

Adults with a more severe learning disability also have a greater likelihood of having autism according to a report published on 31st January 2012 by the NHS Information Centre.

The report combines data from the Adult Psychiatric Morbidity Survey (APMS) 2007 with findings from a new study based on a sample of people with learning disabilities living in private households and communal care establishments.

The report aims to

• Estimate the prevalence of autism in England, furthering previous research that suggests people with learning disabilities are more likely to have autism


• Address the fact that the APMS did not include people with severe learning disabilities.

Department of Health

Call for 'joined-up' elderly care

Call for 'joined-up' elderly care: Older people needing social care are being let down and "passed like parcels" between fragmented services, a group of MPs says. BBC News

NHS directors seek Lords backing

NHS directors seek Lords backing: Peers are urged to support a move to let hospitals do more private sector work as plans to overhaul the NHS in England return to the Lords. BBC News

Baseline spending estimates for the new NHS and Public Health commissioning architecture

Baseline spending estimates for the new NHS and Public Health commissioning architecture:

This document contains estimates of how 2010-11 spend by PCTs would be deployed under the new commissioning arrangements proposed in the Health and Social Care Bill. The main data sources are two major collections of financial information from PCTs which have been brought together with information from other sources to provide these estimates of baseline spend.The baseline estimates, which have been uplifted to 2012-13 values, aim to provide emerging clinical commissioning groups and local authorities with the information they need to support initial planning for the commissioning responsibilities they will take on in the future.

• Spending estimates


• PCT spend by future commissioning route


• Department of Health - publications

Guidance for commissioners

Guidance for commissioners:

The Royal College of Psychiatrists have published four guides to help current and future commissioners plan and deliver high quality mental health services. The guides focus on primary mental health care services, child and adolescent mental health service transitions, dementia services and acute liaison services, and have been produced by the Joint Commissioning Panel for Mental Health. The guides describe what good quality, modern mental health services should look like and bring together scientific evidence, patient and carer experience and viewpoints, and examples of best practice.

• Guidance for commissioners of primary mental health care services


• Guidance for commissioners of liaison mental health services to acute hospitals


• Guidance for commissioners of dementia services


• Guidance for commissioners of mental health services for young people making the transition from child and adolescent to adult services


• The Royal College of Psychiatrists - news

NHS N3 network to be replaced by successor N4 in 2014

NHS N3 network to be replaced by successor N4 in 2014:

Cabinet Office transition plans reveal N3 extension and potential tie-up between N4 and PSN

The NHS's N3 network could be set to run for another year, according to documents released by the Cabinet Office, with plans to establish a successor already under way.

N3, one of the largest VPNs in Europe with more than 40,000 connections, is managed by BT. The seven-year contract with the telco, signed in 2004, was extended in 2010, enabling it to run until March 2013.

The deal now looks likely to be extended for a further year, with the NHS set to build a case for the contract extension and seek approval for the plan in the first quarter of this year.

The probable extension is highlighted in a document setting out the roadmap for the public sector's transition to the PSN.

The roadmap also shows that the NHS is planning to begin laying the foundations for the successor to the N3, known as N4, from the middle of this year. The extension of the N3 contract until March 2014 will "enable orderly transition, exit, migration" to N4, the document says.

Plans for N4, and its potential tie-up with the PSN, are still in the early stages, according to a Department of Health spokeswoman.

"As a member of the PSN board, we are working closely with the PSN programme to determine what will be suitable, for not only health and social care, but also wider aspirations of public service networking and telecommunications. Planning for the future transition of the N3 network to N4 is just beginning and still at an early stage, however, we are committed to aligning our future direction with PSN.

"As we develop our PSN transition plan jointly with the programme we will share it with interested parties. We are currently evaluating options for making the current N3 network PSN compliant and intend to publish our plans at the start of next financial year," she said.

The business case for the move to N4 will be outlined in the first quarter of this year, according to the Cabinet Office document.

Procurement could take place under PSN frameworks where there is a demonstrable value for money, it adds.

Guardian Professional.

Surgeons should inform women if they have PIP breast implants: regulator

Surgeons should inform women if they have PIP breast implants: regulator: Health regulators had to rely on plastic surgeons and clinics to inform women they were given faulty PIP breast implants as no central register exists, it has emerged. The Daily Telegraph

Why Health Bill's biggest critic has a lot to lose from reforms

Why Health Bill's biggest critic has a lot to lose from reforms:

One of the most vociferous critics of the Government's health reforms has a financial interest in a partnership of GPs that could lose out if private providers are given greater freedom to compete with doctors offering NHS services. The Independent

Fragmented care system is failing elderly, MPs warn

Fragmented care system is failing elderly, MPs warn:

Elderly patients are suffering a "diminished quality of life" because the enormous pressures on the social-care system mean they are not receiving the help they need, a committee of MPs warns today. The Independent

Roundtable summary - primary care

Roundtable summary - primary care: Monitor held a roundtable discussion in December to explore what the proposals in the Health and Social Care Bill will mean for primary care providers and clinical commissioners. Our roundtable, held under the Chatham House Rule, brought together a number of leading primary care leaders, practitioners and policy experts.

