News in brief
- East Sussex to invest £50m in IT: East Sussex Healthcare NHS Trust has said it is looking to spend more than £50m on IT over the next five to seven years. The trust’s IM&T strategy, obtained by eHealth Insider via a freedom of information request, reveals the trust’s plans to invest about £35m in strategic projects over the next five years including an electronic patient record system. The strategy – which has not been approved by the board – says the five year programme will see £20m invested in clinical systems. This will deliver replacement secondary care, community and child health systems, including integrated electronic patient records, supported by a trust-wide clinical image store.
- RCGP to facilitate records access: The Department of Health (DH) has enlisted the Royal College of General Practitioners (RCGP) to help implement its ambitious plans for patients to have electronic access to GP services and their GP record by 2015, reported Pulse. As part of the government’s 10 year Information Strategy, launched in May, the DH announced that practices will have to appoint a lead GP to co-ordinate better electronic access, secure lines of communication for patients and direct access to GP records within the next three years. The DH has now asked the college to lead a partnership of professional and patient groups to produce achievable plans by the end of 2012, setting out how this goal can be achieved.
- DH assigns £1.5m for personal health budgets launch: Pharma Times has reported that the government is setting aside £1.5m to help fuel a national introduction of personal health budgets for certain NHS patients, which could take place later this year. More than 60 primary care trusts in England are currently involved in a nationwide pilot programme, which it is hoped, will help clarify how personal health budgets can best benefit patients, the aspects of care they could be spent on, and the best route of their implementation. Evaluation of the pilots is expected this autumn, the DH has identified the funds to ensure that the scheme is ‘good to go’ as soon as the findings are known.
- NHS ‘could get worse from 2013’: The King’s Fund’s quarterly survey of NHS finances shows growing fears that the quality of NHS care may suffer as “financial pressures bite” from next year, reported the Guardian. The survey reveals that two-fifths of NHS finance directors expect the quality of patient care to “worsen over the next few years” and most believe the government’s target of £20bn in savings will not materialise. This “representative survey” of 45 finance directors in the health service shows that, while most are confident of making the £5bn in savings this year, the majority think the NHS will not be able to make productivity gains of this magnitude every year until 2015.
- New data linkage service live: The NHS Information Centre has switched on its new trusted data linkage service, linking patient identifiable data nationally for the first time, reported eHealth Insider. The service went live this month after Chancellor George Osborne made a commitment in his last autumn statement that, from September 2012, the NHS IC would provide a secure data linkage service to enable healthcare impacts to be tracked across the entire health service. The service involves patient identifiable primary care data being linked to identifiable secondary care patient data. Further patient identifiable data types will follow, together with social care data. The NHS Commissioning Board will be the main customer, using the data provided to drive ‘evidence-based commissioning’.
- GPs ‘key’ to more mobile health: The European Connected Health Alliance has said that GPs and new clinical commissioning groups are key to the deployment of more mobile health systems, reported eHealth Insider. A Mobile Healthcare Industry Summit, held this week in London, brought together clinicians, analysts and corporate organisations to discuss m-health technologies such as smartphone apps and ecosystems and the issues that have prevented these solutions being adopted on a wide-scale by NHS trusts. Alliance director Bleddyn Rees told delegates that despite the current obstacles to m-health, such as the complexity of the NHS, he believed the reforms might benefit such initiatives.
- Loss of patient data was ‘serious management failure’: A review into why one of the UK’s biggest NHS trusts lost data about patients has blamed “a serious management failure”, reported the BBC. Referred patients because of suspected cancer were among those affected by the problems at Imperial College Healthcare NHS Trust. The trust, which runs four big hospitals in London, says there is no evidence patients were harmed, however it has apologised to patients for “concern and distress” caused by what it admitted was poor record keeping.
- Cancer death rates set for a ‘dramatic fall’:
According to Cancer Research, death rates from cancer are “set to fall dramatically” by 2030, reported the BBC. About 170 UK deaths per 100,000 of population were from cancer in 2010, and this figure is predicted to fall to 142 out of every 100,000. It says fewer people smoking as well as improvements in diagnosis and treatment will lead to a 17% drop in death rate. Prof Peter Sasieni, from Queen Mary University of London, said: “Our latest estimations show that for many cancers, adjusting for age, death rates are set to fall dramatically in the coming decades.” - A&E performance at its worst for seven years: A Kings Fund analysis has found that more trusts failed the four hour accident and emergency target in the first quarter of 2012-13 than in any first quarter since 2004-05, reported HSJ (subscription required). Between April and June 2012, 35 trusts breached the target for 95% of patients to be admitted or treated and discharged within four hours. In total 188,594 patients waited more than four hours in A&E in quarter 1 of 2012-13. This is a decrease of 17% over the previous quarter in line with seasonal trends but a 16% increase over quarter 1 2011-12. King’s Fund chief economist John Appleby said the figures did not indicate any “particular crisis” at the moment but highlighted concerns expressed by finance directors surveyed for the report about the NHS’ ability to realise necessary savings in the medium term.
