News in brief
McKesson UK put up for sale: McKesson has announced its intention to sell McKesson UK, including subsidiaries System C and Liquidlogic, reported eHealth Insider. The San Francisco-based company will divest its International Operations Group business (IOG). The company said the businesses accounted for only a small percentage of revenues and will enable it to better focus on core business. Almost all NHS trusts use the McKesson Electronic Staff Record HR system, and it remains the third biggest supplier of PAS systems to the NHS. The company’s legacy base dates from before National Programme for Information Technology (NPfIT), but it effectively re-entered the market by buying System C for £87m in 2011. At the time, the deal was billed as one that would bring together McKesson’s client base and financial strength and System C’s modern electronic patient record systems, as NPfIT wound down and the market opened up. However, the company says the planned sale of IOG forms part of wider changes to McKesson’s portfolio.
NHS England to publish IT strategy: NHS England is developing an NHS Technology Strategy and Roadmap, setting a national direction for NHS IT, reported eHealth Insider. NHS England has published its Business Plan for 2013-14 – 2015-16 called ‘Putting Patients First’, which explains how it will deliver its mandate from the government. One of the key targets in relation to IT is to have 95% of trusts using the NHS Number as the prime identifier in clinical correspondence by January 2015. ‘Putting Patients First’ says NHS England will “set the direction for NHS technology and informatics so that commissioners, providers and suppliers can make informed investment decisions…In co-production with key strategic partners and in consultation with stakeholders, we will develop and publish an evidence-based NHS Technology Strategy and Roadmap.” Other developments outlined in the plan include an integrated business intelligence tool, which will “provide the robust information needed for evidence based, insightful decision making for all parts of NHS England.”
Health adviser to prime minister appointed: Nick Seddon, deputy director of right-leaning think tank Reform, has been appointed health and social care adviser to the prime minister, reported HSJ (subscription required). Seddon’s post will be as a special political adviser, rather than a civil servant. However, his appointment comes shortly after Paul Bate, who was civil service chief health adviser to the prime minister, was appointed by the Care Quality Commission. Mr Seddon said in an email to contacts today: “From Monday I shall be the Prime Minister’s special adviser on health and social care, working in Jo Johnson’s policy team at 10 Downing Street. I am excited, if also daunted, by the move. This brings to an end three and a half incredibly happy years working at Reform.” The appointment comes as the government – particularly 10 Downing Street – overhauls its policy teams.
‘Health Online’ to push records access: NHS England is running a ‘Health Online Programme’ working towards 100% electronic referrals and patient access to their records online, reported eHealth Insider. NHS England has published its Business Plan for 2013-14 – 2015-16, called ‘Putting Patients First’, which explains how it will deliver its mandate from the government. It says the Health Online Programme, “makes use of modern technology to transform the service offer of the NHS, empowering patients and citizens to take control and make informed choices.” As part of this, people will have online access to their health records if they want it, by March 2015. Half of all practices will offer the facility to order repeat prescriptions and to book appointments by April 2014 with 100% achieving this by March 2015, the plan says. All practices will have the technical capability to allow people to access their records by April 2014 and 100% will be offering this option to patients by March 2015.
UK healthcare on brink of collapse – NHS regulator: A UK health and social care watchdog has warned that the country’s healthcare system is on the brink of collapse, and that many patients – particularly the elderly – are going to hospital for emergencies when they should have been seen much earlier, reported RT Question More. In his first major announcement since being appointed earlier this year, David Prior, head of the Care Quality Commission (CQC) has called for an urgent investment in community care. He also said that the number of emergency-care beds in hospitals should be scaled back in order to divert much-needed funds to other areas of the NHS. He voiced his concerns at a talk this week at the King’s Fund: “If we don’t start closing acute beds, the system is going to fall over. Emergency admissions through Accident and Emergency are out of control in large parts of the country. That is totally unsustainable.”