Implementing what works: the impact of the individual placement and support regional trainer

Implementing what works: the impact of the individual placement and support regional trainer:

This briefing describes a pilot in Sussex which found that this approach could achieve a 50%-60% employment rate for those with serious mental health problems. NHS Networks

AUDIO: Have views on NHS reform shifted?

AUDIO: Have views on NHS reform shifted?: Dr Michael Dixon, chair of the NHS Alliance, who supports the governments proposed reforms of the NHS and Dr John Lister, director of the Health Emergency campaign group, who opposes them, debate the Health Bill. BBC News

GMC guidance on assisted suicide

GMC guidance on assisted suicide: The General Medical Council launches guidelines on assisted suicide to help it decide if doctors should face a disciplinary panel on the issue. BBC News

Health and Social Care Bill: Lords report stage briefing

Health and Social Care Bill: Lords report stage briefing:

In this briefing to peers, the BMA acknowledges that the Government has made some effort to try to address some of the association’s concerns, but says the Bill remains fundamentally flawed and should be withdrawn.

• Briefing


• BMA - press release

Northants picks Civica to inform CCGs

Northants picks Civica to inform CCGs: NHS Northamptonshire has selected software from Civica to help it supply information to its clinical commissioning groups. E-Health Insider

Structural reform plan progress reports

Structural reform plan progress reports:

The Government has published January progress updates for each department’s Structural Reform Plans.

• Department of Health progress report


• British Prime Minister's Office - news
  

Lost in translation: how much is translation costing the NHS, and how can we both cut costs and improve service provision?

Lost in translation: how much is translation costing the NHS, and how can we both cut costs and improve service provision?:

This report investigates NHS spend on translation services, the overall costs, as well as the individual areas of spend.

• Report


• 2020 Health - publications
  

Backers of NHS shake-up turn against Andrew Lansley's plans

Backers of NHS shake-up turn against Andrew Lansley's plans:

Leading doctors voice concerns that reforms will suffocate GPs and jeopardise promised freedom to commission care

Two prominent backers of the coalition's NHS shake-up have joined the growing chorus of critics by claiming that GPs will be "suffocated rather than liberated" by the planned changes.

Dr Charles Alessi and Dr Michael Dixon have helped Andrew Lansley claim credibility for his plans among doctors over the past 18 months by strongly supporting his radical restructuring. They are leading lights in the NHS Alliance and the National Association of Primary Care, two key pro-reform organisations.

But they now fear that the new consortiums of local doctors, which will start commissioning healthcare for patients in England from next year, will not have the freedom that the health secretary has repeatedly pledged. Lansley has attempted to persuade sceptics that his reorganisation will put family doctors in charge of healthcare.

NHS primary care trusts (PCTs) and strategic health authorities (SHAs) are due to be abolished next year.

But the doctors are worried that the GP-led clinical commissioning groups (CCGs), which will replace PCTs, will find themselves unexpectedly under the control of another organisation, the NHA National Commissioning Board (NCB).

In July the NHS chief executive, Sir David Nicholson, said "CCGs will be the engine of the new system" and that the reformed NHS "gives pride of place to clinical leaders". But the reality is that primary care doctors and clinical commissioners will not have the promised ability to make key decisions because the current bureaucracy is simply being replaced by another that is growing up around the NCB, the pair claim.

The Department of Health's latest document about the design of the new board involves "layers of bureaucracy and management, with complex guidelines. The old 'footprint' [of the PCTs and SHAs], ie 50 local offices, remains there, plus four sector outposts, all using a single operating model," the two organisations said in a joint statement .

The fact that many of the staff of the new NCB will simply be staff who have joined from PCTs and SHAs "adds to clinical commissioners' concerns and perceptions that they will be suffocated, instead of liberated, which in our view is fundamental to the success of clinically-led commissioning", they added.

"What we are hearing and seeing are the same old messages and the same old structures, albeit with new nomenclatures", said Alessi, a key figure in a CCG in south-west London.

"If we put the same ingredients into the mix, the likelihood is that we shall deliver the same inefficient environment and outcomes. This is insupportable in an economy of tight financial restraint."

Most CCGs now see the new board as the greatest threat to their effective functioning, added Dixon, a GP in Devon and chair of the NHS Alliance.

