News in brief
NHS reforms go live: The major reorganisation of the NHS has been put into practice this week, as family doctors take the reins of commissioning health services in England, reported Pharma Times. There are a number of big changes for the NHS – and none bigger than the abolition of 151 Primary Care Trusts and Strategic Health Authorities, which have now been replaced by 211 Clinical Commissioning Groups (CCGs). The CCGs, which are being run by GPs with the help of hospital doctors and specialist nurses, will take on around £65 billion of the NHS budget, with NHS England (formerly the NHS Commissioning Board) taking the other £30 billion for specialised commissioning. NHS England, which is being headed up by Sir David Nicholson, will also be responsible for the new CCGs. To help you come up to speed regarding the NHS reforms, the Department of Health have posted ‘The new health & care system explained’.
NHS shakeup may destroy patients’ trust in GPs, says BMA leader: The coalition’s NHS shakeup could destroy the trust between GPs and their patients by making family doctors responsible for the rationing of treatment, the leader of the medical profession has warned. GPs would be at risk of being seen as “agents of the state” who are implementing government cuts after the historic change in their role took effect on 1 April, Dr Mark Porter told The Guardian. Porter, chairman of the ruling council at the British Medical Association (BMA), said doctors were worried that their role in deciding which patients got access to which treatments, as a result of the formation of 211 GP-led clinical commissioning groups (CCGs) across England, would prove divisive and unpopular.
Putting Patients First: government publishes response to Francis Report: The quality of patient care will be put at the heart of the NHS in an overhaul of the health and care system in response to the Francis Report, reported the Department of Health. In an announcement this week, Health Secretary Jeremy Hunt revealed how a culture of compassion will be a key marker of success, spelling an end to the distorting impact of targets and box ticking which led to the failings at Stafford Hospital. Hospitals and care homes will be encouraged to strive to be the best, the basic values of dignity and respect will be central to care training and, if things go wrong, patients and their families will be told about it. Radical new measures will be introduced to achieve this including Ofsted-style ratings for hospitals and care homes, a statutory duty of candour for organisations which provide care and are registered with the Care Quality Commission, and a pilot programme which will see nurses working for up to a year as a healthcare assistant as a prerequisite for receiving funding for their degree.
Greater Manchester hospitals’ patient data found in street: Two Greater Manchester hospitals are investigating after confidential information about their patients was found by members of the public, reported the BBC. Information about 16 child patients at the Royal Oldham Hospital was found more than 40 miles away on a street in Liverpool. The Pennine Acute Hospitals NHS Trust said any loss of data was unacceptable. Royal Bolton Hospital is also investigating after medical notes were found in the town last week. The documents were believed to have contained details of 25 patients printed on four pages. The patient details found in Liverpool, however, were printed on a single page. A spokeswoman for The Pennine Acute Hospitals NHS Trust said: “We have clear systems in place to ensure the confidentiality of patient data and this information would normally only be handled by a small number of doctors and nurses on the children’s ward. “We will now undertake a full investigation into how this document ended up in Liverpool. As part of this investigation, we will find out what went wrong in this case. We will also be contacting the parents and guardians of all the 16 patients involved.” The Information Commissioner’s Office is investigating both incidents.
First paperless NHS trust helps GP practices go digital: The NHS trust which claimed to be the first to become paperless a year ago is now helping GP practices to do the same, reported The Guardian. St Helens and Knowsley Teaching Hospitals NHS Trust in the north-west is offering family doctors in England what it claims to be the first service of its kind to digitise, store and give GPs immediate desktop access to their Lloyd George paper patient records. So far the Electronic Lloyd George Records Service (e-LGS) has been contracted by the trust’s three local clinical commissioning groups in Halton, Knowsley and St Helens to rid its 85 GP practices of their 500,000 patient paper records. But the trust says it has the capacity to offer e-LGS to any practice in the country. Dr David Wilson who is one of the first GPs to use the e-LGS system said: “The Lloyd George is the only part of my patient record that still remains on paper and has been a huge burden to maintain administratively. I absolutely love the new system.”
Jeremy Hunt orders fresh consultation on rewriting NHS constitution: Health secretary Jeremy Hunt has confirmed that he will begin consultations later this year on changing the constitution following the scandal at Mid Staffordshire NHS trust, where up to 1,200 patients died needlessly, reported The Telegraph. Robert Francis, the chairman of the inquiry, said that one of his top priorities was for the NHS constitution to be rewritten, making it explicit that “patients are put first” and “everything done by the NHS should be informed by this ethos”. He recommended that Hunt also consider stipulating that NHS staff “put patients before themselves”. After much wrangling behind the scenes at the Department of Health, a redrafted constitution was released last month. In comments to The Daily Telegraph, the health secretary insists that the newly published constitution includes a new clause about putting patients first. He says: “Far from dropping any clause about putting patients first, the new constitution actively inserts such wording for the first time as one of the principles that guide the NHS.”
