News in brief
GPs offered ‘new deal’ if they agree seven-day opening: The government is promising a “new deal” for GPs in England – if they sign up to seven-day opening, reported the BBC. Health secretary Jeremy Hunt has promised extra investment and help for under-pressure services. The package includes plans to recruit 5,000 new GPs and another 5,000 support staff, including practice nurses. Financial incentives may even be offered to those willing to work in the most deprived areas. Those who have left the profession or want to work part-time will be given more help. However Hunt has said that in return, GPs need to get on board with his plans for weekend opening, which involves groups of practices pooling together to share the extended hours. It builds on plans set out at the start of this year for NHS England to make the profession more attractive as the NHS is struggling to recruit new doctors. The health secretary has urged GPs to work with him, he said: “I want to be upfront: this is not about change I can deliver on my own.”
IT could save NHS £13.7bn a year: Kelsey: The use of digital technology can create savings in the NHS in England of up to £13.7bn a year by 2020, according to Tim Kelsey, national director for patients and information at NHS England. Kelsey presented the plans in a board meeting for the National Information Board (NIB), which was set up to deliver the goals in the ‘Personalised Health and Care Framework 2020’ to encourage the NHS to embrace modern technology, reported DigitalHealth.net. The plans suggest that the work of the NIB could drive savings of £8.3bn to £13.7bn across six key areas identified by the board. These savings would support the £22bn in efficiency savings required by NHS England in order to fill a £30bn gap between likely demand and funding by 2020-21. The remaining money is set to come from the government, in line with the Conservative Party’s manifesto pledge to find £8bn for the NHS over the next five years. Speaking ahead of the board meeting and during his plenary session at the King’s Fund’s Digital Health and Care Congress, Kelsey warned that he would put a “huge health warning on these figures”, but was still positive they could be achieved. “We are being ambitious, but we are not being aspirational,” he said. “We are saying these are things that can be delivered by 2020. Some things will happen quickly, others will take more time.”
NHS patients to be monitored remotely in digital healthcare revolution: NHS patients with long term illnesses could soon be able to monitor their conditions remotely through high-tech clothing and wearable gadgets which will link directly to their medical records, under new proposals announced by NHS England this week. Within five years patients across the country are likely to be able to go online and speak to their GP via videolink; order prescriptions or see their entire health record as part of widespread digital revolution of healthcare in Britain, reported The Telegraph. People suffering from chronic conditions like asthma, diabetes, heart disease or high blood pressure could be constantly monitored remotely through wearable skins sensors or smartphone apps with data uploaded directly to health records so that problems can be spotted immediately. Wearable tech like Jawbone, Fitbit, Misfit, the Pebble and Apple smartwatches are already able to monitor heart rate, sleeping patterns, steps taken, diet, alcohol intake and running speed. Andy Williams, chief executive of the Health and Social Care Information Centre said: “The proposals announced today are a major step forward in using technology, data and information to transform the delivery of England’s health and social care services.”
Ireland plans five year e-health journey: Ireland’s new chief information officer (CIO) for health, Richard Corbridge, has issued a “Knowledge and Information Strategy” that sets out the building blocks for a transformation of the country’s health services using e-health. Corbridge took up his post as CIO of Ireland’s Health Service Executive in December, and told DigitalHealth.net at the time that he was “getting in at the ground floor” with the opportunity to “start from the beginning, add to a strategy, and pull a team together.” The Knowledge and Information Strategy launched this week follows up on this by focusing on the basics of getting a new IT infrastructure, interoperable systems, data use and patient services in place; and on creating the leadership to do it. A more detailed business case and planning phase will follow, but the strategy says the plans will take at least five years to implement and require significant investment. “Based on international experience, it is expected that the total investment required for this programme will be significant; measured in the hundreds of millions of Euros,” the document says. It adds that the requirements will be “compounded by the chronic underinvestment during past years”, with Ireland having historically spent just 0.85% of its health budget on IT, in comparison with an EU norm of 2-3% per year. The strategy starts from the basics, outlining the ‘target principles’ that those working on the programme will use, and outlining management structures. It says that clinical leadership is key, and that a “role of chief medical information officer of the HSE will be developed” to provide leadership.