The pair's comments are another blow to the health secretary as his health and social care bill prepares to undergo its report stage in the House of Lords, when peers will seek to force the government to accept further amendments to its plans. Labour seized on the men's remarks as further evidence of the growing concerns the bill is causing.

"Things are going from bad to worse for Andrew Lansley. In the last fortnight there has been a deepening crisis of professional confidence in the government's health bill, but until now the health secretary could rely on the support of the NHS Alliance and the National Association of Primary Care," said Andy Burnham, the shadow health secretary.

"Yet the bill's biggest cheerleaders are now lambasting the increasing layers of bureaucracy. Even the health bill's greatest supporters are now concerned that Lansley's plans are so complex and full of worrying uncertainties that they risk thwarting the principle of true clinician-led commissioning."

The British Medical Association also fears CCGs' freedom will be curtailed. "There are significant concerns that CCGs will not have genuine freedoms and sufficient independence to make locally sensitive, locally accountable, patient-focussed decisions," it said.

In a briefing to peers ahead of the report stage it says that, despite ministers agreeing to amend several aspects of the bill, the legislation should still be dropped because it involves too much use of "market forces", and could also affect doctors' relationship with their patients through financial incentives for CCGs.

The Department of Health said: "By handing power and responsibility for choosing and purchasing services to doctors and nurses on the ground, we are shifting the decision making closer to patients and building on the trusted role that GPs and other front line professionals already play throughout the NHS.

"The NHS commissioning Board will provide national standards, but doctors and nurses will have the freedom to make decisions about their patients and their organisations." The Guardian

NHS facing £15.7bn for rising number of clinical negligence claims

NHS facing £15.7bn for rising number of clinical negligence claims: The NHS faces a £15.7 billion bill to settle a rising number of clinical negligence claims, a report by MPs disclosed last night. The Daily Telegraph

Force NHS trusts to admit mistakes to patients, urge groups

Force NHS trusts to admit mistakes to patients, urge groups: NHS trusts should be forced to tell patients when they make errors and cause harm, patients groups have said in a letter to The Daily Telegraph.

GPs fine hospital for A&E failures

GPs fine hospital for A&E failures:

DOCTORS are withholding funding from Kettering General Hospital’s accident and emergency department because it is failing to treat patients quickly enough. Evening Telegraph

Feeding support funding set to end - Northamptonshire Evening Telegraph

Feeding support funding set to end - Northamptonshire Evening Telegraph:

Feeding support funding set to end Northamptonshire Evening Telegraph Funding for the Mum to Mum Peer Supporters group, which has helped 5858 people during the past year, will end in April and is not being renewed by NHS Northamptonshire. The group has 60 volunteers trained to help new mums feed their babies.

Northampton General Hospital treating more patients with alcohol problems - Northampton Chronicle & Echo

Northampton General Hospital treating more patients with alcohol problems - Northampton Chronicle & Echo:

Northampton General Hospital treating more patients with alcohol problems Northampton Chronicle & Echo By Rebekah Smith THE number of inpatients admitted to Northampton General Hospital with alcohol-related health problems has increased by more than 50 per cent in the last five years. Figures released by the Northampton hospital show that more than 5600 ...

PFI hospitals 'get bailout fund'

PFI hospitals 'get bailout fund': Seven English NHS hospital trusts with debts caused, in part, by PFI repayments are to have access to a £1.5bn government bailout fund. BBC News - Health

Hospital patients more at risk at weekends

Hospital patients more at risk at weekends: Patients admitted on a Sunday at 16% higher risk of dying within a month than those admitted midweek, study showsPatients admitted to hospital at the weekend are more likely to die than those whose stay starts during the week, according to a major study that has renewed calls for action to end the "two-tier" NHS.Those admitted on a Sunday have a 16% higher risk of dying within a month than those admitted on a Wednesday, a finding the researchers called "a significant increased risk". Those who become ... Kings Fund Health News

Ed Miliband: NHS reform defeat could save 6,000 nursing jobs

Ed Miliband: NHS reform defeat could save 6,000 nursing jobs: Labour leader to say that official NHS statistics prove that the coalition's reorganisation of NHS is directly affecting patient careEd Miliband will claim on Monday that the total number of nurses working within the NHS has been cut by 3,500 since the general election, and could fall by a further 2,500 by the end of this parliament.The Labour leader will say that official NHS statistics prove that the Tories' reorganisation of the health service is directly damaging frontline patient care.At the ...Kings Fund Health News

999 patients failed by third of ambulance trusts

999 patients failed by third of ambulance trusts: A third of ambulance trusts are now failing to reach enough of the most seriously ill patients within the required time, new figures show.Telegraph Health News

