News in brief
London takes its place among healthcare innovation elite cities of the world: The UK’s worldwide reputation for innovation in healthcare has been sealed as health secretary Jeremy Hunt launched London’s Centre of Innovation Excellence established by US healthcare firm Johnson & Johnson, announced the Department of Health. The new centre will focus on technologies in key areas such as dementia, cancer and surgical devices to make surgery quicker, faster and safer. It will also help promote new jobs and business for universities, research councils and research charities – which will be directly hired in order to deliver on the centre’s science projects. Speaking at Innovation Expo 2013, Jeremy Hunt said: “I want to give doctors and nurses the time and space to deliver patient centred care – to do this we need to innovate. Britain has a worldwide reputation for excellence in innovation – the investment by Johnson & Johnson here demonstrates this and I am delighted to welcome this new centre to the UK.”
NHS ‘gagging clauses’ must end, says health secretary: The BBC has reported that, “gagging clauses” in severance agreements for NHS staff in England must end. Health secretary Jeremy Hunt told the Daily Mail he wanted to see a clampdown on such practices and would seek to introduce wording into agreements making it clear people could still whistle-blow. However fellow Tory MP Stephen Barclay has claimed the move may not go far enough in dealing with a lack of transparency. The use of the clauses in the NHS is thought to have been widespread. In the last five years, more than 400 compromise agreements outlining special severance payments for departing NHS staff have been approved by the Department of Health (DH). But the DH has said it does not know the extent to which payments were tied to clauses stopping recipients speaking out about any problems of patient safety or care. Hunt told the Mail a “culture of openness and transparency” was at the heart of trying to drive up NHS standards.
NHS launches health app library: The NHS Commissioning Board (NHS CB) has launched a library of NHS-reviewed health apps to help people manage their health, reported Pharma Times. The new Health Apps Library so far contains around 70 apps that have been produced by a variety of organisations, which have been reviewed by the NHS to ensure they are clinically safe. The apps in the library will help people with tasks such as getting advice on their condition, booking repeat prescriptions, accessing test results, sharing care plans online, and finding the most appropriate NHS service. One of the apps also enables the public to find clinical trials to participate in, based on conditions they have and where they live. The library is part of the NHS CB’s commitment to improving patient outcomes through the use of technology, and comes just more than a year after the UK Government began its “Maps and Apps” programme, which will lead to GPs being able to “prescribe” apps for patients.
Morecambe Bay NHS trust ‘insolvent’ without £30m cuts: The University Hospitals of Morecambe Bay NHS Foundation Trust has said it could be insolvent without a £30m cut in spending, reported the BBC. The trust which runs hospitals in Barrow, Kendal and Lancaster, told staff it faced a “serious financial challenge”. The cut was part annual efficiency saving and part “a result of the cost of making services safe”. In the letter to staff the trust’s chairman John Cowdall and chief executive Jackie Daniel said: “There have been rumours that the trust might run out of money and be unable to pay wages. The reason this isn’t happening is we are continuing to take action to prevent it.” The Liberal Democrat MP for Westmorland and Lonsdale, Tim Farron said the trust could be put in “a situation where they end up making savings that put people’s lives at risk”. However, the trust said it would not “put finance before the safety of anyone who uses our hospitals”.
CCGs should specify IT requirements from services when commissioning: Leading health expert, Paul Shannon has said that it is important that IT services are made a priority for the NHS as paperless care is vital for improving health outcomes across the country, reported Commissioning.GP. Dr Shannon, CSC’s UK medical director and a consultant anaesthetist at Doncaster and Bassetlaw Hospitals NHS Foundation Trust, has called on CCGs to ensure that IT services are at the forefront of contracts when they are commissioning services. Dr Shannon pointed out that there are a number of benefits for patients and GPs with a more paper-light system. He said: “Sometimes we don’t realise how insecure our current paper-based systems are. You can walk around any hospital and see case notes lying around in a completely insecure way and unauthorised people can view them. People who have no legitimate reason to be looking at medical notes can get hold of them very easily and read them. If you compare the current system to what an electronic system would provide, it is probably a lot more secure.”
