News in brief
Nursing Tech Fund 2 open: Organisations that want to bid for money from the second round of the Nursing Technology Fund have until 2 December to do it, reports eHealth Insider. NHS England announced this week that bidding for the second round is now open, but will close in just a month. It expects to hand out £20m-£25m in this financial year, and £10m-£15m in 2015-16, with a strong focus on giving nurses access to information at the bedside and out in the community. A prospectus says applications should be “aligned” with “digital capture of clinical data at the point of care” and with “mobile access to digital care records across the community.” Other priorities for this round of funding include access to digital images, IT to enable nurses to locate equipment, workforce development, and specific forms of digital assessment. The organisations that can apply to the fund include both trusts and local authorities, charities and voluntary and social enterprises. NHS England has not only published a prospectus for this round, but more detailed guidance on getting value for money, and obtaining references for projects. Health Service Journal (subscription required) reports that over a third of the flagship £100m nursing technology fund launched by the prime minister has been held back, with the Department of Health (DH) declining to confirm a new date for its release. The DH denied the funding had been cut, but said decisions about the next phase of the fund would not be made until “lessons have been learned from this initial investment”.
Tim Kelsey reveals ‘NHS app store’ plan: The NHS is set to make a fresh push to encourage GPs to prescribe the use of apps and other digital tools in a key strategy document next week, according to an NHS England national director. Tim Kelsey, the body’s national director for patients and information, said the proposals, including an “NHS app store”, would be laid out in a strategy document called Personalising Health and Care 2020. Speaking at the EHI Live 2014 conference in Birmingham, he said NHS England would launch a “voluntary kitemark scheme” – a quality standard for apps – although he indicated plans were not yet finalised, reports Health Service Journal (subscription required). Personalising Health and Care 2020 will set out a framework strategy for the new National Information Board, the group in charge of the NHS’s technology and information strategy. It includes representatives from the Department of Health, NHS England and the Health and Social Care Information Centre. Kelsey said: “We want to provide GPs, citizens [and] carers with some level of reassurance… that the NHS has taken a view of a particular digital tool or service and is able to endorse it. We are going to introduce a kitemarking scheme, which we think will really help developers to take advantage of the trust that people have in the NHS [and] in return [they will] voluntarily submit to a degree of assurance, not an endlessly bureaucratic process, but just something that will give people confidence.”
Get IT ‘right this time’ – Williams: The National Information Board’s framework for action will provide a guiding set of principles for a “revolution” in healthcare IT, Health and Social Care Information Centre chief executive Andy Williams has said. Speaking at EHI Live 2014 in Birmingham, Williams said the long-awaited strategy – due to be unveiled on 13 November – will address questions about how to make better use of data and technology in health and social care, reported eHealth Insider. “I think we’ve actually got an amazing opportunity to change healthcare for the better by actually using information and technology right this time. There’s a revolution coming, and like all good revolutions, it’s coming from the bottom up, not the top down.” Williams said the strategy will be backed by a speech on technology by health secretary Jeremy Hunt. It will focus on six key areas: giving care professionals the data they need; supporting care professionals to make the best use of data and technology; making the quality of care transparent; helping patients to make the right health choices; bringing forward life-saving treatments while supporting innovation and growth; and ensuring best value for the taxpayer. “It will provide a guiding set of principles for everybody to implement the technology that certainly I’d like to see across health and social care.” Williams said the strategy will help to close the technology gap between healthcare and other industries.
Senior DH official: trusts ‘need’ IT directors at board level: The Department of Health’s director general of innovation, growth and technology, Will Cavendish, told the EHI Live 2014 conference that hospitals had failed to give IT the priority it warranted for far too long, reports Health Service Journal (HSJ, subscription required). Addressing the conference in Birmingham, Cavendish said: “IT and technology has been treated as a back office function. And it isn’t. It’s a leadership function. It’s a function which is about change and transformation. And we need chief technologists and chief information officers on our boards [and] part of the decision making about transformation of care, not about the investment in kit. About how decisions are made, not about an email system. That is not common across our health and social care service.”
NHS wastes over £2bn a year on unnecessary or expensive treatments: The NHS is wasting about £2bn a year and risking patients’ health by giving them too many x-rays, drugs and treatments they do not need, Britain’s leading medical body has warned. Patients are too readily tested, diagnosed and treated for certain conditions, the Academy of Medical Royal Colleges claims today in a report that has prompted a debate on whether people are being exposed to unnecessary interventions and stays in hospital in the UK. The academy is calling on all doctors and nurses to start questioning the value of every test and treatment they recommend for patients in order to help the NHS withstand the unprecedented financial pressure it is under and improve patient experience. Professor Terence Stephenson, the academy’s chairman, told The Guardian that some of the medical practices the report highlights are the result of doctors doing everything they can to help a patient and were sometimes prompted by “demanding” patients. Professor Sir Bruce Keogh, the NHS England medical director, welcomed the report and told BBC: “We need to be innovative to tackle the huge financial challenges we are facing, but there are also some more everyday changes that we can make to improve efficiency. This report neatly embodies some practical ideas for more efficient practice.”
