HSJ Live 16.09.2014: First round of better care fund plans approved

5.50pm The Guardian reports that the treatment provided by hospitals and GPs is so “dangerously” variable that poor care kills up to 10,000 patients a year, chair of the CQC, David Prior has claimed.

5.05pm The King’s Fund has published a set of priorities for the next government, including a drive to improve productivity, the creation of a health and social care transformation fund and delivering integrated care at pace.

The organisation said earlier this month that it would begin consultation with its very senior managers and clinicians about its proposed changes on 8 September, then with all affected less senior staff today.

However, an email sent to all NHS England staff this afternoon said it had decided to delay the start of consultation with all staff affected by change until 1 October.

4.35pm The Times reportsthat the Professional Standards Authority has been criticised by scientific campaigners by endorsing a register of qualified homeopaths.

The PSA said it had no opinion on whether homeopathic treatment was effective but wanted to reassure potential customers that practitioners met the training and standards set out by homeopaths themselves.

Simon Singh, chairman of the Good Thinking Society said the decision “gives undeserved credibility to one of the highest forms of quackery known to mankind”.

4.30pm A series of CCG tools has been developed by NHS England in response to feedback that users want to be able to interact with the data to identify local priorities for improvement and demonstrate progress.

4.20pm The Guardian reports that justice secretary Chris Grayling has ordered officials from his ministry to start work on developing a network of specialist mental health centres within prisons in England and Wales.

Mr Grayling says he wants to get to “really get to grips with the challenge of mental health in prisons”, shortly after next year’s election.

Speaking yesterday he said: “I want every prisoner who needs it to have access to the best possible treatment.”

The Prison Reform Trust, a charity, has said that 15 per cent of men and 25 per cent of women in prison report symptoms indicative of psychosis, compared with a rate of 4 per cent among the general public.

2.50pm The Foundation Trust Network has responded to the Health Foundation’s report, which argues that money will not be enough to improve quality in the NHS.

Saffron Cordery, director of policy and strategy, said: “It is well highlighted that the NHS is currently in one of the longest periods of financial austerity in its history. There is an expectation that the NHS can deliver high quality care today and focus on transforming care for tomorrow, all while the financial belt is tightening. This assumption can no longer continue. The Health Foundation’s report, including substantial input from the FTN, is a timely call for action to those in the political arena, as well as NHS providers so that together we secure a viable NHS for the future.

“As part of today’s report, the FTN and The Health Foundation held a workshop with leaders from NHS trusts on how they are likely to react to financial pressures and maintain quality. In addition to investment, one of the key themes to emerge is the need to change how care is delivered and to have the time and space to focus on this transformative care. It’s something that providers can only do successfully in partnership with others, including commissioners, so that we create a service that is based truly around the needs of its users. The Health Foundation underlines this need for mutual support and debate so that we deliver consistent and long term quality of care across the NHS.”

The group of CCGs cited problems with arrangements for transport for patients, children’s services and supported living providers as reasons for tendering the service, which is currently contracted to Greater East Midlands Commissioning Support Unit. The contract ends at the end of the month although it will roll over until any alternative arrangements are made.

It covers services for Mansfield and Ashfield, Newark and Sherwood, Nottingham North and East, Nottingham West and Rushcliffe CCGs.

The FT runs a district hospital in the constituency of care minister Norman Lamb, one of two ministers spearheading the initiative.

A trust spokeswoman confirmed to HSJ it had submitted an application. She said: “We have seized the opportunity to be involved in the thinking behind how mutualisation might be applied to an organisation such as the [trust] to benefit patients.”

2.00pm The Department of Health has just tweeted that the sale of e-cigarettes to under 18-year-olds will be banned.

“We are banning smoking in cars and the sale of e-cigs to under 18s says @janeellisonmp”

1.55pm A new group of small and medium sized hospitals has come together to form the New Cavendish Group.

All members of the group are developing new approaches to their future business and operating models and will bring together chief executives of hospital trusts who are working on new solutions to major challenges such as growing demand for health services and funding.

Founder members include Paul Mears of Yeovil District Hospital, Susan Acott of Dartford and Gravesham Trust and Bridget Fletcher of the Airedale Foundation Trust. The group will meet quarterly at the Nuffield Trust’s offices in New Cavendish Street, London.

