The first ever national workforce plan for the NHS has been approved, plus the rest of today’s news and comment.
4.32pm A British doctor held in prison for over a year in Syria has died, the BBC reports.
Dr Abbas Khan, 32, an orthopaedic surgeon from Streatham, south London, travelled to Aleppo last year to treat civilians.
According to his brother Afroze, the Syrian National Security Agency agreed to release him this week, but on Monday said he committed suicide.
4.20pm The Evening Standard reports that the number of people over the age of 16 and over who drink has fallen in recent years.
Data from the Office for National Statistics revealed that the proportion of men who drank between alcohol fell from 72 per cent in 2005 to 64 per cent in 2012. For women, it fell from 57 per cent to 52 per cent in the same period.
The number of people who admitted they drank at least five days a week also declined.
A Department of Health spokesman said: “It is encouraging to see that levels of binge-drinking are decreasing amongst adults. This highlights the importance not just of raising awareness but also ensuring that the right services are available to the people that need them.
“We are helping the NHS target harmful drinkers with measures such as increasing the use of interventions by health professionals, and introducing alcohol liaison nurses in A&E.
“However, there must also be more focus on prevention, not just treatment for those with existing problems. That is why alcohol is addressed by GPs as part of the NHS health check.”
3.36pm In the NHS Voices blog, Elizabeth Wade, deputy director of policy at the NHS Confederation, writes: “Child health outcomes in the UK are not as good as they could be, starkly apparent when compared to our European counterparts.”
She adds: “Fragmentation of the commissioning of children’s health services remains a challenge, with increasing numbers of commissioners needing to communicate and work together. Thankfully, many people in the system are optimistic about their health and wellbeing board’s potential in this area, with many areas working well.
“But the potential for commissioners to be pulled in different directions remains, and this will need to be monitored as various bodies’ new commissioning responsibilities bed in.”
3.31pm Two thirds of child health professionals and service user representatives think acute care is still prioritised over prevention in child health, according to a joint survey by the National Children’s Bureau and the NHS Confederation.
89 per cent of those surveyed said schools are not yet fully utilising their potential to support good child health.
However, 63 per cent thought their local health and wellbeing boards were able to engage the right people to improve services for children, and the majority thought there was a shared agenda for promoting children’s health and wellbeing across national government and its arm’s length bodies.
Hilary Emery, chief executive of the National Children’s Bureau, said: “This study provides a useful snapshot of the mood within the NHS and how those commissioning and delivering services for children perceive the impact of recent reforms.
“There is cause for optimism: for example there may be a more widely-shared agenda between stakeholders to improve child health.
“But there are familiar problems too, and work must be done to support the integration of services, particularly for those with complex health needs, while strengthening preventative measures and fully involving children in decision-making.”
Johnny Marshall, director of policy for the NHS Confederation, added: “The people we surveyed are at the sharp end of delivering health services for children and young people, and their views give us a crucial ‘progress report’ on how we are delivering improvements in health services for children and young people.
“There is no doubt that as the NHS reform programme has been implemented over the past six to nine months, it has required a strong focus to ensure we do not slip backwards in delivering for children.
“But sustaining our position is not good enough for the future - we owe it to our children and young people to help them live healthy lives, and to involve them in how they want us to do this.”
3.20pm BREAKING: NHS England today rejected a proposal that would have seen more than 100 clinical commissioning groups facing real-terms cuts next year so additional funds could be directed to their most underfunded peers, Crispin Dowler reports.
The NHS England board instead approved plans to give all CCGs allocations that are at least flat in real terms for the next two financial years, with £180m available for above-inflation increases for the most underfunded CCGs in 2014-15.
3pm Our sister title Nursing Times reports on shadow health secretary Andy Burnham criticising government plans to cap care for the elderly at £72,000 as nothing short of a “care con”.
2.38pm BREAKING: The first ever national workforce plan for the NHS has been approved this afternoon by Health Education England, promising a 9 per cent increase in the number of training places for nurses, Shaun Lintern writes.
