HSJ Live 25.11.13: Thousands of nurses leaving the profession

5.39pm New Scientist reports on a new study that suggests “people are happy to endure a bit more pain, if it means they spend less time waiting for it”.

The study “could well have implications for medicine and health policy, because an understanding of how people judge pain is important for presenting them with options about potentially painful treatments”.

Giles Story of University College London, who led the study, said: “You should avoid emphasising waiting times.” He added: “And if you can make something seem unavoidable, people may be more likely to confront it to minimise dread.”

5.20pm The Daily Telegraph reports that nearly a quarter of British people are now obese in older age, according to a study published in the International Journal of Obesity

A team at the University of Glasgow examined data from the Health Survey of England and the Scottish Health Survey, comparing the periods 1994-1996 and 2008-2010.

They found that the number of people with a body mass index over 30 (considered obese) rose by 5-15 five per cent on average between these periods, and peaked at up to 38 per cent in the 60-70 age bracket.

5.03pm HSJ is holding a free webinar, Smarter decisions, better care, to explore how clinical decision support technology can improve patient safety on Tuesday 10 December.

The panel will include Dr Rakesh Patel, NIHR academic clinical lecturer in medical education and Dr Peter Williams, consultant in acute and emergency medicine and clinical lecturer for acute medicine at St Helens and Knowsley Trust.

Register today to watch it. If you watch make it, you can always catch up on demand at www.hsj.co.uk/hsj-tv

Clinical decision support is now recognised as a key element of health informatics strategy in acute and primary care, refocusing hospital IT from being a mere replacement for paper processes, to point-of-care systems that can support clinicians to improve patient safety.

4.44pm Over 65s overwhelmingly want greater investment in-home care services, according to a survey.

The Stannah Silver Census questioned over 1,000 people over 65. 93% said investment in in-home services would allow them to be independent at home for longer.

71% of those survey rated think NHS staff are excellent, but management of the NHS  as poor, while think the NHS needs dramatic reform to keep public trust.

However, 81% of said they are “happy with the quality of care I receive from the NHS” and 86% agrees the “NHS is a great institution and I am proud of it.”

The survey also showed some regional differences in attitudes to the NHS. 76% of those surveyed in Wales were strongly in favour of the NHS, compared to 59% in London and Yorkshire.  

4.20pm What impact are the controversial changes in procurement law having on the NHS eight months on? Are commissioners and providers acting differently because of them − and what does this mean for services?

HSJ, in association with business law firm DWF, wants to find out how the new regulators are affecting your organisation. Have your say by taking part in our survey.

4.15pm Pascal Lardier argues in The Guardian: “The most creative technical solutions to the health sector’s problems are unlikely to come from inside the NHS or from large IT companies.” Instead, he thinks entrepreneurs “could help drive innovation in the health sector”.

3.52pm The BBC reports that a two-year-old boy at risk of aggressive childhood leukaemia has been given a bone marrow transplant after his parents appealed for more people in the Asian community to register as donors.

Gaurav Bain from Tipton in the West Midlands, has Monosomy 7 Syndrome, a rare blood immunity, that could lead to him developing a type of leukaemia that is difficult to beat.

James Gallagher, a health and science reporter for BBC News, said: “The extraordinary effort made by Gaurav’s parents show how hard it can be for Asian families to find a matching bone marrow donor.”

He noted how Asians “make up a smaller proportion of the population and are also less likely to register as an organ donor - it means the pool of potential donors is tiny”.

3.40pm For our full coverage throughout BME Pioneers week, with exclusive interviews, profiles and podcasts, click here. It will be updated throughout week, culminating in our first ever powerlist of 50 BME Pioneers working in healthcare, which will be published on Thursday.

3.27pm Monitor has launched an investigation into poor financial performance at Wirral University Teaching Hospital Foundation Trust.

The regulator has announced the probe to establish whether Wirral is in breach of its licence to provide services and is planning to “call in” the trust to explain why its costs have been higher than expected this year, with income lower than forecast.

