News in brief
Heart of England to ‘boost efficiency’ by pooling patient data: One of the country’s largest acute trusts is to embark on a research project collecting patient data to improve health outcomes across its patch, Health Service Journal (HSJ, subscription required) has learned. Insights for Care, a research partnership between Heart of England NHS Foundation Trust, consultancy firm Monitor Deloitte and pharmaceutical company MSD, is expected to launch next month. MSD will fund the project. While details of the scheme, including the cost and how long it will run for, are still being finalised, HSJ has been told that it will initially focus on collecting data from diabetes patients. The data will be anonymised and no patient identifiable information will be released, a Heart of England spokeswoman said. The data will be stored on Monitor Deloitte’s servers. The spokeswoman added: “The objective of Insights for Care is to improve patient outcomes and improve the efficiency of the healthcare system. It will be delivered through a ‘real world evidence project’ to capture patient level data, to understand how patients use health services. We’re initially focusing on patients with diabetes and the information generated will be analysed to build better clinical pathways, reduce patient level variance and treatment and outcomes. [It will also] identify vulnerable patient groups and assess the effectiveness of current treatments.”
NHS faces squeeze on recruitment as financial pressures bite: Hospital chief executives have been told by the NHS regulator to fill vacancies only where “essential” as they attempt to cope with “unprecedented” financial pressures, reported the Financial Times (registration required). David Bennett, outgoing chief executive of Monitor, added that foundation hospitals should implement “safe staffing guidance” in a “proportionate and appropriate way, to deploy substantive staff efficiently across all required shifts including evenings and weekends”. In his letter to hospital bosses, Mr Bennett insisted that “all actions should be consistent with [hospitals’] responsibilities for safety and the delivery of constitutional standards”. However, Andy Burnham, shadow health secretary and a Labour leadership contender, said the advice was “a sign of a serious deterioration in NHS finances. It suggests that the financial crisis in the NHS is threatening to spiral out of control and hit standards of patient care.” Burnham said the suggestion that hospitals could “water down” staffing guidance “will alarm patients and the government must decide if it will overrule this advice”.
European doctors disagree over the future of digital health tools: European doctors are more likely to use digital health technology than their American counterparts, but many are at loggerheads over the impact that mobile technology will have on healthcare in the future, reported Integrated Care Today. Ipsos Healthcare has released a survey titled The Digital Doctor Report 2015 which attempts to uncover how British, German and French doctors feel about digital health and how they see its role developing in the future. Using what Ipsos call the “Digital Doctor Tracker,” they were able to measure doctor’s behaviour towards health applications and forums, attitudes to new digital health technology and concerns regarding uptake of new digital development. Healthcare applications are becoming more and more common around Europe. Recently Integrated Care Today reported on the UK release of Dr. Now, a smartphone application that enables people to book a virtual appointment with a GP and order medicine. The survey found that nearly three quarters (72%) of doctors have used or recommended a digital health application, with four out of five doctors confident that mobile technology is not just a trend that will eventually go away.
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Papworth says no to Epic: Papworth Hospital NHS Foundation Trust has decided not to go with the Epic electronic patient record. Papworth Hospital and neighbouring Cambridge University Hospitals had both intended to deploy the system after a joint procurement process in 2012. The move was part of a 10-year eHospital programme that also came with significant investment in infrastructure, worth £200m in total. Cambridge University Hospitals went live with the system in October last year, while Papworth has spent the time working on its business case. It said in January that it still intended to go with Epic, however board members came to the conclusion that Epic did not provide the best value for money for the trust, which is in the middle of a £165m project to move to a new site at Cambridge Biomedical Campus. In a statement to DigitalHealth.net, a spokesperson said: “Papworth Hospital is committed to providing the most intuitive and cutting edge ICT infrastructure to its staff whilst also being affordable so has therefore decided that the trust should source alternative options for the provision of an electronic patient record programme.” At the end of last week, NHS regulator Monitor announced it had launched an investigation into the implementation of Epic at Cambridge University Hospitals and its impact on the trust’s finances.
