News in brief
NHS facing ‘biggest challenge’ as finances worsen: The King’s Fund has warned that the NHS is facing the biggest financial challenge during 2015/2016, reported Public Finance. Hospitals and other NHS providers in England overspent their budgets in 2014/15 by more than £800m. According to the regular survey, 60% of finance directors at hospital trusts said they were dependent on additional financial support or had drawn down their reserves in 2014/15. The King’s Fund concluded that the financial outlook for 2015/16 was even lower, with two-thirds of hospitals anxious about staying within budget over the next year. 75% of trusts and 68% of clinical commissioning groups believe there is a high or very high risk of failing to achieve the productivity gains outlined in the NHS Five Year Forward View. Performance is also deteriorating with accident and emergency performance at its worst level since 2003. King’s Fund policy director Richard Murray said the monitoring report exposed “some of the biggest financial and performance challenges in recent history, there is considerable scepticism that the £22bn in productivity improvements outlined in the NHS Five Year Forward View can be achieved.”
Parties clash on NHS funding and reform: The health spokesmen of England’s three main political parties have clashed over the future funding and structure of the NHS at a King’s Fund debate ahead of the general election. The health debate focused on the parties’ commitment to find an additional £8 billion a year for the NHS by 2020-21, and on whether this would be enough to deliver the reforms outlined in the Five Year Forward View, reported eHealth Insider. Rob Webster, the chief executive of the NHS Confederation, drew attention to the plan launched by NHS England chief executive Simon Stevens in October. He pointed out that it predicts the gap between funding and demand could reach £30 billion by 2020-21, with £22 billion of this due to be closed with efficiency savings. However, he said there was an additional £4 billion gap in social care; and that NHS providers were facing an immediate financial challenge of at least £1 billion next year. He said: “Why do the parties think that £8 billion is going to be enough?” Both the Liberal Democrats and the Conservatives have promised to come up with the £8 billion; with health secretary Jeremy Hunt telling the debate that this would come from “a strong economy”.
GPs say NHS reforms have harmed patient care: A Pulse survey has shown that just over 37% of 592 respondents said care had got worse since the introduction of the Health and Social Care Act, while only 18% said patient care had improved since April 2013. The survey also reveals that only a quarter of respondents said that they felt more involved in commissioning decisions since the formation of Clinical Commissioning Groups (CCGs) than they did under Primary Care Trusts, with over two-thirds disagreeing. The survey revealed that more GPs felt CCGs had worsened care across the board, including the NHS’s ability to provide care to the most vulnerable, care in the community and variation in treatment. Dr Mark McCartney, a GP partner from Cornwall, said that patients were suffering as a result of the changes. He said: “Our politicians and NHS England seem totally detached from the reality of the crisis in the NHS.”
Labour govt may block Manchester’s NHS devolution deal: An elected Labour government may halt plans to devolve £6bn of NHS spending to Manchester, it has emerged. Shadow health secretary Andy Burnham said he has “real misgivings” about the scheme, which was agreed in February by local authorities and NHS bodies, as well as the treasury, reported Integrated Care Today. Speaking at a health debate, Burnham said he supported greater local decision-making as part of his plans for integrated health and social care, however, Manchester’s plan did not meet his objective. “I support the principle of devolution, and I was the first person on this panel this morning to call for true integration of health and social care,” he said. “But what is happening in Greater Manchester seems to have been drawn up in haste on the back of an envelope, no-one really consulted the MPs of Greater Manchester, and it failed in my eyes the reorganisation test – it’s giving me a new body to write to at the Greater Manchester level. I have real misgivings about it. They’ve signed a memorandum of understanding and we have to see where things have reached.”
Dr Foster focuses on data quality: Dr Foster has called for the quality of NHS data to be given the same priority as hitting targets, reported eHealth Insider. In a new report on the ‘Uses and Abuses of Performance Data in Healthcare’, the benchmarking organisation says performance measurement is essential so politicians, managers and clinicians know what is working and can spot problems and “so patients and taxpayers can know what is being delivered, in their name, and with their money”. However, it says this throws up a dilemma: in order for performance management to work, there must be “open and honest reporting”; but there must be “real consequences for underperformance” that might discourage openness and honesty. It says those designing and working in accountability regimes should be aware of specific problems as well as other, well known pitfalls of targets, such as gaming, tunnel vision, and bullying. The report, authored by former NHS Direct chair and National Audit Office board member Joanne Shaw, Dr Foster co-founder Roger Taylor, and consultant Katy Dix, said more attention should be paid to designing out data problems and the unintended consequences of targets.
