News in brief
A&Es and hospitals face closure amid NHS funding crisis: The NHS is drawing up plans to close services including A&E departments and district hospitals, reported Sky News. Experts have warned there could be a “glut” of services shut down as providers face a £23bn national funding deficit. The disclosure comes after Stafford County Hospital suspended its A&E service for children after senior staff said it was not clinically safe. Campaign group 38 Degrees said the analysis, carried out by health policy experts Incisive Health, “reveals far-reaching plans to close services, which appear to have had little input from patients and the public”. According to the analysis, there are plans to shut the A&E department at Midland Metro politan Hospital and to close one of two district general hospitals as part of a planned merger. In Suffolk and North East Essex there are plans to “reconfigure” acute services within Colchester Hospital University NHS Foundation Trust and to close GP practices. In Dorset, hospital beds are at risk, while there are also proposals to close the equivalent of five wards in the Leeds Teaching Hospital’s Trust. Laura Townshend, director at 38 Degrees, said the findings show the health service is “dangerously under-funded”. She said: “These proposed cuts aren’t the fault of local NHS leaders. The health service is struggling to cope with growing black holes in NHS funding. These new revelations will be a test of Theresa May’s commitment to a fully-funded National Health Service.” The Guardian also reported the cost-cutting shakeup is already sparking a series of local political battles over the future of services, and exposes the health secretary, Jeremy Hunt, to fresh criticism after his controversial role in the junior doctors dispute.
Seven day NHS pledge faces ‘staff shortages’: A confidential review of government plans for a seven-day NHS in England has identified 13 risks, reported the BBC. These include concerns over a shortage of doctors and other health staff. The leaked risk register was drawn up by the Department of Health, and sets out a series of possible problems. The government has promised a “truly seven-day service” by 2020. The documents, obtained by Channel 4 and the Guardian, also said there is a high risk of “workforce overload” and are said to show that senior officials are concerned over the lack of detailed costings, risk assessment, and limited data supporting the policy. Another document which references a meeting with the 7 Day Services Governance Group, said: “The detailed costs of delivering in hospitals, including accurate estimates of additional workforce requirements are not understood early enough.” British Medical Association head Dr Mark Porter said it had repeatedly raised concerns about the “lack of detail and absence of any plan” for the seven-day pledge. He added: “To see in black and white that the government has not only ignored these concerns – and those of other leading healthcare organisations – but has also disregarded its own risk assessment’s warnings about the lack of staffing and funding needed to deliver further seven-day services, is both alarming and incredibly disappointing.” A Department of Health spokesman said: “Over the past six years, eight independent studies have set out the evidence for a ‘weekend effect’ – unacceptable variation in care across the week. This government is the first to tackle this, with a commitment to a safer, seven day NHS for patients and £10bn to fund the NHS’s own plan for the future, alongside thousands of extra doctors and nurses on our wards.”
Officials warn over “extremely constrained” capital for STPs: Health and local government leaders working on major regional transformation plans have been warned capital funding is “extremely constrained” and to be prepared to have IT funding requests turned down, reported Health Service Journal (subscription required). Updates sent to the 44 sustainability and transformation plan leaders working on their final submissions include a renewed warning on the “extremely constrained capital environment”. They are advised to look carefully for “other possible sources” for the funds they need. The letters also include formal feedback on individual draft sustainability and transformation plans (STPs) submitted in June. In relation to capital, the letters said: “If your plan is capital dependent, it will need to set out the minimum capital that is essential to the plan, have a robust case that explains the expected return on investment (and the timescales involved), and where possible explore other possible sources of funding.” STPs have been strongly encouraged to explore land sales, premises sharing and making better use of existing capital budgets; and to look carefully at non-government sources, such as local authorities or “PF2” private finance schemes. There are as yet no known examples of STPs making progress with the latter approaches. The letters also warned about constraints on technology funding. They said: “Whilst we are in the fortunate position to have some capital and revenue to invest in information technology, it is heavily weighted to the back end of the (five year) planning period. You should therefore… have a plan for how you will proceed if we are unable to meet your IT requests.”
