News in brief
Government offers junior doctors’ contract pause: The government has said it is willing to pause the introduction of the junior doctors’ contract in England for five days from Monday to allow for talks, reported the BBC. But it said the doctors’ union must focus discussions on outstanding contractual issues such as unsocial hours and Saturday pay. Junior doctors have repeatedly been on strike over plans to impose new working conditions. Talks over the controversial new contract broke down in February. The prime minister has welcomed the possibility of talks between ministers and the British Medical Association (BMA), saying it was important that the talks focussed on the “10%” of issues in the contract that had not been agreed, “particularly Saturday working”. Dr Johann Malawana, the BMA junior doctor chairman, said: “Junior doctors have said since the outset that we want to reach a negotiated agreement, and have repeatedly urged the government to re-enter talks. We are keen to restart talks with an open mind. It is critical to find a way forward on all the outstanding issues – which are more than just pay – and hope that a new offer is made that can break the impasse.” Shadow health secretary Heidi Alexander welcomed the offer of a pause and said the two sides had to resume discussions: “It is imperative that Jeremy Hunt puts his pride to one side and resumes negotiations with the BMA.”
Bryant to move to HSCIC as IT work shifts from NHS England: Beverley Bryant is to move from NHS England to the Health and Social Care Information Centre (HSCIC) as part of a significant shift of IT responsibilities away from the commissioning board, reported DigitalHealth.net. In a message sent to NHS England staff this afternoon, Karen Wheeler, the national director of transformation and corporate operations, said Bryant will move to the HSCIC, which will be renamed NHS Digital this summer. She added that this will also mark the start of a phased transfer of some areas of ‘duplicate’ and ‘overlap[ping]’ areas of IT work from one body to the other. These areas include: standards development and implementation; the implementation and uptake of digital and online services; the delivery of major programmes and services; and primary responsibility for the procurement and management of contracts and relationships with third parties. Wheeler’s message said: “As part of phase one, Beverley Bryant, director of digital technology, will move to NHS Digital. Beverley’s leadership and energy has helped to begin the transformation of technology across the NHS. We are pleased her expertise will continue to inform and shape how all healthcare organisations work together; helping to clarify the respective roles and responsibilities of the Department of Health, NHS England, and NHS Digital once she moves across.”
First up-to-date GP data reveals depth of primary care crisis: The GP crisis could be worse than previously thought, The King’s Fund has said, as it produced the most detailed and up-to-date data into pressures on GP practices, reported National Health Executive. The King’s Fund report found that in 2010-15, the number of GP consultations increased by 15%, but the GP workforce grew by 4.75%, less than a third of that amount. The practice nurse workforce rose by 2.85%, and funding for primary care as a share of the general NHS budget fell every year, from 8.3% to 7.9%. Although the NHS has promised new measures to support primary care in its GP Forward View, the Patients Association said that these reforms need proper monitoring to ensure they work. Beccy Baird, fellow at The King’s Fund and lead author of the report, said: “Investment alone won’t help the crisis in general practice. To avoid the service falling apart, practical support to do things differently is crucial and must be underpinned by an ongoing understanding of what is driving demand and activity. Only then will working in general practice be an attractive proposition and ensure the service remains at the heart of the NHS.” The King’s Fund said that GP practices could fall apart unless the Department of Health and NHS England immediately provide practical support to them, including accelerated take-up of new technologies, the use of health coaches and volunteers to augment the workforce, reductions in bureaucracy and better signposting of services for patients. In the longer term, the think tank said that NHS England must improve data gathering and develop new methods of general practice and voluntary contracts for practices to lead the development of integrated out-of-hospital services.
