Patient level information and costing systems (PLICS) and reference costs best practice guidance for 2011-12:
This guidance identifies differences between PLICS and reference costs, and provides suggestions of best practice and workarounds used by NHS organisations to produce reference costs from PLICS data. It updates and revises the first edition published in April 2011, and should be read alongside Reference costs guidance for 2011-12 and the NHS Costing Manual, as well as the HFMA Clinical Costing Standards 2011-12.
Monday, 12 March 2012
We must get serious about tackling mental illness
We must get serious about tackling mental illness:
A public health approach to protect children from harm as early as possible is key to ensuring their wellbeing in later life
One half of all mental illnesses begin before the age of 14. If we are serious about preventing and treating mental illness, we must seriously re-evaluate how we raise our children, care for them, teach them to take up supportive and loving relationships, and protect them.
With this in mind, the 3rd World Congress of Cultural Psychiatry, being held this weekend at Queen Mary University of London, is focusing on young people. More than 350 academics, clinicians, practitioners, policy-makers and commissioners from around the globe will consider the best ways of protecting and promoting the mental health and wellbeing of young people, as well as highlight the inequalities they face.
A Unicef survey in 2007 ranked the UK bottom on children's wellbeing compared with north America and 18 other European countries. The UK ranked 24th out of 29 European countries in a similar survey in 2009. Between 60% and 70% of children and adolescents who experience clinically significant mental health problems have not been offered evidence-based interventions at the earliest opportunity, which would help maximise their lifetime benefits.
Adolescents with emotional or conduct disorders are four to six times more likely to smoke, and up to three and a half times more likely to take drugs. Young people with emotional and conduct disorders represent 43% of smokers under the age of 17. In addition, children who are obese are at higher risk of psychological and psychiatric problems as weight gain is associated with discrimination, social rejection and depression.
As these statistics show, young people are operating in stressful situations. The riots of last August and their impact on how young people perceive themselves and are viewed by wider society will be explored at the world congress. Refugees and unaccompanied minors are still on the frontline of risk when it comes to mental health.
What is clear is that young people from diverse cultural backgrounds can benefit society and themselves if they have a fair chance of good health, as well as social and political engagement. When that happens they are less likely (at important points of emotional and social transition) to end up in gangs or be vulnerable to radicalising influences, particularly through the internet and computer-mediated communication.
We know that young people of black Caribbean and black African origin in England and Wales have higher suicide rates in the UK than their white British counterparts. But what is being done about this? On the face of it, very little, which is worrying.
While mental illness costs the economy more than £105bn a year, with £10bn spent on the NHS, less than 0.001% of the mental health budget is spent on prevention. Young people were only last year brought into the fold under No health without mental health, the national mental health strategy, so there is some serious catching up to do.
Prevention is essential as adult mental illness is more common among those experiencing childhood dangers, adversity, discrimination and poverty. Often poor and risky environments bring with them easy access to alcohol, cigarettes, other psycho-stimulant drugs and a collection of unhealthy lifestyles from eating habits, little physical activity and emotional, physical or sexual abuse.
Childhood mental illness is also predictive of adult unemployment and low educational outcomes. This is why it is important to have a public health approach to protect young people from harm as early as possible, and to educate them about emotional regulation and resilience, and how to manage life's difficulties.
Providing appropriate interventions and protection in a culturally diverse and unequal society is not easy. We know that some young people and groups, who are among the most vulnerable in society, do not benefit from programmes directed at improving their health. Indeed, they are usually left behind to become even more marginalised. This can no longer be allowed to continue.
Professor Kamaldeep Bhui is president-elect of the World Association of Cultural Psychiatry, director of the Cultural Consultation Service and the public health lead at the Royal College of Psychiatrists.
Guardian Professional.
One half of all mental illnesses begin before the age of 14. If we are serious about preventing and treating mental illness, we must seriously re-evaluate how we raise our children, care for them, teach them to take up supportive and loving relationships, and protect them.
With this in mind, the 3rd World Congress of Cultural Psychiatry, being held this weekend at Queen Mary University of London, is focusing on young people. More than 350 academics, clinicians, practitioners, policy-makers and commissioners from around the globe will consider the best ways of protecting and promoting the mental health and wellbeing of young people, as well as highlight the inequalities they face.
A Unicef survey in 2007 ranked the UK bottom on children's wellbeing compared with north America and 18 other European countries. The UK ranked 24th out of 29 European countries in a similar survey in 2009. Between 60% and 70% of children and adolescents who experience clinically significant mental health problems have not been offered evidence-based interventions at the earliest opportunity, which would help maximise their lifetime benefits.
Adolescents with emotional or conduct disorders are four to six times more likely to smoke, and up to three and a half times more likely to take drugs. Young people with emotional and conduct disorders represent 43% of smokers under the age of 17. In addition, children who are obese are at higher risk of psychological and psychiatric problems as weight gain is associated with discrimination, social rejection and depression.
As these statistics show, young people are operating in stressful situations. The riots of last August and their impact on how young people perceive themselves and are viewed by wider society will be explored at the world congress. Refugees and unaccompanied minors are still on the frontline of risk when it comes to mental health.
What is clear is that young people from diverse cultural backgrounds can benefit society and themselves if they have a fair chance of good health, as well as social and political engagement. When that happens they are less likely (at important points of emotional and social transition) to end up in gangs or be vulnerable to radicalising influences, particularly through the internet and computer-mediated communication.
We know that young people of black Caribbean and black African origin in England and Wales have higher suicide rates in the UK than their white British counterparts. But what is being done about this? On the face of it, very little, which is worrying.
While mental illness costs the economy more than £105bn a year, with £10bn spent on the NHS, less than 0.001% of the mental health budget is spent on prevention. Young people were only last year brought into the fold under No health without mental health, the national mental health strategy, so there is some serious catching up to do.
Prevention is essential as adult mental illness is more common among those experiencing childhood dangers, adversity, discrimination and poverty. Often poor and risky environments bring with them easy access to alcohol, cigarettes, other psycho-stimulant drugs and a collection of unhealthy lifestyles from eating habits, little physical activity and emotional, physical or sexual abuse.
Childhood mental illness is also predictive of adult unemployment and low educational outcomes. This is why it is important to have a public health approach to protect young people from harm as early as possible, and to educate them about emotional regulation and resilience, and how to manage life's difficulties.
Providing appropriate interventions and protection in a culturally diverse and unequal society is not easy. We know that some young people and groups, who are among the most vulnerable in society, do not benefit from programmes directed at improving their health. Indeed, they are usually left behind to become even more marginalised. This can no longer be allowed to continue.
Professor Kamaldeep Bhui is president-elect of the World Association of Cultural Psychiatry, director of the Cultural Consultation Service and the public health lead at the Royal College of Psychiatrists.
Guardian Professional.
NHS reforms: government to defy order to publish risk register
NHS reforms: government to defy order to publish risk register:
Department of Health had lost latest stage of fight to keep secret an assessment of risks involved in the health service shakeup
The government will not release its own assessment of the risks posed by its NHS shakeup, despite a second legal ruling that it must stop keeping the document secret.
The Department of Health (DH) was ordered on Friday to publish its transition risk register after it lost an appeal against the information commissioner's ruling that it should be made public. Sources within the department confirmed to the Guardian that the register would not be published.
The information rights tribunal rejected the DH's bid to overturn the commissioner's ruling after a two-day hearing earlier this week at which witnesses for the DH argued, unsuccessfully, for it to be kept private lest it set a precedent that would undermine government departments' ability to assess the risks of pursuing particular policies.
Campaigners – including Labour and key medical bodies such as the British Medical Association and the Royal College of Nursing – have argued that it must be released so that peers debating the health and social care bill can have the full information needed to scrutinise it properly.
The DH's brief initial statement in response to the setback on Friday gave no indication that it intended to comply with the tribunal's ruling that it "dismisses the Department of Health's appeal against the information commissioner's decision that the 10 November 2010 Transition Risk Register should be disclosed, except in relation to the name of a junior official which should be redacted". The tribunal is expected to release the reasons for its ruling soon.
The DH said: "We are still awaiting the detailed reasoning behind this decision. Once we have been able to examine the judgment we will work with colleagues across government and decide next steps."
It now has 28 days from the ruling's publication in which to launch a further appeal, this time to the upper tier tribunal, but it must first prove it has legal grounds for doing so, by finding a legal fault with Friday's decision.
The government's other option, if it were to appeal and lose again, would be to deploy the rare tactic of a cabinet veto to prevent publication, in effect overriding the rulings of the bodies that have so far considered it. That veto was used most notably when Tony Blair was in power, to deny campaigners sight of the legal advice the government received about the legality of military action in Iraq in the runup to the start of the conflict in 2003.
Whatever the DH decides, it is highly unlikely that its analysis of the risks inherent in its radical restructuring of the NHS in England will become publicly available before the bill gains its final parliamentary approval, which is likely to come from the House of Lords on 19 March and the House of Commons the day after.
