News in brief

NHS ‘lags behind other health systems’: The NHS lags behind other countries on preventing unnecessary hospital admissions and improving survival rates, a report has suggested. The review by the Nuffield Trust think tank into 15 wealthy nations found lower cancer survival and higher death rates from heart attacks and strokes, reported the BBC. However, on measures such as immunisation and antibiotic prescribing the UK performed better. Overall performance was also showing signs of improvement on most measures. Nuffield Trust chief executive Nigel Edwards said: “Interpreting international data on healthcare systems is notoriously tricky and any comparison should be handled with care. However, it is clear from this analysis that the UK can and should do better. Our poor performance on cancer survival compared with other leading countries is well-known and continues to be a concern. We enter the new parliament with a mountain to climb in reducing preventable hospital admissions and improving survival from common killer diseases, all at a time of continuing austerity affecting public services.”

NHS to reveal cost of missed appointments to patients: Patients who miss appointments will be told how much they have cost the NHS, the health secretary has revealed. Overall, missed GP and hospital appointments cost the health service in England nearly £1bn a year, reported the BBC. Jeremy Hunt said he sympathised with the idea of charging patients for missing GP appointments, although there are no plans for this to happen. However Hunt did say people would have to “take personal responsibility” if the “fantastic” NHS was to continue. The health secretary also announced plans to put a price tag on prescription medicines in the UK under a plan to cut waste in the NHS, along with a stamp reading “funded by the UK taxpayer”, reported City AM. All pharmaceuticals over £20 will have an “indicative cost” on the packaging once the scheme is rolled out next year, as part of an effort to reduce the £300m bill for “wasted” medication, which is prescribed but not used. “This will not just reduce waste by reminding people of the cost of medicine, but also improve patient care by boosting adherence to drug regimes,” Hunt said in a speech to the Local Government Association in Harrogate.

Financial problems ‘now endemic’ in NHS England, says King’s Fund: Patients in England face poorer NHS and social care, including longer waiting times, because of the financial “black hole” that looms over hospitals and other services, says a leading think tank. The King’s Fund warns that already unprecedented deficits reported by trusts for the last financial year will be much worse in future unless the government stumps up more cash or the Department of Health allows the NHS to overspend its £116.4bn budget for 2015-16, reports the Guardian. Its latest survey of financial directors suggests nearly nine in 10 acute hospital trusts are forecasting deficits, up from just over a fifth this time last year, and two-thirds of all trusts predict being in that position, up from a quarter. “Financial problems are now endemic among NHS providers, with even the most prestigious and well-run hospitals forecasting deficits,” the fund’s pre-budget briefing says. Although there is scope to improve NHS productivity, initiatives to reduce funding on agency staff and increase financial control will not be enough to solve trusts’ financial problems, it says.

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Jeremy Hunt calls for national debate about caring for the elderly: Many people in Britain now lead such “atomised lives” that they do not have “any idea” when their elderly relatives are ill or dying, the health secretary, Jeremy Hunt, has said. In a stark call for the public to take more responsibility for the care of elderly relatives and neighbours, Hunt said that local authority care and the NHS cannot alone shoulder the burden of looking after the elderly, reported The Telegraph. He has called for a new “national conversation” about how the elderly are looked after in Britain, compared with those in other countries where multi-generational households are much more common. In a speech to the Local Government Association’s conference in Harrogate, the health secretary pointed to recent statistics showing that in 2011 there were 2,900 council-funded funerals where no relatives could be traced. Hunt suggested that by the end of this parliament, Britain will have one million more people aged over 70, one third of them living alone. “Yes the health and social care system must do a much better job at looking after them. But so too must all of us as citizens as well,” he added.

