Word on the Web
Pressure? Andrew 'Chopper' Lansley isn't feeling it
Despite the BMA calling for a full withdrawal of the Health Bill and a less than convincing address at the NHS Confederation conference two weeks ago, Andrew Lansley was all smiles as he met members of the Air Ambulance crew, and their helicopter, in Cambridge today.
As HSJ’s Simon Lewis pointed out on Twitter earlier - who said Andrew Lansley can’t look relaxed?
Nuffield Trust website relaunches
The new Nuffield Trust website - nuffieldtrust.org.uk - launched last week and aims to provide the health and social care community with a platform for debate and analysis of healthcare reform.
Among the many enhancements, the Talks section will host video and audio content, including interviews, debates and presentations.
The site will also feature blogs from key figures in healthcare, and include pieces from its own team including director Jennifer Dixon, head of policy Dr Judith Smith and head of research Dr Martin Bardsley.
Nuffield Trust publications, research and comment will be available on the website, alongside web tools in the new Data and Charts channel.
Crime doesn't pay... but it might get you free healthcare
It could almost be a joke: “Did you hear the one about the man who robbed a bank of $1 so he could get state healthcare?”
This is exactly what a North Carolina resident in the US did this month. The punchline is, it worked.
After losing his job and, with it, his health insurance, 59-year-old James Verone, who suffers from arthritis, a limp and carpal tunnel syndrome, walked into a local bank, requested the counter staff give him one dollar for a “robbery”, then waited for the police to arrive and arrest him.
To maximise his plight, he wrote to the local paper ahead of his crime, stating: “A bank robbery will have been committed by me for one dollar. I am of sound mind, but not sound body.”
Mr Verone certainly put his sound mind to good use; since being arrested, and jailed, he has been checked by nurses - and has a doctor’s appointment.
The sky's the limit for airport-style health services
HSJ’s eagle-eyed reporter Simon Lewis spotted Andrew Lansley checking into the new lower ground floor outpatients department at Chelsea and Westminster Hospital.
Not for urgent health reasons: Mr Lansley was simply opening the new facility.
The hospital’s chief executive Heather Lawrence said the state of the art department would offer patients a much improved experience; “an ‘airport-style’ quality of service”, no less.
So expect to find long queues, delays, lost personal belongings and people sleeping on the floor.
Emergency at 170ft
Usually, emergency treatments at nearly 200 feet in the air take place on low-flying aircraft. But his was not the case for one ambulance crew in London.
London Ambulance Service responded to an emergency call last Friday (27 May), where a person had been taken unwell on scaffolding at the Union Chapel in London, N1.
The service sent a motorcycle paramedic, an ambulance crew and their specialist hazardous area response team (HART) to the scene, probably not in the knowledge that the patient who was unconscious was fully at the top of the scaffolding.
Undeterred, the crews climbed ladders and scaffolding to reach him at the top of the Union Chapel spire - which stands 170 feet tall.
He was treated on a fire brigade platform before being lowered to the ground, and taken to University College Hospital as a priority.
NHS chief executive PA recognised in annual awards
You may remember a few weeks ago that Christopher Juliff was shortlisted for Hays and The Times PA of the Year 2011.
Well, Word on the Web is pleased to follow that up with the news that Mr Juliff, Diary, Visits and Events Manager to the NHS Chief Executive, was awarded second place at a ceremony at Flemings Hotel in Mayfair, London last month.
Mr Juliff said: “It’s a great feeling to be awarded a high place in this tough competition. I love my job and to be acknowledged for all the effort I put in is very satisfying.”
Christopher’s passion for his career and his expertise, along with his outstanding attention to detail in a high pressured environment, was singled out by the judges in awarding him second place. They also noted his strong personal commitment to the diversity agenda.
Christopher is pictured here receiving his award with Bethan Robbins, Hays regional director, and Michelle Mone, founder and co-owner of MJM International.
Pointing the finger of blame for A&E delays
HSJ reported this week that there’s been a sharp rise in young people attending A&E due to restricted out of hours access to care – and parents won’t be happy if they find themselves waiting in line behind patients such as this one, reported by the BBC on Wednesday.
A&E departments can no doubt regale at length stories of truly unbelievable cases arriving at their doors. But they would be hard pressed to cite an example that less necessitated “emergency” attention than this.
Polyoaks - can Radio 4 out-absurd the current reforms?
