News in brief
Chancellor silent on NHS funding: There was no mention of new NHS or social care funding in Philip Hammond’s first Autumn Statement, reported Health Service Journal (HSJ, subscription required). The chancellor did reiterate in the statement that NHS spending is growing by £10bn in real terms by 2021. The much repeated claim has been criticised by the Commons Health Committee and health policy think tanks. Public Finance emphasised the funding crisis further, citing fears from local government and NHS leaders that the Autumn Statement was a “a missed opportunity” to allay the burgeoning health and social care funding crisis. The Chartered Institute of Public Finance and Accountancy chief executive Rob Whiteman said the statement was “conspicuous for what it left out”, highlighting the lack of commitment for social care. The overstretched sector is in dire need of more resources, while additional funding for this kind of care could help ease the burden on the struggling NHS, council and NHS leaders said. The government announced billions in extra funding for the NHS in March this year – although the exact figure is being hotly debated. Social care has been a worrying issue, which led the BBC to explain that cuts in social care funding in England have been blamed for a sharp increase in the number of patients stuck in hospital beds because care cannot be arranged elsewhere. However, Care Appointments reported that Hammond denied health and social care services are chaos”, telling Labour MP Luciana Berger, “we will work with them to make sure it’s effective because it has got to be spent effectively, it’s got to be delivered effectively. I keep in very close contact with health secretary Jeremy Hunt and he’s working very closely with NHS management. I know it’s tempting for honourable members opposite to paint everything as a crisis or a looming chaos. It’s not the case. We have a programme of investment in the NHS, it is being delivered and we’ll keep a very close eye on the way it’s delivered.”
Britain sleepwalking into care crisis, Ros Altmann warns: Britain is in danger of “sleepwalking into a social care crisis”, a former pensions minister has warned, reported the BBC. Ros Altmann called on the government to use tax breaks to help people save for care in later life, as she said the cost of funding provision was pushing the NHS in England to breaking point. The Department of Health said it was significantly raising the funds local authorities have access to for care. Lady Altmann said the chancellor should have used the Autumn Statement to offer incentives to help families “recognise the need” to prepare for care costs. “This should have been done years ago, but successive governments have failed to offer any help,” she said. “Government spends billions on private pensions tax breaks, and there is a state pension to provide a base level of support, but there are no incentives to set money aside for care costs.” Cuts in social care funding in England have been blamed for a sharp increase in the number of patients stuck in hospital beds because care cannot be arranged elsewhere. “Care has been left to cash-strapped councils,” she said, “who keep cutting provision”. She suggested a new individual savings account (ISA) to help people save for care could be introduced and firms could offer “eldercare vouchers” along the lines of the childcare voucher scheme, which attracts tax relief.
£3m winter funding boost for Scots hospitals: An extra £3m is to be given to NHS boards to help ease the expected increase in demand over winter, reported The Scotsman. The money will be used to improve patient flow through A&E departments, hospitals wards and support people to return to their homes as soon as possible. It comes as the latest weekly figures showed that only 92.9% of people attending emergency departments up to 13th November were seen within four hours, down from 93.6% in the previous week. Health secretary Shona Robison said the £3m funding adds to the previously announced £9m to support A&E departments over winter, and £30m specifically to reduce delayed discharge this year. She said: “We know that over winter, demand on our health service increases. That is why we are working closely with our NHS and social care services to ensure they have the right plans in place.” But Scottish Labour health spokesman Anas Sarwar said the government needed to “ditch the crisis management approach” and come up with a long term plan for the NHS.
Implementing seven-day NHS should be a local decision, argues NHS Confed: Local areas should be free to choose whether to implement the seven-day health service, the NHS Confederation has said in a new briefing paper, reported National Health Executive. The paper, Commissioning and Delivering Enhanced Seven-Day NHS Services, explained: “In some instances, local factors such as demography, local health profiles and geography may mean that it is not appropriate or effective to commission and deliver particular services across seven days, however it is important that this decision is taken by local decision-makers.” The seven-day NHS is a flagship government policy, but implementing it has proved controversial. The government’s efforts to introduce it, matched with new contracts, led to an unprecedented series of junior doctors’ strikes earlier this year. NHS organisations should also stress that they will use seven-day services to improve “outcomes for patients”, not patient convenience, the report added. According to papers leaked in August, the Department of Health has listed 13 risk factors for the seven-day NHS, including “workforce overload” and a lack of robust plans.