NHS spends £23m a year on translators

NHS spends £23m a year on translators: The NHS spends £64,000 a day on translation services, a report has found.
Telegraph Health News

Two glasses of wine a day triples risk of mouth cancer

Two glasses of wine a day triples risk of mouth cancer:

A new government campaign is to warn drinkers that consuming two large glasses of wine or two strong pints of beer a day triples their risk of developing mouth cancer. New adverts aim to show that even drinking just over the recommended daily limit for alcohol increases the risk of serious health problems. Independent

Northampton General Hospital denies late rush to hit A&E target - Northampton Chronicle & Echo

Northampton General Hospital denies late rush to hit A&E target - Northampton Chronicle & Echo:

Northampton General Hospital denies late rush to hit A&E target Northampton Chronicle & Echo By Nick Spoors TREATMENT for more than 8000 A&E patients was pushed through just before they would have breached the waiting time target at Northampton General Hospital, figures show. The yearly NHS figures for 2011 show about 95 per cent of emergency ...

NHS to get £28m cash boost to improve access to dentists

NHS to get £28m cash boost to improve access to dentists:

820,000 more people have already been given access to an NHS dentist since May 2010. Twenty eight million pounds of funding will be announced, which will bring the number of extra people now able to access an NHS dentist to one million.

The funding will be given to PCTs, who have bid for the cash to spend on expanding local services in ways that best meet their patients’ needs. NHS Networks

Personal health budgets and NHS Continuing Healthcare

Personal health budgets and NHS Continuing Healthcare:

This is aimed at healthcare professionals who will have a specific role in this initiative or are considering the future implementation of personal health budgets. Personal health budgets and NHS Continuing Healthcare is the first of a number of informative documents on the subject. NHS Networks

Vitamin D – advice on supplements for at risk groups

Vitamin D – advice on supplements for at risk groups:

This letter from the Chief Medical Officers for the United Kingdom published today, raises awareness of the risk of vitamin D deficiency amongst certain groups particularly:

• All pregnant and breastfeeding women



• Infants and young children under 5 years of age



• Older people aged 65 years and over



• People who have low or no exposure to the sun



• People who have darker skin

The letter also contains a list of recommendations issued by all the UK health departments for people at-risk on whether they may need to take vitamin D supplements. Vitamin D – advice on supplements for at risk groups

Brains may be wired for addiction

Brains may be wired for addiction: Abnormalities in the brain may make some people more likely to become drug addicts, according to scientists. BBC News - Health

GP leaders turn back on NHS plans

GP leaders turn back on NHS plans: The Royal College of GPs calls for the health bill to be scrapped, heaping more pressure on the government's controversial reforms in England. BBC News - Health

Health Bill: 137 changes made to win over House of Lords

Health Bill: 137 changes made to win over House of Lords: The Government has made 137 late amendments to the Health and Social Care Bill in an effort to ease the concerns of worried peers. Kings Fund Health News

Tax and regulate sugar like alcohol and tobacco, urge scientists

Tax and regulate sugar like alcohol and tobacco, urge scientists: Sugar is as toxic to the liver as alcohol and is at the root of obesity and certain types of liver disease, claim US scientistsSugar should be regulated in the same way as alcohol and tobacco because its increasing use in processed foods poses a significant danger to public health, according to a group of scientists. They advocate controlling sales to children under 17 and taxing sugary foods.Sugar, they argue, is as toxic to the liver as alcohol and overconsumption is at the root of growing public ...Kings Fund Health News

Food poisoning link to UK watermelons

Food poisoning link to UK watermelons:

Watermelons may be the source of a salmonella outbreak across the UK which has affected 35 people, leading to one death.
Independent

Outbreak of Salmonella Newport

Outbreak of Salmonella Newport: The Health Protection Agency (HPA) is investigating an outbreak of a strain of Salmonella Newport infection among 30 people in England, Wales and Northern Ireland since the beginning of December 2011. Cases of illness caused by the same strain have been confirmed in Scotland, Ireland and Germany.

Andrew Lansley pledges a million more people will have access to an NHS dentist - Daily Mail

Andrew Lansley pledges a million more people will have access to an NHS dentist - Daily Mail:

Andrew Lansley pledges a million more people will have access to an NHS dentist Daily Mail By James Chapman NHS dentists are to treat an extra million patients following a shake-up in funding. Health Secretary Andrew Lansley will today pledge that everyone who lost their NHS dentist since 2006 will now have access to one.

