Personal health budget pilots: fifth interim evaluation report:
The fifth interim independent evaluation report about the personal health budget pilot programme has been published by the personal health budgets evaluation (PHBE) team.
The report is based on interviews with 52 budget holders and 13 carers and suggests that there is widespread potential for personal health budgets to lead to improvements in health and wellbeing.
The report highlights that the role of information, advice and support is vitally important. It identifies some challenges, and work continues to explore these in more detail, to develop methods to overcome them and help the NHS to deliver personal health budgets in the longer term. Department of Health
Thursday, 21 June 2012
Supporting recovery in mental health
Supporting recovery in mental health: The Implementing Recovery through Organisational Change project is a new approach to helping people with mental health problems that aims to change how the NHS and its partners operate so they can focus more on helping those people with their recovery. NHS Confederation
Financial pressure in NHS 'worst seen' NHS managers warn - Telegraph.co.uk
Financial pressure in NHS 'worst seen' NHS managers warn - Telegraph.co.uk:
 Telegraph.co.uk | Financial pressure in NHS 'worst seen' NHS managers warn Telegraph.co.uk Cinderella services like learning disabilities, mental health for children, some diagnostic services and physiotherapy which are not scrutinised as closely as ... NHS chiefs gloomy about care prospectsFinancial Times Health group warns NHS is 'tanker heading for iceberg'Manchester Evening News Today in healthcare: Tuesday 19 JuneThe Guardian all 136 news articles » |
RCN seeks members’ views on NMC council
RCN seeks members’ views on NMC council: The Royal College of Nursing is seeking feedback from members before responding to a Department of Health consultation on reducing the size of the Nursing and Midwifery Council (NMC) ruling council.
Wednesday, 20 June 2012
Northampton General Hospital cancels ‘small number’ of operations ahead of strikes
Northampton General Hospital cancels ‘small number’ of operations ahead of strikes:
A ‘small number’ of operations scheduled for Thursday have been rearranged and an outpatient clinic cancelled at Northampton General Hospital as a result of strikes by doctors. Northampton Chronicle and Echo
A ‘small number’ of operations scheduled for Thursday have been rearranged and an outpatient clinic cancelled at Northampton General Hospital as a result of strikes by doctors. Northampton Chronicle and Echo
Ambulance service covering Northamptonshire fails to hit response target
Ambulance service covering Northamptonshire fails to hit response target:
The ambulance service covering Northamptonshire was among only two in the country to not hit its non-life threatening call-out targets last year, an NHS report shows. Northampton Chronicle and Echo
The ambulance service covering Northamptonshire was among only two in the country to not hit its non-life threatening call-out targets last year, an NHS report shows. Northampton Chronicle and Echo
Guidance on the health visiting career
Guidance on the health visiting career:
The guidance, A Health Visiting Career, promotes understanding of the current picture, identifies
areas of good practice, and suggests ways that these can be shared and
enhanced. It gives an overview of the novice to expert journey and the pathway
for newly qualified health visitors in their first two years.NHS Networks
The guidance, A Health Visiting Career, promotes understanding of the current picture, identifies
areas of good practice, and suggests ways that these can be shared and
enhanced. It gives an overview of the novice to expert journey and the pathway
for newly qualified health visitors in their first two years.NHS Networks
NHS CB to build My Health portal
NHS CB to build My Health portal: The NHS Commissioning Board is looking to create a new website called My Health where patients will be able to access their GP records, book appointments and order prescriptions. EHI News
RPS publishes report on transfer of medicines information between care providers
RPS publishes report on transfer of medicines information between care providers: Source: Royal Pharmaceutical Society (RPS)
Area: News
The Royal Pharmaceutical Society (RPS) has issued a report titled "Keeping patients safe when they transfer between care providers: Getting the medicines right", which outlines the results of a six-month project involving over 30 healthcare organisations which volunteered to implement RPS guidance on transfer of medicines information. The report calls for improvements to the transfer of information about medicines, and the following recommendations have been made (taken directly from source):
. All suppliers of IT systems to hospitals and general practice should ensure their systems can effectively transfer recommended core content of medicines records . All community pharmacies should have an NHS.net website address to enable secure communications between secondary and primary care . All clinical records should be structured in a recognised and nationally agreed format to assist interoperability and the transfer of information . National sharing ...
Area: News
The Royal Pharmaceutical Society (RPS) has issued a report titled "Keeping patients safe when they transfer between care providers: Getting the medicines right", which outlines the results of a six-month project involving over 30 healthcare organisations which volunteered to implement RPS guidance on transfer of medicines information. The report calls for improvements to the transfer of information about medicines, and the following recommendations have been made (taken directly from source):
. All suppliers of IT systems to hospitals and general practice should ensure their systems can effectively transfer recommended core content of medicines records . All community pharmacies should have an NHS.net website address to enable secure communications between secondary and primary care . All clinical records should be structured in a recognised and nationally agreed format to assist interoperability and the transfer of information . National sharing ...
Doctors' strike: three quarters of surgeries to stay open as usual
Doctors' strike: three quarters of surgeries to stay open as usual: Just one in four doctors' surgeries are expected to take part in tomorrow's industrial action over pensions as the number of GPs prepared to defy the stike increases, figures from 20 primary care organisations suggest.
Telegraph Health News
Telegraph Health News
Health leader warns NHS is heading for disaster
Health leader warns NHS is heading for disaster:
The leader of England's hospital and primary care trusts has
warned that the NHS is heading for disaster and must change course
if it is to survive. Independent
The leader of England's hospital and primary care trusts has
warned that the NHS is heading for disaster and must change course
if it is to survive. Independent
Ambulance response times: all trusts meet eight minute national standard for first time
Ambulance response times: all trusts meet eight minute national standard for first time: *Regional data available from this publication Every single ambulance trust in England for the first time has met the national standard for responding...NHS Information Centre
Tuesday, 19 June 2012
Legionnaires' outbreak 'has peaked', says health secretary
Legionnaires' outbreak 'has peaked', says health secretary: There have been no new cases of Legionnaires’ disease in the outbreak which has claimed two lives, health chiefs in Scotland have said. HSJ
Personal health budget pilots: fifth interim evaluation report
Personal health budget pilots: fifth interim evaluation report:
The fifth interim independent evaluation report about the personal health budget pilot programme has been published by the personal health budgets evaluation (PHBE) team. The report, Personal health budgets evaluation: Experiences and outcomes for budget holders at nine months (PDF, 402K), is based on interviews with 52 budget holders and 13 carers in the pilot.
These interviews suggest there is widespread potential for personal health budgets to lead to improvements in health and wellbeing. The majority of people with a personal health budget benefited through both improved health outcomes and increased satisfaction levels. Increased self-confidence, reduced use of GP services and prescriptions and better relationships with health professionals were among the other reported benefits.
As budget holders’ health improved they reported:
As with the fourth interim report on the pilot published in October 2011, this report highlights that the role of information, advice and support is vitally important. The report identifies some challenges, and work continues to explore these in more detail, to develop methods to overcome them and help the NHS to deliver personal health budgets in the longer term. Department of Health
The fifth interim independent evaluation report about the personal health budget pilot programme has been published by the personal health budgets evaluation (PHBE) team. The report, Personal health budgets evaluation: Experiences and outcomes for budget holders at nine months (PDF, 402K), is based on interviews with 52 budget holders and 13 carers in the pilot.
These interviews suggest there is widespread potential for personal health budgets to lead to improvements in health and wellbeing. The majority of people with a personal health budget benefited through both improved health outcomes and increased satisfaction levels. Increased self-confidence, reduced use of GP services and prescriptions and better relationships with health professionals were among the other reported benefits.
As budget holders’ health improved they reported:
- needing to rely less on family carers
- less anxiety and stress on the part of relatives
- increased ability to take part in family activities
As with the fourth interim report on the pilot published in October 2011, this report highlights that the role of information, advice and support is vitally important. The report identifies some challenges, and work continues to explore these in more detail, to develop methods to overcome them and help the NHS to deliver personal health budgets in the longer term. Department of Health
Choose and Book use drops further
Choose and Book use drops further: National Choose and Book usage has dropped below 50% and is just 25% in some areas. EHI News
Bulletin for proposed CCGs June 2012
Bulletin for proposed CCGs June 2012: Source: NHS Commissioning Board
The June edition of the Bulletin for proposed Clinical Commissioning Groups (CCGs) covers the following topics:
. New web tool signposts learning and development opportunities
. Initiative to help CCGs with commissioning support decisions
. CCG remuneration guidance
. Running costs allowances update
. Authorisation 'surgeries' for waves two and three
. Key elements of authorisation process put in place
. The Functions of Clinical Commissioning Groups published
. Next steps for communications and engagement services
The June edition of the Bulletin for proposed Clinical Commissioning Groups (CCGs) covers the following topics:
. New web tool signposts learning and development opportunities
. Initiative to help CCGs with commissioning support decisions
. CCG remuneration guidance
. Running costs allowances update
. Authorisation 'surgeries' for waves two and three
. Key elements of authorisation process put in place
. The Functions of Clinical Commissioning Groups published
. Next steps for communications and engagement services
Updated factsheet on Health and Social Care Act
Updated factsheet on Health and Social Care Act: Source: Department of Health (DH)
The Department of Health has published a series of factsheets on the Health and Social Care Act 2012, updated to reflect the changes made during the Act's Parliamentary passage. They explain particular topics contained in the Act, including its key themes and include case studies of the policy in action, or answer frequently asked questions about the topic.
