News in brief
Hunt to stay on as health secretary: Jeremy Hunt will remain health secretary, the prime minister David Cameron has announced. According to a report by National Health Executive, Hunt’s reappointment has been hailed by voices across the NHS as providing much-needed continuity. NHS confederation chief executive Rob Webster said: “I would like to congratulate Jeremy Hunt on his reappointment and I look forward to continuing to work with him as we tackle the biggest challenges in the NHS for a generation. His reappointment provides stability in political leadership – something that can only help our members. The political will to support the implementation of the Five Year Forward View, the financial support for the NHS and the consequential changes in the way in which care is delivered will be high on the agenda.” Chris Ham, chief executive of the King’s Fund added that Hunt’s first priority must be to secure additional funding for the current financial year to plug the “growing black hole in NHS finances”.
New ministers join DH in reshuffle: David Cameron has appointed two new health ministers in his government reshuffle, following the reappointment of Jeremy Hunt as health secretary, reported Health Service Journal (subscription required). Alistair Burt is the new minister of state for the Department of Health. Ben Gummer has been appointed parliamentary under secretary of state. Burt, who steps into the position occupied by Norman Lamb in the last government, is the MP for North East Bedfordshire. Meanwhile Gummer is the MP for Ipswich and in the last government served as parliamentary private secretary to education secretary Nicky Morgan. Dan Poulter has stood down as a health minister. Care Quality Commission (CQC) chair David Prior has been appointed under secretary of sate for health, reported Pulse. Prior, a former deputy chairman of the Conservative Party, will take up his new role immediately and step down from his role as the chair of the CQC. George Freeman will remain as the life sciences minister after being re-appointed this week, reported PMLive.
George Osborne outlines city devolution plan for England: English cities will get powers over housing, transport, planning and policing under plans set out in George Osborne’s first post-election speech, reported the BBC. Greater Manchester – which will take on the powers when electing a mayor in two years – should become a blueprint for other large cities, he said. A Cities Devolution Bill will be in the Queen’s Speech later this month. Local government experts have said this presents a challenge to cities such as Leeds, Liverpool and Birmingham, which have so-far resisted creating mayoral posts that cover their wider city regions. However, the government seems determined to drive through the devolution agenda, both to create Osborne’s ‘northern powerhouse’ and to counterbalance increased powers for Scotland, reported digitalhealth.net. In addition, a new Core Cities group has called for more devolution and the establishment of a ‘place-based comprehensive spending review’ to create “integrated and devolved budgets for specific sets of services across a place.” These two sets of pressures make it likely that more cities will take responsibility for health and social care, on the so-called ‘devoManc’ model announced in February. This will see a Greater Manchester Combined Authority take control of the area’s £6bn healthcare budget; “working closely” with clinical commissioning groups, but without taking over local trusts. When the devoManc plans were announced, Richard Humphries, the assistant director of the King’s Fund, said they were a bold way to pursue the health and social care integration agenda that sits at the heart of the ‘Five Year Forward View’ to save the NHS £30bn by 2020-21.
NHS promises delayed e-Referral service will launch in June: The new NHS e-Referral service will launch in June, the Health and Social Care Information Centre (HSCIC) has announced. The service was supposed to go live in November but was delayed after failing 11 out of 26 criteria during an assessment by the Government Digital Service four months earlier. It will replace the 10-year-old NHS booking system Choose and Book, which allows patients to book hospital appointments online, reported ComputerWorldUK. HSCIC said the transition “should not cause any disruption to patient care or working practices” but admitted “it is inevitable that there will be some issues that are identified when the system is live”. All new government digital services are obliged to meet 26 criteria, known as the ‘digital by default service standard’, before being launched. HSCIC said 40,000 patients use the service every day but the change will “enable many more users in future” and help to cut NHS waiting times. The service is a critical step towards achieving paperless referrals and thus a vital part of plans to achieve a paperless health service, according to HSCIC.
