News in brief
Trusts could lose contracts without EPR: The NHS Commissioning Board (NHS CB) is drawing up plans designed to dramatically accelerate the adoption of electronic patient records (EPR) by NHS hospital trusts, reported eHealth Insider. New guidance outlining ‘severe’ financial consequences, including loss of contracts, for NHS trusts that fail to take action to begin implementing EPRs by April 2014, is due to be published this June. The plans being prepared are designed to compel trusts to provide the new data flows required to improve quality of services and provide transparency. The NHS CB believes hospitals can only provide the data flows needed with EPRs.
NHS hospital deaths inquiry widens: The NHS investigation into hospitals with high death rates has been widened to include nine others, amid fears that poor care was to blame, reported The Guardian. This brings the number of hospitals where mortality data will be investigated by a team led by Sir Bruce Keogh, the NHS’s medical director to 14. Keogh said the investigation would be a “thorough and rigorous process”. Each of the five hospitals announced last week as the initial focus of Keogh’s inquiry had unusually high death rates between 2010 and 2012, according to summary hospital-level mortality data, one of the accepted ways of measuring hospitals’ performance. The data suggested the five hospitals had up to 3,000 more deaths than would usually be expected over those two years.
NHS trusts must have legal duty to be open about harms to patients, Francis tells MPs: The cost to the NHS from litigation will get “bigger and bigger” unless the health service tells patients what went wrong and settles their claims as early as possible, Robert Francis QC has told the Parliamentary Health Select Committee, reported BMJ (subscription required). The chairman of the public inquiry into Mid Staffordshire NHS Foundation Trust called on the government to implement his 290 recommendations, including a statutory duty of candour to patients. He was quizzed by MPs on 12 February as part of their inquiry into his report. The annual NHS bill for compensation and legal costs breached £1bn for the first time in 2011-12, when it surged to £1.28bn. Francis said: “They deserve first of all to be told what has happened, and they deserve that, that wrong has been put right.”
Analysis: Francis calls for deceleration of drive towards all-FT NHS: Robert Francis QC has called for a further deceleration of the drive for all NHS providers to become foundation trusts (FT), in order to ensure trusts completing the process are safe. He made the call in an interview with HSJ (subscription required) last week, following publication of his inquiry’s report on the care quality scandal at Mid Staffordshire NHS Foundation Trust. The inquiry had found that, in the case of Mid Staffordshire, “pressure on the system” caused by the drive for universal FT status had meant that “considerable strains were placed on an organisation in financial difficulty to meet required financial targets”, and that “inadequate consideration was given to the risks such strains posed on the standard of service”.
CSUs to spend £670m a year: The commissioning support units (CSUs) that will come into place on 1 April will spend around £700m a year on IT and other support services, according to a new report from EHI Intelligence. The report from eHealth Insider’s research arm indicates that the 22 CSUs, which will provide IT, data collection, warehousing and analysis services, HR and commissioning functions, suggests they will employ 8,700 staff and set a total budget of just under £670m in their first year. As such, there will be an important new market for suppliers, who are already targeting CSUs in order to sell to the clinical commissioning groups that will come into being alongside the NHS Commissioning Board and the other organisations being set up by the ‘Liberating the NHS’ reforms this spring.
NHS chief ‘stopped from speaking on patient safety’: A health service manager claims he was gagged by the NHS from speaking out about his dismissal and his concerns over patient safety, reported the BBC. Gary Walker was sacked as chief executive of the United Lincolnshire Hospitals NHS Trust on grounds of “gross professional misconduct” for allegedly swearing in a meeting. Walker said he had no choice but to sign an agreement linked to a confidentiality clause in April 2011. He has decided to speak out about his concerns over patient safety and the circumstances leading to his sacking from the NHS.
Hospital staff are misusing NHS IT, figures show: Hundreds of NHS staff have been reported for breaching IT guidelines in hospitals, reported OnMedica. Figures published this week show that over the past three years there have been a high number of incidents of password sharing, inappropriate Facebook comments, swearing in emails and the installation of banned software on NHS computers. The data has been revealed through a freedom of information request and relates to the NHS in Scotland. The Scottish Conservatives asked Scotland’s NHS boards to reveal how many IT breaches there had been and were told of 481 incidents. At least 15 workers had been sacked or resigned as a result, while some were given counselling, the boards said. The figure throughout the NHS is predicted to be far higher. Scotland’s largest health board – NHS Greater Glasgow and Clyde – had failed to respond.
NHS shake-up hampers oversight of serious incidents: Loss of staff in the current NHS reorganisation has left primary care trusts struggling to review thousands of serious incidents before their abolition in April, reported HSJ (subscription requited). The news follows the publication of the Mid Staffordshire NHS Foundation Trust public inquiry report, which warned that past structural reorganisations had hindered NHS organisations’ ability to focus on care quality and patient safety. A report to NHS North of England’s most recent board meeting warned that at the end of December the north had 2,447 “open incidents” recorded on the strategic executive information system − the national database for the reporting of serious incidents.
Nicholson challenge putting pressure on care – The King’s Fund: The pressures of the NHS efficiency challenge are beginning to have an effect on quality and access to services, the new quarterly monitoring report by The King’s Fund suggests. Surveys of NHS finance directors and directors of adult social services showed increasing concern over budgets and care, reported Nation Health Executive. The report comes towards the end of the second year of the Nicholson challenge to save £20bn by 2015. A third of finance directors reported that quality of care has worsened during the last year and over a third of social service directors expect to have to cut social services over the next year. Thirty-two of the finance directors were pessimistic about the general financial state of their local health economy and eighteen of the directors of adult social services are predicting an overspend on their budgets.
