News in brief
GPs most trusted by public to protect their data: The public trust their GP practice to protect their private information and use it appropriately more than the rest of the NHS, banks or government ministers, an Ipsos MORI poll has found. The poll, commissioned by the Royal Statistical Society, shows that 49% of 2,019 adults gave GPs a score of eight to ten on a 10-point scale for trusting them to use data appropriately, and just 15% said they had low trust in their GP, reported Pulse. This compared with the next highest scorer, the NHS, to which just 36% of the public gave the highest ranking on the most-trusted scale. The police came third with 28%, while banks and the UK government were trusted by 14% and 13% respectively. The survey also evaluated attitudes to sharing data for specific purposes, such as GPs and the NHS being able to access a patient’s health records for patient care, which 77% said should be allowed, and only 12% opposed. However, sharing health records for purposes other than direct patient care – similar to the proposals for NHS England’s postponed record sharing scheme, care.data – was seen as less acceptable. Only 53% of the public thought that GP records should be shared with academics and researchers to improve treatments, and only 32% thought health records should be shared with private companies – with 45% opposing. Hetan Shah, executive director of the Royal Statistical Society said: “Our research shows a “data trust deficit”. In this data-rich world, companies and government have to earn citizens’ trust in how they manage and use data – and those that get it wrong will pay the price. In particular, there may be big benefits to be had from data-sharing within government, but to get a public mandate, policymakers must be clear about the benefits and show how they will safeguard individual privacy.”
Government ‘loses £700m NHS IT legal battle with Fujitsu’: Taxpayers could be hit with a bill for up to £700m after the government reportedly lost a legal battle with Fujitsu over the failed National Programme for IT (NPfIT), reported the BBC. The case was heard in secret but the arbitrator is thought to have found in favour of the Japanese IT giant. Legal arguments are now thought to be continuing over the size of the damages the company will receive. Fujitsu and the Cabinet Office both refused to comment, after the story appeared in The Daily Telegraph. The Fujitsu and Connecting for Health contract was part of the £12bn NPfIT to digitise patient records in the South of England in 2002 but it was terminated in 2008, after disputes over changes, including a new system for electronically displaying and storing X-rays. The company announced its intention to sue the Department for Health for £700m – the majority of the £896m it would have received for completing the entire project. When the coalition came to power in 2010, the Cabinet Office stepped in to try and broker a deal with Fujitsu but the two parties ended up in arbitration. The legal bill for fighting the Fujitsu case stood at £31.5m, according to a Public Accounts Committee report in September last year. But that is likely to be dwarfed by the size of the settlement, once the arbitration process has been completed. Conservative MP Richard Bacon, a member of the Public Accounts Committee who investigated the Fujitsu case, said he would be surprised if it was as much as £700m, because the company had only completed a relatively small part of the contract. But he warned the government that it could not cover-up the size of the bill when arbitration had finally been completed.
HSCIC data lab details in November: The Health and Social Care Information Centre (HSCIC) will release more information in November about its plans for a secure data lab for viewing patient data, its chief executive Andy Williams has said. Williams discussed the HSCIC’s efforts to improve protection of patient data at a stakeholder meeting in London, along with chairman Kingsley Manning and board member Sir Nick Partridge. The meeting was set up to address public concerns after the Partridge Review found “lapses” in how its predecessor organisation shared patient data, according to eHealth Insider. Williams said the organisation is working on a range of actions to address the issues outlined in the report. “There’s a huge amount of work that has been done since the publication of the report to completely reshape and change all of the processes in the organisation around access requests.” Williams said the organisation is working on plans for a secure data lab where organisations can view sensitive patient data in a sealed environment, rather than sending it out to them. However, he said the HSCIC has not yet decided whether a data lab would become the only way to access the data or whether some organisations could still have data sent to them.
Hunt dismisses Keogh trusts’ finance struggles: Lack of money is no excuse for poor care, the health secretary has insisted after an Health Service Journal (HSJ, subscription required) analysis revealed trusts placed in special measures following the Keogh review predict a collective deficit of almost £140m this year. According to the HSJ analysis, five of the 11 special measures trusts plan to end 2014-15 with deficits equivalent of between 10-12% of their turnover. Many cite extra investment in nursing to improve the quality of care as a key driver of their financial position. Asked by HSJ whether this demonstrated those organisations needed extra funding to be sustainable, Hunt said “the path to lower cost and the path to safer care are [the] same paths”. He accepted ensuring wards were “properly staffed” could have a “short term implication” on finances but safer care would in the longer term cut costs. “There are financial pressures all over the NHS [but] the safest trusts have the best financial [performance]. Money should never be an excuse,” he added. The health secretary urged trusts to consider whether they were making the most effective use of nursing staff as well as whether they needed more. Hunt was speaking to HSJ to mark a year on from the introduction of special measures for failing hospitals – and the successful exit of five of the 11 organisations from the additional regulatory scrutiny.
