News in brief
NHS highlights surgeon performance data: Performance data for almost 5,000 surgeons in England has been released by the NHS in a move towards greater transparency, reports the BBC. Using the MyNHS website, patients can search for information, including mortality rates for individual specialists. However some surgeons say the data may be “crude and misleading”. Other critics say that vital data has not been included in the information released. The MyNHS tool – which has been officially launched – is designed to allow patients and professionals to compare the performance of different NHS services, including consultants. Patients will be able to search for and compare data on certain surgeons, as well as statistics on local hospital performance, mental health care, social care and public health. Health Secretary Jeremy Hunt said: “Transparency is about patient outcomes, not process targets. It uses the power of a learning culture and of peer review, not blame.”
Patients in England can compare quality of GP surgeries for first time: Patients are able to compare the quality of GPs’ surgeries for the first time after the health watchdog published online rankings of every doctor’s practice in England, reported The Telegraph. One in six surgeries was identified as providing care that was potentially below par, with more than one in 10 in the category of “highest concern”, raising fears that hundreds of thousands of people may be receiving poor treatment. Those practices will be inspected in the coming months. The health regulator said that too many patients were having to endure “chaotic” and potentially unsafe care, while others struggled to obtain an appointment to see a doctor at all. Individual risk ratings and reports for England’s 7,661 practices were put online by the Care Quality Commission. It put the information online to allow the public to make more informed choices about their doctors. Politicians said that it would increase accountability in the health service and promised that doctors found to be repeatedly failing patients would be punished. However, leading figures in health care warned patients against drawing misleading conclusions from the information.
£1 billion PCS tender issued: NHS England has issued a £1bn tender for a single provider of primary care support services, reports eHealth Insider. The tender, issued this week, indicates that the commissioning board is looking to hand over the services it is running to a provider willing to shake them up and drive down costs over the four years of the contract. “The initial requirement is to take on the delivery of certain services currently provided by NHS England… and then drive through a transformation plan to enhance service quality and value for money,” it says. Primary care support services encompass a wide range of ‘back office’ services for GPs, commissioners, and other primary practitioners, such as pharmacies and dental practices. These include payment, finance and audit functions, HR and pension administration, support for administrative and clinical systems, patient registration, and the management of records, including their storage and transfer. They also include support for primary care activities such as breast screening and cervical cancer screening, such as sending call and results letters. Organisations wanting to express interest in the work must register with the eSourcing portal, and then complete pre-qualification questionnaires by 11 December. The tender says NHS England is looking for three or four candidates to take forward to the next stage, and the final contract will be awarded on the basis of the “most economically advantageous tender”.
Jones leaves HSCIC amid HES recovery: Max Jones, the former executive director of information and analytics at the Health and Social Care Information Centre, has left the organisation after being in the role for only nine months. Jones’ sudden departure, described as “brutal” by a well-placed source, appears to be related to the HSCIC’s ongoing attempts to recover from the scrutiny put on the Hospital Episode Statistics by the fall-out from the care.data programme. In April, the HSCIC announced it was reviewing access to the HES and other national datasets, cutting off access for a number of organisations. A source told eHealth Insider that Jones’ departure is related to HSCIC chief executive Andy Williams’ plans to re-organise his executive team to deal with the HES issues. Jones was a senior figure in NHS Connecting for Health, and becomes the latest senior figure to depart the HSCIC. A HSCIC spokesperson said Jones is leaving the HSCIC “to follow other career opportunities”. The spokesperson provided a quote from Jones which said he had been “contemplating a change in direction” for some time.
Hunt: Transparency not targets will achieve ‘world class’ NHS: The NHS must adopt a different approach to performance management that focuses on the transparent provision of information rather than chasing targets or extra resource, the Health Secretary has said, reports Health Service Journal (HSJ, subscription required). Such an approach could also be enforced, Jeremy Hunt announced at the Foundation Trust Network conference, with new rights grafted into the NHS constitution. These would give the public access to comparable information about health and care services. Mr Hunt used his speech to challenge the “conventional wisdom” that has been allowed to develop “that the best way to change anything is through yet another target and a bit more money.” He said that while “targets matter” only transparency could help the NHS achieve “truly world class performance”. Mr Hunt revealed new measures to allow people to compare the performance of consultants and organisations. The health secretary also announced a new website, which aims to pull together outcome data for 10 surgical specialties, such as adult cardiac surgery and colorectal surgery, in easy to access formats. Similar data will also soon be available for three more specialties – upper gastrointestinal surgery, neurosurgery and stress incontinence surgery.
