Friday, 18 May 2012
''50,000 fewer patients wait over 18 weeks''
''50,000 fewer patients wait over 18 weeks'': New stats show an average wait for admitted patients of 8.1 weeks, lower than it was in May 2010 Public Service
Mortality among inpatients with diabetes: key findings for England
Mortality among inpatients with diabetes: key findings for England:
This analysis of mortality among inpatients with diabetes used data on over 13 million hospital admissions to assess case-mix and risk factors for inpatient mortality and identify trust level variation in the risk of an inpatient with diabetes dying.The key finding of this analysis was that inpatients with diabetes are 10% more likely to die than those without the condition.
This analysis of mortality among inpatients with diabetes used data on over 13 million hospital admissions to assess case-mix and risk factors for inpatient mortality and identify trust level variation in the risk of an inpatient with diabetes dying.The key finding of this analysis was that inpatients with diabetes are 10% more likely to die than those without the condition.
More help for women with postnatal depression
More help for women with postnatal depression:
The NHS is set to offer more support to women who have postnatal depression or who have suffered a miscarriage, stillbirth or the death of a baby.
The government has announced that it will recruit an extra 4,200 health visitors, who will be given enhanced training to help them spot the early signs of postnatal depression.
The health visitors, who provide services for expectant and new parents after they... Healthcare Today
The NHS is set to offer more support to women who have postnatal depression or who have suffered a miscarriage, stillbirth or the death of a baby.
The government has announced that it will recruit an extra 4,200 health visitors, who will be given enhanced training to help them spot the early signs of postnatal depression.
The health visitors, who provide services for expectant and new parents after they... Healthcare Today
Half of hospital costs are on over-60s
Half of hospital costs are on over-60s:
Analysis of the Hospital Episode Statistics payment by results (PbR) data has revealed that the over-60s account for nearly half of hospital admissions in England and more than half of hospital income from admissions.
Figures show that 43% of all hospital admissions paid under mandatory PbR were of people aged over 60 and accounted for £10.9bn, or 51% of hospitals’ income from admissions that attracted a manda... Healthcare Today
Analysis of the Hospital Episode Statistics payment by results (PbR) data has revealed that the over-60s account for nearly half of hospital admissions in England and more than half of hospital income from admissions.
Figures show that 43% of all hospital admissions paid under mandatory PbR were of people aged over 60 and accounted for £10.9bn, or 51% of hospitals’ income from admissions that attracted a manda... Healthcare Today
What does the abandonment of two commissioning support services mean for the NHS reforms?
What does the abandonment of two commissioning support services mean for the NHS reforms?:
Richard Vize explores the development of the commissioning support services and the wider implications for the health sector. Are cracks beginning to show?
Just weeks after the health reforms passed into law, serious cracks have emerged in the new system that could derail both the quality and financial stability of NHS services.
The NHS Commissioning Board has revealed that as a result of its "Checkpoint 2" tests for the viability of the plans for 25 regional commissioning support services, two have had to be abandoned: West Mercia and Peninsula (Devon and Cornwall). A further nine require "more rapid management" to stop them from failing.
The support services are often wrongly described as providing "administrative functions" for clinical commissioning groups. This does not begin to articulate the breadth of their work and their importance in determining whether the reforms succeed or fail.
They will lead change and service redesign, identify gaps in services, spot and manage risks, identify service providers, manage tendering, negotiate contracts and do much else besides.
Getting the support services off the ground would be difficult enough if they were just run of the mill public sector bodies. But they will eventually be "free standing", selling their services into the NHS. So the commissioning board has been charged with setting them up not only to help CCGs reform the health service but to then blossom into commercial, independent organisations. It takes a fertile imagination to see how a board steeped in a culture of central control can be an incubator for business start-ups.
Any weaknesses in the operation of the support services will be exposed in both service quality and financial stability. The turbulence in the NHS as real-term funding cuts collide with the reforms means there is a serious risk of a financial failure or a local deterioration in quality that goes unspotted or unchecked. The cuts alone increase this risk substantially; support organisations teetering on the brink of failure are unlikely to identify problems and work with providers to address them in time.
The Treasury has been worried about handing over £60bn of public money to new and unaccountable organisations. With the dire verdict of the NHS Commissioning Board on the state of the nascent commissioning support services they now have reason to be terrified.
No-one has ever claimed that GPs' skills lie in managing NHS finances – their strength is in understanding patient needs and clinical pathways. The support services are vital for effective financial control.