Social media linked to complaints increase to GMC: A rise in the number of complaints to the doctors’ regulator has been linked to the negative media coverage of the medical profession and the growing use of social media by patients, reported National Health Executive. This is according to a General Medical Council (GMC) commissioned report, which revealed that while the reputation of the medical profession remains positive overall, it identified that negative press coverage may be ‘chipping away’ at this reputation and resulting in an increased number of people making ‘me too’ complaints to the regulator. In addition, researchers from the Collaboration for the Advancement of Medical Education, Research and Assessment (CAMERA) at Plymouth University Peninsula Schools of Medicine and Dentistry, found that social media has been linked to the increase in complaints. Specifically the use of Twitter and Facebook has led to the development of ‘communities’ and ‘public forums’ where patients discuss their treatment and easily exchange information on how to complain. The report was commissioned by the GMC after enquiries made by the general public to the regulator about doctors’ fitness to practise rose from 5,168 in 2007 to 10,347 in 2012. The aim of the study was to understand this increase with greater clarity. Dr Julian Archer, lead author of the report of director of CAMERA, said: “The process of compiling this report has produced some fascinating findings. They show that the forces behind a rise in complaints against doctors are hugely complex and reflect a combination of increased public awareness, media influence, the role of social media technology and wider changes in society. We found that while a better awareness of the GMC has a role to play in the increase in complaints, it did not necessarily result in an increase in complaints the GMC were in a position to deal with. The report also indicated that there is much to do to improve the wider complaint-handling system, so that complaints made by the general public about their doctors are directed to the appropriate authorities.”
GPs to publish Friends and Family Test data monthly: Every GP practice in England will have to provide monthly data on the Friends and Family Test (FFT) from January next year, NHS England has announced. In guidance for GPs published this week, NHS England outlines the requirements that will be made of GPs as part of the test, which asks patients whether they would recommend services to their friends and family if they needed similar care or treatment, reports Pulse. Giles Wilmore, NHS England’s director of patient and public voice and information, has written to GPs to tell them that they will be required to submit monthly FFT data from January 2015, which will include anonymous patient feedback via a standardised FFT question, plus one other question with a ‘free text’ response field. As part of the test, which will be rolled out to GP practices from December, patients can answer the primary question anonymously on a five-point scale, with responses ranging from ‘extremely likely’ to ‘extremely unlikely’. Practices have been told that they must submit data from the first, standardised FFT question to NHS England once a month and publish the results locally (for example, on their practice website). NHS England has confirmed that they will also publish FFT data on a monthly basis, but have not yet said how this will work. The body says it will ‘road-test’ various options and consult with the General Practitioner Council before a final decision is made. Tim Kelsey, NHS England’s national director for patients and information, said that the key aim of FFT was the publication of results to ‘inform patient decisions and choice’.
A&E patients ‘will wait longer’: Patients should expect “inevitable” greater waits in A&E departments, two health charities have warned. The Nuffield Trust and the Health Foundation said that there was a “perfect storm” of factors leading to an increasing in waiting times in emergency departments across England, according to Health Service Journal (subscription required). The comments come after the latest figures from NHS England show that major A&E departments failed to meet the four-hour admission to treatment or transfer target for 52 weeks running. The charities analysed 41 million A&E attendances from 2010 to 2013 and highlighted a number of contributing factors, which could lead to these breaches. Winter pressures are also associated with higher rates of people waiting for more than four hours, their report states. They also found that the number of people in emergency departments has risen as the population has grown and aged. The report suggests that older people are waiting longer than young adults or children. People over the age of 75 spend an average of three-and-a-half hours in A&E compared with two-and-a-half hours for younger patients, they found. The authors said that older people have more complex problems, which often require longer periods of care. Patients with long-term conditions are also likely to wait longer to be admitted or discharged – and people with more than one of these conditions are forced to wait even longer, they said. “We may have reached the limit of what we can deliver with our current A&E capacity,” said report author and Nuffield Trust senior research analyst Ian Blunt.
