News in brief
Patient payment proposals for extra GP care: GPs should be able to charge patients for some procedures such as vasectomies and mole removals, proposals by Dr Prit Buttar, of the Oxfordshire local medical council, has suggested. He said the plans would allow GPs to increase the overall money available to treat patients, reported the BBC. Health officials said there were strict rules in place to stop GPs charging their own patients. Meanwhile, the doctors union said staff shortages were a more urgent issue. Current NHS rules prevent GPs charging their patients, except in very limited circumstances. But Dr Buttar said he wanted this to change, particularly for procedures such as vasectomies that he feels are underfunded by NHS contracts. Together with a small group of GPs, he is looking into the possibility of third parties charging patients and passing on the fees to surgeries. And he said if his initial proposals are successful, they could be extended to offer out-of-hours appointments. But an NHS England representative said: “All patients have a right to access high quality primary care services which are free at the point of delivery. Strict safeguards are in place to ensure that GPs cannot charge patients for NHS services.”
techUK outlines its Brexit negotiation priorities: The UK technology sector has called for the government to prioritise access to the European Union (EU) market, skills, and cross-border data transfer in forthcoming Brexit negotiations, reported Computer Weekly. As the UK government was being ordered to put the decision to trigger the formal process of leaving the EU through parliament, the UK technology trade association, techUK, announced what it wanted to see in discussions between the UK and remaining EU members. Ensuring the best possible access to the EU market, EU talent and the need for laws around cross-border data transfers are priorities for the tech sector, said the trade body. techUK said the UK’s digitally intensive firms account for 16% of gross value added (GVA), 24% of all exports and three million jobs, and that leaving the EU will disrupt all of this. On the day the Supreme Court ruled that the UK government cannot trigger Article 50 without an act of parliament, techUK unveiled research identifying the risks of Brexit to the IT sector and outlined its four top priorities for negotiations. The organisation also commissioned Frontier Economics to produce an independent report on the impact of the UK’s decision to leave the EU on its world-leading digital economy. The UK digital sectors after Brexit report made it clear that the UK’s successful tech sector is highly integrated with European markets and dependent on legal and regulatory frameworks established at EU level over many decades.
Rate of NHS cyber-attacks quadruples in just four years: Cyber-attacks, including growing rates of ransomware threats, grew from 1,565 reported cases in the NHS in 2013-14 to 7,178 so far this financial year reported National Health Executive. This data excludes recorded unsuccessful attempts, such as the hundreds of thousands of phishing emails trusts receive regularly. The freedom of information (FoI) request was sent to England’s 253 trusts and foundation trusts (FTs). Of the 158 who responded (62.5%), a total of 125 providers agreed to supply their data on cyber-attacks, while 33 either withheld information or didn’t collect it altogether. Those that supplied their data revealed a worrying trend of rising attacks in the NHS, with figures more than quadrupling since 2013-14. The FoI investigation identified that spending across the 75 trusts and FTs that were able to provide this data showed investment in cyber security had, amongst them, broadly remained around the £18m mark since 2013. The results were partly influenced by changing methods of data collection and a greater awareness amongst staff. Nevertheless, the findings closely followed major incidents of cyber-attacks on the NHS which have recently made it to national news, such as the attack on North Lincolnshire and Goole NHS FT in October.
Government ‘frustrated’ with GPs not keeping their side of seven-day ‘deal’: Prime minister Theresa May was speaking out of ‘frustration’ with GP leaders reneging on commitments to seven-day access when she blamed GPs for causing the accident and emergency (A&E) crisis, the health secretary has claimed. Speaking in front of the House of Commons health committee, Jeremy Hunt defended the prime minister’s comments that GPs were “not providing the access patients need”, saying that GP leaders were “scaling back” their seven-day commitments despite NHS England promising to increase primary care funding by 14% by 2020, reported Pulse. But GP leaders pointed out that many seven-day pilots were having to scale down their operations because the funding provided by the government was proving inadequate. Hunt was responding to questions from GP and committee chair, Dr Sarah Wollaston, who said “very many GPs had felt demoralised and scapegoated” by the prime minister’s comments. Hunt told the MPs that the main problem with the schemes was reluctance on the part of GPs. He said: “I think the comments that were made [by Theresa May] were in part a sense of frustration shared throughout the government that some GP leaders had talked about scaling back GPs’ commitment to a seven-day NHS despite the fact that the government made a commitment last year for a 14% real-terms increase in GP’s annual budget by the end of the parliament as part of a very carefully costed and agreed programme towards making sure people are offered seven-day access to GPs.”
