News in brief
NHS ‘has busiest year in its history’: The NHS in England has had the busiest year in its history with more patients than ever seeking help, official figures show, reported the BBC. Nearly 23 million people visited A&E in the 12 months to March 2016 – a rise of more than 500,000 from the previous year. Delays rose throughout the period, with March itself having the single worst performance against the four-hour A&E target since it was introduced in 2004. Targets for cancer, routine operations and ambulances have also been missed. NHS England said the ongoing dispute with junior doctors had started having an impact, with the proportion of patients waiting more than 18 weeks for operations such as knee and hip replacements hitting its highest level. The increase in demand means that while the target was missed, the actual numbers seen in four hours – just over 21 million – was the highest-ever. Other parts of the UK have also been struggling with the A&E target. The data released by NHS England covers March, which means there are now complete figures available for the whole of the measured 2015-16 period. Royal College of Surgeons president Clare Marx said the performance was “worrying”. And she added: “Dedicated frontline doctors and nurses are treating more patients than ever before. We welcome the extra money the government promised, but we still need a long-term plan to address the growing number of patients.”
Junior doctors’ contracts: Fresh talks under way: Fresh talks aimed at ending the dispute over a new contract for junior doctors in England are under way, reported the BBC. The two sides will attempt to resolve outstanding differences, which include Saturday pay and unsocial hours. The government has put on hold, for five days, its plans to impose the contract. The British Medical Association has suspended its threat of further industrial action while the talks last. This latest round of talks will be mediated once again by conciliation service Acas. One of the government’s key arguments behind the push for a seven-day NHS in England – and a new contract for junior doctors – has been patient safety. Meanwhile, researchers from Oxford University have said earlier findings backing the government’s push for a seven-day NHS in England are based on flawed data. The new Oxford University paper concluded that hospital data suggesting a “weekend effect”, where death rates are higher for those admitted over the weekend period, were deeply flawed. It focused on the Oxford Vascular Study covering more than 90,000 people in Oxfordshire, looking at hospital admissions for stroke between 2002 and 2014. The researchers found more than a third recorded as being admitted for stroke were actually in for other things – often low-risk, routine procedures carried out on Monday to Friday. They said these coding errors distorted the mortality figures, making them appear better for patients admitted on weekdays.
PAC says seven-day NHS policy is ‘uncosted’: Health secretary Jeremy Hunt’s plans for a seven-day NHS have taken a hit from a Public Accounts Committee (PAC) report blasting the government for driving forward the plan without having a cost structure in place for it, revealed PharmaTimes.“It beggars belief that such a major policy should be advanced with so flimsy a notion of how it will be funded – namely from money earmarked to cover all additional spending in the NHS to the end of the decade,” said Meg Hillier MP, chair of the PAC. A committee inquiry on the management of clinical staff in the health service concluded that the government and its arms-length bodies had failed to get a grip on the situation, and that “no coherent attempt” had been made to assess headcount implications of major policy initiatives such as the seven-day NHS. It said the government’s commitment to provide an extra £10bn in funding for the NHS by 2020 is a pot the Department of Health “seems to expect will cover everything – despite not having separately costed seven-day services and other initiatives”, and warned: “We are therefore far from convinced that the department has any assurance that the increase in funding will be sufficient to meet all of its policy objectives.”
Jeremy Hunt ‘exaggerated NHS funding claims’, researchers say: Claims by health secretary Jeremy Hunt that he has given the NHS “the sixth-biggest increase” in funding in its history, are misleading and exaggerated, researchers at The King’s Fund have said, according to the Independent. Following analysis of funding allocation to the health service over the last 41 years, they concluded that Mr Hunt has given the 28th biggest funding increase since 1975, rather than the sixth. Professor John Appleby, King’s Fund’s chief economist, said Mr Hunt’s claims do not take into account inflation over different time periods, meaning he is not comparing like with like. When the figure is considered not as a lump sum, but proportionally, Mr Hunt is said to have given a 1.6% funding increase. He also said Mr Hunt’s claims that he has given an extra £3.8bn funding are misleading and puts the figure at closer to £1.8bn. A spokesperson for the Department for Health said: “We are absolutely committed to the NHS which is why we are investing £10bn directly into the service, including almost £4bn upfront this year – and crucially, that is at a time that other government departments are facing significant reductions in their budgets. As this research shows, there are a number of ways of analysing funding and comparing spending across years – our calculation is based on a common sense methodology.”
