News in brief
New study adds to debate over seven-day NHS: A new study, published in the British Medical Journal, has shown the correlation between increased mortality and weekend hospital admissions, raising more questions about the case for a seven-day NHS, reported Integrated Care Today. The study, carried out by leading doctors and statisticians – including Sir Bruce Keogh, NHS England’s medical director – has indicated that people who are admitted to hospital at the weekend are more at risk of death than those admitted during the rest of the week. It explains that those admitted during the weekend tend to be sicker, and acknowledges there are fewer support services available. Using hospital records during 2013-14, the latest study shows patients admitted on a Saturday and Sunday face an increased likelihood of death, even when severity of illness is accounted for. Furthermore, the research shows an “additional risk of death” for admission on Monday and Friday, therefore expanding the so-called “weekend effect” to these two days. About 11,000 more patients die each year within 30 days from admission between Friday and Monday, in contrast to admission on other days of the week, according to the study. Sir Bruce Keogh has said that case for improving hospital weekend care in England is now “unassailable”. He said: “Doctors up and down the country routinely go the extra mile, well beyond any contractual duty, to save and improve lives. But the idea that patients are being harmed because of the way we organise our services is quite simply beyond what any of us can regard as acceptable.”
Consultants agree to contract talks over weekend working
The doctors’ union, the British Medical Association (BMA), has agreed to begin negotiations about changing consultants’ contracts, BBC News reported. The government wants more senior doctors to work on weekends as part of its seven-day NHS plans in England. The BMA said it was prepared to negotiate ending the right to opt out of weekend work, but said there was still much to discuss. In July, Health Secretary Jeremy Hunt said if the BMA did not agree by mid-September to enter serious negotiations over contracts – including the end of opting out of weekend work – he would impose changes to contracts for newly-appointed consultants. Mr Hunt acknowledged there may be “upfront costs” of hundreds of millions of pounds, but there may also be similar levels of savings because of improvements to the process of discharging people from hospital. A Department of Health spokesperson said it was “a positive step” and it was hoped an agreement could be reached quickly.
The NHS has ‘too many trusts’, says Hunt: Jeremy Hunt has said there are ‘too many trusts’ in the NHS and the health service needs to ‘up the pace’ of work on hospital chains and other provider reforms, reported Health Service Journal (HSJ, subscription required). The health secretary’s comment comes amid renewed interest in hospital chains in Whitehall and Westminster, and as NHS England is selecting sites for its “acute care collaboration vanguard”. Asked if he agreed with Salford Royal Foundation Trust chief executive Sir David Dalton that having around 240 NHS providers was no longer a “sensible and affordable” way of delivering reliable care, Mr Hunt told HSJ: “I think we do have too many trusts as independent organisations, but I don’t think the way to solve this is by me as secretary of state coming up with a blueprint, and trying to roll it out across the NHS. We’ve already seen some mergers of community trusts and mental health trusts. I’m sure there will be more mergers, more chains that develop, and I think we need to allow people the space locally to work out what the right solution is.”
Care.data on hold again: The controversial patient data collection programme care.data has been put on hold again while a review of the opt-out model is completed reported DigitalHealth.net. Four care.data pathfinders were due to start testing various elements related to the programme, starting this month with Somerset clinical commissioning group (CCG). However, NHS England has written to the pathfinders to let them know the pilot testing cannot go ahead until Dame Fiona Caldicott has provided advice on the wording of the opt-out. This work is due to be completed by next January. Somerset CCG said in a statement that NHS England wrote to all the pathfinders following the health secretary’s speech at NHS Expo last week, asking them to temporarily pause their programmes. A Somerset CCG spokesperson said: “The purpose of the care.data pathfinder pilot has always been to help NHS England with the testing and evaluation of patient literature and the process by which coded patient data might eventually be extracted from their GP medical records.”
