HSJ Live 27.3.2013: Reactions to Francis response

5.01pm The Royal College of Nursing has responded to news that the High Court has ordered a decision about the closure of a child cardiac surgery unit in Leeds to be quashed.

Chief executive & general secretary of RCN, Dr Peter Carter, said: “The Royal College of Nursing believes that children with complex heart problems, will have the best results when they are supported with the best surgery, nursing and medical care available.  This may involve a smaller number of specialist units.

“Today’s ruling shows the importance of good consultation when such sensitive subjects are being discussed.  We want to see this issue resolved as quickly as possible so that the specialist units can plan for the future, and the care of sick children is not left in jeopardy.”

4.57pm In the third part in her series of blogs, Helen Bevan looks at what social movement leaders can teach the NHS about change.

She writes: “Rather than allocating resources, social movement leaders have to build them.” Read the entire article here.

3.43pm More details on the Leeds heart surgery decision.

According to the press release from Save Our Surgery, High Court judge, the Hon Mrs Justice Nicola Davies, found that the consultation and decision making process which underpinned the Joint Committee of Primary Care Trusts reconfiguration of paediatric cardiac surgery services across England and Wales was flawed, and the assessment of Quality of Services – meant to be at the heart of the reconfiguration decision – was unfair and unlawful.

Based on the outcome of today’s hearing, the National Commissioning Board (the new body replacing the JCPCT) must now re-consider the elements identified by the judge and ask questions about the quality scores and how they were arrived at, including issues of travel and access.  The judge has asked that they then report back on their findings and decide upon which centres are to be designated on those new grounds.  

Sharon Cheng of Save Our Surgery says:  “We are extremely pleased and relieved that the unfair and flawed decision to stop surgery in Yorkshire and the Humber has been quashed.  Today’s judgement vindicates our decision to pursue this case through the courts. We brought this case on behalf of the families and patients of our region whose genuine concerns about the review had been consistently ignored by the NHS. 

“The first line of the NHS constitution states ‘the NHS belongs to the people’.  We now call on the decision makers to reflect that by engaging with us to ensure the final outcome is the correct one for children across the country.”

2.52pm BREAKING NEWS BBC’s health correspondent Jean Dreaper tweets: Leeds campaigners have succeeded in getting the NHS decision affecting their child heart surgery unit overturned. (1/1)

“The judge said there was a compelling and urgent clinical case for concentrating child heart surgery..(2/2)

“but she said the consultation process had been unlawful. NHSCB will now need to take another look at quality scores of Leeds v others.” (3/3)

Read HSJ’s previous coverage of it here.

2.42pm The General Medical Council has launched its annual National Training Survey to the UK’s 54,000 doctors in training.

The junior doctors are being urged to share their views and concerns on the quality of their training. The survey also includes a specific question on whether these frontline doctors have concerns over the safety of their patients or the welfare of their colleagues. 

Niall Dickson, chief executive of the GMC said: “The survey provides us with a picture of what works well and what needs improving. Last year we followed up every patient safety concern raised by the doctors and we will do the same this year – doctors in training have a key role in ensuring patient safety by raising concerns where they feel that patients or their colleagues are at risk.  

“In his final report of the Mid-Staffordshire Inquiry, Robert Francis described these doctors as the ‘invaluable eyes and ears in a hospital setting’ - a view we firmly endorse.  Whenever they can doctors must raise concerns locally, but we hope this question will send a clear signal that front line staff must be listened to, as well as being another powerful way for us to identify risks in the health system.”

11.32am Care Quality Commission board member Kay Sheldon has claimed the CQC registered a number of hospitals despite being aware of concerns about their quality because of pressure from the Department of Health “not to find another Mid Staffs”.

In an interview with Radio 4’s Today Programme this morning Ms Sheldon said the CQC was more concerned with how things looked. The interview can be heard here from about 1 hour 22 minutes in. CQC chief executive David Behan responded to this and other criticisms in an interview with John Humphrey at 2 hours 10 minutes, outlining the CQC’s new inspection regime, revealed by HSJ last week.

11.15am Macmillan Cancer Support has also responded to the government’s announcement.

Ciarán Devane, chief executive of Macmillan Cancer Support, says: “The Government’s response to the Francis Inquiry is a very good first step. It is about time that patient dignity and experience is put at the very heart of the NHS. A deeply shocking situation like that at Mid-Staffordshire NHS Foundation Trusts must never happen again.  

“But the focus should not just be on nurses. Leadership and culture also need to change. Nurses should have the space and time to talk to patients and to reflect on the way they are giving care. Even during long shifts when tiredness hits, they must still able to deliver excellent care with dignity.

“Patient feedback needs to be sought consistently, regularly and nationally. For example, the National Cancer Patient Experience Survey identifies the hospitals and teams with problems. It is crucial that the survey continues, is carried out every year and is expanded beyond cancer.” 

11am The Guardian carries the government response to the Francis report across the whole of page four. The piece focusses on the “naming and shaming” aspect of the new hospital ratings system and most of the spread is taken up with listing what Hunt has decided to do, with some cautious comments from the Royal College of Nursing.