Local authorities ‘not confident’ government can solve social care crisis: Nearly all leading council figures who responded to a recent survey reported they were ‘not confident’ the government’s current plans for health and social care are sufficient to cope with future demand, reported LocalGov. The survey, carried out by the older people’s charity Independent Age and the MJ magazine, sought the views of council leaders, adult social care directors and council cabinet portfolio-holders responsible for adult social services. Out of the 52 who responded, 96% said they were ‘not confident’ with Whitehall’s health and social care plans. Ninety two percent also reported not being confident the introduction of a cap on care costs in 2020 would be introduced in their areas. The survey also found 84% of the respondents – 20 of whom were council leaders – did not expect the number of delayed transfers of care from hospital in their area to significantly drop in 2017. Head of policy at Independent Age, Andrew Kaye, said: “The results of this survey are deeply concerning. Worryingly, few council figures told us they believe that the number of delayed hospital discharges will fall this year. This means thousands of people who are well enough to leave could continue to be stuck in hospital because a social care package has not been put in place.”
Over 10,000 NHS patients now have personal health budgets: The number of NHS patients with a personal health budget to cover their healthcare needs has jumped to more than 10,000, latest official figures have shown. The figures indicated there has been a bigger rise in uptake so far this year than in previous years, although the numbers are currently still well short of the government target of 100,000 budget holders by 2020, reported Pulse. The jump came after a major drive from NHS England to promote the budgets, despite concerns from the British Medical Association and the National Institute for Health and Care Excellence that they should be re-evaluated before the scheme is rolled out any further. The data, from 185 clinical commissioning groups (CCGs), showed they had arranged 10,824 personal health budgets by October last year. This represents a 130% rise in total budget holders compared with the same stage in 2015-16, NHS England said. It means more than 2,400 extra patients took up personal budgets in the first six months of the financial year – after 3,300 new patients signed up for the budgets in the whole of 2015-16 and 2,400 the year before. Under the scheme, patients with complex health needs or long-term conditions are given a budget which they can then use to buy health services of their own choosing. An NHS England spokesperson said: “NHS England currently collects the number of personal health budgets quarterly via a voluntary self-assessment survey. For Q2 2016-17, 185 CCGs responded to the survey reporting a total of 10,824 personal health budgets, representing an increase of 130% compared to the same period in 2015-16.”
GP referrals blocked as NHS sees four-fold rise in hospitals on top alert: GPs continued to face blocks on routine referrals as the number of NHS hospitals declaring the highest possible level of alert more than quadrupled in the second week of 2017, official data has shown. The proportion of trusts that declared a level four alert – the highest possible warning – rose from six in the first week of 2017 to 27 in the second week, analysis by GPonline revealed. Declaring a level four alert indicates that a hospital is facing severe, rising pressure and that it is ‘unable to deliver comprehensive care’. NHS England guidance warns of ‘increased potential for patient care and safety to be compromised’ where hospitals are at this level. A total of 12 of the hospitals that declared a level four alert were in the Midlands and East NHS region, and the remaining 15 in the South of England region. Just one trust in the London region declared an alert, at level three, while 16 trusts in the North of England region reported level three alerts. Level three alerts indicate major, increasing pressure that is ‘compromising patient flow’.
UK’s Digital Marketplace now lists over 3,300 suppliers: The UK’s Digital Marketplace digital services procurement portal is now open to over 36,000 public sector buying organisations across the country, reported Government Technology Review. Gemma Phelan, head of engagement at Government Digital Service, announced that the marketplace is now usable to a wide range of organisations. These include local authorities, district councils and semi-independent bodies including the NHS, universities and police and fire rescue services. Buyers can use the Digital Marketplace to access over 3,300 suppliers across the UK, Phelan said. Currently, 91% of suppliers are small and medium-sized enterprises (SMEs) and 72% are located outside of London. “Suppliers across the country have seen large increases in their turnover and workforce as new jobs have been created locally as a direct result of the sales they have made through the Digital Marketplace,” she said. The Digital Marketplace is now creating registers of organisations and companies that can supply the public sector, in order to build a more accurate picture of buying and selling activity.
