Monday, 17 November 2014

Surgeons warned over death rates

Surgeons warned over death rates Surgeons who refuse to publish their mortality rates could face sanctions, NHS England's medical director says. BBC News

See also:

Hospital declares 'major incident'

NHS trusts chasing private patients at expense of waiting lists, warns Labour

NHS trusts chasing private patients at expense of waiting lists, warns Labour Call for cap on private income to be reintroduced amid fears some NHS hospitals are prioritising paying customers

Hospital Trusts in some parts of England have more than doubled the income they receive from treating private patients following the coalitions controversial lifting of a cap on such earnings, prompting concerns that cash is being chased as NHS waiting lists grow.

Across the country there appears to have been a 10% increase in private income since 2010, but some trusts appear to have radically rethought their attitude to seeking private patients. Continue reading... The Guardian

Premature birth now kills more under-fives globally than anything else

Premature birth now kills more under-fives globally than anything else Britain is among the top ten countries in the world for deaths from pre-term births alongside Serbia, Slovenian, Denmark, Switzerland and Poland. The Daily Telegraph

See also:

Bird flu strain which can be passed to humans detected in Holland

Bird flu strain which can be passed to humans detected in Holland Dutch impose a 30-day travel ban on poultry after discovery of new strain of avian flu. The Daily Telegraph

See also:

Friday, 14 November 2014

Babies could be at risk in Northamptonshire due to infrequent health visitor contact, watchdog says

Babies could be at risk in Northamptonshire due to infrequent health visitor contact, watchdog says A watchdog in Northamptonshire has contacted the NHS about what it sees as a lack of health visitor contact for babies. Northampton Chronicle and Echo

Northamptonshire woman: ‘NHS won’t pay for my second breast’

Northamptonshire woman: ‘NHS won’t pay for my second breast’ Women in Northamptonshire who have survived breast cancer say they are distressed after being told to have photos taken of their chests in order to be judged whether they are eligible for reconstruction surgery.

The women have formed the countywide Breast Reconstruction Awareness (BRA) group to fight what they consider an unfair NHS Nene CCG breast reconstruction policy. But it can exclude some women who have had a mastectomy, but are left with asymmetry. Northampton Chronicle and Echo

NHS Data Breaches

A new report, NHS Data Breaches (PDF), highlights the scale of data breaches in the NHS. The research reveals examples of medical data being lost, shared on social media, and inappropriately shared with third parties.

The report shows that between 2011 to 2014, there have been at least 7,255 breaches. This is the equivalent to 6 breaches every day. Examples of the data breaches include:
  • At least 50 instances of data being posted on social media
  • At least 143 instances of data being accessed for “personal reasons”
  • At least 124 instances of cases relating to IT systems
  • At least 103 instances of data loss or theft
  • At least 236 instances of data being shared inappropriately via Email, letter or Fax
  • At least 251 instances of data being inappropriately shared with a third party
  • At least 115 instances of staff accessing their own records.
  • There have been at least 32 resignations during the course of disciplinary proceedings.
  • There is 1 court case pending, for a breach of the Data Protection Act. In this instance the individual may have also resigned prior to proceedings. Big Brother Watch
See also:

Choice of GP practice

Choice of GP practice Last year’s GMS contract agreement provided that GP practices will be able to register patients from outside their traditional practice boundaries without the requirement to provide home visits or out of hours care. This guidance provides further information on how the new arrangements will work. This includes a commissioning framework to support area team decisions on putting in place urgent primary medical care services. NHS England

News story: Chief Medical Officer Sally Davies talks about the low risk of Ebola in the UK

News story: Chief Medical Officer Sally Davies talks about the low risk of Ebola in the UK The Chief Medical Officer talks about how difficult it is to catch Ebola, the preparedness of the NHS to deal with infectious diseases and what to do if someone returning from West Africa develops symptoms. Department of Health

See also:

NHS winter fears 'prompt cash boost'

Caldicott becomes data guardian

Caldicott becomes data guardian Dame Fiona Caldicott has been appointed national data guardian for health and care; a new role announced in the National Information Board's IT strategy, 'Personalised Health and Care 2020.' E-Health Insider

See also:

Long-term mobile phone use and brain cancer

Long-term mobile phone use and brain cancer "Do mobile and cordless phones raise the risk of brain cancer?" asks the Mail Online.

There are now more mobile phones than people in the UK, so you would expect the commonsense answer to be a resounding "no". But, as we never get tired of saying, it's a bit more complicated than that.

The Mail Online reports on the latest study looking for evidence of a link between mobile and cordless phone calls and brain tumours. This large Swedish study found more than 25 years' use of mobile phones trebled the (very small) risk of glioma, the most common type of brain tumour.

The study matched healthy volunteers with people who had been diagnosed with a glioma, and asked them to estimate the amount of time they had ever spent using mobile and cordless phones. This ranged from less than one year to around 25 years.