In an unusually technocratic issue, The Guardian also features a full-page interview with outgoing NHS London chief executive Ruth Carnall, a  piece by Robin Butler, of Butler Inquiry fame, into the value of public inquiries and a full page on cuts at the Royal National Hospital for Rheumatic Diseases in Bath.

10.47am Jeremy Hunt’s response to the Francis Inquiry report gets a thumbs up from the Financial Times this morning. The paper’s editorial states that the health secretary is “thinking along the right lines”. “First off,” it continues, “accountability needs to be sharpened.

The health secretary has already, and rightly, ended the practice of hospital trusts writing gagging clauses into severance agreements – a practice that has been used to stop employees blowing the whistle on poor care. Now he proposes to revamp the system of hospital inspection, making it more independent and publishing Ofsted-style data on the performance of trusts.”

However, it calls for him to go further in linking financial rewards to care standards. The paper states: “Mr Hunt is considering increasing dramatically the extent to which hospital payments are related to the quality of care they provide. He should do it.”

10.40am The Telegraph has a number of pieces dealing with the government’s response to Francis. “NHS chief was gagged at taxpayer’s expense” – about the confidentiality agreement signed by form Mid Staffordshire boss Martin Yeates, merits a column on the front page.

The main story – “failing NHS managers could be blacklisted” is the lead on page 6.

It is accompanied by a sketch by Michael Deacon on health secretary Jeremy Hunt’s performance in the Commons yesterday.

“Anxious to avoid giving the impression that he’s a lightweight doing a job for a heavyweight, Jeremy Hunt has been working hard to change his style.

“His former style – chirpy voice, camply flailing arms, cheeky little quiff – made him both look and sound like a children’s TV presenter,” Mr Deacon says. “All very well when you’re Culture Secretary, and your brief consists largely of getting people excited about the Olympics. Not quite so ideal when you’re Health Secretary, and your brief consists largely of death and misery.”

There’s also a comment piece by Mary Riddell, in which she argues that the Tories have “had their chance to redeem a failing NHS with the reforms that go live on Monday”.

She writes: “What grieving relatives do not need, from any politician, are pieties or empty crackdowns. The spirit of the NHS will not be saved by Ofsted-style ratings and mandatory compassion, any more than its finances will be rescued by waving credit card machines at migrants.”

10.35am The government’s repsonse to the Francis Report was presented to the parliament yesterday and HSJ has been covering it live - bringing you most up-to-date news, views, and tweets. Reporter Sarah Calkin’s piece on failing NHS managers could be barred became the lead story.

Read our comprehensive analysis here.

10.12am There are renewed calls for Sir David Nicholson to resign this morning, following the publication of the government’s response to the Francis report.

“One vast elephant remains stubbornly in the room”, says the Daily Mail’s lead editorial. “How can Mr Hunt speak of a blacklist [of unfit NHS managers], when the Man With No Shame - who oversaw the culture of neglect at Stafford - continues to enjoy his support as chief executive of the NHS?

“Indeed, Sir David Nicholson is the living symbol of everything the health secretary claims to be fighting.”

Meanwhile the Telegraph’s leader says today: “The sad truth is that shuffling around the regulators, or imposing a new ‘duty of candour’ will do little to push through the fundamental changes in behaviour that are necessary.

“It is good news that those managers who fail could be barred from such work (including, one hopes, Sir David Nicholson). But it is hard to see how Mr Hunt can impose his cherished ‘zero harm’ culture on a monolithic health service where patients are all too often denied compassion, or even basic nutrition.”

10.05am Some news from late on Monday which didn’t get much attention was the re-election of Sir Richard Thompson as president of the Royal College of Physicians.

Sir Richard won by 406 votes in a ballot organised by the Electoral Reform Services. He has been president since 2010. The other candidate in the election was Dr Richard Taylor.

On learning of his victory, he said: “I would like to thank the Fellowship for electing me to continue to lead the RCP, particularly in this year when we will be facing major challenges due to the new structures and commissioning arrangements which will begin on April 1, and when we shall be looking to implement the recommendations of the Francis report to improve patient care and patient safety.  I am particularly looking forward to receiving the report of the Future Hospital Commission, which I commissioned in 2012.”

9.59am Hospital admission rates for patients with long term conditions differ markedly across the country, according to a new analysis from the Health and Social Care Information Centre.

Today’s report: Clinical Commissioning Group Outcomes Indicator Set: Emergency Admissions; presents data for the first time by the 211 proposed CCG areas – and provides more information about indicators within the CCG Outcomes Indicator Set. The report and data aims to provide comparative information for CCGs and Health and Wellbeing boards on the quality of commissioned health services in primary and secondary care and, as far as possible, the associated health outcomes.

8.05am Good morning, each year more than 39,000 women in England are diagnosed with breast cancer, and of these, 33 per cent are aged over 70. A pilot by NHS Brent and Harrow to promote earlier detection of breast cancer in women over 70 yielded has exceptional results, writes Sam Ingram on HSJ today.