Extended access to patient records in Wales: More hospital doctors and pharmacists will now be able to access electronic GP records of Welsh patients, the Welsh government has announced, reported Health IT Central. “This change means that vital information is now available regardless of how a patient comes into our hospitals 24 hours a day, every day of the year, improving the ability of healthcare professionals to provide safer care particularly in patient’s medicines management,” said health secretary Vaughan Gething. The NHS Wales Informatics Service will select key pieces of information of the patient record as strict regulation has been laid out to make sure that data is shared safely and securely: every time a record is accessed, an auditable log will appear automatically on the system. Health professionals will ask patients for their consent in order for the information to be accessed at every new consultation and they can choose to opt out of the scheme by talking to their GP. Rhidian Hurle, medical director of the NHS Wales Informatics Service and chief clinical information officer for Wales, said: “The extended access to the GP record makes it easier for health professionals to provide safer care, saving them time in getting the correct information about the patients they are caring for and therefore allowing them more time to focus on the patients’ needs. It is a win-win for patients and professionals alike.”
Show your passport if you want to use the NHS, patients could be told: Every NHS patient could be asked to show their passport before they receive healthcare, a senior official has said. The Department of Health’s top civil servant said a national scheme could mean the entire population is expected to bring two forms of identification before receiving treatment, reported the Telegraph. Chris Wormald, the permanent secretary, disclosed the proposals as MPs said the taxpayer was being “taken for a ride” by the failure to charge health tourists and those who fall sick while visiting the UK. Wormald told the Public Accounts Committee the government was considering rolling out plans which were “controversial” and would mean a significant change to the culture of the health service. The committee heard that Britain has paid £4.3m towards treatment for Britons in Poland – but received just £1.5m for the cost of treating Poles in NHS hospitals.
NHS cancer testing service ‘at breaking point’: Tests for cancer diagnosis are under threat as labs struggle to cope with rising demand, Cancer Research UK has said, reported the BBC. Without more staff to meet the demand, long waits for test results could become the norm, said the charity. The government said it is investing in cancer services, which includes having the right number and mix of staff. According to the report year-on-year requests for pathology services have been increasing, but staffing levels are not increasing fast enough to keep up. Cancer Research UK said that in the next five to 10 years there will be a shortage of consultants across all areas of pathology. Professor Manuel Salto-Tellez, a Cancer Research UK pathology expert, said: “We need to act now before this situation gets worse. It’s vital that patients are diagnosed at an early stage when treatment is more likely to be successful and pathology plays a crucial role in this.” Dr Suzy Lishman, president of the Royal College of Pathologists, said: “Having the right staff with the right skills will make sure people referred for cancer tests are diagnosed as quickly and accurately as possible.” There were around 352,000 new cancer diagnoses in the UK in 2013. Cancer Research UK estimated this will rise to 500,000 a year by 2035. A Department of Health spokesperson said: “Early and fast diagnosis is crucial in improving patient outcomes and experience. That’s why we have invested over £2.5bn on efficient and robust pathology services across the NHS.”
NHS using Google technology to treat patients: A London NHS hospital trust has teamed up with tech giant Google to share patient data so it can save more lives, reported the BBC. Doctors at the Royal Free London NHS Foundation Trust said partnering with the artificial intelligence arm of Google – DeepMind – could free up over half a million hours per year, currently spent on paperwork, towards direct patient care. Medical staff will get “breaking news” style alerts about their patients. Privacy campaigners are concerned about data breaches as information on more than 1.6 million patients a year will be shared with a subsidiary of Google. Under a five-year agreement, DeepMind will collaborate with Barnet, Chase Farm and Royal Free London using a mobile app called Streams, which will initially alert clinicians to patients with signs of acute kidney injury at its earliest stages. The app will be rolled out from early next year, and if successful will also be used to detect other life-threatening illnesses like sepsis and organ failure. David Sloman, chief executive of the Royal Free London, said: “Doctors and nurses currently spend far too much time on paperwork, and we believe this technology could substantially reduce this burden, enabling doctors and nurses to spend more time on what they do best – treating patients.”
