Experts in the sector have set out their responses to the government’s funding announcement, plus the rest of today’s new and comment.
5.55pm Robert Jenrick, MP for Newark, asks Mr Hunt if there is anything he can do to help hospitals, such as Sherwood Forest, which are in special measures and have heavy private finance initiative debt burdens.
5.50pm Dr Jennifer Dixon, chief executive of the Health Foundation has responded to Secretary of State for Health, Jeremy Hunt’s, statement on the 5 Year Forward View, and the funding announcements expected in Wednesday’s Autumn statement.
She has said: “The to-do list for the NHS set out in Forward View is right but very tough. An extra £2bn is a significant sum, but only covers what the NHS currently needs to meet demand from a growing and ageing population.
“What we all want is better quality care for the money – that will mean progress on a scale never seen before in the NHS.
“The extra funds announced today, while welcome, don’t provide the extent of investment the NHS now needs to transform the way it delivers services. To support the 5 year forward view additional specific, time-limited pump priming investment (a transformation fund) is needed to move to new models of care as well as a commitment to the additional £8bn required by the end of the decade. Without this, the NHS, government and the public will face hard decisions in future as the NHS tries to cope with increasing demand.
“There is plenty of talent and mission among staff to achieve the necessary changes – apart from investment the challenge is to create a stable strategy which mobilises that talent and other assets in the health and care system effectively. No further major structural reorganisation would help.”
5.47pm Responding to the secretary of state for health’s statement to the House of Commons on the future of the NHS, Chris Ham, chief executive of The King’s Fund, said: “The additional funding for the NHS confirmed today will provide a substantial boost for front line services and is an important step forward, especially with the public finances still under significant pressure.
“It underlines how much the debate has moved on over the last few weeks, with the case for more investment in the NHS now accepted by all the main political parties.
“Whoever forms the next government will inherit a service under huge pressure and in need of radical transformation. But there is now an emerging consensus around the agenda for change set out in the NHS Five Year Forward View. This is very important, creating an opportunity to drive through fundamental changes to services that could significantly benefit patients.
“However, even if the very challenging estimates for productivity improvements it outlined can be achieved, an additional £8 billion a year in funding will be needed by 2020. While the investment confirmed today will provide welcome short term relief for hard-pressed services, it is therefore clear that more will be needed to keep pace with future demand and fund changes to services. So this must be the first instalment in a sustained funding increase during the next parliament.
‘The additional funding to improve GP facilities is also welcome at a time when general practice is under significant pressure. This new investment needs to go hand in hand with reform to encourage practices to work together in federations to provide a wider range of services to their patients.”
5.38pm Hunt: Local authorities and CCGs should look in future at commissioning public health together.
5.34pm Hunt is asked: “If you can afford £700m why couldn’t you spend it on a measly one per cent pay rise?”
5.32pm Hunt: NHS trusts are hiring extra agency staff in reaction to the Francis report – as things settle down they need to transfer to using permanent staff.
5.22pm Hunt makes the point that, while the Barnett formula means that the other home nations will get part of the announced £1.7bn, it will not be ring-fenced for health in each nation.
5.20pm Mr Hunt: “We’ve got to move away from people commissioning care piecemeal and to start looking at patients needs in the round.”
5.19pm Ben Bradshaw MP: What has the Secretary of State has been doing about the “scandal” of national mental health services in Devon and Cornwall?
5.15pm Jeremy Hunt agrees it was unacceptable and “this is a problem we must eliminate”.
5.14pm Adrian Sanders points to case where a 16 year old in his constiuency with mental health problems was placed in police cells for two days because there were no mental health beds available anywhere in the UK.
“This really is outrageous,” he says
5.11pm Sarah Wollaston says she “warmly welcomes” the government’s NHS spending boost.
She asks for confirmation that the pledge for a paperless NHS will go through to primary care.
5.10pm Mr Hunt claims under the Labour government poor care was covered up by spin.
He points to Ed Miliband saying he wants to “weaponise the NHS”, but it is not a weapon for political parties.
5.08pm Mr Hunt decribes Mr Burham’s criticisms as “shallow”.
“This is very significant moment” when “we can at last put back more money into the NHS”, he says.
He adds the shadow health secretary should “welcome it, not scorn it”.
5.07pm Mr Burnham sais most of what the health secretary has announced will go to “patching up the problmes he has created” while only a quarter will go to developing the models of care outlined in the NHS five year forward view.
5.04pm Mr Burnham presses the health secretary about the £700m reportedly coming from existing Department of Health budgets.
