Disabled people face unlimited unpaid work or cuts in benefit - The Guardian

Disabled people face unlimited unpaid work or cuts in benefit - The Guardian:

The Guardian

Disabled people face unlimited unpaid work or cuts in benefit The Guardian The Royal College of Psychiatrists (RCP) fears that managers in jobcentres and private companies who specialise in getting people back to work have inadequate health expertise and will push those with mental health issues into inappropriate placements. and more »

Schwartz scheme boosting staff morale in NHS

Schwartz scheme boosting staff morale in NHS:

Schwartz Rounds allows healthcare professionals to explore and discuss difficult emotions and could help boost morale and patient care in the NHS, writes Carol Davis

A groundbreaking workforce scheme that allows NHS staff to use real cases to explore difficult feelings and stressful situations can help tackle low morale in the NHS and promote better patient care.

US lawyer Kenneth B. Schwartz developed the Schwartz Center Rounds® following a lung cancer diagnosis as a means of bringing health professionals together to discuss their dilemmas in a mutually supportive way, with a focus on compassionate care.

Using the concept of a consultant's rounds, the scheme encourages interdisciplinary dialogue – across an entire hospital rather than just a clinical team – using real patient cases to enable participants to explore their own responses and feelings. The hour-long confidential sessions, which are open to staff across an entire hospital and have board level support, focus on an anonymised patient case which staff discuss to explore their feelings.

In one session, a senior nurse talked about how she had felt about a case early in her career, which one participant said "was good for junior staff to see that senior staff have the same dilemmas and difficulties, and don't always have the answer."

Having a multidisciplinary session which included staff from across the hospital also brought surprising insights and anomalies: an aggressive patient might have been extremely courteous to a consultant; or a porter might say they had to explain to a patient what a doctor had said because the patient only pretended to have taken in what their doctor had said.

Researchers at the King's Fund say the model has successfully transferred to the UK, say researchers at the King's Fund. Originally piloted at the Royal Free and Cheltenham hospitals, the rounds are now running in six UK hospitals and another has just been added, with plans for more through the year. The scheme is also now being extended to hospices to improve nursing and medical care.

"There are high levels of stress in the NHS compared to some other occupations," says Joanna Goodrich, programme manager for the point of care programme at the King's Fund, which has also just evaluated the UK rounds.

"Although staff want to provide the sort of kind, compassionate care that they would want for themselves or their own families, it's difficult for all sorts of reasons to do this consistently. Rounds help staff to reflect on the nature of the emotional and social challenges involved, and to support each other."

A point of care workshop found that barriers to compassionate care included staff stress and burnout; conflict between perceptions of professionalism and compassion; a lack of systematic role modelling or mentoring; and training that emphasises professional detachment, as well as natural defences staff develop to cope with continuous exposure to patients in pain and distress.

Despite some initial scepticism, the scheme has worked well in England, says Barbara Wren, consultant lead psychologist in health and work at the Royal Free Hampstead NHS trust. "The rounds help staff to reconnect with the most valuable aspect of their work – their clinical role – and allows them to witness compassion, care and the humanity that drives healthcare staff to go the extra mile, which is motivating and rewarding in these tough times."

There were some initial concerns that an approach from America would not work in a UK context, but these have proved to be unfounded: "We know from our evaluation that staff who attended really welcomed the opportunity to talk openly about the challenges and difficult emotions associated with caring for patients," says Goodrich.

At the Royal Brompton and Harefield NHS foundation trust, Dr Caroline Shuldham, director of nursing and clinical governance, says "the sessions put everyone on an equal footing." "If you are a leader, it helps you learn more about the experiences of colleagues dealing with difficult situations, and the long lasting impact patients can have."

Carol Davis is a Liverpool-based freelance health and travel writer

Guardian Professional.

NHS bill will damage children's health, say paediatricians

NHS bill will damage children's health, say paediatricians:

More than 150 paediatricians have signed a damning letter calling on the government to scrap its health and social care bill

More than 150 paediatricians are calling on the government to scrap its controversial health bill, saying it will have an extremely damaging effect on the health of children.

In a damning letter to The Lancet medical journal, members of the UK's Royal College of Paediatrics and Child Health said there was "no prospect" of improving the health and social care bill, which is going through parliament.

They accused the government of "misrepresenting" the bill as being something that was necessary for the NHS.

The signatories join several royal medical colleges, including the Royal College of General Practitioners and the Royal College of Radiologists, in calling for the bill to be scrapped.

The move will put increasing pressure on the government over the reforms, which have come under repeated fire from healthcare professionals.

Unions, including the British Medical Association, the Royal College of Nursing, and the Royal College of Midwives, are among those calling for the bill to be withdrawn.

Friday's letter said that "if passed, we believe that the bill will have an extremely damaging effect on the healthcare of children and their families, and their access to high quality, effective services".

It added: "We see no prospect for improvement to the bill sufficient to safeguard the rights of access to healthcare by children and their families.

"In our view, no adequate justification for the bill has been made.

"The costs of dismantling existing National Health Service structures are enormous and, at a time of financial austerity for all public services, have resulted in precious resources being diverted to private management firms and away from frontline patient care.

"We believe that the bill will undermine choice, quality, safety, equity, and integration of care for children and their families."

The signatories said the NHS already outperforms most other health systems internationally and is highly efficient, and expressed fears over the potential role of private companies in managing groups of GPs, who will control most of the NHS budget, under the new system.

They added: "Competition-based systems are not only more expensive and less efficient but are associated with gross inequality in perinatal and child health outcomes, including child safeguarding.

"Far from enabling clinicians to control and determine local services, the new commissioning proposals are more likely to lead to increased power for private management organisations attracted to this lucrative opportunity to manage small clinical commissioning groups."

The letter said using multiple private companies "will make it difficult to innovate, co-operate, plan, and improve the quality in children's services".

They warn that care will become more fragmented and families and clinicians will struggle to organise services for children.

"Children with chronic disease and disability will particularly suffer, since most have more than one condition and need a range of different clinicians."

Safeguarding of children will become even more difficult when services are put out to competitive tender and organisations compete instead of co-operate, the letter said.

"Children who are vulnerable, neglected, or abused will inevitably slip through the net."