Super hospital “catalyst” for paperless: The opening of Glasgow’s new £842m super hospital has been a “catalyst” towards moving to a paper-free environment, reports digitalhealth.net. Head of IT at NHS Greater Glasgow and Clyde Robin Wright told digitalhealth.net that all of the city’s hospital sites have been working over recent years to reduce dependence on paper. South Glasgow University Hospitals’ adult hospital opened on 27 April with 1,109 en-suite patient rooms. “The hospital has been purpose-built to be electronically run so it’s flooded with wireless and fully equipped with new equipment so we have the benefit of being able to offer people mobile devices from day one,” said Wright. It also features robot porters that operate in underground tunnels in the basement. The new hospital has a number of cornerstone systems, said Wright. An Orion portal was the main vehicle for delivering an EPR. Electronic nursing documentation had been introduced, but had to be withdrawn due to problems and was being revamped.
Wales aims to become ‘centre of excellence’ for research with £18m Welsh Government investment: More than £18m is set to be invested over the next three years in major health and social care research projects, reported Wales Online. Deputy health minister, Vaughan Gething has confirmed that £6m a year will be ploughed into eight dedicated research centres and units across Wales. The Cardiff University-led Wales Cancer Research Centre, which works alongside Swansea and Bangor Universities and Velindre NHS Trust, will receive £4.5m over the next three years. And the National Centre for Mental Health (NCMH), which looks into the impact of mental illness and learning disabilities, will be given £3m. Other recipients include the Wales Kidney Research Unit (£1.2m), the The Wales BRAIN Unit (£1.2m), the Wales Centre for Primary and Emergency Care Research (£2.7m) and the Diabetes Research Unit (£1.5m). The confirmation of the three-year funding package comes as the Welsh Government unveils a major restructuring of its health and social care research arm.
Delay to 700,000 patient opt-outs: The Health and Social Care Information Centre (HSCIC) is “extremely concerned” that 700,000 patient objections to having their identifiable data shared have yet to be enacted more than a year on from being registered with a GP, reports digitalhealth.net. In supplementary written evidence submitted by HSCIC chair Kingsley Manning to the health select committee, he identified a number of issues which meant the centre had not yet extracted or implemented any “type 2” objections registered by patients with GPs. “We are extremely concerned that the implementation of individuals’ wishes with respect to their data has been significantly delayed, although we are confident that this delay has not had any detrimental impact on their clinical care.” The objections were registered as part of the launch of the controversial care.data programme. When the programme was launched in February 2014, patients were given the option to “opt-out” in two different ways. Under the type 1 objection no information, other than for direct care purposes, would leave their GP practice. Under a type 2 objection, no identifiable information held by the HSCIC would be passed to a third party. Both of these objections were registered on the GP’s clinical system. However, the programme was paused that same month and no data has subsequently been extracted from GP systems as part of the programme.
Software developers get cash for healthcare fixes: Almost £500,000 to support small software developers to produce new and innovative ways to tackle health and social care problems has been invested by the government, reported Contractor UK. Via the Midata programme, the investment will fund two “Pit-Stops”, whereby developers experiment with newly available data and get help and advice on how to overcome barriers. The data, provided from a variety of sources, will be used to develop phone apps and online tools that bring together the records about the health and social care that a person receives. “Data provides huge opportunities to consumers but they remain nervous about how organisations use data that is personal to them,” said Neil Crockett, chief executive of the Digital Catapult, a state-funded centre for advancing digital ideas. “Similarly, data-owning companies are reluctant to release closed data in case it is misused or leaked to competitors. We need to break down these barriers if the UK is going to realise the potential data liquidity in its economy.” Developers will work on ways for individuals to give permission to others to see and use the records to organise more efficient and co-ordinated services.
