News in brief
226 bids worth £360m made to tech fund 2: The second round of NHS England’s tech fund has received fewer bids than the first, and trusts are looking for less money, according to figures from NHS England. The first round of the tech fund – officially titled the ‘Safer Hospitals, Safer Wards: Technology Fund’ – attracted 760 expressions of interest, with trusts applying for more than £650m, when £260m was available. The second round of the fund – known as the ‘Integrated Digital Care Technology Fund’ – has attracted 226 applications, with trusts looking for just under £360m, when £240m is available. The second round of the fund is split over two years, and trusts have made bids worth £161m for 2014-15 and £195m in 2015-16. Karl Grundy, head of eHealth Insider’s (EHI) research arm EHI Intelligence, said the drop might be due to the amount of work triggered by the first round; although some unsuccessful trusts may have been discouraged by the failure of their earlier bids. There were more applications for integrated digital care record projects, to share information between organisations, than there were for digital care records in single organisations in the second round. However, there is still strong interest in e-prescribing. Grundy added: “It is interesting that the largest numbers of bids in the second round have come from the areas in which there is a strong government imperative for action. NHS England has said that it wants to see trusts moving up the Clinical Digital Maturity Index that we developed in partnership with it, and investing in e-prescribing is a relatively easy way for trusts to do this.” In total, NHS England told EHI that there had been 103 applications for integrated digital care record or sharing projects, and 89 for digital care record or single organisation projects.
Police want right to see medical records without consent: Police want new and expanded rights to access medical records and other confidential data without an individual’s consent, a senior police chief has told the Guardian. Sir Peter Fahy, the Greater Manchester chief constable, said the extra access to sensitive data was needed to help police cope with growing numbers of vulnerable people. Fahy said police frequently dealt with people struggling to look after themselves, including elderly people, people with dementia or Alzheimer’s, those with drug or alcohol problems, those with mental health issues and problem families. Perhaps most controversially, he said medical professionals should share information about women suffering from domestic abuse, even against the victim’s wishes. He said demands had changed over the past two decades, with vulnerable groups now accounting for around 70% of police work. “We need to have easier access to information,” he said. Fahy cited the example of basic information such as next of kin for people with Alzheimer’s or dementia, access to which, he said, would enable police to contact relatives and get basic details such as medical history, who a person’s doctor is, and what exactly they are suffering from. Too often officers responded to a 999 call with inadequate information, he said, and getting the information, even if possible, takes too long. “We need to get it in 20 minutes at 3am.” Fahy accepted the public may be sceptical about his calls for greater powers but said privacy concerns that either deny officers access to information or slow the process down cost police money and time.
£1m digital healthcare innovation fund launched in England: A new £1m fund designed to stimulate creative and digital innovation in the UK healthcare sector has been launched by Creative England, reported Integrated Care Today. The fund will also be complemented with the opening of four new programmes designed to foster innovation and improve patient care across England. The first to open is the West Midlands Interactive Healthcare Fund, in partnership with Nominet Trust and the Heart of England NHS Foundation Trust, and will offer five £50,000 investments to support projects that focus on improving quality of care, caring for people with dementia, supporting people with long-term conditions and data visualisation. Bethan Bishop, head of innovation and industry engagement at Heart of England NHS Foundation Trust, said: “This partnership provides an extremely exciting opportunity for all involved. It enables us to give insight into the areas of healthcare, which will benefit from existing and new technology sitting within creative businesses. Importantly the fund will deliver the vital investment required to enable these developments to be used and make a real difference across healthcare services and the health and wellbeing of patients and the community.” Applications will be assessed on a rolling basis and the fund, supported by the Regional Growth Fund, will close on 31 October 2014.