NHS England seeks permission to send patient-identifiable data to commissioners: NHS England (formally NHS Commissioning Board) has applied for a legal exemption so that patient-identifiable information can be extracted and shared with a variety of clinical commissioning groups (CCGs) and information bodies, reported Pulse. If granted, the exemption – called the 251 exemption – would allow the health secretary to set aside the legal duty of confidentiality in certain cases. The decision, which will be made on 18 April, could give NHS England the ability to share data extracted from GP practices with CCGs, Commissioning Support Units and the Health and Social Care Information Centre. Under the clause, which is in the 2006 Health and Social Care Act, certain bodies are able to disclose confidential patient information for medical purposes. This is on the condition that it is not possible to use anonymised information and seeking consent is not practicable, taking the cost and technology available into account.
Orion to build shared record portal: The Bristol, North Somerset and South Gloucestershire health community has signed with Orion Health to develop a shared patient record, reported eHealth Insider. The programme will deliver a local portal, which will integrate clinical and social health data from a variety of sources. It is key to the community’s Connecting Care programme – a commitment between NHS providers and local authorities across Bristol, North Somerset and South Gloucestershire to share more information. Director of informatics and business intelligence for Best West Commissioning Support and Connecting Care programme chair Andy Kinnear, said patient information had been held in silos for too long. “We took a view that we needed a detailed shared record across our community,” he said. The programme will be delivered in two stages and only the first stage is currently financed for less than £300,000.
NHS trust selects Safend suite to replace free McAfee Safeboot solution: Doncaster and Bassetlaw Hospitals NHS Foundation Trust has selected security software provider Wave Systems’ Safend Data Protection Suite, to help it to comply with the Data Protection Act (DPA) 1998, the Information Governance Toolkit and the Department of Health’s mandate that all mobile data must be encrypted, reported Computing.co.uk. The NHS had provided the trust with McAfee’s Safeboot (Endpoint) solution, free of charge, but the trust felt that the solution was lacking an enhanced reporting function as well as in-depth port control. Nigel Hall, ICT infrastructure manager at the trust, told Computing that the hospitals went out to a “mini-tender” through a GPS framework in September 2012 and looked at a number of solutions, including a product from its current anti-virus provider Sophos, however the Safend suite came out on top for a number of reasons.
Guernsey extends TrakCare to community: Guernsey is extending its TrakCare electronic patient record system to 900 social care workers, reported eHealth Insider. The States of Guernsey Health and Social Services department went live with InterSystems’ TrakCare in late 2009 as a key element of its island-wide Electronic Health and Social Care Record project. The department is building the record using a best of breed strategy using InterSystem’s Ensemble integration platform. States of Guernsey director of business and systems development Alan Chapman, said Guernsey had set itself a very ambitious 18-month roll-out plan for TrakCare, but this was “totally unrealistic”. A flexible partnership with InterSystems meant time scales were extended to allow for better clinical engagement, resulting in a much more successful deployment, he explained. The project is now expected to be completed over the next year.
Missed hospital appointments ‘cost east of England NHS £42m’: Patients who miss hospital appointments have cost the NHS in the eastern region more than £42m in the past year, revealed the BBC. There were nearly five million appointments in the east’s 24 NHS hospital and foundation trusts in 2012. But in about 418,000 cases, the patients failed to turn up. Automated reminders are cutting the number of wasted appointments but hospitals say patients must do their bit by not wasting resources. The figures have come from a mix of Freedom of Information requests lodged with the various hospitals and data from the Department of Health. Although the cost of missed appointments varies widely, a number of hospitals apply a rough figure of £100 – and this has been used to arrive at the £42m overall cost amount. A spokesman for Colchester Hospital University Trust said: “It is important that members of the public appreciate that they too have responsibilities, like not wasting precious NHS resources.”