The commissioning board now has to fill the gap left by the abandoned services. The strategic health authorities are moving quickly, and neighbouring services whose preparations are going well could be asked to take over. While expansion has its advantages, changing boundaries and taking on new CCGs and populations will make the further development of their existing operation more complex.
The board also announced it has abandoned plans for a national communications and engagement service for CCGs. The service would have had the advantage of keeping costs down but looked suspiciously like a Ministry of Information for the board, which would have undermined the notion of a locally accountable NHS. Noises are still being made about a nationally co-ordinated communications service, but the hope must be that CCGs will now have more freedom to develop an approach to communications and engagement tailored to their own area – albeit made out of cheap cloth.
But even this is symptomatic of how desperately difficult it is for managers, GPs and the national board to stop the reforms from toppling over. Overlay the problems in support services with the setbacks and difficulties CCGs are experiencing as they struggle to establish themselves, and the wealth of management talent leaving the service, and you have a national picture of growing uncertainty and risk. Staff across the system are fighting to make it all work, but the chances of something going badly wrong are escalating.
Guardian Professional.
Just weeks after the health reforms passed into law, serious cracks have emerged in the new system that could derail both the quality and financial stability of NHS services.
The NHS Commissioning Board has revealed that as a result of its "Checkpoint 2" tests for the viability of the plans for 25 regional commissioning support services, two have had to be abandoned: West Mercia and Peninsula (Devon and Cornwall). A further nine require "more rapid management" to stop them from failing.
The support services are often wrongly described as providing "administrative functions" for clinical commissioning groups. This does not begin to articulate the breadth of their work and their importance in determining whether the reforms succeed or fail.
They will lead change and service redesign, identify gaps in services, spot and manage risks, identify service providers, manage tendering, negotiate contracts and do much else besides.
Getting the support services off the ground would be difficult enough if they were just run of the mill public sector bodies. But they will eventually be "free standing", selling their services into the NHS. So the commissioning board has been charged with setting them up not only to help CCGs reform the health service but to then blossom into commercial, independent organisations. It takes a fertile imagination to see how a board steeped in a culture of central control can be an incubator for business start-ups.
Any weaknesses in the operation of the support services will be exposed in both service quality and financial stability. The turbulence in the NHS as real-term funding cuts collide with the reforms means there is a serious risk of a financial failure or a local deterioration in quality that goes unspotted or unchecked. The cuts alone increase this risk substantially; support organisations teetering on the brink of failure are unlikely to identify problems and work with providers to address them in time.
The Treasury has been worried about handing over £60bn of public money to new and unaccountable organisations. With the dire verdict of the NHS Commissioning Board on the state of the nascent commissioning support services they now have reason to be terrified.
No-one has ever claimed that GPs' skills lie in managing NHS finances – their strength is in understanding patient needs and clinical pathways. The support services are vital for effective financial control.
The commissioning board now has to fill the gap left by the abandoned services. The strategic health authorities are moving quickly, and neighbouring services whose preparations are going well could be asked to take over. While expansion has its advantages, changing boundaries and taking on new CCGs and populations will make the further development of their existing operation more complex.
The board also announced it has abandoned plans for a national communications and engagement service for CCGs. The service would have had the advantage of keeping costs down but looked suspiciously like a Ministry of Information for the board, which would have undermined the notion of a locally accountable NHS. Noises are still being made about a nationally co-ordinated communications service, but the hope must be that CCGs will now have more freedom to develop an approach to communications and engagement tailored to their own area – albeit made out of cheap cloth.
But even this is symptomatic of how desperately difficult it is for managers, GPs and the national board to stop the reforms from toppling over. Overlay the problems in support services with the setbacks and difficulties CCGs are experiencing as they struggle to establish themselves, and the wealth of management talent leaving the service, and you have a national picture of growing uncertainty and risk. Staff across the system are fighting to make it all work, but the chances of something going badly wrong are escalating.
Guardian Professional.
Heart services face closure or merger
Heart services face closure or merger: Heart services treating hundreds of thousands of patients face being closed or merged with others over fears they are too small, it has emerged.