Saving lives by responding first

Saving lives by responding first: Setting up an emergency first responder team in a south Northamptonshire village. BBC Northampton News

Northampton General Hospital denies late rush to hit A&E target

Northampton General Hospital denies late rush to hit A&E target:

TREATMENT for more than 8,000 A&E patients was pushed through just before they would have breached the waiting time target at Northampton General Hospital, figures show. Northampton Chronicle

Personal health budgets and NHS Continuing Healthcare

Personal health budgets and NHS Continuing Healthcare:

The Department has published a discussion paper which explores personal health budgets for people receiving NHS Continuing Healthcare. This is aimed towards healthcare professionals who will have a specific role in this initiative or are considering the future implementation of personal health budgets. Personal health budgets and NHS Continuing Healthcare is the first of a number of informative documents on the subject.

Personal health budgets are currently being piloted in the NHS in England, with over 2,700 participants across 20 sites. A number of sites are piloting personal health budgets with people eligible for NHS Continuing Healthcare. In October 2011, the Secretary of State for Health announced that subject to the evaluation, by April 2014 everyone in receipt of NHS Continuing Healthcare will have a right to ask for a personal health budget, including a direct payment. This will form part of a broader rollout of personal health budgets to people with long term health conditions.

A personal health budget is an amount of money that is allocated to an individual to allow them to meet their health and well-being needs in a way that best suits them. At the heart of a personal health budget is a care plan which sets out the individual’s health (and social care) needs and includes the desired outcomes, the amount of money in the budget and how this will be spent. The care plan has to be agreed between the individual and the professional, before being checked and signed off by the NHS.

Personal health budgets potentially offer greater integration of health and social care for both individuals who need care and their carers, and better partnership working between the NHS and local authorities. Personal health budgets and NHS Continuing Healthcare provides more information about the recent Government announcement and how these budgets are relevant to people receiving NHS Continuing Healthcare and how personal health budgets change the NHS Continuing Healthcare pathway. Department of Health

Developing the NHS Commissioning Board

Developing the NHS Commissioning Board:

These documents have been produced for patients, clinicians, staff and the public. They set out the initial thinking on how the new commissioning system could work and the NHS Commissioning Board’s role within that system.

Developing the NHS Commissioning Board (published July 2011)

Developing the NHS Commissioning Board: Update (published October 2011)

Prostate drug too costly for NHS

Prostate drug too costly for NHS: A drug which could extend the life of prostate cancer patients is too expensive to be used on the NHS in England and Wales, a health watchdog says. BBC News

DH expect 25-35 CSOs in England

DH expect 25-35 CSOs in England: The Department of Health has estimated that there will be between 25 and 35 commissioning support organisations in the reorganised NHS in England - equivalent to one for every two primary care trust clusters. EHI News

EMIS unveils new patient.co.uk

EMIS unveils new patient.co.uk: EMIS has re-launched its patient information website with a new look and plans for a a series of apps; including one that will let patients book an appointment from their smartphone. EHI News

Behaviour change among overweight and socially disadvantaged adults: A longitudinal study of the NHS Health Trainer Service

Behaviour change among overweight and socially disadvantaged adults: A longitudinal study of the NHS Health Trainer Service: This article examines the findings of a study which looked at the potential for the NHS Health Trainer Service (HTS) to improve population health and reduce health inequalities through behaviour change interventions.

Please contact your local health library to obtain the full-text of this article: http://www.hlisd.org/AtoZBrowse.aspx?browsetype=library

Consultation on Commissioning Outcomes Framework indicators

Consultation on Commissioning Outcomes Framework indicators

As part of the process to develop a Commissioning Outcomes Framework (COF) stakeholders have the opportunity to comment on potential new indicators, which have been mapped against the five domains of the NHS Outcomes Framework, encompassing the three dimensions of quality (effectiveness, patient experience and safety). The consultation will close at 5pm on Wednesday 29 February 2012; please see the link below for further information. NICE

National review of asthma-related deaths and launch of online test to identify patients' risk

National review of asthma-related deaths and launch of online test to identify patients' risk
BBC Health has reported on a new online test launched by Asthma UK that helps people with asthma to determine their risk of an asthma attack. Following the result, users will be given advice on how to help avoid having an attack and also what to do if they do have an attack. The online test - 'Triple A: Avoid Asthma Attacks' - is available at the link below.

At the same time, the Royal College of Physicians is launching a national review of asthma-related deaths in the UK, which will collect details of all asthma deaths from hospitals, GPs and families to try to identify how to improve care and reduce deaths in the future. BBC Health

NICE consults on a new treatment for prostate cancer

NICE consults on a new treatment for prostate cancer: NICE, the healthcare guidance body, has issued new draft guidance not recommending the use of abiraterone (Zytiga, Janssen) in combination with prednisone or prednisolone for the treatment of castration-resistant metastatic prostate cancer that has progressed on or after docetaxel-containing therapy.