Survey gives NHS Number another push: NHS England has launched a survey on the use of the NHS Number, which is once again being promoted as the primary identifier for patient information in England, eHealth Insider reports. The commissioning board says the survey will “enable NHS England to create a comprehensive picture of the use of the NHS Number in digital care” and, in particular, in digital correspondence. Trusts are being asked to complete the survey by the end of the month, to allow NHS England to put together a progress report by September, and then offer organisations “targeted support”. In a statement, Beverley Bryant, director of strategic systems and technology, said: “Support in driving the use of the NHS Number will be a cross-organisation initiative, led through our central programme team, working hand in glove with regional leads, clinical commissioning groups and, of course, trusts themselves.” The NHS Number is a ten-digit number that was introduced in 1996 to replace other numbering systems. Its use was advocated in the 1998 ‘Information for Health’ strategy that preceded the creation of the National Programme for IT. It was “mandated” a decade later, when the National Patient Safety Agency published a ‘safer practice notice’ urging trusts to use it as the national identifier for all patients.
Wireless monitor ‘relieves pressure’ on nursing staff: The NHS is starting to test a sticking-plaster-sized patient-monitoring patch, says BBC News. Placed on the chest, it wirelessly transmits data on heart rate, breathing and body-temperature while the patient is free to move around. Independent experts say the system, developed in Britain, could ease pressure on wards and has the potential to monitor patients in their own home. However, the Royal College of Nursing says there is no substitute for having enough staff. Routine checks for vital signs – including temperature, blood pressure and heart rate – are a key part of care and safety in hospitals. Typically they may be carried out every four hours, depending on the patient’s condition. But patients can deteriorate between checks, putting them at risk. A hospital in Brighton run by the private healthcare firm Spire has been testing the battery-powered patch, which updates information on some of the vital signs every couple of minutes. The wireless device, developed by the Oxford-based firm Sensium Healthcare, then issues an alert if the readings fall outside pre-set levels, indicating a potential problem. The patch is placed on the chest just above the heart when the patient is admitted. There are no cables to any monitors. Instead, readings are recorded and transmitted to a box in each room that works like a wifi router, passing on data to the hospital IT system.
North Bristol to swap Cerner for Lorenzo: North Bristol NHS Trust has become the first NHS trust to sign to take the Lorenzo electronic patient record (EPR) system from CSC in an open procurement, reported eHealth Insider. Bristol will also become the first trust in the South of England to take Lorenzo, which will be delivered on a hosted software-as-a-service model. All previous Lorenzo installations have been nationally procured and in the North Midlands and East regions of what was the National Programme for IT. In a further first, Bristol will also become the first NHS trust to replace its Cerner Millennium EPR with Lorenzo. The win is a significant milestone for CSC, which will deliver a cloud-hosted version of Lorenzo, from a secure UK data centre. Dr Chris Burton, North Bristol’s medical director, said that following an extensive procurement exercise, Lorenzo “offered the most scope for future development while at the same time being extremely cost competitive”. We also have significant ambitions, and we were impressed with the vision and appetite CSC showed for working with us to build a truly world-class approach to patient care,” he said.
NHS England seeks new director of intelligence: NHS England is looking to appoint a new director of intelligence to oversee the implementation of a number of key transparency programmes including its delayed care.data information sharing scheme, reports Government Computing. The successful applicant will be charged with leading NHS England’s data and information services that will in turn be used to support new care delivery models and innovative types of research, according to the job description. “With the planned departure of the current post-holder we are now seeking an experienced leader with a passion for improving quality outcomes for patients through transparency and greater choice,” the job advert says. The submission deadline for applications is August 1st. Open data use and the sharing of medical records has become a controversial topic in UK healthcare, with secretary of state for health Jeremy Hunt earlier this month claiming the increased availability of information would be a “great ally” in improving patient safety in the NHS, despite the need for “caution” in how it is made available. Ahead of the care.data launch, Tim Kelsey, national director for patients and information at NHS England also this month told a parliamentary health committee that the programme would be scrutinised by an independent panel during a planned pilot phase. Kelsey said the pilot for care.data was expected to begin this year, either in late October or early November, though a final date would depend on NHS England meeting a number of conditions such as awaiting government regulations outlining restrictions on how data could be used for commercial purposes. However, healthcare professionals – while generally supportive of the overall purpose of the care.data – have continued to express concerns about patient records being shared unless an individual opts-out from inclusion in the scheme.
