Workforce shortages have resulted in waiting lists for some NHS specialties swelling by almost a third over the past four years, plus the rest of today’s news and comment
5.08pm Don’t forget the NHS five year forward view – instigated by the NHS England chief executive to set out the prospects for the service in the run-up to the general election - will be published tomorrow.
It is expected it will indicate the approach and policies which those leading the service believe are needed to make the NHS sustainable.
Simon Stevens decided the report should be drawn up after taking up the post in April and NHS England has since worked with national health bodies and other NHS leaders to draw it up.
The report is also expected to give a new estimate of the scale of the NHS funding shortfall in coming years - potentially putting political leaders on the spot to address this or consider the consequences on care standards.
hsj.co.uk will cover the forward view in detail tomorrow, including comprehensive analysis of what it will mean, and comment and reaction.
The forward view, published by NHS England along with Monitor and other national health bodies, is expected to set a direction for the service on:
- The size of the financial gap facing the NHS until 2020-21, reviewing the £30bn figure published by NHS England last year.
- The potential consequences of continued curbs on NHS healthcare funding, and for longer-term financial settlements for the service.
- New models of delivering care, such as hospitals running general practice services, and GPs forming primary care based multispecialty provider groups, and how different models could apply in different areas of the country.
- How NHS incentives and rules may change to support new models, such as the role of competition or linking income more closely to care quality.
- How some areas could go faster in experimenting with new models, and might be helped to work around system rules which could be preventing them.
- Future approaches to commissioning, for example co-commissioning between CCGs and NHS England, links with local authorities, and personal health budgets.
- How mental healthcare can be improved more quickly.
- The impact of population trends and other factors on NHS demand, and how to better prevent illness.
- The role of non-NHS factors in improving health, including changes to taxation, employers incentivising their staff, and the role of councils and regional authorities, and the role of other government departments.
- The “hidden workforce” including individuals’ own role and carers.
- International examples the NHS could learn from.
- A strategy for specialised services.
For full coverage of the forward view, sign up to receive HSJ’s daily news and breaking news emails, follow our rolling news blog HSJ Live and follow the hashtag #5YFV.
5.03pm What is it that motivates clinicians to achieve excellence in leadership?
HSJ editor Alastair McLellan reflects on our Clinical Leaders 2014, which was unveiled last night at a ceremony in London.
4.45pm To secure sustainable health and social care systems national decisions about funding and access must be made, writes Joanna Killian, chief executive of Essex County Council.
3.36pm As we approach the general election, there is a frenzied bidding war for the contents of a shrinking pot of cash, one with many rivals.
But playing politics with hospitals, countries and newspapers can rebound on the parties, argues Michael White in his weekly HSJ column.
3.10pm The Times reports that a potentially life-saving operation for a baby boy born with only half a heart was cancelled five trimes, an inquest has been told.
Harley Pascoe died at the Bristol Royal Hospital for Children after an operation had been postponed so that surgeons could attend to more seriously ill children.
2.38pm Schools must help children to brush their teeth, because parents are not doing a good enough job, NICE has said.
The Times reports that one in eight children in Britain has tooth decay by the age of three.
Supervised brushing schemes are needed in nurseries and primary schools in areas where children’s teeth are particularly bad, NICE said in guidance to councils yesterday.
2.19pm The Guardian reports that the Labour-controlled Welsh government has hit back at British ministers for what it regards as a cynical campaign to ruin the reputation of the NHS in Wales in order to win votes.
It has also written to all NHS workers in Wales warning that the criticism of the service by the Conservatives and elements of the London-based media will intensify in the run up to the general election.
1.22pm The Daily Telegraph reports on comments made by Jeremy Hunt in the House of Commons,warning that English hospitals close to the Welsh border are under “absolutely intolerable pressure” from the numbers Welsh patients seeking treatment.
“For every one English patient that is admitted for treatment in a Welsh hospital, five Welsh patients are admitted for treatment in an English hospital and that creates huge pressure for him,” the health secretary said.
12.59pm The Daily Mail speaks to patients who have been left on long waiting lists, as part of its investigation into the NHS in Wales.
One of profiled case studies is Robin Williams, 69, who waited three months to be referred to a consultant and further six months to get appointment for an angiogram.
