NHS Voices
Monday, 15 April 2013
The Francis report mustn’t be neglected, says Michelle Mitchell
The Francis report mustn’t be neglected, says Michelle Mitchell: The pace of the news cycle may already have made the Francis report feel like yesterday’s news or a flash in the pan. But nothing could be further from the truth. We know that the issues of poor, undignified care and neglect that prompted the report are the cause for sober reflection among many people … Continue reading » NHS Voices
NHS Voices
Skin cancer twice as bad as previous estimates
Skin cancer twice as bad as previous estimates:
Skin cancer is now nearly as prevalent as all other cancers put together, with more than 200,000 basal cell skin cancers treated with surgery a year. New research has found that, over the past decade, there has been an 80 per cent rise in cases of the skin cancer which are treated with surgery alone. But doctors who carried out the study warn that official government skin cancer figures seriously underestimate the true levels. With costs of treating each case of this form of skin cancer estimated at around £1,000, the financial burden to the NHS could be more than £200m a year. The Independent
Skin cancer is now nearly as prevalent as all other cancers put together, with more than 200,000 basal cell skin cancers treated with surgery a year. New research has found that, over the past decade, there has been an 80 per cent rise in cases of the skin cancer which are treated with surgery alone. But doctors who carried out the study warn that official government skin cancer figures seriously underestimate the true levels. With costs of treating each case of this form of skin cancer estimated at around £1,000, the financial burden to the NHS could be more than £200m a year. The Independent
Bring it on: 40 ways to support patient leadership
Bring it on: 40 ways to support patient leadership: This guide explains what patient leadership means, as well as the role and purpose of patient leaders. It aims to help NHS organisations foster patient leadership by providing descriptions of key concepts, examples, case studies, tools (such as self-assessment frameworks and checklists), top tips and useful background material.
National framework for NHS continuing healthcare and NHS funded nursing care
National framework for NHS continuing healthcare and NHS funded nursing care: This guidance sets out the principles and processes of the National Framework for NHS continuing healthcare and NHS funded nursing care. It has been revised to reflect the new NHS framework and structures created by the Health and Social Act 2012, effective from the 1st of April 2013. The associated tools (a checklist, decision support tool and fast
track pathway tool), which are designed to assist clinicians and practitioners with the decision making process, have also been revised accordingly.
track pathway tool), which are designed to assist clinicians and practitioners with the decision making process, have also been revised accordingly.
'Meltdown' in 111 helpline as calls closed in error
'Meltdown' in 111 helpline as calls closed in error: Leaked report shows evidence of a "meltdown" in the 111 NHS helpline for out-of-hours care.
The Daily Telegraph
The Daily Telegraph
NHS watchdog under fire over baby deaths
NHS watchdog under fire over baby deaths: The NHS watchdog is to face fresh criticism next week over its supervision of a hospital where the deaths of at least eight babies are now under investigation by police amid accusations of a cover-up.
The Daily Telegraph
The Daily Telegraph
'Psychiatric Asbos' were an error says key advisor
'Psychiatric Asbos' were an error says key advisor:
Controversial powers to treat mental health patients in the community while seriously curtailing their freedoms have been criticised by one of their strongest supporters. The Independent
Controversial powers to treat mental health patients in the community while seriously curtailing their freedoms have been criticised by one of their strongest supporters. The Independent
Measles outbreak could spread and hit London and North most, expert warns
Measles outbreak could spread and hit London and North most, expert warns:
The measles outbreak gripping South Wales could spread to other parts of Britain, with London and the North particularly vulnerable, a leading expert warned tonight. The Independent
The measles outbreak gripping South Wales could spread to other parts of Britain, with London and the North particularly vulnerable, a leading expert warned tonight. The Independent
Friday, 12 April 2013
Handling and resolving complaints post-Francis
Handling and resolving complaints post-Francis: The Francis report reminded us that we have a long history of trying to improve the way complaints about health services are handled. Yet we still have a long way to go to make sure patients and family members are heard and their complaints are effectively addressed, says Sondra Roberto. The Health Foundation
Almost 700 cases in measles epidemic
Almost 700 cases in measles epidemic: The number of measles cases in Swansea shows a big jump over the past two days and is now close to 700, says Public Health Wales. BBC News
Heart expert queries Leeds reopening
Heart expert queries Leeds reopening: The director of the National Institute of Clinical Outcomes Research, tells the BBC that heart surgery at Leeds should not have been restarted. BBC News
What GPs really think about CCGs
What GPs really think about CCGs: As CCGs finally take the reins of the NHS in England, do GPs think they will improve the NHS? Graham Clews reports on an exclusive GP survey. GP Online
Ministers ''water down'' Francis proposals
Ministers ''water down'' Francis proposals: The new NHS constitution now states only that the NHS will ''aspire'' to put patients first Public Service
''The health service is bust... promises will be broken''
''The health service is bust... promises will be broken'': Governments have ''over-promised'' on what the health service is capable of delivering Public Service
Clinical audit: statutory and mandatory requirements
Clinical audit: statutory and mandatory requirements: This table provides a summary of the current statutory and mandatory requirements imposed on healthcare providers working in the NHS in England. It includes the 2013/2014 NHS Standard Contract, the introduction of the NHS provider Licence by Monitor, changes to the
Foundation Trust Annual Report, and the review of the NHSLA Clinical Negligence Schemes.
Foundation Trust Annual Report, and the review of the NHSLA Clinical Negligence Schemes.
Paying the price: prescription charges and people with long-term conditions
Paying the price: prescription charges and people with long-term conditions: This report examines the impact of prescription charges on people with long-term conditions in England. It found that people with conditions such as asthma, heart disease, arthritis and HIV are having to choose between food, clothing, bills or prescription costs. It argues that prescription charging is short-sighted as it makes it more difficult for people to manage their conditions effectively, leading to more severe health problems and extra costs to the NHS and society overall.
Safety alert for 20,000 diabetes sufferers
Safety alert for 20,000 diabetes sufferers: More than 20,000 diabetes sufferers have been warned that they may have been issued with faulty medical devices which will not alert them if blood sugar levels are dangerously high.
The Daily Telegraph
See also:
The Daily TelegraphSee also:
- Warning over faulty diabetes meters BBC News
Children at risk until NHS units close, warns Royal College of Paediatrics
Children at risk until NHS units close, warns Royal College of Paediatrics: Almost a quarter of NHS children’s units should close to concentrate expertise in the remainder, the Royal College of Paediatrics says. The Independent
See also:
See also:
- Back to Facing the Future The Royal College of Paediatrics and Child Health
- Hospital paediatric services spread too thinly, says royal college The Guardian
- Children's lives are being put at risk by a 'chronic shortage' of hospital doctors at weekends The Daily Mail
First criminal probe into patient death at scandal-hit Mid-Staffs hospital
First criminal probe into patient death at scandal-hit Mid-Staffs hospital:
A criminal investigation has been launched into the death of a woman at scandal-hit Mid-Staffordshire NHS Foundation Trust following a public inquiry, which concluded patients had suffered “appalling” care. The Independent
See also:
A criminal investigation has been launched into the death of a woman at scandal-hit Mid-Staffordshire NHS Foundation Trust following a public inquiry, which concluded patients had suffered “appalling” care. The Independent
See also:
- Mid Staffs hospital death prompts criminal investigation The Guardian
- Criminal probe into hospital death BBC News
Thursday, 11 April 2013
Health spending reforms risk creating complexity for local commissioners
Health spending reforms risk creating complexity for local commissioners: Government reforms to resource allocation risk creating a more complex process with increasingly fragmented decision-making, according to a new report, Improving the allocation of health resources in England, by The King's Fund.
Shared decision making: whose life is it anyway?
Shared decision making: whose life is it anyway?: It is part of the clinical culture to fix. We train our doctors to find out what’s wrong and then to fix it, our nurses to follow protocols. But what if we taught healthcare professionals that their job is to find out what matters to the patient, to find a solution together that works for the patient and to support them to make it happen? The Health Foundation
Organ donation soars since 2008
Organ donation soars since 2008: The number of people in the UK donating organs after death has increased by 50% in the past five years. BBC News
See also:
Care assistants 'want register'
Care assistants 'want register': Most healthcare assistants in the UK want to see tougher regulation of the profession, a survey suggests. BBC News
See also:
See also:
- Healthcare assistants prefer registration Public Service
Caldicott recommends 'duty to share'
Caldicott recommends 'duty to share': The Caldicott2 review of information governance in the NHS recommends a new duty to share information when it is in the interest of the patient. E-Health Insider
Patient complaints focus on the same doctors
Patient complaints focus on the same doctors:
| Half of all complaints are about 3% of doctors OnMedica News |
Working with patients to manage long-term conditions
Working with patients to manage long-term conditions: People Powered Health is an approach that can improve quality of life and save the NHS money.
The health system is going through significant upheaval and crisis provoked by the combined impact of the NHS reforms and the Francis Inquiry. The result is a sense of unease and uncertainty despite the NHS ranking excellently in international terms. At a recent Lord Darzi discussion on primary care, the mood was summed up as: 'Why does it feel so bad, if we're actually doing so well?'