Board seeks vital legal permission over sensitive data: The NHS Commissioning Board (NHS CB) is to apply for a legal exemption to enable vital information to flow lawfully around the reformed NHS commissioning system from 1 April. HSJ has learned the NHS CB will make a submission to the independent NHS ethics and confidentiality committee, with the intention of allowing patient identifiable data to flow legally between the NHS Information Centre, clinical commissioning groups and the NHS CB, including the commissioning support units it hosts. It is hoped the committee will then make a recommendation to the health secretary to approve an exemption under section 251 of the 2006 Health and Social Care Act. That would set aside normal confidentiality requirements where there is no practical alternative, and where the exemption is in the public interest.
418 ‘serious events’ at Scots hospitals: Hundreds of serious adverse events in Scottish hospitals have been reported in the first in a series of reports into how health boards handle and learn from mistakes, reported The Scotsman. Healthcare Improvement Scotland (HIS) published four reports this week into NHS Fife, Fourth Valley, Western Isles and the State Hospital. The boards together reported more than 400 significant adverse events over a period of 18 months, along with thousands more less serious incidents. An adverse event is described as “an unexpected or avoidable event that could have resulted, or did result in, unnecessary serious harm or death of a patient, staff, visitors or members of the public”. The reviews, which will cover all health boards in the coming months, were ordered by the Scottish government last year after it emerged that NHS Ayrshire and Arran had withheld reports on serious incidents.
Doctors reject Hunt’s mediocrity jibe: President of the Royal College of Physicians (RCP), Sir Richard Thompson has hit back at accusations by health secretary Jeremy Hunt that too many NHS trusts were happy to accept mediocrity, reported OnMedica. Hunt launched the attack in a speech last week at the Nuffield Trust think-tank where he said that part of the challenge of improving quality and performance in the NHS is tackling “mediocrity and low expectations before they turn into failure and tragedy”. He said: “I would never describe the majority of hospitals or wards in the NHS as mediocre – but I do believe our system fails to challenge low aspirations in too many parts of the system.” While Sir Richard said the health secretary was right to highlight that there is variation in the standards of hospital care across the NHS, it was wrong of him to imply that hospital staff are prepared to accept mediocrity, he said: “This is not my experience. Most trusts are struggling to cope with an impossible burden of a relentlessly increasing workload coupled with financial restrictions.”
GPs’ links to private healthcare firms spark fears of conflict of interest: A study by the British Medical Journal has revealed that one in three GPs who are running new organisations that are about to be given £65bn of the NHS’s budget also help run or hold shares in a private healthcare firm, reported The Guardian. The disclosure has sparked concern that such widespread conflicts of interest will threaten patients’ trust in GPs, who they may see as lining their own pockets out of public funds. Overall 426 (36%) of the 1,179 family doctors on a board of one of the 211 clinical commissioning groups (CCGs) in England have an interest in for-profit firms, including those providing common NHS services such as diagnostics and out-of-hours GP care. Some of them are senior directors of such firms, while others have a shareholding in major private health companies. Dr Michael Dixon, the interim president of NHS Clinical Commissioners, which represents 130 of the 211 CCGs, said boards should be trusted to act properly.
Trust chairs believe there are other Mid Staffs-type failures: An HSJ (subscription required) report has revealed that a large majority of provider chairs believe there are “a small number” of trusts failing in a similar way to Mid Staffordshire. Of the 60 chairs who responded, 73.7% said they believed there were “a small number” of organisations with the same scale or problems and 4% thought there were “many trusts” in that position. Only 5% of respondents to the HSJ/Odgers Berndtson survey agreed with the statement “Mid Staffs was a one-off”. The remainder said they did not know. It appears to echo a lack of confidence among executive provider leadership. In an HSJ Barometer survey of hospital chief executives last year, 4% of respondents said they were “not confident” regulators would detect another care scandal.