Patients sent home afraid and with little support: NHS patients in England are being sent home from hospital afraid and with little support, an ombudsman report revealed, reported the BBC. The independent arbitrator investigated 211 such complaints in a year. Among them is the case of an 80-year-old woman, repeatedly sent home in a confused state to an empty house, only to be readmitted to hospital when neighbours raised the alarm. The NHS said the findings will be taken seriously and improvement was under way. The report showed that some of the most vulnerable patients, including frail and elderly people, are enduring harrowing ordeals when they leave hospital. And that poor planning, co-ordination and communication between hospital staff and between health and social care services were failing patients, compromising their safety and dignity. Parliamentary and health service ombudsman Julie Mellor said: “Health and social care leaders must work harder to uncover why 10 years of guidance to prevent unsafe discharge is not being followed, causing misery and distress for patients, families and carers.” The body that produces guidelines – the National Institute for Health and Care Excellence – said its recommendations were clear and should be followed. The Department of Health said the failings were unacceptable and it would ensure “lessons are learnt”.
NHS plans to diagnose cancer within 28 Days: NHS England has announced plans to improve cancer care and give patients a definitive diagnosis within four weeks, reported Sky News. It is hoped a £15m investment boost will allow doctors to diagnose people suspected of having cancer within 28 days of them being referred by their GP. The target was first proposed by health secretary Jeremy Hunt in October and an NHS report suggested the move could save 30,000 lives a year by 2020. Improvement plans include using health experts to analyse data for cancer survival rates, early diagnosis rates, treatment outcomes, patient experience and quality of life, and use it to target areas for improvement. The action plan also follows the NHS’ Independent Cancer Taskforce report published last year, which identified how the NHS can achieve world-class cancer outcomes. Cally Palmer, national cancer director for NHS England, said: “One in two people will be diagnosed with cancer and too many people are being diagnosed when their cancer is advanced. We need to change this.” Dr Fran Woodard, executive director of policy and impact at Macmillan Cancer Support, said: “We are also pleased to see commitments in the plan to ensure more people benefit from personalised care after treatment. NHS England and the government must set out how they propose to fund this essential part of the cancer strategy if the improvements described in the plan are to be delivered.”
Government to replace HSE with health commission: The Irish Government is planning to “dismantle” the Health Service Executive and replace it over time with a new health commission, reported The Irish Times. Under the new programme for government, expected to be published this week, hospital services will be run by statutory trusts which will own their assets and manage the recruitment of their own staff. Hospital groups – which will be replaced by trusts – will have to agree annual performance targets for waiting times, out-patients and emergency department attendances which will be linked to new activity-based funding. It is envisaged that a new performance management unit, with its own ring-fenced budget, will be established. The plan also involves the provision of a special fund of €50m to improve waiting times for treatments in hospitals. It is understood this includes the €15m investment in the National Treatment Purchase Fund, set out in the agreement between Fine Gael and Fianna Fáil.
Majority of NHS efficiency savings will need to be delivered locally, says Stevens: The majority of the £22bn efficiency savings the NHS needs to make by 2020 will need to be delivered by local health economies rather than from the centre, NHS leaders have said, reported National Health Executive. In an appearance before the Health Select Committee this week, Simon Stevens, chief executive of NHS England, said that of the £21.6bn savings needed to meet changing demands on the NHS, £6.7bn would be nationally delivered and £14.9bn would be delivered locally. Health secretary Jeremy Hunt, who appeared alongside Stevens, was challenged by MPs over the government’s promise of £8.4bn in the spending review, which MPs said really represents just £4.5bn of new money because of inflation and an adjusted baseline. Hunt admitted that there would be shortages in health service funding because the government had prioritised achieving the Five Year Forward View. “I recognise that we are talking about £8bn that was needed for NHS England to deliver the Forward View, and that in order to deliver that we have had to make some difficult efficiency savings in the rest of the budget,” said Hunt. “So I do recognise that we didn’t protect the entire health budget, but our determinant as to whether this was sufficient was what NHS England felt they needed in order to put in place the Forward View, and yes, we are making some very challenging efficiency savings in the non-NHS England part of the budget.” He added that the NHS could achieve these savings by making “smart efficiencies” that would improve patient care.
