HSJ Live 21.10.2014: HSJ to announce top 100 clinical leaders

5.42pm The Welsh NHS health minister has hit back at Jeremy Hunt’s claim it is delivering a “second-class service”, the BBC reports.

Welsh health minister Mark Drakeford has launched an attack on the Conservatives for trying to drag the reputation of the Welsh NHS through the mud for “partisan political purposes”.

Mr Drakeford criticised Mr Hunt for selectively quoting from an unpublished report into NHS services in the UK.

5.35pm BBC radio 4’s PM has previewed a few sections of NHS England’s five year forward view. It will include calls for a maternity review, more stable funding for GPs, and a “significant section” on mental health including new commissioning ideas as well as extra staff, according to the programme.

New DH guidance released this week said the health secretary could require FTs to take specific measures if they want interim funding to ensure their viability.

Applications from trusts for loans or public dividend capital are administered by the independent trust finance facility, an advisory committee to the Department of Health.

4.25pm HSJ’s exclusive interview with Nick Clegg has attracted a debate over future funding:

“We don’t want winter pressures funding. Winter happens every year and is eminently predictable. If the funding formula enabled acute providers to cover their costs, then there would be no need for this charade. What we want is a sensible funding formula for acute care that recognises the increasing complexity and load, and is not block funding dressed up in a party frock which is what Monitor/NHSE is proposing.”

“We already have a system in place that funds acute care for changing volumes of care and for changing acuity of care - i.e. national tariff. The argument goes that in winter the increased level of demand has to be staffed with higher cost staff than normal (agency, locums) and services have to be open more than normal (evenings, weekends) in order to cope with the increased volume. However the tariff is based on the average NHS cost and it is the average across the year. So in Winter when average cost is up this will have resulted in the average tariff being up whilst for the rest of the year that it is in theory cheaper this will have resulted in the average tariff being lower. All in all - the average tariff over funds the year when it is cheaper to deliver care and under funds the winter when it is more expensive, all in all though it should average out. So the question I have is: Why is the tariff not a suitable mechanism for reimbursing hospitals during the winter months?”

“The answer to your question is very easy. At a point in time the tariff was related to cost, over time a number of deductions have been introduced (30% marginal rate for emergency admissions; readmissions ‘penalties’ for example) that mean that the tariff is (deliberately) significantly lower than the average cost of delivery, particularly for non-elective care.” 

“When will people get the fact that tariff does not equal cost?! The tariff skewed towards whatever the latest political whim is and is based on ref costs 4 years old!”

“And more spending on mental health should not necessarily equate to more money for mental health trusts. But more spent on the mental health needs of patients however met; that includes acute trusts who do a huge amount of ‘mental health care’ already.”

3.20pm There are some interesting reader comments on our story about Stevens calling for CCGs’ allocations to progress faster to target:

“Sums should be interesting here - how to cover baseline deficits, fill up the spec comm black hole, move under target CCGs closer to target - and not take money off other CCGs? Maybe not on that last one.”

“This needs to be done as soon as possible. The current situation where most inner London CCGs are vastly overfunded generating huge surpluses whereas outer London CCGs are mostly below target and often in deficit is ridiculous. Leads to instability in the under funded CCGs and waste in the overfunded ones.”

2.25pm NHS England has appointed a new national clinical director for innovation, Professor Tony Young.

Professor Young’s role will provide clinical leadership and support in delivering improved health outcomes across the NHS Outcomes Framework. In particular he will focus on generating economic growth through innovation and driving the uptake of proven innovations across the healthcare system.

Professor Young is a practicing consultant urological surgeon at Southend University Hospital and director of medical innovation at Anglia Ruskin University.

He said: “It’s an honour to be appointed to this role. We’ve made great strides in transforming the medical innovation process during my time at Anglia Ruskin. I look forward to working with clinicians to help make innovation happen and bring the latest advances in technology and improvements in care pathways. The challenges we face as a national health system, particularly in the management of chronic disease are piled high. By encouraging economic growth and becoming early adopters of the latest innovations, we can rise to the challenge and help transform patient care and experience. ”

Dr Mike Bewick, deputy medical director for NHS England, said: “We are facing a challenging but exciting time in delivering health services that meet the needs of both current and future healthcare consumers. Tony will be a great asset in helping move this agenda forward and we are looking forward to him joining the team.”

Professor Young will remain in his post at Anglia Ruskin during his time on secondment to NHS England and also continue as a frontline clinician at Southend University Hospital.

In her first interview since joining Care UK as its managing director for secondary care, Philippa Slinger indicated she had anticipated picking up more additional work over the summer, when the funding was expected to be spent.

While Care UK had seen an increase in the number of trusts looking for help to clear waiting lists, demand had been “slower than I imagined it would”, she said.

1.30pm NHS England will be revealing its five year forward view on Thursday, which is expected to set out the direction on a number of key issues including the size of the financial gap the NHS faces until 2020-21, potential consequences of continued curbs on NHS funding and new models of delivering care.

1.10pm During health questions in the House of Commons Jeremy Hunt said that 260 extra doctors will be joining A&E departments this winter.

HSJ previously reported that emergency medic recruitment had hits its highest ever level.

Simon Stevens told MPs yesterday that he wanted NHS England to move all CCGs to within 5 per cent of their target “fair share” funding within two to three years.

Doing so would represent a marked increase on the pace at which groups have moved towards target this year and in 2015-16.

12.26pm Hunt says GPs need to have “personal responsibility” for patients.

12.25pm Hunt says the government has recruited 1,000 extra GPs, and “we need many more”.

12.24pm Burnham says a “flat budget” will not stop the NHS tipping over into failure. Hunt says it is not flat, but real terms increase.

