News in brief
A&E crisis rapidly deepening, new figures show: New figures reported by The Telegraph show the crisis in the NHS is rapidly escalating with worsening access to accident & emergency departments across the country. The official statistics disclose that performance against a target to see patients within four hours – which was the worst for a decade over Christmas – deteriorated sharply over New Year. Fewer than 80% of patients were seen within the timescale in major A&Es, in the week ending January 4 and fewer than 87% were seen within the time in all types of casualty unit. Figures published on Tuesday show that the week before, 85.7% of patients were seen in four hours in major A&Es, with a figure of 90.5% across all types of unit. Those figures prompted major alarm about the scale of the crisis in A&E. On Friday morning two hospitals on the South Coast declared black alerts warning they were “currently ‘bulging” with sick people as staff struggle to cope with the “unprecedented” demand. David Cameron said the current crisis is being fuelled by such difficulties, especially among the frail elderly and said more needed to be done to improve access to GPs.
Unrealistic better care fund targets must be revised, says NHS England: Projected savings of more than £250m from the government’s flagship integrated care policy are at risk after NHS England said the reductions in emergency activity underpinning them would have to be ‘revised downward’ to become more realistic, reported Health Service Journal (HSJ, subscription required). In the autumn ministers claimed the better care fund would save £253m from reduced emergency admissions during 2015-16, accounting for nearly half of the total savings it predicted would be yielded by the policy. The projected saving was based on a forecast cut in non-elective admissions of 3.07%, calculated from local better care fund plans submitted by health and wellbeing boards across the country in September. The fall in admissions and related savings were planned to come about as a result of new, jointly commissioned NHS and social care services. However, new planning information for clinical commissioning groups published by NHS England alongside the 2015-16 planning guidance just before Christmas said these emergency activity forecasts will now have to be revisited.
Circle in talks to exit private contract to run Hinchingbrooke hospital: The healthcare company Circle said it plans to pull out of its contract to manage Britain’s first privately run hospital, Hinchingbrooke in Cambridgeshire, The Guardian has reported. Circle Holdings issued a statement to the London Stock Exchange blaming funding cuts, a surge in demand for accident and emergency services and a failure to deliver “joined up” reform between health and social services. It said the company has entered into discussions with the NHS Trust Development Authority “with the view to ensuring an orderly withdrawal from the current contract.” The announcement comes ahead of a report by the Care Quality Commission’s (CQC) new regime, which is expected to be highly critical of the hospital. The Circle statement said the reports’ conclusions, which follow a preliminary report last year, would be unbalanced and that it would contest many of them. In preliminary findings released in September, the CQC reported patients at the hospital were being neglected, hygiene was inadequate and Hinchingbrooke was facing staffing problems. Steve Melton, Circle’s chief executive, said in a statement: “Like most hospitals, over the past year, Hinchingbrooke saw unprecedented A&E attendances and not enough care places for healthy patients awaiting discharge.”
Stevens calls for digital NHS front door: NHS England chief executive Simon Stevens has called for the creation of a digital urgent care ‘front door’ for the health service, as the performance of A&E has become an early general election issue, reported eHealth Insider. NHS England yesterday released information about where £700m of ‘winter pressures’ funding has been spent, with Stevens arguing that “the NHS, the Department of Health and local clinicians have done everything that could be reasonably expected to plan carefully and expand services over the winter.” However, in a statement accompanying the data he added: “For the future it is clear that we also need a fundamental redesign of the NHS urgent care ‘front door’.” NHS England also released information about A&E performance over the festive season yesterday, which showed that in the immediate run-up to Christmas the NHS saw 446,500 attendances at A&E; up 38,000 on the same week the previous year. The commissioning board argued that since “more than nine out of ten” attendees were still treated within the four hour target time, this meant the health service “successfully treated more patients in under four hours than ever before”.