Statins alert over IT glitch in heart risk tool: Thousands of patients in England may have been wrongly given or denied statins due to a computer glitch, reported the BBC. A third of GP surgeries have been told to contact people who may have been given an inaccurate assessment of their future risk of heart disease. The alert followed the discovery of a problem with a digital calculator for assessing heart risk and the need to prescribe cholesterol-lowering drugs. The medicines regulator said the clinical risk to patients was low. The Medicines and Healthcare products Regulatory Agency (MHRA) has launched an investigation. “We are working closely with the company responsible for the software to establish the problem and address any issues identified. GPs have been informed and they will contact individual patients should any further action be necessary,” said a spokesperson. The computer tool is used to help GPs assess the potential risk of cardiovascular disease in patients. The IT company that makes the software, TPP, said it was working with the MHRA to ensure that clinicians were informed of any patients that may have been affected as soon as possible.
Trust CEO role at risk of becoming ‘impossible job’ due to unprecedented pressures: Interviews with NHS trust chief executives, published by NHS Providers and The King’s Fund, showed many feel the job has never been harder, leading to warnings that it will be hard to recruit the next generation of chief executives, reported National Health Executive. Worries flagged in the report include financial pressures on the NHS and over-inspection and regulation. Chris Hopson, chief executive of NHS Providers, said: “These reflections from some of the NHS’ most experienced leaders show first-hand how all-consuming the job of running an NHS trust is these days. This is a much more hostile environment and, if we are not careful, we risk the CEO role becoming the impossible job that very few people either want or are able to succeed at.” He warned that the average tenure of a chief executive is now three years and he had heard anecdotally that trust management staff are increasingly reluctant to take the top job. Karen Dowman, Black Country Partnership chief executive, said: “Nationally I don’t think there is any acceptance, by any politicians, of just how bad things are. We will have gone from spending at roughly the European average in terms of GDP to what will soon be 6%. And that has happened very rapidly.” She added that the lack of resources meant there wasn’t “a strong pipeline” of CEOs, finance directors and operations directors. John Pelly, former CEO of Moorfields Eye Hospital, said: “For all its sleepless nights and everything else that you have to live with, it is a fantastic job. It is a fantastic responsibility you are given. If you feel you’ve got the ability to do it, I would say you should do it.”
Barts and Homerton to link info exchanges: Barts Health NHS Trust will share patient information with Homerton University Hospital Foundation Trust via a first-of-type UK link between their Cerner Health Information Exchanges (HIEs), due to go-live this summer, reported DigitalHealth.net. Barts Health was the first English trust to go live with Cerner’s HIE in late 2013 and the system links with 142 GP practices. Barts chief information officer Sarah Jensen said the trust was finishing off data sharing agreements with Homerton, but hoped to be live this June or July. The initial link will only allow the exchange of information between the acute providers as the GP practices involved will have to sign new data sharing agreements to allow the primary care data to be viewable. “It will allow Barts Health acute users to see the Homerton acute data and vice-versa and we will phase in GPs being able to see it once another data sharing agreement is done,” said Jensen. She added that lots of eyes are on the Homerton project as it will be the first to link HIEs in the UK.
Patient opt-out offered over Google DeepMind-Royal Free NHS Trust data deal: Patients of the Royal Free NHS Trust can opt out of sharing their data with Google-owned artificial intelligence (AI) company DeepMind, according to the trust, reported Computing (subscription required). It was revealed last week that DeepMind had access to 1.6 million NHS patients’ records, via an agreement reached between the trust and the AI company to develop an app aimed at improving the identification and treatment of patients at risk of acute kidney injury (AKI). DeepMind isn’t the only technology company working to improve AKI, a condition believed to be linked with as many as 100,000 deaths in UK hospitals every year; Patientrack has worked with Western Sussex Hospitals NHS Foundation Trust to develop a system to automatically detect and help prevent AKI. But while Patientrack is a health technology company, DeepMind is owned by one of the biggest technology companies in the world, which already has a lot of consumer data at its disposal, hence the controversy surrounding the deal. The worry from a privacy standpoint is what Google could do with this additional sensitive and private data, particularly as DeepMind is receiving health data that is not necessarily linked to AKI. The Royal Free insisted that it was not selling patient data, and that it would remain the data controller at all times. However, patients can opt out of having their data shared with DeepMind, or any non-NHS organisations that have data-sharing systems with the Royal Free London, by contacting the trust’s data protection officer. Further details can be found in the Royal Free privacy statement.