More than 130,000 people, including footballer Rio Ferdinand and TV star and author Stephen Fry, have signed an e-petition calling for the bill to go.

A spokeswoman for the Department of Health said: "We have listened and substantially strengthened the bill following the listening exercise.

"It's not true to say that the health and social care bill will fragment children's healthcare.

"In fact, the bill will help address the very concerns about fragmentation that the experts raise.

"It will help the NHS and other public services work together better for children, young people and their families.

"These 150 individuals represent just over 1% of the total members of the Royal College of Paediatricians and Children's Health and cannot be taken as an accurate representation of the college, who we continue to work with." The Guardian

Clinics 'palming off breast implant clients on NHS'

Clinics 'palming off breast implant clients on NHS': Beauty clinics faced with women returning with ruptured breast implants are palming them off on the NHS by claiming they do not have the skills to treat them, plastic surgeons have claimed. The Daily Telegraph

Rushed NHS helpline roll-out 'risks endangering patients' warns BMA

Rushed NHS helpline roll-out 'risks endangering patients' warns BMA: A rushed roll-out of the new 111 number to replace NHS Direct could put patients at risk, the British Medical Association (BMA) has warned in letter to the Government. The Daily Telegraph

Dawn of the age of wireless medicine

Dawn of the age of wireless medicine:
Medical treatment is about to go wireless. New advances in microelectronics have enabled doctors to contemplate the day when they will be able to monitor and treat their patients with medical implants that use wi-fi, Bluetooth and other kinds of wireless technology. The Independent

Wide regional variation in percentage of women who smoke at the time of delivery

Wide regional variation in percentage of women who smoke at the time of delivery: Women in the North-East are around three times more likely to be smokers at the time of giving birth than women in London, new figures out today from ... NHS Information Centre

Northampton nurse struck off after giving dementia patient a ‘good whack’

Northampton nurse struck off after giving dementia patient a ‘good whack’:

A NURSE who gave a dementia patient a double dose of medication then boasted about giving him ‘a good whack’ has been struck off from the profession.Northampton Chronicle and Echo

Patients are getting excellent or very good care in the NHS but more needs to be done

Patients are getting excellent or very good care in the NHS but more needs to be done:

The results published show that more patients are being treated with respect and dignity and felt they were involved in decisions about their care and treatment and in the amount of information given to them about their treatment. NHS Networks

Health and Social Care Bill explained

Health and Social Care Bill explained:

The Health and Social Care Bill is now in its Report Stage in the House of Lords. The Bill is a crucial part of the Government’s vision to modernise the NHS so that it is built around patients, led by health professionals and focused on delivering world-class healthcare outcomes.

The Department has published a series of factsheets on the Health and Social Care Bill to explain particular topics contained in the Bill, including its key themes.

The factsheets are:

Overview

Overview of the Bill

Case for change

Overview of health and care structures

Scrutiny and improvements

Key policy areas in the Bill

Clinically-led commissioning

Provider regulation to support innovative and efficient services

Greater voice for patients

New focus for public health

Greater accountabilty locally and nationally

Modernising health and care public bodies

Cross-cutting themes of the Bill

Improving quality of care

Tackling inequalities in healthcare

Promoting better integration of health and care services

Choice and competition

The role of the Secretary of State

Reconfiguration of services

Establishing new national bodies

Embedding research as a core function of the health service

Education and training

Further information

Earl Howe’s letter to peers on Government amendments

On 1 Febuary, Earl Howe wrote to all peers to explain the amendments that we were proposing to the Health and Social Bill. These respond to a range of improvements suggested and concerns raised during committee stage in the House of Lords.

See Earl Howe’s letter to all peers

Amendment briefing notes

The Department also recently published briefing notes on Government amendments to the Health and Social Care Bill, setting out more information about our proposed amendments to the Health and Social Care Bill.

Ten reasons why we need a Bill to make these reforms work

Ten reasons why we need a Bill to make these reforms work:

Health Minister Simon Burns explains why the Health and Social Care Bill is needed to make the changes that are being proposed for the NHS.

Many people have said that we don’t need legislation to make the changes we’re proposing for the NHS. But we don’t believe we can deliver change on the scale we need without making changes to the law. Here are some of the reasons why.

1. If we want to reduce bureaucracy and management costs, then we need legislation. The Bill gets rid of two layers of management in primary care trusts and strategic health authorities. The reforms will save £4.5 billion over the lifetime of this Parliament, which will be reinvested in healthcare.

2. If we want to give doctors and nurses significantly more power than they have now to provide care for their patients, then we have to change the law. Of course, without a Bill, we can ask the managers who run primary care trusts and decide how NHS money is spent to involve doctors and nurses. But without the Bill, doctors and nurses will always run the risk of having their decisions second-guessed by the managers running these organisations. We know this because we’ve tried before to give health professionals a greater say in the decisions made by primary care trusts, and it simply didn’t work.

3. Most people agree that local authorities, because they’re also in charge of schools, town planning, transport and housing, should also be in charge of public health. But we can’t do this without changing the law. Without the Bill, we can’t transfer powers or money from the NHS to local authorities – they won’t be able to play their full role on public health.

4. Most people agree the health and wellbeing boards – which bring together local people and key local services – are a great idea. But without the Bill, they won’t have any power. They’ll be able to give advice about the health needs of the local population, but no one will be obliged to take any notice.

5. We need this to Bill prevent discrimination in favour of private health companies over the NHS – it’s the first piece of legislation to do this.

6. Most people agree that we should give more power to patients – that they should have more choice and be much more involved in decisions about their care. But it’s this Bill that makes that explicit in law. So if you have cancer, and you want a say in what treatment you have, wherever you live, whoever your GP is, your views and preferences have to be taken into account when deciding your care and treatment – no decision can be made about you without you.

7. For decades, governments have tried to reduce the health gap between rich and poor. But in many areas, the gap is getting wider. A man born in Blackpool will still die 11 years earlier than a man born in Kensington and Chelsea. The Bill puts in law for the first time a duty on the NHS and local government to tackle health inequality.

8. Many governments have tried unsuccessfully to integrate health and social care services. But in most parts of the country, it’s still not happening. The Bill places a duty on key organisations to integrate health and social care services.

