Clinicians in management: does it make a difference?:
This research has found that the boards remain dominated by non-clinicians, such as accountants and managers and that clinicians make up an average of just 26% of board members in English hospital trusts, with major variations around the country. It looks at the relationship between having doctors on the boards of trusts and patient satisfaction rates, patient morbidity rates and how highly the hospital’s management is regarded.
Friday, 1 June 2012
Changes to regional offices plan for NHS
Changes to regional offices plan for NHS:
Plans for regional offices to replace primary care trusts and strategic health authorities have been scaled back by the NHS Commissioning Board.
Original plans for 50 local offices are now to be amended so that there will be only 27, that is one fewer than the 28 SHAs that were formed in 2002, before they were slimmed down to 10 by health secretary Patricia Hewitt. Ian Dalton, deputy chief executive of the NHS CB... Healthcare Today
Plans for regional offices to replace primary care trusts and strategic health authorities have been scaled back by the NHS Commissioning Board.
Original plans for 50 local offices are now to be amended so that there will be only 27, that is one fewer than the 28 SHAs that were formed in 2002, before they were slimmed down to 10 by health secretary Patricia Hewitt. Ian Dalton, deputy chief executive of the NHS CB... Healthcare Today
Doctors write open letter explaining their day of action
Doctors write open letter explaining their day of action: Doctors publish open letter in national newspapers to try to quell growing backlash against industrial action over pension reforms.
The Daily Telegraph
The Daily Telegraph
Doctors' industrial action 'could affect one million patients'
Doctors' industrial action 'could affect one million patients': Doctors' industrial action will create a three month backlog and affect one million patients needing surgery or hospital appointments, it has emerged.
The Daily Telegraph
The Daily Telegraph
Commercialisation of NHS trust 'not healthy'
Commercialisation of NHS trust 'not healthy':
An NHS trust has set up an advertising agency to sell billboard space around its hospitals and on its website. The Independent
An NHS trust has set up an advertising agency to sell billboard space around its hospitals and on its website. The Independent
Alcohol dependency drugs: 60 per cent rise in prescription items in eight years
Alcohol dependency drugs: 60 per cent rise in prescription items in eight years: - Report also shows rise in hospital admissions attributable to alcohol The number of prescription items dispensed annually to treat alcohol dependenc... NHS Information Centre
Are we 'overdiagnosing' harmless problems?
Are we 'overdiagnosing' harmless problems?:
Many patients are being “overdiagnosed” and given unnecessary medical treatment for problems that will never harm them, says new research. The study has featured prominently in the press, with the Daily Mail reporting “a plague of overdiagnosis”, and The Independent saying that “an over-reliance on healthcare threatens to bankrupt the world”.
The article, published in the British Medical Journal, argues that overdiagnosis poses a significant threat to human health by labelling healthy people as sick and wasting resources on unnecessary care. Overdiagnosis is when somebody is diagnosed and treated for a condition that is unlikely to cause them harm.
The authors of the report say there is growing evidence that “too many people are being overdosed, overtreated and overdiagnosed”. For example, they say, research has found that almost a third of people diagnosed with asthma may not have the condition, while up to one in three breast cancers detected by screening may actually be harmless.
As a result of overdiagnosis people potentially face the harms of unnecessary tests and side effects from treatment, and resources that could be directed at other patients are wasted.
The authors of this new article say that many different factors are driving overdiagnosis, but a key contributor is technological advance. Tests and diagnosis methods are now so numerous and sensitive that even the tiniest of harmless abnormalities can be detected, they argue.
The authors say new protocols are being developed to bring a more cautious approach to the treatment of incidental abnormalities. They say consideration should be given to raising the thresholds of what is defined as abnormal – in breast cancer screening, for example. At a policy level, reforming the process of defining disease is urgently required, they argue, to rule out financial or professional conflicts of interest.
The authors point out that concern about overdiagnosis does not preclude awareness that many people with genuine illness miss out on healthcare. They argue that resources wasted on unnecessary care can be much better spent treating and preventing genuine illness. “The challenge is to work out which is which.”
Nevertheless, the paper is a useful contribution to the complex debate about how far healthy people should be screened or tested, and how far conditions that may or may not cause harm in the future should be treated. It’s a difficult subject that provokes strongly opposing views among doctors and researchers. For example, a recent paper published in The Lancet argued that everyone over 50 should be given statins because they have been found to reduce the risks of heart attacks even in healthy people.
The article raises a number of concerns about cancer screening in particular, and it should be noted that in the UK the Department of Health announced last October that a full review of the potential risks and benefits of the NHS Breast Cancer Screening Programme is to take place. In terms of cancer screening, much will depend in the future on how far researchers are able to discriminate between ‘harmless’ slow growing cancers that do not need to be treated and those that are more aggressive.
The article should be seen in the context of previous advances in technology and treatments that have brought established benefits in terms of detecting certain conditions early. For example, high blood pressure is symptomless, but it is a recognised risk factor for cardiovascular disease, and there is good research to show that treatment to reduce high blood pressure saves lives.
Overall, the concept of overdiagnosis is one that needs careful consideration, particularly how its potential harms relate to the potential harms of failing to diagnose a disease. Is it better to risk side effects in patients than to risk missing a serious health problem? The issue is perhaps too big to cover in a single article, although this latest opinion paper raises some extremely interesting and thought-provoking points on the issue. Perhaps the key thing now is to look at overdiagnosis on a condition-by-condition basis, for example in the way that alleged overdiagnosis in breast cancer screening is being examined in the UK.
Although there are clearly strong feelings on both sides of the overdiagnosis debate, examinations of the issue should be as comprehensive, objective and evidence-based as possible and focus on specific topics. Overdiagnosis of one condition could be problematic, while it might produce few negative results for other conditions. Next year will see an international conference on the issue of overdiagnosis, which should stimulate both debate and research on this important issue.
Healthy hit by a plague of over diagnosis of conditions that will never cause serious symptoms. Daily Mail, May 30 2012
Is doctors' fixation on treatment making us ill?. The Independent, May 30 2012
Doctors 'overdiagnosing patients with slow or non-progressive diseases'. Metro, May 30 2012
NHS Choices
The article, published in the British Medical Journal, argues that overdiagnosis poses a significant threat to human health by labelling healthy people as sick and wasting resources on unnecessary care. Overdiagnosis is when somebody is diagnosed and treated for a condition that is unlikely to cause them harm.
The authors of the report say there is growing evidence that “too many people are being overdosed, overtreated and overdiagnosed”. For example, they say, research has found that almost a third of people diagnosed with asthma may not have the condition, while up to one in three breast cancers detected by screening may actually be harmless.
What is overdiagnosis?
The authors state that overdiagnosis is when a person without symptoms is diagnosed with a disease that will not cause them to experience symptoms or early death. More broadly defined, overdiagnosis refers to the related problems of increased dependence on medical care and overtreatment, which leads to healthy people with mild problems or at low risk being “reclassified as sick”.As a result of overdiagnosis people potentially face the harms of unnecessary tests and side effects from treatment, and resources that could be directed at other patients are wasted.
The authors of this new article say that many different factors are driving overdiagnosis, but a key contributor is technological advance. Tests and diagnosis methods are now so numerous and sensitive that even the tiniest of harmless abnormalities can be detected, they argue.
How does overdiagnosis happen?
The authors say that people can be overdiagnosed and overtreated in a number of ways:- Screening programmes can detect disease that may be in a form that will never cause symptoms or early death (sometimes called pseudodisease). Contrary to popular notions that cancers are universally harmful and ultimately fatal, the authors point out that some cancers can regress, fail to progress or grow so slowly that the individual concerned dies from other causes. They say there is now strong evidence from randomised trials that a proportion of cancers detected through screening may fall into this category.
- Tests for specific disease and disorders have become increasingly sensitive, enabling less severe forms of disease to be detected. A substantial proportion of the abnormalities that are detected will never progress, they say.
- Diagnostic scanning of the abdomen, pelvis, chest, head and neck can reveal ‘incidental’ findings in up to 40% of people being tested for other reasons. Most of these incidental abnormalities are benign but cause anxiety and lead to further investigations, they say.
- Overdiagnosis also occurs because of the changing diagnostic criteria for many diseases, so that people at lower risk and with milder problems are being defined as sick. For example, say the researchers, most elderly people are now classified as having at least one chronic condition, while many women treated for osteoporosis (weak bones) may be at very low risk of a fracture. The authors argue that diagnostic criteria are often set by panels of health professionals “with financial ties to companies that benefit directly from any expansion of the patient pool”.
What are examples of overdiagnosis?
The authors say there is evidence that the problem of overdiagnosis may exist across many conditions (including those for which underdiagnosis may also be a problem) and cite research on overdiagnosis in several different areas. The authors provide their opinions on various examples of what they see as overdiagnosis:- Breast cancer – a systematic review suggests that up to a third of breast cancers detected by screening may be overdiagnosed, which means they would not actually cause harm or early death if left untreated.
- Thyroid cancer – the likelihood of tests detecting a thyroid abnormality is high but the risk that it will ever cause harm is low. Many of the newly diagnosed thyroid cancers are the smaller and less aggressive forms that don’t require treatment, which itself carries risks.
- Gestational diabetes (diabetes that develops during pregnancy) – an expanded definition of this condition now means that nearly one in five pregnant women are classified as having it, while the evidence of benefit for being diagnosed is weak.
- Chronic kidney disease – an expanded definition of this condition means that one in ten people in the US are now classified as having the disease. One study estimates that up to a third of people over 65 meet the new criteria, yet each year fewer than 1 in 1,000 of this group will develop end-stage kidney disease.