Data cast doubt on Andy Burnham’s NHS privatisation claims: At the heart of Labour’s attack on Conservative management of the NHS on Monday was a claim that the coalition’s actions over the past four years will lead to the service’s “privatisation”. Labour hopes this charge will resonate with a nation that, in contrast with its European neighbours, has long regarded private sector involvement in healthcare provision with suspicion. Andy Burnham, shadow health secretary, on Monday told the BBC that the NHS would be sunk by “a toxic mix of cuts and privatisation”. The Financial Times said he made two specific charges: that the Health and Social Care Act, enacted in April 2013, obliged health commissioners to put all contracts out to tender. His second argument was that legislation that allows hospitals to earn up to half their income from treating private patients, would “change the way our hospitals worked”, creating a US-style two-tier system. John Appleby, chief economist at the King’s Fund, argued that, rather than viewing healthcare through a private/public prism, and making the assumption that private was “bad”, Mr Burnham should focus on securing quality and value for the taxpayer.
English NHS better than Scottish NHS, says Cameron: David Cameron has claimed that the NHS in England, for which his government is responsible, is better than the NHS in Scotland amid the worst accident and emergency crisis south of the Border in a decade, reported The Scotsman. In a fiery Prime Minister’s questions dominated by problems with A&E in England, Mr Cameron refused to accept Labour leader Ed Miliband’s description that it was a “crisis” and insisted his government was doing a better job than Labour and the SNP. The latest figures show at least 14 NHS hospitals in England have declared a major incident, meaning they have been forced to cancel operations and draft in extra staff to support A&E while the target of seeing 95% of patients in less than four hours has been missed. In Scotland, NHS Greater Glasgow, NHS Grampian and NHS Lothian have all admitted to postponing operations because A&Es has been swamped. Defending his own record, Mr Cameron said: “Our changes [to the NHS] have cut bureaucracy and saved £4.9bn. That is why there are 9,000 more doctors, 3,000 more nurses, there are six million more people getting in-patient appointments.”
General practice will be a ‘virtual service’ in new towns, says Stevens: General practice will in future be accessed via a ‘virtual primary care service’ with patients calling GPs on their iPhone and face-to-face interaction happening via video consultation, NHS England’s chief executive has said. Pulse reports, that in an interview with the Financial Times, Simon Stevens said that the concept of physically attending a GP appointment was ‘alien’ to entire generations of people in their teens, 20s and 30s. He said that the NHS will look to pioneer this new health service model in new towns, like Ebbsfleet in Kent, and in high population growth areas like Tower Hamlets. Mr Stevens told the Financial Times these towns would start with ‘the default assumption that digital interaction will be the main way that people will interact with the health service’. He said that rather than registering with a GP, patients would sign on to: ‘the virtual primary care service, and then… rather than booking an appointment, just be able to call up a doctor or a nurse on [their] iPhone, and have the face-to-face interaction there’. He added: “The idea of booking appointments and physically turning up to GP surgeries for routine things is an alien concept.”
HSCIC data lab to launch in March: The Health and Social Care Information Centre (HSCIC) will launch a secure data lab for viewing sensitive patient data in March, allowing it to support the pathfinder stage of NHS England’s controversial care.data programme. It is currently considering four separate but not exclusive options for secure data access, including a physical facility in Leeds, reported eHealth Insider In July, HSCIC chief executive Andy Williams said the organisation was working on plans for a secure data lab, in which organisations can view sensitive patient data in a sealed environment, rather than sending it out to them. However, he said the HSCIC had not yet decided whether a data lab would become the only way to access the data or whether some organisations could still have data sent to them. “It’s a really tricky one: some people say we really ought to only use a data lab service, and some people say that’s a bit inhibitive, but we know it needs to feature in some way. We’ll go through a consultation process to draw the line on, is it for all or is it for some?”
NHS trust signals positive response to data security: The Yeovil District Hospital NHS Foundation Trust has increased spending on cyber security fivefold since 2012, a freedom of information request has revealed. Computer Weekly reported, that the data was obtained by security firm Veracode as part of a wider study to examine information security investment trends in the UK healthcare sector. The major UK political parties have made financial pledges to support the health service ahead of the election, and digitisation of the health service is likely to be central to any pledge to make improvements. At the same time, healthcare data is expected to become a top target in 2015 because it typically includes personal and financial data. According to security firm Websense, there has been a 600% increase in attacks targeting healthcare data in the US in the past year because it is so valuable for enabling identity theft. Chris Wysopal, chief information security officer and co-founder of Veracode, said investment in cyber security is understandably on the rise, as cyber attackers increasingly use more sophisticated tools. “At the same time, organisations rely increasingly on web and mobile applications to operate, which further increases the attack surface available to cyber attackers,” he said.
