News in brief
Health Secretary to strengthen patient privacy on confidential data use: Responding to the Caldicott Review on information governance in health and social care, Health Secretary, Jeremy Hunt has outlined that information and technology will only have a transformational effect on healthcare if this agenda respects the relationship of trust between a medical professional and their patient, reported The Department of Health. Speaking at the Electronic Patient Records Conference, Hunt said that while effective sharing of patient information has enormous potential to improve patient care, services and treatments, this can only be done effectively if patients are given a say over how their personal information is used.
In his announcement, the health secretary said that any patient that does not want personal data held in their GP record to be shared with the Health and Social Care Information Centre will have their objection respected and where personal data has already been shared from a GP practice, a patient will still be able to have the identifiable information removed. The BMA, NHS England and the Royal College of GPs will be raising public awareness so that people are informed of the changes and know how they can lodge an objection and GPs understand the role they need to play in implementing this.
Caldicott report highlights ‘anxiety’ and disagreement over record sharing: The cultural and practical challenges faced by the NHS in sharing patient records between health and social care agencies are outlined in the Caldicott Review, reported HSJ (subscription required). Dame Fiona Caldicott’s government-commissioned review of information governance highlighted “a lack of consensus” on information sharing and said “a culture of anxiety permeates many organisations from the boardroom to front line staff”. The review also warned that the government’s plans for patients to access their records across the health and social care system could be in jeopardy without “a clear plan for implantation”. The report, Information: To share or not to share? The Information Governance Review, said: “The review panel found the anxiety results from instructions issued by managers in an attempt to protect their organisations from fines for breaching data protection laws. This anxiety must be changed to trust, in order to facilitate sharing on the front line.”
Nurses ‘drowning in sea of paperwork’: A survey carried out by the Royal College of Nursing has revealed that nurses are “drowning in a sea of paperwork” with more than one-sixth of the working week taken up doing non-essential paperwork, reported the BBC. The poll of 6,000 nurses found 17.3% of their hours were spent on tasks such as filing, photocopying and ordering supplies. Most reported the amount of paperwork was getting worse and was now stopping them providing direct patient care. The government has said it wants to reduce bureaucracy by a third. Health Secretary Jeremy Hunt has already announced a review of bureaucracy, which is being carried out by the NHS Confederation and is due to report back in the coming months. NHS Confederation chief executive Mike Farrar said: “We recognise very much the survey and we are concerned about it. I think it’s critical that we make sure our staff have got the maximum amount of time to be with our patients. We’re still doing far too much on paper, far too much duplication and it really is taking away the time nurses could have with patients.”
Health Secretary Jeremy Hunt tells SMEs: ‘The NHS needs you’: Health secretary Jeremy Hunt has admitted the NHS procurement process for IT is weighted towards large technology providers, but asked smaller businesses to “hang on in there” for contracts, reported Computer Weekly. When the government came to power in 2010, it pledged that at least 25% of public sector contracts would go to small and medium-sized enterprises (SMEs). However, speaking at a Digital Life Sciences event in the Houses of Parliament this week, the health secretary said current procurement processes damaged the companies they were trying to protect. “I think the NHS has got a long way to go before we are a truly level playing field for SMEs,” said Hunt. “I think that one of the great ironies, or the great mistakes really, is that even procurement law, which is designed to create that level playing field, actually creates procurement processes of such bureaucracy that it puts off SMEs.”
Two thirds of doctors support introduction of electronic health records: Technology company Accenture has unveiled its latest research, which has found that almost two thirds of doctors in England believe that the introduction of electronic health records has improved the quality of patient care. A majority – at 86% – also agree that these will become integral to effective patient care in the next two years, reflecting the government’s paperless NHS by 2018 ambition, reported Public Technology. Amongst 3,700 doctors surveyed, which covered eight countries including Australia, Canada, England, France, Germany, Singapore, Spain and the United States, England has the highest level of doctors supporting full access. “Electronic health records are better for patients and better for medical staff. They help improve patient care quality and capture patient feedback, as recommended in the Francis Report,” said Jim Burke, managing director of Accenture’s health business in the UK.
