Vast majority of people happy with GP services

Vast majority of people happy with GP services: Most patients are happy with their GP service and rate out of hours service as high. Healthcare Today

Summary of guidance important for general practice

Summary of guidance important for general practice: Key points from NICE guidance published in December 2011

NHS executives told to resign under plan to cut trusts

NHS executives told to resign under plan to cut trusts:

Andrew Lansley's proposed shakeup of PCTs is causing confusion at heart of NHS, say service's top managers

Andrew Lansley's decision to shrink the number of NHS trusts has seen health service directors told they will have to leave their jobs by the end of the year, distracting the NHS leadership when it is undergoing the biggest shakeup in 60 years, internal documents reveal.

In a letter to the NHS Confederation – which represents the health service's top managers – senior executives write that a decision to cut both the size and number of primary care trusts, which commission £90bn of healthcare on behalf of patients, has led to the threat of a mass clearout at board level earlier than expected.

"We write to you with almost immediate urgency to express our huge concerns about the efficacy of the current proposals … during the current transitional period created by the health and social care bill," writes Sir Bill Taylor, the chairman of Blackburn with Darwen Teaching Care Trust, on behalf of the chairs of NHS boards in Cumbria and Lancashire, which collectively spend £3.5bn of NHS cash.

Under the health secretary's proposals, many of the chairs and non-executive board members – the local great and the good of the NHS – will be swept away.

While Lansley has made it clear the trusts will be gone by 2013, it was assumed these non-executives would be on hand to ease the transition to a new NHS where GPs call the shots and spend the health service budget. The process has already seen 151 PCTs moving to 52 PCT "clusters".

Describing the proposals to do away with boards as "on the hoof arrangements" the letter – copies of which were sent to No 10 and Lansley – warns there is "a huge potential to lose corporate memory".

The shakeup, claim executives, has left a trail of confusion at the heart of NHS – diverting precious management time away from trying to run the health service. "The whole letters, resignations, reappointments … is divisive and diversionary from the active and effective transference of responsibilities," writes Sir Bill in the letter, seen by the Guardian. Copies have been sent to Downing Street and Lansley.

Andy Burnham, Labour's health spokesman, said the government had "plunged the NHS into a leadership crisis on the brink of the toughest year in its history" and warned this was occurring without parliamentary approval.

The health bill is at a crucial point in the Lords, with the government poised to make concessions to Labour and the Lib Dems as it reaches the end of the decisive committee stage.

"The coalition's bill has still not been approved by parliament but the NHS has been radically altered anyway," said Burnham. "Andrew Lansley looks increasingly like a man on a kamikaze mission to destabilise the NHS.

"Not only has he chosen the worst possible moment to reorganise the NHS, he now removes the very people who were crucial to holding things together. By combining the financial challenge with the biggest-ever reorganisation, the government has created the conditions for a perfect storm that threatens to engulf the NHS in 2012."

The Appointments Commission, which regulates non-executives in the NHS, wrote to directors in Greater Manchester this month saying that it was "sorry to have to write to you in this manner. I know that is particularly hard to resign after you have given years of service to the NHS" but that there were only two routes open: resignation or termination of contract.

Non-executives are the only lay people with intimate knowledge of the NHS trusts, providing checks and balances in the system. The frustration with the sudden disappearance of a tier of oversight in the north of England has been mirrored by similar complaints in the south.

Last week the respected health think tank the King's Fund warned that the government was a making a mistake by handing NHS budgets in London to GPs without any body having oversight of the £20bn of public spending.

There has also been dissent by Conservatives over the turmoil caused by Lansley's shakeup.

Lord Mawhinney, a former Tory health secretary in the 1990s, told peers in October that health bosses had "decided to amalgamate the Peterborough and Cambridge PCTs. Nobody wants this. In Peterborough it did not consult the primary care trust. It did not consult the Peterborough hospital. It did not consult the Peterborough council. It just did it because it would save some money".

A department of health spokesperson said: "Primary Care Trust (PCT) clusters bring together a group of PCTs under a single executive team to ensure clear accountability for the health services provided for their communities.

"The strong feedback we have received from the NHS is that forming a common board across all PCTs in the cluster is the most effective [body]. As common boards form, the number of different non-executives needed will reduce. We have given clusters flexibility to take more time to complete this process, where necessary, and form a strong and representative common boards. The Guardian

European rules on energy conservation could cost NHS £70m a year

European rules on energy conservation could cost NHS £70m a year: European rules on energy conservation could cost the NHS £70m a year and lead to patient funds being diverted to costly building renovations, it has been warned. The Telegraph

£4.5m payout for doctor hounded out of job for having baby

£4.5m payout for doctor hounded out of job for having baby:

The financial crisis engulfing three hospitals in Yorkshire was dramatically worsened yesterday after an employment tribunal awarded £4.5m compensation to a consultant who was hounded out of her job. The Independent

Latest on NHS pension negotiations

Latest on NHS pension negotiations: There has been some discussion in the media this morning (19 December) about public sector pension negotiations. Royal College of Nursing negotiators are in talks with other trade unions and the Department of Health and an announcement by the Government is expected later today.

