News in brief
NHS accused of wasting billions on unnecessary hospital admissions: The NHS is wasting billions of pounds a year by admitting too many patients unnecessarily, persisting with treatments that bring little benefit, and not doing more operations at weekends, reported The Guardian. Dr Foster’s Hospital Guide details how a combination of poor care, inefficient practices and medical and social care outside hospitals are all eating into the NHS’ budget. This is occurring just as the big annual rises it enjoyed, until recently, have been stopped while demand for its services is growing. The guide found that 29% of hospital beds are occupied by patients who were admitted to hospital unnecessarily and could have been treated elsewhere.
You HAVE cut spending on NHS: Official stats watchdog embarrasses Cameron: David Cameron and the Health Secretary Jeremy Hunt have been publicly rebuked by the government’s own statistics watchdog for claiming that spending on the NHS has risen under the Conservatives, reported The Independent. In a deeply embarrassing and damaging intervention ahead of George Osborne’s Autumn Statement, Andrew Dilnot, chair of the UK Statistics Authority, concluded that spending on the NHS is actually lower in real terms now than it was in 2010. Mr Cameron’s pledge to protect health spending from public sector cuts has been central to the Government’s strategy of proving it can be trusted on the NHS. In the election the Tories spent thousands of pounds on advertising promising to “cut the deficit not the NHS”.
Health spending to be protected from cuts: The Chancellor’s Autumn Statement protected the health service budget, despite a Whitehall-wide spending cut of £5bn across other departments, reported National Health Executive. The chancellor also scrapped plans to introduce regional pay into the NHS. A new form of private financing, PF2, could now be used to fund NHS capital projects, whilst allowing the public sector to have greater control of the spending. NHS organisations have greeted the Statement with mixed feeling, and some have criticised the lack of comment on the Dilnot Commission on social care funding. The NHS Confederation’s chief executive, Mike Farrar warned that despite the pledge not to reduce the healthcare budget, the NHS was still facing “immense financial pressures.”
NHS Commissioning Board publishes plans for GPs’ IT: The provision of GP IT services are to be given to clinical commissioning groups (CCGs), in a move which could see doctors’ systems outsourced to third-party providers, according to the NHS Commissioning Board’s (NHS CB) strategy, reported Computer Weekly. The NHS CB is to discharge its operational responsibilities for GP IT services to CCGs, which will then commission these services locally by April 2013. In the NHS CB’s Securing Excellence in GP IT Services, the body lays out how the management of IT systems for GP practices will be organised.
Full hospitals creating potential danger, analysis says: An analysis carried out by a private research group has revealed that hospitals are “full to bursting” in England, creating a potentially dangerous environment for patients, reported the BBC. To cope with surges in demand hospitals should run at about 85% capacity, however the figures show the NHS average hovering around that mark. Ministers denied the NHS is overcrowded and said it could manage demand peaks.
Next ten Lorenzo adopters each get £1m: The next ten NHS trusts that commit to take Lorenzo from CSC under the firm’s new National Programme for IT in the NHS deal will each get a signing-on bonus of £1m for implementation expenses. The £1m would be in addition to up to £4m, eHealth Insider understands, and that each trust that takes Lorenzo can call on for deployment and training costs under the new interim agreement between the Department of Health (DH) and CSC. This would mean that ten trusts could claim up to £5m each. To be eligible for the £1m payment, trusts must sign-off a project initiation document to take Lorenzo before 31 March 2013.
CfH event will discuss new GP systems of choice framework: NHS Connecting for Health (CfH) is to hold an event next week to discuss the future of GP Systems of Choice (GPSoC), the scheme through which the NHS funds the provision of clinical IT systems in GP practices in England, reported Government Computing. The event, on 12th December in London, is aimed at current and prospective suppliers to the primary care IT marketplace with the current GPSoC framework coming to an end at the end of March 2013. The new framework being planned is likely to involve a much broader range of suppliers, CfH said.
Interest high in EMR deployment: Fifty trusts gathered at Basildon and Thurrock University Hospitals Foundation Trust’s electronic medical record summit this week to hear about how the trust procured and implemented a bespoke EMR, reported eHealth Insider. The system went live in October last year and provides clinicians with access to a patient’s historic records and displays real-time information from the patient administration system and a number of others including pathology and radiology. Many of the trusts who attended were looking to procure an EMR system and some are already out to tender.
Circle chief executive Ali Parsa steps down: It was announced this week that Ali Parsa has stepped down from his role as chief executive of Circle, the private healthcare provider that runs Hinchingbrooke Health Care Trust, reported HSJ (subscription required). A statement released by the company said that Circle’s head of mobilisation, Steve Melton, had taken on the chief executive role on an interim basis while the board recruited a permanent successor. Parsa will remain on the board as founder and non-executive director.