PACS/RIS procurement wave opens market for new suppliers: Trusts across England have completed the first major wave of procurement of picture archiving and communication systems (PACS) and radiology information system (RIS) following the end of the NHS National Programme for IT (NPfIT), reported Building Better Healthcare. Research from EHI Intelligence shows that the digital imaging market for NHS trusts is coming to the end of the first of three waves of change that are creating opportunities for new suppliers to the marketplace. Under NPfIT, the majority of companies have been frozen out for the best part of a decade, but the decision to axe the programme means that the market is opening up for the first time. The initial wave of activity has been triggered by trusts in those areas where CSC was the local service provider (LSP) for PACS/RIS, and whose national contracts expire this June. The next two waves of activity will occur as trusts in those areas where Accenture and BT were the LSPs decide what to do as their national contracts come to an end in June next year, and as trusts making ‘tactical’ decisions in the first two waves move onto more ‘strategic’ solutions.
Miliband backs integration of health and social care in NHS to save billions: Ed Miliband is to risk accusations of backing another massive NHS reorganisation after supporting the integration of health and social care in a move that is designed to save billions and produce a more rational whole care service, reported The Guardian. The idea, widely supported within the NHS, will be the subject of a year-long independent commission chaired by Sir John Oldham. He has been told to achieve the reform without extra cost or any top-down reorganisation. Integration already has the support of the shadow health secretary, Andy Burnham, who wanted to make the pledge in his conference speech last autumn but had to stop short after objections over the potential costs. The announcement on Monday is Miliband’s first intervention since a spate of criticisms that he is not doing enough to project a clear image of where Labour would take Britain in office. It is also seen as his major intervention in the county council election campaign.
Dramatic increase in emergency 12 hours ‘trolley waits’ uncovered: Pressure on accident and emergency departments has seen a large increase in the number of hospital trusts reporting patients waiting more than 12 hours to be admitted, an HSJ (subscription required) analysis has found. Department of Health and NHS England figures show a greater number of trusts having to delay the admission of emergency patients by 12 hours or more after clinicians have decided to admit them. Figures for 2012-13 show 167 emergency patients waited more than 12 hours compared with 123 in 2011-12. In the first two weeks of 2013 alone, a dozen trusts have together reported a total of 40 waits of more than 12 hours. The trusts which performed worst in recent weeks blamed a mixture of bad weather, an increase in the seriousness – or acuity – of patients’ condition, and problems caused by the deployment of urgent care phone service NHS 111.
Stafford Hospital bosses to be referred to police: The former chief executive and chairman of Stafford Hospital are to be referred to the police for criminal investigation over the hospital’s care scandal, reported The Telegraph. Martin Yeates and Toni Brisby have been accused of misleading the local council by giving false information about death rates. Stafford Borough Council claims the pair committed misconduct in public office by telling its health scrutiny panel that the 2008 rates were blamed on recording methods as opposed to poor care. It said in a statement: “Stafford Borough Council agreed last night to instruct the chief executive to make a formal complaint to the Crown Prosecution Service (CPS) in that Mr Martin Yeates and Mrs Toni Brisby committed the offence of misconduct in public office by knowingly giving false and misleading evidence to the council’s statutory overview and scrutiny committee.” The CPS said it had spoken to the council and confirmed that the correct procedure would be to make an initial complaint to the police.
Lords rubberstamp controversial competition regulations: The House of Lords has rubberstamped the government’s controversial competition regulations, amid warnings that it will hinder Clinical Commissioning Group’s (CCG’s) powers to act in the best interest of their patients and represents a step towards the privatisation of the NHS, reported Pulse. Peers voted against a motion to ‘kill’ the Section 75 regulations, which state that CCGs must put all services out to tender unless they can prove it could only be provided by one particular provider, by 254 to 146.The regulations have been criticised by the BMA, NHS Clinical Commissioners and CCG leaders, who fear they will hamper CCGs’ freedoms, while the NHS Confederation warned ahead of the vote that it could create ‘a barrage of bureaucratic procedures’ for CCGs. Lord Hunt, the Labour peer who proposed the motion to stymie the regulations, said this represents a step towards privatisation.