Watchdog warns on financial plight of NHS: The National Audit Office (NAO) calls for realistic spending targets, reported the Financial Times (subscription required). The NHS remains on an unsustainable financial trajectory despite an increase of more than 30% in emergency funding this year, the government’s spending watchdog has confirmed. The NAO said that more than two-thirds of NHS trusts were in deficit in 2015-16 and an increasing number of clinical commissioning groups were “unable to keep their spending within budget”. The audit showed that the amount of financial support funding provided by the Department of Health and NHS England in the last financial year was £2.4bn, up from £1.8bn a year earlier. Amyas Morse, who heads the watchdog, said “aggressive efficiency targets” had tipped many trusts into the red and he expressed little confidence in their ability to improve. The government plans to make £22bn of savings and has asked 44 areas across England to come up with so-called sustainability and transformation plans (STP). Ministers insist the NHS has enough money and that STPs will lead to improved services and will put hospitals on a sound financial footing. The watchdog also spotted “indications that financial stress is having an impact on access to services and quality of care” and found trusts with lower-quality ratings had also reported poorer financial performance. John Appleby, chief economist of the Nuffield Trust, said: “The only conclusion one can draw from the NAO’s findings is that at present there simply isn’t enough money in the system for the NHS.”
Virgin Care wins contracts worth £65m in Lancashire: Virgin Care has been awarded another pair of NHS contracts after being announced as the new community and urgent care provider by West Lancashire Clinical Commissioning Group (CCG), reported National Health Executive. The company will take over the five-year contracts for community health services, worth £45m, and urgent care services, worth £20m, on 1st April 2017. The company has acquired a string of NHS contracts recently, including a £700m health and care co-ordination contract in Bath and North East Somerset and a £17m a year community care contract in Guildford and Waverley. Dr John Caine, chair of the CCG, said: “We are pleased to announce that Virgin Care has been successful in this process. Through the bid Virgin Care demonstrated a true understanding of our vision and we are assured it will deliver a quality service for our local community within this new model of care.” The current provider, Southport and Ormskirk Hospital NHS Trust, was not shortlisted for the contracts. It was rated as “requires improvement” by the Care Quality Commission last week, after receiving the same rating the previous year. The other bidders for community care were another private company, Optum Health Solutions, and two NHS foundation trusts, Lancashire Care and Bridgewater Community Healthcare. Optum was the only other bidder for the urgent care contract. Claire Heneghan, chief nurse of NHS West Lancashire CCG, said Virgin Care would “develop and enhance community and local walk-in and out of hour’s services” in order to relieve pressures on urgent care.
OBH’s Outcomes Platform selected to join NHS Innovation Accelerator: A technology developed in the UK by specialist data company Outcomes Based Healthcare (OBH) has been selected for a national NHS acceleration programme to help measure if care is making a meaningful difference to people and to empower the NHS to prevent diseases, reduce severe illness and improve quality of life. NHS England medical director Professor Sir Bruce Keogh and US digital health expert Professor Robert Wachter revealed eight health innovations to join the NHS Innovation Accelerator for 2016, reported Building Better Healthcare. The technology supports healthcare systems, such as commissioners and care providers, who are actively working towards building value-based healthcare models in their organisations. It enables health systems to organise care between different providers more effectively, around outcomes that are important for people and populations. The key focus for OBH is to shift measurement and reimbursement away from simply volume of illness treated towards improving people’s health. This includes preventing disease, reducing severe illness, improving quality of life, and feeling able to confidently manage their health conditions. “Being selected by NHS England as one of its eight innovations for 2016 is a fantastic opportunity to move to rewarding NHS organisations not only for the great work they do to treat patients, but for the serious efforts being made to prevent serious adverse events,” said Dr Rupert Dunbar-Rees, the CEO and founder of Outcomes Based Healthcare. “This reflects the huge amount of hard work the NHS is now putting into defining, measuring and paying for the things which actually matter to people.”