Technology could be the key to help people improve and maintain positive mental health: Technology could be the key to help people improve and maintain positive mental health, reported Medical Press. Over 75% of people who experience symptoms of anxiety and depression get no treatment but leading researchers from the University’s Centre for Assistive Technology and Connected Healthcare (CATCH) have identified technology as a way to help improve access to care and information that can help people manage their condition better. The way the NHS is currently set up means that most services are offered from 9am to 5pm, Monday to Friday, which means lots of people with mental health problems are unable to access care easily and some people find it difficult to speak to people face to face. Dr Katherine Easton from CATCH at the University of Sheffield said: “Technology can increase the availability of services, it can provide services out of hours, it gives people choices and options, and most importantly it helps people take control of their own health. We need to inform the public and health providers about how technology may be used to support people. We need to evaluate technology, which, is being developed all the time, and make sure it is being used and delivered in the public’s interest to provide the highest quality care and ensure people’s safety when we aren’t all in the same place at the same time.”
BSI publishes apps development standard: The British Standards Institution (BSI) has published a set of standards to support developers creating health and wellness apps, reported digitalhealth.net. PAS 277 outlines a set of principles that app developers should follow, to make sure that their products and services can be trusted by healthcare professionals and the public. Its main aim is to define the quality criteria for registries and repositories of healthcare apps, so that they meet the needs of users. However, the BSI suggested that it may also help doctors to select apps to recommend to patients or for organisations to commission bespoke apps. The guidance was developed as a response to the growing environment for health and wellness apps, driven by increasing use of mobile devices such as smartphones and tablets, although it also applies to apps that run on desktop computers. Available as a free download on the BSI website, PAS 277 brings together good practices in app development and healthcare information management. It also draws on existing standards for software life-cycle processes in medical devices and software development.
Choosing Wisely set for digital support: UK doctors are likely to have access to online modules to learn about the dangers of overprescribing medicines, reported digitalhealth.net. The Academy of Medical Royal Colleges has launched the UK arm of the Choosing Wisely campaign, which aims to encourage doctors and patients to have conversations about the value of treatments and address the issue of using unnecessary therapies. It follows similar campaigns in US and Canada, where healthcare professionals have been able to access a range on online education tools concerning the overuse of healthcare resources and how to help patients understand the issue. A spokesperson for the Academy of Medical Royal Colleges said the UK would “probably” follow a similar approach, although it was “too early to tell”.
Handwashing success for Wolverhampton trust: Efforts by the Royal Wolverhampton Hospitals NHS Trust to enhance infection control among staff have paid off, with reports that monitoring of hand hygiene increased by 1,000% in a single month, reported Building Better Healthcare. The trust has deployed TeleTracking Technologies’ Real Time Locating System (RTLS) as part of its Safe Hands programme, an organisation-wide, government-funded initiative that aims to improve staff compliance with handwashing standards. Clare Nash, registered nurse and programme manager said: “Good handwashing practices are crucial for patient safety. The million-plus handwashing observations gives us a greater chance of being compliant with safety standards and, ultimately, protecting our patients and staff from the spread of infections.” In cases of healthcare associated infection (HCAI) outbreak, TeleTracking’s RTLS technology can track the role of every badged staff member who comes in contact with an infected patient and send location and time data back to computer touchscreens in each department.
Orion, eHIS to develop UAE’s health technology systems: Orion Health is set to lend its worldwide expertise to support the vision for digital healthcare being led by the newly formed Emirates Health Informatics Society (eHIS) in the UAE, reported Trade Arabia. The eHIS is supporting the UAE’s health initiatives, such as the need for electronic health records, that will help the country best support the needs of its growing population, said a statement. The society will work in partnership with government and private healthcare providers, it said. Dr Mohammad Al Redha, director, Health Data and Information Analysis Department, Health Policy and Strategy Sector, Dubai Health Authority (DHA), said: “eHIS is creating the platform for health technology innovations in the UAE and beyond. With Orion Health’s expertise, and in collaboration with providers and government, we can create the right environment for digital health to flourish for the country and in time for Expo 2020.”
Opinion
Why is nursing informatics important in healthcare?
Robin Hoover, clinical informaticist and Susan A. Matney, medical informaticist describe the invaluable role of nursing informatics between technology and clinical practice in a HIMMS blog as part of the US’ National Nursing Week.
