News in brief
£35m nursing tech fund shared among 60 bidders: More than 60 bids by NHS and other care providers have received a share of the second tranche of nursing technology fund, an NHS England director has told Health Service Journal (HSJ, subscription required). The second tranche of money from the flagship technology fund was originally worth £70m. But it was cut to £35m by the Department of Health, as revealed by HSJ in November. The winners include 55 NHS trusts and seven voluntary, community or social enterprises. Among the winners were Lancashire Teaching Hospitals Foundation Trust, which has secured funding for its enhancing patient safety through electronic vital sign recording project, and St Barnabas Lincolnshire Hospice for its shared electronic care plan for palliative patients project. Birmingham and Solihull Mental Health Foundation Trust’s bid focused on facilitating mobile working for community nurses. Devon Partnership Trust is using the funding to roll out video consultations for nursing staff. NHS England was unable to provide a full list of winners, but a spokeswoman said full details would be provided in the coming weeks.
SCR reaches 50m patients: The NHS Summary Care Record (SCR) has reached the 50 million patient mark, with more than 30,000 record views now occurring each week, reported eHealth Insider (EHI). The milestone is the latest demonstration of the SCR’s growing use, after it was initially bedevilled with criticisms about confidentiality and low viewing levels. The Health and Social Care Information Centre said 90% of the population is now covered. The record provides a core set of required clinical data, including allergies, medications and adverse reactions, pulled from GP systems, which can be viewed by health professionals involved in a patient’s care. In July 2013, it was expanded to include patients’ end-of-life care information, immunisations, and significant past problems and procedures. Richard Jefferson, NHS England’s head of business systems, told EHI News the milestone is a demonstration of the “significant benefits” that the SCR is delivering to clinicians and patients across the country.
NHS hires Capita to buy in services: The NHS has appointed private sector companies including Capita to help buy billions of pounds of services for hospitals and GPs, reported The Financial Times (subscription required). NHS England has announced that Capita Business Services, Mouchel and Optum, part of United Health, are among private sector companies that are in line to win work worth at least £5bn advising new doctor-led clinical commissioning groups, which spend more than two-thirds of the NHS budget buying care for patients. They will advise on patient care reforms, finances, drug purchasing, negotiating hospital contracts, handling NHS patient care data, supporting organisational change and outsourcing services to private sector providers. A host of NHS organisations were also appointed to the “framework” of preferred suppliers, which can be used by hospitals and GPs to buy services more quickly — £3bn to £5bn of services must be procured by April 2016 to meet EU laws. Bob Ricketts, director of commissioning support strategy at NHS England, said the aim was to strengthen the capability of NHS commissioners so they have the support they need to buy and improve healthcare services.
Scottish health boards to receive additional £282m next year: Health boards in Scotland are to receive an additional £282m in 2015-16, the health secretary has announced. The Scottish Government said territorial health boards have been given a general allocation increase of 3.4% on 2014-15, bringing the total allocation to boards to more than £8.5bn, reported STV News. In addition to this, the Government’s announcement of £30m in 2015-16 to tackle delays in discharging patients from hospital will be added to boards’ budgets, bringing the total increase to 3.8%. Health secretary, Shona Robison said tackling delayed discharge is an “absolute key priority” for the government and the £30m, which forms part of a £100m investment over the next three years, is “crucial” to this effort. Announcing the funding she said: “The Scottish Government’s commitment to increasing health boards’ budgets demonstrates our continuing investment in frontline health spending. This comes as Scotland’s total health spending reaches more than £12bn for the first time ever.”
NHS “to get whistleblower guardians”: NHS trusts will have to appoint a guardian to help whistleblowers in England, ministers have confirmed. The measure was called for by Sir Robert Francis after he warned staff too often faced “bullying and being isolated” when they tried to speak out. Sir Robert, who led the public inquiry into the Stafford Hospital scandal, also said a new national officer should be appointed to help the guardians. The government immediately accepted all his recommendations, reported the BBC. Health secretary, Jeremy Hunt said: “If we don’t get the culture right we will never deliver the ambitions we have for the NHS.” He said he agreed with the proposals in principle, but would now consult on how best to implement them. He added legislation to ensure whistleblowers were not discriminated against when they went for other jobs would also be introduced. Sir Robert’s Freedom to Speak Up Review took evidence from over 600 people about their experiences, while another 19,000 responded to an online survey.
Clarification concerns leave Caldicott unsure of care.data timing: National Data Guardian Dame Fiona Caldicott has said no deadline is currently in place to complete a review of measures required to address concerns around NHS England’s controversial care.data scheme – leaving a launch date to begin trialling the programme uncertain. After being appointed by the Department of Health as the first ever data guardian last year, Dame Caldicott back in December called for clarification on some 27 questions relating to privacy and the wider scope of care.data. Implementing the programme has continued to prove controversial, with pressure groups raising concerns over the confidentiality implications of sharing highly personal data concerning medical and mental health histories. Under a new implementation plan, NHS England is looking to trial care.data at selected surgeries in the Clinical Commissioning Group (CCG) areas of Leeds, Somerset, West Hampshire and Blackburn with Darwen. Speaking to Government Computing, Caldicott said that no formal timetable had been set by either herself or senior health figures like Tim Kelsey, NHS England’s National Director for Patients and Information, for when the clarifications required about the programme will be addressed.
