News in brief
- NHS to increase links to private sector: The NHS is expected to put around £20bn of contracts out to tender in the next few years amid a rapid escalation of private sector involvement in hospitals, GP surgeries and community health services, reported the Financial Times. With the NHS expected to face cost cuts of £50bn by 2020, a report by Catalyst, a corporate finance adviser, says there are “significant opportunities” for private companies. These range from specialist services, such as sexual health clinics, to entire hospitals, such as the landmark takeover of Hinchingbrooke by Circle, a private healthcare provider, earlier this year.
- Eleven NHS foundation trusts have serious financial problems, MPs told: MPs have been told that as part of efforts to rescue a debt-ridden South London Healthcare NHS Trust, key services are set to end, reported the Guardian. In July, the trust, which runs three hospitals in Sidcup, Woolwich and Orpington became the first to be put into administration, having slipped £150m into the red. Administrator, Matthew Kershaw, has said private healthcare firms may end up managing parts of the trust or delivering some of its services. Monitor is investigating the financial health of 13 other foundation trusts including Mid Staffordshire, to which Monitor sent experts last week to help draw up a plan to ensure its continued existence, and Peterborough and Stamford Hospitals, which has run up debts of £56m, partly as a result of a £335m PFI deal.
- Airedale takes SystmOne EPR: Airedale NHS Foundation Trust is deploying the full suite of TPP’s acute systems along with it’s patient administration system, A&E and bed management modules due to be implemented this year, reports HealthTech Wire. The SystmOne EPR will allow more than 200,000 patients health records to be shared between all clinicians. There are currently around 1.1m electronic records held in the trust’s systems that will be transferred to SystmOne. The Airedale contract is the first instance of an acute trust taking the full suite of TPP’s secondary care systems, though some modules are already in use in trusts around England.
- Patient demands should drive PHRs: A new report ‘Personal health records: putting patients in control?’ launched by 2020health has said that patients value online transactional services such as online booking and messaging services above the ability to view their electronic medical record; and to succeed patient access portals must be highly usable. Although, the government has already pledged that all NHS patients will have online access to their GP record by 2015.
- Complaints about doctors up 23% this year: The BBC has reported that the number of medical complaints made to the General Medical Council (GMC) about doctors in the UK has risen 23% in the past year. A report by the GMC showed there were 8,781 in 2011 compared to 7,153 in 2010. The rise is continuing a trend that has seen complaints jump by 69% in three years. The regulator has said there was no evidence to suggest care was getting worse and that the rise was down to greater expectations and willingness to complain.
- HFMA works with Net.Orange: The Healthcare Financial Management Association (HFMA) in the UK has joined with Net.Orange to create a range of mobile clinical support and business applications. The US based Net.Orange developed the Clinical Operating System (cOS) which is being teamed with a portfolio of advisory services, developed with the HFMA, and focused on service integration, care co-ordination and real-time decision support. Dr Vasu Rangadass, Net.Orange chief executive and co-founder told EHI that the cOS provides a platform on which specialist apps can sit and healthcare organisations do not have to remove existing systems to use it.
- Patient data may give NHS an unfair edge: Powerful patient-level costing systems may give NHS hospital providers an unfair advantage in contract negotiations unless they are required to share their data with commissioners, reported HSJ (subscription required). Results of a research project published by the Nuffield Trust to establish whether hospitals can make efficiency savings through the introduction of patient-level information and costing systems (PLICS), showed that the evidence was “modest” when introducing these systems and would only produce short-term savings.
- Records access project led by RCGP: EHI has reported that the Royal College of GPs is to lead a project to make sure that all patients can access their GP record online by 2015. The royal medical college was invited by the government to lead a collaboration of professional and patient groups looking at the issue. Dr Peter Short, clinical advisor to the Department of Health Informatics Directorate and chair of two of the RCGP workstreams said: it is clearly seen and understood centrally as not being a one-size-fits-all exercise, as each practice and GP will have different issues and needs.
- Serco gave NHS false data about its GP service 252 times: Serco, a key private contractor to the government, has admitted that it presented false data to the NHS 252 times on the performance of its out-of-hours GP service in Cornwall. NHS Cornwall primary care trust (PCT) asked the company to audit itself following an investigation by the The Guardian in May. Serco and the PCT revealed the admission in separate statements on Thursday and now the chair of the parliamentary public accounts committee, the Labour MP Margaret Hodge, has asked the National Audit Office to investigate the case.
- Sunderland to deploy Meditech v6.0: In a major refresh of its IT, City Hospitals Sunderland NHS Foundation Trust is implementing Meditech’s electronic patient record version 6.0, reported EHI. The trust, which has undergone a full system upgrade to the latest release has been using Meditech since 1992, and v6.0 will replace the ‘MAGIC’ version that has expanded to 25 clinical and administrative modules that are used on a daily basis by almost 5,000 staff. Andrew Hart, director of IT and information governance, says in a report to the board that the latest implementation, for which the trust has budgeted £3.5m over two-years, is creating a new solution “from scratch”; using the software that has been “anglicised” as part of The Rotherham NHS Foundation Trust EPR project.
