News in brief
Head of NHS England strikes warning note on funding: Simon Stevens struck a warning note about funding this week, saying the health service would need more money each year and suggesting that improvements, such as the government’s promise to run a seven-day service, would have to be phased in, reported The Financial Times (subscription required). The NHS England chief executive was sharing a platform with David Cameron, who used his first big post-election speech to confirm a Conservative pledge to inject £8bn into the service by 2020 and ensure patients received as good a service at weekends and evenings as they did from Monday to Friday. Speaking at a GP surgery that operates extended opening hours, Cameron said investment in the NHS would increase £8bn a year by the end of the parliament. This, he said, would support “an increase in the number of GPs, faster access to new drugs and treatments and a greater focus on mental health and healthy living”. The British Medical Association said the government was yet to explain how it would deliver additional care at a time of “chronic” doctor shortages. Before the election, the Conservatives gave their backing to a plan by Simon Stevens to fill a funding gap estimated at £30bn a year by 2020. This aims to make £22bn in efficiency savings, with the rest coming from taxpayers, reported the BBC.
Tech part of 7-day NHS – Cameron: Prime minister David Cameron used his first major speech since the election to drive forward the Conservative Party’s plans for a seven-day NHS, specifying that this would include making use of technologies such as Skype, reported Digital Health. He spoke alongside NHS chief executive Simon Stevens at the Vitality Partnership GP organisation in Birmingham. Cameron discussed his “vision of a modern NHS working for you seven days of the week – when you need it, where you need it”. Cameron said: “By the end of this financial year, 18 million patients will have access to a GP mornings, evenings and weekends. By the end of this parliament I want that for everyone.” Stevens used his speech to say that more information on how the NHS will find £22bn of efficiency savings by 2020-21 will be set out in the next fortnight. He said this would require “concrete, comprehensive, and sometimes controversial action” on three fronts: prevention; a “fundamental redesign” of NHS services; and putting NHS finances on a sound footing. “None of this will be easy. In fact, the health service is entering probably the most challenging period in its 67 year history.”
Stevens launches hospital chains ‘vanguard’: NHS England will ‘test new ways’ of sustaining smaller hospitals, including ‘chains’ running acute services, in its latest vanguard programme launched by Simon Stevens. The NHS England chief executive said Monitor, the NHS Trust Development Authority and NHS England would be taking forward the work on hospital chains produced by Sir David Dalton last year, reported Health Service Journal (subscription required). This will include looking at: how trusts can create buddying arrangements across medical specialties rather than whole organisations; how hospitals can share back office functions; and the increased use of satellite sites. He cited the eye clinic at Dartford and Gravesham Trust run by Moorfields Eye Hospital Foundation Trust as an example. Speaking at a King’s Fund conference in London, Stevens said: “Rather than automatically assuming that ‘bigger is better’, we want to test new ways of sustaining local NHS hospital services, more sharing of medical expertise across sites, and more efficiency from shared back office administration.”
GPs exceed NHS targets for online record access: Almost all GP practices in England are offering summary care records for patients, topping targets set by NHS England, according to official statistics. The number of practices giving access to summary medical records has soared from 3% to 97% in the last year – surpassing NHS England’s aim for 95% by March 2015, reported GP Online. NHS England is aiming for every patient to have access to their full health records online by 2018. Dr Masood Nazir, GP and national clinical lead for NHS England’s Patient Online programme added: “Online services help to make patients’ lives easier and can reduce the paperwork for those in general practice. As GPs offer more online access we will continue to work closely with them to ensure they feel confident these services deliver real benefits for their patients.”
Three-quarters of NHS 111 referrals to general practice are inappropriate: Only one in four NHS 111 GP referrals is clinically appropriate, a Pulse survey has suggested, with GPs warning that some referrals are ‘harmful’ and an ‘insult to professional integrity’. GPs said they had known of call handlers citing suspicions of Ebola because the patient had visited Barbados, which the call handler thought was in west Africa, ambulances being sent out for a heavy painful period and 80-year old patients being asked if they were pregnant. The survey of 592 GPs found that at least 70% of respondents felt that the majority of referrals were inappropriate, with many GPs backing claims by the British Medical Association (BMA) that patients with colds are being told by call handlers to book a GP appointment immediately. A mid-point analysis showed that, in all, an average of 73% of referrals were deemed as clinically appropriate by GP respondents. It comes as the BMA has called for a radical overhaul of the system, urging the government to carry a serious and urgent analysis of the effect of NHS 111 on the wider health service “to determine where it may be working inefficiently and to ensure that it is cost effective”.
