HSJ Live: 11.12.13 The 100 most powerful people in health

The regulator said Lancashire had performed poorly against the 18 weeks to treatment target since April 2013, prompting it to investigate whether the trust had breached its licence.

The trust, which runs Chorley and South Ribble Hospital and the Royal Preston Hospital, has also exceeded its clostridium difficile infection trajectory for the year.

Mark Brearley had led the provider since May 2011. He was at the helm when the trust was included in NHS England medical director Sir Bruce Keogh’s review of trusts with high mortality rates earlier this year.

When the Keogh review was published this summer, it concluded that staffing on some wards at the trust were “insufficient to meet the basic needs of patients”. It also found that the nursing workforce needed “more leadership, direction and support to achieve acceptable standards of care”.

4.41pm Our sister title Nursing Times reports that a dip in births following an 11-year boom must be seized upon by ministers if England’s long-running midwife shortage is to come to an end chief executive of the Royal College of Midwives Professor Cathy Warwick has said.

4.31pm Some interesting reader comments have been added to our story about pooled budgets between councils and commissioners:

“Pooled budgets, great! Shared risk on community services, great! One-way transfer of funds to local government, no way, anyone who tries this needs to have very assertive push-back from the NHS. Many (Tory) councillors think that is exactly what the funding is for, don’t let them have it!”

“Local councils are cash strapped, and they are looking for an easy way out, I would echo the sentiments above, and particularly in the context of Tory Local Authorities who promote their ability to reduce their council tax. I have managed pooled budgets, and it is possible for them to really make a difference, but you need safeguards. One way transfers will not work, and will put the local NHS under more presssure in subsidising council tax reductions.”

“Caution? Absolutely! A lot of joined up working can be done through intelligent use of well-planned joint investment without any of the paraphernalia of pooled budgets or one-way traffic. I’ve worked long enough in joint planning to know that:
- many councillors look at the NHS as a nice little pot of gold
- many NHS folk have little understanding of the pressures and statutory responsibilities Local Government face. Clear delineation of funding sometimes has its benefits!”

3.43pm Here’s a digest of various leaders’ contributions to the G8 summit on dementia today:

David Cameron said: “It doesn’t matter whether you’re in London or Los Angeles, in rural India or urban Japan – dementia steals lives, it wrecks families, it breaks hearts and that is why all of us here are so utterly determined to beat it.
 
“In generations past, the world came together to take on the great killers.  We stood against malaria, cancer, HIV and AIDS and we are just as resolute today.  I want December 11th 2013 to go down as the day that the global fight-back began.”

In his closing address to the summit, Health Secretary Jeremy Hunt will say: “Nelson Mandela once said that ‘it always seems impossible until it’s done’.  20 years ago, fear, ignorance and stigma surrounded HIV and AIDS – but we know from this that major diseases can be made manageable, even preventable, with sufficient political will.

“Dementia costs an astounding US$604 billion every year, about one per cent of the world’s GDP.  But this isn’t just an economic problem – the impact this disease has, not just on those diagnosed with dementia, but also on their families, their carers and their friends, cannot be measured.

“Already, great strides are being made in understanding this disease and how we might prevent it.  Today we have taken a major step forward in agreeing action to tackle this debilitating disease on a global scale – to push further, to be able to provide treatments and cures so that future generations can face a diagnosis of dementia with confidence, not fear.  Let’s show future generations we were up to the challenge.”

Dr Margaret Chan World Health Organisation director-general said: “WHO warmly welcomes the aims and outcomes of this summit, with its ground-breaking proposals to stimulate research and development to catch up with a runaway human tragedy.

“WHO’s priority will be to help countries, especially in the developing world, cope with their rapidly ageing populations and escalating numbers of people with dementia.”