Mr Williams said authorities displayed “a level of incompetence I’ve not seen before in my lifetime”, the Mail reports.
12.54pm The health secretary’s tweet follows criticisms of the Labour-run Welsh NHS, most notably by The Daily Mail.
The paper continues its week-long investigation into the health service in Wales today, reporting that “shocking” waiting lists have meant patients are dying before they can be treated.
Almost 1,400 patients in Wales annually wait at least a year for an operation, according to the Mail, compared to 574 in England, which is 17 times its size.
12.49pm Health secretary Jeremy Hunt has tweeted:
Time for Labour to put up or shut up on NHS in Wales: if it is as good as England why not back independent study by OECD?
— Jeremy Hunt (@Jeremy_Hunt) October 22, 2014
12.40pm Timothy James, senior lecturer in medical law and Ethics at Birmingham City University has said NHS England’s announcement that it will pay GPs £55 every time they diagnose a case of dementia, said: “It raises a question: why are GPs not diagnosing dementia, and why do they need an incentive to do so? The ethical point is surely that doctors should diagnose illness in order to benefit their patients, not themselves.”
“So the follow-up question must be: do the government think that GPs are unable to diagnose dementia through inadequate diagnostic skills, or unwilling to diagnose it because it will cost them something – money out of their budgets, or an increased workload? If it’s the former, training should be the answer; if the latter, ethics come in,” he added.
“There are indeed question marks over the diagnostic skills of GPs, but the medical authorities will never admit this.
“We should now expect increases in diagnoses of dementia – experience shows these financial incentives are very effective in changing GPs’ practice.”
12.33pm In response to NHS England’s scheme to pay GPs for diagnosing dementia,Professor Sir Simon Wessely, president of the Royal College of Psychiatrists, said: “This government has done well to increase funding and awareness of dementia, and I believe even more needs to be done.
“But at the moment evidence favours either improving social care, or investing in research to find new treatments that actually modify the course of the disease. Until that happens I can see little point in this initiative.”
12.15pm Looking at today’s papers, The Times reports that GPs will be paid £55 for every case of dementia they identify.
The “controversial” scheme is designed to alert tens of thousands of patients that they have the disease and met targets set by David Cameron.
However, doctors and patients said that financial incentives to decide when people had a disease were an “ethical travesty” that would erode trust in GPs and divert money from helping people with the condition.
The story has been widely covered across the national press.
12.00pm HSJ’s online Q&A with Monitor’s head of sector development has just begun.
In an attempt to help NHS providers avoid financial distress, Monitor will this week unveil two new resources intended to solve the problem of bad planning by providers.
To help providers and commissioners understand the new resources, Suzie Bailey will be answering your questions until 1pm.
Participants will be able to discuss the financial and clinical pitfalls of bad planning and how to avoid it. Find out more here.
You will need to be a registered user of hsj.co.uk to take part and post comment. Sign up for free here.
11.39am The dispute between University Hospitals Birmingham and commissioners about out of area referrals could have ramifications across the whole NHS, writes HSJ senior correspondent David Williams.
11.30am There is a just half an hour to go until HSJ’s online Q&A about how to improve strategy planning, with Monitor’s head of sector development Suzie Bailey.
11.23am Jeremy Hughes, chief executive of of Alzheimers Society and chair of National Voices, has tweeted:
Interesting! @PatientsAssoc seem to act against interests of people worried by their memory. Are they happy not to have timely diagnosing?
— Jeremy Hughes (@JeremyHughesAlz) October 22, 2014
11.10am The chief executive of University Hospital Birmingham Foundation Trust has admitted its first attempt to “test the concept of the chains model” with a trust from a distance has not worked.
The trust was recently asked to work with troubled Medway Foundation Trust in Kent to help improve its performance.
Dame Julie said the 12 week project had allowed her to “test the concept” of running a hospital chain, one of the options currently being explored by the Dalton Review of hospital structures.
10.56am The head of a respected foundation trust has called for a major overhaul of financial rules to help popular hospitals cope with the extra demand their reputations attract.
The chief executive of University Hospitals Birmingham Foundation Trust, Dame Julie Moore, told HSJ that well regarded hospitals were financially disadvantaged because increased demand was not matched by additional funding.