Burnham says under Labour, more money for NHS. Under Tories, tax cuts for some and NHS crisis for all.

12.23pm Jane Ellison says smoking prevalence among adults fell to 18.4 per cent in 2013. She says this is a “record low”.

12.22pm Hunt says the number of people being referred for cancer tests has gone up by 50 per cent since 2010.

12.07pm Questions are being asked about the congenital heart disease services review. Greg Mulholland says NHSEngland has “made a mess” of it.

12.04pm Lamb says it is unacceptable that children have to travel to get a mental health bed.

He says they are investing £7bn extra a year into children’s services.

12.03pm Labour asks why there has been a decline in mental health doctors.

Norman Lamb says there has been an increase of 2800 practitioners as part of the Improving Access to Psychological Therapies programme.

12.02pm Jamie Reed says the use of private ambulances has grown.

Jane Ellison says it is “complete nonsense” to frame this as “creeping privatisation”. Trusts will sometimes use private ambulances when under pressure, she says.

12.01pm A question is asked about London Ambulance Service’s performance. Heidi Alexander says there are not enough staff and ambulances are taking longer to reach patients.

Jane Ellison says the service is increasing the number of paramedics, and urgent measures are being taken.

12.00pm Poulter says the government will support following Northumbria’s lead and buy their way out of PFI contracts.

11.57am Nick de Bois says the rebuild of Chase Farm Hospital will be funded by sale of their own land and Treasury money.

11.56am Poulter says the annual cost of PFI contracts is £1.79bn which will rise to £2.7bn.

11.55am Dan Poulter says that PFI contracts have been assessed to identify cost savings and a piece of work on this is underway.

11.52am Hunt says that for every English patient treated in Wales, five Welsh patients are treated in English hospitals.

11.50am Hunt says Dudley Group Foundation Trust has had 350 extra nurses under this government.

11.45am Labour MP Karl Turner says A&E departments have missed the target 64 weeks in a row.

Jeremy Hunt says he should “be careful” not to “politicise” the issue. He says Turner is using a “subset” of A&E data.

11.45am Coastal West Sussex CCG’s decision to award its musculoskeletal contract to a joint venture between Bupa/CSH Surrey has been brought up in the Commons. There is concern that this could destabilise the A&E service at Western Sussex Hospitals Foundation Trust.

Dan Poulter says that the CCG has agreed to continue to commission trauma MSK services from Western Sussex.

11.41am George Freeman says UK sovereignty on health is “not in any way” threatened by TTIP.

11.40am Health questions are now underway in the House of Commons. Green MP Caroline Lucas has asked about the Transatlantic Trade and Investment Partnership. New health minister George Freeman says the NHS is excluded from binding deals in the TTIP.

Lucas asks why the BMA has called for the NHS to be excluded from the agreement if there is no danger to the NHS.

Tim Andrews remains under investigation by NHS England over the governance of Cheshire and Merseyside CSU, which became defunct at the beginning of this month, following its merger with its Greater Manchester counterpart.

The merged organisation, North West CSU, is being led by Leigh Griffin, the former Greater Manchester CSU managing director.

The new requirement was revealed as HEE published details of its “values based assessment tool”.

This will test students and could be used to examine the values of all NHS staff when they look to change jobs.

10.30am The Independent reports that spending on private ambulances has almost doubled in two years, according to freedom of information responses gathered by Labour.

The overall budget for private ambulances in England jumped from £37m in 2011-12 to £67.5m last year. The most dramatic increase was in London, where spending was up by 1,000 per cent from £796,000 to more than £8.8m.

10.15am On BBC Newsnight last night the NHS featured prominently, with questions over why it is facing so much pressure.

HSJ’s exclusive story about extra winter funding to be released to help ease A&E pressures was featured. You can watch it here.

10.10am HSJ will be announcing the top 100 clinical leaders in healthcare tonight, as voted for by our readers.

The announcement will be at 7.30pm and you’ll be able to follow it on Twitter using the hashtag #hsjclinicalleaders.

Here’s the 2013 list in full.

9.57am The Times reports that a paralysed man with a completely severed spinal cord has learnt to walk again in a “historic” British led breakthrough that raises the prospect of treatment for a condition previously thought to be permanent.

The patient was left with no movement or feeling from the waist down after being stabbed four years ago. In what The Times calls a “revolutionary procedure”, cells from his nose were transplanted into the damaged part of his spine and he recovered the ability to walk with a frame.

9.45am HSJ has an exclusive interview with deputy prime minister Nick Clegg.

Nick Clegg told HSJ he was working with Chief Secretary to the Treasury Danny Alexander to ensure the “right amount” of funding for 2015-16 was built into December’s autumn statement.

“We need to make sure as custodians of the NHS that we hand on the NHS in a healthy state to whoever comes into power next,” he said.

9.40am The Daily Mail reports that patients in Wales are seeking private treatment or moving to England because of lengthy waiting lists on the Welsh NHS.

Official figures show that nearly four times as many Welsh patients are treated in Engand as the other way round.

The number of cancer sufferers travelling to England has gone from 3,471 a decade ago to 16,450 last year.

9.28amThe Guardian reports that the NHS must once again start receiving annual multimillion pound increases in its budget to help survive a “perfect storm” of pressures, said Monitor’s chief executive David Bennett.

In an interview with HSJ deputy prime minister Nick Clegg said he would lobby for next year’s NHS budget to be topped up with enough winter pressures funding to leave the service in a “healthy state” for the next government.

7.00am Good morning and welcome to HSJ Live. We begin the day with an opinion piece from Ileana Welte on how the “Cinderella service” of mental health has belatedly risen up the political agenda.