NHS will have to admit to patient safety failures: New rules to toughen transparency in NHS organisations and increase patient confidence have been announced this week by the Health Minister Dr Dan Poulter, reported the Department of Health. From April 2013, the NHS CB will be required to include a contractual duty of openness in all commissioning contracts. This means that NHS organisations will be required to tell patients if their safety has been compromised, and ensure that lessons are learned to prevent them from being repeated. The health minister said: “Patients place great faith in the NHS organisations that treat them, and they in turn have a duty to be honest and open about every aspect of care they deliver. When mistakes are made, we want them acknowledged, patients informed and lessons to be learnt.”
Nurses told to focus on compassionate care: Nurses are being urged to focus on compassionate care, amid concerns that some patients are not receiving the level of treatment to which they are entitled, reported The Guardian. Under a new three-year strategy ‘Compassion in Practice’, recruitment, appraisal and training of staff will be based on values as well as technical skill. Jane Cummings, the chief nursing officer for England, described poor care as a “betrayal” of nursing and other related profession. She said “while the health, care and support system provides a good – often excellent – service, this is not universal, there is poor care, sometimes very poor. Such poor care is a betrayal of what we all stand for.”
Funding pressure ‘may hit NHS care’, warns thinktank: According to a King’s Fund report, waiting times in emergency wards are rising as unprecedented financial strains on the health service start to bite, reported HSJ (subscription required). In the last year the number of patients waiting more than four hours in A&E has risen by 19%. While the report concludes that the NHS is “holding up”, it suggests the health service is entering a period of significant risk which could jeopardise progress made in the last decade.
NHS friends and family benchmark too crude, says ex-Lansley adviser: Rating hospitals by whether patients would recommend their services to families and friends, one of the government’s key new benchmarks for the NHS, is a “narrow and crude” method for assessing complex healthcare treatments, according to Andrew Lansley’s former policy adviser, reported The Guardian. Bill Morgan, who as the former health secretary’s aide helped design the health reforms, is critical of plans unveiled by health secretary, Jeremy Hunt, to financially reward hospitals based on rankings of whether patients would recommend them to a friend and family member. From next April A&E patients will be able to give feedback on the quality of their care, followed in October 2013 by women in maternity units.
NHS medical director wants surgeon league tables: The BBC has reported that Sir Bruce Keogh, medical director of the NHS in England plans to publish individual surgeons’ results within two years. He believes this will force clinicians to focus on their performance and seek help when surgical practice falls below acceptable standards. Health Secretary Jeremy Hunt supports the plan to publish individual surgeons’ results, however the BMA says league tables may lead some surgeons to avoid complex cases.
Webinar Session
Integrated care model – Wednesday 12th December 2012 – 1pm–2pm GMT, Location – at your desk!
Presented by Dr Rob Beardall, chief medical officer, Net.Orange and Dr Graham Butcher, clinical director for medicine, Southport & Ormskirk NHS Trust, the learning outcome of this webinar will enable participants to:
- identify high risk patients and implement explicit, targeted interventions;
- proactively manage transitions (discharge) to reduce readmissions;
- establish a proactive care coordination model focused on key pathway segments within “longitudinal care plans” (clearly define services in the context of what, how, who, where and when care is delivered).
Attendees are required to register, via the following web link: Integrated care model where they will be given all the necessary information on how to join the webinar.
Opinion
Understanding the new care agenda
Neil Matthewman chief executive of national care provider Community Integrated Care, writes in Public Service this week that we can offer better care and support for vulnerable people through more effective provider and commissioner collaboration. He agrees that there is no doubting the fact that the 2012 Health and Social Care Act is transforming the care sector and perhaps represents the biggest change to healthcare provision in the UK since the inception of the NHS and that the reverberations of this seismic change can be seen at every tier of the health system. However, he believes that what has not received the same levels of attention is the issue of how providers will respond to these changes – in particular the move to clinical commissioning.
He says there are three main challenges Clinical Commissioning Groups face in commissioning services:
1. Outcomes. How do you find providers that can deliver the outcomes that people deserve? CCGs are tasked with improving the health and wellbeing of people in their local communities, which is easier said than done.
2. Cost. It goes without saying that real cost savings need to be found in the care sector. Therefore, the new approaches to health commissioning need to deliver truly cost-effective services.
3. Integration. From the CCG boards through to the frontline providers, and everyone in-between, there needs to be a greater focus on partnership and the development of services that are seamless for users.
He adds: “Clinical commissioners have been tasked with improving the quality of services, improving prevention, finding new solutions and delivering better outcomes. By being proactive, creative and receptive, I believe care providers can play their part in making these ambitions a reality.”