Exclusive: Tory plans to extend GP access unachievable, says Wollaston

Exclusive: Tory plans to extend GP access unachievable, says Wollaston The Conservative chairwoman of the House of Commons health select committee, former GP Dr Sarah Wollaston, has said her party's plans for GP access seven days a week across England will not work. GP Online

Mental health: A world of depression

Mental health: A world of depression Depression is a major human blight. Globally, it is responsible for more ‘years lost’ to disability than any other condition. This is largely because so many people suffer from it — some 350 million, according to the World Health Organization. This article gives a global overview of the burden of depression. Nature

Nigel Farage: Ukip will keep the NHS free at the point of use

Nigel Farage: Ukip will keep the NHS free at the point of use UKIP leader claims in column that he doesnt want to give faceless private-sector companies control of the health service.

Nigel Farage has said Ukip will keep the NHS free at the point of use after he was caught on camera saying it should move towards an insurance-based system run by private companies.

The recording, uncovered by the Guardian, shows Farage saying he thought the marketplace could deliver better value for money when it comes to spending on the NHS. Continue reading... The Guardian

UKs mentally ill people more likely to be found in jail than hospital

UKs mentally ill people more likely to be found in jail than hospital Matthew Williams cannibalism holds up mirror to state of health and prison services slated as disintegrating by reform trust

Each decade in Britain appears to contain a symbolic, heinous murder a crime so awful that it reflects a nations pathologies as well as its fears. In the 1990s, the death of James Bulger, a two-year-old who was abducted from a Merseyside shopping centre before being tortured and killed, led to the age of criminal responsibility being changed.

The next decade began with the case of 10-year-old Damilola Taylor, who bled to death after being assaulted on a south London stairwell, presaging years of concern over the rise of such attacks. Continue reading... The Guardian

Fears over soaring cancer cases

Fears over soaring cancer cases Charity warns of 'cracks in the NHS' as services struggle to cope with 40 per cent rise in cases. The Daily Telegraph

See also:

Young gambling addicts in NHS treatment have lost an average of £60,000

Young gambling addicts in NHS treatment have lost an average of £60,000 Young people with thousands of pounds of gambling debts fail to seek help because “they don’t know where to turn”, a charity has warned. The Independent

Thursday, 13 November 2014

New parents angry over hospital parking fine

New parents angry over hospital parking fine A woman from Northamptonshire says it is "disgusting" that her husband got a parking fine while he was waiting for her to have an emergency operation. Sarah Hardy needed a blood transfusion after a last minute caesarean at Northampton General Hospital. ITV News

Health and social care leaders set out plans to transform people’s health and improve services using technology

Health and social care leaders set out plans to transform people’s health and improve services using technology Radical new plans to improve health outcomes and the quality of patient care through digital technology and innovation have been unveiled.

Established by the Department of Health and chaired by NHS England’s National Director for Patients and Information, Tim Kelsey, the National Information Board has set out a bold vision for how technology should work harder and better for patients and citizens by 2020.

The vision commits to giving everybody online access to their GP records, viewed through approved apps and digital platforms, by 2015.

NHS England publishes revised process for operation of its Cancer Drugs Fund (CDF)

NHS England publishes revised process for operation of its Cancer Drugs Fund (CDF) NHS England today published its updated procedure for evaluating drugs in the Cancer Drugs Fund (CDF), which will mean more effective and promising drugs will be prioritised and made available to patients.

See also:

The National Audit of Intermediate Care (NAIC 2014)

The National Audit of Intermediate Care (NAIC 2014) A report into intermediate care, which is provided to patients either when they leave hospital or are at risk of being sent to hospital, has found that capacity must double to meet increasing demand due to an ageing population. NHS Benchmarking Network

In-depth review of the psychiatrist workforce

In-depth review of the psychiatrist workforce This report contains an in-depth review of the psychiatrist workforce in England, with a particular focus on fully trained psychiatrists with a certificate of completion of training (‘CCT holders’) who typically are employed as consultants. The review considered demand and supply for CCT holders in the six psychiatry specialties: general adult psychiatry, psychiatry of old age, child and adolescent psychiatry, forensic psychiatry, psychiatry of learning disability, and medical psychotherapy. Centre for Workforce Intelligence

Guidance: Changes to the health visiting service

Guidance: Changes to the health visiting service This factsheet from the Department of Health provides information for health practitioners, providers and local authorities on changes to the:
  • Healthy Child Programme
  • Health Visiting Programme
  • importance of health visiting
  • transfer of service commissioning for 0 to 5 to local authorities from 2015

Ebola drug clinical trials to start

Ebola drug clinical trials to start The charity MSF says it is to host clinical trials of new Ebola treatments in West Africa, one of them using the blood of recovered patients. BBC News

See also:

Health workers 'neglect hygiene late in their shifts'

Health workers 'neglect hygiene late in their shifts' “Visit hospital in the morning to be sure of a doctor with clean hands,” reports The Daily Telegraph.

The Telegraph cites a US study which found healthcare workers often fail to wash their hands and are more likely to wash their hands as advised at the beginning of their shift (not necessarily the morning) than at the end.

Researchers used electronic ID tags for healthcare workers with detectors placed on soap dispensers and hand gels in patients’ rooms to collect data on when the workers washed their hands.

They found that, at most, workers washed their hands on 42.6% of the occasions that they should have. This figure reduced to 34.8% of occasions by the end of a 12-hour shift. Workers were also more likely to wash their hands after longer time off between shifts.

Despite national and local instructions on hand hygiene and infection control, it’s clear from this study that healthcare workers will forget or not bother. And it seems that the more tired – or less rested a worker is – the more likely they are to forget or overlook handwashing rules.

