News in brief
NHS trusts post £822m deficit for the year: NHS trusts in England have racked up a combined deficit of £822m over the past year, more than seven times the £115m from 2014, reported National Health Executive. The figure combines the end-of-year financial positions for NHS trusts and foundation trusts published by the NHS Trust Development Authority and Monitor. A massive bill for agency staff and record-breaking surge in demand, putting trusts under “sustained and exceptional pressure”, are said to be the key reasons for the overspend. Analysis by Monitor found foundation trusts treated 10.7 million emergency in-patients between April 2014 and March 2015, a 574,000 increase on the previous year. There was also a significant increase in non-emergency patients. Richard Murray, director of policy at The King’s Fund, said: “These deficits have occurred despite substantial extra money having been provided by government, without which the position would have been much worse. The figures underline the huge pressures facing acute trusts, which have collectively overspent by £1bn. This is largely due to increasing demand for services and decisions by hospitals to recruit more nurses in order to maintain quality of care, but it also reflects the squeeze on their incomes as a result of cuts in the prices they are paid for treatment.”
GPs set for government showdown as Queen’s speech confirms seven-day access plans: The Queen’s speech, setting out the government’s agenda for the new session of parliament, confirmed ministers’ plans to ensure more NHS services run on weekends, reported GP Online. The Queen said: “In England, my government will secure the future of the NHS by implementing the NHS’s own five-year plan, by increasing the health budget, integrating healthcare and social care, and ensuring the NHS works on a seven-day basis. Measures will be introduced to improve access to GPs and to mental healthcare.” The Conservatives promised in their election manifesto to ensure every patient in England would have 8 till 8 and seven-day GP access, a proposal which has been bitterly opposed by GPs. In a briefing note accompanying the Queen’s speech, the government said the prime minister’s GP access fund was already extending evening and weekend access and would cover 18 million patients by the end of the year. “That access will be expanded further”, it added. GPC chairman Dr Chaand Nagpaul made a last-ditch appeal to ministers to dump the proposals and focus on the workforce and funding crisis. Dr Nagpaul called on David Cameron to “jettison the political pipe dreams of tomorrow and get real about how we resource, resuscitate and rebuild general practice”. “Ministers must halt their surreal obsession for practices to open seven days when there aren’t the GPs to even cope with current demands”, he said.
Queen’s speech fails to mention social care funding: Social care funding was absent from the Queen’s speech which set out the government’s intention to secure the future of the NHS by increasing the health budget, integrating healthcare and social care and ensuring the NHS works on a seven day basis, reported Care Home. George McNamara, head of policy at Alzheimer’s Society, expressed disappointment in the government’s failure to mention how social care will be funded saying: “Integration of health and social care is vital to providing personalised care fit for an ageing population with increasingly complex needs. Yet strikingly absent from the speech is any reference to social care funding. If the government continues to treat social care as the poor cousin to the NHS, genuine integration can only remain an aspiration. It must be acknowledged that you cannot secure the future of the NHS without investment in social care.” He added: “By the end of the next parliament nearly one million people will be living with dementia. Bold action is necessary to deliver a health and care system designed around people, not rigid, silo-based institutions.”
NHS England announces 97% availability for key online services: Up to 97% of all NHS patients in England are able to book GP appointments, order repeat prescriptions and access a summary of their medical records online, according to NHS England. Based on the latest figures, the number of practices offering these key services online has tripled since the start of the year and a huge increase since April last year where only 3% of GP surgeries offered online options, reported Integrated Care Today. The online services are being offered as an alternative rather than a replacement for existing phone or face-to-face methods. Beverley Bryant, director of digital technology for NHS England said: “Many patients want the flexibility of booking services online so we are delighted that GPs have worked so hard to make this possible. There is more to come as we develop services that will increasingly help patients take more control of their health.”
Health and care system fails to shift balance: There has been no shift in the balance of care from hospitals to the community in the last three years, despite it being a major stated aim of the Scottish government, according to new statistics. While the number of people delayed from leaving hospital has reduced over the past quarter, with figures now at the lowest level for almost two years, figures also showed of the number of beds unavailable due to delayed discharge was over 150,000 in the first quarter of 2015, reported Holyrood. Of the total £4.8bn spent on health and social care in 2013-14, £1.45bn was spent on unplanned admissions by people aged over 65 to hospital. Scottish health secretary Shona Robison said the Scottish government was committed to a “whole system approach” which would lay the foundations for a system where more people will be treated at home or in a homely setting. Integrated health and social care boards have been established, £100m has been allocated to deal with delayed discharge, and £50m has been distributed to health boards as an unscheduled care fund. “There is still much work to do on both A&E performance and delayed discharge. However, we have put record funding and staffing in place and through the integration of health and social care we are committed to tackling these issues further. That means we have the strong foundations in place to ensure our NHS continues to deliver, quick, high quality care for the people of Scotland,” she said.