The NHS is to be lampooned next month in a new Radio 4 satirical comedy co-written by Dr Phil Hammond.
Titled “Polyoaks”, the four-part series set in an NHS polyclinic focuses on two brothers who struggle to cope with the pressures of handling the clinic’s now-massive commissioning budget.
“Anyone who wants to know what’s really happening to the nation’s health service, but can’t wade through the 367 page Health & Social Care Bill, should listen to Polyoaks,” said a Radio 4 source.
HSJ readers will no doubt be tuning in to find out whether the satirical show actually turns out to be less off the wall than current events in the health service.
Is the betting off for Lansley's vision?
David Cameron’s speech on NHS reform at 11:30am yesterday morning did little more than redistribute well-worn Conservative soundbytes like “evolution, not revolution” and reaffirm the government’s robust commitment to pushing on with the process of change.
But will the prime minister show the same support to his beleaguered health secretary Andrew Lansley?
During the speech, Mr Lansley was nowhere to be seen. Despite the listening, pauses and advisers, Cameron had still taken it upon himself to, as BBC 4 political correspondent Norman Smith put it, “make the case for change all over again” - despite it being Lansley’s change he is having to defend.
The health secretary was only mentioned on one occasion during the speech, in passing, towards the end.
And with “substantive changes” again promised by Cameron as he seeks to calm opposition from all sides, the reforms appear to be moving further and further away from Lansley’s original vision.
It isn’t surprising, then, that the 5/1 odds on Lansley being the next Cabinet member to leave office put him second only to Chris Huhne, after allegations over the weekend that the energy secretary had asked other people to take the blame for speeding offences on his behalf.
But with Ladbrokes making Huhne odds on NOT to leave before 1 June, when the Steve Field-led Future Forum is due to report back to Cameron, Andrew Lansley must be cutting a lonely figure just now - and will be hoping he is still hanging on by the time the government announces its reform Plan B.
National recognition for NHS individual - for the right reasons
Not that many people in the NHS have gained national recognition this year for positive reasons.
But Christopher Juliff, NHS chief executive David Nicholson’s PA, has made the final shortlist in the Hays and The Times PA of the Year competition.
Despite entrant numbers being 60 per cent higher than last year, Christopher has remained in contention for the award and now goes into the final round of judging against five other PAs as the only man left in the running.
Mr Juliff, or to give him his full title, Diary, Visits and Events Manager to the NHS Chief Executive, is also the sole public sector representative with a chance of winning.
He says: “I am genuinely thrilled to have been named as one of the UK’s top PAs.
“People often don’t realise the increasingly complex and demanding roles that PAs play in an organisation, especially when working with a particularly senior leader, so it’s pleasing to have my dedication and input recognised.”
The Hays and The Times PA of the Year Award 2011 winner will be announced at a central London awards ceremony on 19 May 2011.
Mr Juliff might want to put that particular event in a few diaries: should he win, it would give the NHS some welcome cheer.
A right royal day to bury bad news
Of all days, the biggest royal wedding for 30 years must have seemed a ripe moment during which to sweep bad news under the carpet.
While Prince William and Katherine Middleton exchanged vows in front of hundreds of millions of people around the world, Guardian writer and Bad Science author Ben Goldacre drew attention to a news story tweeted by the BBC.
Big news though it was, it was likely to have been missed by many – not least on the social network, which was dominated by wedding related updates.
Luckily, as Sam Lister at the Times pointed out, HSJ had already broken the story the day before – so readers could enjoy the wedding in peace.
The government shouldn't cut public health loose just yet
A government’s role in public health campaigns is not only necessary, it is desired and it works, according to speakers at the World Social Marketing conference in Dublin.
The two-day event earlier this month saw experts converge on the Irish capital to present, debate and analyse examples of social marketing campaigns from around the world – Japan, India, Coventry – whose successes have made a real difference to public health.
One aspect that cropped up on several occasions was the role of a government in public health campaigns. And with the present government scaling back marketing budgets in this age of austerity, interesting points were raised.
On Monday, in his paper Don’t Stop Me Now, Mark Blayney Stuart of the Chartered Institute of Marketing cited several instances where government-backed social marketing had had a measurable impact – notably, the Change4Life and THINK! (the Moment of Doubt) campaigns. The latter, according to Department of Transport estimates, has saved society more than £9 for every £1 spent on the marketing, while also saving 1,000 lives and preventing more than 90,000 injuries since its inception in 2007.