5.03pm Mr Burnham: “On mental health does Mr Hunt not accept there is an undeniable need to open more beds immediately, right now?”
5.01pm Shadow health secretary Andy Burnham is up to respond.
5.00pm Mr Hunt has also laid out a £1bn investment fund in primary and community care facilities. These new primary care facilities will be encouraged to join up with other community services such as job centres.
5.00pm The other two pillars are “innovation” and “culture”.
4.57pm “To receive £1.5bn of the £1.7bn we will be providing, we will be asking hospitals to provide sure plans about how they will show their commitment to a paperless NHS by 2018.”
4.56pm: “A strong economy and a focus on prevention are the first to pillars of our approach,” says Hunt.
4.55pm Hunt: “We reject making clinical commissioning groups a part of local government because it would amount to a top down re-organisation.” Cue jeering in the chamber.
4.52pm The Health secretary is to lay out the four pillars of the government’s response to the NHS Five Year Forward View
4.51pm Jeremy Hunt has just got up to speak in the House of Commons. Stay tuned.
4.20pm Monitor and NHS England are encouraging commissioners and providers to adopt capitation payments when negotiating local price-setting arrangements to bring them in line with the way GPs are funded.
The national tariff should move from a list of prices to a framework of rules, the regulator has added.
David Bennett, chief executive of Monitor, said: “Improving how healthcare is paid for will provide significant benefits to patients and the NHS. A more flexible and adaptable payment system should also help to ensure the sustainability of services, making sure that NHS funding goes as far as it can for patients.
“We’ve started the ball rolling already with our work on the 2015-16 national tariff, but we require people at both local and national level to work together to implement the Five Year Forward View if patients are to see all the benefits possible.”
Simon Stevens, chief executive of NHS England said: “NHS payment systems are a means, not an end. Much of the current tariff system was designed to help the NHS achieve a set of goals in the 2000s, such as slashing long waiting lists for routine surgery, which have been achieved. The new challenge is to support the triple integration of care the Forward View highlights: between primary and specialist care, physical and mental health services and health and social care. Today we signal a new, locally flexible direction of travel to advance these goals.”
4.00pm Secretary of State for Health Jeremy Hunt will be giving a statement on the government’s NHS funding pledge and the five year forward view at 4.15pm today in the House of Commons.
We will be covering it live here, so stay tuned.
The report ‘I’m Still Me: a narrative for coordinated support for older people’ is published today with the input of National Voices, UCLPartners, Alzheimer’s Society and the British Geriatrics Society. It sets out how coordinated – or integrated – care and support looks and feels to older people and is written from their point of view.
‘I’m Still Me’ outlines five themes that older people say are key to coordinated support: independence, community interactions, decision making, care and support and terminology.
The publication also calls for a national debate on the use of the word ‘frail’. This word is often used to define groups of older people who could be vulnerable to a crisis, however it is rejected by older people themselves because they don’t see themselves in this way.
3.15pm The Guardian reports that 300,000 disabled people are stuck on housing waiting lists across Britain, forced into accommodation that does not meet their needs, according to a charity.
Leonard Cheshire Disability has accused the government and housing developers of failing disabled people.
The charity wants the government to make housing developers build all new homes so they are easy to adapt if a resident was to become disabled and for 10 per cent of large developments to be fully wheelchair accessible so that disabled people can live independently across the country.
2.40pm Capita Healthcare Decisions has appointed Charles Young as its chief medical officer.
Dr Young is an emergency physician at St Thomas’ hospital and senior healthcare information executive.
His career includes time as executive editor at The Lancet, and as editor-in-chief at The BMJ Evidence Centre. More recently Charles worked as vice president and director of global clinical solutions at Wiley and as a consultant for a range of digital and tele-health companies, advising them on business strategy, editorial process, and clinical governance, with an emphasis on clinical risk management.
Dr Young is also a member of the National Institute for Health and Care Excellence (NICE) external accreditation committee, and a member of the Cochrane Editorial management committee.
2.35pm Nurses at Princess of Wales Hospital in Bridgend, south Wales are being investigated by police for allegedly giving sedatives without prescripton to elderly and difficult patients in order to have an easier shift, The Times reports.
1.55pm The Times reports that thousands of mental health patients are being put in policy custody because hospital provision is not available.
It highlights the case of a 16-year-old girl who spent two nights in policy because there were no mental health beds in the UK. She was moved from the facility after a senior policy officer described the situation as “unacceptable” on Twitter and on television reports.
This is the prediction of former NHS Confederation chief executive Mike Farrar following the publication of the forward view vision for the NHS over the next parliamentary period.
