News in brief
Numbers waiting 18 weeks for NHS surgery could double, leak reveals: Leaked “devastating” documents revealed that the number of NHS patients waiting longer than 18 weeks for surgery is forecast to double in two years, reported The Telegraph. The figures from health service regulators showed total numbers on waiting lists are expected to soar to 5.5 million by 2019, on current trends, compared with a current figure of 3.7 million. It came after the head of the NHS Simon Stevens said worsening waiting times for routine operations were an expected “trade off” for efforts to improve emergency care and cancer treatment. The Royal College of Surgeons said the growing waiting times were “unacceptably high” and would leave patients at risk of death and disability. It said major brain and heart operations were among those likely to be affected by worsening performance. The new documents showed that on current trends, the number of patients waiting at least 18 weeks for operations such as hip, knee and cataract surgery is expected to more than double. Latest official statistics showed around 370,000 patients were waiting this long in February. The leaked documents showed that unless improvements are made, almost 800,000 patients can expect to wait this long by March 2019. Currently about 90% of patients wait longer than 18 weeks, against a target to achieve this in 92% of cases. The document said this is likely to fall to around 85% by 2019, if improvements are not made.
General election 2017: Labour calls for halt to hospital cuts: A Labour government would suspend the planned closures of hospital services across England, the party is promising. It said the national initiative – involving 44 local plans – has lost credibility and needs reviewing, reported the BBC. Under proposals put forward, A&E, maternity and stroke units could be scaled back in many parts of England. NHS bosses – supported by ministers – have launched the programme to modernise the NHS and allow more investment in community services. However, Labour said the process – known as sustainability and transformation plans (STP) – was causing confusion and risked being driven by money rather than what was best for patients. Earlier this year an investigation by the BBC found hospital services in nearly two thirds of the 44 areas were under threat, with widespread concern the infrastructure was not in place in the community to cope. Shadow health secretary Jonathan Ashworth said a “moratorium” was now needed so each of the plans could be properly reviewed. “These decisions have been decided behind closed doors with no genuine involvement of local people. It’s a disgrace. The public deserves better. The Conservatives have dismissed the idea and said funding was in place to pay for the changes.”
Bed-blocking figures drop for third consecutive month: The number of patients kept in Scottish hospitals after being told they were well enough to leave has fallen, new figures have shown. Official statistics from a census carried out in hospitals in March found 1,339 patients had to remain in hospital due to delayed discharge, also known as bed blocking, reported The Herald. The figure has fallen for the third consecutive month, down from the 1,439 recorded in February and 1,482 in January. The report by ISD Scotland showed that, although fewer patients were affected, more days were spent in hospital due to delayed discharge in March than in February. Patients spent 41,493 days waiting to be discharged in March up from 40,246 days the previous month. A total of 1,089 (81%) of patients were delayed for more than three days and of these patients the majority, 776 (71%), were affected by health and social care delays, down from 834 in February. Health secretary Shona Robison said: “The integration of health and social care ensures patients are at the heart of care decisions and receive more treatment in the community, reducing demand for acute hospital usage by reducing avoidable admissions, lengths of stay and delayed discharge. Our key measures are reducing bed days and increasing the amount of delayed patients discharged within three days. We’re making good progress and continue to work to eradicate this problem with a further £107m transferring from the NHS in 2017-18 for integration purposes, taking the total NHS contribution to enhance social care to around £500m per year. This includes £30m specifically to address delayed discharges.”
BMA seeks ‘a vote for health’: The BMA has called on all political parties to give the NHS the ‘unrelenting focus’ it needs during the general election campaign – and has published its manifesto which outlines a credible plan for a fully-funded health service, reported the British Medical Association (BMA). The manifesto calls for action in five key areas, urging politicians to commit to a long-term funding solution for the NHS, address pressures across the healthcare system, ensure the NHS takes priority in Brexit negotiations, stabilise general practice in the face of soaring demand and reverse cuts to public health. BMA council chair Mark Porter said it was vital that the 2017 general election did not become a ‘Brexit election’, at a time when the NHS needs the consideration and will of politicians more than ever. Dr Porter said: “Despite having one of the best healthcare systems in the world, years of investment in the face of rising patient demand means the NHS is now failing too many patients, too often. Our hospitals and GP surgeries are full, social care is on its knees, with staff working under impossible conditions. This election is being fought against the backdrop of one of the worst winters on record for the NHS, with doctors reporting funding cuts and concerns over patient care and safety. Whoever leads the next government must ensure that NHS funding keeps pace with other European nations, that EU doctors in the UK are protected from the impact of Brexit, that general practice is properly supported, that policies protect and enhance the public’s health, and that the pressures impacting the day-to-day delivering of high-quality, safe care are tackled.”