Three South CSUs to merge: Three commissioning support units in the South have become the latest CSUs to announce plans for a merger, reported eHealth Insider. The South, South West and Central Southern CSUs have said they intend to merge on 1 April this year to create South, Central and West Commissioning Support. The South and South West CSUs have been working in partnership as the South and West Commissioning Support Alliance for the last 18 months, and have more recently started to work closely with the Central Southern CSU. Between them, the organisations cover an area from Sussex to Cornwall and up to Gloucestershire and Oxfordshire, and have more than 70 customers, including 37 clinical commissioning groups. The CSUs provide a wide range of commissioning support services, serving a combined health community of over 10 million people. Jan Hull, managing director of South West Commissioning Support, said the proposed merger will “significantly increase the scale of our operations and our ability to develop innovative, high quality and cost effective services for our customers”.
NHS innovation accelerator programme launched: A new programme to encourage innovation within the UK NHS has been launched, reported PHG Foundation. The NHS Innovation Accelerator programme is running as a partnership between NHS England, UCL Partners and The Health Foundation. It seeks applications for assistance with developing and implementing innovative healthcare technologies, services and processes with ‘the potential to make a real difference to patient outcomes’. Specifically, the programme will focus on the necessary conditions and cultural changes to enable rapid, scalable introduction of useful innovations to the NHS and improve equitable patient access to the best healthcare. Emphasis is rightly given to the need for cost-effective, sustainable solutions in an NHS facing the pressures of rising costs and demands in the face of financial constraints.
Orion Health named top vendor in major healthcare IT report: Population health management specialist Orion Health has been named as top-ranked vendor in the annual Clinician Network Management (CNM) report from Chilmark Research, reported eHealthNewsEU. This follows just weeks after the company’s work on the Northern Ireland Electronic Care Record (NIECR) helped win both the HSJ Award for “Enhancing care by sharing data and information” and EHI Award for “Best use of IT to support integrated health services” in recognition of its outstanding contribution to informatics. The Chilmark report, published in December 2014, explores the impact of the changes unfolding in the healthcare market, and reflects the trend for healthcare organisations to be no longer strictly interested in data exchange but instead to seek comprehensive solutions that enable clinically integrated networks to support population health management. Colin Henderson, managing director, UK & Ireland at Orion Health said: “The Chilmark ranking reflects our commitment to creating effective solutions and services that help deliver integrated care across diverse patient populations, and meet the needs for the market now and in the future. Our customers benefit from clinically-relevant functionality and interoperability at scale which means they have the tools to deliver better patient care.”
Ebola survivors in West Africa to share stories via mobile app, to help fight stigma: Ebola survivors in the three West African countries worst hit by the epidemic will share their stories through a mobile application to be launched shortly, reported Reuters. The Ebola outbreak, the worst on record of the highly infectious haemorrhagic fever, has killed over 7,900 people with more than 20,000 cases recorded mostly in Guinea, Sierra Leone and Liberia, according to the World Health Organisation (WHO). Although many people have survived the disease, they still face rejection and stigma from their communities, while the virus continues to spread due to lack of information and denial, according to the WHO and other health organisations. The campaign called #ISurvivedEbola, is funded by US philanthropist and co-founder of Microsoft Paul G. Allen’s foundation which has committed $100mn to fight the disease. Survivors in Guinea, Sierra Leone and Liberia will be given smartphones and will document their stories and exchange tips on how to cope with the disease via a mobile app.
Opinion:
NHS needs national IT infrastructure
Jane Rendall, the UK managing director at Sectra, thinks NHS has a real opportunity to make IT affordable and joined-up care a reality if it can harness its national scale and influence.
“The NHS does have the potential to be the most powerful technology customer in the world. But it needs the mechanisms to support this, and that means taking a different approach to IT strategy and IT infrastructure.
