Ambulances in Northamptonshire help out after ‘teething problems’ at private firm:
The ambulance service for Northamptonshire is being called in to transport upto six patients a day on routine transfers after ‘teething problems’ by the private firm that now runs the service, it has been claimed. Northampton Chronicle and Echo
Tuesday, 24 July 2012
Ramadan – a guide for healthcare professionals
Ramadan – a guide for healthcare professionals: This year’s Ramadan starts on Friday, 20 July, and will continue for 30 days until Saturday, 18 August.
NHS Diabetes has developed an online guide to help healthcare professionals support their patients to manage their diabetes during Ramadan, using a leaflet produced by the University Hospitals of Leicester NHS Trust.
NHS Diabetes has also brought together useful resources, which are available as part of the guide.
NHS Diabetes has developed an online guide to help healthcare professionals support their patients to manage their diabetes during Ramadan, using a leaflet produced by the University Hospitals of Leicester NHS Trust.
NHS Diabetes has also brought together useful resources, which are available as part of the guide.
New commissioning factsheet for CCGs
New commissioning factsheet for CCGs:
This explains:
A number of previous documents have described these commissioning responsibilities, but the factsheet brings the information together in one place and provides further clarity on certain aspects. NHS Networks
This explains:
- Which services CCGs will commission from 1 April 2013
- Those services that will be commissioned by the NHS Commissioning Board (NHS CB)
- Those services that will be commissioned or provided by local authorities and Public Health England.
A number of previous documents have described these commissioning responsibilities, but the factsheet brings the information together in one place and provides further clarity on certain aspects. NHS Networks
Health and social care reform: making it work for mental health
Health and social care reform: making it work for mental health:
It highlights four key areas of concern in commissioning; local decision making; integrated care; and personalisation and patient choice. It makes recommendations to CCGs, health and wellbeing boards, government and MPs in order to overcome any challenges which the reforms might present. NHS Networks
It highlights four key areas of concern in commissioning; local decision making; integrated care; and personalisation and patient choice. It makes recommendations to CCGs, health and wellbeing boards, government and MPs in order to overcome any challenges which the reforms might present. NHS Networks
UK's hidden world of mutilation
UK's hidden world of mutilation: UK women speak out about the hidden world of female mutilation BBC News
VIDEO: Hidden world of mutilation in the UK
VIDEO: Hidden world of mutilation in the UK: About 20,000 children are 'at risk' from Female Genital Mutilation (FGM) every year in the year in the UK. Sue Lloyd Roberts investigates why despite being illegal for many years it still goes on. BBC News
Millions of hospital data errors 'threaten GP commissioning'
Millions of hospital data errors 'threaten GP commissioning': Hospitals in England are consistently failing to supply correct patient data to the wider NHS, which may undermine GP commissioning, according to a landmark report. GP Online
Immigration rules workshop FAQs
Immigration rules workshop FAQs: New frequently asked questions (FAQs) on immigration rules are now available on our website. NHS Employers
National survey of hepatitis C services in prisons in England
National survey of hepatitis C services in prisons in England:
This survey is the first dedicated look at hepatitis C services in prisons in England. Basic information was collected on the types of services provided in prisons for the diagnosis, treatment and follow-up of prisoners with hepatitis C. The survey indicates progress in accessibility, as treatment for chronic hepatitis C infection is now available to prisoners in most prisons in England compared to two thirds of prisons testing in 2007. The survey states that the diagnosis and treatment of chronic hepatitis C in prison is beneficial as it provides access to normally ‘hard-to-reach’ individuals. The results of this survey offer useful information for policy makers, commissioners and service providers on models of good practice for provision of diagnosis, treatment and care of people living with hepatitis C infection in prisons in England.
This survey is the first dedicated look at hepatitis C services in prisons in England. Basic information was collected on the types of services provided in prisons for the diagnosis, treatment and follow-up of prisoners with hepatitis C. The survey indicates progress in accessibility, as treatment for chronic hepatitis C infection is now available to prisoners in most prisons in England compared to two thirds of prisons testing in 2007. The survey states that the diagnosis and treatment of chronic hepatitis C in prison is beneficial as it provides access to normally ‘hard-to-reach’ individuals. The results of this survey offer useful information for policy makers, commissioners and service providers on models of good practice for provision of diagnosis, treatment and care of people living with hepatitis C infection in prisons in England.
Nurse facing sack for Facebook protest
Nurse facing sack for Facebook protest:
A nurse who made a Facebook post about Biggleswade Hospital has been suspended from her job.Bernadette Green wrote on a Facebook group page for hospital supporters: “Did you know Whitbread ward is down to two patients now???? Yet still SEPT deny that beds are being blocked. If it wasn’t so serious it would be laughable." A spokesman for SEPT said: "A member of staff has been suspended pending a... Healthcare Today
A nurse who made a Facebook post about Biggleswade Hospital has been suspended from her job.Bernadette Green wrote on a Facebook group page for hospital supporters: “Did you know Whitbread ward is down to two patients now???? Yet still SEPT deny that beds are being blocked. If it wasn’t so serious it would be laughable." A spokesman for SEPT said: "A member of staff has been suspended pending a... Healthcare Today
'Advance refusal' cards for patients fearing 'death pathway'
'Advance refusal' cards for patients fearing 'death pathway': Terminally ill patients are being issued with special cards warning doctors not to place them on a controversial "death pathway" amid fears the practice is becoming routine.
The Daily Telegraph
The Daily Telegraph
Average worker took six days off sick last year
Average worker took six days off sick last year:
The amount of time lost through sickness absence has fallen to less than 3 per cent in Britain, new research has revealed. The Independent
The amount of time lost through sickness absence has fallen to less than 3 per cent in Britain, new research has revealed. The Independent
Physios to prescribe drugs
Physios to prescribe drugs:
Physiotherapists and podiatrists will be allowed to prescribe medicines, the Department of Health has announced. The Independent
Physiotherapists and podiatrists will be allowed to prescribe medicines, the Department of Health has announced. The Independent
Monday, 23 July 2012
Danetre Hospital wins national award for end-of-life care
Danetre Hospital wins national award for end-of-life care Staff from Danetre Hospital inpatient ward, which is managed by NGH, are celebrating after receiving a national award recognising their high quality of care for people nearing the end of life. NGH News
Northamptonshire’s ambulance trust helps prosecute most alleged attackers
Northamptonshire’s ambulance trust helps prosecute most alleged attackers:
Thugs who attack East Midlands Ambulance Service (EMAS) staff are convicted at double the rate of the next best trust, latest figures show. Northampton Chronicle and Echo
Thugs who attack East Midlands Ambulance Service (EMAS) staff are convicted at double the rate of the next best trust, latest figures show. Northampton Chronicle and Echo
Stores to sell asthma inhalers
Stores to sell asthma inhalers: Asthma inhalers will go on sale in supermarkets for the first time, allowing sufferers to get the medicine without seeing their doctor. BBC News
Best practice guide for CCGs aims to cut costs and boost quality
Best practice guide for CCGs aims to cut costs and boost quality: A best practice guide to a dozen clinical commissioning group (CCG) success stories is the first publication by CCG representative body NHS Clinical Commissioners (NHSCC). GP Online
When doctors and patients talk: making sense of the consultation
When doctors and patients talk: making sense of the consultation:
This report explores the main form of interaction between a patient and a clinician - the consultation. It offers an analysis of the current relationship and describes the potential for a more nuanced model for the consultation. It makes recommendations for commissioning bodies and service providers to develop programmes that will boost patient skills and confidence and also to support doctors who are keen to experiment with new ways of working.
This report explores the main form of interaction between a patient and a clinician - the consultation. It offers an analysis of the current relationship and describes the potential for a more nuanced model for the consultation. It makes recommendations for commissioning bodies and service providers to develop programmes that will boost patient skills and confidence and also to support doctors who are keen to experiment with new ways of working.
Young people’s views and experiences of GP services in relation to emotional and mental health
Young people’s views and experiences of GP services in relation to emotional and mental health:
This research was conducted to assess young people’s experiences of visiting their GP in order to identify responses they would like in relation to their mental and emotional health and what improvements are required to enable them to have a better experience.
This research was conducted to assess young people’s experiences of visiting their GP in order to identify responses they would like in relation to their mental and emotional health and what improvements are required to enable them to have a better experience.
Clinical commissioning in action
Clinical commissioning in action:
This publication shares learning from CCGs around England in the form of case studies. Each case study illustrates an example of successful outcomes and service provision.
This publication shares learning from CCGs around England in the form of case studies. Each case study illustrates an example of successful outcomes and service provision.
Can open data spark long-awaited change in the NHS?
Can open data spark long-awaited change in the NHS?:
In other services, open data is making a real difference and could do the same for healthcare
The coalition government has made transparency and open data a defining theme of its agenda and has set out its ambition for the UK to become a world leader in informatics and healthcare data management.
The prime minister has pledged a "complete revolution in transparency", with the raw data that will allow people to analyse the performance of public services being made freely available.
Ultimately, though, the chief barrier within the health service is culture, not kit. Years ago Rudolf Klein said society had stopped thinking of doctors as high priests and started to consider them more as mechanics, more like the technicians of your local garage than the miracle workers of your local church. In fact, in the main the NHS remains our national religion and the doctors its clergy: can data and information spark the long-awaited reformation in the balance of power?
Publication of clinical outcomes has helped improve the quality of healthcare and many leading NHS providers are developing sophisticated IT systems to manage performance. Reform is working with the Cabinet Office and PA Consulting on a series of events to explore this theme and on 19 July held a breakfast meeting with Earl Howe, parliamentary under-secretary of state for health on the topic of informing people; empowering patients.
Howe made it clear that the open data white paper and the Department of Health's information strategy make publishing of performance data mandatory.
Data about organisational performance can have a transformative effect. As Reform has shown in numerous case studies, high performing systems use every possible channel to care for patients – a dedicated website enables them to browse for information, they can view lab results online through a secure server on the same day as the test, receive email reminders about appointments, drug dosages and more, book appointments online, by email and over the phone, and email or call doctors, nurses and pharmacists with questions.
At Kaiser Permanante and the Cleveland Clinic in the US, to name just two examples, doctors are also benchmarked against each other on clinical indicators, from how good they are at monitoring their patients and reaching out to them through to the outcomes of their treatments.
The opportunities of "big data" groups are considerable. For example, predictive risk modelling can have considerable benefits. In healthcare as in other walks of life the 80:20 rule applies: 80% of the money goes on 20% of the people.
In the US this summer I learned about how McKesson, a global health technology company, won a four-year contract for the Illinois Medicare budget. The first thing they did was run the numbers. They audited terabytes of government data – about patient referrals, treatments and payments – looking for patterns. From this they were able to identify those who were ill and those most at risk of getting ill.