Wirral aims for digital two years early: The Wirral University Teaching Hospital NHS Foundation Trust is using funding from the first round of NHS England’s technology fund to move towards a “fully digital environment” by 2016, according to eHealth Insider. The trust received £3.5m from the ‘Safer Hospitals, Safer Wards: Technology Fund’ and will use the money to develop a patient portal, roll-out mobile devices and share data with GPs. Wirral will also replace further modules of its legacy system with a new electronic patient record. It began deploying Cerner Millennium in 2010, when it went live in A&E, and has switched-on five major implementation phases since. Mark Blakeman, Wirral’s director of informatics, said the funding means the trust can continue its “vision of replacing our current healthcare IT system with a sophisticated integrated digital care record. “This will not only provide great benefit to patient care, it will result in even greater efficiencies for our clinical staff who work on the front line.” Wirral wants to use the tech fund money to extend its health economy shared record project, following the deployment of Cerner’s electronic clinical exchange platform, Health Information Exchange, and the Medical Interoperability Gateway. The trust wants to share and receive more information with GPs, such as patient medications and discharge medications.
Rewarding excellence in healthcare IT: Judging has been completed and the full list of category finalists for this year’s awards ceremony can be found here. Voting for the first round of the Healthcare IT Champion of the Year 2014 closes on Monday. All winners will be announced at the EHI Awards ceremony 2014, which will be held again this year, at the Roundhouse, London on Thursday 9 October 2014.
Big congratulations to Jane and Graeme Eccles for completing the Charity Bike Ride of over 1000 miles in 14 days!
As you may know, eight and half years ago Jane Eccles had an emergency c-section and gave birth to a son, George. Whilst in hospital she fell ill contracting Necrotising Fasciitis (NF), more commonly known as the flesh-eating superbug. She was given two hours to live as once NF gets a hold there can be no stopping it. Jane was in Intensive Care and had numerous surgeries in a short space of time. Surviving against all odds, Jane was told that she would most probably never be able to walk again, let alone return to her role as a teacher. In the same defiant form that helped her survive, Jane spent the next few months in a wheelchair focusing on learning to walk.
Incredibly Jane and her husband Graeme have now completed over 1000 miles in 14 days, with no backup support, raising money for the Lee Spark NF Foundation. The Foundation helps medical professionals become more aware of the NF disease, symptoms and treatments. It’s a huge challenge for Jane, especially as she could not even lift her leg over a crossbar two years ago.
To find out more about the charity cycle visit Jane’s website. To sponsor Jane visit her Virgin Money Giving page. Many thanks for your support!
Opinion
Survey reveals managers’ concerns about integrating health and care
This week on The Guardian Healthcare, Shirley Cramer, the chief executive of the Institute of Healthcare Managers, discusses a survey that reveals that half of healthcare managers don’t believe that integration will ease pressure on NHS.
“Making integrated care a reality will fall to our health and social care managers. Ensuring that they feel comfortable, indeed positive, about the move towards closer integration is paramount. It was somewhat concerning that in spite of the case being made for integration, in our latest survey of Institute of Healthcare Management (IHM) members, more than half said they didn’t believe that integrated care would take the pressure off the NHS. If we are to make integrated care a reality it is important that we listen to managers’ concerns. Digging beneath this statistic there lay many legitimate concerns about integrated care that must be addressed.
“Another anxiety centred around the heavy workloads created by the need to set up new infrastructures for collaboration and integration between the health and care sectors. Managers pointed out that staffing and financial resources were already stretched to breaking point. There was a prediction that there could be some “patch protection” on different sides and each would want to shift the cost to the other. This might lead to delays in integration.
“There is much that we can do to support managers on the journey towards integrated care. It is vital that health and social care leaders create an environment in which managers can act more collaboratively. Integration will require mechanisms that support ongoing interaction between practitioners and managers throughout health and social care – vertically between generalists and specialists, and horizontally between acute, primary and social care.
“Integration rightly has the potential to improve patient care and outcomes for the public significantly in a way that all managers are fully signed up to, but appropriate leadership, co-ordination and resources are going to be vital to make sure the full potential of the initiative is realised.”
NHS leaders must be more confident in tackling waiting lists
As the NHS waiting list tops three million, Ian Gillespie the chief executive of Vanguard Healthcare looks at the challenges facing providers and commissioners, and argues that a confident, local approach could provide the solution.