The topics covered are as follows:
. Overview
. Case for change
. Overview of health and care structures
. Scrutiny and improvements
. Clinically-led commissioning
. Provider regulation to support innovative and efficient services
. Greater voice for patients
. New focus for public health
. Greater accountabilty locally and nationally
. Streamlined arm's length bodies
. Support worker regulation
. Improving quality of care
. Tackling inequalities in healthcare
. Promoting better ...
The Department of Health has published a series of factsheets on the Health and Social Care Act 2012, updated to reflect the changes made during the Act's Parliamentary passage. They explain particular topics contained in the Act, including its key themes and include case studies of the policy in action, or answer frequently asked questions about the topic.
The topics covered are as follows:
. Overview
. Case for change
. Overview of health and care structures
. Scrutiny and improvements
. Clinically-led commissioning
. Provider regulation to support innovative and efficient services
. Greater voice for patients
. New focus for public health
. Greater accountabilty locally and nationally
. Streamlined arm's length bodies
. Support worker regulation
. Improving quality of care
. Tackling inequalities in healthcare
. Promoting better ...
New CCG learning and support tool
New CCG learning and support tool: Source: NHS Commissioning Board
A new Clinical Commissioning Group (CCG) learning and support web tool has been published to support CCGs as they prepare for authorisation, the clinical leadership of commissioning and their development beyond authorisation. It provides access to the development resources that meet current learning needs and which every proposed CCG can expect to be able to access during 2012-13.
A new Clinical Commissioning Group (CCG) learning and support web tool has been published to support CCGs as they prepare for authorisation, the clinical leadership of commissioning and their development beyond authorisation. It provides access to the development resources that meet current learning needs and which every proposed CCG can expect to be able to access during 2012-13.
Continuing professional development: guidance for all doctors
Continuing professional development: guidance for all doctors:
This guidance was published to help doctors across the UK keep their knowledge and skills up to date throughout their working life. It is aimed at helping doctors as they reflect on their practice, prepare for their annual appraisal, and ultimately for their revalidation. It was developed in co-operation with doctors, medical Royal Colleges, employers, patients and the public, following widespread public consultation earlier this year and emphasises that doctors must take account of the needs of their patients and their healthcare teams when considering the learning they may need to undertake.
Kings Fund
Poly implant Prothese (PiP) breast implants: final report of the Expert Group
Poly implant Prothese (PiP) breast implants: final report of the Expert Group:
The NHS Medical Director’s Expert Group has been collecting and reviewing all available data including estimated rupture rates, data on clinical findings when implants are removed, and further examination of the chemical make up of PiP silicone gel. The expert group has studied information on 240,000 implants of different makes used throughout England which have been given to 130,000 women, along with detailed findings from 5,600 removal operations.
Kings Fund
The NHS Medical Director’s Expert Group has been collecting and reviewing all available data including estimated rupture rates, data on clinical findings when implants are removed, and further examination of the chemical make up of PiP silicone gel. The expert group has studied information on 240,000 implants of different makes used throughout England which have been given to 130,000 women, along with detailed findings from 5,600 removal operations.
Kings Fund
Warning issued over fake thermometers
Warning issued over fake thermometers:
The Medicines and Healthcare Products Regulatory Agency have warned parents that fake digital thermometers are being sold on the internet.The MHRA said people should be aware that the fake thermometers, which are on sale for very low prices, could give incorrect temperature readings and be dangerous.The agency said it had seized over 400 digital thermometers - some of which were being sold for 99p... Healthcare Today
The Medicines and Healthcare Products Regulatory Agency have warned parents that fake digital thermometers are being sold on the internet.The MHRA said people should be aware that the fake thermometers, which are on sale for very low prices, could give incorrect temperature readings and be dangerous.The agency said it had seized over 400 digital thermometers - some of which were being sold for 99p... Healthcare Today
Monitor publishes new report on costing
Monitor publishes new report on costing: Monitor has today published an independent report, Strategic Options for Costing, which it commissioned from PwC. The focus of this report is on the costing information that underpins the current Payment by Results (PbR) system.
Monday, 18 June 2012
Diabetes Week 2012: New diabetes risk check service launched in ... - AboutMyArea
 AboutMyArea | Diabetes Week 2012: New diabetes risk check service launched in ... AboutMyArea The service, which is provided by Northamptonshire Healthcare NHS Foundation ... health services for the county from NHS Northamptonshire from 1 April 2013. Northampton Chronicle and Echo |
Ten Northampton General Hospital staff left with £790k pay-off - Northampton Chronicle & Echo
 Northampton Chronicle & Echo | Ten Northampton General Hospital staff left with £790k pay-off Northampton Chronicle & Echo Ten members of staff have been given average pay-offs of £79000 each after they were made redundant by Northampton General Hospital. Northampton Chronicle and Echo |
New recommendations on public health funding published
New recommendations on public health funding published:
For the first time, from 2013, public health funding will be ring fenced and protected with local authorities taking the lead for improving health. This will help to drive up local efforts to maintain and improve the public’s health and wellbeing.
The Department of Health has committed to ensure that no local authority will lose out under the new grants for 2013/14. So local areas will either receive equivalent funding or be better off under the new funding arrangements. NHS Networks
For the first time, from 2013, public health funding will be ring fenced and protected with local authorities taking the lead for improving health. This will help to drive up local efforts to maintain and improve the public’s health and wellbeing.
The Department of Health has committed to ensure that no local authority will lose out under the new grants for 2013/14. So local areas will either receive equivalent funding or be better off under the new funding arrangements. NHS Networks
Consultation deadline extended on proposals to secure shared decision-making
Consultation deadline extended on proposals to secure shared decision-making:
The consultation on detailed proposals to secure shared decision-making and choice for patients has been extended to Friday 31 Aug.
Some organisations have expressed real interest in the consultation while stating their need for additional time to undertake discussion meetings with their members before submitting a formal response. By extending the deadline for this secondary consultation, the aim is to ensure that everyone who wishes to respond will have sufficient time to do so.
The consultation proposes a model of shared decision-making all along the patient pathway, which should be relevant irrespective of patients’ conditions, their clinical pathway or progress along it. The model indicates where patients would be expected to have more say in decisions about their care in primary care; before a diagnosis; at referral to secondary care; and after a diagnosis had been made.
It asks a small number of focussed questions to seek views on:
Read Liberating the NHS: No decision about me, without me – Further consultation on proposals to secure shared decision-making
Department of Health
The consultation on detailed proposals to secure shared decision-making and choice for patients has been extended to Friday 31 Aug.
Some organisations have expressed real interest in the consultation while stating their need for additional time to undertake discussion meetings with their members before submitting a formal response. By extending the deadline for this secondary consultation, the aim is to ensure that everyone who wishes to respond will have sufficient time to do so.
The consultation proposes a model of shared decision-making all along the patient pathway, which should be relevant irrespective of patients’ conditions, their clinical pathway or progress along it. The model indicates where patients would be expected to have more say in decisions about their care in primary care; before a diagnosis; at referral to secondary care; and after a diagnosis had been made.
It asks a small number of focussed questions to seek views on:
- whether we have identified the right areas as well as the right levers for making sure our proposals will give patients more opportunities to make shared decisions about their care and treatment, all along the pathway
- whether our proposals are realistic and achievable
- whether we have missed any key issues
- whether we have identified the right means of delivering our proposals.
Read Liberating the NHS: No decision about me, without me – Further consultation on proposals to secure shared decision-making
Department of Health
Department of Health extends NHS 111 roll out deadline
Department of Health extends NHS 111 roll out deadline: Government extends date for implementation of 111 non-emergency service by 'up to six months'The government has extended the deadline for the roll out of NHS 111 to make sure areas have enough time to plan for the service.The announcement follows criticism of 111 by the British Medical Association and other unions, as well as pressure from clinical commissioning groups (CCGs) and private firms.In a letter to CCGs Jim Easton, national director for improvement and efficiency at the Department of Health ...Kings Fund Health News
Independent report calls for "major cultural shift" to improve dignity in care
Independent report calls for "major cultural shift" to improve dignity in care: Commission presents final report as joint work gets underway to turn recommendations into action. NHS Confederation Press Release
Nine to five culture in NHS has devastating impact
Nine to five culture in NHS has devastating impact: The full extent of the "nine to five" culture in the NHS is disclosed today in research which shows startling differences in levels of emergency treatment at weekends.