Northumbria trust wins bid to run two hospitals

Northumbria trust wins bid to run two hospitals:

NHS foundation trust to take over Cumberland Infirmary in Carlisle and the West Cumberland hospital in Whitehaven

Northumbria Healthcare NHS foundation trust has been named as the preferred bidder to take over the running of two hospitals – Cumberland Infirmary in Carlisle and the West Cumberland hospital in Whitehaven, in Cumbria. North Cumbria university hospitals trust announced plans to accept takeover bids in June 2011 after it realised it would not be able to meet new government targets, which require all NHS trusts to become foundation trusts by 2014.

The winning bid was decided after considering detailed proposals and responses to additional financial questions submitted to interested foundation trusts. It also took into consideration the views from a panel of patients, the public, hospital clinicians and staff, GPs and other key groups. NHS North of England, the region's strategic health authority, local health commissioners, and Northumbria trust will now start negotiations on the final financial arrangements. There will also be further assessments by regulators and a final recommendation by health secretary Andrew Lansley later this year.

Newcastle upon Tyne hospitals foundation trust and Cumbria partnership foundation trust had also put in a joint bid to take over the hospitals' services. Mike Little, chair of North Cumbria university hospitals trust, said: "We were very pleased with the way both organisations have engaged in the process and by their enthusiasm, professionalism and commitment to this opportunity. Our evaluation started in June 2011 and has been a lengthy, detailed and competitive process."

But Stephen Dalton, chief executive of Cumbria partnership foundation trust, said turning down their joint bid was a missed opportunity for "genuinely integrated healthcare." "We are surprised and disappointed that the opportunity for a genuinely integrated healthcare solution has been missed. However, we remain the only major county-wide provider of healthcare and as such we are eager to now see a very public discussion about plans for Cumbria's hospitals in the north and west. I hope that the staff of North Cumbria university hospitals trust finally get the stability and support they deserve."

The decision comes as London's St George's healthcare trust pulled out of its bid to merge with St Helier and Sutton hospitals. In a statement, St George's said that while a merger would be an "excellent strategic opportunity", the current terms of the agreement prevented it from being able to proceed further. Guardian Professional.

Health Bill: 137 changes made to win over House of Lords

Health Bill: 137 changes made to win over House of Lords: The Government has made 137 late amendments to the Health and Social Care Bill in an effort to ease the concerns of worried peers. Telegraph

Private firm vows to breathe new life into struggling NHS hospital

Private firm vows to breathe new life into struggling NHS hospital:

The chief executive of the first private company to take over a failing NHS trust announced a "massive war on waste" yesterday to eliminate its debts and secure its future. Independent

New central resource for Joint Strategic Needs Assessments - including revised core data set - now available from NHS Information Centre

New central resource for Joint Strategic Needs Assessments - including revised core data set - now available from NHS Information Centre: A new, free resource to support organisations in producing an effective Joint Strategic Needs Assessment (JSNA) is now available from The NHS Informat...

Pilot Gritting Scheme launched to prevent Falls - AboutMyArea

Pilot Gritting Scheme launched to prevent Falls - AboutMyArea:

Pilot Gritting Scheme launched to prevent Falls AboutMyArea The project is a joint initiative between Northamptonshire County Council and NHS Northamptonshire, working with Northamptonshire Probation Trust, which is supporting the community-based initiative. The project will see some sites receive gritting when ...

NHS performance

NHS performance: The King's Fund has published its latest analysis of NHS performance results which indicates that while the NHS is generally coping, national statistics mask significant pressures in some local areas. 'How is the NHS performing?' is the fourth quarterly monitoring report which aims to provide a real-time update on how the NHS is coping as it tackles the evolving reform agenda while grappling with the challenges of making improvements in productivity. The report combines publicly available data on selected NHS performance measures with views from a panel of finance directors on key issues their organisations are facing. CASH Full News Feed

Report:
http://www.kingsfund.org.uk/publications/nhs_performance_jan.html

Bowel cancer awareness: national campaign

Bowel cancer awareness: national campaign: The Government's first national cancer campaign to raise awareness of the symptoms of bowel cancer will be launched today by Care Services Minister Paul Burstow. Featuring GPs, the 'Be Clear on Cancer' bowel cancer campaign will encourage people who have had blood in their poo or loose poo for more than three weeks to see their doctor. The new adverts aim to make people aware of the symptoms of bowel cancer and make it easier for them to discuss this with their GP. CASH Full News Feed

2013/14 COF consultation opens

2013/14 COF consultation opens: NICE has today launched its first consultation on potential indicators for the proposed 2013/14 Commissioning Outcomes Framework (COF). Anyone with an interest in health is invited to comment on the 120 indicators, which cover a broad range of topics, including mental health, cancer and asthma. NICE