The national plan details how HEE will spend its £5bn education and training budget spread across 110 healthcare professions to ensure the NHS can meet the future demand and service change.
2.34pm Also on the BBC, a deaf man was treated as if he had dementia by staff at Nevill Hall Hospital in Abergavenny, Wales because no-one had written down the fact he had hearing problems.
2.31pm The BBC also reports on the Belfast Health Trust recalling 1,113 urology patients as a precautionary measure, following a review of a number of patient notes.
2.21pm The president of the Royal College of Physicians has welcomed GlaxoSmithKline’s decision to stop paying healthcare professionals for speaking engagements and attending medical conferences.
Sir Richard Thompson said: “The public needs to be confident that when healthcare professionals are speaking about medicines, they are not influenced by financial or other support from the company that produces those medicines.
“I also welcome the withdrawal of financial incentives and targets for company representatives and gsk’s commitment to continue to support medical education in other ways.”
2.11pm GlaxoSmithKline is to stop paying doctors to promote its products during speaking engagements, according to the BBC.
Its chief executive Sir Andrew Witty said: “Today we are outlining a further set of measures to modernise our relationship with healthcare professionals.
“These are designed to bring greater clarity and confidence that whenever we talk to a doctor, nurse or other prescriber, it is patients’ interests that always come first.”
The pharmaceutical company also plans to stop paying healthcare professionals to attend medical conferences.
2pm Chris Ham, chief executive of The King’s Fund, tweets:
“NHSE planning guidance massively supportive of integrated care. Problem is too many policy barriers still get in the way. Will DH act?”
1.57pm Sensible use of techniques already employed in fighting crime could prove valuable in unmasking abuse against vulnerable people in care homes, writes Billy Boland, lead doctor in safeguarding adults at Hertfordshire Partnership University Foundation Trust.
“The use of cameras and CCTV is now a significant weapon in the armoury of the police to tackle crime against individuals,” he says.
“A balanced and judicious use of cameras, deployed in full consultation with the potential victim, family and staff as appropriate, could be a vital tool in ending abuse where it is yet to be unmasked.”
1.49pm In his weekly HSJ column, Michael White discusses how Jeremy Hunt and Andy Burnham have resumed their rivalry in a particularly rowdy and partisan pre-holiday debate over the Care Bill.
He criticises the health secretary for flipping between “saying the NHS is “the biggest single reason why people are proud to be British” − as he did opening Monday’s debate − to blaming the Mid Staffs scandal and much else on Labour’s “politics before patients” habit of sweeping it all “under the carpet” seems both mischievous and wrong.
“Yes, I know, Labour does it too in opposition, but it is surely the incumbent’s job to be the grown up. As health secretary, Mr Hunt wears the NHS’s Long Trousers of State.”
1.42pm Lord Ara Darzi argues “reality mining” will transform global approaches to healthcare by using smartphones and big data to gather patient information and track epidemics.
He says: “Over the last 50 years we have seen immense advances in medicine and genetics. We now understand the molecular basis of many diseases and the sequencing of the human genome represented another dramatic leap forward.
“But progress has been more uneven in translating those advances into new treatments and, most importantly, into better outcomes.”
1.30pm The Daily Mail reports on former children’s laureate Dame Jacqueline Wilson revealing she is on the kidney transplant list, but has not yet found found a donor.
She told The Mirror: “I have to be realistic about what this means. It’s this strange situation where I just have to wait and see what happens. I am aware that it’s a long list and I’m just one of very many people on it.
“I have had some amazing offers from people wanting to help but, unfortunately, they haven’t been compatible.”
1.19pm The Daily Telegraph also reports on a study which found that fracking could cause brith defects, cancer and infertility if the chemicals involved in the process are accidently spilled to the ground water of communities living near the sites.
1.16pm Back to today’s papers, in The Daily Telegraph Claud Regnard, a consultant in palliative care, has warned against that the closure of the Liverpool Care Pathway was a mistake.
1.12pm Monitor and NHS England have set out new rules for the 2014/15 NHS payment system.
Responsibility for the national tariff has passed from the Department of Health to a joint arrangement between NHS England and Monitor.