Revealed: The STPs in line for biggest funding growth: Benchmarking data used by NHS regulators has shown which health regions are set to receive the largest budget increases over the next four years, reported Health Service Journal (subscription required). A presentation slide used by NHS Improvement at a recent event shows which “sustainability and transformation partnerships (STPs)” are furthest away from their target funding allocations. It uses the net of clinical commissioning group allocations within each STP. Most of these “behind target” areas will be in line for larger funding increases, as part of NHS England’s policy to bring local commissioning bodies further towards their target allocation. The document shows the five STPs furthest below their target allocation are Buckinghamshire, Oxfordshire and Berkshire West; Milton Keynes, Bedfordshire and Luton; Northamptonshire; Surrey Heartlands; and Bath, Swindon and Wiltshire. The five STPs furthest above their target allocation are: Northumberland, Tyne and Wear; South Yorkshire and Bassetlaw; North West London; North Central London; and Derbyshire. These areas will largely be in line for low funding growth. There has long been debate over the way funds are allocated to NHS commissioning areas, and the weight that should be given to factors such as deprivation. There appears to be some correlation between those STPs which are furthest behind their target allocation, and those which have the deepest financial problems.
Trusts chosen to pilot new efficiency rating: Two trusts have been chosen by NHS Improvement and the Care Quality Commission (CQC) to pilot the new use of resources rating, ahead of a national rollout that is expected to be delayed, reported Health Service Journal (subscription required). Ashford and St Peter’s Hospitals NHS Foundation Trust and North Tees and Hartlepool NHS Foundation Trust are the two trusts that will be reviewed for how efficiently they use their resources. It is unclear if more trusts will be brought into this pilot in the next two months. A CQC spokeswoman said: “The pilot work is being led by NHS Improvement and involves an analysis of the data using the methodology proposed in the joint use of resources consultation, in addition to interviews and discussions with the trust executives.” Jeremy Hunt asked the CQC to “include use of resources as one of the key criteria that the CQC look at in their well led domain” in June 2015. NHS Improvement will recommend a rating, but final judgements will remain with the CQC. The CQC spokeswoman said: “The timetable is being reviewed and will be put back. Further information about the work and future implementation [of the rating] will be contained in the [use of resources] consultation response when it is published after the election.” It was originally intended that the response would be published in May. The consultation was launched in late December 2016, but CQC chair Peter Wyman said the response will now be published “as soon as practical after the election” on 8 June.
NHS deal to hand GP data to immigration officials causing ‘serious risk’: Health regulators have warned that public health is at ‘serious risk’ due to the NHS passing patient information to the Home Office as part of its drive to trace immigration offenders. The General Medical Council, Public Health England (PHE) and England’s National Data Guardian have raised concerns about a government deal. GP and chair of the Commons health committee Dr Sarah Wollaston has published correspondence with regulators and the heads of health bodies after asking them about their view on the deal. The General Practitioners Committee told Pulse that it had ‘significant concerns’ over the data sharing agreement, which appears to lower the bar for sharing confidential patient information. Pulse reported in January that a deal between NHS Digital, the Department of Health and the Home Office meant GP patient details, including full addresses, were being handed over to immigration officials. Following these reports, Dr Wollaston wrote to the regulators to canvass their opinion. The correspondence includes evidence from PHE presented to the government in February, which said: “It is the opinion of PHE that this could present a serious risk to public health and has the potential to adversely impact on the discharge by PHE of [Secretary of State, Jeremy Hunt’s] statutory health protection duty.” It also said PHE has been commissioned by the government to review the impact of the data sharing policy on public health in the next two years.
