News in brief
Hunt extends Challenge Fund by £100m: The government will extend its £50m primary care Challenge Fund by a further £100m, Health Secretary Jeremy Hunt has announced. Speaking at the Conservative Party conference, Hunt said the Challenge Fund, launched late last year by Prime Minister David Cameron will be extended to reach “millions more people”. The fund aims to improve access to primary care through extended opening hours, seven day working, email, phone and Skype consultations, reports eHealth Insider. Hunt also announced that every patient in England will get a named GP, “accountable” for their care. This policy was introduced for people over the age of 75 last year, alongside a pledge to make it easier for those with complex conditions to access support services. Guidance from the British Medical Association, NHS England and NHS Employers has since urged GP practices to carry out risk stratification to identify the 2% of their patient populations most at risk of unplanned admission to hospital, and to make sure they are actively case managed. Patients identified through this major expansion of risk profiling will also be given access to an “ex-directory or bypass number” to A&E, ambulance or other out-of-hours services. “I understand the pressures that general practice is facing with an ageing population, but we want to make sure that all patients get personalised care, tailored to their physical and mental health needs, supporting people to live healthier lives,” Hunt said.
Cameron: We will protect the NHS budget: The Prime Minister, David Cameron, has announced in his speech at the Conservative Party conference that he would “protect the NHS budget and continue to invest more” in the next parliament. The statement means a Conservative government would maintain growth of at least the pace of inflation, delivering at least flat funding in real terms, but is not currently committing to greater increases, according to several newspaper reports citing senior Conservative sources. Health Secretary Jeremy Hunt, speaking on Monday and Tuesday at the conference, indicated the government could not afford greater than inflation spending increases for the NHS. Health Service Journal (subscription required) understands debate is still ongoing among senior Tory figures about whether a small amount of additional funding could be found. Cameron used his speech to heavily criticise Labour’s record on the health service, citing the Mid Staffordshire Foundation Trust scandal. “It was the Labour party who gave us the scandal of Mid Staffs,” he said. He accused the opposition of saying “the old rubbish about the Conservatives and the NHS” and “spreading complete and utter lies” at its conference last week.
Keogh calls for TECS support: Sir Bruce Keogh has called on 250 stakeholders to support the uptake of telehealth and telecare as part of the Technology Enabled Care Services programme, reported eHealth Insider. The programme, formerly known as 3millionlives, initially aimed to have 3m people using telehealth or care by 2017 but was taken over by NHS England as part of the shake-up of the NHS in April 2013. The commissioning board undertook a review of the programme, which has “led to a shift in its strategic direction. Its national medical director has now written to 250 stakeholders asking them to support the programme, which “takes the NHS into a new and exciting technological era that will help empower patients and improve health outcomes”. Sir Bruce says in his letter “Present and emerging technologies offer opportunities for us to transform the way we engage in, and control our own healthcare”. “Imagine the degree of personal control that could be afforded by a smart phone configured for medical applications, coupled with wearable biosensors and capable of sensing, analysing and displaying vital signs and alerting you and your clinicians to significant changes or deterioration wherever you are, rather than through check-ups at a hospital or GP practice. Any escalation in a condition could be identified and addressed in a timely and proactive way. It would lead to better health outcomes while being more convenient for the patient, their carer and their clinician,” said Sir Bruce.
A ‘named GP’ for every patient next year, under new deal: Every patient in the country will be given a “named” GP and be able to access their own medical record from next year, the health secretary has announced. A new contract for family doctors will mean that from April, all patients will be assigned one GP, who is accountable for their care, according to The Telegraph. Patients will also be able to access their own medical record online free of charge, Jeremy Hunt said, insisting England would become the first country in the world to “take this huge step”. The plans were announced amid a growing backlash from GPs about a Conservative pledge to give patients’ access to family doctors seven days a week by 2020. The British Medical Association said the plans for seven-day services by the end of the decade did not address the “extreme pressures” facing GPs”. The changes to the GP contract, which have just been agreed, will take effect far more quickly. From April, all patients will be given the name of one family doctor, with whom “the buck stops”. Earlier this year, such changes were introduced for patients aged 75 and over, and for those with long-term medical conditions. The reforms follow years of criticism that Labour’s 2004 contract – which ended the named GP system – had left patients not knowing where to turn.
