News in brief
Sixty-two new clinical commissioning groups given green light to take control of NHS budgets: Local clinicians have now been given the green light to take control of the NHS budget in more than three quarters of England’s local health communities. The NHS Commissioning Board has authorised 62 more clinical commissioning groups (CCGs) to commission healthcare services for their communities. The first 34 CCGs were authorised in December 2012; with a further 67 CCGs authorised in January 2013. A total of 211 CCGs will, from 1 April 2013, be responsible for £65 billion of the £95 billion NHS commissioning budget. The remaining 48 CCGs are set for authorisation in March 2013. The third wave of CCGs will in total plan and commission hospital, community health and mental health services on behalf of more than 13 million people. The 163 CCGs authorised so far will serve a total of around 42 million people.
£80m IT services tender issued: Central and North West London NHS Foundation Trust has issued an IT services tender worth £50 – £80m over five years, reported eHealth Insider. A notice issued in the Official Journal of the European Union (OJEU) says the trust is looking for ICT infrastructure services to support 5,200 end users and 5,500 staff across 150 sites. This includes; service management; data networks and management; videoconferencing and telephony, infrastructure and ICT training. The trust may extend the services contract to cover clinical or information systems, business applications, integration, portals and digital service user engagement, such as telehealth. A trust spokesperson said the tender was for a service to deliver the infrastructure component of a five-year ICT strategic programme of work.
2e2 data centres saved in takeover by Oakley Capital: The data centre business of bankrupt 2e2 has been acquired by Oakley Capital Private Equity reported Computing.co.uk. The acquisition will save existing users from either having to pay up to keep the data centre going or migrating to an alternative provider, while the skeleton staff in Reading and Gateshead will be retained and expanded. Oakley capital has appointed Daisy Group, a communications company listed on the Alternative Investment Market, to manage both data centres, under a “special purpose vehicle” called Daisy Data Centre Solutions Ltd. Matthew Riley, CEO of Daisy said: “This appointment provides 2e2 customers with the opportunity to work with a long-term partner with proven expertise in the growing data and hosting market.”
GPs not there on records access – survey: An overwhelming majority of GP practices are not ready to implement the government’s flagship NHS IT pledge to give patients online access to their records by 2015. An exclusive survey for eHealth Insider, conducted by doctors.net.uk, found that 43% of just over 1,000 GP respondents said “we haven’t started to address this yet” when asked how ready they were to facilitate patient access to records. A further third (29%) said their IT systems still needed work or that the relevant functionality had not been switched on, and a quarter (24%) said they simply did now know how ready their practice was. Just 4% said “our IT system is ready, and is already live.” EHI Primary Care editor Rebecca Todd said: “It is a concern that so many GPs have yet to start thinking about how to implement patient access to records, when the government’s deadline is just two years away.”
Jeremy Hunt warns NHS trusts over ‘defensive culture’: Health Secretary Jeremy Hunt has warned NHS bosses against allowing a culture that is “legalistic and defensive” in dealing with staff who raise concerns over patient care, reported the BBC. In a letter to all English NHS trusts, Hunt highlighted fears that “gagging” clauses were being used to “frustrate” such whistleblowing. He said a climate of “openness and transparency” is essential. In his letter, Hunt called for the NHS to “recognise and celebrate” staff who had “the courage and professional integrity to raise concerns over care” he also warned NHS bosses against the “institutional self-defence” that prevents honest acknowledgement of failure”. It comes after one former NHS trust boss broke a gag to talk to the BBC.
Mid Staffs: Labour government ignored MP requests for public inquiry into deaths: Former health secretaries Andy Burnham and Alan Johnson ignored 81 requests including 20 from fellow MPs for a public inquiry into Mid Staffordshire NHS Trust in the two years after it was first warned of poor NHS care, revealed The Telegraph. Figures from the Conservatives also show 14 NHS trusts with unusually high mortality rates saw around 7,000 more deaths than expected in the four years before Labour left power. Up to 2,800 of these deaths came after alarms were sounded about the Mid Staffordshire hospital scandal and three independent reports warned that not enough attention was paid to quality of care. Charlotte Leslie, a Tory MP for Bristol North West, who was handed the mortality rate figures, accused Labour of trying to “bury the truth” about poor standards.
Monitor: NHS trusts ”reasonably robust”: A health regulator has ruled out a “domino effect” of struggling hospitals following the South London Healthcare NHS Trust going into administration, reported Public Service. Monitor’s chief operating officer, Stephen Hay, told a London conference that the majority of hospitals are achieving efficiency savings without great difficulty. He said: “There are a small number of both foundation and non-foundation trusts which are losing money, and the NHS Trust Development Authority and Monitor are looking at solutions to fix those. There is still quite a lot of fat in the system and lots of foundation trusts are delivering in excess of 5% efficiency a year.” Hay added: “The system is under a lot of pressure, but at the moment it is reasonably robust. There is a risk, and we need to focus on where care is being delivered and how to ensure we don’t incur much bigger problems in years to come.”