ICO outlines GDPR guidance plans for 2017: The Information Commissioner’s Office (ICO) has revealed more details of how it plans to share its guidance on the EU General Data Protection Regulation (GDPR), reported Digital by Default. UK organisations will be required to comply with the GDPR from 25th May 2018 and it is expected that the new UK data protection legislation that will apply after the UK leaves the EU will align with the GDPR. The ICO has published an update setting out what guidance organisations can expect. Speaking in a blog, Jo Pedder, interim head of policy delivery at the ICO, described the guidance on what organisations could expect as “essential reading” because it would help to plan what areas needed to be addressed in 2017. “The update explains the work we will be contributing in the coming year as part of the Article 29 Working Party, as well as the guidance and policy development we have opted to prioritise ourselves,” said Pedder. “As the UK member of the Article 29 Working Party, we are inputting into this process and taking a lead role on a number of priority guidelines aimed at organisations.”
St Helens makes patient safety advances with electronic early warning system: Patients and staff at a North West NHS trust are starting to see the high-impact benefits of technology-enabled care after the introduction of Patientrack’s early warning and alerting technology. The system is helping healthcare professionals across 55 wards at St Helens and Knowsley Teaching Hospitals NHS Trust to quickly identify the sickest patients and manage them in the most-effective way possible, while also enabling more-efficient care practices and so releasing staff time to care, reported Building Better Healthcare. Patientrack is being used by a growing number of NHS hospitals in the UK, where nurses use the software to record vital signs observations. The system then automatically calculates a patient’s early warning score and shows clinicians when signs of deterioration are present enabling rapid intervention. Such intervention is crucial to help prevent a patient’s condition escalating and them requiring additional care. Dr Tushar Mahambrey, consultant in intensive care medicine and anaesthetics and Patientrack clinical lead, said: “Nurses have more time to spend actively caring for patients now that we have introduced Patientrack. They can quickly and accurately capture important patient observations at the bedside which is then shared with clinical colleagues across the hospital instantly.” Donald Kennedy, managing director of Patientrack, said: “This is a compelling example of an NHS trust taking the initiative with innovative technology to make important advances in patient safety. St Helens and Knowsley Teaching Hospitals has chosen to partner with a flexible UK SME to achieve this, where technology is not imposed, but is tailored and adapted to meet local clinical priorities and achieve a rapid impact for the NHS.”
NHS sharing GP data with Home Office on immigration offences: The NHS is sharing patients’ personal information, including their registered address and GP’s contact details, with the Home Office to trace immigration offenders and vulnerable people. The Department of Health (DH) told Pulse that a ‘memorandum of understanding’ (MoU) released this week formalises what information can be shared and under what circumstances. The MoU highlights that no clinical information will be released, but NHS Digital will release personal details, including full name, date of birth and registration with the NHS, last known address, and GP contact details in certain circumstances. The Home Office can ask for this information when it is seeking people with regards to immigration offences and they have failed to get in contact with immigration officials themselves. A DH spokesperson clarified that tracing requests have happened previously, but NHS Digital has the right to reject requests that don’t follow correct procedure or are not in the public interest. NHS Digital figures from August and November 2016 showed 2,244 requests for information were made by the Home Office, and 69 were rejected. NHS Digital were able to trace the individual 75% of the time.
Horder Healthcare implementing electronic patient record in digital transformation plan: Thousands of patients in the South East of England are set to benefit from improved care, as healthcare charity Horder Healthcare gets ready to implement an electronic patient record (EPR), reported Digital Health Age. The charity will deploy an EPR from software provider IMS MAXIMS in an attempt to meet the NHS’s targets of going paperless by 2020. The use of an EPR will allow Horder Healthcare staff to share crucial clinical and administrative information across its five sites in the south east. By using an EPR the charity will aim to enhance the way it delivers specialist services, including orthopaedic, musculoskeletal, physiotherapy, maxillofacial, dental, as well as plastic and reconstructive, eye and hand surgery. The EPR will provide new workflow efficiencies to simplify and speed up many core activities. Andrew Bover, head of IM&T at Horder Healthcare, said: “Moving away from costly paper-based records is fundamental to delivering safer and better care and for better engagement with our patients. The MAXIMS EPR will give us a whole new platform to enable Horder’s transition into the digital healthcare era.” Shane Tickell, CEO of IMS MAXIMS, said: “Horder Healthcare’s decision to choose MAXIMS further adds to the growing community of MAXIMS users within the independent sector and further strengthens the group’s commitment to continuous service improvement and quality customer service. The new system will ensure Horder Healthcare can meet the growing demands on its services in a safe and effective manner, but also future proofs the organisation’s proposition as it looks to expand its expertise to new geographical areas.”