The ruling is a second significant victory for the Labour MP John Healey, who began seeking publication of the register in 2010 when he was shadow health secretary. "The judgment backs the public's right to know about the risks the government is taking with its NHS plans," Healey said. He renewed his call for the document to be published immediately, to help peers with the final stages of their deliberations on the bill, which is due to undergo the final day of its report stage next Tuesday, 13 March, and then have its third reading in the Lords on 19 March.
"It's near the end of the 11th hour for the NHS bill and parliament rightly expects this information before it takes the final irrevocable step to pass the legislation," Healey said. "The government could appeal, and prolong this legal row. But I call on the prime minister to accept today's court verdict and order the Department of Health to publish the risk register immediately."
He added: "This is the second legal direction to the government to release the risk register. The judgment backs the public's right to know about the risks the government is taking with its NHS plans. It gives strong legal support to a full and open debate about the NHS reorganisation.
"Ministers must now respect the law, release the risk register in full and let people make up their own minds on the NHS changes. Today's legal judgment must put an end to the government's efforts to keep this information secret. They have dragged out this process for 15 months, while parliament has been legislating for their NHS plans."
He was backed by the ex-SDP leader Lord Owen, now a crossbench peer, who has been a key critic of the bill in the Lords. Owen said it would be "a constitutional outrage" if the bill won approval from the upper house without peers having had the chance to study the risk register.
Owen, a former doctor and Labour health minister in the 1970s, said he believed the document should be released now and peers given time to analyse it before any further consideration of the legislation.
He added: "The attempt to railroad this legislation through both Houses of Parliament has raised very serious questions about the legitimacy of this coalition government.
"Now at the last moment parliament has a chance to assert its democratic rights and the many Liberal Democrat peers, who know in their heart of hearts that this legislative procedure is fundamentally wrong, have the opportunity to stand by their principles."
In an appeal to former party colleagues, Owen added: "Surely now Liberal Democrat peers, with a long and proud history of supporting freedom of information, will not go along with any attempt by the coalition government to continue with the third reading of this bill in the light of today's information rights tribunal on the NHS transition risk register."
A spokesman for the information commissioner's officer said: "We welcome the decision of the tribunal to uphold the commissioner's decision notice ordering disclosure of the transitional risk register. We will consider the full details of the tribunal's decision once it has been made available."
The decision comes as the bill enters the final stages of its protracted journey through parliament. The legislation underwent an extraordinary "pause" last year after fierce criticism from Liberal Democrats, and was then rewritten, including advice from the advisory NHS Future Forum.
The DH did win one victory on Friday. The tribunal upheld its appeal against the commissioner's decision that a separate document, the strategic risk register, should be published. While the transition risk register focuses on risks specifically associated with the reorganisation, the strategic document tackles broader risks to the delivery of the DH's objectives. Its publication had been sought by the London Evening Standard newspaper, but it will now remain secret, unless the information commissioner decides to mount an appeal. The Guardian
The government will not release its own assessment of the risks posed by its NHS shakeup, despite a second legal ruling that it must stop keeping the document secret.
The Department of Health (DH) was ordered on Friday to publish its transition risk register after it lost an appeal against the information commissioner's ruling that it should be made public. Sources within the department confirmed to the Guardian that the register would not be published.
The information rights tribunal rejected the DH's bid to overturn the commissioner's ruling after a two-day hearing earlier this week at which witnesses for the DH argued, unsuccessfully, for it to be kept private lest it set a precedent that would undermine government departments' ability to assess the risks of pursuing particular policies.
Campaigners – including Labour and key medical bodies such as the British Medical Association and the Royal College of Nursing – have argued that it must be released so that peers debating the health and social care bill can have the full information needed to scrutinise it properly.
The DH's brief initial statement in response to the setback on Friday gave no indication that it intended to comply with the tribunal's ruling that it "dismisses the Department of Health's appeal against the information commissioner's decision that the 10 November 2010 Transition Risk Register should be disclosed, except in relation to the name of a junior official which should be redacted". The tribunal is expected to release the reasons for its ruling soon.
The DH said: "We are still awaiting the detailed reasoning behind this decision. Once we have been able to examine the judgment we will work with colleagues across government and decide next steps."
It now has 28 days from the ruling's publication in which to launch a further appeal, this time to the upper tier tribunal, but it must first prove it has legal grounds for doing so, by finding a legal fault with Friday's decision.
The government's other option, if it were to appeal and lose again, would be to deploy the rare tactic of a cabinet veto to prevent publication, in effect overriding the rulings of the bodies that have so far considered it. That veto was used most notably when Tony Blair was in power, to deny campaigners sight of the legal advice the government received about the legality of military action in Iraq in the runup to the start of the conflict in 2003.
Whatever the DH decides, it is highly unlikely that its analysis of the risks inherent in its radical restructuring of the NHS in England will become publicly available before the bill gains its final parliamentary approval, which is likely to come from the House of Lords on 19 March and the House of Commons the day after.
The ruling is a second significant victory for the Labour MP John Healey, who began seeking publication of the register in 2010 when he was shadow health secretary. "The judgment backs the public's right to know about the risks the government is taking with its NHS plans," Healey said. He renewed his call for the document to be published immediately, to help peers with the final stages of their deliberations on the bill, which is due to undergo the final day of its report stage next Tuesday, 13 March, and then have its third reading in the Lords on 19 March.
"It's near the end of the 11th hour for the NHS bill and parliament rightly expects this information before it takes the final irrevocable step to pass the legislation," Healey said. "The government could appeal, and prolong this legal row. But I call on the prime minister to accept today's court verdict and order the Department of Health to publish the risk register immediately."
He added: "This is the second legal direction to the government to release the risk register. The judgment backs the public's right to know about the risks the government is taking with its NHS plans. It gives strong legal support to a full and open debate about the NHS reorganisation.
"Ministers must now respect the law, release the risk register in full and let people make up their own minds on the NHS changes. Today's legal judgment must put an end to the government's efforts to keep this information secret. They have dragged out this process for 15 months, while parliament has been legislating for their NHS plans."
He was backed by the ex-SDP leader Lord Owen, now a crossbench peer, who has been a key critic of the bill in the Lords. Owen said it would be "a constitutional outrage" if the bill won approval from the upper house without peers having had the chance to study the risk register.
Owen, a former doctor and Labour health minister in the 1970s, said he believed the document should be released now and peers given time to analyse it before any further consideration of the legislation.
He added: "The attempt to railroad this legislation through both Houses of Parliament has raised very serious questions about the legitimacy of this coalition government.
"Now at the last moment parliament has a chance to assert its democratic rights and the many Liberal Democrat peers, who know in their heart of hearts that this legislative procedure is fundamentally wrong, have the opportunity to stand by their principles."
In an appeal to former party colleagues, Owen added: "Surely now Liberal Democrat peers, with a long and proud history of supporting freedom of information, will not go along with any attempt by the coalition government to continue with the third reading of this bill in the light of today's information rights tribunal on the NHS transition risk register."
A spokesman for the information commissioner's officer said: "We welcome the decision of the tribunal to uphold the commissioner's decision notice ordering disclosure of the transitional risk register. We will consider the full details of the tribunal's decision once it has been made available."
The decision comes as the bill enters the final stages of its protracted journey through parliament. The legislation underwent an extraordinary "pause" last year after fierce criticism from Liberal Democrats, and was then rewritten, including advice from the advisory NHS Future Forum.
The DH did win one victory on Friday. The tribunal upheld its appeal against the commissioner's decision that a separate document, the strategic risk register, should be published. While the transition risk register focuses on risks specifically associated with the reorganisation, the strategic document tackles broader risks to the delivery of the DH's objectives. Its publication had been sought by the London Evening Standard newspaper, but it will now remain secret, unless the information commissioner decides to mount an appeal. The Guardian
Hospital consultants should work weekends to cut NHS death rate
Hospital consultants should work weekends to cut NHS death rate: Hospital consultants should work weekends and evenings to help cut the rising number of deaths in NHS hospitals outside normal working hours, a senior doctor has said.
The Daily Telegraph
The Daily Telegraph
Nurses could be given limits on number of patients they care for
Nurses could be given limits on number of patients they care for: New rules could be introduced to limit the number of patients cared for by each nurse in hospital.
The Daily Telegraph
The Daily Telegraph
Blow for Nick Clegg as Liberal Democrats refuse to endorse NHS reforms
Blow for Nick Clegg as Liberal Democrats refuse to endorse NHS reforms: Activists refuse to tell peers to back Health and Social Care Bill.
The Daily Telegraph
The Daily Telegraph
Six in 10 'not getting five-a-day'
Six in 10 'not getting five-a-day': Six in 10 UK adults are failing to eat their recommended 'five-a-day' of fruit and vegetables, according to a survey, with some people thinking tomato ketchup and strawberry ice cream count.
