Highland Marketing would like to say congratulations to James Norman, winner of our chocolate bunny indulgence Easter hamper, well done James!!
News in brief
£3.8bn NHS Better Care Fund policy delayed after damning Whitehall review: A government policy intended to stop the NHS from becoming overwhelmed has been delayed after a confidential Whitehall review concluded it would not work as hoped, revealed The Guardian. Neither would it help to balance the NHS budget or bring about an intended revolution in patient care. The £3.8bn-a-year Better Care Fund was supposed to have been launched last week, but its introduction has become mired in doubt after the Cabinet Office voiced deep disquiet about its viability and argued that there was little or no detail about how the expected savings would be delivered. A Whitehall source said the Cabinet Office believed that the claims for the Better Care Fund did not stack up and wanted “a lot more work done on the policy”. The idea behind the plan, due to be introduced in April next year, was to bring together health and social care services – traditionally funded by local authorities – in the belief that this would reduce the growing pressures on hospitals and help keep people healthier in their own homes. The delay in its launch is a setback for the health secretary, Jeremy Hunt, and local government secretary, Eric Pickles, who were supporters of the plan and had been due to attend its launch last week. The Better Care Fund is partly funded by the Department of Health, which was to have contributed £1.9bn from the £40bn hospital budget from next April in the belief that it would release savings to compensate for the money transferred from the NHS. A team of officials from both departments responsible for the new policy have been told to produce extra evidence to make it more “credible” and overcome deep Cabinet Office scepticism.
NHS England scraps Care.data timetable: NHS England has scrapped its timetable for the care.data patient records project, insisting the programme will only roll out nationally once the “process is right”, reported Health Service Journal (subscription required). NHS England has scrapped its timetable for the care.data patient records project, insisting the programme will only be introduced nationally once the “process is right”. National director for patients and information, Tim Kelsey, has said the programme – currently in the middle of a six-month pause – would not be subject to “artificial deadlines”. He said the decision was taken after fresh consultation with GPs, patients, researchers and privacy campaigners. NHS England had hoped a national rollout would be possible following the pause, but will now only commit to a pilot by autumn. “In light of all these conversations we are now proposing to phase the implementation of care.data work with 100-500 GP practices in the autumn to test, evaluate and refine the data collection process ahead of a national rollout,” Kelsey wrote in an NHS England blog. “We do not subscribe to artificial deadlines here. We will roll it out nationally only when we are sure the process is right.” His blog followed NHS England’s new chief executive’s appearance last week at the Commons health committee. Simon Stevens told MPs that the NHS should not be tied to an “artificial start date”.
Hospitals send dementia patients to homes without food or heating: Dementia sufferers are being sent from hospital to homes without heating or food, a health watchdog has warned as it announced the first national inquiry into the way patients are discharged from wards, reported The Telegraph. Patients’ groups said tens of thousands of patients were being placed at risk because they were sent home too early, without the right care, and in some cases without even basic amenities. Research has found elderly patients being discharged from wards in the middle of the night, with some hospitals discharging one in 10 patients outside daylight hours in order to free up beds. The inquiry by Healthwatch England – the statutory consumer champion for health and social care – will hear evidence from 148 of its community groups about failings to discharge patients safely. The organisation said local groups had uncovered distressing cases of poorly planned discharge, with elderly dementia sufferers discharged to homes without heating or food, and homeless people put back on the streets after major surgery. Official NHS figures disclose more than one million patients a year being readmitted to hospital as an emergency within one month of being discharged – a 27% rise in a decade, costing the NHS an estimated £2.4 billion.
New eProcurement strategy mandates supermarket-style systems to improve NHS purchasing: Eight years of planning has come to fruition with the publication, this week, of the new NHS eProcurement Strategy, which will build a national framework through which supermarket-style technology will be used to improve purchasing and save money, according to Building Better Healthcare. The 32-page document, produced by the Department of Health’s (DH) procurement, investment and commercial division, follows the release, last August, of the government’s Better Procurement Better Value Better Care report, which established a new procurement development programme to help NHS trusts stabilise their non-pay spending so they spend no more than they currently do by the end of 2015/16, thereby realising £1.5billion of efficiencies. The eProcurement Strategy mandates the use of global GS1 coding and PEPPOL messaging standards throughout the healthcare sector and its supply chains. Introducing the strategy, Dr Dan Poulter, parliamentary under secretary of state for health, said: “There have been many previous initiatives to realise procurement efficiencies, but this time we mean business and are determined to deliver efficiencies to free up more money for frontline care. Previous efforts to improve eProcurement in the NHS have been patchy due to a lack of central direction. We have now mandated the use of the GS1 and PEPPOL standards by amending the NHS Standard Contract to require compliance with this NHS eProcurement Strategy. We have also required suppliers to place their product data in a GS1-certified datapool by amending the NHS Terms and Conditions for the Supply of Goods and the Provision of Services.”