NHSmail likely to run another year: The Cabinet Office has been asked to agree an extension to the current NHSmail contract to allow more time for a replacement to be procured. In an interview with eHealth Insider, Alex Abbott, the chief technology officer of the NHS Commissioning Board, said it was looking for an extension to the current contract, which runs out in June. He also indicated the board is now “leaning” towards giving the contract to a single supplier, instead of using multiple suppliers. “Having a range of suppliers was something that we looked at, but now we think that any benefits that we would gain might be outweighed by the extra difficulty of the integration involved,” he said. “We are leaning towards working with a single supplier.” NHSmail was one of the first, national services to be delivered after the launch of the National Programme for IT in the NHS, promising a national directory service and an email address for life.
Medical receptionist prosecuted after unlawfully accessing patient’s details: A former receptionist at a GP surgery in Southampton has been prosecuted by the Information Commissioner’s Office for unlawfully obtaining sensitive medical information relating to her ex-husband’s new wife. Marcia Phillips was prosecuted under section 55 of the Data Protection Act and fined £750 and ordered to pay a £15 victim surcharge and £400 prosecution costs. Phillips was found to have accessed the information on 15 separate occasions over a 16-month period while working as a receptionist at the Bath Lodge Practice. The breach became apparent after Phillips left her job and sent a text message to her ex-husband’s partner referring to highly sensitive medical information taken from her medical record. Deputy commissioner and director of data protection, David Smith, said: “This case clearly shows the distress that can be caused when an individual uses a position of responsibility to illegally access sensitive personal information. “
Hull Royal Infirmary poor patient care, CQC finds: The Care Quality Commission (CQC) has revealed that patients being treated at an acute unit at Hull Royal Infirmary are not receiving proper standards of care, reported the BBC. The health watchdog’s visit to the acute assessment unit in January came after concerns from the public. Inspectors found one patient’s drip had been left to run dry and staff said busy times were “almost impossible”. Throughout the visit inspectors spoke to over 30 patients and staff from nursing, medical and the mental health team. The report said staff told inspectors that busy times were “almost impossible” and that “something has to give”. Lorraine Moore, from the CQC, said: “Patients were waiting on trolleys and had been for more than 12 hours, some up to 24 hours. The CQC has told Hull and East Yorkshire Hospitals NHS Trust that it needs to take action.
Imperial sticks it to Windows: Imperial College Healthcare NHS Trust is to deploy Windows To Go – a version of the new Windows 8 operating system on a USB stick, reported eHealth Insider. It is designed specifically for businesses, allowing users to boot a full version of Microsoft Windows remotely on any Windows 7 or Windows 8 certified device; giving them access to their corporate network, including systems such as email. Windows To Go can be deployed and managed like a traditional desktop PC, using standard Microsoft enterprise software distribution tools such as System Center Configuration Manager. The trust is now looking at making the solution more widely available to staff. The deployment at Imperial is one of the first in the UK and follows a successful trial during the Olympic Games last summer.
Opinion
Customer platform ‘a state of mind’
In an interview this week with eHealth Insider, John Coulthard, the NHS Commissioning Board’s (NHS CB) director of customer relations, said that the ‘customer service platform’ being created by the NHS CB, will encourage the health service to think differently about the way it interacts with patients and potential users.
Coulthard said the new service might take the information held in these different services – and possibly others – and expose it to different users in different ways. He goes onto suggest that a call-up of user reviews “might look like a dashboard of NHS quality”, while a map of local GP practices might help somebody choose the best family doctor for them – and an app holding the same information might provide directions from the street.
Practically, Coulthard said that the NHS CB will not be building a new website, or rebranding services such as NHS Choices. Instead, he indicated that it will commission additional tools, including apps, from a wide range of providers to support the “state of mind” that it will embody.
How can we maximise the benefits of telehealth for patients across the UK?