9. Currently, patients do not have a very strong voice in the system. But through HealthWatch, they will have a hotline to the Care Quality Commission and the NHS Commissioning Board. If a group of people say there are serious problems at a particular hospital, but they’re being ignored by the local trust, through HealthWatch, they will be able to take their concerns directly to the Care Quality Commission.

10. As 52 NHS medical directors and chief executives have pointed out, without the Bill, many NHS trusts will have to shelve their plans for future improvements to patient care. The Bill changes the current arbitrary private patient cap that stifles the development of groundbreaking new treatments by the likes of Great Ormond Street and the Royal Marsden that NHS patients will benefit from.

Department of Health

Drop the Health Bill, says former CCG lead

Drop the Health Bill, says former CCG lead: A former clinical commissioning group (CCG) and LMC lead has called for the health secretary to drop the Health Bill. GP Online

Cameron to target booze culture ''scandal''

Cameron to target booze culture ''scandal'': The Prime Minister has said that he wants to tackle the problem which costs the NHS over £2.7bn a year Public Service

Death by indifference: 74 deaths and counting

Death by indifference: 74 deaths in people with a learning disability and counting:
This report found that although some positive steps have been taken in the NHS, many health professionals are still failing to provide adequate care to people with a learning disability. It highlights the deaths of 74 people with a learning disability in NHS care over the last ten years which could have been avoidable.

• Report
• Report summary
• Mencap - news

Guide to commissioning for maximum value

Guide to commissioning for maximum value:
This guide is aimed at commissioning teams responsible for public services, and is most relevant to those with responsibility for relational services, dealing with what value is and how it may be better understood and taken into account in decision making throughout the cycle of commissioning.

• Guidance
• The SROI Network - news

NHS Midlands launch real time monitoring

NHS Midlands launch real time monitoring: NHS trusts are set to be ranked by patient satisfaction with part of their funding depending on that performance.
The system will be introduced across a quarter of England’s hospitals in 2012-13 with the strategic health authority cluster, NHS Midlands and East, will requiring all acute providers in its region to collect “real time” data on how likely their patients would be to recommend their hospitals to ... Healthcare Today

Commons debate looms as NHS reform petition hits 100000 landmark - Politics.co.uk

Commons debate looms as NHS reform petition hits 100000 landmark - Politics.co.uk:

The Guardian

Commons debate looms as NHS reform petition hits 100000 landmark Politics.co.uk Mental health services should not be the 'poor relation' in the NHS anymore, say charity. On the eve of the second reading of the much maligned Health and Social Care Bill a new poll by Unite the union has shown that over 90 per cent of people do not ... NHS in Chaos as Senior Staff Jump ShipIBTimes.co.uk all 221 news articles »

New forum to address need for NHS leadership

New forum to address need for NHS leadership:

A new policy forum launched by the NHS Confederation will create a new voice for the NHS and put dignity in care for older people higher up the agenda, says Niall Smith

A new style of leadership is needed in the NHS in order to deliver change and meet the scale of the challenge of reform. If the NHS wants to shape policy, it has to be more assertive now than it has been in the past.

With all this in mind, the NHS Confederation has launched a new policy forum made up of NHS leaders from across the system. The aim is to put its members at the centre of our work and provide a strong platform for NHS leaders to set the agenda. The forum will be led by our chair, Sir Keith Pearson, and it has already set out some of the areas that it wants us to work on.

Two of these, the scale of the funding challenge the NHS faces and the need to tackle dignity in care are already key strands of our work.

We have also set up a commission with the Local Government Association and Age UK to look at improving dignity in care for older people. Its report and recommendations will be published in draft later this month. We believe it is absolutely vital for the NHS to own this problem, take responsibility for improving dignity and come up with solutions that will work on the ground. Services will need to change radically.

We will also be advocating for policy makers to see reform as a 10 or 15-year process, not one that lasts an electoral cycle. Most other countries see it this way and we should too. It is the only way we will address the long-term challenges the health service faces.

The confederation already has an excellent reputation of policy analysis and thought leadership that we can build on and the idea is to make the "what" and "why" of policy development much more closely linked to the "how" of implementation.

We also want to benefit from advice from other partner organisations and the forum will work with others in local government and clinical and patient groups. Each member of the policy forum is nominated by a network or partner that speaks for a particular part of the health or social care system, such as the Foundation Trust Network and NHS Alliance.

The end result should be a more assertive confederation that its members genuinely recognise as their own. We are not a managers trade union but the voice of the NHS and we can speak from a position of real authority based on the knowledge and experience of NHS leaders.

Health services are facing at least a decade of funding austerity, starting with a £20bn efficiency challenge no health service has met before and the largest ever reorganisation in NHS history. We will have to change the way services are delivered in order to meet this challenge.

We will also have to address significant problems, highlighted in a number of watershed reports, concerning the basics of care and maintaining the dignity of patients.

A new style of leadership will be needed in the NHS to deliver change and meet these challenges. With more integrated working across organisations reflecting new ways of delivering services we will need less command and control and more local empowerment.

The forum puts members at the heart of the NHS Confederation so that our membership determines what we say and do, ensuring that our policy and influencing work is grounded in the views and opinions of NHS organisations.

Guardian Professional.

Health minister: binge drinking costs NHS £2.7bn a year

Health minister: binge drinking costs NHS £2.7bn a year: Anne Milton, the health minister, calls for a change to the drunken behaviour that "wrecks lives" and costs the NHS millions. The Daily Telegraph

Whitehall health staff paid via 'limited companies'

Whitehall health staff paid via 'limited companies': Department of Health officials have salaries paid to limited companies enabling them to reduce tax bill, it has emerged. The Daily Telegraph

Patients see a succession of doctors in hospital it has been warned

Patients see a succession of doctors in hospital it has been warned: One in four medical consultants believe patient care is being put at risk because they see a succession of different staff in hospital due to cuts in working hours. The Daily Telegraph

Hundreds of NHS patients are being denied chance of IVF

Hundreds of NHS patients are being denied chance of IVF:
Britain's fertility regulator has run up a surplus of more than £3m from charges imposed on the clinics it licenses, enough to provide 1,000 free cycles of IVF treatment on the NHS. The Independent

Online sexual health training now available to the public

Online sexual health training now available to the public: An online training resource, addressing sexual health issues, has been made available to the public by the Royal College of Nursing. Royal College of Nursing

New resources to support nursing education

New resources to support nursing education:

The guide signposts employers to our pre-registration information and guidance, bringing the resources together in one place.

