News in brief
Tech fund 2 delay puts projects at risk: The continued delay in the announcement of who has won money from the second round of the technology fund is putting projects at risk, according to a survey run by eHealth Insider (EHI). NHS England’s director of strategic systems and technology, Beverley Bryant, told EHI Live 2014 in November that she was “beyond sorry” that the results had not been announced, and indicated that the hold-up lay with Treasury ministers. However, the commissioning board is still unable to say when the details will be released. EHI launched a short survey last week to uncover the impact, and this was completed by 50 readers in total. Almost two thirds said it had “put the project in jeopardy / led to additional trust spending”, while one said they had already abandoned their plans. A number of respondents felt that some or all of the money has probably been lost to other, more political priorities, such as the ‘winter crisis’.
Care.data and big data will fill ‘dangerous gaps’ in NHS and futureproof it with genomics, argues Tim Kelsey: Care.data, the NHS’s controversial data-harvesting programme, is “starting again” and will enable the health service to close “dangerous” gaps in patient care through the proper harvesting of big data and analytics, reported Computing. That’s according to Tim Kelsey, NHS England’s national director for patients and information, who was speaking as part of WANdisco’s Big Data Breakfast event at City Hall. Kelsey told the audience that through care.data and other big data and analytics initiatives, the NHS will be able to greatly improve patient care during 2015. This is despite MPs suggesting that the care.data programme should be put on hold due to continuing concerns over patient privacy. Kelsey believes using big data tools to analyse previously unstructured – or some instances, uncollected – information will help to create a better NHSma. “Care.data is starting again now, there are some pathfinders which are beginning to work on extracting data, linking GP data and hospital data in new ways which mean we can analyse the pathway of care that patients travel on,” Kelsey said.
Hinchingbrooke Hospital – Campaigners call for NHS control: Campaigners have urged the NHS to take back control of its first privately-run hospital after a health company’s decision to withdraw from the contract, reported the BBC News. The Circle Partnership last week said its 10-year contract to run Hinchingbrooke Hospital, Cambridgeshire was “no longer viable”. The hospital is currently in special measures after being rated “inadequate” by the Care Quality Commission (CQC). Unions say they want to try to secure its “long-term future” in the NHS. CQC inspectors highlighted particular concerns over accident and emergency and medical care. Steve Sweeney, regional director for the GMB union, said the “experiment” of a private company running a hospital had been an “abject failure”. “What we’re calling for is the hospital to be returned to the NHS as a publically-funded, democratically accountable service,” he said.
GPs to be offered £1bn in new funds if they improve access and elderly care: Family doctors will have to increase the number of appointments they offer and improve their care of older patients in order to share in a new £1bn NHS fund to overhaul crumbling GP surgeries, reported The Guardian. NHS bosses have decided that England’s 8,500 GP practices must offer patients more time with doctors and expand the services they offer in return for receiving some of the money. NHS England believes using the £1bn to transform existing GP surgeries and build some new premises will help reduce the pressure on hospitals buckling under the strain of unprecedented demand. In a letter on Thursday to all GP practices, it made clear that they must do much more to keep patients healthier at home for longer to receive some of the new “primary care infrastructure fund”. Dame Barbara Hakin, an ex-GP and NHS England’s national director of commissioning operations, made clear that in distributing the money “the key metrics for prioritisation will be: access to general practice, including increased appointment and patient contact time; and/or reduction in emergency attendance or admission to hospital of over-75s”.
