Healthcare Roundup – 4th May, 2012

Information strategy will put IT centre stage in NHS

IT will move from being the ‘back-room’ to become a critical front-room service’ when the much-delayed NHS Information Strategy is published this month. Better data sharing will also be a core concept, according to Guardian Government Computing.

The NHS Information Centre (NHS IC) will be at the forefront of new developments. CEO Tim Straughan, said: ‘People don’t just want to see raw information, they want to see information and data that’s linked together across a number of care settings that starts to link input data with output data. For example, what does somebody do to something in terms of an intervention, and what difference does it make?’

The NHS Commissioning Board will say what data should be used and set standards. NHS IC will get new powers around collecting, processing, linking and analysing data. It will be allowed to handle some patient identifiable data – one of many sticking points when the government was attempting to get the bill passed.

EHI says the strategy will acknowledge that working with data forms a ‘huge part of care’ in the NHS. It quotes Jim Easton, NHS national director for improvement and efficiency, as saying: ‘We are going to push really hard for integrated care, as that’s what patients ask for. The glue that will hold integrated care together is information, and that’s what needs to flow effectively between organisations’.

In a stark warning about the need to find more efficient ways to deliver care he added that the current NHS efficiency savings are a ‘dress rehearsal for the next 20 years’.

Technology could tackle prescribing errors

More effective use of IT could cut medical errors, with research showing that one in 20 prescriptions contain mistakes. A report from the General Medical Council declared that while 42% of the errors are minor, 54% are moderate and 4% severe.

Wider use of computer systems which flag potential mistakes, and closer working between GPs and pharmacists, were identified as potential solutions. This could make a significant difference to safety as 550 identified errors were life threatening.

According to BMJ the most serious errors included failure to adequately monitor warfarin, and the prescribing of drugs to patients with a documented allergy. EHI quoted GMC chair, Professor Sir Peter Rubin, as saying: ‘Using effective computer systems to ensure potential errors are flagged and patients are monitored correctly is a very important way to minimise errors.’

Computerisation is also seen as a key means of giving patients a greater involvement with their own care, with a government announcement that data will be collected on which practices are giving people online access to their records. The information will then be published.

The data gathering exercise will be used to highlight any blocks or problems in the rolling out of the government’s plan for all records to be available online by 2015.

Winning the war on hospital infections

A hand washing campaign directed at hospital nurses has successfully pushed down rates of potentially deadly healthcare associated infections (HAIs) such as MRSA and C. diff. The Telegraph reports that an evaluation of Cleanyourhands showed it had been ‘exceptionally effective’.

Evidence shows that as soap and gel orders went up, infection rates came down with those for MRSA halving from 1.88 to 0.81 cases per 10,000 bed days. The authors claim they have provided the first solid evidence that national campaigns of this kind have a clear and beneficial impact.

Further evidence of success in the battle against HAIs comes from Bath where the Chronicle says that MRSA cases at the Royal United Hospital have dropped from 17 in 2009-10 to one in the past year.

However recent newspaper reports have caused concern that a new flesh-eating superbug that spreads through coughs and sneezes may have hit the country. The NHS Behind the Headlines team have sought to calm fears, which are described as ‘alarmist’. The claims followed research into MRSA which was actually looking at why the illness rarely affects healthy individuals.

In a bizarre twist on the superbug issue a 76-year-old Scottish great grandmother, Elizabeth Miller, has ended her 11-year battle for compensation over an MRSA infection from Glasgow Royal Infirmary. The case came to an end when it was finally revealed that the medical notes had been wrong and she never had MRSA at all.

Private firms boycott NHS 111 while staff stage work-in

Private companies are failing to bid to provide NHS 111 urgent care call services amidst concerns about its ‘rushed’ and ‘shambolic’ procurement process. At the same time, nurses and health advisers at a Devon NHS Direct centre staged a work-in protest at plans to replace the service with the new 111 helpline, claiming it will create problems with patients simply being referred to other overstretched services.

HSJ (subscription required) reports that Serco has decided not to bid for any of the NHS 111 contracts which are being awarded on a primary care trust cluster or regional basis. Capita and Care UK, which formed a 111 partnership, are now undecided about whether to bid.

One prospective bidder said the process was rushed and warned it was impossible to predict demand before the pilots had been fully evaluated.

Meanwhile demands have been made for a new approach, involving a combined NHS 111 and out-of-hours service led by local GPs in England. GP online (registration required) highlighted a GP-led organisation that integrated out-of-hours care with the roll-out of the non-emergency number as offering a potential solution. It is suggested that GP input would improve the pathways system used to triage NHS 111 calls.

The Department of Health insists that the new helpline, due to launch next April, will ensure patients ‘get to the best service … first time’.

News in brief

  • ICO issues first penalty to the NHS following serious data breach: A Welsh health board has become the first NHS organisation to be served a monetary penalty from The Information Commissioner’s Office (ICO) following a serious breach of the Data Protection Act. The BBC revealed that the Aneurin Bevan Health Board (ABHB), will have to pay a £70,000 penalty.
  • NHS trust overspends on Cerner patient record system: The Guardian has reported on confirmation that North Bristol NHS Trust has overspent on its IT budget by almost 100% as a consequence of the roll out of its Cerner electronic patient record system. The trust has spent £4.5m implementing the Cerner system to date, the majority of which was spent during this January and February.
  • Private profit fears: Private company Circle will keep the first £2m of any annual surplus following its takeover of the debt-ridden Hinchingbrooke Hospital in Cambridgeshire. The Telegraph reports Andy Burnham, the shadow health secretary, as accusing the government of putting profit before patients.
  • Patients update own hospital records: The Queen Elizabeth Hospital in Birmingham has piloted a system from its own informatics team, which lets patients update their own records. Hospital Doctor says feedback shows that patients have responded well, taking more control over their conditions.
  • Aspirin cancer trials: Evidence gathered from eight clinical trials has concluded that aspirin does cut cancer deaths. The researchers say that worries remain about striking the right balance between the benefits and the risk of internal bleeding.
  • NI in healthcare IT push: Northern Ireland is establishing a forum to encourage industry, academics and health professionals to collaborate on using IT to deliver patient solutions. At the launch, health minister Edwin Poots said the province’s emphasis on connected health is already making a real difference to people’s lives.
  • Welsh NHS bailed out: A cash injection of £12m prevented three Welsh health boards from ending the year in financial deficit. An external financial review has now been ordered to try and ensure boards operate within their means.

Blog

Is there a post-Health and Social Care Act malaise in the NHS – what will it take to bring about genuine and radical change? Dr Jennifer Dixon, writing on the Nuffield Trust website, argues that the time has come to start handing more power to thrusting young doctors.

‘This could be a post-Bill slump in the NHS, a response to the long grind of making cuts with no end in sight, and the sheer weight of detail to be worked through with what is now the Health and Social Care Act.

‘Far more important must be how much oomph there is in the service to make radical change, scrutinise the quality of care, and sort out the mess that is social care eligibility, funding and provision.

‘People have grown grey discussing what motivates individuals in large organisations. The economists, sociologists, organisational psychologists, management theorists all have their own constructs with language to match.

‘My vote is for youth: get a bunch of young docs and managers circa age 30 in the room and the freshness/energy/bravery would be almost palpable. In the 1940s the doers in the Ministry of War were mostly under 40. Let’s bypass some of the gerontocracy, because maybe the war is just starting.’

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