Telegraph health News
Telegraph health News
British population is getting too fat for the planet
British population is getting too fat for the planet: UK responsible for 3 per cent of flab despite representing 1 per cent of world's people, research shows.
Telegraph Health News
Telegraph Health News
NHS is 'failing' mental health patients
NHS is 'failing' mental health patients:
Three-quarters of people suffering from mental illness do not have access to treatments which would improve their lives and save billions of pounds every year, experts warn today. Independent Health News
Three-quarters of people suffering from mental illness do not have access to treatments which would improve their lives and save billions of pounds every year, experts warn today. Independent Health News
RCN says NHS 111 is pause needed
RCN says NHS 111 is pause needed: The Royal College of Nursing has reiterated its call for a pause before the move from NHS Direct to NHS 111 services in England.
Advice for RCN members during BMA industrial action
Advice for RCN members during BMA industrial action: The RCN has published guidance for nursing staff (Word 4KB) who may be affected when members of the British Medical Association (BMA) take industrial action on Thursday 21 June.
Friday, 15 June 2012
Councils invest £167m in tobacco
Councils invest £167m in tobacco: East of England councils that are due to take on anti-smoking health campaigns, are investing more than £167m in tobacco firms. BBC Northamptonshire
Payout for woman after Northampton General Hospital error - BBC News
Payout for woman after Northampton General Hospital error - BBC News:
 BBC News | Payout for woman after Northampton General Hospital error BBC News A woman has been paid £50000 in damages by Northampton General Hospital after she was given an operation she did not need. Claire Millward, 37, from ... Northampton mum claims Jade Goody's death saved her lifeNorthampton Chronicle & Echo all 2 news articles » |
Are independent commissioning support services the right way to go? | Chris Naylor
Are independent commissioning support services the right way to go? | Chris Naylor: Chris Naylor looks at what the future shape of support arrangements for clinical commissioning groups (CCGs) will look like. (Blog, 14 Jun 2012) Kings Fund
New Healthcare Associated Infection Surveillance system
New Healthcare Associated Infection Surveillance system:
Clara Swinson, Director, Health Protection, has written to all NHS chief executives to highlight the development of a new web based Healthcare Associated Infection (HCAI) surveillance computer system. It will replace the existing system used to collect the mandatory HCAI surveillance data for reporting MRSA, MSSA, and E. coli bacteraemias, and C. difficile Infection (CDI). It is expected to go live in April 2013.
Further information about the new system will be available via a webcast on Thursday 28 June 2012.
NHS chief executives are asked to nominate a local Implementation lead from their organisation and encourage users of the new system to register by 27 June 2012 to take part in the webcast.
Read letter: Mandatory Health Care Associated Infection Surveillance: redevelopment of the HCAI data capture system (MESS) Department of Health
Clara Swinson, Director, Health Protection, has written to all NHS chief executives to highlight the development of a new web based Healthcare Associated Infection (HCAI) surveillance computer system. It will replace the existing system used to collect the mandatory HCAI surveillance data for reporting MRSA, MSSA, and E. coli bacteraemias, and C. difficile Infection (CDI). It is expected to go live in April 2013.
Further information about the new system will be available via a webcast on Thursday 28 June 2012.
NHS chief executives are asked to nominate a local Implementation lead from their organisation and encourage users of the new system to register by 27 June 2012 to take part in the webcast.
Read letter: Mandatory Health Care Associated Infection Surveillance: redevelopment of the HCAI data capture system (MESS) Department of Health
Mental health quality profiles
Mental health quality profiles:
These quality profiles show how individual trusts compare across a range of quality indicators encompassing the domains of the Outcomes Framework.
These quality profiles show how individual trusts compare across a range of quality indicators encompassing the domains of the Outcomes Framework.
NHS atlas of variation in healthcare: diabetes atlas
NHS atlas of variation in healthcare: diabetes atlas:
Following the publication of the NHS atlas of variation in healthcare work has been undertaken to produced themed versions of the atlas. It is intended to support local decision making to increase the value which a population receives from the resources to spent on their healthcare. It supports the search for unexplained variations, the identification and attention to unwarranted variation, helping clinicians to understand what is going on in their area and where to focus attention to improve the care they provide.
Following the publication of the NHS atlas of variation in healthcare work has been undertaken to produced themed versions of the atlas. It is intended to support local decision making to increase the value which a population receives from the resources to spent on their healthcare. It supports the search for unexplained variations, the identification and attention to unwarranted variation, helping clinicians to understand what is going on in their area and where to focus attention to improve the care they provide.
CBI Public Services The right care the right place: delivering care closer to home
CBI Public Services The right care the right place: delivering care closer to home:
This report argues that delivering care closer to the home could provide better, healthier outcomes for patients and help ease NHS budgetary pressures by saving £3.4 billion a year. It sets out recommendations to remove barriers in order to make the delivery of care close to the home more widespread.
This report argues that delivering care closer to the home could provide better, healthier outcomes for patients and help ease NHS budgetary pressures by saving £3.4 billion a year. It sets out recommendations to remove barriers in order to make the delivery of care close to the home more widespread.
Most GPs not participating in strike
Most GPs not participating in strike:
Surveys have suggested that most GPs are not intending to participate in the BMA’s industrial action over pensions on June 21.
A survey undertaken by NHS Gloucestershire found that just 26% of the 51 practices and 261 GPs who responded to the PCT were planning to take action, while a survey by the GP newspaper Pulse found that just 29% of GPs expect their practice to take part fully in the day of action and a f... Healthcare Today
Surveys have suggested that most GPs are not intending to participate in the BMA’s industrial action over pensions on June 21.
A survey undertaken by NHS Gloucestershire found that just 26% of the 51 practices and 261 GPs who responded to the PCT were planning to take action, while a survey by the GP newspaper Pulse found that just 29% of GPs expect their practice to take part fully in the day of action and a f... Healthcare Today
Series of MPs admit to suffering mental illness for the first time ... - Daily Mail
Series of MPs admit to suffering mental illness for the first time ... - Daily Mail:
 The Guardian | Series of MPs admit to suffering mental illness for the first time ... Daily Mail 'We have got to talk about mental health in this House. ... His Mental Health (Discrimination) Bill will remove the blanket ban that forbids 'mentally disordered ... MPs discuss mental health problems in emotional Commons debateThe Independent Mental health problems no longer a bar to becoming an MPThe Guardian MPs reveal mental illness battlesThe Press Association Telegraph.co.uk -BBC News -The Northern Echo all 14 news articles » |
Department of Health extends NHS 111 roll out deadline
Department of Health extends NHS 111 roll out deadline:
Government extends date for implementation of 111 non-emergency service by 'up to six months'
The government has extended the deadline for the roll out of NHS 111 to make sure areas have enough time to plan for the service.
The announcement follows criticism of 111 by the British Medical Association and other unions, as well as pressure from clinical commissioning groups (CCGs) and private firms.
In a letter to CCGs Jim Easton, national director for improvement and efficiency at the Department of Health (DH), says that after careful consideration and having sought the views of senior CCG representatives, an extension of up to six months of the original April 2013 deadline may be necessary in some cases.
"That extension will be by application to an expert clinical panel, and should not delay roll out in those areas that are ready to move ahead," says the letter. "It will however, help ensure that in those areas that need it, time can be taken fully to engage local clinicians and build delivery models for NHS 111 that have the support and endorsement of all local stakeholders."
It goes on to say that the clinical panel will publish the criteria on which it will judge applications shortly. CCGs that want their areas to be considered for an extension should submit an application in writing to their strategic health authority.
At the end of last month, Capita expressed concerns about the 111 tender process and said it was not constructed "to result in cost-effective services that can flex to dynamic needs of the public". Around the same time, Serco and Care UK confirmed that they had taken the decision not to bid in the multimillion pound replacement programme to provide a new 24 hour urgent care service.
Despite these concerns, a number of areas are moving ahead with their 111 plans, including Wandsworth and Suffolk primary care trusts, which recently awarded care services specialist Harmoni a contract to operate its services.
With the help of NHS Direct and NHS Choices, the DH is currently trialling an NHS 111 online service as part of a plan to provide a service to complement locally-driven telephone services.
Commenting on the government's announcement to extend the deadline, Nick Chapman, chief executive of NHS Direct, said that the period of transition from the 0845 number to the new NHS 111 service is now likely to take longer.
He said: "NHS Direct believes that the DH's decision to allow further time to plan and implement these national changes to the urgent and emergency care service is the right one. It will allow for greater clinical engagement and ensure that the service is the best it can be for patients.
"As we understand it, the next step is for local commissioners who want an extension to make an application to the DH. We won't know until these applications have been made how many areas will request an extension, and what implications that may have for the 0845 service and for NHS Direct staff." Guardian Professional.
The government has extended the deadline for the roll out of NHS 111 to make sure areas have enough time to plan for the service.
The announcement follows criticism of 111 by the British Medical Association and other unions, as well as pressure from clinical commissioning groups (CCGs) and private firms.
