News in brief
NHS budget cuts threaten adoption of new technology: Cash-strapped NHS trusts are being urged to take an early hit by investing money in new medical technologies in order to reap the benefits from improvements in performance and patient outcomes in the future, reported Building Better Healthcare. A new report from health think-tank, The Nuffield Trust, admits that NHS organisations will have to make tough decisions in order to meet the government’s £20billion savings target over the next four years, however, it urges commissioners to be forward-thinking and embrace state-of-the-art equipment, despite growing pressure on capital within the system.
Make telehealth plans public, says Labour: The Department of Health (DH) is under renewed pressure to publish evidence to support its claims that using telehealth could save the NHS £1.2bn, after the Labour party joined those calling for publication of its calculations. Shadow health minister Andrew Gwynne confirmed to HSJ (subscription required) he had tabled a parliamentary question on the matter after the subject was brought to his attention at the EHI Live 2012 conference. Mr Gwynne told the conference: “That information should be put into the public domain so that GPs can see the financial benefits for themselves.” He said he would “table some parliamentary questions to get it into the public domain.”
Patients should be given power to correct record errors, says DH adviser: Dame Fiona Caldicott, head of the government’s information governance review told delegates at the EHI Live conference in Birmingham that patients should have the power to correct errors in their medical record, but should not be able to change their medical histories. Pulse reported earlier this year that NHS Future Forum chair Professor Steve Field had recommended patients should be able to add to their records, correct errors and agree transfer of information to other parts of the NHS. Dame Caldicott – who is leading an ongoing review for the DH on how records should be used – said Professor Field had raised an important point that the data belongs to the patient.
NHS ‘must be tougher negotiator’ on private deals: The National Audit Office has said that the NHS must get tougher at negotiating future private deals after signing a contract with a firm to manage an NHS hospital in Cambridgeshire requiring “unprecedented” targets, reported the BBC. Circle is aiming to make over £300m of savings in the 10 years it has been given to run Hinchingbrooke Hospital. The auditors said that Circle’s ability to make the savings was not properly tested, however Circle says the heavily-indebted hospital can break even in 2013.
NHS ‘fragmenting’ as hospitals opt out of national pay deals, warns Labour: Labour has warned that regional pay is becoming entrenched in the NHS with hospitals opting out of national wage agreements, leaving health service staff to face the prospect of working longer for less money and losing sickness entitlements. The shadow health secretary, Andy Burnham, will tell parliament that ministers are pushing for regional agreements as a way of saving money in the health service. The NHS has to save £20bn over the next four years, reported The Guardian.
Hunt backs new standards for NHS managers: A new set of standards for NHS managers, non-executives and GP leaders will put “care, compassion and respect for patients” at the heart of leadership in the health service, the health secretary has said, reported HSJ (subscription required). The standards for members of NHS boards and CCG governing bodies in England require board members to commit to seeking excellence in clinical care, accessibility, patient safety and patient experience as well as achieving long term financial sustainability.
NHS to be provided with fully integrated EPR: St Helens and Knowsley Teaching Hospitals NHS Trust has partnered with IMS MAXIMS to offer the NHS a fully integrated electronic patient record. The organisations are working together to provide a suite of tailored clinical and administrative software solutions to improve efficiency and enhance patient safety and outcomes, reported Healthcare IT News. NHS organisations across the UK that choose to work with St Helens and Knowsley Teaching Hospitals and IMS MAXIMS will be able to utilise the expertise of a healthcare IT company combined with the first-hand experience of an NHS team.
IT ‘needs to become more professional’: Informatics and IT within the health service needs to become more professionally recognised areas of work, representatives of The Chartered Institute of IT have told delegates at the inaugural CCIO Leaders Network Annual Conference, reported eHealth Insider. Mike Sinclair, vice chair professionalism, and Dr Justin Whatling, chair elect of BCS Health, argued that with IT becoming increasingly important in healthcare, standards of competence must be established. “Given how many more people can now be killed by IT, I think we now have an obligation to get a little more organised,” said Sinclair. The two speakers suggested that changing that situation will in large part depend on defining the developing role of the CCIO.
Justin Whatling elected as new Chair of BCS Health: Dr Justin Whatling has been elected the new Chair of BCS Health, part of BCS, The Chartered Institute for IT. Justin takes over from Matthew Swindells who stands down at the end of his three-year tenure in the role. Adam Drury has been elected secretary for BCS Health. Justin has already played an important role in the development of BCS Health, working alongside Matthew as vice chair, strategy and policy. His appointment comes at a critical time as the DH, NHS staff and industry bodies seek to implement a ten-year government strategy to transform the use of IT in the NHS, public health and social care.
