News in brief

Leaders urge politicians to put NHS at forefront of general election debate: Health leaders have called on politicians to not shy away from their responsibility to fix the NHS as all of the UK’s major parties prepare to get on the campaign trail in preparation for the general election scheduled to take place on 8th June, reported National Health Executive. The call comes after the shock announcement by Theresa May that there would be another general election this year, despite the prime minister assuring the country last year that there would not be a general election until the scheduled year of 2020. Now, organisations have stated that the imminent change in government should be used as an opportunity for the NHS to be turned around following its alleged worst winter on record. “Health is always one of the most important issues for the people of this country and with the NHS at breaking point, having been put through one of the worst winters on record, it must be a central issue in the upcoming election,” argued Dr Mark Porter, chair of the British Medical Association council, who said that the NHS could not be pushed to the margins in the focus on Brexit.

NHS fails to hit targets over “worst winter on record” despite mild weather: Emergency departments are still struggling to meet NHS targets under increased demand from patients, NHS England’s performance figures for February 2017 have revealed. The figures show that at the end of a winter period that health organisations have described as the “worst on record”, standards were not being properly met in a number of areas, including ambulance response times and cancer waiting times, reported National Health Executive. Jim Mackey, chief executive of NHS Improvement, agreed that the statistics showed the NHS had gone through a “tough winter”. “Over a thousand extra people were coming through the doors of our emergency departments each day and the NHS was also dealing with increased numbers requiring an ambulance or emergency admissions,” Mackey said. “This, naturally, has had a knock-on impact on the number of people waiting for routine operations.” However, Mackey also thanked the hard work of staff and initiatives like the Emergency Care Improvement Programme for ensuring that the vast majority of patients received speedy, high-quality care. “And things are getting better,” Mackey assured patients. “From talking to staff on the ground, I know that the picture in April is likely to be very different to the one reflected in these statistics.”

£7.3m funding for 11 Welsh digital health innovations: Eleven health innovations selected through the Efficiency Through Technology Fund in Wales will receive £7.3m in funding for further development, Vaughan Gething, Welsh health secretary, has announced. The National Welsh Informatics Service is set to receive £1.18m to accelerate the process of IT transformation and digital patient records, focusing on nursing e-forms “as a priority area”, reported British Journal of Healthcare Computing. The molecular diagnostics for gastrointestinal infections project, which was led by Public Health Wales, is also set to receive approximately £2.5m during the next three years, while other innovations include the design and deployment of a remote reporting system for patients with deep pressure ulcers. Meanwhile, the Powys health board will receive funding for a digital cognitive behavioural therapy platform, expected to increase efficiency of mental health services in Wales. Gething revealed nearly 150 applications were submitted, with innovations facing “fierce competition”. “It is fantastic to see organisations coming up with innovative schemes to improve our health care services. I am looking forward to visit some of the projects in the near future to see first-hand what they can achieve,” he added.

NHS cancer referrals: More than 100,000 wait at least two weeks to be seen by specialist: NHS England aims for 85% of cancer patients to start treatment 62 days after referral, but this target has been missed annually for three years, reported The Independent. New figures show more than 100,000 patients waited longer than two weeks to see a cancer specialist after being urgently referred by their GP last year. Two weeks is the maximum waiting time allowed by the NHS in England for cancer referrals, with hospitals and surgeries required to investigate and offer a list of alternative clinics if the target is exceeded. Waiting longer than 14 days for tests leaves patients in an “appalling state of limbo”, Macmillan Cancer Support has said, while experts have warned failing to act quickly could risk lives if tumours are not spotted soon enough. In 2016, 102,697 people did not see a consultant within two weeks of referral, according to analysis of NHS data by the House of Commons Library. A Department of Health spokesperson said that cancer survival rates were “actually now at a record high”. “The NHS treated over 110,000 patients – 82% – within the target of 62 days last year, as the NHS rises to the challenge of an increase in urgent referrals for suspected cancer of over 90% compared to 2009-10,” they added.