Provider deficits decline in Q1, but may mask “a more troubling” picture: The first financial figures for NHS providers this year show they have exceeded stringent efficiency targets in some areas, but ongoing concerns about its finances remain, reported National Health Executive. New figures from NHS Improvement have shown that in the first quarter of 2016-17, NHS providers’ total deficit was at £461m against a £466m target. At the same point last year, the deficit was £930m and 190 trusts were in deficit, which has now fallen to 153. Jim Mackey, chief executive of NHS Improvement, said: “It’s early days – and there is still much work to be done – but these figures demonstrate that providers are meeting some of the ambitious plans that trusts boards have signed up to and this is a promising start to the year.” In order to deliver the £22bn of efficiency savings by 2020 target, NHS England recently announced that money from the £1.8bn Sustainability and Transformation Fund (STF) will only be granted to trusts which are able to meet specific financial controls. As of last month, 214 out of 238 trusts have now accepted their individual control totals, of which 185 have now met their targets and received their STF funding. However, NHS Providers also published a survey today, showing that 38% of trust finance directors are not confident of meeting their targets. Chris Hopson, chief executive of NHS Providers, said: “These findings show the strain NHS trusts are operating under. There is now a clear and widening gap between what the NHS is required to deliver and the funding available. In reality, we have only just kept our heads above water because we have transferred the investment intended to fund long-term transformation into reducing the deficit that the majority of NHS trusts face.”
Hospitals to reduce operations to combat winter threat: Non-urgent operations and outpatient appointments risk being cut back on in the run-up to Christmas over fears of NHS shortages, reported ITV News. Hospitals in England are being ordered to minimise such services in preparation for possible winter crisis – including a “drastic” deficiency in accident and emergency nurse numbers. It is feared the country could “buckle” under the pressure, while some doctors warn the NHS could be “poleaxed” if a bad winter flu breaks out. In a joint submission, the Department of Health and NHS England said hospital trusts would be required to draw up “specific plans” for winter which would be “assured” by officials nationally. Measures include reducing the number of “elective” procedures carried out in the period immediately before Christmas to create more “non-elective capacity” and cancelling some outpatient activity. Trusts will also be required to produce “clear discharge plans” for inpatients prior to the holiday period to provide more beds and patients will be encouraged to make “appropriate choices” on using pharmacies, walk-in centres and GPs to reduce “inappropriate attendance” at A&E. The Royal College of Nursing (RCN) told a Commons Health Committee it was “very concerned” about staffing levels in A&E departments. “It is clear that the pressure is affecting the whole system, however, A&E units are often the place where effects are most visible,” it said. A spokesman for NHS England said: “We are already preparing for the upcoming winter with hospitals, GPs, social services and other health professionals coming together to work out the best way of responding in every area of the country.”
Plan to “transform” NHS could lead to downgrade of major London hospitals: Council leaders have refused to sign up to a plan to “transform” NHS services amid fears two major London hospitals, Ealing and Charing Cross, are to be downgraded and will lose their A&E units and other acute services, reported the Guardian. Both west London hospitals are highly valued by local residents and have been the subject of campaigns to save them when they were threatened with closures in the past. Leaders at both Ealing and Hammersmith & Fulham councils said they are determined that these hospitals should remain open with their A&E and operating surgeries and so have refused to sign up to the North West London sustainability and transformation plan (STP). Steve Cowan, leader of Hammersmith & Fulham council, said that NHS officials were being forced to drive through the changes by the government. “We condemn the Tory government for drawing up these plans. This is about closing hospitals and getting capital receipts. It’s a cynical rehash of earlier plans and is about the breaking up and selling off of the NHS. It will lead to a loss of vital services and will put lives at risk,” he said. Julian Bell, leader of Ealing council, said: “We refused to sign up to the STP plans because we do not support the closure of Ealing and Charing Cross acute hospitals … We have made it abundantly clear that we will campaign until our last breath to save Ealing and Charing Cross hospitals. We do support some of the proposals for more integrated health and social care but we feel we will be punished for not signing up to these plans.”
