Health Service Journal
24 November 2011

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A new era for performance management in the North

Last month’s clustering of strategic health authorities ushers in a new era of performance management in the North of England.
Andrew Lansley: the NHS pension scheme - for a sustainable future

Now is the time for NHS leaders to engage with staff to let them know exactly what the revised pension offer entails, and why the scheme is worth sticking with.
AWP criticised over patient homicides

PERFORMANCE: Avon and Wiltshire Partnership Trust has been criticised for failing in the care of two patients from Swindon who went on to kill people within months of each other.
Bedford Hospital needs extra CT scanner

FINANCE: Bedford Hospital Trust is to buy or lease an additional CT scanner to cope with rising demand and reduce waiting time.
Birmingham and Solihull picks AQP services

FINANCE: The Birmingham and Solihull cluster has selected three services for which patients will be offered a choice under the “any qualified provider” framework.
Birmingham's only remaining red-rated CCG disbands

STRUCTURE: An inner city clinical commissioning group is being disbanded after being red rated.
Buckinghamshire plans reconfiguration programme

STRUCTURE: Commissioners and clinicians in Buckinghamshire are planning to redesign services to develop centres of excellence for specialist care, ensure acute hospitals are sustainable and move more services into the community.
Bucks trust struggles on C diff

PERFORMANCE: Buckinghamshire Healthcare NHS Trust is well above its cumulative infection control target for 2011-12.
Bury ‘patients champion’ charged with £60,000 fraud

WORKFORCE: A “patients champion” and former chair of Bury’s local involvement network has been charged with committing £60,000 of VAT fraud, in the course of half a decade of paid consultancy work for the NHS.
Cambridgeshire Community Services breaching 28 targets

PERFORMANCE: Cambridgeshire Community Services Trust is breaching 28 targets, its board heard.
Cambridgeshire Community Services predicts £670,000 surplus

FINANCE: Cambridgeshire Community Services Trust is predicting a year end surplus of £670,000, a board meeting heard.
Cameron backs changes to GP sign off powers

The prime minister has backed calls for GPs to be stripped of their responsibility for signing people off work for long-term sickness.
CCG management allowance set at £25 per head

Clinical commissioning groups are expected to be given £25 per head of population to spend on management from 2013-14, it has been announced today.
CCG staff assignment to accelerate despite redundancy fears

Primary care trusts will be told to assign more staff to clinical commissioning groups to prevent a lack of support hindering CCG development.
CCG staffing must be 'commensurate' with delegated budgets

Primary care trust clusters will have to demonstrate they are allocating staff to clinical commissioners at levels that are “commensurate” with the budgets they have taken over.
CCG to fund diabetes diet service in East Sussex

STRUCTURE: A clinical commissioning group in East Sussex is to fund a two year pilot of a community dietetic service for diabetes patients.
CCGs 'feasible' if covering 100,000 or more

Clinical commissioning groups will need a population of at least 100,000 to be able to carry out all their statutory functions, a report commissioned by the Department of Health has found.
CCGs may be 'ill-equipped' to meet information governance standards

Clinical commissioning groups will be subjected to an increasing range of information governance requirements, but may be may be “ill-equipped” to meet the more rigorous standards, official guidance has said.
Chair of Norfolk mental health trust reappointed

WORKFORCE: Maggie Wheeler has been reappointed chair of Norfolk and Waveney Mental Health NHS Foundation Trust after accepting an extension to continue her role.
Commissioners and providers seek move to long-term contracts

Both commissioners and providers are calling for a “fundamental shift” towards long-term contracts of more than five years to allow for better strategic planning, the Future Forum has heard.
Community group launches survey following London HIV drugs change

PERFORMANCE: A community group has launched a survey to assess the impact of changes to London HIV drug prescribing rules.
Competition panel takes York FT complaint to next stage

COMMERCIAL: The Co-operation and Competition Panel has announced a second-stage investigation of a complaint by Assura East Riding about York Hospitals NHS Foundation Trust and NHS North Yorkshire and York.
Concern over HPV vaccine uptake in Eastern and Coastal Kent

PERFORMANCE: NHS Kent and Medway immunisation teams raised concerns in October about the numbers of parents that had failed to return consent forms for their daughters to have the HPV vaccine.
Consultants working on 'clear and credible plans' with North Tyne CCGs

STRUCTURE: Management consultants are working with clinical commissioning groups in North Tyneside PCT to develop “clear and credible” commissioning plans for 2012-13.
Contraception clinics expanded in Medway