Four new digital exemplars expected, including Imperial: Imperial College Healthcare NHS Trust is likely to be named as a global exemplar, in conjunction with the neighbouring Chelsea and Westminster Hospital NHS Foundation Trust, reported DigitalHealth.net. The trusts will likely be named along with three other hospital trusts. These are understood to be Alder Hey Children’s Hospital, The Newcastle upon Tyne Hospitals, and Cambridge University Hospitals NHS foundation trusts. The five trusts would join the 12 global exemplars, which between them are set to share £100m of national investment. Exactly how much funding will be available to the exemplars is also unclear. An initial pot of £100m was set aside, with each exemplar able to claim up to £10m that they would then have to match locally. However, with 12 exemplars initially selected, and another four on their way, it is unclear whether this pot will increase or be divided into smaller chunks. A further announcement is also expected on the first “national exemplars sites”, which earlier this month NHS chief information officer Will Smart said would be expanded to include mental health, specialist and ambulance trusts. Approximately 20 trusts are expected to receive up to £5m each.
HSJ Awards 2016 winners revealed: Marianne Griffiths of Western Sussex Hospitals Foundation Trust has been named chief executive of the year at the 2016 Health Service Journal (HSJ – subscription required) Awards. Judges said Griffiths was a “selfless and devoted” leader who inspired and supported staff do their best for patients. The trust was awarded an outstanding rating by the Care Quality Commission in 2016. Other winners included Liverpool Clinical Commissioning Group, which was named Clinical Commissioning Group of the year, and East London NHS Foundation Trust, which won the Provider Trust of the Year category. London Ambulance Service Trust was the winner in the Workforce category, for its innovative approach to mentoring which judges said made a “real difference to staff morale and patient care in a challenging environment”. Portsmouth Hospitals Trust with Wessex academic health science network (AHSN) was winner in the Primary Care Innovation category for its Mission project to identify patients on GP registers at risk of asthma and chronic obstructive pulmonary disease.
Ireland to go-live with national maternity electronic record: Ireland’s biggest maternity hospital will go-live with Cerner next month, as part of an upgrade that will see all its maternity units switch to the electronic health record (EHR) system, reported DigitalHealth.net. Cork University Maternity hospital will deploy Cerner on the weekend of 3rd December. This will eventually be rolled out to a further 18 maternity hospitals that will share a single nationwide Cerner maternal and newborn clinical management system. eHealth Ireland chief executive Richard Corbridge said that Cerner had rebuilt and validated the system specifically for Ireland’s maternity context. “This will be a single instance across 19 hospitals to promote the sharing of information,” he said. It is the first in a series national EHR projects planned in Ireland that will also create a separate single national EHR for specialist oncology hospitals and another for acute hospitals, providing funding is approved. Cerner has also won a contract to provide the digital national laboratories information platform in Ireland, which is scheduled for roll-out at the first three sites in the second quarter of 2017. These moves are part of a broader eHealth Ireland strategy to digitally transform a national health service that is still largely run on paper.
Opinions
Data vs doctors: What does the future hold for the medical profession?
With the rapid progression in wearable devices and a greater global reliance on big data, the role of the GP is changing dramatically. Greg McEwen, partner at insurance law specialist BLM, explores what the future might hold for the medical profession as we journey towards an ever-more digital lifestyle.
In an article to Digital Health Age, he says: “With the progression of the 21st century, the world of big data has slowly begun to invade and chip away at the notion of the doctor as sole diagnostician and decision maker.
“The medtech industry’s early ventures into consumer-friendly technology has resulted in a number of relatively inexpensive products, which will pave the way for an ever-greater pool of information and data in the future.