NHS anti-bullying whistleblower hotline pilot for staff goes live: A whistleblowing phone line for NHS staff has gone live this week, reported the Scotsman. The introduction of the line, which is free and confidential, follows last year’s revelations that a bullying culture existed in parts of NHS Lothian, and publication of the Francis report into failures at the Mid-Staffordshire NHS Trust in England. The phone line, which is available to staff at NHS boards across Scotland, will be piloted for one year and is run by Public Concern at Work, an independent organisation. Scottish Health Secretary Alex Neil said: “It is important that all NHS workers feel that they can raise any concerns they may have safely and confidentially, and following the Francis Report, be reassured that health boards will listen. “All areas of concern must be investigated and lessons will be learned to ensure that the NHS in Scotland is providing the best possible service to patients. We already have whistleblowing policies in place. Staff can be assured that these policies will be enforced and the alert line will give staff the best possible support.”
Satisfaction with the NHS at 61%: There has been little change in public satisfaction with the NHS since last year, the British Social Attitudes Survey has shown, reported National Health Executive. The King’s Fund health think tank, which sponsors the health questions on the survey, found there had been “no recovery following the considerable drop in satisfaction seen in 2011”. Overall satisfaction with the NHS rose from 58% in 2011 to 61% in 2012, but the British Social Attitudes Survey stated this was “not statistically significant”. Satisfaction with A&E services rose to 59%, and 64% with outpatient services. Satisfaction with inpatient services dropped to 52%. 56% of respondents were satisfied with dentists and 74% with GPs. Professor John Appleby, chief economist of the King’s Fund, said: “With no real change in satisfaction with the NHS in 2012, this suggests the fall in 2011 was not a blip and that the ground lost may take some time to recover.”
NHS will check doctors’ language skills: New checks are being introduced to make sure all doctors who work for the NHS can speak English well enough to treat patients in a hospital or GP practice, following concerns raised by the Health Committee, reported Public Service. This will mean that for the first time European doctors wanting to work for the NHS will have to demonstrate their English skills when applying for a job. From 1 April 2013 there will be a legal duty to make sure a doctor can speak the necessary level of English to perform their job in a safe and competent manner. At the moment, EU law dictates that the UK automatically recognise the medical qualifications of doctors from countries in the European Economic Area and to register them to work in the UK. There will also be a single national list that every GP will have to be on before treating NHS patients. Previously, every primary care trust held a list of GPs but the idea is that one centrally held list would protect patients by ensuring poor performers will no longer be able to slip through the gaps between different local lists. Every GP will have to demonstrate their ability to speak English to be accepted on to the new list.
Opinion
Five ways the NHS is changing
In an article on the BBC website Nick Triggle, BBC Health Correspondent discusses five key ways the NHS will change as a result of the government reforms.
1. The first is the ‘end of the special relationship’.
“Under the reforms GPs are getting control of the bulk of the NHS budget, so they can decide what local services to fund. The theory is that as they are close to patients they will be better placed to know how money should be spent. But the prospect of them holding the purse strings has caused concern that the “special relationship” could be damaged.”
2. Number two is the ‘rise of the private sector’
Probably the most controversial change and the one that has lead critics to claim as ‘privatisation of the health service’. The key concern is that health companies will be able to “swoop in to “cherry pick” the most profitable services and destabilise NHS in the process”.
3. In third place is the ‘new kid on the block’ – the management of chronic conditions
There has been “a push to improve the coordination of care for people with chronic conditions such as diabetes and dementia for which there is no cure”.
4. The penultimate change is ‘emptying the bins and getting you fit’ – or more emphasis on public health
An often overlooked part of the reforms aims to “promote physical activity and better diets as well as stop smoking services” in an attempt to prevent disease and prolong life. The responsibility will now lie with local government as “the belief is that councils will be better placed to influence people’s lives through their powers over planning, education and leisure services”.
5. Bringing up the rear is ‘the biggest change – no change’
For most people there will be no noticeable change to health services. You will still go to your GP or local hospital when you are ill and need treatment.
“The upheaval that has taken place so far has largely been to the management structure.” There is more to come though – “It is just that the NHS, with its 1.4m staff and hundreds of different organisations, really is, has often been said, a bit like a supertanker – a change in direction does not happen immediately.”
Are public relations professionals necessary for the NHS?
This week, Grant Fisher, an NHS business director for Aurora Healthcare Communications with previous experience in communications roles in the NHS, talks to the Guardian to provide some clarity of the roles of PR professionals in healthcare.
Fisher argues that the way we communicate has changed dramatically and messages from NHS trusts are expected 24/7: “Gone are the days when you would get your information about local services through the local media or a visit to your GP. We now have 24-hour news and online forums, driven by social media and citizen journalism. People gather the information they need from many different outlets.”