If you’re in hospital or you’re visiting an inpatient, you also have a responsibility to wash your hands before entering areas where patients are and wherever prompted, as well as when leaving. And don’t be afraid to ask health professionals if they've washed their hands too.

Mental healthcare standards in UK immigration centres remain poor

Mental healthcare standards in UK immigration centres remain poor This is despite a series of damning reports and government assurances that action would be taken, say doctors. OnMedica

NHS patients facing unacceptable wait for scan results

NHS patients facing unacceptable wait for scan results Radiologists warn shortage of specialists means many suspected cancer patients waiting a month to discover diagnosis

Tens of thousands of suspected cancer patients are facing waits of more than a month to find out if they have the disease because of delays in analysing scans and x-rays.

Radiologists and cancer experts have warned that the hold-ups could endanger patients chances of survival if the tests confirm they have a malignant tumour. Continue reading... The Guardian

Film shows Nigel Farage calling for move away from state-funded NHS

Film shows Nigel Farage calling for move away from state-funded NHS Farages September 2012 remarks contrast with Ukips new claims that it is opposed to privatisation of health service.

Nigel Farage has been caught on camera telling Ukip supporters that the state-funded NHS should move towards an insurance-based system run by private companies.

The recording shows Farage saying he believes the marketplace could deliver better value for money when it comes to spending on the NHS. Continue reading... The Guardian

NHS must use fewer temporary staff and sell land to save £10bn, says Hunt

NHS must use fewer temporary staff and sell land to save £10bn, says Hunt Health secretary tells NHS leaders that the service must undertake a fundamental rethink of how it spends £110bn budget.

Jeremy Hunt is to tell the NHS to save £10bn a year by using fewer temporary staff and management consultants, selling off unused buildings and reducing drug errors.

The health secretary will warn an audience of NHS leaders on Thurday that the service must undertake a fundamental rethink of how it spends its £110bn budget in order to remain viable in the face of unprecedented demand for care. Continue reading... The Guardian

Police probe into dentist patient death follows biggest recall of patients in NHS history

Police probe into dentist patient death follows biggest recall of patients in NHS history Police are investigating the death of a young woman who died weeks after being treated by the dentist at the centre of the alleged Nottingham blood contamination scandal. The Independent

See also:

Wednesday, 12 November 2014

Commissioning and contracting for integrated care

Commissioning and contracting for integrated care This report describes how CCGs in England are innovating with two broad models – the prime contract and alliance contract. It draws on experiences from five geographical areas, covering different population and disease groups (cancer, end-of-life care, musculoskeletal services, mental health rehabilitation, and older people’s services). It concludes by highlighting four lessons that CCGs, other commissioners and providers should keep in mind as they embark on new models of commissioning and contracting to support integrated care. The King's Fund

Out-of-hours GP services in England

Out-of-hours GP services in England  The urgent and emergency care system is complex and people struggle to know which is the right service to use.

Too many people are unaware of the different urgent care options – such as out-of-hours GP services, walk-in centres, urgent care centres and A&E departments – and of how to contact them.

This means people may not receive care in the most appropriate setting. As a result of the confusion, too many go to A&E when they do not need to.

About a third of adults in England have either not heard of NHS 111 or have heard of it but do not know what it is for. In addition, a quarter of adults have not heard of out-of-hours GP services. Awareness was lower still among certain groups including younger people and people from black and minority ethnic communities. Public Accounts Select Committee

See also:

Government response: Response to The People’s NHS campaign about TTIP

Government response: Response to The People’s NHS campaign about TTIP Department of Health’s response to The People’s NHS campaign about the Transatlantic Trade and Investment Partnership.

The government believes that the inclusion of health in the TTIP does not threaten the public nature of the NHS, but provides an opportunity for European businesses, including improving access to the US market for the UK’s world-class pharmaceutical and medical devices sectors.

Decisions about the commissioning of NHS care will remain with local GP-led commissioners, who will continue to act solely in the best interests of patients.

The European Commission has explicitly ruled out public services from the scope of any market liberalisation in the TTIP. The agreement will not require participating EU members to open up their national health systems to private providers. Following the most recent round of negotiations, both EU and US negotiators have confirmed this position.

The rules on investment protection for the TTIP will be negotiated carefully to preserve the right of the government to regulate in the public interest, whilst offering international investors access to justice if they feel they have been discriminated against unfairly. This agreement is not new, and the UK has over 90 similar agreements in place.

The European Commission carried out a public consultation on the investor protection provisions earlier this year. The consultation sought stakeholder views on what modern investment provisions should look like in the TTIP.

RCN launches new guidance for handling feedback

RCN launches new guidance for handling feedback New guidance to help health care workers deal with feedback, concerns, complaints and compliments. Royal College of Nursing

Patients recalled over virus risk

Patients recalled over virus risk Some 22,000 patients of a Nottinghamshire dentist are to be recalled for tests to see if they have been infected with blood-borne viruses. BBC News

See also:

Lamb: NHS 'needs a cash injection'

Lamb: NHS 'needs a cash injection' Up to £1.5bn of extra funding for the NHS should be found ahead of the general election to prevent a "crash" in services, according to the Liberal Democrat Health Minister Norman Lamb. BBC News

See also:

NHS wi-fi access 'up, but not by enough'

NHS wi-fi access 'up, but not by enough' A rise in the number of healthcare staff who have wireless internet access is "good but not good enough", according to the organiser of a survey on NHS wi-fi. E-Health Insider

Claims cannabis 'rewires the brain' misleading

Claims cannabis 'rewires the brain' misleading "Cannabis use 'shrinks and rewires' the brain," reports The Daily Telegraph, with much of the media reporting similar "brain rewiring" headlines.