‘Health tourist’ info added to SCR: Data about the surcharge status of immigrants using the NHS will be uploaded to the Summary Care Record (SCR), the Health and Social Care Information Centre (HSCIC) has confirmed. The Immigration Health Charge came into force last month to tackle so-called ‘health tourism’. It charges people from outside the European Economic Area who use NHS services 150% of the cost of treatment, based on the standard NHS tariff. This does not apply to GP and emergency care. The Department of Health has also introduced a health surcharge for people from outside the European Economic Area coming to the UK for longer than six months. The surcharge is £200 per year for non-students and £150 per year for students and applies to visa applications made on or after 6 April, including those of non-EEA nationals already in the UK who apply to extend their stay. In a comment to Digital Health, a HSCIC spokeswoman said that as part of the process the HSCIC receives a limited amount of data from the Home Office on each individual. This includes their name, date of birth, gender, address, nationality and surcharge status. This is then turned into a health record and “applied to the relevant Summary Care Record”. She added that data is updated via a weekly secure email and can be viewed only by those who have the appropriate permissions on the SCR.
New partnership to support Scottish eHealth drive: A new partnership between Microtech and Trustmarque Solutions has been announced, reported Integrated Care Today. This new partnership combines 28 years’ of IT experience in the Scottish healthcare market to offer health board’s rapid access to a wider range of software and IT services. The partnership will enable health boards working towards the productivity and clinical ambitions of Scotland’s eHealth strategy to easily procure a flexible range of vital IT services. Under the NHS National Services Scotland Software and Services framework agreement, all NHS organisations in Scotland can purchase software and IT services and benefit from favourable pricing and consistent contract terms. Trustmarque and Microtech will use their experience of the Scottish marketplace to help deliver complex IT projects and programmes within time and financial constraints. Chris McMail, managing director for Microtech said: “The Scottish healthcare market is going through a period of transformation and IT is at the heart of it. We’re seeing deployments of technologies such as clinical portals and patient management systems, which will deliver significant benefits for clinicians and patients. IT support services from specialist partners are underpinning the successful delivery of such projects by working closely with the health board’s IT teams.”
Connecting Care ramps up: Bristol’s shared care record scheme has moved into phase two, with the aim of reaching 10,000 users over the next five to seven years, reported Digital Health. The Connecting Care programme went live in Bristol, North Somerset and South Gloucestershire in December 2013. It shares real-time patient data between GPs, community providers, local authorities and three acute trusts via an Orion portal. The pilot phase involved 500 users in urgent and unplanned care settings. The project has now entered phase two which aims to reach 10,000 users over the next five to seven years. It also involves some redesign work on the way the portal operates, based on feedback from the pilot. Natasha Neads, senior business analyst said, “We are currently defining the vision for the programme over the next five to seven years. We hope that by the end of June we will have a shared vision across all partners for what we want it to do.” Users have to sign into the portal separately, but the aspiration is for them to access Connecting Care from within their clinical system.
Bridgend council leads £6.7m Welsh integrated care plan: Bridgend County Borough Council is expected by the end of this year to become the first authority in Wales to deploy a single national Community Care Information Solution (CCIS) designed to integrate health and social service provision as part of a £6.7m capital grant. Under the investment, which has seen Careworks contracted to supply the CCIS technology that will allow sharing of care information, Bridgend has served as the lead authority for the procurement process, reported Government Computing. Other authorities are now developing “readiness plans” in order to deploy the technology at a later date, the Welsh government has confirmed. To support wider roll-out across Wales, a national programme board has been set up that will hold its first meeting on June 12 this year. The £6.7m provided by the Welsh government for the project, which forms part of a larger £14.9m investment package unveiled earlier this year, will cover costs for national hardware and all-Wales licences to allow councils and health boards to implement the system at a fraction of traditional ICT replacement costs. The introduction of the CCIS forms part of a wider digital transformation plan to overhaul how devolved services are provided across Wales.