Kelsey attempts to dispel GP data privacy fears: NHS England’s national director for patients and information said there was “never any proposal to collect confidential data” as part of the Prime Minister’s Challenge Fund (PMCF), reported National Health Executive. In a letter to Dr Sarah Wollaston MP, chair of the Health Select Committee, Tim Kelsey attempted to dispel some of the fears sparked by a Daily Mail article last month, which claimed the NHS “demanded confidential details of millions of GP appointments”. The article said that a letter from Tracey Grainger, programme director for the PMCF asked EMIS to provide data including the date, time and duration of appointments, most of the patient’s postcode and their date of birth. She added: “We are seeking your assistance to obtain extracts of de-identified patient level data from systems that either record appointments or record consultations or in some cases both. This extract needs to be in place by September 2015.” But Kelsey defended the actions by saying that currently GP staff are analysing patient data locally and providing aggregate returns for evaluation which are anonymous – a slow and costly process that gives rise to variation in data quality. “As a result, NHS England was asked by some of those GPs participating in the PMCF schemes, if we could develop a simpler method – an automated extraction of data and subsequent aggregation through the Health and Social Care Information Centre (HSCIC) on their behalf,” he said.
Tech support offered to vanguards: Interoperability and information governance are among the technological priorities for NHS vanguard sites, according to a support package published by NHS England, DigitalHealth.net reported. The package was said to have been developed to provide help and advice to the 29 original vanguards and, in addition, NHS England was reported to have announced the first batch of funding for the vanguards, with just under £20m going to three organisations and another £41m to be allocated this month. According to the news website, NHS England says its vanguard package has been put together following a series of site visits, and covers eight areas, one of which is harnessing technology. Vanguards will be supported to “rethink how care is delivered, given the potential of digital technology to deliver care in radically different ways” and to “help organisations to more easily share patient information”.
‘Cash is king again’: trust chiefs respond to Monitor letter: Trust leaders have told Health Service Journal (HSJ, subscription required) about their wide ranging concerns over the implications of a letter sent by regulators calling on them to take tough measures to improve their financial positions. Monitor and the NHS Trust Development Authority wrote to all trusts on Monday saying current financial forecasts for 2015-16 were “simply unaffordable” and asked trusts to revisit their plans. HSJ has spoken to a number of chief executives, who have raised concerns about the letter’s implications for patient safety, staffing and waiting lists. One chief executive said there was nothing more that could be done to cut costs without affecting patient safety. “We don’t think we can go further than we already have and the board are not prepared to compromise on quality,” they said. Another trust chief executive said the reference in the letter to safe staffing guidance being used in a “proportionate” way was not consistent with Care Quality Commission inspections. They said there needed to be a clear definition of what “proportionate” means “because what it means to you and what it means to me might be two entirely different things”, and trusts could be criticised by the Care Quality Commission for not strictly following the guidance.
Healthcare Big Data Analytics Market to Rise to $18.7bn: The global healthcare IT analytics market is expected to grow to $18.7bn by 2020, according to a new report by whatech.com. The market should grow at a compound annual growth rate (CAGR) of 26.5% within that time period, reported HealthITAnalytics. The report noted that federal mandates for Health Information Technology (HIT) implementation and electronic health records adoption are contributing to this growth. The implementation of meaningful use programs, the widespread availability of health IT analytics, and the increased emphasis on quality-based payments over fee-for-service payments are other contributing factors to this market growth. However, lack of trained personnel, the gap between payers and providers, and the rising costs of analytics may hinder the growth of the HIT analytics market. The HIT analytics market is split into three groups which include descriptive/retrospective analytics, predictive analytics, and prescriptive analytics. It is also split by region including North America, Europe, Asia, and The Rest of the World (RoW). The report stated that descriptive/retrospective analytics will account for the largest share of the market, as will the North American section.
NHS gets smart with contactless cards: NHS trusts will have access to contactless smartcards, so staff can log into clinical systems on tablet computers, from autumn this year, reported DigitalHealth.net. The Health and Social Care Information Centre (HSCIC) is testing the new cards, which are designed to work with Windows tablet devices with built-in “near field communication” technology that can read the card signals. Rather than swiping a magnetic strip, users can tap the back of the tablet, enter their log-in details, and have access to the clinical system in place at their hospital. The project is the latest step in the HSCIC’s Care Identity Service programme, which enables any organisation that uses Spine services to authenticate a care professional’s identity using smartcards. Andrew Meyer, head of the digital delivery centre at the HSCIC, said: “When we successfully transitioned from the old, externally run Identity Access Management service to the in-house Care Identity Service, we knew we had a real opportunity to develop a system which meets the needs of healthcare workers now and in the future. We have been working closely with users, and this pilot is another way to help us gain valuable feedback about how health and care staff actually use the system, so that we can design a national solution that is intuitive and helps them to deliver the best possible care.” The contactless cards are due to launch in September or October this year.