“The National Programme for IT was in part a success but it failed to deliver the ability to share information seamlessly across a region, let alone the country. However, the idea of an NHS that utilises common infrastructure at a national level, may make technology far more affordable for hospitals and allow them to get the tools they need.
“The NHS needs a technology infrastructure that allows it to plug specialist tools into a backbone capable of sharing information across a wider audience. Hosted solutions, cloud solutions and pay as you go models that can be scaled to a national level are a way forward for the NHS. IT infrastructure must deliver the best it possibly can to different people across the enterprise at the lowest possible price. This does not mean that specialists need to sacrifice their specialist applications, rather the infrastructure layer needs to be commoditised and standardised.
“We need to move away from a disparate, dysfunctional approach to IT. We have a national health service to be proud of, but there is nothing national about the IT strategy that underpins it. The NHS now has the opportunity to address this and to move from being a fragmented NHS to one NHS.”
2014 was the year the cracks began to show in the NHS
Kailash Chand, the deputy chair of the British Medical Association (BMA), tries to explain on The Guardian why, despite overworked staff, the system can’t cope with the number of patients.
“Looking back on the last 12 months, if I had to sum up what 2014 meant for the NHS, it would be the year that the cracks began to show. In the last year – more than any other period during my time as a doctor – I’ve seen a combination of years of underfunding and an unstoppable rise in demand really start to bite.
“While workloads are rising, wages have been chipped away at and are now at 2008 levels. Morale is low. This matters because frontline staff are the beating heart of our health service. The NHS needs a motivated and enthusiastic workforce if it is to rise to the challenges facing it yet in many parts of the NHS, especially general practice and emergency medicine, the pressure is becoming too much, sparking a recruitment and retention crisis.
“In the longer term, the scale of the challenge facing the NHS is eye watering. One in three people in the UK are aged over 50. The number of over 65s is expected to increase by 50% in the next 20 years. By 2030 a third of Britons are projected to be obese. Remarkable advances in healthcare mean people are living longer and survival rates for diseases such as cancer are improving. But this also means more people are living with life-long conditions, such as diabetes, and have complex medical needs. Unless we find a sustainable way of dealing with an unprecedented rise in demand, our health service will not be able to cope.
“Healthcare isn’t a privilege, or a charity, it is a fundamental human right. We need to fight for it.”
15 predictions for 2015
eHealth Insider asked 15 experts, ranging from government, NHS and commercial backgrounds, for their 2015 healthcare IT predictions. Opinions varied from financial challenges, political influence, efficiency drives and future clinical requirements.
Natalie Bateman, head of health, social care and local government, TechUK predicted: “One of the biggest changes will be the evolution of new care models that advance the move to integration and shared budgets. This will encourage a culture shift in how the NHS makes a decision about investing in technology; from the benefits to service delivery in an individual organisation/department to benefits to the patient and sector in a wider sense.”
Shane Tickell, chief executive of IMS MAXIMS commented on the role of collaboration in the next year: “The popularity of sharing and promoting best practice amongst communities will grow through new, energised methods of collaboration between clinicians, developers and patient advocates, facilitated by open source products and people. The accessibility of patient records in both primary and secondary care sectors will play an important role which will see the enhancement of mobile applications linking to EPRs become the norm.”
Rachel Dunscombe, chief information officer, Bolton NHS Foundation Trust said informatics will need to become a core strategic asset for all health organisations: “Personally, I am looking forward to working with our academic health science network and the Health and Social Care Information Centre / NHS England on Code4Health, on developing open source ventures, and supporting SME developers. I am also looking forward to further strengthening the team of four substantive chief clinical information officers building the clinical intelligent client for the trust.”
Andy Williams, chief executive of the Health and Social Care Information Centre talked about the success of transforming the Spine, before adding: “In 2015, we will be doing more programme transformations like this. By the end of January, we will also have new service standards in place for our customers for data. Introducing more rigorous controls has had some difficult consequences for some customers, and we hope to resolve these so we can release data in a timely, responsible and transparent way.”
Highland Marketing blog
The new year has got off to a bumpy start for the NHS; but what do the months ahead promise? Rob Benson summarises what the experts predict for healthcare technology in 2015, and gives some important dates for your diary.