Queen’s Speech: Abolition of Audit Commission to be completed: A bill to complete the abolition of the Audit Commission, which oversees spending by local government and NHS trusts in England, has been announced in the Queen’s Speech, reported the BBC. The process of abolishing the body began in 2010, but was delayed as officials worked out how to replace it. Ministers believe that the commission’s closure will save taxpayers money. The commission’s in-house audit team was outsourced in 2012, but the residual commission currently continues to have a role in contracting private-sector auditors to perform the tasks it once undertook itself. The Local Audit and Accountability Bill, if passed by Parliament, will replace the remnants of the commission with a new system of local auditing. Under the plans, the smallest local public bodies – those spending less than £25,000 a year – will no longer be audited.
NHS chiefs demand urgent action to tackle A&E pressures: Health service chiefs have demanded urgent action to tackle the growing pressures on A&E departments, reported the BBC. NHS England has given regional health bosses until the end of the month to come up with plans to tackle problems. Emergency funds will be made available to help amid warnings from the regulator that hospitals will no longer be able to cope if demands keep rising. The Care Quality Commission said another Stafford Hospital scandal was being risked because of the problems. In recent months the NHS has been struggling to hit its four-hour waiting time target. NHS England said it now wants regional health bosses to work together to ensure plans are in place for each A&E in their patch, with extra money being made available where problems are identified. Prof Keith Willett, of NHS England, said: “When pressure builds across the health and social care system, the symptoms are usually found in the A&E department. We need the whole NHS system, in the community and hospitals, to recognise the problems and help to relieve the pressure on their colleagues in A&E.”
East Cheshire NHS Trust selects HCS and Net.Orange to help deliver vision for joined-up care: East Cheshire NHS Trust is to partner with HCS, to help drive forward the development of integrated care across Eastern Cheshire’s Health and Social Care system, reported Yahoo Finance. The HCS Care Coordination service will provide expert assistance to the trust to support the delivery of integrated care as a key partner in Eastern Cheshire’s Caring Together Program, which aims to commission and deliver patient-centered joined up, pro-active care services. Samantha Nicol, Caring Together program director at NHS Eastern Cheshire Clinical Commissioning Group, said: “Our aim is for improved care for our local population in all areas: clinical, the care pathway and the experience for patients. In addition, we wish to improve the experience for the professional staff delivering that care. Working with HCS provides an opportunity for us to take advantage of a significant amount of expertise and resource that aligns completely with our Caring Together vision and which will help us deliver the success we are looking for.”
New Choose and Book by end of year: NHS England plans to have a redeveloped Choose and Book service operating by the end of this year, reported eHealth Insider. Industry leaders are concerned that the re-platforming of the electronic booking service is being rushed to meet an impossible timescale. NHS England’s new business plan says it will have a new NHS e-referrals service operational by December 2013. It says the re-launch of Choose and Book is part of the ‘Paperless NHS’ programme and aims to make electronic referrals “universally and easily available to patients and their health professionals for all secondary care services by 2015.” The plan adds that all referrals will be done electronically by March 2017. The contract for delivery of Choose and Book is with Atos Healthcare and runs out in December 2013, with no further options for extension.
East Kent buys portal to save time: East Kent Hospitals University NHS Foundation Trust hopes to save up to 20 minutes of A&E doctors’ time per patient with the deployment of a clinical portal, reported eHealth Insider. The trust has more than 7000 staff across five sites and has signed a pilot agreement for 500 licences for Harris Healthcare’s clinical portal. It gives clinicians a single view of patient information held in systems that currently work in isolation. The initial phase of the implementation will integrate data from six major clinical systems; the patient administration system; pathology; document management; vital signs monitoring; theatres; and the picture archiving and communications system. Bob Reeves, head of IT at the trust, said the aim was to enable staff to operate more efficient and paperless clinics in line with the trust’s IT strategy and the government’s challenge to create a paperless NHS by 2018.
