Nurses call for health bill withdrawal
The Royal College of Nurses and the Royal College of Midwives have called on the health bill to be dropped, claiming their repeated efforts to help make it workable have been ignored. Health secretary Andrew Lansley raised media eyebrows by claiming that the organisations support the principles of the proposed legislation. Shadow health secretary Andy Burnham said it was time for the government to listen to what the NHS is saying.
Peter Carter, general secretary of the RCN, told the Guardian that: ‘The RCN has worked with the government at every possible turn.’ He added: ‘Despite all this, our concerns have not been listened to and the genuine anxieties we have on behalf of patients in England have been, to a large extent, ignored.’
Among the RCN’s principal concerns is the recent announcement that foundation trusts would be allowed to raise 49% of their income from private care – which it claims will push NHS patients to the back of the queue.
Mr Lansley said to the Telegraph that he believed: ‘the trade union aspect of the Royal College of Nursing has come to the fore, they want to have a go at the government … And the RCN and the RCM are very clear that they support the principles of the Bill. What they are unhappy about is pay, pensions and jobs.’
Prompt payments faster but treatment slower
The DH is setting the pace for prompt payment of suppliers with figures showing that 95%, or more, were paid within five days between July and December 2011. At the same time the department has announced an additional £100 million for Clinical Commissioning Groups to spend on improving local services. The money is also to reduce pressure during the colder months.
Patients, however, are having to wait longer for treatment with the number exceeding the 18-week limit having rocketed by 43% since the coalition came to power. This means that by November last year more than 29,500 people had not been treated within the required time – 13.9% higher than the same point in 2010.
The Guardian says the revelations cast serious doubt on David Cameron’s personal pledge to keep patient waiting times low and are the direct consequence of Andrew Lansley’s moves to relax targets.
In a bid to cut NHS costs the Audit Commission and Monitor have jointly published a guide called Delivering sustainable cost improvement programmes. The document is aimed at acute, ambulance, mental health, and specialist NHS trusts and foundation trusts. It summarises how successful organisations approach cost improvement. Many of the examples emphasise the need for effective data gathering and analysis.
Reshaping of health services
Credit ratings agencies, including those accused of failing to spot the financial slump, may be used to measure hospital finances. Monitor wants trusts to achieve an investment grade rating (BBB by Standard & Poor’s, Baa3 by Moody’s and BBB by Fitch).
The system would be like that of the electricity market, giving the regulator warning of financial difficulties building up. But critics claim the idea will mean that money and the markets are put ahead of patients and the quality of their care.
Elsewhere, HSJ reports that plans for England’s biggest ever health and social care provider have been approved in the Midlands. The Staffordshire and Stoke-on-Trent Partnership Trust will take on a 907-strong social care workforce and an annual budget of £153m from Staffordshire County Council. The new organisation will have a turnover of £350m and provide for one million residents.
The trust will be four times larger than the next biggest health and social care provider, Sirona Care and Health in Bath and North East Somerset. There are currently just six organisations providing a similar model of integrated community health services and social care.
Doctors and industrial action
One of the biggest issues of the week is the threat by doctors to take industrial action over proposed changes to their pensions. The BMA is on the verge of balloting members, while the government says there will be no concessions. Both sides claim that the issue could have far-reaching effects on the country, the medical profession and patients. You can make up your own mind by clicking here to see what the BMA has to say and here to read the government version from Pulse.
Research integrity under scrutiny
Thirteen per cent of doctors or scientists have witnessed colleagues altering or fabricating data during their research for the purposes of publication, according to a survey cited in Hospital Doctor. The news comes as the wider integrity of medical research came under sharp scrutiny.
The survey highlights the need for better systems to deter, detect, and investigate research misconduct. Dr Elizabeth Wager, chairman of the Committee on Publication Ethics, said: ‘This survey chimes with our experience from COPE where we see many cases of institutions not co-operating with journals and failing to investigate research misconduct properly.’
At the same time the BMJ reports that in the USA Prof. Dipak Das, a leading researcher on the beneficial properties of resveratrol, a compound found in the skin of red grapes, has been found guilty of 145 counts of fabrication and falsification of data. The University of Connecticut Health Center reached its conclusion after a three year investigation of Prof. Das.
