News in brief
NHS is running out money claims King’s Fund: It is just a matter of time before the NHS runs out of money, the King’s Fund has warned in a new report. Despite stringent efficiency savings demanded by the government, a lack of funds is now inevitable, it said. Waiting times will rise, staff will have to be cut and quality of care will deteriorate, John Appleby, chief economist at The King’s Fund and lead author of the report, said. The report comes as new data from the Office of National Statistics revealed that the UK spends less on health than any other G7 country after Italy. The King’s Fund called for a significant increase in funding for the NHS, reports The Telegraph. Professor Appleby said: “There is still scope to improve efficiency in the health service, and efforts to release savings should be redoubled. However, it is now a question of when, not if, the NHS runs out of money. Without significant additional funding, this will lead to rising waiting times, cuts in staff and deteriorating quality of care. It is essential that politicians from all parties are honest about the scale of the financial pressures facing the NHS and initiate a public debate about the long-term sustainability of the health and social care system before, not after, the general election.” With more than a quarter of trusts already in deficit, the report warns that a financial crisis is now inevitable by 2015/16 and could arrive sooner.
Stevens launches quick-fire NHS England ‘structure’ review: The new NHS England chief executive has initiated a quick-fire review of the organisation’s national structure and systems, amid staff concern about its “hierarchical” approach, revealed Health Service Journal (HSJ, subscription required). Simon Stevens has asked commissioning development director Rosamond Roughton and Karen Wheeler to lead the review and report by the end of May. Wheeler was recruited last month from the Department of Health to become the organisation’s director of transformation and corporate operations. The main purpose of the review is to consider NHS England’s national structures, including whether to abolish its policy directorate, whose director Bill McCarthy is leaving the organisation. The review is not considering whether to reorganise its four regional and 27 area teams. However, many directors of NHS England area teams are responding to the review with wider concerns. These worries centre on what they see as the organisation’s hierarchical way of working and its size, operating as it does with large national, regional and area team tiers and 5,500 staff. Several area and national-level directors reported similar concerns to HSJ. One area director described NHS England as “the most hierarchical organisation I have worked in”. Also commenting on Stevens’ first appearance at the health select committee the Guardian reports on his deep scepticism about the effectiveness of integration schemes being planned as part of the Better Care Fund. Steven’s highlighted research published last month by York University, which found that not one of 38 integration schemes in eight countries – including 13 projects in England – secured a sustained, long-term reduction in hospital admissions.
Government launches £6m fund for social enterprise tech innovation: Local Partnerships has launched a fund to provide public sector spin-outs with access to loans to invest in technology to improve health and social care services, reported ComputerWorldUK. The loans, which will range in value from £250,000 to £1 million, will help spin-outs gain access to finance that would otherwise be unavailable to them in the commercial market. The first loans will be available from this summer and are likely to average £500,000. Spin-outs are employee-led social enterprises previously in the public sector that provide public services. The Technology Spin-out Fund (TSF) will be eligible to spin-outs that have already launched, and will provide technology either to help deliver and improve services or to make organisational efficiencies, such as integrating patient care records or updating systems and software. Care and support minister Norman Lamb said: “Spin-outs and mutuals are driving new, innovative ways of delivering better health and care services to their local areas. But they need the right technology to help them – having the right systems and software can help integrate services and free up staff time to spend with patients rather than paperwork. I have seen first-hand the impressive work of many staff-led spin outs and believe this fund will support them in going even further for their patients.”
Care.data timetable could face fresh delays: NHS England’s new chief will not commit to an “artificial” timescale for re-starting the care.data project, raising the prospect of fresh delays to the controversial flagship project, the health committee has heard. Simon Stevens described the current six month “pause” period, which runs until September, as “an important moment to listen much more carefully to what a range of people have got to say” and said that the programme should not be tied to an “artificial start date”, reported Health Service Journal (subscription required). Facing MPs on the committee for the first time since becoming NHS England chief executive, he said there was “a real medical benefit as well as a research benefit” in building the new patient database. However, he said he did not want it to go live before “we have properly had a chance to consider the concerns”. He told MPs: “I don’t think there should be an artificial time scale. Clearly this is an important moment to listen much more carefully to what a range of people have got to say about how this programme should develop.” Stevens’ comments follow an announcement in April by Tim Kelsey, NHS England’s national director for patients and information, that the GP data extraction process would “begin in the autumn” and involve between 100 and 500 pilot practices ahead of a national roll out.