Most people don’t know they have the right to view medical records online: More than two-thirds of patients do not realise that they have the right to see their records online, research shows. As many as 71% of people are unaware that technology allows them to access their GP record online or via a smartphone, according to the results of a YouGov survey of 2,243 adults. Respondents added that they would use the technology, or thought it would help manage their health better, reported The Guardian. From next April, all patients registered with a GP in England should be able to have online access to their medical records, under a commitment given by health secretary Jeremy Hunt as part of the Patient Online initiative, designed to allow patients to book appointments, order repeat prescriptions and monitor their records online. Although the target forms part of GPs’ contracts for 2014-15, it is estimated that around 3% of GPs currently offer the service to their patients. Judith Wright, a GP in Oxfordshire, says online record access for patients has reduced the workload for her practice. “Around 250 of our patients currently use Patient Access [an online service run by EMIS] to view their records. We thought it might result in more patient queries but … it can help to cut consultation times. For example, a patient using the service was able to check her test results, so we were able to focus entirely on discussing treatment with her.” GPs with this system can now control the amount of information given to patients online, by using settings tailored to particular groups of patients, for example, those with long-term conditions.
GPSoC contracts to be signed early 2015: The final contracts for suppliers on the GP Systems of Choice (GPSoC) framework will be signed by early next year, the Health and Social Care Information Centre (HSCIC) has told eHealth Insider. Kemi Adenubi, a programme director at the HSCIC, said lot three of the GPSoC framework will help to expand the use of systems and services to improve interoperability between GP practices and other care settings. GPSoC is a framework contract which funds GP IT systems for 75% of practices in England. The framework originally expired in March 2013, but was extended for another year while the Department of Health tendered for a new contract, worth up to £1.2 billion. Adenubi said the original aim of the framework was to expand the number of suppliers available to GP practices while also improving interoperability within primary care. “What we were trying to do was acknowledge the fact that we couldn’t just rely on the primary systems to deliver functionality to GP practices. “We asked GPs what they wanted, and they wanted the opportunity to access other software, and asked to open up interfaces to GP systems so they could go to third party companies.”
NHS Wales presses on with GP IT: NHS Wales is on time and under budget to complete the roll out of a centrally hosted IT service to its GPs by July 2015, reports eHealth Insider (EHI). Andrew MacBean, NHS Wales Informatics Service director for operational services, told the audience at the Information for Commissioning conference at EHI Live 2014 that 65% of practices have now switched to a new system. All Welsh surgeries are moving to a centrally hosted service after a national framework contract was agreed in mid-2012, with Emis and INPS named as the two successful suppliers. Each practice could choose which GP IT system they would like to use and the split is about even between the two suppliers. The first migration was in mid-2013 and MacBean told EHI that migrations are “motoring on” at around four to five per week. “It’s increasingly painless because of the preparation we have done and the work and thinking that’s gone into it that enables it to go ahead like that,” he said. “We are very pleased with it.” During his conference session in Birmingham MacBean said feedback on the new centralised IT support service has been positive.
Many hospital spells wrongly priced, finds official review: A Department of Health-commissioned study of 50 acute trusts found that on average 7% of providers’ spells of care were incorrectly priced due to inaccurate coding, reveals Health Service Journal (HSJ, subscription required). At one trust the error rate in audited care spells was as high as 45.8%. The best performing trust was found to have an error rate of 1.1%. Increasingly tight deadlines for those working in coding departments, inexperienced staff and vacant posts were found by auditors to increase the risk of coding errors. The study, carried out by Capita CHKS, audited 8,990 episodes of care, amounting to £15.3m of NHS spending. Auditors also said that the poor quality of paper case notes which form the source for many coders was a “persistent cause for concern”. “When paper case notes are in a poor condition, it slows the coders’ work and makes it difficult to extract the right information from them,” it said. “To hit deadlines coders often rely on discharge summaries to clarify diagnoses and treatments. However the information in the discharge summaries is often poor and incomplete, resulting in errors.” Providers were found to have “consistently under-recorded” treatment episodes for patients with co-morbidities.
