News in brief
- NHS lost 1.8 million patient records in a year: Official statistics showed that at least 1.8 million sensitive papers went missing throughout the health service in just 12 months, reported The Telegraph. Among the breaches included data security records dumped in public bins and electronic records found for sale on an internet auction site. According to figures compiled from reports of Data Protection Act breaches filed by the Information Commissioner’s Office (ICO) over the 12 months from July 2011 in England, Wales and Northern Ireland, a total of 1,779,597 records were reported lost in 16 major incidents involving NHS bodies. Officials at the ICO are asking for new powers to conduct compulsory audits on hospitals and NHS trusts.
- Farrar to open CCIO Annual Conference: NHS Confederation chief executive Mike Farrar is to give the opening keynote speech at the first CCIO Leaders Network Annual Conference, being held as part of EHI Live 2012 next week, reported eHealth Insider. Farrar will announce that the NHS Confederation has become an official partner to eHealth Insider’s CCIO Leaders Network, which was set up to take forward the objectives of EHI’s campaign to establish chief clinical information officers in the NHS. The event will see clinical and nursing staff join IT colleagues and suppliers to explore ways to promote and develop clinical information leadership within the health service.
- Telehealth needs link to savings: Stephen Johnson, the deputy director of long-term conditions at the Department of Health (DH) told the Telehealth 2012 conference that there must be more evidence about the cost effectiveness of telehealth in order to make it more attractive to NHS commissioners, reported Government Computing. Johnson said that “a picture is starting to emerge” from research into telehealth, including the Whole System Demonstrator programme. This was showing that telehealth can improve outcomes for patients without necessarily making more work for professionals. The DH will be publishing guidance on using telehealth, Johnson promised. However, he said that the department will not dictate which technologies should be used or how.
- South London Healthcare ‘should be dissolved’: An administrator has said that South London Healthcare NHS Trust should be broken up, leading to a radical overhaul in services across south-east London, reported the BBC. In July the trust was put in to administration after being declared bust. The move, if agreed by ministers, would lead to the reorganisation of A&E, maternity and non-emergency surgery across seven hospitals. It is the first time such measures have been taken in the NHS. In other news, EHI has reported that the trust will stick with its decision to implement Cerner despite the trust’s break-up.
- Nearly £3bn returned to Treasury: The DH has returned nearly £3bn of its funding to the Treasury over the past two years, despite facing its tightest financial settlement for five decades. A Treasury spokesman this week confirmed to HSJ (subscription required) the department had handed back around £1bn of the funding it was allocated for health spending in 2011-12. Just £316m of the £1.4bn that the DH left unspent last financial year has been carried over for it to use in 2012-13. The final sum clawed back from last year’s health allocation is double the £500m estimate that was published in chancellor George Osborne’s March Budget.
- NHS use of private sector rises: The number of routine NHS operations and treatments carried out by the private sector has risen by more than 10% in a year, official figures the Health and Social Care Information Centre have shown. The BBC reported that private providers treated 345,200 non-emergency NHS patients in 2011-12, a 32,900 rise on the previous year. These were for planned care, such as knee and cataract operations and represents 4.3% of all the routine NHS treatments. The reports says that the rise is partly explained by a jump in the number of people needing non-emergency treatments as well as reflecting a shift towards more people choosing to use private providers – something they are entitled to do under patient choice.
- ICO: online medical records ‘open to exploitation’: Plans to give patients online access to their medical records by 2015 could lead to a number of security breaches, an ICO spokesman has warned, reported Computing.co.uk. David Evans, a member of the strategic liaison team at the ICO urged DH officials to take into consideration the possibility of security breaches, when accessing records online. He used unwarranted access to police data as an example of a similar problem, when secure data about those connected to crimes has been breached.
- MPs criticise department of health over bankrupt hospitals: MPs have chided the DH for not having a “failure regime” for bankrupt hospitals after it emerged that two could be privatised and another will lose its A&E department as a result of the first declaration that an NHS trust is insolvent, reported The Guardian. The cross-party Public Accounts Committee warned there was “a growing number of NHS trusts and NHS foundation trusts in financial difficulty, but it is not clear what will trigger them being placed in special administration, or exactly how the process will work, including the role of ministers”.
- Worcestershire takes OneView: Worcestershire Health and Care NHS Trust will deploy an integrated electronic patient records system from Oasis Medical Solutions, reported eHealth Insider. The trust, which was formed just over a year ago, has announced that it is to work with Northgate Public Services and Oasis on a project to create integrated and accessible EPRs. Mark Dickens, the trust’s adult mental health delivery unit service lead, said its staff needed to be able to access records from a wide range of settings and update them promptly.
- Hospital admissions rise ‘due to fragmented NHS’: According to a think-tank report, hospital admissions have increased by almost three million in the last seven years due to the fragmented nature of the NHS, reported The Telegraph. In the report the organisation suggests that a lack of co-ordination between Primary Care Trusts, GP practices, and acute hospitals has led to an increase of hospital admissions for patients with long-term conditions such as diabetes and Alzheimer’s who could be treated elsewhere. The report calls for the DH to run a pilot scheme of “integrated care organisations” which would bring together all local services into one organisation, operating under a single budget.
