The coming financial year will be a ‘transition’ period with few new national requirements so the NHS ‘can focus on core aspects’, NHS England suggests, plus the rest of today’s news and comment
5.10pm A legal direction has been placed on a clinical commissioning group by NHS England following the discovery of a large backlog of elective patients at its main provider.
Barnet CCG is one of the first groups to be given a legal direction since it became a statutory body in April 2013.
Barnet and Chase Farm Hospitals Trust discovered a backlog of around 179 patients who had waited over a year for surgery in June. It merged with Royal Free London Foundation Trust in July.
3.45pm In its response to comments on proposals for changes to its current methodology for evaluating new drugs, the National Institute for Health and Care Excellence is positioning itself for a wider role in the way drugs are developed, evaluated and taken up in the NHS.
Following a consultation, the institute has decided to undertake further work before making changes to the way it appraises new medicines and other technologies for use by the NHS. It argues that any changes to NICE’s methods need to be made as part of a wider review of the innovation, evaluation and adoption of new treatments (including those for cancers) involving patients, people working in or with the NHS, the life sciences industries and health researchers.
Alongside any changes to its methods, NICE proposes:
- an office for innovation inside NICE to provide companies with a ‘flight path’ through the stages of the development, evaluation and adoption of their products into the NHS
- agreement between NICE, NHS England and the Department of Health, on the NHS’s willingness to pay for new treatments, which would take account of any special cases, such as ultra-orphan conditions and cancer
- more productive sharing of risk between companies and the NHS. The aim would be to progressively reflect the value of new treatments as our knowledge of what they can offer to patients increases (NHS England’s “commissioning through evaluation” process could be used to for this).
The institute’s proposals follow a detailed examination of its role in determining which new technologies the NHS should pay for. In 2013, the Department of Health asked the institute to consider additional “terms of reference” in the appraisal of new health technologies. The aim was to supplement the existing NICE methodologies.
Earlier this year, NICE published its proposals on “value-based assessment” for consultation. They were intended to give more direction to the independent committees which appraise new technologies on behalf of the institute.
NICE’s board of directors, which has met at a public meeting in Kendal, has considered the results of the three month consultation of stakeholders – including patient groups, the Department of Health, companies, learned societies, charities and researchers.
The board found no agreement in responses on the proposed changes.
The chief executive of NICE, Sir Andrew Dillon, explained: “We’ve been looking in detail at how to change the way we appraise medicines and other technologies on behalf of the NHS. Following an extensive consultation, it’s clear that just changing NICE’s methods will not overcome concerns about how the NHS accesses new treatments.
“We also need to look at other processes, including the model of pharmaceutical research and development, the expectations that companies and patient groups have about how risk and reward is shared between the industry and a publicly funded NHS, and in the arrangements for commissioning expensive new treatments.
“There have been exciting changes in research and development of new medicines and other health technologies which is increasingly challenging all those involved in bringing new treatments to patients. This requires a wider review of the NHS’ arrangements for supporting innovation and evaluating and adopting new treatments. And it’s essential that industry also recognises its role in making innovative treatments available to people at a fair price.”
3.42pm The head of the Care Quality Commission has admitted a gap in the regulatory system is preventing the investigation of historic patient complaints, after NHS England pulled out of a proposed joint investigation.
The Care Quality Commission’s chief executive has admitted that a “gap” in the regulatory system is preventing the investigation of historic patient complaints.
David Behan made the comment in response to the collapse of a proposed joint investigation by the CQC and NHS England into the case of the death of baby Elizabeth Dixon in 2001.
3.39pm At 7.30pm tonight HSJ will publish our first ever list celebrating lesbian, gay, bisexual and trans healthcare leaders and staff who are working to promote inclusion and lead by example with their day to day work.
3.00pm In his HSJ column this week, The Guardian’s Michael White discusses the hot debate over the The Trans-Atlantic Trade and Investment Partnership, which critics loudly argue will open up the NHS to yet more private companies and strip away protection for workers.
2.45pm The coming financial year will be a ‘transition’ period with few new national requirements so the NHS ‘can focus on core aspects’ such as financial sustainability and waiting time targets, NHS England has indicated.