IBM Watson helps children in need at UK’s first cognitive hospital: The UK is set to see its first ‘cognitive’ hospital, with IBM providing its Watson technology platform to Alder Hey Children’s NHS Foundation Trust, reported Computer Business Review. Alder Hey hopes the use of Watson will greatly enhance patient experience by: identifying patient anxieties and providing information and reassurance on-demand; reminding young patients and their parents about appointments and about aftercare; and providing insightful feedback to clinicians based on the tone and sentiment of these interactions. Using these insights generated by Watson, Alder Hey hopes to make a hospital stay for a child less scary and daunting – both in making the service more personalised for the child and being able to identify clinical trends more quickly that could affect patient flow and effectively save money. Mr Iain Hennessey, a paediatric surgeon and director of innovation at Alder Hey said: “This is an unprecedented opportunity for Alder Hey to pilot this ground-breaking technology and learn how to transform IT capability and working practices in healthcare, not just in the UK but across the world. Helping our patients and their families prepare properly for coming into hospital will really reduce their anxiety and could mean we can get them better and home faster.”
Student nurses ‘going digital’ with obs technology training: Student nurses at the University of Manchester have become the first in the world to be trained in how to use a type of vital signs observation technology before they set foot onto the ward, reported Nursing Times (subscription required). The move has been described as signalling the start of a changing focus in the classroom for a “paperless” generation of nurses from the earliest stages of their training. Hospitals in Manchester and other parts of the UK have already been using the system, which is intended to help identify deteriorating patients. Manchester’s student nurses will still be taught how to record bedside observations on traditional paper charts. However, this year, 400 have already been taught how to capture patients’ vital signs digitally through Patientrack, on their iPads, from the very beginning of their training. Clinical skills tutor Carol Wilde said: “Learning how to carry out patient observations and recording accurate vital signs is the bread and butter of nursing practice. As the NHS becomes paperless, we need to give students a real feel for the systems they will use,” she said. Professor Steven Pryjmachuk, director of NHS education contracts and external liaison at the nursing school, said: “Our NHS trust partners use Patientrack, and now our students are able to test out the technology in a safe, simulated clinical setting, in preparation for use in real clinical environments.”
Lincolnshire’s Path Links moves to digital pathology: Path Links, a pathology service for Lincolnshire, is to upgrade to digital pathology in a bid to enhance cancer diagnostics, reported DigitalHealth.net. The switch to digital pathology could do for histopathology what PACS has done for radiology, said Path Links general manager Mick Chomyn. The solution provided by Omnyx, a joint venture between GE Healthcare and University of Pittsburgh Medical Center, will see pathologists ditching glass slides and microscopes in favour of digital images that can be viewed on an HD screen. Chomyn said: “The case for digital pathology is compelling. By adopting the latest digital pathology solution we will provide clinicians with access to innovative diagnostic tools, with goals of achieving greater clinical accuracy, reducing diagnostic time in cancer care and creating real benefits to patient care.” Path Links chose the Omnyx solution because it offers compact storage of pathology images, compressing them to 200MB, and software that allows images to be streamed by remote users. The streaming technology has been likened to Google Earth and allows a user to download just the part of the image that is needed at a given time.
102 million patient health records managed by Orion Health software: Orion Health has announced its software now manages 102 million patient health records globally, reported eHealthNews.eu. This new record firmly establishes Orion Health as a leading vendor in the capture and delivery of electronic healthcare information to enable better health and wellness outcomes. Orion Health CEO Ian McCrae said: “Surpassing 100 million patient health records is a significant milestone. The more records that are managed by Orion Health software, the easier it is to provide additional functionality at the point of care as we enhance our world-leading solutions.” Orion Health anticipates that in five years the majority of patient health records will be in the cloud in most of its key markets. This will be necessary to enable the capture, storage and delivery of rich and detailed information about every healthcare consumer. McCrae continued: “Today the health record primarily consists of a patient’s medical history, soon it will include a richer data set comprising of a patient’s genetic, environment and social information. This will enable the practice of personalised healthcare known as precision medicine.”