Paul Mears, CEO of Yeovil District Hospital said: “We have got used to the idea that different elements of the NHS – hospitals, GP surgeries, community services – are separate units, often working in isolation. However, the changing needs of an ageing population mean we need to think differently and more collaboratively in the future.

“A more joined-up and sustainable health and social care system can only be achieved if hospital leaders are prepared to innovate, taking the initiative in the development of new models of care, rather than waiting for these solutions to emerge from commissioners and policymakers in isolation.

“The New Cavendish Group will provide the chance to share and test out these ideas in a safe and stimulating environment.”

The New Cavendish Group will be run by and for hospital leaders, with the Nuffield Trust providing administrative support and guidance.

Nuffield trust Chief Executive Nigel Edwards said: “Changes in medicine have led to a significant centralisation of services, but it’s becoming clear that there is potential for smaller hospitals to reinvent themselves to adapt to the particular circumstances of their own populations. Much of the really exciting innovation is already happening at a very local level – from bringing family doctors into hospitals, to using telemedicine to support prisons and nursing homes.

“By bringing together leaders engaged in this kind of work, we hope to become a reference point for people inside and outside the NHS to understand how the traditional hospital can adapt to the future. At a time when we hear a great deal about hospital failure and deficits, this group will help us focus on solutions to some of the NHS’s most intractable problems.”

HSJ understands the review has similarities with work commissioned in February by Monitor, NHS England and the NHS Trust Development Authority in 11 “financially challenged” health economies.

As with that programme, private sector consultancies are understood to be bidding for the work in West Hertfordshire.

The regulator announced it would send a team of management consultants to Tameside Hospital Foundation Trust to consider whether and how such a shift could take place.

It could involve the hospital potentially offering public health, social care and wellbeing services, and represents the first time the NHS has “tried to create a full integrated care organisation at a foundation trust”, according to Monitor.

Roger Taylor, co-founder of the health data company Dr Foster Intelligence, told HSJ that information published on individual consultants’ outcomes from audits does not reflect the “true variation” in surgeons’ performance.

He said the clinical societies responsible for managing the audits had a vested interest in not exposing significant performance differences.

1.10pm There are just two weeks left to enter HSJ’s Emerging Leaders competition.

The annual Emerging Leaders competition fosters emerging talent in health and social care, and provides an unrivalled opportunity to build your profile as one of tomorrow’s leaders.

Entrants are offered the chance to win a £5,000 bursary; to receive two years’ of professional mentoring and to be published in HSJ.

1.00pm In our Comment section, waiting times expert Rob Findlay argues that it’s time to stop incentives for perverse waiting list management.

Elsewhere on referral to treatment data, we have interactive maps of local NHS waits around England in July, showing the pressures and one year waits, with links to all the detail by organisation and specialty.

12.15pm The first five better care fund plans have been signed off by NHS England.

These cover Nottinghamshire, Sunderland, Greenwich, Reading and Wiltshire. These have been approved a month ahead of the national deadline.

Better care fund programme director, Andrew Ridley said: “To have their plans approved before the national deadline demonstrates how dedicated these areas are to transforming services for local people. Their plans show great ambition and will inspire the rest of the country as the remaining plans are finalised. We will now support these five areas to make their ideas a reality.”

The remaining plans will be submitted on Friday 19 September to be assured by the end of October.

The organisations have agreed to attend a meeting of all DH arm’s length bodies called by Healthcare UK, the organisation tasked with helping UK healthcare providers do more business abroad.

Healthcare UK - part of UK Trade and Investment - and the DH said the talks were intended to establish what “appetite” existed among the arm’s length bodies for raising revenue overseas.

11.55am Nearly 66,000 frontline workers have been attacked in the last three years, including over 23,000 incidents against doctors, nurses and ambulance workers, according to figures from the Greater London Authority Conservatives.

65,970 workers in the UK have been attacked whilst on duty in the last three years, working out at over 400 incidents every week.

12,386 physical assaults have been reported on doctors and nurses working in acute services. These incidents did not involve medical factors such as mental ill health or learning disabilities.

11,336 ambulance first responders and paramedics have been assaulted – the most affected being London, North West and South Western Ambulance Services.

The report urges the transport sector and emergency services to begin trials of affordable wearable technology, initially in London, to help protect frontline workers, especially if they are mobile or work alone.