Jeremy Hunt: ‘I would scrap QOF if I could’: Health secretary Jeremy Hunt has said that the reduction of Quality and Outcomes Framework (QOF) targets in this year’s GP contract did not go far enough, telling a conference that he would ‘remove the lot of them if he could’. Hunt, who was delivering a keynote speech at an NHS Clinical Commissioners Conference in London this week, said there was a need for change to restore the bond between doctors and patients, and that QOF reductions had been one attempt at doing this, according to Pulse. However, commenting on the remarks, GPC deputy chair Dr Richard Vautrey said they would cause concern. The health secretary said: “I think at the heart of the changes that we need, is to restore that strong bond between doctor and patient at a local level, outside hospital. That’s why we changed the GP contract, introducing, bringing back named GPs for those 75 and over, and removed 40% of the QOF targets – and I’d like to remove the lot of them if I could – because I think continuity of care is absolutely core to the vision that we all want, in terms of out of hospital care for people with chronic and long term conditions.” At the conference the NHS Clinical Commissioners (NHSCC) presented a manifesto to the health secretary saying that Clinical Commissioning Groups need more power and financial responsibility to realise their full potential, reported GPOnline. The manifesto is split into eight ‘critical asks’, calling for greater investment in CCGs from the NHS, an increase in the freedom of clinical commissioners and financial incentives to allow a continuation of NHS reforms.
EPRs should ‘include location data’: A patient’s location history should be a key piece of data going into new electronic health records, a geographic health expert has said. Speaking at Wired Health, part of eHealth Insider’s Digital Health Festival, Bill Davenhall, from ESRI, said that geographical data can allow medical practitioners to easily view and account for environmental factors when considering a patient’s potential health risks. During his presentation on the issue of geomedicine – combining geographic information with clinical databases – he said geography is an increasingly important factor in healthcare, with 20-30% of a person’s health future “locked up” in environmental exposures in the places they have lived. “Each one of these places has their own environmental history: we have such things as sick buildings that have their own complex data points.” Davenhall said healthcare professionals need to “connect all the dots” and become better at gathering and analysing data about a patient’s environment to ensure they are aware of all possible influences on their health. “There’s no randomness to disease or treatments for disease. With the environments that we live in, if we presume everything is the same, we’re missing a huge part of the data. We’ve not used geographic information as the least common denominator to put the data together and help you with your health.”
Majority of GPs say government’s extended access strategy will harm patient safety: More than half of GPs believe that the government’s move towards seven-day GP access will negatively affect the safety of patient care, a Pulse survey has revealed. The survey of 431 GPs found that 58% believed that seven-day GP access will impact the safety of patient care ‘negatively or very negatively’, as opposed to 17% who said it affected care ‘positively or very positively’. Some 68% also said they would not support a move towards seven-day GP access even if it was properly resourced. This comes as a blow to the government’s push for extended access, which this month saw the announcement of a series of new schemes funded through £50m of central Government money, involving more than 1,000 GP practices piloting such initiatives as 24-hour telephone access and weekend surgeries for working people. GPs and leading academics have already warned that the extended access strategy will make general practice more overstretched and could subsequently reduce the continuity of patient care. Pulse reported last week that NHS Central Manchester clinical commissioning group has claimed its extended hours scheme has reduced unnecessary A&E attendance by a quarter in three months. But respondents to the survey warned that secondary care services will not be fully available if seven-day access is rolled out nationwide and it will reduce continuity of care.
Waiting time data undermined by errors: Confidence in hospital trusts meeting the 18 week waiting time standard for non-emergency care is being undermined by errors, according to OnMedica. This is the finding of The Public Accounts Committee which this week published its 54th report, ‘NHS waiting times for elective care in England’. While the Committee found that the success of trusts to meet the target meant that patients were waiting less time for treatment, it found that ‘errors in trusts’ recording of waiting time information undermine public confidence in reported performance’. More importantly, the Committee noted that the system of fines for trusts who miss the standards were not being used by all commissioners to drive improved performance. Commenting, the Rt Hon Margaret Hodge MP, chair of the Committee of Public Accounts, said: “Public confidence in the success hospital trusts have had in meeting the 18 week waiting time target is inevitably undermined by errors in trusts’ recording of waiting time information. Trusts are struggling with a hotchpotch of IT and paper-based systems that are not easily pulled together, which makes it difficult for trusts to track and collate the information needed to manage and record patients’ waiting times.”