The health system is going through significant upheaval and crisis provoked by the combined impact of the NHS reforms and the Francis Inquiry. The result is a sense of unease and uncertainty despite the NHS ranking excellently in international terms. At a recent Lord Darzi discussion on primary care, the mood was summed up as: 'Why does it feel so bad, if we're actually doing so well?'
Dementia 2013: the hidden voice of loneliness
Dementia 2013: the hidden voice of loneliness: This second annual report on how well people with dementia are living found that over half of the general public believe that people with dementia have a bad quality of life . This was echoed in the feedback from people with dementia with 70 per cent saying they had stopped doing things they used to due because of lack of confidence. The majority of people with dementia also felt anxious or depressed, and a third of people said they’d lost friends after a diagnosis. It calls on commissioners to ensure appropriate support services are available, and urges people and organisations to play their part in helping ensure
their communities are dementia friendly.
their communities are dementia friendly.
End-of-life care improvement fund launched
End-of-life care improvement fund launched: The government has announced a £60m improvement fund for end-of-life care. Healthcare Today
See also:
See also:
- Guidance: Hospices Funding Breakdown Department of Health
Inquiry into failings in NHS emergency care
Inquiry into failings in NHS emergency care: MPs are to launch an inquiry into NHS emergency care amid fears that patients are being put at risk by catastrophic failings in the operation of a new 111 helpline.
The Daily Telegraph
See also:
The Daily TelegraphSee also:
- Paramedics slam new 111 non-emergency phone service The Daily Telegraph
Old before their time: Britons now ageing quicker than their parents
Old before their time: Britons now ageing quicker than their parents:
We are living longer yet growing less healthy. That is the paradoxical conclusion reached by researchers who have found successive generations building up medical problems worse than those faced by their forbears. The Independent
See also:
We are living longer yet growing less healthy. That is the paradoxical conclusion reached by researchers who have found successive generations building up medical problems worse than those faced by their forbears. The Independent
See also:
- Today's adults 15 years 'older' than parents The Daily Telegraph
Wednesday, 10 April 2013
BMA GP contract survival guide
BMA GP contract survival guide: This guide focuses on funding and finance.
Long shadow cast by MMR scare
Long shadow cast by MMR scare: The long shadow cast by the MMR scare. BBC News
Why death rates aren't an exact science
Why death rates aren't an exact science: Why mortality data acts as the NHS's smoke alarm. BBC News
How Prozac entered the lexicon
How Prozac entered the lexicon: How Prozac changed the way people think BBC News
Children's heart surgery suspended over inaccurate data
Children's heart surgery suspended over inaccurate data: But despite data turning out to be 'very poor', the decision to suspend surgery was the right decision, insists Sir Bruce Keogh. Public Service
Ethics tool kit for students
Ethics tool kit for students: This tool kit aims to provide a general introduction to common ethical problems and practical ways of thinking about these problems to help solve issues which arise. It is structured around a number of cards providing advice on issues including medical electives, working with senior colleagues, consent, and confidentiality, referring to any relevant legal provisions involved.
Delivering high quality care for patients: the accountability framework for NHS Trust Boards
Delivering high quality care for patients: the accountability framework for NHS Trust Boards: This framework sets out how the NHS Trust Development Authority will work with NHS Trusts on a day-to-day basis, how it will assess the progress NHS Trusts are making, and how it will provide the development support each organisation needs to meet the challenges that lie ahead.
How conflicts of interest in CCGs will be regulated
How conflicts of interest in CCGs will be regulated: Reconciling GPs’ commercial interests with the responsibilities of CCGs. Health Service Journal
Well Happy app aims to revolutionise healthcare
Well Happy app aims to revolutionise healthcare:
Well Happy presents information about mental and sexual health and substance abuse in a readily accessible format.
Homeopathy on the NHS is 'mad' says outgoing scientific adviser
Homeopathy on the NHS is 'mad' says outgoing scientific adviser: Former government scientific adviser describes use of homoeopathy by NHS described as 'mad'.
The Daily Telegraph
The Daily Telegraph
British children facing bleaker future than rest of Europe, warns Unicef
British children facing bleaker future than rest of Europe, warns Unicef: Children's prospects in Britain are poorer than those in much of the rest of Europe because of the high rate of youth unemployment, teenage pregnancy and under-age drinking, Unicef warns today.
The Daily Telegraph
The Daily Telegraph
The Cuban diet: eat less, exercise more - and preventable deaths are halved
The Cuban diet: eat less, exercise more - and preventable deaths are halved:
A country whose citizens collectively succeeded in losing weight and increasing their level of physical activity saw their health improve and death rates plunge. The Independent
A country whose citizens collectively succeeded in losing weight and increasing their level of physical activity saw their health improve and death rates plunge. The Independent
Tuesday, 9 April 2013
Cost of waste medicines puts pressure on healthcare budgets
Cost of waste medicines puts pressure on healthcare budgets: So you ordered your repeat prescription a week too early. So there's a bit of a build up in your medicine cupboard. It's only a few pills. What harm can it do?
Unused prescription medicines cost... NHFT News
Unused prescription medicines cost... NHFT News
Placing patients at the heart of the business plan to improve care and access for all
Placing patients at the heart of the business plan to improve care and access for all: NHS England today published a plan confirming our commitment to putting patients at the heart of improving care now and for future generations.
Putting Patients First: the NHS England business plan for 2013/14 – 2015/16 is a three year plan that will measure how health and care services are performing with a strong emphasis on making sure feedback from patients, their families and NHS staff is heard and acted upon.
Putting Patients First: the NHS England business plan for 2013/14 – 2015/16 is a three year plan that will measure how health and care services are performing with a strong emphasis on making sure feedback from patients, their families and NHS staff is heard and acted upon.
NHS should learn from Veterans Health
NHS should learn from Veterans Health: The NHS should swap digital health ideas with the US Veterans Health Administration in order to achieve a paperless NHS, says a report by 2020health. E-Health Insider
Compassion is what’s common in our NHS, not cruelty, says Lisa Rodrigues
Compassion is what’s common in our NHS, not cruelty, says Lisa Rodrigues: Back in 1973 at The Hospital for Sick Children, Great Ormond Street, no-one talked about compassion. You were either a good student nurse or a bad one. Or, as in my case, one with plenty of room for improvement. It was a Saturday lunchtime, and I was in handover on the infectious ward. I was allocated … Continue reading »
NHS Voices
NHS Voices
BMA launches ethical toolkit for medical students
BMA launches ethical toolkit for medical students:
| New guidance gives advice on social media and raising concerns about colleagues Related items from OnMedica Junior doctors’ potential too often wasted, report shows Doctors seek more advice on use of social media Commitment to safeguard medical graduate jobs Education and training – the next stage |
2013/14 general medical services (GMS) contract: guidance and audit requirements for new and amended services
2013/14 general medical services (GMS) contract: guidance and audit requirements for new and amended services: This guidance includes the two extended clinical Directed Enhanced Services and other new or existing Enhanced Services. It provides primary care organisations with information to help support the continuation or introduction of these services.
Doctor know: a knowledge commons in health
Doctor know: a knowledge commons in health: This paper argues that society's growing ability to mobilise
knowledge from different fields and sources is beginning to show the potential of a 'knowledge commons' in healthcare: an open system of knowledge with researchers, practicing clinicians, patients, their families and communities all involved in capturing, refining and utilising a common body of knowledge in real time. It sets out what this might mean in practice, and steps that can be taken to get there.
knowledge from different fields and sources is beginning to show the potential of a 'knowledge commons' in healthcare: an open system of knowledge with researchers, practicing clinicians, patients, their families and communities all involved in capturing, refining and utilising a common body of knowledge in real time. It sets out what this might mean in practice, and steps that can be taken to get there.
The friends and family test is unfit for purpose
The friends and family test is unfit for purpose: A well-designed survey can be a powerful tool but the single-question A&E survey being introduced in hospitals is unclear, ambiguous and will not stand up to meaningful analysis.
Monday, 8 April 2013
Danger of child abuse caseloads in Northamptonshire
Danger of child abuse caseloads in Northamptonshire: Some children’s social workers in Northamptonshire have almost double the number of recommended cases in their in-trays. Northampton Chronicle and Echo
VIDEO: Analysing Leeds heart surgery data
VIDEO: Analysing Leeds heart surgery data: Professor Brian Jarman from the Doctor Foster Unit at Imperial College, London, which monitors death rates in UK hospitals, explains how the data about Leeds General Infirmary was analysed, as it is announced that children's heart surgery is set to restart at the hospital. BBC News
Changes begin for disability benefit
Changes begin for disability benefit: The new system of disability benefits begins for new claimants in some areas, as critics express fears that support will be reduced. BBC News
New podcast - Slaying the myths and getting started with social media
New podcast - Slaying the myths and getting started with social media: Presented by Dean Royles this podcast slays five big social media myths preventing your organisation from engaging with social media. NHS Employers
Drug giant agrees to release all Tamiflu trial data
Drug giant agrees to release all Tamiflu trial data:
| Roche agrees to release 74 trials data after three-year battle Related items from OnMedica Also in the press Resistance to Tamiflu - 'to be expected' says Roche Evidence on Tamiflu remains unclear say experts Questions remain about effectiveness of Tamiflu, experts warn NICE to reconsider Tamiflu at BMJ’s request |
Health visitor implementation plan quarterly progress report: October to December 2012
Health visitor implementation plan quarterly progress report: October to December 2012: This report is an update on progress with the health visitor implementation plan 2011 to 2015. The main aims of the implementation plan are to improve services and health outcomes in the foundation years for children, families and local communities, through expanding and strengthening the health visiting service.
