News in brief
Stafford Hospital trust to go into administration: The trust which runs Stafford Hospital is to be put into administration by the health regulator Monitor, reported the BBC. Mid Staffordshire NHS Foundation Trust will be run by two specially appointed administrators to “safeguard the future of health services” currently provided. Dr Hugo Mascie-Taylor and Alan Bloom of Ernst and Young will take over the running of the trust. It will become the first foundation trust to go into administration. A report for Monitor, written by a panel including Dr Mascie-Taylor in February, said services at the trust were “unsustainable”. It recommended the closure of its maternity unit, intensive care unit and accident and emergency department. It said services could instead be provided at neighbouring trusts including the University Hospital of North Staffordshire, the Royal Wolverhampton or Walsall Healthcare NHS Trust. The trust “was likely to become unable to pay its debts”, it said. Last year, the trust reported a drop in annual income of about £4m and received a £20m bailout from the government.
Professional record standards body launched at HC2013: A new standards body for patient care records has been launched at HC2013 – the health and informatics conference in Birmingham, reported Public Technology. In a presentation by the body’s chair Professor Iain Carpenter, it was revealed that it would be the first point of call for professionals, professional organisations, service providers, commissioners, policy makers and system suppliers for expertise on all matters related to care records. With an impressive lineup of board members including representatives from both the medical profession, and technology industries such as the Royal College of Physicians and the British Computer Society, the organisation will be a Community Interest Company limited by guarantee. This means it will be a legal entity, owned by its members, and tied with professional bodies, explained Carpenter.
Just 61 practices offer records access: Just 61 GP practices in England are offering patients full online access to their patient records, revealed eHealth Insider. The government has said on a number of occasions that all patients who want online access to their GP-held records should have it by 2015. This pledge was one of the few commitments in the ‘Power of Information’ strategy published last year, and will be mandated for suppliers in the GP Systems of Choice framework replacement due by the end of the year. However, data collected by the Health and Social Care Information Centre and revealed on its Indicator Portal, shows that one fifth of practices do not have the functionality to do this. As of December last year, those practices listed as using INPS, Microtest, iSOFT and Informatica did not have the ability to offer records access. The rest have the functionality, but of more than 6,200 practices, just 61 have actually switched it on.
Fifty NHS trusts targeted in first wave of new inspections regime: Fifty NHS trusts that are giving cause for concern over care standards are to be targeted in the first wave of inspections led by the new chief inspector of hospitals in the wake of the Mid Staffordshire scandal, reported The Guardian. Five elite teams are expected to be set up to carry out the four-week probes and will include leading doctors, nurses and managers seconded from high-performing trusts. For the first time, inspectors will formally check on the quality of leadership of trusts as well as the safety and quality of services. The government is to launch a consultation on how named managers and board members of all providers of health and social care, including private companies and charities, should be held personally to account. The new Care Quality Commission strategy will take forward some of the key responses by the health secretary, Jeremy Hunt, to the public inquiry led by Robert Francis QC into the failings at hospitals run by the Mid Staffordshire NHS trust.
NHS England plans to lead ‘radical’ service change: NHS England is planning to continue the health service’s current savings drive after 2015, and to recast it as a programme of “ambitious and radical” service change led by its area teams. The organisation, formerly known as the NHS Commissioning Board, will extend the quality, innovation, productivity and prevention savings programme beyond its current April 2015 end date, which is also the end of the current spending review period. In an exclusive interview with HSJ (subscription required), NHS England policy director Bill McCarthy revealed it was drawing up plans for the programme to focus in future on large-scale service reconfiguration, rather than on smaller incremental savings schemes. Unlike the current QIPP programme, which was initiated by the Department of Health, the next phase will be developed and led by NHS England. The current programme is intended to generate about £20bn of NHS efficiency savings over the four years to April 2015.
Kelsey hails breakthrough for care.data: Tim Kelsey, the national director of patients and information, has claimed a breakthrough in linking-up data flows between secondary and primary care. Kelsey said that NHS England “will shortly be making a big announcement with the Royal College of General Practitioners and the British Medical Association that will enable much better data flow out of primary care and link to secondary care.” After a session at HC2013 in Birmingham, Kelsey told eHealth Insider that the announcement would be a key step, clearing the way to develop care.data as the portal to link together patient data from different care sectors for the first time. Care.data is designed to capture and link data so it can be used by the NHS to analyse outcomes and feed the patient choice and transparency agendas.
