Health bill to become law

The government’s health bill has passed its final hurdle in the Lords and the Commons and is now set to become law. Opposition, however, is likely to continue with HSJ (subscription required) reporting that a protest group of NHS doctors intends to field candidates against Coalition MPs at the 2015 election. Labour pledged to repeal the bill at the earliest opportunity.

A number of groups have now signalled their intention to do all they can to make the legislation work. Pulse quotes Dr Richard Vautrey of the BMA GP Committee as saying: ‘Our job now is to mitigate the worst elements of these reforms. We’ve got to make absolutely sure they work in favour of patients and not big business.’

Mike Farrar, chief executive of the generally pro-government reform NHS Confederation, told HSJ (subscription required) that post-bill guidance is needed to simplify implementation and aid service redesign, which he said could be hampered by the bill.

The Guardian quotes a call for unity by Mr Farrar who said: ‘We have to find our way through the considerable confusion and complexity that has been handed to us as we build and stress-test the new NHS system. We need to heal the rifts that have opened. We need to completely redesign NHS services against a backdrop of unprecedented financial pressure, bringing the public and staff with us. We have to do all this with significantly reduced management capacity.’

A DH source said: ‘Everybody is a bit bored with talking about the processes and structures. It was a very important debate, but we all want to get back to talking about people’s health and making people better.’

The Telegraph says that Royal Assent could come as early as next week, after the last of more than 1,000 amendments have been approved.

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Another £20bn NHS savings to be demanded

NHS budgets are to be squeezed for the rest of the decade following a government decision that the Nicholson Challenge savings drive will continue beyond 2015. The FT says that the DH director-general of policy, strategy and finance Richard Douglas, told NHS directors earlier this month that they were ‘deceiving themselves’ if they thought that efficiency savings would not be ongoing.

The Nicholson Challenge saw NHS chief executive, Sir David Nicholson, demand year-on-year savings of 4% and was first set out in Chancellor George Osborne’s four-year spending review in 2010.

Reports suggest that another £20bn may be demanded. According to Pulse, Mr Douglas showed projections suggesting that further savings will be necessary because of increasing demand from an ageing population and more expensive medicines.

David Stout, NHS Confederation deputy chief executive, said: ‘The working assumption is that the NHS will be required to continue to produce significant savings beyond 2015. The initial £20bn is not the end game.’

The news comes as the latest figures show continuing falls in NHS nurse numbers, and staffing levels overall. Peter Carter, general secretary of the Royal College of Nursing, said the figures were ‘incredibly worrying’.

He added: ‘Despite the rhetoric, we know that frontline jobs are not being protected and NHS trusts must stop making cuts in a quick fix attempt to save money. Put bluntly, the idea that cutting hundreds of jobs from a hospital will not affect the care of patients is ludicrous.’

DH acts on patient safety and end of life care

The DH has made a series of announcements on investments to improve patient safety, end of life care and service integration. The research centres at Imperial College Healthcare NHS Trust and NHS Greater Manchester will share £13m to come up with practical ways to cut prescription errors, improve diagnosis of cancer and rare diseases and reduce accidents during surgery.

Initiatives will include surgical safety check lists, online symptom checkers for serious and rare illnesses and ‘medication passports’ so staff know what medication patients are on if they are admitted to hospital.

A further £1.8m is being invested to fund pilot sites, including one for terminally ill children, which will ensure the support is available for people to die in the setting of their choice. More than 50% of people in the UK say they would prefer to die at home but only 19% are currently able to do so. The DH wants to create a fairer system, which supports people to be cared for in the setting of their choice and enables end of life care to reach all in local communities who need it.

New online tools are being introduced to help the NHS join up the services provided, allied health professionals such as physiotherapists, dieticians, podiatrists, speech and language therapists. The DH says integration could save millions of pounds and have a dramatic impact on care for people with diabetes, cancer, musculoskeletal problems and for stroke survivors.