The national commissioning body revealed its expectations of the planning process for 2015-16 in a board paper to be discussed at its meeting on Friday.
Planning guidance will be published in December, as in previous years, but will not “revisit in detail all of the priorities and commitments” in last year’s guidance, the paper said.
1.22pm HSJ, working with NHS Employers, the NHS Leadership Academy and the British Medical Association, is seeking to celebrate the outstanding contributions professionals from black and minority ethnic backgrounds make to healthcare – and nominations are now open.
This November we will be celebrating individuals working within healthcare who can be considered to be BME pioneers – people from BME backgrounds who, through exceptional leadership abilities or their day to day example, are inspiring others and helping to shape and deliver excellent care for all.
Nominees can be working across health and social care, and at all levels, and can be from a clinical or non-clinical background – we want to identify and celebrate people you are proud to work with and who inspire you. We are particularly looking for people who you believe meet two or more of the following criteria:
- Benefit: how has this individual’s work benefited patients? To what extent have his or her efforts helped enhance access to and/or the quality of care?
- Influence: to what extent has the individual been a game changer in his or her organisation, or more widely?
- Leadership: to what extent has this individual created a platform for others? Has he or she enabled greater numbers of BME staff to take up roles at all levels of the health sector?
- Inclusivity: to what extent is the individual having a long term impact on the debate around inclusivity within the health sector?
A panel of expert judges will decide on the final list, which will appear online and in print in HSJ during November.
For more details and to make a nomination, click here.
1.20pm A clinical commissioning group leader has called on the Care Quality Commission to allow CCGs to join inspections of their local hospitals.
Hambleton, Richmondshire and Whitby CCG chief clinical officer Vicky Pleydell has twice written to the CQC to make the request.
However, chief inspector of hospitals Sir Mike Richards has rejected it “due to potential conflicts of interest”.
12.20pm People referred for anxiety or depression therapy have a markedly different wait for treatment depending on where they live in England, new figures show.
In 2013-14, the proportion of referrals to IAPT services seen within 28 days of referral ranged from three per cent in one clinical commissioning group area to 96 per cent in another, according to the Health and Social Care Information Centre.
Nationally, of the 709,000 referrals entering treatment in 2013-14, about six in 10 had their first treatment appointment within 28 days of referral (435,000 or 61 per cent), and about nine in 10 within 90 days (632,000, or 89 per cent).
Today’s figures are from the HSCIC’s second annual report about psychological therapies, which shows IAPT services received 1.1 million referrals in 2013-14. These related to just fewer than 950,000 individuals, of whom:
Almost two thirds were for females (63 per cent, or 597,000);
25 to 29-year-olds had the highest access rate by age, at just over three per 100. This compares to just under two in every 100 of the overall adult population.
Today’s report shows that in 2013-14:
Just fewer than 920,000 referrals (this figure will include referrals made this year and some continued from the previous year) ended. Of these:
Four in 10 had finished a course of treatment (364,000, or 40 per cent), and more than half of these showed reliable improvement (218,000, or 60 per cent).
Almost four in 10 ended without being seen by the IAPT service (336,000, or 37 per cent).
Of the 160,000 referrals where the person was taking psychotropic medication at the start of treatment, almost 20,000 (13 per cent) were no longer being prescribed it at the end of treatment.
Today’s report also includes a new level of detail on activity by provisional diagnosis, although this information is not recorded for all referrals. Just under six in 10 (59 per cent , or 415,000) of referrals entering treatment in the year had a recorded diagnosis.The most common diagnosis for those referrals entering treatment in the year was ‘mixed anxiety and depressive disorder’ at 15% (108,489) of all referrals entering treatment in the year.
Considering finished treatment courses, the mean number of treatment sessions varied by diagnosis; ranging from nine for Obsessive Compulsive Disorder (OCD), to five for Mental and Behavioural disorders due to alcohol.
The highest level of recovery was for referrals with a provisional diagnosis of ‘specific isolated phobias’ (964 out of 1533 referrals recovered, or 63 per cent).