NHS CSU to provide data management services for 24 CCGs: NHS Arden & Greater East Midlands Commissioning Support Unit (CSU) has won a large contract to provide a range of data management services for 24 clinical commissioning groups (CCGs) in the north-west of England. The deal, which is worth nearly £2m a year, is the first of its kind and means the CSU will be directly supporting a regional health and social care partnership board, reported Computer Weekly. The CSU will handle the area’s data management services, including operating the Data Services for Commissioners programme, which was established by NHS England to ensure local commissioning decisions are based on robust, standardised data. As part of the programme, 10 regional offices have been set up around the UK to provide data services, secure infrastructure and analytical expertise required for data processing and management, including handling confidential patient data. The CSU will operate the north-west office and is the first to directly support the devolution arrangement. The managing director of NHS Arden & Greater East Midlands CSU, John Parkes, said the unit has “extensive experience of providing data management and analytics across different regions and diverse populations”.
Encrypted medical record databases can leak information, warns Microsoft: Microsoft researchers have warned that databases holding electronic medical records could potentially leak information, reported Integrated Care Today. The research shows how electronic medical information from many types of databases could be attacked using real patient records from 200 US hospitals. Researchers focused on encrypted relational databases based on the design of CryptDB, which allows SQL queries to be performed on scrambled data. Databases of this design often use property-preserving encryption (PPE) schemes to allow searching, which have been long known to leak non-trivial information. “When the encrypted database is operating in a steady-state where enough encryption layers have been peeled to permit the application to run its queries, our experimental results show that an alarming amount of sensitive information can be recovered,” the researchers wrote.
Scotland trials radical changes to general practice: GP practices in Scotland will work together to offer faster appointments, and GPs will take on expanded roles and forge closer links with community services under a massive overhaul of the way primary care delivers services being trialled in Scotland, OnMedica reported. Over the next two years, ten health centres across Scotland will form ‘community care teams’ and test different ways of delivering healthcare including local surgeries working together for faster appointments. GPs and health professionals, such as physiotherapists, will work together in multidisciplinary teams so that patients see the right professional quickly, and local centres will provide treatments which patients currently have to travel to hospital to receive – including short stay in-patient beds for assessment and treatment. First Minister Nicola Sturgeon said: “Nobody wants to go into hospital if they don’t have to and with these new plans, people will see a better service and be able to be treated in the local community.” The ten trial sites will be in Glasgow, Edinburgh, Fife, Tayside, Forth Valley, Campbeltown, West Lochaber, Islay, Mid-Argyll and Clackmannanshire.
Shelford Group chief takes on new role with tech firm: The departing chief executive of Oxford University Hospitals Trust, Sir Jonathan Michael, is to move to IT software firm 6PM, as chief medical officer, reported Health Service Journal (HSJ, subscription required). Sir Jonathan has been chief executive at Oxford University Hospitals since 2010. 6PM supplies software to more than 150 NHS trusts and its products include electronic patient record systems for HIV medicine, stroke patients and people with dementia. Sir Jonathan will be responsible for ensuring 6PM’s software can support the ambitions set out in the Five Year Forward View. Prior to this appointment he served as chief executive at Guy’s and St Thomas Hospitals Trust, and as the managing director of BT Health and before becoming involved in management he worked as a consultant nephrologist. Sir Jonathan said: “The future challenge is going to be to redesign the way we deliver healthcare so that it’s more focused on being responsive to what patients need. That means we need to be able to share information, not only within the health and social care system, but with patients.” He praised 6PM’s ability to respond to the system’s changing needs, calling it an “innovative, growing, yet flexible organisation”.
NHS warns nurse immigration rules ‘harm patient safety’
Leading NHS figures have warned that “stringent” immigration rules are preventing them from getting enough nurses on wards in time for winter, reported BBC News. The heads of 10 leading trusts, along with the NHS Employers organisation, have written to the home secretary to say patients are being put at risk. NHS Employers believes that 1,000 certificates of sponsorship, allowing nurses from outside Europe to work here, will be needed in the next six months and it says “large numbers” of applications have already been rejected. Chief executive, Danny Mortimer, told BBC News: “These are nurses who’ve been recruited and could start work in the NHS shortly – but we can’t get them into the country. Their absence will be keenly felt. We are asking Theresa May to relieve the pressure on already stretched services as we head into the winter months.” Mr Mortimer said: “The public might, like us, be surprised to learn that the list of occupations with shortages includes computer games designers and even ballet dancers – but not nurses.” The Migration Advisory Committee is reviewing this aspect of the immigration system but is not due to report until the end of the year. The NHS leaders argue action is needed before then – because extra UK nurses who are in training now will not be available until 2017 at the earliest.