“Many PR professionals in the NHS are communications specialists. Their role is to communicate to a variety of audiences making sure they are involved, informed and understand what is going on locally. This is an increasingly difficult task considering the constant change within the health sector and the vast array of services.”
Fisher continues by suggesting outsourcing can support NHS PR professionals and that the value of communications is vital for informing patients of the trust’s activities:
“The tightening of budgets also has an effect on their ability to deliver effective communications. The use of specialist communications agencies can help deliver innovative communications on larger projects and shouldn’t be seen as a waste of money.
“NHS communicators are doing a good job in a difficult climate. We should be pleased that the NHS spends money on PRs, because without them we would know a lot less about it and the services it provides. Without these specialists, NHS organisations wouldn’t be able to cope and the public wouldn’t have the information that they deserve and crave.”
Spanish intuition: lessons for a paperless NHS
In this week’s HSJ (subscription required) Vicent Moncho, chief information officer at Hospital Marina Salud de Denia, discusses how the transition to paperless is not just possible, but clinically essential. Vicent says that putting technology at the heart of care at his hospital in Spain has improved efficiency and care.
“When Jeremy Hunt challenged the NHS to become fully “paperless” by 2018, he faced scepticism about whether it could be achieved. As the chief information officer of a Spanish hospital that has already made that vision a reality, my advice to colleagues in the NHS is simple: not only is it possible, it is essential.
It is inevitable that when targets are set for delivery, the debate focuses on “when”. However, at Hospital Marina Salud de Denia in Valencia our starting point when considering health IT was “why”.”
He continues by saying that they did not set out to become paperless for the sake of it but did so because they recognised that technology could improve the quality and affordability of their care.
“At a time of squeezed budgets, those are savings we can’t afford not to make. Austerity does not prevent technology investment, it necessitates it.”
“Delivering a paperless NHS by 2018 is an ambitious task. However, the experience of Hospital Marina Salud de Denia should encourage those in the NHS.”
“Rapid digitilisation is possible. Success hinges on viewing technology not as the end objective, but as the tool to transform the delivery of care. The question is not whether the NHS can digitilise in five years, but how that will benefit patients in the years after that through improved outcomes, safety and efficiency. Achieving paperless status may be difficult, but our experience shows it is worth striving for.”
The NHS needs calm heads, not panic headlines
There is a danger of a knee-jerk response to the media coverage of the Francis Report and the closure of Leeds’ children’s heart unit. Michael White, politics writer for the Guardian explains why now more than ever the NHS need cool heads and not panic headlines.
“Despite the icy Easter blast I’ve tried all week to avoid getting ill because I keep being told that, as of its latest reorganisation, the NHS is fast sliding into chaos and privatised bankruptcy, in England at least. There is much to be concerned about but, as usual, militant critics damage their case by crying “United Healthcare wolf” too loudly. It wasn’t American health providers which caught my eye in the wake of renewed hand-wringing over the Mid Staffs scandal prompted by Jeremy Hunt’s interim response to the Francis report. No, it was a classic example of Sod’s law making an instant mockery of the plea by Malcolm Grant − chair of what we must now call NHS England, not that boring old commissioning board − that everyone try harder to keep politics out of health.”
“The classic in question was that drama over children’s cardiac operations (400 a year) and their sudden suspension at Leeds General Infirmary after the intervention of Sir Bruce Keogh, medical director of the NHS, fired up by alarming new mortality data and “an agitated call” from a local cardiologist aware of five years of disquiet over the hopsital. Surely this is how the post-Francis world is supposed to work? Mindful of their wider duty to protect patients, medics express concern. A surgeon with a question mark over his performance voluntarily stands aside from such operations.”
“White goes on to say “Except that it doesn’t work like that at all. History, popular local sentiment, the high court and dear old politics kick in. LGI’s cardiac unit for kids had been earmarked for closure as such sensitive work is concentrated in seven specialist centres; all sensible, unpopular stuff and nothing to do with the NHS’s “privatisation” drama. Except that the reaction is much the same.”
“There’s a danger here far beyond the NHS. In welfare reform, bank regulation, even police checks to weed out sex offenders, we see a Mid Staffs, Savile or Northern Rock style disaster, produce a panic response and loads of new regulation (much of it self-contradictory). All at a time when all affected systems are under pressure to save money.”
“It’s a moment for calm heads, not easy headlines.”
Highland Marketing Blog
In this week’s blog Mark Venables looks at the need to communicate effectively within large organisations.