More than 400,000 extra A&E visits: The number of A&E visits in England soared by more than 400,000 in 2014, reported the BBC News. The College of Emergency Medicine said that was the equivalent of filling an extra nine emergency departments. The Health Select Committee has been taking evidence after the worst waiting times in A&E for a decade and many hospitals declaring “major incidents”. Doctors said it was “absurd” to blame patients, who were advised to go to A&E by services including NHS 111. Figures for England showed 92.6% of patients had been seen within four hours during the October-to-December quarter. The target is 95%. Then, last week, data for the start of the new year showed the proportion had dropped to a new weekly low of 86.7%. The figures include walk-in centres and minor injury units. Once you strip them out, just one in seven major A&E units are hitting the target. Prof Chris Ham, from The King’s Fund health think tank, said there was no simple explanation for the extra pressures on A&E. He said: “The causes are many, varied and complex. We think the most important causes are outside hospital.”
Sheffield picks suppliers for portal: Sheffield Teaching Hospitals NHS Foundation Trust has announced it will use HP, Orion and Imprivata to create a clinical portal that will give its staff single sign-on access to trust IT systems, reported eHealth Insider. The trust has picked HP Enterprise Services as the primary contractor for the project, with Orion Health providing the portal technology and Imprivata the single sign-on element. The trust has made a big commitment to investment in IT via a five-year, ‘Transformation Through Technology Programme’. In a statement, the trust’s medical director, David Throssell, said: “This new portal will act as an umbrella across a number of our current computer systems, meaning hospital and community health staff will only have to log-in once to view the different patient information systems, on one screen”. Colin Henderson, managing director, UK and Ireland, for Orion Health, said it would be implementing its web-based clinical portal, Rhapsody Integration Engine, and Healthcare Pathways products at the trust. Henderson said that as a result of the implementation: “Clinicians will have a fuller picture of patients’ medical history, and staff will be able to co-ordinate care more effectively”, giving patients a “faster journey through the hospital and community services”.
Bidders shortlisted for £1bn primary care support contract: Three bidders have been shortlisted for a £1bn, 10-year contract to provide critical primary care support services, NHS England has confirmed. The tender is one of largest single outsourcing deals ever proposed in the NHS, reported Local Government Chronicle (LGC). The three shortlisted bidders are Capgemini, with South East Commissioning Support Unit, Capita with Anglian Community Enterprise, and Equiniti. Community support units were understood to be interested in bidding for the services. However, Health Service Journal understands they were barred from directly applying. This is because they are currently part of NHS England, and any decision to award the contract to them could be challenged under procurement law once the units become autonomous in 2016. Final bids will be submitted at the end of February and the contract will be awarded in “early spring,” according to NHS England. NHS England issued a contract tender notice in the autumn, appealing for bidders to run primary care support services. The national commissioning body decided to outsource the functions last summer.
Top doctor links A&E chaos to NHS advice line: The health service’s 111 telephone advice line is a key cause of the unprecedented pressures facing hospital emergency departments, the president of the College of Emergency Medicine told the Financial Times (subscription required). The number of visits to A&E departments rose 446,000 last year, equivalent to the capacity of eight or nine emergency units, said Dr Clifford Mann. Of these, 221,000 involved people being told to attend by the 111 service, and 222,000 cases were brought in by ambulances dispatched by the service. “I don’t think we should blame people for attending A&E departments when we’ve told them to go there,” Dr Mann told a hearing of the House of Commons health committee. He also complained that some A&E departments appeared to have seen none of the extra £700m that was set aside by the government last year to help the NHS cope with winter pressures.
Monitor to take action against providers who block joined-up care: Health service regulator Monitor says it will “take action” against providers who block efforts to deliver joined-up care for patients, reported National Health Executive. This is the first time the regulator has produced guidance to help providers comply with the integrated care condition of the NHS provider licence. The licence is Monitor’s main tool for regulating NHS providers and contains a specific condition requiring providers not to block the delivery of integrated care when it can benefit patients. The new guidance sets out core principles – such as working effectively with other health and social care organisations locally in order to identify and improve ways of delivering person-centred, co-ordinated care for patients. Toby Lambert, director of strategy and policy at Monitor said: “Patients want the NHS to be joined-up, with providers of health services working together to deliver the best care possible. Providers must not stand in the way of integrating care, and we’re clear that if they do, we’ll use the regulatory powers we have.”