‘Remarkable’ trust given CQC’s top rating: Northumbria Healthcare NHS Foundation Trust has become the fourth in the country to be rated outstanding by the Care Quality Commission (CQC), reported Health Service Journal (subscription required). Twenty of the trust’s core services received the top rating – the most awarded to any trust to date. The CQC called the level of consistency in outstanding ratings “remarkable” and “a first” for the NHS. The trust was inspected by the CQC in November and December. In its inspection report, published on Thursday, the regulator has rated Northumbria as outstanding in four of its five domains – caring, effective, responsive and well led. All four of Northumbria’s main hospitals were rated outstanding. The CQC said it had found “inspirational leadership and strong clinical engagement” at the trust. A recent acute services reconfiguration, which culminated with the opening of a new emergency care hospital at Cramlington in June, “had been managed effectively”. The CQC did identify some areas where Northumbria needed to make improvements. It asked the trust to ensure its clinical strategy met recommendations from NHS England’s national maternity review, as well as making improvements to the storage of emergency drugs and improving the entrance and exit to its new birthing centre. David Evans, Northumbria’s chief executive, said he was “delighted” with the CQC’s findings, which he said were the result of clinical ownership and an “open culture” at the trust.
Google given access to healthcare data of up to 1.6 million patients: A company owned by Google has been given access to the healthcare data of up to 1.6 million patients from three hospitals run by a major London NHS trust, reported The Guardian. DeepMind, the tech giant’s London-based company most famous for its innovative use of artificial intelligence, is being provided with the patient information as part of an agreement with the Royal Free NHS Trust, which runs the Barnet, Chase Farm and Royal Free hospitals. DeepMind announced in February that it was developing a software in partnership with NHS hospitals to alert staff to patients at risk of deterioration and death through kidney failure. The technology, which is run through a smartphone app, has the support of Lord Darzi, a surgeon and former health minister who is director of the Institute of Global Health Innovation at Imperial College London. However, the agreement on patient record sharing has caused concern among those who have already been concerned about Google’s moves in the healthcare sector. A spokesperson for the Royal Free said patients would not be aware that data was being made available but it was encrypted and such an arrangement was standard practice. Dominic King, a senior scientist at Google DeepMind, said that access to timely and relevant clinical data was essential for doctors and nurses. “This work focuses on acute kidney injuries that contribute to 40,000 deaths a year in the UK, many of which are preventable,” said King.
London develops Health and Care Information Exchange: Health and social care organisations across the capital are working to develop a London Health and Care Information Exchange, reported DigitalHealth.net. The programme aims to allow the seamless transfer of patient records between healthcare providers spanning London and beyond. A proof of concept for how the exchange could work was presented at the recent eHealth Week conference. The idea is the brainchild of the London Digital Programme, which is one of the 13 transformation programmes that make up the Healthy London Partnership. The partnership programme is worth £18m over three years and includes all 32 clinical commissioning groups, NHS England (London), the academic health science networks, 28 trusts, the London CIO Council and representation from the capital’s local authorities. Chief officer of Waltham Forest CCG Terry Huff explained that London has a population of nine million with thousands of healthcare providers and 30 information exchanges, none of which can talk to each other or are scalable at London-level. Rather than developing something entirely new, the programme aims to build on some of the information sharing systems that are already available by developing The London Health and Care Information Exchange. Suppliers that have participated in developing the prototype are: EMIS Health, Cerner, InterSystems, Adastra and Coordinate my Care.
Department of Health seeks to cut £50m data collection burden: Collecting data in the health and social care system needs to be made simpler, the Department of Health has said as it published a paper showing that it cost £50.7m and 65,131 working days last year, revealed National Health Executive. The department’s Data Reduction plan was developed in response to a concordat signed by the department and arm’s length bodies, following recommendations from the NHS Confederation, to secure a more collaborative and systematic approach to the collection of data in areas such as NHS performance. The concordat requires the department and related bodies to collect data, which is proportionate and with a clear business purpose, not duplicate other data collections, work through the Health and Social Care Information Centre as the national base for all data and review the need to collect the data regularly. Areas where the Department of Health collects data include information on NHS estates (£906,998 and 3,336 days every year), monitoring cancelled operations (£10,963 and 48.16 days) and general practice and dental complaints (£299,122 and 800.2 days).