Data breaches ‘should lead to jail time’: A leading privacy watchdog has called for tougher penalties for breaches of the Data Protection Act (DPA), arguing that present legislation is not enough of a deterrent. Big Brother Watch says courts should be given the option of imposing custodial sentences on those who breach the act, and that the “worst offenders” should be left with a criminal record, according to eHealth Insider. It also argues that staff should be given better training in a report that identifies 7,255 breaches of the DPA in the NHS over three years. Emma Carr, director of Big Brother Watch, said: “With an increasing number of people having access to patient information, the threat of data breaches will only get worse. Urgent action is therefore needed to make sure that medical records are kept safe and the worst data breaches are taken seriously.” Privacy campaigners have been calling for tougher laws for those who illegally access confidential information for almost a decade. The biggest fine imposed on the NHS to date was levied on Brighton and Sussex University Hospitals NHS Trust in 2012. It was fined £325,000 and paid £260,000 after a contractor sold old hard drives containing patient information on eBay. Despite this, the latest Big Brother Watch report says “the current level of sanctions for serious data breaches does not deter individuals who are intent on breaking the law” or make it possible to “effectively punish individuals that knowingly flout the rules by accessing, and in some cases selling, personal information to third parties.”
Temple Street Children’s Hospital goes live with Orion Health Clinical Portal: Dublin’s Temple Street Children’s University Hospital (TSCUH) has gone live with Orion Health’s Clinical Portal as part of a major ICT transformation that is in accordance with the country’s eHealth strategy, reported ICS. For the first time, clinicians can access patient data from a range of critical sources including patient administration system, lab system, radiology, theatre and the emergency department, in a single place, helping them have more time to care for the thousands of children they treat every year. TSCUH intends to make 80% of its paper patient record electronic with Orion Health’s technology. “Clinicians were frustrated at having to negotiate multiple systems to access all the clinical information they need,” said David Wall, head of ICT at TSCUH. “Now they have a single unified view of patient data across the hospital, accessible through an easy-to-use web-based interface. Graphs, alerts, appointments, lab results, x-rays, radiology tests and theatre activity are available at the touch of a button,” said Wall. Colin Henderson, managing director, UK & Ireland at Orion Health, recognised that meeting clinical needs is central to good digital health: “Our portal has been developed by clinicians for clinicians and we look forward to supporting TSCUH and others on this journey.”
Bungling health board faces fine after records left at supermarket: The Information Commissioner’s Office (ICO) launched an investigation after patient records were found in public areas of Aberdeen Royal Infirmary five times and the local supermarket. STV News reminds that the issue was reported to NHS Grampian in December 2011, but the health board failed to act. NHS Grampian has been ordered to improve or face regulatory action, which could include the £500,000 fine. Ken Macdonald, ICO assistant commissioner for Scotland, said: “It’s a fundamental requirement of the Data Protection Act that organisations understand what personal information they hold and who is responsible for looking after it on a day-to-day basis. NHS Grampian failed to do this despite committing to addressing this problem when our office highlighted it as an issue during an audit three years ago. We hope this enforcement notice gives the organisation a further chance to put their house in order and look after the information of the people they serve.” An NHS Grampian spokeswoman added: “We are fully committed to meeting the commissioner’s notice requiring NHS Grampian to produce a high level information asset register. We will ensure that we will take the steps required by the information commissioner. All the incidents were investigated in full at the time, and we took any necessary actions to reinforce correct practice.”