- Solent NHS Trust patient data left at market stall: Patients’ confidential information has been left at a market stall and on top of a parking meter in a series of data breaches by Solent NHS Trust. A Freedom of Information (FOI) request by the BBC revealed the trust had breached data protection 93 times in the past two years. Michael Parr, director of performance, said the cases were “regrettable” and in common with other NHS trusts, the majority of breaches have been found to result from human error.
Opinion
Power to the people
In this week’s unusually moving and thought provoking opinion in EHI, Paul Hodgkin, CEO of PatientOpinion recalls an incident when an 84 year old man named Lammie posted on the PatientOpinion website about his struggle to deal with his wife’s dementia.
Lammie wrote: “But now she takes everything seriously you cannot make a quip any more. Everything is the gospel, you have to bite your tongue before saying anything and it slowly destroys you as well. This is double illness – the patient and carer – and so many people don’t know that.”
Hodgkin writes about how the latest information policies and innovations might help Lammie and his wife, such as access to GP records and telemedicine.
He writes: “If we can do it, then Lammie might well be a beneficiary. Fewer lost notes, more coordinated care. He would probably like easier access to making appointments and ordering repeat prescriptions, too.
“Telemedicine is clearly a good thing but edges easily into something ‘we’ do to ‘them’; a medicalised version of CCTV. Would Lammie welcome such surveillance? Hard to tell.
“If his wife still had her sense of humour, you can imagine them giving the box a name and making jokes about it. But as they walk their difficult road together, who knows whether he would find its winking constancy comforting or oppressive.”
Hodgkin concludes: “Great care depends on great information. It also depends on staff feeling supported and, at some level loved. Despite important moves towards the first it seems to me we are farther away than ever from the second.”
Dan Poulter: NHS and social care integration is ‘the holy grail’
Ahead of his presentation as keynote speaker at EHI Live 2012, 6th November 2012, NEC Birmingham, Dr Dan Poulter, Parliamentary Undersecretary of State at the DH spoke to the Guardian to explain his vision for the NHS – and why he’s going back to work as a hospital doctor.
“The staff in the NHS are one of our strongest assets. It doesn’t matter if you’re a nurse, midwife, occupational therapist or a porter, everyone in the NHS is there to care about patients. It’s very much a vocational calling. One weakness I picked up on working full-time in the NHS before I was elected is that we occasionally lose sight of the most important thing, looking after patients, because of the process measures and other measurements you have to do on a day to day basis – the collecting data, which is crudely called a tickbox exercise of healthcare. To continue to do better in the NHS we need to remove that tickbox mentality and focus on patients.
“We need to gear up the NHS to ensure that we deliver more care in a way that is going to be able to provide dignity for and meet the needs of the growing number of older people, some of whom are living longer with multiple conditions such as diabetes, dementia and heart disease. Part of addressing that is about making sure we deliver more services in more preventative, more community-focused ways, and that we’re not always picking up the pieces for things that have gone wrong, but that we’re keeping people well in their own communities, in their homes; preventing people from getting broken rather than fixing them afterwards.”
Payment by Results: time for a rethink?
It’s now a decade since Delivering the NHS Plan made a specific commitment to a new way of paying hospitals that would align payment for work done – delivering on the promise that ‘money will follow the patient’. John Appleby, chief economist, health policy at the King’s Fund evaluates the fixed price system – Payment by Results (PbR), 10 years on and suggests that despite its relative success: succeeding in boosting activity, reducing length of stay, and encouraging more day cases over inpatient work and without reducing reduced quality of care, it will need to evolve. Given the goals and the financial environment have changed a payment system that rewards doing more for more is less and less appropriate!
“The NHS Commissioning Board and Monitor will soon be taking on the design and pricing functions of PbR. So how should they approach this job? Things could carry on more or less as they have been over the past few years, with incremental development of PbR alongside approaches better suited to current needs – such as bundling or ‘year of care’ payments. Or, Monitor and the NHS Commissioning Board could develop a wider range of payment systems centrally and mandate them to the NHS.
“[However,] in our view, they should allow and encourage local experimentation, but within a national framework. Commissioners and providers would be required to seek approval for, and commit to evaluating, the impact of local variations. The NHS Commissioning Board and Monitor would provide technical support and track the innovations adopted.
“This active encouragement of local experimentation is more likely to identify the blend of payment systems needed to support the rapid development of new models of care.”
Read more… or view the King’s Fund’s new report: Payment by Results: How can payment systems help to deliver better care?
Highland Marketing Blog
With EHI Live 2012 next week, Highland Marketing’s conference and expo veteran Laura Steward gives her essential guide to planning and attending an exhibition.
If you missed last week’s blog your chance again to read Susan Venables’ review of the Foundation Trust Network’s first annual conference and exhibition.
