HSJ Live 16.05.2014: Foundation trusts will be told to look again at overly optimistic plans

5.20pm Valuing research and questioning what you do and why you do it are what gives leaders a real edge in today’s health service, says Janet Messer of the Health Research Authority.

4.58pm In our Comment section the Foundation Trust Network’s director of communications, Nick Samuels, calls for meaningful public consultations.

He replaces David Richardson, who has been in the position for nine years. Mr Richardson is stepping down on 30 June after completing three terms in office, the maximum period allowed under the trust’s constitution.

Lord Patel has been an independent peer since 2006, serving as minister in the governments whips office in the Lords. He also chaired the national prison drug treatment strategy review group, which led publication of the Patel Report and reforms in the delivery of prison drug treatment. 

4.05pm Local Berkshire reports that Heatherwood and Wexham Park Foundation Trust has introduced robots to load and dispense medicines to patients and wards after the Care Quality Commission raised concerns over the number of prescribing errors at the trust.

3.37pm In The Telegraph, the chief executive of the General Medical Council has called for a change in the law which allowed doctors to keep their positions, despite their role in a botched operation that led to the death of a pregnant woman.

Niall Dickson said he was “very disappointed” by the decision of the tribunal. Mr Al-Abed made the fatal error after attempting the complicated operation on Maria De Jesus, 32, at Queen’s Hospital, Romford, Essex.

“We believe that, although this was a single clinical incident, the seriousness of it - and the subsequent tragic death of Mrs de Jesus - warranted the suspension of both doctors’ licence to practise,” Mr Dickson added.

“At present, we have no direct right of appeal against the decisions made by the autonomous MPTS (Medical Practitioners Tribunal Service panels).

“Instead, we have to refer such cases to the Professional Standards Authority, which extends the process yet further, not only for patients and their families, but for the doctors concerned too.

“This convoluted, indirect procedure is one of the reasons why we are urging the government to give the required parliamentary time to the Law Commission Bill published last month.

3.25pm In an HSJ special report on whistleblowing Claire Read looks at how NHS leaders can create a working environment where managers and staff can communicate freely.

3.13pm In our Commissioning section, Mike Hobday and Julie Flynn argue that we are on the brink of a data revolution in the NHS, and many of the most promising initiatives are taking place within cancer care in England.

The Royal College of Surgeons review, the full version of which was only released this week, provides further details of its investigation into the deaths of five patients at the trust following unusual complications.

It concludes that the deaths were “probably” due to a key-hole techniques used by surgeons which have now been stopped.

2.21pm Monitor is to review a proposed merger of the pathology services of Southport and Ormskirk Hospital Trust and St Helens and Knowsley Teaching Hospitals Trust, in the north west of England.

The health sector regulator will undertake an initial review of the pathology services in the local area and determine whether the proposed partnership might adversely affect patients and taxpayers.

If Monitor finds that there is likely to be a negative impact on patients, the regulator will look into whether the potential patient and taxpayer benefits of the merger outweigh the loss of choice and competition.

The regulator will publish its findings at each stage of the inquiry, but the final decision will be a matter for the trusts involved and the NHS Trust Development Authority.

2.16pm There are some interesting reader comments beneath our story on Barbara Hakin calling for providers to clear an elective backlog over the summer. If you’d like to join the discussion register here.

“Shame the system can’t afford to clear the backlogs. Need to think about better funding mechanisms, then commissioners won’t pull all the stops out to keep providers on the very edge of 18 week delivery and then the providers could get themselves some headroom.”

“The latest figures (Feb’13 to Jan’14) show that 611,219 patients a year had clock-stops beyond the ‘guaranteed’ maximum (18 weeks). These breaches often occur because individuals that the system will predictably let down do not benefit from ‘choice’. Traditional booking and scheduling systems are not geared to delivering this. A central ‘Clearing House’ could offer patients earlier access to treatment, thereby helping to further reduce waiting times and ‘allow patients more opportunity to choose whichever provider they want, be it a Trust, a charity, or an independent provider, all as part of an NHS service and at PbR prices.”

“Its almost certain that the same person who is encouraging us to clear our “backlogs” will be the same person who chastises the service for the inevitable deterioration in the (retrospectively reported) position which will occur initially, before waits start to reduce again…..”

“Really sad that waiting times have slipped, this has been a gradual effect since 2010 (the Lansley effect).
We need a sustainable effort and focus on treating those who need elective care. And, reference the person commenting earlier - it should not be one rather than the other. We need excellent mental health care and lower waiting times for elective care. Why does everyone turn into accountants on this stuff? If we solve the problem, we’ll have a more efficient and cost effective system.”

The foundation trust regulator is concerned that plans show the sector overall is projecting improvement in its finances in 2015-16, despite widespread acknowledgement that this year will place unprecedented financial strain on the NHS.

In that year clinical commissioning groups will have to transfer around £2bn from existing budgets into the Better Care Fund. This will be used for joint commissioning of out-of-hospital and social care, at a time when hospital trusts are running out of traditional ways to make cost savings.

Ishak Nadeem, currently a GP board member at the CCG and the organisation’s lead for urgent care and communications, will take over the position in October.

Dr Nadeem has been a GP partner at a medical centre in the area for 14 years, and he has experience of working in both acute care and general practice in India, Saudi Arabia and the UK.

Current chair Elizabeth Johnston tweeted, indicating she will be stepping down to spend more time at her GP practice.

12.25pm The Health Foundation has over £3m available for up to seven project teams to take successful health care improvement interventions and deliver them at a larger scale.