UK most sceptical EMEA country regarding robotics in healthcare: British patients are the most sceptical in Europe, the Middle East and Africa (EMEA) when it comes to having robotics and artificial intelligence (AI) involved in their healthcare, according to report by PwC, reported The Actuary. The report revealed that 55% of consumers across these regions would be willing to use the technology to answer health questions, perform tests, make diagnosis and recommend treatment, rather than human doctors. However, this varies across countries, with just 39% of UK patients happy to do so, in contrast with 94% in Nigeria, despite the technology having the potential to transform healthcare delivery, making it more accurate, accessible and faster. The PwC report is based on a survey of over 11,000 people from 12 countries across EMEA, finding that 73% of respondents would be happy for a robot to perform a minor surgical procedure. Again, the UK was found to be the least willing to have such procedures using the technology, with British patients also the most reluctant to have major surgery using it, although men, and the younger demographic are more open-minded.

Scotland issues £1.5m tender for radiology IT connectivity solution: NHS National Services Scotland (NSS) has issued a £1.5m tender for a radiology IT connectivity solution, required to underpin the National Model for Radiology, reported Health IT Central. The notice revealed NHS NSS was tasked with the implementation of the model on a regional and national basis at the end of the summer last year, with the IT connectivity solution set to offer the ability to “request and report upon images across” hospitals in Scotland and then return to the “originating host” NHS board radiology information system (RIS). “This may be achieved by a new software platform, or by maximising functionality of existing software solutions. The expectation is that implementing an IT connectivity solution which integrates fully with the picture archiving and communication system (PACS) and/or RIS systems will allow image reporting on every site which would feedback into the host health board RIS,” it is explained in the tender notice. The value of the contract is estimated to reach £1.5m over a period of three years, subject to renewal, although bidders are asked to provide proof of minimum “yearly” turnover of £100,000 for the last two years. The solution is expected to integrate with both the current Scottish PACS and the re-procured version which is set to start in two years and provide a ‘unified information system’ that will allow staff to work on a “national basis”.

IMS MAXIMS electronic patient record selected for NHS framework: NHS hospitals across the country will be able to respond to paperless and personalised care ambitions by procuring IMS MAXIMS electronic patient record (EPR) technology through a new clinical technology framework, reported Building Better Healthcare. The pioneering technology specialist has been awarded a place on the new Clinical and Digital Information Systems Framework Agreement (CDIS) launched by the NHS London Procurement Partnership (LPP). Following robust scrutiny by LPP, IMS MAXIMS scored highly for its EPR technology, which is now available through the framework to acute care, mental health, and community providers. Shane Tickell, chief executive of IMS MAXIMS, said: “NHS organisations are often constrained by lengthy procurement processes that can delay the implementation of digital technologies urgently needed by the health service and subsequently the benefits for staff and patients. The CDIS framework gives NHS service providers an alternative, more-effective route to buying technology that will enable them to deliver the government’s target of becoming paperless by 2020, and to place important information where it is needed to deliver personalised and more-effective patient care.”

Digital tech pilot helps NHS trusts keep track of beds: Several NHS trusts, selected by NHS Improvement, are piloting new Fitbit-style technology to track beds, staff, patients and assets to provide real-time information on bed status, patient pathway tracking and asset management to increase bed capacity, reported Digital Health Age. This group of trusts, including The Countess of Chester NHS Foundation Trust, University College Hospitals London NHS Foundation Trust, and the Mid and South Essex Success Regime, have become patient flow software implementation pilots, deploying TeleTracking Technologies’ to provide a real-time view on bed status, which patients need beds, where hospital assets and equipment are located, and the nearest staff. Adam Sewell-Jones, director of improvement at NHS Improvement said: “A key part of NHS Improvement’s role is to support NHS trusts in developing new ways of working to improve patient care and meet rising demand. TeleTracking is one example of that ambition. This new technology enables staff to see real time data on beds available within the hospital, enabling patients to be allocated to the most appropriate ward first time. If the NHS is to meet rising demand it must continue to innovate and develop new technologies that enhance and improve patient care.”

