News in brief
NHS trusts get another chance to apply for £500m of tech fund cash, as phase two is launched: The second wave of the £500m ‘Integrated Digital Care Fund’, (formerly the ‘Safer Hospitals, Safer Wards Technology Fund’), opened to applications this week, announced NHS England. NHS trusts, and now local authorities, can apply for part of £240m of funding to digitise and integrate patient information across the health and care sector, driving improvements in patient care. It builds on the first wave of £260m of Department of Health capital funding announced by NHS England last July to support NHS trusts to digitise records and develop electronic systems for prescribing medicines quicker and more accurately. Beverley Bryant, director of strategic systems and technology at NHS England, said: “The focus for health and care staff is their patients but historically, staff have had to work within the limitations of paper records and slow bureaucratic systems. Digitisation removes this barrier – staff don’t need to wait for a set of paper records to be transferred to where their patient is – they can be available at the touch of a button by the staff who need them, when they need them. Demands on healthcare are increasing and we need to be smarter in the way we deliver care. Modern technology, when used well, provides a string to our bow that we didn’t have twenty years ago. We need to continue to embrace it as a tool for great patient care.” The application process for wave two of the fund will run until 14 July 2014. The £240m will be split – 2014/15 (£160m) and 2015/16 (£80m). Applications will be reviewed by a multidisciplinary team to ensure the funding will deliver benefits for staff and patients and value for money.
Labour pledges £100m to reintroduce 48-hour target to see GP: Labour leader Ed Miliband has pledged to end the ‘scandal’ of patients waiting more than a week for a GP appointment and reintroduce a right for patients to see a GP within 48 hours, according to Pulse. Miliband announced that a Labour government would reintroduce the target scrapped in June 2010 for patients to have a guaranteed appointment at their GP surgery within 48 hours. He also said that patients would gain a right to be seen by a GP on the same day if they need to be seen quickly and be able to book appointments more than 48 hours ahead ‘with the GP of their choice’. Labour leader pledged to invest an extra £100m a year in GP practices to pay for an additional three million GP appointments every year. He said this additional funding will come from repealing the requirements to use competition in the NHS and cutting back on what he called ‘quangos’, such as Monitor, the Trust Development Authority and commissioning support units. He said: “I can announce the next Labour government will put in place a new set of standards: a same-day consultation with your GP surgery with a guarantee of a GP appointment if you need it that day, a GP appointment guaranteed for all within 48 hours, and the right to book further ahead with the GP of your choice if your priority is to plan ahead or to see your preferred doctor. This will be better for patients, because they have better access to their GP surgery; better for the NHS, because it will save money currently spent in A&E; and better for Britain, because it is the kind of health service we need.”
MPs look abroad for records inspiration: Patients should be allowed to “own” and interact with their medical records if they are to be fully involved in their own care, a new parliamentary report has argued. The report on patient empowerment, released by a coalition of six health-based All-Party Parliamentary Groups, says NHS England should be aiming further than its goal of providing online access to GP records by 2015, reported eHealth Insider. UK governments have promised patients greater access to their healthcare records, with Labour promising to give patients ‘records on a stick’ a decade ago. The present government promised that patients would have access to all their records as it came into power, but the pledge has steadily been scaled back, to cover GP records and then the information in the Summary Care Record. The latest guidance from NHS England says GPs should have ‘plans’ to open up access by the target date; although there is an expectation that most practices will go further and also offer patients ‘transactional’ services, such as booking. The parliamentary groups looked at overseas examples of patient empowerment to determine how they might be used in a local context. The report says patient empowerment is now widely recognised as “a fundamental pillar of healthcare for the 21st century”, with self-management and individual responsibility an important part of managing pressure on modern healthcare. As part of this, it says a number of countries around the world are now allowing patients to interact with or jointly own their health records, rather than simply providing access.