WebGP to reach millions: GP e-consultation and self-help web service expects to reach 2 million patients by this time next year, reported DigitalHealth.net. WebGP was started by doctors at the Hurley GP group. Hosted on a practice’s website, it brings together a range of self-help tools including video content created by some of the group’s GPs. Also symptom checkers and advice on the various places a patient can get help, such as a pharmacist or NHS 111 or an available app. A registered patient can also fill out an e-consultation form available for 100 common general practice scenarios and symptoms, which is sent to their practice for review by a GP. Dr Arvind Madan, chief executive of Hurley Innovations, told a recent Wessex LMC meeting that the project to design a system to redirect patient demand to other services started three years ago. It was driven by the group’s inability to deal with demand and attracted some support from NHS England. “We wanted to see how we could disrupt the traditional model and start using a click-first approach,” he said. “Our focus was on making our workload more manageable.” Twenty practices were part of a pilot of Web GP which ran from August 2013 to March 2014.
Worcestershire NHS trusts outsource IT services to Computacenter: NHS hospitals, health centres and GP surgeries in Worcestershire will receive IT support from services provider Computacenter, as part of a five-year deal, reported Computing. According to the initial notice in the Official Journal of the European Union, the contract was valued at between £12m and £18m. Worcestershire Acute Hospitals NHS Trust, Worcestershire Health & Care NHS Trust and Worcestershire’s three Clinical Commissioning Groups (CCGs) – Redditch and Bromsgrove CCG, South Worcestershire CCG and Wyre Forest CCG – will share the service. The contract covers remote and desk-side support for more than 9,000 NHS employees across 160-plus sites, including eight hospitals and 66 GP surgeries. As part of the five-year contract, there are a number of IT transformation initiatives being planned including better connectivity for GP surgeries within the county, and establishing unified communications for community and mental health workers. James Longmore, ICT director for Worcestershire Acute Hospitals NHS Trust, said that the new contract would enable the trust to “improve efficiency, patient safety and health outcomes by minimising ICT downtime and disruption for clinical and administrative staff”.
The NHS should embrace wearable tech, says Royal Free CIO: The NHS should adopt wearable technologies to improve patient monitoring and care, Royal Free Hospital CIO Will Smart has said. “I’m sure wearables will become embedded within NHS practice, though I suspect it is probably a few years off,” he told ComputerworldUK. The most obvious application is the ability to pull physiological data from wearables into a system that can be used to alert clinicians on patients’ condition in real time, Smart said. Its uses are likely to expand as the technology develops, from simply providing alerts for staff to being an important part of clinical practice and surgical operations, he predicted. However he warned: “There are a series of privacy issues we need to look at first. For example some have been interested in how Google Glass might be used to record operations. Microsoft have their virtual reality headset, we can begin to see how that might be used in simulation or to connect to operating robots.” To support the use of wearables, NHS trusts will first have to ensure they have adequate means to collect, store and analyse digital patient data in real time. The Royal Free Hospital expects to have finished digitising all of its legacy patient records by this Christmas, Smart said.
NI Audit Office: Health facing ‘unprecedented financial challenge’: The scale of financial difficulty facing Northern Ireland’s five health trusts was so severe in 2013 and 2014 that four failed to break even, reported the BBC. In a report, auditor general Kieran Donnelly confirmed that the health and social care service was facing an unprecedented financial challenge. This has led to trusts carrying forward an underlying deficit of £115m into 2014/15, however, only the Belfast Trust broke even, as a result of the extra money it received. The report acknowledges that as continued reliance on additional funding is unrealistic, sustainable solutions to the increasing financial pressures must be found. The report also raises the issues of failed cancer treatment targets and tackling potential fraud. Hospitals did not meet the target to ensure that 95% of patients began their first cancer treatment within 62 days, following an urgent GP referral in any month during the two-year period to 31 March 2014. While fraud was not identified by the report, £5.7m of potentially inappropriate expenditure was found and this was sufficient evidence to proceed with disciplinary action.