The Daily Telegraph
The Daily Telegraph
Rise seen in mixed-sex NHS ward breaches
Rise seen in mixed-sex NHS ward breaches:
The number of breaches of rules on mixed-sex NHS wards rose by nearly 100 last month, according to new figures. The Independent
The number of breaches of rules on mixed-sex NHS wards rose by nearly 100 last month, according to new figures. The Independent
Statins 'may even help healthy over-50s'
Statins 'may even help healthy over-50s':
Everyone over the age of 50 should be given statins because the “cholesterol-busting” drugs reduce the risk of a heart attack even in healthy people, according to the Daily Telegraph and many other papers today.
The story is based on a systematic review of 27 studies looking at the effect of lowering low-density lipoprotein cholesterol (LDL, the “bad” cholesterol) using statin therapy in 175,000 individuals. It found that for every 1.0 mmol/L reduction in cholesterol, taking statins reduced the risk of heart attacks, strokes and other “major vascular events” by about a fifth (21%), even among those without existing vascular disease or at low risk of developing it.
Current guidelines recommend prescribing statins for people who have at least a 20% chance of developing cardiovascular disease within 10 years. Doctors normally calculate this risk by looking at a range of factors including the patient’s age, blood pressure, cholesterol levels, whether they smoke and whether they have diabetes.
This large review of studies suggests the cholesterol-lowering drugs are suitable for those without existing heart or vascular disease and those who are not considered at high risk of developing it. The 21% reduction in risk of heart disease and stroke sounds impressive.
However, it’s worth noting that the number of people who stand to benefit from statins gets smaller as the risk threshold for treatment is reduced. For example, one thousand people at low risk would need to be treated (have a 1 mmol/L reduction in bad cholesterol) for five years in order for 11 of them to benefit. This suggests that someone at low risk may wish to consider whether the possible benefit of taking statins would outweigh the inconvenience.
An accompanying editorial argues that the current guidelines should be revised to use age as an indicator for statins (over 50 years old), rather than expensive screening tests. The commentary forms part of a running debate as to whether middle-aged people without any known risk of cardiovascular disease should be “medicated”, and if so, how much (whether with statins, aspirin or a “polypill”, as previously suggested).
The study was published in the peer-reviewed medical journal, The Lancet.
The study – in particular the commentary arguing for all over 50s to take statins - was covered widely and accurately in most of the media.
The authors pointed out that their previous analysis of studies suggested that statin therapy to reduce LDL cholesterol in people without a history of vascular disease ultimately reduced their risk of heart attacks and strokes by about a fifth. However, uncertainty remains as to whether statins have an overall “net benefit” in this group, given that they are at low risk to begin with. The authors said that at least half of all heart attacks and strokes (vascular events) occur among individuals without previous disease.
The authors said they have now taken individual patient data from each trial within the database, allowing a more complete assessment of the effects of lowering LDL cholesterol in low-risk individuals.
They grouped the participants into five categories depending on their risk of a vascular event within five years and compared those taking a statin with control groups or with group taking a lower-dose statin. The risk categories were:
They also pointed out that, under present guidelines, such individuals would typically not be regarded as suitable for statin therapy.
They concluded: "The present report shows that statins are indeed both effective and safe for people with a five-year risk of major vascular events lower than 10% who would typically not be judged suitable for statin treatment … and, therefore, suggests that treatment guidelines might need to be reconsidered."
Although the study looked at whether statins increased the risk of cancer and death from other causes, it did not include possible adverse effects. Statins are safe drugs that have been associated with a small risk of side effects. As the authors stated, the risk of side effects when giving statins to everyone over the age of 50 would have to be taken into account when calculating the overall benefit.
The current guidelines on statin therapy from the National Institute of Health and Clinical Excellence (NICE) are reportedly to be updated soon, at which point NICE will take this and any other new evidence into account.
There is good existing evidence that a healthy lifestyle (including regular exercise, stopping smoking and a healthy diet) are also important factors in cardiovascular health. This study helps to answer previous uncertainty about which apparently healthy individuals could benefit from taking statins.
NHS 'should consider giving statins to healthy people'. BBC News, May 17 2012
Statins could benefit health of millions. The Guardian, May 17 2012
All over 50s should be taking statins. The Daily Telegraph, May 17 2012
Statins 'could benefit the healthy'. The Independent, May 17 2012
Why EVERYONE over 50 needs to be taking statins: Cholesterol-busting pills cut risk of heart attack or stroke. Daily Mail, May 17 2012
The story is based on a systematic review of 27 studies looking at the effect of lowering low-density lipoprotein cholesterol (LDL, the “bad” cholesterol) using statin therapy in 175,000 individuals. It found that for every 1.0 mmol/L reduction in cholesterol, taking statins reduced the risk of heart attacks, strokes and other “major vascular events” by about a fifth (21%), even among those without existing vascular disease or at low risk of developing it.