New Standards for health identifiers will improve patient safety for everyone: Ireland’s Health Information and Quality Authority (HIQA) has published new information governance and management standards for the introduction of individual health identifiers in Ireland. Health minister Leo Varadkar said the individual health identifier was a major step forward in modernising the health service. “It will allow us to follow patients and staff as they move through the health service in a way we currently can’t,” he said. “This will improve patient safety, reduce duplication and errors, and give us a huge amount of new data that we can use to make services more efficient and improve planning.” HIQA’s acting director of health information, Rachel Flynn, said: “Individual health identifiers are the cornerstone of eHealth systems and are key for implementing electronic health records and eHealth solutions such as ePrescribing. These electronic systems will greatly improve patient safety. HIQA has developed these standards to support the introduction of health identifiers into the Irish healthcare system by providing standards that the health identifiers operator must put into practice.”
GP charges needed for NHS to achieve savings: Individual charges to see a GP may be necessary for the NHS to meet its expected £22bn of efficiency savings over the next five years, according to public finance experts. The Chartered Institute of Public Finance and Accountancy (CIPFA) has published a report which contains stark warnings that the NHS is not on track to achieve the efficiency savings that the government is seeking from it – £22bn to plug the £30bn gap in its finances by 2020, reported OnMedica. The report says it is clear that the NHS faces “severe financial challenges” and the government’s plans to deal with them are inadequate. “Current plans are based on the Five Year Forward View’s assessment that £30bn of pressures are faced over the five years to 2021, and that £8bn of that will be offset by additional funding,” it says. “CIPFA concludes that the key figures of £30bn pressures and £22bn savings are both optimistic.” In its The Health of Health Finances report, CIPFA said that as things stood, the government was left with three choices: new charges, such as a charge for patients to use some services such as a flat rate contributory fee to see the doctor (including GPs) or paying a proportion of treatment costs, reduce services and increase funding. In addition, matters could be made worse and even more savings would be needed because of Conservative manifesto pledges such as increasing seven-day working in the NHS.
World Economic Forum recognises 14 health companies as ‘technological pioneers’: As part of the 2015 Technology Pioneers Programme, the World Economic Forum recognised 14 life science and health companies as being “early-stage companies from around the world that are involved in the design, development and deployment of new technologies, and are poised to have a significant impact on business and society”, reported Integrated Care Today. One of these health companies is ElMindA, a technology platform that allows high resolution visualisation and evaluation of the complex neuro-physiological interconnections of the human brain at work, capturing information on the composition, connectivity, synchronisation and operation of brain networks. Another company, HealthTap, was also recognised as a ‘technology pioneer’ for its phone application that connects patients with 70,000 doctors online. The programme also recognised AliveCor as another technological pioneer. The company’s mobile ECG allows patients to use it at home or on-the-go and know straight away if their ECG is normal.
£200m cuts to public health could threaten NHS contracts: The in-year cuts to public health budgets are going ahead as planned despite opposition from councils and practitioners, the government has confirmed, meaning that some contracts with the NHS could have to be re-examined. A long-awaited consultation on how the savings should be applied was unveiled, asking councils to suggest how the cuts should be implemented, reported National Health Executive. It suggests either a flat rate of 6.2% applied to all or varied percentages based on different circumstances that would still add up to £200m. The in-year cuts announced on 4 June are part of a wider government action on deficit reduction and would apply to 2015-16 health grants to local authorities. Yet they could force several local authorities to save on money already allocated to long-term contractual health work in the NHS and other organisations, many of which require six-month notice of changes. Many of the services threatened by the cuts are also required by law, including tackling alcohol and drug misuse, smoking and obesity, as well as generally promoting a healthier lifestyle. Councillor Lisa Mulherin, Leeds City Council executive member for health and wellbeing, said the affected services are “vital to improving the long-term health of people in Leeds and every other community”.
Liverpool scientists launch world-leading genetic research which could lead to cancer cure: A pioneering project which could lead to a cure for cancer and change the NHS has been launched at Liverpool Women’s Hospital. Liverpool is one of 11 sites across England which has been selected to take part in a £300m world-leading genetic research project. A team of Liverpool scientists, doctors and nurses will be recruiting 4,500 patients from Merseyside to take part in the scheme. Their blood samples will be used for ground breaking research as part of the 100,000 Genomes Project, which aims to sequence the genomes of patients in order to find out more about rare diseases and cancers. Angela Douglas, scientific director for genetics at Liverpool Women’s NHS Foundation Trust and chair of the British Society for Genetic Medicine (BSGM), told the ECHO the “ultimate goal” is that it could help find a cure for life-threatening illnesses.