GLA Conservative crime spokesman Roger Evans said: “Affordable wearable technology such as wearable panic buttons and body worn cameras will help bolster the security and protection of these essential workers. They would act as visible deterrents for criminals, monitor the safety of staff and call for help in an emergency. Furthermore, video evidence from cameras would make it easier to report crimes, avoid disputes and shorten trials.”

11.40am The Times reports that a consultant who used to work at Addenbrooke’s Hospital admitted in court yesterday to sexually assaulting cancer sufferers as young as eight and to making indecent images of children.

Myles Bradbury, a paediatric haematologist, worked at the Cambridge hospital from 2009 to 2013 and also at Birmingham Children’s Hospital.

Keith McNeil, chief executive of Cambridge University Hospitals Trust, which runs Addenbrooke’s, said: “There is a very ancient and sacred trust that exists between a doctor and his patients and, quite frankly, it sickens me to think that trust has been breached”.

11.00am The Guardian reports that an independent Scotland will face NHS budget cuts, according to the ‘No’ campaign leader Alastair Darling.

Mr Darling said new powers for the Scottish parliament, which would be set in train the day after a no vote, would result in a stronger, more secure health service. Those powers would enable Holyrood to raise extra money to spend on the NHS as well as borrow more to build hospitals and facilities for the elderly.

Referring to confidential papers passed to the BBC which suggest the NHS in Scotland is facing a funding gap of more than £400m and that sweeping cuts will be needed for health boards to break even, Darling said: “Today we learned that [Scottish National party leader and deputy] Alex Salmond and Nicola Sturgeon have been deceiving us. I find that quite appalling.”

Alex Salmond said it was “absolutely untrue” that there would be cuts to the NHS budget in Scotland, describing Darling’s argument as “totally mythical, totally made up and meant to misrepresent the situation”.

Asked directly about the cuts suggested in the leaked papers, Salmond insisted that the figures referred to efficiency savings that would be ploughed back into the health service.

Following the Francis Inquiry, the government announced that health and care organisations would receive “Ofsted-style” ratings - outstanding, good, requires improvement, or inadequate - and now officials want these ratings to be clearly displayed for all patients to see.

At present, people can delve into information about their provider by looking into detailed reports published on the Care Quality Commission’s (CQC) website. But not all patients have access to the internet and others may not research how well their hospital is performing prior to a visit.

10.35am The president of the UK Faculty of Public Health, John Ashton, has taken a “voluntary leave of absence” following a recent heated Twitter exchange with a supporter of e-cigarettes.

The Faculty released this statement: “FPH apologises unreservedly for the comments our President, Professor John Ashton, made during a Twitter exchange on Saturday 6 September. Professor Ashton used inappropriate and offensive language, which unnecessarily personalised a public health issue, and we do not condone its use. An investigation is currently underway into the matter, in line with FPH’s complaints policy.

“Professor Ashton has taken a voluntary leave of absence whilst the matter is investigated; he has not resigned, stepped down or been suspended.  During this period, Dr John Middleton, FPH’s Vice President for Policy, will take on the role of acting President and will be covering Professor Ashton’s duties.”

Many patients waiting for psychological therapies have also self-harmed and had suicidal thoughts, a powerful coalition of health charities, royal colleges and service providers said.

The coalition, called We Need to Talk, said that there were “huge variations” in referral rates and waiting times around the country which were leading to patients becoming more unwell.

10.10am The Guardian reports that the NHS is facing a mounting financial crisis with more than half of all hospitals now in deficit and the service likely to end the year almost £1bn in the red.

The paper writes that figures, due to be released by Monitor and the Trust Development Authority on Friday, will show a sudden, sharp and dramatic deterioration in its financial health between the first months of 2014 and the first quarter of this financial year.

The need to hire extra staff in the wake of the Mid-Staffordshire scandal, demand for A&E care and cuts in fees for treating patients have all been cited by hospital chief executives as reasons why they have been unable to balance their budgets.

HSJ reported four weeks ago that the the NHS acute sector is expecting to record a net deficit in excess of £750m for the current financial year.

10.05am The Telegraph reports that the SNP Government is planning almost half a billion pounds worth of cutbacks from Scotland’s NHS according to a leaked document.

9.40am Good morning. A report from the Health Foundation argues that financial resources alone will not be enough to close the ‘quality gap’: the difference between the quality of care the NHS should deliver, and what it is capable of delivering.