NHS trust is fined £185,000 after posting private details of 6000 staff on its website: A health trust has been hit with a £185,000 fine after it posted the private details of thousands of members of staff – including their sexual orientation – on its website, reported the Daily Mail. Blackpool Teaching Hospitals NHS Foundation Trust inadvertently published workers’ confidential data which also included their National Insurance number, date of birth and religious beliefs in March 2014, watchdogs revealed. The organisation failed to notice the mistake for 10 months and then took a further five months to alert affected staff, the Information Commissioner’s Office (ICO) said as it announced the penalty. Stephen Eckersley, head of enforcement at the ICO, said: “This trust played fast and loose with the highly sensitive and private information that was entrusted to them. It seems they ignored their duty to put rules in place to protect staff who deliver hospital services to others. Any measures taken to protect this information from reaching the public domain were woefully inadequate or non-existent. The fact that the error went unnoticed for so long beggars belief.” The breach related to spreadsheets containing confidential and sensitive personal data relating to 6,574 employees past and present. Information was volunteered by staff as part of the trust’s commitment to publish annual equality and diversity metrics on its website. The ICO said the trust failed to notice that the published spreadsheets also contained hidden data that became visible by simply double-clicking the table.
Unmanned robot surgery works in pig trial: An unmanned robot has been used to stitch together a pig’s bowel, moving science a step closer to automated surgery, reported the BBC. Unlike existing machines, the Star robot is self-controlled – it doesn’t need to be guided by a surgeon’s hands. In tests on pigs, it at least matched trained doctors at mending cut bowel. But it is very early days and it remains to be seen if people would trust such a “hands-off” approach. Robots performing surgery are not new. Hospitals in the UK and the US already use robot assistants to help cut out hard-to-reach tumours, such as prostate cancer. These devices, such as the da Vinci System, are an extension of the surgeon – gadgets that give the operator better sight of the target and more adept tools to get the job done. But scientists are now trying create a new generation of robots that will work independently, albeit under close supervision, to remove human error. Mr Shafi Ahmed, from the Royal College of Surgeons of England, said it was a radical step to try to replace a surgeon with a machine, but not necessarily a bad one in certain situations. Ahmed said: “All humans make errors. We have emotions and we get tired, whereas robots are objective. We need to ask whether machines might be better at doing some parts of surgery.”
Two-thirds believe UK spends too little on NHS: Almost two-thirds of people in the UK believe too little public money is spent on healthcare, according to a new poll, reported Health Service Journal (subscription required). The survey, commissioned by consultancy firm Incisive Health, was carried out in six European countries by polling firm Populus. More than 1,000 adults in each country responded over eight days in March. OECD data suggested the UK spends proportionately less than 12 of the 15 original EU countries. When asked which of four statements reflected their views on health spending, 62% of respondents in the UK chose “too little is spent on health”. This was a far higher proportion than in the other countries (the figure was 53% in Spain, 39% in France and 34% in Germany). In the UK, 5% said “too much” public money was spent on health, while 24% said it was “about right”. Nine per cent said they did not know. Despite small real terms increases in NHS funding since 2010, health spending in the UK as a proportion of GDP has declined slightly. Mike Birtwistle, founding partner at Incisive Health, said: “These figures not only show that politicians can benefit from promising to boost NHS spending, but hint at the real truth. We are spending less on health compared to elsewhere in Europe, and that is why we are more worried than people in other countries.” The Department of Health would not comment on the poll findings. However, it has previously highlighted a report from the Commonwealth Fund suggesting the NHS is the most efficient health system in the world.
Derby NHS trust implements new technology to improve clinical safety: Derby Teaching Hospitals NHS Foundation Trust has announced it is to work with a new clinical information system, ORBIS ICU-Manager, to collect data and to improve clinical safety, reported Health IT Central. Implementing the ORBIS solution will allow Derby Teaching Hospitals to collect the most accurate data from monitors and devices in the ICU, eradicating the need for manual transcription. By speeding up workflow and decreasing the risk of potential errors, it can help the hospital to improve clinical safety, efficiency and cost effectiveness. It also includes ORBIS Medication, which offers the prescribing of drugs from the patient’s admission to discharge that encompasses drug prescription with clinical decision support, drug administration, pharmaceutical validation and resupply. Dr Nick Reynolds, consultant in intensive care medicine at Derby Teaching Hospitals, said: “Critical care is a highly technological and hugely data intensive ’24/7′ environment. Even basic hourly charting can result in over 2,000 manually annotated observations, per patient, per day. Patients will benefit from more actively-tailored, accurate and reactive care. The time released by automating data collection and charting will be recycled into providing more personal and pastoral care for patients and their families.”
