Care quality chief quits
Cynthia Bower, head of the Care Quality Commission (CQC), which checks hospital standards in England, will quit after a highly critical government review. The CQC and Ms Bower have been under intense fire during the public inquiry into failings at the Mid Staffordshire Foundation Trust – where patients were allegedly neglected (subscription required) in the rush to cut costs and meet targets.
The report makes 23 recommendations for change. HSJ (subscription required) says the DH acknowledges considerable achievements by the CQC but says it ‘underestimated’ the challenge of registering 21,000 care providers and has failed to be clear about its role.
Pulse claims that the CQC was running over budget and that its approach to regulation may have forced care providers, including dental practices, to close. The CQC was also accused of failing to act when the BBC’s Panorama programme raised concerns about the Winterbourne View care home. Three people who worked at the home admitted ill-treatment of residents but eight cases are still to be heard.
Ms Bower, who will leave in the autumn, said: “I am pleased that the review recognises the scale of what has been achieved … I’m confident that CQC will continue to build on the progress already made, delivering increasing benefits to people who use services by shining a light on poor care.”
Government attempts health bill fight back
The government has attempted to regain the political initiative in the long battle to get the Health and Social Care Bill through parliament. The DH is promoting a series of fact sheets, which attempt to explain its benefits. The prime minister tried to change the mood by hosting a summit at Number 10 of organisations which were either neutral or broadly supportive of the bill.
Shortly after the meeting, intended to discuss implementation of the bill, one of the groups attending, the Royal College of Paediatrics and Child Health (RCPCH), called for it to be abandoned. The Royal College of Physicians, also in attendance, expressed far-reaching concerns of its own – with some members angry that their leaders had even been there. Members of the Royal College of Radiologists added their voice by voting for the withdrawal of the bill at an extraordinary general meeting.
Further troubles loom as Lib Dem opponents of the bill have tabled an emergency motion for it to be debated at the party’s spring conference. It was a backlash against the bill at last year’s event which led to the long ‘pause’ during which hundreds of minor amendments were made.
Dame Fiona Caldicott to lead patient confidentiality review
Dame Fiona Caldicott has agreed to lead an independent review of the balance between protecting patient information and its sharing, to improve patient care the Department of Health has announced.
Dame Caldicott will be calling on an expert panel made up of clinical, social care, research and other professionals, as well as patients and service users to determine the scope and priorities for the review. The review is expected to be published in 2012 and the government expects to respond following its publication.
Emergency 111 worries and ghost patient payments
NHS Direct and the BMA have severe misgivings over the new 111 phone service for patients with serious but not life-threatening illnesses. The BMA supports the principle behind NHS 111 but is concerned that its roll out is being rushed and may put existing services under strain. It has asked that the delivery deadline be relaxed. According to the BBC the government will consider BMA concerns.
Nick Chapman, chief executive of NHS Direct, which is leading work in four of the seven 111 pilot sites, said the new service has potential but expressed worries. These are largely because more patients tend to be referred for face-to-face care than under previous arrangements – potentially putting GP and A&E under pressure.
Meanwhile, GP funding has come under the spotlight with claims that England’s doctors are earning £162m from 2.5 million ‘ghost patients’. The Daily Mail claims that an audit showed that dead patients, including some who passed on 30 years ago, remained on lists – attracting annual practice payments of £64.49 each. Many patients who had moved, or left the country, were still on lists. GP online says doctors have questioned the Audit Commission figures.
Apps on prescription
Healthcare apps could soon be prescribed by GPs to help patients manage their conditions. The greater use of smartphones is being seen by the DH as the ‘next step’ in giving patients more control over their own health.
Further details of how this will work will be in the government’s Information Strategy expected this spring. One advantage of apps on prescription is that it could potentially reduce the costs for many people.