Build and they will come
In an opinion in Building Better Healthcare this week, Wayne Parslow, VP EMEA Harris Healthcare explores the reasons why the health sector has fallen so far behind other industries in the deployment of technology. He argues that in order to provide true value-based healthcare, not only must patient information be made available across different care settings and geographical boundaries but the systems that support that process must be built so flexibly that they are future proofed for decades to come. He adds that the underlying architecture that supports the systems is of equal, if not, more importance than the actual solution.
“While I believe that architecture needs to be higher up the clinical agenda, it is the real decisions-makers within the NHS that need to be clearer and stronger about the demands they make on suppliers. That is not only listing exactly what they need but in turn ensuring solutions are then built and tailored to their every requirement. They also need to be insistent and set criteria that states to suppliers that ‘we will not work with you unless your products integrate with others so that we are not locked into any one vendor’.”
The King’s Fund on how general practice should change
There is much to celebrate about today’s general practice, writes Dr Anna Dixon. Significant improvements have been made in managing chronic illness over the past decade and the majority of patients report a good experience of care.
The Royal College of General Practitioners (RCGP) recently ran its own consultation on the future of general practice which also recognised the need to develop new models of primary care to meet changing health needs.
If general practice is to rise to this challenge, among other things it needs to:
- Work with a wider range of health and social care professionals to deliver more integrated care for patients with complex health and social care needs.
- Work with hospitals and community service providers to develop models of shared care that ensure timely and appropriate access to urgent care for patients 24/7.
- Be more proactive in reaching out to high-risk groups and working with local authorities to promote health and prevent disease.
Dr Dixon adds: “There are fine ‘proactive and innovative’ examples of practices leading the way such as Kent, Birmingham and Fulham and Hammersmith, although there are specific struggles for London, where there are less GPs per head of population.
“Looking ahead, clinical commissioning groups need to engage their member practices in understanding these variations and identifying priorities for improvement. A wealth of data is available which, if presented in accessible ways, can shed light on the health needs of local population groups and the priorities that need to be tackled. Data can also help to identify high performing practices from which others can learn, as well as those that need extra support to improve.”
Nurses have not stopped caring
In a week when a three-year strategy to focus on “compassionate care” was announced by Jane Cummings, chief nursing officer for England, Ellie Mae O’Hagan asks Guardian readers why it is politically expedient to blame substandard NHS care upon cold-hearted staff rather than disastrous health policies?
“I’ve always found it strange that when a privatised institution is accused of wrongdoing, the resulting conversation usually frames those involved as bad apples that must be disposed of in order for the institution to carry on as normal. But when the same happens to a public institution, the individuals involved are ignored in favour of ideas about institutional crisis and bad behaviour becoming routine.
“It was evident again this week when the Labour MP Ann Clwyd revealed the appalling treatment her husband received as he was dying in the University Hospital of Wales, in Cardiff. Clwyd, the MP for Cynon Valley since 1984 said her husband lay crushed “like a battery hen” against the bars of his hospital bed with an oxygen mask so small it cut into his face and pumped cold air into his infected eye. She suggested that a “normalisation of cruelty” is now rife among NHS nurses, and that her husband’s treatment had become “commonplace”.
“I am not interested in detracting from Ann Clwyd’s experience, which sounds horrific. But I do think it’s important that, if there is a decline in NHS care, we ask why it might have happened. It simply does not make sense that nurses have suddenly become cruel and lacking in compassion, if indeed they have, without any motivating factor or change in circumstances.
While writing this piece, Ellie spoke to health professionals anonymously who wished to respond to the negative stories surrounding nurses this week. One nurse told her that she worked a shift where there was no clean linen available in the entire hospital and patients had to lie in their beds naked: “I hated seeing my patients like that”. Ellie goes on to say that NHS employees cannot speak to the press unsolicited – as it is considered gross misconduct, (the same charge as killing a patient). Those who approached her did so because their desperation had finally outweighed their fear.
“When a government wants to dismantle a beloved institution, it is expedient to suggest that it is suffering from a malignancy. It is easier for the media to imagine nurses as the feckless bad mothers of the NHS, rather than dedicated professionals struggling to maintain standards in a system being gradually hollowed out. Awful experiences like Ann Clwyd’s are given disproportionate focus by a political and media class that would like us to believe that things are simple: that nurses have just stopped caring. The reality is complicated, and – since we all need the care of a nurse sooner or later – it’s time we started to acknowledge that.”
Highland Marketing Blog
In this week’s blog, our industry advisor Ravi Kumar discusses whether social media in healthcare marketing is an opportunity or obstacle and offers a few tips for best practice.
