News in brief
Sir David Nicholson: “I am the right man to lead NHS”: Sir David Nicholson has insisted he is the right man to continue leading the NHS, despite MPs on an influential Commons’ committee accusing him of doing too little to stop the Mid Staffordshire hospital scandal, reported The Guardian. Nicholson, who has been under growing pressure to resign, told the health select committee he was “absolutely determined” to stay in his post in order to see the service through the major changes happening in April and ensure that major improvements are made to quality of care, patient safety and NHS regulation. The healthcare investigator who uncovered the scandal has also urged him to go and 20 MPs have signed a Commons early day motion demanding his departure. David Cameron, health secretary Jeremy Hunt, and Deputy Prime Minister Nick Clegg have all so far stood by Nicholson.
Kelsey dilutes digital records target: An NHS Commissioning Board target for all hospitals to have electronic patient record systems (EPR) by 2014 has been watered down, the director overseeing the work has told HSJ (subscription required). The board’s director for patients and information Tim Kelsey has admitted the target, which was derived from its 2013-14 planning guidance, would be “literally physically impossible” for some trusts. The planning guidance, called Everyone Counts and published in December, said: “We will expect secondary care providers to be able to account for the outcomes of all patients they treat and to adopt modern, safe standards of electronic record keeping by 2014-15.” Kelsey told HSJ in January that acute trusts which did not yet have EPR systems in place had just a year left to rectify this because the guidance “implied the existence of [an EPR]”. However, he told HSJ this week: “What we are saying is that, ideally, we expect trusts to have done it by April 2014.
Central funding decision due by April: Six southern acute procurement groups hope to hear by April whether their IT investment plans will be backed-up by central funding, reported eHealth Insider. Twenty-one acute trusts that received nothing from the National Programme for IT in the NHS have collaborated to invest in a variety of IT systems ranging from ePrescribing to portals. They aim to secure central funding for the systems and the consolidated outline business case is awaiting Cabinet Office and Treasury approval. Frimley Park Hospital NHS Foundation Trust, Ashford and St Peter’s Hospitals NHS Trust and Heatherwood and Wexham Park Hospitals NHS Foundation Trust have formed a group to procure a clinical electronic document management system. Frimley Park chief executive Andrew Morris said the trusts decided to work together because they had similar patient administration systems and electronic patient record strategies.
Regulators team up on ‘failure and distress regime’: Monitor and the Care Quality Commission (CQC) are developing a “single failure and distress regime” which aims to increase the consequences of quality failures for trusts. In an exclusive interview with HSJ (subscription required), CQC chief executive David Behan said the CQC was also planning to again review its core standards. The plans are in response to last month’s Francis report into the failure of regulators and others to spot and act on care failings at Mid Staffordshire NHS Foundation Trust. In his report Robert Francis QC recommended the CQC take on Monitor’s powers over financial and corporate governance of foundation trusts. HSJ understands this is unlikely to be enacted but the government wants to increase the consequences of care failures.
London hospitals fear more mergers as NHS trusts tackle £140m deficit crisis: London hospitals are facing a deficit crisis of more than £140 million, reported the London Evening Standard. Figures reveal that at least six hospital trusts have overspent their budgets – and some have asked for extra funding to break even. In some cases, the crisis is threatening to affect other hospitals as health chiefs resort to further mergers and cutbacks. Top of the list is South London Healthcare NHS Trust, which is forecasting a £49.5 million deficit by the end of this financial year. The trust will be broken up in October but its debts have already hit Lewisham hospital, which was downgraded despite protests. Barking, Havering and Redbridge University Hospitals NHS trust said that it will end the financial year £39.7 million in the red. John Lister, of campaign group London Health Emergency, said: “Some trusts are saddled with monstrous PFI debt — and it’s costing them a fortune to service this.”
GPSoC to mandate online patient access: A new report has revealed that the IT necessary to provide patients with online access to their GP records needs to be mandated via the GP Systems of Choice contract, reported eHealth Insider. The government has committed that by 2015 all patients will have secure online access to their GP record if they want it. All practices must also make transactional services available online such as booking appointments and ordering repeat prescriptions. The government asked the Royal College of GPs to lead on development of guidance to make this goal a reality. Its report, Patient Online: The Road Map, concludes that there are demonstrable benefits for giving patients online access to transactional services, but not to their records. “Providing online access to records is acknowledged to be potentially empowering for patients and a shared goal for the consumers and funders of health care,” it says.