Additionally, the new briefing, Changes to Nursing Education: Sharing Local Experiences, is informed by interviews with employers that introduced the new standards in 2011. It details their experiences around key points of implementation and provides tips and advice for organisations currently in the planning phase. NHS Networks

DH rejects MPs' warning on effect of public health reform

DH rejects MPs' warning on effect of public health reform: Health select committee hits out at potential negative impact of plans to tackle health inequality. GP Online

Health gap widens as experts warn over DH plans

Health gap widens as experts warn over DH plans: Health divides in England have continued to widen as experts warn that paying local authorities to reduce inequalities may backfire. GP Online

NHS spending millions on FoI instead of patients

NHS spending millions on FoI instead of patients: NHS staff are being taken away from their patient focussed duties, warns Foundation Trust Network Public Service

CQC registration and the RCGP quality programme

CQC registration and the RCGP quality programme:
Practice accreditation helps GP practices enhance their organisational systems and procedures, such as risk assessment and processes for notifying patients of staff changes. Following a consultation, the Department of Health agreed to postpone the registration of most primary medical services with the Care Quality Commission (CQC), most of which are GP practices. This joint statement, produced in conjunction with CQC, provides further information on the RCGP quality programme.

• Joint statement
• RCGP - news

The NHS must accelerate its reforms on treating learning disabled patients

The NHS must accelerate its reforms on treating learning disabled patients:

Five years on from our shocking report into the discriminatory treatment of learning disabled people, little is different

When Mencap published its Death by Indifference report in 2007 it sent shockwaves through the health sector. The study contained damning evidence that people with a learning disability were dying unnecessarily due to institutional discrimination in the NHS. Such was the strength of the report it triggered an independent inquiry and an investigation by the parliamentary and health service ombudsman.

Despite these welcome initiatives, five years on from the publication we continue to hear heartbreaking stories of unnecessary pain and death. These cases form the basis of our report published on Wednesday , Death by Indifference – 74 Cases and Counting, which looks at progress that has been made in the NHS. Sadly, it finds that the NHS has still not got to grips with treating people with a learning disability and is putting the lives of patients at risk.

Prejudice, ignorance and indifference as well as failure to abide by disability discrimination laws still feature too frequently in the treatment of patients with a learning disability. This is illustrated by the case of Alan MacDonald, who died suddenly in Lister hospital, Hertfordshire, in 2009 after being admitted with stomach cramps. From the time MacDonald was admitted, his family felt that they had "to beg" staff to treat him, only to be met with what they described as "hostility". In a society that prides itself on its universal healthcare system, such treatment is incomprehensible.

We know that regular health checks for people with a learning disability, training for healthcare staff and the appointment of specialist nurses greatly improve health outcomes. Indeed, successive governments have accepted the recommendations of the independent inquiry, which called for these measures. But, as our report shows, efforts to implement them have been slow and in some cases non-existent. Policy may have been changed but practice must follow.

For the most part, health professionals do an incredible job and want the best for each patient – we take heart that more than 200 healthcare organisations have signed up to Mencap's Getting it Right charter – but where progress has been made, it has been patchy or has come about as the result of the avoidable death of a learning disabled patient.

How many people must die before the service takes this issue seriously? At a time when the NHS is going through changes there's a risk that the progress made will be lost, and the health needs and human rights of people with a learning disability left unheeded.

• Mark Goldring is chief executive of Mencap The Guardian

NHS patients 'will pay under health bill'

NHS patients 'will pay under health bill': Patients will have to pay for treatment that is currently free on the NHS under the Government's health bill, a leading adademic has claimed. The Daily Telegraph

TripAdvisor-style reviews by patients 'predict worst hospitals'

TripAdvisor-style reviews by patients 'predict worst hospitals': Patients are accurately predicting which hospitals have high death rates and super-bug infections when they rate their treatment on a TripAdvisor-style website, according to new research. The Daily Telegraph

74 deaths in NHS 'were avoidable'

74 deaths of people with Learning Disablities in NHS 'were avoidable':

The deaths in NHS care of 74 people with learning disabilities could have been avoided and were a result of institutional discrimination, a charity claims in a report. The Independent

NHS reform may put patients at risk, say reports

NHS reform may put patients at risk, say reports:

The Health Secretary, Andrew Lansley, has suffered another major setback in his struggle to get his highly controversial plans for NHS reform on the statute book. The Independent

The Chron looks at how a state-of-the-art simulation suite is helping our ... - Northampton Chronicle & Echo

The Chron looks at how a state-of-the-art simulation suite is helping our ... - Northampton Chronicle & Echo:

Northampton Chronicle & Echo

The Chron looks at how a state-of-the-art simulation suite is helping our ... Northampton Chronicle & Echo Immediately a Northampton General Hospital anaesthetist sets about removing them, as well as her hair. And Betty becomes Dave. Fortunately Chron photographers and NGH staff are not normally as rude as this with patients but Betty – or Dave – is no ...

Safeguarding and quality in commissioning care homes

Safeguarding and quality in commissioning care homes:

The government has identified six guiding principles on safeguarding which seek to increase the protection for those most at risk in society. NHS Networks

New NHS Pension Scheme calculators published

New NHS Pension Scheme calculators published:

Proposals for a new scheme from April 2015

Calculators have been developed to enable members of the NHS Pension Scheme to estimate their future benefits and see any changes to their current scheme benefits, under the Government’s proposed new scheme. There are separate calculators for Agenda for Change staff and medical and dental staff in the hospital and community health services.

Entering personal, career and salary details into the appropriate calculator will provide estimates of the following information:

• the amount of pension entitlement a member would have received at their current normal pension age (NPA) under the existing scheme to which they belong, at current prices



• how much longer it will take a member to accrue the same benefits under the proposed new scheme



• the amount of pension entitlement a member will have if they retired at the new scheme’s NPA.

They also provide members with the opportunity to estimate the amount of pension entitlement they will be entitled to, at a retirement date they specify.