Elderly care shortages cost NHS £669m as toll of bed-blocking crisis spirals: The crumbling care system in England has cost the NHS £669m over the last five years with hospitals forced to care for elderly patients who could otherwise be discharged, a study has found. Analysis by Age UK concluded that the NHS lost 2.4m bed days as a result of so-called “bed-blocking” because of a lack of care and support outside hospitals, reported The Telegraph. The charity said the figure underlined the scale of the crisis in the elderly care system and the knock-on effect on institutions like the NHS. The Age UK study, based on NHS figures, shows that patients collectively spent an estimated 399,000 days in hospital while waiting for a place in either a care or nursing home to become available in the last year alone. Delays while patients waited for special handrails or stairlifts to be installed enabling them to carry on living at home added almost 41,400 days to the total. While an NHS bed costs taxpayers an average £1,925 per week, a typical place in a residential care home costs a more modest £558 per week or £357 for care at home. Caroline Abrahams, director of Age UK, said: “These figures show that year on year, older people are being trapped in hospital in ever greater numbers because of a delayed assessment, care home place, home care package or home adaptation. Without decent social care when discharged, whether to their own home or to a care home, hospital stays are often much longer than they need to be and older people are more likely to be readmitted because their recovery stalls.”
Welsh Government extends NHS website to social care: The Welsh Government has highlighted the push to integrate health and social care with the extension and rebranding of the My Local Health Service website to provide information on social issues, reported UK Authority. Now named My Local Health and Social Care, it has taken in social services data for each local authority in Wales. In cases where the council data is not available it provides it at a national level. This has been added to the data on the performance of different healthcare organisations around Wales. Health and social services minister, Mark Drakeford, said: “My Local Health Service has helped to improve transparency in our NHS. The refresh will increase it even further, providing a wider range of easily accessible information about health and social services. It will also provide a platform to display the shared health and social services measures from both the NHS and social services outcomes frameworks, showing clearly how these services are performing.” The site is pulling in data on a range of social issues, including numbers on delayed transfers of care, incidences of sexual crime, employment rates for the over 50s and disabled people, key stage two and four results for children in need, and the percentage of children in the Flying Start programme reaching development milestones at the age of three. It has been added to healthcare data such as hospital mortality and healthcare infection rates, nurses to patient ratios and the results of patient satisfaction surveys.
NHS overpays for IT by more than 900% – survey: The NHS is overpaying by more than 900% for bog-standard computer kit, in some cases – not just PCs and laptops, but also cabling, memory sticks and other IT sundries. And that is according to the IT buyers themselves, reported Computing. The claim was made in a survey by benchmarking organisation KnowledgeBus, which revealed that one health service procurement head had paid 920% above trade price for a particular (unnamed) item. The Society of Information Technology Management (SOCITM) has suggested that buyers ought to be paying a margin of about 3%. “The research from KnowledgeBus reviewed IT spending across 20 sectors including banking, retail and manufacturing. This revealed that the NHS had paid a margin 920% above the trade price for one product. One charity also paid a mark-up of 850%,” claimed the organisation. It called on health trusts to sharpen up their procurement operations, which could save millions of pounds that could be better spent on medical services.
Dell report predicts major changes in IT market: Technology giant, Dell, has released a new report predicting 10 technological events that it believes will take place in the next five years. These technologies will be major catalysts for organisations to transform the performance, cost, and agility of their technology infrastructure to meet current and future needs, reported Building Better Healthcare. The report also outlines how “a day in healthcare” will look in the year 2020, showing IT significantly more central to operations than it currently is. The 15-page document, entitled Dell Technology Outlook 2015, states: “Technology innovations once took considerable time to become mainstream; they are now doing so at an unprecedented pace. These innovations challenge how we work, think, and plan for the future. They also have a fundamental impact on organisations, which today must be more responsive, more efficient, and smarter. Some organisations – and even entire industries – will become irrelevant if they are unable to anticipate the changing expectations of customers and users, and the technical innovations that can enable these changing expectations.” Click here to read the Dell report in full.