Confed wants e-mental health strategy: The Department of Health and NHS England should create a national strategy for e-mental health and invest in a national programme to support this, says a report by NHS Confederation. The report, titled ‘The future’s digital – mental health and technology’, surveyed the members of the Confederation’s Mental Health Network about their current use and plans for utilising technology. It found that although organisations were clear that technology could be used to improve patient care, there was a lack of a sense of “future vision and the right skills” in the workforce, reported eHealth Insider. “Our existing ways of evaluating new products and services, and ensuring their safety, are too slow to enable our services to keep up with the pace of technological change we see all around us,” says the report. It says that although there are “fantastic examples across the country”, these need to be learned from and adopted across the board. “However, there are some common problems it makes sense to tackle at a national level, under the banner of the development of a national strategy for e-mental health,” it adds. The report calls on several organisations, including Public Health England, the Care Quality Commission, Monitor and Health Education England, to collaborate on the strategy. It also says the document should detail how workforce, commissioning, governance, investment, innovation and public health should be addressed.
Brighton and Sussex trust responds to IT disruption concerns: Brighton and Sussex University Hospitals (BSUH) NHS Trust has said it is in the process of implementing measures to prevent future possible disruption to its IT infrastructure after a “major problem” when its systems last week briefly, yet significantly threatened its ability to manage services, reported Government Computing. In a statement on the IT problems, BSUH chief executive, Matthew Kershaw said the trust took the decision to call an “internal major incident” after losing access to its staff info-net, e-mail and a number of important clinical systems over a five hour period. “Our IT infrastructure is massively complex and a huge amount of time, thought and expense goes in to ensuring that one problem does not mean the system fails, it is too important for that,” said Kershaw. “In this case the problem could not be predicted or prevented, it just happened, so we need to work out why to help ensure it doesn’t happen again.” He added that upon realising the nature of the IT problems, the trust’s technical team, in collaboration with a number of partners and the assistance of neighbouring authorities were able to work on how best to manage service interruptions. According to Kershaw, most clinical services lost during the afternoon were functioning again by 8pm the same day, reflecting what he claimed to be a “professional and skilful response” by staff to try and minimise disruption. While the affected systems were now largely thought to be “back to normal”, Kershaw believed significant work was still going on behind the scenes relating to IT across its hospitals.
HCA International to deploy innovative multidisciplinary imaging software solution across all UK hospitals: HCA International are to collaborate with Swedish-based medical imaging specialists Mawell to transform the delivery of frontline care, enhance their service to patients and improve clinical safety and security reports the British Journal of Healthcare Computing. Launching across all HCA International′s clinical UK sites early next year, Picsara, a unique multidisciplinary imaging software solution, will enable medical staff across various specialities to capture, store, distribute, analyse, annotate and measure all non-radiology medical images and videos efficiently and securely to help improve clinical workflow and strengthen clinical documentation. Kaye Bonython, head of imaging informatics at HCA International said: “Picsara signifies a breakthrough in the way we will deliver care. We will be able to give patients confidence about the security of their personal data and help us to enhance the patient journey by ensuring that the information is immediately available to clinicians at the point of care.” A successful pilot conducted in July last year at HCA International′s Portland Hospital in central London found that the versatile imaging software provided the opportunity for clinical staff to save up to 45 minutes to an hour a day by using video rather than taking notes, allowing valuable time to be reallocated to other patients. Bonython explained: “As part of the pilot, we investigated the use of video capture software to film children during physiotherapy treatment sessions and then storing the video of the treatment in their permanent records. This video could also be taken home and used by parents and patients to ensure they were completing their exercises correctly.”
Health Fabric supports NHS England in digital transformation challenge: Digital health experts Health Fabric are backing the drive for digital transformation in the NHS with extensive support for the 2014/15 NHS Innovation Challenge Prizes and the winners of the digital patient and clinician engagement category. HealthTech Wire reports that this category challenges NHS organisations to show how they can use information, communications or diagnostic technologies to connect patients and clinicians as partners in their care. As well as providing the technical platform for the entire application process, the Birmingham-based company will offer professional advice and mentoring to the prize winner, and the use of its dedicated Innovation Centre. The NHS Innovation Challenge Prizes exist to recognise and reward ideas from frontline staff that see patients, day in, day out, and encourage the adoption of these ideas across the NHS. Digital patient and clinician engagement is one of several areas the NHS England competition is looking to support. Data and digital transformation is heralded as a key driver in ensuring the future of the NHS. According to NHS England at least £8bn savings a year are possible if the service can make better use of technology. To support this, the 2014/15 Innovation Challenge Prizes offers the winner of its digital patient and clinician engagement category £100,000, as well as Health Fabric’s support to help them drive the spread and adoption of their innovation across the NHS. Satnam Bains, chief executive officer of Health Fabric said: “Patients best understand how a condition affects them. Clinicians know how to treat the illness, and help patients manage their condition. Engaging both patients and clinicians in treatment saves lives and saves money. It is no wonder the US healthcare commentators hail such engagement as ‘the blockbuster drug of the century.”