‘Shock’ at lack of GP-A&E data link: Many patients are ‘shocked’ that many accident and emergency doctors do not have automatic access to their GP records, a poll suggests. The majority are fearful that a lack of information sharing between family doctors and hospitals could lead to mistakes in their treatment, according to healthcare information specialist EMIS Group. In some parts of the country systems have been streamlined so A&E staff have access to GP records, but in other parts of England the access is more fragmented, according to Health Service Journal (subscription required). The latest poll of more than 2,000 adults found that 58% were unaware that many hospital doctors are not able to automatically access information from a patient’s GP medical record. And 30% of those polled said they were “shocked” that this was not commonplace across all hospitals. Meanwhile, 61% feared that this could result in delays in treatment or medical errors. A Department of Health spokesman said: “We’re giving the NHS £1bn to make all patients’ records digital by 2018 so their information can be seen wherever they are treated, whether it is a GP practice, hospital or a care home.”
NHS set to save millions as NPfIT storage deals come to an end: Hospitals across England and Wales are set to reap savings of 90% on storage hardware procurement costs as storage deals, designed under the National Programme for IT (NPfIT) in the NHS, draw to a close reports Computing. Under the contracts for the picture archiving and communications (PAC) systems dictated nationally by the NPfIT, hospital trusts were locked into purchasing out-dated tier-one storage hardware to work with MIA, the PAC system database designed and run by BT. Not only that, but the price of the same storage hardware had been fixed centrally under NPfIT and became progressively less competitively priced every year as storage per megabyte fell in price – but the NPfIT storage hardware did not. Dzinja Kabambe, head of strategic IT projects at Homerton University Hospital Foundation Trust, said that instead of spending £50,000 per year to extend its tier-one storage estate, it would now be spending just one-tenth of that on more appropriate hardware. “There were, effectively, two huge contracts for these PAC systems. With one of them, in the northern half of the country, the contract expired last year, but the service terminated this year. The London contract will expire this year, while the service will terminate next year,” Kabambe said. “So there are double-digit numbers of trusts in London all undergoing these same sorts of exercises in one form or another at the moment,” he added.
Scottish independence: Free healthcare ‘guaranteed’ in constitution: Alex Salmond has proposed the inclusion of a right to free healthcare in the written constitution of an independent Scotland, reported the BBC. The first minister said the NHS in England was facing a programme of steady privatisation, but Scotland had a chance to choose a different path. Supporters of the Union have accused Salmond of scaremongering. They have pointed out that health policy is devolved, with decisions about the NHS already made at Holyrood. The founding principle of the NHS – set up in 1948 under UK Health Minister Aneuryn Bevan – was healthcare free at the point of delivery and based upon clinical need, not the ability to pay. Salmond said: “For me that is not a simple a matter of policy, it’s a fundamental part of Scotland’s national identity. In England, despite the protest of many, the NHS is being eroded and the founding principles handed down by Bevan have been scorned and betrayed by successive Westminster governments. It’s now well understood that voting ‘Yes’ will allow us to protect Scotland’s NHS from the threat to budgets here as a consequence of the cult of austerity and privatisation being forced on the NHS in England.” The guarantee of free healthcare would be proposed for consideration by a constitutional convention, which would be given the task of drafting a written constitution for Scotland if voters back independence in the forthcoming referendum. Despite Salmonds view, a survey for the British Medical Journal found that just 33% of doctors believe that Scotland should break from the Union, while 6% were undecided and 1% will abstain, reported The Telegraph.
Liverpool trust switches to G-Cloud for EDMS needs: The Royal Liverpool and Broadgreen University Hospital NHS Trust has cancelled a tender for an electronic document management solution (EDMS) to archive medical records that was issued earlier this year, favouring using the government’s G-Cloud framework to procure the technology instead, reports Government Computing. In a notice published August 9, the trust said the tender it issued back in April for a document scanning system to allow the hospital to digitise and index records that could then be imported into its EDMS had been cancelled and would not be re-issued. “The current procurement does not offer the most economically advantageous approach to addressing the needs of the trust,” read the notice. “It is not in compliance with sound financial management i.e. does not obey the principles of economy, efficiency and effectiveness. We do not intend to re-issue this tender. Instead we intend to purchase through G-Cloud.” Late last month, G-Cloud programme director Tony Singleton said that total sales of services procured through the framework had exceeded £200m since its launch in 2012. However, Singleton said the need to demonstrate the potential benefits to central government departments and other public sector bodies of using G-Cloud remained the key challenge facing the framework over the next twelve months.
