Government delays decision on cap in care cost
The government has delayed its decision on how much people will have to pay for care saying it is unable to commit to introducing a new funding system at this stage. The Dilnot Commission last year suggested that care costs should be capped between £25,000 and £50,000 per individual. However, HSJ reports [subscription required] that the government’s latest progress report says: “There was a discussion on the level of the cap, with some people suggesting that a cap could be set at the top of the commission’s range – or even slightly higher (e.g. at £75,000) – without undermining the principles of the system.”
The government added that funding reform needs to be considered alongside other priorities and the right place to do this is at the next spending review, which is expected in 2015. Launching the social care white paper, ministers also confirmed that an extra £300m will be found from NHS efficiency savings to “support the transformation of local services”. The extra £300m will be distributed to councils from the NHS budget via the NHS Commissioning Board.
Clarity over NHS Informatics leadership
EHI has revealed that responsibility for NHS IT at a national level is to be split three ways between the Department of Health, the NHS Commissioning Board, and the Health and Social Care Information Centre. An NHS Informatics draft business plan says an NHS Informatics Futures Board has been set up to oversee the division of its functions – and to get the different organisations to liaise on IT issues. In addition, EHI reported that Katie Davis, managing director of NHS Informatics, will leave her post by September. Tim Donohoe, currently responsible for the day-to-day delivery of NHS programmes and services, will take on her role until NHS Connecting for Health is abolished next March.
The draft business plan outlines a split between future NHS IT policy, systems, and management when this happens. It also identifies some of the big risks of moving to this structure as being the need for “greater skills and capacity in ‘local’ NHS organisations” and that there could be a failing to develop the ‘vibrant supplier market place.’ The move to the new structure is likely to cost around £2.5m, and will mean considerable disruption for some parts of NHS Informatics.
Virgin Care to take over children’s health services in Devon
Sir Richard Branson’s Virgin Care has been named preferred bidder for a £130m contract to run core NHS and social care services for children and young people in Devon, reports The Guardian. The company will take over integrated children’s services in the South West in March 2013 and will run frontline services for three years. Virgin will take over about 1,100 staff employed by NHS Devon and Devon County Council, which currently oversees about 2,400 children with disabilities, children’s mental health services and school nurses and health visitors. Virgin has also signed a £500m contract with NHS Surrey to run community health services, beating competition from two rival bidders.
Rebecca Harriott, director of commissioning development at NHS Devon, said there were “many benefits” to the deal. “We know that these are important and sensitive services and it is vital to ensure that everyone can be confident that a winning bidder is able to deliver the best possible outcomes for children and young people across Devon.
A Virgin Care spokesman said: “We have a strong track record of delivering investment and complex care for children and young people as well as a wider range of NHS services across the country. Since 2006 we have treated over 2 million people delivering services that offer improved accessibility, convenience, satisfaction and most importantly, that deliver improved health outcomes while at the same time providing improved value for money.”
Critics have warned that such deals herald the breakup of the NHS, with private firms’ cherry picking services.
First NHS trust put into administration
South London Healthcare NHS Trust has become the first NHS trust to be put into administration following ongoing financial difficulties, the government has announced. The BBC reports that Health Secretary Andrew Lansley has appointed a ‘trust special administrator’ to go into the trust, which serves more than one million people and deals with a high demand for emergency services. Earlier this year the trust admitted that even in the best case scenario its yearly deficit would shrink to £15m over the next five years.
Mr Lansley said the decision to put the trust into administration followed a recent statutory consultation with the trust board, the strategic health authority and local NHS commissioners. The special administrator’s role will take effect from 16 July and he will “assume full control of South London Healthcare NHS Trust, replacing the functions of the trust board and assuming the role of the accountable officer”, the health secretary said.
North Bristol concerned about Cerner costs
North Bristol NHS Trust has reported concerns about the cost of its Cerner Millennium implementation, which went live in December 2011. Campaign4Change says that the trust’s latest board papers claim “overall the level of spending on Cerner continues to be a major concern and the IM&T director is working to develop a plan to identify what will be needed in the current year”.