3.10pm Esther Rantzen has launched Silver Line, a free 24-hour confidential line for older people, nationwide after a year-long pilot, as reported in our sister title Nursing Times. It comes 27 years after she launched the children’s helpline Childline.

Silver Line also runs a befriending scheme. Linda Kelsey, who volunteers in the scheme, writes in The Daily Telegraph: “I have found myself wondering what exactly a weekly phone call from a befriender, or the availability of a 24-hour helpline, can do to alleviate the myriad difficulties of old age. But the only people who can really answer that question are those who benefit from the service themselves.

As one satisfied customer put it: “You get so down, you think, ‘Why do I bother’, but now I feel less shuffled under the carpet and I don’t feel alone any more – thanks to my Silver Line friend.”

2.53pm In the NHS Voices blog, Dean Royles, chief exective of NHS Employers, says “I do not believe we can continue to manage pay by constant freezing”.

“The history of public-sector pay is one of a pendulum swing; we erode and eat away at pay until it reaches a recruitment crisis and industrial unrest, then pump money in, leading to pay disparities between the public and the private sectors. We have to stop that.”

He suggests: “We need a cross public-sector approach and political bravery to establish a medium-term plan that will bring us out of a period of pay restraint safely and sensibly.”

2.46pm Kailash Chand, deputy chair of the BMA, writes in The Guardian that “changing the culture of the NHS cannot be achieved by policies that sit on shelves or by legislation in the parliament.”

“The culture of apathy, complacency, and lack of shared ownership has eroded the confidence of patients”, he adds.

“While senior management have to take the lead, each employee must now look at how they might change their practice – or if they witness bad practice, challenge it ”

2.33pm Also in Local Government Chronicle, Sandie Keene, president of the Association of Directors of Adult Social Services says the Care Bill groundwork lacks impetus. Click here to read her full article.

2.30pm Andrew Cozens, chair of the Carers Trust, argues in our sister title Local Government Chronicle that there is a worrying amount of fog swirling around adult social care at the moment obscuring the welcome clarity of vision and direction generated by the Care Bill, now back in Parliament. Read more here.

2.19pm Funding has been diverted from primary care to hospitals in the last eight years, according to research by the Royal College of General Practitioners.

Between 2005/06 and 2011/12 the overall British NHS budget grew by 18% in real terms, however funding for general practice decreased by 8.3% in real terms. Research by the RCGP found that funding for general practice in England declined in real terms by £400m in the three years up to and including 2012/13.

The RCGP claims there is a “funding black in general practice” of 9bn in England, £925m in Scotland, and £250m in Wales. This comes in spite of the British population having grown by 2.6m.

RCGP Chair Dr Maureen Baker said: “The drift of funding away from general practice to secondary care is a deep-seated and long-term trend which is starving general practice of the money it needs to deliver high levels of patient care.

“The vast majority of GPs think that the decline in funding for general practice will regretfully lead to longer waiting times for patients over the next two years. This lengthening of waiting times is a continuous process, and will inevitably worsen this winter as temperatures plummet.

“This is bad news for patients and bad news for the whole of the NHS. If waiting times become longer, this will make it more difficult for GPs to ensure that problems are caught early, and risks intensifying pressure on already overstretched A&Es.

“GPs want to offer their patients faster and more convenient access but are being held back from doing so by a chronic lack of resources. The Government must take urgent action to pump more resources into general practice so that family doctors can treat patients in the community, thereby taking the pressure off hospitals.”

2pm Following the government’s response to the Francis report, Michael West, senior fellow at the King’s Fund, argues why fostering compassion should not be about threatening criminal sanctions but about relieving stresses on staff. Read more here.

1.51pm A national survey of the role of health and wellbeing boards offers a degree of optimism for the future, but they still face a steep learning curve, says Richard Humphries, assistant director of policy at the King’s Fund. Read his full article here.