Watchdog starts inquiry into hip replacements

Watchdog starts inquiry into hip replacements: Concerns grow that metal-on-metal implants could destroy muscle and bone and cause 'systemic toxicity'Regulators have begun an inquiry into metal hip replacements amid fears that thousands of British patients are at risk of being poisoned.The Medicines and Healthcare products Regulatory Agency (MHRA) said it had taken "prompt action" over the concerns, but added that most people were at low risk of developing serious problems.The action comes as an investigation by the Sunday Telegraph found more ...Kings Fund Health News

Cold weather plan: Level 3 alert issued

Cold weather plan: Level 3 alert issued: Source: Department of Health (DH)

Area: News

Further to the level alert 2 issued on 27 January, the levels across England have now risen to Level 3.

The Met Office has forecast severe cold weather between 1000 on Monday and 1000 on Friday in parts of England (see link below for further regional forecasts). This weather could increase the health risks to vulnerable patients and disrupt the delivery of services therefore health and social care providers are requested to refer to the Department of Health Cold weather plan for England.

Care clusters and mental health Payment by Results - British Journal of Psychiatry

Care clusters and mental health Payment by Results - British Journal of Psychiatry:

Care clusters and mental health Payment by Results British Journal of Psychiatry MacDonald & Elphick 1 have lucidly described the proposed introduction of Payment by Results into mental health. They mention, however, that 'concerns include the validity and reliability of the MHCT' (mental health clustering tool), and there is also ...

Funding plan for NHS Commissioning Board published

Funding plan for NHS Commissioning Board published:

A 50% reduction in funding has raised question about how well the NCB will be able to function

A report setting out how much funding the NHS Commissioning Board is to receive and the risks it faces has been published.

The document, issued by the NHS Commissioning Board Authority, the precursor to the final NCB, says the running costs of the organisation in 2014-15 will be £492m – a 50% reduction in previous funding.

In the outline of how the NCB will work, which includes details on the organisational structure and workforce numbers, the document acknowledges the risk in the "delivery of functions with 50% less resources".

However, the report states there will be a one-off extra fund to aid transition in 2013-14 – the board's first full year of operation.

Other anticipated risks include differences with the Department of Health (DH) over what is included in the £492m figure, pressure to take on extra functions without funding and whether resources and business processes will be in place by 2014-15.

While the cost of commissioning public health services on behalf of Public Health England, a department within the DH, will be funded separately, there will be funding for a new leadership academy.

The report says work is still continuing with the DH to "identify the full costs associated with delivering information standards, governance, national IT applications, infrastructure and services".

The board emphasises a move to local areas across four commissioning areas. These will be based on areas now covered by current Strategic Health Authority clusters but will be "significantly smaller and will not operate as separate entities in their own right," the report says.

The overall workforce will number 3,500 full-time equivalent staff, including 2,500 across 50 local offices, which will each hold around 50 staff. "To carry out its key functions of direct commissioning, supporting and assuring CCGs and managing relationships with local stakeholders, the board will have to deploy the majority of its staff at sub-national level," the authority says.

Some local offices will run services on behalf of others and so workforce size and funding will vary. Areas which could be taken over by local offices could include:

• Specialised and primary care commissioning.

• Military and offender health.

• Support for clinical networks.

• Family health services.

The authority says that quality, clinical leadership, patient and public voice, promoting equality and reducing health inequalities would be "hard-wired" into the new organisation and one of the board's key direct commissioning responsibilities will be for specialised services, which are currently commissioned at national or regional level.

Responsibility for these will lie across a number of directorates, including medical, nursing, commissioning and operations, with the latter responsible for the assurance and assessment of CCGs, the NHS constitution and "information flows to allow public and parliamentary accountability".

The NCB will be based primarily in Leeds but there will be opportunities for flexible working and working within a number of local offices, yet to be determined, and other teams. Guardian Healthcare Network

Letter: Fragmenting the NHS

Letter: Fragmenting the NHS: SIR - The Clinical Commissioning Group (CCG) leaders who support the Health and Social Care Bill (Letters, January 28) do not represent the majority of GPs, who believe that the Bill will seriously damage patient care. More than 90 per cent of GPs polled by the Royal College of General Practitioners said that the Bill should be withdrawn. Telegraph

Half of doctors at risk of burnout: research

Half of doctors at risk of burnout: research: Half of doctors feel cynical and negative about their patients and are emotionally exhausted, a study has suggested. Telegraph

Hopes rise for development of universal flu vaccine

Hopes rise for development of universal flu vaccine:

Newly discovered flu molecules shared by most strains of the virus could help scientists develop a "universal vaccine", it was claimed today. Independent

Dropping the Health Bill would save £1bn

Dropping the Health Bill would save £1bn: Abandoning the Health Bill would save the government just over £1bn in 2013, a leading academic has claimed. GP Online

Second stage of board governance guidance for aspirant foundation trusts published

Second stage of board governance guidance for aspirant foundation trusts published:

In December 2011, the Department of Health published the first stage of the assurance framework, which is a mandatory board governance memorandum for all aspirant foundation trusts.