Productivity in the NHS ‘stubbornly stagnant’, reveals report: A new report has revealed that productivity in the NHS remains “stubbornly stagnant”, its workforce is shrinking and GP surgeries are receiving less money than before to spend on patient care, reported The Guardian. A growing number of NHS organisations, especially hospital trusts, are getting into financial difficulties partly because of the cost of private finance initiative deals. And exposing health services to competition makes staff less, rather than more, productive, the analysis of NHS finances shows. But despite its tight budget and rising demand for healthcare, the NHS in England still generated a £1.4bn surplus last year from its £105.4bn budget, which the Treasury mostly clawed back, giving just £316m back to the Department of Health.
Southern Cerner live sites collaborate: Nine Cerner live sites in the South have formed three groups to procure a replacement for Millennium beyond October 2015, reported eHealth Insider. The trusts received Cerner’s Millennium electronic patient record system as part of the National Programme for IT in the NHS, initially from local service provider Fujitsu, and then from BT. The contracts run out in October 2015. Senior representatives of the trusts meet regularly as part of a Cerner live site group, but they have not previously released details of their plans. NHS South East Coast chief information officer Tad Matus said the southern trusts had formed three groups to work on their plans for post-NPfIT contracts. “The nine organisations won’t go as a single consortium, but three broad flavours of how they want to specifiy what they want to do,” he said.
NHS trust upgrades old Microsoft CRM in favour of new, heavily customised version: Cumbria Partnership NHS Foundation Trust has upgraded its old Microsoft Dynamics CRM solution with a new version which has been implemented by Optevia, reported Computerworld UK. The solution is being used to analyse stakeholder engagement activity. The trust’s GP stakeholder engagement team was established to work with partners in the area, namely GPs, to gain feedback on what action could be taken to improve healthcare services across the six districts in the region. Tom Bell, GP stakeholder engagement manager at Cumbria Partnership NHS Foundation Trust told ComputerWorld UK that the trust struggled with the previous Microsoft CRM solution because it was too standardised and didn’t allow the team to develop new fields to capture data. The trust’s new CRM system took approximately six months to implement and the team has met with over 300 organisations and captured data from 600 meetings to improve healthcare services in the area.
NHS ‘privatisation’ reform ‘could place people in danger’: The chairman of the Academy of Royal Medical Colleges has said exposing more of the NHS to private competition could cause a “dangerous” fragmentation of health services in England, reported the BBC. Prof Terence Stephenson said patients could be “in danger from complications” if the NHS is not “joined up”. He has written to health minister Lord Howe to request an urgent meeting. A Department of Health spokesperson said they were working to address the “concerns” of clinicians.
GPs could be first for Ofsted ratings: GPs could be the first healthcare providers to be subject to new Ofsted-style ratings but it could take up to five years to develop the system for hospitals, reported HSJ (subscription required). Jennifer Dixon, Nuffield Trust chief executive was asked to look into the feasibility of an Ofsted-style standards rating for health and social care by health secretary Jeremy Hunt in November. She is due to report this month. In a webcast on hsj.co.uk last week Dixon suggested the first providers to receive single ratings “might be social care and possibly less complicated providers in health, meaning general practice”. “Hospitals might take longer to develop properly if we want to move down into clinical service areas where the data has yet to be developed,” she added.
Dr Jenny Dean joins Harris Healthcare Solutions as medical director: Harris Healthcare Solutions has named Dr Jenny Dean as its new medical director for Europe, the Middle East and Africa (EMEA), reported Building Better Healthcare. Helen Parslow, director of marketing and business development Harris Healthcare Solutions EMEA said: “Dr Dean’s ability to draw on her broad knowledge and experience accumulated through years of clinical practice, an MBA with entrepreneurial focus, healthcare management consulting and networking will be a huge asset for Harris Healthcare.” Dr Dean will be responsible for providing clinical input, from product management and road mapping to ensuring the solutions offered meet the changing needs of the market.
Stalis and IPROS CUBE collaborate to support quality service improvements across all healthcare settings: Stalis and IPROS CUBE have announced a partnership to launch a Patient Experience feedback module, reported eHealth News. This new solution will bring together a blend of technology expertise for healthcare providers to manage, monitor and analyse online patient experience surveys to support performance measurements and delivery of quality service improvements in line with government targets. The Patient Experience module allows patients to provide confidential feedback, via an online questionnaire which is tailored to the requirements of the healthcare provider. Christine Whitehouse, managing director at Stalis said: “With a drive towards patient empowerment in a more consumer-orientated NHS, there is a clear requirement for an integrated electronic patient feedback solution to ensure healthcare providers meet care quality standards.”