Open source focus for ‘tech fund 2’: A focus on open source solutions in the second round of the technology fund has been welcomed by suppliers, who say they expect significant interest from trusts. Applications have opened for the second round of what is now called the Integrated Digital Care Fund, with a ‘prospectus’ released this week outlining details for the £240m of funding. The prospectus includes a sharp focus on open source solutions, and says NHS England wants to encourage the development of open source software and create a community of “developers, implementers and users” to improve the solutions. “The intention is plain; by taking an open source approach, it will be possible to gain better engagement from clinicians and other frontline users across multiple NHS organisations.” The open source approach will also help to eliminate supplier lock-in and allow trusts to stick with trusted software while using alternate suppliers to support and innovate as needed, the prospectus says. The prospectus includes a “catalogue” of 11 open source suppliers and encourages applicants to use their products or those from any other credible open source solutions. eHealth Insider spoke to several suppliers who say they are positive about the role of open source within the tech fund. IMS MAXIMS, chief executive Shane Tickell said that he is hopeful the technology fund will give trusts the power to move forward with open source solutions where they have been “stifled” in the past. Tickell said the fund’s focus on open source, coupled with open application programming interfaces and interoperability standards, should accelerate integration across all care settings. He added that while many trusts are open to the idea once they see that it can provide a “robust and agile” system while also giving them flexibility with their support options.
NHS e-Referral service will ‘build on success’ of dumped £356m Choose and Book system: The NHS’s e-Referral service will “build on the successes and use the lessons learnt” from the dumped £356m Choose and Book system, rather than starting from scratch, NHS officials have claimed. Earlier this week, a report from the House of Commons Public Accounts Committee revealed that the NHS was to replace the Choose and Book system, according to Computing. The committee said that the system was a “missed opportunity to improve patient care and data quality”, and its under-use meant that annual savings of up to £51m were being missed. Beverley Bryant, director of strategic systems and technology for NHS England, said that up to 40,000 patient referrals are made through Choose and Book every day, and that over 40 million bookings have been made through the system to date. However, she acknowledged that the system has worked for some GPs and not for others, and that a combination of electronic and paper referrals are still being used in some areas. “Managing a mixed economy of paper and electronic referrals is onerous for hospitals,” Bryant admitted. With the new NHS e-Referrals Service we want to build on the successes of Choose and Book and use the lessons learnt. This isn’t about reinventing the wheel; it is about taking the next step.” The decision to use a new system is part of NHS England’s commitment to make all referrals electronic by 2018, Bryant said.
NHS technology funding faces £60m shortfall: The technology fund set up by NHS England to help hospitals move away from paper based systems appears to have been slashed by £60m, official documents suggest. The reduction was revealed in a bulletin circulated to clinical commissioning groups by NHS England that said the body had allocated £200m of the £260m originally earmarked for its first funding round, reported Health Service Journal (HSJ, subscription required). “In July 2013 NHS England launched the Safer Hospitals, Safer Wards technology fund [and] over £200m of capital investment was awarded to organisations,” the bulletin said. “A further £240m for the second tranche of the technology fund – renamed the Integrated Digital Care Fund – was announced in September 2013.” The Safer Hospitals, Safer Wards fund was worth £260m when it was first announced in May last year. HSJ understands that efforts to distribute the funding were hampered by a tight application timetable and the tough value for money test that project applications must pass. NHS England said it was unable to comment on the discrepancy. The technology fund aims to help NHS providers move away from paper based systems for patient notes and prescriptions toward integrated electronic care records, as well as the development of electronic prescribing and referral systems.
EPRs to improve care for the elderly: The healthcare sector must make the most of new technological advances like electronic patient records (EPR) to build “networks of care” for elderly people and reduce demand on formal care providers, an independent charity has said. Innovation charity Nesta has released an investment report, ‘Who Cares?’, which focuses on how technology can be used to increase the supply and improve the efficiency of unpaid “informal care” provided to the elderly by their friends and family, reported eHealth Insider. Nesta estimates that more than nine million older people could need informal care from their friends and family in ten years’ time, and says there is “a significant market opportunity” to use technology as a means of improving access to care. “Care will always need to be delivered by people but technology is the tool to bring together individuals, communities and healthcare professionals to build ‘networks of care’ – putting the individual at the centre and building effective support around them,” says the report. The report identifies four areas of opportunity for technological innovation: communication tools to increase social interaction and reduce isolation, platforms to engage potential informal carers from the community, care management tools to build networks of support, and tools to improve integration between individuals, informal carers and formal care providers. It says one of the main problems is the large number of different people who can be involved in an elderly person’s care, such as informal carers and primary care, social care and voluntary sector providers, and the lack of communication between them. Developing tools to improve information sharing and communication, such as a platform allowing GPs to update the network of carers on medicine adherence, can help to improve care management and reduce the need for more expensive formal care at a later stage, the report says.
