The future of NHS commissioning: no map or clear destination

The future of NHS commissioning: no map or clear destination After more than 20 years of repeated reorganisations (culminating in one so big you can see it from outer space), policy-makers have finally navigated the purchaser–provider divide to focus their attention on the structure of health care providers. When the NHS five year forward view (Forward View) was published in 2014 (with its focus on developing new, locally designed integrated models for providing health and care) the broad thrust of English health policy shifted from commissioners and competition to providers and collaboration.

Although any pause in the cycle of top-down reorganisation is welcome, there is now a clear (and perhaps conscious?) gap in the policy landscape. How will clinical commissioning groups (CCGs) be affected as new integrated provider models such as accountable care organisations (ACOs) emerge and sustainability and transformation partnerships (STPs) and accountable care systems (ACSs) (that involve both commissioners and providers) are layered on top of an already complex NHS landscape? The King's Fund

A map for better care: making effective care pathways for people with interstitial lung disease

A map for better care: making effective care pathways for people with interstitial lung disease A new report finds that many people living with idiopathic pulmonary fibrosis (IPF) still aren’t getting the diagnosis, support or care they need.

Idiopathic pulmonary fibrosis (IPF) is currently an incurable lung condition with no known cause. The average life expectancy in the UK after diagnosis is 3 years.

Yet access to services, treatment and support for patients with IPF is fragmented. This urgently needs to change. We need to make health systems work for everyone living with IPF.

Patients can’t afford to waste the precious time they have left going from service to service for help. They need speedy, seamless access to the care they need, when they need it. British Lung Foundaton

See also:

• NHS urged to end 'inhuman' treatment of IPF sufferers The Daily Mail
• Lung disease patients failed by system OnMedica

Getting flu jab is best way to protect everyone, says Public Health England

Getting flu jab is best way to protect everyone, says Public Health England Public Health England has stressed the importance of being vaccinated against flu, as NHS leaders are warned to brace themselves for a ‘pressurised’ flu season this winter. NHS Employers

See also:

• Weekly national flu reports Public Health England

Southern Health NHS Trust admits guilt over Connor Sparrowhawk's death

Southern Health NHS Trust admits guilt over Connor Sparrowhawk's death An NHS trust has admitted guilt over the death of a teenaged patient who drowned in the bath while in its care.

Southern Health Trust pleaded guilty at Banbury Magistrates' Court earlier to breaching health and safety law in the case of Connor Sparrowhawk, 18, who died at Slade House in Oxford in 2013.

His death led to the discovery the trust only properly investigated 272 unexplained deaths of 722 in its care.

Sentencing is due to take place on 12 October at Oxford Crown Court.

The trust was prosecuted by the Health and Safety Executive (HSE) under Section 3 of the Health and Safety at Work Act 1974 following its investigation into the death of a patient under its care. BBC News

Record numbers of joint replacements carried out

Record numbers of joint replacements carried out A record number of joint replacement procedures have been carried out, new figures show.

In its report, published today, the orthopaedic joint replacement register for England, Wales, Northern Ireland and the Isle of Man highlights a record number of procedures were carried out in the financial year 2016/17, with just fewer than 243,000 cases submitted to the National Joint Registry (NJR). This sees a significant increase of more than 20,000 joint replacement operations recorded in the registry on the previous period.

Today's National Joint Registry 14th Annual Report presents outcome data in relation to hip, knee, shoulder, elbow and ankle replacements. OnMedica

NHS spends £80m on private ambulances a year, data shows

NHS spends £80m on private ambulances a year, data shows Staff shortages and rising demand have forced NHS trusts to hire non-NHS ambulances, leading to fears of lower care standards

The NHS is spending almost £80m a year hiring private ambulances to answer 999 calls and take patients to hospital for appointments, new figures show.

Widespread shortages of paramedics and rising demand forced England’s 10 NHS ambulance trusts to spend £78.4m in 2016-17 on help from non-NHS providers to supplement their own services. That was down on the £79.7m trusts spent in 2015-16, but 22% more than their £64.2m outlay in 2014-15, according to data obtained by the Press Association under freedom of information laws. Continue reading... The Guardian

The NHS should see care homes as partners, not problems

The NHS should see care homes as partners, not problems Care homes provide the majority of long-term healthcare to older people but provision is uneven. Our study shows how services can work together better

Care homes provide the majority of long-term healthcare to older people. They rely on primary care for access to medical support and referral to specialist services, yet studies consistently show that healthcare provision for care home residents across England is unpredictable and uneven.

