News in brief
Jeremy Hunt: Doctors ‘must back seven-day working’: Health secretary Jeremy Hunt has said he is prepared to impose seven-day working on hospital doctors. Hunt told the BBC that a “Monday to Friday culture” in parts of the NHS had “tragic consequences” and said 6,000 people die each year because of this. British Medical Association (BMA) leader Dr Mark Porter said the union supported more seven-day working but accused the health secretary of being “too simplistic”. A September deadline is expected to be set by Hunt for a deal with the BMA. The current consultant contract means senior doctors can opt out of weekend work as long as it is non-emergency in nature – although they are still expected to be on call. By ensuring all new consultants do not have this right, the health secretary believes over the course of the parliament he will gradually get enough senior doctors in place to drive up standards at weekends. While he is within his powers to impose such a deal, the move threatens to sour relations with the medical profession – especially as a number of hospitals have already started altering rota patterns to create a more even spread of cover. The BMA pulled out of talks last year amid concerns over workload. Stormont health minister Simon Hamilton has also given his support to a seven-day health service in Northern Ireland, reported the BBC. “I welcome the debate started by health secretary Jeremy Hunt around how we can move towards a seven-day NHS,” he said.
Health secretary sets out ambition for a 21st century NHS: Health secretary Jeremy Hunt has said that the NHS needs a profound culture change which puts power into the hands of the millions of patients who use the NHS every day, enabling them to make informed choices about the services they use, reported Gov.uk. Hunt called for a step change in transparency – what he referred to as ‘intelligent transparency’. He said that by next March, England will become the first country in the world to publish avoidable deaths by hospital trusts as well as ratings on the overall quality of care provided to different patient groups in every local area. Hunt also announced that the NHS will become the world’s safest and largest learning organisation through the establishment of NHS Improvement – the new name for the jointly led TDA and Monitor– modelled on the air accident investigation branch used by the airline industry, which will be led by Dr Mike Durkin.
Lane Fox to focus on digital health: Internet entrepreneur Martha Lane Fox will develop proposals to improve take-up of digital innovations in health, the health secretary has said, reported Digital Health.net. In a speech at The King’s Fund, Jeremy Hunt said the health service needs to use technology to enact a “radical permanent shift in power towards patients”. “If we are to embrace the potential for technology to shift power to patients, we need patients to be willing and able to harness that technology,” he said. “Digital inclusion is as vital in healthcare as everywhere else – not least because some of the greatest impacts of new technology in health is with the most vulnerable patients. I have therefore asked Martha Lane-Fox to develop some practical proposals for the NHS National Information Board before the end of the year as to how we can increase take-up of new digital innovations in health by those who will benefit from them the most”. In response to the news Lane-Fox tweeted: “Looking forward to it – massive gains for vulnerable patients + frontline staff I think”. Hunt also spoke about the development of electronic patient records. “Within the next five years our electronic health records will be available seamlessly in every care setting,” he said.
Cornwall gets first county-wide devolution deal: Ministers have approved a devolution deal for Cornwall to give the county greater control of adult skills spending and regional investment. It also introduces an integrated health and care system, although Cornwall will not be required to elect a mayor, reported Public Finance. The agreement, reached with Cornwall Council, is the first devolution deal agreed with a county authority as part of the government’s attempts to boost the powers of local authorities. Following the election of the Conservative government, Chancellor George Osborne said he wanted to devolve powers to councils, although he insisted that mayors would be needed for city combined authorities. The powers agreed will enable Cornwall Council and the council of the Isles of Scilly to work with local health organisations on a plan for integrating health and social care services without such a post. Announcing the agreement, communities secretary Greg Clark said the Cornwall deal could be the first of many for counties around the country. He added: “This ‘one nation’ government is determined to end the hoarding of power in Whitehall and put it in the hands of local people who know their area best. This historic deal ensures Cornwall has the powers and resources that will allow it to create the jobs and services it knows are best suited to the area and that will help local people and the county thrive.”