GP support services could be ‘offshored’ to India: Administrative support services for GPs could be outsourced to India under proposals to be considered by NHS England to slash costs, Pulse has learnt. The proposal, which could involve unidentified support functions being ‘off-shored’ to NHS Shared Business Service’s operations in India, is one of two proposals to provide services that also include processing medical records and performer and contractor list administration. NHS England will vote on this proposal at its board meeting next week, alongside an alternative proposal to keep the services in-house but reduce the number of offices from 38 overall to 13, and a third option billed as ‘full market testing with an open public procurement’. But GP leaders have said that removing the local aspect of the support services could lead to the loss of local expertise, which could cause further problems for practices. The vote, which will take place in a closed session at the board meeting, follows a review of support services intended to save £40m from its £100m primary care support services budget, including cutting a series of services no longer to be centrally funded. The proposal by Shared Services Connected Limited (SSCL) – a joint venture between the Cabinet Office and Steria – would see it subcontracting the service to NHS SBS, which itself is a joint venture between the Department of Health and Steria, and is currently responsible for administering GP payments.
Health chiefs flock to Twitter to talk to staff and the public: Trust chiefs have taken to Twitter in significant numbers in a bid to keep in contact with staff, swap ideas and drive good practice, Health Service Journal (HSJ, subscription required) research has revealed. More than one in three acute trust chiefs are active on the social network site, HSJ analysis shows. Just more than half of mental health chiefs post tweets and a third of community provider chief executives have Twitter handles. Health chief tweeters told HSJ they also used the service to mentor junior colleagues, boost staff engagement and keep up with academic research. Sarah-Jane Marsh, chief executive of Birmingham Children’s Hospital Foundation Trust, has 1,890 followers. She said her team’s Twitter activity “had to be a factor” in a rise in response rates to the national staff survey within her own trust. These had risen from 44% in 2012 to 59% in 2013. Gavin Boyle, chief executive of Chesterfield Royal Hospital Foundation Trust, has 1,022 followers. He uses Twitter as a staff engagement tool. Two thirds of his followers are hospital employees. He said: “I see Twitter as a good tool for organisational development and I see that as a fundamental part of my role. [Engaging on Twitter] is something you make time for, I look at Twitter once or twice a day.” Despite its benefits, some chiefs could still be put off from engaging with social media, according to Karen Lynas, deputy managing director of the NHS Leadership Academy, which provides training to NHS staff. Some were deterred for fear of breaching confidentiality, worries about online exposure and the pressures of day to day work.
First intuitive monitoring solution for care homes launched in the UK: Staff in homes caring for the elderly and people with learning disabilities, will now be able to identify and respond faster to potential safety issues following the launch of the first acoustic monitoring (AM) solution in the UK care sector, reported Same Difference. The technology developed by AM experts, CLB, responds to a recent BBC Panorama documentary ‘Behind Closed Doors: Elderly Care Exposed’. The programme highlighted examples of poor care, including the need to better support staff in attending unnoticed calls for help by residents. To address these issues, CLB’s solution represents an essential way for care homes to ensure residents are safe and their privacy is maintained. If residents are unable to physically alert staff to a problem and no alternative monitoring technology is in place, such as video, there is the potential for them to be left unattended until the next periodic room check. AM sensors installed in residents’ rooms are able to identify a concerning sound without human intervention, such as a cry for help, and alert staff immediately. Mathijs de Bruin, director of CLB, said: “Caring for people with differing conditions is very challenging and it is crucial that we support staff to deliver high quality care. There is increasing attention on the quality of care within the industry and technology can play a very positive role in enabling staff to provide care as and when it is needed.”