NHS Digital picks up pace on paperless healthcare: NHS Digital needs to be more innovative and customer focused to achieve a paperless 2020, according to its director of digital transformation, Beverley Bryant. Speaking at UK e-Health week in London, Bryant said the organisation, which has often been criticised for moving at too slow a pace, is picking up speed and changing, reported Computer Weekly. “We’ve been given the responsibility to deliver a paperless 2020 so we have to become a modern IT organisation that demonstrates pace and agility,” she said. Bryant added that although some things could be done better and quicker, the organisation is changing to become more focused on users and is ensuring the right building blocks are in place. “Alright, there could be more money, we could get the money out quicker, and let’s be honest, it would not be the NHS if we didn’t have the odd controversial policy to talk about. But we’re doing this now – we’re not just talking about it. There’s no toxic legacy, there’s no wilderness, we’re not instructing and planning, and we’re delivering,” she said. Bryant launched a strategic partnership with trade body techUK to help transform the way suppliers engage with NHS Digital. “The partnership will aim to ensure that industry can begin to gear up for all the potential opportunities and inform our strategy, and we’re going to continue to work closely with suppliers,” said Bryant.
Campaign launches to unite health informaticians: A group of professional organisations has come together to create a new campaign focused on uniting healthcare informaticians. Well Connected, headed by The Federation for Informatics Professionals in Health and Social Care (Fed-IP), aims to inspire those working in healthcare IT to harness technology to put people and their communities first, reported DigitalHealth.net. David Evans, director of policy and community at BCS, said the creation of the campaign marks an exciting time for health informatics and addresses the societal need for better health and care. “We’re bringing together people with shared values, and empowering individuals to take ownership as a community of professionals which will attract new generations into the profession. This is their campaign, and we know that the best is only possible when we come together to put our citizens and communities first.” The campaign is organised by a coalition comprising BCS, The Chartered Institute for IT, the Chartered Institute of Library and Information Professionals, the Institute of Health Records and Information Management, and Socitm (the society for IT practitioners in the public sector). There is an open pledge that anyone in the NHS – along with members of the public – can sign to show their commitment.
IMS MAXIMS launches vital signs mobile application: IMS MAXIMS has launched a vital signs application at e-Health Week. The app has been designed to improve patient outcomes by enabling staff to respond to a patient’s condition from anywhere in the hospital before it becomes life-threatening, reported the Health Tech Newspaper. The application uses physiological observations such as blood pressure and heart rate to calculate the severity of a patient’s condition and gives staff crucial decision support. Using clinical scoring protocols such as NEWS (National Early Warning System), it recommends how often to monitor a patient, issues reminders if observations are not completed on time, and provides early detection, alerting, and escalations to senior members of staff if the condition deteriorates. Users have the added advantage of integrating the data into the hospital’s electronic patient record, as the app harnesses APIs that have been developed with open standards, plus interoperating with other clinical systems means information can be incorporated into the patient’s care pathway. Michael Thick, chief clinical information officer and chief medical officer of IMS MAXIMS said: “Mobile apps can provide vital support to healthcare professionals that are already under great pressure to meet service demands. The 24/7 monitoring system and vital decision support make it quicker and easier for staff to observe a patient’s condition and prevent them from getting any worse.”
Patients Know Best lets Surrey view single care record: NHS organisations across Surrey have begun using patient-controlled personal health record technology to allow clinicians to view a single digital care record across four NHS trusts, GPs and four clinical commissioning group areas. Within six months, clinicians will be able to see a shared integrated record from all the different health organisations using shared record technology supplied by Patients Know Best (PKB), reported DigitalHealth.net. The next step will be to extend PKB to patients as well. The initiative is expected to eventually cover one million people across the county. Steve Abbott, programme director for Surrey Heartlands local digital roadmap, said he wants PKB to give “our clinicians access so that our carers have the best information at hand to deliver care at the point of delivery”. The project builds on Surrey and Sussex Healthcare NHS Trust’s existing work with PKB that uses patient-controlled records for its 3,200 inflammatory bowel disease patients. Abbott said having one integrated digital care record would mean that patients would not have to repeat themselves each time they have to deal with a different health professional, or encounter a different part of the health service. “They’re [clinicians] actually working with the latest data that’s available, so they’re not asking questions that have already been asked.” PKB is already used in a similar way by the Care Information Exchange in North West London, where it was rolled out in 2016. Abbott said the announcement was “the first step in a long interoperability journey” for the area.