Wales invests £3m in sharing documents: The Welsh Government has announced that £3m will be spent on rolling out a system to enable hospital staff and GPs to share information, including tests and clinical correspondence, reported eHealth Insider. The Emergency Department Clinical Information Management Scheme is the latest element of Wales’ plan to create a suite of national IT systems for its health service to be given the go-ahead by ministers. It will be introduced in the Abertawe Bro Morgannwyg and Betsi Cadwaladr University Health Boards initially; but all health boards will be expected to adopt the system eventually. Health and social services minister Mark Drakeford said in a statement: “The development of the Emergency Department Clinical Information System is a major step forward, which will eventually allow information sharing across all emergency departments and minor injuries units across Wales. It will support service re-design by allowing electronic patient information to be shared across NHS Wales, allowing improved integration and co-ordination of services.”
Nurse scoops regional innovation award for tracking technology: Clare Nash, from the Royal Wolverhampton NHS Trust, has received the NHS Innovator of the Year for the West Midlands region award in the NHS Leadership Recognition Awards, reported Nursing Times (subscription required). Ms Nash, an intensive and critical care nurse, won the accolade for her work enhancing patient safety at the trust through the SafeHands programme, for which she is programme manager. The SafeHands programme uses real-time locating software provided by TeleTracking. The innovation has helped the trust enhance infection prevention and control by automatically monitoring hand-washing compliance. It uses a combination of infra-red and radio-frequency technology to accurately pinpoint the locations of tagged equipment, badged patients and staff. The information can be monitored in real-time on large touch screens and computers. Its New Cross Hospital increased hand-washing monitoring by 1,000% in one month and, last year, the system helped the trust achieve over one million hand hygiene observations versus 600 visual observations.
E-Referrals set for ‘extended testing’: The Health and Social Care Information Centre (HSCIC) will start extended testing of the new NHS e-Referral Service at the end of the month, after its go-live was delayed due to technical defects, reported eHealth Insider. The new e-Referral Service was scheduled to go live in November last year, but in October the roll-out was pushed back, because of the need for “significant test, assurance and defect resolution activity” to be completed. In a progress update on the HSCIC’s website, the organisation says it and NHS England are “jointly committed to ensuring a smooth and efficient transition” from the existing Choose and Book referral service, but had to delay the launch to complete “on-going rigorous testing”. The update said it is also essential that the transition to the new service is as seamless as possible, with a focus on making the new system looking and functioning in a very similar way to Choose and Book to minimise the need for staff retraining. The testing will ensure the service can be integrated with the controls that allow authorised staff to refer patients, book appointments, and upload and review clinical information.
Gateshead NHS migrates over one million radiology images: Gateshead NHS Foundation Trust has migrated over one million images and scans to a central archive, which can be viewed from any department in the hospital, reported Computer Weekly. Following the end of a National Programme for IT (NPfIT) contract with Accenture, Gateshead chose BridgeHead to deliver the archiving system, which provides the trust with added sharing and protection capabilities for the radiology department. Images such as CT, MR, ultrasound and computed radiography are stored in Carestream’s Vue PACS system. But before the images could get to that point, BridgeHead had to take the data from the Accenture platform and migrate it into a supplier-neutral format before transferring it to the PACS. Clare Jones, radiology IT systems manager at Gateshead Health NHS Foundation Trust, says that, over the nine month project, the “burning concern” was localising the imaging data from the locked-down Accenture platform to the VNA.
NHS England launches the NHS Innovation Accelerator (NIA) for tried and tested innovations to scale across parts of the NHS: The NIA invites leading healthcare pioneers from around the world to bring their tried and tested innovations to the NHS. The programme aims to select a broad range of innovations – products, processes and technologies – to be more rapidly developed and scaled across the health service, to improve patient care, and reduce costs. The programme will select up to twenty pioneers from the UK and internationally, with the first wave launched in January 2015 through an open application process, scaling enrolled innovations across parts of the service to improve care and reduce costs. NHS England and the hosts for the programme, UCL Partners and the Health Foundation, will work with the selected pioneers and NHS organisations to achieve this. A broad portfolio of innovations will be selected including products, processes and technologies.