These calculators are based on the NHS Pension scheme specific discussions and have been developed, shared and discussed with the NHS trade unions.

See calculator for Agenda for Change staff

See calculator for medical and dental staff in the hospital and community health services

Department of Health

Keeping patients in work not part of GP role, experts warn

Keeping patients in work not part of GP role, experts warn: Plans to require doctors to push patients to stay in work or return to work are unrealistic and not part of their core role, medico-legal experts have warned. GP Online

Tackling list inflation

Tackling list inflation:
This paper offers a how to guide to tackling list inflation or list cleansing, as it is sometimes known. It describes the work needed to ensure that GP patient lists are accurate, including identifying and removing inappropriate patient records.

• Briefing
• PCC - news

New debate needed on organ donation

New debate needed on organ donation: The British Medical Association has released a report which calls for a new discussion about the subject of organ donation.Dr Vivienne Nathanson, one of the report's authors, said people should consider if fresh ways of getting people to donate organs should be considered or if the current problem of patients dying on the waiting list for donor organs should perpetuate. Healthcare Today

Profiting from fear: a management consultant's view of the NHS - Open Democracy

Profiting from fear: a management consultant's view of the NHS - Open Democracy:

The Guardian

Profiting from fear: a management consultant's view of the NHS Open Democracy He forecasts a worrying future in which consultants play a central role as the NHS prepares itself for radical reforms. Rapid policy change often leads to pressure, confusion and uncertainty. And wherever you find management under pressure and ... Live discussion: long-term conditions and mental healthThe Guardian all 5 news articles »

NHS reforms: government concedes raft of fresh amendments

NHS reforms: government concedes raft of fresh amendments:

David Cameron and Nick Clegg come out in support of embattled health secretary Andrew Lansley

The government has conceded a fresh raft of amendments to its NHS reforms despite the prime minister and his Lib Dem deputy coming out to defend the embattled health secretary, Andrew Lansley.

Downing Street launched an offensive, dismissing a call by the Lib Dem deputy party leader, Simon Hughes, for Lansley to leave office. The prime minister's spokesman said: "It's not an issue for Simon Hughes. The government is fully behind the health bill."

Hours later Nick Clegg, the deputy prime minister, told the BBC: "Andrew Lansley is the architect of the NHS bill. He cares passionately about the NHS. He's the right man for the job and he must see it through."

Despite such support the government made, according to Labour, "major concessions" on the health bill concerning the training of doctors. Ministers accepted an amendment which will force private providers of NHS services to give staff certain levels of training and education to head off fears that they could offer cheaper services by having less qualified workers.

The bill has suffered two defeats in the House of Lords and in the light of such reversals it appears that ministers are picking their fights more carefully.

In the Lords, the government was also questioned about the role of the management consultancy firm McKinsey in helping to frame the bill following a report in the Mail on Sunday claiming that senior staff at the NHS body Monitor, whose role under the plans would include regulating healthcare contracts, had been "lavishly" entertained at the company's expense.

Labour's Lady Royall said the company seemed "to be setting the rules in the health bill and benefiting from the outcome".

Earl Howe responded saying that "I know of no such impropriety. There are very strict rules … on declaring hospitality. If I discover any substance I will write and place a copy in the library. I very much doubt that I will find any substance."

He added that between 2006 and 2010 McKinsey got £30m in work from the Labour government.

Lansley has also broken his silence over his reforms, penning an article for Health Service Journal in which he says competition in the NHS will bring in innovation and compares health to the changing face of music. "After all, in any other sector, it is the thousands of individual decisions to adopt a new technology – from, say, cassettes to compact discs to mp3 players – which combine to sweep away less effective services."

Andy Burnham, Labour's shadow health secretary, said the article revealed Lansley's "real agenda for the NHS – to turn it from a national, collaborative health service into a competitive, market-based system." The Guardian

Progressive blindness cases to rise by a third in a decade

Progressive blindness cases to rise by a third in a decade:

The number of people suffering from progressive blindness is set to rise by a third in the space of a decade, amid growing concern that the NHS has significantly underestimated the prevalence of the condition, new research warns. The Independent

Debbie thrilled to win Queen’s Nurse Award

Debbie thrilled to win Queen’s Nurse Award:

Multiple Sclerosis nurse Debbie Quinn says she is thrilled after finding out she is set to be presented with the prestigious Queen’s Nurse Award. Evening Telegraph

Renewed partnership agreement between health unions, employers and government published

Renewed partnership agreement between health unions, employers and government published:
The agreement provides a guiding set of principles for the department, employers and unions to work together at national, regional and local levels. By adopting the principles set out in the partnership agreement, all parties agree to recognise and respect each other’s roles and functions, which are distinct but complementary. NHS Networks

Practice list clean-up could save millions

Practice list clean-up could save millions:

As many as a million non-existent patients are registered with GPs, according to official estimates. These "ghost" patients account for on average 5% of practice lists across England
but as many as 30% in some PCT areas. This so-called list inflation results in unfair distribution of resources. PCC has produced a briefing explaining the scale of the problem and suggesting practical measures for tackling it. NHS Networks

Personal health budgets update – Winter 2012

Personal health budgets update – Winter 2012:

A pilot programme involving around half the primary care trusts in England is currently underway to test out personal health budgets in the NHS. The Winter 2012 edition of the personal health budgets newsletter has been published by the Department of Health and includes information on:

• personal health budgets update – Winter 2012


• personal health budgets and NHS continuing healthcare


• personalisation: learning from others


• personal health budgets peer network and new peoplehub


• interviews with people who have a personal health budget


• programme milestones


• update on SEND pathfinder programme for children and young people

VIDEO: Lansley hits back over NHS bill

VIDEO: Lansley hits back over NHS bill: Health Secretary Andrew Lansley says the government is "committed" to the NHS bill, amid reports that three Tory cabinet ministers have concerns. BBC News

'Fresh debate' needed on donation

'Fresh debate' needed on donation: Society should have a fresh debate on organ donation, according to a new report by the British Medical Association. BBC News

Pension strike threat as union prepares to ballot members

Pension strike threat as union prepares to ballot members: Health union Unite has warned that strike action is a 'real possibility' unless ministers back down on plans to cut NHS pensions. GP Online

Medicines security audit results

Medicines security audit results:

The Department of Health is asking all NHS acute hospitals to submit results of recent audits of their compliance with published standards for the safe and secure handling of medicines. This is in response to recent concerns about the handling of medicines in hospitals, and to support patient safety. The results of the audits, together with any remedial action plans, should be returned to the Care Quality Commission by 31 March 2012.