Healthcare IT projects forge ahead

The world’s first scalable, secure medical cloud network for pathology is to be delivered by a strategic alliance between Aperio and Dell. eHealth News says the deal will see Dell host the system – the company already manages five billion medical images and studies. Aperio’s ePathology Network aims to provide secure, compliant, worldwide access to pathology consultations.

This week brought good news for Agfa with Cardiff and Vale University Health Board upgrading its picture archiving and communications system as part of a four-year contract extension. The arrangement will include a complete refresh of all equipment. The board’s PACS and RIS serve nine hospitals, are used by 3,000 staff, and create 44 million images a year from 500,000 radiology examinations.

EHI reports that Ascribe has announced the successful go live and implementation of its Web Pharmacy solution at two East Lancashire Hospitals NHS Trust sites. The upgrade to Ascribe’s latest web-based pharmacy solution is said to provide a clinically rich platform for growth and improvements to patient safety.

Alder Hey Children’s and Liverpool Women’s NHS foundation trusts are to use Perceptive Software’s ImageNow system for a document management project. The announcement comes after the trusts, which share IT services, said they are looking to outsource their IT, in one of the biggest acute outsourcing deals to date.

Meanwhile Healthcare Software Systems has been bought by newly created holding company – Wellbeing Software Systems – and plans to significantly re-invest in its businesses. EHI reported last month that Radman House Group, the parent company of HSS, had been placed into administration.

News in brief

  • Oxford NHS trust treats ills caused by electronic patient records roll out: According to The Guardian, Oxford University Hospitals NHS trust is dealing with issues around data quality and delays at its contact centre following the implementation of Cerner Millennium.
  • Lothian manipulated waiting times: James Barbour, head of NHS Lothian, has apologised ‘unreservedly’ for unacceptable practices. The BBC reports that Scotland’s second largest health board marked patients as unavailable in order to artificially reduce the numbers in breach of waiting times guarantees.
  • NHS trusts seek 111 non-emergency services supplier in £60m deal: The Guardian reports that primary care trusts in the north west of England are seeking a supplier of non-emergency telephone services to support NHS 111 in the region.
  • Aspirin can prevent and cure cancer: Data from trials involving 77,000 patients suggest that low dose aspirin can prevent many cancers from occurring and also stop them spreading. However, leaders of an ongoing UK trial believe it has no preventative effect on cancers of the gastrointestinal tract.
  • NHS £1.5bn surplus: The health service is on course for a £1.5bn surplus (subscription required) – £300m more than planned. However the trust sector surplus of £26m is £31m lower than intended.
  • Cystic fibrosis trial starts: The BMJ says a UK trial involving 130 patients is about to start which aims to repair the genetic fault which causes the illness.

Blog

A contribution from the medical frontline this week, with Hospital Doctor featuring a blog by Manchester consultant anaesthetist Katherine Teale. After seeing a patient haemorrhaging several pints of blood when a cosmetic surgical procedure went wrong, she raises questions about patient choice – and the trend to make face lifts, breast implants, and fertility treatment as easy as clothes shopping.

‘This particular patient appeared to know nothing about the risks of the surgery she’d undergone … Small private clinics are commonplace these days – the message is that surgery is no big deal, you can just fit it in around your day. ‘Patients having to choose their healthcare provider is like me buying a new laptop – they don’t understand the language, don’t know what to ask, don’t know how to judge good from bad, and they’re suckers for dodgy stats. I chose my last laptop in the end because it had a nice blue case – patients choose their hospital largely according to how much it costs to park and how far it is too travel. None are great indicators of anything that matters.

‘This week a BMJ article confirmed what we always suspected – one third of adult patients have difficulty reading and understanding basic health-related written information. What chance have they got in a system where companies compete for their custom?’

Highland Marketing blog

After the passing of the health bill Ravi Kumar considers the road ahead for the ‘liberated’ NHS.

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