Despite the trust claiming that its issues with Cerner had been “overcome” in May, last month’s board papers hint that some difficulties are continuing with the overspend on Cerner being around £900,000 over a two-month period. The paper say the “costs of Cerner remain a risk as some of the forecast spend may need to be re-classified as revenue.” Meanwhile EHI as revealed that Martin Bell is leaving his position as director of IM&T at North Bristol NHS Trust after ten years of service.
News in brief
- Morecambe Bay comes under scrutiny: University Hospitals Morecambe Bay NHS Foundation Trust has come under increased scrutiny this week as the trust admitted that 19,000 outpatients had their follow-up appointments delayed. Despite the trust saying that all patients are now receiving appropriate care, reports have claimed that the health of more than 650 patients may have deteriorated as a result of delayed appointments. The trust is already being investigated regarding deaths at the baby unit at Furness General Hospital and health regulators have criticised standards at Royal Lancaster Infirmary’s A&E unit. The interim chairman of the trust, Sir David Henshaw said: “We have made a good start over the last few months and we are committed to making sure that the improvements that are needed are implemented as quickly and effectively as possible.” The BBC said that the trust has prioritised changing the outpatients booking system to ensure these delays cannot happen again.
- South West pay consortium to press ahead with Agenda for Change plans: A consortium of 19 NHS trusts in the South West has met for the first time and agreed to press ahead with plans to break away from Agenda for Change. The consortium steering group met for the first time on 29 June and agreed to develop detailed plans in coming months as part of a full business case to identify options to reduce the pay bill in the South West. Christina McAnea, head of health at Unison and chair of the NHS staff council of 16 unions, labelled the move “highly provocative”. The full business case is anticipated to be completed by the end of 2012, reports HSJ [subscription required].
- Big pharma is in big trouble – or at least it should be: Two pharmaceutical giants – GlaxoSmithKline and Roche – have serious questions to answer as a result of investigations by The Medicines and Healthcare Products Regulatory Agency (MHRA), reports the dailymail online. GSK has been fined £2bn in the USA for activities that include free trips for doctors, paying a medical radio show host £150,000 to promote one of its antidepressants, paying for articles to appear in reputable medical journals and encouraging the prescription of the antidepressant drug, Paxil (marketed in the UK as Seroxat) to children, which is known to trigger suicidal thoughts. Roche has been called to account for 15,000 deaths and 65,000 adverse drug reaction reports, which had not being forwarded from its USA subsidiary, Genentech, to Roche’s drug safety team.
- ICO takes action after medical records sent to the wrong address: The Information Commissioner’s Office (ICO) has issued a penalty of £60,000 to St George’s Healthcare NHS Trust in London after a vulnerable individual’s sensitive medical details were sent to the wrong address. While the letters were addressed to the correct recipient, they were sent to an old address, despite the correct address having been logged on the national care records service, known as NHS SPINE, in June 2006. Stephen Eckersley, the ICO’s head of enforcement, said: “It’s hard to imagine a more distressing situation for a vulnerable person than the thought of their sensitive health information being sent to someone who had no reason to see it. This is the fourth monetary penalty we have issued to the NHS in the past two months. It is vital that these organisations make sure they have the necessary measures in place to keep patients’ details secure.”
- Competition panel to probe referral management: HSJ has reported that the NHS Cooperation and Competition Panel have begun a probe of the competition implications of providers operating systems to manage patient referrals. The panel said it had received a number of requests for advice in recent months about how NHS competition rules apply to financial incentives relating to referrals. Questions have previously been raised about GPs referring patients to their own services. It has also received queries about the rules around attempts by providers to manage referral processes “in a way that may affect patient choice or competition”, for example referral management services operated by GPs or community service providers.
- E-referral almost complete in Wales: NHS Wales is approaching the completion of the roll-out of its e-referral system, with more than 90% of GP practices now using it, reports EHI. The Welsh Clinical Communications Gateway was first implemented 18 months ago and allows clinical messages to be sent securely in an electronic format from the GP to the hospital, replacing patient referral letters.