- Asthma – the authors concede that while asthma can be underdiagnosed and undertreated, one large study suggests that almost a third of those diagnosed may not have the condition and that two-thirds of this group do not require medication.
- Pulmonary embolism (a blockage in the artery leading to the lungs, caused by a blood clot) – while pulmonary embolism is potentially fatal, the authors say that newer and more sensitive diagnostic tests are leading to the detection of smaller clots that may not require treatment.
- Attention deficit hyperactivity disorder (ADHD) – a widened definition of this condition has led to concerns about overdiagnosis, with one study showing that boys born at the end of the school year have a 30% higher chance of diagnosis and 40% higher chance of requiring medication than those born in the following month.
- Osteoporosis – expanded definitions of this condition mean many women at low risk of fracture may be given treatment that can result in adverse effects.
- Prostate cancer – research shows that the risk of a cancer detected by prostate specific antigen (PSA, a marker for prostate cancer found in the blood) being overdiagnosed may be more than 60%.
- Lung cancer – the authors cite research suggesting that around 25% of cases of lung cancer detected by screening may be overdiagnosed.
- High blood pressure – the authors cite research suggesting there is a possibility of “substantial overdiagnosis” of high blood pressure.
- High cholesterol – the authors cite research that estimates that up to 80% of people being treated have near-normal cholesterol levels.
What are the causes of overdiagnosis?
The authors say that overdiagnosis is being driven by several factors, including:- technological advances that can detect ever-smaller harmless abnormalities
• commercial and professional vested interests involved in the expansion of disease definitions and the writing of new guidelines for diagnosis and treatment - legal incentives that ‘punish’ underdiagnosis but not overdiagnosis
- health system incentives favouring more tests and treatments
- the cultural belief in early detection of disease and medical intervention
What solutions do the researchers recommend?
The authors argue that action is needed to tackle the problem of overdiagnosis. They say that medical professionals should aim to differentiate between benign abnormalities and those that will go on to cause harm, while the public and professionals should be given “more honest” information about the risks of overdiagnosis, particularly related to screening.The authors say new protocols are being developed to bring a more cautious approach to the treatment of incidental abnormalities. They say consideration should be given to raising the thresholds of what is defined as abnormal – in breast cancer screening, for example. At a policy level, reforming the process of defining disease is urgently required, they argue, to rule out financial or professional conflicts of interest.
The authors point out that concern about overdiagnosis does not preclude awareness that many people with genuine illness miss out on healthcare. They argue that resources wasted on unnecessary care can be much better spent treating and preventing genuine illness. “The challenge is to work out which is which.”
Conclusion
This is a powerfully argued and controversial article that claims that many people are being overdiagnosed and overtreated for mild problems that may never cause them harm. It is timed to coincide with the announcement of an international conference on the topic, which will take place next year, partly hosted by the BMJ and Bond University, where some of the authors are based. It should be noted that the article is not a systematic review of the evidence on screening or on overdiagnosis, but a strong opinion piece that cites research in support of the authors’ argument.Nevertheless, the paper is a useful contribution to the complex debate about how far healthy people should be screened or tested, and how far conditions that may or may not cause harm in the future should be treated. It’s a difficult subject that provokes strongly opposing views among doctors and researchers. For example, a recent paper published in The Lancet argued that everyone over 50 should be given statins because they have been found to reduce the risks of heart attacks even in healthy people.
The article raises a number of concerns about cancer screening in particular, and it should be noted that in the UK the Department of Health announced last October that a full review of the potential risks and benefits of the NHS Breast Cancer Screening Programme is to take place. In terms of cancer screening, much will depend in the future on how far researchers are able to discriminate between ‘harmless’ slow growing cancers that do not need to be treated and those that are more aggressive.
The article should be seen in the context of previous advances in technology and treatments that have brought established benefits in terms of detecting certain conditions early. For example, high blood pressure is symptomless, but it is a recognised risk factor for cardiovascular disease, and there is good research to show that treatment to reduce high blood pressure saves lives.
Overall, the concept of overdiagnosis is one that needs careful consideration, particularly how its potential harms relate to the potential harms of failing to diagnose a disease. Is it better to risk side effects in patients than to risk missing a serious health problem? The issue is perhaps too big to cover in a single article, although this latest opinion paper raises some extremely interesting and thought-provoking points on the issue. Perhaps the key thing now is to look at overdiagnosis on a condition-by-condition basis, for example in the way that alleged overdiagnosis in breast cancer screening is being examined in the UK.
Although there are clearly strong feelings on both sides of the overdiagnosis debate, examinations of the issue should be as comprehensive, objective and evidence-based as possible and focus on specific topics. Overdiagnosis of one condition could be problematic, while it might produce few negative results for other conditions. Next year will see an international conference on the issue of overdiagnosis, which should stimulate both debate and research on this important issue.
Links To The Headlines
Healthy people being harmed by over-diagnosis. The Daily Telegraph, May 30 2012Healthy hit by a plague of over diagnosis of conditions that will never cause serious symptoms. Daily Mail, May 30 2012
Is doctors' fixation on treatment making us ill?. The Independent, May 30 2012
Doctors 'overdiagnosing patients with slow or non-progressive diseases'. Metro, May 30 2012
Links To Science
Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. BMJ 2012; 344NHS Choices
Thursday, 31 May 2012
New care centre marks end of a 30-year vision
New care centre marks end of a 30-year vision:
The Willowbrook Health Complex in Corby has offered a range of health services to the community since the 1950s.Evening Telgraph
The Willowbrook Health Complex in Corby has offered a range of health services to the community since the 1950s.Evening Telgraph
Are we wasting money on care that patients don't want? | Anna Dixon
Are we wasting money on care that patients don't want? | Anna Dixon: Could there be a much simpler solution towards making savings? What would happen if patients were fully informed about their care and treatment options? What if patients were asked what care they wanted? (Blog, 29 May 2012) Kings Fund
A&E waiting times hit eight-year high as NHS struggles to meet productivity challenge
A&E waiting times hit eight-year high as NHS struggles to meet productivity challengeThe proportion of patients spending more than four hours in A&E has increased by more than a quarter over the last year, reaching its highest level since 2004 Kings Fund
Patient safety: learning from Europe
Patient safety: learning from Europe: As a nation that often looks to the US for insights into healthcare improvement, we perhaps sometimes overlook how much there to learn from Europe, says Jo Bibby. Health Foundation
Paul Burstow announces £60m of funding for hospices
Paul Burstow announces £60m of funding for hospices:
Care services minister Paul Burstow has announced that hospices are to benefit from up to £60m of funding to help improve the quality of care for people nearing the end of their lives. NHS Networks
Care services minister Paul Burstow has announced that hospices are to benefit from up to £60m of funding to help improve the quality of care for people nearing the end of their lives. NHS Networks
Children aged five 'depressed'
Children aged five 'depressed': Children as young as five are being referred for treatment for depression and anxiety, a BBC investigation finds.
VIDEO: Doctors take action over pensions
VIDEO: Doctors take action over pensions: Doctors will stop providing non-urgent care for a day next month in the first industrial action by the profession for nearly 40 years. BBC News
'Training gap' in healthcare sector puts patients at risk, finds survey of managers
'Training gap' in healthcare sector puts patients at risk, finds survey of managers: , the research demonstrates that the Department of Health and NHS still have an uphill struggle on their hands to achieve this. A quarter (24%) of managers surveyed by the IHM feel they ... HR Magazine
All school children should be given flu vaccine
All school children should be given flu vaccine:
The Joint Committee on Vaccination and Immunisation has said it believes that all children should be given annual flu vaccinations at school.
At present, the jab is offered to people aged over 65, pregnant women and anyone with an underlying health condition but the panel, which advises the Government, says the vaccine should be given to pupils aged five to 17 on the NHS. They said it would help prevent the sprea... Healthcare Today
The Joint Committee on Vaccination and Immunisation has said it believes that all children should be given annual flu vaccinations at school.
At present, the jab is offered to people aged over 65, pregnant women and anyone with an underlying health condition but the panel, which advises the Government, says the vaccine should be given to pupils aged five to 17 on the NHS. They said it would help prevent the sprea... Healthcare Today
Discharged to the streets: homelessness and the NHS
Discharged to the streets: homelessness and the NHS:
As a new study reveals seven in 10 homeless people are discharged from hospital to the street, Homeless Link calls for the NHS to act
Seven out of 10 homeless people who end up in hospital are discharged back onto the streets, according to our latest research published this week. Homeless clients are often discharged without their underlying health problems being addressed, damaging their health and costing the NHS money. All this could be avoided.
It's well known that being homeless can harm your health, especially if you end up sleeping rough. Life on the streets can make you vulnerable to disease, mental health and physical issues. Many people arrive on the streets with existing health issues; the longer they spend out, the more these problems can multiply.
Every day, the NHS feels the impact of this. According to research we undertook in 2010, in a six month period 40% of homeless people used accident and emergency at least once, and nearly a third were admitted to hospital.
Yet despite the heavy, and at times inappropriate, use of acute services by homeless people, not enough NHS services use this opportunity to get their needs properly assessed and work with others to plan for life after hospital.
In 2003, the Department of Health and issued guidance recommending that all acute hospitals should have policies that help identify homeless people on admission and ensure that homeless services are contacted. A Homeless Link survey carried out in 2010 indicated that only 39% of areas had these policies in place.
While things have improved, this week's report finds that in too many areas it is an issue that is still being ignored.
Yet where NHS services do take this issue seriously it can result in significant benefits. The approach taken by UCL Hospitals Pathway Homeless Team is just one example.
