News in brief
Regulator moves to put Mid Staffs in administration: Healthcare regulator Monitor has begun the process of putting Mid Staffordshire NHS Foundation Trust into administration, reported HSJ (subscription required). The move would make the troubled acute provider the first foundation trust subjected to the “failure regime” powers granted to the regulator under the 2012 Health and Social Care Act. In a statement issued this week, the regulator said it was consulting Health Secretary Jeremy Hunt and key organisations about the prospective appointment of trust special administrators to lead the changes in Mid Staffordshire. A decision in principle was taken by Monitor’s board yesterday following a recommendation from experts in the “contingency planning team” sent into the trust five months ago. The team concluded earlier this year that the troubled trust was neither clinically nor financially sustainable in its current form in the long term.
Tories say Sir David Nicholson has to go: Despite the Prime Minister insisting that the NHS chief executive Sir David Nicholson should not be made a “scapegoat” over the Stafford Hospital scandal, approximately 20 Conservative MPs are expected to ask for Nicholson to step down, reported Public Service. The MPs are likely to sign a House of Commons early day motion tabled by the Tory Charlotte Leslie demanding accountability over what happened. Leslie said: “There has been a thunderous silence around the scandal and relatives of those who died needlessly have been screaming into a vacuum for those in positions of authority who were responsible to be held to account.” She added: “Those involved must be held accountable for their actions and face the consequences. David Nicholson was then in overall charge of Mid Staffs. In no other walk of life would a man who had overseen such a diabolical catastrophe keep his job. So why should he be immune from responsibility? If talk of accountability is to mean anything at all, he must surely resign.”
CCGs get £186m for IT: Clinical Commissioning Groups will get £186m a year to spend on GP IT. A spokesperson for the NHS Commissioning Board (NHS CB) confirmed to eHealth Insider that a national budget has been set based on estimated current costs of £186m. “We are currently in the process of collecting plans from CCGs on local requirements in order to allocate the £186m out to CCGs,” the spokesperson said. The money will need to be shared between England’s 211 proposed CCGs, which will formally take over commissioning local NHS services on 1 April. The NHS CB announced it was devolving responsibility for funding a significant part of GP IT to CCGs in June. However, it has not previously revealed details of how much funding will be available or how it will be allocated.
NHS provider regulations to be reviewed: Health Secretary Jeremy Hunt will review NHS provider regulations, government sources suggest, following accusations that the government was trying to introduce privatisation of the NHS “by the back door”, reported National Health Executive. The NHS (Procurement, Patient Choice and Competition) Regulations 2013, made under section 75 of the Health and Social Care Act could effectively open up all NHS services to competitive tendering. The regulations seem to remove CCG discretion to introduce competition for certain services, and give Monitor the power to compel CCGs to introduce competition. The guidelines say CCGs must consider private providers on the same basis as existing NHS providers and must “treat providers equally and in a non-discriminatory way, including by not treating a provider, or type of provider, more favorably than any other provider, in particular on the basis of ownership”. The regulations are due to be considered in the House of Lords in March.
Ed Miliband pledges to scrap NHS reorganisation: Labour leader, Ed Miliband, has pledged to “scrap the reorganisation” of the NHS if voted to power, reported The Telegraph. Speaking to nurses, he said he wanted to save “billions of pounds” that Labour claim will be spent on implementing the Health and Social Care Act, and keeping healthcare workers employed. His comments, made to the annual congress of the Royal College of Nursing in Harrogate, appeared to go further than before. In a well-received speech, he told them: “If we were in government tomorrow, we would scrap the reorganisation, we would end the waste of billions of pounds.”
Lib Dem pressure forces Jeremy Hunt to rewrite NHS provider regulations: Health Secretary, Jeremy Hunt, is to be forced by his Liberal Democrat coalition partners to rewrite controversial regulations that prompted Labour warnings of a backdoor privatisation of the NHS, reported The Guardian. Hours after Mr Hunt accused Labour of scare tactics, government sources said the Health Secretary was prepared to review the regulations to satisfy the Lib Dems amid fears of a fresh rebellion over health reforms at the party’s spring conference. Andy Burnham, the shadow health secretary, said: “The government has been caught out trying to force through privatisation of the NHS by the back door. This is another humiliating U-turn to add to the government list, but we believe ministers will stop at nothing to drive through their plans to put the NHS up for sale to the highest bidder.”
Humber trust first to deploy CSC Day Care Management solution: Humber NHS Foundation Trust has become the first organisation in the country to deploy CSC’s Day Care Management module, furthering the capabilities of its electronic patient record system, Lorenzo, reported Building Better Healthcare. The module is servicing teams across the trust’s child and adolescent mental health service (CAMHS) and the early intervention in psychosis team (PSYPHER). Lee Rickles, head of innovation at the trust, said: “Time-consuming tasks such as producing letters per individual appointment and cancelling multiple or selected sessions are now easier to manage, reducing the likelihood of human error and leading to more effective communications with patients.” This week eHealth Insider also reported that CSC is working with Salsibury NHS Foundation Trust to develop and deploy a full suite of next-generation laboratory products. The trust has agreed a five-year extension of its current contract for CSC’s laboratory information system and will adopt new modules as they become available, starting with a new cellular pathology system.