“Waiting lists are at an all time high, having grown significantly since the coalition government came into power in 2010. Couple this with the fact that, in April, 9.95% of people were waiting more than 18 weeks – alarmingly close to the 10% maximum – and we have a real challenge on our hands.
“Many insist that this is a seasonal issue. The reality, however, is that the NHS is running hot 365 days a year. That is why the sticking plaster solutions that have been applied in the past simply have not worked, and why with an ageing population and endemic health problems, pressure on NHS services is only set to grow. Advances in care are contributing too; more surgical intervention may be great for the patient, but with more people having surgery, the strain increases for hospitals.
“Current budget shortfalls have played their part in creating this problem. There is increasing pressure on all levels of the NHS to cut costs, and with the funding gap never far from the media agenda, there is a growing belief that there simply is not the funding available to tackle waiting lists effectively.
“The truth is, not tackling waiting lists for fear of putting extra strain on budgets is a false economy. It costs money to keep patients holding on for surgery and places additional administrative strains on hospital staff, not to mention causing discomfort and distress to the patient.”
In this week’s Industry View on eHealth Insider Shane Tickell, the CEO of IMS MAXIMS, shares his thoughts on releasing the IMS MAXIMS product as open source and provides answers to some of the most common questions. This update on the progress comes almost exactly a year after the company decided to pursue the open source route.
“A year ago – almost to the day – I wrote an Industry view declaring that IMS MAXIMS was considering making its MAXIMS PAS and EPR available as an open source solution to the NHS.
“Our open source strategy has since developed with the vision of encouraging more innovation in the health service and facilitating the transition to a safer, patient focused, paperless NHS.
“A recent announcement by electronic car company, Tesla Motors, has really resonated with IMS MAXIMS. Last month, it announced that it would open source its entire patent portfolio as part of its wider aim to accelerate the advent of sustainable transport.
“Tesla does not see other electronic car providers as a threat. Instead, it sees petrol and diesel car manufacturers as a danger to sustainable transport models. In the same way, IMS MAXIMS does not necessarily see other PAS and EPR companies as competitors. It does see paper and inefficiency in the NHS as an increasing threat to providing better, safe care.
“But despite our commitment there is, of course, still some resistance from the NHS and suppliers alike. As the adoption of new technologies can take decades in the NHS, this resistance should be expected. It is now a matter of continuing to demystify the concerns about potential risk and being as transparent as possible.
“From our point of view, becoming open source is not about saying, “here you go – do what you want with it.” It is about opening the solution up to scrutiny, creating a community and in turn mainstreaming improvement through development.
“Ultimately, the roadmap is ours to deliver. But by enabling the NHS to have greater input and influence on that roadmap, we can apply the transfer of good practice. […] The more users we have of our solutions, the more expertise, input and enhancements we will have.”
Technology will play a growing role in care delivery
This week in the Financial Times (subscription required), journalist Sarah Murray dissects the use of technology and its growing importance in today’s world. She analyses the increasing demand and different approaches to digital solutions in healthcare.
Murray says that “if technology is accelerating medical advances, IT will also play a critical role in reshaping health systems as the industry struggles to meet rapidly rising demand for care.
“First, IT can help shift care from the hospital to the home, cutting costs sharply and giving individuals a better quality of life. Home-based systems can, for example, monitor blood-sugar levels in diabetics and transmit that information wirelessly to the clinic. Sensors in shoes can detect changes in gait and alert caregivers if a patient or relative has fallen.
“Another technology tool that is proving critical in advancing healthcare is the electronic medical record. Once used merely to collect information about individual patients, the EMR is becoming a data source providing the insights necessary to design preventive strategies and more customised interventions. Information generated by EMRs also enables the development of standardised care episodes – the range of treatments needed over a set time to address a condition, whether it be a hip replacement or congestive heart failure.
“Lack of interoperability is not the only hurdle on the road to the technological transformation of healthcare. In an industry that is more highly regulated than most, new technologies may run up against legislative barriers.
“Payment models also lag behind technological advances. While IT enables remote consultations, saving time and money, virtual consultations will fail to take off if doctors are not paid for communicating with patients via email or video.
“Clearly in the adoption of healthcare technology, there are plenty of wrinkles to iron out and moral issues to grapple with. However, most agree that IT has the potential to transform an industry that badly needs new ways of coping with rising demand.”
Highland Marketing blog
In this week’s blog, Chris Marsom analyses how the paperless 2018 vision influences the reputation of healthcare IT.