Western Isles looks to link up records: NHS Western Isles is working on an electronic patient record project that will integrate records across its healthcare services. The Scottish health board’s ‘eMRec’ project will join up patient case notes from hospitals, mental health, community services and GP practices in one system. Jon Harris, head of IT at the health board, told eHealth Insider that because the Western Isles cover a lot of territory, 15 islands, stretching over 130 miles, it was particularly important to have a single patient record. “We have got good systems in place, but they are all in silos. The case notes aren’t always in the right place at the right time,” he said. “We’re looking at getting the right information available to clinicians at the point of care. That’s regardless of location. Staff are very aware that they are sometimes looking at an incomplete record. If we can deliver the case notes electronically, no one misses out on the information.” The system will be delivered by information management solution company, Plumtree Group, and will integrate with systems already in place at GP practices and hospitals, including the Topas patient administration system.
Public sector fined £2m by ICO last year: NHS bodies accounted for nearly half of all public sector fines, reported Government Computing. The number and total of value of fines made by the Information Commissioner’s Office (ICO) has almost doubled from £1.17m in 2011/12 to £2.6m in 2012/13. A Freedom of Information request has also found that the ICO imposed a total of 20 monetary penalties for data breaches in 2012/13, up from nine in 2011/12. The private sector accounted for a greater proportion of penalties in 2012/13 (four out of 20) compared to 2011/12 (one out of nine), but public sector organisations still accounted for the majority of those receiving fines in both years. Interestingly, although local councils accounted for half of all public sector penalties (eight out of 16), with NHS bodies comprising six, the NHS received the greatest proportion of penalties by financial value, accounting for almost half of all public sector fines (£1m of £2.09m). This figure will have been boosted by a £325,000 fine served to Brighton and Sussex University Hospitals NHS Trust, the highest civil monetary penalty yet, in June 2012. The penalty was issued as a result of the discovery of highly sensitive personal data belonging to tens of thousands of patients and staff – including some relating to HIV and genito urinary medicine patients – on hard drives sold on an internet auction site in late 2010.
NHS bosses ponder hospital hotels to ease ward pressure: Plans for hospital hotels to care for patients who no longer need 24-hour medical care are being considered by NHS managers, reported the BBC. Under the proposals, patients such as the elderly waiting to be discharged, new mothers and stroke patients would recover in hotel-style facilities. The idea is being reviewed by the new commissioning body, NHS England. Supporters say the scheme, based on a Scandinavian model, would ease demand on hospital beds. Patient hotels are common in Scandinavia, especially in Sweden and Norway. As well as offering more freedom for patients, the buildings are designed to save money, since a hotel room is cheaper than the price of a hospital bed. The issue has been investigated by Baroness Greengross, a cross-bench peer.
Another CSU collapses: The Surrey and Sussex Commissioning Support Unit (CSU) will close down and look for options to merge with other organisations, reported eHealth Insider. The CSU, which provides IT and other support services to local clinical commissioning groups, has decided it is no longer able to stay in operation. A spokesperson from Surrey and Sussex CSU told eHealth Insider: “We are currently in a period of stabilisation – further improving service delivery and customer satisfaction and determining the sustainable future operating model for our services. “[However] we have come to the conclusion that Surrey and Sussex CSU is not sustainable as an independent CSU.” The creation and development of CSUs is proving fraught. The Department of Health initially estimated that between 25 and 35 CSUs could be set up to provide support services to CCGs. But that number has fallen steadily, with some collapsing at a late stage.
NHS leaders ”show commitment to staff”: NHS chief executives have attended a summit to underline their commitment to the health and wellbeing of the NHS workforce, reported Public Service. Attended by Dame Carol Black of the Department of Health, health minister Dr Dan Poulter, NHS England head Sir David Nicholson, David Bennett of Monitor, Mike Farrar of the NHS Confederation, and Care Quality Commission head David Behan, the summit was the first full gathering of NHS leaders since the new health system came into being on 1 April. Opening the event, NHS Employers chief executive Dean Royles said: “It’s great to see the new NHS leaders firmly supporting the health and wellbeing agenda. We all recognise that supporting staff to be alert and healthy helps them to deliver safe, quality patient care. Any well-planned investment into staff health and wellbeing is taxpayer’s money well-spent.”