Mistakes by staff have seen NHS complaints rise by 50 per cent: The Independent has reported that complaints to the NHS about the failure of doctors, nurses or managers to admit mistakes or apologise when things go wrong have leapt by 50 per cent in a year. In one case a man with malignant melanoma, the most serious form of skin cancer, was misdiagnosed by his GP practice six times but was unable to get the practice to acknowledge their failings when he complained. A report by the health service ombudsman, Dame Julie Mellor, says “careless communication, insincere apologies and unclear explanations” are unacceptable.
New group to be customer for national IT: National director for patients and information, Tim Kelsey, is set to chair a new informatics services commissioning group that will become an “intelligent customer” for national IT, reported eHealth Insider. Tim Straughan, NHS Information Centre chief executive, told EHI Live 2012 that the group will sit under the slimmed down DH, the new NHS Commissioning Board, and other bodies with an interest in information and technology. It will decide what infrastructure, standards and data sets need to be commissioned from the ‘new’ IC, which will work closely with clinical commissioning groups, their commissioning support services, and the emerging data management integration centres.
Patient, professional and NHS bodies announce joint push on reconfiguration: The NHS Confederation, the Academy of Medical Royal Colleges and National Voices have announced a joint project to produce practical advice on how to reconfigure health services, reported HSJ (subscription required).
CCG leaders favour integration over competition: The leaders of the commissioning groups created under the government’s NHS reforms want to encourage their current service providers to work more closely together, and share more of the health service budget with local authorities. The results of the first HSJ (subscription required) Clinical Commissioning Group Barometer survey reveal a strong enthusiasm for integrating services and budgets. Significantly fewer leaders plan to use competition to try to improve services, and some are concerned about being required to apply it.
NHS constitution reform to include new end-of-life care commitments: New commitments on end-of-life care and single-sex wards are set to be included in the NHS constitution under proposals unveiled this week, reported The Guardian. Rules on involving patients and families in treatment decisions are being strengthened following an outcry over secretive use of the Liverpool Care Pathway, which involves withdrawal of fluids and food. Ministers said the wide-ranging package of reforms would empower patients and ensure their wishes come first. The constitution, which sets out individual’s rights in the health service, has been in place since 2009 but ‘few people know about it [and] fewer still use it to uphold their expectations of the NHS’, the independent NHS Future Forum has found.
EHI Live 2012 Roundup
EHealth Insider launches EHI Imaging Informatics Channel at EHI Live 2012: EHealth Insider (EHI) has launched a new channel focused on digital imaging systems at EHI Live 2012, reported eHealth News. The new channel, EHI Imaging Informatics, will strengthen EHI’s existing coverage of this emerging discipline, which requires close collaboration between knowledgeable clinicians, specialist informaticians and industry experts.
Linda Davidson, co-founder and director of eHealth Media, said, “We have a long record of covering imaging informatics and supporting those working in this area. With imaging informatics now encompassing a wide range of disciplines beyond traditional radiology, and with images and reports forming a key part of the complete electronic patient record for many patients, we felt it was an appropriate time to create a dedicated space where our audience can meet to discuss issues and explore best practice.”
Keynote Speech at First CCIO Leaders Network Annual Conference at EHI Live 2012: Mike Farrar, chief executive of the NHS Confederation has delivered his keynote speech at the first Chief Clinical information Officer Leaders’ Network Annual Conference at EHI Live 2012, reported eHealth News. Farrar announced that the NHS Confederation is to become an official partner to EHI’s CCIO Leaders Network – established to support the objectives of the CCIO campaign – joining other influential organisations such as the Royal College of Physicians and the British Computer Society.
The campaign, launched in June 2011 by eHealth Insider, is calling for every NHS provider organisation to consider appointing a CCIO. Farrar said: “We have supported EHI’s CCIO campaign from the outset. The experiences of the NHS over the past ten years show that strong clinical leadership plays a key role in almost all successful IT projects. With the NHS increasingly looking to make use of technology to improve patient care and deliver efficiencies, the CCIO role has become an important one for all our members.”
Chief Clinical Information Officers Bring Seniority and Deep Clinical Expertise to New Role: The results of the first CCIO survey were released on the eve of the CCIO Leaders Network’s first annual conference reported eHealth News. The results of the survey carried out by the CCIO Leaders Network in conjunction with eHealth Insider highlighted the deep clinical experience that is being brought to the new role. It also shows CCIOs are spending 50% more time on the role than their organisations have budgeted for, as they make clinical engagement and information strategy their top priorities.