Set up in response to a concern that homeless patients were being discharged with little support, UCLH now checks the housing status of patients on admission. Homeless patients are assessed and a care plan drawn up with other agencies. Patients also get support from mentors, whose own experience of homelessness makes them well placed to support and challenge homeless patients while in hospital.
By personalising its services to homeless people's needs and working with other services in the community, UCLH has reduced total bed days relating to homeless admissions by a third – saving £100,000. Because of its success, this model is now spreading to other hospitals.
So what needs to change? Our report sets out some good advice and best practice for hospital staff. Not everywhere needs a UCLH approach (some areas won't see enough homeless people to warrant it) but every hospital can take action.
Frontline NHS staff can help identify people who are homeless or at risk of losing their home by asking the right questions. Hospital managers can build up strong links with partners such as homelessness charities and local authority housing teams, so they can become involved immediately if someone is identified as homeless.
More fundamentally, councils, the NHS and the voluntary sector must work together. The NHS can play a first role in helping to identify homeless people and not discharging them straight onto the street, but ultimately only finding appropriate housing for homeless people will reduce unplanned readmissions to accident and emergency, improve the health of homeless people and save the NHS money.
Alice Evans is head of policy for Homeless Link Guardian Professional.
Seven out of 10 homeless people who end up in hospital are discharged back onto the streets, according to our latest research published this week. Homeless clients are often discharged without their underlying health problems being addressed, damaging their health and costing the NHS money. All this could be avoided.
It's well known that being homeless can harm your health, especially if you end up sleeping rough. Life on the streets can make you vulnerable to disease, mental health and physical issues. Many people arrive on the streets with existing health issues; the longer they spend out, the more these problems can multiply.
Every day, the NHS feels the impact of this. According to research we undertook in 2010, in a six month period 40% of homeless people used accident and emergency at least once, and nearly a third were admitted to hospital.
Yet despite the heavy, and at times inappropriate, use of acute services by homeless people, not enough NHS services use this opportunity to get their needs properly assessed and work with others to plan for life after hospital.
In 2003, the Department of Health and issued guidance recommending that all acute hospitals should have policies that help identify homeless people on admission and ensure that homeless services are contacted. A Homeless Link survey carried out in 2010 indicated that only 39% of areas had these policies in place.
While things have improved, this week's report finds that in too many areas it is an issue that is still being ignored.
Yet where NHS services do take this issue seriously it can result in significant benefits. The approach taken by UCL Hospitals Pathway Homeless Team is just one example.
Set up in response to a concern that homeless patients were being discharged with little support, UCLH now checks the housing status of patients on admission. Homeless patients are assessed and a care plan drawn up with other agencies. Patients also get support from mentors, whose own experience of homelessness makes them well placed to support and challenge homeless patients while in hospital.
By personalising its services to homeless people's needs and working with other services in the community, UCLH has reduced total bed days relating to homeless admissions by a third – saving £100,000. Because of its success, this model is now spreading to other hospitals.
So what needs to change? Our report sets out some good advice and best practice for hospital staff. Not everywhere needs a UCLH approach (some areas won't see enough homeless people to warrant it) but every hospital can take action.
Frontline NHS staff can help identify people who are homeless or at risk of losing their home by asking the right questions. Hospital managers can build up strong links with partners such as homelessness charities and local authority housing teams, so they can become involved immediately if someone is identified as homeless.
More fundamentally, councils, the NHS and the voluntary sector must work together. The NHS can play a first role in helping to identify homeless people and not discharging them straight onto the street, but ultimately only finding appropriate housing for homeless people will reduce unplanned readmissions to accident and emergency, improve the health of homeless people and save the NHS money.
Alice Evans is head of policy for Homeless Link Guardian Professional.
200 fattest Britons 'cost NHS £16 million a year'
200 fattest Britons 'cost NHS £16 million a year': At least 200 Britons are so overweight they cannot leave their own homes - and cost the NHS £16 million a year, it was reported today.
The Daily Telegraph
The Daily Telegraph
Accident and Emergency waiting times at eight year high
Accident and Emergency waiting times at eight year high: Number of patients facing waiting times of more than four hours in England's A&E units has reached eight-year peak, study finds.
The Daily Telegraph
The Daily Telegraph
Diagnoses of increasingly antibiotic resistant gonorrhoea infections rise by 'unprecedented' 25 per cent
Diagnoses of increasingly antibiotic resistant gonorrhoea infections rise by 'unprecedented' 25 per cent:
The number of diagnoses of the sexual transmitted infection gonorrhoea has increased by an “unprecedented” 25 per cent in the past year, the Health Protection Agency has revealed. The Independent
The number of diagnoses of the sexual transmitted infection gonorrhoea has increased by an “unprecedented” 25 per cent in the past year, the Health Protection Agency has revealed. The Independent
Wednesday, 30 May 2012
DH issues procurement guidance
DH issues procurement guidance:
NHS Procurement: Raising Our Game sets out proposed actions for NHS trusts and the department and focuses on six areas of improvement..
This guidance is launched in advance of a procurement strategy planned for later in 2012 that will be developed following a wider call for evidence. It aims to start the journey to world-class procurement by identifying those issues and actions that require immediate attention in order to lay the foundations for a fuller and further-reaching strategy later in the year.
NHS Procurement: Raising Our Game sets out proposed actions for NHS trusts and the department and focuses on six areas of improvement..
This guidance is launched in advance of a procurement strategy planned for later in 2012 that will be developed following a wider call for evidence. It aims to start the journey to world-class procurement by identifying those issues and actions that require immediate attention in order to lay the foundations for a fuller and further-reaching strategy later in the year.
Failing the frail: a chaotic approach to commissioning healthcare services for care homes
Failing the frail: a chaotic approach to commissioning healthcare services for care homes:
Overall the report outlines concerns about the standard of and access to healthcare of older people in England who live in care homes, who typically have greater and more complex health needs than their peers who live in the community. The report suggests that improvements in access to healthcare will benefit this population and reduce unplanned and costly demands on the NHS. NHS Networks
Overall the report outlines concerns about the standard of and access to healthcare of older people in England who live in care homes, who typically have greater and more complex health needs than their peers who live in the community. The report suggests that improvements in access to healthcare will benefit this population and reduce unplanned and costly demands on the NHS. NHS Networks
Third edition of Long Term Conditions Compendium published
Third edition of Long Term Conditions Compendium published:
The Department of Health has published the third edition of the Long Term Conditions Compendium of Information. It is aimed at commissioners as well as health and social care professionals, to provide the evidence for improving care and outcomes for people with long term conditions (LTCs). It updates the second edition of the compendium published in January 2008.
This document contains the latest statistical data on long term conditions, links to the LTC QIPP (quality, innovation, productivity and prevention) workstream and provides data from the ongoing evaluation of the Whole System Demonstrator Programme on telehealth and telecare, which supports the delivery of 3 Million Lives. It also showcases examples of innovative projects across the country where organisations and communities are pushing the boundaries to deliver improvements in LTC care.
The information and evidence captured in this third edition of the compendium continues to reinforce why a focus on LTCs should be a priority.
Download the Long Term Conditions Compendium of Information – third edition (PDF,2251K)
Find out about the long term conditions strategy. Department of Health
The Department of Health has published the third edition of the Long Term Conditions Compendium of Information. It is aimed at commissioners as well as health and social care professionals, to provide the evidence for improving care and outcomes for people with long term conditions (LTCs). It updates the second edition of the compendium published in January 2008.
This document contains the latest statistical data on long term conditions, links to the LTC QIPP (quality, innovation, productivity and prevention) workstream and provides data from the ongoing evaluation of the Whole System Demonstrator Programme on telehealth and telecare, which supports the delivery of 3 Million Lives. It also showcases examples of innovative projects across the country where organisations and communities are pushing the boundaries to deliver improvements in LTC care.
The information and evidence captured in this third edition of the compendium continues to reinforce why a focus on LTCs should be a priority.
Download the Long Term Conditions Compendium of Information – third edition (PDF,2251K)
Find out about the long term conditions strategy. Department of Health
Video: DH warns on implications of competition rules for CCGs
Video: DH warns on implications of competition rules for CCGs: Plans for AQP procurement regulations leave CCGs open to legal challenge from private firms.
£60m to improve care quality in hospices
£60m to improve care quality in hospices: Hospices will get £60m to help improve the quality of care for people nearing the end of their lives Public Service
Guidance on the rules on use of cookies and similar technologies
Guidance on the rules on use of cookies and similar technologies: The Information Commissioner's Office has published updated guidance on the need to obtain consent to the use of cookies on websites, including when it might be possible to imply consent. Information Commissioner's Office
BMA industrial action update
BMA industrial action update: The BMA industrial action ballot closes this week and this page sets out our understanding of what is planned and how we can support employers if industrial action goes ahead. NHS Employers
Dentistry: an OFT market study
Dentistry: an OFT market study:
The purpose of this study was to examine whether the UK dentistry market is working well for patients. It examined how dentistry services are sold and the extent to which patients have access to accurate and impartial information to help make informed decisions. It considered patients' ability to assess and act on the information that is provided, as well as the nature of competition between providers of dental services. These issues were considered within the context of both NHS and private dentistry.
The purpose of this study was to examine whether the UK dentistry market is working well for patients. It examined how dentistry services are sold and the extent to which patients have access to accurate and impartial information to help make informed decisions. It considered patients' ability to assess and act on the information that is provided, as well as the nature of competition between providers of dental services. These issues were considered within the context of both NHS and private dentistry.
Patients’ preferences matter: stop the silent misdiagnosis
Patients’ preferences matter: stop the silent misdiagnosis:
This paper challenges the NHS to stop the 'silent misdiagnosis' of patients’ preferences for their care and argues that by doing so it will improve health system performance as a whole.