The Daily Telegraph
The Daily Telegraph
Children's obesity is a 'national emergency'
Children's obesity is a 'national emergency':
Labour's failure to tackle the "chips and PlayStation 3 culture" means one-fifth of primary-school leavers are now obese, the shadow health minister Diane Abbott has admitted, in a warning that the health of Britain's children is a national emergency. The Independent
Labour's failure to tackle the "chips and PlayStation 3 culture" means one-fifth of primary-school leavers are now obese, the shadow health minister Diane Abbott has admitted, in a warning that the health of Britain's children is a national emergency. The Independent
Friday, 9 March 2012
Simple actions 'cut NHS no-shows'
Simple actions 'cut NHS no-shows': Measures as simple as getting patients to write down the time of their doctor's appointment themselves can cut non-attendance rates, a study suggests. BBC News
The week: issue 238
The week: issue 238:
In this week’s edition, read about the Secretary of State’s NHS Constitution announcement about changes to whistleblowing and the set up of a new expert group chaired by Professor Steve Field. Department of Health
Download ‘the week’: issue 238, 2 – 8 March 2012 (PDF, 55KB)
In this week’s edition, read about the Secretary of State’s NHS Constitution announcement about changes to whistleblowing and the set up of a new expert group chaired by Professor Steve Field. Department of Health
Download ‘the week’: issue 238, 2 – 8 March 2012 (PDF, 55KB)
Weekend working 'needed in NHS'
Weekend working 'needed in NHS': Hospital consultants should consider working weekends to cut the spike in deaths on Saturdays and Sundays, a doctors' leader says. BBC News
Clinicians to get £1bn to lead NHS IT locally, says Lansley
Clinicians to get £1bn to lead NHS IT locally, says Lansley: Doctors and nurses will no longer have to 'bend over backwards' to fit in with technology, says Health Secretary E-Health Insider
Abuse of vulnerable adults statistics
Abuse of vulnerable adults statistics: The Information Centre has published 'Abuse of Vulnerable Adults in England 2010-11: Final Report, Experimental Statistics'. Some key facts are that in 2010-11, 62 per cent of the referrals were from women. Sixty one per cent were for older adults aged 65 and over. Almost half of the referrals (49 per cent) were for adults with a physical disability, 23 per cent were for mental health clients, 20 per cent were for learning disabled clients and the remaining 7 per cent were for adults with a substance misuse problem or other vulnerable adults. NHS Information Centre
CQC report: Meeting the health care needs of people in care homes
CQC report: Meeting the health care needs of people in care homes: Source: Care Quality Commission (CQC)
The Care Quality Commission (CQC) has published the results of a review of how older people and people with learning disabilities living in care homes access healthcare services, whether they have choice and control over their healthcare and whether they receive care that is safe and respects their dignity. Inspection teams visited 81 care homes within 9 PCT areas, interviewing managers, residents and staff, observing care and examining case files.
Key findings with respect to medication were as follows:
. Over half of homes (59%) indicated that they offered residents the option to self-administer their medicines, although only a small number of case files (4%) seen during the review contained evidence of self-administration of medicines.
. The majority of homes (93%) indicated that they 'always' recorded medicines errors and had arrangements in place to learn from errors relating to prescribing, monitoring, dispensing or administering ...
The Care Quality Commission (CQC) has published the results of a review of how older people and people with learning disabilities living in care homes access healthcare services, whether they have choice and control over their healthcare and whether they receive care that is safe and respects their dignity. Inspection teams visited 81 care homes within 9 PCT areas, interviewing managers, residents and staff, observing care and examining case files.
Key findings with respect to medication were as follows:
. Over half of homes (59%) indicated that they offered residents the option to self-administer their medicines, although only a small number of case files (4%) seen during the review contained evidence of self-administration of medicines.
. The majority of homes (93%) indicated that they 'always' recorded medicines errors and had arrangements in place to learn from errors relating to prescribing, monitoring, dispensing or administering ...
NHS Diabetes report: Foot care for people with diabetes- the economic case for change
NHS Diabetes report: Foot care for people with diabetes- the economic case for change:
A new report published by NHS Diabetes sets out the cost to both patients and the NHS of poor quality diabetic foot care. The report shows that around £650 million is spent on foot ulcers or amputations each year. Around 7% of people with diabetes currently have, or have had, a foot ulcer, which can lead to amputation, and 50% of people who have a major amputation die within 2 years; many of these amputations could be avoided with the right care. NHS Diabetes is calling on the NHS to set up specialist diabetes foot care teams as a matter of urgency, as these have been shown to reduce amputations by up to two thirds. NHS Diabetes
A new report published by NHS Diabetes sets out the cost to both patients and the NHS of poor quality diabetic foot care. The report shows that around £650 million is spent on foot ulcers or amputations each year. Around 7% of people with diabetes currently have, or have had, a foot ulcer, which can lead to amputation, and 50% of people who have a major amputation die within 2 years; many of these amputations could be avoided with the right care. NHS Diabetes is calling on the NHS to set up specialist diabetes foot care teams as a matter of urgency, as these have been shown to reduce amputations by up to two thirds. NHS Diabetes
Developing the role of the clinical academic researcher in the nursing, midwifery and allied health professions
Developing the role of the clinical academic researcher in the nursing, midwifery and allied health professions:
This strategy document outlines the increase in research training that will be offered to nurses, midwives and allied health professionals. The aim is to put research at the heart of frontline services and that successful applicants will be able to develop research projects that inform the care that they deliver for their patients on a daily basis.
This strategy document outlines the increase in research training that will be offered to nurses, midwives and allied health professionals. The aim is to put research at the heart of frontline services and that successful applicants will be able to develop research projects that inform the care that they deliver for their patients on a daily basis.
The NHS constitution for England
The NHS constitution for England:
This updated constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. In addition to this, the Health Secretary has announced the formation of a new independent expert panel which will contribute to a Government report on the NHS Constitution.
This updated constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. In addition to this, the Health Secretary has announced the formation of a new independent expert panel which will contribute to a Government report on the NHS Constitution.
The health and social care experiences of black and minority ethnic older people
The health and social care experiences of black and minority ethnic older people:
This briefing has been updated to look at changes in policy and outcomes for older black and minority ethnic people since 2008. It considers the ongoing relative scarcity of resources on this subject, but also relevant documents such as the dementia and diabetes strategies.
This briefing has been updated to look at changes in policy and outcomes for older black and minority ethnic people since 2008. It considers the ongoing relative scarcity of resources on this subject, but also relevant documents such as the dementia and diabetes strategies.
Monitor to publish 'blacklist' of health services
Monitor to publish 'blacklist' of health services: The regulator Monitor is set to be given the go-ahead to publish an annual blacklist of health services which must be reconfigured.
An amendment to the Health Bill will see the regulator identify each year where services are being “put at significant risk” by the configuration of those health care services. The NHS Commissioning Board and clinical commissioning groups in affected areas would also be notified,... Healthcare Today
An amendment to the Health Bill will see the regulator identify each year where services are being “put at significant risk” by the configuration of those health care services. The NHS Commissioning Board and clinical commissioning groups in affected areas would also be notified,... Healthcare Today
Doctors threaten to withdraw labour
Doctors threaten to withdraw labour: A protest at changes to NHS pensions could see doctors cancelling non-emergency work.
They are actively discussing the move and while the British Medical Association has ruled out an all-out strike, it is set to ballot members on other forms of industrial action. The precise forms of action have not yet been decided but could include taking all contractual breaks or refusing to engage in commissioning activity an... Healthcare Today
They are actively discussing the move and while the British Medical Association has ruled out an all-out strike, it is set to ballot members on other forms of industrial action. The precise forms of action have not yet been decided but could include taking all contractual breaks or refusing to engage in commissioning activity an... Healthcare Today
Labour uses e-petition to win Commons debate on Health Bill
Labour uses e-petition to win Commons debate on Health Bill:
MPs will get one last chance to derail the Health Bill after Labour used a e-petition calling for the reforms to be scrapped to secure a House of Commons debate. The Independent
MPs will get one last chance to derail the Health Bill after Labour used a e-petition calling for the reforms to be scrapped to secure a House of Commons debate. The Independent
NHS managers 'must support whistleblowers' under constitution
NHS managers 'must support whistleblowers' under constitution: Hospital managers must pledge to support whistleblowing staff, under changes being made to the NHS Constitution.
The Daily Telegraph
The Daily Telegraph
NHS trusts can raise half of cash from private patients, say Lords
NHS trusts can raise half of cash from private patients, say Lords: Lords have agreed to allow NHS trusts to derive up to half their income from private patients, in a move described by Labour as "the starkest sign yet" of how the health service will be if the Government's reforms are passed.
The Daily Telegraph
The Daily Telegraph
Helping more people die at home would save NHS cash: charity
Helping more people die at home would save NHS cash: charity: Helping more people to die at home rather than in hospital could save the NHS millions of pounds, a charity has calculated.