Current guidelines recommend prescribing statins for people who have at least a 20% chance of developing cardiovascular disease within 10 years. Doctors normally calculate this risk by looking at a range of factors including the patient’s age, blood pressure, cholesterol levels, whether they smoke and whether they have diabetes.
This large review of studies suggests the cholesterol-lowering drugs are suitable for those without existing heart or vascular disease and those who are not considered at high risk of developing it. The 21% reduction in risk of heart disease and stroke sounds impressive.
However, it’s worth noting that the number of people who stand to benefit from statins gets smaller as the risk threshold for treatment is reduced. For example, one thousand people at low risk would need to be treated (have a 1 mmol/L reduction in bad cholesterol) for five years in order for 11 of them to benefit. This suggests that someone at low risk may wish to consider whether the possible benefit of taking statins would outweigh the inconvenience.
An accompanying editorial argues that the current guidelines should be revised to use age as an indicator for statins (over 50 years old), rather than expensive screening tests. The commentary forms part of a running debate as to whether middle-aged people without any known risk of cardiovascular disease should be “medicated”, and if so, how much (whether with statins, aspirin or a “polypill”, as previously suggested).
Where did the story come from?
The study was carried out by researchers from Oxford University and the University of Sydney. It was funded by several institutions including the British Heart Foundation, the UK Medical Research Council and Cancer Research UK.The study was published in the peer-reviewed medical journal, The Lancet.
The study – in particular the commentary arguing for all over 50s to take statins - was covered widely and accurately in most of the media.
What kind of research was this?
This was a meta-analysis of individual patient data from 27 trials looking at the effects of lowering LDL cholesterol with statin therapy, including trials of those without vascular disease or at low risk of cardiovascular disease.The authors pointed out that their previous analysis of studies suggested that statin therapy to reduce LDL cholesterol in people without a history of vascular disease ultimately reduced their risk of heart attacks and strokes by about a fifth. However, uncertainty remains as to whether statins have an overall “net benefit” in this group, given that they are at low risk to begin with. The authors said that at least half of all heart attacks and strokes (vascular events) occur among individuals without previous disease.
The authors said they have now taken individual patient data from each trial within the database, allowing a more complete assessment of the effects of lowering LDL cholesterol in low-risk individuals.
What did the research involve?
The researchers conducted a meta-analysis of data from 175,000 participants in 27 randomised trials, to explore the effects of lowering LDL cholesterol with statin therapy. Trials were included if:- They included at least one treatment where the main effect was to lower LDL cholesterol.
- There were no other differences in treating risk factors.
- At least 1,000 participants were recruited for a duration of at least two years’ treatment.
They grouped the participants into five categories depending on their risk of a vascular event within five years and compared those taking a statin with control groups or with group taking a lower-dose statin. The risk categories were:
- less than 5%
- 5% to less than 10%
- 10% to less than 20%
- 20% to less than 30%
- 30% or more
What were the basic results?
The researchers found that:- Reducing LDL cholesterol with a statin reduced the risk of major vascular events (relative risk 0.79, 95% confidence interval 0.77 to 0.81 per 1.0 mmol/L reduction), largely irrespective of age, sex, baseline LDL cholesterol or previous vascular disease, and of vascular mortality and all-cause mortality.
- The reduction in major vascular events was at least as big in people in the two lowest risk categories as those in the higher risk categories.
- For stroke, the reduction in risk in participants with a 5-year risk of major vascular events lower than 10% (relative risk per 1.0 mmol/L LDL cholesterol reduction 0.76, 99% confidence interval 0.61 to 0.95) was also similar to that seen in higher-risk categories.
- In participants without a history of vascular disease, statins reduced the risks of deaths from vascular disease and any other cause (relative risk 0.91, 95% confidence interval 0.85 to 0.97).
How did the researchers interpret the results?
The researchers calculated that in individuals with a five-year risk of major vascular events lower than 10%, each 1 mmol/L reduction in LDL cholesterol produced an absolute reduction in major vascular events of about 11 per 1,000 over five years. They said this benefit “greatly exceeds any known hazards of statin therapy”.They also pointed out that, under present guidelines, such individuals would typically not be regarded as suitable for statin therapy.