Department of Health to build ‘Dementia Village’ at Healthcare Innovation Expo: The Department of Health (DH) is hosting a major dementia event at the Healthcare Innovation Expo at ExCeL London on 13th/14th of March 2013. A dedicated area of the exhibition hall will be devoted to a ‘Dementia Village’ to showcase good practice and innovation in dementia care, dementia friendly communities and research. The village will contain a main stage for speakers, a village green and bandstand with leisure and entertainment activities to get involved in, and a house demonstrating ways that we can support people with dementia and their careers to live well.
Opinion
Patients and staff can both promote innovation
In this week’s opinion on HSJ (subscription required) Paul Corrigan, director of strategy and commissioning of the NHS London Strategic Health Authority discusses the main ways for spreading innovation in other industries are through staff and customers and why the NHS should follow suit.
“When I worked as a political adviser in Whitehall people would regularly come to see me with a gizmo they said would save the NHS. Sometimes it was private companies, sometimes NHS staff. What they wanted to know was: who was the person they needed to go and see who would be able to tell the whole NHS to implement their innovation, and could I introduce them? They had already tried seeing X and Y, but they didn’t seem to have the power to make this happen.”
Corrigan goes on to say that the people who went to see him were hoping there would be a single person that would tell the NHS − with its million public consultations every 36 hours − what to do. As imaginative innovators, they were desperate for the NHS to be a Stalinist organisation that would tell everyone to carry out their very new innovation.
“In other industries the main way innovation is spread is the pull of innovation into every corner of the industry. The main mechanisms for pulling the spread of innovation are staff and customers. In these industries, senior staff bring the new idea into their organisation. They think: “If we don’t keep up and exceed the speed in which other organisations are pulling innovation into them, then we will fail.” Staff are constantly scanning the horizon for new ideas for their organisations and the better they scan, the better the organisation does.
“Let’s learn from others and publish which practices are not complying and give the public the right to quickly and easily move to those that are. Patient groups would provide some of the power of pull to make this happen.”
From the frontline
In an article this week for eHealth Insider, Andrew Carr, an emergency nurse practitioner at Cambridge University Hospitals NHS Foundation Trust, discusses the impact of NHS staff using social media.
Following guidance called ‘HR and Social Media in the NHS’ by NHS Employers, which outlines many opportunities to engage with online audiences, Carr suggests social media is yet to be adopted by the NHS: “Most NHS IT networks block staff access to any form of social media with paternalistic vigour, so it’s hard to avoid the conclusion that most trusts are suspicious about social media and how it might be used to impact on their reputation.
“Social media offers an opportunity to promote leadership, direct learning, and unparalleled democratisation of access to decision makers. No other medium allows the voice of the individual to be heard as an equal.
“Helping staff to use it will, no doubt, create a few sticky moments. But as even NHS Employers acknowledges: “The next generation of NHS staff will never have known a world without the internet or mobile phones. How the NHS embraces their use of social media for the benefits of staff and patients will be crucial in creating a sustainable NHS.”
An NHS doctor’s top 10 tips to meet the Digital Challenge
Following heath secretary Jeremy Hunt’s paperless challenge, Dr Paul Shannon, consultant anaesthetist in the NHS and medical director at CSC explains to Building Better Healthcare how care coordination is essential to avoid duplicate treatment and to prevent medical errors and provides his own top ten tips on how the digital challenge can support this.
He adds that GPs, hospitals, other healthcare providers or local authorities are all at different levels of implementing IT but that for healthcare providers to properly exchange information and coordinate care, it should be in “near-real time.”
In his piece, Dr Shannon advises that we make more use of existing, national tools that are already “up and running” such as “NHSmail, Choose and Book and the Summary Care record.” He also raises the importance of automating the discharge summary, implementing ePrescribing and exploiting ‘departmental’ systems to the maximum.
Among others he advises that trusts should need to get their heads into a ‘portal mentality’ and ensuring business continuity.
Blog
In this week’s blog Joanne Murray asks from a patient’s point of view ‘what is causing the hold up to a paperless NHS?’