CQC to search for patient feedback on GPs using Facebook and Twitter: The Care Quality Commission (CQC) will search for positive and negative comments about GP services on social networking sites such as Facebook and Twitter, in order to discover the ‘reality’ of the care that patients are receiving, reported Pulse. Launching a document which lays out their strategy and purpose for the next three years, the regulator said that it wanted to ensure they were responding to patient concerns more effectively. The report also said it would introduce a ‘more robust’ test for new primary care providers applying for registration, although a CQC spokesperson confirmed that GP practices that have already registered would not be affected by the new process. It also said that a proposed chief inspector of primary and integrated care will look at patients’ experiences as they move between different services. Jeremy Hunt, secretary of state for health announced in February that he was considering plans for a chief inspector to provide an ‘expert view’ of primary care to mirror the appointment of chief inspectors for hospitals, to uphold standards and make the final call when a practice is failing.
Involve junior doctors in IT development, conference told: Health service IT managers should draw on the experiences of junior doctors when designing new processes, one such doctor has said, reported HSJ (subscription required). Speaking at HC2013 in Birmingham, , Dr Wai Keong Wong said junior doctors could offer valuable insights into hospital operations. Dr Wong, a haemotology registrar at the Royal Free London Trust, highlighted the fact that most junior doctors are aged 24-38, the age range largely responsible for innovations at tech firms such as Google, Facebook, Apple and Microsoft. “In most other organisations this is the age where efforts are put into cultivating and developing the skills necessary to lead organisations and services in the future,” Dr Wong said. “This doesn’t quite happen in the NHS and I think we are missing a trick.”
Tiani Spirit launches into UK healthcare market: Health and social care professionals in the UK will now have the opportunity to improve safety and efficiency throughout the care setting with the launch of Tiani Spirit, a healthcare information exchange solution, reports British Journal of Healthcare Computing. Tiani Spirit helps NHS staff make use of real-time, consolidated, patient-centric data to support informed decision making and to place the patient at the centre of care to improve clinical outcomes. Tiani Spirit′s solution for the NHS builds on the company′s experience supporting some of the world′s largest cross-community healthcare information exchanges, such as epSOS, which allows patients to receive secure, seamless access to their healthcare records across 23 European countries. Jonathan Taylor, managing director of Tiani Spirit UK, said: “The NHS has recognised the importance of sharing real-time, consolidated, patient-centric information to improve patient safety and deliver higher quality care more efficiently across multiple care settings. At the same time, patients rightly expect the NHS to respect their privacy and their wishes about how their information is used.”
Bristol Community Health becomes first NHS provider to pilot TotalMobile™ App platform: TotalMobile Ltd has chosen HC2013 to announce that social enterprise and NHS provider Bristol Community Health will begin a pilot this spring of the TotalMobile App Platform, a mobile workflow management solution which allows healthcare professionals to spend less time on administration and travel, and more with patients, reported eHealth News. The provider of NHS-funded community healthcare in Bristol and its surrounding areas, will deploy an initial six-month license for up to 100 staff members, selected from four different teams. Bristol Community Health team manager, David Pugh, who manages the phlebotomy team, which will be part of the mobile working pilot, said: “We’re really excited to be part of this pilot and welcome the potential benefits it will give us in terms of improved ways of working and interaction with colleagues in other services.”
Keogh criticises poor data in NHS following Leeds row: NHS England medical director Sir Bruce Keogh has criticised clinicians and organisations which do not gather or report quality data in the wake of the Leeds children’s heart surgery controversy, reported HSJ (subscription required). NHS England also defended its decisions to first raise serious concerns over the performance of the service in Leeds, and then to back the resumption of services earlier this week. At an NHS England board meeting this week Sir Bruce said the mortality data which had caused concern about Leeds was “incomplete and inadequate”. “People undertaking surgical and other procedures in our NHS have a duty to describe what they do and define how well they do it. Otherwise, I think they forfeit some of their professionalism. This applies both to individuals and to organisations.”