Care.data trial practices unveiled as objection concerns remain: NHS England maintains no information will be extracted under care.data without data guardian’s consent, as critics call for greater clarity on a patient’s right to opt-out, reported Government Computing. Three out of the four clinical commission group (CCG) areas selected as pathfinders to trial the care.data programme have now published lists of surgeries that will participate in the testing process. However, NHS England has insisted that no extraction will take place without approval from the national data guardian Dame Fiona Caldicott. Somerset, West Hampshire and Blackburn with Darwen CCG areas have all released lists of GP practices that will support the trials of care.data to better inform any national rollout of the scheme. The care.data project has been devised to share health and social care information on a patient for reasons other than direct healthcare. Medconfidential, a pressure group campaigning for better security around the management of medical records, said it welcomed the publication of lists of a number of GP practices trialing the scheme so that affected patients would now be required to consult with GPs and take a decision on whether to opt-out of providing their details for use beyond direct care. Medconfidential coordinator Phil Booth added that the organisation still held “serious concerns” around care.data, not least around ensuring patient understanding of the programme.
GP recruitment problems force NHS to run more surgeries: BBC Scotland research has shown that difficulties with GP recruitment have led to more doctors’ surgeries being taken over by health boards. NHS boards said 42 practices were now under their control – a measure used in special circumstances and emergencies. Scottish Labour called it a “crisis” and claimed the number of patients registered at an “understaffed” GP practice was at least two million. The Scottish government said there was no crisis in healthcare. Public Health minister Maureen Watt said another £50m would be spent on primary care to ensure patients get the service they deserve. Most of Scotland’s 987 general practices are owned and run by GP partners. However, some surgeries have previously been run by health boards rather than GP partners, often because they were situated in rural areas such as the Highlands, where they might otherwise have struggled to attract an independent practice run by GPs. But in recent years, health boards have also had to step in in urban areas as an emergency measure to ensure patients continued to have access to a GP, after practices lost a number of doctors within a short space of time.
NantHealth buys Harris: Genomics company NantHealth has bought systems integrator Harris Healthcare Solutions for an undisclosed sum, reported Digital Health.net. NantHealth is a subsidiary of NantWorks; a cloud-based information technology provider combining genomic science and big data. Harris Healthcare is a clinical systems integration innovator with around 170 staff, many of whom are based in the UK. Harris retained its US government healthcare services business and financial terms of the transaction were not disclosed. Harris’ systems include business intelligence tools and patient and clinical portals and are used at a number of NHS trusts including NHS Fife and The Royal Liverpool and Broadgreen University Hospitals NHS Trust. NantHealth has developed the NantOmics Analytics Platform for genomics sequencing interpretation and annotation and was recently announced as one of the four companies that will work on the government’s ambitious 100,000 Genome Project. “The acquisition of Harris Healthcare Solutions brings unique and proven technology that significantly furthers our stated goal to improve patient outcomes by efficiently providing healthcare professionals with integrated, clinically relevant patient-centric information in real-time,” said Dr. Patrick Soon-Shiong, chief executive and founder of NantHealth. “At the same time, we have added an extensive client base of leading clinical and health IT innovators across North America and Europe, as well as a talented and experienced leadership team.”
Review of NHS 111 a ‘step in the right direction’ – BMA: The British Medical Association (BMA) has welcomed plans by NHS England to review how NHS 111 and GP out-of-hours services are procured in the future reports National Health Executive. It was revealed last week that NHS England told commissioners to suspend all GP out-of-hours and NHS 111 procurements, regardless of the stage they are in, until September. Dame Barbara Hakin, commissioning operations director at NHS England, said the halt to tenders will give the national body time to create commissioning standards and a clinical model for a “functionally integrated, urgent care access, treatment and clinical advice service”. Dr Charlotte Jones, BMA GP Executive team lead on NHS 111, said that she is pleased that NHS England is reviewing its procurement process, particularly rethinking the separation of the call handling system from GP out-of-hours services. “A lot of work still needs to be done, but this is a step in the right direction,” she said.