Hospitals and GPs to start providing free Wi-Fi: Every hospital and GP surgery in England is likely to start providing free Wi-Fi in a move by the NHS to keep patients entertained and help doctors and nurses use much more technology in their work reports The Guardian. The government’s National Information Board (NIB) has commissioned a feasibility study into the viability of turning the whole NHS estate in the country into a massive free Wi-Fi zone. Hospitals and GP practices which have already introduced free Wi-Fi for everyone on the premises have found it very popular. At the College Road GP surgery in Birmingham, for example, a recent three-month trial let patients use its website to book appointments and repeat prescriptions and to access their medical records and NHS Choices website. The Mount Hospital in Leeds is about to start offering not only free Wi-Fi to older patients with dementia and mental health problems, but also to provide tablet computers for them and their carers. Tim Kelsey, NHS England’s national director for patients and information, who chairs the NIB, is keen on the idea. The pan-Whitehall body, hosted by the Department for Health, sets the strategy for transformation.
Cancer patients offered access to treatment records via new online portal: Cancer patients are being offered easy access to their treatment records under a scheme headed up by Cancer Research UK, reported Good Health Suite. Online access via the Patient Portal has demonstrated how patients respond to being able to view their details online. “At the end of a pilot study in March this year, 88 patients had asked for access to their records and 50 had used the new system to view them,” says Cancer Research UK. Working in partnership with the National Cancer Registration Service (NCRS) and the brain tumour support charity Brainstrust, the scheme is working towards making cancer registry records available to users of Patients Know Best (a company that manages patient-controlled medical records), by the end of 2015. Patients who choose to access their information on the Patient Portal can view full text pathology reports, information on hospital stays and treatment received from Patient Administration Systems and some imaging reports. Patients can keep track of their care using online tools, and record information about their quality of life to aid discussions with their clinical team. Cancer Research UK said that “as well as potentially helping patients to understand their own diagnosis, it also allows patients to flag up if something is missing or incorrect in their records to help improve the accuracy and quality of the data the NCRS holds”.
NHS e-Referral Service down “until further notice”: The new NHS e-Referral Service (ERS) has been inoperable this week, 48 hours after its launch as work continues to fix technical difficulties identified by the Health and Social Care Information Centre (HSCIC), reported Government Computing. Authorities said that the service, which replaced the Choose and Book online and telephone appointment solution when it launched on June 15, was expected to remain unavailable until further notice in order to perform “essential maintenance”. ERS has been designed to allow patients and healthcare professionals to select appointments with providers either online or by phone in a way that is functionally equivalent to the previous Choose and Book system, before expanding the service to provide services at a later date. However, the launch has seen a number of disruptions this week for users logging into the system as development continues on trying to stabilise the service for wide-scale use. Further updates are expected to be given on the service difficulties, with a spokesperson for the HSCIC declining to provide further details on the nature of technical issues experienced with the service.
Choices rebranded as NHS.uk: NHS Choices will be rebranded as NHS.uk as part of plans to make it a “digital hub” for people to access health services, according to Beverley Bryant, NHS England’s director of strategic systems and technology, reported DigitalHealth.net. NHS Choices will be retained as part of the hub as an information directory. “NHS.uk will be a clinically profiled directory of services encompassing health and social care services,” said Bryant, who added that the NHS is lagging behind other industries when it comes to digital services. NHS England is also working on developing its use of a variety of channels to connect with patients, research by the organisation has shown that a “multichannel offer is the thing the public have told us they want more than anything and it’s important to make the service relevant for local areas, saying that NHS Choices has been a bit too national,” said Bryant.
