The Care Quality Commission has completed its inspection of the “Keogh trusts”, plus the rest of today’s news and comment.
5.40pm The Care Quality Commission has completed its inspection of the “Keogh trusts”, HSJ has learned.
Taking place under the care regulator’s revamped regime, the inspections will play a crucial part in determining whether 11 of the trusts are removed from “special measures”. The results are expected to be published by the end of July.
5.35pm The Independent’s John Rentoul agrees that Ed Miliband should have used Prime Minister’s Questions to probe David Cameron on primary care in the NHS.
“[The Labour leader] could have said the Labour government had been solving the problem when the coalition came in and top-down-reorganised it back to the Dark Age,” he argues.
“I doubt if Miliband has the long-term solution to the problems of primary health care, but a top-down target would be popular and a good start.
“But no, he wanted to make abstract points about markets and ideology. So he got nowhere on Pfizer and Cameron, although he shouted too much, pointed out that Miliband hasn’t asked about the NHS since November.”
5.22pm The New Statesman’s George Easton questions why Ed Miliband chose to lead on the Pfizer-Astra-Zeneca deal in instead of the NHS at Prime Minister’s Questions earlier today.
He writes: “The choice of subject was questionable; after Monday’s policy announcement on GP appointments, the NHS seemed the obvious choice. Certainly, the issue resonates with more voters than the machinations of the pharmaceutical industry.”
He adds that in a week where Labour’s poll ratings have been declining, the Labour leader “missed an opportunity to put the NHS (which Labour leads on by 12 points) centre stage. If he is [to] turn the polls around, raising the salience of this issue will be vital.”
5.06pm The Daily Telegraph reports that the All Party Parliamentary Group on Skin recommending extending restrictions on the use of tanning beds in England to bring them in line with the rest of the UK.
Unmanned coin operated tanning booths have been banned in Scotland, Northern Ireland and Wales but are in use in England.
4.43pm The Daily Mail also reports that the NHS employed 50 per cent more nurse from Europe last year compared to the year before. The figures were revealed following a parliamentary question.
The paper notes that the of training places in place in England has fallen from 20,829 places in 2009/10 to 18,009 last year.
4.15pm The Daily Mail reports that the National Institute for Health and Care Excellence (NICE) is poised to ban the us of the drug abiraterone, which is used to treat men with advanced prostate cancer.
NICE chief executive Sir Andrew Dillon said it would not be cost effective at that stage of treatment.
Cancer Research UK’s chief clinician Peter Johnson said: “Nice has previously agreed that abiraterone is an effective and cost-effective drug for men with prostate cancer who have already had docetaxel [chemotherapy], and there is no reason for it to be any less effective before the chemotherapy – if anything, the reverse.”
3.52pm There are some interesting reader comments on our story earlier today about a group clinical commissioning groups in north-west London agreeing to bring their commissioning support services in-house.
You can read a few of them below:
“This was always inevitable with csu’s having their own overheads and profits to offset. It was never likely that any economies of scale that csu’s can deliver would be out of the system in 12 months of starting.”
“Well there’s a surprise - NOT. Of course it’s cheaper to bring it in-house as you don’t need to make a profit and/or charge for overheads such as infrastructure!
The real crime her was the creation of separate CSUs in the first place. It’s only a matter of time before any number of CCGs follow suit and more CSUs crumble!”
“Part of the problem of the operation of CSUs is their remoteness from the customer base and their perceived strategic focus on their own development. Moving staff to CCGs will support development of a clearer focus on the CCGs strategic goals and better working relationships. The risk is around the strategic management of providers and how that plays out across the CCGs within the footprint. All in all not a bad thing, I guess I would take the potential savings with a pinch of salt, just on the basis if it was that easy to release costs then given the precipitous nature of the situation it would have been done.”
3.37pm NHS England has published the prospectus for £240m worth of funding which NHS trusts and local authorities can apply for to finance integrated digital care projects (see prospectus attached).
The integrated digital care fund is the second tranche of around £500m of funding NHS England has earmarked for improving the health and social care services digital systems.
