No confidence vote as thousands march against health bill

Senior doctors have defied their own leadership to pass a vote of no confidence (subscription required) in health secretary Andrew Lansley by a margin of four to one. BMA chair Dr Hamish Meldrum had advised the organisation’s consultants’ committee against the move saying we ‘do politics but cannot be doing personal politics’.

Backers of the motion argued that it was important to go ahead in order to ‘address the myth’ being put around by the government that it has the backing of medics. At the same time HSJ (subscription required) says more than 2,000 NHS staff took part in a march and rally demanding the scrapping of the health bill. Among the speakers was Lord Owen who claimed that the coalition government lacks any mandate for its reforms.

Last week’s decision that the Commons would not debate the scrapping of the bill, despite a GP’s e-petition which has gathered 170,000 supporters, has been overturned. An intervention by shadow health secretary Andy Burnham has resulted in a debate being agreed for next Tuesday – which Pulse says is a last-ditch attempt to derail the legislation.

In a letter to GP magazine health secretary Andrew Lansley has strongly denied that the proposed reforms would lead to inequalities in which patients can get what drugs. Lansley argues that it will have the opposite effect, enabling commissioners to be more responsive to patients’ needs.

Government hopes that the opposition to its reforms will disappear once legislation has been past appear to be evaporating, with the Guardian Healthcare Network predicting ongoing professional and political resistance.

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NHS informatics shake-up

A major shake-up will see responsibility for the informatics strategy being shifted from NHS Connecting for Health to the NHS Commissioning Board by April 2013. Guardian Healthcare Network says the change was announced by Alan Perkins, the resources and transition director at NHS Connecting for Health, at London’s Public Sector Efficiency Expo.

He said that the board will provide a ‘whole range of things from policy through to strategy, to delivery and even ownership of some systems’. Perkins added that where there is a need for a single IT system across the NHS nationally, the DH will continue to provide it, but that the department intends to stimulate a ‘vibrant healthcare marketplace’ for technology locally.

The DH says the change will mean a leaner delivery organisation to manage existing national applications and services such as the Spine, Choose and Book, Digital X-rays, the Electronic Prescription Service, the Summary Care Record and a secure broadband network.

The emphasis will be on local healthcare providers being responsible for their own IT needs. Health secretary Andrew Lansley has also promised a greater role for SMEs in health service IT. He said: ‘Key to future success will be the NHS as a more intelligent customer and small and medium-sized suppliers no longer excluded from introducing their products. The local NHS is no longer being told what to do when it chooses its IT’.

Telemedicine drive in disarray

The government’s telemedicine drive has a less than 40% chance of being cost-effective according to researchers who the DH asked to appraise its proposals. Unpublished results from an assessment of the Whole Systems Demonstrator pilot project have been described as ‘very disappointing’. Research into its effectiveness involved the Nuffield Trust and the London School of Economics.

Pulse has revealed unpublished data in which researchers say the telemedicine pilot has shown little effect on quality of life, but costs £88,000 per QALY (quality adjusted year of life). Health minister Paul Burstow this week claimed that the government’s plans could save the NHS £1.2 billion a year. Early data had also looked promising with suggestions of a 45% fall in mortality and 20% drop in emergency admissions.

HSJ (subscription required) says that Nuffield Trust director Jennifer Dixon told its recent health summit that the evaluation showed ‘very disappointing results in emergency admissions’. Catherine Hendersen, a research officer at the London School of Economics, said analysis after 12-months showed QALY costs were ‘very high’ compared to the NICE threshold of £30,000.

Fraud could rocket due to personal care budgets

Fears have been raised that DH plans to introduce personal healthcare budgets could see fraud cases rocket. The concerns have emerged at the same time as a string of court cases revealed the breadth and depth of fraud in the NHS.

GP online reports that a personal care budget scheme in the Netherlands, similar to the one proposed for England, has been branded ‘unsustainable’ because of widespread suspected fraud and a 10-fold surge in costs. One of the biggest problems has come from the emergence of companies which specialise in brokering arrangements between clients and providers.

Researchers have warned that: ‘Unless the lessons of the Dutch experience are learnt, the unintended and negative consequences will outnumber the positive, empowering role of personal budgets’.

Meanwhile there have been a series of fraud convictions involving the theft of many hundreds of thousands of pounds of NHS money. These include:

  • The use of forged documents by Romario Gordon to steal £250,000 from Heatherwood and Wexham Park Hospitals (HWP) NHS Foundation Trust. Some of the money was spent on a Porsche and a Caribbean holiday.
  • False overtime payments for nearly £20,000 to Hitchin nurse Margaret Cowley who falsified work records.
  • Illegal immigrant Herbert Sengati’s use of a forged passport and visas to fraudulently obtain over £116,000 in salary from Moorfields Eye Hospital where he was a porter.
  • The theft of £100,000 by Brixton dentist Young Jun Suh for treating fictitious patients.

News in brief

  • Clinical information leader network launched: The new EHI CCIO leaders network was launched this week by Andrew Lansley. The health secretary said it will help to bridge the gap between the IT that clinicians use in their daily lives and the IT they use at work. EHI is running a wider campaign to encourage all NHS providers to appoint a chief clinical information officer to lead on IT projects.
  • £100m for clinical research: The DH has announced that over £100m will be invested in NHS clinical research. Some of the money will employ more nurses and technicians while there will also be investment in research on rare diseases.
  • Alzheimer’s research shows drug benefits: Trials on nearly 300 UK patients shows that dementia drug Aricept slows the decline of patients even in the later stages of Alzheimer’s. This could double the number of patients benefiting – as its use is currently mostly restricted to those with moderate symptoms.
  • Hospital consultants work weekends: The BMA wants consultants to help cut the 10% spike in mortality rates by working at weekends. The BBC says the organisation agrees with mounting evidence that the presence of more senior staff would be a vital step forward.

Blog

Welcome to the world of GP IT. Jobbing Doctor looks back to the days when computers were a novelty, and reflects of how current bureaucracy is holding practices back from achieving the best results for themselves and their patients.

‘When computerisation started in General Practice, in the early 1980s, I was keen but my senior partners thought that computers did not have a future. We started off with a commodore 64, and used it largely as a database.

‘Our practice went fully computerised nine years ago, and since then the hardware has not kept pace … Today we are getting a new server. The PCT decided on the size, speed and specification. I hope they have the future planned, as more and more will go onto the computer. We might need another new server soon. ‘In the meantime we will have two days without any computer as the new one is fitted, and the data is transferred. Today I shall sharpen my steely fountain pen, and plunge back into the 1980s, writing everything down.’

Awards

The awards season looms again and time is already running short to organise entries for some of them. The deadline for the Patient Safety Awards is 23, March – categories include Technology and IT to Improve Patient Safety and Data/Information Management. The Care Integration Awards have the same deadline – these emphasise advances in care for particular conditions such as dementia and diabetes. Entries are now being invited for the EHI Awards 2012. These have 11 categories including new ones for Outstanding Work in Imaging Informatics and Innovation in Healthcare Integration.

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