• Letter


• Department of Health - news

The firm that hijacked the NHS: MoS investigation reveals extraordinary extent of international management consultant's role in Lansley's health reforms

It has earned at least £13.8million from Government health policy since the Coalition took office – and the Bill opens up most of the current £106 billion NHS budget to the private sector, with much of it likely to go to McKinsey clients.

Read more

NHS productivity has risen in 10 years says study

NHS productivity has risen in 10 years, says study:

Paper published in Lancet says taxpayers have got more for their money out of the NHS, undermining government claims

NHS productivity has "almost certainly" risen in the past decade, with taxpayers getting more out of the health service for every pound spent – undermining one of the government's key arguments for its reforms, according a new paper.

In a paper published in the Lancet, Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine, said that although the health secretary, Andrew Lansley, claimed NHS productivity had fallen 15%, the opposite was almost certainly the case.

"Despite such confident statements, rather than declining, the productivity of the NHS has probably improved over the past decade," Black said. "To justify the reforms to the NHS that the Conservative party wanted to introduce, the claim of declining NHS productivity was necessary."

Black, who is an adviser to the Department of Health and is widely respected across the political spectrum, challenged the view that productivity in NHS hospitals had dropped by 1.4% a year despite the budget swelling from £60bn in 2000 to £102bn in 2010.

When the figures were produced by the public accounts committee last year, David Cameron taunted Labour for "doing nothing" while the coalition was "reforming the NHS".

However, Black produces a slew of evidence that questions the analysis of the Office of National Statistics used to work out the productivity of the health service. The ONS looked at the return for taxpayers by comparing public expenditure with how much patients used the health service and what the outcomes were.

Black's work, the first of its kind, argues that the measures the ONS used do not reflect the substantial improvements in NHS care. It points out that between 2000 and 2009, such were the advances that a baby born in 2009 could expect to live three years longer than one born in 2000.

Black says far fewer people were dying in specialist procedures in the NHS. He notes declines occurred in adult critical care (2.4% a year), dialysis (3.3% a year), and coronary artery bypass surgery (4.9% a year).

Patients' experience of how they were treated also improved. There were annual relative increases in the proportion of patients treated within four hours in accident and emergency departments (2.5% a year) and in the numbers operated on within 28 days of their operation having been cancelled for non-clinical reasons (10.4% a year).

Such was the NHS's popularity that in the annual British Social Attitudes survey, 70% of respondents reported they were overall satisfied with the NHS. This was the highest figure ever recorded by the long-running survey – the lowest was 34% in 1997, at the end of the Conservatives' 18-year tenure in office.

Black accepts that pay rose for frontline staff in the NHS but says this does not mean money was wasted. "The myth is that lots of extra money went into the NHS and productivity went down. Easy to see why if you pay a surgeon 30% more and he still works the same number of hours, clearly you think productivity went down. But this neglects quality improvements which you can measure."

The paper does not put a figure on the rise in NHS productivity, and Black said this would need more work. "It's beyond the scope of this work. However I am certain NHS productivity did not drop."

Such is the prevalence of the idea that cash was poured into the NHS with little to show that, said Black, "many high-ranking Department of Health officials were very surprised by my data".

The Department of Health responded with a statement from the health minister Simon Burns. He said: "We have always been clear that productivity in the NHS needs to improve and are committed to better outcomes for patients across the country.

"We are investing an extra £12.5bn in the NHS, but we want to make every penny count. We know the NHS can meet this challenge – we have already made £7bn in efficiency savings over the last 18 months as performance has improved: record low infection rates, mixed-sex wards down by over 90% and people waiting over a year reduced by half."

Andy Burnham, the shadow health secretary, said: "This analysis is hugely embarrassing for the prime minister. It demolishes an anti-NHS argument that Cameron and his ministers have repeatedly trotted out. Far from falling, NHS productivity increased in the last decade at the same time as the NHS was achieving record patient satisfaction. It is this successful NHS that, inexplicably, is being turned upside down by the Tory-led coalition.

"But, as well as destroying their arguments, this analysis exposes the prime minister's duplicity on the NHS. Professor Black explicitly criticises the Tories for propagating a myth that NHS productivity was declining to create a false justification for their health and social care bill." The Guardian

Only one in four supports health reforms, claims study.

Only one in four supports health reforms, claims study.: Only one in four people supports the Government's controversial health reforms, according to a trade union study. The Daily Telegraph

NHS managers want to limit Freedom of Information requests

NHS managers want to limit Freedom of Information requests: NHS managers are seeking to limit the public's ability to use the Freedom of Information Act by making them pay for all but the most minor of queries. The Daily Telegraph

Falling productivity in the NHS is a 'myth'

Falling productivity in the NHS is a 'myth': Extra money pumped into the NHS has not been wasted and claims of a reduction in productivity in the health service is a myth, experts have suggested. The Daily Telegraph

Sectioned patients' deaths 'hide failures'

Sectioned patients' deaths 'hide failures':

Five mentally ill people are dying in hospital every week on average amid claims that failures are being covered-up and lessons not being learnt. The Independent

Perspectives on ageing series

Perspectives on ageing with a learning disability:
This Perspectives paper from the Joseph Rowntree Trust explores what people with learning disabilities and their families have to say about getting older, their experiences and feelings, and what is most important to them in later life.

Cally Ward gathered views from a range of people with learning disabilities, who often have high levels of unmet health needs as a result of the inequalities they have experienced in the health system: read more

This is one of a number perspectives on ageing papers that also includes:

• Dementia
• South Asian Families
• Gypsy Families
• Lesbians, Gay Men and Bisexuals

Report raises questions over equality of access to end of life care community services

Report raises questions over equality of access to end of life care community services:

‘Deprivation and death: Variation in place and cause of death’ reveals that 61% of deaths amongst people living in the most deprived quintile (the poorest 20% of areas) occurred in hospital – compared to 54% amongst the two least deprived quintiles.