The headlines are based on a study that compared the brain structure and connections of cannabis users with those of non-users.

The researchers identified several differences between cannabis users and non-users in a region of the brain called the orbitofrontal cortex.

This is part of the reward network, and is enriched with cannabinoid 1 receptors. These bind THC, the active ingredient in cannabis.

Some of the differences seen by the researchers were associated with how long people had used cannabis or the age they started using the drug.

However, although brain differences were found, it is not clear they were caused by cannabis use. It is possible that brain differences mean it is more likely that certain people use cannabis.

Ebola: how NHS hospitals are preparing for an outbreak

Ebola: how NHS hospitals are preparing for an outbreak Training exercises for British medical professionals in dealing with Ebola cases are essential for stopping transmission of the virus

Hillingdon hospital is the nearest acute healthcare provider to Heathrow airport and could be on the frontline of treating Ebola.

A twelve-hour flight is all that separates us from the virus and, while an outbreak is unlikely, would you take the risk of being unprepared as a nurse? Continue reading... The Guardian

See also:

Cataract inquiry shows patients suffered potentially serious harm

Cataract inquiry shows patients suffered potentially serious harm Nineteen patients at Mount Stuart hospital in Torquay received antibiotic overdoses during eye surgery contracted out by NHS.

Two patients suffered potentially serious harm from overdoses of an antibiotic into their eyes and four others showed symptoms more than six weeks afterwards, according to an internal investigation into mistakes in cataract operations contracted out by the NHS to a private hospital.

In all, 19 patients received overdoses during surgery at Mount Stuart hospital, Torquay, part of the international private company, Ramsay Health Care on 26 July. The same drug error may have happened at the hospital the previous month, according to a report written in September and published by Ramsay on Tuesday .Continue reading... The Guardian

New GP conflict of interest fears over financial links to out-of-hours companies

New GP conflict of interest fears over financial links to out-of-hours companies Public spending watchdogs have warned that GPs could award lucrative contracts to companies providing out-of-hours services in which they have a shareholding. The Independent

Tuesday, 11 November 2014

Planning for the Better Care Fund

Planning for the Better Care Fund The Better Care Fund is an innovative idea but the quality of early preparation and planning did not match the scale of the ambition. Current plans forecast £314m of savings for the NHS rather than the £1 billion in early planning assumptions. National Audit Office

See also:

Health and wellbeing boards 'should not run NHS commissioning'

Health and wellbeing boards 'should not run NHS commissioning' Health and wellbeing boards (HWBs) are too often dominated by local councils and should not take over NHS commissioning, CCGs have said. GP Online

See also:

Midwife abortion objection case due

Midwife abortion objection case due The UK's highest court is to be asked to rule on whether midwives have a right to refuse to take any part in abortion procedures on moral grounds. BBC News

See also:

New Bill set to improve worst parts of NHS reforms

New Bill set to improve worst parts of NHS reforms Moves to improve issues that raised concern from the NHS reforms of last year have been taken with the publication of a new parliamentary Bill.

The National Health Service (amended Duties and Powers) Bill focuses on reinstating and enhancing the health secretary’s duties to promote and to provide healthcare, a move welcomed by the BMA. OnMedica

CCGs’ strong financial performance at risk

CCGs’ strong financial performance at risk Managers warn worsening NHS financial position will spread to CCGs. OnMedica

Hundreds of NHS managers given pay-offs are STILL being rehired as total passing through revolving door hits 4,300

Hundreds of NHS managers given pay-offs are STILL being rehired as total passing through revolving door hits 4,300 EXCLUSIVE: The NHS under Health Secretary Jeremy Hunt is rehiring 50 staff a month who have been given redundancy pay-outs, which Labour blamed on the coalition's health reorganisation. The Daily Mail

The NHS can no longer act as if minds dont matter

The NHS can no longer act as if minds dont matter The physical basis of mental illness is clear. Parity of esteem in health services is a necessity, not a luxury

A century ago, even the greatest mind doctor of them all, Sigmund Freud, predicted that one day mental illnesses would be explained physically, once scientific techniques for the study of the brain became possible. In a typically prescient but off-the-mark way, he even experimented with treating patients with a chemical remedy cocaine.