Camden and Islington NHS Foundation Trust deploys Docman: Camden and Islington NHS Foundation Trust has implemented the Docman EDT Hub to transfer patient letters electronically to GP practices, reported Building Better Healthcare. The Docman solution is linked to RiO, the trust’s core electronic patient record system, to send patient letters electronically to 38 surgeries in Camden. These include discharge summaries, admission summaries, leaving plans, CPA reviews and clinic letters. The implementation has helped to improve communication with GPs, reduced paper communication and associated costs, led to safer transfer of patient information, and reduced reliance on fax machines to communication information
Opinion
Mobile technology – the key to service transformation in NHS Scotland
In Public Service this week, Colin Reid, CEO of TotalMobile explains how mobile working in its truest sense, can support Scottish government targets by giving frontline health workers the tools to do their job at the point of patient care.
To improve patient safety and outcomes, there needs to be a shift in the way ‘mobile working’ operates, Reid explains: “Many staff are already ‘mobile workers’, moving between wards and outpatient clinics on different sites or treating patients at home or in GP surgeries. Yet current approaches to mobile working are often highly inefficient.”
Reid cites the following example of how nurses and other frontline healthcare workers can utlilise mobile technologies such as tablets and smart phones, to reduce administration and travel: “Using traditional IT solutions, a community nurse will typically begin their day by travelling to their ‘base’ at a hospital health centre for a team meeting and to plan their day’s schedule. Then they need to make sure they have gathered all the patient records and other documents they will need during the day, before finally heading out for their first visit.
“With the latest mobile technology to support them, the nurse does not need to travel to the office. They can simply log on to an app on their smartphone from home and get access to all the information they need for the day’s visits, from lists of appointments and tasks to comprehensive electronic patient records, including results, photographs and x-rays. They have saved both time and the cost of an unnecessary journey in to the office thanks to a smartphone app.”
Understanding competition and choice in the NHS
The Nuffield Trust has joined forces with the Institute for Fiscal Studies to produce a joint research programme to establish a long-term expertise in the use of competition and market mechanisms in health care in England and internationally.
“The Government’s Health and Social Care Act 2012 marks a major milestone for the NHS in England’s 20-year journey from a planned system to a competitive market for the supply of health care services.
“While the reforms do not propose to introduce a fully competitive market for health care, they do seek to strengthen the role of competition and choice for the provision of health services, based on quality.
“They give providers greater independence through the completion of the programme to establish all hospitals as foundation trusts, and make them more independent through lighter touch financial and governance oversight by Monitor.”
The research programme will result in a series of publications and debates that seek to address specific questions around the use of competition and market mechanisms in health and is expected to be published this year.
The new NHS: what it means for journalists
A write up by the National Union of Journalists on their recent ‘Reporting on our healthcare’ masterclass saw a panel of journalists, including Shaun Lintern, of the Health Service Journal and Nursing Times, give their opinion on the NHS reforms and how it affects the news industry.
In a piece which cites a lack of transparency in the new NHS, freelance journalist Kate Griffin wrote: “Lintern…raised another barrier to quality health reporting: the lack of paid health reporting posts. It’s a deep irony that health service cuts are being underreported because of staffing cuts in our own newsrooms. Shaun was the man who broke the Mid Staffs story, but he wasn’t even a specialist health reporter at the time.”
The challenge, it seems, is the time constraints on today’s journalists: “He said that we “need to get back to old-fashioned journalism” – not just accepting press releases but digging around, talking to people and so on. He described staying up until the early hours reading the board papers of health service bodies.
“[The papers] won’t have a story – but they might have a clue to the story. Then you can talk to someone.” But he believes that for this approach to be successful, editors need to take the lead, giving reporters time and permission to attend conferences, read through health service paperwork and so on.”
Highland Marketing blog
In this week’s blog Myriam McLoughlin asks ‘would you be willing to substitute your hospital bed for a hotel bed?’