GP comparison websites set up across the country by Healthwatch: Regional branches of Healthwatch – which is the government mandated ‘consumer champion for health and social care’ – have set up their own websites that allow patients to rate their practices in a similar way to that of NHS Choices, reported Pulse. However, the websites go further, releasing information on practices’ patient survey scores and giving information on their access. GP leaders say that the sites could be used as “a stick to beat GPs”. The Healthwatch websites takes it a step further, including elements such as: Healthwatch Central Bedfordshire providing patients with advice on making complaints; a Trip-Advisor review system, with patients rating them between one and five stars in six categories – cleanliness, staff attitude, waiting time, treatment explanation, quality of care and quality of food. Dr Katherine Rake, chief executive of Healthwatch England said: “By helping people to know what services are on offer we can ensure people are going to the right place to get the care and support they need.”
e-procurement specialist Healthlogistics acquires hTrak: Health sector e-procurement specialist Healthlogistics has acquired the Australian supplier of procedure costing and billing solutions hTrak, reported Government Computing. Healthlogistics, whose UK customers include Barnet, Enfield and Haringey Mental Health Trust, Oxford Health NHS Foundation Trust, Coventry and Warwickshire Partnership NHS Trust, and Derby Hospitals NHS Foundation Trust, suggests the two companies’ combined product offering will provide NHS trusts with an end-to-end solution for their e-procurement requirements, resulting in significant efficiency savings. Through this acquisition, Healthlogistics argues it will be able to provide trusts with accurate procedure costing information for each patient, supported by bar code scanning, contract pricing of consumables, auto-replenishment of stock and full track-and-trace, all via the web.
UK healthcare plan offers digital tech opportunity: The government, with the support of the NHS and academics, wants UK-based firms to play a leading role developing next generation technologies for healthcare in later life, reported ElectronicWeekly.com. Digital healthcare events in London and Edinburgh next month will present the government-backed initiative, Innovate UK’s £4m SBRI Long Term Care Revolution National Challenge, which aims to give UK businesses a head start in developing healthcare technologies for long term care. “Opportunities like this come along very rarely. The UK has a history of innovation and there is a significant and unique opportunity for the country’s start-ups and tech community to get involved and shape a burgeoning industry that has huge market potential,” said Justene Ewing, CEO of Scotland’s Digital Health and Care Institute. The Long Term Care Revolution £4m competition will accept entries until 2nd September 2015. Funding will be awarded to successful projects of up to a 24 month period from January 2016 to January 2018.
New safe staffing indicator for English trusts to launch this summer: A new nursing safer staffing indicator for hospitals in England is set to be launched this summer on the NHS Choices website, reported National Health Executive. The new composite indicator will give trusts a Red, Amber or Green rating based on a range of data, including staff sickness rate, the proportion of mandatory training completed, completion of a performance development review, staff views on staffing and patient views on staffing. A new recommended twice yearly assessment of the amount of time nurses spend giving direct care to patients will sit alongside the new indicator and is part of the safer staffing focus since the publication of the Francis report into poor care at Mid Staffordshire Foundation Trust in 2013. News of the indicator was revealed in a letter sent from England’s chief nursing officer, Jane Cummings, to the chief executives and nursing directors of trusts in England. The letter says: “These indicators will support the patient safety information already published on NHS Choices and provide comparable information for trusts to use and for patients and service users to enable them to make an informed choice of care provider. It will also be used by the regulatory bodies as part of their trust assurance process.”
Innovative software improves patient safety at Calderdale and Huddersfield NHS Trust: Calderdale & Huddersfield NHS Trust has begun deploying Nervecentre electronic observations, Hospital at Night, handover and clinical assessments software using mobiles devices across its two hospitals, reported Building Better Healthcare. Funded through the Nursing Technology Fund’s first round, nursing staff and doctors will use iPad and iPod to record patient observations and clinical data in order to manage essential clinical information anywhere in the hospitals 24 hours a day, seven days a week. The successful completion of the pilot signalled the software rollout to all clinical staff in both Calderdale Royal Hospital and Huddersfield Royal Infirmary during April 2015, with completion expected by the end of the year. Vicki Kaluza, senior nurse consultant for Nervecentre Software, added: “The software pilot at Calderdale Royal Hospital meant we could tailor our system specifically to meet the needs of all the clinical staff in the different and varied wards across the hospital. We identified and implemented several new adaptations to the software functionality to ensure specific patient safety requirements were achieved.”
Coventry to procure new EPR: University Hospitals Coventry and Warwickshire NHS Trust is looking for a new electronic patient record (EPR) to replace its existing in-house clinical results reporting system. January board papers say the trust has given “approval to entering into the next phase of the procurement process” for an EPR. A spokesperson confirmed to eHealth Insider that the trust is looking for an “entirely new EPR system” and that it is “very early in the process with the business case for the Trust Development Authority being outlined as we speak”. The spokesperson added that the trust is “very excited” about the development, but is unable to provide more detail until the business case had been approved.
MDU advises GPs on patient access: The Medical Defence Union (MDU) has produced guidance for GPs to help them to safeguard the privacy and accuracy of medical records being made available to patients online, reported eHealth Insider. This includes; whether they need to limit access to sensitive information; how to deal with parents’ requests to access children’s records; and what to do if a patient challenges the accuracy of a record. The MDU says that the age at which a child becomes competent will vary and GPs should keep any access by parents under regular review. The MDU advises GPs to think about how the patient’s identification will be verified and the need to educate patients about the implications if they share their log-in details with others. Also, how to identify third party information which will need to be withheld and the importance of giving patients the opportunity to correct inaccurate or incomplete records, “but not amend content simply because they find it upsetting”.