New €5m connected health research centre launched: A new €5mn research centre which will see industry and academia collaborate on specific health projects was officially launched this week. The Applied Research for Connected Health (Arch) technology centre at University College Dublin (UCD) aims to transform how certain diseases are treated by combining technology and research across several areas and disciplines, reported the Irish Times. During its initial research phase, the centre has focused the care provided to dementia sufferers in Ireland. The collaborative model will now be applied to other clinical conditions such as diabetes and heart disease. The centre is headquartered at NexusUCD where researchers will collaborate to deliver on the connected health research agenda defined by its industry steering group. There are several industry heavyweights steering its research programme including Boston Scientific, Hermitage Medical Clinic, ICON, OpenHealth, and Novartis. The centre is funded by the Department of Jobs through Enterprise Ireland and supported by IDA Ireland.
Moving off XP cut help desk calls by 60%, says NHS ICT head: Help desk calls fell by 60% after Imperial College Healthcare NHS Trust migrated from Windows XP to Windows 7, according to ICT head Kathy Lanceley. Many NHS trusts are still running Windows XP even though security support finished last month, after the expiry of a government negotiated £5.5mn 12-month extension to the official April 2014 deadline. Experts have warned outdated, unsupported Windows XP systems cannot support a number of modern IT tools and leave trusts vulnerable to cyber-attacks. However most of them are yet to take the plunge because moving off XP is expensive, difficult and “requires significant effort”, Lanceley told ComputerworldUK. The trust finished its migration last April, just before Microsoft withdrew support for the operating system. “I can absolutely understand everybody’s reluctance to start the journey…it took 18 months and cost us £3.7mn”, she said. Imperial is the largest NHS trust in England and Wales. It sees one million patients every year, has an income of £1bn, 1,500 beds and 9,000 staff across five sites and runs 8,500 desktops. Moving to Windows 7 allowed the trust to cut its applications from 3,000 to 900, by ensuring they were all running the same software versions and removing obsolete or underused applications.
CSC splits off US operations: CSC, the global technology company that markets the electronic patient record Lorenzo, has announced it is splitting into two separate businesses. The company’s UK health operations will come under the newly created CSC Global Commercial, which houses all of CSC’s commercial business and its public sector work outside the US. These operations have annual revenues of around $8bn. The other firm will be known as CSC US Public Sector and will focus on IT, infrastructure and business services for public services in the US, including federal, state and defence agencies. The split comes at a crucial time for CSC in the UK, as it is looking to retain the business that it secured for Lorenzo and other iSoft products during the National Programme for IT, and to extend their use as its contracts come to an end. When asked by Digital Health if the move would impact the company’s UK operations, a spokesperson for the company said: “It remains business as usual for our UK business.” CSC’s chief executive, Mike Lawrie, said in a statement that the decision to split is part of a restructuring process for the company that began three years ago. This “get fit” period has seen CSC introduce a common operating model and streamline its cost structure, making a significant number of redundancies, not least in the UK.
Edinburgh beckons for long term care technologists: Health technologists, SMEs, entrepreneurs and academics are being urged to attend a unique event in Edinburgh in June to find out how they can help deliver the new generation of cutting edge health technology that will support the growing population with long term care needs. Scotland’s Digital Health and Care Institute (DHI), in partnership with Innovate UK and RBS, is producing the Long Term Care Revolution Live event, which is free to attend, in Edinburgh on Monday 1st and Tuesday 2nd June 2015. It will bring together businesses, academics, policy makers and investors in a spirit of open innovation and will highlight networking, partnership and funding opportunities to delegates. Interested parties can register here. DHI CEO Justene Ewing said: “Startups and entrepreneurs – bring us your brightest, most challenging, but affordable ideas. Opportunities like this come along very rarely. We’re on the verge of a massive change and you need to get on board now.” Startups and early stage businesses will also have the opportunity to pitch their ideas to an expert panel at ‘Pitch Perfect’, with winners receiving a 12 month NatWest / RBS Mentorship programme of meet ups and connections, access to the bank’s knowledge base and links to external networks. Businesses interested in pitching should apply here and to read the full event programme click here.