Western Sussex rolls out kidney alerts: An alerts system developed by Western Sussex Hospitals NHS Foundation Trust to identify patients at risk of acute kidney injury (AKI) will be rolled out across the trust by the end of summer reports eHealth Insider (EHI). The alerts system has been developed with the support of vital signs system provider Patientrack, with the intention of reducing the number of patients who develop the condition. Dr Lui Forni, the consultant renal physician leading the initiative at the trust, told EHI the project team developed an alerts algorithm as part of efforts to better understand the variables that determine a patient’s risk of developing an AKI. Patients who are at risk of developing an AKI will be flagged with an amber alert, allowing doctors to carry out necessary actions to help prevent an injury such as reviewing their drug charts and ensuring sufficient fluid intake. Forni, who is the chair of the AKI section of the European Society of Intensive Care Medicine, said “You can think of it as the canary in the coalmine: when you’ve already got AKI, the canary is dead, but where you’re at risk, the canary is still singing so you can still intervene. If we can stop even 10% of patients from getting an AKI that will have a significant impact.” The trust received funding for the project after winning a Small Business Research Initiative competition run by the Department of Health to find innovations in kidney care. Forni said the trust is currently testing the alerts on its servers, with plans to start collecting data and introduce the system towards the end of summer. “We will be able to see in real time if things are working in the places they’re in, so we should be able to see the influence it’s having very quickly.” Forni said the trust is focussing on ensuring the interoperability of the alerts system, with hopes that it can be adopted across the NHS if the go-live proves a success. AKI affects as many as one in five emergency admission patients and has been estimated to cost the NHS up to £620m per year.
West Herts signs five-year deal with CGI: West Hertfordshire Hospitals NHS Trust has signed a five-year contract with CGI worth approximately £25.5m to replace its “aging” infrastructure, reports eHealth Insider (EHI). The contract will see CGI develop an infrastructure and service management programme to support staff across the trust’s three hospitals in Watford, St Albans and Hemel Hempstead, as well as at smaller sites throughout west Hertfordshire. The outcome-based contract is intended to deliver more reliable and robust IT services and support, including faster networks, improved telephone systems and increased IT security. Lisa Emery, the trust’s chief information officer, told EHI the trust identified the need for an infrastructure upgrade in its IM&T strategy produced a couple of years ago. “We’ve had a number of years of historical under investment in our IT – it’s aging, old, and it doesn’t support giving clinicians the quick access to data that they need.” Emery said the network upgrade will involve setting up wireless internet access across all three hospitals. There are also plans to look into instant messaging and videoconferencing solutions to improve communication between staff and allow them to work in the community and across the different sites. “It’s about freeing up people to work in a more agile way and giving people the right tools to work across different areas.” Emery said CGI is also providing a clinical data repository to give a single view into clinical systems and access to the trust’s electronic patient record.
Thousands of NHS operations cancelled at last minute: Staff shortages, failed equipment and a lack of beds have led to thousands of NHS operations being cancelled at the last minute, figures have revealed. Between April and June this year, 15,661 scheduled operations were cancelled for non-medical reasons on the day they were due to go ahead, the highest number for nine years, says The Telegraph. But the Department of Health said the proportion of operations cancelled at the last minute was only 0.8%, not markedly different from previous years. It said the NHS carried out an extra half a million operations this year as demand is boosted by an aging population and advances in medical care. Most patients whose procedures were cancelled had their operation rescheduled within a month, although 800 had to wait longer. According to NHS guidance, common non-medical reasons for cancelling an operation include lack of beds, missing surgeons, anaesthetists or theatre staff, sudden emergencies, equipment failure, or lack of a critical care bed.