System C will link child health records across the south: System C has been awarded a contract to create a single child health record across six regions in the south of England, reported DigitalHealth.net. The supplier will use its CarePlus Child Health software to integrate 800,000 health records across 14 clinical commissioning groups, five local authorities and six unitary authorities. The project is being led by South, Central and West Commissioning Support Unit (CSU). It won the NHS England procurement for a comprehensive child health record for Oxfordshire, Buckinghamshire, Berkshire, Gloucestershire, Swindon and Bath and North East Somerset in September last year. Iona Rees, head of child health information services at the CSU, told DigitalHealth.net that the integration of records will improve care. “The different child health IT systems don’t talk to each other [currently] so it’s a real challenge when a child moves or moves into the area to make sure that you pick them up and they don’t get missed. The real benefit [is] that within our region we’ll all be on the same system so we can track children much more easily.” The unified record is due to be live by the end of October, and will be created by migrating data from TPP’s SystmOne, Servelec’s Rio and Advanced’s CareNotes.

EuroKing to be deployed at Royal Cornwall Hospital Treliske: The maternity team at Royal Cornwall Hospital Treliske (RCHT) is set to deploy EuroKing’s state of the art maternity information system across the hospital and community teams, reported the Health Tech Newspaper. The RCHT will replace their legacy system with EuroKing’s E3 solution, in order to enhance safety for mums and babies across their rural community – including the Isles of Scilly – and to work towards the trust’s paperless agenda. The trust will be working with EuroKing to implement the solution and a range of additional modules, including central monitoring and community offline – which enables midwives to access and update patient records when out of the hospital, even without internet connection. David Smith, associate director of the women and children’s division at RCHT said: “The E3 system will replace our legacy maternity system, helping us move towards a paperless service and meeting the 2020 paperless agenda. We are planning to integrate electronic CTG [cardiotocography] recording with an option to convert to ST analysis [STAN, a combination of fetal heart rate interpretation and analysis of the fetal electrocardiogram] as required, which will ensure our patients are offered the best possible care in line with the national Saving Babies Lives care bundle. E3 is an easy and intuitive system to use, we are really looking forward to deployment.” The project commenced at the end of February, with a planned go live in June/July.

NHS Digital appoints Home Office CTO as new CEO: NHS Digital has appointed Home Office chief technology officer (CTO) Sarah Wilkinson, as its new CEO. Wilkinson is currently the chief digital, data and technology officer at the Home Office. She will join NHS Digital later this year, replacing interim CEO Rob Shaw, who has been holding the fort since Andy Williams retired at the end of March, reported DigitalHealth.net. NHS Digital chair Noel Gordon said: “Sarah brings vast experience of implementing complex technology projects, alongside a deep insight into bringing about positive change to a broad range of communities through digital delivery.” Wilkinson joined the Home Office at the start of 2015 to lead transformation of the department’s IT capabilities. Her previous background was of 20 years’ experience in the finance sector. Wilkinson said: “I am thrilled to be joining an organisation that has such a major role to play in supporting health and care organisations to provide preeminent services. Digital and technical capabilities and the fast-evolving market in platforms, software, devices and analytics, are transforming the ability of the medical profession to prevent, diagnose and treat diseases. To be asked to work at the forefront of delivering these capabilities is hugely exciting.” She added: “A major draw of the role is the opportunity to work with and alongside an incredibly talented team of medical practitioners, technologists and other specialists. It is a huge privilege to be asked to be part of this community.”

Opinions

Four reasons why a 2017 general election could be good news for the NHS
Viewed over a three to five-year timeframe, the decision by Theresa May to call a snap election on 8th June could prove to be a net positive for the NHS, writes Alastair McLellan, editor of the Health Service Journal (subscription required).

“If we assume we are not in for another seismic political shock, the election is likely to return a Conservative government with an increased majority. This would be good news – when compared to the current situation – for the NHS on four fronts.  