Lives not improved by telehealth: Telehealth does not improve quality of life for patients with long-term conditions, according to a new report on the Whole Systems Demonstrator (WSD) programme, reported eHealth Insider. The paper, published in the British Medical Journal, reports on an evaluation of the three WSD pilot sites in Kent, Cornwall and Newham. These were set up by the Department of Health to find evidence to support the use of telehealth and telecare technology. However, the new paper not only says that they were not effective but that more research should be done on the potentially harmful effects of telehealth on patient wellbeing. Researchers from a number of universities found that telehealth did not improve quality of life or psychological outcomes for patients with chronic obstructive pulmonary disease, diabetes or heart failure, over 12 months.
NHS 111 yet to go live in two out of three sites: Less than a third of England has fully launched the NHS 111 service, with just three weeks to go before the national rollout deadline. The new non-emergency phone number is due to replace NHS Direct’s 0845 number from 21 March. However, research by HSJ (subscription required) has found NHS 111 is not yet up and running in 53 percent of the country, including the whole of the West Midlands, North West, South East Coast and Yorkshire and the Humber. In a further 16 percent of the country, measured by the population served, NHS 111 has only “soft launched” – meaning it receives redirected GP out-of-hours calls but not NHS Direct calls. Six areas could not confirm a planned full launch date when contacted by HSJ last week. Ten areas were planning to launch fully within four days of the deadline.
Optometrists need EPRs: Optometrists should use electronic systems to improve data collection and referrals, says a report published by the College of Optometrists, reported eHealth Insider. Entitled ‘Better data, better care: ophthalmic public health data report 2013’, the report says improving data collection by introducing electronic systems would help optometrists communicate with hospitals, GPS and local health authorities. David Parkins, vice president for the College of Optometrists and chair of the data project steering group, said that good quality information was central to providing good quality patient care. “An improved electronic system for referrals would reduce the cost burden of eye care to the NHS, helping to eliminate unnecessary referral appointments in addition to duplicated tests.”
Rotherham NHS Trust IT failure delays cancer treatment: Failures in a new appointment system could have delayed treatment for cancer patients at a troubled health trust, according to a health watchdog, reported the BBC. Problems have led to 5,000 missed outpatient appointments and lost Rotherham NHS Foundation Trust £1.4m. The electronic patient record system could now cost £40m, said NHS regulator Monitor. The trust said an immediate review had been ordered and an independent expert engaged to resolve the issues. Monitor said failings in the appointment system “seriously compromises the ability of the trust to manage quality of care” because it could place only “limited reliance” on operational data. The watchdog said the trust had not managed the system in an effective way and could not tell if any patients had been harmed.
Patient guidance for records access: Guidance for patients on how to keep their online health records safe has been jointly published by the Department of Health and the BCS, The Chartered Institute for IT, reported eHealth Insider. The government has mandated that all patients must have online access to their GP records by March 2015. ‘Keeping your online health and social care records safe and secure’ gives advice on what health records are, how to protect them and how to share them. The key suggestions are around creating a strong password, protecting devices used to access online records, and thinking carefully before choosing to share a health record with others. Dr Wai Keong Wong, who led the development of the guidelines on behalf of BCS Health, said the guide was created because patients were increasingly accessing their health and care records or holding their own. “These records contain potentially sensitive personal information, so it’s important that individuals know how to keep them safe,” he said.
Northern Lincolnshire FT instigates external ‘sustainability and quality’ review: A foundation trust whose high mortality rates are under review has hired consultants to examine “the sustainability and quality” of its clinical services. Northern Lincolnshire and Goole NHS Foundation Trust has commissioned Ernst and Young to carry out the work, reported HSJ (subscription required). It was named earlier this month as one of 14 trusts to be reviewed by the NHS Commissioning Board for having higher than expected death rates for two successive years. Ernst and Young has also been appointed to review the long term financial and clinical sustainability of services at Mid Staffordshire NHS Foundation Trust, about which it is due to report to Monitor.
New directors at NHS Confederation: The NHS Confederation has appointed Dr Johnny Marshall and Matt Tee to director-level roles, reported PMLiVE. Dr Marshall, who is currently an associate director at the UK NHS managers’ body, will take over as director of policy, while Tee joins as chief operating officer. Dr Marshall has been a GP since 1992, and served as chair of the National Association of Primary Care from 2008 to 2011. In his new role, he will lead on all areas of the NHS Confederation’s policy work, including encouraging the growth of the organisation’s partnership work. Tee’s appointment is his first role at the NHS Confederation, following a career that has seen him gain experience in health, communications and government.