GP practice warns patients about social media criticism after staff abused online: A GP surgery has warned patients it is taking a ‘zero tolerance’ approach – which includes the possibility of patients being deregistered – to the posting of abuse about the surgery on social media after a string of personal messages were made against staff. The St Lawrence Medical Practice, in Braintree, Essex issued signs warning patients that abusive comments online could still contravene the NHS’s zero tolerance policy on aggressive or abusive behaviour to staff, which could lead to patients being deregistered, reported Pulse. They asked patients to address any compliments or complaints to the practice manager so the issue could be addressed, and added this would also minimise the risk of breaching patient confidentiality. In an interview with the BBC, practice manager Alison Rudkin said the policy was a response to comments on a local newspaper’s Facebook page which used ‘appalling language’ and mentioned staff by name. Rudkin told the BBC: “Those sort of comments and that sort of language is a form of bullying. We would much rather people come and see us in person if they have something they want to say.” The practice has had to amend the wording on the sign to clarify that it was a call for direct feedback, rather than an attempt to prevent patient complaints.
Manchester sees end of Emis Web roll-out: Emis Web is set to be rolled out across all Manchester GP practices by the end of the year, the Greater Manchester Commissioning Support Unit (CSU) has said. Andrew Rebanks, the senior project manager for Manchester Clinical Commissioning Groups, told eHealth Insider that Manchester had been “one of the worst areas” in terms of rolling out Emis Web. Rebanks said Emis Web has now been implemented at 67 of 96 practices in Manchester, with 78 sites having had the hardware and software upgrades. CSU programme manager Martin Sheridan told EHI the roll-out of Emis Web will help to improve integrated care in Manchester and expand joint services, such as a project to give patients extended access to GP practices via data-sharing. “If everyone is all on the same clinical system then it’s really easier for us.” Sheridan said Emis Web will also be used in the acute setting, with the Greater Manchester Electronic Clinical Correspondence project set up to allow hospitals to electronically send letters about a patient’s care to their GP in real time using PCTI’s Docman. Rebanks said the CSU is developing the e-prescribing component of Emis Web as a separate project, with plans to start an engagement plan with GPs and pharmacists once the system is “bedded in” at the GP practices. Sheridan said the roll-out of Emis Web will also allow Manchester GP practices to introduce the Summary Care Record (SCR), with the older systems unable to allow it to be introduced. “Previously we didn’t have clinical systems able to do that, but every site that’s upgraded will have the SCR two weeks later.” Manchester should be fully compliant with the SCR requirements by February 2015, he said.
Opinion
Is the Better Care Fund preventing integration rather than promoting it?
Ben Gowland, the chief executive at NHS Nene Clinical Commissioning Group and formerly director of service improvement and quality at Croydon Health Services NHS Trust, asks to what extent the Better Care Fund is preventing integration rather than working towards improved care outcomes and good, collaborative relationships between health and care.
“While politicians from the major parties joust for position, the Better Care Fund is increasingly becoming more of a political football and a driver of real integration.
“The problem is essentially a financial one. The NHS is short of money and councils have even less. Along came the Better Care Fund with its promise of money from health for social care. Cue panic in the NHS, followed by constant changes in the guidance making any transfer of funds less and less likely.
“So we are attempting to pool budgets to reduce expenditure in health to use the savings to support social care, when there is no evidence that this works! Not much of a surprise, then, that those who stand to lose the most (the hospitals) have made so much noise, and by one means or another brought about the change that funding can only be released when actual savings are made.
“The danger is the knock on effect. The imposition of the Better Care Fund and the threat of change, unacceptable to both parties, leads to the adoption of entrenched positions and a deterioration in local relationships between health and social care which in turn leads to less integration.
“Good, collaborative relationships are key to making integration effective. Whilst the evidence shows that health and social care integration in much of the UK has not delivered better outcomes at lower costs, there is a small growth in the evidence that health and care systems working collaboratively can start to reduce the demand pressures on both social care and acute hospitals. But success requires effective collaboration and whole system sign up to improving outcomes in both areas.”
NHS leaders and politicians have yet to convince patients of need for reforms
A big debate is needed ahead of the 2015 general election about how to fund a health service fit for the future says Guardian professional, Dick Vinegar as he shares his thoughts on polls, voters and the NHS.