The Daily Telegraph
The Daily Telegraph
Thursday, 8 March 2012
Smoking and Health - 50 years on from landmark report
Smoking and Health - 50 years on from landmark report:
Fifty years ago the landmark report Smoking and Health was published by the Royal College of Physicians, which both drew the link between smoking, cancer and other diseases, and had a big impact on the public consciousness.
There is some very interesting footage from the time on the BBC's web site showing public reaction to the report. The article also traces the history of smoking and tobacco control policies since 1962, as well as the change from smoking being linked with affluence to it being linked to social disadvantage.
The RCP have now published 50 Years Since Smoking and Health which reviews the progress made since the original report as well as looking at the current situation in the UK and reviewing policy priorities.
Smoking is still an important public health concern though, and 100,000 people in Britain still die from tobacco related diseases every year.
With one month to go until larger shops will be required to hide tobacco displays from public view (and all shops by 2015), a debate about removing all branding from cigarette packs and National No Smoking Day on the 14th of March, 50 years on, smoking is still a vital health issue.
 |
| The RCP 1962 report |
There is some very interesting footage from the time on the BBC's web site showing public reaction to the report. The article also traces the history of smoking and tobacco control policies since 1962, as well as the change from smoking being linked with affluence to it being linked to social disadvantage.
The RCP have now published 50 Years Since Smoking and Health which reviews the progress made since the original report as well as looking at the current situation in the UK and reviewing policy priorities.
Smoking is still an important public health concern though, and 100,000 people in Britain still die from tobacco related diseases every year.
With one month to go until larger shops will be required to hide tobacco displays from public view (and all shops by 2015), a debate about removing all branding from cigarette packs and National No Smoking Day on the 14th of March, 50 years on, smoking is still a vital health issue.
Hospital car parking fine 'error'
Hospital car parking fine 'error': Motorists parking at a Northamptonshire hospital are wrongly chased over fines by a private debt collection agency. BBC Northamptonshire
The problem with SUIs
The problem with SUIs: Until we trial independent investigations for the most serious of incidents (ie quality not quantity of investigations is critical), SUI reports will disappear into a filing cabinet and will still fail to capture the real lessons, says Martin Bromiley. Health Foundation
High costs drugs
High costs drugs:
There are a number of high cost drugs that are excluded from the Payment by Results (PbR) tariff. They are typically specialist, and their use is concentrated in a relatively small number of centres rather than evenly across all trusts that carry out activity in the relevant HRGs. These drugs would therefore not be fairly reimbursed if they were funded through the tariff. For all excluded activity, commissioners and providers should agree local prices.
The following guidelines, linked to current or expected future use, are intended as an appropriate indication of the drugs that may be considered by the high cost drug steering group for inclusion on the high cost drug exclusion list:
The final date for proposals to be considered for exclusion (and inclusion) to PbR is 31 March for the following years tariff.
This request portal should not be used for high cost devices or chemotherapy. These have separate portals available from:
There are a number of high cost drugs that are excluded from the Payment by Results (PbR) tariff. They are typically specialist, and their use is concentrated in a relatively small number of centres rather than evenly across all trusts that carry out activity in the relevant HRGs. These drugs would therefore not be fairly reimbursed if they were funded through the tariff. For all excluded activity, commissioners and providers should agree local prices.
The following guidelines, linked to current or expected future use, are intended as an appropriate indication of the drugs that may be considered by the high cost drug steering group for inclusion on the high cost drug exclusion list:
- the drug and its expected associated costs of care are disproportionately high cost compared to the other expected costs of care within the HRG, which would affect fair reimbursement
- there is, or is expected to be, more than £1.5 million spend or 600 cases in England per annum.
- high cost drugs are defined by the cost of the average expected use or unit of the drug. Low cost drugs, irrespective of prescribing volumes, will not be considered for inclusion on the HCD list
- a high cost drug is a high cost drug irrespective of reason for prescription, though DH may choose to exclude certain drugs from PbR for specific indications
- when a decision is made to exclude a high cost drug from PbR, it is added to the list using its British Approved Name (where available).
- if a drug does not appear on the high cost drug exclusion list, then it is within the scope of PbR, unless it is part of an excluded service
- the Oncology Regimens (OPCS 4 Chemotherapy Regimens) list of drugs is maintained by the Oncology Regimens Steering Group.
The final date for proposals to be considered for exclusion (and inclusion) to PbR is 31 March for the following years tariff.
This request portal should not be used for high cost devices or chemotherapy. These have separate portals available from:
'No evidence' for NHS risks fear
'No evidence' for NHS risks fear: There is "no real evidence" that releasing private documents would stop civil servants giving candid advice to ministers, a tribunal has heard. BBC News
NHS fights 'hitting patient care'
NHS fights 'hitting patient care': The controversy over NHS reform and pension changes is diverting hospital doctors away from improving patient care, a union leader says. BBC News
Telehealth could save NHS £1.2bn, but fears remain
Telehealth could save NHS £1.2bn, but fears remain: Minister points to major savings potential from telehealth, but fears voiced about isolation and local understanding Public Service
NHS bill on course to become law
NHS bill on course to become law: The House of Lords back amendments to the government's health bill, which now looks on course to become law within weeks. BBC News
NHS Confederation warns over risk to mental health improvement plans
NHS Confederation warns over risk to mental health improvement plans: The head of the NHS Confederation has warned that plans to improve the nation's mental health are at risk as the basic building blocks are not yet in place to make them a success.
Think child, think parent, think family: final evaluation report
Think child, think parent, think family: final evaluation report:
In July 2009, SCIE published a guide entitled Think child, think parent, think family: a guide to parental mental health and child welfare to help services improve their response to parents with mental health problems and their families. This is the final evaluation report of the project, documenting the progress made by the sites involved, and making recommendations for future activity.
In July 2009, SCIE published a guide entitled Think child, think parent, think family: a guide to parental mental health and child welfare to help services improve their response to parents with mental health problems and their families. This is the final evaluation report of the project, documenting the progress made by the sites involved, and making recommendations for future activity.
An economic case for patient and public involvement in commissioning
An economic case for patient and public involvement in commissioning:
This work, commissioned by the Department of Health, looks at the economic case for public and patient engagement as well as developing a decision support tool. Fourteen detailed case studies were carried out to identify how meaningful and effective involvement in commissioning can drive economic, quality and user experience benefits for the NHS and partner organisations – as well as the populations they serve.
This work, commissioned by the Department of Health, looks at the economic case for public and patient engagement as well as developing a decision support tool. Fourteen detailed case studies were carried out to identify how meaningful and effective involvement in commissioning can drive economic, quality and user experience benefits for the NHS and partner organisations – as well as the populations they serve.
Premature births down after smoke ban
Premature births down after smoke ban: The premature birth rate in Scotland has fallen by 10% since the country introduced a ban on smoking in public places in 2006.
Researchers believe this is another benefit of the smoke-free approach, alongside reductions in heart disease and childhood asthma.
Writing in the journal Plos Medicine, researchers examined data for 700,000 women over a 14-year period and looked at smoking and birth rates for p... Healthcare Today
Researchers believe this is another benefit of the smoke-free approach, alongside reductions in heart disease and childhood asthma.
Writing in the journal Plos Medicine, researchers examined data for 700,000 women over a 14-year period and looked at smoking and birth rates for p... Healthcare Today
'NHS should rent telehealth equipment like iPhones': health minister
'NHS should rent telehealth equipment like iPhones': health minister:
Care services minister Paul Burstow wants the NHS to pay for telehealth and telecare through monthly contracts
Paul Burstow, the care services minister, has indicated that he would like to see telehealth and telecare services provided to the NHS without the need for up-front capital payments.
Speaking at the King's Fund international congress on telehealth and telecare, Burstow said a community nurse supervisor should be able to pay for a blood pressure monitor through a monthly contract, in a similar way to that in which people pay for iPhones or Blackberrys.
Such a strategy is already used in Gloucestershire, where the NHS is working with provider Tunstall. The company covers the up-front costs, such as clinical engagement, pathway redesign and training, and supplies NHS Gloucestershire on a per patient per month basis.
"NHS Gloucester avoids the need for large scale up-front costs, and it enables the supplier to build relationships with patients and customers that it otherwise would not have," the minister said.
Burstow also predicted that in time the cost of the telehealth and telecare technologies will start to fall.
"Costs in the UK are significantly higher than they are in the US, and it is no wonder because in the current situation we have only 6,000 users, compared to 10 times that number in the veterans' association in the US," said Burstow. "That is why we are looking at promoting our campaign, 3millionlives, why we want to grow this rapidly."
One of the principal challenges to the large scale take up of telehealth and telecare is broadband capacity, said Burstow, particularly because many of those who stand to benefit from the technologies live in rural areas where broadband provision is worst, although the government has earmarked £530m of funding to improve the situation.
There are also issues, according to Burstow, with NHS and social care staff not having sufficient skills and understanding about telehealth and telecare.
To resolve this issue, the government has asked the NHS Institute to develop a support programme for staff and patients so they can make the most of these technologies at a local level. Guardian Professional.