Companies win funding for patient flow projects: An NHS England initiative has handed out £700,000 to support a group of digital projects aimed at helping healthcare organisations to improve their flow of patients, reported UKAuthority. The Small Business Research Initiative for Healthcare (SBRI Healthcare), led by the Academic Health Science Networks (AHSNs), has allocated the money to eight companies to support feasibility testing of their plans over the next six months. It intends to follow this up with second rounds of funding for prototype development and accelerating the adoption of their products. The projects are focused on improving patient flow, largely through the use of new digital products, and have been awarded up to £100,000 each. Among the eight companies to receive funding are: Nervecentre Software, with a bed management system and PMD Device Solutions, to develop a suite of digital interfaces for the integration of its respiratory produce and electronic medical record systems. Shirlene Oh, director of commerce at Imperial College Health Partners commented: “Media reports have stated that hospitals across the country are under significant pressure during the winter period. AHSNs are working together to find innovative solutions which address patient flow through hospital systems and acute care. The eight successful companies are developing exciting approaches to support the NHS in responding to these challenges.”
£500m health IT infrastructure framework awarded: Thirteen suppliers have been picked as part of a £500m health IT framework covering more than 80 NHS organisations, reported DigitalHealth.net. The two-year framework is divided into 10 lots covering IT hardware, infrastructure and services. These include desktop computers, clinical monitoring systems, “green IT” and scanners and printers. It is titled, ‘Manchester and Sheffield: Computer equipment and supplies’, however the contract award notice said it was available to “all public-sector bodies”. It is estimated that £500m worth of contracts will be agreed through the framework. There is the option to renew the framework by up to an additional two years. NHS IT frameworks are designed to standardise procurement of systems, in theory reducing costs and improving quality for trusts, and providing a more assured commercial pathway for suppliers into the NHS. NHS Shared Business Services and North of England Commercial Procurement Collaborative manage this framework. The collaboration has more than 80 member NHS trusts, clinical commissioning groups and social care organisations, concentrated mostly in the Midlands and north of England. Supplies on the framework include: Centerprise International, Dell Corporation and HP Inc UK.
Redcentric crowned winner on ‘vital piece’ of HSCN framework: Redcentric has become the sole supplier on a significant contract which forms part of the Health and Social Care Network (HSCN), which replaces the N3 national private network, reported Computer Reseller News (subscription required). The managed services player has now been awarded the HCSN Peering Exchange Services contract, which will run for three years. This section forms part of a wider HSCN framework, which replaces the N3 programme, which was previously run entirely through BT. According to CRN, no details were given about the value of the contract, but paperwork published online prior to yesterday’s award shows the deal is expected to be worth around £12m over its lifetime. “NHS Digital can confirm that Redcentric Solutions has been awarded the Health and Social Care Network Peering Exchange Services contract for three years, following a competitive procurement process,” NHS Digital reportedly said. The Peering Exchange allows the interconnection of multiple supplier networks, enabling HSCN consumers using different network suppliers, to reliably communicate. It is a critical component of the HSCN infrastructure and the contract is a significant step forward in establishing an HSCN marketplace of assured network services to drive competition among suppliers, improve consumer choice, support innovation and deliver value for money.
MPs approve new head of NHS watchdog: The new parliamentary and health service ombudsman (PHSO) has been approved after appearing before MPs in the House of Commons last week, reported Health Service Journal (HSJ, subscription required). Mr Rob Behrens (currently head of the Office of the Independent Adjudicator in Higher Education) will replace Dame Julie Mellor. Chair of the Commons Health Committee, Sarah Wollaston, said: “We felt that Mr Behrens’ professional background and skills will allow him to bring a deep understanding of the role of ombudsman to the challenges he will face as the PHSO. We wish him every success.” Mr Behrens is currently a visiting professor at the UCL Institute of Education and is a non-executive board member of the Bar Standards Board and chair of its qualifications committee. He will lead the PHSO through a transition period as parliament considers major reforms to the ombudsman service, including the creation of a new Public Service Ombudsman with new powers and governance structures to make the watchdog more transparent and accountable.