Integration will not save money, HSJ commission concludes: Political leaders’ belief that health and social care integration is the “silver bullet” for the NHS’s financial difficulties is a “myth” and “Messiah concept” that has no realistic prospect of success, reports Health Service Journal (HSJ, subscription required). This is the chief conclusion of the HSJ/Serco Commission on Hospital Care for Frail Older People, which also criticises the coalition’s flagship integration project, the better care fund, as having been planned in a “hokey cokey” fashion. Formed by an influential group of health leaders, the commission says it supports efforts to integrate health and social care but warns that doing so will not ease cost pressures or reduce reliance on hospital beds. “There is a myth that providing more and better care for frail older people in the community, increasing integration between health and social care services and pooling health and social care budgets will lead to significant, cashable financial savings in the acute hospital sector and across health economies,” the report states and adds: “The commission found no evidence that these assumptions are true.”
Private health firms set to secure UK NHS contracts worth £9bn: More than £9bn worth of UK NHS contracts for patient-related services is set to be secured by various private health firms, research has revealed. According to the analysis of an independent campaign group NHS Support Federation, private firms such as Bupa, Virgin Care and Care UK secured 131 contracts valued at £2.6bn to offer NHS services since April 2013, reports Hospital Management. The services tendered, valued at £18.3bn, include more than £1bn worth of contracts for elective surgery, diagnostics (£1.2bn), community care services (£1.9bn), musculoskeletal care (£785m), ambulance and patient transport services (£583m) and pharmacy (£558m). British Medical Association chair Dr Mark Porter was quoted by the news publication saying: “These figures show the extent of privatisation in the NHS following the pushing through of the Health and Social Care Act. An act that the government denied loud and long would lead to privatisation, has done exactly that.”
GEM CSU and Arden CSU to merge: Great East Midlands CSU (GEM CSU) and Arden CSU will merge on 1 April 2015, following approval from NHS England, claims The Commissioning Review. After the merger, the newly formed organisation will provide services including informatics, Continuing Health Care, service transformation and corporate functions such as finance and human resources. The two organisations currently provide specialist support to 37 clinical commissioning groups (CCGs) over a wide geographic area, serving customers from Lincolnshire, Worcestershire and Essex. The CSUs believe the merger will provide opportunities to develop new and innovative services as well as allow healthcare staff to develop new skills. John Parkes, managing director of GEM CSU, said: “This merger will bring together the best innovations from two successful CSUs to deliver excellent services and value for money. We are very excited about our new organisation and our contribution towards improving health outcomes for our population.” Rachel Pearce, managing director of Arden CSU added: “Our two organisations already have strong working relationships and we share the same values and commitment to making CSUs a highly valued partner for our customers.”
Fewer (but better) cyber-attacks for 2015 – mobile auto-logins and healthcare targeted: A new report indicates that although the number of hacking attempts is likely to diminish next year, the abandonment of ‘carpet bombing’ techniques will be balanced by an increasingly targeted and more user-specific exploitation of Personally Identifiable Information (PII) in order to facilitate unauthorised access – and that these more elaborate attacks will be increasingly aimed at the healthcare sector, says The Stack. The report, by cybersecurity firm Websense, identifies the healthcare sector as a significant attack vector for cyber-criminals because of the large amount of PII available in patient records. In the UK and the United States the slow and problematic progression away from paper-based medical records also means that the sector is currently more focused on the logistical problems of the transition than on security, providing a window of opportunity for attackers. The report states: “In an environment still transitioning millions of patient records from paper to digital form, many organisations are playing catch-up when it comes to the security challenge of protecting personal data […] As a result, cyber-attacks against this industry will increase.”
Infant heart-rate monitors have no proved medical use, claims expert doctor: Baby monitors which send parents live information about their child’s heart rate, breathing and temperature have “no proved use in safeguarding infants”, despite their growing popularity in the USA, a British expert has warned. Although the monitors are not yet available in Europe, they represent a growing industry in America where they are marketed as offering “reassurance” to parents, reports The Independent. However, David King, a clinical lecturer in paediatrics at the University of Sheffield, said that parents should be aware that none of the existing products had been regulated as medical devices and therefore had not had to undergo trials of their effectiveness. The devices, which can be worn by newborn babies and relay information to the parent via a monitor or even a smartphone, have proved popular amid persistent concern about cot death, also known as sudden infant death syndrome (SIDS). Although none of the devices claim to reduce the risk of cot death, Dr King said that parental fears about the condition had driven their development and were a theme in the marketing.