Then they contacted each citizen to verify this and assigned them case managers: at-risk patients received intensive preventative care; "frequent flyers" were carefully monitored with regular calls and checks, visited at home by social workers, given advice about diet and exercise, treated in local clinics rather than the emergency room, and so on. Over four years from 2005-2009, McKesson saved the government $569m (£362m) and improved the quality of the care.
This shows that compassion and technology aren't necessarily incompatible; they can be mutually reinforcing. But there are further spin-offs. Aggregating this kind of information will enable us to understand much better which clinical therapies deliver most value. In this, there are, as PA's Colm Reilly explained at the meeting, growth opportunities for the UK's life sciences industry.
So far, progress in the NHS has been slow. In 1858 Florence Nightingale penned a "Proposal for Improved Statistics of Surgical Operations", but only in 2006 did the Society of Cardiothoracic Surgeons start to make their mortality data publicly available. They were pushed into doing so by the president, Bruce Keogh, now medical director of the NHS.
Since then, raw data for individual surgeons has been openly displayed online against a mortality range based on patient characteristics. No other speciality has managed to do the same. Veena Raleigh, from the King's Fund, pointed out the paucity and integrity of clinical information about care quality in general practices and community services is worrying. A recent BMJ editorial also called on the royal colleges and the medical societies – naming and shaming them – to show leadership. "What are you doing?" asked its editor, Fiona Godlee.
There are legitimate reasons for caution, of course. It is essential that data is of a high quality, that there are high standards, that the data is secure (Kaiser Permanante's My health manager patient portal is set up with higher security than most online banking sites), and that it is protected not only with good protocols but also good governance.
If it is to do so, not only will the medical profession have to let go: patients will have to get more involved. We have to engage the public with the simple truth that the health service cannot succeed in the future unless users and citizens recognise their own role in helping those services do more with less. We have to make our own efforts, whether it is looking after our health or managing our own conditions.
We also need to be willing to share data about our lifestyle and health conditions, but fear holds people back. Simon Eccles, a doctor, suggested the following question: "would you mind me sharing information about your health with my colleagues if it would save your life?" Two reports published by the Health Foundation on 19 July – When doctors and patients talk and Helping people share decision making – add to a growing body of research. If information is power, then shared information is shared power.
Nick Seddon is deputy director of the Reform thinktank Guardian Professional
The coalition government has made transparency and open data a defining theme of its agenda and has set out its ambition for the UK to become a world leader in informatics and healthcare data management.
The prime minister has pledged a "complete revolution in transparency", with the raw data that will allow people to analyse the performance of public services being made freely available.
Ultimately, though, the chief barrier within the health service is culture, not kit. Years ago Rudolf Klein said society had stopped thinking of doctors as high priests and started to consider them more as mechanics, more like the technicians of your local garage than the miracle workers of your local church. In fact, in the main the NHS remains our national religion and the doctors its clergy: can data and information spark the long-awaited reformation in the balance of power?
Publication of clinical outcomes has helped improve the quality of healthcare and many leading NHS providers are developing sophisticated IT systems to manage performance. Reform is working with the Cabinet Office and PA Consulting on a series of events to explore this theme and on 19 July held a breakfast meeting with Earl Howe, parliamentary under-secretary of state for health on the topic of informing people; empowering patients.
Howe made it clear that the open data white paper and the Department of Health's information strategy make publishing of performance data mandatory.
Data about organisational performance can have a transformative effect. As Reform has shown in numerous case studies, high performing systems use every possible channel to care for patients – a dedicated website enables them to browse for information, they can view lab results online through a secure server on the same day as the test, receive email reminders about appointments, drug dosages and more, book appointments online, by email and over the phone, and email or call doctors, nurses and pharmacists with questions.
At Kaiser Permanante and the Cleveland Clinic in the US, to name just two examples, doctors are also benchmarked against each other on clinical indicators, from how good they are at monitoring their patients and reaching out to them through to the outcomes of their treatments.
The opportunities of "big data" groups are considerable. For example, predictive risk modelling can have considerable benefits. In healthcare as in other walks of life the 80:20 rule applies: 80% of the money goes on 20% of the people.
In the US this summer I learned about how McKesson, a global health technology company, won a four-year contract for the Illinois Medicare budget. The first thing they did was run the numbers. They audited terabytes of government data – about patient referrals, treatments and payments – looking for patterns. From this they were able to identify those who were ill and those most at risk of getting ill.
Then they contacted each citizen to verify this and assigned them case managers: at-risk patients received intensive preventative care; "frequent flyers" were carefully monitored with regular calls and checks, visited at home by social workers, given advice about diet and exercise, treated in local clinics rather than the emergency room, and so on. Over four years from 2005-2009, McKesson saved the government $569m (£362m) and improved the quality of the care.
This shows that compassion and technology aren't necessarily incompatible; they can be mutually reinforcing. But there are further spin-offs. Aggregating this kind of information will enable us to understand much better which clinical therapies deliver most value. In this, there are, as PA's Colm Reilly explained at the meeting, growth opportunities for the UK's life sciences industry.
So far, progress in the NHS has been slow. In 1858 Florence Nightingale penned a "Proposal for Improved Statistics of Surgical Operations", but only in 2006 did the Society of Cardiothoracic Surgeons start to make their mortality data publicly available. They were pushed into doing so by the president, Bruce Keogh, now medical director of the NHS.
Since then, raw data for individual surgeons has been openly displayed online against a mortality range based on patient characteristics. No other speciality has managed to do the same. Veena Raleigh, from the King's Fund, pointed out the paucity and integrity of clinical information about care quality in general practices and community services is worrying. A recent BMJ editorial also called on the royal colleges and the medical societies – naming and shaming them – to show leadership. "What are you doing?" asked its editor, Fiona Godlee.
There are legitimate reasons for caution, of course. It is essential that data is of a high quality, that there are high standards, that the data is secure (Kaiser Permanante's My health manager patient portal is set up with higher security than most online banking sites), and that it is protected not only with good protocols but also good governance.
If it is to do so, not only will the medical profession have to let go: patients will have to get more involved. We have to engage the public with the simple truth that the health service cannot succeed in the future unless users and citizens recognise their own role in helping those services do more with less. We have to make our own efforts, whether it is looking after our health or managing our own conditions.
We also need to be willing to share data about our lifestyle and health conditions, but fear holds people back. Simon Eccles, a doctor, suggested the following question: "would you mind me sharing information about your health with my colleagues if it would save your life?" Two reports published by the Health Foundation on 19 July – When doctors and patients talk and Helping people share decision making – add to a growing body of research. If information is power, then shared information is shared power.
Nick Seddon is deputy director of the Reform thinktank Guardian Professional
Doctors fear 'catastrophes' on hospital wards at weekends
Doctors fear 'catastrophes' on hospital wards at weekends: One in eight doctors does not think hospitals provide high-quality care at weekends.
The Daily Telegraph
The Daily Telegraph
Private hospital told doctors to delay NHS work to boost profits
Private hospital told doctors to delay NHS work to boost profits:
A private hospital which accepts NHS work has instructed its doctors to artificially delay operations on non-paying patients to encourage them to pay fees. The Department of Health last night branded the practice "unacceptable" and pledged to intervene. The Independent
A private hospital which accepts NHS work has instructed its doctors to artificially delay operations on non-paying patients to encourage them to pay fees. The Department of Health last night branded the practice "unacceptable" and pledged to intervene. The Independent
Centre for Economic Research Report 'How Mental Health Loses Out in the NHS',
How mental health loses out in the NHS This report from the London School of Economics finds that mental illness accounts for 23% of the total burden of disease. Yet, despite the existence of cost-effective treatments, it receives only 13% of NHS health expenditure. Furthermore only a quarter of those suffering mental health problems are receiving any form of treatment. London School of Economics
Friday, 20 July 2012
£1.89bn repayment for £379m of vital PFI funded work
£1.89bn repayment for £379m of vital PFI funded work:
The total cost of building work and maintenance of the county’s schools, street lighting and hospitals, agreed under Private Finance Initiatives (PFI), will total almost £1.9billion by the time the deals have been paid off. Northampton Chronicle and Echo
The total cost of building work and maintenance of the county’s schools, street lighting and hospitals, agreed under Private Finance Initiatives (PFI), will total almost £1.9billion by the time the deals have been paid off. Northampton Chronicle and Echo
Updated guidance on viral haemorrhagic fevers
Updated guidance on viral haemorrhagic fevers:
The Advisory Committee on Dangerous Pathogens (ACDP) has published updated specialist guidance on the management of patients with viral haemorrhagic fever (VHF) or other infectious diseases of high consequence.
The guidance replaces previous ACDP guidance issued in 1996 and provides advice on how patients suspected of being infected with a VHF should be comprehensively assessed, rapidly diagnosed and safely managed within the NHS, to ensure the protection of public health.
Read the updated guidance on Management of Hazard Group 4 viral haemorrhagic fevers and similar human infectious diseases of high consequence (PDF, 762K) Department of Health
The Advisory Committee on Dangerous Pathogens (ACDP) has published updated specialist guidance on the management of patients with viral haemorrhagic fever (VHF) or other infectious diseases of high consequence.
The guidance replaces previous ACDP guidance issued in 1996 and provides advice on how patients suspected of being infected with a VHF should be comprehensively assessed, rapidly diagnosed and safely managed within the NHS, to ensure the protection of public health.
Read the updated guidance on Management of Hazard Group 4 viral haemorrhagic fevers and similar human infectious diseases of high consequence (PDF, 762K) Department of Health
Memorandum: An update on the government's approach to tackling obesity
Memorandum: An update on the government's approach to tackling obesity: This update was prepared for the Public Accounts Committee. It outlines the government's approach to tackling obesity in England. National Audit Office
999 recordings highlight pressures
999 recordings highlight pressures: Dramatic recordings of 999 calls highlight ambulance pressures BBC News
Video: BMA chairman explains decision to halt industrial action
Video: BMA chairman explains decision to halt industrial action: Watch BMA chairman Dr Mark Porter explain why BMA Council decided not to take further industrial action over changes to the NHS pension scheme. GP Online
Reducing agency spend - new best practice case study
Reducing agency spend - new best practice case study: United Lincolnshire Hospitals Trust undertook a series of actions to understand and reduce their agency spend NHS Employers
Progress in implementing the 2010 adult autism strategy
Progress in implementing the 2010 adult autism strategy:
This memorandum outlines the progress that has been made in the two years since the adult autism strategy was published in March 2010. 24 of the 56 commitments in the strategy have been implemented, and work has begun on most of the remaining commitments. However, less progress has been made in some areas, such as improving access to social care assessments, personal budgets and diagnostic services, which can all help adults with autism to access services and support.