Change4Life, which started early in 2009, will cost £75m over the course of its three years – yet its goals of tackling obesity, which costs the NHS £4.2bn a year, have far greater saving potential.
It aims to reverse the growing trend in child obesity by 2020 to the levels seen 11 years ago, and with a purported 20 per cent of mothers with young children said to have made lifestyle changes as a result of the campaign already, by 2020 the savings to society could be running into billions of pounds – long after the campaign’s meagre-by-comparison spending has ended.
Furthermore, joining up with commercial partners has given the Change4Life message wider exposure at key points of intervention without extra outlay.
But the campaign also highlights one of the dilemmas facing government-led public health social marketing. There is an increasing demand for instant, positive results and return on investment, when the reality is that public health outcomes can take several years to emerge.
As a result, said Mark Blayney Stuart, the government faces another dilemma in being accused of doing too little to tackle health issues when there aren’t quick results on show.
The difficulty in addressing such criticism is appearing too interfering – a “nanny state” government, Mr Blayney Stuart added.
Yet according to findings presented on Tuesday by Dan Wellings, Ipsos MORI’s head of public health research, government intervention is encouraged in public health, but only under certain conditions.
The study, which looked at responses to five types of government intervention in 24 different countries including the UK, found that there was a generally high support for public health information provided by a government. Similarly, the use of incentive schemes to encourage positive changes in public health was also generally well supported.
However, when it came to optional legislation as a form of public health intervention, a pattern emerged that saw wealthier countries, including the UK, less in favour of government involvement; a trend that increased further when mandatory legislation was proposed.
Despite that though, the two sets of research certainly seem to suggest that government-backed interventions as a method of driving improvement in public health can work, and have worked.
But if the result of significant marketing activity cuts in the area means that the effectiveness of such campaigns also shrinks, it would be a disastrous withdrawal of support for a health service embarking on a long road toward already challenging public health targets.
Can social marketing campaigns lead a local public health revolution?
One of the few areas where the coalition’s health reforms are generally being recognised to have potential to ‘do good’ is in public health.
The changes are expected to address long term conditions and young and older people’s services, while the added responsibility GPs and organisations will take on is assumed to put local services back in the hands of the community.
It couldn’t have come sooner. HSJ reported last month that seven per cent of hospital admissions were directly caused by alcohol related illnesses, and just three weeks later, major health bodies withdrew from the government’s “responsibility deal” on alcohol claiming they lacked scope and were not measurable.
Seven major grocers promptly pledged allegiance to the deal, which aims to inform customers on the dangers of unhealthy food and drink consumption without the need to bring in new regulation.
A government that has thrown its full support behind the corporate sector in this week’s Budget might be less concerned about the one-sided backing the deal has received so far.
But they will still need to assuage health bodies in the longer term if they want to devolve public health responsibility away from the centre.
Public awareness will be vital. And for behaviours to be changed, campaigns will need to do much more, much quicker, in successfully promoting better health in society - or calls for legislation will grow louder.
Social marketing has had a very limited impact on public health to date, and typical PH issues are weighing heavily on the resources of the NHS, resources which will now be in the hands of local service providers expected to start relieving some of that burden.
In some trusts, innovative ways of improving public engagement with NHS consultations are being trialled - with some impressive success.
Yet if the public remains so blissfully unaware of the dangers coursing through their arteries, it is clear that now is the time for innovation in public health communications too.
Perhaps there will be some interesting answers provided at next month’s World Social Marketing Conference, where the focus will be on public health campaigns.
Putting the trust in technology
The health service has a reputation – though perhaps not entirely warranted – for looking fondly to the past, particularly at times of great change.
Performance targets and care standards are usually held up against the (halcyon) days of the early NHS, and even periods before that, as advances in medicine and treatment seem to correlate exactly to a decline in how the health system is seen to be performing.
And with the public view of the health service often just one “exposé” away from full scale distrust, the next couple of years could be an absolutely vital period for the government, the NHS and the public in the formation of a harmonious three-way marriage.
One of the ways in which NHS organisations are reaching out to the public, as opposed to waiting for them to show up at the doors, is through less traditional and more immediate communication channels.
Twitter, which is infiltrating just about every sector at present, has seen everyone from PCTs and FTs to managers, nurses and private hospitals and providers set up profiles through which to engage more directly with service users and patients.