QOF is “bad for health”, says NHS England official: Speaking at a Westminster Health Forum event this week, NHS England leaders said Clinical Commissioning Groups should “take on the entirety of commissioning for their locality”, arguing that the current commissioning split had created “artificial barriers” between services, reports GP. They recommended moving away from national frameworks and more towards systems that allow for greater local freedom, built around the needs of patients. Deputy medical director for NHS England Dr Mike Bewick said the Quality and Outcomes Framework (QOF) was “becoming bad for health”, and that it was more focused on creating “indicators for incentives” than improving patient care. Speaking at the event, he said: “I think QOF is probably here to stay, but we should be developing indicators that are not always linked to incentives, but to how we enhance professionals working together with the end view to deliver better care.”
St George’s exits BT for RiO: St George’s University Hospital NHS Foundation Trust has become the first community trust in London to leave the BT data centre, after moving to a direct contract for Servelec’s RiO electronic patient record system. The trust migrated its data from the data centre last December, moving to RiO7 on a hosted service provided by Capita, with 1,000 users. St George’s opted to sign a direct contract with Servelec Healthcare last July 2014, following a procurement process under the Camden framework. Trusts that deployed RiO under the National Programme for IT in the NHS need to exit the BT data centre and their central contracts by October this year. John-Jo Campbell, the trust’s chief information officer, told eHealth Insider that the new contract and system has “built in some additional functionality and flexibility and future-proofing”. Campbell said the trust is particularly interested in rolling out Servelec’s Store and Forward mobile working solution to allow community nurses to access records and work offline. He said the move from BT to Servelec was relatively smooth, after the trust and its suppliers worked hard on preparing for the exit. “There was a reasonable amount of work for Servelec and the trust and our new hosting partners to undertake – there were a couple of minor issues to deal with, but everything went largely well.”
Problems with patient records system add to GP workload: Doctors are now facing extra work to amend records following consultations, after network problems left them unable to view records and prescribe electronically. Andrew McHugh, medical practice director at Horsefair Surgery in Oxfordshire, told GP that the situation was a ‘nightmare’. “It’s been extraordinarily frustrating to have records up one moment and off the next,” he said. “If we don’t have access to the medical records, we cannot provide a safe service to our patients. All the time that it’s been down, it’s just backing up work that doesn’t go away. The GPs are constantly running to try and catch up with themselves.” The problems have been going on since last week, when the Health and Social Care Information Centre (HSCIC) raised the issue as a national service incident. INPS put the problems down to server and router problems at its data centres hampering connections to the N3 network. “Intermittent connectivity issues at our data centres have caused short interruptions to the hosted service for a number of practices in England. We continue to work closely with BT N3 and the HSCIC to seek a full and permanent resolution at the earliest opportunity,” a spokesperson for INPS said.
Hinchingbrooke Hospital appeals for £10m taxpayer-funded bailout: The only NHS hospital run by a private company has asked for a £10m taxpayer-funded bailout, reported The Independent. Hinchingbrooke Hospital in Huntingdon, Cambridgeshire, is due to be handed back into NHS hands in March after the company outsourced to manage it, Circle, said it could no longer cope with rising demand and funding cuts. However, the hospital trust’s latest financial statement reveals Circle is expecting to leave behind a deficit of between £7.7m and £12m. Under its contract, the company is only liable to pay £5m to cover deficits incurred at the trust, and has already paid £4.8m. The hospital has now applied to the NHS Trust Development Authority (TDA), a Government health authority responsible for leadership of 99 NHS bodies, for £9.6m in “public dividend capital” funding, and also expects to borrow extra cash from the TDA.
Google adds medical information to its search results: Google is rolling out a health feature that provides information about “common” medical conditions in response to related searches, reported the BBC. The facility provides medical illustrations, possible treatments and other data ahead of its traditional links to others’ sites. The firm says it worked with doctors to develop the service, but adds that it is not intended to replace visits to a professional. Initially limited to the US, the firm says it plans to extend the service across the globe, adding rarer ailments in time. British doctors have welcomed the initiative, but caution that the information needs to be edited to become suitable for local markets. Speaking at the launch of the feature Prem Ramaswami said: “One in 20 Google searches are for health-related information. We’ll show you typical symptoms and treatments, as well as details on how common the condition is – whether it’s critical, if it’s contagious, what ages it affects, and more. For some conditions you’ll also see high-quality illustrations from licensed medical illustrators. Once you get this basic info from Google, you should find it easier to do more research on other sites around the web, or know what questions to ask your doctor.” The effort is the latest in a series of moves into health by the search giant.