TPP signs GPSoC: TPP has signed the contract for the GP Systems of Choice framework (GPSoC), one month after the previous contract expired, according to eHealth Insider. The Health and Social Care Information Centre (HSCIC) announced that TPP has finally signed the contract as the last of the 17 suppliers on the framework. Frank Hester, TPP’s founder and chief executive said “We’re delighted to be part of the new framework as this will provide both reassurances for our existing customers and great opportunities for potential new GP practices to move over to SystmOne.” GPSoC is a framework contract, which funds GP IT systems for 75% of practices in England. The framework expired last March, but was extended for another year while the Department of Health tendered for a new contract, worth up to £1.2 billion. The previous contract expired on 1 April this year and 16 of the suppliers signed the contract before its expiry date, but TPP and the HSCIC have been locked in further negotiations regarding the terms of the framework.
Fund to assist technology upgrade across practices in Wales: A new £9.5m grant will allow health boards across Wales to invest in new technology to help improve patient care, reported Integrated Care Today. Around £1m of the grant has been awarded to the NHS Wales Informatics Service to fund two projects, both to encourage the seamless delivery of healthcare through the adoption of new technology for optometry. Chief executive of Optometry Wales (OW), Sali Davis, said: “This news is very welcome and we are delighted that practices will finally receive a technology refresh. The challenge now will be to ensure that as the negotiating body in Wales, OW is able to ensure that the funds are evenly distributed across all optometric practices across Wales and that funding is continued after the 12 month period.” The Welsh health government minister, Mark Drakeford, said: “Thousands of patients across Wales have benefited from the Welsh Government’s Health Technologies Fund since its launch in 2013. Technology plays a key role in achieving the best outcomes for patients and reduces the need for patients to have to travel to hospital for their care.”
Scotland live with 111: Scotland has gone live with NHS 111 as the new contact number for the Scottish health advice helpline NHS 24; a year after England began its troubled launch of the service, according to eHealth Insider. In a statement on the launch, the Scottish health secretary Alex Neil said the “new, free and easy to remember number for NHS 24” will make it easier for people seeking help. “By introducing the 111 number we are removing any barrier for the public to access the health advice out of hours. This will help to ensure people have access to health information and support, including access to a GP, when they really need it. In Scotland, the 111 number will be run by NHS 24 as a public service, in public hands – serving the needs of patients. This is in complete contrast to the approach adopted by the NHS in England, where different organisations, including private sector providers, are contracted to provide the number in different regions,” he said. In England, the NHS 111 service has been surrounded by problems since its launch in Easter 2013. It also contributed to the closure of NHS Direct, which had previously provided the 0845 service, and was providing the successor service to around a third of England. The contracts have temporarily been taken over by alternative providers, most of them ambulance services.
New central list for hospital supplies ‘to save £500m’: A new central procurement list for NHS England aimed at ensuring hospitals get the best price for supplies could help save £500m, the government says. Health secretary Jeremy Hunt said the “radical” move would ensure every penny of the health budget was spent wisely, reported the BBC. A “procurement tsar” will produce the list – made up of prices negotiated and set between the NHS and suppliers. However, Labour said the government’s overhaul of the NHS had wasted millions and these plans would not change that. The new central procurement list will mean that hundreds of everyday hospital supplies will be bought in bulk to help harness the “buying power” of the health service. The government has committed to making savings of £1.5bn to £2bn on procurement by the end of 2015/16. The Department of Health said it expects this NHS core list to make up £500m – roughly a third – of these overall savings. Hospitals currently negotiate prices for supplies individually and as a result cannot always secure the best prices for products, it said. The NHS will centrally negotiate with suppliers, using its scale to “drive a harder bargain” and trusts will then shop for what they need from the list. It claimed the new core procurement list would “drive out variation and secure better prices with our suppliers”.
18 NHS hospitals sign up to social media feedback solution in first week: Just a week after its launch, 18 NHS hospitals and three GP practices have signed up to a new mobile and web application that enables them to monitor patient feedback, reported Building Better Healthcare. The organisations are working with HealthBerry, a London-based start-up that has developed a mobile and web application enabling the NHS, third sector and private health and care organisations to measure patient feedback to inform improvements to health services, promote self-care, and listen and engage with patients to improve the patient experience – using social media. The launch last week comes after NHS England recently announced new guidance aimed at increasing the use of social media to improve transparency, health service delivery and the overall patient experience. Putting Patients First, the NHS England business plan for 2014/15, makes it a priority for NHS organisations to obtain direct feedback from patients, their families and NHS staff. A spokesman for Surrey and Borders Partnership NHS Foundation Trust, which is among those to have signed up, said: “As a provider of specialist mental health, learning disability and drug and alcohol services, we’re aware of the role that social networking can play in challenging stigma, influencing how people view their health and care condition, how they relate to organisations and the choices they make about how to address their concerns. One of the means by which we are trying to manage our social media presence is by using HealthBerry. We particularly like its capability to channel all social media content – from Twitter, Facebook, Patient Opinion, NHS Choices etc – to one platform from where our staff can respond.”