Paul Burstow, the care services minister, has indicated that he would like to see telehealth and telecare services provided to the NHS without the need for up-front capital payments.
Speaking at the King's Fund international congress on telehealth and telecare, Burstow said a community nurse supervisor should be able to pay for a blood pressure monitor through a monthly contract, in a similar way to that in which people pay for iPhones or Blackberrys.
Such a strategy is already used in Gloucestershire, where the NHS is working with provider Tunstall. The company covers the up-front costs, such as clinical engagement, pathway redesign and training, and supplies NHS Gloucestershire on a per patient per month basis.
"NHS Gloucester avoids the need for large scale up-front costs, and it enables the supplier to build relationships with patients and customers that it otherwise would not have," the minister said.
Burstow also predicted that in time the cost of the telehealth and telecare technologies will start to fall.
"Costs in the UK are significantly higher than they are in the US, and it is no wonder because in the current situation we have only 6,000 users, compared to 10 times that number in the veterans' association in the US," said Burstow. "That is why we are looking at promoting our campaign, 3millionlives, why we want to grow this rapidly."
One of the principal challenges to the large scale take up of telehealth and telecare is broadband capacity, said Burstow, particularly because many of those who stand to benefit from the technologies live in rural areas where broadband provision is worst, although the government has earmarked £530m of funding to improve the situation.
There are also issues, according to Burstow, with NHS and social care staff not having sufficient skills and understanding about telehealth and telecare.
To resolve this issue, the government has asked the NHS Institute to develop a support programme for staff and patients so they can make the most of these technologies at a local level. Guardian Professional.
NHS bill: last-ditch opposition as coalition bids to push it through
NHS bill: last-ditch opposition as coalition bids to push it through:
Shadow health minister pins hopes on risk assessment, desertion of last two royal colleges, and activists condemning the bill at Lib Dem conference
Shadow ministers are preparing a last-ditch attempt to delay the health bill next week, as most signs pointed to the bill reaching the statute book on 20 March, prompting a new two-year argument outside parliament on the bill's true impact on the NHS.
Ministers and officials acknowledge in private, with an almost gallows humour, the political damage caused by the bill. They think the sooner it is law and out of the limelight, the better. No more amendments or pauses will be contemplated. The hysterical predictions about its impact can then be exposed, ministers argue.
But Andy Burnham, the shadow health secretary, was refusing to give up the fight, even though the Lords had voted through some of the most controversial measures on Tuesday night with large majorities.
He admitted: "One of the frustrating things in the past fortnight is that the more friendless this bill becomes, the more determined the government seems to be to push it through.
"I hope the dynamic can still be changed, but it is getting desperately late." He is pinning his remaining hopes on three external forces.
First, a tribunal – probably this week – may rule the NHS risk assessment should be published , which is bound to lead to an appeal by the government. If so, Burnham hopes peers at the third reading next week will delay the bill for a further month until the risk assessment is published. Lord Owen, the former SDP leader who went down a storm at the NHS workers' rally tonight, is likely to try to move for such a delay next week. Labour peers, disappointed by the scale of their defeats this week, still say there is a realistic chance crossbench peers could be persuaded to delay the bill on this basis.
Second, it is likely that two further royal colleges will come out against the bill shortly, leaving an embarrassed coalition government in the awkward position of supporting a bill designed to empower professionals, but deserted by health professional bodies themselves. The Royal College of Surgeons will meet on Thursday after a demand for an extraordinary general meeting was accepted. Up until now, the RCS has refused to oppose the bill outright, preferring engagement on specific issues. The Royal College of Physicians is due to complete a survey of its 30,000 members next Thursday, and is likely to join opposition.
Burnham's third hope is that the Lib Dem activists at their Gateshead conference this weekend will stand up to pressure from their leaders and vote to drop the bill, a decision that would be a huge embarrassment for Nick Clegg.
On Friday, the party's federal conference committee will have to choose between two rival emergency amendments to put forward for debate – one opposing the bill outright and another saying the bill has been amended enough to make it worth supporting. The latter amendment, supported by Lady Williams, argues that significant changes have been made to the bill as a result of Lib Dem pressure in the Lords, including "ensuring that competition in the NHS is in the interests of patients, based on quality not price; securing the commissioning process against damaging conflicts of interest; ensuring that any profits from treating private patients in foundation trust hospitals are invested in the NHS; [and] underpinning the independence of public health".
The underlying argument is that the Lib Dems have made the NHS better protected from the private sector than it had been under Labour, an argument Burnham rejects as "the most distorting piece of spin I have ever heard. The whole point of this bill is that it takes the NHS in a new direction."
Williams has admitted frustration in the Lords that the detailed virtues and vices of the bill are now little debated as two big entrenched encampments face each other. She complained that the legitimate balanced role of competition in the NHS was being forgotten.
She told peers : "I am thoroughly fed up with reading pieces on social network sites such as Twitter, which have presented the debate in terms of how we must be in favour of marketisation. That is simply absurd and it makes me angry. It adds to what has become a silly debate, a fictional debate. I am fed up with reading about how I am actually a secret marketiser when I know when perfectly well I am not."
Indeed it must be frustrating for peers. Few will have followed the complex proceedings, and compromises, over the role of Monitor, national tariffs, and the expansion of competition.
Williams retains a special status in her party, and she must know she will have disappointed many by her judgment call – one she admits may prove to be wrong. The weekend conference will reveal whether she can take her unhappy party with her. The Guardian
Shadow ministers are preparing a last-ditch attempt to delay the health bill next week, as most signs pointed to the bill reaching the statute book on 20 March, prompting a new two-year argument outside parliament on the bill's true impact on the NHS.
Ministers and officials acknowledge in private, with an almost gallows humour, the political damage caused by the bill. They think the sooner it is law and out of the limelight, the better. No more amendments or pauses will be contemplated. The hysterical predictions about its impact can then be exposed, ministers argue.
But Andy Burnham, the shadow health secretary, was refusing to give up the fight, even though the Lords had voted through some of the most controversial measures on Tuesday night with large majorities.
He admitted: "One of the frustrating things in the past fortnight is that the more friendless this bill becomes, the more determined the government seems to be to push it through.
"I hope the dynamic can still be changed, but it is getting desperately late." He is pinning his remaining hopes on three external forces.
First, a tribunal – probably this week – may rule the NHS risk assessment should be published , which is bound to lead to an appeal by the government. If so, Burnham hopes peers at the third reading next week will delay the bill for a further month until the risk assessment is published. Lord Owen, the former SDP leader who went down a storm at the NHS workers' rally tonight, is likely to try to move for such a delay next week. Labour peers, disappointed by the scale of their defeats this week, still say there is a realistic chance crossbench peers could be persuaded to delay the bill on this basis.
Second, it is likely that two further royal colleges will come out against the bill shortly, leaving an embarrassed coalition government in the awkward position of supporting a bill designed to empower professionals, but deserted by health professional bodies themselves. The Royal College of Surgeons will meet on Thursday after a demand for an extraordinary general meeting was accepted. Up until now, the RCS has refused to oppose the bill outright, preferring engagement on specific issues. The Royal College of Physicians is due to complete a survey of its 30,000 members next Thursday, and is likely to join opposition.
Burnham's third hope is that the Lib Dem activists at their Gateshead conference this weekend will stand up to pressure from their leaders and vote to drop the bill, a decision that would be a huge embarrassment for Nick Clegg.
On Friday, the party's federal conference committee will have to choose between two rival emergency amendments to put forward for debate – one opposing the bill outright and another saying the bill has been amended enough to make it worth supporting. The latter amendment, supported by Lady Williams, argues that significant changes have been made to the bill as a result of Lib Dem pressure in the Lords, including "ensuring that competition in the NHS is in the interests of patients, based on quality not price; securing the commissioning process against damaging conflicts of interest; ensuring that any profits from treating private patients in foundation trust hospitals are invested in the NHS; [and] underpinning the independence of public health".
The underlying argument is that the Lib Dems have made the NHS better protected from the private sector than it had been under Labour, an argument Burnham rejects as "the most distorting piece of spin I have ever heard. The whole point of this bill is that it takes the NHS in a new direction."
Williams has admitted frustration in the Lords that the detailed virtues and vices of the bill are now little debated as two big entrenched encampments face each other. She complained that the legitimate balanced role of competition in the NHS was being forgotten.
She told peers : "I am thoroughly fed up with reading pieces on social network sites such as Twitter, which have presented the debate in terms of how we must be in favour of marketisation. That is simply absurd and it makes me angry. It adds to what has become a silly debate, a fictional debate. I am fed up with reading about how I am actually a secret marketiser when I know when perfectly well I am not."
Indeed it must be frustrating for peers. Few will have followed the complex proceedings, and compromises, over the role of Monitor, national tariffs, and the expansion of competition.