Health IT supplier CSC confirms redundancies in UK: Software supplier CSC is undertaking another round of redundancies in its healthcare unit ahead of a merger with Hewlett Packard Enterprise Services. The US-based company, that was contracted to deliver Lorenzo under the National Programme for IT, has 6,500 employees in the UK. A spokesperson would not confirm the exact number of UK healthcare jobs that are undergoing redundancy, but said it was proposed to be between 10 and 20%. In a statement provided to DigitalHealth.net, CSC said: “In order to align skills and resources to the demands of the market, we are restructuring parts of our UK organisation. As a result, we have identified a number of roles that potentially will be made redundant. We have a voluntary redundancy programme underway and expect the majority of the job reductions to come through this programme.” The statement added there would be opportunities for employees to reskill, with the potential of joining other areas of CSC’s UK business. It finished saying that, “throughout the restructuring we are ensuring we continue to meet all of our client commitments”. The spokesperson also said that the redundancies would not affect trusts who are using the CSC-supplied Lorenzo electronic patient record. In May 2014, CSC said it would make 750 UK workers redundant, as part of its “ongoing transformation strategy”, followed by another 750 staff one month later. This followed job losses in 2012 from staff working on its NHS account, with 500 people made redundant. This announcement led to protests in CSC’s Chesterfield, Chorley, Leeds and Solihull sites.
Opinions
Is the NHS really facing a humanitarian crisis?
The health service is under unprecedented pressure, but we must be wary of frightening patients and undermining confidence, writes Amber Davenport, head of policy at NHS Providers in The Guardian.
“There is no escaping the fact that the NHS is under immense pressure and this winter feels slightly more wearing than any other. Comments such as ‘unprecedented’ and ‘record’ levels of demand are correct, and reflections from clinicians that pressures in accident and emergency (A&E) are ‘the worst I can remember’ ring true.
“The four-hour A&E waiting time standard is widely known but the reasons behind a breach of this standard are complex and, as our recently published briefing explores, if taken in isolation does not necessarily paint an accurate picture of the standard of care being delivered. One thing is definitely clear – trusts are treating a record number of patients. More than 60,000 people attended A&E departments on 27th December 2016 – the second highest level for a single day.
“Some trusts are even reporting increases in A&E attendances of more than 20% compared with this time last year. In reality the NHS is neither ‘breaking down’ nor ‘coping well’ – the vast majority of trusts are delivering a good service and high quality care to patients, despite the pressure they are under.
The NHS will never have enough cash: Our national religion needs a reformation
Paul Ormerod, visiting professor at University College, London, shares his opinion about the current situation of the NHS and indicates what Britain could learn from the other countries in terms of health provision.
In an article for City AM, he writes: “We British like traditions. A well-established one which comes round every year is the ‘winter crisis’ in the NHS. Health provision is a political hot potato not just for this government, or indeed for any particular UK government, but for governments across the developed world.
“One of the key assumptions made by economists about human behaviour is that there is no limit to the amount of things that people want. In the splendid jargon of economic theory, this is referred to as “non-satiation”.
“An Institute of Economic Affairs monograph by Dr Kristian Niemietz shows how things could be run much better. The intriguing title summarises the contents: ‘Universal Healthcare without the NHS’. Niemietz begins with a simple point to debunk the popular view that the NHS is the envy of the world: its structure has never been copied anywhere outside the UK.
“In fact, in international comparisons of health system outcomes, the NHS almost always ranks in the bottom third of developed world countries, sitting with places such as the Czech Republic and Slovenia. If the UK’s breast, prostate, lung and bowel cancer patients were treated as in Germany, 12,000 lives a year would be saved.
“We are, quite rightly, steaming ahead with Brexit, but Europe still has valuable things to teach us in the case of health provision.”
New Scottish eHealth strategy focuses on data
Scotland must overcome interoperability issues, make better use of data, and involve all stakeholders, as it moves forward national plans published late last year, says Pieter van de Graaf, in an interview with the British Journal of Healthcare Computing.
Following December’s publication of the country’s Health and Social Care Delivery Plan, the Scottish government’s eHealth clinical strategy team leader agues there is now an opportunity to build on core systems that have been put in place.
He says: “The current eHealth strategy is more focused on systems, whereas the new strategy will be more centred around data. As part of our current eHealth strategy, delivered by NHS Scotland and the Scottish government, we have been putting core IT systems in place and going forward we will be building on this as we are moving towards much more explicit transformations for the delivery of care.
“The need to involve stakeholders from all communities of interest is fundamental to securing sustainable and scalable solutions to the wicked problems we face. The perceived effort it takes to engage the public can be reduced and the outcomes magnified by using innovative methods to support the process.
“We’re building on existing infrastructure, systems that have been in place for a while now so they’re not necessarily flexible and can limit the opportunity to make good progress. That particularly links to interoperability issues, but is also means that it’s hard sometimes to make improvements to healthcare processes.”