Danish healthcare system to provide Elsevier’s ClinicalKey to clinicians across entire country: Elsevier, a world-leading provider of scientific, technical and medical information products and services, has announced that Denmark has decided to provide access to Elsevier’s ClinicalKey to more than 19,000 healthcare professionals across the country, according to eHealthNewsEU.Portal. The Danish Regions and Denmark’s Electronic Research Library (DEFF) chose to provide ClinicalKey, Elsevier’s innovative online search tool, to make electronic medical information available to healthcare professionals in a cohesive, simple way. “ClinicalKey is an excellent resource for both practicing healthcare professionals and trainees. Our clinicians find it easy to use and it provides detailed search results incredibly quickly,” explained Conni Skrubbeltrang, head of the Medical Library at Aalborg University Hospital. “It offers huge breadth of content, with access to books and multimedia. Videos are particularly popular with clinicians. It can inform clinical decision-making and streamline learning,” Skrubbeltrang added. Anders Mejlbjerg, business consultant for DEFF said: “Elsevier is a key provider in the field of knowledge-based information in digital format. They are a natural partner and provider of the main part of the licences that DEFF administers to our clients and customers in Denmark. The hospitals within the Danish regions have had a licence to Elsevier’s ScienceDirect and the database MDConsult since 2007. So when ClinicalKey came onto the market, it was an obvious decision to take advantage of it as it brings together all of Elsevier’s medical content into one easy to use clinical search engine.”
CSC to cut 750 UK jobs: CSC has announced its plans to make another 750 redundancies to its UK workforce as part of its “ongoing transformation strategy”. The company offers its electronic patient record system Lorenzo to trusts in the North, Midlands and East of England as part of a deal between the government and CSC. In an interview with eHealth Insider last month, the company’s UK healthcare boss Philippe Houssiau said CSC is also aiming to win contracts outside the government deal. However, the company has also been working on redesigning its operations across the globe, which has led to 750 employees in the UK estimated to lose their jobs. “The redesign has resulted in the loss of some jobs in locations throughout CSC’s network, including the UK,” said a CSC spokesperson. “We estimate that up to 750 employees will be impacted in the UK, all of whom will be supported professionally, compassionately and with assistance, where necessary, in their transition from CSC.” Although the company, which employs more than 7,000 people in the UK, maintains that these “adjustments” are not directly related to any “specific clients or programmes in the UK”, it may affect workers in the healthcare side of the business.
Opinion
It will happen
NHS commentator, Roy Lilley, blogs about how social media is transforming the way the NHS manages complaints and warns that communication teams need to embrace the technology within their healthcare organisations.
“The power of social media is… well… very powerful. If a company has a complaints department, avoid them, it means they have so many complaints they need a department to cope. If you ring and they so; ‘Oh, really, you want to complain? Just a minute, I’m not sure what to do… can I put you through to the boss?’ …you know this is a company that doesn’t get many complaints!
“Social media works… as doctors are finding out. An article in Management in Practice tells us patient complaints about doctors, on social media, have driven 400% more calls for help from the Doc’s defence union.
“Figures released by the MDU [Medical Defence Union] reveal patients are increasingly turning to websites such as Facebook, Twitter, YouTube and NHS Choices to criticise doctors.
“For ages, the NHS has been fiddling about with social media not knowing what to do. The public do!
“A picture of a hospital acquired bed sore on Twitter with a caption, ‘Given away free at the #St Anywhere NHS Trust’ should do the trick. A meal left out of reach, a bell pull draped beyond pulling – post a picture and #name the @Trust. Oh, and smart phones do videos and record sound, don’t they?”
What MedCity can learn from TechCity
On the Guardian Health Innovation Hub, Jess Bland, senior researcher in technology futures at Nesta, discusses the £4m initiative to bring life science companies to London, Oxford and Cambridge and says that it is likely to create the same kind of buzz that TechCity did.
“This month, Boris Johnson launched MedCity, an initiative with £4m to bring life science companies to London, Oxford and Cambridge. For those who examine and directly support innovation in the healthcare sector, this announcement was met with general murmurs of approval.