- NHS has cash reserves of almost £4bn, report shows: A report has revealed that the NHS has stockpiled cash reserves of almost £4bn despite more than doubling the number of hospital trusts and PCTs in the red. The Telegraph writes that two per cent of the entire NHS budget – half of which was not spent in 2011-12 alone – is sitting in the bank, even as cuts have increased and the number of nurses has reduced. Commenting on the report Dr Peter Carter, general secretary of the Royal College of Nursing, said: “Patients will question why as many as 61,000 posts are at risk in the NHS when there is an overall surplus of £1.6bn.”
- Southampton launches My Health Record: University Hospital Southampton NHS Foundation Trust has become the first acute trust to launch a personal health record built on Microsoft’s HealthVault platform, reported EHI. My Health Record, which the trust developed with Microsoft and US developers Get Real Consulting, was launched at a local cinema. Trust IT director Adrian Byrne told the launch he hoped it would enable patients to update their own demographic information and, eventually, book and manage their own appointments.
Opinion
Forget your enemies, it’s your Facebook friends you need to fear
This week’s NHS Network blog describes how most other industries have seized the power of virtual dialogue but that in the NHS, social media is in its infancy and is used to ‘lecture’ patients rather than engage.
“While we exhort NHS colleagues to give patients a voice, we deny NHS staff the means to listen or reply by blocking access to social media in the workplace. People who think there is no place for social media at work or that it should be left to the pointy heads in the comms team are missing the point.”
The blog goes onto say that Facebook alone shows the art of what is possible and in the eight years since its inception, it has 950 million active users – engagement to die for.
“Social media promotes easy access to information, connects people in ways that were not possible before, enables collaboration and dynamic networks – virtual organisations able to form and disband at speed.
“Harnessing people power is good for business – that’s the evidence from the commercial world, where companies that adopt social media enjoy a 50% increase in customer satisfaction, according to McKinsey.
“Commissioning organisations, hospital trusts and other providers don’t need to worry about regulators or government departments; it’s their friends and followers they need to fear.”
Mike Farrar interview
In this interview Mike Farrar chief executive of the NHS Confederation talks to Nuffield Trust senior fellow in health policy Ruth Thorlby, about what he believes are the key ambitions for the government in the Health and Social Care Act. He outlines the biggest challenges facing clinical commissioning groups and providers of care, comparing the restructure to recent health reforms in the US.
Jeremy Hunt must make tough decisions on closing NHS services
As health secretary Jeremy Hunt struggles to get to grips with his new brief, Guardian Professional Richard Vize says the new health secretary cannot ignore the mounting evidence for widespread reconfiguration of services and thinks that it will become increasingly clear to him that the big issue he faces is shutting services – lots of them.
“The evidence supporting the case for widespread reconfiguration of services keeps piling up. Just in the last few days Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, used a fascinating interview with the Guardian’s Denis Campbell to point out that it simply isn’t safe, let alone financially viable, to maintain the current 218 children’s inpatient units. Poor quality in some of these centres appears to be contributing to the UK’s high child mortality rate.
“Despite compelling evidence to the contrary, the Department of Health maintains the NHS is in a “strong overall financial position”. This is a press statement better suited to the last financial war; the problem is not that the system as a whole is running into deficit as it did in 2006 and 2007, it is the increasing instability of many acute trusts.
“Like pensions, energy and defence, healthcare needs policy which is focused on the long term, not the next election. Hunt needs to face up to all this. If he just toys with the health service – a bit of private sector here, a bit of choice there – he might just as well go home. He needs to take big, tough decisions.”
Blinded by the average…
Senior research analyst Ian Blunt at The Nuffield Trust blogs this week about the contentious topic of Patient-level costing, highlighting a new report which analyses the impact of computerised information systems and the realisation that patient-level costing is a powerful tool for health care organisations.
“Why does that matter? Well, in these chastened times the NHS desperately needs to make efficiency savings (famously in the order of £20 billion by 2014). One major lead in the search for inefficiency is unwarranted variation – where similar patients are treated differently for similar conditions. [For patient-level costing] Usually costs are calculated by dividing the running costs of a department by the number of patients it treats, but patient-level costing tracks the cost of each element of care that a patient receives (which may span over many departments).
“If a hospital only knows average costs then it is blind to this variation. For example, for a treatment with an average cost of £2,000 there could be ten cases all costing £2,000 each or nine cases costing £1,000 and one costing £11,000. Patient-level costing provides a way to reveal this variation. When implemented well it makes accessible a vast array of useful and accurate data on distributions of expenditure and profitability against income.
“However, just knowing the costs doesn’t by itself save any money. The provider must make use of this information in terms of influencing practice to become more efficient. So far there is limited evidence for cost savings as a result of patient-level costing, and those that are documented involve relatively small amounts. It would seem that patient-level costing is a long-term investment rather than a short-term saving.
“Despite this, trusts without access to high-quality cost information will find it challenging to ensure their efficiency savings are cutting waste, not care.”