All these years later, Freuds conjecture is bolstered by firm evidence. A psychiatrist, Tim Cantopher, says that if he were to draw fluid from the spinal cord of depressed patients he would find a deficiency of two chemicals: serotonin and noradrenaline, essential neurotransmitters that regulate a host of functions in the body and brain. Continue reading... The Guardian

GPs will 'prescribe' health and fitness apps

GPs will 'prescribe' health and fitness apps New strategy will see NHS set up its own 'app store' endorsing programmes to help people lose weight, exercise more and monitor health conditions. The Daily Telegraph

New drug resistant strain of STD gonorrhea found in Australia

New drug resistant strain of STD gonorrhea found in Australia A new strain of the sexually transmitted disease (STD) gonorrhoea which is resistant to a range of antibiotics has been identified in Australia. The Independent

Monday, 10 November 2014

Children’s centres to have hours cut and services moved

Children’s centres to have hours cut and services moved Parents are to be consulted over plans to move children’s centre services in several areas, and reduce openining hours in others. Northamptonshire Telegraph

See also:

Will the 18-week waiting time target be met by the end of the year?

Will the 18-week waiting time target be met by the end of the year? In years gone by, the commonest criticism of the NHS was its tolerance of long waiting times for patients. The historic reduction in waiting times achieved by 2008 – as enshrined in the 18-week maximum wait from referral by a GP to treatment – has in turn become an iconic measure of NHS performance for politicians and the public alike.

Fears the target would be broken led the Secretary of State to announce an extra £250 million to buy extra treatments and, ultimately, to ensure the waiting time target was under control by the end of the year. How likely is this to happen?

NHS Culture Change: Contributions from Occupational Psychology

NHS Culture Change: Contributions from Occupational Psychology The practical steps required to implement culture change in the NHS is the subject of a new report.

The report, ‘NHS Culture Change: Contributions from Occupational Psychology’, presents a series of essays by leading Occupational Psychologists, each drawing on evidence and expertise from the science of people at work to address the question of how successful culture change, as recommended by the Francis Report and subsequent Berwick Review, can be implemented within the NHS.  Free registration is required to access the report from the British Psychological Society

The efficient use of the maternity workforce and the implications for safety and quality in maternity care: a population-based, cross sectional study

The efficient use of the maternity workforce and the implications for safety and quality in maternity care: a population-based, cross sectional study The performance of maternity services is seen as a touchstone of whether or not NHS care is high quality. Staffing has been identified in numerous reports as being a critical component of safe, effective, user-centred care. There is little evidence regarding the impact of maternity workforce staffing and skill mix on the safety, quality and cost of maternity care in the UK. The objective of this research was to understand the relationship between organisational factors, maternity workforce staffing and skill mix, cost and indicators of safe and high-quality care. NHS National Institute for Health Research

News story: Autism statutory guidance consultation launched

News story: Autism statutory guidance consultation launched The government is seeking views on proposed new statutory guidance to local authorities and NHS organisations, to support the implementation of ‘Think Autism’, the update to the 2010 adult autism strategy.

The consultation looks at issues including staff training, identification and diagnosis of autism in adults and the planning of services, preventative support and safeguarding and employment for adults with autism.

Responses are invited from a wide range of people and groups, including adults with autism, families and carers, health and social care organisations that plan, commission and provide services for adults with autism and their families.

New 2015 NHS Pension Scheme regulations - summary for employers

New 2015 NHS Pension Scheme regulations - summary for employers View NHS Employers summary of the new 2015 NHS Pension Scheme regulatory consultation, which includes further details on how you can submit your comments to NHS Employers.

Hundreds of obese young need surgery

Hundreds of obese young need surgery Nearly 40% of under-25s who have weight-loss surgery in the UK are classified as super-obese, according to new figures. BBC News

See also:

Have the Danes cracked childhood obesity?

Have the Danes cracked childhood obesity? Childhood obesity has become a global epidemic, but it is not easy to treat. Now a scheme proven to help children shed pounds by asking them and their families to make numerous lifestyle changes has been adopted across Denmark. BBC News

GP emergency admissions to hospital fall

GP emergency admissions to hospital fall Meanwhile emergency admissions via A&E have soared, an analysis shows. OnMedica

See also:

Only half of prostate cancer sufferers receive the best care, says UK audit

Only half of prostate cancer sufferers receive the best care, says UK audit Treatment and quality of care for the most common form of cancer affecting men varies worryingly around the country

Treatment and quality-of-life care for the most common form of cancer found in men varies worringly across the country, campaigners have suggested.

Reacting to a first-of-its-kind audit of prostate cancer services across England and Wales, Owen Sharp, chief executive of Prostate Cancer UK, called for services to be improved without delay. Continue reading... The Guardian

See also:

Doctor to appear in court in UK's first gender abortion prosecution

Doctor to appear in court in UK's first gender abortion prosecution Doctor exposed in Telegraph investigation served summons to face conspiracy allegation in landmark sex-selective abortion private prosecution. The Daily Telegraph

Friday, 7 November 2014

KGH bed fall led to Desborough man’s death

KGH bed fall led to Desborough man’s death A man who suffered a head injury when he fell out of his bed at Kettering General Hospital died two weeks later, an inquest was told. Northamptonshire Telegraph

The financial sustainability of NHS bodies

The financial sustainability of NHS bodies The financial position of the NHS has worsened since 2012-13, with growing financial stress in NHS trusts and foundation trusts. According to the National Audit Office, these trends are not sustainable.

At the end of June 2014, NHS trusts were forecasting a net deficit for the current financial year of £404 million and foundation trusts a net deficit of £108 million. This compares with initial plans of a net deficit of £425 million for NHS trusts and £20 million for foundation trusts.

