News in brief
Autumn Statement confirms increase in NHS spending: George Osborne confirmed plans to increase NHS spending by around £2bn in 2015-16, funded largely on the assumption that other government departments will continue to underspend their budgets, reported the Health Service Journal (HSJ, subscription required). The chancellor’s Autumn Statement said the government would provide “£2bn of additional funding for the frontline NHS in England in 2015-16”, in support of the vision set out in the NHS Five Year Forward View. The money is comprised of a £250m investment in improving out of hospital services, funded from fines paid by banks for exchange rate manipulation; £700m of centrally held Department of Health and NHS England budgets that will be reallocated to NHS commissioners; and a £1bn increase in the baseline NHS budget. The latter chunk of money is expected to be funded by future underspends by other government departments. Speaking in the Commons, Osborne said the government had “got the pace right” on cutting public spending. He continued: “And because of careful management, we can afford to put part of that underspend money into our National Health Service to cope with the pressures it faces.”
Hunt says £2 billion is for ‘change’: Health secretary Jeremy Hunt has said the £2bn ‘additional’ funding that Chancellor George Osborne has announced in his Autumn Statement will be used to support change in the NHS, claims eHealth Insider. Speaking at a Reform conference, Hunt said the coalition was behind the NHS Five Year Forward View drawn up by Simon Stevens, the chief executive of NHS England, to try and close a projected funding gap of £30bn by 2020-21. Hunt said change was essential if the NHS is going to cope with an ageing population, which he described as “the political challenge of our generation.” Reprising other recent speeches, he said his ‘four pillars’ for the NHS of the future were a “strong economy”, “better care for people with long-term conditions”, “the faster uptake of technology”, and better “accountability and transparency”. NHS England has said the £1.5bn will be allocated to normal commissioning budgets for 2015-16, so it is unclear how Hunt’s requirements will be applied. The national commissioning body is due to decide its allocation process at a board meeting on 17 December, added Health Service Journal (HSJ, subscription required).
Autumn Statement: Extra £125m to be spent on NHS in Scotland, Swinney confirms: Scotland’s Deputy First Minister has confirmed that an extra £125m announced in the chancellor’s Autumn Statement would be spent on the Scottish NHS, reports the BBC. John Swinney said additional cash was always welcome but he added it could not compensate for the £2.7bn of real terms cuts made since 2010. Secretary of State for Scotland, Alistair Carmichael, said the Autumn Statement was good for Scotland. He added that the Scottish Government should “crack on” and spend the money. The funding boost for the health service north of the border is to mirror the additional investment being ploughed into the NHS in England. Increased spending on health in England means an automatic increase in funding for Northern Ireland. The change is due to the operation of the Barnett Formula, which will allocate about £33m to Northern Ireland. Around £65m to £78m in extra funding will be given to Wales from the UK government’s budgets.
Chancellor’s £1.2bn GP fund will shift specialist care into community: The £1.2bn primary care investment fund unveiled as part of Chancellor George Osborne’s Autumn Statement will be used to build new premises to provide advanced, specialist treatments in the community, reported GP Online. The new health centres will be linked with job centres in order to help support people back into work. Osborne told MPs that the government, “instead of returning the foreign exchange fines paid by the banks back to the City, is using that windfall for a £1.2bn investment in GP services across the UK”. The four-year fund will “pay for the modern premises and technology that will give patients access to advanced care, such as chemotherapy and dialysis, in their local communities”, Treasury documents said. “These new primary care facilities will also be encouraged to join up closely with local job centres, social services and other community services, in order to ensure that the NHS is also supporting people back into the labour market.” NHS England will decide exactly how the new money is spent, but £1bn has been earmarked for ‘infrastructure investment’, with an additional £200m transformation fund in 2015/16 to “deliver the first year of the Five Year Forward View”.
NHS chiefs warn on deteriorating finances: NHS finances are deteriorating at an even faster rate than predicted, according to a survey of health service finance directors, claims the Financial Times (registration required). Unforeseen rises in the wage bill, partly caused by a rise in the use of agency staff, combined with lower than expected savings from cost reduction plans, are behind the worsening picture. The Healthcare Financial Management Association (HFMA), whose membership includes a third of finance staff working in UK healthcare, made its assessment days after Chancellor George Osborne announced an additional £2bn a year for the NHS. Paul Briddock, director of policy at the HFMA, said while it was welcome, the additional money announced for 2015-16 was not a “quick fix”. He said: “It is clear that there has been a rapid deterioration in the financial position of the NHS during this financial year and financial pressure is being felt across the whole NHS system, but particularly in acute trusts.” There should be “an open and honest debate” about how the additional money should be spent, to maintain existing services and quality while ensuring “fundamental transformation of the service”, he added.