Williams retains a special status in her party, and she must know she will have disappointed many by her judgment call – one she admits may prove to be wrong. The weekend conference will reveal whether she can take her unhappy party with her. The Guardian
Dementia is 'next global health time bomb'
Dementia is 'next global health time bomb': Dementia should be made a top health priority on a par with cancer and lung disease, a leading expert has said, after it has become the next global "time bomb".
The Daily Telegraph
The Daily Telegraph
Three million could benefit from 'doctor by broadband' by 2017, claims minister
Three million could benefit from 'doctor by broadband' by 2017, claims minister: Some three million patients could be consulting their doctors and managing their health conditions online by 2017, saving the NHS £1.2 billion, Paul Burstow, the Care Services Minister, has claimed.
The Daily Telegraph
The Daily Telegraph
Alzheimer’s treatment in late stages of disease does slow progression
Alzheimer’s treatment in late stages of disease does slow progression:
More than 100,000 people in the UK suffering the “savage” effects of advanced Alzheimer’s disease could benefit from drug treatment to slow its progression. The Independent
More than 100,000 people in the UK suffering the “savage” effects of advanced Alzheimer’s disease could benefit from drug treatment to slow its progression. The Independent
Wednesday, 7 March 2012
Nearly 40 NHS Northamptonshire back room staff lost jobs or took redundancy in 16 months
Nearly 40 NHS Northamptonshire back room staff lost jobs or took redundancy in 16 months:
REDUNDANCY money worth more than £1million has been handed out to NHS staff since health secretary Andrew Lansley visited Northampton and launched the handover of NHS services to GPs in 2010. Northampton Chronilce and Echo
Revised guidance on Clostridium difficile issued
Revised guidance on Clostridium difficile issued:
The Department today issued revised guidance on how to test, report and manage C. difficile infections. In particular, the new guidance will help healthcare providers by identifying which two types of tests, which when used in combination, will deliver the most accurate results for C. difficile infection testing.
The guidance includes a testing algorithm that provides a step-by-step means of optimising performance, with the ability to clinically categorise patients with much greater accuracy.
It sets out:
- who should be tested and the type of samples that should be taken;
- the types of tests that should be used for detecting infections, and
- what healthcare providers should do, depending on the outcome of the tests.
The updated guidance on the diagnosis and reporting of Clostridium Difficile provides a cost-effective and evidence based way of improving the accuracy of testing for the infection, and delivering better patient management and care. Department of Health
Extra funding to pay for new health equipment and buildings
Extra funding to pay for new health equipment and buildings:
More than £330 million of extra funding will be spent on providing state of the art equipment and facilities to improve services for patients in England, the Prime Minister David Cameron announced today.
Hospitals around the country will get funding for facilities and services such as:
- urgent care facilities, including operating theatres and a new accident and emergency department
- CT scanners and ultrasound equipment
- a new paediatric unit and a dedicated women and children’s unit
- improved maternity services and equipment, including a new labour suite and ultrasound equipment
- improved cancer care and screening, increasing women’s access to breast screening equipment
Read the press release.
See the breakdown of spending by strategic health authority (SHA), by type and by region.
Extra cash found for NHS services
Extra cash found for NHS services: A host of new building projects, including upgrades to maternity and A&E units, has been unveiled by ministers. BBC News
Huge gulf in diabetes amputations
Huge gulf in diabetes amputations: Leg amputation rates for people with diabetes are 10 times higher in some parts of England than in others. BBC News
Care homes 'lacking NHS services'
Care homes 'lacking NHS services': Vulnerable people in care homes may be struggling to get access to GPs and routine medicines in England, a review suggests. BBC News
Exclusive: PCT funding failure hits dementia care
Exclusive: PCT funding failure hits dementia care: Memory services crucial to cutting the billion-pound burden of dementia on the NHS are being critically underfunded, a GP investigation has found. GP Online
The medical leadership competency framework: self assessment tool
The medical leadership competency framework: self assessment tool:
This tool helps doctors and medical students review their leadership skills. It consists of a series of multiple choice questions based on leadership qualities, after which users can choose to generate an action plan to develop their skills and are also given access to a range of materials to support their leadership skills development.
The best of clinical pathway redesign - practical examples delivering benefits to patients
The best of clinical pathway redesign - practical examples delivering benefits to patients:
This publication showcases some of the innovations that have enabled thousands of patients to enjoy better health and well-being thanks to practical service improvements implemented on various clinical pathways.
NHS Commissioning Board to take over NHS IT strategy
NHS Commissioning Board to take over NHS IT strategy: 
Assent for health and social care bill would see NHS Connecting for Health pass responsibility for informatics to NHS Commissioning Board
Responsibility for NHS IT strategy could fall to the NHS Commissioning Board from next year.
Alan Perkins, the resources and transition director at NHS Connecting for Health, told the public sector efficiency expo in London that the new arrangements "are going to be established in 2012 for implementation in April 2013" subject to parliamentary process and the health and social care bill getting royal assent.
The NHS Commissioning Board would replace the current lead on NHS informatics, NHS Connecting for Health, and provide a "whole range of things from policy through to strategy, to delivery and even ownership of some systems".
The NHS Commissioning Board, which currently exists as a special health authority, would also commission IT for delivery on a national basis from a separate "lean organisation".
Perkins said that where there is a need for a single IT system across the NHS nationally, the DH will continue to provide it, but that the department intends to stimulate a "vibrant healthcare marketplace" for technology locally - "quite a significant change from where we have been in the past", he added.
"For those local systems, the thinking is that each provider will be responsible for their own requirements, although providers might choose to work together and share systems, securing better value for money."
Policy around health and social care informatics will be governed by a small team within the Department of Health, Perkins said. Guardian Professional.
NHS forgetting needs of care home residents, warns review
NHS forgetting needs of care home residents, warns review: 
Study shows medical care neglected in some districts with patients waiting for up to 18 weeks for health checks
The healthcare needs of older care home residents are being neglected in some areas of the country, according to a review published by the British Geriatrics Society and the Care Quality Commission.
Most primary care trusts plan healthcare for their local population by assessing the needs of people who live in their own homes – so elderly people living in care homes may be out of sight and out of mind. The BGS says PCTs "do not accord sufficient priority" to their health needs.
There are 376,250 older people living in 10,331 care homes in England and many are frail and vulnerable, with more health needs than most of the population. Around 40% have dementia, many are on cocktails of medication, and the average lifespan when they get to a care home is one to two years.
"The NHS disengaged from care homes when they became private sector nursing homes," said Prof Finbarr Martin, BGS president and co-author of the report, Quest for Quality. "The NHS disengaged except for the statutory responsibility to provide GPs.
"Care home residents have potentially become disenfranchised from a lot of community health services they would expect to get if they were in their own homes. There is an assumption that they are taken care of. The NHS, if it is about patient-centred care and equitable access, has to look at care home residents and meet their needs."
If the health needs of this vulnerable elderly population are not properly met, they end up in hospital instead, he said.
Data on the healthcare provided to residents was collected by the CQC, which has the job of monitoring standards in care homes, but analysed by doctors from the BGS. They found that the amount of NHS care offered to people varied widely.
Elderly residents had access to a geriatrician who could take an overview of their complex age-related health problems in only 60% of PCTs, the analysis shows.
The residents needed a whole range of medical services, including mental health teams, dietetics, occupational therapy, physiotherapy, podiatry, continence, falls and tissue viability (dealing with wounds, pressure sores and ulcers). Only 43% of PCTs made all of these available to care home residents. Where the services were available, it could take a long time for an elderly person to be seen – sometimes as long as 18 weeks, which could lead to a deterioration in health.
"The fault in many cases is not with care homes but with those responsible for ensuring that the NHS plays its part in ensuring that healthcare needs of residents are met," says the BGS.
It wants local health service commissioners to agree clear service specifications with hospitals and other providers.
"It is evident that while there are pockets of excellent NHS care, such as in Sheffield, Leeds or south Manchester, there are striking geographical differences," said Martin.
"It is unacceptable to leave people waiting for over three months to receive treatment that could significantly improve their quality of life, especially when you consider that the average life expectancy of an older person entering a care home is between one and two years.
"It is time that commissioners and health service planners matched their obligations to ensure that the healthcare needs of this vulnerable group are adequately met."
The CQC also looked at how staff in a small sample of care homes dealt with the health needs of residents. They found good practice in most cases in identifying residents' medical needs and planning, but there were also problems.
Thirty-five per cent of homes said they "sometimes" had difficulties getting medicines to residents on time, and only 38% of care homes said GPs made routine visits, while 10% paid the GP surgeries to visit.
Under the health changes, the CQC no longer has responsibility for monitoring the work of commissioners. The British Geriatric Society says it is concerned to know "who is looking out for the needs of this very vulnerable group of older people. The Guardian
Cancer screening 'risks being a casualty of NHS reform'
Cancer screening 'risks being a casualty of NHS reform': Councils given public health funds by Lansley will spend it on potholes instead, experts warn .