Patients will have to travel further to receive better care

Patients will have to travel further to receive better care:

A wide-reaching review into acute healthcare provision in the region won’t lead to huge changes for patients in north Northamptonshire, health bosses have said. Evening Telegraph

National Audit of Dementia

The Royal College of Psychiatrists National Audit of Dementia is working with hospitals providing general acute inpatient services to measure criteria relating to care delivery which are known to impact on people with dementia admitted to hospital. 

You can find the executive summary here

You can find the full report here

Troubleshooters to help 'troubled' families

Troubleshooters to help 'troubled' families: Louise Casey heads up the 'Troubled Families Team' with a budget of £448m Public Services

Services for people with neurological conditions

Services for people with neurological conditions: These services are not as good as they ought to be, despite a large increase in spending. National Audit Office

Report of the Steering Group on Remediation

Report of the Steering Group on Remediation:
In January 2010, the Department of Health established a Steering Group to consider

remediation, focussing on managing competence and capability issues in the small minority of doctors where there is concern about their health, conduct, clinical

competence and capability.

Many members of the Group had considerable personal experience of tackling clinical

competence and capability problems and were able to draw upon this experience as

well as the Department of Health survey and other recent work in developing their

ideas.In looking at how remediation could be better managed, the Group made six broad

recommendations:

• Performance problems, including clinical competence and capability issues, should normally be managed locally wherever possible
• Local processes need to be strengthened so as to avoid performancemproblems wherever possible, and to reduce their severity at the point ofmidentification;
• The capacity of staff within organisations to deal with performance concerns needs to be increased with access to necessary external expertise as require
• A single organisation is required to advise and, when necessary, to co­ordinate the remediation process and case management so as to improveconsistency across the service;
• The medical Royal Colleges to produce guidance and provide assessmentand specialist input into remediation programmes;
• Postgraduate deaneries and all those involved in training and assessment need to assure their assessment processes so that any problems arising during training are addressed

Report of the Steering Group on Remediation

BMA publishes authorisation guidance for CCGs

BMA publishes authorisation guidance for CCGs: The BMA has made a number of recommendations and highlighted its concerns over government plans for the future of clinical commissioning groups (CCGs) as they approach authorisation. GP Online

Person-based resource allocation

Person-based resource allocation: The Nuffield Trust has published a research summary 'Person-based resource allocation: new approaches to estimating commissioning budgets for GP practices'. This summary provides an outline of person-based resource allocation, why it was developed, and how. The report is aimed primarily at GP and commissioning leaders, policy-makers, and senior managers in the NHS. It summarises the approach developed in a series of analyses over time and is based on work by a range of organisations.

Competition, integration and incentives

Competition, integration and incentives: The Nuffield Trust has also published a Viewpoint by Provost of Harvard University, Professor Alan Garber, which provides a US expert view on the question of how best to balance incentives to promote innovation in the NHS. 'Competition, integration and incentives: the quest for efficiency in the English NHS' provides insight into the factors that improve health system performance. While sympathetic to integration as a way of delivering higher performance, Professor Garber warns against the blanket dismissal of competition, observing that when it comes to the organisation of health services 'we don't know which approach works best'. A competitive, flexible approach to delivery is, he argues, more likely to encourage innovation.

Raising a concern with CQC: A quick guide for health and care staff about whistleblowing

Raising a concern with CQC: A quick guide for health and care staff about whistleblowing: Source: Care Quality Commission (CQC)

The Care Quality Commission (CQC) has published a quick guide on whistleblowing for health and care professionals who need to raise a concern about their workplace. It provides advice on speaking out about poor care and what protection there is from the law.

Health Survey for England - 2010

Health Survey for England - 2010: Source: NHS Information Centre

The Health Survey for England is part of a programme of surveys commissioned by The NHS Information Centre for health and social care. It provides information on a range of aspects concerning the public's health and many of the factors that affect health. The series of Health Surveys for England was designed to monitor trends in the nation's health, to estimate the proportion of people in England who have specified health conditions, and to estimate the prevalence of certain risk factors and combinations of risk factors associated with these conditions. The survey is also used to monitor progress towards selected health targets. The main focus of the survey in 2010 was respiratory health and lung function. Additional areas covering contraception and sexual health, wellbeing, kidney disease and dental health.

Foundation trusts reveal wage bill cuts

Foundation trusts reveal wage bill cuts: At least five foundation trusts predict wage bill cuts of 10% or more. Healthcare Today

Preventative care and early intervention in mental health - The Guardian

Preventative care and early intervention in mental health - The Guardian:

The Guardian

Preventative care and early intervention in mental health The Guardian At any one time in London, one in six adults suffers mental health symptoms and suicide is the biggest killer of young men in the capital. The issue was raised at a recent London assembly health and public services committee meeting. ... AMs call for regional supervision of mental health servicesMayorWatch New ways of working across blue light services are key to future success for ...Bapco Journal all 6 news articles »

Five million children get wrong dose of penicillin dose

Five million children get wrong dose of penicillin dose:

Almost five million children who are prescribed penicillin each year for infections are getting too little of the antibiotic to be effective, putting them at risk of serious complications. The Independent

RCN expresses concern over dementia report

RCN expresses concern over dementia report: The Royal College of Nursing has said it is ‘extremely worrying’ that the majority of staff who responded to a recent survey say that their training and development in the field of dementia care is not sufficient.