Scottish health officials stress vital role of pharmacy in integrated care: The chairman of the Scottish Pharmacy Board has called for a greater understanding of the role pharmacists play in patient care, reported Nursing in Practice. Dr John McAnaw spoke at the Pharmacy Management Forum in Scotland alongside the country’s chief medical officer. He said that pharmacists have a pivotal role to play in the drive for a more integrated approach to patient care at a local level. “I am convinced that, as Scotland leads the way in integrating so many aspects of health and social care, we can work across the professional boundaries more for the greater benefit of patients and the public,” he added. Scotland’s 4,300 pharmacists are more involved than ever before in day-to-day decisions about medicines in communities, primary care and hospitals. But there is also an understanding that they will need the right support and working environment to fulfil their professional duties. McAnaw said: “There needs to be increasing recognition of the role pharmacists can play in Scotland’s health service. To fully utilise the full breadth of their skills as medicines experts, they need to be able to practice as an integrated part of the healthcare team with the right support being made available to them.” Scotland’s chief medical officer, Dr Catherine Calderwood, added that pharmacists are often the first professional a patient turns to in the community and, not only offer an alternative to a GP visit, but also can spot the signs of serious illness. She said: “We need to continue to listen to the strong voice of pharmacists in assessing the value of medicines to patients based on whether they deliver the outcomes patients want.”
Serious issues with GP training payments since Capita handover, warns BMA: GP practices are not receiving reimbursements for training payments since this became the responsibility of Capita, the BMA has warned, reported Pulse. Practices from a wide range of regions said that since NHS England regional teams stopped doing the task, and it was outsourced to the NHS England (NHSE) support services provider, the new payments system has “hit serious problems”. The BMA said that this comes at a time “when practice budgets are being squeezed” and “causing serious issues for the practices involved”. Dr Krishna Kasaraneni, the GPC’s Education, Training and Workforce Subcommittee chair said: “Practices up and down the country are now left without support for calculation of trainee’s salary and are not getting the salary reimbursed. Practices cannot absorb this level of financial drain at a time when they are stretched to the breaking point already. We have escalated this as a matter of priority to NHSE and anything less than immediate resolution will not be satisfactory.” Recent problems included Capita mistakenly flagging patients for removal from practice lists in error, and practice staff being put at risk after a two-week delay in removing a violent patient. Earlier this year, GP practices were struggling with delayed transfers of patient records as well as a lack of basic clinical supplies. The GPC also said that practices reported patient notes going missing, leading to the Information Commissioner’s Office enquiring about information governance breaches. Last month, the GPC passed a motion of no confidence in Capita for its primary care support services in light of the failures, which it claims are putting patients at risk.
Successor to Care.data awaits government sign-off: A new data service capable of recreating key elements of the controversial Care.data project is being developed by the National Information Board and is likely to receive Treasury backing as soon as next month, reported Health Service Journal (subscription required). The new “data services platform” will comprise IT infrastructure and software applications that will “collect, store, process and analyse patient level data” from health and social care providers, including primary care, according to a document. NHS Digital has started to show the proposals to potential suppliers. A presentation produced for a market engagement event last month said the aim of the new programme is to “put in place effective services and activities to deliver ‘secondary’ uses of patient data”. It is intended that the platform will feed into a “customer facing data access and analytics service”. This would make data available to customers with “legitimate requests” and would comply with “emerging national data standards for secondary use data” – a reference to the recommendations set out in the Caldicott report published last month. “What was clear from the event is that Care.data is not dead. The digital services platform will be built at a scale and flexibility to effectively take in all available GP data,” a source who attended a presentation said. They added: “So while the digital services platform has not been designed as a replacement for Care.data, it could easily become that. The danger is that in doing so it could fall into exactly the same sort of problems that Care.data did.”
Virgin Care beats local NHS bid to land £17m a year community contract: Virgin Care has been named as the preferred supplier to co-ordinate adult community health services in Guildford and Waverley as part of an alliance contract, reported National Health Executive. The private company, in partnership with Royal Surrey County Hospital NHS Foundation Trust, Surrey and Borders Partnership NHS Foundation Trust, Age UK Surrey and Surrey County Council, beat off a local joint NHS bid to land the contract worth £17.6m a year. Local GP federation Procare, Sussex Community NHS Foundation Trust and Royal Surrey County Hospital NHS Foundation Trust had made a joint bid for the contract that covers 17 different services, but was rejected by NHS Guildford and Waverley Clinical Commissioning Group (G&WCCG). The adult community health services contract, which starts on 1 April 2017, will last two years with the option of extending for a further eight under a lead provider contract. It includes services such as community nursing, therapy services and community hospitals. Vicky Stobbart, executive nurse, director of quality and safeguarding G&WCCG, said: “The CCG is committed to commissioning high-quality, safe, patient and carer centred services that are compassionate, responsive and needs-led. It is important that we work collaboratively towards achieving improved health and wellbeing for our local population.” Virgin Care will work collaboration with a range of health, social care and voluntary organisations to develop and deliver fully integrated care. The CCG said primary care will be at the heart of this.