STRUCTURE: NHS Medway has announced that contraception services will be held in four new clinics, while services will cease at an “outdated” site.
CQC chief executive Cynthia Bower: I'm not self-serving

The chief executive of the Care Quality Commission has said she underestimated the “turmoil” that would be involved in setting up the regulator. She admitted she should have decided to “wave a flag” calling for outside help rather than carrying on trying to do an “impossible job”.
CQC non-exec to blow the whistle at Mid Staffs inquiry

Two new Care Quality Commission whistleblowers - including one board member - have been called to give evidence to the Mid Staffordshire Foundation Trust Public Inquiry.
CQC orders DHUFT to make improvements

PERFORMANCE: The Care Quality Commission has identified two areas of moderate concern and five minor concerns about services at a clinic run by Dorset Healthcare University Foundation Trust.
Debt deferral measures to support would-be foundation trusts

The Department of Health has indicated that the vast majority of trusts needing financial support to achieve foundation trust status will receive it through the deferral of their loan repayments.
Dorset County no longer in breach

PERFORMANCE: Dorset County Hospitals Foundation Trust is no longer in breach of its terms of authorisation after Monitor’s compliance board committee was satisfied that the trust had delivered necessary improvements in its finances.
Down's syndrome patient died after being wrongly detained in hospital

A patient with Down’s Syndrome had his basic human rights ignored after he was detained in hospital and then kept locked up before he died, an investigation has found.
Dozens of CCGs not meeting rules must find 'alternatives'

The dozens of clinical commissioning groups which do not meet the government’s size and shape requirements will have to agree “alternatives” in the next few months.
East London PCTs still have to find £5.6m unidentified savings

FINANCE: NHS Barking & Dagenham and NHS Havering still have £5.6m unidentified savings to make.
Elective admissions up but emergency admissions down at West Herts

PERFORMANCE: Activity levels at West Hertfordshire Hospitals Trust was showing significant changes on last year as the PCT tried to reduce demand.
Emergency waits regularly exceed target at Telford and Wrekin

PERFORMANCE: In September the longest median wait for admitted patients among Telford and Wrekin’s providers was 350 minutes and regularly exceeded the 205 minute standard.
Exclusive: Dr Foster names 10 trusts overlooking fast recovery processes

Ten hospital trusts which do not follow evidence-based processes for fast recovery from surgery have been named by Dr Foster Intelligence.
Exclusive: London cluster to consult on 'ambitious' reconfiguration plans

NHS North West London will next June consult on “ambitious” reconfiguration plans to move the local health economy “to a more sustainable clinical and financial basis”, HSJ has learned.
Exclusive: NHS begins planning CCG authorisation 'pipeline'

The NHS has begun constructing a “pipeline” to authorise clinical commissioning groups, in an effort to avoid a log jam before the April 2013 target.
First summary care record goes live in Surrey

PERFORMANCE: Surrey’s first summary care records were successfully created at a GP practice this month.
Foundation trust director suspended

WORKFORCE: An associate director of Royal Surrey County Hospital Foundation Trust has been suspended while allegations of impropriety are investigated.
Four hour target sole national A&E measure for 2012-13

The accident and emergency clinical indicators will continue to be monitored at local rather than national level during 2012-13, leaving the old four hour standard as the sole national measure of A&E performance.
From Tokyo to Torbay, integrating services will prove to be the future

Healthcare services in Torbay, England and in Tokyo, Japan both provide valuable insight into how the health service in the UK might look in the future. In getting ready, there are some stark lessons to learn, writes Mark Britnell.
Government public health plans 'ineffective', says study

Many of the government’s plans for tackling public health lack robust evidence and in some cases have been shown not to work, new research suggests
Government will appeal risk register decision

The government is to appeal against a ruling that it should release confidential risk assessments of its controversial health reforms, it has been announced.
Great Yarmouth set to deliver £1m surplus

FINANCE: NHS Great Yarmouth and Waveney is on track to deliver a surplus of £1m this financial year.
Great Yarmouth to introduce local rates for critical care

FINANCE:NHS Great Yarmouth and Waveney is planning to introduce local rates for critical care, rehabilitation and stroke services in 2012-13, rather than relying on a block contract.
Healthcare without wires: the next generation of technology for health organisations

The use of wireless technology in healthcare looks set to become the norm. Dominic List looks at the benefits for organisations ready to adopt the new generation of technology.
Home care services to have CQC inspections