“In most instances, it is improving patient care, enabling doctors to remotely monitor things such as their patients’ drug adherence whilst having a greater overview of how a treatment is working.
“For many, there’s a sense of unease as we embrace this brave new world of patient data. For others, it’s the beginning of a revolution in the empowerment of patients. Data it would appear, has both the ability to elevate and undermine doctors depending on how they use it.
“Without industry standards, you cannot be sure that the products will ‘talk’ to each other as they should. The wearable tech may prove incompatible or only partly compatible with certain software, meaning patients could have a cause of action against their doctor for the latter’s choice of product(s).
“In this scenario, are they now doctors or technology experts?
“What’s clear is that the risk is multiplying for all involved in the delivery of healthcare in the digital age. As technology, patients and doctors feel their way together, we’re likely to see a myriad of new issues cropping up. The price of progress, one might argue.”
Listening to patients and staff key to the future of health and care
Listening to feedback from staff and patients should be an essential part of sustainability and transformation plans, writes John Morley, CEO of Formic.
In an article for OnMedica, Morley says the most successful organisations in the world aim to deliver high quality services that are built around the needs of the customer, informed by the voice of frontline staff. He argues the same should apply in healthcare.
“It is common sense. Ask patients for their views on the care they receive, and use this feedback to inform the quality of care delivery and identify areas for service improvement. It was a key recommendation from a recent report by The King’s Fund on maternity services.
“We also need to listen to staff to deliver the best health and care we can. The link between patient and staff experience and the quality of care was recognised by NHS Employers in 2014.
“NHS England’s director for patient experience, Neil Churchill, has pointed out that patients who have a better experience of care generally have better health outcomes.
“The inspection regime of the Care Quality Commission reinforces the need to listen to staff and patients to inform quality and service improvement.
He adds: “If we do listen to people’s feedback, we know that most people think that the care they receive from the NHS is amazing.
“There will be areas for improvement; there always are. But the NHS has access to an enviable depth of customer insight.
“Many businesses would be envious of how many of its customers share a vast amount of positive feedback about the service as a whole, as well as providing helpful views on quality and service improvement.”
What are the true costs of analogue care?
With current approaches to Scotland’s social services labelled unsustainable, and health care similarly under pressure, Tom Morton, CEO of Communicare247 urges providers to realise the potential for digital technology now, in an article for PublicTechnology.net.
“In Scotland, rising demand and costs for public services mean that, by 2020, the country’s 32 councils will have to spend an extra £700m on top of the £3.1bn per year spent now. That’s according to the Accounts Commission chairman, Douglas Sinclair, who has described current approaches as ‘not sustainable’.
“Many providers are looking to address these issues by delivering more person-centred services within the citizen’s home. For many this means wider use of telecare or technology enabled care (TEC) to provide remote monitoring, responsive alarms, and round-the-clock support for these individuals.
“Telecare is delivering benefits; one report found that widespread, targeted use of telecare could create potential savings of between £3m to £7.8m for a typical council, equating to 7.4% to 19.4% of the total older peoples’ social care budget.
“So with such evidence of impact, it is disconcerting that only around one in seven of the over 65s have access to telecare services.”
The author notes that current telecare is reliant on landlines – ‘analogue’ technology that should be replaced by digital systems.
“We need to invest in digital telecare if we want to maintain a society where our senior and vulnerable citizens can be cared for in an acceptable way.
“Digital telecare builds on existing approaches to home-based care, but makes it more efficient and more reliable. Unlike analogue systems, digital has an ‘always-on’ connection between a wider range of sensors such as smoke and heat, movement and activity, local environment, and personal alarms.
“By linking these to a digital platform that can share information with health and care providers, neighbours and next of kin, those most in need can be supported in their own home and for as long as possible.”
Highland Marketing blog
Autumn Statement leaves NHS pining for the fjords
This year’s Autumn Statement and rows over NHS investment have echoes of Monty Python’s dead parrot sketch, writes Highland Marketing’s CEO Mark Venables.