Department of Health to collaborate via cloud: The Department of Health (DH) has started using a cloud-based collaboration tool, Kahootz, to work with external groups such as doctors, social care workers and local government staff, according to ComputerWorld. The contract took just two months to set up from start to finish and costs £2.03 per user per month, according to its CloudStore listing. It is one of the first major procurements the department has done via G-Cloud, information management lead, Sophie Rawlings said. The service will be used for “external-facing collaboration and communications with stakeholders or partners”, according to Rawlings. She said: “For example, it will be used by project teams, communities of interests, boards, outside members and policy development groups for things like consultations, surveys, policy work, file sharing, working together on documents and so on.” DH piloted Kahootz in one of its arm’s length bodies and technical design teams, and will take some time to become fully familiarised with it before rolling it out to the rest of the department from the end of May, Rawlings added. The Kahootz Enterprise software will replace the department’s legacy IBM Quickr software. It will be open to both the department and various arm’s length bodies such as NHS England, the Care Quality Commission, the NHS Health Research Authority and 20 other agencies, potentially encompassing thousands of users in future.
Three times as many A&E patients waiting over four hours: The number of patients waiting too long in accident and emergency departments has nearly tripled in five years, according to Audit Scotland. A report showed 104,000 people waited beyond the four-hour target in 2012-13, compared with about 36,000 in 2008-09, reported the BBC. Scottish health secretary, Alex Neil, said the NHS in Scotland was “treating more emergency patients than ever before”. However, Labour called for a “full-scale review” of the ability of health services to cope in the future. The new report from Scotland’s public spending watchdog revealed the proportion of people being seen within the four-hour target fell from 97.2% at the end of 2009 to 93.5% by December 2013. Gilbert Bain Hospital in Lerwick, Shetland and the Royal Aberdeen Children’s Hospital were the only two to meet the 98% target in each month of the financial year 2012-13, with most other hospitals failing in every month. The study also discovered a spike in admissions during the last 10 minutes of the four-hour period. Caroline Gardner, auditor general for Scotland, said: “Delays in A&E can be a sign of pressure across health and social care. While there has been improvement in performance, such as the progress made in tackling the longest waits in A&E, performance against the target still remains lower than it was when we last reported.” The Telegraph also reported this week that the King’s Fund think tank had found that nearly half of people were dissatisfied with the performance of A&E units in England, as they are regularly being forced to wait too long. Only 53% of people questioned said they were satisfied. This is the lowest satisfaction rating in this survey since 2008 and has followed rises in waiting times.
PAC doubts e-referrals success: The Commons’ Public Accounts Committee (PAC) is “sceptical” about NHS England’s ability to fully utilise the e-referrals service, reported eHealth Insider. In a report on ‘NHS waiting times for elective care in England’, the PAC said that following the introduction of Choose and Book, which has had a poor uptake among GPs and secondary care providers, it is doubtful of the success of the new e-referrals service. It said that the Choose and Book service, which was intended as one of a number of new, digital services to make the NHS more convenient, “has been a missed opportunity to improve patient care and data quality”. Choose and Book was launched by the former Labour government as an attempt of introducing the NHS to an ‘airline-style booking’ system, but the deployment was significantly delayed, and usage has stalled at around 50%. Speaking at the launch of the report, PAC chair, Margaret Hodge, said: “The online Choose and Book appointment system has been underused by both patients and healthcare professionals. We are sceptical about the NHS’s ability to ensure that the replacement system, e-referrals, will be used any more fully.”
NHS will avert crisis on mutual roots and integration: Integrated Care Today has reported that the solution to the NHS funding crisis lies in radical institutional reform and a return to the NHS’ mutual roots, argues an independent think tank. ResPublica, suggested that successfully integrating current health care provision would drastically reduce A&E admissions and save the NHS at least £4.5bn over the coming decade, in their latest report ‘Power to the People: The mutual future of our National Health Service.’ Integration would help to ensure that the NHS remains free at the point of use without the need for additional taxation or charging, suggests the think tank. ResPublica further suggested that health mutuals represent a balanced solution between public and private models. Their report recommends they should play a much needed new role, helping to deliver ‘whole-person care’ and making the necessary institutional and cultural changes that integration of health care services demands. The £4.5bn savings would be made from treating more patients in the community, at home and in more specialist settings. Phillip Blond, director, ResPublica said: “Moving away from fragmented and failing public service provision, and towards a system of whole person-care, is the only way to deliver the holistic healthcare, NHS patients so desperately need. The NHS is simply not designed to treat modern chronic conditions associated with ageing and lifestyle and diet related illnesses, such as obesity, diabetes, heart disease, depression and cancer.”