In a letter to CCGs Jim Easton, national director for improvement and efficiency at the Department of Health (DH), says that after careful consideration and having sought the views of senior CCG representatives, an extension of up to six months of the original April 2013 deadline may be necessary in some cases.
"That extension will be by application to an expert clinical panel, and should not delay roll out in those areas that are ready to move ahead," says the letter. "It will however, help ensure that in those areas that need it, time can be taken fully to engage local clinicians and build delivery models for NHS 111 that have the support and endorsement of all local stakeholders."
It goes on to say that the clinical panel will publish the criteria on which it will judge applications shortly. CCGs that want their areas to be considered for an extension should submit an application in writing to their strategic health authority.
At the end of last month, Capita expressed concerns about the 111 tender process and said it was not constructed "to result in cost-effective services that can flex to dynamic needs of the public". Around the same time, Serco and Care UK confirmed that they had taken the decision not to bid in the multimillion pound replacement programme to provide a new 24 hour urgent care service.
Despite these concerns, a number of areas are moving ahead with their 111 plans, including Wandsworth and Suffolk primary care trusts, which recently awarded care services specialist Harmoni a contract to operate its services.
With the help of NHS Direct and NHS Choices, the DH is currently trialling an NHS 111 online service as part of a plan to provide a service to complement locally-driven telephone services.
Commenting on the government's announcement to extend the deadline, Nick Chapman, chief executive of NHS Direct, said that the period of transition from the 0845 number to the new NHS 111 service is now likely to take longer.
He said: "NHS Direct believes that the DH's decision to allow further time to plan and implement these national changes to the urgent and emergency care service is the right one. It will allow for greater clinical engagement and ensure that the service is the best it can be for patients.
"As we understand it, the next step is for local commissioners who want an extension to make an application to the DH. We won't know until these applications have been made how many areas will request an extension, and what implications that may have for the 0845 service and for NHS Direct staff." Guardian Professional.
Patients do not know how to contact GP outside normal hours: survey
Patients do not know how to contact GP outside normal hours: survey: Four in ten patients do not know how to contact their GP out-of-hours services, a government survey has found.
The Daily Telegraph
The Daily Telegraph
MPs discuss mental health problems in emotional Commons debate
MPs discuss mental health problems in emotional Commons debate:
A Tory MP disclosed she suffered suicidal feelings after having a baby as a series of MPs spoke today of their personal battles with mental illness in an emotional Commons debate. The Independent
A Tory MP disclosed she suffered suicidal feelings after having a baby as a series of MPs spoke today of their personal battles with mental illness in an emotional Commons debate. The Independent
Doctor warned over preaching religious beliefs in practice
Doctor warned over preaching religious beliefs in practice:
A doctor who preached to a patient that only Jesus could cure him of his problems has received an official warning from the General Medical Council (GMC) that his career could be at risk if he continues to proselytise. The Independent
A doctor who preached to a patient that only Jesus could cure him of his problems has received an official warning from the General Medical Council (GMC) that his career could be at risk if he continues to proselytise. The Independent
New eHealth position statement launched
New eHealth position statement launched: The RCN has published new eHealth guidance which reviews what eHealth is.
Thursday, 14 June 2012
Money management charge criticised
Money management charge criticised:
The county council has come under fire following the announcement that it will charge people without the mental capacity to run their finances nearly £400 a year to manage their money. Evening Telegraph
The county council has come under fire following the announcement that it will charge people without the mental capacity to run their finances nearly £400 a year to manage their money. Evening Telegraph
End of life care for people with dementia living in care homes
End of life care for people with dementia living in care homes:
It aims to provide an overview of a range of issues important to care home residents, carers and providers. NHS Networks
It aims to provide an overview of a range of issues important to care home residents, carers and providers. NHS Networks
A&Es see rise in sports injuries
A&Es see rise in sports injuries: The number of people attending A&E units with sports injuries has jumped by 15% a year, official figures show. BBC News
'Stop opposing assisted dying' - BMJ
'Stop opposing assisted dying' - BMJ: The British Medical Journal has called on doctors' organisations to stop opposing assisted dying for terminally ill, mentally competent adults. BBC News
The Mental Health Act 2007: a review of its implementation
The Mental Health Act 2007: a review of its implementation:
This report examines key issues in the operation of the Mental Health Act five years on. It finds that while there have been some improvements in the treatment of people detained under the Act there remain major concerns about the use of compulsory powers and the availability of advocacy and support for the most vulnerable people. It argues that CCGs and local authorities must ensure that they uphold the rights of people detained under the Mental Health Act as they take up their new responsibilities.
This report examines key issues in the operation of the Mental Health Act five years on. It finds that while there have been some improvements in the treatment of people detained under the Act there remain major concerns about the use of compulsory powers and the availability of advocacy and support for the most vulnerable people. It argues that CCGs and local authorities must ensure that they uphold the rights of people detained under the Mental Health Act as they take up their new responsibilities.
The functions of CCGs: updated to reflect the final Health and Social Care Act 2012
The functions of CCGs: updated to reflect the final Health and Social Care Act 2012:
This updated guidance is a summary to which GPs and emerging CCGs can refer. It aims to be helpful in informing the planning and implementation of CCG responsibilities. It sets out the key responsibilities and statutory powers for CCGs.
This updated guidance is a summary to which GPs and emerging CCGs can refer. It aims to be helpful in informing the planning and implementation of CCG responsibilities. It sets out the key responsibilities and statutory powers for CCGs.
NICE launches free British National Formulary Smartphone App for NHS England
NICE launches free British National Formulary Smartphone App for NHS England: The National Institute for Health and Clinical Excellence (NICE) has today launched a free British National Formulary (BNF) Smartphone application for download by health and social care professionals who work for or who are contracted by NHS England. NICE
Lansley: Reforms not linked to NHS ratings fall - BBC News
Lansley: Reforms not linked to NHS ratings fall - BBC News:
 Daily Mail |
Lansley: Reforms not linked to NHS ratings fall
BBC News Health Secretary Andrew Lansley has rejected a Labour suggestion that his stewardship of the NHS in England prompted a record decline in public approval of how the service is run. At his departmental question session on 12 June 2012, shadow health ... Politics blamed for drop in NHS satisfactionPolitics.co.uk Stats show record fall in NHS satisfaction – but Lansley says it's at a highThe Independent Record slump in public satisfaction with NHSWebMD.Boots.com Financial Times -Marketing Week -Daily Mail all 169 news articles » |
Cash strapped councils strip £900m from elderly care
Cash strapped councils strip £900m from elderly care: Elderly and disabled care budgets have been slashed by £900 million this year alone as local councils struggle to balance the books, social services chiefs have disclosed.
The Daily Telegraph
The Daily Telegraph
Report – People with Learning DIsabilites in England 2011
Report – People with Learning Disabilities in England 2011:
This report summarises information collected by several government departments about people with learning disabilities. It estimates how many people with learning disabilities there are in England and summarises information about the health and social care services they use.
This report summarises information collected by several government departments about people with learning disabilities. It estimates how many people with learning disabilities there are in England and summarises information about the health and social care services they use.
Wednesday, 13 June 2012
The funding formula: age vs deprivation
The funding formula: age vs deprivation: Following recent press reports floating the suggestion that NHS funds in England should be distributed to local areas solely on the basis of the age of the local population, doing so would be a profoundly retrograde step, says Professor Peter C Smith. The Health Foundation
NHS Pension Scheme proposal – what it means for doctors
NHS Pension Scheme proposal – what it means for doctors:
The global economic situation has changed since 2008 and finances, both public and private, are under pressure. The Hutton Review said that current public service pensions are unsustainable. Reform is necessary as people live longer than previous generations.
Here we explain what the proposed NHS pension deal means for doctors:
The global economic situation has changed since 2008 and finances, both public and private, are under pressure. The Hutton Review said that current public service pensions are unsustainable. Reform is necessary as people live longer than previous generations.
Here we explain what the proposed NHS pension deal means for doctors:
- Pension reform is required because people are living longer. Today, a 60-year-old doctor retiring can expect to enjoy 29 years of retirement. This means drawing a pension for almost the same time as they worked for the NHS – 36 years. In contrast, a doctor retiring at 60 in 1984 could only expect to enjoy 20 years of retirement. Both would have paid similar amounts for their pension but the extra 9 years would cost approximately £440,000 and the extra cost is picked up by the taxpayer.
- The 2008 reforms to NHS pensions are not enough. Despite raising the pension age to 65 for future members, the 2008 reforms did not allow the costs of increases in longevity to be managed fairly or sustainably. The agreement allowed members to remain in their existing arrangements with a pension age of 55 or 60, despite the improvements in longevity from which they had benefited. Future generations of NHS workers and taxpayers would have to pay for the increasing time existing pension scheme members can expect to spend in retirement, with only a limited contribution made by members in the form of higher contributions before retirement.