GP commissioning leader defends CCGs over NHS 111 failure: Blaming local commissioners for the failure of NHS 111 in some parts of the country is a “bit rich”, the president of NHS Clinical Commissioners has told HSJ (subscription required). At a meeting last week, the board of NHS England agreed to commission two reviews, one examining the future sustainability of the NHS 111 service model and one looking at lessons to be learned from the NHS 111 programme. More than a month after the original intended go-live date for the service, providers in almost half of the country are still relying on support from NHS Direct’s 0845 number to meet demand. NHS England interim chief operating officer and deputy chief executive Dame Barbara Hakin told the meeting: “We need to ask how it was possible that contracts were awarded to providers who, on day one, couldn’t deliver the service.” However, Mike Dixon, interim president of NHS Clinical Commissioners described Dame Barbara’s comments as a “bit rich”. He said that, although clinical commissioning groups were operating in shadow form during the period 111 was being procured; many were not involved in the process.
Minister backs call for CCGs to take on commissioning of GP services: A government minister has signalled that they will look at whether CCGs should be able to commission primary care services direct from GPs locally in order to promote integrated care, reported Pulse. Health and care minister Norman Lamb said that he was ‘very interested’ in ideas such as CCGs commissioning ‘PMS-style’ contracts with local GPs and that the government was keen to tackle ‘barriers’ to integration with NHS England. Speaking at a King’s Fund conference on integrated care this week, Mr Lamb said the Department of Health would shortly be publishing a framework to ‘normalise’ integrated care in the NHS, with tools to help commissioners, such as standard contracts and support for ‘pooled budgets’. Lamb also reiterated the government position that the recent surge in demand at A&E departments was due to patients not being able to access primary care. He said this was an example where general practice needed to do things ‘differently and better’.
Hospitals ‘not reporting hundreds of blundering doctors’: Almost 200 doctors have not been reported to the General Medical Council (GMC) for potentially fatal errors despite new legislation following the Harold Shipman case, reported The Telegraph. It is feared the number could be even higher as only a third of hospitals answered a Freedom of Information request. In one hospital 42 doctors received more than two complaints that were not reported, while other NHS trusts did not tell doctors’ new employers about cases of negligence. After the inquiry into serial killer Dr Harold Shipman, rules were drafted requiring trusts to report doctor errors to the GMC, but they have not been ratified. Medical negligence consultant Ann Harris used the Freedom of Information Act to ask England’s 163 NHS trusts how many doctors had two or more complaints made against them in the past five years, and how many had been reported to the GMC. The 54 that responded revealed a total of 204 such doctors, but just eight were referred to the GMC. Two of the trusts that failed to refer blundering doctors to the GMC – Basildon and Queens Hospital, Burton – are on a list of 14 trusts currently under investigation over high deaths by NHS England.
Junior doctors have poor grasp of NHS reforms: A study published online by The Junior Royal Society of Medicine (JRSM) reports has revealed that many junior doctors have a poor grasp of the NHS reforms and GPs’ role in commissioning health services, reported OnMedica. JRSM published research that found a surprising lack of understanding amongst junior doctors of the NHS reforms, the overall NHS budget and health politics. A survey of 102 foundation year junior doctors found that around 72% of them did not know who would be responsible for healthcare commissioning after the reforms (GPs), 18% could not name the health secretary, and 67% did not know the budget of the NHS. When asked to identify who would be involved in healthcare commissioning under the NHS reforms, only 30% correctly stated GPs with other parties or as part of clinical commissioning groups. In addition, 41% thought GPs alone would be involved in commissioning, while just 2% thought the now defunct primary care trusts would take on this role. Researcher Dr Stefano Palazzo, from Chelsea and Westminster Hospital, and report co-author, said: “Most worryingly, almost three quarters of foundation doctors surveyed were unaware of significant changes that could affect their own training, namely that deaneries will no longer be responsible for coordinating education.”
Opinion
Nuffield Trust responds to the Queen’s Speech 2013
Following the State Opening of Parliament on Wednesday 8th May, Nuffield Trust gives its official response to the healthcare reforms set out in the Queen’s Speech.
Nuffield Trust Chief Executive, Dr Jennifer Dixon said: “The Government’s commitment to reform funding for social care based on the principles laid out by the Dilnot Commission is a landmark on the path to a fairer system.
“After twenty years of stalling on this issue from all parties, [Wednesday’s] announcement is a welcome recognition that we cannot continue placing so much of the burden of payment on the unlucky few facing catastrophically high costs”
Dr Dixon goes on to explain that the gap between funds available for social care and demand continues to grow and that this also needs to be addressed.