The report concludes that the gap is not solely accounted for by factors such as differences in the causes of death between the social groups.

CQC publishes reports from its review of services for people with learning disabilities

CQC publishes reports from its review of services for people with learning disabilities:

The programme is looking at whether people experience safe and appropriate care, treatment and support and whether they are protected from abuse. A national report into the findings of the programme will be published in the Spring.

An area of concern to emerge from an initial analysis of the first 40 reports is that many services are failing to provide patient-centred care – that is, care that is based on the individual needs of people using the services. NHS Networks

The week, issue 234

The week, issue 234:

In this issue, read about Change4Life’s first alcohol campaign as well as the latest medical device alerts from the Medicines and Healthcare products Regulatory Agency.

Download ‘the week’: issue 234, 3 – 9 February 2012 (RTF, 524K) Department of Health

Fear of NHS bill damage to Tories

Fear of NHS bill damage to Tories: The influential ConservativeHome website calls the planned NHS overhaul in England "an unexploded bomb" under Tory electoral prospects. BBC News

Safeguarding and quality in commissioning care homes

Safeguarding and quality in commissioning care homes:

This guide aims to support NHS and local authority commissioners of care homes to ensure that safeguarding is central to the commissioning process and a primary concern for residential and nursing care home providers. The government have identified six guiding principles on safeguarding which seek to increase the protection for those most at risk in society. Key points for commissioners are outlined here in relation to each of the principles.

• Guide

Partnership agreement: an agreement between Department of Health, NHS Employers and NHS Trade Unions

Partnership agreement: an agreement between Department of Health, NHS Employers and NHS Trade Unions:

This agreement provides a guiding set of principles for the Department of Health, employers and unions to work together at national, regional and local levels. By adopting the principles set out in the partnership agreement, all parties agree to recognise and respect each other’s roles and functions, which are distinct but complementary.

• Partnership agreement


• Department of Health - news

Psychologists fear US manual will widen mental illness diagnosis - The Guardian

Psychologists fear US manual will widen mental illness diagnosis - The Guardian:

Daily Mail

Psychologists fear US manual will widen mental illness diagnosis The Guardian Hundreds of thousands of people will be labelled mentally ill because of behaviour most people would consider normal, if a new edition of what has been termed the psychiatrists' diagnostic bible goes ahead, experts are warning. Shyness in a child and depression after bereavement could be classed as mental ...Daily Mail Lonely? Shy? Sad? Well now you're 'mentally ill', tooThe Independent New mental health manual is "dangerous" say expertsReuters UK all 45 news articles »

Government announces £2.2bn public health funding for councils

Government announces £2.2bn public health funding for councils:

Health secretary Andrew Lansley reveals first estimates for local government funding, but confusion over future responsibilities remains

The Department of Health has announced the first estimates for public health funding under the new NHS structure, promising that at least £2.2bn will be paid directly to local authorities.

The announcement, made on Tuesday by health secretary Andrew Lansley, will see £5.2bn spent on public health services in total, although it is not yet clear exactly which areas councils will take responsibility for. Lansley said: "In the future, we want money to get to where it matters most – to the front line, where it can have the greatest impact on health.

"There is more work to do, but these estimates mean that Clinical Commissioning Groups and local authorities can begin planning how to deliver the frontline services that matter the most," he added.

The Local Government Association (LGA) welcomed the announcement, but warned against basing funding estimates on out of date information. Councillor David Rogers, chair of the LGA's community wellbeing board, said: "Local authorities are ready to pick up the mantle of public health but we must be given the right resources to do so. Only then can councils truly be at the forefront of tackling the social factors that contribute to poor health and providing services that help people to live long and healthy lives."

Michael Gosling, cabinet member for adult social care and health at Surrey county council called for more specific information about how the £2.2bn would be distributed.

"Our worry at the present time is not what the headline figure is, but how much of that will come to Surrey as a county. There is no doubt about it that there are authorities that have a greater need for public health money than ourselves, but Surrey still has issues and worries about certain social factors within public health," he said.

"We now need to understand which of the public health roles are fully with Public Health England and which are devolved to the local authority. I would like to see an end to uncertainly so we can get on and do what we need to do."

The Guardian Professional.

Failure to deal with long-term health issues 'costs NHS £13bn'

Failure to deal with long-term health issues 'costs NHS £13bn':

King's Fund report states that people with conditions such as diabetes or heart disease are more likely to have mental health problems, with each costing up to 45% more to treat

The NHS is failing to address the problem of people suffering both long-term physical conditions and mental health problems, and could be costing the organisation as much as £13bn a year, according to a new report.

The report, published by the King's Fund on Thursday, says that people suffering long-term conditions such as diabetes or heart disease are two to three times more likely to suffer mental health problems such as depression, anxiety and dementia, with each costing up to 45% more to treat.

However, despite accounting for between 12% and 18% of the estimated £77bn spent on people with long-term conditions, the King's Fund says there has been a systemic failure in identifying problems and providing support. It says better integration between services for physical and mental health problems will be key to improving outcomes.

Chris Naylor, King's Fund fellow and lead author of the report, said: "The prevailing approach towards improving care for people with long-term conditions is at risk of failing unless we look at patients' needs as a whole, including their mental health needs. To achieve this, mental health provision cannot simply be tacked on to physical care but needs to be an integral part of it."

Around a third of people in England have a long-term condition, rising to half in those over 60, and are the most frequent users of healthcare services, according to the Department of Health.

But the report suggests that some figures may be higher. While 11% of the NHS's secondary healthcare budget is spent on mental health services, it says the figure doesn't include costs to primary care "or increased costs elsewhere caused by poor mental health exacerbating other health problems and hindering their treatment. Nor does it take account of the wider economic impact of mental health problems through their effect on employment and workplace productivity."

While the number of people in England with long-term conditions is likely to remain relatively consistent over the next decade, the number of people with co-morbid long-term physical and mental health problems is expected to rise by a third. They are more likely to live in deprived areas and have less access to resources which the report says contributes to – and perpetuates – health inequalities.

Sean Duggan, chief executive of the Centre for Mental Health said "failing to support the mental health of people with long-term physical conditions is costing the NHS billions of pounds at a time it can ill afford to spend money unwisely. Untreated or poorly managed mental ill-health among this group is cutting lives short, reducing quality of life and increasing health inequalities."