This paper challenges the NHS to stop the 'silent misdiagnosis' of patients’ preferences for their care and argues that by doing so it will improve health system performance as a whole.
Welfare reforms see mental health teams taking on more advocacy roles - The Guardian
Welfare reforms see mental health teams taking on more advocacy roles - The Guardian:
 The Guardian | Welfare reforms see mental health teams taking on more advocacy roles The Guardian Professionals working in community mental health teams have ever increasing work pressures. The current changes to the NHS and local authorities mean mental health patients are "clustered" according to their symptoms as the means of obtaining funding ... |
A new style of leadership for the NHS
A new style of leadership for the NHS:
Chris Ham summarises issues discussed at the Leadership and Management Summit and explores the challenges NHS faces
A new style of leadership is needed in the NHS in which leaders engage staff, patients and partner organisations to improve patient care and health outcomes. That is the message of the King's Fund's latest report Together we can, and it was a message strongly endorsed by the chair and chief executive of the NHS commissioning board at our leadership summit on 23 May.
The question, however, is whether they mean it, and even more important, can they deliver it.
There are three reasons for the scepticism. The first is the emphasis on a 'pace-setting' style that has, in some cases, improved patient care through the use of targets and performance management. Why should NHS give it up if it has proved so effective?
The second reason is the ability of old dogs to learn new tricks. The chief executive of the NHS, David Nicholson, was refreshingly honest at the leadership summit in 'fessing up that his own style is an extreme example of pace-setting. Like many chief executives he does not find it easy to adopt a more engaging approach because, quite simply, old habits die hard.
The third reason is the challenge of maintaining high standards of performance while implementing the biggest organisational changes in its history. The risks involved are huge and it would be understandable for leaders to want to keep a tight grip on finance and the quality of patient care during the transition.
The chair of the NHS commissioning board, Malcolm Grant, was clear that now is the time to break with old habits. He emphasised that the board is sincere in its desire to let go and to allow space and opportunity for managers and clinicians to innovate and excel. This won't happen overnight but the aim must be to move towards improvements in patient care being led bottom up within a clear national framework.
Both Grant and Nicholson underlined the need for the NHS to work with local authorities and other partners to develop more integrated care to meet the needs of an ageing population in which chronic diseases are increasingly prevalent. Our report argues that for this to happen leaders must be able to work across boundaries and services.
The view of the King's Fund is that public sector leaders have a choice. They can either adopt a fortress mentality in which they focus on the interests of their own organisations and survival in a hostile financial climate. Or they can work with their partners to use resources as effectively as possible, even if this means relinquishing a degree of sovereignty.
The first option is understandable, but the second is essential in the straitened circumstances that will cast a long shadow over public services for the foreseeable future.
Chris Ham is chief executive of the Kings Fund. For more coverage of the Leadership and Management Summit, please see our Today in Healthcare blog and interview with Jan Sobieraj here. Guardian Professional.
A new style of leadership is needed in the NHS in which leaders engage staff, patients and partner organisations to improve patient care and health outcomes. That is the message of the King's Fund's latest report Together we can, and it was a message strongly endorsed by the chair and chief executive of the NHS commissioning board at our leadership summit on 23 May.
The question, however, is whether they mean it, and even more important, can they deliver it.
There are three reasons for the scepticism. The first is the emphasis on a 'pace-setting' style that has, in some cases, improved patient care through the use of targets and performance management. Why should NHS give it up if it has proved so effective?
The second reason is the ability of old dogs to learn new tricks. The chief executive of the NHS, David Nicholson, was refreshingly honest at the leadership summit in 'fessing up that his own style is an extreme example of pace-setting. Like many chief executives he does not find it easy to adopt a more engaging approach because, quite simply, old habits die hard.
The third reason is the challenge of maintaining high standards of performance while implementing the biggest organisational changes in its history. The risks involved are huge and it would be understandable for leaders to want to keep a tight grip on finance and the quality of patient care during the transition.
The chair of the NHS commissioning board, Malcolm Grant, was clear that now is the time to break with old habits. He emphasised that the board is sincere in its desire to let go and to allow space and opportunity for managers and clinicians to innovate and excel. This won't happen overnight but the aim must be to move towards improvements in patient care being led bottom up within a clear national framework.
Both Grant and Nicholson underlined the need for the NHS to work with local authorities and other partners to develop more integrated care to meet the needs of an ageing population in which chronic diseases are increasingly prevalent. Our report argues that for this to happen leaders must be able to work across boundaries and services.
The view of the King's Fund is that public sector leaders have a choice. They can either adopt a fortress mentality in which they focus on the interests of their own organisations and survival in a hostile financial climate. Or they can work with their partners to use resources as effectively as possible, even if this means relinquishing a degree of sovereignty.
The first option is understandable, but the second is essential in the straitened circumstances that will cast a long shadow over public services for the foreseeable future.
Chris Ham is chief executive of the Kings Fund. For more coverage of the Leadership and Management Summit, please see our Today in Healthcare blog and interview with Jan Sobieraj here. Guardian Professional.
Healthy people being harmed by over-diagnosis
Healthy people being harmed by over-diagnosis: Healthy people are being harmed by routine over-diagnosis of breast cancer and osteoporosis, experts have warned.
The Daily Telegraph
The Daily Telegraph
Is doctors' fixation on treatment making us ill?
Is doctors' fixation on treatment making us ill?:
An NHS chief executive, who runs three hospitals with 1,500 beds, has explained why the health service is facing bankruptcy unless something is done to curb the rising tide of patient expectations. The Independent
An NHS chief executive, who runs three hospitals with 1,500 beds, has explained why the health service is facing bankruptcy unless something is done to curb the rising tide of patient expectations. The Independent
Tuesday, 29 May 2012
Guidance aims to improve procurement across healthcare system
Guidance aims to improve procurement across healthcare system:
Guidance aimed at improving procurement across the healthcare system has been published by the Department of Health.
‘NHS procurement: raising our game’ sets out proposed actions for NHS trusts and the Department and focuses on taking immediate action to start tackling six key areas for improvements:
This guidance is launched in advance of a procurement strategy planned for later in 2012 that will be developed following a wider call for evidence. It aims to start the journey to world class procurement by identifying those issues and actions that require immediate attention in order to lay the foundations for a fuller and further-reaching strategy later in the year.
In support, we are also publishing NHS Standards of Procurement, which will support trusts in understanding what good procurement looks like and in planning their improvements at a local level.
The standards can be used to identify what a trust’s areas of strengths and weakness are in their procurement and suggest ways in which they can start to monitor and measure improvements.
Read NHS Standards of Procurement
Guidance aimed at improving procurement across the healthcare system has been published by the Department of Health.
‘NHS procurement: raising our game’ sets out proposed actions for NHS trusts and the Department and focuses on taking immediate action to start tackling six key areas for improvements:
- levers for change
- transparency and data management
- NHS standards of procurement
- leadership, clinical engagement and reducing variation
- collaboration and use of procurement partners
- suppliers, innovation and growth
This guidance is launched in advance of a procurement strategy planned for later in 2012 that will be developed following a wider call for evidence. It aims to start the journey to world class procurement by identifying those issues and actions that require immediate attention in order to lay the foundations for a fuller and further-reaching strategy later in the year.
In support, we are also publishing NHS Standards of Procurement, which will support trusts in understanding what good procurement looks like and in planning their improvements at a local level.
The standards can be used to identify what a trust’s areas of strengths and weakness are in their procurement and suggest ways in which they can start to monitor and measure improvements.
Read NHS Standards of Procurement
Homeless Link and St Mungo’s publish report on hospitals and the homeless
Homeless Link and St Mungo’s publish report on hospitals and the homeless:
Homeless Link and St Mungo’s have published a report, commissioned by the Department of Health, on how homeless people are treated by hospitals.
The report was produced to inform the National Inclusion Health Board and delivers the Ministerial Working Group on Homelessness commitment to identify what more must be done to prevent people at risk of rough sleeping being discharged from hospital without accommodation.
The report indicates that more than 70% of homeless people are being discharged from hospital back onto the streets, damaging their health. But it also cites examples of best practice. It found that NHS staff can improve health outcomes for homeless people and save the NHS money by ensuring all patients have somewhere appropriate to stay when they are discharged from hospital.
Minister of State for Care Services Paul Burstow acknowledged these findings during a visit to the Pathway homeless team at University College Hospital (UCH) in London today. The dedicated homelessness team at UCH were named as an example of best practice in the report. Paul Burstow said:
‘We commissioned this report to expose poor practice and share best practice. What it reveals is too many hospitals simply discharging homeless people back to the streets. Patching a person up and sending them out without a plan makes no sense.
‘The good news is the report shows that there are hospitals doing brilliant work to join up care and support and reduce the cycle of revolving door admissions. I am challenging the rest of the NHS to learn from the best and make it the norm.’ Department of Health
Find out more about the report on the Homeless Link website.
Homeless Link and St Mungo’s have published a report, commissioned by the Department of Health, on how homeless people are treated by hospitals.
The report was produced to inform the National Inclusion Health Board and delivers the Ministerial Working Group on Homelessness commitment to identify what more must be done to prevent people at risk of rough sleeping being discharged from hospital without accommodation.
The report indicates that more than 70% of homeless people are being discharged from hospital back onto the streets, damaging their health. But it also cites examples of best practice. It found that NHS staff can improve health outcomes for homeless people and save the NHS money by ensuring all patients have somewhere appropriate to stay when they are discharged from hospital.