GPs to send patients to France for surgery: GPs in one area of England will be asking patients whether they would prefer to have surgery in France, revealed Pulse. The situation has arisen after NHS South Kent Coast clinical commissioning group (CCG) invited providers to apply to be contracted with the CCG for elective surgery under the Any Qualified Provider (AQP) scheme. Two hospitals in Calais, Foundation Hospedale and Calais Hospital, have applied to be on the list of approved providers of treatments including general surgery, gynaecology, cataract surgery, pain management and orthopaedics, the CCG said. Accountable officer Hazel Carpenter said: “It will then be possible for patients who need this treatment to choose to have it in France if they wish, after discussion with their GPs. The NHS will pay for their medical treatment but patients will pay their own travel and other incidental costs.” A CCG spokesperson said plenty of NHS patients are already making “similar choices” as this was “no different” to choosing for example a London hospital for treatment, with the “cost and distances easily comparable”.
CCG roadmap target a ‘tall order’: It is a “very tall order” to expect clinical commissioning groups (CCG’s) to deliver digital roadmaps for their local health economy by April 2016, a GP leader has told DigitalHealth.net. Chairman of the British Medical Association’s GP committee Dr Chaand Nagpaul explained that many CCGs are already struggling with the advent of co-commissioning. With winter pressures coming up as well, to ask them to put in place plans for full digitisation of their health economies by April next year “is an extremely ambitious time frame.” He added: “We are finding that CCGs are having an escalating level of responsibility passed on to them without the commensurate increase in organisational capacity.” By November, CCGs and healthcare organisations will need to report back on where they are now in terms of their digital capabilities, which will feed into a new digital maturity index, to be completed in January 2016. William Lumb, NHS Cumbria CCG chief clinical commissioning officer, believes the April deadline is achievable, but urges CCGs to work together to share knowledge about what is technically possible. “It’s not going to be easy; CCGs are going to have to work together and share.”
Date set for MPs to debate ‘no confidence’ in Hunt: The House of Commons Petitions Committee has set a date to debate a vote of no confidence in health secretary Jeremy Hunt after an online petition received more than double the needed signatures, reported National Health Executive. The Committee has scheduled a debate on Monday (14 September) at 4.30pm to discuss the petition, which called for Hunt to be sacked as health secretary after he “alienated the entire workforce of the NHS by threatening to impose a harsh contract and conditions on first consultants and soon the rest of the NHS staff”. The petition garnered almost 220,000 signatures, above the 100,000 threshold needed to trigger a debate in Parliament. It reflects widespread outrage sparked after Hunt launched what doctors see as an attack on their profession, by issuing a contract ultimatum over seven-day working in July. In response to it, the government said it “feels it is under an obligation to the public to do all it can to make NHS care at the weekend as safe as during the week through the delivery of seven day services”. The debate will be led by Labour MP Helen Jones and broadcast live from Westminster Hall.
Norman Lamb to chair mental health commission: Norman Lamb will chair a commission looking at the links between poor mental health, public services and the economy, set up by local authorities in the West Midlands, reported Health Service Journal (HSJ, subscription required). The West Midlands Commission on Mental Health panel will include NHS England national clinical director for mental health Geraldine Strathdee and Public Health England director of health and wellbeing Kevin Fenton, as well as the Liberal Democrat former care minister. It has been created by the West Midlands Combined Authority, a body for regional cooperation between councils. The area’s clinical commissioning groups are also supporting the work. HSJ understands it will look at the West Midlands specifically but those involved hope it will produce proposals that can be applied more widely. Lamb said: “This is a really interesting and exciting opportunity to make a difference for those with mental ill health. It’s brilliant that local authorities in the West Midlands have taken this initiative.”
Awards
For the second year running, Highland Marketing is sponsoring the EHI Awards social media category, which will recognise the winner for its “best use of social media to deliver a health campaign”. Good luck to all the finalists, we look forward to presenting the winner with their award.
Opinion
Doctors really do want seven day working
Eddie Saville, general secretary of the Hospital Consultants and Specialists Association, writes: “The key to a successful outcome to current discussions over seven day services will hinge on the needs of patients, the NHS and consultants. Safety, fairness and work-life balance are a must.