Merseyside shares 5.5m records in a year: The GP records of patients in North Merseyside have been shared 6.5 million times amongst health and social organisations in the region as a result of the area’s iLinks Transformation Programme. The bulk of the sharing has happened in the past year, when records held by local practices on the Emis Web system were shared 5.5 million times with hospital staff, social workers and other professionals working in health and social care and using different record systems, reported Digital Health.net. Between the start of the project and 2014, records were shared one million times across the region, which covers a population of around 750,000 people across three clinical commissioning groups in Liverpool, South Sefton and Southport and Formby. The project has accelerated since the publication last year of the iLINKS Informatics Transformation Strategy 2014-2017, which sets out a plan for health and social care providers and suppliers in the area to collaborate on sharing patient data to support integrated patient care. Discussing the figures at the iLinks conference in Aintree, Dr Rob Caudwell, chair and clinical IM&T lead at Southport and Formby CCG, said that they were aiming for one million instances of record sharing in the past year, but that usage has “exponentially taken off”.
Oxford cuts blood cost with e-requesting: Oxford University Hospitals NHS Trust saved £500,000 in the cost of blood products over a year after implementing an electronic blood requesting system. The trust believes it is the first in the country to have a fully paperless system for clinicians to order blood products, including decision support. Consultant haematologist at Oxford University Hospitals Mike Murphy told Digital Heath.net the trust saw the implementation of the Cerner Millennium electronic patient record in 2011 as an opportunity to develop an electronic blood requesting system. A Millennium module for blood ordering was already in use in the US, but had not been implemented in the NHS. Oxford went live in April last year in haematology and the system is being rolled out across the trust. The final departments will be done by October. Rather than using a pink paper request form, doctors use the electronic patient record to request blood products and must provide justification for the transfusion. Before implementation, the trust’s compliance with agreed triggers was as low as 40%. This means up to 60% of transfusions were potentially unnecessary or even potentially putting patients at risk, explained Murphy.
Supermarkets set to offer NHS health checks at the checkout: Supermarkets could begin conducting NHS health checks using in-store tannoy announcements to attract shoppers, reported Pulse. The suggestion forms part of Greater Manchester Devolution board’s strategy to boost public health by increasing uptake to the national cardiovascular screening programme. The proposal has been discussed alongside plans to also boost awareness about the NHS Health Check programme, which in Manchester could include promoting it in mosques and other “places of worship”, the papers said. A case study published alongside the Greater Manchester Devolution Board’s public health strategy said: “In Trafford and Oldham negotiations are underway with supermarkets to offer health checks in store and advertise them over tannoys so people who may not otherwise want to visit their doctor can access the service there and then.”
Patients set to benefit through fresh boost to innovation: More than £150,000 will be awarded to new ideas to address England’s biggest healthcare challenges in the first wave of this year’s NHS Innovation Challenge Prizes, reported Integrated Care Today. The Challenge is part of a broader drive to embed innovation across the NHS which includes the NHS Innovation Accelerator and Test Bed programmes, the vanguard sites around the New Models of Care and the Health and Care Innovation Expo in September. Applications for this year’s prize fund will be accepted from 15th July and are open to anyone working in the NHS with an innovation that will improve the way that services are delivered. The two categories in the first wave are: A cancer challenge to recognise initiatives that demonstrate clear delivery of the NHS Cancer Strategy and Five Year Forward View through new models of care and a series of ‘acorn’ prizes to be awarded to small innovations that have the potential to make a big difference to patients. NHS England chief executive Simon Stevens said: “The NHS has the opportunity to become one of the fastest adopters of innovation in the world. These prizes are just one of a number of initiatives to support new ideas that will allow us to meet the challenges we face and to transform care for our patients.”
NHS is ‘over-treating, over-diagnosing and over-prescribing’: The NHS has been spending billions on unnecessary over-treatment, over-diagnosis and over-prescribing, a new report by think-tank the King’s Fund has found. The investigation, ‘Better Value in the NHS’, determined that general over-use is common across the NHS, particularly with elective treatments of low clinical value and over-prescription of drugs that are not needed or likely to be ineffective. Over-utilisation of the hospitals themselves also contributes to excessive spending – often due to a lack in alternatives. Hugh Alderwick, one of the authors of the report, told National Health Executive: “There’s a range of reasons why over-use or too much care happens. They include failure to follow professional guidelines when delivering care or, in some cases, lowering the threshold for treatment. Over-use of hospitals at the end of people’s lives is often cited as an example where there are significant costs from treatment, but the contributing factor of over-use in that scenario is often a lack of alternative to treatment in the community. In many cases, reducing an over-use might require investment in some out of hospital services, which over the longer term are likely to be cheaper.” The report also estimated that £500m a year could be saved if the NHS cut down on low-value elective procedures, despite there being little agreement on which services are of low value.