Opinion:
Patients must drive a digital revolution in NHS
Former managing director of NHS Choices, Jonathon Carr-Brown, tells the Guardian that the health service should follow the banking, airline, holiday and insurance industries by adopting technology – and the public can lead that change.
Carr-Brown insists that if sustaining an NHS free at the point of need then more people should take responsibility for the service: “What is the first step? Help the NHS adopt technology. In a world where digital innovation can sweep the globe in months, the NHS is one of the most non-viral institutions in the world.
“In 2015 the public needs to do for the NHS what it has done for the banking, airline, holiday and insurance industries – adopt and demand digital approaches to the management of healthcare.
“People need to bring their technology to the NHS’s door. Ask why appointments can’t be booked by phone. Send a secure message to ask if it’s really necessary to see a doctor. Use a video call without having to leave work. Demand to know why you can’t record the way you want to be treated in an emergency in advance of a crisis.
“And like a parent, the NHS has to let go and trust its children. The NHS needs to believe people can make their own trade-offs between convenience and security. Understand that individuals will know when it’s appropriate to use technology and when it is not.”
Is the NHS failing to leverage transformation from technology?
The NHS spends a great deal on IT, but rarely embraces the service redesign opportunities this offers, writes Dr Adam Hill, chief medical officer at Sectra, in Building Better Healthcare.
“The real opportunity to reshape the delivery of clinical services hand in hand with the deployment of IT programmes can be seen by taking a glance at the recent history of diagnostic services within the NHS.
“Not only does service redesign impact the health of our population at risk, but it can have any number of indirect benefits. As just one example, it could mean freeing up and consolidating vastly under-utilised real estate in the NHS. Clinicians providing a diagnostic service with a digital workflow can arguably report from an office, a hot-desk reporting hub, from home or while on the move with equal fidelity. But radiology is yet to really harness this opportunity.
“Embracing IT infrastructure at the same time as the service redesign opportunities that new deployments offer can unlock the potential to transition clinical care provision from centralised environments, through to decentralised models and distributed networks of care.
“Innovators will embrace the opportunity to use IT to redesign healthcare, achieving affordable health outcomes today; the risk of being a late adopter is that cost efficiencies are not realised until much later, failing patients that can’t wait for our health system to meet their needs tomorrow.”
NHS England must combat the growing tide of cynicism
Scepticism, as it shades into cynicism, has the potential to interfere with the health service’s vision, writes Alastair McLellan, editor of Health Service Journal.
“Scepticism should be the default setting when considering plans hatched by governments and national agencies – most fail to achieve all their goals.
“The relationship between the centre and service has always been marked by mutual suspicion, regardless of the structures in place. This is one of the few negatives of a monopsony system, which needs to be balanced against its many advantages and factored into decisions and strategies.
“But there are times when scepticism shades into cynicism and begins to actively interfere with the NHS’s ability to achieve its ambitions. It is not that dark yet, but it is getting there.
“The flow of leadership talent has been away from the centre (and, indeed, commissioning) and towards providers. Another factor of anxious times is the tendency for leaders to sit tight – welcome given the butterfly lifespan of many senior NHS executives, but a challenge for organisations needing an injection of talent.
“NHS England specifically also needs to demonstrate how it will allow the work of leaders with recent and relevant experience to directly influence policy and not have their sometimes inconvenient truths smothered in an attempt to steer a “steady ship.
“But a clearer compact with the service would engender a more positive dialogue and allow a greater focus on the real challenges ahead.”
Blog
Effective communication is essential if plans for a sustainable NHS are to be realised, argues Matthew D’Arcy.