Local price setting (excluding block contracts) currently comprises about a quarter of the £67bn covered by the NHS payment system.
The organisations argue the new rules allow for local experiments in ways of paying for NHS-funded services.
Monitor and NHS England agreed that providers should make annual efficiency savings of 4%. They claim the new the national tariff takes into account rising NHS costs of 2.5%, so the prices providers are paid for acute services next year should decrease by 1.5% on average.
Ric Marshall, Monitor’s director of pricing said: “The 2014/15 payment system is designed to help commissioners and providers address the key challenges facing NHS care in their localities.
“We are offering them more opportunities to encourage the development of new service models, maintaining incentives to provide care more efficiently and providing greater financial certainty to underpin effective planning for patients.”
Sam Higginson, director of strategic finance at NHS England, said: “This is good news for patients and good news for the NHS. NHS England has worked with Monitor to adjust the price hospitals are paid to treat patients, in recognition that some hospitals will incur additional costs to improve patient safety and care.
“The change to the tariff sits alongside work NHS England is already implementing, and we expect it to be used to ensure all patients are treated with dignity and compassion, every time.”
1pm HSJ is starting a conversation that will draw on the expertise of our community.
We are inviting you to join this conversation by answering the question: What policies, techniques and approaches have you seen improve the care of frail older people in hospitals?
A selection of the best responses will be published in HSJ, and will inform our Commission for Frail Older People.
If you have not had login details email: andrew.snowball@emap.com
12.40pm UPDATED: NHS England has announced factors including delayed transfers of care and levels of emergency admissions will impact on how much money each area receives from the new £3.8bn integration fund, HSJ’s David William reports.
Planning guidance published today by NHS England confirms that £1bn of the total will be paid depending on local performance and how well arrangements are put in place with the intention of safeguarding integrated services.
The performance related element will apply from 2015-16, when the “better care fund” – formerly known as the integration transformation fund – takes full effect.
12.35pm Chris Hopson, chief executive of the Foundation Trust Network, writes in The Guardian that the integration transformation fund, recently renamed the better care fund, has the potential to be “a catastrophe or a catalyst”.
“The health and social care system badly needs the latter but, to avoid the former, we must effectively manage the significant risks that the fund creates,” he says.
“If all goes well, we will look back on the better care fund in 10 years’ time as a key step to an integrated health and social care system. But that will only happen if we successfully manage the risks that accompany the creation of the fund.”
12.30pm In today’s papers this lunchtime, The Guardian reports on findings in published in the Annals of Internal Medicine that vitamin supplements have no obvious health benefits - and might even be harmful.
The Guardian is also running an open thread for readers to discuss whether they take vitamins, and whether this latest study has changed anyone’s mind about supplements.
12.22pm NHS Clinical Commissioners has criticised the “persistent scaremongering” about the NHS, which it said “undermines hardworking staff, needlessly worries patients and ignores the generally strong performance of the health service overall”.
The CCG representative body has called for a more postive outlook towards the NHS in the new year.
Dr Steve Kell, co-chair of the NHS Clinical Commissioners leadership group, said: “During 2013, there has been persistent scaremongering and criticism of the NHS in the media and by politicians which is not helpful.
“We know the health service needs to change. However, there is a natural tendency to focus on the negative. But what we rarely hear about is when things go well, and the NHS does lots of things extremely well.
“Let’s start 2014 on a more positive note. We feel at the moment the NHS is being used as a political pawn which undermines the thousands of hardworking staff and gives a distorted view to patients who needlessly worry about the quality of the service they might receive.
“Clinical commissioners are working hard to improve local services by making responsible, clinically led decisions in partnership with GPs, patients, and providers. We are already seeing significant progress in transparency, clinical outcomes and patient empowerment.”
His co-chair Dr Amanda Doyle, added: “It is essential that clinical commissioners are given the space to succeed. While the recent national debates regarding ambulances and urgent care services are important, these must be balanced fairly with what is happening locally. Clinicians should be free to work with patients to determine what local services are needed.