IT system for GP records criticised: A new GP IT system designed to improve quality and planning in the NHS in England has been criticised for running over budget and behind schedule, by a finance watchdog, reported the BBC. The National Audit Office (NAO) found the General Practice Extraction Service had cost £40m to set up instead of £14m. The system was meant to make data from GP systems in England available to bodies across the health service. But the system has provided information to just one organisation – NHS England. The NAO said in its current form, it was “unlikely” the system could deliver what it was set up for. The idea was to create a system that could help gather information from GP surgeries, such as the number of patients being diagnosed with dementia or getting immunised, to help with research and monitoring. It also provides information to determine how much doctors are paid. As well as finding that GPES had run over budget, the National Audit Office also said it was delivered late. A spokeswoman for the Health and Social Care Information Service, which runs the system, said: “It is clear the procurement and design stage was not good enough.” She said the organisation was in the process of improving the system.

Stevens reiterates importance of tech: The use of new technology will play an important part in achieving the £22bn in efficiency savings that NHS services in England need to make in the next five years, according to the NHS England’s chief executive Simon Stevens, reported Digital Health.net. Stevens, who was speaking at a Cambridge Health Networks event in London, said: “We’ve got a huge transformation ahead of us in healthcare. Not just in this country. And no industry has undergone the kind of transformation and productivity gains that we are going to need without being fundamentally technology enabled. That’s true right throughout human history, whether it is from hunter gatherers to agriculture to the industrial revolution to the information age. It has to be tech enabled.” The NHS needs to address a projected gap of £30bn between annual funding and rising demand and costs by 2020, according to Stevens’ ‘Five Year Forward View’, published last year. This gap will be partly filled by £8bn of extra investment, as promised by the Conservative manifesto, leaving a further £22bn to be made from efficiency efforts. Tim Kelsey, NHS England’s director for patients and information, told a recent meeting of the National Information Board (NIB), which he chairs, that new technology could save the NHS £8.3bn to £13.7bn per year. This is on the basis of a report looking at the potential for new, technology enabled ways of working across six key areas identified by the NIB, which has not been made public.

National report sheds light on health and wellbeing of young people: Statistics on the health, care and wellbeing of young people in England – from birth to young adulthood, have been published in a report from the Health and Social Care Information Centre (HSCIC). It brings together in one place for the first time a range of information, including use of hospital services, talking therapies, prescribing, immunisations and lifestyle trends. The report aims to provide a more joined-up picture of key areas of health and care among younger age groups. HSCIC lead clinician Professor Martin Severs said: “Today’s report shines a light on the lifestyles and behaviours of young people from cradle to teenage years and beyond. With this information we are able to gain a clearer understanding of how the NHS is used by this generation. This is absolutely vital to give people in charge of commissioning services for young people the building blocks of information they need to plan for now and the future.” The full report can be accessed on the HSCIC website.

Care.data, NHS.uk and N4 get red lights: The successful delivery of care.data, NHS.uk and N4 “appears to be unachievable”, according to a report published by the government’s Major Projects Authority. The report, tracks the progress of all major government projects giving ratings ranging from green to red. It gives urgent red confidence assessment ratings to NHS England’s plans to roll out care.data; to overhaul NHS Choices as NHS.uk; and to launch the Health and Social Care Network (HSCN), formerly known as N4, reported Digital Health,net. The Major Projects Authority report highlights several issues with the programme, including the need to “agree and communicate the programme scope” and “reconstitute the programme board with a clear role and responsibilities.” It also recommends that care.data recruit a senior responsible owner and other key personnel; approve explicit go/no go criteria; and clarify the financial situation of the programme. A red label was also given to NHS England’s plan to revamp the NHS Choices website from being a health information provider to an interactive digital hub for the NHS under the name NHS.uk, encompassing NHS Choices, NHS 111, e-Referrals, a health app library and other digital tools.

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NHS devolution to Greater Manchester ‘a bureaucratic mess’: The deal devolving NHS powers to Greater Manchester is in danger of becoming “a bureaucratic mess”, reported National Health Executive (NHE). The Lords discussion on the Cities and Local Government Devolution Bill saw government minister Baroness Williams struggling under an onslaught of governance questions from the Labour benches. NHE previously reported that it emerged in Lords debates last week that the health secretary would have the power to overrule decisions made by authorities in Greater Manchester under their devolved health and social care powers. Labour peer Lord Warner described such an arrangement as “an Exocet under some of the principles in the Bill”, and returned to the issue during the debate held on Monday. “What we do have is the minister’s expressed view, which causes me the greatest concern, that the health secretary could overturn local agreements if he thought them wrong – or ‘bad’, in her words,” Lord Warner said. “In other words, agreements hammered out locally could be overturned by a minister in Whitehall because he did not like the look of them or he had been got at by an adversely affected particular interest. I can assure the minister, having been a health minister who sat in Whitehall and dealt with hospital closures and changes, that there is no shortage of people coming forward to tell you it is a thoroughly bad idea.”