Opinion
Enhancing health care in care homes: integration in practice
The fact that one of the new models of care set out in the Five Year Forward View focusses on enhanced care in care homes is good news for several reasons, says David Oliver, a visiting fellow at The King’s Fund.
“With six vanguard sites currently taking work forward to offer older people better, more joined-up care and rehabilitation services, the potential for better integration is one of the several reasons Oliver outlines in a blog on the think tank’s website.
“If we are looking at the need for more integrated working to support older people across several sectors, care homes could play a critical role,” he writes. “There are thousands of facilities – from small private concerns, to those run by social enterprises, charities and large chains – all sitting at complex interfaces with primary, acute and community care, palliative care, mental health care, statutory home care services and housing. It’s a complex web.”
It’s time to be open minded about NHS technology
In HSJ (subscription required) this week, Shane Tickell CEO of IMS MAXIMS, asks if a different mindset to new technologies is needed in order to deliver nationwide health IT strategies at a local level.
“To gain real benefit from technology and the strategies that are put in place to help support its adoption, we must be open to new ways of working, challenge the norm and encourage knowledge whether that be our community or with organisations like NHS England, which appear to have evolved into more of a facilitator of change than a top down, bureaucratic body. We have been in an information age for more than 40 years and we need to be open minded about not only how are we using information now but also planning and looking ahead to advance healthcare.
“I truly believe that those who are not open to new ideas, models and innovations, whether it be open source, telehealth or apps, should consider why they are working in healthcare and if it is because they want to improve patient safety and care through whatever means possible, then reconsider their mindset.
“The Five Year Forward View together with the Personalised Health and Care 2020 (PHaC2020) framework are not just documents that need to be read. It should be people’s business to understand it, to absorb it and to align their organisations with the key points. Meanwhile the key goals and objectives need to be continuously highlighted and healthcare professionals encouraged to take action right the way up to 2020. At which pace this happens is likely to depend on the mindset of the leaders in NHS trusts.
“After all, we are all aiming for the same goal: better, safer patient care. Information and knowledge are key enablers for this, and can make previous ways of working obsolete, and even supersede tried and tested treatments or processes. But this can only be achieved if those that matter are open minded to different technologies.”
Is VNA the new option for accessing patient records?
The shake-up of England’s medical imaging market is well underway – and it may provide a useful route to achieving a true EPR, says Mark Winstone, sales and marketing director at SynApps Solutions.
“As the multi-billion pound, ten year National Programme for IT (NPfIT) comes to an end, what was effectively centrally-managed off-line storage for the vast PACS (Patient Archiving and Communications System) X-ray and MRI imaging is also coming to a halt. As a result, there is a major reshuffle of the country’s entire PACS and RIS (Radiology Information System) market taking place, with trusts up and down England implementing exit plans from what had in some cases been decade-long arrangements.
“A VNA (Vendor Neutral Archive) is a standards-based way for storing complex data types such as X-ray images – and may be the solution health informatics leaders are seeking. Indeed, evidence on the ground suggests as much, with at least 15% of trusts opting for a PACS refresh going down this route, according to our estimates. A key term is ‘DICOM’, the file format PACS vendors use to handle, store, print and transmit medical image data. However, fully-compliant VNAs are able to store non-DICOM as well, without the need to DICOM-ise documents.
“In essence, that means a VNA will make it easier for CCIOs wanting to change PACS supplier as it’s a universal data standard. However, that’s not its only attraction; when used strategically, VNA architectures offer many other benefits – from making it easier to share images to forming the basis for wider IT platforms and even in some cases as a critical component of a next generation of EPRs (Electronic Patient Records).
“There are questions to be faced if you open the VNA to EPR door. But, a VNA buttressed by an enterprise content management capability can be a powerful tool for getting us nearer to the modern and efficient integrated care setting we all want.”
Highland Marketing guest interview
Person-centred care has long been an ambition for the UK. The technology is ready to support the vision but an underinvestment in IT could spell further delays to making it happen, Natalie Bateman, head of health, social care and local government at techUK tells Highland Marketing.