- The current scheme is not financially sustainable. The Government pays pensions from the public finances. Currently, the contributions received into the NHS pensions scheme are greater than the cost of benefits paid out to retired members, creating a £2 billion positive cash flow that some describe as a ‘surplus’. All this means is that the cost of future pension entitlements being built up is greater than those being paid out at the moment. It reflects the fact that the size of the NHS workforce has been growing over the last decade. It does not mean that the scheme is financially sustainable. The current gap between contributions made and benefits paid out is set to disappear by 2016 as NHS workforce growth reaches a plateau and a generation of members reach retirement.
- The reforms still provide an excellent pension. The current NHS pension scheme provides the average full time consultant retiring at 60 with a pension of over £43,000 a year for life and a tax free lump sum of around £135,000. Compare this with a newly qualified doctor joining the reformed scheme after 2015. He can expect a pension of over £53,000 at age 65 (the normal pension age for new joiners) or a pension of around £68,000 a year at his state pension age of 68.
- Doctors’ pensions will still be amongst the highest in the public sector. They will also be significantly higher than the vast majority of the working population. The average NHS pension is around £7,300 a year.
- The NHS pension scheme will remain one of the best available. An inflation-proof pension of £68,000 a year would require a pension pot of nearly £2 million in the private sector. Most taxpayers will have to work longer and contribute more for their pensions with no hope of getting benefits as good.
- Most staff do not have to work until their state pension age in order to get the same level of pension expected under existing arrangements. For the same pension and lump sum, the average 40-year-old consultant would only need to work an extra two and a half years and a 24-year-old doctor starting out on their medical career a little after the age of 66. Those who can expect to live longer are being asked to work longer.
- Higher paid NHS staff do not pay an unreasonable amount for their pension. Doctors contribute a similar proportion of their salary as other NHS staff on much more modest incomes but usually achieve better benefits. Tax relief on pension contributions means that from April 2012, a consultant earning over £110,000 would contribute 6.54% of their salary after tax relief (9.9% before tax relief) whilst a nurse earning a quarter of that would pay 6.4% after tax relief.
- Those closest to retirement will see no change. All NHS staff within 10 years of their pension age will remain in the current scheme. Limited protection will be provided to staff who are outside this group but within 13.5 years of their pension age. This means around 35% of the NHS workforce will see no or little impact on their pension arrangements. All staff will have the pension that they have accrued by 2015 fully protected.
- Pension reform affects all public servants not just NHS staff. Pensions are one element of wider remuneration packages that, of course, vary between different sectors. For example, the average salary of a civil servant is around £23,000 a year, for a nurse it is around £31,000 and for a secondary school teacher £36,000. Civil servants pay a lower contribution rate towards their pension compared with other public servants. However, pay levels for civil servants have always taken this into account. Department of Health
Public satisfaction with the NHS and its services
Public satisfaction with the NHS and its services:
The King's Fund have published the topline results and trends of the British Social Survey 2011 relating to NHS and healthcare, ahead of the full survey being released later this year. Overall, the results show that public satisfaction with the NHS has fallen 12% between 2010 and 2011.
Responses and comments
The King's Fund have published the topline results and trends of the British Social Survey 2011 relating to NHS and healthcare, ahead of the full survey being released later this year. Overall, the results show that public satisfaction with the NHS has fallen 12% between 2010 and 2011.
Responses and comments
Enablers and barriers to integrated care and implications for Monitor
Enablers and barriers to integrated care and implications for Monitor:
A consortium, led by Frontier Economics, and including The King’s Fund, The Nuffield Trust and Ernst & Young, was appointed by Monitor to consider issues relating to the delivery of integrated care. This report sets out the evidence, analysis and findings. Monitor are seeking comments on the findings of this report and will be accepting comments until 13th July 2012.
A consortium, led by Frontier Economics, and including The King’s Fund, The Nuffield Trust and Ernst & Young, was appointed by Monitor to consider issues relating to the delivery of integrated care. This report sets out the evidence, analysis and findings. Monitor are seeking comments on the findings of this report and will be accepting comments until 13th July 2012.
Facilitating improvement in primary care: the promise of practice coaching
Facilitating improvement in primary care: the promise of practice coaching:
Practice coaching, also called practice facilitation, assists general practices with the desire to improve in such areas as patient access, chronic and preventive care, electronic patient record use, patient-centeredness, cultural competence, and team-building. This briefing clarifies the essential features of practice coaching and offers guidance for health system leaders and policymakers on how best to structure and design these programs in primary care settings.
Practice coaching, also called practice facilitation, assists general practices with the desire to improve in such areas as patient access, chronic and preventive care, electronic patient record use, patient-centeredness, cultural competence, and team-building. This briefing clarifies the essential features of practice coaching and offers guidance for health system leaders and policymakers on how best to structure and design these programs in primary care settings.
Elderly will be able to 'sue' the NHS
Elderly will be able to 'sue' the NHS:
Care Minister Paul Burstow has said elderly patients will be able to sue the health service if they experience discrimination because of age.He said that from October this year older patients who have been refused care as a result of their age can sue the NHS.The decision, which covers hospitals in England, Wales and Scotland, comes after a consultation on the subject by the Home Office.According to a re... Healthcare Today
Care Minister Paul Burstow has said elderly patients will be able to sue the health service if they experience discrimination because of age.He said that from October this year older patients who have been refused care as a result of their age can sue the NHS.The decision, which covers hospitals in England, Wales and Scotland, comes after a consultation on the subject by the Home Office.According to a re... Healthcare Today
NHS compensation rises to £98m
NHS compensation rises to £98m:
The amount of money paid out to patients as compensation by the health service has increased from £56 million in 2009-10 to over £98 million in 2010-11.The NHS payouts to people who did not have their illness detected or diagnosed revealed that one in 10 were related to cancer not being spotted.The information was released by the NHS Litigation Authority (NHSLA) after a Freedom of Information request.M... Healthcare Today
The amount of money paid out to patients as compensation by the health service has increased from £56 million in 2009-10 to over £98 million in 2010-11.The NHS payouts to people who did not have their illness detected or diagnosed revealed that one in 10 were related to cancer not being spotted.The information was released by the NHS Litigation Authority (NHSLA) after a Freedom of Information request.M... Healthcare Today
NHS satisfaction levels fall 'due to NHS bill'
NHS satisfaction levels fall 'due to NHS bill': As an annual survey finds that patient's happiness with the NHS has fallen by record levels, the lead author of the report by the King's Fund, John Appleby, describes what he thinks are the reasons for it.
The Daily Telegraph
The Daily Telegraph
Doctors' checks 'needed now to maintain trust in medics', says Patients Association
Doctors' checks 'needed now to maintain trust in medics', says Patients Association: Patients' trust in doctors will fall if doctors are allowed to hold up compulsory checks being brought in to ensure they are still competent, Andrew Lansley, the Health Secretary, has been warned.
The Daily Telegraph
The Daily Telegraph
Director-governor interaction in NHS foundation trusts: A best practice guide for boards of directors
Director-governor interaction in NHS foundation trusts: A best practice guide for boards of directors: Monitor, working in conjunction with PA Consulting, conducted a research project to identify the key factors for establishing strong director-governor interaction within foundation trusts. The findings are encapsulated in this best practice guide, which is aimed at existing foundation trusts and aspirant foundation trusts.
Monitor
Monitor
Tuesday, 12 June 2012
Public satisfaction with NHS plummets in 2011
Public satisfaction with NHS plummets in 2011: Why has the British public's satisfaction with the way the NHS runs taken a nose dive in 2011 – falling from 70 per cent (its highest ever level) to 58 per cent? (Blog, 12 Jun 2012) Kings Fund
NHS waiting lists 'recategorised'
NHS waiting lists 'recategorised': The Royal College of Surgeons condemns NHS Trusts in England for changing clinical criteria and dropping patients from operation waiting lists without notice. BBC News
New medical and dental pay circular published
New medical and dental pay circular published: NHS Employers has published an updated pay circular. It contains the pay scales and allowances for medical and dental staff effective from 1 April 2012. NHS Employers
New summary guide to prevention of illegal working
New summary guide to prevention of illegal working: The UK Border Agency has produced a summary of its full guidance for preventing illegal working in the UK. NHS Employers
Health visitor employment: from training to practice - a guide for employers
Health visitor employment: from training to practice - a guide for employers:
This briefing outlines an employment model to help meet the required increase of health visitor training places. It describes the employment model, its benefits and what you need to consider if you decide to implement this approach. It aims to help provide a commitment of employment to students, increasing the confidence of undecided potential applicants to move into the profession.
This briefing outlines an employment model to help meet the required increase of health visitor training places. It describes the employment model, its benefits and what you need to consider if you decide to implement this approach. It aims to help provide a commitment of employment to students, increasing the confidence of undecided potential applicants to move into the profession.
Taking stock: assessing the value of preventative support
Taking stock: assessing the value of preventative support:
This report argues that elderly and vulnerable people are being put at risk by cuts to home-based care. It is the result of a survey of GPs and the general public and highlights concerns that a lack of support for people in their own homes is having a negative impact.