Home care services are to be subject to inspection under a programme announced by the Care Quality Commission.
How a COPD care bundle is reducing readmissions

Implementing a COPD care bundle can reduce readmissions and aid patient self-management. But it is only part of the solution, say Trish Winn, Maria Buxton and Mary Noone at the North West London Hospitals Trust.
Imperial to take on national patient safety role

A leading London acute trust is to take on responsibility for collecting information on patient safety incidents at NHS trusts when the National Patient Safety Agency is wound up next year.
Improvements claim at Morecambe maternity unit

PERFORMANCE: The trust running a maternity unit at the centre of a police investigation has said it has made “significant improvements” ahead of today’s deadline to raise standards or possibly face closure.
Improving cardiac care for clinicians while reducing cost to the NHS

Can you improve patient cardiac care and working practice for GP clinicians while reducing the cost of cardiac care to the NHS? Dr Jonathan Lieberman explains how a telemedical ECG service has achieved this at his surgery in Manchester.
Integrated Care Service failing to realise savings

FINANCE: NHS Outer North East London plan to reduce emergency admissions by 255 against 2010-11’s total of 2,718 is failing to do so, a report says.
James Paget misses performance targets

PERFORMANCE: James Paget University Hospital Foundation Trust missed a number of targets over the summer, the council of governors heard.
Lansley reluctant to reveal the risks of his reforms

Health secretary Andrew Lansley has said it would be “completely misleading” to release a document written by officials listing the risks posed by his reforms.
Leicestershire PCTs choose final three AQP priority services

FINANCE: The final three priority services for “Any Qualified Provider” have been named by the cluster.
Less haste would have led to less waste

HSJ’s revelation that primary care trusts’ initial calculations of public health spending were about 10 per cent wide of the mark does little to inspire confidence in reform of the area.
Looped Lansley welcome message defended

Andrew Lansley has defended a video message which is being projected to patients in hospital wards on a continuous loop.
Luton on track to break even

FINANCE: NHS Luton was on track to break even but has identified around £2m of pressures, September’s board meeting heard.
Make an ‘impossible job’ easier by following a NICE example

“I don’t mind people thinking I’m incompetent, although I don’t want them to,” Care Quality Commission chief executive Cynthia Bower told HSJ this week.
Marketing helps specialist trust halt activity decline

FINANCE: Activity levels have improved at the Royal National Hospital for Rheumatic Diseases Foundation Trust leading to the forecast year end position improving by £50,000.
Maternity services 'overwhelmed' by rising births

Maternity services in England and Wales have been “overwhelmed” by a rising number of births, including more complex cases, according to a new report.
Media Watch: nursing numbers adding up to a 'crisis'

The Royal College of Nursing’s claim that 56,000 NHS posts have been lost or marked “at risk” during the past year featured in most of the Sunday papers.
Michael White: ministers' fears of a CQC tick box regime

Hurt feelings are easy to detect in the system as the winter nights draw in. Officials at the Care Quality Commission sound hurt at what they feel is unfair media treatment of their efforts to ensure the super-regulator is fit for purpose.
Ministers focus on older people's care ahead of Operating Framework launch

Ministers are stressing the importance of supporting care for older people as they prepare to release the NHS Operating Framework today.
Most commissioners see readmissions rate rise despite harsh penalties

Most commissioners have seen an increase in emergency readmission rates despite the imposition of new penalties that are set to cost providers more than £400m this year, an HSJ investigation has found.
Neurology services in need of new headache pathways to improve productivity

The consistent failure to properly manage headache referrals have put unwelcome pressures on clinical neurology services already struggling with capacity. New pathways for headache patients could relieve some of the pain, says Hedley Emsley.
New chair for North Staffs mental health trust

WORKFORCE: Ken Jarrold CBE has been appointed as chair of the North Staffordshire Combined Healthcare NHS Trust.
New duties on waiting times and readmissions for providers in Operating Framework

The operating framework has set out new duties around waiting times and readmissions, as well as holding the line on existing targets.
New health inequalities group launched

Tackling health inequalities will be the responsibility of a new institute being launched today.
NHS sees first CO2 reductions from buildings

The NHS has reduced the carbon footprint resulting from energy use in its buildings for the first time. However, trusts have been told that further energy savings of £40m are possible
Noel Plumridge: increased demand is the answer, not the question