UK artificial intelligence healthcare pioneer helps fight against Ebola and other deadly viruses: Deontics, a medical artificial intelligence spinout of the University of Oxford, University College London and Cancer Research UK, has developed a breakthrough approach in the treatment of Ebola and similar illnesses that could save lives and halt the spread of disease, reported Medical News Today. The current epidemic sweeping across the West African region has now killed five times more than all other known Ebola outbreaks combined. Several healthcare workers returned to the UK in March after exposure to the virus, and one military healthcare worker tested positive. In response, Deontics has used its advanced software to give doctors the ability to view guidance on the best treatment possible for Ebola and other deadly viral haemorrhagic fevers (VHF) when seeing those returning to the UK from areas at risk. Deontics is now looking to extend this capability by producing tools for use by doctors on the ground to treat Ebola patients in West Africa. “Global health issues such as Ebola are a constant threat that needs a global response, and software such as ours can have the required impact. Our technology incorporates and deploys the clinical logic of the experts in the field to help those treating patients to make the right clinical decisions that can save lives,” says Dr Guy Wood-Gush, CEO of Deontics.
Boston-based life healthcare technology group seeks London IPO: A Boston-based healthcare technology company whose board includes high-profile business leaders including Chris Viehbacher is to seek $160m in a London stock market flotation, reported the Financial Times (subscription required). The initial public offering planned by PureTech Health next month would add to the growing momentum behind life science investment in the UK after a series of recent fundraisings. Daphne Zohar, PureTech’s co-founder and chief executive, said: “We realised the UK was the best place for us because investors understand the model.” Several of PureTech’s ventures already involve digital technology including computer games to diagnose and treat neurological disorders and the use of voice-monitoring technology to identify changes in a patient’s health. Zohar said PureTech was especially interested in the convergence of medicine and technology and the arrival of non-traditional players in healthcare — demonstrated by recent investments by Google and Apple in the sector. “We are looking for different approaches to problems that have not been tried before,” she said. “We screen everything that’s going on, look at what has failed in the past and think what we could do differently.”
Ambulance trust ends NHS 111 contracts after problems with call answering: Another NHS 111 provider has pulled out of its contract after admitting that it has struggled to meet call answering target, reported Pulse. South Western Ambulance Service NHS foundation trust (SWASFT) announced that it would stop providing services in Devon and Cornwall from next March, having already lost the contract in Somerset. Dr Mark Sanford-Wood, interim GP medical secretary at Devon Local Medical Committee (LMC), said: “Any destabilisation of NHS 111 services can lead to complications for GPs. The LMCs locally have been working closely with SWASFT in the way that 111 services are delivered and we will now need to have all those discussions again with another provider.” NHS 111 has been beset by problems since it was introduced, attracting much criticism. In July 2013 GPC chair Dr Chaand Nagpaul said that “the implementation and planning of NHS 111 has been an abject failure.”
“Groundbreaking” GPS dementia watch pilot launches in Kent: GPS-enabled watches will relay location information for dementia residents to a local control centre under an ambitious partnership between Medway Council and Kent Police, reported Integrated Care Today. The three-month scheme can send alert messages if the watch-wearer presses the SOS button for help, strays outside a pre-determined perimeter outlined by friends and family or fails to return home. Robin Cooper, Medway Council’s director for regeneration, community and culture, said: “We are pleased to be embarking on this pilot scheme with Kent Police, which is set to help people with dementia to maintain their independence and give their families peace of mind that there will always be someone on hand in our control centre in Strood to alert them, or the emergency services, if there is concern.” Superintendent Lee Russell, of Kent Police, said: “The force is very pleased to be supporting Medway Council in the dementia watch pilot.”
Allscripts expands Patient Administration System presence in United Kingdom: Allscripts has announced that East Kent Hospitals University NHS foundation Trust and Maidstone and Tunbridge Wells NHS Trust have each signed an agreement to deploy Allscripts Patient Administration System (PAS), reported eHealth News EU. The Allscripts PAS will replace the trusts’ existing system and will empower the organisations to use a highly flexible and configurable solution to manage patient data. Andrew Barker, chief information officer said: “East Kent is committed to ‘putting patients first,’ and our agreement to deploy the Allscripts PAS will help us better deliver value-added, comprehensive client care. Allscripts has shown that it offers a value-added, best-in-class solution, for us to keep on delivering excellent care for patients.”