The apps by prescription announcement was made as part of the ‘maps and apps’ competition, to seek out new ideas in smartphone healthcare. The competition attracted 500 entries. Some 12,600 votes were cast on which ideas were best. The most popular were apps to:
- help manage long-term conditions such as diabetes
- help deal with post-traumatic stress
- track and monitor conditions such as high blood pressure
- help people find NHS services on a map
get practical information about keeping fit and eating healthily.
The government has also launched the Cloudstore app store to help SMEs offer IT services to the public sector. It will feature 1,700 apps from over 250 suppliers, many of them smaller companies, and is hoped to be a source of substantial savings.
NHS staffing – the ups and downs
Nurse numbers have fallen by 1.3% in the past year while the figure for senior managers is down 8.7%. HSJ reports on data from the NHS Information Centre which shows that in the year to November 2011 there was a decline in qualified nurses from 281,836 to 278,140.
There are now around 10,786 senior managers, down from 11,816. At the same time there has been a 2.9% rise in the number of midwives working full-time equivalent, from 20,428 to 21,028 in November 2011. Health visitors, though, are down 1%.
The number of doctors, including locums, has gone up from 100,204 to 101,668 – a rise of 1.5% across England. Overall, there were 1,193,344 NHS staff working full or part-time in November 2011, down 24,370 (2%) on November 2010 (1,217,714).
News in brief
- Microsoft announces joint company details: Microsoft and GE Healthcare have announced details of their new joint company, Caradigm. According to EHI Caradigm will develop and market an open, interoperable technology platform and collaborative clinical applications focused on enabling better population health management.
- New Millennium: Cerner used the HIMMS12 event in Las Vegas to launch Millennium+ which EHI says will integrate cloud-based services and mobile applications.
- Welsh health record goes live: The Welsh Individual Health Record (IHR) is now up and running, with 300 GP practices making summary care records for two million patients available to emergency care providers.
- Gene therapy progress: The newly published Gene Therapy Advisory Committee (GTAC) annual report shows that in 2010 it considered seven applications for clinical trials (four for cancer) and looks at what it has done to adapt to reduce bureaucracy and create a more streamlined research sector.
- Twitter founder gives keynote on healthcare: Twitter Founder, Biz Stone gave the keynote address at HIMSS this week and claiming that the world needs social tools to make sense of ‘infinite information’ and to transform information into understanding and action.
- GP software incentive scheme pulled: TPP has pulled its offer to give GPs M&S vouchers and tea at the Ritz for hosting SystmOne software demonstrations. Pulse says the new assurances follow a revelation that the practice had been resumed, even though the DH had been told it had stopped.
Blogs and opinion
Chris Ham head of the King’s Fund argues that inertia rather than privatisation is the greatest threat to the NHS. He outlines three areas which he regards as essential for progress.
‘First, NHS leaders must be ruthless in identifying and copying best practice wherever it exists. After all, much innovation is really adaptation of ideas initiated elsewhere, and shameless plagiarism is an underrated virtue.
‘Second, leaders must create time to look outside their organisations, while also attending to operational imperatives.
‘Third, there is a need to invest in the training and development of staff to enable continuous improvements in patient care. High-performing health care organisations do this systematically and are rightly admired for the results they achieve.
‘The most effective response to concerns that the core values of the NHS are under threat is to show it can adapt rapidly. If NHS organisations demonstrate that they can deliver high-quality and responsive care, they have nothing to fear from choice and competition.’
Alan Milburn, the former Labour minister recently tipped as a possible recruit to the Cameron government to replace Andrew Lansley as health secretary, has written a detailed article for the New Statesman giving his views of the future of the NHS.
‘In the next decade and beyond, governments will need to think of themselves less as big spenders when it comes to health care and more as switch spenders, where resources are switched from less optimum services to others that produce better outcomes for lower costs. That will entail resources being switched from hospitals to community services and from treatment to prevention. And it will demand driving forward reforms that empower patients, financially incentivise outcomes, increase competition, improve transparency and devolve accountability to local care organisations.’
Highland Marketing blog
This week Mark Venables reports back from the HIMSS12 event in Las Vegas.