“Clinically led decision making, based upon local engagement and local patient need, is essential if we are to meet the challenges facing the NHS. Everyone needs to stop all the negativity and work together so that we continue to provide the excellent service patients want and need.”
12.11pm HSJ’s Sophie Barnes (@sophieevebarnes) tweets that at the next NHS England board meeting in January, there will be a paper on the future of CSUs.
12.06pm Mark Critchard, a partner at DLA Piper, looks at the key obstacles and challenges facing NHS organisations when looking at reconfiguring pathology services, and finds Lord Carter’s recommendations are still valid.
11.56am Norfolk police will take “no further action” against a James Paget Hospital worker arrested in connection with the death of patient, reports Judith Welikala.
11.51am BREAKING: from the NHS England board meeting, HSJ’s Crispin Dowler (@CrispinDowler) tweets that all CCGs will get at least flat real growth for next two years, with increases of up to 4.9% for most underfunded.
11.45am The chief executive of Northumberland, Tyne and Wear Foundation Trust is moving to become chief executive at The Pennine Acute Hospitals Trust, Will Hazell writes.
Gillian Fairfield had led Northumbria, Tyne and Wear, one of England’s largest mental health and learning disability trusts, since 2008.
11.43am The NHS is being told to overhaul services according to a set of six “models of care” in order to create a “sustainable health and care system”, HSJ’s Dave West reports.
Landmark guidance set to be published by NHS England today sets out how services should develop over the next five years.
It also confirms new finance rules and expectations, including asserting that “hospital emergency activity will have to reduce by around 15 per cent” by 2015-16 in order to fund the government’s mandated pooled budget with councils.
11.38am Barbara Hakin has called for NHS England Area Teams to publish exactly what they have spent on primary care, and said they will need to account to local stakeholders.
11.36am At the board meeting, Paul Baumann has revealed that out of the 34 CCGs that are expected to end year in deficit, 31 are under-funded.
11.26am BREAKING: NHS England has announced factors including delayed transfers of care and levels of emergency admissions will impact on how much each area receives from the new £3.8bn integration fund.
More to follow shortly…
11.21am Regarding allocation options, Baumann said one option is that those CCGs with more than 5 per cent should not get more than real terms growth.
11.17am An update on the NHS board meeting, chief financial officer Paul Baumann said NHS Enfland is proposing to put an adjustment in that redistributes 10% of CCG funding on the basis of relative deprivation.
He said the standardised mortality rate under 75 is a much more robust measure than DFLE, adding deprivation is not the only factor. It sits alongside frail elderly and population.
Baumann also noted there is under-funding in general in the Midlands and East.
Follow HSJ’s Sophie Barnes (@sophieevebarnes) on Twitter for further updates.
The Science and Technology Committee has launched an inquiry into national health screening programmes to see whether they should be extended to include such conditions.
11.04am There are “striking” geographical variations in the numbers of people who donate kidneys afterthey die, a study by the British Journal of Anaesthesia has found.
11.01am Six in 10 top-tier councils have a director of public health who reports directly to the chief executive, according to research by the Faculty of Public Health.
The faculty has welcomed the finding, shared with HSJ’s sister title Local Government Chronicle, as a sign that most authorities are taking the “right approach” to their new responsibility for public health, by giving the directors a seat at the top table.
However, its president John Ashton said he believed the 40 per cent of councils not observing this structure “don’t seem to get public health”.
10.49am Malcolm Grant said this is the first time in history of the NHS that these decisions have been made in public. He added the people of england entitled to see how decisions made.
He said a critical part of the Health and Social Care Act in allocations decisions is inequalities. The government expects equal access matches equal need to be at heart of decisions.
He also revealed the board has received a petition from Enfield citizens and shadow health secretary Andy Burnham sent a letter with questions.
10.46am Nicholson said if the Better Care Fund doesn’t shift activity out of hospitals then it can’t work.
NHS England’s interim deputy chief executive Dame Barbara Hakin added the most important thing is whether patient sfeel their care is integrated. She said we get carried away with organisations talking about integrating.