Putting patients first: the NHS England business plan for 2013/14–2015/16
Putting patients first: the NHS England business plan for 2013/14–2015/16: This plan describes an 11 point scorecard which NHS England will introduce for measuring performance of key priorities, focused on receiving direct feedback from patients, their families and NHS staff. This supports the cultural change needed to put patients at the centre of the NHS, a key theme in the Francis report. It builds on Everyone Counts: Planning for Patients 2013/14, the previous planning guidance for commissioners which was published in December 2012.
1,000 GPs gagged from talking about local health services
1,000 GPs gagged from talking about local health services: More than 1,000 family doctors have been issued with gagging orders, banning them from talking about the work of new organisations running local health services. The Daily Telegraph
The highest sums paid for NHS agency doctors
The highest sums paid for NHS agency doctors: An investigation by The Telegraph has uncovered more than £2bn spent on locum doctors by the NHS in the last three years. These are the largest payments made last year:
Hospitals must downsize or close, doctors warn
Hospitals must downsize or close, doctors warn: Hospitals face being downsized or closed because half of their services could be better provided elsewhere, doctors claim.
The Daily Telegraph
See also:
The Daily TelegraphSee also:
- Hospitals must shrink or shut, doctors warn The Guardian
Drugs firms pay UK medics £40m in just one year
Drugs firms pay UK medics £40m in just one year: UK-based doctors, nurses and other healthcare professionals were given £40 million by big pharmaceutical companies in just one year, figures suggest. The Independent
Friday, 5 April 2013
First paperless NHS trust helps GP practices go digital
First paperless NHS trust helps GP practices go digital:
The NHS trust which claimed to be the first to become paperless a year ago is now helping GP practices to do the same.
St Helens and Knowsley teaching hospitals NHS trust in the north-west is offering family doctors in England what it claims to be the first service of its kind to digitise, store and give GPs immediate desktop access to their Lloyd George paper patient records.
So far the Electronic Lloyd George Records Service (e-LGS) has been contracted by the trust's three local clinical commissioning groups in Halton, Knowsley and St Helens to rid its 85 GP practices of their 500,000 patient paper records. But the trust says it has the capacity to offer e-LGS to any practice in the country.
Dr David Wilson is one of the first GPs to use the e-LGS system which he says is transforming administration and saving money at his Grove House practice in Runcorn where he is senior partner. Digitising all its 11,000 Lloyd George records is, he estimates, reducing admin costs by the equivalent of about one person a day each week. The practice is as paperless as it is possible to be in the current NHS system where trusts still send some paper correspondence. "We are paper light plus because we still receive paper from trusts although we immediately scan the paper into the system," Wilson said. "We are as advanced as GPs can be."
Practice staff in the past would often spend up to two or three hours manually searching the paper records for specific past referral letters, test results or details of a GP's written account of a previous consultation. With the new system they can remotely access a digital database that contains all the material previously held in the Lloyd George by clicking an icon on a computer screen and logging on to a secure site. The move to e-LGS has also freed up more than 20 sq metres of space in the practice as it no longer needed its Lloyd George library.
Wilson said: "The Lloyd George is the only part of my patient record that still remains on paper and has been a huge burden to maintain administratively. I absolutely love the new system."
The e-LGS system was created by St Helens and Knowsley health informatics service at the trust, which developed its own paperless patient records system a year ago. The trust's IT experts created a similar electronic system for GPs that allows them to access a digital database of the practices' paper records, which have previously been scanned and stored. All the paper records held in the Lloyd George are destroyed – only the covering brown envelope is retained by the practice in case a patient registers with a new GP and a paper copy of their original record needs to be created.
Neil Darvill, director of informatics at the health informatics service said: "I don't think that any other organisation is offering this end-to-end service although some commercial companies will offer archiving and scanning of paper records and provide practices a backup with a DVD. Where we are different is that we take the paper records away, scan them and then provide online access with no data stored in the practice."
Signing up to e-LGS for five years costs a practice £3 for each Lloyd George record, or 60p a record a year. There is a 10% discount for individual clinical commissioning groups. Any profit made is ploughed back into the trust's health informatics service.
The national launch of e-LGS comes three months after Jeremy Hunt, the health secretary, set the NHS a challenge to become paperless by 2018. All NHS trusts are already expected to have their patient records online by 2014.
Guardian Professional.
St Helens and Knowsley teaching hospitals NHS trust in the north-west is offering family doctors in England what it claims to be the first service of its kind to digitise, store and give GPs immediate desktop access to their Lloyd George paper patient records.
So far the Electronic Lloyd George Records Service (e-LGS) has been contracted by the trust's three local clinical commissioning groups in Halton, Knowsley and St Helens to rid its 85 GP practices of their 500,000 patient paper records. But the trust says it has the capacity to offer e-LGS to any practice in the country.
Dr David Wilson is one of the first GPs to use the e-LGS system which he says is transforming administration and saving money at his Grove House practice in Runcorn where he is senior partner. Digitising all its 11,000 Lloyd George records is, he estimates, reducing admin costs by the equivalent of about one person a day each week. The practice is as paperless as it is possible to be in the current NHS system where trusts still send some paper correspondence. "We are paper light plus because we still receive paper from trusts although we immediately scan the paper into the system," Wilson said. "We are as advanced as GPs can be."
Practice staff in the past would often spend up to two or three hours manually searching the paper records for specific past referral letters, test results or details of a GP's written account of a previous consultation. With the new system they can remotely access a digital database that contains all the material previously held in the Lloyd George by clicking an icon on a computer screen and logging on to a secure site. The move to e-LGS has also freed up more than 20 sq metres of space in the practice as it no longer needed its Lloyd George library.
Wilson said: "The Lloyd George is the only part of my patient record that still remains on paper and has been a huge burden to maintain administratively. I absolutely love the new system."
The e-LGS system was created by St Helens and Knowsley health informatics service at the trust, which developed its own paperless patient records system a year ago. The trust's IT experts created a similar electronic system for GPs that allows them to access a digital database of the practices' paper records, which have previously been scanned and stored. All the paper records held in the Lloyd George are destroyed – only the covering brown envelope is retained by the practice in case a patient registers with a new GP and a paper copy of their original record needs to be created.
Neil Darvill, director of informatics at the health informatics service said: "I don't think that any other organisation is offering this end-to-end service although some commercial companies will offer archiving and scanning of paper records and provide practices a backup with a DVD. Where we are different is that we take the paper records away, scan them and then provide online access with no data stored in the practice."
Signing up to e-LGS for five years costs a practice £3 for each Lloyd George record, or 60p a record a year. There is a 10% discount for individual clinical commissioning groups. Any profit made is ploughed back into the trust's health informatics service.
The national launch of e-LGS comes three months after Jeremy Hunt, the health secretary, set the NHS a challenge to become paperless by 2018. All NHS trusts are already expected to have their patient records online by 2014.
Guardian Professional.
NICE publish first guideline for conduct disorders and antisocial behaviour in children and young people
NICE publish first guideline for conduct disorders and antisocial behaviour in children and young people: Conduct disorders are the most common reason why children are referred to mental health services and it’s estimated that around 5% of all UK children aged 5-16 have a diagnosis of the condition. Around half of the young people affected by conduct disorders go on to have a serious mental health problem as an adult. [read the full story...] The Mental Elf
Halve our salt intake and save millions of lives, says new report
Halve our salt intake and save millions of lives, says new report:
If we could end our love affair with salt we would save tens of thousands of lives in Britain and millions around the world, researchers claim today. Independent
If we could end our love affair with salt we would save tens of thousands of lives in Britain and millions around the world, researchers claim today. Independent
Nursing and Midwifery Council resumes overseas registration
Nursing and Midwifery Council resumes overseas registration: The NMC has resumed overseas registration from 2 April 2013 following an review of its policies. NHS Employers News
Putting patients first: government publishes response to Francis Report
Putting patients first: government publishes response to Francis Report:
Health secretary Jeremy Hunt has announced how a culture of compassion will be a key marker of success, spelling an end to the distorting impact of targets and box ticking which led to the failings at Stafford Hospital.
Radical new measures will be introduced to achieve this including Ofsted-style ratings for hospitals and care homes, a statutory duty of candour for organisations which provide care and are registered with the Care Quality Commission, and a pilot programme which will see nurses working for up to a year as a healthcare assistant as a prerequisite for receiving funding for their degree. NHS Networks
Health secretary Jeremy Hunt has announced how a culture of compassion will be a key marker of success, spelling an end to the distorting impact of targets and box ticking which led to the failings at Stafford Hospital.