Minister of State for Care Services Paul Burstow acknowledged these findings during a visit to the Pathway homeless team at University College Hospital (UCH) in London today. The dedicated homelessness team at UCH were named as an example of best practice in the report. Paul Burstow said:
‘We commissioned this report to expose poor practice and share best practice. What it reveals is too many hospitals simply discharging homeless people back to the streets. Patching a person up and sending them out without a plan makes no sense.
‘The good news is the report shows that there are hospitals doing brilliant work to join up care and support and reduce the cycle of revolving door admissions. I am challenging the rest of the NHS to learn from the best and make it the norm.’ Department of Health
Find out more about the report on the Homeless Link website.
Improving hospital admission and discharge: for people who are homeless
Improving hospital admission and discharge: for people who are homeless:
This report indicates that more than 70% of homeless people are being discharged from hospital back onto the streets, damaging their health and costing the NHS money. It found that NHS staff can improve health outcomes for homeless people and save the NHS money by ensuring all patients have somewhere appropriate to stay when they are discharged from hospital.
This report indicates that more than 70% of homeless people are being discharged from hospital back onto the streets, damaging their health and costing the NHS money. It found that NHS staff can improve health outcomes for homeless people and save the NHS money by ensuring all patients have somewhere appropriate to stay when they are discharged from hospital.
Minimum standards for healthcare support workers and adult social care workers in England
Minimum standards for healthcare support workers and adult social care workers in England:
Skills for Health and Skills for Care have been commissioned by the Department of Health to jointly convene a project to develop a code of conduct and standards which set out high-level proficiencies for the role and expectations around: healthcare support workers (reporting to registered nurses and midwives); and adult social care workers (working in support of health and social care professionals, independently, for Care Quality Commission registered residential care providers, or as domiciliary care workers in England). The on-line consultation is live between 25th May and 29th June 2012.
Skills for Health and Skills for Care have been commissioned by the Department of Health to jointly convene a project to develop a code of conduct and standards which set out high-level proficiencies for the role and expectations around: healthcare support workers (reporting to registered nurses and midwives); and adult social care workers (working in support of health and social care professionals, independently, for Care Quality Commission registered residential care providers, or as domiciliary care workers in England). The on-line consultation is live between 25th May and 29th June 2012.
Helping hospitals deliver better care: a new toolkit for quality improvement
Helping hospitals deliver better care: a new toolkit for quality improvement:
A team from RAND and the University HealthSystem Consortium developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.
A team from RAND and the University HealthSystem Consortium developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.
Creating a culture of innovation: final report of the Creating a Culture of Innovation project
Creating a culture of innovation: final report of the Creating a Culture of Innovation project:
This report provides an overview and analysis of activities and insights that have been gathered over the course of the Creating a Culture of Innovation project and a review of literature on encouraging creativity within organisations. The project initially focused on two aims: to introduce individuals to using creativity tools in a project setting, and for individuals to design a process for ideas within their own organisations. It supports individuals to think creatively, strategically and with insight to develop successful and innovative services and support that deliver tangible benefits for people who use services.
This report provides an overview and analysis of activities and insights that have been gathered over the course of the Creating a Culture of Innovation project and a review of literature on encouraging creativity within organisations. The project initially focused on two aims: to introduce individuals to using creativity tools in a project setting, and for individuals to design a process for ideas within their own organisations. It supports individuals to think creatively, strategically and with insight to develop successful and innovative services and support that deliver tangible benefits for people who use services.
Tool to help GPs quickly assess child growth
Tool to help GPs quickly assess child growth:
The Royal College of Paediatrics and Child Health has produced a range of tools to help GPs and colleagues to quickly and simply assess the growth of school-age children.
The aims of the growth charts, training notes and resources is also to help avoid intimate examinations of children to determine premature or delayed puberty. The tools simplify use of BMI for healthcare professionals to be able to assess whethe... Healthcare Today
The Royal College of Paediatrics and Child Health has produced a range of tools to help GPs and colleagues to quickly and simply assess the growth of school-age children.
The aims of the growth charts, training notes and resources is also to help avoid intimate examinations of children to determine premature or delayed puberty. The tools simplify use of BMI for healthcare professionals to be able to assess whethe... Healthcare Today
Male psychiatric patients 'more likely to die' following cancer diagnosis - Netdoctor
Male psychiatric patients 'more likely to die' following cancer diagnosis - Netdoctor:
Male psychiatric patients 'more likely to die' following cancer diagnosis Netdoctor Men who have psychiatric problems are more likely to die after receiving a diagnosis of cancer than men without mental health problems, a study has found. Researchers at University College London, alongside colleagues at the University of Southampton ... Early cancer diagnosis is vital for male psychiatric patientsPrivate Healthcare UK all 2 news articles » |
Social care funding gap in England 'can be plugged' - BBC News
Social care funding gap in England 'can be plugged' - BBC News:
 BBC News | Social care funding gap in England 'can be plugged' BBC News By Nick Triggle Health correspondent, BBC News The funding gap for reforming social care in England could be plugged by raiding the NHS surplus or restricting access to benefits such as the winter fuel allowance, experts say. |
Dentists forcing 500,000 NHS patients to pay privately: report
Dentists forcing 500,000 NHS patients to pay privately: report: Dentists are forcing 500,000 patients a year to pay for expensive private treatments by failing to tell them they are available on the NHS, according to an investigation by the Office of Fair Trading.
The Daily Telegraph
The Daily Telegraph
Monday, 28 May 2012
EMAS aims for foundation status
EMAS aims for foundation status: East Midlands Ambulance Service says gaining foundation trust status would improve its efficiency. BBC Northamptonshire
New service for patients
New service for patients:
PATIENTS in Wellingborough and surrounding area will soon benefit from a new service to treat minor injuries and other health problems. Evening Telegraph
PATIENTS in Wellingborough and surrounding area will soon benefit from a new service to treat minor injuries and other health problems. Evening Telegraph
Julia still denied breast reduction
Julia still denied breast reduction:
A WOMAN who has lost seven-and-a-half stone to have a breast reduction is still being denied the operation by medical chiefs. Evening Telegraph
A WOMAN who has lost seven-and-a-half stone to have a breast reduction is still being denied the operation by medical chiefs. Evening Telegraph
Ambulances hit 999 calls target
Ambulances hit 999 calls target:
THE county’s under-fire ambulance service has managed to hit its emergency response times target for two successive months after struggling for the past year. Evening Telegraph
THE county’s under-fire ambulance service has managed to hit its emergency response times target for two successive months after struggling for the past year. Evening Telegraph
Chance to shape the future of the NHS
Chance to shape the future of the NHS:
PEOPLE interested in the NHS are invited to have their say on the future of healthcare in Corby. Evening Telegraph
PEOPLE interested in the NHS are invited to have their say on the future of healthcare in Corby. Evening Telegraph
Safeguarding girls at risk of female genital mutilation
Safeguarding girls at risk of female genital mutilation:
Following recent media coverage, the Chief Medical Officer and the Director of Nursing have asked all health care professionals to familiarise themselves with the actions they need to take where they have reason to believe that a girl has undergone, or is at risk of, Female Genital Mutilation.
Read the letter on Safeguarding girls at risk of female genital mutilation Department of Health
Following recent media coverage, the Chief Medical Officer and the Director of Nursing have asked all health care professionals to familiarise themselves with the actions they need to take where they have reason to believe that a girl has undergone, or is at risk of, Female Genital Mutilation.
Read the letter on Safeguarding girls at risk of female genital mutilation Department of Health
NHS told to do more for homeless
NHS told to do more for homeless: NHS hospitals are being urged to do more to help homeless patients, in a report commissioned by the government. BBC News
NHS Prescription Services launch new information services portal to improve access to prescribing and dispensing data
NHS Prescription Services launch new information services portal to improve access to prescribing and dispensing data NHS Prescription Services are launching a new information services portal to improve access to prescribing and dispensing information. The initial release incorporates replacements for the existing QIPP and prescribing toolkit reports. Further phases will see all other prescribing reports incorporated into the new system.
Realising the benefits of community health services
Realising the benefits of community health services: This Briefing outlines why community health services are central to a more efficient and patient-centred NHS. It also sets out the steps that must be taken to realise the potentially huge dividends for both patient experience and NHS finances. NHS Confederation
End of life care modelling tools
End of life care modelling tools:
The National End of Life Care Programme has published a suite of tools in conjuction with partner organisations designed to support end of life care commissioning and planning. These tools were developed to support organisations to achieve the vision of the National End of Life Care Strategy and the NHS QIPP agenda of improving quality and productivity through innovation. Together the tools are designed to enable commissioners and providers of end of life care services to identify the end of life care needs of their population over a 10-year period, to assess what workforce skills are required to ensure quality care provision and to establish how many people dying in hospital could reasonably end life in an alternative care setting and to calculate costings for this.
The National End of Life Care Programme has published a suite of tools in conjuction with partner organisations designed to support end of life care commissioning and planning. These tools were developed to support organisations to achieve the vision of the National End of Life Care Strategy and the NHS QIPP agenda of improving quality and productivity through innovation. Together the tools are designed to enable commissioners and providers of end of life care services to identify the end of life care needs of their population over a 10-year period, to assess what workforce skills are required to ensure quality care provision and to establish how many people dying in hospital could reasonably end life in an alternative care setting and to calculate costings for this.
Break state monopoly over mental health counselling, urges major new report
The NHS is failing to offer the mentally ill a full choice of psychological counselling and therapies, according to a major new report published by the Centre for Social Justice. The report, ‘Commissioning Effective Talking Therapies,’ is highly critical of the NHS’s talking therapy service, and urges the NHS to slash its red tape and use therapists from the private and voluntary sector to allow people more choi... Healthcare Today
New A&E target 'missed in six of last ten months'
New A&E target 'missed in six of last ten months': Hospitals have missed the new easier A&E waiting time target in six out of the last twelve months, figures have revealed.