Orion Health appoints new EMEA Executive Vice President to drive population Health Strategy: Orion Health veteran Wayne Oxenham has been appointed Executive Vice President for the Europe, Middle East and Africa (EMEA) region to drive forward the company’s population health management strategy, reported eHealthNews.eu. Appointed in April 2015, Oxenham is to focus on delivering successful projects for existing customers and will take on full operational regional leadership across EMEA. He will provide leadership to existing general managers across the region, and be responsible for business development, partnerships, and growing delivery capability. “We are working with some of the most forward-thinking groups in global health in the EMEA region. This role gives me the opportunity to support those customers in helping them achieve their integrated care, service improvement and population health management ambitions, and spread the good practice that is happening across the area,” Oxenham said.
Opinion:
Can technology save the NHS?
Digital devices able to remotely monitor a range of conditions could help get the health service off the critical list says Jon Excel, editor of The Engineer.
“By 2030, there will be 50% more over-65s and more than double the number of over-85s alive in England than in 2010. And this rapid growth of the number of people living into their late eighties, as well as a corresponding decrease in the number of younger people able to look after them, will create unprecedented pressures for the healthcare system in general, and its hospitals in particular.
“Against this backdrop, it’s difficult to be optimistic about the service’s future. But could technology help fundamentally reshape the way we approach healthcare, and in the process get the NHS off the critical list?
“Beverley Bryant is director of strategic systems and technology for NHS England and agrees that sensing technologies have huge potential, but she says that a lot of work needs to be done on the service’s underlying IT infrastructure if the technologies are to really have an impact.
“There’s no point really pushing this stuff if none of it joins up with the NHS,” she said. “Currently, despite 100% digitisation within primary care, secondary care is yet to really enter the digital world. A lot of hospitals are still on paper and hold everything about you in filing cabinets, so there’s no point putting wearables and digital devices in the hands of patients if when you press a button it goes into a black hole.”
“It’s fair to say that the NHS doesn’t have a great track record when it comes to addressing this particular problem: the abortive National Programme for IT, which cost the taxpayer £10bn, has been described as one of the biggest IT failures ever seen. So how can the organisation get it right this time round?”
Election 2015: five questions on NHS funding that the campaigns are avoiding
Questions remain unanswered on how services are to be funded and when that money will actually go into the system, writes the NHS Providers chief executive Chris Hopson on the Guardian’s Healthcare Network.
“It’s no wonder that the debate on future NHS funding has been one of the main features of the general election. But there remain five vital questions that none of the campaigns have answered,” he says.
“Most of the focus has been on whether the parties will sign up to the £8bn of extra funding the NHS says it needs in its Five Year Forward View and how this will be paid for. What’s missing is that the Five Year Forward View set out a £30bn funding gap by 2020 with only £8bn of the £30bn coming from extra taxpayer funding. The other £22bn is intended to come from NHS efficiencies.
The £22bn has received only a “tiny fraction of public attention”, he says. “The first question is can the NHS really save £22bn through proven cash releasing efficiencies and, if so, what are these?
“Other unanswered questions include when will the money arrive, and where the money will go. But he also says parties have not answered how they will pay for innovation and transformation needed, or how political parties’ promises on staff numbers will match up to the NHS’s financial needs and the availability of people with the appropriate training and skills.”
Interview with Mark Large, CIO, Central and North West London NHS
Central and North West London (CNWL) NHS Trust’s Mark Large goes under the spotlight in CIO this week, to talk about his role in delivering the Central and North West London NHS technology strategy.
Describe a disruptive measure you’ve led or played a major part in
“With mobility and videoconferencing, I pushed the boundaries to allow remote consultations by video and remote patient monitoring. Technology is on trial for videoconferencing as part of service and care pathway redesign programme led by the medical director.
“As part of my chairmanship of the London CIO Council, I led the push to the practical delivery of interoperable systems.
“I also selected the system for the clinical systems programme that will transform CNWL’s systems landscape. The five separate clinical systems have become one that is capable of providing mobile access to a single view of the patient record that is visible to all our healthcare partners, as appropriate.”
What major transformation project has been recently completed or is under way at your organisation?
“As well as the infrastructure, clinical systems programme and organisation design projects described above, as chairman of London CIO Council (regularly attended by CIOs and IT directors from all healthcare settings, with regular attendance from CSUs, representatives of the chief clinical information officer (CCIO) community, the Health and Social Care Information Centre and NHS England) I hope to persuade all organisations to send their CIO or IT director as well as getting CCIOs involved because the Council’s agenda and objectives matter to all NHS organisations, not only in London, but nationally. We regularly invite guest speakers, provide networking opportunities, share experience and update each other on upcoming projects we can help each other with.”
Blog
Rob Benson summarises healthcare blogs covering the latest comments in health and social care.