10.44am Back at the board meeting, Ciarán Devane has asked whether the Better Care Fund (previously known as the Integration Transformation Fund) is popping up in lots of places - is risk that it will be used as answer for everything and it won’t work?
10.35am Away from the NHS England board meeting, the Care Quality Commission has appointed Dr Sheila Shribman to assist with plans to inspect specialist children’s and young people’s health services.
Dr Shribman is the former national clinical director for children, young people and maternity at the Department of Health.
Reporting to the chief inspector of hospitals, Professor Sir Mike Richards, she will lead a team to design the methodology for how the CQC inspects children’s services, including at stand-alone hospitals.
Dr Shribman said: “This is about recognising the importance of specialist services for children and young people and making sure CQC’s new approach considers the complexities of such provision.”
Professor Richards said: “We are committed to making sure children and young people using specialist services get the best possible outcomes in the new approach to hospital inspection.”
10.31am Non executive director said Ciarán Devane said he loves the ideas, but questioned how it will all joinup.
Nicholson replied that they tried be flexible in the way CCGs and local government come together at health and wellbeing board level.
Chief finance officer Paul Baumann, added they developed this hand in hand not only with CCGs but also providers. The NHS Trust Development Authority and Monitor were heavily involved.
10.26am NHS England chair Malcolm Grant noted that CCG chairs might ask how much of this isachievable.
Nicholson has responded that very little of this will be a surprise to CCGs, the surprise is how it is brought together in one place. He has asked whether the NHS has the capability and capacity to make this happen, given that it has never done this before, adding “my guess is we’ll have to do several iterations to get this in the right place”.
HSJ’s Sophie Barnes, who is at the meeting, has the latest updates on Twitter:@sophieevebarnes
10.24am Nicholson wants to move to between 15-30 major specialist centres across country. NHS England currently commissions from more than 300, HSJ’s Sophie Barnes tweets.
10.20am Nicholson added the planning guidance involves making primary care more widely available, moving it away from “a cottage industry” as some describe it, to a larger scale.
10.19am Nicholson said planning guidance is “a radical document that will have an impact in years to come”.
10.11am David Nicholson said there is still a big group of NHS staff who do not feel they can raise issues, it so can’t be complacent, HSJ’s Sophie Barnes (@sophieevebarnes) tweets.
10.00am Chief nursing officer Jane Cumming has announced a £150m change to tariff.
9.46am Tim Kelsey, NHS England’s national director for patients and information, said recent data on general practice is the most important data published in this area. He also said now 30 million users of NHS Choices.
9.41am David Nicholson has announced that this a landmark meeting with “a big agenda of change”.
9.38am HSJ reporters Crispin Dowler and Sophie Barnes are the NHS England board meeting this morning. Sophie tweets that non-executive director Naguib Kheraj has announced his resignation.
For more updates, follow Sophie on Twitter @sophieevebarnes
9.35am BREAKING: Some NHS clinical commissioning groups could face real terms budget cuts in 2014-15 under a radical approach to funding allocations that will be considered by the NHS England board this morning.
HSJ’s Crispin Dowler reports that over the past year, NHS England has conducted a “fundamental review” of health service allocations. The organisation has concluded that current CCG funding is based on allocations which are “at least three years out of date” and which do not “recognise the substantial shifts in population and health needs which have taken place over that period”.
7.00am Welcome to HSJ Live. Ahead of NHS England’s decision on funding allocations for commissioners, its chief financial officer Paul Baumann says maintaining the status quo is no longer a low risk option.
“Funding allocation is too often presented as a set of simple choices between targeting deprivation, ageing or population growth. In reality the choices are not that simple,” he argues.
“Starving communities of the resources to fund high quality care for the elderly and frail would be as damaging as underfunding communities tackling the impacts of deprivation.
“We must do both, but that inevitably involves a readiness to change – which, in a time of limited real growth, equally inevitably involves resource moving between communities to best fit the needs of their shifting populations.”
Follow HSJ Live throughout today for the latest news from NHS Englan’ds board meeting.
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