Read the modules and listen to Laura Roberts, head of provider leadership development at DH, on why the new framework will be so valuable for NHS trusts. NHS Networks

VIDEO: NHS changes have created 'unholy mess'

VIDEO: NHS changes have created 'unholy mess': Changes to the NHS in England have created an "unholy mess", the editors of three leading journals have said. BBC News

NHS reforms criticised by leading healthcare publications

NHS reforms criticised by leading healthcare publications:

British Medical Journal, Health Service Journal and Nursing Times condemn shakeup as a 'damaging … unholy mess'

The coalition's NHS reforms, the biggest shakeup of the health service in 60 years, are a "damaging … unholy mess" that will need overhauling in five years' time, the editors of three leading healthcare publications claim.

In an editorial published simultaneously by the British Medical Journal, Health Service Journal and Nursing Times, their editors say the NHS "is far too important to be left at the mercy of ideological and incompetent intervention" and argue ,"we must make sure that nothing like this ever happens again".

The health secretary, Andrew Lansley, will attempt to soothe the anger of critics, particularly in the House of Lords where the health and social care bill will return next month, by proposing 200 amendments to the legislation later this week. However, the editorial bluntly states that the damage has already been done.

"The government's NHS reforms have proved divisive and destructive. They have slowed the improvement of NHS services and cost the UK money that it can ill afford."

In a second BMJ editorial published on Tuesday, Kieran Walshe, professor of health policy at Manchester Business School, says that abandoning the bill now would save just over £1bn in 2013.

He says there are three clear benefits to dispensing with the bill. First, it would put an end to the damaging period of prolonged organisational uncertainty in the NHS that started when the white paper was published 18 months ago. Second, it would allow NHS organisations to focus on what is the real and urgent problem for the NHS - finding £20bn in efficiency savings.

Finally, Walshe says the savings from the proposals have already been made. "Going ahead with the bill means setting up the NHS Commissioning Board (with an annual running costs of £492m), 260 clinical commissioning groups (with an annual running costs of £1.25bn), and the new economic regulator, Monitor (with its anticipated annual running costs of £82m). Each of these new statutory organisations will have additional set-up costs – perhaps amounting to a one-off spend of £360m. If the bill were stopped now, it would save all those set-up costs, and at least £650m in annual running costs – just over £1bn in 2013."

Labour seized on the analysis. Andy Burnham, the shadow health secretary, said: "The chorus of protest against Andrew Lansley's ill-conceived plans for the NHS grows louder by the day, uniting voices across the health world. This is a powerful and scathing critique of the government's handling of its NHS re-organisation from three of the most respected voices in healthcare.

"It reflects the strength of feeling in the health professions and echoes the widely-held that this bill is unnecessary and a distraction from the financial challenge facing the NHS."

However, it was dismissed by Lansley's aides as "not exactly unexpected".

A Department of Health spokesperson said: "Our reforms are based on what NHS staff themselves have consistently said; they want more freedom from day to day bureaucracy and political interference so they can get on with the job of caring for patients. That is exactly what this bill achieves.

"It's completely untrue to suggest that dropping the bill would save the NHS money. Our plans will reduce needless bureaucracy by a third and save £4.5bn over the course of this parliament and £1.5bn every year afterwards. Every penny saved will be reinvested in frontline care for patients." The Guardian

More NHS reform in five years 'guaranteed' if Bill goes through, say editors

More NHS reform in five years 'guaranteed' if Bill goes through, say editors: The NHS will need another major re-organisation within five years if the Government presses ahead with its controversial reforms, the editors of three reputed health journals warn today. The Daily Telegraph

New study estimates autism prevalence among adults with learning disability

New study estimates autism prevalence among adults with learning disability: Adults with a more severe learning disability also have a greater likelihood of having autism according to today's report; Estimating the Prevalence o... NHS Information Centre

PIP silicone gel breast implants - update

PIP silicone gel breast implants - update:

The Chief Medical Officer, Dame Sally Davies, has written to health professionals, with some more detailed guidance. The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.

• Letter


• Patient information


• Department of Health - publications

Care in crisis 2012

Care in crisis 2012:

This report reveals that this year spending on older people’s social care in England has fallen by £500 million and the funding gap is growing. It projects that by 2012-2013 the Government would need to spend £1 billion more than this year to stop the situation getting any worse.

• Report


• Age UK - publications