The capital funding follows the safer hospitals safer wards fund which was launched last July to support NHS Trusts to digitise records and develop electronic systems for prescribing medicines quicker and more accurately.
The application process for wave two of the integrated digital care fund will run until 14 July 2014.
The £240m will be split – 2014-15 (£160m) and 2015-16 (£80m). Applications will be reviewed by a multidisciplinary team to ensure the funding will deliver benefits for staff and patients and value for money.
Organisations which are eligible to apply are NHS Trusts, Foundation Trusts and local authorities. Applications will be limited to one per individual organisation and one per joint/partnership application.
3.18pm In response to NHS England warning of an “even more challenging” financial year than 2013-14, Chris Hopson, chief executive, Foundation Trust Network, said: “Given that the new financial year is well under way, this feels like we are in a ‘hand-to-mouth’ budgeting phase and many providers are now providing services without agreed contracts to ensure patient care is uninterrupted.
“This makes planning bigger changes needed to make the NHS clinically and financially sustainable even harder.
“NHS England’s honesty is welcome and will encourage realistic dialogue between commissioners and providers to agree deliverable contracts.”
Earlier today, HSJ reported that only one in four clinical commissioning groups have balanced plans.
3.05pm As waits get worse under a growing waiting list, there are opportunities for clinical commissioning groups to make sure a good crisis does not go to waste, writes waiting times expert Rob Findlay in our comment section.
2.52pm Patients queued around the block to say farewell when their much-loved GP retired after 32 years, The Times reports. (paper only)
The Hanway Medical Practice in Portsmouth arranged a two-hour session on Saturday for patients who wanted to express their gratitude to Dr Richard Hughes.
2.37pm The Times reports that family doctors are making at £3m a year by charging patients up to £100 for their medical records or a written note.
GPs charge on average £30 a time when they provide patients with medical evidence for insurance claims, legal cases or benefit appeals, according to research by Citizens Advice published today.
2.23pm Councils are using NHS cash to prop up existing services rather than improve care for the elderly, a report by consultancy MHP Health suggests.
The Times reports that the consultancy asked 152 local authorities how they had been spending their share of the Better Care Fund. They found that a quarter of the money, totalling £349m, was spent on maintaining access to existing services.
Click here to read the full report.
2.11pm The Guardian’s financial editor Nils Pratley notes that Pfizer’s chief executive has refused to reveal his savings plans for if the US drug fiirm’s take over of AstraZenenca.
He writes: “The most revealing answer from Ian Read came when he was asked if he would drop his bid for AstraZeneca if the UK government opposed a takeover. “We want to come where we are welcome, but we are going to operate within the appropriate laws of the UK,” replied Pfizer’s chairman and chief executive.
“Rough translation: the UK government’s legal hand is weak, there is virtually nothing it can do to stop us and, if necessary, I am prepared to make myself deeply unpopular by driving this deal through.”
1.47pm On The Guardian’s front page, the chief executive of AstraZeneca warned that an aggressive cost cutting plan by Pfizer in its proposed takeover of the UK drugs company could cost the lives of cancer patients.
“Any distractions on work we are doing now [on developing life-saving cancer drugs] could run the risk of delaying our drugs pipeline,” Pascal Soriot told the business select committee.
He added: “What will we tell the person whose father died from lung cancer because one of our medicines was delayed – and essentially was delayed because in the meantime our two companies were involved in saving tax and saving costs?
“It is logical to assume that a merger like this could mean substantial cost savings, and cost savings could mean job losses.”
1.26pm Moving onto today’s paper’s this lunchtime, there is a lot of coverage of the proposed takeover of British pharmaceutical firm AstaZeneca by US rival Pfizer. The Financial Times has a front page story on Pfizer chief executive Ian Read acknowledging that the takeover would result in a job cuts and a fall in research and development spending. Mr Read made the comments on during a parliamentary hearing.
1.05pm In an effort to reduce the number of bed days used in hospitals, trusts have focused on making same-day ambulatory emergency care the default option for emergency patients, write Deborah Thompson and Vincent Connolly for Resource Centre.