NantHealth plans IPO for its personal medicine platform: NantHealth, which has developed genomic and protein-based molecular testing services – starting with cancer care – on a personalised medicine platform, has filed SEC registration papers to conduct an initial public offering of stock valued at up to $92m, reported Health Data Management. The company plans to expand beyond oncology to facilitate genomic sequencing and determination of diagnoses for other diseases. “As a pioneer in the era of big data and augmented intelligence, we believe we are uniquely positioned to benefit from multiple significant market opportunities as healthcare providers and payers transition from fee-for-service to value-based reimbursement models and accelerate their pursuit of evidence-based clinical practice,” the company noted in its SEC filing. Jeffries and Cowen and Company are the major investment managers of the IPO. NantHealth in 2015 had revenue of $58.3m and a net loss of $72m.
London NHS trust fined £180K by information commissioner for HIV data leak: The ICO has levied a £180,000 fine against a London HIV clinic for accidentally divulging the names and email addresses of 780 patients, reported SC Magazine. The 56 Dean Street sexual health clinic based in Soho, London, has been slapped with a £180,000 fine by the Information Commissioner for leaking sensitive patient information last year. In September, 780 patients of 56 Dean Street – who had signed up for email notification of their test results and other information – received an email newsletter with recipients names and email addresses exposed in the ‘to’ line. The Information Commissioner’s Office (ICO) found that there had been a serious breach of the Data Protection Act which was likely to cause great distress. Patients at the time were quoted in The Guardian newspaper saying that they recognised names of people on the list to whom they had not previously disclosed their own HIV status. Of today’s judgement, the information commissioner Christopher Graham said, “People’s use of a specialist service at a sexual health clinic is clearly sensitive personal data. The law demands this type of information is handled with particular care following clear rules, and put simply, this did not happen.” The investigation found that this was not the first mistake of this type that the Chelsea and Westminster Hospital NHS Foundation Trust, which operate the clinic, had made. “It is clear that this breach caused a great deal of upset to the people affected. The clinic served a small area of London, and we know that people recognised other names on the list, and feared their own name would be recognised too. That our investigation found this wasn’t the first mistake of this type by the trust only adds to what was a serious breach of the law,” Graham said.
Joined-Up Health & Care Conference to share interoperability stories from Lincolnshire to New York: InterSystems, a global leader in health information technology, will bring pioneers from across the world to Sutton Coldfield in May, to share ground-breaking stories on how joining-up health and social care is becoming a reality, reported eHealthNew.eu. Joined-Up Health & Care, which is free to attend, will provide delegates at The Belfry on 24th May an opportunity to hear how health economies from Lincolnshire to New York are tackling the challenges of sharing information across care settings to help improve the co-ordination and delivery of sustainable healthcare systems. Mark Palmer, country manager at InterSystems, said: “Health and social care integration is vital to ensure the delivery of a sustainable health system. Our annual Joined-Up Health & Care conference provides an opportunity for those professionals involved in healthcare IT to meet with their peers and industry experts to discuss the technologies, strategies, and methodologies required when embarking on a health and social care integration project.” A full agenda for the day can be found here, and delegates wishing to attend this free event can register here.
Opinion
How the UK Is driving a global revolution of 21st century healthcare innovation
How is the UK transforming healthcare through technology? What is the impact of biomedical science and genetics on care delivery? George Freeman, minister for life sciences provides his take on the above in The Huffington Post.
“Digitalisation is transforming individual care, systems safety and performance, and research. It is putting patients in control, allowing diagnosis and treatment from home to reduce avoidable hospital admissions. The explosion of health apps and handheld tools is radically empowering and supporting patients and clinicians. Breakthroughs in robotics and MRI are revolutionising surgery and diagnosis.
“But this progress also raises some big questions for healthcare systems around the world. How are we going to afford all this technology? How are we going to change our care pathways to focus less on hospitalisation and ‘seeing the Doctor’ and more on intelligent self-management of conditions? How will we value and pay for drugs which cure a disease rather than just prolong life?