In 2009 the UK spent 9.8 per cent of its GDP on healthcare. The equivalent figure for 2008 was 8.8 per cent. Such a year on year increase shows theimpact of continuing investment in the NHS even as the recession took hold.
Nottingham City endorses AQP priorities

FINANCE: The PCT has endorsed four “any qualified provider” priority services.
Notts City issuing out of hours tender

COMMERCIAL: The PCT is launching a tender for GP out of hours provision.
Notts County unveils chosen AQP services

FINANCE: The PCT has identified the services for which patients will have a choice of provider through the “any qualified provider” framework.
Number of consultants retiring early rises

Consultants taking voluntary early retirement have increased by 72 per cent in one year - with dissatisfaction with the NHS largely to blame, according to doctors’ leaders.
Outer NE London cluster takes BHRUT to arbitration

FINANCE: A London cluster is taking Barking, Havering and Redbridge University Hospitals Trust to arbitration over over-performance.
Parking restrictions eased for community nurses in Lambeth

WORKFORCE: Lambeth Council has agreed new parking arrangements for nurses and other health professionals who visit patients at home.
PCT public health spending revealed

Primary care trusts spent just 4.6 per cent of their total funding allocation on public health last year, analysis by HSJ suggests.
PCTs begin 'formal performance managment' of Sunderland FT

FINANCE: Commissioners have “instigated a formal performance management process” because of City Hospitals Sunderland Foundation Trust’s elective and emergency overperformance.
Peterborough misses choose and book target

PERFORMANCE: Only 26.3 per cent of eligible bookings were made through Choose and Book in the first four months of the financial year, against a target of 90 per cent, NHS Peterborough’s board was told.
Peterborough needs QIPP savings to balance books

FINANCE: NHS Peterborough is predicting it will finish the financial year in balance - but that relies on delivering very large QIPP savings and using contingency reserves.
Poole and Royal Bournemouth agree next step towards merger

STRUCTURE: The boards of Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts have agreed to pursue a merger in order to ensure the retention of “sustainable local services”.
Princess Alexandra heads for £1.5m deficit

FINANCE: Princess Alexandra Hospital Trust is heading for a £1.54m end-of-year deficit with a £1.04m deficit at the end of month six, despite transitional support promised by PCTs, according to board papers.
Princess Alexandra trials mobile screens to enhance privacy

Princess Alexandra Hospital Trust had nine breaches of single sex accommodation in September and is trialling the use of mobile screens to enhance privacy and dignity, its board heard.
Protected training funds could increase, says Nicholson

NHS chief executive Sir David Nicholson has hinted that the £5bn pot of “ringfenced” training money could be expanded.
'Punitive' sanctions for bodies not using the NHS number

NHS organisations not using the NHS patient number consistently by the end of March 2013 will face “punitive contract sanctions”.
Putting patients first: an HSJ primary care supplement

This week’s special HSJ supplement looks at how patients can benefit from being at the centre of primary care services.
Reconfiguration attention turns to acute services in the South East

Just as the dust was settling on the reconfiguration of community services in the South East Coast region, manoeuvring in the acute sector looks set to throw things up in the air once again.
Reforms will cost £3.4bn - Burnham

The coalition government’s reforms of the NHS will cost nearly £3.4bn, Labour’s shadow health secretary has claimed.
Revealed: the six trusts that need DH support with their PFI

Six hospital trusts have been identified as needing Department of Health cash support with their private finance initiative payments in order to make foundation trust status, HSJ can reveal.
Ridgeway partnership has lowest financial risk rating

FINANCE: The Ridgeway Partnership reported a year to date deficit before adjustment of £858,000 at the end of October, £1.1m worse than planned.
Rise in PCTs reporting above-average costs

The past financial year saw a sharp rise in the proportion of primary care trusts reporting above-average costs for providing NHS services, new Department of Health figures show.
Royal Surrey County considers academic health science centre

STRUCTURE: Royal Surrey County Hospital NHS Foundation Trust is considering moves to develop an academic health science centre in Surrey.
RUH behind on CIP

FINANCE: Royal United Hospital Bath has achieved less than half of its cost improvement plan year to date and is predicting a year end shortfall of £5.8m.
Setting out the principles for integrated care

Patient Voices policy director Don Redding outlines some principles that should guide commissioners, regulators and professional groups in integrating health and social care services.
Shrewsbury and Telford review after 'blind' concerns