“The first is that the government is unlikely to continue to tie itself to the pledges made in the 2015 manifesto not to raise taxes and could possibly even abandon its commitment to the triple lock on pensions. This, in turn, would give them the opportunity to revisit the 2015 spending settlement and provide a 70th birthday present to the NHS during the leanest years stretching from 2018-19 and beyond. In making this case the NHS will have to change its narrative to align with the priorities of a newly strengthened May-led government. Health Foundation chief economist Anita Charlesworth argues persuasively that the NHS must work harder to demonstrate how it contributes to the nation’s wealth.

“We already know that the PM and the Chancellor believe their predecessors were very generous to the NHS – especially in comparison to other public services – and could well decide the already-trailed capital boost in the autumn budget is all the service should expect. There will also no longer be the pressure to boost NHS funding in 2018 or 19 to prepare the ground for a 2020 election. Finally, there is also the continuing danger that a preoccupation with Brexit will simply crowd out all else.”

Could shared medical appointments help the NHS and patients?
It is surprising that shared appointments have not been taken up more widely in the NHS, writes Lord Darzi in The Guardian.

In an article for the newspaper’s Healthcare Network, Lord Darzi, the former Labour health minister and current Paul Hamlyn chair of surgery at Imperial College London, looks to the US where shared appointments have impacted on waiting times and patient experience.

“In medicine, the private one-to-one consultation is sacrosanct.Yet shared medical appointments have been used successfully for years at the Cleveland Clinic in the US. Patients appreciate them. They compare experiences with other patients, learn from their questions, gain more advice than they might otherwise, and improve their understanding of their symptoms. 

“For the hospital, the gains are seen in improved outcomes, higher patient satisfaction, dramatically reduced waiting times and lower costs. 

“Here, then, is an innovation that could help the NHS, caught between rising demand and squeezed budgets, which is leading to longer waiting lists and growing discontent. By sharing appointments, more patients could be treated more quickly, reducing waiting times, saving costs, yet raising standards of care.

“They have been tried by GPs in Edinburgh, Sheffield and Newcastle, following the lead of doctors in the US and Australia. As a surgeon, I can see the potential benefits in bringing together patients undergoing the same procedure for pre- and post-surgical care. 

“Shared appointments are not appropriate for all patients or all conditions. They should always be offered, never imposed, and patients would always retain the option of a one-to-one consultation, if that was what they preferred. There might, however, be trade offs. Patients might be offered a one-to-one consultation in four weeks or a shared appointment in 48 hours.”

What the 2017 Conservative manifesto should say about the NHS
There is one critical pledge which Theresa May should make in her snap election manifesto: the NHS must have its own 2% inflation target, writes Tony Hockley, visiting senior fellow in the department of social policy at the London School of Economics and Political Science. 

Hockley calls for recognition of the reality of health spending and outlines the consequences of not committing to the 2% inflation target.

Hockley says: “The Guillebaud Report of 1956 nailed the myth that demand on health services would decline as population health improved. In 1985 Nick Bosanquet produced a substantive study on health funding showing that an increase of 2% a year was needed just to keep pace with technical advance and demographic change. Nothing changed. Life expectancy continues to improve and technology continues to expand the range of what is possible to improve quality of life. Meanwhile health spending has defied this logic.

Firstly, the boom-bust cycle stokes NHS inflation, making many of the declared crises very real. Booms inflate costs as the service tries to catch up on the recent past. This is most evident in the workforce, which is the majority cost of a health system.  

“Secondly, the rollercoaster makes real innovation almost impossible. No organisation can invest the time and energy in reform if it expects its resources to randomly boom or bust. It will simply survive in anticipation of the next bail-out.

“Debates about funding systems and structural reform are simply a diversion from recognition of the fundamental truth of health and social care spending.

 “One simple but effective policy change would be to amend the NHS Constitution to create a firm commitment to a target range for health and social care annual spending growth. This should be based around Bosanquet’s 2% doctrine.”

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