This memorandum outlines the progress that has been made in the two years since the adult autism strategy was published in March 2010. 24 of the 56 commitments in the strategy have been implemented, and work has begun on most of the remaining commitments. However, less progress has been made in some areas, such as improving access to social care assessments, personal budgets and diagnostic services, which can all help adults with autism to access services and support.
Rest assured? A study of unpaid carers' experiences of short breaks
Rest assured? A study of unpaid carers' experiences of short breaks:
This research describes the findings of a Scottish study into unpaid carers’ experiences of short breaks from caring. It explored, from the carers’ perspective, the benefits of short breaks (provided by formal services and family and friends), good practice in planning and provision, and areas for improvement.
This research describes the findings of a Scottish study into unpaid carers’ experiences of short breaks from caring. It explored, from the carers’ perspective, the benefits of short breaks (provided by formal services and family and friends), good practice in planning and provision, and areas for improvement.
£2.5m spent on NHS CB staff
£2.5m spent on NHS CB staff:
New figures in annual report covering the period October 2011-March 2012 have revealed that the National Commissioning Board Authority spent £2.5m on staff in the first five months of its existence.
The documents details staff costs including up to £265,000 for its chief executive and national directors, most of whom were only working for the NHS CB for 40% of their time. Chief executive Sir David Nicholson was... Healthcare Today
New figures in annual report covering the period October 2011-March 2012 have revealed that the National Commissioning Board Authority spent £2.5m on staff in the first five months of its existence.
The documents details staff costs including up to £265,000 for its chief executive and national directors, most of whom were only working for the NHS CB for 40% of their time. Chief executive Sir David Nicholson was... Healthcare Today
Public health briefings for local government
Public health briefings for local government: NICE has published a series of public health briefings for local government. The aim is to offer advice on the public health actions that are most effective and provide best value for money.
New skills check-up for doctors
New skills check-up for doctors:
Doctors are to have their skills reassessed every year to ensure they are fit to practise, the General Medical Council said. The Independent
Doctors are to have their skills reassessed every year to ensure they are fit to practise, the General Medical Council said. The Independent
New report shines a light on the quality of data across health and social care
New report shines a light on the quality of data across health and social care: A new report published for the first time today by the Health and Social Care Information Centre (HSCIC) shines a light on the quality of data across ... NHS Information Centre
Advocacy by and for adults with learning disabilities in England.
This report finds that from 2009-10 to 2012-13 funding for learning disability specific advocacy services fell by 15.1% as commissioners cut their total spend for self-advocacy organisations and also moved specialist contracts to generic advocacy organisations. Learning Disabilities Observatory
Thursday, 19 July 2012
Ambulance delay due to lunchbreak
Ambulance delay due to lunchbreak:
A coroner has criticised East Midlands Ambulance Service (EMAS) after an inquest heard how paramedics left an elderly man who had fallen over and sustained brain damage untreated for 45 minutes because they were on a lunch break.
West Lincolnshire Coroner Stuart Fisher said the service had let down Harold Tinsley, 78, who died in hospital on September 27 last year, four days after falling on his driveway outside ... Healthcare Today
A coroner has criticised East Midlands Ambulance Service (EMAS) after an inquest heard how paramedics left an elderly man who had fallen over and sustained brain damage untreated for 45 minutes because they were on a lunch break.
West Lincolnshire Coroner Stuart Fisher said the service had let down Harold Tinsley, 78, who died in hospital on September 27 last year, four days after falling on his driveway outside ... Healthcare Today
Shared decision making: a common understanding
Shared decision making: a common understanding: There is an emerging consensus amongst professionals, patients and politicians that patients have a central role in the decision making process about their health. But scratch the surface of that consensus and the waters get a little more murky, says Adrian Sieff. Health Foundation
Lansley pledges to investigate PCT rationing
Lansley pledges to investigate PCT rationing: Health secretary Andrew Lansley has pledged to investigate evidence of PCTs rationing services after the issue was raised again in parliamentary questions. GP Online
NHS share of government spending to rise to 10%
NHS share of government spending to rise to 10%: Health costs will account for almost 10% of all government spending within 50 years, the Office of Budget Responsibility (OBR) has predicted. GP Online
N3 GP refresh to roll out this year
N3 GP refresh to roll out this year: The GP Next Generation Access project will increase bandwidth on N3 for 70% of English GP practices by March next year. E-Health Insider
Follow the bear
Follow the bear: The government may have axed the National Programme for IT in the NHS twice, but it has left behind some big pieces of unfinished business. E-Health Insider
GMC National Training Survey 2012
GMC National Training Survey 2012: The General Medical Council (GMC) has published the results of its National Training Survey 2012 which provides a snapshot of the quality of postgraduate medical education and training. NHS Employers
The full report is available on the GMC web site.
The full report is available on the GMC web site.
GPs outnumbered on commissioning group boards
GPs outnumbered on commissioning group boards:
NHS reorganisation was designed to have GPs making financial decisions, but there are only two or three GPs on some boards
GPs are outnumbered in nearly half the new clinical commissioning group boards, with some clinical commissioning groups having just two or three GPs, according to research carried out by Pulse.
In some parts of the country, GPs made up only a fifth of the boards and were in the minority in 44% of them.
Despite the Department of Health's requirement that each board should include a consultant, the research found very few included. Only 36% of groups had a reserved position for a secondary care doctor – and just seven positions have been filled.
The analysis was based on Freedom of Information requests from 100 groups, which covered more than 1,300 board positions. Researchers said that the figures suggest that groups are failing to engage grassroots GPs, and that practices risk being forced out of the commissioning process.
"In some areas, financial restraints have forced CCGs to actively cut the number of GPs on their boards, despite health secretary Andrew Lansley's insistence that it is GPs who are 'best placed' to improve NHS commissioning," said Pulse, the magazine for health professionals.
Dr George Rae, secretary of Newcastle and North Tyneside local medical committee, said the balance of management staff to GPs had swung too far. "If it is GP-led commissioning, the correct balance isn't GPs in the minority. There are other people who have to have input, but we must not sell ourselves short," he said.
But others have said that the struggle to keep down costs was having an impact on the balance of the boards. For example, Dr Guy Mansford, clinical lead and deputy chair of Nottingham West commissioning group, said practices in his area had decided to cut the number of GP board members from five to two to reduce costs and to counter accusations of a conflict of interest.
"With a large board there is a massive workload for governance, and innovation was just going out of the window," he said. "For small CCGs trying to live within the £25 per head budget, it is very hard to do everything."
Bob Senior, head of medical services at RSM Tenon, an accountancy advisory firm, and chair of the Association of Independent Specialist Medical Accountants, said the £25 management allowance was a factor in the composition of many boards: "The economies of scale don't work so smaller [groups] are having to use that money judiciously, which means you can't have quite as big an involvement from GPs."
The findings are likely to lead to criticism of health secretary Andrew Lansley's plans to put GPs at the helm of NHS commissioning. Commissioning groups will be responsible for some £60bn of NHS budget from April 2013.
• On 44% of commissioning group boards, fewer than half of members were GPs. Groups with the lowest proportion of GPs included Nottingham West, which had two GPs (20%), Bury, with three GPs (21%), and Newcastle, also with three GPs (21%).
• While women do feature on boards, they make up just 21% of board members. Guardian Professional.
GPs are outnumbered in nearly half the new clinical commissioning group boards, with some clinical commissioning groups having just two or three GPs, according to research carried out by Pulse.
In some parts of the country, GPs made up only a fifth of the boards and were in the minority in 44% of them.
Despite the Department of Health's requirement that each board should include a consultant, the research found very few included. Only 36% of groups had a reserved position for a secondary care doctor – and just seven positions have been filled.
The analysis was based on Freedom of Information requests from 100 groups, which covered more than 1,300 board positions. Researchers said that the figures suggest that groups are failing to engage grassroots GPs, and that practices risk being forced out of the commissioning process.
"In some areas, financial restraints have forced CCGs to actively cut the number of GPs on their boards, despite health secretary Andrew Lansley's insistence that it is GPs who are 'best placed' to improve NHS commissioning," said Pulse, the magazine for health professionals.
Dr George Rae, secretary of Newcastle and North Tyneside local medical committee, said the balance of management staff to GPs had swung too far. "If it is GP-led commissioning, the correct balance isn't GPs in the minority. There are other people who have to have input, but we must not sell ourselves short," he said.
But others have said that the struggle to keep down costs was having an impact on the balance of the boards. For example, Dr Guy Mansford, clinical lead and deputy chair of Nottingham West commissioning group, said practices in his area had decided to cut the number of GP board members from five to two to reduce costs and to counter accusations of a conflict of interest.
"With a large board there is a massive workload for governance, and innovation was just going out of the window," he said. "For small CCGs trying to live within the £25 per head budget, it is very hard to do everything."
Bob Senior, head of medical services at RSM Tenon, an accountancy advisory firm, and chair of the Association of Independent Specialist Medical Accountants, said the £25 management allowance was a factor in the composition of many boards: "The economies of scale don't work so smaller [groups] are having to use that money judiciously, which means you can't have quite as big an involvement from GPs."
The findings are likely to lead to criticism of health secretary Andrew Lansley's plans to put GPs at the helm of NHS commissioning. Commissioning groups will be responsible for some £60bn of NHS budget from April 2013.
The findings
• GPs held 645 out of 1,325 board positions (49%). Managers and finance officers accounted for 267 positions, alongside 140 lay members, 65 nurses, 50 public health representatives, 46 from local authorities, 42 practice managers and 70 others.• On 44% of commissioning group boards, fewer than half of members were GPs. Groups with the lowest proportion of GPs included Nottingham West, which had two GPs (20%), Bury, with three GPs (21%), and Newcastle, also with three GPs (21%).
• While women do feature on boards, they make up just 21% of board members. Guardian Professional.