Ex-care minister: ‘Quarter of NHS cash boost should go to social care’: A quarter of the £2bn NHS funding boost announced this week should be allocated to social care or home care services will fall into crisis, former care minister Paul Burstow has warned. Burstow was speaking ahead of the launch of his Commission on the Future of the Home Care Workforce, which made extensive recommendations to boost investment in care workers’ wages, training and development. Burstow said it would be a mistake for the extra funding to go solely to health services, reports Community Care. He warned: “If all of the money just finds its way into the NHS and not social care, and in particular home care, then clearly implementing our recommendations will be difficult. We will end up with fewer people having access to home care and the support they need and instead finding themselves in crisis.” Instead, the former care minister suggested that half a billion of the approximately £2bn announced for 2015-16 be earmarked for social care. This could be transferred through the Better Care Fund, the £3.8bn-a-year pooled budget for integrating health and social care services that commences in 2015-16.
Call for better community services data: The King’s Fund has urged the Department of Health to work with other national bodies to “develop a clear road map for radically improving quality measurement in community services”. In a short report issued this week, the think-tank says assessing and managing the quality of community services is hampered by a lack of metrics and data; which is caused, in part, by a lack of IT to collect information, reports eHealth Insider. The researchers behind the report on ‘Managing quality in community health services’, say half of their interviewees felt their organisations were doing well, and that two thirds felt they had the data they needed to improve quality. However, they comment that: “Given the overall paucity of both data and quality metrics for the community services sector, it is questionable whether this level of confidence is warranted.” The report notes that community health services – including health visiting, school nursing, community nursing, physio and other therapy, and end of life services – are used by millions of people every year and account for around £10bn of the NHS budget. Despite this, it notes that the sector has been more subject to reorganisation than almost any other part of the NHS, with the most recent shake-up triggered by the Transforming Community Services programme.
New data sharing system will ‘help nurses prevent future Baby Ps’: Nurses and other frontline staff across England will soon be able to use a “landmark” nationwide data sharing system that will alert them to children who may be at risk of abuse or neglect, reports the Nursing Times. It is intended that the Child Protection – Information Sharing system (CP-IS) will help to avoid repeating cases of abuse, such as the Baby P scandal, by providing a “red flag” for a child that is on a protection plan or is in the care of a local authority. In addition to the ‘red flag’, non-clinical information including the child’s frequency of visits to accident and emergency departments or urgent care centres will also be made available via the electronic programme. The new CP-IS system – developed by the Department of Health, and run by NHS England and the Health and Social Care Information Centre – is expected to be available to clinicians working in all unscheduled care settings, such as Accident & Emergency (A&E), out-of-hours GPs and walk-in centres, by 2018. Launching the system, health minister Dr Dan Poulter said: “As a practising NHS doctor, I understand the importance of health and care professionals working together and sharing the right information to stop tragedies like Baby P being repeated.”
Corbridge steps up as Irish health CIO: Richard Corbridge has told eHealth Insider he will use the lessons he learned from the English National Programme for IT (NPfIT) in his new role as the first chief information officer (CIO) for Ireland’s health service. Corbridge has been appointed as the CIO of Ireland’s Health Service Executive, with a brief to improve the country’s use of technology in healthcare. He will start in the role on 15th December. Corbridge is currently chief information officer at the NHS National Institute for Health Research’s Clinical Research Network, which provides information systems and business intelligence to a workforce of around 10,000 NHS staff. The network’s open data platform was a finalist at the EHI Awards 2014 for ‘excellence in healthcare business analytics’, for bringing clinical research data sets together with multiple forms of data analysis and visualisation. Before that, Corbridge worked at the NHS Information Centre, as well as at NHS Connecting for Health during the days of NPfIT.
Concerns raised over incorrect ethnicity data in NHS hospital records: Up to 40% of people belonging to minorities could have their ethnicity wrongly recorded in their NHS hospital records, with potentially profound implications for the analysis of inequalities in care quality or disease prevalence in different ethnic groups, research suggests. As The Guardian notes, minority ethnic groups have been found to have different probabilities of developing different diseases and of surviving them. A paper published in the Royal Statistical Society’s (RSS) magazine Significance indicates that some analysis could have been based on flawed data. The paper’s author, Dr Katie Saunders, a health statistician, with colleagues from the Cambridge Centre for Health Services Research, examined data from the 2010 Cancer Experience Survey, comparing the self-reported ethnicity of almost 60,000 people with the ethnic group they were assigned to in their hospital record. They found only 5% of people had their self-reported ethnicity wrongly reported in their hospital records overall, because the vast majority of white British people had their ethnicity correctly recorded, but among ethnic minorities it rose to 40%. Saunders said: “If the aim [of analysis] is to compare outcomes between white and non-white groups the classification system will work well but a degree of caution is required when interpreting more detailed evidence on ethnic inequalities in care quality or disease incidence and prevalence.”