According to the policy blueprint, GP practices should morph into larger provider organisations to offer wider ranges of services than are currently available.
1.05pm In this week’s HSJ leader column, editor Alastair McLellan argues that Simon Stevens is “to be congratulated for successfully resetting negotiations on NHS funding, but he know that the work has just begun”.
“Given his age and political background, Mr Stevens is unlikely to be a big fan of Margaret Thatcher. But his message to the service in the wake of the announcement that the government has decided to add £2bn to the NHS baseline would certainly have echoes of the former PM’s Falklands exhortation to “rejoice, just rejoice”.
“The sum roughly matches the money pledged by Labour at its party conference in September. At the time, HSJ said the cash injection – though welcome – was unlikely to soften the brutality of the efficiency challenge ahead. There is nothing to suggest that Mr Osborne’s promise will do more – as HSJ’sexclusive on the details of how the funding will be distributed shows.”
Jeremy Hunt told the Chief Nursing Officer for England’s Summit last week he wanted a “big push” on nursing in the community while maintaining the current number of hospital based posts and beds.
He added that the models of care envisaged by the NHS Five Year Forward View pointed to a shift “the centre of gravity from hospital based care to home and community based care”.
12.10pm The Guardian reports that Labour would look at introducing a mandatory limit on fat, salt and sugar in children’s food, the shadow health secretary has said.
Andy Burnham said more radical action needed to be considered as the “status quo simply isn’t working”. The MP for Leigh also voiced support for making referrals for physical activity available in all GP surgeries.
12.05pm A community and mental health provider has blamed increased agency spending and difficulties delivering its cost improvement plan for a £7.1m unplanned deficit halfway through the financial year.
Solent Trust is only one of six NHS trusts to have gone into unplanned deficit halfway through the 2014-15 financial year.
The trust, which had planned to be in net surplus of £1.2m in October has also highlighted the cost of replacing inherited IT systems as a contributor to its worsening financial position.
NHS England chief executive Simon Stevens had previously cautioned against group mergers.
A spokesman for NHS England had told HSJ that because CCGs had only been established 18 months ago it would “generally support stability rather than CCG mergers”.
11.40am The Daily Telegraph reports that Stephen Dorrell, the Conservative MP and former health secretary has been accused of a conflict of interest after taking a job as an adviser with accountancy giant KPMG, which is targeting a £1bn NHS contract.
Mr Dorrell announced last week he would be stepping down as an MP at the next election as he had accepted a job as a health policy consultant.
However, it is claimed that he is starting his new three-days-a-week job on Monday, meaning that he will be in both positions for six months.
KPMG is considering bidding for a £1bnm deal to manage patients’ medical records.
Dr Clive Peedell, co-leader of the National Health Action party, told the Daily Mirror: “Stephen Dorrell admits his new job is incompatible with being an MP. If that’s the case, he should resign immediately or give up the new role.”
Mr Dorrell said that there was “no incompatibility between being an MP and being a KPMG advisor”, just with taking on the role and seeking re-election.
11.30am Maureen Baker, chair of the Royal College of GPs, said the government’s funding announcement was “excellent news for GPs, the NHS and most importantly our patients”.
She added: “We are delighted that the Chancellor and the Health Secretary have been listening to our concerns and the calls of our ‘Put patients first: Back general practice’ campaign. This injection of funding can transform the care GPs and our teams deliver to our patients.
“General practice is the cornerstone of the NHS. GPs and their teams conduct 90 per cent of all NHS patient contacts for just 8.3 per cent of the overall budget. New research by Deloitte has shown that for every £1 spent on general practice services, it will save the NHS nearly £5 in the long-term - it has also shown that properly resourcing general practice could prevent 1.7m patients from going to A&E unnecessarily every year.
“We look forward to more details about the plans in Wednesday’s Autumn Statement and hope that this is the start of sustained investment in general practice and frontline patient care.
“We look forward to working with the government and NHS England to ensure that we have 8000 more GPs in England by 2020 and that general practice receives 11 per cent of the overall NHS budget by 2017.
“By strengthening general practice, we can deliver the care that our patients need and deserve and build a stronger NHS for the future.”
11.25am NHS Providers, formerly Foundation Trust Network, has “strongly welcomed” the £2bn funding pledge.
Chief executive Chris Hopson said: “We strongly welcome £2bn extra funding for the NHS in 2015-16. The Government has recognised the size of financial gap the NHS was facing next year and has responded positively to requests to fill that gap, despite the tight overall public expenditure position.