Wearable tech in the NHS has potential for ‘lifestyle advice to replace medication’: Streaming wearable data to patient medical records in the NHS ‘opens the potential for lifestyle advice to replace medication’, the chief medical officer at leading medical software vendor EMIS told ComputerworldUK. Software provider EMIS have produced a Personal Health Record that lets primary care patients stream their fitness tracker data through the Apple HealthKit app, to their own medical record. Around half of all GP practices in the UK use EMIS Web software, which has an option for patients to opt in to share their data this way. This offers a host of benefits to both patients and the NHS as a whole, CMO Dr Shaun O’Hanlan said. “A GP could view results of blood pressure readings taken at home and at the surgery on the same graph in EMIS Web”, for example. “Patients can choose whether or not to share the information in their Personal Health Record (PHR) with their doctor (who cannot view the PHR without the patient’s permission). When shared however, the PHR can provide clinicians with a more comprehensive insight into their patients’ overall health than has ever been possible before. This heralds the arrival of ‘precision medicine’ to the NHS, which will be transformational in how we all interact with the health service and look after our own health and wellbeing”, he added.

Accenture confirmed for £60m NHSmail2 contract: The Department of Health (DH) has formally announced it has awarded Accenture a £60m contract to deliver the new NHSmail service in a move designed to overhaul sharing of sensitive data between healthcare bodies, reported Government Computing. Under the contract, the replacement service – dubbed NHSmail2 – is expected to run until at least 2020. According to the DH, the procurement process was weighted primarily based on technical merit, with finance identified as the second most important consideration for the contract. The NHSmail2 contract has been awarded though the government’s managed email framework, which allows public sector bodies to acquire email services through a single agreement. The nhs.net email service was down for most of Monday following a network error reported Pulse. The Health and Social Care Information Centre (HSCIC), which provides the service to GPs, said it is up and running again although some users may experience delays created by the backlog of emails accumulated while the service was down. An HSCIC spokesperson said: “We were made aware of an issue earlier today affecting users accessing NHSmail caused by the network. We apologise for any inconvenience caused.”

FDs predict more time in A&E for NHS finances: NHS finance directors in England have forecast a weak fiscal pulse in the health service’s finances for this year, in the first research into their financial projections since the 2014/15 year end and the new government taking office, reported the Financial Director. According to the Healthcare Financial Management Association (HFMA), almost eight out of ten provider trust finance directors expect to be in a worse financial position at the end of 2015/16 than they were in 2014/15, with two thirds forecasting a deficit for the end of this financial year, up by a third compared to the 47% that finished 2014/15 in deficit. Paul Briddock, director of policy at the HFMA, said: “The NHS’s financial performance continues to nose-dive at an alarming rate. Our members have told us 2015/16 is looking even worse than last year, with increasing numbers expecting to end the year in the red. Add to this the fact that many finance directors don’t feel they have sufficient resources to achieve longer-term financial plans without further cash injections something the government has made clear is not going to happen beyond the £8bn promised as a result of the Five Year Forward View – and we have a deeply worrying picture. To help with financial planning, we urgently need details on how and when the £8bn will be deployed.”

