News in brief
‘Sunshine rule’ to force NHS staff to disclose gifts and hospitality from drug and equipment suppliers: Doctors and other NHS staff will have to declare any gifts, payments or hospitality received from pharmaceutical companies and medical device manufacturers, the Department of Health has announced. The new measure, called the ‘sunshine rule’, is aimed at increasing transparency in the NHS and means that keeping a record of gifts and hospitality will be mandatory from next year, reported Supply Management. Staff that fail to disclose such information will face sanctions and disciplinary action. Health secretary, Jeremy Hunt said there was “disturbing” evidence that a small number of NHS staff had tried to influence purchasing decisions in return for gifts, payments or hospitality. “Part of the problem is just how many sales reps are targeting our hospitals, with 65 reps on site at any one time according to a recent report. The NHS is indirectly paying for every one of those reps, through staff time and the amount paid for drugs and products,” Hunt said. “As with so many issues in the NHS, the answer is greater transparency. These tough new rules will for the first time expose improper relationships between staff and pharmaceutical companies. Only those serving their own self-interest should have anything to fear, with patients and taxpayers set to benefit.”
Complaints about cancelled NHS appointments soar in one year: Complaints about cancelled and delayed NHS appointments have shot up by one fifth in a year, new figures show. Official data shows the number of patients raising concerns about outpatient appointments has risen from 9,040 in 2013/14 to 10,800 in 2014/15. There was a similar rise in complaints about ambulance services, the new figures from the Health and Social Care Information Centre (HSCIC) show. Experts said the figure could reflect the fact a number of ambulance services took over the running of the 111 “non-emergency” line, reported The Telegraph. In total, 8,039 patients raised concerns with ambulance trusts, compared with 6,873 the previous year, an increase of 17% in one year, the statistics show. Overall, there were 205,000 written complaints about NHS services in England in 2014/15 – 562 per day. The figures include 121,000 complaints about hospital services, up 5.7% on the 114,000 in 2013/14. The patient watchdog, Healthwatch England, said the number of people who wish to complain is estimated to be nearer one million. It is calling for a reform of the complaints system, including making it easier to complain and better complaints handling. HSCIC said changes in the way data about GP and dental services is recorded meant total numbers of complaints could not be compared, year on year.
Investment into clinical research and development in Welsh hospitals announced: A £5.7m investment into clinical research and development in Wales has been announced by deputy health minister Vaughan Gething. The funding will be used to support three clinical trial units in Bangor, Cardiff and Swansea Universities over three years, reported Wales Online. Funding will be split between two units based in Bangor University. The North Wales Organisation for Randomised Trials in Health will be receiving £1.1m and The Welsh Health Economics Support Service will receive £1.2m. The South East Wales Trials Unit, which is based in Cardiff University will receive £2.6m. Swansea Trials Unit, based at Swansea University will receive £800,000. The funding will support the trials units in their bids to attract more investment for large-scale trials and to support the growth of the units. Gething said: “Our vision is for Wales to be internationally recognised for its excellent health and social care research, research that benefits the health, wellbeing and prosperity of the people of Wales. This will build on our excellent reputation as a place for well designed clinical trials and studies. This investment is aimed at getting the maximum benefit in terms of research from trials and studies in Wales.”
NHS Supply Chain makes Carter savings pledge in new deal: NHS Supply Chain has pledged that it will use the ‘opportunities’ for greater savings highlighted in the Carter review as part of a deal that will see its contract extended until 2018, reported Health Service Journal (subscription required). It will look to make £150m worth of cash releasing savings by 2018, on top of the £150m already promised by March next year. NHS Supply Chain, set up in 2006, is a joint venture between NHS Business Services Authority and logistics firm DHL. The financial value of the contract extension has not been revealed. Lord Carter’s interim report into NHS provider productivity, published in June, included recommendations the Labour peer said could save the service up to £5bn a year by 2019-20. In a statement, the authority said: “As part of the extension, the NHS Business Service Authority and NHS Supply Chain will work closely together to deliver on the opportunities for savings and efficiencies highlighted in Lord Carter’s report.” An authority spokesman said that the £300m cash releasing savings target will form part of savings that Lord Carter wants to achieve from the procurement of consumable medical products including syringes, hip joints and cardiology devices.