‘Outstanding’ CCG announces £8m savings target: A Yorkshire clinical commissioning group (CCG) rated as outstanding last month has announced it needs to make £8.4m savings this year, reported the Health Service Journal (subscription required). It announced in a statement that the increasing demands of a growing and ageing population were putting a strain on its £190m programme allocation for this financial year. Its quality, innovation, productivity and prevention programme (QIPP), or savings plan was £8.4m for 2016-17. Its QIPP target in 2015-16 was £5m. NHS England has said that, nationally, CCG QIPP targets have increased by 50% in 2016-17. The CCG’s chief officer Amanda Bloor said in a statement that the CCG would focus on making sure taxpayers receive value for money during a time of “unprecedented challenges”. The CCG said the number of people attending emergency departments between April and June 2016 was 2.7% higher than last year – adding an unplanned cost of £125,000. Ms Bloor said: “It is important that everyone using the NHS appreciates the pressures it faces through growing demand and cost, and takes responsibility for using it most effectively so we can help secure high quality local health services. The CCG is working to identify as many efficiency savings as it can. This will mean a renewed focus on self-care and healthy lifestyle choices by individuals and may include reduction or withdrawal of certain services that do not improve outcomes.” The CCG said one of the proposals being discussed was no longer providing over the counter medicines on prescription such as paracetamol, which cost it £260,000 last year. The CCG was one of 10 given the highest rating of “outstanding” by NHS England when it launched a new annual ratings system in July.
Individual patient identifier live in Ireland: Every patient in Ireland has been assigned a unique identifying number, in an effort to improve patient safety and data quality, reported DigitalHealth.net. The Individual Patient Identifier (IHI) went live in Ireland earlier this month and is now being used in electronic referrals to hospitals. Much like an NHS number, the IHI is a national register of all patients, linked to their basic patient information such as name, sex, and date of birth and demographics. Initially drawn for data by the Primary Care Reimbursement Service and Department of Social Protection, the IHI will be used in both health and social care services. Richard Corbridge, chief information officer at the Health Service Executive, said select hospitals and 30 GP practices would be first to start using IHIs internally this year. “This is probably the single largest patient safety initiative that the Irish healthcare system has deployed to date,” he said. Corbridge said he was confident that there was strong buy-in from both health and social care. “This is very much about patient safety and using information to stop mixing people up,” he added. This could help in the UK as well, as IHI is so similar to the NHS number that they could potentially be used across the countries in the future. As well as reducing record duplication and errors, the IHI will also form the foundation for a planned national electronic health record across Ireland.
First wave of successful bidders to £15m mental health fund revealed: The first wave of successful bids for the government’s £15m mental health fund have been revealed, with 15 NHS trusts and partnership organisations covering 11 police force areas receiving a total of £6.1m reported National Health Executive. The projects have been focused where use of police cells as a place of safety has previously been amongst the highest in the country. The funding is part of the mental health crisis care agreement (Crisis Care Concordat) to support people in a mental health crisis. North Essex Partnership University NHS Foundation Trust and South Essex Partnership University NHS Foundation Trust received the largest slice of funding – £818,500 – for upgrading health-based places of safety across six Essex locations including Basildon, Chelmsford, Colchester, Harlow and Rochford. Derby and Derbyshire Crisis Care Concordat group received £695,000 for a new adult health-based place of safety and crisis vehicles for driving vulnerable people across the East Midlands, whereas Avon and Wiltshire Mental Health Partnership Trust will use £500,000 to create a new crisis house offering short stay support in a safe and supportive environment for people in crisis. Home secretary Amber Rudd said: “We have seen good progress on our manifesto commitment to reduce the use of cells, with numbers dropping by 32% across England and Wales in just one year. The police should never be the default response for someone experiencing a mental health crisis. And we are going further, bringing important changes to legislation through the Policing and Crime Bill to ensure that police cells are only used as a place of safety for adults in exceptional circumstances, and will ban their use altogether for under 18s.”