Volunteers sought for Code4Health pilots: NHS England is looking for NHS trusts and other healthcare providers to act as pilot sites for its re-animated Code4Health programme, says eHealth Insider. The pilots form part of a plan to establish a “franchisee” model, with organisations providing virtual and physical Code4Health courses that lead to recognised qualifications. Peter Coates, NHS England’s open source programme manager, has expanded on plans for Code4Health at a number of recent open source events. At a recent meeting, Coates described the programme as “an important part of the whole ecosystem” as a development and learning platform for clinicians and developers. “To me, it’s all about developers, designers and clinicians having a better understanding of each other’s worlds and understanding the possible.” Coates said part of the Code4Health programme will be based on creating a “self-sustaining community” of franchisees, such as trusts, clinical commissioning groups, and GP organisations, to run a set of courses and activities on digital health and health informatics.
Report suggests 600,000 face waits of 24 hours in A&E: More than 600,000 patients a year are being forced to wait more than 24 hours in Accident & Emergency (A&E) departments, suggests a new report. The Care Quality Commission (CQC) report on A&E comes amid growing concern that casualty units are buckling under the strain even before winter sets in. The worst score goes to Tameside Hospital Foundation Trust, in Greater Manchester followed by Medway Foundation Trust, in Kent. Both were put into special measures during summer 2013 amid concern over failings in care and high death rates. In November an investigation by The Telegraph found A&E patients waiting up to 35 hours at Medway trust, which in September was responsible for almost one quarter of the country’s long trolley waits. Other poor performers include Barking, Havering and Redbridge University Hospitals Trust, in East London, which recently had one of the worst records in the country for trolley waits of up to 12 hours, with 186 such cases in the week ending 23 November. Katherine Murphy, chief executive of the Patients Association, said: “It is outrageous that more than 600,000 people a year are waiting at least 24 hours in A&E. Long waits in emergency departments are hugely distressing for patients, who are at their most vulnerable,” she said.
UCL dementia programme director outlines how NHS can combine huge data sets to improve understanding of diseases: The NHS is just at the start of capitalising on the data that is accessible to it, according to experts including University College London (UCL) programme director Piers Kotting. Speaking at The Drum’s Disruption Day event in London last week (27th November) Kotting, who is programme director for the National Institute for Health Reseach National Director for Dementia Research at UCL, called on the industry to create “one more disruption” to actually turn data and research “into something that delivers answers”. “We see big data as an opportunity to allow us to do both cross sectional and longitudinal analysis of data across all these different diseases [cancer, dementia, stoke etc] and across different data modalities.” Kotting continued: “At UCL the university is looking at how it can integrate and collate all the different factors across different scales. For example, it is looking at the changes in cells that cause dementia and hopes to combine those with ‘massive population data sets’ to begin to collate the two together to drive understanding.”
Database will track doctors’ careers to help university selection: Doctors’ entire careers from medical school through to consultant level will be tracked by a database designed to find the best way of selecting and testing doctors, Health Service Journal (HSJ, subscription required) has learned. The General Medical Council (GMC) database will also track fitness to practise decisions levelled against doctors during their careers, and no opt out will be available. Establishing this database is one of the main recommendations in a report by the Medical Schools’ Council called Selecting for Excellence, which is due to be published next week. It points to ways of improving university selection to ensure more students from a lower class background are chosen by medical schools. A spokesman for the GMC said: “We collect a wealth of information about the medical profession and the organisations where doctors practise and train. Partners across the UK are already using our data to supplement their own intelligence about providers of care and to evaluate and improve medical education and training.”
#HMvideo @EHILive
At EHI Live 2014, Highland Marketing met and interviewed senior personnel from various healthcare IT vendors and healthcare providers to ask their views on what they consider to be the essential issues facing the industry and the improvements technology can bring to healthcare service delivery.
Below we have the last in our series of published videos.
Tim Taylor, managing director of ThinkVitals, talks to Highland Marketing at EHI Live about how innovative open source e-observations software is supporting nurses and doctors in managing acute patients more effectively and efficiently.
Clare Nash, nurse at The Royal Wolverhampton NHS Trust talks to Highland Marketing at EHI Live about how its tracking technology is helping to manage the trust’s infection control leading to increased compliance of hand washing by staff.
Lee Minall of Ascom UK tells Highland Marketing at EHI Live that his organisation is reacting to current resourcing challenges in the healthcare industry by, in one example, “moving the information to the nurse rather than moving the nurse to the information”.