For the NHS, care homes are a conundrum; they provide care that used to be supplied by the health service, but are often perceived as a poor alternative that generates avoidable demand on hospitals. Continue reading... The Guardian

Sepsis: the truth about this hidden killer

Sepsis: the truth about this hidden killer Sepsis is responsible for more deaths in the UK than bowel, breast and prostate cancer combined. So why is so little known about it?

At the end of May, the World Health Organization adopted a new resolution mandating all of its member states to have national action plans in place to tackle sepsis, a disease being called the “deadliest killer you’ve never heard of”. Even conservative estimates place the annual death toll at 6 million worldwide, a health burden equivalent to that of tobacco. In the UK alone, sepsis is responsible for 44,000 deaths every year, more than bowel, breast and prostate cancer combined. Despite this, a recent survey found that 44% of people in the UK have never heard of sepsis and have little idea that it is a life-threatening emergency.

So, what exactly is sepsis and why does it continue to slip through the net of our collective consciousness? The new international definition of sepsis describes it as a condition that arises when the body’s response to infection causes organ dysfunction. “There’s a range of ways in which this can happen,” says Prof Anthony Gordon, chair in anaesthesia and critical care at Imperial College London, and an National Institute for Health Research professor investigating sepsis. “The body’s immune response can be simply overwhelmed by the infection, or there’s a dysfunctional response producing too much inflammation. The body may already be immunosuppressed due to a trauma or fighting an initial infection, so the immune response is too weak.” Continue reading... The Guardian

NHS chiefs read the riot act over poor A&E performance

NHS chiefs read the riot act over poor A&E performance NHS hospital chiefs have been hauled in by Jeremy Hunt over poor performance, in a desperate bid to head off an Accident & Emergency crisis.

It follows warnings that the NHS could be facing the worst flu season in its history, and orders to all NHS trusts to empty thousands of beds.

Ministers and health officials fear that one in three hospitals are struggling so badly that safety could be compromised as pressures mount.

Two chief executives have just been forced out, with around 60 more ordered to a mandatory all-day meeting yesterday, where they were warned to make urgent improvements. The Daily Telegraph

What does the public think about the NHS?

What does the public think about the NHS? This report, based on polling data carried out by Ipsos MORI, explores public attitudes towards the health service. It finds that despite the significant challenges it faces, the NHS still holds strong support amongst the majority of the general public with 66 per cent of respondents stating that they would be willing to pay more taxes in order to fund the NHS. The King's Fund

See also:

• Two-thirds support higher taxes to maintain NHS funding The Guardian

Getting into shape: delivering a workforce for integrated care

Getting into shape: delivering a workforce for integrated care The Government is rightly committed to a radical reshaping of NHS delivery, based on a shift to new care models and treatment in the community. Its management of the NHS workforce, however, has not delivered with nearly three times more doctors, and four times more nurses in the acute sector than in the community. Since 2009, the number of consultants has risen by nearly a third, whilst the number of GPs has fallen. Freedom of Information requests made for this report found that, across 61 acute trusts, only 6 per cent of consultants work in the community for at least one session per week.

As the Government and the NHS leadership have repeatedly said, the priority for the NHS is to increase its speed of innovation. To do this, the NHS is rightly seeking to devolve decision-making and to deregulate. For the workforce, however, policy remains highly centralised and tightly regulated. This paper shows how to bring the same reform ideas to the workforce as the NHS is applying to other areas. Reform

See also:

• Local NHS bosses should take control of staffing The Guardian

Guidance: Health matters: preventing drug misuse deaths

Guidance: Health matters: preventing drug misuse deaths This updated professional resource outlines how providers and commissioners can prevent deaths from drug abuse. Public Health England

Have you got the wrong impression about schizophrenia?

Have you got the wrong impression about schizophrenia? Schizophrenia does not mean you have a split personality or automatically become violent, a mental health charity has warned.

Rethink Mental Illness said a survey of 1,500 people showed that the condition is widely misunderstood.

Schizophrenia commonly causes hallucinations, such as hearing voices, or delusions and can make people lose interest in life.

But it should not be "a dirty word or a term of abuse", the charity said.

The organisation warned such myths are dangerous.

One in 100 people has schizophrenia, but 45% of those surveyed thought the illness was much more common. BBC News

See also:

• Rethink Schizophrenia: Challenging attitudes and changing lives Rethink Mental Illness

'Golden goodbyes' for NHS managers now costing £39 million as redundancies soar

'Golden goodbyes' for NHS managers now costing £39 million as redundancies soar Spending on so-called “golden goodbyes” and voluntary redundancy deals has shot up to £39 million a year at the Department of Health (DoH) - an eightfold increase on the previous year - official figures reveal.