Private providers push for bigger NHS role: Private health companies are seeking talks with ministers and health service leaders to secure a bigger role in providing NHS care amid frustration that the Conservatives have failed to drive the growth of the sector. The NHS spent just under £7bn buying services from private providers in 2013-14 but the sector believes hundreds of millions of pounds of additional investment by companies could be unlocked if there was a more stable operating environment, reported the Financial Times (subscription required). When the coalition government introduced the health and social care bill in 2010 it appeared to pave the way for a bigger role for private companies by stating that “any willing provider” would be able to bid for NHS-funded services and would be allowed to compete on price. An investigation by the British Medical Journal found that just 6% of about 3,500 contracts it examined had been awarded through competitive tender, despite critics claiming that the Health and Social Care Act amounted to “forced privatisation”. David Mobbs, chief executive of private hospital group Nuffield Health, said the relationship needed to be “revisited and refreshed” to keep the NHS financially sustainable as it faces a £30bn funding gap by the end of the decade.
Genomics England names tech partners: Genomics England has announced the four companies that will help interpret human genomes as part of the government’s ambitious 100,000 Genomes Project, reported DigitalHealth.net. From 1 August gene specialists Congenica, Omicia, Nanthealth and Wuxi Nextcode will work on assessing the genomes of the first 8,000 patients involved in the project, which intends to map the DNA of 100,000 patients to give a greater understanding of the relationship between genes and disease. They will all make use of genomic data that has been sequenced by US technology firm Illumina at a £27m sequencing centre funded and built by the Wellcome Trust on its Genome Campus in Cambridge. Both Congenica, a Cambridge-based spinout from The Wellcome Trust Sanger Institute, and Omicia, a California-based genomics company, will work on interpreting the data of people with rare diseases. Another Californian firm, NantHealth, will work on interpreting cancer data, while WuXi NextCODE will analyse data from both cancer and rare disease patients. Lockheed Martin in partnership with Cypher Genomics has been appointed by Genomics England as reserve bidder. The companies were chosen after a ‘bake off’ contest in spring 2014 where 28 participants were challenged to interpret the genomes of 15 rare disease trio samples and 10 samples that were either normal or from cancer patients.
NHS England launches £1m hunt for tech innovation: The Small Business Research Initiative for Healthcare (SBRI Healthcare) has launched its latest £1m hunt for ideas from companies focused on addressing challenges in older people with multiple-morbidities, reported Integrated Care Today. SBRI Healthcare, an NHS England funded initiative to develop innovative products and services that address unmet health needs, will reward up to 12 small businesses with £100,000 Phase 1 product development funding. SBRI Healthcare works with Academic Health Science Networks to identify priority areas where technology can be applied to address major clinical challenges. “With people living longer and patients’ needs changing as a result, the NHS faces particular challenges in supporting frail older patients living with a range of chronic conditions. The latest SBRI Healthcare competition recognises the increased burden being put on primary care services and challenges companies to come forward with enabling ideas,” commented Karen Livingstone, director of SBRI Healthcare. “We are always excited to see innovative technologies at an early stage in their development and in this case, to support companies in realising the potential of their products to extend patients’ lives and maximise NHS resources.” The competition closes on August 11, 2015 with winners announced in December.
Thousands of potential donors may have been missed off organ register: Large numbers of patient requests to be put on the blood and organ donor register may have gone missing over eight years due to an admin error, GP leaders have discovered. The revelation comes as NHS England stopped processing blood and organ donor registrations nationally from April this year, expecting GPs instead to record them for their patients. GP leaders say they suspect that the Thames Valley recording error is not an isolated case, but NHS England declined to comment further. An NHS England spokesperson told Pulse: “Thames Valley Primary Care Support Service (PCSS) gave notice to GP practices in 2007 that they were no longer registering patients on the donor database. Practices could then offer the service themselves, or guide patients on self-registration. Any requests from GP practices since this time are returned to the practice for their action, with guidance on how it can be managed.”
Watchdog outlines serious failings by NHS trusts: A catalogue of serious failings by NHS trusts across the country have been outlined in a damning report by the health service ombudsman. A litany of complaints made by patients and their families, such as a man with dementia left on a trolley for 33 hours and relatives of a woman forced to listen to her die from the other side of a curtain, highlight poor complaint handling and failures across the NHS, reported The Telegraph. The report, published by the Parliamentary and Health Service Ombudsman, contains the details of 163 investigations into unresolved complaints made over two months last year, including breaches of cancer waiting times, families resorting to putting their family in private care following unsafe discharges from A&E on Christmas Day and the death of an unborn baby following missed opportunities to deliver it early. The ombudsman said that of 618 complaints made during October and November 2014, 41% were upheld. Some 80% of its investigations are about the NHS in England whilst others concern government departments and their agencies. Ombudsman Dame Julie Mellor said: “These cases show the impact that service failure can have on individuals and their loved ones.”