Opinion
Autumn Statement: Why the NHS needs more than Christmas cheer
Anita Charlesworth, chief economist at The Health Foundation comments on this week’s Autumn Statement in The Guardian and considers why the next government will face a much bigger challenge.
“The NHS desperately needs additional money to keep the show on the road. It is a sign of just how worried the government must be that, despite the deteriorating public finances, the chancellor appears to have been persuaded to find money he doesn’t really have for the NHS.
“Hospitals are failing to achieve the four-hour target in A&E departments, waiting times for in-patient care are increasing and there has been a steady decline in performance against the targets for cancer care. The financial pressures on the NHS next year are expected to be around £2bn greater than the budget. Against this backdrop, it is difficult to see how the NHS can get through without additional funding – hence the significance of the Autumn Statement.
“The government’s own Health and Social Care Act is part of the story. When the NHS knew it was facing an unprecedented financial challenge in 2010, the plan was to start with some short-term, tactical actions such as reducing administrative costs and holding down pay. This was to run parallel with implementing more fundamental changes to the way care is delivered to unlock sustainable, efficiency savings. These including supporting people with long-term conditions better so they can remain at home, and avoiding long hospital stays for patients that are due where services to discharge in the community are not available. “Osborne’s Autumn Statement injection of short-term cash should stave off a pre-election NHS crisis but whoever wins the general election next year faces a much bigger challenge – how to find the money the NHS needs given the huge cuts already planned for other public services, and a deficit reduction plan that looks to be off track. There has been much pre-election talk of tax cuts. The outlook for the NHS and the state of the deficit suggest we should all prepare for post-election debate about tax increases.”
Child Protection – Information Sharing system: Beyond technology
Hilary Garratt, NHS England director of nurse commissioning and health improvement, reflects on the launch of the Child Protection – Information Sharing system.
“CP-IS is a new national alert system to help prevent child abuse. The system will bring information from local authorities about looked after children and children with a child protection plan into one place for clinicians in unscheduled care settings to access.
“Healthcare staff are in a key position to identify warning signs of abuse or neglect. Using CP-IS they will be able to see whether a child has frequently attended emergency departments or urgent care centres over a period of time. Until now we have not had the facility nationally for child protection information to be shared. Therefore it has not been possible for staff in health and social care to easily and swiftly identify if children were making multiple visits to different unscheduled care settings across the country. This information will be shared through CP-IS.
“Developing CP-IS has involved many agencies and professionals. Whilst we have made some local progress in recent years with local authorities and health organisations sharing some information about the children who are resident within their boundaries, we have not until today developed a national system that will identify all children who enter unscheduled and emergency care settings, regardless of where they live.
“The programme has taken four years to develop. The technical support and detail behind the system construction has been phenomenal. However, what has also been commendable is the amount of integrated work we have done with the organisations that have supported it: Department of Health, Department for Education, Health and Social Care Information System, regulators, Royal colleges and safeguarding boards.
“Today marks a huge turning point to securing better information sharing for vulnerable children and its success now needs to continue being driven by the commitment and vigilance of all NHS and local authority organisations to use it well and to demonstrate its benefits. If we do this, the system has scope and potential to identify more individuals who are vulnerable. I look forward to rapid roll out so we have 80% of local authorities signed up to sharing information by 2015.”
Treat NHS managers with respect during the election campaign
Managers in the NHS are too often unfairly criticised and singled out for blame, writes HSJ editor Alastair McLellan.
“NHS managers are unfortunately all too used to being unfairly criticised and singled out for blame. Rarely a day goes by on which managers are not accused of: not understanding an issue; acting in an underhand way; and/or soaking up valuable resources which could be better exploited on the front line.
‘There is little concern for the truth in these attacks. No consideration is given to the fact that managers have skills vital to the NHS that are not found elsewhere in the service; or that an increasing number have a clinical background. Few are prepared to acknowledge that – whisper it softly – some clinicians and campaigners are highly adept at twisting the odd fact to support their cause, knowing they will never receive the same level of challenge as managers.”
McLellan is leading a campaign to ‘redress the balance’ citing a recent open letter to The Times signed by leading clinicians, patient campaigners and two former health secretaries in support of NHS managers.
“Of course, some NHS managers deserve criticism and HSJ will hand that out where it is justified. But it is also our responsibility to address the imbalance in the public debate about the NHS and together with Managers in Partnership we will continue our campaign up to and during the general election.
“Among those who rejected our invitation to sign the letter – and readers will be able to guess who they might be – some gave a reasoned response, some just provided weasel words, while others simply ignored us. We would ask all of them to reflect on the support shown for NHS managers by our co-signatories and join them in this worthwhile cause.”
Highland Marketing blog
In this week’s blog, Marta Sieczko asks whether, despite many opposing opinions, patient choice is the key to improving performance in the healthcare system.