“But what will this complex collaboration, coordinated by the Mayor of London and King’s Health Partners, Imperial College Academic Health Science Centre and UCL Partners with cooperation from the Universities of Cambridge and Oxford, actually do? Boris Johnson gave a quick description of its remit at the launch:
“’MedCity will span everything from research to clinical trials to manufacturing, across biotech, med tech and health tech. I am in no doubt that having the whole ‘chain’ from small spin-offs to massive companies doing their research, clinical development and manufacturing here in London and the south east can be as important to our economy as the financial services sector is today’.’”
“I wonder if the most interesting part of the TechCity template is the part it was most criticised for – the buzz. The community that has grown up around TechCity might breed a kind of excruciatingly trendy exclusivity, but that has also given it a kind of soft power: an attraction that defies measurement.
“How does this translate into advice for MedCity? Maybe the quickest route to successfully coordinating the disparate communities Boris Johnson pointed to is to develop a similar kind of attraction. MedCity’s imposing advisory board includes the great and good of the scientific establishment. This gives the organisation stature, but doesn’t make it very attractive or approachable. I am keen to see MedCity cultivate a less formal organisational persona. Perhaps they could build directly on the TechCity network, linking to digital health in a more convincing way than they have so far.”
The NHS needs to put power back in patients’ hands
A “stand-in-line-and-wait system of rationing”, where people cannot get to see a GP without experiencing unanswered phone calls or a long wait in the morning, does not work for patients, doctors, or nurses, Douglas Carswell, Clacton MP said in the Daily Telegraph this week.
“Imagine if your local supermarket was shut at evenings and weekends. Or if you had to phone the cinema for an appointment to see a film – only to be told to try again next week. People would feel outraged. Yet that’s the experience of many of my Essex constituents when it comes to their family healthcare.
“The fundamental problem is that when it comes to healthcare, as patients, we don’t have any power. We have to stand-in-line-and-wait because if we want access to healthcare, that line is the only way of getting it.
“The way that we ration healthcare today is one of the last remaining relics of that system of rationing that was introduced during the Second World War. Of course, we no longer ration food or clothes that way, so why healthcare?
“What is more, since 1948, lots of other countries – France, Germany, Australia, Singapore – have developed their own systems for providing healthcare. They are free at the point of use, fair for everyone and mostly achieve better health outcomes.
“They each have [an] element of patient power. The patient, being the customer, gets to access health care on their terms, not just the providers.”
Wanted: an even Better Care Fund
The King’s Fund’s chief executive, Chris Ham, this week explains that their new analysis of serious and growing financial pressures in the NHS should serve as a wake-up call to politicians of all parties. As the analysis shows, with an increasing number of providers in deficit, and the prospect of a further seven years of no growth in funding, the NHS is rapidly approaching a major crisis.
“The arrival of the crisis has been accelerated by the transfer of almost £2 billion into the Better Care Fund in 2015/16. The purpose of the Fund – to support moves to integrate health and social care – is well intentioned. If it is used to support the kind of interventions we summarised in our recent evidence-based guide, it should deliver benefits to the NHS as well as to social care. However, it will put additional stress on an NHS already struggling to balance the books and maintain acceptable standards of patient care. Acute hospitals will be particularly affected by the requirement to find even higher levels of efficiency savings than they have achieved to date.
“Our view is that the government should create a transformation fund over and above existing funding for the NHS and indeed for social care. The purpose of this fund would be to pay for the new services that are needed to bring about the transformation in how and where care is provided that we and others have advocated.
“A critical difference between this fund and the Better Care Fund would be a requirement that NHS providers, particularly acute providers, are closely involved in developing plans for its use alongside clinical commissioning groups and local authority partners.
“Finding extra money in the current financial climate is a big ask, especially as further cuts in public expenditure will be needed, whoever forms the next government. This is why all the political parties must enter into a public debate about the long-term sustainability of the NHS, before, not after, the general election.”
Ideas, innovation and technology – answers for NHS change
Technology can drive the change needed in the NHS but we must elevate the role of IT leaders and give them a voice, Jonathan Edwards from The Advisory Board Company tells Highland Marketing. More…
The Big Walk to Work
On Friday May 16th 2014, Shane Tickell, IMS MAXIMS CEO, will set off from his home in Kendal and walk to IMS MAXIMS UK Head Office in Milton Keynes, a total distance of 212 miles. This will take eight days at an average of 26 miles a day (a marathon a day). To find out more on why Shane is doing the Big Walk to Work or to show your support click here.