Doctors suspended strikes over pensions... for now
Doctors suspended strikes over pensions... for now:
Doctors have suspended plans for more strikes over pension reforms but have said they will not rule out further industrial action in future. The Independent
Doctors have suspended plans for more strikes over pension reforms but have said they will not rule out further industrial action in future. The Independent
Wednesday, 18 July 2012
People being urged to have their say on health
People being urged to have their say on health:
People are being asked their views on a new organisation being set up to improve health and social care services in Northamptonshire. Evening Telegraph
People are being asked their views on a new organisation being set up to improve health and social care services in Northamptonshire. Evening Telegraph
Health boss speaks over ambulance station closures
Health boss speaks over ambulance station closures:
East Midlands Ambulance Service has proposed to close every ambulance station in Northamptonshire, except Kettering and Northampton. Evening Telegraph
East Midlands Ambulance Service has proposed to close every ambulance station in Northamptonshire, except Kettering and Northampton. Evening Telegraph
Ambulance stations to close in bid for faster 999 call-outs
Ambulance stations to close in bid for faster 999 call-outs:
Northampton is set to move from two ambulance bases to just one, East Midlands Ambulance Service has revealed. Northampton Chronicle and Echo
Northampton is set to move from two ambulance bases to just one, East Midlands Ambulance Service has revealed. Northampton Chronicle and Echo
CCGs and PCTs – not so different after all? | Chris Naylor
CCGs and PCTs – not so different after all? | Chris Naylor: There will be important differences between clinical commissioning groups (CCGs) and primary care trusts (PCTs). But in terms of the population size they cover – a hugely significant issue for any commissioning body – CCGs and PCTs look increasingly similar. (Blog, 17 Jul 2012) Kings Fund
Toolkit for doctors and managers to improve quality for patients
Toolkit for doctors and managers to improve quality for patients:
It involves a series of steps each requiring conversations between all parties to identify any development required. NHS Networks
It involves a series of steps each requiring conversations between all parties to identify any development required. NHS Networks
Inactivity 'as deadly as smoking'
Inactivity 'as deadly as smoking': A lack of exercise, contributing to diseases such as diabetes and cancer, is now causing as many deaths as smoking across the world, a study suggests. BBC News
Research backs greater pharmacist role in long-term conditions care
Research backs greater pharmacist role in long-term conditions care: Pharmacists should be more involved in the long-term management of people with type 2 diabetes to improve patient outcomes, researchers say. GP Online
Alcohol-related hospital admissions rise in young
Alcohol-related hospital admissions rise in young:
Data released by public health minister Anne Milton has shown an increase in the number of young people from deprived families who were admitted to hospital because of alcohol.The information revealed that 17.5% of under 18-year-olds who were admitted to hospital with alcohol-associated problems in 2010/11 were from the poorest 10% of families in England.This figure increased from 2009/10, when 16.5% of young p... Healthcare Today
UK has third most inactive population in Europe
UK has third most inactive population in Europe:
Two-thirds of British adults fail to take recommended amount of exercise needed to keep them healthy, research shows
The UK is home to the third most slothful population in Europe, with two-thirds of adults failing to take enough physical exercise to keep themselves healthy, according to research.
Only in Malta and Serbia do the over-15s exert themselves less than in the UK, according to data from one of a series of papers published in the Lancet medical journal.
In the UK, 63.3% of adults (with higher rates in women than in men) do not meet recommended amounts of activity, such as walking briskly for 30 minutes or more five times a week or taking more vigorous exercise for 20 minutes three times a week. In Malta, 71.9% of adults are inactive and in Serbia the proportion is 68.3%.
The most active countries are Greece, where 16% are inactive, Estonia (17%) and the Netherlands (18%). The US scores 41% and Canada 34%.
Inactivity causes between 6% and 10% of four major diseases – coronary heart disease, type 2 diabetes and breast and colon cancer, reported the Lancet. In 2008, it was responsible for about 5.3 million out of the 57 million deaths worldwide.
Pedro Hallal from Universidade Federal de Pelotas in Brazil and colleagues collected and compared data from 122 countries. Overall, a third of adults, and four out of five adolescents, were insufficiently active.
Hallal added: "Although the technological revolution has been of great benefit to many populations throughout the world, it has come at a major cost in terms of the contribution of physical inactivity to the worldwide epidemic of noncommunicable diseases."
Many different things have been tried to encourage people to walk, cycle or take other exercise more often. One of the most successful is in Bogota, Columbia, reports another Lancet paper. A programme called CiclovÃa closes city streets to traffic for the use of walkers, runners, skaters and cyclists on Sunday mornings and public holidays. It attracts about a million people every week – mostly those on low incomes.The Guardian
The UK is home to the third most slothful population in Europe, with two-thirds of adults failing to take enough physical exercise to keep themselves healthy, according to research.
Only in Malta and Serbia do the over-15s exert themselves less than in the UK, according to data from one of a series of papers published in the Lancet medical journal.
In the UK, 63.3% of adults (with higher rates in women than in men) do not meet recommended amounts of activity, such as walking briskly for 30 minutes or more five times a week or taking more vigorous exercise for 20 minutes three times a week. In Malta, 71.9% of adults are inactive and in Serbia the proportion is 68.3%.
The most active countries are Greece, where 16% are inactive, Estonia (17%) and the Netherlands (18%). The US scores 41% and Canada 34%.
Inactivity causes between 6% and 10% of four major diseases – coronary heart disease, type 2 diabetes and breast and colon cancer, reported the Lancet. In 2008, it was responsible for about 5.3 million out of the 57 million deaths worldwide.
Pedro Hallal from Universidade Federal de Pelotas in Brazil and colleagues collected and compared data from 122 countries. Overall, a third of adults, and four out of five adolescents, were insufficiently active.
Hallal added: "Although the technological revolution has been of great benefit to many populations throughout the world, it has come at a major cost in terms of the contribution of physical inactivity to the worldwide epidemic of noncommunicable diseases."
Many different things have been tried to encourage people to walk, cycle or take other exercise more often. One of the most successful is in Bogota, Columbia, reports another Lancet paper. A programme called CiclovÃa closes city streets to traffic for the use of walkers, runners, skaters and cyclists on Sunday mornings and public holidays. It attracts about a million people every week – mostly those on low incomes.The Guardian
Schools deny girls cervical cancer jabs on religious grounds
Schools deny girls cervical cancer jabs on religious grounds:
Female pupils not being offered potentially life-saving vaccine at schools that oppose premarital sex
Schoolgirls are being denied a potentially life-saving cervical cancer jab at their schools on religious grounds.
Some schools in England have opted out of the HPV vaccination programme because their pupils follow strict Christian principles and do not have sex outside marriage. The jab guards against two strains of the human papillomavirus (HPV) virus – 16 and 18 – which cause 70% of cases of cervical cancer. It is offered routinely to girls aged 12 to 13.
But an investigation by GP magazine found 24 schools in 83 of England's 152 primary care trust (PCT) areas were opting out of the vaccination programme, many of them on religious grounds.
The magazine found the majority of schools opting out did not tell their local GPs, where the girls could be offered the vaccine.
Just two of the 15 PCTs where schools are denying the vaccination course told GPs of their decision.
Only five of the 15 PCTs said they informed pupils or guardians how to obtain the vaccine elsewhere, the figures show.
The reasons schools gave for not giving the jab included "not in keeping with the school ethos", "pupils follow strict Christian principles, marry within their own community and do not practise sex outside marriage" and "the school does not want parents/students to feel pressured by peers or the school setting".
The Royal College of General Practitioners (RCGP) said GPs needed to be informed about which pupils were being denied vaccines at school to help cut cervical cancer deaths.
Every year, 1,000 women in the UK die from cervical cancer.
RCGP immunisation lead Dr George Kassianos told GP magazine: "If GPs are going to be provided with vaccines and there is an agreement that GPs can vaccinate those falling behind, then it is even more important that GPs are informed of who has missed HPV vaccination at school.
"GPs also need to know of completion of vaccination courses.
"No matter which system you examine, here in the UK or abroad, there will be parents or individuals who will refuse vaccination.
"None of our immunisations are compulsory. We therefore must accept that some children or adults will not be vaccinated. It is hard to understand how immunisation against cancer can be rejected but that is how it is out there in the community."
Dr Richard Vautrey, the deputy chairman of the British Medical Association's general practitioners committee, said: "It is a concern that so many areas are reporting that schools have refused to allow their children to receive HPV vaccine on the premises.
"This is placing their children at risk in later life and should be challenged. It is also a concern if PCTs are not informing practices about HPV uptake. Once the responsibility for this activity has been transferred from PCTs to public health departments based in local authorities next year there should no longer be any excuse for failing to protect children in this way." The Guardian
Schoolgirls are being denied a potentially life-saving cervical cancer jab at their schools on religious grounds.
Some schools in England have opted out of the HPV vaccination programme because their pupils follow strict Christian principles and do not have sex outside marriage. The jab guards against two strains of the human papillomavirus (HPV) virus – 16 and 18 – which cause 70% of cases of cervical cancer. It is offered routinely to girls aged 12 to 13.
But an investigation by GP magazine found 24 schools in 83 of England's 152 primary care trust (PCT) areas were opting out of the vaccination programme, many of them on religious grounds.
The magazine found the majority of schools opting out did not tell their local GPs, where the girls could be offered the vaccine.
Just two of the 15 PCTs where schools are denying the vaccination course told GPs of their decision.
Only five of the 15 PCTs said they informed pupils or guardians how to obtain the vaccine elsewhere, the figures show.
The reasons schools gave for not giving the jab included "not in keeping with the school ethos", "pupils follow strict Christian principles, marry within their own community and do not practise sex outside marriage" and "the school does not want parents/students to feel pressured by peers or the school setting".
The Royal College of General Practitioners (RCGP) said GPs needed to be informed about which pupils were being denied vaccines at school to help cut cervical cancer deaths.
Every year, 1,000 women in the UK die from cervical cancer.
RCGP immunisation lead Dr George Kassianos told GP magazine: "If GPs are going to be provided with vaccines and there is an agreement that GPs can vaccinate those falling behind, then it is even more important that GPs are informed of who has missed HPV vaccination at school.
"GPs also need to know of completion of vaccination courses.
"No matter which system you examine, here in the UK or abroad, there will be parents or individuals who will refuse vaccination.
"None of our immunisations are compulsory. We therefore must accept that some children or adults will not be vaccinated. It is hard to understand how immunisation against cancer can be rejected but that is how it is out there in the community."
Dr Richard Vautrey, the deputy chairman of the British Medical Association's general practitioners committee, said: "It is a concern that so many areas are reporting that schools have refused to allow their children to receive HPV vaccine on the premises.
"This is placing their children at risk in later life and should be challenged. It is also a concern if PCTs are not informing practices about HPV uptake. Once the responsibility for this activity has been transferred from PCTs to public health departments based in local authorities next year there should no longer be any excuse for failing to protect children in this way." The Guardian
GPs 'too expensive' to run health authorities
GPs 'too expensive' to run health authorities: Bureaucrats will still run local health authorities, despite Government plans to put clinicians in charge, according to GPs who say the money is not there to pay enough doctors to run them.
The Daily Telegraph
The Daily Telegraph
Andrew Lansley complains 'people always want more'
Andrew Lansley complains 'people always want more': Andrew Lansley complained that "people always want more" after charities and campaign groups criticised him for failing to cut the costs of elderly care.