The Daily Telegraph
The Daily Telegraph
Better buying 'to save NHS £1.2bn' claims minister
Better buying 'to save NHS £1.2bn' claims minister: Health ministers hope to save taxpayers £1.2 billion over the next four years by getting NHS managers to become better at buying millions of medical items from surgical gloves to MRI machines.
The Daily Telegraph
The Daily Telegraph
HRT shows why health scares can't be trusted
HRT shows why health scares can't be trusted: For much of the past 60 years HRT has been dogged by controversy. Now a recent scare has been re-evaluated, reports Max Pemberton.
The Daily Telegraph
The Daily TelegraphConsultants told to supervise new doctors to end NHS 'killing season'
Consultants told to supervise new doctors to end NHS 'killing season':
It is known as "Black Wednesday" – the start of the "killing season" in the NHS, when a fresh crop of medical graduates starts on the wards. The Independent
It is known as "Black Wednesday" – the start of the "killing season" in the NHS, when a fresh crop of medical graduates starts on the wards. The Independent
Friday, 25 May 2012
Homes win new awards for care
Homes win new awards for care:
SOME of the best performing county care homes have been honoured at NHS Northamptonshire’s first Care Homes for Excellence Awards. Kettering Evening Telegraph
SOME of the best performing county care homes have been honoured at NHS Northamptonshire’s first Care Homes for Excellence Awards. Kettering Evening Telegraph
East Midlands Ambulance Service receives most criticism and complaints from Northamptonshire patients
East Midlands Ambulance Service receives most criticism and complaints from Northamptonshire patients:
AMBULANCE patients in Northamptonshire made more complaints to NHS bosses than any other division in the East Midlands, a new report shows. Northampton Chronicle and Echo
AMBULANCE patients in Northamptonshire made more complaints to NHS bosses than any other division in the East Midlands, a new report shows. Northampton Chronicle and Echo
Why engagement matters | Chris Ham
Why engagement matters | Chris Ham: If the NHS is to address the financial challenges that lie ahead, while improving patient care, leaders will need to balance the pace-setting style that predominates among top leaders by valuing and encouraging the contribution of others. (Blog, 24 May 2012) Kings Fund
Patients' ratings 'to boost care'
Patients' ratings 'to boost care': A new NHS patient rating system - known as the "friends and family test" - is to be introduced to help improve nursing care in England. BBC News
Details of all 212 CCGs published
Details of all 212 CCGs published: Details of the areas covered by all 212 proposed clinical commissioning groups (CCGs) in England, as well as their budgets and constituent practices, have been released. GP Online
You can find the detailed breakdown on the NHS Commissioning Board site.
You can find the detailed breakdown on the NHS Commissioning Board site.
GPs 'must be able to sack CCG boards'
GPs 'must be able to sack CCG boards': Practices must be able to sack CCG leaders if they fail to deliver, LMCs have said. GP Online
NHS reforms risk data breach ''epidemic''
NHS reforms risk data breach ''epidemic'': Data protection experts have warned of new threats to the security of confidential patient data Public Service
Alive and clicking: information that benefits all
Alive and clicking: information that benefits all: The NHS Confederation has published 'Alive and clicking: information that benefits all'. This paper explores the potential for using and sharing information in the NHS. It looks at the costs and benefits of informing and communicating with patients through web and social media platforms versus the costs of not doing so effectively. Managing information is an essential part of delivering good healthcare but historically difficult to get right. While the NHS drowns in information and spends more and more to gather it, it has struggled to use it to good effect for patients, often shying away from being transparent about how services are run and responding openly when things go wrong.
Failing the frail: a chaotic approach to commissioning healthcare services for care homes
Failing the frail: a chaotic approach to commissioning healthcare services for care homes:
This report is an analysis of data collected by the Care Quality Commission about PCT support for the healthcare of older people living within nursing and residential care homes. Overall the report outlines concerns about the standard of and access to healthcare of older people in England who live in care homes, who typically have greater and more complex health needs than their peers who live in the community. The report suggests that improvements in access to healthcare will benefit this population and reduce unplanned and costly demands on the NHS.
This report is an analysis of data collected by the Care Quality Commission about PCT support for the healthcare of older people living within nursing and residential care homes. Overall the report outlines concerns about the standard of and access to healthcare of older people in England who live in care homes, who typically have greater and more complex health needs than their peers who live in the community. The report suggests that improvements in access to healthcare will benefit this population and reduce unplanned and costly demands on the NHS.
Health Committee - first report: education, training and workforce planning
Health Committee - first report: education, training and workforce planning:
This report states that Government plans to reform education, training and workforce planning in the NHS are unclear and lack crucial detail. The report examines and makes recommendations on areas such as: the challenge of workforce planning, the organisation of education, training and workforce planning, and the funding of education and training.
This report states that Government plans to reform education, training and workforce planning in the NHS are unclear and lack crucial detail. The report examines and makes recommendations on areas such as: the challenge of workforce planning, the organisation of education, training and workforce planning, and the funding of education and training.
NHS "must abandon command-and-control leadership style" - Pharma Times
NHS "must abandon command-and-control leadership style" - Pharma Times:
 Belfast Telegraph | NHS "must abandon command-and-control leadership style" Pharma Times The NHS should move away from the predominant "pace-setting" style of leadership based on meeting targets, and towards a new model based on stronger engagement between staff, clinicians and patients, says health policy think tank The King's Fund, ... Better bosses 'make NHS healthier'Belfast Telegraph all 14 news articles » |
'New challenges' as survey shows hospitals can leave you feeling worse
'New challenges' as survey shows hospitals can leave you feeling worse:
One in sixteen patients in hospital last year had an infection contracted as a result of their medical care that made them sicker rather than better. The Indepdendent
One in sixteen patients in hospital last year had an infection contracted as a result of their medical care that made them sicker rather than better. The Indepdendent
'Negligible risk' from UK rabies case
'Negligible risk' from UK rabies case:
The Health Protection Agency has confirmed a case of rabies in London. The patient became infected after being bitten by a dog in South Asia, but is now being treated in the UK. The HPA says the risk to others is “negligible”, but as a precautionary measure health staff and those who have had close contact with the patient are being examined and vaccinated when necessary.
The case has featured widely in today’s newspaper reports, often accompanied by images of vicious-looking dogs preparing to attack. However, it’s important to note that rabies does not circulate in either wild or domestic animals in the UK, so the risk of catching it through a pet bite is virtually non-existent here. Equally, rabies is only passed on through injuries such as bites and scratches (and not through airborne particles), so it seems highly unlikely that the infection could spread beyond this patient. Rabies is very rare in the UK. Four cases have been identified here since 2000, all of which were acquired from dog bites abroad.
Some internet sources have highlighted that bats in the UK carry a rabies-like virus. While this is true, bats live off insects rather than human blood, and therefore pose a negligible risk for the general public.
Initial symptoms can include anxiety, headaches and fever. As the disease progresses, there may be hallucinations and respiratory failure. Spasms of the muscles used for swallowing make it difficult for the patient to drink. The incubation period between being infected and showing symptoms is between two and eight weeks, depending on the site of the initial infection.
Once symptoms have developed, rabies is almost always fatal, although there is a small number of people who are reported to have survived.
The UK has been rabies-free since the beginning of the 20th century, with the exception of a rabies-like virus in a single species of bat (see below). The last recorded rabies case in the UK was in Northern Ireland in 2008. In that instance, the patient had been working for an animal charity in South Africa. A small number of cases continue to be reported in other developed countries, most being the result of a bite from a wild animal rather than a domestic dog.
Most mammals can carry the rabies virus, but the majority of cases result from being bitten by an infected dog. In 2003 it was recognised that some UK bats may carry a rabies-like virus. A bat handler died from this infection, which was probably acquired in Scotland. However, the types of bats found in the UK principally live off a diet of insects and are not “vampire” bats that live on a diet of blood.
If you aren’t sure whether to have a rabies vaccine before you travel, ask your GP or nurse as far in advance as possible to ensure you can receive a full course of the vaccine before you leave, if necessary. The vaccine, which consists of three injections over the course of a month, is not available on the NHS. It can be given by GPs and travel clinics on a private basis and costs £120-150.
Many of the regions where rabies is prevalent carry the risk of other diseases, such as malaria. It’s important to look into other diseases, vaccinations and risks ahead of travel. Appropriate travel health insurance is also advisable when going abroad, given the cost and complexity of arranging emergency healthcare in some countries.
If someone is known to have been bitten by an animal suspected of having rabies, they will be given emergency treatment to stop the virus spreading beyond the site of the bite or scratch, even if they have had a vaccination ahead of travel. This treatment consists of cleaning the wound, administering a special preparation of antibodies which can help neutralise the virus and, if necessary, administering a course of the rabies vaccine. There are currently no antiviral drugs available outside of clinical trials to treat the rabies virus.
Travellers to countries that are not rabies-free should avoid contact with cats, dogs and other animals wherever possible. It is also important to educate children about the dangers of stroking unknown animals. This is particularly true for animals that appear unusually tame, because this is an early sign of the rabies virus in animals. Children should be examined daily for cuts and scratches and should be made aware that being bitten by an animal is dangerous.
The World Health Organization estimates that 40% of people who are bitten by suspect rabid animals worldwide are children under the age of 15.
The HPA says that the rabies vaccine is extremely effective at preventing rabies in people who have been bitten, even when this is given some time after the bite. Those who do not get medical treatment while abroad should still seek it on returning to the UK.