Healthcare IT champion of the year: The voting is now open to find this year’s eHealth Insider Healthcare IT Champion of the Year. Click here to view the shortlisted candidates. Voting closes on Friday 11th September at 4pm. Good luck to all our shortlisted individuals. The winner will be announced at the EHI Awards ceremony on Thursday 1st October 2015.
Wearable tech: could it save the NHS?
Wearables are widely predicted to take off within the NHS over the next five years, thanks to their vast potential to improve care and save money. But first, the NHS will have to deal with some major challenges: security, culture and funding, to name but a few, says Charlotte Jee.
“It’s almost become something of a cliché to say our lives are set to be transformed by wearable technology. Whether tracking our steps on a Jawbone or FitBit, paying to get on the tube using an Apple Watch or capturing video using soon-to-be-relaunched Google Glass, these gadgets are becoming increasingly pervasive.
“The NHS has a tortuous history when it comes to adopting any technology (the £10 billion National Programme for IT, anyone?), never mind the most cutting-edge innovations. Few NHS organisations have started actually using consumer wearables, aside from the odd pilot.
“The potential benefits offered by wearable technology within healthcare are vast.
They could make it much easier to get reliable data to monitor conditions like diabetes or asthma, ensure patients remember to take their medication and reduce the need for hospital or GP visits, the Health Foundation’s strategy director Jo Bibby suggests.
“It could also save a lot of money, something not to be sniffed at in an era of austerity and with the NHS facing a funding gap of at least £30 billion by 2020.
“However the barriers are almost if not equally vast, and present a real challenge. For all our sakes, we can only hope the NHS finds a way to overcome them.”
Reaching the majority
Dr Katie Coleman asks whey person-centred care isn’t happening, in an NHS England blog this week.
“The vice-chair of Islington CCG and RCGP (Royal College of General Practitioners), and clinical champion for collaborative care and support planning, Dr Coleman says we need to capitalise on the enthusiasm of patients, service users and citizens to make person centred care a reality.
“Even if there are pockets where person-centred care is embraced, these are the innovators and early adopters – we have a long way to go before it reaches the majority,” she writes.
“So how can we achieve this vision of person-centred care being the norm?
“We know from the pockets of great practice that there needs to be a whole-system approach with senior buy-in, from commissioners and providers. We need champions who are opinion leaders, who are listened to, respected and can promote the cultural shift needed. We need systems that are user-centric, not provider-centric and which reward quality care. But for me, we need to harness our most valuable resource; our citizens, our service users, our patients.
“We need to capitalise on the enthusiasm of those people in our population who are telling us that person-centred care is what they want.
“We need to ensure that these groups are aware of the resources available to them, such as care planning in primary care, diabetes self-management programmes and Patient Online. We need to find out what would enable them to go further faster, engaging with them, so they feel empowered to ask practitioners for the care they want and deserve.
“Enabling those within society with the right skills, knowledge and confidence to take an active role in their care, will allow resources to be refocused to support those who have the greatest need.”
We need clarity around how competition law will affect new care models
Both competition and collaboration have been hot topics in the NHS in the recent past – the question is whether the two can align? Will the existing competition law get in the way of the integration agenda, asks Amber Davenport, chief policy adviser of regulation for NHS Providers.
“The forward view made clear that the NHS cannot continue to run harder and faster within existing care models. Instead, the sector needs to focus on a longer term strategy and adopt more integrated and collaborative models of care, which Simon Stevens has confirmed will “involve mergers and reconfigurations in some cases”, as well as the development of networks and vertical collaborations.
“This approach is a far cry from (former health secretary, Andrew) Lansley’s concept of competition between providers – subject to competitive tendering – being the future of the NHS.
Davenport explains why there should be cause for concern: “The alignment of the national policy narrative with the current application competition law is still somewhat confused.
“However, our concerns are that if NHS organisations are unable to pursue longer term strategic options, including vertically integrating or establishing joint ventures to deliver shared services, they could potentially fall into financial or operational difficulty with a direct impact on quality and access to services.”
In this week’s blog Gregor MacKenzie exposes five key components of a successful brand strategy that could deliver long-term success for your business.