UK based medical record firm raises $1.7m: UK based Patients Know Best (PKB), the world’s only fully patient-controlled online medical records system raised $1.7m of investment led by global venture capital fund Maxfield Capital, reports Computer Business Review. Patients Know Best is an online tool enabling patients to better organise, manage and control access to their own healthcare records – it also saves the time of physicians and doctors by enabling secure online consultations, remote monitoring and shared care planning. Dr Mohammad Al-Ubaydli, founder and CEO of Patients Know Best said: “We believe that putting patients in control of access to their medical records is crucial to improving patient care and driving efficiency in the NHS and beyond. Today, PKB is connecting patients’ data across hospitals, community nursing teams, social care, mental health trusts and prisons. The technology is used across eight countries in eleven different languages. This investment will enable us to develop the product further and hire additional clinical staff to support the company’s continued rapid growth.”
#HMvideo @EHILive
At EHI Live 2014, Highland Marketing met and interviewed senior personnel from various healthcare IT vendors and healthcare providers to ask their views on what they consider to be the essential issues facing the industry and the improvements technology can bring to healthcare service delivery.
Below we continue with our series of published videos, with more to come in future issues of the Healthcare Roundup.
Dr Mark Davies, medical director of MedeAnalytics talks to Highland Marketing at EHI Live 2014 about how patient outcomes will be improved if information architectures are changed so that they are focused around a patient rather than an organisation.
Geoff Broome, founder and director of Apira argues that there is no magic wand solution to increase healthcare technology adoption and that leadership and engagement are the only way forward.
Opinion
Chronic care: investigating the era of the ‘hyper-connected’ patients
James Norman, healthcare business director at EMC and the former director of IM&T Royal Liverpool and Broadgreen University Hospital NHS Trust reviews on The Guardian how the recent investigation of the era of “hyper-connected” patients and citizens with IDC opens the door to new opportunities for disease control and management, in particular chronic care condition.
“Effective public health interventions and policies aimed at common health risk factors can lead to improved health status and quality of life of the population, and also yield substantial savings on costs associated with chronic diseases, due to reductions in healthcare costs and gains in economic productivity. However, it has been estimated that, despite the potential cost-effectiveness of preventive interventions, European countries spend as much as 97% of health budgets on curative care, whereas less than 5% is invested in prevention.
“At these rates, it is clear that Europe will not be able to afford the current pace of healthcare expenditure growth. With healthcare costs growing faster than overall economies, it is high time that healthcare systems became truly proactive, adopting a holistic approach to a patient and maximising preventative efforts that can help keep people healthy for longer, at the least possible cost.
“This era of “hyper-connected” patients and citizens also opens up a vast array of new opportunities to improve the management of chronic diseases and to proactively engage with patients.
“But, it is not an easy path. For people to change behaviour, they have to have sufficient motivation, be free from barriers preventing the change, and have the required resources and abilities.
“The vast amount of variety and velocity of data that forms the hyper-connected patient ecosystem represents an opportunity to better inform prevention and care delivery. With almost all major technology players looking with interest at the wearables trend for an answer, with particular interest surrounding fitness and health apps, more attention should be paid to data.
“However, structured and strategic programs need to be implemented, with a particular focus on informing and encouraging citizens to understand and use the devices and apps that will support data driven healthcare. It will only be with buy-ins from healthcare providers, the government, technology providers and citizens that we will see the benefits from the future vision of healthcare.”
Why is cloud computing in such poor health in the NHS?
Cloud doesn’t get mentioned once in the NHS’s five-year plan. Diginomica’s guest contributor Gary Flood wonders if this indicates rejection or ignorance of the cloud’s potential?
With the word ‘cloud’ only mentioned once in Simon Steven’s forward view, Flood comments: “Before you ask, the word ‘technology’ appears 12 times. So it’s not as if Stevens and his team at NHS England are ignoring the potential of IT to help the NHS – far from it.
“But it is interesting that despite the Cabinet Office’s ‘Cloud First’ mandate, which specifically states that ‘purchases through the cloud should be the first option considered by public sector buyers of IT products and services’ being in place for 18 months or so, the amount of purchases made through the CloudStore (now Digital Marketplace ) by health organisations is still astonishingly low.