Yves Leterme deputy Secretary-General of the OECD said: “We need to modernise the innovation model in health in order to accelerate innovation in dementia prevention and care. The OECD supports the UK government efforts to encourage multi-stakeholders international collaboration to address dementia and welcomes the UK decision to appoint a Global Dementia Innovation Envoy. We hope that through our combined efforts we will be able to better deal with the human, social and economic cost of dementia.”

3.33pm Here is Jeremy’s Hunt full speech delivered at the introduction to the G8 summit on dementia.

“Ladies and gentlemen,

It is fantastic to see you all here today for the world’s first G8 Dementia Summit.

And it is right we should be here. As life expectancy goes up, our generation has a unique challenge: will those extra years at the end of our lives be ones we can look forward to with anticipation - or will they be ones we end up dreading?

One in three of us will get dementia. And if we don’t do better, for one in three those later years could be years of agony, heartbreak and despair - not just for those of us with the condition, but for our families, friends and loved ones too.

9 years ago Britain hosted the G8 in Gleneagles in Scotland. And we faced up to a different health challenge - HIV/AIDS. We did a brave and wonderful thing, declaring that anti-retroviral drugs should become available to all who needed them. Thanks to that, we have turned the global tide in the battle against AIDS.

Now we need to do it again.

We will bankrupt our healthcare systems if we don’t. Here in the UK the cost of dementia is £23 billion and globally it is approaching $600 billion. One in four people in UK hospitals have dementia, but the costs extend well beyond hospital care into social care, community care and the opportunity costs for carers.

But the real reason to do something about dementia is not financial.

The real reason is human. Everyone deserves to live their final years with dignity, respect and the support of loved-ones. That was the dream of universal healthcare coverage when we founded the NHS in the UK 65 years ago. Now with an ageing population we need to reinvent the model.

So let us focus on three areas of action for this summit.

Firstly to redouble our efforts to find a drug that can halt or reverse the brain decay caused by dementia. We thought we could never combat HIV. But just 9 years after the Gleneagles summit and with the involvement of some of Britain’s best universities, we are talking about a potential vaccine. We need that spirit of scientific endeavour for dementia and Alzheimer’s as well - and there is some fantastic work going on in our universities and research laboratories.

Secondly we need to improve diagnosis rates. In this country, despite our brilliant NHS, less than half of dementia patients get a diagnosis. Too many people - even some doctors - think there is no point. But with a diagnosis we can give out medicines that help some people; we can put in place support for families; we can encourage lifestyle change - all of which can mean people live at home happily and healthily for many years longer.

Thirdly let’s fight the stigma around dementia in society. When I was born in the 1960s, people didn’t like talking about cancer. The first step to improving treatment was to make it normal - we need to do that for dementia. So following the inspiring programme in Japan, we are trying to recruit one million dementia friends in England - people who know the basics and can be ambassadors for fighting stigma.

Right here we have the A team. Health ministers, science ministers, pharmaceutical companies, researchers, voluntary organisations, the OECD and the WHO. And we have some even more special guests: people who themselves have dementia and have had the courage to come today. Let us recognise them.

Let us today match their courage by daring to aim big. By showing future generations we were up to this challenge, ready to do what it takes to harness science, research and humanity to turn one of humanity’s greatest threats into one of its greatest achievements.

Thank you.”

3.29pm Jeremy Hunt also said that comparisons have been made between cancer funding and dementia funding. He said that cancer only received significant funding once people “stopped sweeping the issue under the carpet”.

3.27pm A press conference is underway at the G8 summit on dementia. Jeremy Hunt has responded to a question from the audience about what is currently being done to help dementia sufferers. He said that “the amount of money going into research is too little” and the government have doubled it over this parliament and will double it again through the next parliament.

3.12pm A new ‘Health Informatics’ course from the National Skills Academy will give young health apprentices in the north west experience within a hospital’s admin and finance department.

The Academy will be working with Skills for Health Academy North West, Information Skills Development, City of Liverpool College and Local NHS Trusts, to support the delivery of this new Health Informatics Cadet Apprenticeship.