‘Parents and employers could spy on online patient records’: Plans to place the medical records of NHS patients online are still raising privacy concerns, with fears from the UK’s information watchdog that employers, parents and others could attempt to force access to sensitive personal data, reported Public Service. GPs across the country are required to give patients access to their medical records over the internet by 2015. But Dawn Monaghan, the public services group manager at Information Commissioner’s Office, said this raised concerns about “enforced subject access. We see this with rouge employers, we see it sometimes with insurance companies,” she said. “We are concerned that by being able to access to your online record, someone else then forces you to go in so they can view it.” The government has mandated that GP surgeries provide people with an online patient record as part of a wider move designed to empower people and improve care.
Hospitals ‘need doctor in charge’: Every hospital patient should have a single doctor who is in overall charge of their care to help prevent another Mid Staffordshire disaster, the head of the report into the NHS scandal has claimed, reported The Telegraph. Robert Francis QC said systemic failings which led to the preventable deaths of up to 1,200 patients at the trust between 2004 and 2009 could mean there are “other Staffords” in the NHS. Speaking at the International Forum on Quality and Safety in Healthcare in London, Francis expressed fears that hospitals are not acting quickly enough to improve standards following his damning report, which was published in February, as he criticised what he called the NHS tendency to “wait for someone else to tell it what to do”. Ensuring that every patient in every NHS hospital has one doctor in overall charge of their wellbeing is one step hospitals should implement to ensure medical staff take responsibility for patients, he said. Some elements of the Francis Report have already been accepted by government, although its official response last month did not address every recommendation in detail.
NHS Scotland chief Derek Feeley to leave post for US: The head of Scotland’s NHS has announced he is leaving his post to take up a job in America, reported the BBC. Derek Feeley, chief executive of NHS Scotland, said it had been a “privilege” to run the health service in Scotland since 2010. He will be taking up a new position as executive vice-president of the not-for-profit Institute for Healthcare Improvement in the US.Mr Feeley, who is also the director general of the Scottish government’s health and social care department, first worked in health in 2004 when he worked on the Kerr Report, which recommended far-reaching reforms of the NHS.
Awards
Healthcare Innovation Awards 2013
Entries are now open for the Healthcare Innovation awards. The entry deadline is midnight Friday 28 June 2013. Click here for a list of categories. A shortlist of finalists will be announced in late September and the winners announced at an awards ceremony at the Guardian offices[GT1] on Thursday 24 October 2013.
Opinion
Paying for UK health
With pressure on the NHS purse strings continuing to tighten, FT.com (subscription required) discusses if now is the right time for co-payment.
“Since it was set up in 1948, the National Health Service has provided treatment that is “free at the point of use” to every British Citizen. This principle is understandably popular with the public, however frustrated some may be with the day-to-day realities of NHS care.”
FT.com continues by saying that politicians view “tampering with a totemic model” as fraught with danger and that despite the NHS being “the biggest beneficiary of largess under the last Labour administration”, it has been spared from the majority cost cutting imposed elsewhere – however this won’t last.
“On past trends of growth, the NHS budget would cost the equivalent of one-fifth of gross domestic product in less than ten years.
“Even after the heroic productivity gains the government is pencilling in for the NHS, this would leave a funding gap of about £20bn a year if the current funding settlement continues. No wonder some officials, such as Malcolm Grant, the boss of the new NHS commissioning body for England, are warning that some payment for use may have to be considered.”
Still no change in NHS finance after Francis
In this week’s HSJ (subscription required) Noel Plumridge, an independent consultant and former NHS finance director, explains that although we were told that the Francis report is meant to change everything – so far the finance regime looks remarkably like “business as usual”.
“There’s a terrible blame culture in the NHS, runs the old saying. And I’m about to tell you just whose fault it is. Of course we prefer not to do blame, recrimination and all that nasty stuff. Yet everyone knew Robert Francis QC’s report on where it all went wrong at Mid Staffordshire Foundation Trust would make uncomfortable reading. Even the dogs in the street knew broadly what the wise QC would write, so then also presumably did NHS England when, in December, it published Everyone Counts, its planning guidance for 2013-14.”