1.43pm A Nursing Times campaign to to protect staff that raise legitimate concerns about safety has been back by five more organisation.

1.38pm Also in Nursing Times, matrons at Epsom and St Helier University Hospitals Trust are to extend their working hours from today, meaning they will be present from 7am to 8pm, every weekday. Full story here.

1.37pm Our sister title Nursing Times reports that the Faculty of Sexual and Reproductive Healthcare, which represents doctors working in sexual and reproductive health, has voted to widen its membership to include nurses. Read more here.

1.31pm According to The Daily Mail, at least 40 hospital trusts are actively recruiting nurses from abroad to “plug a crisis in NHS staffing”.

1.18pm In 2003, Trevor Phillips, former chair of the Equality and Human Rights Commission, described the NHS as a pyramid- white at the top and black at the bottom. Five years later, HSJ looked at why are there were still so few senior NHS managers from BME backgrounds. How much has changed in 2013? #HSJBME

1.07pm Policymakers, expert commentators and directors within the top of NHS Leadership gathered at the HSJ Summit earlier this month to discuss the most pressing challenges facing the NHS today. Just two were from a minority background.

What more can be done for the leadership within the NHS fails to better reflect the diversity of the population it serves? Let us know your thoughts on hsj.co.uk, Twitter and LinkedIn. #HSJBME

12.53pm Our panel for our live webinar includes Mark Flannagan, chief executive of Beating Bowel Cancer, Kate Heaps, chief executive of Greenwich and Bexley Community Hospice, Dr Gill Levitt, clinical lead for children and young people workstream of the National Cancer Survivorship Initiative and Cheryl Vidall, past president of the UK Oncology Nursing Society.

The webinar will be chaired Professor Arnie Purushotham, director of King’s Health Partners Cancer Centre.

Can’t make it this time? Don’t worry, you can catch up on demand at www.hsj.co.uk/hsj-tv

12.51pm Join us Wednesday 12.30pm for live webinar on balancing clinical efficacy of treatments with quality of life.

This might be considered particularly pertinent when it comes to cancer treatments. Researchers continue to search for a cure, but were that cure to involve unpleasant side effects - as chemotherapy and radiotherapy often currently do – would patients want it? Would they prefer a treatment which offered an 80 per cent certainty of cure but involved no side effects at all?

Make sure you register today to watch this webinar.

12.41pm In his column for the The Daily Telegraph, psychiatrist Max Pemberton critcises how much time clincians spend on paperwork.

“Many will be shocked that so much time is spent on paperwork, rather than caring for the sick, but I’m amazed that it is apparently so little,” he writes.

“I frequently feel I am drowning in forms to be completed, statistics to be gathered and boxes to be ticked. I trained to be a doctor because I wanted to work with people, not complete forms that have no tangible, meaningful impact on the patient.”

12.33pm The Guardian also reports that Liz Kendall, the shadow care minister, said patient choice in the NHS is “going backwards”. Her claim follows new figures showing a drop in the number of people choosing to receive outpatient hospital treatment.

12.32pm Hospitals are reopening closed wards to create thousands of extra beds to alleviate pressure on the NHS this winter, according to The Guardian.

Barbara Hakin, deputy chief executive of NHS England, said the service was implementing unprecedented measures to prepare for the increase in admissions this winter.

12.29pm The General Medical Council has released the number of criminal records held by practicing doctors in response to a Freedom of Information request, The Daily Telegraph reports.

Over 750 doctors are still working despite being convicted of offenses including taking indecent images of children, drug trafficking and fraud.

12.27pm The Public Accounts Committee will today press for reform of Government contracts outsourced to the private sector, according to The Independent. Margaret Hodge, chairman of the committee, wants to see open-book accounting on all Government contracts.

The committee is also pushing for the National Audit Office to have full access to contractual and financial details of outsourced contracts, and for more information relating to the deals to be disclosed under Freedom of Information requests.