GP leaders to vote on whether to support patient charges for appointments: GP leaders are set to vote on whether the General Practitioners Committee (GPC) should ‘explore national charging for GP services’ at the Local Medical Committee (LMC) conference later this month, reported Pulse. The motion, put to conference by the agenda committee and set to be proposed by Wiltshire LMC on the day, suggests general practice is ‘unsustainable in its current format’ and that “it is no longer viable for general practice to provide all patients with all NHS services free at the point of delivery”. The motion concludes: “That conference… calls on GPC to explore national charging for general practice services with the UK governments.” A Pulse survey of 440 GPs last July showed that just over half of GPs are in favour of the NHS charging a small fee for routine appointments, with many believing it is the only way of managing their workload and curbing rising patient demand. Other topics scheduled for debate at the annual policy meeting, set to be held 22-23 May in York, include whether or not clinical commissioning groups (CCGs) should commission primary care, with several LMCs arguing that this will “fatally damage relations between CCGs and their constituents”.
Trusts make PACS refresh solo effort: The lack of collaboration between trusts on picture archiving and communication systems (PACS) deals is surprising, the clinical lead for the National PACS Programme, has said. The installation of PACS and radiology information systems, bought centrally through five contracts for clusters of regions, was one of the more successful elements of the National Programme for IT and resulted in the number of English acute trusts using PACS and RIS trebling from 42 to 128, reported eHealth Insider. However, the national programme’s decade-long contracts with the cluster providers began to expire last year, and unlike some central deals, such as NHSmail and the GP Systems of Choice framework, trusts are now required to buy their own systems. Speaking at the NHS Supply Chain’s PACS/RIS event in Doncaster last week, Dr Tony Newman-Sanders, the Health and Social Care Information Centre’s clinical lead for the programme, said there has been less collaboration between trusts than he expected in establishing new contracts. He said that these can help groups of trusts provide seven-days-a-week diagnostic imaging services, by letting radiology staff from any trust in a group provide cover. “I think we all underestimated the technical and information governance challenges,” said Dr Newman-Sanders. He added that collaboration makes sense, due to the rapidly-increasing number images, increasing specialisation among radiologists and the need to provide analysis of images within 24 hours, including at weekends.
NHS Blood and Transplant wants help with data centre migration: NHS Blood and Transplant (NHSBT) has issued a pre-tender to find a migration partner to lead the discovery, migration planning and execution of existing services from its current data centres to those of a new supplier, reported Government Computing. The tender covers the proposed acquisition of co-location data centre space to accommodate forty 3-4kw racks, spread across two data centre sites. According to the tender, “the synchronous nature of the technologies require that the separation of both primary and secondary routes between the sites cannot exceed two milliseconds. In addition, the key application requires a cable distance separation of no greater that circa 50 kms”. NHSBT’s principal data centre, which supports the majority of its core service, is located outside London in the South East, with an additional data centre located 10 miles away to provide an alternative disaster recovery facility in the event of a significant incident. A third, smaller, data centre facility is located in the South West inherited as part of the integration of UK Transplant Services some years ago. The NHSBT data centres and IT infrastructure support a range of mission critical services, including the safe and reliable supply of blood components, solid organs, stem cells, tissues and related services to the NHS, so any extended periods of service outages during the data centre migrations will not be possible. NHSBT anticipates engaging a supplier to provide co-location services for its existing data centre workloads in a secure data centre environment over a 3-5 year contract term.