Once an individual or organisation creates a Twitter profile, others who might be interested in what they have to say ‘follow’ their profile – in other words, subscribe to their Twitter updates.
As an example, some trusts are using the site as a digital soapbox, to better share news and important information with their users, helping direct people to their website to find out the latest quicker than ever before.
Other trusts, however, are taking the bolder step of using Twitter to engage one-on-one with some of their users: answering requests for specific advice, giving out details on available services or just sharing handy health guidance for a grateful few.
When it comes to complaints, the site provides a direct and less faceless channel through which to approach the organisations. And while issues aren’t always resolved within Twitter’s 140 character limit, the key is that it’s proving to be a crucial link between NHS bodies and patients, ensuring a channel for dialogue between the two remains open and available.
Already revolutionising the relationship between provider and consumer in other industries, the health sector seems on the verge of going the same way, with over 100 ‘tweeting’ trusts on HSJ’s Twitter list.
But it’s not just in popular social media where the NHS is dipping its toe.
NHS Direct is imminently launching an ‘app’ (mobile application) for smartphones such as Blackberry and iPhone devices, which is likely to allow users to look up symptoms on mental health and sexual conditions and find out further related information.
It forms part of the service’s plans to become an “online-first” resource, rather than a telephone-based service.
And with an estimated 16 million of the UK population – roughly 25 per cent – accessing the internet from their mobile phones, the NHS Direct website exceeding 155,000 mobile users a month and billions of apps being downloaded every year, the app market is undoubtedly prime for the health sector to move into.
The approach seems certain to put more power into the hands of the public when it comes to getting health advice, checking symptoms or just keeping abreast of important health information, something which in the pace of today’s world is of increasing importance to the public.
It may take a little while to come to fruition – even the relatively old hat telehealth programmes are struggling to get take-up, despite repeated endorsements – but the question of whether the health service will embrace technology is one of when, rather than if. The NHS organisations getting into the game now are already benefiting, and following their lead (as well as their Twitter feed) is where the smart money’s going.
Bill announcement sparks web comments frenzy
It isn’t every month that Health Service Journal gets to cover a newly announced Health and Social Care Bill.
The largest piece of health legislation ever published (three times the size of the founding legislation in 1946) and the most radical in decades, it managed even to dwarf the icy debate over pay freezes that had dominated discussion previously.
HSJ readers flocked to the site following Andrew Lansley’s announcement, commenting as fast as possible on the spiralling number of news angles spawned by the largesse of clauses, quotes and paragraphs that make up the bill. And, unsurprisingly, given that the incumbent government has had to make some of the most unpopular financial decisions in the last two decades, immediate feeling towards the bill fell little short of full-scale outrage.
Hailed by the government as “evolutionary”, it was instead hailed by HSJ readers as “disastrously poor quality”, “non-viable” and a “car crash” of a bill, while the health secretary’s comments as he announced the policy were “absolute bilge” or “unmitigated tosh”, depending on your mood, and simply outlined what one reader described as a “fingers-in-ears approach” to NHS reform.
Even more contentious was David Cameron’s open letter to GPs, a move clearly intended to pacify the critics that backfired rather spectacularly on HSJ.co.uk.
Denounced as “floundering”, “desperate” and “egotistical nonsense”, the word on the web was that Cameron’s letter was merely “full of spin and rhetoric” but importantly “lacking in detail”, making no mention of the “pound of flesh GPs are expected to give in return” for their new powers - something that is severely lacking in detail for some.
Once that initial furore had calmed a little, however, discussion became more measured. Several readers were in agreement that “change has to happen”, with one admitting that the health service “cannot go on the way it is”. The new structure could “change NHS behaviours” for the good, commenters argued on one story, suggesting perhaps that chinks of light could be seen in the bill - if only in regard to public health, at least.
And while GPs remain thoroughly unconvinced as to the benefits of leading commissioning consortia, the early take up of ‘pathfinder’ groups suggest the changes might be given a fair trial. The eventual abolition of PCTs was, in some quarters, even looked upon favourably: “Consortia won’t employ people with imaginative job titles to sit in meetings and eat sandwiches,” remarked one user.
There is no doubt, though, judging from the wider vehemence on the web this month, that the most radical reform in the NHS’s history has a long, long way to go in persuading healthcare professionals that it really does present a pathway to a world-class health service. And with two years before the reformed structure and processes are fully in place, such vocal opposition is unlikely to die down for some time yet.