In the Guardian this week Ileana Welte, head of Bosch Healthcare in the UK, explains why technology-enabled integrated care is working well for many health organisations, helping patients stay in their own homes.
“There is no doubt about it, for those of us in the telehealth industry, this month has seen a disappointing development. The Whole System Demonstrator (WSD) project presented its second stage of research findings, which reported no evidence base to show that telehealth improves people’s quality of life.
“Having worked for more than 18 years as both a nurse and telehealth specialist, I find it amazing that we are still talking about whether it works. Based on my experience, the question should be “how can we make it work?”
Ileana goes on to say that we must not forget, however, that technology-enabled integrated care is working well for many health organisations and patients across the UK. The respected health thinktank 2020health recently published the findings of its own study of a telehealth hub pilot in Yorkshire. There it found that telehealth-enabled care co-ordination can reduce hospital admissions, provide care at home and improve patient outcomes.
“I do not doubt the very real benefits that technology-enabled care can have on people’s health and wellbeing and, in turn, the positive impact this will have on their communities. From what I have read so far, nothing in the WSD reports will change that.”
What is the NHS for?
In this week’s blog on the BMJ, Pritpal Tambel discusses the landmark decision that saw the people of Leeds successfully halt the NHS’ plans to reform children’s heart services, which leads him to ask what the NHS is really for?
“The technocrats behind the reforms clearly have a different understanding of what the NHS is for. They probably believe it should provide the best outcomes possible for the local community, even if it means people having to travel to a neighbouring city for surgery. It’s easy to see, then, that citizens and providers have a different understanding of what the NHS is for. They’re operating from different contexts.
“Most large organisations work hard to understand what they’re for. They develop a clear sense of purpose, often defined as vision, mission, and values, to underpin their every decision.”
Tambel suggests that the main purpose of the NHS is not about providing care, but providing information in order to discuss and agree what care to provide.
“Let’s consider examples from the real world. Most people think Coca-Cola and Tesco simply exist to make money. Making money is, indeed, an important part of what they do, but Coca-Cola actually wants to “refresh the world,” “inspire moments of optimism and happiness,” and “make a difference.” Meanwhile Tesco uses its slogan, “every little helps,” as a guiding philosophy in everything they do…both organisations strive to be internally and externally consistent.
“So what is the NHS for? I believe last week’s ruling was a defining moment in the history of the NHS (and note that it’s one delivered by citizens, not bureaucrats or politicians). It illustrated the disconnect that exists between providers of care and the citizens they serve.
“The citizens of Leeds have challenged the NHS to define its purpose. Whether NHS England is sufficiently well led to rise to the challenge is yet to be seen.”
Why haven’t electronic health records made us any healthier?
This week we have taken an opinion from a US perspective looking 20 years on from the first big conference discussing the future of healthcare information technology, held by the Healthcare Information and Management Systems Society (HIMSS) in San Diego.
Glen Tullman, the former CEO of Allscripts and now founder of 7Wire Ventures, was among one of the attendees made up of a “grab bag of physicians, technologists, visionaries, engineers and entrepreneurs who shared one idealistic goal: to use information systems and technology to fundamentally change healthcare”. Not long after this conference Tullman began building Allscripts which initially focused on electronic prescriptions.
Two decades later, with a wealth of experience working in the healthcare IT sector, Tullman asks the question: “Did our industry succeed in doing what we said we would do.” He agrees there is still a long way to go but quotes Arthur C Clarke:
“Technology, properly applied, is indistinguishable from magic. It is the “applied” part of that dream we are still working on. But I’m confident we’ll get there. A connected system will help patients take responsibility for their health. Strong teams of physicians, nurses and caregivers will use an intelligent network to make their results better and their jobs easier. It does sound like magic. And we are getting closer each year. Just take a walk around HIMSS and you’ll see the future.”
Blog
In this week’s blog Jeremy Nettle questions whether the recommendations from the Caldicott Review will finally give the health service the push it needs to share its data.