Candace Miller Director of the National Skills Academy for Health said: “High quality information when and where it is required within the NHS has never been more important for supporting clinicians and patients. We already have a number of successful apprenticeship programmes underway - but often with a focus on clinical, patient-based roles.

“Increasingly, young people who decide they don’t want to take a more ‘traditional’ route into employment – such as further and higher education – are looking to apprenticeships as a practical way of learning new skills, that will dramatically improve their chance of permanent employment at the end of their initial course. There is also a very a ‘real appeal’ of being able to ‘earn while they learn’, rather than amassing debts whilst studying – an option that simply might not be viable for many of them.”

The first cohort of local cadets is just about to complete their six week college based induction to the qualification which crosses two curriculum areas - Healthcare and ICT. The cadets will go on to be placed in the information management departments of NHS organisations across Cheshire and Merseyside for four days of the week with one day in college.

2.24pm The thinktank IPPR has published a report on uptake of digital innovation in health and social care, launched yesterday with Google and the shadow chief secretary to the treasury, Chris Leslie.

IPPR says: “Given the rapid pace of technological change and take-up by the public, it is a question of when not if public services become ‘tech-powered’. This new paper asks how we can ensure that innovations are successfully introduced and deployed.”

2.02pm Editor-in-chief Alastair McLellan gives his analysis of the HSJ100 list.

The HSJ clinical commissioning group leader barometer survey, carried out with Marie Curie Cancer Care, reveals more than eight in 10 respondents believe pooled budgets will mean their funding helps to pay for councils’ services outside of health and care.

The pooled budget initiative was announced by the government in July and will see £3.8bn of NHS funding shared between CCGs and local authorities in 2015-16. It is unclear exactly who will hold the money and how it will be controlled.

In the HSJ clinical commissioning group barometer survey, run with Marie Curie Cancer Care, 28 per cent said interactions with their commissioning support unit were unhelpful or very unhelpful.

This is an increase from 6 per cent in answer to the same question in January and 7 per cent in April.

Consultant surgeon David Paul Berry, based at University Hospital Wales, has been banned by the General Medical Council from doing any further liver surgery.

A professional review of 31 of his patients while with the Cardiff and Vale University Health Board, found that 10 went on to die, and “eight of those 10 deaths were avoidable.”

The report summarises three investigations by the ombudsman into care standards following the deaths of three babies and a mother at University Hospitals of Morecambe Bay Foundation Trust and notes that statutory supervision of midwives consistently failed to identify poor practice.

The report concludes that persistent failure to answer affected families’ questions and a failure to learn from poor midwifery care were common themes across all of the cases.

1.05pm And here’s the interactive list of all the 100.

1.04pm Today we announce the HSJ100, a rundown of the 100 most powerful people in health.

Here’s some twitter reaction to the list so far:

“The #HSJ100 is out! The NHS equivalent of #XFactor. A bit of annual seasonal fun. Enjoy!”

“With all respect to my boss, still sad to see more Davids than women at the top of the list… ”

“Great to see 15 GPs on the #hsj100”

Mr Burnham indicated that reintroducing the 48-hour pledge, which was scrapped within months of the coalition taking office, could be put before the Commons for a vote next week.

He was speaking as health workers revealed the pressures on A&E services at a meeting organised by Labour in Parliament.

Mr Burnham said: “It is now clear that 2013 has been the worst year in a decade in A&E. The pressure that we have seen all year hasn’t abated. In recent weeks it has been running at winter levels before winter has begun in earnest.

12.38pm Here’s some more detail on the CQC’s dementia inspection announcement:

The Care Quality Commission is to undertake unannounced inspections of 150 care homes and hospitals to review the care of people with dementia in England.

12.36pm The chair of Tower Hamlets Clinical Commissioning Group, the first to introduce a “mutual assurance process” with NHS England, has said the process has helped to join up commissioning.