HSCIC chair Kingsley Manning said: “Today’s report provides a new dimension of understanding to this important area of care. Depression and anxiety are known to affect a broad spectrum of people within our society – and today’s figures point to almost two thirds of referrals for Psychological Therapy being for women.
“It is vital to ensure those in charge of commissioning services have as much salient information at their fingertips as possible. For example, one of our other recent reports showed there were almost 9,000 hospital admissions for anxiety in the 12 months to November of last year, almost two thirds of which were for women.5”
To view today’s report visit: www.hscic.gov.uk/pubs/psycther1314
10.55am Four of the first five better care fund plans to receive official approval are all aiming for less than the ‘expected minimum target’ of a 3.5 per cent reduction in emergency admissions.
Despite this, some hospital providers remain sceptical that the approved schemes will achieve the falls in non-elective activity their commissioners are predicting, the published plans reveal.
10.50am More needs to be done to help poor women through pregnancy, experts have said, after new research found that they have a worse experience than better-off mothers-to-be.
Researchers from Oxford University analysed the 2010 National Maternity Survey, which included findings from more than 5,300 women who had given birth in England.
10.48am The coming financial year will be a ‘transition’ period with few new national requirements so the NHS ‘can focus on core aspects’ such as financial sustainability and waiting time targets, NHS England has indicated.
The national commissioning body revealed its expectations of the planning process for 2015-16 in a board paper to be discussed at its meeting on Friday.
Planning guidance will be published in December, as in previous years, but will not “revisit in detail all of the priorities and commitments” in last year’s guidance, the paper said
10.45am The Care Quality Commission is having its board meeting today. Click here to watch it live.
10.41am Four of the first five better care fund plans to receive official approval are all aiming for less than the ‘expected minimum target’ of a 3.5 per cent reduction in emergency admissions.
Despite this, some hospital providers remain sceptical that the approved schemes will achieve the falls in non-elective activity their commissioners are predicting, the published plans reveal.
For more on David Williams’ story - click here.
10.38am The Times reports that an “unethical” breast screening trial for three million women should be stopped, according to senior doctors who say many of those involved may not even realise they are part of an experiment.
The national study looking at extending the ages at which women are screened has been criticised after evidence emerged that it may do more harm than good. A 2012 review found that for each breast cancer death prevented by screening, another three “overdiagnosed” cases would be identified, meaning women received chemotherapy or surgery they did not need.
10.30am NHS England has begun a consultation on a new set of standards for congenital heart disease services, in the latest chapter of the long-running debate on the future of children’s cardiac surgery.
Its consultation document sets out how the organisation believes services should be organised to achieve the highest quality of care for patients.
10.27am A legal adviser to the Labour Party has rejected claims it would have to ‘dismantle’ the commissioner-provider split in order to remove the effect of EU procurement rules on the NHS.
Lawyer Hamish Sandison, who is advising the party’s health team, denied it would require a major upheaval to soften the effect of 2006 European procurement rules on NHS commissioning. He said it could be achieved simply by repealing regulations enacted by the current coalition government.
The intervention follows NHS England’s rejection, on the basis of the EU rules, of Labour’s call for a moratorium on competitive NHS contracting, as revealed on hsj.co.uk last week.
10.15am Looking towards this morning’s newpapers,The Daily Telegraph reports that the mother of a young boy abused by a cancer specialist who committed a string of sexual offences against children has told how discovering the truth about him was like hearing her son had been diagnosed with cancer all over again.
The woman, who has to remain anonymous for legal reasons, said her son, now 10, had so admired Myles Bradbury, a paediatric haematologist at Addenbrooke’s Hospital, in Cambridge, that he wanted to became a doctor when he grew up.
10.00am HSJ is launching a search for the key influential people from black and minority ethnic backgrounds working within healthcare. We want your nominations.
The BME Pioneers list, now in its second year will recognise those individuals who are at the heart of creating a high quality, inclusive health service. Through their exceptional leadership, passion and outstanding abilities, these people are helping to create and deliver excellent care for all. You can nominate a colleague here.
7.00am Good morning. The relatively new concept of ‘dispersed leadership’ highlights different dimensions of an organisation and its leadership model. Debabrata Biswas and colleagues explain how it enhances empowerment among staff.
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