Radical new measures will be introduced to achieve this including Ofsted-style ratings for hospitals and care homes, a statutory duty of candour for organisations which provide care and are registered with the Care Quality Commission, and a pilot programme which will see nurses working for up to a year as a healthcare assistant as a prerequisite for receiving funding for their degree. NHS Networks
Smoking and Mental Health
Smoking and Mental Health: This report examines the issue of smoking in people with mental health conditions. It argues that much of the lower life expectancy of people with mental disorders can be attributed to smoking which is overlooked and neglected by the NHS. However, there is a moral duty to provide this group with the same health interventions. 20 % of the general population are smokers compared to 40% of those with a mental disorder. The report states that there is a general acceptance of smoking of people with mental disorders by health professionals and it is often engrained in the culture of the institutions who provide care for these populations. Key recommendations include quickly identifying smokers and providing appropriate support, mental health settings to be smoke free and mandatory training for professionals in the awareness of smoking issues. CASH News
New Single drug fund list to bring fairer system for cancer patients
New Single drug fund list to bring fairer system for cancer patients:
NHS England is today (Thursday) taking action to end regional variation of access to the Cancer Drugs Fund. There will be one national list of approved fast-track drugs giving uniform access to treatment across the country.
From 1 April, NHS England took on responsibility for the operational management of the Cancer Drugs Fund, creating for the first time a single national system for deciding which drugs are available and for which conditions. The Cancer Drugs Fund provides an additional £200m each year to enable patients with cancer in England to access drugs that are not routinely funded by their local NHS. It was established in 2010 and will continue to run until the end of March 2014.
Sean Duffy, National Clinical Director for Cancer at NHS England said,
“This is a national levelling up of the number of approved treatments that are available under the Cancer Drugs Fund. This means more people will benefit. It is really important that we stretch every penny of the Cancer Drugs Fund so we get maximum benefit to the most people we possibly can.
“This is a step forward for the Cancer Drugs Fund. In recent weeks cancer specialists from across the country have been working together to agree one national list of approved fast-track drugs for the Cancer Drugs Fund, which will then allow more uniform access to treatment and reduce variation of prescribing across the country. Having one consistent method for consideration of overall clinical benefit and funding means that all applications will be assessed by the same criteria. Regional variation of the past is clearly not acceptable for patients. Clinicians can still apply for drugs to join the national list of approved fast-track cancer drugs. Clinicians can also continue to make individual funding requests for cancer drugs on behalf of their patients. Doctors will still be able to apply for any cancer drug through the Cancer Drugs Fund on behalf of their patients.”
Doctors will still be able to apply for any cancer drug through the Cancer Drug’s Fund on behalf of their patients. The single national list of approved fast-track drugs will contain 28 drugs which will treat approximately 70 different cancer conditions. A small number of drugs which were previously on local lists are now available more widely to patients through normal hospital treatment with no special application needing to be made.
NHS England stresses that any patient who is already receiving funding for a cancer drug, or has received confirmation that they will receive funding as part an agreed treatment plan, will continue to receive treatment, despite any changes made to the national list, as long as they and their clinicians consider it clinically appropriate. Any changes to the treatment plan for individual patients will be made as part of the regular clinical reviews of care and this will include any drugs that were prescribed on a time limited basis.
Until now, the Cancer Drugs Fund has comprised ten regional areas each with different regionally approved lists of fast-track drugs and the cancers they can be used to treat.There has also been a variety of processes for managing their availability to patients. This has led to differential access to drugs and different processes for reviewing patient’s requests. Clearly this is not acceptable. In anticipation of a single clear national approach to the Cancer Drugs Fund, the regional clinical leads for the ten areas worked with the National Cancer Action Team during the early part of 2013 to draft the single, national list of approved fast track drugs and the cancers they can be used to treat.
NHS England has established a national Clinical Reference Group for Chemotherapy which has approved the proposed list. This strong, clinically-led process ensures that access to the Cancer Drugs Fund is based on the best available trial data – ensuring swift access to innovative therapies but importantly ensuring that patient safety and quality of life are central to the process. View the Standard Operating Procedures document
The Cancer Drugs Fund Standard Operating Procedures document and the national list of drugs and indications that will be routinely funded from the Cancer Drugs Fund are published on the dedicated webpage.
Additionally, NHS England will consider applications for cancer medicines made by clinicians to treat individuals with rarer types of cancers including those affecting children. More details on how to make Individual CDF Requests (ICDFRs) are set out on the Cancer Drugs Fund webpage. NHS England
NHS England is today (Thursday) taking action to end regional variation of access to the Cancer Drugs Fund. There will be one national list of approved fast-track drugs giving uniform access to treatment across the country.
From 1 April, NHS England took on responsibility for the operational management of the Cancer Drugs Fund, creating for the first time a single national system for deciding which drugs are available and for which conditions. The Cancer Drugs Fund provides an additional £200m each year to enable patients with cancer in England to access drugs that are not routinely funded by their local NHS. It was established in 2010 and will continue to run until the end of March 2014.
Sean Duffy, National Clinical Director for Cancer at NHS England said,
“This is a national levelling up of the number of approved treatments that are available under the Cancer Drugs Fund. This means more people will benefit. It is really important that we stretch every penny of the Cancer Drugs Fund so we get maximum benefit to the most people we possibly can.
“This is a step forward for the Cancer Drugs Fund. In recent weeks cancer specialists from across the country have been working together to agree one national list of approved fast-track drugs for the Cancer Drugs Fund, which will then allow more uniform access to treatment and reduce variation of prescribing across the country. Having one consistent method for consideration of overall clinical benefit and funding means that all applications will be assessed by the same criteria. Regional variation of the past is clearly not acceptable for patients. Clinicians can still apply for drugs to join the national list of approved fast-track cancer drugs. Clinicians can also continue to make individual funding requests for cancer drugs on behalf of their patients. Doctors will still be able to apply for any cancer drug through the Cancer Drugs Fund on behalf of their patients.”
Doctors will still be able to apply for any cancer drug through the Cancer Drug’s Fund on behalf of their patients. The single national list of approved fast-track drugs will contain 28 drugs which will treat approximately 70 different cancer conditions. A small number of drugs which were previously on local lists are now available more widely to patients through normal hospital treatment with no special application needing to be made.
NHS England stresses that any patient who is already receiving funding for a cancer drug, or has received confirmation that they will receive funding as part an agreed treatment plan, will continue to receive treatment, despite any changes made to the national list, as long as they and their clinicians consider it clinically appropriate. Any changes to the treatment plan for individual patients will be made as part of the regular clinical reviews of care and this will include any drugs that were prescribed on a time limited basis.
Until now, the Cancer Drugs Fund has comprised ten regional areas each with different regionally approved lists of fast-track drugs and the cancers they can be used to treat.There has also been a variety of processes for managing their availability to patients. This has led to differential access to drugs and different processes for reviewing patient’s requests. Clearly this is not acceptable. In anticipation of a single clear national approach to the Cancer Drugs Fund, the regional clinical leads for the ten areas worked with the National Cancer Action Team during the early part of 2013 to draft the single, national list of approved fast track drugs and the cancers they can be used to treat.
NHS England has established a national Clinical Reference Group for Chemotherapy which has approved the proposed list. This strong, clinically-led process ensures that access to the Cancer Drugs Fund is based on the best available trial data – ensuring swift access to innovative therapies but importantly ensuring that patient safety and quality of life are central to the process. View the Standard Operating Procedures document
The Cancer Drugs Fund Standard Operating Procedures document and the national list of drugs and indications that will be routinely funded from the Cancer Drugs Fund are published on the dedicated webpage.
Additionally, NHS England will consider applications for cancer medicines made by clinicians to treat individuals with rarer types of cancers including those affecting children. More details on how to make Individual CDF Requests (ICDFRs) are set out on the Cancer Drugs Fund webpage. NHS England
NHS England publishes clinical access policies for specialised services
NHS England publishes clinical access policies for specialised services:
NHS England is today publishing an agreed set of clinical access policies for specialised commissioning. For the first time ever, specialised services will be commissioned using a nationally consistent approach, meaning that patients will have equal access to high quality services, regardless of where they live.
The policies, along with a number of specialised services specifications, were the subject of a short public consultation between December 2012 and February 2013. The consultation attracted more than 3,500 web and email responses from patients, carers, the general public and wider stakeholders, all of which have been used to inform the final versions of the policies.
The consultation covered a total of 135 service specifications and 44 clinical access policies. The draft service specifications will be subject to a period of further engagement with stakeholders during the coming months. A full consultation report, outlining all feedback, will be published by NHS England in due course.
In addition to publishing clinical commissioning policies, NHS England is also developing a new approach for widening access to some services that are not routinely commissioned by the NHS.
‘Commissioning through Evaluation’ enables treatments or procedures to be commissioned initially on a limited basis whilst further evaluation is carried out to determine whether a substantive commissioning policy should be developed for future use.
NHS England is considering a number of treatments and medical devices as potential subjects for the ‘Commissioning through Evaluation’ approach. These include deep brain stimulation for the treatment of epilepsy; Mitraclip – a device used in the repair of heart valves; renal denervation for the treatment of chronic high blood pressure, and selective dorsal rhizotomy, a treatment aimed at reducing spasticity in children with cerebral palsy.
Patients, carers and wider stakeholders will continue to help NHS England in the development of evaluation criteria for ‘Commissioning through Evaluation’. Patient and carer members of the 74 specialised services Clinical Reference Groups (CRGs) will play a vital role in this work. The recruitment of patient and carer members to CRGs is now open. NHS England
NHS England is today publishing an agreed set of clinical access policies for specialised commissioning. For the first time ever, specialised services will be commissioned using a nationally consistent approach, meaning that patients will have equal access to high quality services, regardless of where they live.