‘Do you have the bottle to step up?’ Swindells asks e-Health Week audience: NHS England director for commissioning operations and information challenged NHS IT leaders on whether they had “the bottle” to step up on embedding digital into care pathways, reported DigitalHealth.net. In an uncompromising speech Swindells said it was not enough to just implement new systems and software, the challenge had to be to ensure technology supported reduced cost, and improved quality and efficiency. Recurring themes of his keynote presentation, opening e-Health Week, were that many NHS leaders did ‘not get it’ and that the NHS lagged 10 years behind healthcare systems, with the US cited as the model for using technology to change delivery models. “Do we have the bottle to step up? Do you have the bottle? Or is it more comfortable to sit in your office delivering one more maternity system?” He said technology was “not an end in itself” but had to support the improvements in patient care set out in the Five Year Forward View, and supporting patient pathways. “The measurement of success is, did we impact on patient experience, did we improve a patients’ outcomes? Not to install systems and walk away. This is not about making NHS more fun for the Apple Watch generation but enabling people to manage their lives better and keeping people from being admitted into hospital.” He said the Next Steps update of the Five Year Forward View “makes 14 IT commitments with dates and objectives and fit with wider strategy”. Swindells said the challenge for the NHS is to now embed these objectives into local strategies.
NHS trust to electronically screen every patient automatically for sepsis: Nottingham University Hospitals NHS Trust (NUH) has become the first UK trust to roll-out a real-time, mobile sepsis screening application with integrated clinical alerts to get the right intervention from the right doctor at the right time, reported The Journal of mHealth. Every adult patient across the 75 wards in Nottingham Hospitals is now being automatically e-screened for Sepsis using the latest software from Nervecentre. There are 8,500 sets of electronic observations taken each day at NUH, and all are automatically screened for sepsis and follow the latest NICE guidelines. Evidence shows the chance of death from sepsis increases by 8% for every hour it remains untreated, therefore the real-time alerts generated to the 6,000 clinical users of Nervecentre at NUH can significantly help prevent deterioration, by reducing communication delays to zero. Early detection of sepsis is high on all NHS trust agendas and the roll-out allowed NUH to be compliant with their agreed sepsis commissioning for quality and innovation (CQUIN) targets. Other NHS trusts are already piloting the patient safety focused software and will be rolling it out in the next few months, and NUH will be rolling out to paediatrics imminently.
NHS Digital Academy to work with GDEs and fast followers first: The NHS Digital Academy will involve 50 leaders from global digital exemplars (GDEs) and their fast followers in its first stage, Harpreet Sood, NHS England Associate CCIO and NHS Digital Academy Lead, told Health IT Central. At this week’s UK e-Health Week, Sood explained they are currently still in the procurement process after having received a number of “strong bids” that they will evaluate this month. It is expected the academy will be launched towards the end of September this year, firstly bringing together 50 people from exemplars and then opening it “to the wider healthcare system”. He also emphasised that no organisation is currently “nurturing” CIOs and CCIOs that are driving the digital transformation agenda in the UK, adding that the NHS Digital Academy will be focused on creating a “world class programme”, setting the pace towards making the NHS a globally recognised “brand” that would attract international mentors set to “advise on transformation”. The academy will be underpinned by a “mixed delivery model”, with the vast majority of training being provided “virtually”, including specialist tutorials/webinars and workshops and two on-site programmes. In his presentation, Sood revealed the NHS Digital Academy will be expected to upskill current CIOs and CCIOs, while also enable cohorts of professionals to further drive technology-enabled transformation processes.