They concluded: "The present report shows that statins are indeed both effective and safe for people with a five-year risk of major vascular events lower than 10% who would typically not be judged suitable for statin treatment … and, therefore, suggests that treatment guidelines might need to be reconsidered."
Conclusion
Current guidelines recommend statins for people who have a 20% or greater chance of developing cardiovascular disease within 10 years. This large review of studies, which is a further assessment of previous research, suggests they may also benefit those without existing cardiovascular disease and those who are not considered at high risk of developing it. However, the individual benefit for those at low risk may be small.Although the study looked at whether statins increased the risk of cancer and death from other causes, it did not include possible adverse effects. Statins are safe drugs that have been associated with a small risk of side effects. As the authors stated, the risk of side effects when giving statins to everyone over the age of 50 would have to be taken into account when calculating the overall benefit.
The current guidelines on statin therapy from the National Institute of Health and Clinical Excellence (NICE) are reportedly to be updated soon, at which point NICE will take this and any other new evidence into account.
There is good existing evidence that a healthy lifestyle (including regular exercise, stopping smoking and a healthy diet) are also important factors in cardiovascular health. This study helps to answer previous uncertainty about which apparently healthy individuals could benefit from taking statins.
Links To The Headlines
Give statins to everyone over 50. Daily Express, May 17 2012NHS 'should consider giving statins to healthy people'. BBC News, May 17 2012
Statins could benefit health of millions. The Guardian, May 17 2012
All over 50s should be taking statins. The Daily Telegraph, May 17 2012
Statins 'could benefit the healthy'. The Independent, May 17 2012
Why EVERYONE over 50 needs to be taking statins: Cholesterol-busting pills cut risk of heart attack or stroke. Daily Mail, May 17 2012
Links To Science
Cholesterol Treatment Trialists' Collaborators. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. The Lancet. Published online May 17 2012 NHS ChoicesThursday, 17 May 2012
Northamptonshire doctor banned from working for the NHS over deadly spider venom probe
Northamptonshire doctor banned from working for the NHS over deadly spider venom probe:
A GP from Northamptonshire who was banned from working for the NHS after trying to buy deadly venom from the black widow spider and death stalker scorpion insists she is the victim of a ‘set-up’. Northampton Chronicle and Echo
A GP from Northamptonshire who was banned from working for the NHS after trying to buy deadly venom from the black widow spider and death stalker scorpion insists she is the victim of a ‘set-up’. Northampton Chronicle and Echo
Integrated care and why the NHS needs more deviant leaders | Chris Ham
Integrated care and why the NHS needs more deviant leaders | Chris Ham: If integrated care is to emerge at scale and pace, the NHS needs more positive deviants. (15 May 2012) Kings Fund
Preparation for commissioning picks up pace – Barbara Hakin
The pace is picking up now in terms of establishing CCGs, with less than ten months left until the new system goes live in April 2013.
Across the country, groups of practices have been coming together and identifying the shape and configuration of their CCG. It is a fantastic achievement that these geographies are now sorted and we have emerging CCGs covering the whole of England coming forward for authorisation.
The reforms are based very firmly on three key principles; that patients in their communities should be at the heart of everything we do; that clinicians should be in the driving seat in shaping services; and that we should focus on outcomes based on sound evidence. CCGs are the cornerstone of delivering these aspirations. GP practices know their patients and largely serve specific communities with whom the practice has had a relationship for many years. They already act as the hub of care for their patients; linking patients with other clinicians and ensuring that, through the registered list and the single lifelong record, all the care patients receive is coordinated in one place. This model is envied around the world and is key to delivering better care, better experience, better outcomes and improved safety. So it is only logical that these practices should be at the heart of determining how the range of local services can best meet their patients’ needs.But good commissioning is mainly about bringing together all those with expertise and an interest in care in order to arrange the services which can deliver these quality outcomes. So the responsibility on the CCG to involve patients and the public, and the full range of health and social care colleagues, is huge.
There is also lots going on to shape the rest of the commissioning system. This means putting in place all the elements of the NHS CB’s own architecture, the national support office, regional teams and local area teams. The NHS CB will be responsible for ensuring the whole commissioning system works well together and that the £80bn of taxpayers’ money is turned into the best possible outcomes for patients. It will support and oversee CCGs who will have the majority of this resource, as well as commissioning specialised services, primary care, prison and military health services, as well as many public health services on behalf of Public Health England.