“Hospital doctors have lately been reduced to frustrated bystanders as the public debate on seven day working and fundamental changes to contracts has raged.
“On 16 July, when the Review Body on Doctors’ and Dentists’ Remuneration released its observations on these issues, our profession felt the full force of the media juggernaut, with combative news anchors demanding to know why consultants appeared to be putting up resistance to such a well intentioned goal.
“Within the last 12 months Hospital Consultants and Specialists Association (HCSA) members chose to take action short of a strike in support of our lower paid colleagues in other unions. Far from guided by self-interest, hospital doctors are part of the family of the NHS – as concerned about the health of the whole medical system as they are about the patients they treat on a daily basis.
“The key to a successful outcome to current discussions will be one that balances the needs of patients, the NHS and consultants. This means that it must adhere to three basic principles – safety, fairness and work-life balance. Ultimately, neglect in any of these three areas will mean that patients, and the reputation of our world class NHS, will also suffer.
“HCSA is proud to state that it is in favour of safe seven day services – safe for patients, safe for doctors and ensuring the NHS’s future is safe too.”
The burning technological platform for person-centred care
The rising demands of an ageing population are putting increasing pressure on care providers, but the technology that can help alleviate some of those pressures is analogue in a digital world, says Communicare247 CEO, Tom Morton.
“Integrated, person-centred care is seen as a driving force for building public services around individual needs. It aims to bring care out of the hospital and into the community and home to cope with the growing burden of 3 million people who will have over three long-term conditions by 2018. It will also help acute hospitals to address the ever increasing costs associated with our ageing population.
“Meanwhile, life in our homes and communities is becoming fragmented. One in four (2.9 million) people aged 65 and over feel they have no one to go to for help and support, according to a 2015 report from Age UK and The Campaign to End Loneliness.
“With research indicating that social isolation leads to higher mortality, what point is there keeping people out of hospital, if only they are left home alone, and without the necessary support? Person-centred care will have minimal success if we do not recognise this fact; people need someone to look out for them. Current approaches are not building the foundations that society needs to help grasp the nettle of providing round-the-clock personal care.
“Care packages are built around the ability to deliver those packages, rather than what care that person needs. Without data on who needs what and when, care providers deliver homogenised packages of support that are manageable in the short term, but unaffordable and undesirable on the whole.
“UK adoption of digital telecare is mixed. In England and Wales, for example, the government has left it to localities and regions to develop their own solutions for telehealth and telecare. Multiple initiatives begin but never seem to get past the pilot stage, as can be seen with the 3million lives telehealthcare campaign.
“Ultimately there has to be a scalable alternative to pull information together for a specific purpose, focussed on individual rights and needs. Digital technology can respect those rights and help deliver against those needs.”
Creating a digital fabric for integrated care!
In a world where the customer experience is the panacea every type of business is striving for, the integration of care for the patient is when care delivery becomes like liquid and is able to flow around the patient says Richard Corbridge, chief information officer at HSE.
“What examples of an integrated business model exist where the customer truly is at the centre of the delivery and that health information technology can learn from? One of the most customer focused businesses in action is niche but worth exploring as an analogy.
Café Mambo on the strip of St Antonio, Ibiza, attracts customers from 8am through the day and night, by keeping the customer engaged and delivering an integrated experience. It doesn’t matter to the Café whether the sun drenched reveller wants a perfect Huevos Rancheros for breakfast at 8am or is dancing the night away to a soundtrack at 2am in the morning. The customer journey is always a high quality one, centred on an experience that is well defined: a great view, soundtrack and service with a smile. With the correct systems, not technology, the customer feels the journey is an integrated experience.”
“If we can do it for café culture on the White Isle then surely we can achieve similar in the integration of care delivery”.
“The trick is how to take that experience and apply it to the delivery of care. Café Mambo has built from a shack on the beach to a global brand. In Ireland we are trying to build from the proverbial shack on the beach to create a national infrastructure that supports the delivery of integrated care, in five years.”
Blog
In this week’s blog, new team member Hetty Simmonds writes on how Pinterest can help your healthcare marketing.