Quarter of UK care homes ‘at risk of closure’: About 5,000 homes are at risk of closure because they carry too much debt and do not make enough profit to cover loan repayments, reported the BBC. The Department of Health said it was working to make sure care providers had “strong contingency plans”. The research, carried out for Radio 4’s You and Yours programme by business risk analysts, found individual care homes were borrowing about 61% of the value of the business on average – a figure that amounted to £4bn across the industry. There are 20,000 care homes in the UK, which are operated by 5,871 individual owners who make, on average, about £60,000 profit as operators. Business risk adviser Nick Hood, from Opus Business Services, said the figures made investment difficult. He added: “It leaves a very small pot to encourage people to stay in this market and run care homes and to invest in them.” You and Yours reporter Samantha Fenwick said the profitability of care homes had also been hit by rising costs, including the new national living wage of £7.20. John Strowbridge, managing director of Avery Health Care Group, which operates 47 care homes across England, said the new living wage was costing it an additional £2m a year. He also said the fees provided to operators to care for local authority residents were often not enough to match care costs.
West Suffolk live with £19m Cerner EHR: West Suffolk NHS Foundation Trust has gone live with its £19m Cerner electronic patient record (EPR) deployment called e-Care, reported DigitalHealth.net. The EPR went-live over the bank holiday weekend, replacing the hospital’s 20-year-old patient administration system. A hospital spokesperson said: “West Suffolk NHS FT staff (clinical, technical, administrative & senior leadership) and Cerner UK staff have worked tirelessly to achieve this implementation, which is proceeding as planned.” The trust said this “unprecedented overhaul of its IT system” is the biggest single investment it has ever made in IT, but warns that it will take time to bed-in and there will be a period of “potential disruption in the coming weeks”. Stephen Dunn, the trust’s chief executive said: “e-Care is one of the leading IT systems available in this country. It will revolutionise the hospital and bring a whole range of benefits to our patients by modernising and transforming our services. We have spent the last two years preparing for the launch and our staff have received extensive training. However, we are expecting there to be a short period of time when people will find it harder to do their jobs as they learn the way the system works. The benefits of this system over the longer term will far outweigh any short term disruption and our staff who have experienced similar systems working in other hospitals are very excited about the potential it offers.”
Vote for the most influential woman in UK IT 2016: Voting has opened for your chance to help choose the most influential woman in UK IT for 2016. Computer Weekly’s list of the 50 most influential women in UK IT, now in its fifth year, aims to showcase role models in the IT sector and discuss how diversity can make a huge difference to the future of IT. This year’s winner of the title will be announced during a special event as part of London Technology Week on June 23, during which guests can hear talks by industry leaders on the best practices and successful strategies for delivering a more diverse tech workforce. A judging panel has decided the shortlist of 50 of the most influential women in the UK IT industry from a longlist of more than 150 women nominated by our readers – the highest entry we have seen, reflecting the growth in the number of successful and influential women in the sector. In advance of the readers vote on the top 50 list of the most influential women in UK IT, Computer Weekly has also added four of the industry’s most longstanding and successful women to its Hall of Fame, which is designed to showcase women who have made a lifetime contribution to the women in IT agenda. This year, Jacqueline De Rojas, Baroness Joanna Shields, Jane Moran and Dr Sue Black join the Hall of Fame, alongside Dame Wendy Hall, Dame Stephanie Shirley and Baroness Martha Lane Fox who were the Hall of Fame’s inaugural entrants.
Opinion
Healthcare innovation demands understanding, not imitation
We must embrace innovation, not run from it, if the £22bn funding black hole is to be tackled head on, says Paul Kirkham, researcher in the field of entrepreneurial creativity with Nottingham University Business School.