Another key plank of the systems will be dedicated commissioning support units. While CCGs will be able to buy their support services from whoever they choose, we need to ensure they have the full range available to them from day one. Many independent and third sector organisations can offer fantastic niche commissioning support or highly sophisticated tools and products to aid commissioners. But the capacity and capability to deliver the full range of commissioning support sits with high experienced individuals currently in PCTs, and we must ensure this expertise is supported to deliver the best range of services from which CCGs can choose.
In the final analysis, our success will be predicated on whether healthcare services deliver better outcomes which meet local needs, whether these services deliver integrated care, and whether local communities feel they have a real voice in shaping services which suite them. The key vehicle in ensuring this happens will be the local health and wellbeing board. These vital structures are still in their early development but need to be the focal point for communities, bringing together patient and public representatives, alongside all the players who commission or provide care in the locality, in one place in order to ascertain the needs of the population and outline the overarching strategic plan on which individual components will be based.
There is still much to do in a relatively short space of time. But much is already in place, and we should be optimistic that this greater clinical and patient engagement will bring about the changes we need to see in order to keep improving the quality of care in this difficult economic environment.
GPs and their practices have been placed centre stage in this arena in a way we have never seen previously. CCGs will only be successful if the majority of practices seize this opportunity and make the CCG their own. Their leaders are already emerging, trusted to oversee much of the day to day aspects of clinical commissioning. But without the support of the majority of their practice colleagues their task will be too great. It is the action of all GPs and their practice teams through their connection with their patients, and all others who care for them, which will create a wealth of collective experience which will make the difference. NHS Commissioning Board
Ambulance changes ''may save 150 lives''
Ambulance changes ''may save 150 lives'': A new way that 999 calls are received will prioritise call-outs to the most critically ill patients Public Service
Nurses fear spending cuts will put people with learning disabilities at risk
Nurses fear spending cuts will put people with learning disabilities at risk: Three in four nurses have seen cuts to services in their area in the past year, survey revealsNurses who work with people with learning disabilities have "real concerns" about the safety of their clients because of cuts in services, according to a study published on Wednesday.A survey of 500 nurses revealed that three out of four saw spending cuts to services in their area in the past year. The Royal College of Nursing (RCN) said its survey also uncovered cuts in the range of services offered, such ...
Race equality in mental health
Race equality in mental health: This Briefing summarises the findings and recommendations from a recent report, commissioned by the Department of Health, into race equality in mental health. The report is based on a series of interviews with NHS and local authority leaders. NHS Confederation
Smart guides to engagement
Smart guides to engagement:
The next set of guides in this series of 10 have been published. This set covers practices and patient engagement; listening, learning and responding; and community development and population health.
The next set of guides in this series of 10 have been published. This set covers practices and patient engagement; listening, learning and responding; and community development and population health.
NHS 'should consider giving statins to healthy people' - BBC News
NHS 'should consider giving statins to healthy people' - BBC News:
 BBC News | NHS 'should consider giving statins to healthy people' BBC News The Oxford researchers says the NHS should consider giving statins to healthy people. The NHS drugs watchdog, NICE, is reviewing the evidence. However, statins have been linked to side-effects such as kidney failure. They are among the most widely ... Statins could benefit health of millionsThe Guardian All over 50s should be taking statinsTelegraph.co.uk all 16 news articles » |
Why today's NHS leaders need to be more engaging
Why today's NHS leaders need to be more engaging:
High quality leadership is more important than ever, a King's Fund report has judged. It recommends a shift away from traditional 'heroic' leadership towards a more engaging style
The NHS is facing some of its biggest financial and quality challenges since its inception. An ageing population poses significant challenges to our health care system. The increase in demand means that the NHS needs to make efficiency savings worth £20bn by 2015. Older people are more likely to have complex conditions, requiring better co-ordination and integration of care. Never before has effective leadership and management been so vital for our healthcare system.
In May last year, the King's Fund published a report, called No More Heroes, into the future of leadership. It found that, contrary to prevailing assumptions, the NHS was not over-managed. Cuts in management will result in the loss of thousands of experienced leaders at a time when their expertise is most needed to secure essential productivity gains.
The report also found that a shift away from the strong heroic leader model relied upon to meet targets was needed. It judged that leaders are far more likely to meet today's challenges, and deliver better results financially and in terms of quality of care, by engaging populations, patients, carers and staff. More engaging leadership styles will also be important in enabling patients and their families to receive better co-ordinated care across systems.