CACI to help manage CQC inspection planning: IT and data consultancy CACI has picked up a £1.16m contract from the Care Quality Commission (CQC), the regulator of health and adult social care in England, to provide a national resource planning solution until 2017, reported Government Computing. The deal, awarded after a procurement competition, will see CACI assist the CQC in managing almost 20,000 yearly inspections. As part of the contract, CACI will provide the CQC with a national resource planning solution to assist in its entire remit of inspections through its business management software, Cygnum. This will schedule CQC inspections and give inspectors access to essential information in the field, as well as capturing the information to support financial and resource planning and the reporting tool will allow inspectors to manage information in real time. Mark Cullen, head of business development at CACI said: “Inspection services is a growing market in the UK and a business priority for CACI. This contract is an important milestone for us as the CQC provides some of the most important inspection services in all of England, ensuring that health and care services in this country are held to the highest standard.”
Utilise E-health to reduce burden of heart disease, cardiology experts say: A paper published this week by the European Society of Cardiology (ESC), has shown that E-health is “vital” to winning the battle against heart disease, particularly apps, reported The Commissioning Review. Examples are mobile applications (Apps) for monitoring physiological signs such as blood pressure, telemedicine for remote monitoring of patients with heart failure, electronic medical records, e-prescribing, e-referrals, decision support systems for physicians, and disease registries. Experts from the European Society of Cardiology (ESC) said that E-health will become a core part of the ESC’s research activities, in a paper published in European Heart Journal. Lead author Professor Martin R. Cowie, professor of cardiology at Imperial College London explained: “The ESC sees E-health as vital to achieving its mission of reducing the burden of cardiovascular disease in Europe and will take a proactive role in developing, assessing and implementing ICT innovations to support cardiovascular health.” By 2017 more than 3 billion people worldwide will own a smartphone and half will use health Apps, their research suggests.
GPs offered £150k to provide online consultations from home: A private health insurer is claiming GPs can earn up to £150,000 per year working from home on its online consultation service. Vitality – formerly PruHealth – is looking for 10 UK-based GPs to staff the online GP service offered to all of its health insurance customers. The GPs would have to undertake 20 hours of training, within a fortnight, after which the health insurer is promising pay of £60 per hour. GPs will provide 15-minute GP consultations via webcam and authorise electronic private prescriptions. The advert – which has been placed in Pulse and featured in Roy Lilley’s NHS Manager’s blog – said the UK-based company is aiming to expand its recruitment of GPs “as quickly as possible as it is proving to be an extremely successful service”, adding that interested GPs “could potentially earn up to £150k per year just for working from home”. The news comes as Pulse reported last month on a new online service offering patients 10-minute online GP consultations via video link for £25 per session. The new service – called Push Doctor – has a network of more than 7,000 GPs who are available from 6am to 10pm for appointments, and works through an app that patients can download.
North Middlesex extends use of VNA to drive data transformation programme: North Middlesex University Hospital NHS Trust plans to extend its use of Bridgehead Software’s vendor neutral archive (VNA) and will use it alongside its electronic document management system (EDMS) to build an enterprise wide repository and meet its obligations under the government’s ambitions towards a paperless NHS, reported Government Computing. The hospital’s Local Service Provider contract for PACS was due to end in June this year, prompting a procurement exercise which first began in 2012 for a new PACS radiology information system (RIS) and an independent VNA. The exercise concluded with a contract awarded to Bridgehead in September 2014. North Middlesex has since gone further, deciding to expand the use of the VNA to act as the repository for the EDMS project which is intended to scan all patient notes and provide for electronic access for clinicians. The hospital intends to interface its own internally developed clinical portal into the VNA to provide both mobile and fixed access to patient notes at the point of need. Musadiq Subar, the hospital’s IT programme manager and clinical technical architect said: “For us, it makes absolute sense to use our VNA alongside our EDMS. I have no doubts about the suitability or robustness of the system.”
Scotland eradicating paper letters and postal results between hospitals and GPs: The NHS in Scotland is saving millions of pounds after the widespread implementation of a new system between hospitals and GP surgeries. The nationwide deployment of Electronic Document Transfer (EDT) is removing the need for millions of paper documents that have traditionally been sent via post from hospitals to GP surgeries, reported Building Better Healthcare. NHS Scotland first signed up to the national deployment of the Docman Hub in 2011 so that all Scottish hospitals could send documents including outpatient letters and results digitally to GPs. IT support organisation Microtech has now completed the rollout across every mainland health board in the country, meaning significant savings on printing and postal costs, as well as far more secure and timely delivery of vital information for healthcare professionals and their patients. Dr Beena Raschkes, GP and joint clinical IT lead at NHS Tayside, said: “EDT is transformational. It has completely changed communication between primary and secondary care and taken clinical care truly into the 21st century. Patient discharge information arrives into our GP surgery soon after the patient leaves the hospital and is legible, clear and informative. In fact, using EDT means we can receive hospital correspondence electronically 48 hours earlier than paper.”