The policies, along with a number of specialised services specifications, were the subject of a short public consultation between December 2012 and February 2013. The consultation attracted more than 3,500 web and email responses from patients, carers, the general public and wider stakeholders, all of which have been used to inform the final versions of the policies.
The consultation covered a total of 135 service specifications and 44 clinical access policies. The draft service specifications will be subject to a period of further engagement with stakeholders during the coming months. A full consultation report, outlining all feedback, will be published by NHS England in due course.
In addition to publishing clinical commissioning policies, NHS England is also developing a new approach for widening access to some services that are not routinely commissioned by the NHS.
‘Commissioning through Evaluation’ enables treatments or procedures to be commissioned initially on a limited basis whilst further evaluation is carried out to determine whether a substantive commissioning policy should be developed for future use.
NHS England is considering a number of treatments and medical devices as potential subjects for the ‘Commissioning through Evaluation’ approach. These include deep brain stimulation for the treatment of epilepsy; Mitraclip – a device used in the repair of heart valves; renal denervation for the treatment of chronic high blood pressure, and selective dorsal rhizotomy, a treatment aimed at reducing spasticity in children with cerebral palsy.
Patients, carers and wider stakeholders will continue to help NHS England in the development of evaluation criteria for ‘Commissioning through Evaluation’. Patient and carer members of the 74 specialised services Clinical Reference Groups (CRGs) will play a vital role in this work. The recruitment of patient and carer members to CRGs is now open. NHS England
NHS England publishes generic commissioning policies
NHS England publishes generic commissioning policies:
NHS England has published a number of interim generic policies, ensuring fair and consistent decision-making across its direct commissioning function.
The 14 policies cover all aspects of NHS England’s direct commissioning responsibilities including specialised services, primary care, screening, military and offender health.
The policies, agreed by the Clinical Priorities Advisory Group (CPAG), set out NHS England’s approach on a variety of funding issues including Individual Funding Requests; access to treatments for patients moving between different sets of commissioners and services providers, and the process that NHS England will adopt for implementing guidance produced by the National Institute of Clinical Excellence (NICE).
Other policies include the Ethical Framework for Priority Setting and Resource Allocation which sets out a fair and consistent approach to decision-making.
The policies are being adopted on an interim basis to enable NHS England to carry out further engagement with patients, carers and the public over the next 6-12 months in refining and agreeing final versions.
NHS England plans to bring together a steering group which will lead development of the policies, working in partnership with a range of stakeholders. This group will test the principles on which the policies are based and will revise them, where appropriate, in order to make them more accessible. This transparent approach to policy development reinforces NHS England’s commitment to ensuring that patients and carers are at the heart of the planning and development of NHS services. NHS England
Access the individual policies.
NHS England has published a number of interim generic policies, ensuring fair and consistent decision-making across its direct commissioning function.
The 14 policies cover all aspects of NHS England’s direct commissioning responsibilities including specialised services, primary care, screening, military and offender health.
The policies, agreed by the Clinical Priorities Advisory Group (CPAG), set out NHS England’s approach on a variety of funding issues including Individual Funding Requests; access to treatments for patients moving between different sets of commissioners and services providers, and the process that NHS England will adopt for implementing guidance produced by the National Institute of Clinical Excellence (NICE).
Other policies include the Ethical Framework for Priority Setting and Resource Allocation which sets out a fair and consistent approach to decision-making.
The policies are being adopted on an interim basis to enable NHS England to carry out further engagement with patients, carers and the public over the next 6-12 months in refining and agreeing final versions.
NHS England plans to bring together a steering group which will lead development of the policies, working in partnership with a range of stakeholders. This group will test the principles on which the policies are based and will revise them, where appropriate, in order to make them more accessible. This transparent approach to policy development reinforces NHS England’s commitment to ensuring that patients and carers are at the heart of the planning and development of NHS services. NHS England
Access the individual policies.
Thursday, 4 April 2013
Patients costing NHS Nene £4.6m by stockpiling medicine
Patients costing NHS Nene £4.6m by stockpiling medicine:
The cost of wasted NHS medicines in Northamptonshire this year could have paid for 600 life-saving heart operations. Northampton Chronicle & Echo
The cost of wasted NHS medicines in Northamptonshire this year could have paid for 600 life-saving heart operations. Northampton Chronicle & Echo
Health tourism costing NHS billions, senior doctor claims:
The growing epidemic of health tourists exploiting the NHS is costing the British taxpayer billions every year, a senior doctor has warned.
Telegraph
The growing epidemic of health tourists exploiting the NHS is costing the British taxpayer billions every year, a senior doctor has warned.
Telegraph
Guidance for commissioners on ensuring the continuity of health care services
Guidance for commissioners on ensuring the continuity of health care services:
This framework sets out an end-to-end process that guides commissioners from initiating the work of designating services as commissioner requested services through to deciding which services should be defined as location specific services in the event that a provider fails financially. In addition to this guidance, an interactive toolkit has also been developed to guide commissioners through the framework and to provide a mechanism to record the evidence used and the thinking underlying a decision to designate or not. NHS Networks
This framework sets out an end-to-end process that guides commissioners from initiating the work of designating services as commissioner requested services through to deciding which services should be defined as location specific services in the event that a provider fails financially. In addition to this guidance, an interactive toolkit has also been developed to guide commissioners through the framework and to provide a mechanism to record the evidence used and the thinking underlying a decision to designate or not. NHS Networks
Health service in England warned to keep data secure
Health service in England warned to keep data secure: ICO urges health sector to keep patients' personal data secure now that the Health and Social Care Act has become a reality. Health and Social Care News
British Social Attitudes survey data
British Social Attitudes survey data:
According to advance data published by The King's Fund, public satisfaction with the NHS stabilised last year after a record fall.Satisfaction with the way that the NHS is run now stands at 61 per cent, the third highest level since the survey began in 1983. Survey findings The King's Fund - press release Kings Fund Blog
According to advance data published by The King's Fund, public satisfaction with the NHS stabilised last year after a record fall.Satisfaction with the way that the NHS is run now stands at 61 per cent, the third highest level since the survey began in 1983. Survey findings The King's Fund - press release Kings Fund Blog
NICE support for commissioners of dementia care
NICE support for commissioners of dementia care:
This resource supports commissioners, clinicians and managers to commission high-quality evidence-based care for people with dementia and their carers. It provides practical advice for commissioners to improve
the integration of health and social care. This will help ensure that more people with dementia receive an early diagnosis and can access the care and support that they, and their carers, need to live well and independently with dementia for as long as possible.Commissioning guidance Kings Fund Blog
This resource supports commissioners, clinicians and managers to commission high-quality evidence-based care for people with dementia and their carers. It provides practical advice for commissioners to improve
the integration of health and social care. This will help ensure that more people with dementia receive an early diagnosis and can access the care and support that they, and their carers, need to live well and independently with dementia for as long as possible.Commissioning guidance Kings Fund Blog
China: Four more have H7N9 bird flu
China: Four more have H7N9 bird flu: Four new cases of the H7N9 bird flu virus, not previously seen in humans have been identified by authorities in China. BBC News
Family nurse scheme extended across England
Family nurse scheme extended across England:
| One-to-one support for 16,000 disadvantaged parents by 2015 OnMedica |
RCP achieves NICE accreditation
RCP achieves NICE accreditation:
The National Institute for Health and Care Excellence (NICE) has accredited the processes used by the
Royal College of Physicians (RCP) to produce guidance.
Professor David Haslam, chair of the NICE
Accreditation Advisory Committee, said:
read more
RCGP News
Royal College of Physicians (RCP) to produce guidance.
Professor David Haslam, chair of the NICE
Accreditation Advisory Committee, said:
read more
RCGP News
Wednesday, 3 April 2013
No show patients 'cost hospitals £42m'
No show patients 'cost hospitals £42m': Patients failing to make hospital appointments are costing the eastern region NHS £42m a year, it emerges. BBC News
'Postcode lottery' for GP IT
'Postcode lottery' for GP IT: GPs are at risk of a "postcode lottery" of IT support that will affect practice performance and ultimately patient care, a negotiator for the BMA's GP Committee warns. EHI News
Indian drug ruling hailed by health campaigners
Indian drug ruling hailed by health campaigners:
| Generic version of cancer drug Glivec will be available at a tenth of the cost of the original Onmedica |
NHS reforms jeopardise future of primary health estate
NHS reforms jeopardise future of primary health estate:
Experts suggest the government may have launched NHS Property Services with an intention to sell it off in future
NHS reforms will result in less local flexibility to manage NHS surplus property, competition between centralised bodies managing NHS estates and concern by private sector investors that future primary care building projects will become more expensive.
The government's controversial decision to abolish primary care trusts – which came into effect from 1 April – has led to concerns among funders over the strength of the new organisations with which they will be contracting.
In 2011, the government created NHS Property Services as a limited company, run by chief executive Simon Holden, to take over the management of the bulk of the primary care estate. In previous reorganisations, NHS property has been passed on to the new local NHS organisations. But much of it is now being transferred to this new, central organisation.