PERFORMANCE: A review at Shrewsbury and Telford Hospital Trust has found no patients have become blind while on waiting lists for treatment, following concerns.
South Central Ambulance improves on response times

PERFORMANCE: The South Central Ambulance Service improved against performance targets in all but one of its primary care trust areas during August.
South Central Ambulance reports £1.8m surplus

FINANCE: South Central Ambulance Service NHS Trust finished September with a £1.8m surplus - £160,000 off target.
South Central sees ambulance demand increase

PERFORMANCE: Demand for ambulance services in the South Central region is rising in 2011-12 on the previous year.
Staff warning after asbestos dust found in Alder Hey Children’s Hospital

WORKFORCE: Alder Hey Children’s Foundation Trust has issued warning letters to staff after discovering levels of airborne asbestos dust on its site that are above legal limits.
Suffolk not expecting to name community services bidder until 2012

STRUCTURE: NHS Suffolk is not expecting to select bidders to provide its community services until the new year.
Suffolk overspending by £2.7m

FINANCE: NHS Suffolk was overspending on budgets by £2.7m at the end of month five, although its hosted services were significantly underspending improving the ‘bottom line’ figure to a surplus of £2.5m at the end of month five, a board meeting heard.
Telford and Wrekin could be heading for deficit

FINANCE: The PCT could be heading for a £4.6m deficit under a “pessimistic” assessment of its quality, innovation, productivity and prevention (QIPP) plans.
The seven simple steps to support cost improvement plans

Cost improvement projects are necessary to increase efficiency and reduce spending for trusts, but to succeed, they need the same simple understanding required when driving a vehicle, says Leigh Cantero.
'This is the kind of disruptive innovation the NHS needs'

The US integrated healthcare system Kaiser Permanente is an example of ‘innovative disruption’ in all its joined-up glory. The King’s Fund chief executive Chris Ham highlights some of the benefits a similar system could give the NHS.
'Top leaders' to help trusts get through FT pipeline

The NHS Top Leaders programme has launched a drive to send senior managers into NHS trusts needing help with savings plans or getting through the foundation trust pipeline.
Trust spending on carers to be scrutinised

NHS trusts will be forced by the government to say how they spend cash intended for carers after research suggests it does not always reach the frontline.
Two CCGs responsible for £2m of Hertfordshire's overspend

FINANCE: Two clinical commissioning groups were responsible for £2m of a £2.1m overspend on commissioning budgets by the end of month four, NHS Hertfordshire’s board has been told.
Two Surrey FTs working towards possible merger

STRUCTURE: Frimley Park is assessing a possible merger with neighbour Royal Surrey County Hospital Foundation Trust.
UHL predicted to fail eight targets by year end

PERFORMANCE: The trust’s PCTs are predicting it will fail on eight indicators for the year 2011-12.
Underperformance contributes to £0.6m lag at Harrogate FT

FINANCE: Performing less activity than planned has contributed to Harrogate and District NHS Foundation Trust being £591,000 behind plan as of September.
Unions warned over strike ballot turnouts

Reform of strike law will become “very pressing” if public sector workers push ahead with industrial action, ministers have warned.
Uniting HealthWatch with CQC a 'mistake', says advisory group

The decision to make HealthWatch England part of the Care Quality Commission is a “mistake”, according to a group advising on the proposals.
'We have not found an area where improvement has not been possible'

Transforming services is a massive undertaking for any trust, but securing the engagement, encouragement and valuable input from patients and staff is arguably the most important step if patient care is to be improved. Peter Homa outlines what has happened at his trust.
West Hertfordshire £2.4m behind on surplus target

FINANCE: West Hertfordshire Hospitals Trust was £2.4m behind its planned surplus at the end of month five, board papers show.
Why a better understanding of emergency admissions needs better data

Emergency attendance and admission will only be reduced by greater understanding of the demand. It is vital, says Simon Rowe, to make sure you use the most appropriate data.
Why behaviour change marketing can still deliver long-term cost savings

The spending freeze on public sector communications amd marketing spending, in place since 2010, has seen fewer public awareness campaigns receive government funding. But this could be counter-productive, argues Mark Blayney Stuart, when evidence suggests there are clear financial benefits to be had.
Worcestershire negotiating increase to agreed £3m surplus

FINANCE: The PCT is in negogiations with NHS West Midlands to increase its agreed year end forecast surplus of £3m.

Alastair McLellan

Health Service Journal24 November 2011

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Health Service Journal
24 November 2011