Royal Orthopaedic first to pick PICS: The Royal Orthopaedic Hospital NHS Foundation Trust has become the first customer for the PICS clinical decision support system developed by University Hospitals Birmingham NHS Foundation Trust, distributed by Servelec Group. In a statement to DigitalHealth.net, Tony Eardley, the trust’s chief information officer, said six different suppliers had been considered before the decision was made. “The PICS solution will form the cornerstone of a future electronic patient record (EPR) for the hospital, and the choice of other solutions to contribute to the EPR will be determined by how well they work with PICS. Roll-out will be phased, and is likely to start in the third quarter of 2016.” University Hospitals Birmingham developed the ‘prescribing information and communications system’ as an e-prescribing system, but has gone on to incorporate numerous patient management and clinical decision support tools. The hospital announced in 2010 that it would work with CSE Healthcare, which is now part of Servelec Group, to develop the system so that other healthcare providers could buy it, and to supply integration and support services.
Medical applications lead the way in 3D printing, says Gartner: According to a report carried out by the information technology research and advisory firm Gartner, 3D printing in the medical field is progressing rapidly, and has already become the norm in certain areas such as the production of hearing aids, reported Integrated Care Today. Pete Basiliere, Gartner research director, said: “In the healthcare industry, 3D printing (3DP) is already in mainstream use to produce medical items that need to be tailored to individuals, such as hearing aids and dental devices. Pointing out that the majority of major hearing aid manufacturers now provide devices that are personalised according to a customer’s ear shape, this is evidence that using 3DP for mass customisation of consumer goods is now viable, especially given that the transition from traditional manufacturing in this market took less than two years. Routine use of 3DP for dental implants is also not far from this level of market maturity.” Gartner has predicted that, within the next two to five years, 3D printing will be in mainstream use in the hip and knee replacement industry. The report also looks at bioprinting, which is reportedly at least five to ten years from mainstream use.
Emis helps send emergency patients home: An urgent care centre at the Royal Free Hospital’s A&E department is using Emis Web to conduct rapid assessments of patients, enabling it to discharge or divert 26,000 a year, reported DigitalHealth.net. Half of the 70,000 patients who present annually at the Royal Free London NHS Foundation Trust between 10am and 10pm are now rapidly assessed using information from the GP record held in Emis Web. The trust is able to discharge half of these patients at the front door with basic health advice. The remainder are directed to their own doctor, or to the GP-staffed urgent care centre for further investigation and treatment. Only 10% of assessed patients are sent on to the main emergency department. The urgent care centre is run by Haverstock Healthcare, a federation of 37 GP practices in Camden. Medical director Dr Mike Smith explained that all of the GP practices in Camden use Emis Web and it is also deployed in the A&E. “This means that when patients arrive at the door, we are able check their medical history with their consent, and make fully informed clinical decisions,” he said. “Without their notes, there is a risk of starting patients on a care journey that is not needed. For example, we are ordering fewer x-rays and blood tests than our emergency colleagues at other hospitals. Emis Web helps make our job less time-consuming and arduous, and enables us to work more effectively.”
3D tumour model will shed light on cancer: Scottish scientists have developed a 3D simulation of a cancer tumour, which has shed light on how experts could help to slow progress of the disease. The computer model, built using a series of mathematical algorithms, demonstrated how even the tiniest movement of cells could rapidly transform the make-up of an entire tumour, reported The Scotsman. Researchers from Edinburgh University studied how tumours start with one rogue cell, which multiplies to become a malignant mass containing many billions of cells. The digital model revealed that the movement and turn-over of cells in a tumour allows those cells that are the most well suited to the environment to flourish. Any one of these can take over an existing tumour, replacing the original mass with new cells quickly – often within several months. Lead author Dr Bartlomiej Waclaw, from Edinburgh University’s school of physics and astronomy, said: “Computer modelling of cancer enables us to gain valuable insight into how this complex disease develops over time and in three dimensions.”
NHS patients in Wales ‘waiting much longer’ for treatment: The Welsh political party Plaid Cymru, say that the number of patients waiting longer than 36 weeks to begin treatment on the NHS has more than tripled, from 7,434 in September 2011 to 25,373 in June of this year, reports ITV News. The party’s research also indicates that the number of patients waiting at least 26 weeks has jumped from 8.5% of all patients to 15.2%. Elin Jones, Plaid Cymru shadow health secretary said: “No one should have to wait six or even nine months for treatment. These figures highlight that overall performance in the NHS is getting worse despite increases in the health budget. And the facts are that patients in Wales are waiting longer for treatment than in Scotland and England. The Welsh Government needs to up its game.” But the Welsh Government maintains that the NHS in Wales continues to work hard to ensure patients receive treatment promptly. A Welsh Government spokesperson said: “The majority of patients continue to wait less than 26 weeks, and half of patients in Wales wait less than 10 weeks. At the end of June 2015, more than eight out of 10 people were waiting less than 26 weeks and more than nine out of 10 were waiting less than 36 weeks.”