Three trusts to procure joint EPR: Three trusts in the Greater Manchester area are looking to procure a joint electronic patient record system across the organisations, reported eHealth Insider. Stockport NHS Foundation Trust, University Hospital of South Manchester NHS Foundation Trust and East Cheshire NHS Trust have issued a prior information notice saying that they are seeking to “procure an Electronic Patient Record (EPR) system and associated services” as part of a wider transformation programme at the trusts. In a statement, a spokesperson from Stockport said that the trusts have developed “a commitment” to collaborate and jointly work towards a new EPR. “The joint procurement and implementation of an EPR is a key part of a wider transformation programme across the trusts and is an underpinning enabler to support and deliver new clinical models of service provision,” said the spokesperson. “The trusts’ shared aim is to deliver a patient-centric record that enables information to be shared seamlessly across health and social care organisations in the region.” The trusts see the prior information notice as a “market engagement exercise” to test the supplier market in terms of “the achievability of the scope, scale and timeframe of our EPR requirements and to encourage input from potential suppliers to the design of the service provision.” An official procurement is planned to commence in June this year and the trusts aim to award a contract in spring 2015.
Nervecentre to sponsor the Patient Safety Congress: Nervecentre will sponsor the Patient Safety Congress at the BT Convention Centre in Liverpool on 21-22 May 2014. The company will be exhibiting on stand D14 and presenting the first session of the ‘how technology can improve patient safety’ stream on the 21st May at 14:30. Supporting them at the event will be Dr Patrick Davies, a consultant in Paediatric Intensive Care at Nottingham University Hospitals NHS Trust (NUH). Dr Davies will be discussing the complexities of early warning scores (PEWS) in children – with particular reference to how NUH has been working with Nervecentre to deploy recording of vital signs and the impact that will have on patient care. Managing director of Nervecentre, Paul Volkaerts said: “Patrick and the entire Nottingham University Hospitals team have been inspirational in our development of an electronic EWS and PEWS system for the recording of vital signs. Nottingham University Hospital NHS Trust are recognised leaders in ‘Recognise and Rescue’, having recently been shortlisted for the Patient Safety Awards for the second year running. “NUH originally deployed Nervecentre to address their out-of-hours processes in 2010, a project that was widely acclaimed and has led to similar deployments across the UK. NUH has built upon this platform continuously adding specialist referrals, porterage, and dementia assessments onto the platform, which will be used to deploy electronic capture of vital signs and electronic handover.”
Two large CSUs announce merger: North Yorkshire and Humber commissioning support unit (NYH CSU) and West and South Yorkshire and Bassetlaw (WSYB) CSU have revealed plans to merge, according to The Commissioning Review. The new organisation will have a turnover of around £90 million, supporting 23 clinical commissioning groups (CCGs) and a population of 5.6 million people. The two CSUs currently employ 1,200 people, work with 17 area teams as well as local authorities, mental health and hospital trusts, and general practice. The move will create one of the largest commissioning support service providers in England. Alison Hughes, managing director of WSYB CSU said: “This is an exciting move for us. By combining our strengths we’re able to offer our customers a wider choice of services and skills, from a broader pool of talented, expert and creative staff from across our region.” Maddy Ruff, managing director of NYH CSU said: “This move also allies us with the Yorkshire and Humber region, an area which has always been innovative and forward-thinking, and now has a global reputation. Our vision as a merged organisation is to deliver truly transformational change and we are well-placed, both geographically and economically, to do this.” The process of merging is still at a very early stage, and staff and customers are being fully consulted.
HSJ Awards
Entries have opened for the Health Service Journal (HSJ, subscription required) annual healthcare awards. Now in their 33rd year, the HSJ Awards recognise and reward best practice in healthcare organisations throughout the country. HSJ invite you to nominate examples of innovation and excellence in your organisation that have made a real difference to patients and staff. Entries will be judged by HSJ’s experts and peers, with achievements to be celebrated at an awards ceremony in London on 19th November. The closing date for entries is 23rd June 2014.
Shane Tickell, CEO of IMS MAXIMS has begun walking 212 miles to raise awareness of the early signs of cancer. Starting from his home in Kendal to offices in central Milton Keynes, the walk will cover approximately 26 miles per leg, across a total of eight legs. To show your support, please visit the website of the IMS MAXIMS Foundation, a charity run by the employees.