In addition, Dr Dixon explains: “Our review for the Secretary of State set out how policy-makers could develop a system of rating health and social care providers for quality in a way which gives an accurate picture to patients, and helps professionals to drive up standards.
“More detailed scrutiny of quality will be crucial as the budget for the NHS becomes much tighter in the next few years.”
Transforming the NHS requires less talk, more action
Ciarán Devane, chief executive at Macmillan Cancer Support, talks to HSJ (subscription required) about how the playing field of the NHS has changed, but the people on the ground can still establish a positive working culture by talking less and doing more.
Devane said: “What is not yet there is the culture. Culture is established ways of working; tacit knowledge of how to get things done; relationships that will see people through disputes; or shared visions of what the world will be like. But even here, there are more than glimmers of hope.”
Devane argues that a streamlined health service is the key to future success: “So my belief is that part of what the new NHS should do quickly is change a few things that just make life easier. Scrap a few reports, simplify a few forms, abolish a few rules, question more, and, perhaps at times, rebel. Release people’s time to do good things and those good things will happen. Encourage them to test and learn, not to analyse themselves into stasis.”
Is the NHS really that bad – what does the evidence show?
In the Guardian this week Chris Hopson discusses why the negative press surrounding the Care Quality Commission’s annual inpatient survey is by no means all justified.
“Judging by recent media coverage, you might be forgiven for thinking that the NHS has become a patient’s nightmare, with doctors and nurses routinely mistreating or ignoring those in their care, leading to thousands of unnecessary deaths in hospitals across the country. What does the evidence say?
“The Care Quality Commission’s annual inpatient survey – looking at the experiences of more than 64,500 people admitted to NHS hospitals in England in 2012 – got precious little media coverage. But it paints a very different picture.
“In 2012, 80% of patients said they were always treated with dignity and respect in hospital, with only 3% saying they weren’t. 80% said they always had confidence in the doctors treating them and 76% always had confidence in the nurses treating them, with only 3% not having confidence in either case. Ninety percent of the patients surveyed said they were always given enough privacy when being examined or treated; only 1% said they weren’t.
“It’s not a uniformly positive picture; there are a number of areas where the NHS needs to do better. No one can be satisfied that 20% of patients didn’t feel they were given enough information about their treatment or that 48% of patients felt that they had to wait three minutes or longer for their call button to be answered.
“But, overall, this evidence confirms the view that poor pockets of care are exactly that – pockets – and that poor care is not widespread, universal or endemic. We should, therefore, celebrate the successes of the NHS with the same enthusiasm and regularity as we, rightly, criticise the places where care has failed.”
Analyse this
In the week’s eHealth Insider Aasiya Moreea, assistant director of clinical information and business intelligence at Bedford Hospital NHS Trust, finds herself being driven dashboard crazy.
“When I started working at a previous trust, I asked for a copy of all of its dashboards. To my astonishment, I received back a pile of printouts as thick as a copy of the Yellow Pages (before they became electronic). It didn’t help that there were different dashboards for each of the clinical divisions (of which there were seven). And, of course, there was no consistency about how things were reported across them. Added to that, were the slight variations in the indicators, depending on who had requested them or the committee at which they were being presented.
Moreea continues describing the time that it took to reduce the dashboards down to a manageable number. However, she says that it was still taking far too much time to produce them each month. Moreea then skips to the present day.
“When I arrived at Bedford Hospital, I once again asked for a copy of all the dashboards. This time, there aren’t as many. Phew! However, this time round I found myself thinking ‘I need to create a new dashboard, as we haven’t got enough!’ To get something in quick and useful, we created a weekly dashboard in Excel, with core KPIs (key performance indicators) and a simple visual look of performance.
“My view is that a dashboard should be easy on the eyes, tell you very quickly if you have an issue (good, bad, could become bad in the near future) and an indication of whether or not it is improving or deteriorating. It has got to be simple and easy, highly visual – and tell you just what you need to know.”
Highland Marketing blog
In this week’s blog Joanne Murray asks whether entering industry awards are good for your organisation or all hype?!