“Speaking to the Secretary of State this morning, we have reinforced the importance of this £2 billion being used to deliver existing performance commitments, rather than new ones, and for it to flow through the mainstream 2015/16 NHS funding mechanisms so that it fully reaches the NHS hospital, mental health, ambulance and community frontline where it is needed.
“We also welcome the wider intention to deliver a 1.5 per cent real terms funding increase for the next Parliament, meaning that all three main political parties are now committed to providing extra funding for the NHS in the next Parliament. This shows the enormous benefit of the NHS having laid out its long term strategic funding requirements in the NHS Five Year Forward View and through providers’ five year plans.
“We all know that this still provides a huge challenge for the NHS to meet in 2015/16 and beyond so it is important that we all work together to squeeze every penny of value out of this extra funding.”
11.22am The chief executive of Cambridge University Hospitals Foundation Trust has responded to the sentencing of Myles Bradbury.
Keith McNeil said: “Our thoughts today are with our patients and families who were victims of Bradbury’s shocking and cynical abuse. Today’s sentencing of Bradbury cannot undo the damage he caused but he is finally behind bars and is no longer a risk to vulnerable children. The lengthy sentence shows Bradbury’s abhorrent betrayal and manipulation of his position as a doctor has been fully recognised.”
11.20am Andy Burnham MP, Labour’s Shadow Health Secretary, has said the government “chose to put NHS finances on a knife edge when he wasted £3bn on a damaging reorganisation” in response to the £2bn funding announcement yesterday.
He added: “That’s why the NHS is in today’s fragile financial position.
“This is exactly the same pattern we saw under the last Tory government: winter crises, followed by emergency bailouts.
“Labour will rescue the NHS with a £2.5bn a year Time to Care fund - on top of Tory spending plans - to fund new staff, including 20,000 more nurses.
“NHS patients are already seeing waiting times and cancer care heading downhill on this Government’s watch - people will fear that much worse will be in store next year. It is clear you can’t trust the Tories with the NHS.”
Myles Bradbury admitted abusing 18 children in his care at Addenbrooke’s Hospital, Cambridge, between 2009 and 2013.
Bradbury has admitted 25 offences, including sexual assault, voyeurism and possessing more than 16,000 indecent images.
The judge told him his offences were a “gross and grotesque breach of trust”.
Sentencing him at Cambridge Crown Court, Judge Gareth Hawkesworth said: “In many years on the bench, I’ve never come across a more culpable or grave course of sexual criminality which has involved such a gross and grotesque breach and betrayal of your Hippocratic Oath and trust reposed in you by your patients.”
The judge told Bradbury, a blood cancer specialist, he had no doubt he had caused psychological harm to his victims and was at risk of doing so in future.
In September, he pleaded guilty to six counts of sexual assault and 13 counts of engaging in sexual activity with a child.
11.10am NHS England chief executive, Simon Stevens, has responded to the £2bn pledge.
He said: “Last month the NHS itself came together to chart a new direction for health in this country. Our NHS Forward View unleashed an amazingly wide consensus – amongst patient groups, local communities, frontline staff and NHS leaders. People now get the fact that a growing and aging population means we’re going to have to supercharge our work on prevention, on care integration, and on treatment innovation.”
“But we also told it as it is: services are under pressure. We know times are tight, but the economy is now growing. Sustaining a high quality health service in the years ahead will therefore require both challenging new efficiencies and genuine new investment.
“That’s the case I’ve been making on behalf of the NHS to government, and today they’ve listened and responded with the funding we need for next year to sustain frontline NHS services and kick-start transformation. Of course there will still be pressures and difficult choices, but the government has played its part and the NHS will step up and play our part too. Today represents an extremely welcome vote-of-confidence in the NHS’ own five year plan.”
11.05am The government’s £2bn funding pledge for the NHS will bring the it through “what looked like an impossible year”, Nuffield Trust Chief Executive Nigel Edwards has said:
He added: “Our analysis suggests the extra £1.7bn will mean English health service funding keeps pace with the growing and aging population next year. Further increases like this will be needed every year to 2020, alongside deep reform, for the NHS to keep its current shape and standards. I’m glad the Government has started facing up to the very difficult decisions this will mean.
“£550m of this funding will come from the Department of Health’s projected underspend. Taking money from elsewhere in the health budget may not be an option in coming years, as the vast majority already goes towards the NHS and underspends are running out. Future increases will have to be almost entirely new money.
“The £1.5bn boost to general NHS funding will allow organisations and staff some respite from fire-fighting, and make progress where reform is underway. However, it is only around the sum which will be needed to match the growing costs and demand for treatment – we still need to ensure local leaders have the time and money for long term reform.