Seven in 10 trusts ‘require improvement’ or are ‘inadequate’, says CQC: Seven out of 10 NHS trusts rated by the Care Quality Commission (CQC) under its new inspections regime were found to be inadequate or requiring improvement, a Health Service Journal (HSJ, subscription required) analysis of published ratings reveals. Sixty-eight per cent of the 47 trusts whose ratings are already released received scores at the bottom half of the CQC’s four point scale. Five were found inadequate, 27 required improvement, 14 were good and just one was outstanding. The results in part reflect the CQC’s early focus on trusts at a higher risk of providing poor quality care. A number of other clear themes emerged. An analysis of five key inspection areas indicates trusts performed best in the caring category, with 91% of the 47 rated as at least good. However, providers performed worse on safety, with 81% rated as requiring improvement or inadequate. In the responsiveness rating, which assesses waiting times and how well trusts react to patients’ needs, 68% were rated as requiring improvement or inadequate. Saffron Cordery, director of policy and strategy at the Foundation Trust Network, hailed the hospital sector’s performance in the caring category: “It’s important given the Francis report and what happened at Mid Staffs, where we were talking about the quality of care. The notion that now we are seeing no trusts have been marked inadequate around caring is a fundamental step forward.”
Frimley Park Hospital NHS Foundation Trust awarded first outstanding rating by chief inspector of Hospitals: England’s chief inspector of hospitals has rated Frimley Park Hospital NHS Foundation Trust as outstanding following a Care Quality Commission inspection, reports Commissioning.GP. The trust is the first in England to be rated outstanding overall following a new-style CQC inspection. The hospital has also been rated as outstanding overall. The trust was first inspected under the new system in November 2013, prior to ratings coming into force. Inspectors rated Frimley Park Hospital as outstanding for accident and emergency (A&E), medical care, surgery, critical care and end of life care. Maternity and family planning, children’s care and outpatient services were rated as good. CQC rated the trust overall as outstanding for being caring, responsive and well-led, and rated it as good for being safe and effective. CQC’s chief inspector of hospitals, Professor Sir Mike Richards, said: “When we inspected Frimley Park Hospital, we found the vast majority of care to be outstanding. Even where we rated services as good, these were found to be towards the upper end of that scale… One of the most striking things about this trust is the way that teams work together across the hospital, and with other providers, to make sure that people get the best possible treatment and care. This is something that other trusts could learn from – and we hope they will take note of our findings here.”
Northern Ireland appoints new health minister: The Northern Ireland Assembly has appointed a new health minister, with Jim Wells replacing Edwin Poots, reported Pulse. Wells, a Democratic Unionist member of the legislative assembly (MLA), took on the role as minister for health, social services and public safety on 23rd September. Poots, who was appointed health minister in 2011, has been a driving force in introducing Northern Ireland’s ‘Transforming Your Care’ (TYC) health reforms which are focused on integrating health and social care services. Wells is now expected to continue rolling out the reforms, however in welcoming the new minister Northern Irish GPC chair Dr Tom Black warned he would face “difficult choices” in the process. Dr Black said: “It is clear from the challenges ahead that a focus on investment in primary and community services is required if the shift of work from secondary care as envisioned in TYC is to be achieved.” It comes as the British Medical Association warned last week that GP waiting times and out-of-hours services may worsen as a result of harsh budgetary constraints in Northern Ireland, with some parts of TYC having to be put on hold as funding failed to materialise.
EHI Awards 2014: Highland Marketing is sponsoring the ‘Best use of social media to deliver a healthcare campaign’ category at this year’s EHI Awards. Media such as Twitter and Facebook are useful tools to seek out hard-to-reach groups and deliver information to support health campaigns. This category will identify the smartest operators and most successful campaigns. Finalists include: The King’s Fund digital advent calendar – using Vine to spread important health messages; Feel well, choose well – NHS Arden Commissioning Support; Facetime for ITU – The Walton Centre NHS Foundation Trust and MyHealth – Patient.co.uk. The awards take place on Thursday 9th October at the Roundhouse, London.
Opinion
Being open, an open and not quite shut case?
Judith Carr, writer for InformationDaily.com, argues that open data policies should become as commonplace as health and safety policies.