Each successful team in the new Scaling Up Improvement programme will receive up to £500,000 to support the implementation and evaluation of their work. Teams can be from any health or health and social care provider organisation in the UK where NHS services are delivered free at the point of delivery. Projects could include but are not limited to mental health, learning disabilities, care homes, home care, maternity and children’s services.

Dr Jane Jones, assistant director at the Health Foundation, said: “This is a really good opportunity for those working within health care to apply for substantial funding.

“We are looking for projects that aim to improve health care delivery or the way people manage their own health care. The ideas for these projects should come from interventions that have proven to be successful on a small scale and can be delivered on a larger scale.”

The deadline for the first stage of the application process is 12 noon, Monday 16 June 2014.

The staffing shortfall is revealed in the trust’s board papers which say that one in ten nursing posts are unfilled. Vacancy rates were of particular concern on its neuroscience wards.

Shortages were resulting in significant numbers of wards having fewer nurses than recommended for the “level and acuity” of workloads, the paper add.

11.50am The Daily Telegraph reports that a tribunal has permitted consultant surgeon and a junior doctor to keep their jobs, despite the latter being left unsupervised in an operation in which he accidently removed the ovary of pregnant woman instead of her appendix, resulting in her death.

11.49am Hospital admissions and deaths from hepatitis C virus infection are rising, yet health and wellbeing boards are failing to make hepatitis C a priority, a new report from HCV Action has found.

The report found that:

• only 3 of the top 10 areas of high prevalence have a detailed needs assessment of hepatitis C
• 52 per cent of health and wellbeing boards fail to mention hepatitis C at all within their joint strategic needs assessments or in their joint health and wellbeing strategies
• only 5 per cent of JSNAs have a specific section dedicated to hepatitis C

Dr Stephen Ryder, consultant hepatologist, Nottingham University Hospitals Trust and chair of HCV Action, states: “The report highlights the alarming disconnect between the prevalence of hepatitis C and how local health and wellbeing boards prioritise the diagnosis and treatment of the virus.”  

The Immigration Rules were amended in 2011 to impose sanctions on non-UK residents with unpaid NHS debts of £1,000 or more.

The sanctions include refusing individuals permission to enter or remain in the country.

These sanctions have been catching would-be immigrants who have not yet won the legal right to reside.

11.06am Monitor has opened an investigation into West Suffolk Foundation Trust, due to concerns about its financial performance.

The regulator is to examine why the trust failed to deliver its planned savings and overspent by around £4m last year. The trust has stated this is because of a number of factors including an increase in the number of emergency admissions and delays in discharging patients after treatment at the hospital.

Monitor’s regional director for the Midlands and East of England, Adam Cayley, said: “We need to understand why West Suffolk NHS Foundation Trust’s financial position has deteriorated and be assured that our concerns about its financial performance are suitably addressed and do not impact on the trust delivering the care its patients deserve.”

There is not yet a completion date for the investigation.

11.00am What are the top challenges facing health and wellbeing boards?

HSJ and sister title Local Government Chronicle are conducting research to reveal the top challenges facing health and wellbeing boards, and the extent to which they can and will become strategic leaders.

Clinical commissioning groups, social care directors and other stakeholders are invited to take part in the survey to share their views on how to take health and wellbeing boards to the next level and the barriers to working effectively together.

Readers can take part before 23 May by completing our survey.

The appeal is made in a pre-qualification questionnaire issued this month by Birmingham South and Central Clinical Commissioning Group, soliciting bids to run a community and inpatient mental health services, serving patients from birth to the age of 25.

The service will cover the whole city, with the Birmingham South and Central CCG tendering on behalf of itself, Birmingham Cross City CCG, part of Birmingham and Sandwell CCG, and Birmingham City Council.

10.15am With just under a year to go until the general election, the King’s Fund has launched a new election tracker on its website.

This will track key election-related developments in health and social care between now and polling day.

The King’s Fund aim to provide a wide range of commentary, analysis and other resources in the run up to the general election.

10.10am Unite has set its ballot deadline for members to vote over whether they should strike over pay.

The ballot will close on 30 May.

Unite head of health Rachael Maskell said: “At a very positive meeting of the national health sector committee, it was decided that the strength of feeling by our members demanded a consultative ballot at what is a very insulting ‘divide and rule’ pay offer.

“We will be urging our members for a decisive mandate to move to the next stage of a full industrial ballot with the prospect of industrial action in July.”

10.02am The Financial Times reports that a panel of independent experts will examine whether a British Medical Journal article that over-stated the likely side-effects of statins should be formally retracted.

9.55am Older migraine sufferers are more likely to have “silent strokes” that could be a sign of more serious problems, The Times reports.

Research by the University of Miami compared 104 people with migraine to 442 without. Using MRI scans they found more signs of damage in people with migraine even after adjusting for other causes of stroke.

9.52am The Times reports that more than three quarters of hospitals are struggling to recruit enough nurses, according to research by NHS Employers.

Half of hospitals are recruiting nurses abroad, mainly from Portugal, Spain and Ireland, because they cannot find enough qualified staff in Britain.

One in ten nursing posts is empty and a third of hospitals said they had up to 100 hard-to-fill vacancies.

Dame Barbara Hakin told NHS England’s May board meeting a “programme of work” was being rolled out to ensure the health service was back on top of its elective workload before urgent care pressures began to rise in winter.

Missing the 18-week elective care target had been “disappointing”, she said and NHS England was working with the NHS Trust Development Authority, Monitor, trusts and councils to redress catch up.

9:30am Good morning and welcome to HSJ Live. In the third article in the Lessons from India series, Ajit Abraham explores the many possibilities created by compassionate clinicians.