Opinion
Putting digital to work for patients
Tim Kelsey, NHS England’s National Director for Patients and Information looks at how unleashing the power of technology and data can improve patient care:
“Published in October 2014, the Five Year Forward View sets out a clear direction for the NHS – showing why change is needed and what it would look like. Since then, the National Information Board (NIB) has been examining how the NHS can harness the power of data and technology to transform health and care services and deliver greater quality and efficiency.
“Today we go a step further by publishing detailed plans for how we will deliver on these commitments including offering patients the chance to view and take control of their full health records online; increasing the offer of digital health services and extending the provision of remote care provided through online platforms.
“These plans are for discussion with the public and every part of the NHS. The aim is not to create a single rigid course of action. That would miss the point. It’s the energy and commitment of NHS staff, of our patients and our partners that can generate the solutions to the challenges the NHS faces. As Simon Stevens, the NHS’s Chief Executive, has stressed, we offer “direction without dictation”.
“The NHS faces three fundamental challenges: a growing and ageing population, the rapid rise of long-term conditions and the expectation that the NHS will deliver ever more expansive and expensive treatments. These challenges do not present themselves uniformly across the nation and accordingly the NHS’s response has to be diverse and different.
“These proposals mark the next steps for the NHS on its journey to harness the power of data and technology to transform citizens’ experiences of health and care services, deliver greater quality and efficiency and put patients firmly in the driving seat of their own care.”
Local systems of care: one of the solutions to the challenges facing the NHS
Providers should work together to form local systems of care, with leadership provided by the most experienced managers and clinicians in the NHS, says The King’s Fund chief executive Chris Ham, in a blog this week.
“This does not mean another top-down reorganisation,” he writes on the organisation’s website.
“Rather, it requires providers to agree how they will collaborate in areas that are meaningful to them and the populations they serve. The establishment of new systems of care is also quite different from mergers and acquisitions, which typically take an age to transact and at best have a mixed record.
“Virtual provider networks would be created based on well-thought-through governance arrangements. This would have to be done in a way that didn’t fall foul of competition rules but also defined the scope of the system to be covered by these networks. Neither of these challenges is trivial but both can be addressed if the case for local systems of care is accepted.
“The scope of networks is likely to vary from horizontal integration in some areas to vertical integration in others. Both are of course possible and the involvement of independent sector providers is also an option.
“Unlike some of the ideas in the Dalton review and Jeremy Hunt’s proposal to create foundation trust chains, local systems of care would be formed by providers working in the same area. The rationale is that it is difficult to provide buddying support at a distance and that for the most part health care provision is essentially local.”
Comparing the NHS to supermarkets
How can a hospital make sure it is prioritising the right services on those days? Nick Woznitza, a BIR member and reporting radiographer at Homerton University Hospital, says seven-day working doesn’t necessarily mean that every single job function has to be covered at all times.
“One of the analogies given is we need to offer an NHS similar to a 24-hour supermarket. If you can buy your cigarettes at 4am then you should be able to have your lung cancer examination then, too.
“But if you actually go into a Tesco at that time on a Tuesday the fish counter won’t be open, the butcher will be closed, there will be no freshly baked bread, and there will be no tills because the staff in store will be preparing for the next day’s work and stocking shelves.
“So while Homerton does offer routine imaging such as ultrasound to patients at the weekend, the hospital prioritises urgent investigations where an accurate diagnosis can guide immediate treatment or appropriate discharge. There simply isn’t the capacity to extend services any further.
“If you are running every machine seven days a week, you just need more people. There is a shortage of radiologists and radiographers. But you can’t meet staffing through erosion of working conditions or, importantly, by not replacing capital investment.”
Blog
In this week’s blog Rob Benson tells the health secretary that the game has changed for healthcare access – wake up and smell the cricket.
