Huge funding problems and record-breaking job losses loom
Large numbers of English hospital trusts face financial difficulties in the year ahead according to the latest report from the all-party Commons Public Accounts Committee. The PAC found that four in five of the 113 hospitals which have not yet achieved Foundation Trust status are expecting problems.

The report adds that most face strategic challenges, performance issues and governance problems. Twenty have declared that they will never make foundation status in their present circumstances.

The PAC states that: ‘London is in a particularly shocking state and nobody has got a grip on long-standing problems. We remain to be convinced that combining struggling hospitals into larger trusts – as with South London – will somehow produce viable organisations offering good quality, accessible healthcare.’

The BBC’s coverage suggests that mergers may lie ahead. The King’s Fund think tank has called for the government to work closely with failing hospitals to find solutions, adding that in some cases closures may be the only answer.

Meanwhile HSJ reports that the NHS foundation trusts plan 35,000 job cuts – the largest number since records began. It also says the trust sector as a whole could be heading for a £201m deficit in 2011-12.

IT is the key to Northern Ireland healthcare
An independent review into the future of healthcare in Northern Ireland puts IT centre stage. A future model, unveiled by health minister Edwin Poots, emphasises a shift of services from hospitals to nursing homes, social and community services and GPs.

EHI says the devolved government sees a significant role for technology, and describes it as ‘a key enabler of the delivery of the new model of care’. A forum is likely to be set up to ‘take forward how technology will support the new model of care, linking the service to industry and academia to ensure the optimum and best value for money solutions are taken forward.’

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Specific proposals include plans to create an electronic care record (ECR) for every patient that will include data from GP records, community information systems, pharmacy and hospital records, and be shared through a common ECR platform.

Lifestyle issues still blighting Scottish health
Scotland’s chief medical officer Harry Burns has warned that obesity, poor diet and excessive drinking are still causing unacceptable levels of ill health. On a more positive note, the BBC says his annual report pointed out that deaths from the ‘big three’ killers – cancer, heart disease and stroke – were continuing to fall.

Figures from the Scottish Health Survey indicate the scale of the problems and suggest that a quarter of Scots ate poorly, did not get enough exercise, drank too much and were overweight

Dr Burns stated that the proportion of men who reported that their drinking exceeded the recommended daily limits rose from 43% to 45% between 2003 and 2010. There was also a steady increase in the number of overweight or obese adults between 1995 and 2010, with the numbers aged 16-64 increasing from 52.4% to 63.3%.

Cancer survival rates threatened
Cancer survival rates could fall because of a rise in the cost of diagnosis and treatment over the next 10 years. A report sponsored by Bupa says that by 2021 the number of new cancer cases will rise to 383,000 per year at an increased cost of care of £15.3 billion.

Bupa suggests that this increased need could be met by focusing on:
• improving patient understanding and treatment choice
• changing how and where cancer patients are cared for, including treatment at home
• making the most appropriate use of diagnostic techniques and treatments

BMJ says that Cancer Research UK is cutting its spending on research by 10% over the next three years because of a dip in income brought on by the economic climate.

UK children get fatter
More than one in three children aged 10-11 are now officially overweight or obese. The figure has risen from 31.6% in 2006-07 to 33.4% in 2010-11. According to the Telegraph the problem seems to emerge during school years, as there is a decline in the number of pre-school children who are obese or overweight.

Children tended to be fatter in urban and deprived areas, the figures revealed. Paul Sacher, paediatric dietitian at MEND (Mind, Exercise, Nutrition … Do it!), said: ‘The government must intervene to protect the health of our nation’s children and prevent this crisis from continuing to spiral out of control.

‘With the health consequences of obesity including type 2 diabetes, heart disease and some types of cancer currently costing the NHS £5.1bn per year, the significant financial and human costs associated with obesity has never been clearer.’

News in brief
Who cares for London?: The King’s Fund wants the government to say who will be responsible for improving Londoners’ health after the abolition of the strategic health authority. It points to potential chaos as the city already faces problems over GP performance, health inequalities and the scrapping of valuable services.
Renal first: North Mersey, the Isle of Man and North Wales are planning the UK’s first region-wide information exchange for renal patients. CyberREN, already live at sites such as Royal Liverpool, will allow information to be shared across hospitals and satellite sites, with the potential for including home monitoring.
Diabetes deaths: Diabetes UK claims that 24,000 deaths a year could be avoided with basic health checks, a good diet and regular medication. Up to 75,000 of the 2.3m people with diabetes in England die every year – about 15% of all deaths.
New PACS plan: EHI says NHS Connecting for Health hopes to have a framework to help trusts re-procure picture archiving systems established by the end of 2012. The goal is to help trusts exercise local choice over their future systems.
TB research hope: Researchers believe a new drug regime could cut the treatment of latent Mycobacterium tuberculosis from nine to three months, and increase the completion rate, by using rifapentine in addition to isoniazid.

DH news
The latest issue of The Week, the DH’s own publication on health sector news, is now available. It’s a handy opportunity to get up to date on key issues like the NHS Outcomes Framework 2012-13 and the Any Qualified Provider Map of Services.

Opinion
The latest British Social Attitudes Survey shows public satisfaction levels with the NHS at a record high of 70% – with just 18% expressing discontent. John Appleby of the King’s Fund looks at the reasons behind our changing views.
‘We know from past surveys that people who have had recent contact with the NHS tend to express greater satisfaction than those with little or no contact. We also know that there seems to be a link between expressions of satisfaction, the political party in power and the political allegiance of those surveyed: if the party you support is in power, you tend to be more satisfied with the NHS.’

Life sciences report
How can the NHS do its upmost to support innovation and change in the life sciences? A new report entitled Innovation Health and Wealth; accelerating adoption and diffusion in the NHS looks at the actions the health service needs to take. It also quantifies some of the huge benefits the NHS brings to society.

Blogs
Questions are being asked about the future of healthcare in Europe. The EU has warned of a one million shortfall in healthcare workers by 2020. Tessa Richards, analysis editor of the BMJ, considers the factors that are driving people away from careers as nurses and doctors.
‘Discontent is less about numbers or poor wages, the study suggests, than difficult and discouraging work environments. Older, sicker, heavier patients who are being propelled ever more rapidly through secondary care have made the job of being a nurse more stressful, and management takes too little notice of nurses concerns. Fewer would leave and more might be attracted to the profession if their concerns were addressed, the meeting agreed.

Highland Marketing blog
This week Sarah Bruce asks Are ‘three million lives’  really ready for telehealth?.

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