Opinion
Seven ways to unify the NHS without the Better Care Fund
Health and social care organisations must standardise their services to join-up care, Colin Cram said in an article for the Guardian Public Leaders Network this week.
It was one of seven actions outlined that needed to happen in the move to integrated health and care.
“The delay of the £3.8bn Better Care project to integrate health and social care looks like a euphemism for its demise,” he wrote. “The Department of Health still maintains that implementation will start from April 2015. One month before the general election? I don’t think so.
“The intention is worthy, but the solution is fudged. The project requires joint working between many semi-independent organisations of varying capability, including 150 local authorities, 160 acute hospital trusts and 52 mental health trusts. The £40bn NHS hospital budget was to provide £1.9bn of funding. But there are fears that some cash-strapped local authorities might divert the funds to other purposes, highlighting an absence of executive authority and accountability to ensure success. This cannot reside in both the NHS and local government.
“Successive governments have been too timid in mandating good practice in the vain hope that a combination of big schemes, encouragement, incentives and limited pressure would do the trick. They haven’t. Jeremy Hunt must bite the bullet and mandate – now – to give the NHS breathing space to survive beyond the medium term.”
Take care CCGs: it was the conflict of interest that tripped them up last time
This week The King’s Fund features a blog by Ruth Robertson where she discusses the latest solution to the problems in primary care and ‘co-commissioning’, and reminds us of the risks and previous experiences with similar initiatives.
“This extended role in primary care could bring many potential benefits. At a time when general practice is struggling to meet growing demands from patients it feels crucial for CCGs to use their leverage as membership organisations to encourage GPs to work in new ways, at scale, and in multidisciplinary teams to develop primary care services fit for our future needs.
“However, an extended role in primary care comes with risks. Maintaining close links with GP members will be essential for CCGs hoping to drive real change in primary care. At the same time, if CCGs take on responsibility for policing their colleagues, good relationships may be hard to preserve.
“CCGs looking to take on greater responsibility for commissioning primary care services would be wise to look back on the experience of GP fund-holding. That experiment in GP-led commissioning in the 1990s was undermined at least partly by public outrage at claims of GPs lining their own pockets. CCGs must demonstrate that they have clear, robust governance processes in place that show NHS spending decisions have not been influenced by vested interests, to avoid challenges from providers and the public.
“Perhaps one solution is for CCGs to focus on pathway design and strategy, while the area teams and, potentially, commissioning support units retain responsibility for the mechanics of the procurement and contract management process – allowing primary care to reap the benefits of CCG involvement without the potential pitfalls.
“If they manage to do this successfully, their move into co-commissioning could bring a much-needed boost to the primary care sector, as it seeks to reshape itself to meet our current and future needs.”
Change at pace and scale – the NHS one year on
Dr Mike Bewick, the deputy medical director of NHS England analyses progress the organisation has made as it reaches its first anniversary and discusses its future objectives.
“For me, the new, clinically-led system is much less hierarchical and more open to innovation, pulling in ideas and views from doctors, nurses, commissioners and patients to improve treatment and care. At the same time, it’s also more centralised, as we work to ensure uniformly high-quality primary care and specialised services across the country, wherever in England people live.
“First, we need to improve and simplify the way we do things. We need patients, health professionals and organisations to understand how it works. We must also make sure we don’t just respond to regulation, but set the agenda and deliver great care.
“We have to accept that access and quality varies and it is the job of CCGs to do address this. We also know that we won’t get it right every time, but primary care is a great example of delivering real change when we do get it right.
“While there are risks attached to translating complicated processes and treatments into terms we can all understand, those with rare illnesses and cancers deserve better, so it’s vital we use the opportunities of central clinical leadership to revolutionise, and improve their care.
“These are just a few of the many challenges facing the NHS but I’m an eternal optimist. … But we need strong clinical leadership to make sure we deliver more of these transformative changes. GPs, nurses, pharmacists and allied health professionals up and down the country are redesigning services for the benefit of patients.
“We know what we need to do, and by working together to develop ideas and build consensus, we can make it happen.”
Highland Marketing blog
In this week’s blog, account executive Marta Sieczko asks whether you are social media mature enough?