King’s picks Civica for EDM: King’s College Hospital NHS Foundation Trust is implementing an electronic document management (EDM) to support its electronic patient record and the struggling Princess Royal University Hospital. The trust took over Princess Royal after the dissolution of the underperforming South London Healthcare NHS Trust in 2013, but has been beset by historical issues at the site, including poor availability of medical records leading to cancelled appointments. To help overcome these issues, the trust will use Civica’s WinDIP EDM to process historical medical documents and integrate them with the trust’s electronic patient record (EPR), which is based on the iCM clinical suite developed by iSoft (now CSC), but enhanced by the trust’s in-house IT team. Colin Sweeney, director of ICT at King’s College Hospital, told DigitalHealth.net that WinDIP will first be used at its Denmark Hill campus. It will then be rolled out to the Princess Royal once the IT team has completed the implementation of the EPR at the site. “We thought that rolling out document management at the same time as the EPR would be a bit too much to take,” he said. “We decided to reassess and make sure the hospital was as running as paper free as possible before implementing the EDM.”
Opinion
Councils and health and care agencies collaborate to join up local health economies
Integrating services across health and social care is becoming reality, writes MedeAnalytics general manager Wayne Parslow, in Local Government Chronicle this week.
Parslow says forward thinking local authorities are overcoming the information-sharing obstacles that he believes have been the major stumbling block to integration.
“Information, integrated across entire health economies at patient level, is essential for better commissioning, enhanced reporting and for redesigning services to clients and patients in a way that identifies and responds to individual needs,” he says. “It allows patient pathways to be understood so services can be modelled in new ways, enabling interventions to be precisely targeted to prevent hospital encounters.”
Hertfordshire is one pioneer, he says, where the county council and two local clinical commissioning groups are creating a shared intelligence system, making integrated data available to heath and care professionals and commissioners. “Collaborating with MedeAnalytics, confidential information is now de-identified before it leaves the data controller, allowing a lawful flow of data for important purposes including risk stratification,” says Parslow. “Authorised professionals with legitimate direct care relationships can re-identify patients so that they can execute intervention plans.
“Hertfordshire is a pioneer in attempting to achieve a genuinely joined-up local health economy, and is making real its plans to integrate services with ideas that have since been reflected in NHS England’s new care models.”
Will Jeremy Hunt be able to join up health and social care?
The health secretary is not new to his brief, but that won’t make it any easier to bridge the damaging culture gap between health and social care and successfully integrate services says Anne Perkins in this week’s Guardian.
“Once again the professionals are nervously circling the utopian future of integrated health and social care, trying to calculate quite how to get to it without letting go of what they’ve got. Some argue for piling in transformational cash now, others fear it will only be used to shore up the present. “What will happen to the Better Care Fund?” one expert in local government pondered. “No one wants it. But no one has any better ideas.” At a King’s Fund event last week an NHS boss came to just the same conclusion.
“The obvious difficulty is that while the NHS is in dire straits financially, social care is being bled dry. Local government has already had cuts over the past five years averaging more than 23%, and over 40% in some areas like Westminster, and it’s only going to get worse. At the same time, the Care Act, which came into force last month, will create real pressure in costs of provision of social care. By raising the amount of assets people who need care can keep before they have to meet their own care costs, many more will be entitled to support from their local authority.
“There is a damaging, possibly unbridgeable, culture gap between health and social care that at the very least underlines an institutional failure of imagination and an inability to focus on what individual patients want and need to lead healthier (less expensive) lives.
“Much hangs on the success of the pioneering project to devolve the health budget in Manchester that was announced in March. Its overarching ambition is to improve health outcomes, and optimists hope it could lead to a real revolution in the way healthcare is managed and delivered. Pessimists fear it will be another structural challenge to an organisation that is already weakened by multiple and conflicting accountabilities. Right now, it’s hard to envy the health secretary.”
Health 3.0: with Thomas Meek
Digital Health reporter Thomas Meek considers the potential of the iWatch – and why so many electronic patient record vendors are looking to link up with it, particularly in the US.
“The possibilities have already captured the interest of several major US-based EPR suppliers, among them Cerner; which last month announced it was launching its HealtheLife app on the Apple Watch as part of a pilot with two major healthcare providers.
“Patients involved in the project use a set of devices, such as glucose meters, to record personal information and upload to the app using HealthKit, from where this data can be sent directly to a patient’s electronic health record on Cerner Millennium.”
Meek suggests that the NHS is at a disadvantage when it comes to illustrating efficiency gains: “This means its healthcare providers may be in a better position to add on innovations like HealthKit and the Apple Watch than hospitals in the UK; none of which have yet announced similar ventures with their EPR providers (although some have set up personal health records using the less flashy Microsoft HealthVault).
“The US’ divided healthcare system also allows big, well-endowed, providers to test innovative new technologies at pace, in an environment in which there is general enthusiasm for new tech.”
Highland Marketing blog
In this week’s blog Rob Benson gives his tips on what the Queen’s speech means for healthcare marketing and PR professionals.