The King's Fund said better integration between mental health support, primary care services and chronic disease management was an opportunity to improve outcomes. It also recommends closer working between mental health specialists and other professionals, which is says is often neglected.

While integration has been moving up the healthcare agenda, the report says health and social care services in England are not currently organised in the best way to support those suffering physical and mental health problems.

It calls on clinical commissioning groups (CCGs) to make joint mental and physical care a top 10 priority. Mental health trusts that have received £2bn to fund more responsibilities for community services can also contribute, the report says, while other organisations such as the new NHS Commissioning Board and the regulator, Monitor, also have a duty to promote integration.

On a practical level, collaborative care arrangements between primary care providers and mental health specialists can improve the problem "with no or limited additional net costs", while redesigning payment mechanisms will remove some of the policy barriers to integration.

The report also suggests that "innovative forms of liaison psychiatry" show that better support can reduce physical care costs in acute hospitals.

Making changes will also help deliver on the government's Quality, Innovation, Productivity and Prevention (QIPP) agenda, the King's Fund says, which aims to develop innovation in health services and better outcomes with less money.

The Guardian Professional.

Health bill in fresh trouble as first signs of cabinet dissent emerge

Health bill in fresh trouble as first signs of cabinet dissent emerge:

Plans being laid for call at Liberal Democrat spring conference for bill to be scrapped

The government's beleaguered health bill has run into fresh trouble after it emerged that plans are being laid for a call for it to be scrapped at the Liberal Democrat spring conference.

It is also expected that the influential Conservative Home website, seen as the voice of the party grassroots, will publish an editorial on Friday calling for the bill to be dropped altogether. It is understood that Conservative Home has been urged to make the call by three cabinet members who believe David Cameron is not listening on the issue. One source said: "We have almost been instructed to write this." It is extraordinary that cabinet members feel so frustrated at the political deadlock that they have resorted to urging Conservative Home to raise the flag of rebellion.

It has been widely canvassed within the government that non-contentious parts of the bill covering public health, social care and GP commissioning could be retained, while controversial parts dealing with an extension of the private sector could be abandoned altogether, something that would be a humiliation for the health secretary, Andrew Lansley.

Stephen Dorrell, Conservative chairman of the health select committee, has been one of many Tory MPs pointing out that many of the changes could have been implemented without the need for legislation or such controversy.

The shadow health secretary, Andy Burnham, has offered to strike a deal to bring in wider GP commissioning. Labour tabled a vote on Thursday to force the government to publish a report assessing the threats posed by proposed changes to NHS finances and patient care.

Senior Lib Dems have acknowledged that they are in a terrible place over the bill, but in discussions at the beginning of the week with Cameron, Nick Clegg agreed to let the bill continue in the Lords.

There is frustration in Downing Street that the support of health professionals has been lost after they were laboriously courted and consulted during the pause last year, agreed after the Lib Dems' spring conference voted to oppose large tracts of the bill. The current move is being organised by the same group of party activists.

The Lib Dem leadership managed to keep a second health rebellion off the agenda of the autumn conference, but will face intense grassroots pressure if it tries to prevent debate again.

An emergency motion can be kept off the floor of the conference if it is not deemed an emergency by the federal conference committee, or it is not selected for debate in a ballot of delegates.

It is being argued by diehards in the cabinet that the struggle to get the legislation on the statute book will last only a few more months and after that it will be shown that the warnings of the protesters were ridiculously overblown. Cameron is trying to resell the package as a way of reducing bureaucracy in the NHS.

In an effort to keep up the pressure, the shadow cabinet agreed to hold an opposition day debate later this month on making the risk assessment public, in what Burnham said would be a defining moment in the campaign to get the bill axed.

Critics believe the risk register, which Lansley has repeatedly refused to publish, contains damning warnings about rising costs and confusion. Concern has been heightened after it emerged on Wednesday that a risk assessment by the London NHS warned some organisations could fail financially and care, including maternity and children's services and public health, could suffer. Such is the anger about the register that nine Liberal Democrats are already among 50 MPs who have signed an early day motion also calling for it to be published – and Labour believes more Lib Dems will support its move.

To put further pressure on the coalition, Burnham will urge Labour MPs to visit hospitals and surgeries during next week's half-term break, so they can recount their stories from the NHS front-line in the debate on 22 February. "The defining question in this debate now is, by pressing on and not listening, to what extent are they putting patient safety and quality of services at risk, and that's why the risk register becomes absolutely central to this," said Burnham.

Labour's move follows another torrid week for the government over the bill, with former supporters of the plans coming out against the current version – which has had more than 1,000 amendments – and the coalition's first defeat on the bill in the House of Lords on Wednesday.

Reflecting growing frustration inside the government at Lansley's handling of the bill, a Downing Street insider was quoted earlier this week saying the health secretary should be "taken out and shot". In response, the prime minister's spokesman said the Tory minister had David Cameron's "full support".

Lansley will face fresh embarrassment on Friday when a report by the right-of-centre thinktank Reform says the government's entire reform of public services is being undermined by the Department of Health's management of NHS changes.

The Scorecard report on 10 government departments with responsibility for different areas of public sector reform also singles out the prime minister for criticism for personally intervening with detailed promises on issues such as waiting times and nurses visiting patients' beds every hour. The criticisms by Reform will be particularly damaging because they accuse the health bill of causing exactly the opposite of what it is intended to achieve – holding back reform of the NHS and damaging services for patients.

Burnham has offered the government a compromise, that in return for dropping the bill Labour would enter talks about how to introduce GP-led commissioning of healthcare, without the wider reform of the NHS structure proposed by the bill. The Guardian

Pensioner forces NHS to reconsider £80m private deal

Pensioner forces NHS to reconsider £80m private deal: A pensioner who lives in a care home has succeeded in forcing his local health authority to reconsider automatically handing an £80million annual contract to a private organisation. The Daily Telegraph

Bishops fight to save NHS chaplains

Bishops fight to save NHS chaplains: Leading bishops led calls to defend hospital chaplains in the face of a campaign to exclude religious influence from the National Health Service. The Daily Telegraph