NHS faces a potential nursing drought, study warns: A government-commissioned report has revealed the NHS could be crippled by a shortage of nearly 200,000 nurses in just three years’ time, reported HSJ (subscription required). The report, compiled by the Centre for Workforce Intelligence, is not yet in the public domain but has been submitted to the Department of Health and is understood to have been read by ministers. HSJ’s sister title Nursing Times has learned details of the report. It says that in the worst case scenario, the gap between supply and demand will grow year-on-year, leading to an overall shortage of around 190,000 registered nurses by 2016. Under this scenario, demand for registered nurses will rise from 600,000 staff in 2011 to 700,000 in 2016, but the supply of nurses will fall from around 570,000 to around 510,000 over the same period.
GP occupational health services in jeopardy as NHS Commissioning Board reviews funding: GP occupational support services are in danger of having their funding removed after the NHS Commissioning Board (NHS CB) decided to review all their contracts, with Clinical Commissioning Groups (CCGs) in some areas forced to step in to ensure they continue after April. Pulse has revealed that at least four CCGs have decided to take on the funding of existing services providing health and wellbeing support to GPs, as the NHS CB conducts a review of current services. The Board says it has no statutory responsibility to carry over such services, but Royal College of General Practitioners chair, Professor Clare Gerada, says that it would be a ‘false economy’ to get rid of the services for GPs.
NHS waiting list scandal puts public trust at risk: New evidence of the potential manipulation of NHS waiting times has emerged in a major report published today by Scotland’s spending watchdog, reported The Scotsman. Audit Scotland warns that public trust in the system has been jeopardised and finds numerous examples of patients being listed as “socially unavailable” for treatment, meaning they fall outside waiting-time targets. However, the authors said that because the management and scrutiny of waiting lists had “not been good enough”, there was a lack of evidence about what had happened to patients. This lack of monitoring, as the Scottish Government and health boards pressed ahead with cutting waiting times, meant there was not enough information available to Audit Scotland to judge whether patients were taken off lists by mistake or deliberately to meet targets.
App allows real-time feedback: Birmingham Children’s Hospital NHS Foundation Trust has launched an app to allow patients to give feedback in real-time, reported eHealth Insider. Children, young people and their families can send their thoughts and comments directly to a ward with the click of a button. The message, which is anonymous, goes to the manager in charge and a message is sent to the patient’s phone saying what action has been taken. Michelle McLoughlin, chief nurse and project lead, told eHealth Insider that the project was about getting feedback and being able to do something about it. The trust believes the app is the first of its kind in the NHS.
Top 10 healthcare trends facing execs In 2013: A new report released this week by the ECRI Institute highlights the key issues at the forefront of healthcare c-level executives minds in 2013. Hot topics include the safety of electronic health records, imaging technology and alarms, reported Healthcare Global. With particular regard to EHRs, the report suggests that there are still a lot of concerns regarding ways in which to “quantitatively determine” how things like adverse drug events and medication errors are being minimised. “It’s widely agreed upon that work-arounds are most often put in place if a system is considered too intrusive, or if workflow changes are required,” reads the report. ECRI director of applied solutions Robert Maliff, said that hospital leaders should make a point to ask if newer technologies or procedures actually improve care, a big concern with regard to mobile health technologies, according to the report’s authors.
The King’s Fund’s Anna Dixon to join Department of Health: Dr Anna Dixon, currently director of policy at The King’s Fund, will join the Department of Health (DH) in early May to take up the position of director of quality and strategy and chief analyst. Una O’Brien, permanent secretary at the DH said: “ At a time of great change for the Department, Anna brings expert insight in to a wide range of health and care policy. I look forward to working closely with her.” Anna has conducted research and published widely on healthcare funding and policy. She has given lectures on a range of topics including UK health system reform and patient choice.
Ricketts to open EHI commissioning event: Bob Ricketts, the NHS Commissioning Board’s director of commissioning support strategy and market development, will open eHealth Insider’s latest conference, Information for Commissioning. The event, which will take place at the Royal College of General Practitioners in London on 15 May, has been established to focus on the IT and information needs of clinical commissioning groups and their commissioning providers. Ricketts, who has worked in the NHS for more than 20 years and has led on the Department of Health’s choice, procurement and provider development policies, will provide the big picture on the direction of commissioning in England.