The Daily Telegraph
The Daily Telegraph
Delays in seeking treatment 'lead to cancer deaths'
Delays in seeking treatment 'lead to cancer deaths':
Nearly 40% of people who fear they might have cancer delay visiting a doctor because they are worried about what they will find, according to new research. The Independent
Tuesday, 6 March 2012
The next ten years
The next ten years:
This collection of essays highlights the trends that will be important over the next decade and investigates the types of policy responses that will be required in the light of these trends. The essays centred around healthcare in the next ten years discuss issues such as the management of long-term conditions; localised services; reconfiguration of services; innovation and competition; and the future healthcare workforce.
Dual diagnosis: a challenge for the reformed NHS and for Public Health England
Dual diagnosis: a challenge for the reformed NHS and for Public Health England:
It looks at the likely implications of the reforms and makes eight recommendations to integrate services and improve outcomes. NHS Networks
Surgeons: 'Don't use metal hips'
Surgeons: 'Don't use metal hips': Expert surgeons in the UK say patients should no longer be given all-metal hip replacements, despite assurances from regulators following safety concerns. BBC News
Concessions promised on NHS bill
Concessions promised on NHS bill: The government is to introduce further concessions on its controversial health bill for England, in an effort to assuage Liberal Democrat concerns. BBC News
Exclusive: CCGs risk 'culture of dependency' on private firms
Exclusive: CCGs risk 'culture of dependency' on private firms: Clinical commissioning groups (CCGs) risk developing a culture of dependency on support from private consultancy firms, GP leaders have warned. GP Online
CCGs unhappy with commissioning support
CCGs unhappy with commissioning support: Clinical commissioners are unhappy with the NHS commissioning support programme and say they are being given little choice of provider, a survey reveals. E-Health Insider
NHS Sustainability Day
NHS Sustainability Day: In recognition of NHS Sustainability Day on 28 March, the NHS Employers organisation has published information about what you could do to mark the day, as well as details of a new web portal with a range of resources and guidance for trusts. NHS Employers
Review of the evidence on fall prevention in hospitals
Review of the evidence on fall prevention in hospitals:
To facilitate the development of a hospital falls prevention resource guide, this paper systematically reviews and documents the existing evidence base for interventions to prevent falls in hospitals and provides an overview of the performance of existing tools with known measurement properties. It also identifies a wide variety of tools for the prevention of falls in hospitals.
Human rights review 2012
Human rights review 2012:
This review examines how well public authorities deliver human rights protection and promotion. It concludes that people in England and Wales have their human rights upheld in many ways but more could be done to improve human rights protections for some - including people using care services and victims of crime. The review identified key areas for improvement and highlights the need commissioners and service providers to improve their understanding of their human rights obligations.
Adopting integration and innovation in the NHS is a cultural change
Adopting integration and innovation in the NHS is a cultural change: 
Chief executive of Whittington Health, Dr Yi Mien Koh, explains to Jessica Fuhl that the biggest challenge to integration and efficiency is getting staff on board
Whittington Health has ambitions plans for the future. It hopes to achieve foundation trust status by 2014 and its first step to ensure it made sufficient efficiency savings in order to do so was to fully integrate local community services with the hospital last year. In January it had reached 98% of its cost improvement programme (CIP) target for the financial year as a result.
The integrated health organisation is a merger of the formerly named Whittington hospital, Islington PCT and Haringey PCT – including Haringey children's services.
Dr Yi Mien Koh was appointed as chief executive of the organisation almost a year ago in time to oversee the integration of the services. In an interview with the Guardian's healthcare network at the Nuffield Trust health policy summit last week she said that one of the biggest challenges of the merger was integrating staff's ways of thinking.
"It was three different cultures, three different ways of working, three different sets of conditions. But as a result what we now have is one structure that takes the patients all the way from the front door in to the community."
Koh has had to find new ways to incentivise staff as the trust moves forward with its strategic plan for to improve efficiency and the quality of healthcare through integration.
"Incentivising clinicians to work in a different way is key", she said. "For example, not asking patients to turn up at out patients, but instead asking can we go out in to the community; asking clinicians to work via telephones and emails."
The trust has already introduced telephone consultations with patients, something to be continued in the long-term provided all clinicians adopt the approach. For some staff, "taking the patient all the way from the front door" is taken so seriously that they communicate with patients online via online platforms such as Twitter.
Koh explained: "Certainly with children, for example, who have long-term conditions like diabetes, they are already communicating with their pediatricians how to manage their condition on a day-to-day basis through Twitter. The young people get real time feedback which is better."
The chief executive has asked GPs to adopt other new ways which she hopes will drive efficiency and improve the quality of care at Whittington Health. GPs are incentivised to communicate with patients through emails by being paid a small amount extra for each email correspondence used instead of letters.
Whittington Health has also bought a new electronic patient records system that will integrate GP and social care systems next year. But, according to Koh, buying the IT is only part of the challenge.
"Ten per cent of the challenge is finding the money, and 90% is culture change – getting staff to want to use it. The NHS is very good at implementing new technology, but keeping the old. We're just not keeping the old.
"What we want to do by the end of the year is have 50% of all communication with patients by emails. But the GPs are actually resisting because they say that patients who don't have internet access will have to print it off anyway, as will GPs who don't adopt the electronic patient records system.
"We are thinking about how we can make electronic the easier option, as it costs a lot of money to process the paper."
For Koh the challenge to drive innovation and efficiency at Whittington Health is a big one, but it is one she is determined to meet by bringing her staff with her.
"We're on a triathlon. This is the analogy I usually use for my team. We have the swimming and the cycling and the running. We are now starting to swim but we are only are only in the beginning – we still have cycling and running to do. So I say, don't tire yourself out too much. We still have a lot to do.
"But some people, if they are not fit, then you're just going to drop out half way. So we need to be leaner, and part of being lean is getting the organisation of staff structurally fitter.
"It is very challenging but the biggest thing for me is bring staff with me on this journey. So that we have the same goal and that we share the same vision to provide high quality care for the population." Guardian Professional.
Treatment of elderly amounts to torture, says equality watchdog
Treatment of elderly amounts to torture, says equality watchdog: Government watchdog says cases of neglect meet legal definition of torture.
The Daily Telegraph
The Daily Telegraph
IT firm behind 'unworkable' NHS database keeps IT deal
IT firm behind 'unworkable' NHS database keeps IT deal: Ministers have agreed to give the American company responsible for the "unworkable" NHS database almost £1 billion in health contracts, The Daily Telegraph can disclose.
New safety concerns over knee replacements
New safety concerns over knee replacements:
The long-term safety and effectiveness of millions of knee replacement implants is unknown, highlighting inherent problems in the regulation and monitoring of medical devices, according to a leading surgeon. The Independent
Monday, 5 March 2012
Heavier and growing population prompts £400,000 mortuary expansion at Northampton General Hospital
Heavier and growing population prompts £400,000 mortuary expansion at Northampton General Hospital:A HEAVIER and increasing population has prompted a £400,000 extension to the mortuary at Northampton General Hospital. Northampton Chronicle and Echo
Should GPs be given statutory commissioning roles? | Nick Goodwin
Should GPs be given statutory commissioning roles? | Nick Goodwin: Many aspects of the Health and Social Care Bill have given rise to heated debate, but one of the most controversial has been the question of whether GPs should have formal statutory responsibility for commissioning. (Blog, 2 Mar 2012) Kings Fund
Over £100m given to support groundbreaking clinical research
Over £100m given to support groundbreaking clinical research:
The money, provided by the National Institute for Health Research, will be spent on research nurses and technicians at 19 of the facilities around the country. A huge number of new treatments for conditions including cancer, diabetes, stroke, dementia and obesity will be developed by researchers at the facilities. NHS Networks
VIDEO: New techniques help hip replacements
VIDEO: New techniques help hip replacements: Demand for hip replacements remains at an all time high. While the surgery is now regarded as routine, it is still an area for medical innovation. BBC News
Publication battle over NHS risks
Publication battle over NHS risks: Demands that the government publish risk assessments of their controversial plans for the NHS in England will be heard at an information tribunal later. BBC News
Johns Hopkins risk tool used in South
Johns Hopkins risk tool used in South: More than 200 GP practices in South Central England are getting quarterly risk stratification and predictive modelling information on their patient populations. E-Health Insider
Review of services for people with learning disabilities
Review of services for people with learning disabilities:
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.
CCGs need to be able to choose AQP
CCGs need to be able to choose AQP: The government has agreed to carry out a review of its policy about how Clinical Commissioning Groups (CCGs) are able to choose Any Qualified Provider (AQP).After pressure from the Commissioning Coalition of the NHS Alliance and NAPC, the Department of Health said it would review the policy in October this year. Dr Mike Dixon, chair of the NHS Alliance said: "It's the outcome of what we've been able to persu... Healthcare Today
MRSA: How one NHS trust cut infection rates by 80%
MRSA: How one NHS trust cut infection rates by 80%: 
Gill Hitchcock reports on how Royal Liverpool and Broadgreen University hospitals NHS trust tackled healthcare associated infections
When Diane Wake began a new role at Royal Liverpool and Broadgreen University hospitals NHS trust in 2007 she faced a major challenge. The 800-bed trust was a "national outlier" in terms of its healthcare associated infection rates and, as the trust's new executive director of nursing and operations and director of infection prevention and control, Wake was tasked with tackling this.