Meanwhile, an existing government agency, Community Health Partnerships (CHP), where Sue O'Connell is chief executive, will take the PCT stakes in NHS Lift companies. These are private sector-led public/private partnerships building new primary facilities.
Banks and investors have raised concerns that these two organisations will have a lower credit rating than the old PCTs, which were backed by central government and were therefore seen as "investment grade".
"As schemes are being developed for head tenants that are limited companies without the benefit of a UK government covenant, it may be harder for developers to get 25-year money for their schemes," said Matthew Newing, a partner at law firm Speechly Bircham, who is working on such deals.
There are also concerns over how NHS Property Services and CHP will work together. "There is a general feeling that we don't need both," said one private sector expert. "These are two UK government-owned companies that are competing in the same space."
Some experts suggest the government may have launched NHS Property Services with an intention to sell it off, along with the estate it manages, at some point in the future. Guardian Healthcare Network
NHS reforms will result in less local flexibility to manage NHS surplus property, competition between centralised bodies managing NHS estates and concern by private sector investors that future primary care building projects will become more expensive.
The government's controversial decision to abolish primary care trusts – which came into effect from 1 April – has led to concerns among funders over the strength of the new organisations with which they will be contracting.
In 2011, the government created NHS Property Services as a limited company, run by chief executive Simon Holden, to take over the management of the bulk of the primary care estate. In previous reorganisations, NHS property has been passed on to the new local NHS organisations. But much of it is now being transferred to this new, central organisation.
Meanwhile, an existing government agency, Community Health Partnerships (CHP), where Sue O'Connell is chief executive, will take the PCT stakes in NHS Lift companies. These are private sector-led public/private partnerships building new primary facilities.
Banks and investors have raised concerns that these two organisations will have a lower credit rating than the old PCTs, which were backed by central government and were therefore seen as "investment grade".
"As schemes are being developed for head tenants that are limited companies without the benefit of a UK government covenant, it may be harder for developers to get 25-year money for their schemes," said Matthew Newing, a partner at law firm Speechly Bircham, who is working on such deals.
There are also concerns over how NHS Property Services and CHP will work together. "There is a general feeling that we don't need both," said one private sector expert. "These are two UK government-owned companies that are competing in the same space."
Some experts suggest the government may have launched NHS Property Services with an intention to sell it off, along with the estate it manages, at some point in the future. Guardian Healthcare Network
Annulling competition rules is the most important NHS battleground
Annulling competition rules is the most important NHS battleground:
The government may have hoped new health service regulations on competition could be quietly ushered in, but healthcare professionals and more than 250,000 patients have called for their withdrawal
Never has a statutory instrument created such a furore as SI 2013(257) on NHS procurement – the regulations that effectively put the entire NHS up for tender. These obscure orders give effect to ministerial decisions and simply come into force within 40 days unless revoked (in either House) by "negative procedure" – an almost unheard of occurrence. This is the route the government has chosen to flesh out the NHS and Social Care Act, but if it was hoping to slip unnoticed through this legislative back door it has had a rude shock.
Spurred on by a 250,000 signature petition organised by the formidable 38 Degrees, politicians and professional groups have awoken to what is happening. Calls for withdrawal of the regulations have come from the BMA, RCGPs, RCN and the UK Faculty of Public Health – even the conservative Academy of Royal Colleges has joined in, as has the normally loyal NHS Alliance. The obscure Lords scrutiny committee has reeled under the weight of an unprecedented 2000-plus representations, and the crucial "prayer" for annulment will be laid by Labour in the Lords on 24 April.
Taking refuge in claims of "poor drafting" and "inadvertently created confusion", the coalition hastily redrafted the offending regulations. In this new version, assurances are given that CCGs will be free to determine their own procurement decisions, and the option of "integrated care" is belatedly rediscovered. The competition enforcing body, Monitor, is portrayed as an avuncular alternative to the judicial process, and everything being proposed is said to be there to simply ensure "patient interest".
There are many reasons why this simply won't wash:
• The regulations still give primacy to the "sole provider" exemption: the only relevant ground upon which CCGs can decline to go out to tender is where the service is only capable of being delivered by one provider – an impossibly high bar.
• UK and EU competition law trumps whatever is in the regulations: even if a commissioner decides (conceivably with Monitor's consent) that the sole provider test has been met to ensure "patient interes"' an aggrieved provider can still take, or threaten to take, judicial action.
• The concept of "patient interes"' is undefined in the regulations: the task of determining what it is will be left to Monitor whose working assumption is that the main determinant of such benefit is choice of provider enforced via competition law.
• The regulations stipulate that any tenders above £1,000 should be advertised, creating very substantial transaction costs that will have to be diverted from patient care.
• Competitive markets constitute the default setting of the system even though the evidence base for this is, at best, flimsy: the "burden of proof" lies on other approaches to demonstrate (against unclear criteria) why and how an alternative model could be preferable.
Not only do the regulations, even as amended, effectively articulate the role of competition in the NHS, they also invest it for the first time with a statutory basis. Previous procurement rules (which bear some similarity to the new regulations) have been seen as "guidance" - a voluntary code of principles. Regulation is different to guidance – it is in effect mandatory. Moreover the legal focus now will now be upon the subject of a proposed contract, not the broader strategic needs of a locality or the potential impact of salami-slicing the portfolio of an existing public sector provider. Nobody is any longer "running the system".
In the meantime, the traditional public sector structure of the NHS is also being chipped away at from other directions. While the procurement regulations concentrate upon healthcare commissioners, the Competition Commission is spreading its tentacles into NHS providers. For example, we now have the bizarre situation in Bournemouth and Poole whereby two NHS providers contemplating a merger to improve local services are being told they cannot communicate with each other.
More along these lines will follow from the Commission and from the Office of Fair Trading – an unprecedented intrusion into the NHS. In this they will be aided and abetted by Monitor which has just published its "fair playing field" review. In this it proposes a whole host of ways to open up the NHS to the private sector, such as underwriting access to NHS pension rights and longer term contracts which will be difficult to review or rescind. Commissioning support units and GPs themselves are identified as being next in line for scrutiny and exposure to market forces.
1 April has been identified as the day the NHS changed forever. There is truth in this, but in a sense the really important date is 24 April, for this will be when the ideological changes are planned to be approved. Annulling SI 2013(257) is currently the most important NHS battleground. Guardian
Never has a statutory instrument created such a furore as SI 2013(257) on NHS procurement – the regulations that effectively put the entire NHS up for tender. These obscure orders give effect to ministerial decisions and simply come into force within 40 days unless revoked (in either House) by "negative procedure" – an almost unheard of occurrence. This is the route the government has chosen to flesh out the NHS and Social Care Act, but if it was hoping to slip unnoticed through this legislative back door it has had a rude shock.
Spurred on by a 250,000 signature petition organised by the formidable 38 Degrees, politicians and professional groups have awoken to what is happening. Calls for withdrawal of the regulations have come from the BMA, RCGPs, RCN and the UK Faculty of Public Health – even the conservative Academy of Royal Colleges has joined in, as has the normally loyal NHS Alliance. The obscure Lords scrutiny committee has reeled under the weight of an unprecedented 2000-plus representations, and the crucial "prayer" for annulment will be laid by Labour in the Lords on 24 April.
Taking refuge in claims of "poor drafting" and "inadvertently created confusion", the coalition hastily redrafted the offending regulations. In this new version, assurances are given that CCGs will be free to determine their own procurement decisions, and the option of "integrated care" is belatedly rediscovered. The competition enforcing body, Monitor, is portrayed as an avuncular alternative to the judicial process, and everything being proposed is said to be there to simply ensure "patient interest".
There are many reasons why this simply won't wash:
• The regulations still give primacy to the "sole provider" exemption: the only relevant ground upon which CCGs can decline to go out to tender is where the service is only capable of being delivered by one provider – an impossibly high bar.
• UK and EU competition law trumps whatever is in the regulations: even if a commissioner decides (conceivably with Monitor's consent) that the sole provider test has been met to ensure "patient interes"' an aggrieved provider can still take, or threaten to take, judicial action.
• The concept of "patient interes"' is undefined in the regulations: the task of determining what it is will be left to Monitor whose working assumption is that the main determinant of such benefit is choice of provider enforced via competition law.
• The regulations stipulate that any tenders above £1,000 should be advertised, creating very substantial transaction costs that will have to be diverted from patient care.
• Competitive markets constitute the default setting of the system even though the evidence base for this is, at best, flimsy: the "burden of proof" lies on other approaches to demonstrate (against unclear criteria) why and how an alternative model could be preferable.
Not only do the regulations, even as amended, effectively articulate the role of competition in the NHS, they also invest it for the first time with a statutory basis. Previous procurement rules (which bear some similarity to the new regulations) have been seen as "guidance" - a voluntary code of principles. Regulation is different to guidance – it is in effect mandatory. Moreover the legal focus now will now be upon the subject of a proposed contract, not the broader strategic needs of a locality or the potential impact of salami-slicing the portfolio of an existing public sector provider. Nobody is any longer "running the system".
In the meantime, the traditional public sector structure of the NHS is also being chipped away at from other directions. While the procurement regulations concentrate upon healthcare commissioners, the Competition Commission is spreading its tentacles into NHS providers. For example, we now have the bizarre situation in Bournemouth and Poole whereby two NHS providers contemplating a merger to improve local services are being told they cannot communicate with each other.