This report argues that elderly and vulnerable people are being put at risk by cuts to home-based care. It is the result of a survey of GPs and the general public and highlights concerns that a lack of support for people in their own homes is having a negative impact.
Stats show record fall in NHS satisfaction – but ministers say it's at a high
Stats show record fall in NHS satisfaction – but ministers say it's at a high:
Ministers clashed yesterday with health experts over whether public satisfaction with the NHS is holding up despite the harsh economic climate. The Independent
Ministers clashed yesterday with health experts over whether public satisfaction with the NHS is holding up despite the harsh economic climate. The Independent
Elderly patients win right to sue if medical treatment is denied because of age
Elderly patients win right to sue if medical treatment is denied because of age:
Elderly patients are to receive legal protection against being denied medical treatment simply because of their advanced years, ministers will announce today. The Independent
Elderly patients are to receive legal protection against being denied medical treatment simply because of their advanced years, ministers will announce today. The Independent
Monitor publishes independent report into 'Enablers and Barriers to Integrated Care and Implications for Monitor'
Monitor publishes independent report into 'Enablers and Barriers to Integrated Care and Implications for Monitor': Monitor has published an independent report today to inform the development of its policy on integrated care. The report titled Enablers and Barriers to Integrated Care and Implications for Monitor was commissioned by Monitor from Frontier Economics, the Nuffield Trust, the Kings Fund and Ernst & Young and is another part of the growing evidence base that Monitor will use to determine its approach as sector regulator.
Monday, 11 June 2012
Emergency calls rise over Jubilee
Emergency calls rise over Jubilee: Ambulance crews in Northamptonshire experienced a 25% increase in emergency call-outs over the Jubilee weekend, figures show. Evening Telegraph
Concern that rise in child neglect cases could cripple services in Northamptonshire
Concern that rise in child neglect cases could cripple services in Northamptonshire:
The NSPCC is warning that a sharp increase in reports of neglect cases will place additional pressure on already stretched children’s services across Northamptonshire.Northampton Chronicle & Echo
The NSPCC is warning that a sharp increase in reports of neglect cases will place additional pressure on already stretched children’s services across Northamptonshire.Northampton Chronicle & Echo
Small rise in Legionnaires' cases
Small rise in Legionnaires' cases: The number of confirmed and suspected cases of Legionnaires' disease in the Edinburgh outbreak rises slightly to 82. BBC News
Doctors' tribunal service begins
Doctors' tribunal service begins: Doctors will be referred to a new independent tribunal service if they are involved in fitness to practise hearings, as part of reforms by the General Medical Council. BBC News
Health visitor employment: from training to practice – new briefing
Health visitor employment: from training to practice – new briefing: NHS Employers has published a briefing outlining an employment model to help meet the required increase of health visitor training places.
Guidance on the appointment and employment of locum doctors
Guidance on the appointment and employment of locum doctors: The NHS Employers organisation has published guidelines and standards for the appointment and employment of NHS locum doctors in order to safeguard the quality of patient care.
Low cost and high quality integrated care: what can we learn from Japan?
Low cost and high quality integrated care: what can we learn from Japan?:
Natasha Curry, of the Nuffield Trust, explores Japan's long-term care insurance system and the lessons we can learn about caring for an ageing population
While changing demographics are putting considerable pressures on health and care systems in all Western countries, nowhere is it more acute than in Japan. A baby girl born today in Japan can expect to live to 86 and a baby boy to 79. By 2030, almost one in three people will be 65 or older.
Meeting the needs of an ageing population, against a backdrop of a diminishing total population, presents an enormous challenge for its Government. Yet Japan manages to provide universal health care coverage for its population (albeit with some co-payments) while spending around 8.5% of GDP – lower than the UK, Germany, New Zealand and a whole host of other OECD countries.
Just how is Japan managing to do it? To explore this question (among others) the Nuffield Trust organised a study visit to Japan with the generous support of the Great Britain Sasakawa Foundation.
Part of the answer to Japan's relatively low expenditure lies in its tight grip on costs. It operates a fee for service system but, instead of restricting access, it uses the fee schedule – which is revised every two years – to keep prices under control.
Another key part of the answer lies in Japan's long term care insurance system (LTCI). Established in 2000, LTCI was designed to socialise the care of older people, shifting responsibility away from family and into the public domain.
In so doing, the scheme sought to lift the burden of care from families (particularly women), enabling them to enter the workforce, and to relieve pressure on the health system.
Introduction of the scheme entailed significant cultural and systemic change and was not without controversy. Historically, there was stigma attached to putting your elderly parents in a care home yet there was no stigma attached to admitting them to hospital as it was seen to be a medical issue.
Lengths of stay grew and the number of institutional beds used for long-term care expanded rapidly. The trend towards older people living alone was also putting increasing pressure on health services.
Twelve years on, the scheme is embedded, well-established and widely considered a success. As such, it provides an interesting model for us as we grapple with the thorny issue of social care funding.
Part insurance-based and part tax-funded, the scheme operates alongside the existing health system, which is similarly part insurance-based and part tax funded. When people turn 40, they are required to start contributing to LTCI. Contributions vary according to locality but are typically around £30-40 per month.
Interestingly, debates at the time of its introduction focused on the possible erosion of traditional family values, and less on the extra financial burden on top of existing compulsory health insurance premia.
On turning 65, people become entitled to wide-ranging social care support, from home-based help with cooking and dressing to residential respite, intermediate and permanent care. Unlike our narrow definition of social care, long-term care in Japan includes some nursing and medical care for long-term conditions.
An individual's needs are assessed and they are assigned a care level which determines their entitlement. Individuals are required to pay some co-payments and 'hotel costs' for residential services (means-tested). The oil in the machine is the care manager who holds the budget and puts together a package of care.
Long-term care services have developed to wrap around mainstream health services. A competitive market of provision has emerged and many thousands of providers offer services. Many established hospitals have branched out into social care provision, extending their services to include home-based support and residential homes for those with dementia.
Of course, it's not perfect and growing financial pressures are giving rise to debates about eligibility and access. Before advocating for such a scheme to be introduced here, we must consider the context.
The Japanese scheme was introduced at a time of relative financial and political stability and in a very different cultural setting. In addition, the very limited system of provider regulation and quality assessment are elements that few here would find acceptable.
However, as the debate rages in England about how we might tackle the same issues, Japan offers one example of how wide-ranging reform can be achieved.
And, with 12 years of experience under their belts, we have the luxury of being able to observe and learn about what works and what doesn't and just how a parallel system of care can work and take the pressure off an overloaded health service.
Natasha Curry is senior fellow in health policy at the Nuffield Trust. Guardian Professional.
While changing demographics are putting considerable pressures on health and care systems in all Western countries, nowhere is it more acute than in Japan. A baby girl born today in Japan can expect to live to 86 and a baby boy to 79. By 2030, almost one in three people will be 65 or older.
Meeting the needs of an ageing population, against a backdrop of a diminishing total population, presents an enormous challenge for its Government. Yet Japan manages to provide universal health care coverage for its population (albeit with some co-payments) while spending around 8.5% of GDP – lower than the UK, Germany, New Zealand and a whole host of other OECD countries.
Just how is Japan managing to do it? To explore this question (among others) the Nuffield Trust organised a study visit to Japan with the generous support of the Great Britain Sasakawa Foundation.
Part of the answer to Japan's relatively low expenditure lies in its tight grip on costs. It operates a fee for service system but, instead of restricting access, it uses the fee schedule – which is revised every two years – to keep prices under control.
Another key part of the answer lies in Japan's long term care insurance system (LTCI). Established in 2000, LTCI was designed to socialise the care of older people, shifting responsibility away from family and into the public domain.
In so doing, the scheme sought to lift the burden of care from families (particularly women), enabling them to enter the workforce, and to relieve pressure on the health system.
Introduction of the scheme entailed significant cultural and systemic change and was not without controversy. Historically, there was stigma attached to putting your elderly parents in a care home yet there was no stigma attached to admitting them to hospital as it was seen to be a medical issue.
Lengths of stay grew and the number of institutional beds used for long-term care expanded rapidly. The trend towards older people living alone was also putting increasing pressure on health services.
Twelve years on, the scheme is embedded, well-established and widely considered a success. As such, it provides an interesting model for us as we grapple with the thorny issue of social care funding.
Part insurance-based and part tax-funded, the scheme operates alongside the existing health system, which is similarly part insurance-based and part tax funded. When people turn 40, they are required to start contributing to LTCI. Contributions vary according to locality but are typically around £30-40 per month.
Interestingly, debates at the time of its introduction focused on the possible erosion of traditional family values, and less on the extra financial burden on top of existing compulsory health insurance premia.
On turning 65, people become entitled to wide-ranging social care support, from home-based help with cooking and dressing to residential respite, intermediate and permanent care. Unlike our narrow definition of social care, long-term care in Japan includes some nursing and medical care for long-term conditions.