- Practices start registration with CQC: More than 2,000 GP practices in England have begun registration with the Care Quality Commission (CQC) reports GP Online. A CQC spokesman urged practices to visit the website as soon as possible. “The advantage is that you can start thinking now about anything that you may not be compliant on. You can print it all out, and take it to practice meetings.” Practices have between September and December 2012 to register, with places allocated on a first-come, first-served basis.
- Majority of hospitals seek electronic records post NPfIT: The majority of hospitals are seeking electronic patient records outside the National Programme for IT, with three in five already selecting alternative systems, according to research from Computer Weekly. In a survey of 178 health professionals, three-quarters of which were based in secondary care, 68% said they intended to spend less than £5m on electronic patient records over the next two years.
Opinion
Nicholas Timmins: The aftermath of reform
Ahead of the publication of his report Nicholas Timmins, a senior fellow at the Institute for Government and the King’s Fund, talked exclusively to HSJ regarding the background to his inside story on the process of the NHS reforms.
“Two years ago this week, Andrew Lansley published Liberating the NHS. His white paper – launched after repeated Tory and coalition promises of no more “top down” reorganisations – set out arguably the biggest structural upheaval the service has ever seen and certainly the biggest transfer of power and accountability in its 63-year history.
“What resulted is widely seen as one of the biggest “car crashes” ever in terms of both politics and policy making – one to which the service must never again be subjected.
“Over the past few months, the Institute for Government and the King’s Fund have jointly tried to piece together how and why this happened and what lessons might be learned.”
‘Never Again?‘ tells the story of how and why the Health and Social Care Act 2012 – by far the most controversial piece of NHS legislation in more than two decades – became law. It relates the story to that of a political thriller – from the legislation’s origins 20 years ago, through the development of the 2010 white paper “Liberating the NHS” and the resultant bill; a bill so controversial that it appeared at times as though the Government might lose it.
It tells the story from the view point of opponents and critics, but also from the point of view of the man with whom this legislation is uniquely identified – the current health secretary. On the way, it explains just what it was that Andrew Lansley was trying to do and why the bill was so vast and controversial.
Do changes to the NHS mean there needs to be changes to the NHS brand?
In an opinion piece in HSJ, Richard Hudson, marketing director for the Association for Healthcare Communications and Marketing questions how the NHS identity rule book can be applied when mergers are becoming more commonplace and new areas of the NHS such as CCGs are emerging.
“The coming together of community and mental health, acute and community and the future possibility of all manner of permutations is a real challenge to branding. We fastidiously apply the NHS Identity rulebook to pantone colours, NHS logo, name and all manner of logos.
“It is becoming increasingly difficult to develop meaningful brand architecture for these NHS organisations. We need to adopt a new approach to NHS branding that reflects the changes that have been developing and I believe that it is time to consider the adoption of a silent parent brand approach for NHS trust names where appropriate.”
Securing future NHS funding: is a productivity boost enough?
“The theory goes that in order to meet the challenge of future health care demand due to changing demography, lifestyle and new technology innovation, resources must shift into more community, home-based and self-service provision.”
But as Sue Slipman OBE, chief executive of the Foundation Trust Network continues to observe in her blog “…there’s plenty of push on hospitals to get demand out but little pull in alternative provision. In effect, the Nicholson challenge is a save to invest scheme for service transition across the NHS.”
Roundtable: Full measures
Getting commissioning right will depend on getting the right data. But what does that mean? And what can we do to deliver all the data CCGs will so desperately need in just 12 months’ time?
HSJ reporter Daloni Carlisle commentates on a lively expert debate with participants including Dr Charles Alessi, chairman, National Association of Primary Care; Dr Shahid Ali GP and clinical lead for the NHS Commissioning Board’s patients and intelligence directorate; Chris Calkin chair, HFMA policy committee and Dr Mark Davies executive medical director, Health and Social Care Information Centre.
Highland Marketing blog
Following the announcement this week of the Health Secretary’s social care white paper, Susan Venables shares her views on NHS reforms and hope for change.