Awards
Healthcare IT champion of the year: The voting is now open to find this year’s eHealth Insider Healthcare IT Champion of the Year. Click here to view the shortlisted candidates. Voting closes on Friday 11 September at 4pm. Good luck to all shortlisted individuals. The winner will be announced at the EHI Awards ceremony on Thursday 1 October 2015.
Opinion
What impact do accountable care organisations have on care quality?
Rachel Addicott, senior research fellow, writes about how the UK and US have a common purpose in their health systems: to improve the quality of care and to control its cost.
“Both systems use similar approaches to achieve this – namely, new care models that bring providers together, offer more co-ordinated and patient-centred care, and incentivise outcomes rather than activity.”
“The US system is largely reliant on two organisational approaches to meet these challenges – primary care medical homes (PCMHs), which emphasise care co-ordination, and accountable care organisations (ACOs), groups of providers that take collective responsibility for the quality and cost of population health. Both models prioritise the central role of primary care. The Commonwealth Fund and the Kaiser Family Foundation recently published the results of a survey of providers’ views on these models.
“Although these survey results present only a partial story of the evolution and performance of integrated organisational models in the US, we can draw out some lessons for the NHS.
“Impact takes time. New structures or contracts will not fast-track these relationships. Information is key. If providers are expected to work more closely together and bear increasing financial and clinical risk, it is essential that they have ready access to the information they need to understand and manage that risk. Loosen the reins. Giving professionals more clinical and financial control might have a greater impact on the quality of care than rewarding or penalising performance.
“Although the ambitions of the care models in the US may resonate with our intentions here, we would be wise to learn from the early experiences of those who went before us.”
Don’t judge vanguards on what they weren’t designed to do
If the success of the vanguard sites is measured against their contribution to the NHS’s current financial issues they will fail. The transformation fund needs an ‘efficiency strand’, argues Adam Roberts, senior economics fellow at the Health Foundation.
“Following the publication of the NHS Five Year Forward View last year, 37 NHS sites have been selected to become vanguards. They are charged with testing new models of care to improve the way that services are provided by the NHS in England.
“With some different approaches, the new models all focus on providing more care out of hospital, through improved services from your GPs and in the community. This will allow the NHS to identify the best approaches to meet the needs for the population in the most cost effective way. Because we don’t yet know what these best models are, NHS England is not attempting a full roll-out of an untested idea.
“Instead, vanguard sites are being run as a series of trials, covering just over a tenth of the English population. Those trials that aren’t making progress will be stopped, while models that genuinely improve the quality of care can be rolled out across the whole NHS, improving the service provided to everyone.
“The current issues highlight why the success of the vanguards is so crucial for the future. But they will not achieve results at the speed and scale that is required to close the financial gap this year, or even in five years’ time. Even in the most optimistic scenario in the forward view, they don’t provide any benefits until 2018-19.
“It’s crucial that we don’t allow the vanguards to fail because they don’t achieve something they aren’t designed to do.”
How mobile apps can help young people with mental ill health
Jamie Prangnell, managing director of Appadoodle, shares his story of working with a mental health trust in developing a series of ‘game-style’ apps that aim to help improve young people’s chances of recovery.
“Mental ill health is a huge issue for young people. It is estimated that one in five young people have a mental health problem in any given year.
“Technology is playing a crucial part in the diagnosis and treatment of mental health conditions, especially for the young.
“The apps Appadoodle has developed are all part of early awareness and engagement for young people that aim to help prevent problems from getting worse, and support ongoing interventions that are being deployed in mental health services.
“The potential for the Silver Linings app is outlined by Dr Erin Turner, consultant psychiatrist from the early intervention service at BSMHFT: “From a patient perspective the app will help them to understand and manage their illness, and empower them on their road to recovery.
“From a clinical perspective, it helps us to know that patients are involved in managing their own recovery, and can give us longitudinal information that helps us to tailor our treatment plans.”
“The success of health apps in the mental health field will require young people to engage with them and use them.”
Blog
In this week’s blog Natalie Challen, explains why direct mailers are still highly relevant and have a place in a modern marketing strategy.