News in brief
- Tele-care concordat: The 3millionlives project, aimed at rolling out tele-health and tele-care technology on ‘an industrial scale’ has been formally launched by the DH. EHI says a concordat has been signed between industry and government which will allow local decision-makers to determine how it is delivered in their areas.
- Cloud gives NHS trust storage performance a boost: St Helens and Knowsley Teaching Hospital NHS Trust has turned to the cloud to support its growing demand for storage, reports the The Guardian.
- Bacon calls a halt on Millennium: EHI reports that Richard Bacon MP has called for a halt to all Cerner Millennium deployments following appointment problems and delays at the latest trusts to go-live with the system – North Bristol and Oxford. He said the two hospitals had been “brought to their knees” by the implementation of the new electronic patient record system.
- Edible chips: GP online reports that Lloyds Pharmacy is to start selling pills with soluble microchips that monitor heart rate, respiration and temperature. The data is then sent to the care team which can monitor patients’ response to treatment.
- Data encryption: The Information Commissioner’s Office has secured a promise from Praxis, a care provider for patients with mental ill health, to encrypt patient data after the loss of a memory stick with 160 sets of personal details.
- Cutting missed appointments: A mobile phone texting service which not only reminds patients of appointments but allows them to cancel or reschedule has cut non-attendances at Barts Hospital, London, by 20%, says EHI.
- GPs regularly breach confidentiality: GPs regularly breach patient confidentiality in computer generated referral letters. Pulse says irrelevant histories are sometimes contained in correspondence, such as parasuicides and abortions from 30 years before.
Blogs & opinion
Despite 25 years researching health systems, including writing over 30 books and 500 academic papers, Prof. Martin McKeefrom the London School of Hygiene and Tropical Medicine says he can’t understand the government’s plan for the NHS. Hospital Doctor wonders if anyone else can either.
‘His [The professor’s] first problem is in understanding what the changes are trying to solve. The government argues that reform is needed because the NHS is performing badly. Yet the evidence it has produced, such as deaths from heart attacks, has been totally discredited, while independent reports show that the UK is now improving at a faster rate than almost anywhere else. His second problem is to understand what is being proposed. “The prime minister has reassured us that he will not privatise the NHS. Yet management of one hospital has just been handed over to what is essentially a private equity consortium”.’
The emergent Clinical Commissioning Groups (CCGs) are central to the ongoing NHS reforms and have come in for a great deal of criticism. Dr Michael Dixon, writing in Primary Care, has come to their defence and claiming they can potentially deliver an NHS led from the front line.
‘An NHS which involves its patients as full partners in improving population health; this has been hard won – but for future generations of clinicians it promises liberation on a grand scale. Allowing them to make a real difference to the services each patient receives and the health each enjoys outside the consulting room. Only by extending the role of clinician from care of the individual to care of all local people, in this way, can we create a better, fairer and more cost effective health service.
‘We are now about to reach the point of no return. Clinical commissioning is here to stay. We must press ahead, impatiently without delay…’
Tony Eardley of the UK Council for Health Informatics (UKChip) expresses concern that the use of unqualified people to handle medical information could be fatal.
‘Would you trust an unqualified surgeon to replace your hip? Then why do we persist with unregistered staff managing clinically critical health systems and crucial and confidential medical information? The same goes for health informatics. We need people with specific qualifications subject knowledge, skills and tools to collect information, manage and share it to support the delivery of healthcare. In an age where medical research and delivery of health services depend on reliable computer-based systems and accurate and up-to-date information, health informatics staff should be encouraged if not required to demonstrate their competence through professional registration.’
Events
The annual eHealth Week takes takes place on 7-9 May in Copenhagen, Denmark. eHealth News EU carries details of the event which includes an eHealth conference co-organised by the European Commission. The event brings together industry partners and providers from across Europe with government and regional decision makers.
Of interest to some vendors will be sessions designed to give CIOs the tools to justify IT investment, inspirational speakers on cutting edge hospital IT and a special symposium on the potential and challenges presented by mobile health. There will also be an SME village for businesses to showcase their products and new ideas.
Highland Marketing blog
This week Ravi Kumar looks at the NHS reforms one year on and explores what the consequences may be.