GP funding ‘putting patients at risk’ in Scotland: The Scottish government’s failure to adequately fund GPs is putting patients at risk, according to the organisation that represents general practitioners. The Royal College of General Practitioners (RCGP) warned of “dangerous consequences for patients in the light of continued underfunding”, reported the BBC. A study by the body suggested one in four Scots cannot get an appointment with their GP within a week. The Scottish government said GP funding in Scotland was at record levels. But the RCGP said the Draft Budget for next year showed a real-terms funding drop of 2.2% for GPs. It also claimed long waiting times for appointments, short consultations and weakening relationships between doctors and patients were contributing to a “crisis in general practice”. The RCGP said it had based its conclusions on an analysis of figures from the Scottish government’s Health and Experience Survey 2013/14 and a ComRes poll carried out earlier this year. The poll suggested that a majority of people believe there are too few GPs and would like to see funds moved from other parts of the health service to GPs. One in four of those surveyed said they were unable to obtain an appointment with their GP within a week and, when this happened, 11% of people said they would neither take the later appointment nor seek help elsewhere. RCGP said this raised concerns about untreated conditions.
68% of healthcare breaches caused by loss or theft of devices and files: After analysing three years’ worth of breach records available through the Department of Health and Human Services (HHS), a security firm found that nearly 70% of incidents since 2010 were caused by loss or theft of devices and files, reports SC magazine. While 68% of breaches over the three-year period were attributed to protected health information (PHI) “gone missing,” only 23% of breaches were linked to hacking, said the report, released Tuesday by Bitglass. According to the study called, “The 2014 Bitglass Healthcare Breach Report,” the “overwhelming majority” of healthcare breaches share a common denominator: “inadequate security around devices (or paper) containing PHI,” the report said. The study later added that organisations should “beware of hackers – but pay even closer attention to that employee packing up for the weekend, or taking his/her laptop out the door to his/her car.”
GPs must provide ‘honest explanation’ to patients if something goes wrong, says GMC: Pulse reports that GPs and other medical professionals must provide a ‘clear and honest explanation’ to patients when something goes wrong with their treatment, under new joint guidelines devised by the General Medical Council (GMC) and Nursing and Midwifery Council. The draft guidance proposed in the regulators’ consultation, Openness and honesty when things go wrong: the professional duty of candour, outlines that doctors, nurses and midwives will have a ‘professional duty of candour’ to be open and honest with patients or those close to them, if something goes wrong with their patient care. It also states that if someone in their care has ‘suffered harm or distress’ because something has gone wrong, then the healthcare professional should apologise as soon as it becomes apparent. This follows a joint declaration made by healthcare regulators on the issue last month. The draft guidance calls on clinical leaders and employers to support doctors, nurses and midwives by creating ‘cultures in the workplace that are open, honest, and where people learn from mistakes so that future patients are protected from harm’.
Investment will double number of people getting home healthcare: A £10m fund to increase the number of people receiving diagnosis and treatment at home will support the roll-out of new technology across Scotland’s NHS, according to the health secretary, reports STV. The investment, announced earlier in 2014, will be used to fund a substantial expansion across the country of technology-enabled care. Alex Neil told the Scottish Telehealth and Telecare Conference that the programme will double the number of people receiving clinical consultations using technology and home health monitoring by 2016. Speaking ahead of the event, the health secretary said: “Telehealth and telecare is here and already working, supporting thousands of people in or close to their home. It can reduce the hospitalisation rate of older people with multiple conditions significantly, and improve outcomes for patients who can find it difficult to travel or those who can self-manage their condition.”
Two community trusts get FT status: Two community trusts have been awarded foundation trust status for the first time, Monitor has confirmed. Bridgewater Community Healthcare NHS Trust in the north west of England, Derbyshire Community Health Services NHS Trust have been authorised as foundation trusts (FTs), starting in November. In addition, as The Commissioning Review reports, Royal United Hospital Bath NHS Trust has been authorised as a foundation trust, bringing the total number of FTs in England to 149. The trusts will now be able to give patients, staff and the public the chance to become members or governors with a formal say over how their trusts are run. The trusts will also have more freedom to shape services that match the needs of local people. Miranda Carter, executive director of Provider Appraisal at Monitor, said: “We are pleased to announce the creation of these new foundation trusts. Millions of patients could now have a greater say over their healthcare and the new foundation trusts will have greater freedom to provide services that meet the needs of local people.
#HMvideo @EHI Live
At this week’s EHI Live, Highland Marketing met and interviewed senior personnel from healthcare vendors to ask their views on various essential matters. Below is the first of a series of videos published, which will feature in the HCRU over the coming weeks.
Dr Adam Hill, CMO of Sectra, talks to Highland Marketing at EHI Live 2014 discussing the most important aspects in healthcare IT to help transform the NHS for a sustainable future.
Shane Tickell, CEO of IMS MAXIMS talks to Highland Marketing at EHI Live 2014 about the market reaction to its openMAXIMS solution and some of the governance and security misconceptions of open source software in the healthcare IT industry.
Opinion
Big data: enabling the future of healthcare
By collecting patient data, clinicians can use predictive analytics to prevent potentially deadly conditions says Anthony Jones, chief marketing officer, Philips Healthcare.