Even in environments where rabies does not circulate, an animal bite or scratch still carries the risk of other infections such as tetanus and general bacterial infections. See our section on treating animal bites for guidance on what to do in this situation.
Doctors miss rabies 3 times. The Sun, May 24 2012
British grandmother seriously ill with rabies was sent home THREE times by her GP and A&E department before she was diagnosed. The Daily Mail, May 24 2012
Rabies case: Patient treated for potentially fatal disease in London after being bitten by dog in South Asia. Daily Mirror, May 24 2012
Grandmother fights for her life in first British rabies case since 2008. Metro, May 24 2012
Rabies case in UK after dog bite in Asia. The Independent, May 24 2012 NHS Choices
The case has featured widely in today’s newspaper reports, often accompanied by images of vicious-looking dogs preparing to attack. However, it’s important to note that rabies does not circulate in either wild or domestic animals in the UK, so the risk of catching it through a pet bite is virtually non-existent here. Equally, rabies is only passed on through injuries such as bites and scratches (and not through airborne particles), so it seems highly unlikely that the infection could spread beyond this patient. Rabies is very rare in the UK. Four cases have been identified here since 2000, all of which were acquired from dog bites abroad.
Some internet sources have highlighted that bats in the UK carry a rabies-like virus. While this is true, bats live off insects rather than human blood, and therefore pose a negligible risk for the general public.
What is rabies?
Rabies is a very serious viral infection that affects the brain and central nervous system. It is called a “zoonotic” infection, which means it passes from animals to humans. The virus is transmitted to humans via animal bites, and can’t spread through physical contact or airborne means in the way that other zoonotic infections can. This means it does not spread from human to human. Despite around 55,000 cases of rabies globally a year, there has yet to be a single confirmed case of human-to-human transmission.Initial symptoms can include anxiety, headaches and fever. As the disease progresses, there may be hallucinations and respiratory failure. Spasms of the muscles used for swallowing make it difficult for the patient to drink. The incubation period between being infected and showing symptoms is between two and eight weeks, depending on the site of the initial infection.
Once symptoms have developed, rabies is almost always fatal, although there is a small number of people who are reported to have survived.
How did the patient get it?
The Health Protection Agency (HPA) has confirmed that this case of rabies is in a London patient who became infected after receiving a dog bite in South Asia. Some newspapers have reported that the patient is a woman in her 50s who was bitten by a puppy in India and that she is in intensive care at the Hospital for Tropical Diseases, London, but these details haven’t been officially confirmed.Is there any risk to the public from this case?
The HPA has stressed that this case poses no real risk to the general public or to patients and visitors at the hospital where the patient is receiving treatment. As a precautionary measure, family members and healthcare staff who have been in close contact with the patient since they became unwell have been assessed and offered a vaccination against rabies, where appropriate. Once again, the rabies risk during this “infectious period” is negligible as the patient would have to somehow transmit the virus to another person’s bloodstream.How common is rabies?
There are an estimated 55,000 cases of rabies each year worldwide, with most cases occurring in the developing world. The vast majority of cases occur after a bite from an infected dog.The UK has been rabies-free since the beginning of the 20th century, with the exception of a rabies-like virus in a single species of bat (see below). The last recorded rabies case in the UK was in Northern Ireland in 2008. In that instance, the patient had been working for an animal charity in South Africa. A small number of cases continue to be reported in other developed countries, most being the result of a bite from a wild animal rather than a domestic dog.
How is it spread?
Rabies is transmitted through the saliva of an infected animal and can be caught if an infected animal bites or scratches a human. It may also be transmitted if the saliva from an infected animal comes into contact with a graze or cut on someone’s skin. Although this is far less common, it’s important to note that you don’t have to be bitten to get rabies. For example, as a precautionary measure the World Health Organization recommends that people are immediately given a vaccination if a potentially rabid animal nibbles uncovered skin, or causes minor scratches or abrasions without bleeding.Most mammals can carry the rabies virus, but the majority of cases result from being bitten by an infected dog. In 2003 it was recognised that some UK bats may carry a rabies-like virus. A bat handler died from this infection, which was probably acquired in Scotland. However, the types of bats found in the UK principally live off a diet of insects and are not “vampire” bats that live on a diet of blood.
Can I catch it from another person?
There have been no confirmed cases of rabies spreading between humans. The risk to other humans from a patient with rabies is considered to be negligible.How big is the risk abroad?
Most cases of rabies occur in the developing world, particularly Africa and Asia. Half of all rabies cases occur in India. The countries associated with the biggest risk of rabies are:- Colombia
- Cuba
- Dominican Republic
- Ecuador
- El Salvador
- Guatemala
- India
- Mexico
- Nepal
- Pakistan
- Peru
- Philippines
- Sri Lanka
- Thailand
- Turkey
- Vietnam
Do I need a vaccination?
In the UK, the vaccine against rabies is not given routinely and is only recommended for people who are thought to be at high risk. These include laboratory workers who may be in contact with the rabies virus, people whose work includes handling bats or animals from abroad, and people whose travel activities may put them at increased risk. This will depend on the location they are visiting, the length of time they will be spending there and the availability of medical treatment should they get bitten.If you aren’t sure whether to have a rabies vaccine before you travel, ask your GP or nurse as far in advance as possible to ensure you can receive a full course of the vaccine before you leave, if necessary. The vaccine, which consists of three injections over the course of a month, is not available on the NHS. It can be given by GPs and travel clinics on a private basis and costs £120-150.
Many of the regions where rabies is prevalent carry the risk of other diseases, such as malaria. It’s important to look into other diseases, vaccinations and risks ahead of travel. Appropriate travel health insurance is also advisable when going abroad, given the cost and complexity of arranging emergency healthcare in some countries.
Is rabies treatable?
A pre-exposure vaccination is an effective treatment for stopping people bitten by animals from becoming infected by rabies.If someone is known to have been bitten by an animal suspected of having rabies, they will be given emergency treatment to stop the virus spreading beyond the site of the bite or scratch, even if they have had a vaccination ahead of travel. This treatment consists of cleaning the wound, administering a special preparation of antibodies which can help neutralise the virus and, if necessary, administering a course of the rabies vaccine. There are currently no antiviral drugs available outside of clinical trials to treat the rabies virus.
What is the best way to prevent rabies?
The HPA says it is essential to get health advice if you are travelling to countries where rabies is common or if you know you will be working with animals. Talk to your doctor or nurse about whether or not a rabies vaccine is appropriate before you travel.Travellers to countries that are not rabies-free should avoid contact with cats, dogs and other animals wherever possible. It is also important to educate children about the dangers of stroking unknown animals. This is particularly true for animals that appear unusually tame, because this is an early sign of the rabies virus in animals. Children should be examined daily for cuts and scratches and should be made aware that being bitten by an animal is dangerous.
The World Health Organization estimates that 40% of people who are bitten by suspect rabid animals worldwide are children under the age of 15.
What do I do if I or someone in my family is bitten?
Anyone who is bitten, scratched, or licked by a warm-blooded animal in a country that has rabies should immediately wash the wound or site of exposure with plenty of soap and water. Seek medical advice without delay, even if you have been previously vaccinated.The HPA says that the rabies vaccine is extremely effective at preventing rabies in people who have been bitten, even when this is given some time after the bite. Those who do not get medical treatment while abroad should still seek it on returning to the UK.
Even in environments where rabies does not circulate, an animal bite or scratch still carries the risk of other infections such as tetanus and general bacterial infections. See our section on treating animal bites for guidance on what to do in this situation.
Links To The Headlines
Rabies case confirmed in Britain after dog bite in Asia. The Daily Telegraph, May 24 2012Doctors miss rabies 3 times. The Sun, May 24 2012
British grandmother seriously ill with rabies was sent home THREE times by her GP and A&E department before she was diagnosed. The Daily Mail, May 24 2012
Rabies case: Patient treated for potentially fatal disease in London after being bitten by dog in South Asia. Daily Mirror, May 24 2012
Grandmother fights for her life in first British rabies case since 2008. Metro, May 24 2012
Rabies case in UK after dog bite in Asia. The Independent, May 24 2012 NHS Choices
Thursday, 24 May 2012
Keeping patient safety on the agenda
Keeping patient safety on the agenda: At the Health Foundation, patient safety remains a great concern to us, especially as we believe that these competing demands may divert attention away from the provision of high quality, harm free care, says Jane Jones. Health Foundation
New end of life care primary care trust profiles
New end of life care primary care trust profiles:
Each profile provides a snapshot of the PCT’s position compared to England. This will help commissioners and providers of end of life care to understand the specific needs and characteristics of their local population to help with service planning.
The data is also presented in the InstantAtlas tool which enables users to view the data in map, chart and table format and make comparisons across indicators and PCT areas. All the data can also be exported from the InstantAtlas tool for local analysis. NHS Networks
Each profile provides a snapshot of the PCT’s position compared to England. This will help commissioners and providers of end of life care to understand the specific needs and characteristics of their local population to help with service planning.
The data is also presented in the InstantAtlas tool which enables users to view the data in map, chart and table format and make comparisons across indicators and PCT areas. All the data can also be exported from the InstantAtlas tool for local analysis. NHS Networks
Change to the requirements for a second opinion appointed doctor’s opinion for a consenting patient on supervised community treatment
Change to the requirements for a second opinion appointed doctor’s opinion for a consenting patient on supervised community treatment:
The rules about when the treatment of patients on supervised community treatment (SCT) has to be approved by a second opinion appointed doctor (SOAD) change on 1 June 2012. Section 299 of the Health and Social Care Act 2012 changes this aspect of the Mental Health Act 1983. The effect of the changes is that SOAD approval is generally no longer necessary if the patient is able to consent to the treatment in question.