“We tried to get specifics on what proportion of G-Cloud sales actually have gone to the NHS, but have so far been unable to get very far. But we know from the feedback we get from suppliers that there is a definite air of malaise about the G-Cloud and NHS informatics.
“The reality is that the NHS is still recovering from all the ins and outs of the National Programme for IT, is going through massive re-organisational change – and probably just hasn’t stopped firefighting long enough to take the measure of what the G-Cloud could offer. But we really do hope it does – and soon.
“As huge opportunity for the sort of tech-enabled change Stevens says it needs could be missed otherwise, if this way of procuring innovative, useful health IT systems is neglected.”
Life sciences minister: Go digital for NHS savings
Speaking exclusively to PMLiVE shortly before the government’s digital health strategy was released, George Freeman MP, the UK life sciences minister, talked about how greater use of health technology could free funds for drug spending.
Freeman said that rather than investing large sums of money into the NHS each year, it is “more important” to utilise “the increasing pace of digitalisation and precision medicine” to help drive down costs.
Freeman, who spent years working in the pharma sector before becoming an MP, also backed health secretary Jeremy Hunt’s vision for both a paperless NHS, and one that uses new telehealth and telemedicine to reduce the strain on the NHS budget and even allow the government to pay for more drugs.
“You need only look to the oft cited example of Airedale in North Yorkshire where 24/7 home iPad and webcam telehealth for respiratory and cardiac patients have dramatic impacts on the reduction on GP appointments, and hospital admissions, whilst being hugely influential on clinical outcomes and saved substantial funds,” Freeman said.
“We only have to roll this out at scale across the system and we can start to deliver really significant efficiency gains which we can then re-invest in paying for more medicines.”
“There are numerous examples where innovation strips out a huge amount of waste – so, for example, just moving paper prescriptions to digital prescriptions in the pharmacy sector, and in the way we make GP appointments.
“There are huge efficiencies from innovation, but what we need to look at is how we incentivise people in the system to adopt those innovations.”
2020 vision
eHealth Insider’s reporter Sam Sachdeva gathers the analysts’, trusts’ and suppliers’ reactions to the recently published 2020 vision of NHS.
‘Personalised Health and Care 2020’ emphasises that it is “not a strategy in the conventional sense” – and certainly not a “national plan” – but a “framework for action.”
Further detail is promised in a series of forthcoming ‘roadmaps’, but Karl Grundy, the head of EHI’s research arm, EHI Intelligence, sums up the cautious optimism that has been the initial response of many to the initial plan.
“I think it’s a better document than many thought would come out of the NHS,” he says, welcoming, in particular, its focus on interoperability, encouraging smaller suppliers, and promoting clinical leadership.
Importantly, the strategy has also picked up initial support from trust and clinical IT leaders. Daniel Ray, director of informatics at University Hospital Birmingham NHS Foundation Trust and chair of EHI’s Health CIO Leaders Network, says it is “fundamentally saying the right thing.”
Markus Bolton, the joint chief executive of System C, says the “sensible light touch” of the document and its focus on integration marks a progression from previous strategies, which dealt with getting basic IT into individual healthcare organisations.
“They’ve done a pretty good job of that… most hospitals have got pretty good basic infrastructure, and it’s definitely time for that next step to become joined-up healthcare,” he says.
Shane Tickell, chief executive of IMS Maxims, says the plan’s focus reaffirms his long-held view about the importance of local innovation. “Locally, you are best placed to make decisions on local needs and you can use all of your endeavour to try and do that – don’t wait for other people, get on with it yourself,” he advises.
Joe McDonald, a consultant psychiatrist in the North East, and chair of the advisory group for EHI’s CCIO Leaders Network, says he is heartened by the NIB framework’s emphasis on empowering chief clinical information officers to lead local transformation programmes to support the adoption of IT. “It’s nice that we’ve gone from a pretty small crowd to being part of government policy in a fairly short period of time.”
Tim Kelsey, the director of patients and information at NHS England, and chair of the NIB, has told EHI that the new targets are ‘hard stops’ – and must be met if the Five Year Forward View is to be delivered.
Highland Marketing blog
In this week’s HM blog, Myriam McLoughlin asks whether healthcare vendors should use emotional engagement in order to stand out from the crowd.