A written parliamentary answer shows that more than 500 staff who left the DoH in 2016-17 because of restructuring and cost-cutting programmes received exit packages. In 2015-16, only nine people who were laid off from the department were given such settlements.

The figure of £39 million covers the whole of the department and its agencies and compares with a spend of £5 million for the previous year. The Independent

Unions call for 3.9% pay rise plus £800 for a million NHS staff

Unions call for 3.9% pay rise plus £800 for a million NHS staff Demand is based on inflation and seven years’ back pay, after lifting of prison and police officers’ pay cap

Unions have ramped up the pressure on Theresa May over public sector pay by demanding a 3.9% rise for 1 million NHS staff plus an extra £800 to make up for lost earning power during austerity.

Health service personnel from nurses and midwives to paramedics and therapists across the UK are urging Philip Hammond to ensure they receive a salary boost that would add an extra £3bn to the NHS pay bill. Continue reading... The Guardian

‘I was the first baby delivered by the NHS. It has saved my life eight times’

‘I was the first baby delivered by the NHS. It has saved my life eight times’ Aneira Thomas was named by her mother after the architect of the health service

It was coming up to midnight on Sunday 4 July 1948 and my mother, who had been in labour for 18 hours, was just about ready to give birth to me. She wanted to start pushing. But the doctors and midwives looked up at the clock on the wall and said, “Stop. Hold on, Edna, hold on.” They knew they were moments away from the start of the National Health Service and wanted me to be the first baby born into this new service. So my mother took a deep breath and held on. That’s how I was born at one minute past midnight on Monday 5 July 1948 – the first NHS baby.

That was in a cottage hospital in a little corner of west Wales called Glanamman. It was the staff there who told my mother, “You must call her Aneira,” the female form of Aneurin, after Aneurin Bevan, the architect of the NHS. They knew it was significant that Bevan’s dream of a health service that was free for everyone to use had come to fruition that day.

I never knew any of my grandparents because they died between the ages of 30 and 50. My mother lived until she was 95 Continue reading... The Guardian

‘Cut-price’ medics lured to the NHS from the US with promises of long holidays touring Europe

‘Cut-price’ medics lured to the NHS from the US with promises of long holidays touring Europe ‘Cut-price’ medics are being lured to the UK from the United States with promises of long holidays touring Europe, in a bid to plug widespread staffing shortages.

The NHS is attempting to train or recruit up to 3,200 “physician associates” who can carry out minor operations and carry out ward rounds, after just two years' training.

Medical leaders have issued new guidance in order to expand the programme, amid shortages of medics.

The new role is not supposed to substitute for a doctor, though the associates can carry out some of the tasks they normally do. The Daily Telegraph

Two junior doctors left to care for 436 patients amid dangerous staff shortages, NHS report warns

Two junior doctors left to care for 436 patients amid dangerous staff shortages, NHS report warns Just two junior doctors have been left to look after 436 patients amid a staffing crisis in the NHS, a report warns.

Medics said patients had been left at risk during a “very unsafe shift” at Derriford Hospital in Plymouth.

A safety report given to the trust’s board says one of the two doctors was pulled away from a day shift in breast surgery because otherwise there would have been just one medic left to cover the night shift.

Doctors said they were left angry that patients were let down, while one said they were left feeling ill with no breaks, and just “a couple of biscuits from the patient trolley” during a whole weekend. The Daily Telegraph

NICE diabetes guidance backs GP referral to lifestyle programmes

NICE diabetes guidance backs GP referral to lifestyle programmes NICE has updated its 2012 guidance on preventing type 2 diabetes to put greater importance on lifestyle-change programmes to promote healthier diets and exercise in high-risk patients. GP Online

See also:

• Diabetes test for everyone over 40 revealed by officials Mail Online
• More than a million people should be offered lifestyle tips as a way to avoid type 2 diabetes NICE

Childhood vaccines may go into one jab

Childhood vaccines may go into one jab A technology that could eventually see every childhood vaccine delivered in a single injection has been developed by US researchers.

Their one-shot solution stores the vaccine in microscopic capsules that release the initial dose and then boosters at specific times.

The approach has been shown to work in mouse studies, described in the journal Science. BBC News - Health

See also:

• 'Super injection' delivers several doses of drug at once The Daily Mail