The Daily Telegraph
The Daily Telegraph
British Medical Association staff to stage fresh strike tomorrow in dispute over pay
British Medical Association staff to stage fresh strike tomorrow in dispute over pay:
Staff employed by the British Medical Association will stage another strike tomorrow in a dispute over pay. The Independent
Staff employed by the British Medical Association will stage another strike tomorrow in a dispute over pay. The Independent
Use of deprivation of liberty safeguards shows 59 per cent increase since introduction
Use of deprivation of liberty safeguards shows 59 per cent increase since introduction: The number of Deprivation of Liberty Safeguards (DoLS) applications rose to 11,400 in 2011/2012, says a report out today from the Health and Social Ca... NHS Information Centre
Tuesday, 17 July 2012
Northamptonshire has 692,000 people, census shows
Northamptonshire has 692,000 people, census shows:
The population of Northampton is about 212,000 people according to official census data released on Monday morning. Northampton Chronicle and Echo
The population of Northampton is about 212,000 people according to official census data released on Monday morning. Northampton Chronicle and Echo
Northamptonshire’s ambulance service saved 221 cardiac arrest patients
Northamptonshire’s ambulance service saved 221 cardiac arrest patients:
East Midlands Ambulance Service resuscitated 221 cardiac arrest patients in 11 months, new statistics show today. Northampton Chronicle and Echo
East Midlands Ambulance Service resuscitated 221 cardiac arrest patients in 11 months, new statistics show today. Northampton Chronicle and Echo
Elderly resident had no pain relief for five days at Northamptonshire nursing home
Elderly resident had no pain relief for five days at Northamptonshire nursing home:
An elderly resident at a Northamptonshire nursing home was denied pain relief for five days, inspectors found. Northampton Chronicle and Echo
An elderly resident at a Northamptonshire nursing home was denied pain relief for five days, inspectors found. Northampton Chronicle and Echo
England and Wales population up
England and Wales population up: The population of England and Wales has reached 56.1 million, a rise of 3.7 million in a decade, the 2011 Census shows. BBC News
Most schemes to cut unplanned admissions do not work
Most schemes to cut unplanned admissions do not work: Most interventions designed to cut unplanned admissions fail to do so, and only a few techniques focused on specific groups are effective, researchers have found. GP Online
Update on education and training reform
Update on education and training reform: Progress on the reform of the education and training system is outlined in a letter to NHS leaders from Debbie Mellor, deputy director workforce education at the Department of Health. NHS Employers
BMJ report: Only a fifth of NHS underspend will be carried into next year's budget
BMJ report: Only a fifth of NHS underspend will be carried into next year's budget:
According to a report in the British Medical Journal (BMJ), the NHS in England underspent its budget by £1.7bn in 2011-12; however only 18% of this (£0.3bn) was surrendered through the budget exchange system, which allows departments that underspend (up to a "reasonable limit") in any financial year to get an equivalent increase the next year. The same happened the previous year, when the NHS underspend was £900m, of which only £400m was rolled over, the rest going back to the Treasury.
The Department of Health says that a large part of the 2011-12 underspend was the result of cuts in management costs of £1bn and in spending on information technology by £0.4bn. The health minister commented that the amount spent on "frontline services" in 2011-12 had risen by £3.4bn, and that "While spending has increased on patients, we have reduced inefficient spending, saving over £1.5bn on bureaucracy and IT". British Medical Journal (BMJ)
According to a report in the British Medical Journal (BMJ), the NHS in England underspent its budget by £1.7bn in 2011-12; however only 18% of this (£0.3bn) was surrendered through the budget exchange system, which allows departments that underspend (up to a "reasonable limit") in any financial year to get an equivalent increase the next year. The same happened the previous year, when the NHS underspend was £900m, of which only £400m was rolled over, the rest going back to the Treasury.
The Department of Health says that a large part of the 2011-12 underspend was the result of cuts in management costs of £1bn and in spending on information technology by £0.4bn. The health minister commented that the amount spent on "frontline services" in 2011-12 had risen by £3.4bn, and that "While spending has increased on patients, we have reduced inefficient spending, saving over £1.5bn on bureaucracy and IT". British Medical Journal (BMJ)
Guide to health records access
Guide to health records access:
This guide is about shared Personal Health Records (PHRs) - a new development with potential to facilitate a step change in the extent to which individuals are involved in managing, and making decisions about, their health. It is aimed at practitioners, managers and patient organisations in health and social care in the UK. It gives a vision for the future of PHRs, and an understanding of some of the challenges and barriers which must be overcome in order to realise their full potential. It points to solutions to these barriers and is, in effect, a call to action.
This guide is about shared Personal Health Records (PHRs) - a new development with potential to facilitate a step change in the extent to which individuals are involved in managing, and making decisions about, their health. It is aimed at practitioners, managers and patient organisations in health and social care in the UK. It gives a vision for the future of PHRs, and an understanding of some of the challenges and barriers which must be overcome in order to realise their full potential. It points to solutions to these barriers and is, in effect, a call to action.
Care now and for the future: an inquiry into social care
Care now and for the future: an inquiry into social care:
This paper was written in response to the Care and Support white paper and draft bill and it identifies a roadmap of practical reforms to prevent the social care system being placed on the 'critical list'. It makes recommendations on what can be done between now and 2015 to reform the care system and meet current funding challenges.
This paper was written in response to the Care and Support white paper and draft bill and it identifies a roadmap of practical reforms to prevent the social care system being placed on the 'critical list'. It makes recommendations on what can be done between now and 2015 to reform the care system and meet current funding challenges.
Rapid access to treatment and rehabilitation for NHS staff
Rapid access to treatment and rehabilitation for NHS staff:
Rapid access is a system which will secure rehabilitation and occupational health treatment for NHS employees with a view to facilitating a return to work which is as fast as practical and reasonable. This guidance is intended for trust boards making decisions about how to manage rapid access services for staff in their organisation.
Rapid access is a system which will secure rehabilitation and occupational health treatment for NHS employees with a view to facilitating a return to work which is as fast as practical and reasonable. This guidance is intended for trust boards making decisions about how to manage rapid access services for staff in their organisation.
Cataract surgery cuts
Cataract surgery cuts:
NHS trusts have placed "harsh restrictions" on cataract surgery which could affect many elderly patients, the Daily Mail reports.The paper said the amount of cataract surgeries being carried out by the NHS had fallen by more than 25% in some regions of the country.Research published by the Royal National Institute of Blind People showed more than 50% of health service trusts had put in force ... Healthcare Today
NHS trusts have placed "harsh restrictions" on cataract surgery which could affect many elderly patients, the Daily Mail reports.The paper said the amount of cataract surgeries being carried out by the NHS had fallen by more than 25% in some regions of the country.Research published by the Royal National Institute of Blind People showed more than 50% of health service trusts had put in force ... Healthcare Today
The Channel 4 Goes Mad season challenges mental health stigma - The Guardian
The Channel 4 Goes Mad season challenges mental health stigma - The Guardian:
 The Guardian | The Channel 4 Goes Mad season challenges mental health stigma The Guardian Viewers are invited to make their own judgment, as they watch potential employers and psychiatrists observe candidates and try to determine who is the most employable, without any knowledge of their health history. Channel 4 Goes Mad begins next week ... |
How learning disability liaison nurses are transforming patient care
How learning disability liaison nurses are transforming patient care:
Amid concerns that similar roles will be lost in the NHS reforms, we celebrate the work and impact of the specialist nurses
Specialist learning disability liaison nurse Jainab Desai is making meticulous checks of the complex arrangements to receive a tricky patient with learning disabilities, with staff of the day surgery unit at Royal Bolton hospital.
She has worked for weeks with staff, family and carers of the profoundly disabled and terrified woman (who needs a vascular procedure). This is to make sure that the patient will not freak at the entrance to the operating theatre, forcing the cancellation of the operation.
Desai has identified a hospital back entrance that the patient will not recognise and organised a screened alcove to be equipped like a sitting room for waiting. Most importantly, two consultants will follow the vascular surgeon, while the patient (a diabetic) is still under anaesthetic, to carry out vital retinopathy and dental checks she would not receive in any other way. A check the next day reveals a resounding success.
"The key objective is a successful health outcome," says Desai. "But you want it to happen with a positive experience for the learning disabled patient and minimum distress. It only works in this hospital, because there's commitment from the top down."
At any time Desai could be co-ordinating the care of up to six people with learning disabilities at Royal Bolton hospital. This is set to rise as researchers predict that the numbers of people with learning disabilities in the UK will increase by 14% between 2001 and 2021. They are also 58 times more likely to die aged under 50, often of preventable causes.
The fight to get specialists such as Desai into integrated posts in acute settings has been hard won. She was already in post in 2007 when Mencap's explosive report Death By Indifference, highlighted the cases of six people with learning disabilities believed to have died unnecessarily as a result of receiving worse healthcare than people without learning disabilities. She was a rare breed at the time.
Sir Jonathan Michael's report, Healthcare for All (2008) added fuel to Mencap's campaign by identifying gaps between the law, policy and the delivery of effective services for people with learning disabilities.
Since then progress has been made – 79% of acute settings have a nurse appointed to this kind of role – but there is concern that these roles will be sacrificed in the scramble to reorganise the NHS against a background of service cuts. Mencap's report earlier this year (74 Deaths And Counting), reveals continued institutional discrimination in the NHS towards people with a learning disability.
The Royal College of Nursing's nursing advisor for learning disabilities, Ann Norman, already knows of cuts to at least four UK's consultant nurse roles (of around 35). An RCN survey of 500 disability nurses in May showed that three out of four were experiencing cuts in services. Reports from primary care echo this. Norman says: "We are having to run to keep up, to protect frontline services."
Desai's role is a model of what learning disability campaigners want to keep in place. Based in the hospital since 2006, she works in partnership with the integrated service run by Bolton council, carers, staff in community posts and patients themselves to smooth their way into hospital and ensure they receive the best and most appropriate care.
This means knowing who is being admitted, tweaking the services to accommodate them and visiting the wards during their stay. She is also on hand to help staff with emergencies.
Much of Desai's work is about training. At first many staff could not recognise learning disability, let alone deal with it. Now, most of them understand and accommodate their needs. This could be by creating a low-stimulation area for a hypersensitive person, bringing in a parent to teach nurses how to feed an autistic patient with rigid behaviour patterns, or simply arranging for an elderly parent to stay with their disabled offspring overnight.
She's also worked with the PALS services to produce a hospital passport, detailing specific care needs such as eating and drinking. Her work is incorporated into the fabric of the hospital's work, through her role as Safeguarding Adults lead.
This is a complete change from the way the Blackburn-born nurse started out, doing some of her early training in Calderstones – one of the large Victorian institutions where most people with learning disabilities then lived.
She is passionate about her work: "It is also about their families. I have seen how parents struggle with an adult offspring who is not sleeping and self-harming because they can not communicate their pain."
The fear of campaigners for learning disabilities is that a combination of cuts and NHS reorganisation will see posts and services go. Mencap's national officer, Beverley Dawkins, sees this as reflecting fundamental attitudes: "When they get services right for people with learning disabilities, they get them right for a whole lot of others, like the elderly and people with dementia and stroke victims."