Opinion
Why one NHS trust is experimenting with social media
This week, the Guardian Healthcare Network talks to Victoria Betton, deputy director of Leeds and York partnership NHS Foundation Trust, about how a new social media strategy has helped the organisation become more social and increase its digital footprint.
Betton says the reasons for using social media on a corporate and clinical level are simple: “The incentives, to us, are clear – the ability to enter into conversations with different stakeholders, and getting authentic feedback to create meaningful change and improve services.”
With a longer-term vision to enable practitioners to support people’s recovery journeys in both their offline and online lives, the shift to social media channels such as YouTube and Pinterest is proving successful in reaching greater numbers.
“From an operational perspective we have ditched automated tweets, broadcasting and self-congratulation. We have realised the importance of getting our extended network online and focus on building capacity. And while we continue to make every effort to ensure the right policies, processes and safeguards are in place, we realise the need to continually experiment and improvise our activities online to find the best fit.”
Francis report: creating patient power is the only way forward
Now that some of the dust thrown up by the Francis report has begun to settle, Peter Beresford, professor of social policy at Brunel University and chair of Shaping Our Lives gives his thought to its likely long-term consequences.
“There are reasons for concern. It is even possible that one of the effects of the inquiry may be to make things worse as politicians and policymakers use the same hopeless management techniques of inspection, review, standard setting and top-down control that gave rise to the problems in the first place. There are already warning signs that this is a direction they are likely to go in, with talk of more inspectors, more audit, more top-down control. The government has announced that it intends to create a new role within the Care Quality Commission (CQC) of chief inspector of hospitals, balanced with an equivalent role of chief inspector of social care. But it is from such top jobs that problems originated.”
Beresford goes on to say that it is also difficult to feel anything other than concern about the Francis’ recommendation, that staff not reporting poor care should be made a legal offence. Talk about blaming the victim. We are still seeing too many whistleblowers inadequately protected, having their life torn apart. There are almost always whistleblowers, as there were in Mid Staffs, but too often their voices are either stifled or not listened to.
“The simple truth though is that if patients have effective lines of communication, if patients’ voices are heard, then tragedies such as Mid Staffs might never have happened. What is really needed now are not more investigations, more reports, more consultants or more inspections, audits and measuring.”
Achieving trust in procurement
Mike Mayers, the head of business processes at NHS Stockport, writes an insightful piece in HSJ this week on NHS procurement, saying that “NHS commissioners and providers can both benefit from ditching the “checklist” culture and learning to trust each other.” He goes on to make interesting analogies with sport and how professionals within the NHS need to redefine their relationships with each other.
“A good analogy, following the 2012 Olympics and the more recent Lance Armstrong revelations, is the use of banned substances in sport. In the beginning athletes were more or less trusted to compete fairly. Now to ensure a level playing field there is a list of banned substances. This can polarise attitudes: those who will use the substance if it’s not on the list and those who will avoid everything in a spirit of fair play. What is apparent is that reliance on the “list” has become inexorable.
“Thus, the more checklists we apply, or the less we trust, the more we drive up transactional costs. If we get it right, using “professional” trust can be used as a tool to make informed decisions around how we do business with each other. We can make more agreements based on the desired effect and trust everyone to deliver the best way they see fit, in the process saving significant amounts of money.”
Digital health: Are we patient or consumers?
With HIMSS 2013 just around the corner, Thomas Martin, manager of mHIMSS ask whether digital health is changing our role as a patient and consumer?
He writes: “Years ago, using the word ‘consumer’ to describe a patient in the healthcare setting would have you labelled a healthcare heretic quite quickly. To refer to patients as consumers highlighted the commercial aspect of healthcare often avoided, until recently… it is clear that one of the big questions in healthcare is no longer “Are we patients or consumers?” – but rather ‘When do the roles change, if at all?’
“There is a growing confluence of both the patient and the patient as a consumer, which is reflected in the devices coming to market that are targeted toward consumers and clinicians.
“First, let’s clarify that the common underlying role of healthcare is to communicate. Patients communicate symptoms and providers communicate treatments.”
He adds: “Now, the answer to the question of when are patients really consumers most likely lies within workflow and how technology is applied. Consumers become patients once care begins. In the mobile and wireless world, however, this is becoming almost indiscernible; hence the question should really be “when do consumers truly become patients?”
Martin concludes: “Let me just leave the discussion at this: Remember the underlying goal is to communicate better in healthcare. Or for the mathematically inclined, communication + innovation/patient engagement = better health outcomes. So, are patients really consumers and has technology enabled better communication?”
Highland Marketing Blog
In this week’s blog Ravi Kumar invites comment on the “Big stick approach to accelerating the digitisation of the NHS”.