Tweets measuring quality of care: Health authorities are starting to use social networks to monitor the quality of healthcare providers, with the Department of Health’s information strategy, published in 2012, suggesting social media aggregation “[has] the potential to provide rapid indicators and early warnings of some areas of performance”. Researchers however now believe their study, which was published in BMJ Quality and Safety, is the first to systematically measure tweets sent to healthcare providers to determine whether they can help healthcare providers to improve their services, according to eHealth Insider. They collected nearly 200,000 tweets mentioning NHS hospitals’ official Twitter accounts over a one-year period, performing both a basic quantitative analysis of all the tweets and a qualitative analysis of 1000 that were randomly selected. The researchers said only 11% of the tweets related to care quality, with the majority of those related to a patient’s experience with staff, facilities and access to care. Of the tweets related to care quality, 77% were positive in tone. The researchers said their findings show that healthcare authorities need to be cautious when using social media to judge the quality of services, due to the small volume of tweets related to care and the “signal to noise ratio”. “While some tweets contain valuable information, it is unstructured, poorly labeled and hidden within a larger set of less relevant information,” said the study.
Shane Tickell is walking 212 miles to raise awareness of the early signs of cancer. Starting from his home in Kendal to offices in central Milton Keynes, the walk will cover approximately 26 miles per leg, across a total of eight legs. To show your support, please visit the website of the IMS MAXIMS Foundation, a charity run by the employees.
Opinion
How today’s healthcare industry resembles the tech industry of the 1980s, and why that gives me hope
Scott Rubschnuk, EVP, group account director, and lead at Hill Holliday’s healthcare practice, explains how today’s healthcare industry resembles the tech industry of the 1980s.
“I believe there’s a tremendous lesson to be learned from another industry that radically transformed from a closed, confusing system into one that is now open, user friendly, accessible, and aligned with the needs of consumers. It’s an industry that went from treating the consumer’s experience as an afterthought to its North Star. This industry is information technology, more commonly known as IT.
“Take a look at your smartphone. Not only is the information technology residing in this device infinitely more powerful than that of a box 20 times its size 20 years ago, it’s now also intuitive, accessible, customizable, and nothing short of miraculous when you consider the data, services, and connectivity it provides the user. Remember that we are one generation removed from the era when Ken Olsen, founder of Digital Equipment Corp, allegedly remarked, “why would anyone ever want a computer in their home?” He couldn’t imagine one even more powerful in your teenager’s hand.
“I believe that the healthcare industry today is where the information technology industry was in the late 1980s. Consumers are playing more active roles in their health care than ever before, yet the system remains dominated by experts speaking in coded languages to other experts. These experts show precious little interest in opening this closed system to the humans on the other end.
“We’re all waiting for a Steve Jobs, Bill Gates, or Mark Andreessen to emerge in health care. We are seeking ideas that will blow the doors off of this broken system. It’s time for “a healthcare system for the rest of us.”
Do online patient services work in the UK?
This week, Integrated Care Today features an infographic produced by Patient.co.uk exploring the myths and realities of online patient services, and asks whether patients are becoming active partners in their own healthcare?
The infographic starts by dispelling the myth that only young IT savvy people will use online patient services stating that 64% of users are over 35, and almost one in four users are 55+. It also argues that location of patients is not an issue for online services uptake as one in six users live in small towns or villages, opposing the myth that it will only catch on in big cities.
Looking ahead, the infographic illustrates that by 2020 it is predicted around 40% of healthcare will be online. In fact 71% of patients would like to add their own self recorded medical values to their records, with a further 85% of patients supporting the viewing of online records for long term conditions, confirming that patients are likely to take a more active role in their own healthcare.
The importance of digitising healthcare
This week on eHealth Law & Policy, Paul Cooper, head of research at IMS MAXIMS, talks about how digital health can revolutionise healthcare as we know it and how patients can be empowered to take ownership of their own health data.
“I believe that patients need to be empowered. Currently patients are completely in the hands of the doctor or nurse and as much as the government has recently said ‘no decision about me, without me’ I do not see much evidence of patients being involved in their care or indeed in decisions about them on the basis that they do not really have access to the same information that their clinicians have access to and therefore I believe that if digital health is going to be revolutionised, we need to give much greater access and involvement to the patients themselves.
“There has been research done that suggests that harm is actually done if information is not adequately shared by healthcare professionals and there is a great deal of fear amongst healthcare professionals that if they open up access to electronic health records someone will see it that should not, so they will be in breach of patient confidentiality. But if you turn that on its head and say that it is not the NHS or the healthcare professional that is responsible for the record but the patient, all of a sudden it is the patient who controls who has access.
“The technology is there to enable it. How quickly it will happen will depend to some extent on public pressure. If the NHS has a cultural shift that results in patients being allowed to take ownership of their health record if they would like to, then I think it will happen much more rapidly.”
Highland Marketing blog
This week our industry advisor, Simon Rollason, marvels at the joy of language, but reflects on the perils of misinterpretation!