Mencap is now working on a primary care charter aimed at commissioning CCGs. Dawkins adds: "We're actively trying to influence the new NHS structure." Guardian Professional.
Specialist learning disability liaison nurse Jainab Desai is making meticulous checks of the complex arrangements to receive a tricky patient with learning disabilities, with staff of the day surgery unit at Royal Bolton hospital.
She has worked for weeks with staff, family and carers of the profoundly disabled and terrified woman (who needs a vascular procedure). This is to make sure that the patient will not freak at the entrance to the operating theatre, forcing the cancellation of the operation.
Desai has identified a hospital back entrance that the patient will not recognise and organised a screened alcove to be equipped like a sitting room for waiting. Most importantly, two consultants will follow the vascular surgeon, while the patient (a diabetic) is still under anaesthetic, to carry out vital retinopathy and dental checks she would not receive in any other way. A check the next day reveals a resounding success.
"The key objective is a successful health outcome," says Desai. "But you want it to happen with a positive experience for the learning disabled patient and minimum distress. It only works in this hospital, because there's commitment from the top down."
At any time Desai could be co-ordinating the care of up to six people with learning disabilities at Royal Bolton hospital. This is set to rise as researchers predict that the numbers of people with learning disabilities in the UK will increase by 14% between 2001 and 2021. They are also 58 times more likely to die aged under 50, often of preventable causes.
The fight to get specialists such as Desai into integrated posts in acute settings has been hard won. She was already in post in 2007 when Mencap's explosive report Death By Indifference, highlighted the cases of six people with learning disabilities believed to have died unnecessarily as a result of receiving worse healthcare than people without learning disabilities. She was a rare breed at the time.
Sir Jonathan Michael's report, Healthcare for All (2008) added fuel to Mencap's campaign by identifying gaps between the law, policy and the delivery of effective services for people with learning disabilities.
Since then progress has been made – 79% of acute settings have a nurse appointed to this kind of role – but there is concern that these roles will be sacrificed in the scramble to reorganise the NHS against a background of service cuts. Mencap's report earlier this year (74 Deaths And Counting), reveals continued institutional discrimination in the NHS towards people with a learning disability.
The Royal College of Nursing's nursing advisor for learning disabilities, Ann Norman, already knows of cuts to at least four UK's consultant nurse roles (of around 35). An RCN survey of 500 disability nurses in May showed that three out of four were experiencing cuts in services. Reports from primary care echo this. Norman says: "We are having to run to keep up, to protect frontline services."
Desai's role is a model of what learning disability campaigners want to keep in place. Based in the hospital since 2006, she works in partnership with the integrated service run by Bolton council, carers, staff in community posts and patients themselves to smooth their way into hospital and ensure they receive the best and most appropriate care.
This means knowing who is being admitted, tweaking the services to accommodate them and visiting the wards during their stay. She is also on hand to help staff with emergencies.
Much of Desai's work is about training. At first many staff could not recognise learning disability, let alone deal with it. Now, most of them understand and accommodate their needs. This could be by creating a low-stimulation area for a hypersensitive person, bringing in a parent to teach nurses how to feed an autistic patient with rigid behaviour patterns, or simply arranging for an elderly parent to stay with their disabled offspring overnight.
She's also worked with the PALS services to produce a hospital passport, detailing specific care needs such as eating and drinking. Her work is incorporated into the fabric of the hospital's work, through her role as Safeguarding Adults lead.
This is a complete change from the way the Blackburn-born nurse started out, doing some of her early training in Calderstones – one of the large Victorian institutions where most people with learning disabilities then lived.
She is passionate about her work: "It is also about their families. I have seen how parents struggle with an adult offspring who is not sleeping and self-harming because they can not communicate their pain."
The fear of campaigners for learning disabilities is that a combination of cuts and NHS reorganisation will see posts and services go. Mencap's national officer, Beverley Dawkins, sees this as reflecting fundamental attitudes: "When they get services right for people with learning disabilities, they get them right for a whole lot of others, like the elderly and people with dementia and stroke victims."
Mencap is now working on a primary care charter aimed at commissioning CCGs. Dawkins adds: "We're actively trying to influence the new NHS structure." Guardian Professional.
Deadly drugs still given to the elderly
Deadly drugs still given to the elderly: Elderly patients in some parts of England are six times more likely to be prescribed potentially deadly drugs than in other areas, official figures show.
The Daily Telegraph
The Daily Telegraph
Trainee doctors 'fear for patient safety'
Trainee doctors 'fear for patient safety':
One in 20 junior doctors is concerned about patient safety at the place where they train, it has emerged. The Independent
One in 20 junior doctors is concerned about patient safety at the place where they train, it has emerged. The Independent
Monday, 16 July 2012
Ambulance service fails to hit target
Ambulance service fails to hit target:
East Midlands Ambulance Service failed to hit its targets of reaching the most serious emergencies within eight minutes in Northamptonshire in May. Evening Telegraph
East Midlands Ambulance Service failed to hit its targets of reaching the most serious emergencies within eight minutes in Northamptonshire in May. Evening Telegraph
University of Northampton student helped save heart attack victim’s life
University of Northampton student helped save heart attack victim’s life:
The quick actions of a University of Northampton student paramedic helped save the life of a man who suffered a heart attack while out walking with his family. Northampton Chronicle
The quick actions of a University of Northampton student paramedic helped save the life of a man who suffered a heart attack while out walking with his family. Northampton Chronicle
VIDEO: NHS pay cuts 'a sign of chaos'
VIDEO: NHS pay cuts 'a sign of chaos': A proposal to cut the pay and change the conditions of health workers in south-west England is a sign of "the chaos engulfing the NHS", Labour has said. BBC News
NHS staff who don't agree to pay cut face sack
NHS staff who don't agree to pay cut face sack: Thousands of NHS staff could be threatened with the sack unless they agree to take pay cuts as hospital managers struggle to balance the books, it has emerged.
The Daily Telegraph
The Daily Telegraph
Surgeons 'seek to protect title'
Surgeons 'seek to protect title': Leading doctors are calling on the government to legally protect the title "surgeon" so the public can be clear about practitioners' qualifications. BBC News
NHS campaign to tackle 50 million 'unnecessary' GP visits a year
NHS campaign to tackle 50 million 'unnecessary' GP visits a year: A campaign to cut pressure on GP practices by encouraging patients to self care for minor ailments such as hayfever has been launched by NHS chiefs. GP Online
National confidential enquiry into suicide and homicide by people with mental illness: annual report - England, Wales, Scotland and Northern Ireland
National confidential enquiry into suicide and homicide by people with mental illness: annual report - England, Wales, Scotland and Northern Ireland:
This update of an annual report collects data on the number, trends and risk factors linked to suicide, sudden unexplained death and homicide amongst mental health patients in the UK.
This update of an annual report collects data on the number, trends and risk factors linked to suicide, sudden unexplained death and homicide amongst mental health patients in the UK.
Preventing type 2 diabetes: risk identification and interventions for individuals at high risk
Preventing type 2 diabetes: risk identification and interventions for individuals at high risk:
This guidance provides advice on identifying people at high risk of developing type 2 diabetes and the provision of clinically and cost effective interventions to help reduce the risk or delay the onset of the condition. It outlines the best ways of identifying people at high risk of developing type 2 diabetes, encouraging them to take steps to reduce their risk and maintain a healthier lifestyle.
This guidance provides advice on identifying people at high risk of developing type 2 diabetes and the provision of clinically and cost effective interventions to help reduce the risk or delay the onset of the condition. It outlines the best ways of identifying people at high risk of developing type 2 diabetes, encouraging them to take steps to reduce their risk and maintain a healthier lifestyle.
Half of FTs behind 2011/12 savings
Half of FTs behind 2011/12 savings:
A significant number of foundation trusts are struggling to meet savings plan targets.
Monitor’s review of the last financial year found that more than half missed targets, with pay costs a major reason behind this.
The document stated: “Anecdotal evidence suggests that demand for acute services has not dropped in line with commissioners’ intentions, potentially constraining trusts’ ability to i... Healthcare Today
A significant number of foundation trusts are struggling to meet savings plan targets.
Monitor’s review of the last financial year found that more than half missed targets, with pay costs a major reason behind this.
The document stated: “Anecdotal evidence suggests that demand for acute services has not dropped in line with commissioners’ intentions, potentially constraining trusts’ ability to i... Healthcare Today
Why antibiotics are losing the war against bacteria
Why antibiotics are losing the war against bacteria: As bacteria become ever more resistant to drugs, world health experts fear a future without antibiotics
. The Daily Telegraph
. The Daily Telegraph
NHS pays £1,600 a day for nurses as agency use soars
NHS pays £1,600 a day for nurses as agency use soars: NHS hospitals hiring nurses at rates of up to £1,600 a day in bid to cope with rising staff shortages, investigation reveals
. The Daily Telegraph
. The Daily Telegraph
Use left-over NHS cash to pay for elderly care, say MPs
Use left-over NHS cash to pay for elderly care, say MPs: Left-over cash from NHS budgets should be handed over to local councils to pay for care for the elderly and disabled, according to MPs. The Daily Telegraph
New films explain Health and Social Care Act
New films explain Health and Social Care Act: The Royal College of Nursing has published new online resources on the Health and Social Care Act.
One in 20 hospital deaths preventable
One in 20 hospital deaths preventable:
Poor hospital care is “needlessly killing 1,000 NHS patients a month”, The Daily Telegraph headline reads. It says that the largest ever study of errors in British hospitals has found that one patient in 10 is affected by potentially serious medical errors, with half of them dying as a result.
This study was a review of the patient records of 1,000 adults who died in 10 hospitals across England in 2009. Medical reviewers who examined the records considered that one death in 20 had a greater than 50% chance of being preventable.
The researchers defined a “preventable death” as:
Most of these “possibly preventable” deaths occurred among elderly, frail patients with multiple other medical problems. This raises debate over whether these deaths were actually “preventable”.
Based on these figures the reviewers estimated that almost 12,000 (11,859) adult deaths would have been preventable in England during 2009. These are important findings, but are estimates only – the reviewers only examined the records of 1,000 patients from a sample of hospitals.
While a single preventable death is one too many, the researchers actually found that the number of preventable deaths was far lower than previously thought. Some previous estimates put the number of preventable deaths occurring every year in England as high as 40,000. The researchers were keen to stress, “this does not mean that preventable deaths should be ignored and no attempt made to improve our understanding of their causes”.
The media coverage is generally representative of this research, but the Independent’s headline states that doctors are to blame for the deaths. While doctor-related factors such as misdiagnosis or treatment errors were considered to have contributed to some of the deaths, the study has not reported the specific errors, or implied any responsibility for the errors.