- NHS ‘on high alert during change’: As the NHS in England gears up for the biggest change in its history the head of the NHS has said they are on “high alert” to make sure there are no failings. The health service is currently busy getting ready for the government’s reforms to go live in April. In an interview with the BBC, Sir David Nicholson said the coming months were “significant” and that he was determined to make sure care did not suffer during the changes and bedding-in process. Under the reforms, GP-led clinical commissioning groups, will take charge of much of the NHS budget, replacing PCTs which will be scrapped.
- ‘I’m Mobile’- first app deployed: Informatics Merseyside has deployed its first bespoke app to a community health provider as part of its ‘I’m Mobile’ programme, reported EHI. The health informatics service is developing a number of apps for clinicians to use on their smartphone or tablet devices when treating patients. The organisation has formed a partnership with NDL, which has provided the software for Merseyside’s in-house development team to design and build bespoke apps for the nine NHS trusts it is responsible for in the region.
Opinion
The looming crisis in the hospital sector
In his latest blog Mark Newbold, CEO of Heart of England NHS Foundation Trust talks about the developing crisis in the acute sector and whether the healthcare sector can truly survive the coming years unchanged. He writes:
“But what options do boards have? Roughly speaking, the annual efficiency requirement is the same as in recent years – that is 4-5% for trusts without deficits they have carried forward. But a careful look at trust accounts will show that few have genuinely achieved this on a year-on-year basis. Most have topped up their efforts with non-recurrent (one off) measures, or offset them with income growth that has come with increased activity. To do 4-5% in the present ‘flat cash’ situation is hard, even unprecedented. Other measures have to be explored, especially as the present economic constraints are likely to continue for some years yet. But what other measures are there?
“Hospitals alone, therefore, seem to be facing an insurmountable challenge? I suspect the solution, assuming there is one, must come from a ‘whole system’ approach. This will require hitherto unseen levels of collaborative working, in order to drive down demand across the health economy. It would also require a different kind of leadership, a sharing of risk and reward, and a commitment to a common goal that transcends the narrow interests of individual organisations. This would be truly transformational. Are we up for it?”
How should a multibillion pound quango be held to account?
Director of policy at the King’s Fund, Anna Dixon discusses the NHS Commissioning Board, she writes:
“The creation of the Board has its origins in debates that have raged throughout the past decade about the separation of politicians from the day-to-day running of the NHS. All NHS providers will be taken out of direct control of the Department of Health and will be regulated in much the same way as NHS foundation trusts and private providers of NHS – funded care (by the Care Quality Commission and Monitor). The creation of the NHS Commissioning Board also separates commissioning from direct political control.
“Previous attempts at separation, such as the NHS Executive (which was located in Leeds to underline the point) and the NHS Management Board before it, were not sustained and politicians quickly reverted to type, intervening when public and political concerns about the NHS arose (see our publication on governing the NHS for more). So will it be any different this time?
“The Board has made it clear that it wants the mandate to contain fewer objectives. While we agree there are objectives that should be in the framework agreement or dropped, the Board cannot escape the fact that there must be a clear set of measurable and stretching objectives if public accountability is to be effective. How the battle between the Board and the Department of Health over the mandate ends will determine where the lines are drawn in the balance of power between the politicians and the NHS.”
A mounting case for change, but will it drive change in a ‘liberated NHS’?
Candace Imison, deputy director of policy at The King’s Fund blogs on recent reports from the Royal College of Physicians, Hospitals on the edge? Time for action, and hot on its heels, The state of medical education and practice in the UK, from the General Medical Council. She reflects on how both describe a fundamental misalignment of the medical workforce, and the way in which care is organised, with the needs of the patients.
“The RCP describes wide variation in the seniority of the medical staff available on site at night and at weekends, ranging from junior doctors just out of medical school to consultants. There is also a worrying variation in the number of patients that doctors are expected to be responsible for out of hours. The patient to doctor ratio varies from 1:1 to 400:1, with an average of 61:1.
“So what is to be done?’ The RCP identifies ten priority areas for action including changes to medical practice across primary and secondary care – increasing availability 24/7, changing the way in which care is organised, and reforming medical education and training. It argues for a much stronger application of national standards in the interest of patient care. It remains to be seen whether this approach is adopted in a ‘liberated NHS’.
“The RCP report adds further compelling evidence to support ‘a case for change’. There is an urgent need to realign the health and social care system, including the working practices of doctors, to better meet the needs of patients. In the new system these messages need to influence the priorities set by local commissioners and the new provider-led local education and training boards (now holding the NHS training budget). Let us hope they do.”
Highland Marketing blog
In this week’s blog, industry advisor Jeremy Nettle talks about the opportunities for health IT companies in the pharma world but warns they must be quick.