Trusts in surplus in 2013-14 were likely to have a lower surplus than in the previous financial year. The number of trusts and foundation trusts with a surplus also fell from 222 in 2012-13 to 182 in 2013-14.

Today’s report notes that financial risk is increasing in NHS trusts and foundation trusts, and those in severe financial difficulty continue to rely on in-year cash support from the Department of Health. In 2013-14, over £0.5 billion extra money was issued to 21 NHS trusts and 10 foundation trusts to ensure that organisations in difficulty have the cash they need to pay staff and creditors.

NHS England underspent by £279 million compared with its original plan but, within this net total, it overspent £377 million on specialised services. The overspend was partly owing to over-ambitious planning assumptions. NHS England offset this pressure through use of its reserves.Forty-nine clinical commissioning groups performed less well than originally planned: 12 of these had forecast a surplus but ended the year in deficit. The local auditor of clinical commissioning groups referred 19 bodies in deficit to the Secretary of State for spending more than their authorised resource limit.

To discourage unnecessary emergency admissions, trusts receive 30% of the full tariff payment for admissions above the level experienced during 2008-09. However, this arrangement has not contained demand. Increasing demands for emergency admissions will also reduce the resources commissioners have to invest in alternative primary or community care services.

Some NHS bodies have not made large enough cost savings, or contained the increasing demand for services within their available funding, whilst meeting quality and access targets. There remains considerable uncertainty about the impact of initiatives such as the Better Care Fund, which the Department and NHS England expect will reduce demand for acute hospital services. The NAO will look again at the planning process for commissioners and providers in 2015 to determine how well regulatory bodies are checking consistency between different parts of the health and social care system. National Audit Office
See also:

What is preventing progress? Time to move from talk to action on reducing preventable illness

What is preventing progress? Time to move from talk to action on reducing preventable illness This report highlights how in England tackling common risk factors such as smoking, inactivity, unhealthy diet and alcohol would drastically reduce the number of people affected by common diseases such as heart disease, cancer, lung disease, type 2 diabetes, asthma and stroke, while helping to prevent or delay the onset of conditions like dementia. It outlines nine key calls to action through which political leaders and key decision-makers can ensure disease prevention is placed at the top of the agenda. Richmond Group of Charities

Savile hospital abuse inquiry widens

Savile hospital abuse inquiry widens The number of hospitals investigating allegations of abuse by Jimmy Savile is extended to 41. BBC News

See also:

Pharma industry gets high on profits

Pharma industry gets high on profits Imagine an industry that generates higher profit margins than any other and is no stranger to multi-billion dollar fines for malpractice.

Throw in widespread accusations of collusion and over-charging, and banking no doubt springs to mind.

In fact, the industry described above is responsible for the development of medicines to save lives and alleviate suffering, not the generation of profit for its own sake. BBC News

GPs sign open letter urging immediate withdrawal of 'unethical' dementia DES

GPs sign open letter urging immediate withdrawal of 'unethical' dementia DES An open letter co-signed by over 50 leading doctors, including 35 GPs, has demanded that the 'unethical' dementia enhanced service be 'withdrawn without delay'. GP Online

See also:

The real reason doctors are being instructed in the ethics of waste

The real reason doctors are being instructed in the ethics of waste Medical staff are used to their resources being endlessly eroded no wonder they resist change that seems to put money before patients.

All waste is immoral, but some waste is more immoral than other waste, and sometimes what looks like waste isnt actually waste at all. Wasting food is really bad (the perfect solution, although not available to everyone, is to keep pigs). Recycling the dress bought in a moment of self-delusion via the charity shop is not a perfect solution, but it is less bad than wasting food. Using disposable instruments in hospital instead of relying on sterilising machines looks wasteful but actually saves money by not giving patients avoidable infections.

Waste in the NHS is a favourite moan of its critics who mostly think it is too big to prosper. But that doesnt mean its not a problem how could it not be in an organisation with a budget of £100bn a year. One wrong decision is going to ramify with appalling waste across the country. So although it seems a superfluous edict, it was good to hear the Academy of Medical Royal Collegesdeclare that doctors have an ethical duty not to waste. Continue reading... The Guardian

Ebola expert warns of tragedy in British hospitals due to safety failings

Ebola expert warns of tragedy in British hospitals due to safety failings A leading global expert on the Ebola virus has warned there will be “tragedy” in a British hospital – because safety procedures are not being followed strictly enough to prevent medical staff from becoming infected. The Independent

See also:

Thursday, 6 November 2014

Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care

Protecting resources, promoting value: a doctor’s guide to cutting waste in clinical care  Most waste in the NHS lies within clinical practice and models of care. Low value services and unnecessary use of clinical resources undermine the sustainability of high value care and hinder the development of new interventions.

This report provides a framework for a way in which doctors can think critically about waste from a clinical perspective and provides examples of doctors improving the value of health care by reducing waste. Estimates suggest that around 20% of mainstream clinical practice brings no benefit to the patient as there is widespread overuse of tests and interventions. Academy of Medical Royal Colleges

See also:

The Better Care Fund: will the plans work?

The Better Care Fund: will the plans work? Last week’s announcement about the Better Care Fund plans coincided with the annual gathering of social care leaders in Manchester, the publication of a grim ‘state of the nation’ assessment of social care funding by the Local Government Association and Association of Directors of Adult Social Services, and further evidence of deteriorating NHS performance as shown in our latest NHS quarterly monitoring survey.