She said the Care Quality Commission’s drive to highlight poor care had not fed through into changes in funding rules.
10.46am Workforce shortages have resulted in waiting lists for some NHS specialties swelling by almost a third over the past four years.
Trusts recorded a 32 per cent increase in the number of patients waiting for rheumatology treatments, when figures for August this year are compared with the same month in 2011.
The increases for neurology and dermatology in August increased by 28 and 31 per cent respectively over the same period.
10.19am Private providers treated fewer than one in 10 of the patients left on NHS waiting lists for more than 18 weeks during the government’s summer drive to cut queues, HSJ analysis reveals.
Just 8 per cent of patients were transferred by the NHS to private providers for treatment between July and September, according to Freedom of Information responses from 99 acute trusts.
The proportion of patients picked up by private providers was even slimmer for acute trusts with the longest lists. Only 2 per cent of patients cleared from queues of 18 trusts with some of the largest lists received treatment in the private sector - 1,700 patients out of almost 77,000.
The findings come after the government distributed £250m to hospitals over the summer to help cut the number of patients waiting a long time for treatment.
10.08am The 100 Clinical Leaders for 2014 were announced last night at an event in London.
Now in its second year, this power list showcases those individuals making the greatest impact on health policy, service transformation, and innovation.
Some of the individuals selection are well known, others much less so; for some their inclusion barely warranted debate, for others the discussion was intense.
The list, you will also be able to see, is partially ranked. The fact that we have ranked 21 rather than a more rounded 20 is deliberate.
Our original intention was, indeed, 20 but the consensus was that the 21 chosen (after much wrangling) were all more than worthy contenders, and therefore to excise one purely for arithmetical reasons would have been artificial. So 21 it stayed. The other 79 names are simply listed alphabetically.
HSJ fully expects the choices we have made to be controversial. We also hope they will spark debate about the changing nature of clinical leadership and influence within healthcare.
10.05am The Care Quality Commission will today begin its first inspections of private hospitals under the body’s new inspection regime.
During a two day inspection, a team will visit Spire Southampton Hospital in Hampshire, looking at services including surgery, medical care, critical care, children and young people’s care and outpatients and diagnostics.
Inspectors will also spend one day at the London Welbeck Hospital looking at surgical and outpatient services.
The chief inspector of hospitals Professor Sir Mike Richards said: “The first inspections at Spire Southampton and London Welbeck hospitals are the starting point for CQC to hold the independent sector to the same standards as the NHS.
“As we have seen in the NHS, these new-style inspections will allow us to get under the skin of the organisation to give us a much more detailed picture of independent hospital care in England than ever before.
“We are significantly increasing public access to information on independent healthcare, which is good news for people who use services, as it will help people to make informed decisions about their care.”
A further six independent hospitals are due to be inspected by the end of December 2014. Thet are:
- Baddow Hospital, Essex
- BMI Mount Alvernia, Surrey
- The Lister Hospital, London
- Nuffield Health Tees Hospital, County Durham
- Oaklands Hospital, Salford
- Shepton Mallett NHS Treatment Centre, Somerset
9.50am Discuss the pitfalls of bad planning with Monitor’s head of sector development.
Join Suzie Bailey for an online Q&A at 12pm today
Last month Monitor chief executive David Bennett said: “NHS foundation trusts are striving to overcome the challenges they face while still meeting patients’ expectations for quality care. However, we believe trusts can make further progress by improving their planning.”
It followed a warning in May from the regulator that providers’ two year plans were unrealistically optimistic given the escalating financial pressure.
In an attempt to help NHS providers avoid financial distress, Monitor will this week unveil two new resources intended to solve the problem of bad planning by providers.
To help providers and commissioners understand the new resources, Suzie Bailey will be answering your questions at 12pm-1pm.
Participants will be able to discuss the financial and clinical pitfalls of bad planning and how to avoid it.
You will need to be a registered user of hsj.co.uk to post a comment, sign up for free here.
7.00am Good morning. In Essex an ageing population is top of the agenda. Joanna Killian argues that funding and access decisions must be made nationally to secure sustainability.
No comments yet