12.26pm In today’s papers, The Financial Times reports that the Department of Health has been urged to amend the pharmaceutical price regulation scheme (PPRS), only days after the new system was announced. Leslie Galloway, head of the Ethical Medicines Industry Group, criticised the decision to reduce the existing “taper”, which is designed to protect smaller pharmaceutical companies.

The government is currently holding talks with industry bodies on the PPRS, with final ratification of the new scheme expected at the end of the week.

12.18pm Ranjit Sanghera, senior manager for equalities and health inequalities NHS England tweets:

@HSJEditor very proud of HSJ for breadth & depth of articles , my plea is to continue debate & not tackle as one off yearly issue!

@HSJEditor also the solutions are out there in NHS, but need to capture, share & learn & not fear them but embrace, involve & engage!

Join in the discussion. What can be done to create a more diverse mix at the top of NHS leadership? #HSJBME.

12.11pm A BBC investigation into a UK-based Amazon warehouse uncovers conditions that stress expert Professor Michael Marmot said could cause “mental and physical illness”.

12.02pm In the BBC’s weekly Scrubbing Up column, Dr Naeem Nazem of the Medical and Dental Defence Union of Scotland explores whether the doctor-patient relationship can ever be extended into social media?

11.52am What everyday actions do you think could make a difference to diversity in NHS leadership? Join in the discussion on hsj.co.uk, as well as on Twitter and LinkedIn. Our hashtag is #HSJBME.

11.49am As part of our BME Pioneers week, on our Learnist page we take a look through HSJ’s news archive over the last five years and some of the pay-outs and compensations that not tackling equality has had on the NHS’ financial pocket.

11.44am NHS services need to adapt so they can address both physical and mental health issues - and not deal with them separately, according to Geraldine Strathdee, national clinical director for mental health for NHS England. Click here to read more.

11.41am EXCLUSIVE: Jeremy Hunt last week called the leaders of a number hospital trusts that have failed to hit accident and emergency waiting times targets, HSJ has learned.

This is despite the 2012 Health Act removing responsibility for the day to day running of the health service from the health secretary and giving it to NHS England, which would normally be expected to intervene alongside regulators in cases of poor perfomance. Read more here.

11.37am The number of nurses actively choosing to leave their profession has jumped just over a quarter since the coalition government came into power.

HSJ has obtained data from the Nursing and Midwifery Council which reveals a large rise in the numbers “opting not to practise” as nurses, with 5,422 leaving the profession in 2012-13 alone. Read the full story here.

11.33am The chief executive of the Office of Fair Trading has admitted there is scope for “significant improvement” in the way the competition authorities that have taken over NHS merger controls engage with hospital trusts.

But, in an exclusive HSJ interview, Clive Maxwell rejected the suggestion floated recently by NHS England chief executive Sir David Nicholson that the government might need to legislate to prevent the new system of competition regulation from obstructing improvement to NHS services.

11.23am: A private hospital favoured by the royal family is to expand its facilities after receiving a grant worth up to £30m.

King Edward VII’s Hospital admitted the Duke of Edinburgh for five days last year over a bladder infection and treated the Duchess of Cambridge during her pregnancy. Full story here.

9.59am On HSJ’s Pinterest site, take a look at the history of influential leaders from BME backgrounds working within the health sector.

9.57am Debbie Weekes-Bernard, senior research and policy analyst at Runnymede, takes a look back at over 50 years of Asian migrant workers in the NHS and the contribution Asian staff have made in the UK health system.

9.56am Shahnaz Ali, former director for inequality, inclusion and human rights at NHS North West, writes on how BME staff can scale what NHS chief Nigel Crisp described as the “snowy peaks” of NHS leadership.

9.52am Good morning. All this week HSJ will be looking at looking at what can be done to create a more diverse mix at the top of NHS leadership.

It will be publishing its first ever celebration of healthcare’s influential leaders from BME backgrounds, by revealing 50 BME Pioneers judged to be making an outstanding contribution to shaping and leading quality care today.