Health and local care must work together: A new report, published this week, sets out how health and local care systems can work together, reported OnMedica. NHS Clinical Commissioners (NHSCC) and the Local Government Association (LGA) launched its joint publication: Making It Better Together, at the Local Government Association’s Annual Conference in Harrogate. The publication sets out how, within the existing arrangements, health and wellbeing boards (HWBs) can be the place for the local health and care system to come together to make key decisions and set shared strategies for local health and care priorities, tackle the prevention agenda and ensure all part of the system are working together, including housing, leisure and education. Dr Steve Kell, co-chair of NHSCC said: “Clinical commissioning groups and local authorities have a joint responsibility to improve health and wellbeing outcomes. HWBs have provided an opportunity for joint working between organisations that have been working independently for far too long. NHSCC and the LGA have come together to develop this report to remind everyone that the strength of HWBs is that they combine different roles, legitimacies, experience and strengths, and have the potential to create a whole greater than the sum of their parts. We have made a commitment to work together as national membership bodies to support local areas to achieve their ambitions for patients and populations.”

Microtech Group expands integrated care proposition with TeleHealth Solutions acquisition: IT organisation Microtech Group has acquired telehealth technology provider TeleHealth Solutions to expand its range of self-care services to help UK health and social care organisations and their patients manage long-term conditions, reported eHealth News EU. Microtech, which already offers telecare solutions for GP surgeries and supported housing, can now provide innovative telehealth services that mean care providers can monitor people’s health remotely. The acquisition will allow NHS and local authority commissioners to access a full service offering for telehealth and telecare support contracts in one place. Amongst the products within the TeleHealth Solution’s portfolio is HomePod, an intuitive touchscreen device which enables people to be monitored for health changes from where they live, and SurgeryPod, a touchscreen device for patients to record information such as weight, height, blood pressure prior to their GP or hospital appointment. Chris McMail, managing director at Microtech Group, said: “We are continuing to enhance upon our core competencies, and by TeleHealth Solutions joining our group, we are developing huge opportunities to make a real difference for patients looking to take control of their conditions. The technologies we have inherited will also help busy clinicians and give GPs more time to care.”

Allscripts, NantHealth trade nine-figure investments as NantHealth eyes IPO: Electronic Health Record (EHR) vendor Allscripts and NantHealth, the digital health wing of Dr. Patrick Soon-Shiong’s NantWorks portfolio of companies, have announced a major cross investment, with Allscripts paying $200m for a stake in NantHealth and Soon-Shiong making a $100m investment in Allscripts via his personal investment vehicle NantCapital, reported Mobil Health News. “We’re taking an important step forward in our strategic partnership that fully aligns our resources and furthers Allscripts’ strategy to invest in new technologies that can revolutiose service to hospitals and physicians,” Paul Black, president and CEO of Allscripts, said in a statement. “Under the leadership of Dr. Soon-Shiong, NantHealth is pioneering extraordinarily innovative, personalised healthcare solutions that will empower more efficient and effective clinical decisions. We’re confident that our joint efforts will help Allscripts lead the way in our vision of delivering open, integrated and precision-based medical solutions to physicians and patients.” The two companies announced back in March that they would work together to develop a clinical decision support tool for cancer treatment that would include both genomic data and the rest of the patient’s health data stored in the EHR. NantHealth brings its Genomic Proteomic Sequencing diagnostic test, or GPS Cancer, to the partnership, as well as care planning tool Eviti, while Allscripts provides scale for implementation with its hospital customers.

Salford conference to help make new models of care a reality: Practical ways of achieving the new models of care outlined in NHS England’s Five Year Forward View will be the central focus of a landmark health and care conference, hosted and led by the University of Salford in collaboration with NHS England and MedeAnalytics. Leaders and communities from across health and social care will come together at the Digital Health Summit, to explore how they can fundamentally redesign services around individuals and enable local health economies to achieve genuine integration, predictively model and meet the entire health needs of individual patients, reported eHealth News EU. Wayne Parslow, UK general manager at MedeAnalytics, said: “Managing the health and particularly wellness of individual patients very differently and placing them at the heart of local health economies is the future. We have a real opportunity to move from centuries-old generic approaches of public health, to really understanding the individuals that make up populations so that we can take responsibility for their entire outcomes, join-up services around patients and unlock opportunities around risk stratification, predictive care and more. The Digital Health Summit takes place at the beginning of this journey and will help shape the direction of travel, drawing on powerful examples from the North.” The Digital Health Conference will be held at Salford University on 7th July 2015. Click here to register to attend.