"We had large amounts of MRSA, an excessive rate of clostridium difficile, which I felt was totally and utterly unacceptable," she says. "You don't expect a patient who comes into the hospital to leave with something they didn't have when they arrived. For me that really set us off on a journey of what do we need to do differently in this organisation."
The journey to improvement has taken the trust through some radical changes and Wake on an eye-opening trip to Johns Hopkins hospital in Baltimore to learn about its success in tackling healthcare associated infection.
"They had published several articles in the New England Journal of Medicine, about reducing MRSA, and particularly to zero on their critical care units," Wake says.
"And that made me think, how have they done that? Patients, particularly in critical care environments, can be more susceptible to things like MRSA. And that seemed like a massive achievement."
One of the key innovations she witnessed during her five days in Baltimore was the use of hydrogen peroxide vapour for decontamination.
"When they discharged a patient who had an infection, they would clean the room and then use the hydrogen peroxide vapour to decontaminate it," Wake says. "That was something that we were not doing here in the UK and it really interested me."
Johns Hopkins was using the vapour in what Wake describes as a "reactive" way to treat equipment after an infection, but she decided to use the technique "proactively". The trust adopted a system supplied by Johnson and Johnson Medical to apply hydrogen peroxide vapour "across the board in the organisation, whenever we have discharged a patient".
Wake emphasises, however, that the vapour is not a substitute for cleaning and that the trust's cleaners have been "incredibly resourceful" in increasing the amount of cleaning of wards and departments.
She also saw that Johns Hopkins used non-ported cannulas to administer fluids into patient's veins, while Liverpool and Broadgreen was using ported cannulas. There was always a suspicion that ported cannulas could be a reservoir for pathogens, Wake explains.
"So we changed that. And we looked at how we decontaminated patients skin prior to introducing cannulas and then we embarked on a trust-wide training and education programme."
Liverpool and Broadgreen also introduced mattresses auditing. When Wake took up her post there was no regular mattress auditing, making it very difficult to control their lifespan. "Mattresses in a hospital have an eight-year life, all mattresses have a cover which is cleaned once the patient discharged," she explains.
"We did not recognise in 2007 that covers only had a life of three years, so after that timeframe, if a patient is incontinent in bed, there is a risk that if you don't change the cover after three years you can get some seep through to the mattress itself."
Following the initial audit, 80% of mattresses were condemned and replaced, and the trust now dates all its mattresses and covers and carries out weekly checks.
Changes to antibiotic prescribing and management were also introduced because, as Wake explains, there is much research to show that excessive antibiotic prescribing can result in increased clostridium difficile.
"It is about managing antibiotic prescribing well across the organisation," she says. "Certainly our pharmacy team have worked very closely with medical microbiologists, infection control teams and clinicians to make sure that we are really rigorous in ensuring that we are not prescribing inappropriately."
The infection control team was strengthened with the appointment of nurses who specialised in the field. Training for junior doctors has changed to help them with antibiotic prescribing.
"We also implemented something called a 'medicine man' which is basically the figure which we give to junior doctors to put in their pockets and it indicates, according to our antibiotic prescribing policy, if a patient had, for example, an upper respiratory tract infection or chest infection, what the right antibiotic is in the first instance."
Statistics released by the trust shows the MRSA infection rates were reduced by 88% between 2008-09 to 2011-12, representing a fall from 34 cases to four. Similarly, clostridium difficile infection declined by 84%, with a drop from 353 cases in 2008-09 to 58 in 2011-12.
Wake maintains that this improvement has resulted from a change of culture. "We really tightened up everything that we did," says Wake. "It is about everybody in the organisation being signed up to the agenda, reducing healthcare associated infection." Guardian Professional.
David Cameron 'prepared to take hit' on NHS
David Cameron 'prepared to take hit' on NHS: 
Prime minister says there is no going back on reforms, as chorus of opposition grows louder
David Cameron has said he does not care about "taking a hit" on the government's radical shake-up of the NHS in England, vowing there was no going back on the reforms.
Addressing the Conservative spring forum, the prime minister said the controversial overhaul was "unavoidable and urgent".
But he sought to reassure party activists over the crucial doorstep election issue, claiming the NHS was "in the party's DNA and that's not going to change".
Cameron's comments come as the chorus of opposition to the coalition's NHS reforms grew louder this week, with the Royal College of Radiologists joining a growing list of medical bodies denouncing the health and social care bill.
On Friday, the college called on ministers to withdraw their plans for a radical shake-up of the NHS in England after a survey of its members.
The British Medical Association (BMA) said on Thursday that the reforms would be "irreversibly damaging to the NHS" and irreparably damage the relationship between family doctors and patients.
But Cameron, rallying Tory activists at the private event in central London on Saturday, said "fortune favours brave governments".
He claimed it was right to take "tough decisions" in a range of areas for the good of the country, including agreeing to go ahead with plans for a high-speed rail link between London and the North that will carve up key Tory heartlands.
That prompted one party member to cry out "No". "Oh, yes it is," the prime minister replied. The Guardian
Whitehall defends dual health roles of chairman of NHS watchdog
Whitehall defends dual health roles of chairman of NHS watchdog: 
Lord Carter chairs the NHS Co-operation and Competition Panel (CCP) and is UK head of US-owned healthcare firm McKesson
The Department of Health said it had "every confidence" in the head of the body that polices competition in the NHS after concerns were raised that he also runs one of the UK's biggest healthcare companies.
Scrutiny of the role played by Lord Carter as chairman of the NHS Co-operation and Competition Panel (CCP) comes at a particularly sensitive time for the government as it faces growing opposition to its healthcare reforms, which would usher in a big expansion of private competition.
It is also embarrassing for Labour, which elevated Lord Carter of Coles to the House of Lords under prime minister Tony Blair, and is now leading the political opposition to the health and social care bill, and in particular what it regards as creeping privatisation.
There is no suggestion that Carter has done anything wrong. His role as UK chairman of US-owned healthcare giant McKesson and other companies was well known when he was appointed to chair the CCP, and all jobs are clearly recorded on his parliamentary profile.
On its website, US-owned McKesson says it has contracts with more than 90% of NHS organisations, as well as with other private health companies. However, it is likely to cause further concern about companies that are seen to benefit from a widespread programme of private involvement in public services. There have been calls for more investigation into how much private consultants advising government on the controversial health reforms stand to make from the changes.
Under proposals in the health and social care bill going through parliament, the CCP is due to be merged with another regulatory body, Monitor, which will oversee what is expected to be a huge expansion of private sector companies in the NHS.
Reacting to Carter's dual roles, Dr Clare Gerada, chairman of the Royal College of General Practitioners, said: "He cannot have any credibility when he is also heading a company with such huge interests in the very contracts his organisation is meant to police. GPs are being minutely scrutinised for possible conflicts of interest. But if we are going to have to have transparency, it has to apply throughout the system."
The Department of Health defended the peer's dual roles, in a statement that said: "We do not believe there is any evidence of a conflict of interest. Since the CCP was established, they have done an excellent job in helping to ensure good procurement practice and fair competition, and we continue to have every confidence in Lord Carter."
In a separate statement, McKesson said: "Lord Carter steps down from any investigation where there is potential conflict of interest. Lord Carter was appointed for his experience in this area. It is also worth noting that the CCP only has an advisory role in making recommendations to either the DoH or Monitor. The CCP has a track record of making objective assessments."
The company also stressed that the scope for conflict of interest was "limited" because CCP was in charge of patient services and had no remit over the IT contracts in which McKesson specialises.
McKesson has operated in the UK since 1990, employs 450 staff in the UK, and boasts that its NHS HR and payroll IT system is the world's largest. The Guardian
Let's just admit it - the NHS is a rotten way of doing things
Let's just admit it - the NHS is a rotten way of doing things: One day a politician will be brave enough to transform a health service riven by fear, says Charles Moore.
The Daily Telegraph
The Daily Telegraph
Public health could be 'devastated' by NHS reforms warn doctors
Public health could be 'devastated' by NHS reforms warn doctors: Public health programmes could be "devastated" by the Government's controversial reform of the NHS, as councils take money set aside for much-needed projects, doctors have warned.
The Daily Telegraph
The Daily Telegraph
NHS transplant service apologises for giving patients cancer
NHS transplant service apologises for giving patients cancer: The NHS transplant service has apologised to two patients after they contracted cancer from donated kidneys. The Independent
Friday, 2 March 2012
Our ambulance service needs cash injection
Our ambulance service needs cash injection: An operations chief at the region’s ambulance service says more money is needed to meet a surge in demand from patients requiring life-saving treatment. Northamptonshire Evening Telegraph
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