More along these lines will follow from the Commission and from the Office of Fair Trading – an unprecedented intrusion into the NHS. In this they will be aided and abetted by Monitor which has just published its "fair playing field" review. In this it proposes a whole host of ways to open up the NHS to the private sector, such as underwriting access to NHS pension rights and longer term contracts which will be difficult to review or rescind. Commissioning support units and GPs themselves are identified as being next in line for scrutiny and exposure to market forces.
1 April has been identified as the day the NHS changed forever. There is truth in this, but in a sense the really important date is 24 April, for this will be when the ideological changes are planned to be approved. Annulling SI 2013(257) is currently the most important NHS battleground. Guardian
NHS failed to meet four-hour A&E targets for past two months
NHS failed to meet four-hour A&E targets for past two months:
Government figures show casualty departments falling short of goal of dealing with 95% of patients within timeframe
The NHS has failed for the last two months to meet its target of dealing with 95% of A&E patients within four hours, according to official figures that underline the growing pressures on hospitals.
The NHS has missed the target in each of the last nine weeks, with 93.3% of patients being admitted, transferred or discharged within four hours in the most recent week for which data are available – ending on 24 March.
The Department of Health data emerged just after the East of England ambulance service took the unprecedented step of erecting a "major incident tent" in which to treat patients outside the Norfolk and Norwich hospital, to relieve pressure on its A&E unit over the Easter weekend.
The four-hour target covers three types of A&E units: those based at major hospitals, those at specialist hospitals, such as Moorfields eye hospital in London, and minor injury units or urgent care centres.
Major hospitals are under the most intense pressure. Labour highlighted DoH data showing that as a whole hospitals offering consultant-led A&E care, so-called type 1 A&E departments, which treat more than 60% of all emergency patients, have not met the target for 26 consecutive weeks.
In the week ending 24 March, for example, 27,273 of the total of 272,505 patients who sought A&E help – some 10% – were not admitted, transferred or discharged within four hours. Type 1 departments have not met the 95% target since mid-September 2012, the figures confirm.
The last Labour government brought in the target in 2002 to end the scandal of patients sometimes waiting many hours to be seen in casualty. They ordered that 98% of patients had to be dealt with in that time but the coalition, which opposes targets it says are not clinically justified, watered that down in 2010 to 95%.
About 14 million patients a year are seen in major A&E units, about 600,000 in specialist units and almost 7 million a year in minor injury units and urgent care centres.
The DoH accused Labour of making misleading claims by focusing on just type 1 units. In fact 96% of patients have been dealt with within the required four hours at all three types of A&E centres since April 2012, the DoH said. A&E centres are seeing 1 million more patients than two years ago and are coping well, it added.
Prof John Appleby, chief economist at the King's Fund health thinktank, said: "Looking at all types of A&E department, the NHS has missed its four-hour target for the last nine weeks, which is slightly worse than previous winters.
"That's a reflection of the time of year, with norovirus more of a problem than it was last year, financial pressures on hospitals meaning some can't get patients out quickly enough to take someone else in and also what some hospital finance directors say is inadequate social care planning in their area."
Dr Peter Carter, chief executive of the Royal College of Nursing, said emergency care was under strain. "These figures are yet more proof of a system running at capacity, and patients are suffering as a result. Our members are regularly telling us that pressure on the system is rising while staffing levels fall, and as a result any increase in demand results in unacceptable waits for patients who are already going through a difficult time." Guardian
The NHS has failed for the last two months to meet its target of dealing with 95% of A&E patients within four hours, according to official figures that underline the growing pressures on hospitals.
The NHS has missed the target in each of the last nine weeks, with 93.3% of patients being admitted, transferred or discharged within four hours in the most recent week for which data are available – ending on 24 March.
The Department of Health data emerged just after the East of England ambulance service took the unprecedented step of erecting a "major incident tent" in which to treat patients outside the Norfolk and Norwich hospital, to relieve pressure on its A&E unit over the Easter weekend.
The four-hour target covers three types of A&E units: those based at major hospitals, those at specialist hospitals, such as Moorfields eye hospital in London, and minor injury units or urgent care centres.
Major hospitals are under the most intense pressure. Labour highlighted DoH data showing that as a whole hospitals offering consultant-led A&E care, so-called type 1 A&E departments, which treat more than 60% of all emergency patients, have not met the target for 26 consecutive weeks.
In the week ending 24 March, for example, 27,273 of the total of 272,505 patients who sought A&E help – some 10% – were not admitted, transferred or discharged within four hours. Type 1 departments have not met the 95% target since mid-September 2012, the figures confirm.
The last Labour government brought in the target in 2002 to end the scandal of patients sometimes waiting many hours to be seen in casualty. They ordered that 98% of patients had to be dealt with in that time but the coalition, which opposes targets it says are not clinically justified, watered that down in 2010 to 95%.
About 14 million patients a year are seen in major A&E units, about 600,000 in specialist units and almost 7 million a year in minor injury units and urgent care centres.
The DoH accused Labour of making misleading claims by focusing on just type 1 units. In fact 96% of patients have been dealt with within the required four hours at all three types of A&E centres since April 2012, the DoH said. A&E centres are seeing 1 million more patients than two years ago and are coping well, it added.
Prof John Appleby, chief economist at the King's Fund health thinktank, said: "Looking at all types of A&E department, the NHS has missed its four-hour target for the last nine weeks, which is slightly worse than previous winters.
"That's a reflection of the time of year, with norovirus more of a problem than it was last year, financial pressures on hospitals meaning some can't get patients out quickly enough to take someone else in and also what some hospital finance directors say is inadequate social care planning in their area."
Dr Peter Carter, chief executive of the Royal College of Nursing, said emergency care was under strain. "These figures are yet more proof of a system running at capacity, and patients are suffering as a result. Our members are regularly telling us that pressure on the system is rising while staffing levels fall, and as a result any increase in demand results in unacceptable waits for patients who are already going through a difficult time." Guardian
Dementia patients 'need relationships'
Dementia patients 'need relationships':
People with dementia should be involved in decisions about their care and must be helped to maintain relationships and to participate in their communities, according to official guidance published today. Independent
People with dementia should be involved in decisions about their care and must be helped to maintain relationships and to participate in their communities, according to official guidance published today. Independent
Tuesday, 2 April 2013
What Northants health service changes mean to you - Northampton Chronicle & Echo
What Northants health service changes mean to you - Northampton Chronicle & Echo:
Northampton Chronicle & Echo |
What Northants health service changes mean to you
Northampton Chronicle & Echo Northamptonshire will fall under the wing of three main CCGs. As one of the largest CCGs in the country, Nene CCG will cover most of the county, including 350 GPs and 625,000 patients. The rest of the county is covered by the Corby CCG, the smallest in ... and more » |
Northamptonshire pilot for ‘rural paramedics’
Northamptonshire pilot for ‘rural paramedics’:
Rural areas of Northamptonshire may be given paramedics who will only serve a small local area, in response to fears about emergency coverage in villages. Northampton Chronicle and Echo
Rural areas of Northamptonshire may be given paramedics who will only serve a small local area, in response to fears about emergency coverage in villages. Northampton Chronicle and Echo
Hepatitis B scare at Northampton General Hospital
Hepatitis B scare at Northampton General Hospital:
Two NGH patients were given emergency immunisations after unknowingly using the same blood cleaning machine as a man with Hepatitis B. Northampton Chronicle and Echo
Two NGH patients were given emergency immunisations after unknowingly using the same blood cleaning machine as a man with Hepatitis B. Northampton Chronicle and Echo
Trainee GP denies sexual assault at surgery
Trainee GP denies sexual assault at surgery:
A trainee GP employed at a surgery in Northampton has appeared in court after he was charged with sexually assaulting a female patient during a medical examination. Northampton Chronicle and Echo
A trainee GP employed at a surgery in Northampton has appeared in court after he was charged with sexually assaulting a female patient during a medical examination. Northampton Chronicle and Echo
Breastfeeding service in Northampton to close again
Breastfeeding service in Northampton to close again:
A breastfeeding support service in Northampton is set to close for the second time after the NHS decided not to fund it. Northampton Chronicle and Echo
A breastfeeding support service in Northampton is set to close for the second time after the NHS decided not to fund it. Northampton Chronicle and Echo
Inquiry into premature deaths of people with learning disabilities
Inquiry into premature deaths of people with learning disabilities:
The Department of Health funded the inquiry which identified failings in understanding of the Mental Capacity Act, use of information systems and co-ordination of care. NHS Networks
The Department of Health funded the inquiry which identified failings in understanding of the Mental Capacity Act, use of information systems and co-ordination of care. NHS Networks
All A&E and hospital inpatients to be asked if they would recommend services from today
All A&E and hospital inpatients to be asked if they would recommend services from today:
NHS England hailed the introduction of the friends-and -family test in hospitals as a major step forward in its drive to give patients a greater voice.
From 1 April 2013, every patient in England who visits an A&E, and all patients who stay in hospital overnight will be asked whether they would recommend the service they used to their friends and family members.
Patients will have six choices of answer, ranging from “extremely likely” to “extremely unlikely.” They will then be invited to answer follow-up questions to give more detail on the reasons for their answer. Results, drilling down to individual wards, will be published on NHS Choices, allowing the public to compare patient feedback and make choices about their care.
