Healthcare Roundup – 11th February, 2012

Lords defeat for health bill as PM denies wanting Lansley shot

Health secretary Andrew Lansley faces a torrid time with the Lords defeating the government in the first of the latest round of votes on the health bill. At the same time the Prime Minister was forced into what the Telegraph described as a lukewarm defence of Mr Lansley – denying reports that he wanted him ‘taken out and shot’.

Other amendments were debated by the Lords and more votes are on the way. In the House of Commons David Cameron rebuffed calls to drop the bill entirely, while Labour leader Ed Miliband described it as a “complete disaster”.

Health Service Journal reports that the Faculty of Public Health (subscription required) has become the latest professional body to call for the bill to be scrapped. The BMA has redoubled its own opposition with calls for both the bill and Mr Lansley to go. At the same time a survey of BMJ readers has indicated that over 90% want the legislation dropped.

One piece of positive news for the government was that 53 hospital bosses signed a letter to The Times supporting the plans to allow foundation trusts to get up to 49% of their income privately.

However, the pro-reform NHS Confederation has now joined attacks on the bill, saying it is unlikely to encourage much-needed service integration. This view reinforces the findings of the latest report by the Commons’ own – Tory led – Health Select Committee.

Electronic record success brings cheer amidst IT worries

The introduction of an electronic record viewer has been greeted by emergency doctors at Scarborough Hospital as like ‘turning on a light’. EHI reports that lead A&E consultant Dr Andy Volans says staff can barely remember how they coped before TPP’s new CRV went live in January. The viewer, which allows clinicians to access a read-only view of the patient’s full electronic record, will soon be rolled out to other departments.

By contrast University Hospitals of Morecambe Bay NHS Foundation Trust is working through a backlog of 14,000 patients who failed to receive follow-up outpatient appointments because of administrative and IT problems linked to Lorenzo. EHI says a report into the backlog paints a damning picture of failures at the trust.

In a warning of potential future problems, responses to the government’s open data plans have raised a variety of concerns – including doubts about whether IT systems will be able to deliver patients with the information which they will have the right to see. The report contains a whole section on IT, and there is substantial discussion of the need to create patient portals.

Billions in savings linked to mental health

The King’s Fund claims that billions of pounds are wasted because mental health conditions go undetected where there is a co-existing long-term physical condition. The fund and the Centre for Mental Health say that people with long-term conditions, such as diabetes or heart disease, are two to three times more likely to face mental health problems than the general population.

The problem is that the mental health problems can often go unidentified – even though they exacerbate the physical condition and make treatment more costly. The organisations also claim that where a mental health problem is identified, it is often treated separately, when it would be more efficient to gear treatments to patient needs.

An estimated £1 in every £8 spent on long-term conditions is linked to poor mental health, equating to £8-13 billion of NHS spending each year. Large savings could be made by taking a fresh approach. This, say researchers, would cut hospitalisation rates, increase outpatient service use and improve patient outcomes.

PFI nationalisation and bailouts

The second-ever PFI hospital, Carlisle’s Cumberland Hospital, may be nationalised as part of a deal to take over the troubled North Cumbria University Hospitals Trust. HSJ (subscription required) reports that the bid for control, by Northumbria Healthcare Foundation Trust, would create a trust stretching the breadth of England, from Whitehaven on the west coast to North Shields in the east.

The idea of taking the hospital, which was built under a deal dating to 1997, into public hands has been sparked by huge PFI charges of £21.3m last year – nearly 10 per cent of its turnover. It is also suffering falling income and historic deficits.

The government has also announced that £1.5 billion will be made available to seven NHS hospital trusts to help pay mounting PFI debts. BBH News said the DH has announced that they made need help for up to 30 years.

The trusts affected are Barking, Havering and Redbridge NHS Trust, Dartford and Gravesham NHS Trust, Maidstone and Tunbridge Wells NHS Trust, North Cumbria NHS Trust, Peterborough and Stamford Hospitals NHS Foundation Trust, South London Healthcare NHS Trust and St Helen’s and Knowsley NHS Trust.

Worries about private providers and finance have led the regulator Monitor (subscription required) to propose a debt ceiling. It also wants to restrict their ability to either use essential assets for security or to make payouts to shareholders if this would push their resources below a critical level for services.

News in brief

  • Millions lost in translation: The NHS spends £60,000 a day on translating documents, according to think tank 2020Health (subscription required). It suggests that much of the work repeats what has been done elsewhere and could be saved by creating a central pool of translated documents.
  • Two Yorkshire trusts can EPR procurements: According to EHI, Sheffield Children’s NHS Foundation Trust and Doncaster and Bassetlaw Hospitals NHS Foundation Trust both recently informed suppliers that their EPR tender notices have been cancelled.
  • NI’s electronic future: Northern Ireland health minister Edwin Poots has announced closer links with North America and Europe in order to develop better electronic healthcare. He told an audience at the Connected Health conference in Finland that the province’s £18 million tele-monitoring service shows the way ahead.
  • Call to publish more GP data: GP online reports calls to publish more data about which practices offer what treatments such as knee replacement or bariatric surgery. The Quality, Innovation, Productivity and Prevention (QIPP) Right Care Team claim it would address the postcode lottery over access to some forms of care.
  • First artificial jawbone transplant: An 83-year-old woman has been implanted with the world’s first 3D printer-created jaw. The titanium jaw is a major advance as the creators faced many technical challenges, such as how to incorporate the nerves necessary for normal movement of the jaw.

Opinion

Ivan McConnell of PA Consulting argues that the NHS is missing out on major financial benefits and opportunities to improve patient health by not rolling out telehealthcare and telecare on a larger scale. Indeed, the latest DH evidence highlights that over 90% of people with long-term conditions say they want to be more active self-carers.
‘Patients who suffer from long-term conditions make up 31% of the population, but 69% of primary and acute care budgets in England are spent on them. They account for more than half of GP appointments and nearly two-thirds of all outpatient appointments. The 5% of patients who have one or more long-term conditions account for 49% of all inpatient bed days.
‘Telehealth and telecare provide opportunities for delivering care more efficiently. They deliver both cost savings and improved care to patients with long-term conditions. The benefits have primarily been in preventing unplanned hospital admissions and facilitating early discharge.
‘Additionally, taking their own readings can provide patients with a greater understanding of their condition thereby promoting improved self-management.’

Blog

Are patient choice and market competition the best way forward for the NHS? Recent reports and government initiatives have emphasised the potential benefits. Catherine Foot of the King’s Fund says that its new book suggests that another route may be better.
‘Several of the National Service Frameworks (NSFs) of the early Labour years have been shown to have had significant impact on the quality of services. In our book looking at the effect of Labour’s market reforms we argue that some of the more direct clinical strategies like the NSFs had considerably greater impact than some of the major policy levers like choice or competition.’

Highland Marketing blog

Industry advisor, Jeremy Nettle takes a look at the latest health bill developments.

Top strategies your health tech marketing agency should implement
Versatile writing models for impactful PR and marketing
Natasha Phillips: Health tech vendors and nurses must work more closely together
Standing up for health tech and SMEs: Shane Tickell’s vision
The power of video marketing for health tech