These are the three big problems said to be facing care homes in Wales: Urgent action is needed to deal with the “triple whammy” of issues battering care homes across Wales, reported Wales Online. Chairman of Care Forum Wales, Mario Kreft MBE, claimed the industry is facing chronic underfunding, issues surrounding staff pay increases and an increase in the number of elderly people. He has called on the Welsh government to act after new figures revealed the number of people aged 85 or over has risen to more than 184,000, an increase of 145% since 2011. He said the sector is also being hit by chronic underfunding and the prospect of having to give staff a 30% pay increase without knowing where the money is coming from. Mr Kreft believes social care is at a tipping point in 2016 and the Welsh government needs to respond. He said: “Labour’s manifesto for the recent Assembly elections very clearly stated that they saw social care as a sector of national importance which is something with which I wholeheartedly agree. Social care should be seen as being as important as our road and rail infrastructure. It helps to underpin the NHS and is the glue that binds communities together. The pressure on the NHS today in Wales is directly affected, negatively, by a lack of foresight, connectivity and planning in social care policy in Wales.” Mr Kreft said health boards and local councils “do not talk, let alone work together” on delivering social care. “The current system is clearly dysfunctional and the Welsh government needs to deliver on it manifesto promise,” he said.
47% of NHS trusts in England admit to falling victim to ransomware: Forty-seven per cent of NHS trusts in England have been hit by ransomware in the past year, according to data from a freedom of information (FOI) request, reported SC Magazine. The FOI requests were filed by security company NCC Group. Sixty trusts responded and 31 of these withheld information with many citing patient confidentiality. As many as 28 confirmed they had indeed been a victim of ransomware. Only one trust said they had not been hit in the last year, but that they had been infected in the past. Ollie Whitehouse, technical director at NCC Group said: “The damage that a successful ransomware attack can cause makes these findings not simply an issue for a trust’s IT team, but for its board of directors too. Paying the ransom – which isn’t something we would advise – can cost significant sums of money, yet losing patient data would be a nightmare scenario for an NHS trust. There is no silver bullet or one single solution that can stop this type of attack, despite what many security companies may claim. Instead, we would recommend a multi-layered approach, applying robust controls such as regular patching of software, using up-to-date anti-virus and educating staff as to the risks posed by phishing and ransomware.”
Innovation culture set to disrupt global surgical industry: The growth of emerging markets is poised to transform the delivery of surgical care around the world by 2030, reported Digital Health Age. The emphasis will be on affordable technology for early diagnosis, portable modular equipment for minimally invasive and robotic surgery; and smart systems incorporating low-cost sensors and mobile technology to track clinical outcomes and improve team-based surgery. The report summarises the findings of a workshop held in Boston earlier this year by product design and development firm Cambridge Consultants. It offered insight into the future of emerging markets surgical care. “More than 85% of the world’s population lives in emerging markets, yet many of these people have no access to affordable quality healthcare, particularly complex treatment like surgery,” said Rahul Sathe, head of surgical innovation for emerging markets at Cambridge Consultants. Infrastructure and regulations are still being formed, and industry legacy is not particularly strong – offering a lower barrier to innovation compared with developed markets. The primary role of technology will be twofold, said the report. It can extend the ‘hospital ecosystem’ across the continuum of care from early diagnosis and surgical intervention to postoperative monitoring. Workshop delegate Agustin Zabulanes, Latin America marketing manager at Boston Scientific said: “Local emerging market companies may provide stiff competition to multinational companies – but they may also prove to be powerful partners in global surgical care. Success will require industry players to evolve the way they do business, organise for innovation and use enabling technology.”