In the current study, trained medical reviewers examined the records and identified issues with care that could have contributed to the deaths. The researchers say that a retrospective review of medical records is the most sensitive approach in determining the proportion of hospital deaths that are preventable. They based their study design on previous similar reviews that have been performed in the UK, the Netherlands and the US.
As only a random sample of hospitals and patient records was examined, the number given of annual preventable deaths across England is only an estimate. Also, though the researchers ensured all medical reviewers were fully trained, and checked their assessments, the review will unavoidably contain an element of subjective judgement.
The researchers wanted to focus on general medical and surgical admissions, so excluded paediatric, obstetric and psychiatric hospital admissions.
Judgement of preventable deaths was carried out in two stages. First, the reviewers were asked to judge whether there had been any problem in care that had contributed to the patient’s death. Such care problems were defined as:
This two-stage process was used because some care issues that contributed to death may not necessarily have been the result of poor practice. For example, if a patient with a heart attack was appropriately given an anti-clotting drug, but giving that drug then caused them to die from a brain bleed, the death would not be considered preventable. Reviewers judged preventability on a six-point scale ranging from one (definitely not preventable) to six (definitely preventable). Deaths were judged to be preventable if reviewers gave a score of four, five or six on the scale. That is, there was a more than 50% chance that the death was preventable.
The reviewers were general medical doctors recruited through the Royal College of Physicians, who received training in the review process. To validate their assessments a sample of 25% of the notes was examined by another reviewer, and each case that was considered to be a preventable death was discussed with the principal investigator and an expert reviewer.
Patients with preventable deaths were more likely to have been admitted under surgical specialties, and most of the problems occurred during ward care. In 73% of preventable deaths more than one problem in care was identified. The most frequent problems were related to:
The researchers considered that if 5.2% of deaths in hospital are preventable, there would be 11,859 preventable adult deaths in English NHS hospitals each year (based on 228,065 adult deaths in hospitals in England in 2009).
The main thing to be aware of is that these are estimates based on a relatively small sample only. The researchers reviewed only 1,000 deaths from 10 English hospitals. However, the researchers did make careful attempts to ensure that their selection was a representative sample of hospitals from across England.
The researchers also ensured that the medical reviewers were fully trained in the review process, and they also validated their assessments by performing a second review of a sample of 25% of the notes. Additionally, each case that was considered to be a preventable death was discussed with the principal investigator and an expert reviewer. Despite this, there will still have been some subjective analysis, and a different set of reviewers may have come up with different figures.
Related to this is the use of the six-point scale. Scores of four to six were considered to be preventable deaths, though the researchers say that using a more stringent definition of preventable (scores of five and six only) gave an estimate of 2.3%, rather than 5.2%. Though, similarly, using a more relaxed definition of preventable (scores of three to six) would raise the proportion of possibly preventable deaths to 8.5%.
Despite the alarmist media headlines, the researchers conclude that the number of preventable hospital deaths is actually much lower than previous estimates. They consider that “given the low proportion of deaths due to problems with healthcare”, focusing on patient deaths may not be the best way of finding ways to improve healthcare. This seems to be a sensible conclusion.
Of interest is the fact that the independent National Confidential Enquiry into Patient Outcomes and Death (NCEPOD), an independent charitable organisation, commissioned by the Healthcare Quality Improvement Pathway (HQIP), performs regular reviews of medical and surgical practice in UK hospitals and makes recommendations for improving the quality of healthcare. It does this through extensive confidential surveys and research covering many different aspects of care, including the review of medical and surgical records of patients who have died, and interviews of the treating consultants. NCEPOD produce several reports a year focusing on specific aspects of healthcare. These typically involve the review of several thousand records. It would be well worth comparing NCEPOD’s findings with those of this study.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on twitter.
This study was a review of the patient records of 1,000 adults who died in 10 hospitals across England in 2009. Medical reviewers who examined the records considered that one death in 20 had a greater than 50% chance of being preventable.
The researchers defined a “preventable death” as:
- caused by a failure in correctly diagnosing or treating a condition
- caused by treatments that should never have been considered because of safety concerns
Most of these “possibly preventable” deaths occurred among elderly, frail patients with multiple other medical problems. This raises debate over whether these deaths were actually “preventable”.
Based on these figures the reviewers estimated that almost 12,000 (11,859) adult deaths would have been preventable in England during 2009. These are important findings, but are estimates only – the reviewers only examined the records of 1,000 patients from a sample of hospitals.
While a single preventable death is one too many, the researchers actually found that the number of preventable deaths was far lower than previously thought. Some previous estimates put the number of preventable deaths occurring every year in England as high as 40,000. The researchers were keen to stress, “this does not mean that preventable deaths should be ignored and no attempt made to improve our understanding of their causes”.
Where did the story come from?
This study was conducted by researchers from the London School of Hygiene and Tropical Medicine, the National Patient Safety Agency, Imperial College London and the University of Newcastle. The study was funded by the National Institute of Health Research, Research for Patient Benefit Programme. It was published in the peer-reviewed British Medical Journal Quality & Safety.The media coverage is generally representative of this research, but the Independent’s headline states that doctors are to blame for the deaths. While doctor-related factors such as misdiagnosis or treatment errors were considered to have contributed to some of the deaths, the study has not reported the specific errors, or implied any responsibility for the errors.
What kind of research was this?
This was a review of the medical records of adults who died in hospitals in England during 2009. The researchers say that previous national and international studies have given wide estimates of the number of preventable deaths that occur in hospital, with estimates for England ranging from 840 to 40,000 deaths a year. However, these studies have not assessed whether adverse events could have contributed to death. This is what the current review aimed to assess.In the current study, trained medical reviewers examined the records and identified issues with care that could have contributed to the deaths. The researchers say that a retrospective review of medical records is the most sensitive approach in determining the proportion of hospital deaths that are preventable. They based their study design on previous similar reviews that have been performed in the UK, the Netherlands and the US.
As only a random sample of hospitals and patient records was examined, the number given of annual preventable deaths across England is only an estimate. Also, though the researchers ensured all medical reviewers were fully trained, and checked their assessments, the review will unavoidably contain an element of subjective judgement.
What did the research involve?
The researchers identified deceased patients from 10 randomly selected English acute hospital trusts. The random sampling had been stratified to ensure it contained:- a spread of hospitals representative of each region of England
- hospitals containing different numbers of beds
- both teaching and non-teaching hospitals
The researchers wanted to focus on general medical and surgical admissions, so excluded paediatric, obstetric and psychiatric hospital admissions.
Judgement of preventable deaths was carried out in two stages. First, the reviewers were asked to judge whether there had been any problem in care that had contributed to the patient’s death. Such care problems were defined as:
- errors of omission or inaction (for example, failure to diagnose and treat when needed)
- errors of commission or actions (for example, giving incorrect treatment)
- harm as a result of unintended complications of healthcare
This two-stage process was used because some care issues that contributed to death may not necessarily have been the result of poor practice. For example, if a patient with a heart attack was appropriately given an anti-clotting drug, but giving that drug then caused them to die from a brain bleed, the death would not be considered preventable. Reviewers judged preventability on a six-point scale ranging from one (definitely not preventable) to six (definitely preventable). Deaths were judged to be preventable if reviewers gave a score of four, five or six on the scale. That is, there was a more than 50% chance that the death was preventable.
The reviewers were general medical doctors recruited through the Royal College of Physicians, who received training in the review process. To validate their assessments a sample of 25% of the notes was examined by another reviewer, and each case that was considered to be a preventable death was discussed with the principal investigator and an expert reviewer.
What were the basic results?
In the first stage of review, 131 patients were identified as having experienced a problem in care that contributed to their death. In the second stage of review 52 of these deaths (5.2% of the total sample reviewed) were judged to be preventable (95% confidence interval 3.8% to 6.6%). This was 39.7% of the 131 cases identified to have had a problem in care contributing to death. These 52 deaths had received a score of four to six suggesting there was a greater than 50% chance the death was preventable. There were no significant differences between the proportions of preventable deaths found at each of the 10 hospitals.Patients with preventable deaths were more likely to have been admitted under surgical specialties, and most of the problems occurred during ward care. In 73% of preventable deaths more than one problem in care was identified. The most frequent problems were related to:
- clinical monitoring (such as failure to act upon test results or monitor patients appropriately) – identified as a problem in 31% of preventable deaths
- diagnosis (such as problems with physical examination or failure to seek a specialist opinion) – identified as a problem in 30% of preventable deaths
- drugs or fluid management – identified as a problem in 21% of preventable deaths
The researchers considered that if 5.2% of deaths in hospital are preventable, there would be 11,859 preventable adult deaths in English NHS hospitals each year (based on 228,065 adult deaths in hospitals in England in 2009).
How did the researchers interpret the results?
The researchers conclude that the incidence of preventable hospital deaths in England is lower than previous estimates, though the burden of harm from preventable problems in care is still substantial. They say that “a focus on deaths may not be the most efficient approach to identify opportunities for improvement given the low proportion of deaths due to problems with healthcare”.Conclusion
This was a well-conducted study that has important findings. Around 5% of the 1,000 patient deaths examined were judged to have been preventable due to issues with healthcare. The reviewers used this figure to calculate that almost 12,000 deaths a year are preventable – the 1,000 a month figure quoted in the media.The main thing to be aware of is that these are estimates based on a relatively small sample only. The researchers reviewed only 1,000 deaths from 10 English hospitals. However, the researchers did make careful attempts to ensure that their selection was a representative sample of hospitals from across England.
The researchers also ensured that the medical reviewers were fully trained in the review process, and they also validated their assessments by performing a second review of a sample of 25% of the notes. Additionally, each case that was considered to be a preventable death was discussed with the principal investigator and an expert reviewer. Despite this, there will still have been some subjective analysis, and a different set of reviewers may have come up with different figures.
Related to this is the use of the six-point scale. Scores of four to six were considered to be preventable deaths, though the researchers say that using a more stringent definition of preventable (scores of five and six only) gave an estimate of 2.3%, rather than 5.2%. Though, similarly, using a more relaxed definition of preventable (scores of three to six) would raise the proportion of possibly preventable deaths to 8.5%.
Despite the alarmist media headlines, the researchers conclude that the number of preventable hospital deaths is actually much lower than previous estimates. They consider that “given the low proportion of deaths due to problems with healthcare”, focusing on patient deaths may not be the best way of finding ways to improve healthcare. This seems to be a sensible conclusion.