An individual's needs are assessed and they are assigned a care level which determines their entitlement. Individuals are required to pay some co-payments and 'hotel costs' for residential services (means-tested). The oil in the machine is the care manager who holds the budget and puts together a package of care.
Long-term care services have developed to wrap around mainstream health services. A competitive market of provision has emerged and many thousands of providers offer services. Many established hospitals have branched out into social care provision, extending their services to include home-based support and residential homes for those with dementia.
Of course, it's not perfect and growing financial pressures are giving rise to debates about eligibility and access. Before advocating for such a scheme to be introduced here, we must consider the context.
The Japanese scheme was introduced at a time of relative financial and political stability and in a very different cultural setting. In addition, the very limited system of provider regulation and quality assessment are elements that few here would find acceptable.
However, as the debate rages in England about how we might tackle the same issues, Japan offers one example of how wide-ranging reform can be achieved.
And, with 12 years of experience under their belts, we have the luxury of being able to observe and learn about what works and what doesn't and just how a parallel system of care can work and take the pressure off an overloaded health service.
Natasha Curry is senior fellow in health policy at the Nuffield Trust. Guardian Professional.
Handling concerns about a practitioner's behaviour and conduct: an NCAS good practice guide
Handling concerns about a practitioner's behaviour and conduct: an NCAS good practice guide:
This guidance sets out principles and practical steps for handling concerns regarding poor professional behaviour and conduct within the NHS.
This guidance sets out principles and practical steps for handling concerns regarding poor professional behaviour and conduct within the NHS.
Quality, innovation and value in cardiac rehabilitation: commissioning for improvement
Quality, innovation and value in cardiac rehabilitation: commissioning for improvement:
This interactive digital resource captures all the learning from the development, roll out and implementation of the DH Commissioning Pack for Cardiac Rehabilitation (2010) together with other leading NHS Improvement work driving up quality and efficiency in cardiac rehabilitation services.
This interactive digital resource captures all the learning from the development, roll out and implementation of the DH Commissioning Pack for Cardiac Rehabilitation (2010) together with other leading NHS Improvement work driving up quality and efficiency in cardiac rehabilitation services.
A glossary for NHS finance and governance
A glossary for NHS finance and governance:
This briefing covers a variety of terms regularly used by both commissioners and healthcare providers when discussing the key areas of NHS finance and governance.
This briefing covers a variety of terms regularly used by both commissioners and healthcare providers when discussing the key areas of NHS finance and governance.
Red Cross warns of 'false economy' of 'dangerous' social care cuts
Red Cross warns of 'false economy' of 'dangerous' social care cuts: Elderly people are being put in jeopardy by "dangerous" cuts to basic home care which will end up costing the taxpayer thousands of pounds, GPs today warn.
The Daily Telegraph
The Daily Telegraph
Doctors issue new warning on legal highs
Doctors issue new warning on legal highs: Doctors and police have issued a warning over a 'legal high' called Benzo Fury after a man died and two people were taken to hospital at a music festival.
The Daily Telegraph
The Daily Telegraph
10-year low for cervical cancer tests
10-year low for cervical cancer tests:
Cervical cancer testing among women in England is at a 10-year low, with 20 per cent not being screened. The Independent
Cervical cancer testing among women in England is at a 10-year low, with 20 per cent not being screened. The Independent
Update 8 June: Increase in cases of cryptosporidiosis
Update 8 June: Increase in cases of cryptosporidiosis: The Health Protection Agency (HPA) continues to lead a multi-agency investigation to determine whether recent cases of cryptosporidiosis are linked to a common source.
Friday, 8 June 2012
The family and friends test: will hospitals raise their game? | Jocelyn Cornwell
The family and friends test: will hospitals raise their game? | Jocelyn Cornwell: From April 2013, every NHS hospital will be required to ask patients in A&E and on the wards whether they would want a friend or relative to be treated there. But will this drive hospitals to raise their game? (Blog, 7 Jun 2012) Kings Fund
The 15 Steps Challenge: Quality from a patient’s perspective
The 15 Steps Challenge: Quality from a patient’s perspective:
The 15 Steps Challenge encourages patients and staff to work together to identify improvements which may enhance the patient experience, highlighting what is working well and what might be done to increase patient confidence. NHS Networks
The 15 Steps Challenge encourages patients and staff to work together to identify improvements which may enhance the patient experience, highlighting what is working well and what might be done to increase patient confidence. NHS Networks
CCGs seek clarity about commissioning support
CCGs seek clarity about commissioning support: As authorisation begins, Marina Soteriou looks at clinical commissioning groups' (CCGs') next steps. GP Online
An atlas of variations in social care: an analysis of the quality of social care services in England
An atlas of variations in social care: an analysis of the quality of social care services in England:
This report reveals the financial and personal costs of variations in social care provision. It uncovers that £115 million of Government expenditure earmarked as ‘additional’ in 2011/12, and to be transferred from the NHS to local authorities for improving social care, is being used by commissioners to prop up eligibility criteria for existing services. Eligibility criteria are the indicators and measurements used to assess people’s social care needs and the services they should be able to access.
This report reveals the financial and personal costs of variations in social care provision. It uncovers that £115 million of Government expenditure earmarked as ‘additional’ in 2011/12, and to be transferred from the NHS to local authorities for improving social care, is being used by commissioners to prop up eligibility criteria for existing services. Eligibility criteria are the indicators and measurements used to assess people’s social care needs and the services they should be able to access.
Celebrating early implementer achievements - one year on: 150 years of health visiting services (1862-2012)
Celebrating early implementer achievements - one year on: 150 years of health visiting services (1862-2012):
This report provides more detail about the outcomes of the heath visitor early implementer sites’ (EIS) activities. It is a ‘one stop’ access point to the main elements of learning that came from the initial group of early implementers . It will be used to inform a second wave of service roll out, enabling to further improvement and development of local services. The twenty six case studies (one from each EIS), reflects learning and development stemming from the first wave of implementation and is aimed at the health visitor workforce, clinical leaders and commissioners.
This report provides more detail about the outcomes of the heath visitor early implementer sites’ (EIS) activities. It is a ‘one stop’ access point to the main elements of learning that came from the initial group of early implementers . It will be used to inform a second wave of service roll out, enabling to further improvement and development of local services. The twenty six case studies (one from each EIS), reflects learning and development stemming from the first wave of implementation and is aimed at the health visitor workforce, clinical leaders and commissioners.
NHS bursary scheme rules
NHS bursary scheme rules:
This document outlines the new rules which are applicable for students who started courses on or after 1st September 2012. The rules for students who started their courses before this date are set out in the thirteenth edition of the NHS bursary scheme rules.
This document outlines the new rules which are applicable for students who started courses on or after 1st September 2012. The rules for students who started their courses before this date are set out in the thirteenth edition of the NHS bursary scheme rules.
NHS millions used to 'prop up crumbling care system', report shows
NHS millions used to 'prop up crumbling care system', report shows: More than £100 million of taxpayers money set aside to improve care for the elderly and disabled has been spent by councils simply propping up the existing system, a report shows. The Daily Telegraph
NHS compensation to misdiagnosed patients rises to £98 million
NHS compensation to misdiagnosed patients rises to £98 million: Payouts to misdiagnosed patients increases by three-quarters in the last year to nearly £100 million.
The Daily Telegraph
The Daily Telegraph
New information measures published today about GP practices in England
New information measures published today about GP practices in England: Twenty new information measures about GP practices in England have been published today by the Health and Social Care Information Centre (HSCIC).
CT scans 'linked to brain cancer risk'
CT scans 'linked to brain cancer risk':
“CT scans can triple the risk of children developing leukaemia and brain cancer,” The Independent has today reported. Computerised tomography, or CT, is a technique that uses advanced X-ray technology to build up a detailed picture of a patient’s insides. Like regular X-rays, CT exposes patients to radiation that could potentially increase the risk of cancer.
Today’s news is based on a 24-year study that investigated whether or not children and adolescents given CT scans had an increased risk of brain tumours and leukaemia in the years that followed. The research compared the risk among children who were exposed to high doses of radiation during the scans with that of children who were exposed to the lowest dose of radiation. They found that the risk of developing leukaemia or a brain tumour increased as radiation exposure went up. Children who were exposed to a dose of radiation equivalent to two-to-three CT scans were at nearly three times the risk of developing a brain tumour in the next 10 years compared with children with the lowestexposure. Those who had been exposed to a dose equal to 5-10 scans had approximately three times the risk of developing leukaemia compared with those who received the lowest dose. However, it should be noted that the total number of cancer cases was low, and the overall risk of developing either a brain tumour or leukaemia remained well below 1%.
This study suggests that children who are exposed to higher levels of radiation during a CT scan may have an increased risk of developing certain types of cancer. This increase in risk is small in real terms, but should still be weighed up alongside the benefits of a scan. It’s important to note that these risks don’t apply to MRI scans, which are alternative scans that don’t use the ionising radiation of X-rays. However, MRI scans don’t always provide the same detail as CT scans and are therefore not always the most appropriate scanning method.