Yeovil Hospital hopes TrakCare system will help make it a paperless pioneer: In what is described as “a major step towards becoming paperless”, Yeovil District Hospital NHS Foundation Trust has become the first of three local NHS trusts to deploy TrakCare, the unified healthcare information system from InterSystems, reported Government Computing. Around £27.5m worth of benefits can be expected at Yeovil Hospital alone following the replacement of previously separate patient information systems by TrakCare. InterSystems suggested that the new system is delivering “significant benefits” across Yeovil Hospital, including improved alerting and accurate electronic capturing of clinical outcomes, which is enabling more timely actions and confidence in planning. It said that with the ability to track real-time bed state information, specialists can search for patients with specific conditions and thus free up beds. Clinical teams can access the new system directly at the point of care, and remotely. The second phase of the TrakCare deployment has now begun, with a claim that the move can make Yeovil Hospital one of the most digitally advanced NHS trusts in the UK. Dr Anthony Smith, chief clinical information officer at Yeovil Hospital said: “Clinical staff at the hospital have taken real ownership over TrakCare and its potential to enhance patient outcomes and join up services, playing a key role in influencing how the system works for us in practice. Having a single source of truth on the patients in our care will help us to deliver safer and more effective care based on a complete view of the patient’s journey.” Jason Maclellan, Yeovil Hospital’s chief information officer, said: “Better information is about more than efficiencies and savings. The big prize of bringing data into one place rests in the possibilities for real transformation. Our TrakCare go-live has laid the foundations for integration across the entire health economy.”
South East councils urge Hunt to back integration plan: A group of councils across the South East of England has called on Jeremy Hunt to back a plan for greater social care integration, saying they are “ready, willing and able” to lead collaboration across the region, reported Public Finance. In a letter to the health secretary, the South East England Councils (SEEC’s) group said that it was clear that the current approach of separate health and social care systems was “unaffordable in the long-term”. The organisation, which represents 54 of the 74 councils in the region, set out a plan to help improve coordination. It suggested that councils should be recognised as equal partners to the NHS in redesigning services and agreeing a definition of integration that sets measurable goals for all organisations. It also called for local government to co-chair the development of sustainability and transformation plans and ensure government programmes, incentives and guidance align with these goals. Roy Perry, SEEC’s deputy chair said the sustainability and transformation plans could offer a way forward for integration, but were mainly NHS led. Rapid growth in the ageing population would mean extra social care funding would be needed, Perry stated. Current budgets will not meet needs as the number of over-75s in the South East is predicted to almost double to 1.5 million by 2039. “We feel opportunities are being missed to create partnerships that also draw on councils’ skills in delivering efficient, locally-tailored services that meet people’s needs and focus on prevention,” he added.
Forthcoming techUK health and social care events to sign up to: Heading into autumn, techUK is set to host a number of insightful health and social care events. A few that are fast approaching include: A business intelligence workshop on the 30th August that will be co-hosted by the NHS Digital’s National Data Services Development (NDSD) Programme, a NHS WiFi programme industry consultation webinar on the 6th September that will provide an overview of the programme plan and the options for implementation currently under consideration, and a Health and Social Care Network briefing with NHS Digital on the 13th September that will update the market on the latest developments, answer questions and outline their next steps. Other events that are set to take place a little later in the year include: Big Data Roadshow: Manchester on the 25th October, and a market insight event: Commissioning Services to Deliver Better Care Through Smart Use of Tech on the 27th October.
EHI Awards – tickets on sale now: Don’t miss out on the 10th anniversary of the annual EHI Awards, 29th September at the Lancaster hotel, London. The awards are the UK’s only dedicated healthcare IT award scheme. Ruby Wax, entertainer and advocate for mental health awareness, will be hosting the evening’s proceedings. The recently announced finalists include: NHS Fife, Central Manchester University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, and Cambridge University Hospitals NHS Foundation Trust. Highland Marketing will be there as a sponsor, join us for an evening of celebration, book your tickets here.
Opinion
The £22bn question: how can improvement be spread in the NHS?
The King’s Fund’s Beccy Baird blogs about the barriers and solutions to improving services in the NHS, reflecting on her own experiences in the Modernisation Agency and a cancer network.
“In the mid-1990s, the service improvement methodologies developed by Don Berwick at the Institute for Healthcare Improvement in Boston, US, were first used in the NHS. In 2001 the Department of Health established the Modernisation Agency to develop and spread service improvement skills more widely throughout the NHS. And yet there is still a mountain to climb in terms of both service improvement and productivity, and there is significant variation across the country. Why is it that the best ideas are so hard to spread?”