Individual hospitals and wards will use this real-time feedback, alongside other information, to identify and tackle concerns at an early stage, improve the quality of care they provide, and ensure recognition of the very best care so that best practice can be spread around the health service.
The introduction of the Friends and Family Test was a key commitment in “Everyone Counts”, the planning guidance for the NHS published by NHS England (formerly NHS Commissioning Board) in December 2012.
Over the coming years, NHS England will manage and oversee the rollout of the Friends and Family Test to all NHS-funded services. Maternity services will be next to introduce the question, in October
Tim Kelsey, NHS England’s National Director for Patients and Information, said: “The Friends and Family test is an important first step in changing the nature of the relationship between the NHS and the people it serves. To make improvements, and make them quickly, it is vital that we welcome honest, up-to-the-minute feedback from our patients, listen to them and act upon their views.
“When regular feedback from patients reaches ward or A&E staff, it can have a tremendous impact in a really short space of time. I’d encourage all patients to give their feedback whenever they are asked to do so – we are eager to hear their views.”
Jane Cummings, Chief Nursing Officer for England, said: “The Friends and Family test is a really simple way for patients to let us know if we could improve the standard of care we’re giving, and that’s really important. Giving compassionate care is at the heart of what we do and listening to the experiences and feedback of patients is central to NHS values.” NHS Commissioning
NHS England hailed the introduction of the friends-and -family test in hospitals as a major step forward in its drive to give patients a greater voice.
From 1 April 2013, every patient in England who visits an A&E, and all patients who stay in hospital overnight will be asked whether they would recommend the service they used to their friends and family members.
Patients will have six choices of answer, ranging from “extremely likely” to “extremely unlikely.” They will then be invited to answer follow-up questions to give more detail on the reasons for their answer. Results, drilling down to individual wards, will be published on NHS Choices, allowing the public to compare patient feedback and make choices about their care.
Individual hospitals and wards will use this real-time feedback, alongside other information, to identify and tackle concerns at an early stage, improve the quality of care they provide, and ensure recognition of the very best care so that best practice can be spread around the health service.
The introduction of the Friends and Family Test was a key commitment in “Everyone Counts”, the planning guidance for the NHS published by NHS England (formerly NHS Commissioning Board) in December 2012.
Over the coming years, NHS England will manage and oversee the rollout of the Friends and Family Test to all NHS-funded services. Maternity services will be next to introduce the question, in October
Tim Kelsey, NHS England’s National Director for Patients and Information, said: “The Friends and Family test is an important first step in changing the nature of the relationship between the NHS and the people it serves. To make improvements, and make them quickly, it is vital that we welcome honest, up-to-the-minute feedback from our patients, listen to them and act upon their views.
“When regular feedback from patients reaches ward or A&E staff, it can have a tremendous impact in a really short space of time. I’d encourage all patients to give their feedback whenever they are asked to do so – we are eager to hear their views.”
Jane Cummings, Chief Nursing Officer for England, said: “The Friends and Family test is a really simple way for patients to let us know if we could improve the standard of care we’re giving, and that’s really important. Giving compassionate care is at the heart of what we do and listening to the experiences and feedback of patients is central to NHS values.” NHS Commissioning
Cancer survivors deserve 'care plan'
Cancer survivors deserve 'care plan': All cancer patients should receive a 'recovery package' at the end of their treatment offering ongoing support, the government has announced. BBC Health News
Charity urges more diabetes checks
Charity urges more diabetes checks: Only one in five people with diabetes in England and Wales are meeting targets for keeping their condition under control, a charity warns. BBC Health News
Male bowel cancer 'on the increase'
Male bowel cancer 'on the increase': Male bowel cancer rates have increased by more than a quarter in 35 years - but the figure is much less for women, a Cancer Research study suggests. BBC Health News
Data flows transition manual
Data flows transition manual:
The major re-organisation of health and social care bodies taking place on 1st April 2013 will result in significant changes to data flows. To support transition arrangements the Department of Health, NHS England and the NHS Information Centre have developed this advisory note and FAQs which describe the practical steps bodies need to take to ensure information flows for purposes other than direct care are handled safely, securely and lawfully. King Fund Blogs
The major re-organisation of health and social care bodies taking place on 1st April 2013 will result in significant changes to data flows. To support transition arrangements the Department of Health, NHS England and the NHS Information Centre have developed this advisory note and FAQs which describe the practical steps bodies need to take to ensure information flows for purposes other than direct care are handled safely, securely and lawfully. King Fund Blogs
GPs call for rethink on delayed 111 health hotline
GPs call for rethink on delayed 111 health hotline:
The 111 non-emergency health phoneline will not be operational nationwide until June and is currently in full use for less than half of the population of England, NHS England has said.
The service, intended to take the weight off an overburdened 999 network, was originally due to come into full effect on Monday, but lines in 23 areas are not yet in operation.
"Everyone should have a service in place by June," said an NHS England spokeswoman. "Each service will be assessed before it goes live. Some are provided by ambulance services and some are provided by companies that have been successful winning contracts."
GPs welcomed the delay, saying it was an opportunity to rethink the way the system worked, amid concern that it is increasing the burden on clinics because of a lack of adequate advice that could avoid the need for callers to attend accident and emergency clinics or GP surgeries.
NHS England said the 111 hotline for the north of Tyne & Tees area was switched on on Monday, albeit with the NHS Direct 0845 number still running as a backup, bringing to 23 the number of areas of England where the service is in full use. In another 23 areas it is not in use or is in partial use, with full switchover dates set between now and June.
The free round-the-clock service is for "when you need medical help fast but it's not a 999 emergency", public information produced by the NHS explains. It should be used by people who think they need to go to A&E or another urgent NHS service, as well as those who do not know whom to call or do not have a GP to contact. In areas where the number is not yet in full operation, the 0845 NHS Direct number remains available as a backup.
Fourteen different organisations are providing the service, including NHS Direct, seven local ambulance services, and private companies including Harmoni, which is running 111 in three London areas, and Derbyshire Health United.
"Going slowly is what we asked for and is what they should have planned for initially," said Dr Richard Vautrey, deputy chairman of the British Medical Association's general practitioners' committee. "The original plan to have 111 as a standalone service from 1 April hasn't materialised.
"The key problem is they don't have the capacity to take on the number of calls that the system is generating. We also need greater clinical involvement with nurses and doctors to work alongside the call handlers."
The Patients Association said last week it was very concerned about the imminent introduction of the 111 helpline, citing confusion as to when people are supposed to use it and concern about outcomes in pilot areas such as Manchester. Guardian
The service, intended to take the weight off an overburdened 999 network, was originally due to come into full effect on Monday, but lines in 23 areas are not yet in operation.
"Everyone should have a service in place by June," said an NHS England spokeswoman. "Each service will be assessed before it goes live. Some are provided by ambulance services and some are provided by companies that have been successful winning contracts."
GPs welcomed the delay, saying it was an opportunity to rethink the way the system worked, amid concern that it is increasing the burden on clinics because of a lack of adequate advice that could avoid the need for callers to attend accident and emergency clinics or GP surgeries.
NHS England said the 111 hotline for the north of Tyne & Tees area was switched on on Monday, albeit with the NHS Direct 0845 number still running as a backup, bringing to 23 the number of areas of England where the service is in full use. In another 23 areas it is not in use or is in partial use, with full switchover dates set between now and June.
The free round-the-clock service is for "when you need medical help fast but it's not a 999 emergency", public information produced by the NHS explains. It should be used by people who think they need to go to A&E or another urgent NHS service, as well as those who do not know whom to call or do not have a GP to contact. In areas where the number is not yet in full operation, the 0845 NHS Direct number remains available as a backup.
Fourteen different organisations are providing the service, including NHS Direct, seven local ambulance services, and private companies including Harmoni, which is running 111 in three London areas, and Derbyshire Health United.
"Going slowly is what we asked for and is what they should have planned for initially," said Dr Richard Vautrey, deputy chairman of the British Medical Association's general practitioners' committee. "The original plan to have 111 as a standalone service from 1 April hasn't materialised.
"The key problem is they don't have the capacity to take on the number of calls that the system is generating. We also need greater clinical involvement with nurses and doctors to work alongside the call handlers."
The Patients Association said last week it was very concerned about the imminent introduction of the 111 helpline, citing confusion as to when people are supposed to use it and concern about outcomes in pilot areas such as Manchester. Guardian
GPs accused of conflict of interests
GPs accused of conflict of interests:
Doctors who take over two-thirds of the NHS budget from today will award contracts to companies they are also involved in, critics have warned. Independent
Doctors who take over two-thirds of the NHS budget from today will award contracts to companies they are also involved in, critics have warned. Independent
Get back on the ward: patients tsar tells nurses to talk less and care more
Get back on the ward: patients tsar tells nurses to talk less and care more: 
Nurses should be encouraged to spend less time less time talking and more time caring for patients by removing out-of-the-way nursing stations, the head of the Government's review into patient complaints has suggested. Independent
Nurses should be encouraged to spend less time less time talking and more time caring for patients by removing out-of-the-way nursing stations, the head of the Government's review into patient complaints has suggested. Independent
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