This approach to leadership was also explored by the NHS Institute of Innovation and Improvement and the Academy of Medical Royal Colleges, which used a medical scale to measure levels of engagement amongst clinicians. Initially working with 30 hospitals, the study concluded that there was a very strong association between medical engagement and clinical and financial performance, as assessed by the Care Quality Commission.
The new national structures, such as the NHS Commissioning Board and Leadership Academy, will have a key role to play in developing leadership across the systems but, importantly, local NHS bodies and local authorities will be instrumental in embedding it throughout the system.
There are already some exciting programmes working on real challenges within communities. In Surrey, clinicians are focusing on optimising the care of the frail elderly, working with the King's Fund on a whole system leadership programme.
The work has encompassed social care, community providers, GPs, mental health and acute care along with nursing homes. This is just one example where openness and communication amongst a multitude of players is at the core of effective and sustainable change in pursuit of delivering high value care.
The challenges for the NHS and local government to continue to enhance the range and quality of services within a very challenging fiscal environment requires the very highest quality of leadership. The case for a more distributed and engaging style of leadership is compelling and needs to be the norm now more than ever before.
The King's Fund is holding its second annual summit on leadership and management on 23 May and will be publishing a follow-up to the No More Heroes report at the event.
Guardian Professional.
The NHS is facing some of its biggest financial and quality challenges since its inception. An ageing population poses significant challenges to our health care system. The increase in demand means that the NHS needs to make efficiency savings worth £20bn by 2015. Older people are more likely to have complex conditions, requiring better co-ordination and integration of care. Never before has effective leadership and management been so vital for our healthcare system.
In May last year, the King's Fund published a report, called No More Heroes, into the future of leadership. It found that, contrary to prevailing assumptions, the NHS was not over-managed. Cuts in management will result in the loss of thousands of experienced leaders at a time when their expertise is most needed to secure essential productivity gains.
The report also found that a shift away from the strong heroic leader model relied upon to meet targets was needed. It judged that leaders are far more likely to meet today's challenges, and deliver better results financially and in terms of quality of care, by engaging populations, patients, carers and staff. More engaging leadership styles will also be important in enabling patients and their families to receive better co-ordinated care across systems.
This approach to leadership was also explored by the NHS Institute of Innovation and Improvement and the Academy of Medical Royal Colleges, which used a medical scale to measure levels of engagement amongst clinicians. Initially working with 30 hospitals, the study concluded that there was a very strong association between medical engagement and clinical and financial performance, as assessed by the Care Quality Commission.
The new national structures, such as the NHS Commissioning Board and Leadership Academy, will have a key role to play in developing leadership across the systems but, importantly, local NHS bodies and local authorities will be instrumental in embedding it throughout the system.
There are already some exciting programmes working on real challenges within communities. In Surrey, clinicians are focusing on optimising the care of the frail elderly, working with the King's Fund on a whole system leadership programme.
The work has encompassed social care, community providers, GPs, mental health and acute care along with nursing homes. This is just one example where openness and communication amongst a multitude of players is at the core of effective and sustainable change in pursuit of delivering high value care.
The challenges for the NHS and local government to continue to enhance the range and quality of services within a very challenging fiscal environment requires the very highest quality of leadership. The case for a more distributed and engaging style of leadership is compelling and needs to be the norm now more than ever before.
The King's Fund is holding its second annual summit on leadership and management on 23 May and will be publishing a follow-up to the No More Heroes report at the event.
Guardian Professional.
Number of elderly receiving free home care falls by 11 per cent
Number of elderly receiving free home care falls by 11 per cent: Cuts to social care budgets have been blamed for an 11 per cent fall in the number of vulnerable people who have their care services paid for by their local authority, it was reported.
The Daily Telegraph
The Daily Telegraph
Giving patients choice 'will drive hospital closures'
Giving patients choice 'will drive hospital closures': Hospitals will close under Government plans to give patients more choice about where they are treated in a drive to push up NHS standards, senior health figures have admitted.
The Daily Telegraph
The Daily Telegraph
'No excuse' for diabetes errors
'No excuse' for diabetes errors:
Almost one in three diabetic hospital patients are victims of medication errors that can cause dangerous blood glucose levels, a report has found. The Independent
Almost one in three diabetic hospital patients are victims of medication errors that can cause dangerous blood glucose levels, a report has found. The Independent
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