Experts from The Institute of Cancer Research said that abiraterone should be offered to men before they undergo chemo.
The drug could offer many men not eligible for chemotherapy additional months to live with improved quality of life, they said.
They said NICE had made its decision on the basis of costs.
12.20pm Monitor has also welcomed the Competition and Markets Authority’s “swift decision” over the proposed merger of Heatherwood and Wexham Park Foundation Trust and Frimley Park Foundation Trust.
Heatherwood and Wexham Park was put in special measures last week by the regulatory body, following concerns raised by the Care Quality Commission over inadequate care and poor leadership.
Monitor advised the CMA that aquisition of Healtherwood and Wexham Park by Frimley was “the best available solution to the problems faced by Heatherwood and Wexham Park, and the most likely way to achieve improvements in services for patients,” according to a statement by the body.
“Monitor also advised that the merger was likely to deliver a quicker and more sustainable solution to the issues faced by the trust than further regulatory intervention”, statement continues.
“In its advice to the CMA, Monitor said the underlying cause of the trust’s failures was a long-standing problem with staff and culture, and an urgent solution was required to inject new, strong and effective leadership.
“Monitor advised that, owing to the problems of recruiting individual leaders to Heatherwood and Wexham Park, the solution is to find a whole leadership team capable of addressing the trust’s problems. Frimley Park is a high performing trust with a stable leadership team and a high performing team of consultants which has been responsible for delivering high quality care over a significant period of time.”
Monitor will now review of the merger proposals to identify the risks around sustainability of the enlarged organisation so they can be managed appropriately.
Monitor has already arranged for Surrey-based Frimley Park to partner with its troubled neighbour to provide practical support as it is turned around, and appointed an Improvement Director to deliver immediate changes.
Monitor chief executive David Bennett said: “This decision gives a clear signal that the merger authorities can act swiftly to approve transactions between NHS foundation trusts. In particular it demonstrates that the competition rules don’t get in the way of well thought-out transactions.
“Subject to final approvals, this will be the first merger between foundation trusts. We will continue to help trusts find and utilise innovative solutions, including mergers or take-overs where clearly in the interests of patients, to challenges they face in relation to care quality, leadership and sustainability.”
11.57pm The Foundation Trust Network has welcomed the decision by the Competiton and MarketsAuthority to allow the takeover of Heatherwood and Wexham Park NHS Foundation Trust by the neighbouring Frimley Park Hospital Foundation Trust.
FTN chief exective Chris Hopson said he “strong welcomes” the decision, “particularly the speed at which it has been reached”.
“We led calls for a new approach to NHS merger control that placed greater emphasis on patient and NHS need, for the statutory sector to work more effectively together and for a faster process,” he added.
“It’s good that these have been delivered in this decision. We need this to continue in future cases. It will, though, be a frustration to the Foundation Trusts in Bournemouth and Poole that they haven’t been able to benefit from this changed approach.”
11.54am The Competition and Markets Authority (CMA) has cleared the proposed takeover of Heatherwood and Wexham Hospitals Foundation Trust by Frimley Park Hospital Foundation Trust.
A statement by CMA said: “The ability of patients and commissioning bodies to choose between hospitals gives healthcare providers strong incentives to improve quality and efficiency of their services for the benefit of patients. The CMA analysed the merger on the basis of its impact on competition to attract patients for both inpatient and outpatient services, and to provide both elective (where the patient does not require immediate medical care) and emergency services for commissioning bodies.
“It carefully examined evidence provided by the hospitals and a number of third parties, including Monitor, Clinical Commissioning Groups (CCGs), NHS England Specialised Commissioning Teams, other NHS hospitals, the Care Quality Commission, patients and patient groups, and local representatives. The majority of third parties supported the merger. Monitor told the CMA that in its view the merger represents the best available solution to improve patient services at Heatherwood and Wexham.