Writing in Health Service Journal (subscription required), Kirkham says: “Not least in light of the recent revelation that the NHS in England has no convincing plan to plug a £22bn ‘black hole’ in funding, the need for healthcare solutions that are both imaginative and cost-effective appears more pressing than ever. The answer may well lie in radical innovation, the general goal of which is to bring value by doing things differently.
“By way of illustration, consider the example of the NHS trust that embraced a novel concept proposed at a creative problem-solving session hosted by Nottingham University Business School. The idea came from one of the trust’s podiatrists, who described how renal patients, particularly those who are also diabetic, are at grave risk of losing their legs as a consequence of circulation issues or pressure sores. Although substantial evidence highlights the advantages of preventive treatment, lack of mobility makes it difficult for these patients to attend clinics. Instead they require home visits, which, because of the amount of time spent on dialysis, are themselves hard to arrange. But what if dedicated renal podiatrists could see patients during dialysis, allowing more of them to receive in-clinic care?
“Senior managers present at the session agreed the proposal could be viable and promised to support it through commissioning routes. The new approach was up and running just a few months later and has since shown itself to be unusually capable of satisfying the ‘triple burden’ of a patient-centred, cost-effective, high-quality service.
“Yet it’s vital to grasp that imitation alone would represent only a Pyrrhic victory for the cause of radical innovation. For the reality is that it’s not enough simply to adopt such a scheme: it’s necessary to comprehend the mindset that made it possible in the first place.
“’Let’s do what they do’ is a short-term philosophy; ‘How did they come up with that?’ is a response much more conducive to a brighter future.”
The industry CCIO: going over to the dark side?
Michael Thick, the chief medical officer and chief clinical information officer of IMS MAXIMS, discusses some of the downsides and benefits of leaving the world of NHS IT for the supplier community.
Writing on DigitalHealth.net, Thick says clinical practice is not the only way to care.
“It is short sighted to imagine that only the clinical fraternity have a passion for good patient care. In every care organisation you will come across very dedicated managers, technicians, administrative and clerical staff,” he writes.
“Their motivation in the morning is to make their place of work one of the best at health care delivery. In fact, wherever you find good quality care, you will also find mutual respect for the importance of each other’s roles.”
He continues: “As with all other major advances, the invention and adoption of tools is critical to moving forwards. The evolution and integration of acute, primary, community and social care information systems can (and already does) greatly amplify the abilities of all staff.
“It does this by giving them the intelligent tools to do more things more effectively with fewer people. However, powerful tools need careful processes and controls in their construction (maybe think cars and emission controls?!)
“It is in this area that the industry CCIO demonstrates their value by bringing the ‘clinical conscience’ into completely different domains.
“Who benefits? Suppliers, the NHS – and patients.”
Dame Fiona Caldicott on data-sharing in health and care
With her much anticipated review into patient data standards due to be published soon, Dame Fiona Caldicott, national data guardian for health and care, speaks to The King’s Fund about data-sharing and the security of data in the health and care sector.
Caldicott outlines the impact she hopes her recommendations will have on health and care: “If the public is willing to trust health and care services with its data, there can be huge benefits for everyone. ‘Information about me’ can be combined to create ‘knowledge about us,’ which is vital for a wide range of uses, from researchers finding breakthroughs in life-saving medicine to regulators realising promptly when things go wrong.
“But there is little public awareness of the way that information is shared, and that trust has not yet been earned. There must be an honest and ongoing conversation with the public and professionals about how data is used and about the choices that people should have and how they can make them.
“The review proposes new data security standards and a new way in which individuals can opt out of their information being used for reasons other than their individual care. I am very clear that the publication of our report is not the end of a process.
Caldicott reveals that new issues around data security were also identified as part of the report: “The Review team found a lot of good practice. However, there are inconsistencies across the system, which is why clear, agreed standards are needed.
“It is essential that we build a robust data security system that protects patients from malicious threats or common human errors, as far as it is possible to do so. It is vitally important that we are never complacent about protection of the precious health and care information of patients and service users. I am optimistic that if the recommendations of the review are accepted we will be moving to an even more reliable and trustworthy system.”