“A patient walks into the clinician’s office and the clinician reviews the patient’s medical history and current medication that is in the electronic health record (EHR) with him. The patient’s daughter is a nurse and he wonders how nurses are involved in these new EHRs.
“Hospitals and physician offices are transitioning from paper charts to EHRs as a result of the American Reinvestment and Recovery Act. In order for adoption to take place there needs to be nurses who understand the clinical workflow as well as the language of computers. Informatics Nurses fill that role.”
Hoover and Matney suggest informatics nurses are able, amongst other things, to:
- “Assist in the analysis, development, and testing of applications used within an EHR
- Provide initial support and training during the implementation of the electronic health record (EHR) as well as clinical and technical support to the staff as needed post go-live
- They also act as a liaison between all departments and the vendor
- Increase the accuracy and completeness of nursing documentation
“So to answer the patient’s question regarding how nurses are involved: end-users need the support of nurses who understand the clinical aspects of patient-centered care as well as how the EHR captures the data and can be customized to fit the correct workflow for all clinicians. Without informatics nurses, end-users would have no advocate to turn to for the support they need to make such a major transition and patients could not have retrievable, sharable, comparable data within the EHR.”
Time for a technology check-up: what NHS staff need their IT managers and suppliers to know
Julia Ball, assistant director of nursing at University Hospitals of Leicester NHS Trust, reflects on some anxieties around implementing IT systems for busy NHS hospital staff – and how to overcome them.
“When I walk through the doors of a supermarket, I usually have a very good idea of what I want to buy. When NHS trusts are looking to procure an IT system however, they will often only have a basic knowledge of their specific requirements. One example of this is when clinical and IT teams do not have a common understanding around what is needed from the technology.
“This can cause difficulties, as IT suppliers may misinterpret goals or encourage implementation of IT software and products that do not fulfil, or fit with, a trust’s needs. Precious taxpayer money can be wasted and everyone loses out, including the clinical staff, managers, IT suppliers and, most importantly, the patients.
“When you are responsible for a major IT project and entering new territory, it comes with some sleepless nights. You continuously ask yourself: will the IT infrastructure support the software? Will staff find the mobile devices convenient and accessible? Are there security risks we have failed to cover? The excitement at recognising that we could change our processes to improve patient outcomes is coupled with extreme anxiety about letting the clinical teams down – it can be your biggest fear.
“It is therefore very reassuring when you have an IT supplier who can speak the specialised ‘clinical language’ of the NHS – it instils confidence and credibility that they can deliver.
“Healthcare and IT are two very complex areas, and thus, shopping for the right software and hardware can be riddled with obstacles and a great deal of uncertainty. Implementing the right IT system that meets a healthcare organisation’s goals will only be truly realised if it is fully aware of its stakeholders’ needs and its specific requirements and by partnering with the right technology supplier.”
Industry view: David Patterson
The cardiologist and founder of Helicon Health, David Patterson, explains why he hopes his patients may one day do him out of a job, by doing more of their own healthcare prevention and treatment monitoring.
“There is good evidence that if you give people the confidence and competence to manage certain vital aspects of their health, not only do they become as good as health professionals, but often better.
“Take stroke prevention. Stroke causes varying degrees of disability, or death, for more than 150,000 people a year in the UK alone. This equates to approximately 410 patients suffering strokes in the UK every day. One in five of strokes is associated with atrial fibrillation, the commonest rhythm abnormality.
“In the UK, a much smaller proportion of people self-test than other European countries, for example, Germany. And yet the support among UK patients for self-testing is growing, which means we have a motivated army of volunteers, ready and waiting.
“Importantly, there are other benefits to recruiting patients to self-manage their health. Atrial fibrillation contributes about 15-20% to the total risk of stroke; high blood pressure contributes about 50% and other factors such as smoking and a sedentary lifestyle contribute significantly too. Each of these can be addressed by the self-management approach – with significant benefits for all.”
Blog
Following the reappointment of Jeremy Hunt as health secretary, Myriam McLoughlin questions whether he will be able to deliver on his party’s election pledges for the NHS.