There is a new statutory form (CTO12) to be used by the approved clinician in charge of the patient’s treatment to record that the patient has the capacity (or competence if under 16) to consent to the treatment in question and has done so. The form is introduced by The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2012.
SOADs will continue to complete the current form (CTO11) when an SCT patient either does not consent or is not able to consent to the treatment.
An SCT patient who has consented may at any time withdraw that consent or could lose the capacity to consent. In either case, this will mean that a form CTO12 would no longer be valid, and a SOAD will have to record an opinion on form CTO11 instead.
Treatment may continue when a patient has lost capacity to consent, but it cannot continue against the wishes of a patient who still has capacity to consent, unless the patient is recalled to hospital. There is no legal authority to treat an SCT patient even if a SOAD has completed form CTO11.
There is no change to the rule that clinicians may not give electroconvulsive therapy (ECT) to patients under 18 without the approval of a SOAD. But they may give medication or ECT without a completed form CTO11 or CTO12 in an emergency, where it is immediately necessary.
Read The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2012
Printed copies of form CTO12 will be available from the NHS forms website soon. For immediate use, download Form CTO12 Regulation 28(1A) (PDF, 29K) Department of Health
The rules about when the treatment of patients on supervised community treatment (SCT) has to be approved by a second opinion appointed doctor (SOAD) change on 1 June 2012. Section 299 of the Health and Social Care Act 2012 changes this aspect of the Mental Health Act 1983. The effect of the changes is that SOAD approval is generally no longer necessary if the patient is able to consent to the treatment in question.
There is a new statutory form (CTO12) to be used by the approved clinician in charge of the patient’s treatment to record that the patient has the capacity (or competence if under 16) to consent to the treatment in question and has done so. The form is introduced by The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2012.
SOADs will continue to complete the current form (CTO11) when an SCT patient either does not consent or is not able to consent to the treatment.
An SCT patient who has consented may at any time withdraw that consent or could lose the capacity to consent. In either case, this will mean that a form CTO12 would no longer be valid, and a SOAD will have to record an opinion on form CTO11 instead.
Treatment may continue when a patient has lost capacity to consent, but it cannot continue against the wishes of a patient who still has capacity to consent, unless the patient is recalled to hospital. There is no legal authority to treat an SCT patient even if a SOAD has completed form CTO11.
There is no change to the rule that clinicians may not give electroconvulsive therapy (ECT) to patients under 18 without the approval of a SOAD. But they may give medication or ECT without a completed form CTO11 or CTO12 in an emergency, where it is immediately necessary.
Read The Mental Health (Hospital, Guardianship and Treatment) (England) (Amendment) Regulations 2012
Printed copies of form CTO12 will be available from the NHS forms website soon. For immediate use, download Form CTO12 Regulation 28(1A) (PDF, 29K) Department of Health
New clot drug for heart patients
New clot drug for heart patients: Hundreds of thousands of heart patients could benefit from new blood thinning drugs to cut their risk of stroke, guidelines recommend BBC News
NHS trusts 'ration eye surgery'
NHS trusts 'ration eye surgery': A growing number of primary care trusts are placing restrictions on access to eye surgery, figures obtained by campaigners show. BBC News
NHS 'paid £17 for pizza base'
NHS 'paid £17 for pizza base': Two prescription gluten-free pizza bases can cost the NHS as much as £35, BBC Newsnight has learned. BBC News
Renewal of the GPS framework agreement for the supply of temporary nursing staff
Renewal of the GPS framework agreement for the supply of temporary nursing staff: Government Procurement Service (GPS) is in the process of renewing the framework agreement for the supply of temporary nursing staff NHS Employers
Junior doctors to be quizzed on patient safety
It is the first time trainee doctors in the UK have been given the opportunity to raise concerns in this way over the safety of their patients.
The annual National Training Survey has been organised by the GMC and it wants every one of the country’s 55,000 trainee doctors - who provide much of the basic care in the NHS... Healthcare Today
Improve your knowledge on guidance for common mental health problems
Improve your knowledge on guidance for common mental health problems: Common mental health disorders affect one-in-six adults, and cost UK employers £25 billion each year through lost work days. NICE
Deep concerns over government plans to cut benefits for alcoholics and drug addicts who refuse treatment
Deep concerns over government plans to cut benefits for alcoholics and drug addicts who refuse treatment:
Doctors and addiction charities today expressed deep concerns over government plans to cut the benefits of people suffering from alcoholism or drug addiction who refuse treatment. The Independent
Doctors and addiction charities today expressed deep concerns over government plans to cut the benefits of people suffering from alcoholism or drug addiction who refuse treatment. The Independent
Controversial plans to change the way NHS spends its £100bn budget being considered
Controversial plans to change the way NHS spends its £100bn budget being considered:
Senior health service managers are considering controversial plans to change the way the NHS spends its £100bn annual budget across different parts of England. The Independent
Senior health service managers are considering controversial plans to change the way the NHS spends its £100bn annual budget across different parts of England. The Independent
New local authority staff to maintain access to NHS Pension Scheme
New local authority staff to maintain access to NHS Pension Scheme: It has been confirmed that NHS staff transferring to local authority employers next year will retain access to the NHS Pension Scheme. RCN
Wednesday, 23 May 2012
New style of NHS leadership could deliver better patient care and financial performance says The King’s Fund review
A year-long review carried out by The King's Fund argues that a new style of leadership in the NHS could deliver lower mortality, better patient experience and outcomes, and financial savings.
The management of adult diabetes services in the NHS
The management of adult diabetes services in the NHS: Diabetes care in the NHS is poor, with low achievement of treatment standards, high numbers of avoidable deaths and annual spending reaching an estimated £3.9 billion. National Audit Office
Chronic pain under-treated - NICE
Chronic pain under-treated - NICE: Many patients with advanced cancer and other debilitating conditions are being "under-treated" for their pain, according to new guidance. Video coverage here BBC News
'Emerging hospital bug' warning
'Emerging hospital bug' warning: Rates of hospital-acquired infections such as MRSA are going down but figures suggest other bacteria are an emerging problem in England. BBC News
PCTs fail to invest in extra cancer tests
PCTs fail to invest in extra cancer tests: Half of PCTs are failing to invest in extra cancer tests despite long waiting times, putting plans to improve NHS cancer outcomes at risk. GP Online
Final death knell for HealthSpace
Final death knell for HealthSpace: The NHS's own health organiser, HealthSpace, has been confirmed as an unlikely casualty of the NHS information strategy, published earlier this week. E-Health Insider
Mortality among inpatients with diabetes
Mortality among inpatients with diabetes: Diabetes Health Intelligence has conducted an analysis of mortality among inpatients with diabetes. The study used data on over 13 million hospital admissions to assess case-mix and risk factors for inpatient mortality and identify trust level variation in the risk of an inpatient with diabetes dying. The key finding from the study was that inpatients with diabetes are 10% more likely to die than those without the condition.
Stuck at home: the impact of day service cuts on people with a learning disability
Stuck at home: the impact of day service cuts on people with a learning disability:
This report finds that nearly a third of local authorities have closed day services in the last three years which results in one in four adults with a learning disability now spending less than one hour a day outside of their home due to these cuts.
This report finds that nearly a third of local authorities have closed day services in the last three years which results in one in four adults with a learning disability now spending less than one hour a day outside of their home due to these cuts.
NICE guideline to standardise opioid use in palliative care and address patient's concerns
NICE guideline to standardise opioid use in palliative care and address patients? concerns: A new clinical guideline published today (23 May) by the National Institute for Health and Clinical Excellence (NICE), will help ensure safe and consistent prescribing of opioids as a first-line treatment option to relieve pain for patients receiving palliative care for chronic or incurable illnesses. NICE
NHS education reforms 'lack detail' - The Press Association
NHS education reforms 'lack detail' - The Press Association:
NHS education reforms 'lack detail' The Press Association The Government's plans to reform education and training in the NHS are unclear and lack detail, MPs have warned. The health select committee said the success of Health Education England (HEE), which will oversee the training across services in England, ... GP training plans lack crucial detail, MPs sayGP online MPs criticise delays in education and training reformHealth Service Journal all 3 news articles » |
Health watchdog: extend IVF treatment to older women
Health watchdog: extend IVF treatment to older women: Sir Andrew Dillon, the CEO of the National Institute for Health and Clinical Excellence (Nice) explains why the NHS should provide IVF to women over 40 and same-sex couples.
The Daily Telegraph
The Daily Telegraph
Health care assistants 'must be registered' say MPs
Health care assistants 'must be registered' say MPs: Patients are being put at risk because health care assistants (HCAs) who make serious mistakes are not banned from the profession, MPs warn today.
The Daily Telegraph
The Daily Telegraph
Diabetes timebomb: Only half of NHS patients receiving acceptable care
Diabetes timebomb: Only half of NHS patients receiving acceptable care:
Sweeping variations in standards of care for diabetic patients is costing thousands of lives and wasting tens of millions of pounds every year, the government’s spending watchdog reveals. The Independent
Sweeping variations in standards of care for diabetic patients is costing thousands of lives and wasting tens of millions of pounds every year, the government’s spending watchdog reveals. The Independent
Patients to get choice of where they have medical tests
Patients to get choice of where they have medical tests:
Patients will be able to choose where they have essential medical tests under a new scheme announced today. The Independent
Patients will be able to choose where they have essential medical tests under a new scheme announced today. The Independent
Subscribe to:
Posts (Atom)