“The CMA’s investigation looked at whether the merger is in the overall interest of patients and found that the merger will not lead to a material reduction in competition between hospitals in the area or loss of choice for patients, CCGs, or NHS England. It noted that there are a number of other strongly-performing NHS hospitals located nearby which offer similar services, including Royal Berkshire Hospital NHS Foundation Trust, Ashford and St. Peter’s Hospitals NHS Foundation Trust, Royal Surrey County Hospital, and the Royal Buckinghamshire Hospital.
“In summary, the CMA does not believe that the merger will lead to a material reduction in the quality of services for patients (including clinical factors such as outcomes, infection rates and mortality rates and non-clinical factors such as waiting times and patient experience) and will not materially reduce the hospitals’ incentives to innovate and improve their services.”
Nelson Jung, CMA’s director of mergers, said: ‘We are confident that this merger will not substantially weaken competition so as to reduce the quality or range of healthcare services provided to patients in the area. Our constructive discussions with the hospitals prior to their formal notification of the proposal, along with the close cooperation between the CMA and Monitor, has enabled us to complete this investigation swiftly.”
11.48am In his weekly HSJ column, Michael White says politicians have made a poor fist of protecting whistleblowers in the latest batch of sad, botched public spirited protests.
11.00am A group of clinical commissioning groups have agreed to bring their commissioning support services in-house, in a move they claim could save them £5m by 2015-16.
The decision, made last week by eight north-west London CCGs, comes as their counterparts across the country begin negotiations on new service level agreements with commissioning support units.
10.48am More than £650m a year of public health funding will be withheld from local authorities until after next year’s general election, it has emerged.
The cash has been held back as NHS England struggles to hit a target set by the prime minister to increase health visitor numbers.
10.36am HSJ’s Nick Renaud-Komya tweets from the NICE annual conference:
First session of the day @ProfSteveField says he is seeing increasing no. of whistleblowers in general practice #NICEconf2014— Nick Renaud-Komiya (@NickRenKom) May 14, 2014
Live poll from #Niceconf2014 - 35% of audience don’t think the NHS is safe 1 year on from Francis. 38% don’t know pic.twitter.com/6ZuKkLKvUO— Nick Renaud-Komiya (@NickRenKom) May 14, 2014
Prof David Behan @CareQualityComm CEO: I’m not confident that people who whistleblow can be treated well by CQC This is a work in progress.— Nick Renaud-Komiya (@NickRenKom) May 14, 2014
10.22am HSJ reporter Nick Renaud-Komiya will be tweeting live from the NICE annual conference throughout the day.
Follow @NickRenKom on Twitter for regular updates.
Papers due to be seen by the body’s board tomorrow also pointed to “significant weaknesses” in its specialised commissioning budget. These were described as a risk to the organisation’s finances this year.
10.05am Entries have opened for the most sought-after accolades in healthcare.
Now in their 33rd year, the HSJ Awards’ 22 categories recognise and reward best practice in healthcare organisations throughout the country.
We invite you to nominate examples of innovation and excellence in your organisation that have made a real difference to your patients and staff.
Your entries will be judged by our experts and your peers and your achievements will be celebrated at an awards ceremony in London on 19 November.
Click here to find out about the 2013 HSJ Awards winners and finalists
Enter the 2014 HSJ Awards here
9.47am Andy Burnham believes repealing the Health Act 2012 would insulate the NHS from the effect of EU procurement and competition law, he has told HSJ.
The shadow health secretary spoke to HSJ yesterday, following a major speech by party leader Ed Miliband on the NHS on Monday in which he said a Labour government would make savings in the service by removing the effect of competition rules.
Mr Burnham said: “We’re clear that the [Health and Social Care] Act brings the NHS fully into the glare of EU procurement and competition law by saying that services have to be tendered.”
He said commissioners were currently “being forced to tender services… That’s the reality.”
7.00am Good morning and welcome to HSJ Live. We begin the day with the news that a £500m technology fund set up by NHS England to help hospitals move away from paper based systems appears to have been slashed by £60m, official documents suggest.
The reduction was revealed in a bulletin circulated to clinical commissioning groups by NHS England that said the body had allocated £200m of the £260m originally earmarked for its first funding round.
It still plans to distribute £240m of second round funding, details of which are to be announced within weeks
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