This clearly highlights the growing importance of the CCIO. Dr Wai Keong Wong, chair of the CCIO Leaders Network advisory panel, said: “This in-depth survey reveals that the challenges that CCIOs face across different organisations have greater similarities than differences. Most identified the majority of their work as guiding clinicians and decision makers in their workplace through the process of digitisation of healthcare, the most significant change in work practice in the past century.”
Opinion
Mike Farrar: steps to success for commissioning board mandate
In the coming weeks the government will be setting out its mandate for the NHS Commissioning Board, effectively a national statement of priorities for the new NHS. Mike Farrar, chief executive NHS Confederation says on this:
“It is clear that the nature and implementation of the mandate will be crucial in creating the right conditions for success. To get it right, we must learn from the past and use this opportunity to produce a clear, concise set of aims that the NHS is given time to achieve. The NHS wants and needs the NHSCB to be successful. The right kind of mandate will be critical if that is to happen.”
After discussions with the members the NHS Confederation have set out what they see as six keys to success:
- Keep it simple
- Get the right balance between localism versus centralisation
- Make a plan and stick to it
- Recognise that Rome wasn’t built in a day
- Ensure value for money
- Put principles into practice
NHS budget surpluses: the law of unintended consequences
As the NHS grapples (this last 18 months) with the toughest financial settlement it has ever experienced, Anita Charlesworth, chief economist at Nuffield Trust examines the detriment to the NHS that is being caused through the stacking up of NHS financial surplus’. This, at a time when 25 per cent of foundation trusts are in deficit and 20 NHS trusts are considered financially unviable in their current configuration. Further still, investment in general practice fell in real terms between 2010-11 and 2011-12.
“The NHS and Department of Health run a pretty tight ship financially so overspending is unlikely – on balance you would probably expect that health spending in the first year of austerity and the Quality, Innovation, Productivity and Prevention programme (QIPP) to come in pretty much on budget, wouldn’t you?
“Well, it didn’t. Spending of the NHS and health as a whole was under budget. The Department of Health recorded an aggregate under-spend of £829 million of revenue and £566 million capital. Primary care trusts under-spent £527 million of revenue and strategic health authorities under-spent their revenue resource limit by just over £1 billion in 2011-12. In the NHS this is known as a surplus (profit in the private sector). It is clearly preferable to a deficit but is it a good thing for the NHS and health to be delivering surpluses of this scale? It is beholden on the NHS to use that money well and deliver value. The NHS needs to eliminate waste, improve productivity and commission services which meet the population needs. Losing financial control and running up deficits is clearly not compatible with doing the job well. But it does not follow that posting a surplus is a good thing. In some cases it may be – for example, to fund an investment programme to improve services. But if health service leaders are serving a population with poor health outcomes and the local health economy is spending below its needs-based allocation, shouldn’t we consider whether a large surplus is in fact a sign of failure not of success? Surpluses matter because when the health budget as a whole is under-spent the money is no longer routinely carried over into the next year.
“Perversely if this continues it may make financial failure more and not less likely as this under-spending could have been used to invest in the service redesign which is so necessary if the NHS is to cope when the Government’s pay freeze ends and years of austerity really start to bite.”
Small is beautiful
No healthcare IT conference week would be complete without the mandatory summary of what went on at the event. This week, EHI rounds up the speeches and views of speakers, exhibitors and delegates from EHI Live 2012.
Journalist, Daloni Carlisle highlights one of the key themes running throughout the conference-that SME’s are key to NHS IT.
“Take the rhetoric about small and medium sized enterprises. Speech after speech talked about the need to engage with the vibrant SME sector and the benefits that the NHS could wring from making more use of it. Liam Maxwell, deputy chief government information officer, gave a rousing speech in which he said that SMEs were generally much cheaper and more flexible than large companies.
“Markus Bolton, co-founder of Shearwater Healthcare Solutions, urged NHS organisations to include the sector in tenders. He argued that this would enable the health service to take advantage of more imaginative thinking and approaches; even if trusts went on to work with a large company.
“But on the floor of the exhibition, many of these SMEs were close to despair at their continued exclusion from NHS business. ‘You can’t get a sniff if you don’t have a turnover of over £100m,’ said one. “I am struggling every month to pay my staff. Yet everyone I talk to is excited by what we are trying to do.”
She concluded: “As EHI Live 2012 shows, technology is now, more than ever, seen as the solution not the problem. The creativity is there – the challenge for the NHS is to unleash it.”
Highland Marketing Blog
In this week’s Highland Marketing blog, HM’s Myriam McLoughlin reports back from EHI Live and highlights the role that social media played in the event.