Imaging and pathology IT restored at Barts Health: Access to viewing diagnostic images has finally been restored at England’s largest trust, nine days after a major computer network failure downed a series of essential clinical IT systems at the trust. Barts Health NHS Trust had to cancel 136 operations and several hundred chemotherapy appointments from 20th April to 2nd May after a “major computer equipment failure”, reported DigitalHealth.net. In a statement, the trust said pathology, imaging and chemotherapy prescribing were now working. “We have made significant progress in many areas including pathology (blood testing), with chemotherapy prescribing and image viewing now restored across the trust. There are still some other areas where it will take time before we are on track again.” The trust said clinical teams are conducting a patient-by-patient review, and apologised to those affected with promises of rescheduled appointments. Barts added that the trust was using “tried and tested contingency plans to keep our patients safe”. In a statement, released when imaging and pathology were still operating an incomplete service, the trust said images were being accessed through a web-based tool.
Opinions
Manifestly important: health, social care and the General Election
Nigel Edwards, chief executive at Nuffield Trust, outlines three core issues facing the NHS that politicians may want to keep in mind during the short election campaign.
“It would be a tremendous lost opportunity if manifestos do not seek to put both health and social care funding on a more sustainable footing, outline a clear intention to address the looming workforce problems in both sectors, and give government the space to provide the financial and legislative support the NHS needs to transform services.
“While specific sums of money may make good election slogans, there is a real danger in making overly specific pledges on health and social care funding. In the current environment, any amount that is politically credible is unlikely to be fiscally credible unless services are to be reduced. Instead the manifestos should afford government the flexibility to respond to the changing landscape and outline a commitment to a free-at-the-point-of-use, taxpayer-funded NHS, accompanied by a pledge to deliver a sustainable long-term settlement for both health and social care spending soon into the new parliament.
“Staff shortages, dwindling morale and the looming impact of Brexit on a sector already dependent on overseas workers promise to make the next decade extremely challenging. The new government will need to support initiatives to address the impact of these pressures.
“The new government will inherit an NHS in the midst of a major change programme. The Five Year Forward View offers the right vision for the health service by shifting care closer to people’s homes, but is unlikely to be realised without upfront investment in community services alongside hospital care and changes to the legal status of some NHS bodies.”
Being a patient convinced me to bring my digital expertise to the NHS
The NHS saved my life. Now I want to ensure patients and clinicians have the technology, services and insight necessary to deliver the right care, writes Juliet Bauer, director of digital experience for NHS England, in The Guardian.
“I was fortunate to be treated by excellent NHS staff who saved my life and that of my premature baby daughter. But, as I observed healthcare from a hospital bed, I became fascinated by how the service struggled to make the most of information and technology, and provide the insight, products and services that are commonplace in other areas of modern life.
“Patients want to access their test results, book appointments and view their records in the same quick, convenient digital way we access our bank accounts and do our shopping. Without these facilities, patients have less control and clinicians’ valuable time is used with non-clinical questions, reducing the time they have to spend on care.
“At a time when the NHS is under real pressure and people living longer than ever before, we need to use information and technology to work more efficiently, help people live healthier lives and provide patients with the intelligent, personalised, high-quality care they deserve.
“I have the chance to deliver the online products and services that enable patients to access health and care information, advice and treatment simply and conveniently and to allow clinicians to focus on what’s most important. We are creating new solutions that put the information they need to make good decisions at their fingertips and are developing new tools to help them interact with, and make choices about, health and care services. Central to this work is the transformation of the NHS Choices website.”
Highland Marketing opinion
How can SMEs engage with the NHS?
In a guest blog post in the Health Tech Newspaper, Highland Marketing outlined how SMEs and other innovators can best engage with the complicated beast that is the NHS, based on over two decades’ experience working with the service. Key advice included being market-led rather than product-led; getting the right message to the right audience; and being patient and persistent. It concluded: “The more you know your market, promote the right messages, and stay an active participant, the greater your chance of success in a complex but immensely rewarding sector.”
Selling into the NHS; it’s not about luck, it’s about having the right approach
In a recent article on the possibility of selling products and services to the NHS in its current state, NHS commentator Roy Lilley said to kit and caboodle makers, such as health technology suppliers, ‘good luck with that’. Highland Marketing CEO Mark Venables responded vigorously to say, thanks Roy, it is not about luck, it is about having the right approach, as we have seen time and time again. “Nobody is pretending that selling into the NHS is easy. But with the right advice, it is perfectly possible,” he said.