“There are innumerable service improvement resources online, endless case studies, myriad tools (for example, these are just the some of the ones for endoscopy). But however good, these tools and resources do not produce change on their own. What really made the difference back in the days of the Modernisation Agency was people. People whose job it was to become skilled in improvement methods, who could work in partnership with clinicians and patients, and who had the time to examine each issue forensically.”
“In my mind there is just no replacement for actively implementing service improvement, from the bottom up, with trained expert facilitators working with frontline teams again, and again and again.
“It’s not cheap. But it works. The fund has previously argued for a coherent strategy for quality improvement. As we noted in that report, ‘Improvements in the quality of care do not occur by chance. They come from the intentional actions of staff equipped with the skills needed to bring about changes in care, directly and constantly supported by leaders at all levels. They do not come free and will require a substantial and sustained commitment of time and resources.’
“The NHS must invest in improvement skills and use staff dedicated to improvement to support frontline staff, not just in acute trusts but also in general practice, mental health and community health services, if it is going to have a hope of implementing the recommendations of the Carter review, or the ambitious steps being outlined in sustainability and transformation plans. The national improvement and leadership strategy due to be published by NHS Improvement in the autumn will be vital in driving this forward.”
What if antibiotics stopped working?
While antimicrobial resistance is an unavoidable process of natural selection, tackling the issue involves solutions that must be adopted on a global scale, writes Dame Sally Davies and Rebecca Sugden.
In an article for Health Service Journal, they say: “Imagine if we reverted to a world without antibiotics. We would lose modern medicine as we know it.
“Each year, around 4 million operations are carried out in England and for most of these, antibiotics are key to preventing infections both pre- and post-operatively. One in four births in England is by caesarean section, where antibiotics are used to protect mother and baby.
“Most cancer treatments suppress the body’s ability to respond to infections, so antibiotics, antifungals and antivirals help to keep people alive while they receive routine cancer care.
“Without effective antibiotics, would you opt for routine surgery, such as hip replacement, if the risk of dying from infection was unreasonably high or would you soldier on with your dodgy hip? We know which we would pick!
They continue: “Antimicrobial resistance is something that is happening now, and we all have a role in the fight.
“If we do not, it is entirely possible that we could see a return to a situation where 40% of the population die prematurely from infections we cannot treat.”
Our NHS is struggling to survive in its current form. Time for a radical overhaul
Jeremy Warner, assistant editor of The Daily Telegraph, discusses the pressure on the NHS and how ‘rationing’ in healthcare has to stop.
“Some will be old enough to remember rationing. First it was petrol, then as the war intensified, it was bacon, butter and sugar. In today’s world, few would find the deprivations of rationing remotely tolerable. Imagine going to Sainsbury’s for the weekly shop and being limited by government diktat in the choice and quantity of what you could buy; such practices can only be justified at times of national emergency.
“Yet oddly, rationing is not entirely dead. It is alive and well and making a comeback in our ‘precious’ National Health Service. With NHS funding now stretched to breaking point, overt rationing is on the rise. Thousands of operations and appointments are to be cancelled this winter in an attempt to make more resources available for accident and emergency departments. Corners are being cut. Waiting times are rising.
“Three new elements have entered the equation in recent years to make an already grave situation much worse. One is the advent of mass communications. Second, society is ageing. And finally, there is the ceaseless march of technology.
“We seem to be doing well in terms of bangs for our bucks, but this is little consolation if the patient falls victim to preventable death. The unpalatable truth is that UK health care is coming up short in many areas.
“None of this is to denigrate those who work selflessly against the odds in British health care for the betterment of the UK public. It is merely to point out that the post-war model of funding no longer works and needs a radical overhaul. It would be a brave prime minister who questioned this sacred cow, but with meaningful Labour Party opposition all but vanished and the challenges and opportunities of Brexit likely to force change across the policy landscape, there could scarcely be a better time for some radical thinking than now.
“We wouldn’t countenance rationing in anything else. Why on earth are we prepared to tolerate it in healthcare?”
Highland Marketing blog
In this week’s Highland Marketing blog, Hetty Simmonds outlines the importance of cyber security in healthcare.