Royal Berks finances hit by Millennium: Royal Berkshire NHS Foundation Trust is facing significant operational and financial pressures after implementing Cerner Millennium and expects to spend another £6.2m implementing the system this year, reported eHealth Insider. The trust went live with the electronic patient record system in June last year, more than 1,000 days from project start-up. A brief presented to the trust’s most recent Council of Governors meeting reveals that implementation costs are expected to be £6.2m in 2013, against a budget of £2.5m. Chief executive Ed Donald’s briefing said the increased costs were due to significant data correction being required each month and an increased number of patient administration staff being needed to run the system.
TotalMobile to support mobile working across all care settings: Healthcare professionals working on mobile devices, such as smart phones and tablets, will now be able to update patient information and record medical tasks at the point of patient contact with the launch of the management workflow solution, TotalMobile, into the UK market, reported HealthTech Wire. Building on its experience in local government and social care markets, international mobile expert TotalMobile has identified ways the software can benefit healthcare organisations. The solution draws information from multiple systems to a mobile device, to allow users to reduce their time on administrative tasks and travelling, spending more time on patient-related activity. This increases both productivity and quality of care throughout the care pathway whilst delivering efficiency savings. TotalMobile is low-cost, easily deployed, quickly implemented and delivers a rapid return on investment without the need to replace current infrastructures.
A&E waits ‘highest for a decade’: The number of people in England facing long A&E waits has risen by a fifth in a year – and is now at its highest level for a decade, a report suggests. The King’s Fund review found from October to December 2012 more than 232,000 patients waited more than four hours, reported the BBC. That is a rise of 21% compared with the same period in 2011 and the highest figure for those months since 2003. A&E doctors blamed a combination of rising pressures and staff shortages. The report – part of the King’s Fund quarterly update on NHS performance – also found a growing number of finance directors were concerned about budgets.
NHS IT contractor demand at historical high: Demand for IT contractors from the NHS climbed in January to a historical high, ahead of a radical transformation of how the NHS operates, revealed Contractor UK. IT recruiter max20 said it had placed more than 50 contractors in the four weeks since December 2012, compared with 100 over the first quarter of the year. That represents the highest level of contractor billings to date, said the agency, pointing to particular demand for business analysts, project managers and tech support contractors.
Opinion
Forget outsourcing – the NHS needs to empower its own champions
In this week’s opinion piece in PublicService.co.uk, Julian Osborne from IMS MAXIMS considers what the NHS could learn from major IT provider, 2e2, going into administration.
Osborne asks whether it is perhaps time for the health service to stop relying on outsourcing and bring IT services back to the NHS?
“The biggest concern for those trusts using the company’s services, many of which relied solely on them to support their entire IT infrastructure, will undoubtedly be around business continuity. How will they continue to provide the same level of service themselves? How can they ensure that their IT applications, many of them now critical for the trust’s operations and more importantly to provide patient care, are not disrupted?
“These are all valid and important questions that need answering but I wonder whether they would be asked if the NHS hadn’t chosen to outsource to a commercial company and instead it looked to other local trusts for support…I question whether, in today’s evolving and slightly more commercially focused NHS, trusts could pull on each other to do this themselves. Opportunities exist if trusts communicated in such a way where local NHS organisations understood each others requirements, worked in partnership, shared IT services, drew on resources when required, and perhaps most importantly, provided back-up systems for each other and hosted each other’s data.”
How do we fix the NHS?
In this week’s Guardian Healthcare Network, independent health policy analyst and commentator Roy Lilley pleas for NHS board members and management to consult with frontline staff to improve customer service levels at trusts.
Following the Francis report last week, Lilley claims: “Francis is a lawyer so we have a lawyer’s response; more law, more regulation, more oversight… We must never forget the plight of patients, callous clinicians and managers preoccupied with money. However, Mid Staffs is also a story of corporate priorities given precedence over organisational purpose.”
Lilley calls for the NHS to “create a sense of common purpose and refocus on what is important”, drawing on examples of businesses where a diverse, engaged workforce understands that culture is rooted in beliefs and assumptions, history and tradition.
Lilley continues by demonstrating that culture is built from the ground up: “A climate that creates opportunities to compare what we do and how we do it; in pursuit of excellence, not blame. A climate where working together is the norm. A climate where everyone knows all that matters is frontline, customer-facing staff on the ground. Everything else exists to facilitate, enable and make that a place where “best” is normal.”
Information overload: CCGs and data innovation
Sean Ridell, now retired ex chief executive of EMIS Group, writes for HSJ this week. He explains that “commissioning groups have more data available to them than ever before” and looks at how it can be used to deliver real change.
“Clinical commissioning groups and individual GPs are also feeling the impact of the drive for data. A significant milestone is the launch of the GP Extraction Service − which will, for the first time, release national data from GP records to try to improve patient care and efficiencies. CCGs are also beginning to contract bespoke data extraction services to help them gain a better and deeper understanding of local health services.
“But how does the drive for “open data” translate into real change? Liberating the data is only the first step. The information then has to be translated into knowledge and, finally, integrated into clinical workflows if it is to make a difference on the front line.”
Ridell then goes on to look at various issues such as ‘data disconnect’, ‘making the data work’ and ‘evidenced based IT’.
Highland Marketing blog
In this weeks blog, Alex Leyton explains why creative leadership in the NHS is so important.