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Opinion

Shall we tell you a story? Are you sitting comfortably? Then let’s begin…
The first ever survey of children and young people on health care is a major step forward, explain Ruth Hudson, Amy Frounks and Kath Evans in a blog on NHS England’s website this week. 

Frounks, a member of the NHS Youth forum and a user of children’s services, says in the blog: “Children, just like adults, desire patient centred care and have valid thoughts and feelings that need to be listened to.

“After spending time as an inpatient on paediatric wards, I can vouch that younger people have a different outlook on life and different interpretations as to what good quality care consists of, in comparison to parents or carers.

“It’s essential to gain that insight from a child’s perspective and collate the information to inform NHS services on what is good, and equally how they can improve the service. Without listening to children alongside adults, how can we truly improve services to suit all?”

Commenting on the survey, Kath Evans, NHS England’s head of patient experience for children and young people adds: “The Health and Social Care Act commits us to involving the public of all ages in their own health care and in the delivery of services. This survey has provided the opportunity to hear if we’re delivering on these policies by seeking feedback specifically from children, young people and families.

“Our challenge now is to take action on that feedback. Our children and young people deserve the very best health care experiences. It’s within our gift to deliver them. What is needed is focus and commitment.

“The poorer experiences highlighted by those with complex and mental health needs cared for in general inpatient settings requires our urgent attention.

“It’s also vital we continue to seek out and hear the stories from children and young people who are often unheard.”

Human plus machine equals better medicine
Is the future of medicine human versus machine? Machines will never take over from doctors but they could improve the practice of medicine dramatically writes Dr. Guy Wood-Gush, CEO of Deontics, in OnMedica.

On the potential of artificial intelligence (AI) to change in the way healthcare is delivered, Wood-Gush explains: “The fundamental difference is that AI adds a layer of analytics and automation to medicine that removes the need for duplication, reduces error, and drives patients towards the correct pathways while avoiding the danger of missing unusual diagnoses.  

“It makes sure that the right things happen to the patient at the right time, in the right place, and in the right order, and reduces unwarranted variation in clinical practice. It brings together clinical data with guidelines and allows clinicians to make the best-informed decisions for each individual. 

“This is human plus machine and I would argue that it equals better medicine.

“With AI, the role of the doctor changes to become more like the pilot of a modern aeroplane. The computer does a lot of the flying but the plane still needs the pilot. The doctor can be released from the paperwork and spend more time with the patient. AI enables the patient to join in shared decision making based around the same evidence as clinicians.

“Early AI systems relied on coding and structured logic; but people are unique. Advanced AI can provide a smarter approach that starts from where the patient is now and changes as the patient’s parameters change. Think of it as a ‘sat nav’ for medicine.” 

Improving patient care: Electronic Health Records, tablets & the NHS
One focus of the ongoing UK health reforms is improving access to the best healthcare for more people, says Neil Anderson, UK & I PPS Pre Sales Manager and Enterprise Sales, Hewlett Packard.

“Technology is a cost-effective and increasingly potent means to connect local clinics with medical centres in large cities and their specialists. Given the importance of digitising healthcare, there is a need to ensure clinicians, doctors and nurses are kept up to date with technology that can follow them from the hospital room to their office and even to the A&E.

“One of the biggest beneficiaries of this emphasis on technology has been electronic health records (EHRs). They, alongside mobile health and telehealth, are changing the way organisations think about their work and care for patients, with the ultimate goal of improve care through technology efficiency.

“With EHRs, for example, patients’ health information is available in one place, when and where it is needed. This means that healthcare providers have access to the information they need – at the time they need it most – to make informed decisions.

“In addition, by placing accurate and complete information about patients’ health and medical history at their fingertips, they can give the best possible care at the point of care. This can lead to a better patient experience and, most importantly, better patient outcomes.

“It is clear that technological breakthroughs are revolutionising the way healthcare is being delivered and that modern technology, from device to records, has changed the structure and organisation of the entire medical field.”

 

Blog
On the NHS integration journey we need to think about both the content and the structure of our language, writes MedeAnalytics medical director Dr Mark Davies in this week’s blog.

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