Of interest is the fact that the independent National Confidential Enquiry into Patient Outcomes and Death (NCEPOD), an independent charitable organisation, commissioned by the Healthcare Quality Improvement Pathway (HQIP), performs regular reviews of medical and surgical practice in UK hospitals and makes recommendations for improving the quality of healthcare. It does this through extensive confidential surveys and research covering many different aspects of care, including the review of medical and surgical records of patients who have died, and interviews of the treating consultants. NCEPOD produce several reports a year focusing on specific aspects of healthcare. These typically involve the review of several thousand records. It would be well worth comparing NCEPOD’s findings with those of this study.
Analysis by Bazian. Edited by NHS Choices. Follow Behind the Headlines on twitter.
Links To The Headlines
‘Doctors' basic errors are killing 1,000 patients a month’. The Independent, July 13 2012Links To Science
Hogan H, Healey F, Neale G, et al. Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study. BMJ Quality and Safety, published online July 7, 2012Friday, 13 July 2012
Care home medication change scheme declared a success
Care home medication change scheme declared a success:
A scheme aimed at ensuring patients in care homes are getting the the right medication as been declared a success.Evening Telegraph
A scheme aimed at ensuring patients in care homes are getting the the right medication as been declared a success.Evening Telegraph
NHS trust put into administration
NHS trust put into administration: The government takes the unprecedented step of putting a London NHS trust into administration after it ran into financial trouble. BBC News
Elderly 'low prescribing' warning
Elderly 'low prescribing' warning: More elderly patients should be prescribed drugs to tackle high blood pressure and cholesterol, experts say. BBC News
Breast cancer 'reoperation risk'
Breast cancer 'reoperation risk': One in five women who has breast conserving surgery, rather than a mastectomy, in England ends up having another operation, a study says. BBC News
St George's fined for stray letters
St George's fined for stray letters: St George's Healthcare NHS Trust has been issued with a £60,000 fine for sending a vulnerable patient's medical details to the wrong address. E-Health Insider
Never again? The story of the Health and Social Care Act 2012
Never again? The story of the Health and Social Care Act 2012:
This book, published jointly by The King's Fund and the Institute for Government, explains why and how the Act became law; from the legislation’s origins 20 years ago, through the development of the 2010 White Paper Liberating the NHS to the passage of the controversial Bill through both Houses of Parliament. It focuses on what Andrew Lansley, Secretary of State for Health, is trying to achieve through the NHS reforms and considers the role the Liberal Democrats played in introducing amendments to the legislation and passing the Bill.
This book, published jointly by The King's Fund and the Institute for Government, explains why and how the Act became law; from the legislation’s origins 20 years ago, through the development of the 2010 White Paper Liberating the NHS to the passage of the controversial Bill through both Houses of Parliament. It focuses on what Andrew Lansley, Secretary of State for Health, is trying to achieve through the NHS reforms and considers the role the Liberal Democrats played in introducing amendments to the legislation and passing the Bill.
Accrual of statutory annual leave on long term sick leave
Accrual of statutory annual leave on long term sick leave: Following the recent decision of the European Court of Justice (ECJ) holiday pay case (ANGED), we have updated our existing guidance and employer FAQs on the accrual of statutory annual leave on long term sick leave. NHS Employers
Improved NHS services through new perspectives: a toolkit for doctors and managers to improve quality for patients
Improved NHS services through new perspectives: a toolkit for doctors and managers to improve quality for patients:
This online toolkit aims to help implement positive change in NHS trusts. It offers a way of improving productive working between doctors and managers in a series of steps that requires conversations between all parties and identifies any development required.
Please note: this toolkit requires free registration in order to access it.
This online toolkit aims to help implement positive change in NHS trusts. It offers a way of improving productive working between doctors and managers in a series of steps that requires conversations between all parties and identifies any development required.
Please note: this toolkit requires free registration in order to access it.
Health visitor teaching in practice: a framework intended for use for commissioning, education and clinical practice of practice teachers (PTs)
Health visitor teaching in practice: a framework intended for use for commissioning, education and clinical practice of practice teachers (PTs):
This framework pulls together all of the information around health visitor practice teachers. It aims to improve understanding of the role and the importance of the practice teacher, their preparation and responsibilities in order to deliver improved outcomes for children, families and communities aligned with the health visitor programme and service vision.
This framework pulls together all of the information around health visitor practice teachers. It aims to improve understanding of the role and the importance of the practice teacher, their preparation and responsibilities in order to deliver improved outcomes for children, families and communities aligned with the health visitor programme and service vision.
Doctors broke abortion law in 13 NHS trusts - The Guardian
Doctors broke abortion law in 13 NHS trusts - The Guardian:
 The Guardian | Doctors broke abortion law in 13 NHS trusts The Guardian Except in emergencies, two doctors must agree on the reason for an abortion: a risk to the life or physical and mental health of the woman, a risk of serious physical or mental abnormalities in the baby, if born, or a risk to the physical and mental ... and more » |
Will the government's mandate put patients at the heart of the NHS?
Will the government's mandate put patients at the heart of the NHS?:
It's said to 'liberate' the NHS from top-down interference, but can the mandate avoid conflict between local and national desires?
The publication of the government's draft mandate for the NHS is big news for managers and clinicians. It sets out the priorities for the NHS Commissioning Board for the next two years and beyond. What is in the final version and how the board delivers it will have a profound impact on the culture and practice of the new NHS.
Until now the key NHS document has been the annual operating framework, the embodiment of the command and control culture which spells out the targets, priorities and rules NHS bodies must follow. The mandate is intended to be more long-term than the operating framework has been, promising stability rather than lurching from priority to priority as the political winds change.
The first mandate, to be published following the end of consultations in September, will run from 2013 to 2015, while setting "ambitions" for improving outcomes over five to 10 years. It will, however, be revised annually. Will ministers resist the temptation to squeeze in one more target?
The mandate is intended to reflect the NHS outcomes framework, first published in 2010 to set indicators for healthcare performance. The board will be expected to demonstrate progress against each of the framework's dozens of indicators.
In inviting responses to the draft mandate, the first question being asked is the right one: will the mandate drive a culture which puts patients at the heart of everything the NHS does? That mirror must be constantly held up to the mandate itself, and the way the commissioning board implements it. Managers and commissioners should resist anything violating that principle.
The mandate claims "the NHS is being liberated from day-to-day top-down interference in its operational management". Commissioners might want to pin this "free at last" commitment to their wall, and point it out to visitors from the board's local and regional outposts whenever they stray over the line.
But there is one area where the presumption of autonomy does not apply – service reconfigurations. The board is to take a leading role in "supporting" clusters of clinical commissioning groups in handling major changes. While this is against the spirit of local control, the alternative is paralysis. The demise of strategic health authorities means that unless the board intervenes there is no organisation with the big picture view and organisational clout to make change happen. Yet the opportunities for conflict between local desires and national and regional imperatives will be considerable.
This issue is further complicated by local government's role. The speech by commissioning board chief executive Sir David Nicholson to last month's Local Government Association annual conference was poorly received; the board clearly has some distance to go in understanding the role of local politics in the new NHS.
The health secretary, Andrew Lansley, should be applauded for stressing, in the heart of the mandate, the importance of improving the health and healthcare of NHS staff. Stressed, unsupported staff will not deliver high quality care. As Elisabeth Buggins, chair of Birmingham Women's Foundation Trust, has argued: if we demand that staff expend emotional energy in providing patient-centred care, the staff themselves need support.
Plaudits are also due for the prominence given to mental health, which continues its journey towards the centre of the healthcare system. The draft mandate points out it is the single largest cause of disability, and declares it to be as important as physical health.
But the mandate risks setting some precise yet difficult to measure targets. Objective 5 is: "Improve patient safety, reducing Quality Adjusted Life Years lost to NHS patients … through avoidable harm by X% by 2015; X% by 2018; and X% by 2023."
While the intention is laudable, it could generate industrial scale monitoring to secure data of questionable robustness. Managers need to work through what each of the objectives would mean for their clinicians and managers. If there are unintended consequences, now is the time to point them out. Guardian Professional.
The publication of the government's draft mandate for the NHS is big news for managers and clinicians. It sets out the priorities for the NHS Commissioning Board for the next two years and beyond. What is in the final version and how the board delivers it will have a profound impact on the culture and practice of the new NHS.
Until now the key NHS document has been the annual operating framework, the embodiment of the command and control culture which spells out the targets, priorities and rules NHS bodies must follow. The mandate is intended to be more long-term than the operating framework has been, promising stability rather than lurching from priority to priority as the political winds change.
The first mandate, to be published following the end of consultations in September, will run from 2013 to 2015, while setting "ambitions" for improving outcomes over five to 10 years. It will, however, be revised annually. Will ministers resist the temptation to squeeze in one more target?
The mandate is intended to reflect the NHS outcomes framework, first published in 2010 to set indicators for healthcare performance. The board will be expected to demonstrate progress against each of the framework's dozens of indicators.
In inviting responses to the draft mandate, the first question being asked is the right one: will the mandate drive a culture which puts patients at the heart of everything the NHS does? That mirror must be constantly held up to the mandate itself, and the way the commissioning board implements it. Managers and commissioners should resist anything violating that principle.
The mandate claims "the NHS is being liberated from day-to-day top-down interference in its operational management". Commissioners might want to pin this "free at last" commitment to their wall, and point it out to visitors from the board's local and regional outposts whenever they stray over the line.
But there is one area where the presumption of autonomy does not apply – service reconfigurations. The board is to take a leading role in "supporting" clusters of clinical commissioning groups in handling major changes. While this is against the spirit of local control, the alternative is paralysis. The demise of strategic health authorities means that unless the board intervenes there is no organisation with the big picture view and organisational clout to make change happen. Yet the opportunities for conflict between local desires and national and regional imperatives will be considerable.
This issue is further complicated by local government's role. The speech by commissioning board chief executive Sir David Nicholson to last month's Local Government Association annual conference was poorly received; the board clearly has some distance to go in understanding the role of local politics in the new NHS.
The health secretary, Andrew Lansley, should be applauded for stressing, in the heart of the mandate, the importance of improving the health and healthcare of NHS staff. Stressed, unsupported staff will not deliver high quality care. As Elisabeth Buggins, chair of Birmingham Women's Foundation Trust, has argued: if we demand that staff expend emotional energy in providing patient-centred care, the staff themselves need support.
Plaudits are also due for the prominence given to mental health, which continues its journey towards the centre of the healthcare system. The draft mandate points out it is the single largest cause of disability, and declares it to be as important as physical health.
But the mandate risks setting some precise yet difficult to measure targets. Objective 5 is: "Improve patient safety, reducing Quality Adjusted Life Years lost to NHS patients … through avoidable harm by X% by 2015; X% by 2018; and X% by 2023."
While the intention is laudable, it could generate industrial scale monitoring to secure data of questionable robustness. Managers need to work through what each of the objectives would mean for their clinicians and managers. If there are unintended consequences, now is the time to point them out. Guardian Professional.
Subscribe to:
Posts (Atom)