NHS innovation search closes in three weeks: Health innovators from home and abroad have just over two weeks left to apply to be part of the NHS Innovation Accelerator programme, as the deadline for innovators looms, reported Integrated Care Today. NHS England in partnership with The Health Foundation and UCL Partners is inviting healthcare pioneers from around the world to apply to develop their tried and tested innovations across the NHS. The programme will focus on the conditions and cultural change needed to enable the NHS to adopt innovations. Sir Bruce Keogh, NHS England’s Medical Director said: “The Innovation Accelerator will build on our enviable history of discovery and innovation by embracing cutting-edge healthcare innovators from around the world to improve patient care while reducing costs and providing better value for the taxpayer.” Applicants should be experienced innovators in healthcare who are currently leading or working on new technologies, services and processes that have the potential to make a real difference to patient outcomes. The first wave application process is now open. Innovators from across the international healthcare spectrum are invited to apply. The closing date for applications is 12 noon on 27 February 2015.
Opinion
Joe’s view: An SCR iPhone App?
Apple’s latest operating system comes with an emergency medical screen for users to fill in. Joe McDonald wonders why it doesn’t link to the Summary Care Record; or even a detailed care record.
“When I downloaded iOS 8 to my iPhone, I was delighted to see that the new HealthKit app now includes the ability to click through the phone’s lock screen to an emergency medical record, ‘Medical ID’.
“The information is obviously entered by the holder of the phone, and they enter it in the hope it might help them in an emergency. Therefore, they have, by virtue of the process, given consent for it to be viewed in an emergency.
“Why not allow patients to insert a hyperlink into the app’s emergency information (Medical ID) screen that will display the SCR? This would put it, potentially, into the hands of anyone who needs it – at no cost to the NHS and with the patient deciding on consent. In fact, why not let the “digital cavalier” with a complex condition and a good understanding of information governance have a link to their own, detailed care record?
“The growth of the SCR has been phenomenal over the last year. Accessing the SCR at the right place and time is now the key to its utility; so it’s time to put it in the patient’s pocket and hence the paramedic’s hand. Could Apple and the SCR team talk to each other?
“Given the rapid development of patient access to records online, with clear targets being set and enforced, the SCR will need a patient-centred smartphone access app to stay relevant.”
The NHS safety record needs to be as good as the airline and motor industries
The problem of patient safety persists, with about 1.2 million incidents reported every year. The NHS needs a less heroic, more systematic approach to ‘zero harm’ and patient safety says Ari Darzi on Health Service Journal (subscription required).
“As many as one in every three dollars spent on healthcare in the US arises from failures in management, including errors and overtreatment, research shows. This extraordinary sum is unlikely to be very different in the NHS.
“About 1.2 million incidents are reported each year. At the Institute of Global Health Innovation at Imperial College London, which I lead, we are researching better ways of collecting and disseminating the data.
“For too long the mindset has been that patient harms are inevitable, that silos are natural and that heroism rather than thoughtful design keeps patients safe. Other industries, notably airline and motor, have effectively managed errors and reduced harm. But in healthcare we have taken a local, more heroic, less systematic approach, and the problem of patient safety persists.
“If we are to save more lives and significantly reduce patient harm, we need to adopt a holistic, systematic approach that extends across cultural, technological and procedural boundaries – one that is based on the evidence of what works.
“In some cases, technology can help. One of the biggest causes of harm in hospitals is errors in prescribing and dispensing medicines. A combination of computerised prescription forms, barcoding and automated dispensing machines that, unlike humans, are not prone to distraction, has been shown to improve safety.
“From April, all NHS trusts will be mandated to investigate deaths in their hospitals in a standardised way by specially trained consultants. These are welcome moves and indicate that we are starting to take safety in the NHS seriously. But there is a long way to go before we match the achievements of the airline and motor industries.”
One-stop dispensing has had its day — time to embrace technology
University Hospitals of Leicester NHS Trust’s deputy chief pharmacist Graeme Hall, chief medical information officer Tim Bourne, and head of nursing Jeanette Halborg say hospitals should explore the use of technology to help streamline the inpatient medicine supply process for the benefit of patients and staff.
“Acute care hospitals in England supply patient medicines using so-called one-stop dispensing (OSD), which combines medicines used while a patient is an inpatient with those given to take home. Dispensing once so the patient is ready for discharge seems logical. However, scratch the surface and problems emerge. In acute care, patients move wards frequently and medicines are often changed. As a result, patients miss doses, nursing time is misspent and wastage becomes an issue.
“Most NHS hospitals will be familiar with the problems of OSD. For example, part packs of medicines have to be stored or recycled after a change in medication; full packs of medicines have to be redispensed if lost; medication errors result from poor checking, poorly written drug charts and inaccurate prescribing; and nurses waste time looking for medicines drug charts.
“We are careful not to make assumptions about what works and therefore are doing research to gather evidence on how this system could improve the medicines supply process in our hospital. Evaluation is being carried out independently by Loughborough University funded by the East Midlands Academic Health Sciences Network, and we will find out the results of our pilot later in the year.
“We encourage colleagues in other hospitals to consider the use of technology to improve medicines supply, supported by research and evaluation. Perhaps the NHS will discover that one-stop dispensing has had its day.”
Highland Marketing blog
Self service healthcare could save the NHS billions – and could transform healthcare on a wider scale, if taken to its logical conclusion, argues Rob Benson.