Local government secretary Eric Pickles declared in a parliamentary written statement that health and social care services were being integrated ‘for the first time’ under these plans, a historically curious assertion to which Health Secretary Jeremy Hunt added ‘the time for talk is over – our plans will make this vision a reality’.

Guidance: Antimicrobial prescribing: resources for professional development and practice

Guidance: Antimicrobial prescribing: resources for professional development and practice These resources can be used by pharmacists and healthcare professionals for continuing professional development (CPD), and as sources of information and reference material about antibiotic prescribing in both primary and secondary care. Public Health England

Guidance on prevention and management of stress at work

Guidance on prevention and management of stress at work For the past two years, 38 per cent of staff have told the NHS Staff Survey that they have suffered stress in the previous 12 months. NHS Employers also estimates that over 30 per cent of all sick leave is now caused by work-related stress in the NHS, costing up to £400 million each year. This guidance aims to help managers throughout the NHS reduce stress in the workplace and better support staff who experience it. NHS Employers

VIDEO: Ebola chief: 'This disease is still a crisis'

VIDEO: Ebola chief: 'This disease is still a crisis' The United Nations mission charged with fighting Ebola does not yet have the capacity to defeat the disease, the operation's head tells BBC News

Get IT 'right this time' - Williams

Get IT 'right this time' - Williams The National Information Board's framework for action will provide a guiding set of principles for a "revolution" in healthcare IT, Health and Social Care Information Centre chief executive Andy Williams has said. E-Health Insider

Most people dont know they have the right to view medical records online

Most people dont know they have the right to view medical records online Only 3% of GPs currently offer service to patients although all will be expected to by April 2015

More than two-thirds of patients do not realise that they have the right to see their records online, research shows.

As many as 71% of people are unaware that technology allows them to access their GP record online or via a smartphone, according to the results of a YouGov survey of 2,243 adults. Respondents added that they would use the technology, or thought it would help manage their health better. Continue reading... The Guardian

Fears that UK is not tackling preventable diseases

Fears that UK is not tackling preventable diseases Charities say th UK is not doing enough to help people live healthier lives and reduce their chance of diseases fuelled by obesity, alcohol and smoking. The Daily Telegraph

Lives will be lost unless the Government acts on off-patent drugs, charities warn

Lives will be lost unless the Government acts on off-patent drugs, charities warn Leading medical charities have warned “lives could be lost” if the Government does not act to make a group of low-cost, safe drugs for conditions including breast cancer, multiple sclerosis (MS) and Parkinson’s available to patients. The Independent

£55 dementia diagnosis scheme sets 'dangerous precedent', claim doctors

£55 dementia diagnosis scheme sets 'dangerous precedent', claim doctors A group of leading doctors and patient advocates have said NHS plans to pay GPs £55 for every dementia diagnosis have set a “dangerous precedent” and should be scrapped. The Independent

Wednesday, 5 November 2014

Handling Complaints with a Compassionate Human Touch

Handling Complaints with a Compassionate Human Touch The NHS complaints system still exposes many patients to a grueling and unsatisfactory process, despite numerous high level calls for reforms, a new report warns.

A survey of more than 1,200 patients found high levels of dissatisfaction with the complaints process with patients frequently encountering unhelpful and defensive staff, complicated procedures to negotiate and sometimes dishonest replies. The Patients Association

See also:

Serious problems with children’s and adolescents’ mental health services

Serious problems with children’s and adolescents’ mental health services A report published on 5 November 2014,  concludes that there are serious and deeply ingrained problems with the commissioning and provision of children’s and adolescents’ mental health services. Health Select Committee

See also:

VIDEO: Inside UK-funded Ebola centre

VIDEO: Inside UK-funded Ebola centre An 80-bed Ebola treatment centre, funded by the UK and built by the British Army, is to open its door near Freetown, Sierra Leone's capital. BBC News

See also:

RCN announces new President and Deputy President

RCN announces new President and Deputy President The results of the elections for RCN President and Deputy President have been announced. Royal College of Nursing

Short height 'linked to dementia death risk'

Short height 'linked to dementia death risk' "Short men more likely to die from dementia," The Daily Telegraph reports, though the results of the study it reports on are not as clear cut as the headline suggests.

Researchers combined the results of 18 surveys, which included more than 180,000 people. They aimed to see whether reported height was associated with deaths from dementia over 10 years of follow-up.

They found decreasing height was associated with higher rates of death from dementia. Each standard deviation decrease in height was associated with a 24% increase in risk of dementia death for men, and a 13% increase for women. This was after adjustment for factors such as age and smoking.

However, there are important limitations to consider. Despite the large cohort size, only 0.6% of the cohort died from dementia. These are small numbers on which to base any analysis.

Also, despite the trend, none of the smaller height categories were associated with a significantly increased risk of dementia death.

So, for both men and women, the smallest people in the study did not have a significant increased risk of dementia when compared with the tallest.

This means the association seen between height and dementia death isn't entirely convincing.