“Data holds no value until a human can understand it (or maybe nowadays when a machine can read and report to another machine). Why is it, then, that the common perception is that machines ‘know’ what they are doing? That they, and therefore their creators, talk the same talk?
“It doesn’t matter what type of data you talk about, people have the same problems. I went to one of the data challenge days at the newly formed Transport Catapult in Milton Keynes. My knowledge of the data that transport people use is limited but as it turned out I need not have worried, they all talked of the same problems, too much, too restrictive, cannot get it all, cannot share, not complete, not compatible, privacy, security, etc.
“The national police database was effectively an example of internal sharing, for yes there can be degrees of opening, and it is true that departments, divisions, working for the same organisation do not share. I am sure those who look at business processes come across examples all the time of spreadsheets and databases being created that mirror those of other departments or even just other teams, in the information they are collecting, even if methods may differ.
“Whether you want to go slowly or speed up, unless people know more about ‘opening up’ and discussions start in all departments, then an open data policy may just flounder as something IT should look at. For opening up needs champions in other functions. Open data policies need to become as common place as health and safety policies.”
If only we could focus on the end rather than the means
Dr Judith Smith talks about integrated care and how structural change is the last thing the NHS needs right now.
“My heart sank when we got a glimpse of Labour’s thinking about post-election health policy, with hints that hospitals would be expected to evolve into integrated care organisations providing all health and social care in an area. What bothered me about the suggestion of hospitals moving to become integrated care organisations was the implicit assumption that a single structural solution might be needed for what we know to be very difficult problems in the organisation of health and social care.
“Governments presiding over universally funded health systems have a tendency to see something they think is good, and then mandate it for all, on the basis that national and consistent organisational arrangements are automatically the answer. There are lessons to be learned from doing things differently. In New Zealand, the independent practitioner associations resisted government attempts to abolish them in the early 2000s. Instead, the IPAs shifted their focus and worked with the grain of Labour health policy to concentrate on managing the health of local populations, whilst retaining their strong roots in general practice. The result is that New Zealand now has strong and effective primary health networks that are increasingly taking on the role of what we often call an ‘integrated care organisation’.
“This takes me back to my concern about the apparent move to mandate a single model of integrated care organisation. It is clear from the rich variety of schemes emerging in response to the Government’s Integrated Care Pioneer programme that there are many ways in which health and social care can be tailored to local needs. We need these kinds of experiments, and there is no doubt that acute hospitals should take a role in developing new forms of integrated care.
“Structural change is the last thing the NHS needs right now. It needs investment and support to do that most difficult of tasks – carefully redesigning care and supporting professionals to make this happen. In some cases this will indeed entail a local hospital forming an ‘integrated care organisation’ with GPs and social care, but in many others the solution will take a different form.”
A simple manifesto to earn GPs’ vote at the next election
Pulse editor Nigel Praities discusses the general election and government progress on the NHS.
“A mere seven months before the general election, and in the midst of party conference season, it seems an opportune time to review the Government’s progress on the NHS. The coalition agreement – forged by the Conservatives and the Liberal Democrats in the heady days after the 2010 election – makes interesting reading four years on. The promise to ‘stop the top-down reorganisations of the NHS’ has been famously and comprehensively broken. But what of the other pledges? The ‘greater involvement of independent and voluntary providers’ in the NHS? That can be ticked off with the controversial section 75 regulations.
“A Pulse survey shows that while half of GPs are so disillusioned with politicians that they do not trust any party to run the NHS, most remain undecided on how to vote next May. So my challenge to Messrs Cameron and Clegg is this: have a read of your Rose Garden agreement again and perhaps focus on fulfilling just one pledge before May. I suggest the following: ‘Doctors and nurses need to be able to use their professional judgement about what is right for patients and we will support this by giving front-line staff more control of their working environment.’
“So here is a three-point plan to achieve this by May (and I know you like those). Firstly, slim down all the CQC criteria to just one question: ‘Are you a risk to patients?’ and restrict inspections to practices identified by local GPs as below standard. While you are at it, scrap all those infantile ‘Ofsted’ ratings for practices – and the 17-page document on how to display them. They will not improve patient care. Secondly, get rid of all requirements on GPs that are not proven to have a directly beneficial effect on health and simply give practices the attached resources to support their patients better.
“Lastly, and most importantly, stop bashing GPs in the media and work with the profession. Your words have an effect, so stop harping on about how practices are failing patients while saying they should be open every day from dawn until dusk. This raises expectations far beyond what is desirable or affordable.”
Highland Marketing blog
In this week’s blog, Chris Marsom asks whether Skype is the limit for the NHS.