Opinion
Frontline teams are the key to delivering better value care for patients
We need to talk about patients not pounds if we are to engage clinicians in meeting the NHS productivity challenge, argues Ruth Robertson, health policy fellow at The King’s Fund.
Writing in a blog, she says this means focusing on providing the best possible health outcomes at the lowest possible cost, rather than a single-minded push to save money.
“Past performance shows we need a new approach. Since the 1980s, NHS productivity – that is outputs (activity) divided by inputs (physical inputs, mainly staff) – has increased by around 1% a year on average.
“That figure has been higher over the past five years but this has been mainly due to the freeze of NHS wages and real-terms reductions in the tariff price paid for services. These centrally driven measures cannot slice much more from NHS budgets, as demonstrated at the end of last year by the first pay-related strike action in the NHS for 30 years (we await the NHS reaction to the latest pay deal announced in the budget) and re-emphasised this year, when the majority of NHS providers rejected proposals for the reduced 2015/16 tariff for hospital services.
“To get anywhere near the 2–3% annual productivity growth required to meet the £22bn productivity challenge set out in the NHS Five Year Forward View will require clinical teams to find ways to improve the quality of their services and get more value from every pound spent on health.”
We all have a role to play in driving forward mental health services
It is absolutely possible to transform mental health outcomes across the NHS, writes Jacqui Dyer, in a blog on the NHS England website this week.
“People are absolutely fed up with having their minds and bodies being treated as if they were disconnected, or as if mental health lacks importance,” says the vice chair of the Mental Health Taskforce for England. “We must end approaches which don’t encourage integration and our services must respond to the needs of our communities. Anything else puts our NHS at risk of not being worthy of the 21st century.”
“Where there is will, there is always a way – so surely by 2020 we can at least apply what we already know. We must be SMART, clear and precise about what needs to be put in place between now and 2020 to really make change happen, recognising that each step will take us closer to realising our vision.
“Effort must be both individual and concerted, and the days of working in silos must end. We need our leadership from the front, as well as the top – and from each person, in every position within and across the system. Anything less than integration, as well as multi-disciplinary and networked working, is not fit for purpose.”
The future of remote healthcare could be woven into your clothes
Sensors in the fabric of clothing could provide detailed, real-time information and allow patients to be monitored at home, says Dr Kathryn Wills, higher research scientist, smart textiles at the National Physical Laboratory and Coventry University.
There are significant potential benefits to be had from monitoring patients’ conditions as they go about their daily lives.
“While smart watches have created a lot of buzz in the world of healthy living, they are currently unable to capture the type of information that could be really valuable for healthcare. However, new innovations involving integrating electronics directly into the fabric of clothing could be first step towards creating smart technology that could revolutionise remote healthcare; allowing more patients to live normal lives, reducing hospital administration and freeing up beds.
“Sensors placed on the right part of the body can provide detailed, real-time information. Patients can be continuously monitored away from the hospital and if there is a warning sign, for example high blood pressure or swelling, medical professionals can be alerted.
“The data collected can also offer valuable insights into the effectiveness of treatments. This information can be used to develop personalised recovery plans, which can be adapted during the process without the need for check-ups. Pharmaceutical companies could also use the data to better understand how their drugs perform outside the lab.
“Wearables are not yet at the stage where they can be relied on for remote healthcare, but that is changing: printing circuits directly onto fibres has the potential to provide real-time healthcare that can integrate into the patient’s daily life. Electronics integrated into clothing could open up many new opportunities, bringing huge benefits to both healthcare professionals and patients.”
Blog
In this week’s blog Myriam McLoughlin argues that the time has come for the general public to become a responsible user of the healthcare system.
