3.31pm: While we await the Monitor decision, HSJ reporter Ben Clover has provided some analysis of minutes of last month’s board meeting:
The board notes: “Draft guidance had already been used by the Contingency Planning Team at Mid Staffordshire Foundation Trust. Board members noted the feedback that had been received from the CPT and, in particular, the value of further clarification of the term ‘Protected Services’. As a result, it was noted that Monitor would refer to Services with No Alternative Provider in the future.”
So “SNAP services” replace “protected services”. To a layman “Services with no alternative provider” and “protected services” sound like two different things. Decision on whether to put Mid Staffs in the failure regime expected later today.
3.27pm: Meanwhile, Monitor’s board is meeting this afternoon and is due - in private - to make a decision about whether to apply its failure regime - known as trust special administration - to Mid Staffordshire Foundation Trust. Observers say such a move is likely. It would be the first trust put into special administration by the regulator, and only the second organisation to be subject to such a process at all. South London Healthcare Trust was put into administration by the health secretary, as a non-foundation trust, last year.
2.56pm: Twenty-one healthcare leaders have been announced as members of a national advisory group to the review, led by NHS Commissioning Board medical director Sir Bruce Keogh, into 14 hospital trusts which have had higher than expected mortality rates.
The review was announced by the prime minister following the Francis report.
The advisory group’s members include Care Quality Commission chief executive David Behan, former minister Lord Darzi, former Healthcare Commission chair Sir Ian Kennedy, and Sir Jonathan Michael, Oxford Radcliffe Hospitals Trust chief executive.
The size and prestige of the group suggests the review could be quite an extensive and significant process.
Sir Bruce said in a statement: “These investigations are an opportunity to take a good look into some of our hospitals which for one reason or another are persistent outliers on mortality indicators. I want to assure patients, the public and Parliament that these hospitals understand why they have a higher than expected mortality rate and that appropriate action is being taken.”
An NHSCB statement said: “The investigation will seek to determine whether there are any sustained failings in quality of care and treatment being provided to patients and to identify whether existing action to improve quality is adequate. It will also seek to identify whether any additional external support should be made available to these Trusts to help them improve.”
2.03pm: An HSJ reader, commenting on our exclusive with Lord Howe this morning, reminds us that the controversial competition regulations do not only apply to clinical commissioning groups, but also the NHS Commissioning Board, which controls primary care and specialised services.
1.32pm: A major story for junior doctors is breaking. HSJ reporter Shaun Lintern has summarised the situation:
More than 7,000 potential foundation year doctors face confusion over their future after an examination blunder by the UK Foundation Programme Office.
The error emerged last night in an email sent to medical students 24 hours after they had learned which deaneries they would be placed in for their first NHS posts, starting in August.
As a result of the mistake examination results will now have to be remarked and the UKFPO has said it may need to re-run its allocation algorithm meaning student doctors face being sent to different regions than they had expected.
The error centres on the marking of the Situational Judgement Test which is designed to assess the professional attributes of students ahead of becoming a foundation doctor.
The UKFPO said it will now manually remark all the affected answer sheets and warned some scores could change as a result.
The Foundation Programme Office and British Medical Association have issued statements.
12.19am: HSJ editor Alastair McLellan will imminently chair a live webcast on the debate about whether to re-introduce star-ratings for NHS hospitals. It will begin at 12.30pm. The debate will also include Jennifer Dixon, chief executive at the Nuffield Trust, who is leading a review of how health services should be rated for the government.
11am: Robert Francis QC has been making interesting comments at an all-day King’s Fund report on the fall out from his public inquiry report today. HSJ reporter Sarah Calkin is covering on Twitter.
10.56am: Leading Liberal Democrat MP Tim Farron, whose constituency is served by troubled University Hospitals of Morecambe Bay NHS Foundation Trust, has highlighted figures on confidentiality clauses uncovered by HSJ.
A statement from his office says he has “has asked the government to act on evidence unearthed by the Health Service Journal into gagging clauses in the NHS”.
“Over 500 ‘compromise agreements’ were signed across 20 hospital trusts and 24 primary care trusts between March 2009 and March 2012. The Health Service Journal estimate that 80% of trusts have ‘at least one compromise agreement’ and that 98% of those agreements contained a confidentiality clause.”
“Tim has called for an end to NHS confidentiality deals such as those used at the University Hospitals of Morecambe Bay NHS Foundation Trust.
“UHMBT and its former chief executive, Tony Halsall, signed a confidentiality deal when Mr Halsall stepped down in February 2012.
“The deal prevents the disclosure of details of his departure, including whether he worked his six-month notice period and whether he was paid for it.
“Tim has written to the Secretary of State for Health, Jeremy Hunt MP, and asked him to write to every NHS trust in the country and instruct them to not use these deals.”
10.49am: Health minister Lord Howe has made some interesting comments in an interview with HSJ reporter James Illman about the controversial competition regulations. While acknowledging the rules will be reviewed, as promised by his fellow ministers, he says lawyers have advised the government that the current wording is correct.
10.07am: Ben Clover has revealed significant news on a London hospital merger. He tweets: “Breaking: West Middlesex University Hospital’s preferred merger partner is Chelsea+Westminster FT, not Imperial College Healthcare Trust”
That will be a signficant development for Chelsea and Westminster.
8.53am: Bear in mind, in reading the previous post, that HSJ’s survey of CCG chairs and accountable officers found strong evidence they favour developing integrated services ahead of using competition.
8.50am: NHS Clinical Commissioners - which represents the majority of clinical commissioning groups - has commented on the procurement regulations published earlier this month under the Health Act, which have faced opposition from campaigners and politicians. They extend the scope of competition in the NHS. Ministers yesterday indicated they would review the regulations, under political pressure.
A lengthy and carefully balanced statement says:
“NHS Clinical Commissioners welcomes the announcement that the government are to review the regulations they have published to implement Section 75 of the Health and Social Care Act.
“Clinical commissioners are determined to use all of the tools at their disposal to deliver the highest quality services for their patients and populations.
“They want to be able to commission integrated services which which place the patient in control and provide a seamless passage across health and social care and through different health services.
“Clinical commissioners must be provided with the freedom to use the full range of procurement tools including integration, collaboration, innovation pilots and a variety of tendering mechanisms where appropriate that are all based on achieving the highest quality and best value for patient outcomes, not price alone.
“To do this they need to be free to choose what is the most appropriate tool for any given situation. Our concerns is that the regulations laid under Section 75 of the Health and Social Care Act have been interpreted by some as appearing to skew the balance and will mean that CCGs will feel obligated to carry out virtually all commissioning through competitive tendering.
“It is essential that CCGs are given greater freedom to choose when and how to procure new services and that the risk of referral to Monitor or the courts does not place a chilling effect on commissioner’s ability to take a more inclusive route if that is what they feel is appropriate.”
8.10am: Good morning, we need to roll out the use of telehealth and telecare right across the NHS, Miles Ayling, director of innovation and service Improvement at the Department of Health writes on HSJ today. The use of new technologies needs to become routine for the NHS. The QIPP £20bn efficiency programme is not a one-off he writes.
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