GPs will not control primary care commissioning under new CCG reforms

GPs will not control primary care commissioning under new CCG reforms Clinicians will not control commissioning of primary care when CCGs are handed expanded powers, NHS England has revealed. GP Online

See also:

Trade agreement between EU and US - ‘bad for patients’

Trade agreement between EU and US - ‘bad for patients’A free trade agreement between the European Union and USA goes against the interest of UK patients, experts warn this week.

In an editorial in The BMJ, John Hilary, Executive Director of campaign group War on Want warns that The Transatlantic Trade and Investment Partnership (TTIP) is designed to meet the interests of corporations rather than patients. OnMedica

MPs vote to make sex selection abortion illegal

MPs vote to make sex selection abortion illegal MPs vote 181 to 1 for a motion brought forward by a cross-party alliance of MPs in an effort to end uncertainty over the law. The Daily Telegraph

Is general practice in crisis?

Is general practice in crisis? A policy briefing that provides an evidence-based overview of the current state of general practice in England, and offers policy-makers some potential solutions. Nuffield Trust

See also:

Tuesday, 4 November 2014

Northamptonshire health chief 'takes over Twitter' to give insight into her role

Northamptonshire health chief 'takes over Twitter' to give insight into her role The Chief Executive of Northamptonshire Healthcare NHS Foundation Trust (NHFT), Angela Hillery, is embarking on a twitter takeover week on the Trust's official account @nhftnhs. Over the course of the week Angela will be updating followers on what she’s doing, what her priorities are for NHFT and giving an insight on some of the challenges she faces. Northampton Herald and Post

Library information skills programme for 2015

Library information skills programme for 2015 Need to find some information to inform your practice? Need to make a decision but can't find the evidence? Found the evidence but not sure of it's validity? We can help. All of our training programme dates for 2015 are now available on the Library's web site.

People in control of their own health and care: The state of involvement

People in control of their own health and care: The state of involvement The idea that people should have a stronger voice in decisions about their health and care, and that services should better reflect their needs and preferences, has been a policy goal of politicians and senior policy-makers in health for at least 20 years. Patients want it, and the evidence shows that when they are involved, decisions are better, health and health outcomes improve, and resources are allocated more efficiently. The King's Fund

See also:

Openness and honesty when things go wrong: the professional duty of candour

Openness and honesty when things go wrong: the professional duty of candour This joint consultation (running until the 5th January 2015) asks for views on guidance which is designed to support doctors, nurses and midwives in fulfilling their professional duty to be open and honest about mistakes. It also calls on clinical leaders and employers to support doctors, nurses and midwives by creating cultures in the workplace that are open, honest, and where people learn from mistakes so that future patients are protected from harm.General Medical Council and the Nursing and Midwifery Council
See also:

A vision for hepatitis C

A vision for hepatitis C This report calls for the government to improve hepatitis C services now to prevent thousands of unnecessary deaths. It highlights concerns from clinicians and patient and professional groups about the rising rate of hepatitis C related deaths and the need for improved screening and diagnosis. Hepatitis C Coalition

Is there really a crisis among GPs?

Is there really a crisis among GPs? A decade ago they got a new contract that allowed them to give up night and weekend cover, while seeing their pay shoot through the £100,000 a year barrier.

More recently, this government's reforms in England have put them at the heart of decision-making in the NHS by giving them responsibility for two thirds of the NHS budget.

And yet the profession, it seems, is at its wits end. A recent survey of 1,000 doctors by the British Medical Association found GPs had lower levels of morale and work-life balance than their medical colleagues elsewhere in the health service. BBC News

Ebola: Are cases levelling off?

Ebola: Are cases levelling off? We may be entering a new phase of the Ebola epidemic in West Africa.

There is growing - but certainly guarded - talk within the World Health Organization that the overall number of new cases is levelling off.

Officials have told me they now expect the figure to stick at around 1,000 fresh cases each week.

It is in sharp contrast to the early phase of the outbreak when the number was doubling every three to four weeks. BBC News

See also:

Hike in checks for most vulnerable

Hike in checks for most vulnerable Applications to restrict freedom of people with illnesses like dementia and autism for their own safety rises ten-fold since a landmark court ruling. BBC News

Dying in the UK – nurses raise “profound” concerns

Dying in the UK – nurses raise “profound” concerns Almost half a million people die in the UK every year and RCN members are concerned about the ability of health services to deliver high quality care to them. Royal College of Nursing

See also:

Weight loss surgery cuts diabetes risk in very obese

Weight loss surgery cuts diabetes risk in very obese “Weight loss surgery can dramatically reduce the odds of developing type 2 diabetes,” BBC News reports.

The underlying research identified a group of 2,167 obese adults without diabetes, the majority of whom were severely obese, with a body mass index (BMI) of 40 or above.

This group had undergone weight loss surgery, so researchers compared them with a comparison group matched for age, sex and BMI, who did not have surgery. They looked at the development of type 2 diabetes in both groups.

Using the maximum follow-up period in the study (seven years), they found that the “surgery group” had an 80% reduced risk of developing diabetes compared with the “no surgery” group.

These findings are mainly applicable to those with a very high BMI (over 40). Results at lower BMIs (30 to 35) were still positive, but did not have statistical significance.

It's important to stress that weight loss surgery is no magic bullet and is associated with both short- and long-term risks and complications, such as unsightly excess skin.