“I know what I think about the NHS, warts and all, but I find it hard to find what patients in general think. A Guardian/ICM poll asked voters about the funding pressures on the NHS. I know that voters may not necessarily be patients, and patients are not necessarily voters, but I found that the poll answered some of my questions. Along the way, it also gave a few clues to health insiders and politicians on how to devise messages for the general election. A third of respondents quoted the ageing population as the main financial challenge facing the health service. This is good news for us oldies, as it seems that the general public recognises that more funds should be devoted to looking after us. Seventeen percent blame the coalition’s market-based reforms for the funding crisis. They seem to be saying “repeal the Andrew Lansley Act, and all will be well. More shockingly, 14% blame self-serving medics more interested in pay cheques than patients.
“All the voters in the poll seem to agree that the NHS needs more money. That is a clear message for all the political parties. So, where do they think the extra money should come from? Forty-eight percent would like to raise taxes. Whether they would be happy to vote at the general election next year for a party that declares it would raise taxes is of course another question.
“None of those polled considered that the answer lies in any of the solutions put forward by the thinkers at the top of NHS England or the Department of Health (DH): care in the community, the rebalancing of secondary care, the integration of the NHS with social care or the savings to be made by new technology. These are the things that need to be debated, to move the NHS from its present doldrums into the future.”
“The poll shows there is a long way to go before the electorate understands any of this. The poll was really just commenting on what the NHS is today, not what it is going to be like tomorrow. A big debate and a lot of skilled persuasion by doctors and politicians is needed before the voters and patients can make sensible judgements before they vote in May 2015.”
The chief executive of Cisco UK and Ireland and the chairman of the government’s Technology Strategy Board, Phil Smith, speaks to eHealth Insider on the potential of digital health, both in and outside of healthcare.
Smith says that health, like much of the UK public sector, remains engaged in the foundation stage of digitisation. Some of the new ideas, he predicts, will prove extremely disruptive or even, “in many instances, bypass current services.”
But he expects that, in the process, they will highlight variability in outcomes that will drive improvements in processes.
This reinvention is harder for health than for other industries, he says, “because the health service is such a gigantic beast” and it can sometimes “try and eat the whole elephant, rather than cutting it up into bite-sized chunks.”
Still, he notes that every other sector that has argued it is ‘different’ and that has thought the internet and other digital technologies would not affect it has been proved completely wrong. “Every industry has been transformed by this, without exception.”
Turning back to the market for innovation, and still speaking as chair of the Technology Strategy Board, he says there are “an encouraging number of companies developing things to meet NHS requirements.”
But he says there remain significant challenges in getting innovation adopted. “For a small company, selling to a largish sized NHS body can be extremely difficult.”
An NHS tax is needed to keep the NHS free to all at the point of need
On the King’s Fund website this week, Nick Pearce of Institute for Public Policy Research discusses how a dedicated NHS tax might work.
“The NHS is facing a serious funding gap if demand continues to increase and budgets remain frozen – up to £30 billion by 2021 according to NHS England.
“As our population ages and increasing numbers of people have multiple long-term chronic conditions, pressure on our services increases. This government has more or less maintained the NHS budget in real terms, but this contrasts with the historical 4% annual increases that until now have made the NHS able to respond to growing demand. If we are to avoid a financial crisis in health in the next few years, the NHS needs a cash injection to accelerate innovation and reform.
“A dedicated NHS tax or National Insurance increase would boost NHS revenue while not affecting other departments’ budgets. The public may be sceptical about tax increases in general, but is likely to be more supportive of those used to finance the NHS. A one percentage point increase in one of the National Insurance rates, ring-fenced for the NHS, would raise £4 billion and could be popular.
“The government would, of course, need to be transparent that this funding was additional, not just filling gaps created elsewhere. It would also need to show that the new funding was having a measurable effect and not simply disappearing without trace into the NHS budget.
“An NHS tax or increased National Insurance contribution would not generate the full £30 billion but it would be a significant contribution towards it. It could have a near-immediate effect in kick-starting a programme of innovation and reform to redesign health and social care services to better meet patient needs and reduce demand over time.
“An NHS tax could play a significant – and immediate – role in reducing the funding gap while maintaining quality of care and keeping the NHS free at the point of need.”
Highland Marketing blog
In this week’s blog, account executive Marta Sieczko busts five common health myths.