“Spending a further £1.1bn over four years to improve general practice and out of hospital services shows the right priorities. GPs working together, often in large organisations, will be the basis for future reforms but they need more money to make this work.”
11.00am The Guardian splashes with the headline “Osborne under fire over £2bn NHS pledge”. The paper says the chancellor has come under fire because £750m of the extra £2bn given to the NHS includes £750m being reallocated from within the Department of Health.
Government sources confirmed that £750m was coming from internal health department savings – “essentially moving money from [the back office] to the NHS front line” – while the rest would come from underspends in other government departments.
Andy Burnham, the shadow health secretary, said the £2bn figure was “spin” because Osborne was “proposing to recycle funds already in the DH budget”.
The Royal College of GPs chair Maureen Baker told HSJ she supported the forward view’s conclusion that fresh means of delivering care were essential to secure the health service’s future.
She said the new models were needed because “the people we’re caring for now and the problems that people have now are quite different”.
10.45am NHS England has denied that its urgent care overhaul has been put on hold, as reported by The Guardian yesterday.
Professor Keith Willett, the NHS England Director and trauma surgeon who runs the Urgent Care Review for Sir Bruce Keogh, said: “There is absolutely no question of slowing down on the review. It is a central part of the NHS five-year forward view and the pace is about to accelerate. Sorting out the urgent care system is one of the most important priorities for the public and for the NHS. The heavy lifting starts in 2015-16, which will include the formation of urgent care networks to include all hospitals with A&E Departments across England. We expect networks to identify the 40 to 70 emergency centres which have specialist services.”
10.25am Our story on Osborne’s £2bn funding pledge for next financial year has prompted some questions from readers. Here are a selection:
David Dalton, CEO, Salford Royal - “This is welcomed news. I sincerely hope that the funds are targeted to enable transformation and do not get soaked into the balance sheets of organisations in persistent difficulty. We need new approaches to assure high standards, which can be delivered reliably and within available resources. Providing better care at lower cost will come through adopting new care models (as per Forward View) which can be delivered through revisions to organisational forms. Integrated care, joint ventures, and mechanisms to standardise and spread successful systems should all now be on the agenda and supported by this additional funding. This must be seen as an investment to deliver sustainable solutions.
“This is a welcome response that proves the government can listen (sensitive hearing 6 months before an election!). We need much better metrics about acute care to know whether we are spending the money productively, rather than just waiting to see how long the ambulance queues are. What is being done about that?”
“What are the other DH budget underspends that are providing a big slice of this money? Outside DH and arm’s length body running costs, these are presumably Health Education England, research budgets and Public Health England. If that is the case then this looks like very short sighted spending - particularly if the commitment is recurring.”
10.20am The Daily Telegraph reports this morning that dementia sufferers lack proper care because the illness is not recognised as a terminal diagnosis, according to a group of leading charities.
A report, by Marie Curie and the Alzheimer’s Society, highlights the issues faced by dementia sufferers in the late stages of their lives and barriers to the high-quality care they require.
It addresses the terminal nature of the illness, calling it “the forgotten aspect of what has been referred to as a ‘silent epidemic’”.
10.10am The Daily Mail reports that hundreds of patients are being given “potentially deadly” organs from drug addicts, cancer sufferers and the elderly.
At least a quarter of all transplants that took place last year involved ‘high-risk’ organs that could be damaged or infected, the paper claims.
The figures obtained from NHS Blood and Transplant show that last year 333 patients were given high-risk organs.
10.00am The Financial Times reports that Osborne’s £2bn pledge has underlined the pivotal role the health service will play in determining who secures the keys to Number 10.
It emerged yesterday that Mr Osborne had met Mr Stevens three times last week to hammer out the proposed extra funding.
The paper says that the chancellor hopes by developing a health funding strategy with Mr Stevens he can block Labour’s attempts to turn NHS funding into an issue in the election campaign.
However, Labour claimed Mr Osborne’s pledge was “falling apart” after it emerged that £750m was being reallocated from “non-frontline” savings from other parts of the health budget, including an underspend.
9.50am Yesterday chancellor George Osborne announced an extra £2bn would go to the NHS in 2015-16.
HSJ obtained exclusive details of where the money will come from and how it will be spent.
7.00am In the next decade healthcare is set to become more accessible, effective and democratic, irrespective of where in the world you are, believes Ali Parsa, founder and former chief executive of Circle, and founder of Babylon Healthcare.
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