“The NHS needs to modernise, and by embracing technology and innovation we believe we can accelerate that process and make the UK a leader in the development, testing, adoption and reimbursement of novel healthcare technologies.
“However, we can only progress these technologies if the public trust us with their data. That’s why in the UK we have set up a powerful new National Data Guardian, Dame Fiona Caldicott and commissioned independent reviews of data security from her and the Care Quality Commission, due to be published shortly.
“Precision Medicine is changing the way we adopt, assess and reimburse innovative treatments into our health systems. That’s why I have introduced the Early Access to Medicine Scheme, made Electronic Health records mandatory and launched the Accelerated Access Review to reform our processes for the development of drugs, devices and diagnostics. The aim is to come up with new ways of making sure the most innovative treatments can reach patients as quickly as possible.”
Urgent action is needed to save the NHS’s efficiency drive
“The Carter efficiency drive has been going nowhere fast, but needs to be a mainstream priority – here’s how to make it so.” writes Alastair McLellan, editor of Health Service Journal (HSJ, subscription required).
“The £22bn target may have brought the NHS’s efficiency drive into disrepute, but few of the service’s leaders would dispute there are significant savings to be made. Lord Carter’s review into “unwarranted variation” in NHS acute sector productivity and performance remains the most useful piece of work done to date on this challenge. The report does not pretend to be the final answer – and its comprehensiveness and focus provide a good start. Most importantly, it alone gives some hope the NHS can find some breathing space during the unprecedented cash squeeze of coming years.
“Which is why it is particularly worrying the initiative is going nowhere fast. Momentum has to be established before the summer break or the programme will risk losing any credibility with NHS leaders. The Carter review is, like the Five Year Forward View, a vision of what can be achieved – with some guidance as where to start. It now needs the equivalent of December’s “Delivering the Forward View” to make that vision a reality.
“The delivery plan should:
- Stipulate the appointment of a number of full time Carter champions for each workstream.
- Acknowledge that, while NHSI is the right home for initiative, it should be owned and funded additionally by NHS England and the Department of Health – and possibly also the Treasury.
- Make sure trusts are not left in a situation where making progress on Carter threatens their ability to deliver any of the system’s other “must-dos”.
- Make it clear that a condition of NHSI sanctioned financial support will be a trust adopting the best practice set out in Carter.
- Set out how trusts will be given the air time to get their Carter work going.
- Give more time to NHSI to merge, sorry integrate, its Monitor and NHS Trust Development Authority arms so it can increase its focus on delivering Carter.
“It is very easy to be cynical about NHS efficiency programmes and at present there is very little incentive for trusts to engage with Carter given their competing priorities. But cynicism serves little use other than giving those who would prefer not to take difficult decisions an excuse for inaction.
Our ambition to create world class cancer services
Rapid progress has been made on how best to implement some of the key recommendations of the NHS’s Independent Cancer Taskforce, writes Cally Palmer.
Palmer, NHS England’s national cancer director, says: “More people are surviving cancer than ever before, but as half of those born after 1960 will be diagnosed at some point in their lives, we know there is more we can do to ensure we deliver truly world-class cancer services for all patients in England.
“In its report last year, the NHS’s Independent Cancer Taskforce, established as part of the NHS Five Year Forward View, set us a significant challenge – but it is one that we are committed to meet.
“It has given us a great opportunity to refocus our efforts and shift resources to ensure we deliver better prevention and earlier diagnosis, while providing modern treatments and compassionate care.
“Since publication of the taskforce report, rapid progress has been made on how best to implement some of the key recommendations.
“And now, in our new publication “Achieving World-Class Cancer Outcomes: Taking the Strategy Forward”, we have set out plans to take action across all strategic priorities, with more cancers prevented, more people surviving for longer following a cancer diagnosis, everyone with cancer having consistently good experiences of treatment and care, and a better long-term quality of life.
“We will achieve these goals by supporting strong local leadership and with the robust use of data across cancer pathways.”
Highland Marketing blog
In this week’s blog, Gregor MacKenzie explores the reasons why you should look beyond YouTube to improve your video marketing campaigns