“Everyone’s talking about the importance of big data in healthcare. Yet, as the data piles up – most of it is isolated in different silos, and health systems are struggling to turn big data from a concept into a reality. Here’s how I see it having a substantial impact on the health of populations, today and in the future.
“Most healthcare organisations today are using two sets of data: retrospective data, basic event-based information collected from medical records, and real-time clinical data, the information captured and presented at the point of care (imaging, blood pressure, oxygen saturation, heart rate, etc). Pioneering technologies have succeeded in putting these two data pieces together in a way that allows clinicians to grasp the relevant information and use it to identify trends that will impact the future of healthcare – otherwise known as predictive analytics.
“But what if we take data a step further and introduce gene sequencing into the picture? Today, gene sequencing is used primarily to determine the course of treatment for cancer patients. As gene sequencing becomes more common, the cost may fall, making it more likely that we’ll see gene sequencing become a routine part of a patient’s health record. Imagine the kind of impact this data will have on treating infectious diseases, where hours and even minutes matter. The next time there’s a disease outbreak, we could potentially know the genome of the infectious organism, the susceptibility of the organism to various antibiotic therapies, and therefore determine the correct course of action without wasting precious resources in trial and error.
“There’s no doubt that this is a mammoth task, and while we might not be there yet, we are certainly getting closer. There are still challenges ahead: organisations are learning lessons from the early adopters and trying to determine the best ways to cooperate and share data. Undoubtedly the amount of investment required to make big data technologies work is more than what a single segment of the market can afford. That means all stakeholders, including pharmaceuticals, will have to work towards a common vision. But with public-private partnerships paving the way for payers and providers to work more closely together, we are heading towards success, and more importantly, better patient care.”
The Better Care Fund: will the plans work?
After last week’s announcement about the Better Care Fund (BFC) plans Richard Humphries, assistant director at The King’s Fund, evaluates whether the plans will work.
“There’s no doubt that the BCF has galvanised councils and NHS partners to have essential conversations. There is nothing like money to concentrate the mind and there is some excellent work going on, for example in Greenwich and Wiltshire, as we heard at our recent integrated care summit. But much of this work pre-dates the BCF and accords with the evidence that the benefits of joined-up care take years to achieve.
“The fundamental limitations of the BCF have not changed – it is not new money, amounting to less than 5%t of total NHS and social care spend – though Norman Lamb has talked of ‘total pooling at local level by 2018’. It does not address the cost of the service changes needed to reduce hospital admissions by shifting care closer to home. The central proposition – that the BCF will reduce hospital admissions by a surprisingly precise figure of 3.07% – is the shakiest.
“Meanwhile the financial and service pressures on the NHS and care system are simultaneously intensifying as our latest quarterly monitoring report and last week’s LGA/ADASS report testify. Although I have never known a time in my own career when local government’s commitment to working with the NHS has been greater, the mood among local authority delegates in Manchester last week was sombre. The BCF rule changes this summer have soured relationships with the NHS, with a barely concealed feeling that NHS England had reneged on the initial deal. The shift of financial risk back towards councils will come back to bite the NHS when the consequences of next year’s local authority budgets become clear.
“So, as the NHS and local government edge closer to the financial precipice, the BCF is well-intentioned but no substitute for a proper transformation fund to meet the double-running costs of shifting care closer to home and short-term action to address the gathering financial storm. In the longer-term we need a new settlement to place health and care on a sustainable footing.”
Is general practice really in crisis? Moving beyond the headlines
Jonathon Fagge, CEO at the Norwich Clinical Commissioning Group, blogs on how recent media coverage is not telling the whole story of the growing gap in the GP workforce and reducing access to services over the next decade.
“A sample of headlines about general practice over any seven day period for the last six months would likely describe a service either on the brink of – or already engulfed within – a serious and potentially intractable crisis.
“A further narrative has developed in the press about quality, modernisation, and efficiency. The positive side of the debate offers a vision for a future model of primary care – practices coalescing around populations of up to 100,000 patients, offering seven day services from purpose built facilities.
“And if the analysis that 90% of all patient contact occurs in primary care is accurate, the consequences of service decline are serious for every part of the NHS. In excess of 10,000 patients per day visit their doctor’s surgery in Norfolk. By comparison, the total daily attendance at A&E across the three local hospitals is around 600. Small ripples in primary care make for very large waves across the rest of the service.
“However, careful analysis of the stories reveals mostly speculation, anecdote, and extrapolation from small data. The absence of reliable information on the national picture makes it difficult for policy-makers to distinguish a genuine crisis from the general picture of the wider NHS under sustained financial and operational pressure.”
Highland Marketing blog
With the announcement of the Nursing Technology Fund round two and reports on reducing waste in the health service, Mark Venables asks ‘is technology getting its fair share of NHS cash?’