He continues by asking if, as we have been told, Francis changes everything, what is actually changing in the NHS business and financial regime?
“The business regime is, you will recall, rather central to Francis’s findings. One reading of what happened in Stafford is that a trust board, browbeaten by a performance management culture and errified of not becoming a foundation trust, placed financial balance above patient care. In pursuit f acceptable earnings before interest, taxes, depreciation and amortization (EBITDA), frontline staffing levels were hacked away. Quality and safety were allowed to slip catastrophically.”
“Finally, if all else fails, blame the boss. “The man with no shame,” as the Daily Mail describes him. And his successor. And the next boss too.”
Another view
eHealth Insider’s Primary Care columnist Neil Paul is not sure about giving patients online access to their notes; although he has lots of other ideas for helping them digitally.
“The government is having another push on making sure that patients can get access to their GP-held records. In fact, one of the few, definite, commitments that has made on the NHS IT front is that patients should have online access by 2015. Yet, I’m not convinced that this is something that people really want; even though there may be some benefits when we get around to implementing the idea that have not been discussed yet.
“My opinion is people only want to see their notes when they feel they are being messed around. Really, what they want to do is to check up on people; to make sure everything is happening properly. It’s more about tracking things and making sure they haven’t fallen between the cracks.
“I recently ordered a camera from Hong Kong. I signed up for text alerts on its progress, and I was regularly texted so I knew where it had got to. I think this is what patients want. They know they had a CT scan; they want to know when it will be reported and when will they hear the results. They know they were told they needed an operation, but they have no idea where they are on the list or when they will be called. If they are number 137, they will probably be fine with that, as long as they can see the list going down regularly.
“Instead of worrying about giving patients access to the GP record, I think we should put more effort into mapping patient flows and using flags to mark where things are up to.
“I suspect this will be better received. I also suspect it will also show-up good performers as compared with poor ones. If one hospital texts its patients after three weeks to report a CT scan, and one texts the same day – which would you go to? If one consultant takes a month to let you know your tests were normal and the other rings you the same day – which are you going to ask for?
Paul concludes by saying: “DHL wasn’t afraid to tell me that the camera spent 12 hours in their sorting office. Should the NHS be afraid to tell me it takes one hospital eight weeks to write a discharge summary and another only two days? Is this unfair comparison on unfair targets or clever way of pushing for efficiencies?”
Not sleeping your way to the top
This week in HSJ (subscription required), former local authority director, Blair Mcpherson questions whether senior managers can uphold a balanced and healthy lifestyle whilst maintaining a demanding job. Mcpherson describes the timetable of those ‘on top of their game’ in healthcare:
“If we are to believe the top business people interviewed in The Guardian they organise their time outside of work with the same discipline that they apply in the office, operating a rigid and punishing timetable. They build in quality time with their children and partner, but the impression is of rather selfish people who fit family and friends in around the demands of work, who see their daily workout to be as important as time with family and are rather glad when everyone else is a sleep and they can catch up with their emails.
“These are highly effective people, very focused and very successful but surely not typical of senior managers? Well, yes and no. From my experience of senior managers in the public sector, long hours is the norm. Routinely taking work home – whether reports to read for the next day’s meetings or reading emails in the evening – is common place. Being somewhat preoccupied with work and finding your thoughts drifting to a work issue when you’re with the family or lying awake at night happens a lot.”
Mcpherson concludes: “That despite the best endeavors of busy professionals to enjoy a balanced lifestyle, the reality is the ‘love of the job’ drives where many senior managers spend their time: “Being too tired to do much on an evening except watch TV. Falling asleep on the sofa on a Friday night after a bottle of wine. Having every intention of going to the gym at least three times a week to justify the membership but mostly lacking the energy and certainly not able to go before work. Needing that lie-in on a Sunday morning. And yes, selfishly putting the job first but being totally unaware of this because most of the time you like work, you enjoy the status and you have the trapping of success.”
Highland Marketing blog
This week saw HC2013 open its doors, providing delegates and exhibitors the chance to network and share ideas on the ever-changing health IT market. In this week’s blog, Gemma Thomson shares her experience of how sitting on the other side of the fence has given her a new perspective on the benefits of industry events.