Opinion
What the NHS can learn from innovative healthcare practices abroad
The Guardian Healthcare Network talks to Thomas Cawston, research director at the independent think tank Reform, about how the UK can adopt models of affordable healthcare from around the world.
With the NHS’ “shrinking budgets and rising costs”, Cawston believes the NHS should learn from lessons abroad, and indeed from different industries to bring innovation for models of care no longer fit for purpose:
“Taking inspiration from the checklists commonly used by international airlines, LifeSpring has standardised clinical services through using protocols and checklists. By limiting and simplifying services these hospitals have been able to dramatically boost the productivity of doctors and nurses, and at the same time, used technology and data to keep a tight grip on quality.
“The future job of the NHS will be to provide better care for elderly patients often with multiple chronic conditions and “integration” is the option.
“These examples show how it can be done and the NHS needs to raise its game to keep up. Instead of driving change from the centre, now is the time to set the innovators free. We want to offer many lessons for the Department of Health and the NHS on how to deliver change at pace and scale.
“Perhaps the most important will be to be open to fresh thinking and new approaches that are already transforming care from Bangalore to Boston.”
Did GPs get off lightly from Francis?
The Guardian Healthcare Networks Patient from Hell, Dick Vinegar explores the implications of the Francis report for GPs and asks – Will they revert to their pre-Mid Staffs attitudes?
“Last October, I was scared that Robert Francis’s report into the Mid Staffordshire scandal was being delayed four months because various individuals or bodies had nobbled him, and he would produce an emasculated whitewash (to mix a metaphor outrageously). In that he blamed no one personally, I may have been half-right.”
Dick starts with GPs, who he thinks got of lightly: “They are the most important guide and advocate on a patient’s journey through the jungle. I am not at all sure that most GPs see it that way. The Francis report confirms that they don’t.
“My mind goes back about 12 years, when I read that a hospital where I had just had a thyroid operation had just been rated the hospital with the highest post-operative death rate in the country. Pleased to be still alive, I asked my GP why he had sent me to such a place. He replied that you should judge a hospital ward by ward, and he had confidence in the consultant. I accepted this, as the consultant was an ex-rugby international and tough enough to insist on a clean ward.
“This incident reinforced my view that I rely on my GP to know about the strengths and weaknesses of the local hospitals, and I am pleased that Francis gives “a responsibility to all their patients to keep themselves informed of the standard of service available at various providers in order to make patients’ choice a reality. A GP’s duty to a patient does not end on referral to hospital, but is a continuing relationship.
“Let’s see whether GPs, a stroppy lot at the best of times, are prepared to take up this burden, and whether funds are found for new serried ranks of GPs to be hired to do the job. Or will they revert to their pre-Mid Staffs attitudes, and not care a stuff about what happens to their patients in hospital?”
Small steps on the digital journey starts now
In this week’s blog, Shane Tickell, CEO IMS MAXIMS, writes about how trusts need to begin with small steps towards their digital journey now if they are to realise their digital potential. However, he adds that the targets set by the NHS Commissioning Board cannot detract from the importance in ensuring that the digital vision also ensures the right systems are put in place to provide the right care at the right time.
“In healthcare empathy is paramount, especially when dealing with people who are feeling vulnerable. A digital NHS should not detract from this, but enhance the national service. In fact, as technology is embedded more and more in our everyday lives, patient’s expectations on how IT is deployed throughout the NHS is as high as ever.
“The potential improvements in patient care outcomes are huge; key to these successes are the intra-operability and developing systems built for clinicians that collect data as a consequence of their daily activities. Providing accessibility for patients, clinicians and analysts can only result in more accurate records, better healthcare and the opportunity for a more transparent health service.”
The NHS needs to think long term about contracts
Writing in this week’s HSJ Nigel Edwards, senior fellow at the King’s Fund and Robert Breedon, partner at Wragge & Co say “the NHS needs to stop being short-termist and develop new ways for devising contracts, payment systems and procurement strategies.”
They argue that there are a number of important trends in the design of payment systems and contracting that suggest the need for some new approaches. Plus they believe the risk is that short-term contracts and fragmented payment models will hold back the creation of integrated care and methods such as prime contractor and alliance contracting that can be used to deliver more integrated care.
They also make reference to US examples that the UK could follow, such as the Centres for Medicaid and Medicare, and reference new proposals announced by Norman Lamb.
They conclude that moving to new models of provision will require new models of contracts, different relationships and a more strategic approach to procurement.
Blog
In this week’s blog, Myriam McLoughlin asks what the real value of online access to electronic health records is and whether we are getting ahead of ourselves?