The study was published in the peer-reviewed medical journal The Lancet.
The media reported the story accurately, with most news outlets emphasising that the “absolute risk” of developing cancer remained quite low even after repeated CT scans. “Absolute risk” presents a person’s overall risk of developing a condition, rather than how much a person’s risk is raised by an event such as a CT scan. News coverage also reported that the benefits of scans generally outweigh the risks.
CT scans are used to create images of the body that are much more detailed than those obtained by a typical X-ray. CT scans are usually used to diagnose a number of conditions, including cancers, and bleeding or swelling in the brain. They may be used after serious accidents in order to determine whether or not there are serious internal injuries. The amount of radiation absorbed during a CT scan depends on various factors including the body part scanned, the tissue or organ of interest, the age of the scanning technology used and the patient’s age and sex. The researchers took these factors into consideration in order to estimate the amount of radiation each patient was exposed to.
This was a large, long-running retrospective cohort study. A study of this type can establish the association between exposure to CT radiation and cancer risk, but can’t conclusively show that one causes the other.
They then determined how many of the patients went on to develop a brain tumour or leukaemia (a type of blood cancer) and determined the risk of developing one of these cancers over an average of 10 years based on radiation dose. The researchers then compared the risk of developing one of these cancers in the higher radiation-dose groups with the risk in the lowest-dose group.
Compared with patients exposed to the lowest dose of radiation:
CT scans (like many other scans such as X-rays) expose the body to doses of ionising radiation, although it is not entirely definite that this exposure increases leukaemia or brain tumour risk. However, as the researchers have rightly pointed out, when considering whether or not to conduct a CT scan doctors should weigh up the benefits of the scan against its small increase in brain tumour and leukaemia risk. Like any other test or treatment, doctors must consider whether a CT scan is the best option for the patient and what the overall balance of benefits and harms is.
The researchers added that the radiation doses of CT scans should be kept as low as possible, and that CT should only be used once other diagnostic tests with lower or zero radiation doses (such as ultrasound or MRI scans) have already been used or ruled out.
It is important to remember that the three-fold risk increases covered in the media headlines are relative increases, and that the absolute risk increase of developing a brain tumour or leukaemia following childhood CT scans is well below 1%.
UK regulations already state that CT scans should only be used when clinically justified, and the UK is reported to have lower levels of CT scanning compared with other countries. CT scans are an invaluable diagnostic tool in many medical situations, and although this research does suggest a potential link with brain cancers and leukaemia, the benefits of this accurate and fast test appear to outweigh the risks associated with radiation exposure.
Analysis by Bazian
CT scans could triple risk of a brain tumour in children. The Daily Telegraph, June 7 2012
CT scans 'triple risk of children getting cancer'. The Independent, June 7 2012
Child's risk of brain cancer triples after just two CT scans. Daily Mail, June 7 2012
Related editorial
Einstein AJ. Beyond the bombs: cancer risks of low-dose medical radiation. The Lancet, Early Online Publication, June 7 2012
NHS Choices
Today’s news is based on a 24-year study that investigated whether or not children and adolescents given CT scans had an increased risk of brain tumours and leukaemia in the years that followed. The research compared the risk among children who were exposed to high doses of radiation during the scans with that of children who were exposed to the lowest dose of radiation. They found that the risk of developing leukaemia or a brain tumour increased as radiation exposure went up. Children who were exposed to a dose of radiation equivalent to two-to-three CT scans were at nearly three times the risk of developing a brain tumour in the next 10 years compared with children with the lowestexposure. Those who had been exposed to a dose equal to 5-10 scans had approximately three times the risk of developing leukaemia compared with those who received the lowest dose. However, it should be noted that the total number of cancer cases was low, and the overall risk of developing either a brain tumour or leukaemia remained well below 1%.
This study suggests that children who are exposed to higher levels of radiation during a CT scan may have an increased risk of developing certain types of cancer. This increase in risk is small in real terms, but should still be weighed up alongside the benefits of a scan. It’s important to note that these risks don’t apply to MRI scans, which are alternative scans that don’t use the ionising radiation of X-rays. However, MRI scans don’t always provide the same detail as CT scans and are therefore not always the most appropriate scanning method.
Where did the story come from?
The study was carried out by researchers from Newcastle University and other institutions throughout the UK, US and Canada. The research was funded by the UK Department of Health and the US National Cancer Institute.The study was published in the peer-reviewed medical journal The Lancet.
The media reported the story accurately, with most news outlets emphasising that the “absolute risk” of developing cancer remained quite low even after repeated CT scans. “Absolute risk” presents a person’s overall risk of developing a condition, rather than how much a person’s risk is raised by an event such as a CT scan. News coverage also reported that the benefits of scans generally outweigh the risks.
What kind of research was this?
This was a retrospective cohort study of children and adolescents that examined the association between estimated radiation exposure during a computed tomography (CT) scan and the risk of developing a brain tumour or leukaemia.CT scans are used to create images of the body that are much more detailed than those obtained by a typical X-ray. CT scans are usually used to diagnose a number of conditions, including cancers, and bleeding or swelling in the brain. They may be used after serious accidents in order to determine whether or not there are serious internal injuries. The amount of radiation absorbed during a CT scan depends on various factors including the body part scanned, the tissue or organ of interest, the age of the scanning technology used and the patient’s age and sex. The researchers took these factors into consideration in order to estimate the amount of radiation each patient was exposed to.
This was a large, long-running retrospective cohort study. A study of this type can establish the association between exposure to CT radiation and cancer risk, but can’t conclusively show that one causes the other.
What did the research involve?
The researchers examined the medical records of over 175,000 patients under the age of 22 years old who had undergone a CT scan between 1985 and 2001. The researchers estimated the amount of radiation that the patients were exposed to during these scans and grouped the patients based on this estimated dose.They then determined how many of the patients went on to develop a brain tumour or leukaemia (a type of blood cancer) and determined the risk of developing one of these cancers over an average of 10 years based on radiation dose. The researchers then compared the risk of developing one of these cancers in the higher radiation-dose groups with the risk in the lowest-dose group.
What were the basic results?
Among the 175,000 patients there were a total of 135 brain tumours and 74 cases of leukaemia diagnosed during the follow-up period. The researchers found that the risk of both of these cancers increased with higher radiation doses.Compared with patients exposed to the lowest dose of radiation:
- Patients exposed to a dose equivalent to two-to-three CT scans had over a three-fold increased risk of developing a brain tumour (relative risk [RR] 3.32, 95% CI 1.84 to 6.42).
- Patients exposed to a dose equivalent to 5-10 CT scans had over a three-fold increased risk of developing leukaemia (RR 3.18, 95% CI 1.46 to 6.94).
How did the researchers interpret the results?
The researchers concluded that, while the absolute increase in risk was low, “radiation doses from CT scans ought to be kept as low as possible.”Conclusion
This well-conducted research suggests that, among children, the risk of developing a brain tumour or leukaemia goes up as doses of radiation from CT scans increase. This absolute increase in risk, however, is quite small.CT scans (like many other scans such as X-rays) expose the body to doses of ionising radiation, although it is not entirely definite that this exposure increases leukaemia or brain tumour risk. However, as the researchers have rightly pointed out, when considering whether or not to conduct a CT scan doctors should weigh up the benefits of the scan against its small increase in brain tumour and leukaemia risk. Like any other test or treatment, doctors must consider whether a CT scan is the best option for the patient and what the overall balance of benefits and harms is.
The researchers added that the radiation doses of CT scans should be kept as low as possible, and that CT should only be used once other diagnostic tests with lower or zero radiation doses (such as ultrasound or MRI scans) have already been used or ruled out.
It is important to remember that the three-fold risk increases covered in the media headlines are relative increases, and that the absolute risk increase of developing a brain tumour or leukaemia following childhood CT scans is well below 1%.
UK regulations already state that CT scans should only be used when clinically justified, and the UK is reported to have lower levels of CT scanning compared with other countries. CT scans are an invaluable diagnostic tool in many medical situations, and although this research does suggest a potential link with brain cancers and leukaemia, the benefits of this accurate and fast test appear to outweigh the risks associated with radiation exposure.
Analysis by Bazian
Links To The Headlines
CT scans warning after study claims too many could lead to brain cancer. The Guardian, June 7 2012CT scans could triple risk of a brain tumour in children. The Daily Telegraph, June 7 2012
CT scans 'triple risk of children getting cancer'. The Independent, June 7 2012
Child's risk of brain cancer triples after just two CT scans. Daily Mail, June 7 2012
Links To Science
Pearce MS, Salotti JA, Little MP et al. Radiation exposure from CT scans in childhood and subsequent risk of leukaemia and brain tumours: a retrospective cohort study. The Lancet, Early Online Publication, 7 June 2012Related editorial
Einstein AJ. Beyond the bombs: cancer risks of low-dose medical radiation. The Lancet, Early Online Publication, June 7 2012
NHS Choices
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