Healthcare providers face 1.5% price cut
A 1.5% cut in prices is to be imposed on NHS healthcare providers while commissioners have been told to enforce financial penalties strictly and to clear their own debts. HSJ’s coverage of the newly published DH operational plan for 2012-13, aims to accelerate its £20bn savings programme.
Observers were surprised when the expected encouragement for PCTs to move away from payment-by-results, and a reversal of the harsh new fines for emergency readmissions, failed to materialise. PCT clusters will be able to use contractual penalties to punish providers if they are not satisfied with the completeness and quality of their data.
Pulse reports that the operational plan is likely to bring a wave of CCG mergers after the management allowance for patients was set at £25 a head, at the lowest end of the expected range. This comes after a government-backed paper from the NHS Alliance and NAPC warned that funding at that level would mean CCGs would need to cover at least 100,000 patients in order to manage clinical and financial risk.
Patchy progress towards better cancer survival rates
Some cancer survivors in England and Wales are living nearly six times longer than 40 years ago according to new figures from Macmillan Cancer Support. But the BBC quotes the charity as stating the data highlights a ‘woeful’ lack of progress for some types of the disease, such as lung and stomach cancer.
Macmillan analysed median survival times and estimates for 20 cancers, drawing on research by the London School of Hygiene and Tropical Medicine. The results showed that more cancer patients are living longer, yet many struggle with long-term problems caused by their treatment. These include fatigue, infertility, and damage to the lungs and heart. Some cancer survivors also need psychological support.
Reverse loss of psychiatric beds
The NHS needs an extra 3,000 psychiatric beds according to a professor who is challenging the inane chant of ‘community good, hospital bad’. Hospital Doctor reports that Peter Tyrer, Professor of Community Psychiatry at Imperial College London, believes the shift from hospital to community care has now gone too far.
Prof. Tyler says that throughout the history of psychiatry there has been conflict between the administrative and clinical aspects of psychiatry. The former, the ‘out of sight, out of mind’ policy of the Victorian era has now been replaced by an ‘out of hospital, do not mind’ one. He concludes that we need to get ‘good in-patient care back on the agenda and fight the continuing urge towards bedlessness’.
Better model for predicting NHS commissioning
A new model for predicting GPs’ future spending could mean a major change in the funding formula for commissioners. Pulse reports that a DH-commissioned study used data from 2005-6 and 2006-7 to predict costs in 2007-8, then later compared them to actual spending.
The researchers developed a model which performed well by international standards, predicting 77% of hospital costs per practice, with subsequent analysis increasing this figure to 85%. The NHS Commissioning Board could use the new model to set CCG budgets. But they warned that the best formulae tested could only predict about 12% of next year’s hospital costs per individual, suggesting the model should be used only to guide allocations to practices, and not for use at an individual level.
Sick leave can’t be left to doctors
GPs in England should be stripped of much of their responsibility for deciding whether people with long term illness are fit to work, according to a new review. The Independent Review of Sickness Absence says the current system pushes people away from work and provides little support for them to return.
BMJ and PublicNet cover the story which advises that a new independent service should sign off people for long term sick leave rather than their GP. The report also states that the longer people remain on sick leave the harder it is to get back into work and that work is good for health and can aid recovery. Each year 300,000 employees start claiming health-related benefits. This costs the taxpayer £13bn a year and the country as a whole is misses out on £15bn in economic output.
Trials point to DES reduction of repeat revascularisation
Trials suggest that drug-eluting stents (DES) with controlled release of anti-proliferative drugs from durable polymer surface coatings reduce the risk of repeat revascularisation compared with bare-metal stents (BMS).
Early generation, durable polymer DES, however, are associated with an increased risk of very late stent thrombosis (ST) compared with BMS. This has raised concerns about the long-term safety of DES. It has been argued that the persistence of durable polymer material on the stent surface after completion of drug release is a potential trigger for chronic inflammatory responses that lead to very late ST.
News in Brief
Medical imaging boom: The global market for 3D medical imaging is forecast to reach $5.9 billion by 2017, with Europe as the largest regional market, according to a Global Industry Analysts.
Can CCGs cope with complex cases?: Practical Commissioning carries a report warning of doubts over the ability of CCGs to commission complex and specialist care. Among those raising concerns are Prof. Chris Ham of the King’s Fund.
Quicker EPR brings delays: Oxford University Hospitals Trust has warned outpatients of administrative delays while staff get used to a new £15.7m Cerner EPR. The trust says the system will be more streamlined than the old one and will make the right information more accessible for the staff.
Emergency readmissions rise: Around 55% of commissioners have seen an increase in emergency readmission rates despite the imposition of new penalties that are set to cost providers more than £400m this year, claims HSJ.
Killing the ghosts: The DH is planning a national list-cleansing campaign to remove up to 2.5 million ‘ghost patients’ from GP lists across England, says Pulse, in a move that could cost an average practice as much as £30,000.
Cancer Study Gears Up: Some 240 people have joined Cancer Research UK’s Stratified Medicine Programme. This will evaluate the new approach to therapy in 9,000 patients. Phase one is a small pilot study to demonstrate how the NHS can provide molecular diagnosis for all cancer types routinely.
An opinion article by Michael Thick, Vice President, Clinical Strategy and Governance at McKesson, in Primary Care Today says far-reaching changes are essential to achieve the government’s ambition for patients of ‘no decisions about me without me’.
‘For too long, informatics has had the clinician as its primary customer, but as patients begin to take more responsibility for their health and shared decision-making becomes the norm, it is clearly time for a rethink. In the NHS of the future, the end-user is as much the patient as it is the doctor. And in order to correct the imbalance, the tools being used must change to reflect this. Making the patient’s needs central to the process – and building that patient’s needs into every stage of the development of a service – its design, implementation and evaluation, has to be the way forward.’
From the blogosphere
Victims of media misrepresentation or simply smug? The Patient from Hell explains what happened when he challenged doctors’ leaders over the need to improve aspects of the NHS.
‘I get very uptight when NHS panjandrums try to claim that everything in the NHS garden is lovely. My fury came to a head earlier in the month at the Westminster Health Forum’s seminar on the future of the NHS. On the platform were Dr Hamish Meldrum, chairman of the British Medical Association council, Dr Claire Gerada, chair of the Royal College of GPs, and Howard Catton, head of policy at the Royal College of Nursing. They were saying things like “the NHS is the envy of the world”. OK, healthcare in the UK has come out quite high in recent international league tables, but “the envy of the world”, no way! And they never mentioned any of the scandals, or what they were doing to fix them.’
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