Oxfordshire Clinical Commissioning Group is set to record a £7.6m deficit in 2014-15, plus the rest of the day’s news and comment
5.04pm Andy Burnham says that services can’t be siloed.
“AB: Silo services are a luxury the country can no longer afford. I will make the HWB pre-eminent.”
4.57pm Back to the Shelford Group and Reform conference where Andy Burnham is giving a keynote speech.
Ben Clover is tweeting:
“AB: 3 fundamental mistakes Gov has made - 1, saying they protect NHS budget but cutting social care, they’re connected…2, topdown re-org disrupted QIPP. Bourne/Poole decision ‘ludicrous’ … 3, ideology of competition restricts trsts doing right thing.”
4.50pm The Telegraph reports that the risk of Alzheimer’s Disease may develop in the womb according to preliminary findings by researchers at the University of Southampton.
Scientists found that offspring of mice fed a high-fat diet were more likely as adults to experience impaired blood flow in the brain, a feature linked to the disease.
When the offspring were also fed a high-fat diet their brains became less able to rid themselves of harmful amyloid protein, which accumulates in sticky tangles in the brains of Alzheimer’s patients.
More work is needed but the study could have important implications for humans, the researchers believe.
3.38pm Plans to expand the number of NHS staff who train as reservists for the armed forces were discussed today in a summit delivered by NHS Employers, NHS England and Health Education England.
Leaders aim to significantly expand programmes between the Ministry of Defence and NHS organisations.
Organisations committed to support the objectives of last year’s Ministry of Defence White Paper ‘Reserves in the Future Force 2020: Valuable and Valued’ which stated that, by 2020, volunteer reservists in the UK will need to make up around 29 per cent of the nation’s defence capacity. Currently over 2,000 NHS staff are trained and registered reservists.
Defence Minister Anna Soubry MP said: “I am delighted to have attended this summit which has proved very useful in exploring future opportunities for NHS staff to join the Reserves. The NHS has long played an invaluable role providing Reservists to our Armed Forces and we are committed to utilising the skills that every healthcare professional brings. Reserve Service makes for a healthier Armed Forces and a stronger NHS; it is to our mutual benefit.”
Sue Covill, director of employment services at the NHS Employers organisation, said: “We are extremely pleased with the progress made today and are now committed to take things forward with the Ministry of Defence and organisations represented. Reservists are highly committed individuals who bring value and a wealth of skills to the NHS including decision-making, leadership, team building and the ability to work under the utmost pressure. It is lifesaving training which has huge benefit to patients.”
3.31pm In The Guardian GP Zara Aziz writes that one year on there are still power gaps in CCGs.
The Arden, Greater East Midlands, North Yorkshire and Humber, West and South Yorkshire and Bassetlaw commissioning support units announced in January they would work in an alliance to secure a place on NHS England’s “lead provider framework”. The framework, which clinical commissioning groups will be encouraged to use to purchase support services, is being put in place later this year.
However, the CSUs today announced they had decided not to continue with the single alliance, and instead have formed two separate groups in order to bid to join the framework.
3.08pm Dorset Healthcare has appointed Ron Shields as its permanent chief executive.
Mr Shields was already acting as interim chief exec over the past four and a half months.
3.06pm An extension has been granted in the investigation into Morecambe Bay maternity care, reports the North West Evening Mail.
The investigation, led by Bill Kirkup, was due to report findings in July but now a short delay has been granted by Jeremy Hunt because of the “significant volume of material” the investigation has received.
2.59pm The BBC reports that Public Health England is urging for fluoride to be added to water to improve dental health.
PHE found that in fluoridated areas, there were 45 per cent fewer children aged one to four admitted to hospital for dental-related problems.
2.48pm In her speech Dame Julie Mellor says that organisations that her trust mentors have cut everything except frontline services.
“Dame Julie: organisations we mentor have cut everything except front-line. No maintainance, no education. When we go in we have to hire IT”
2.18pm At the conference the chief executive of Central Manchester Foundation Trust Mike Deegan says that acquisitions are more effective than mergers, as reported by Ben Clover on Twitter (@benclover):
“MD: Acquisition more effective than merger, allows for quick, effective change if providers, commish and regulators align”
2.08pm Dame Julie Moore is now speaking at the conference:
“Dame Julie: We demand clinicians use evidence but we don’t use it for service configurations”
“Dame Julie: We are looking at fewer organisations but the same number of hospitals. Sainsbury’s local analogy”
1.37pm Here’s another update from reporter Ben Clover at the Reform and Shelford Group conference:
“Dan Poulter: £450M could be saved by best practice in temporary staff costs.”
1.35pm Our reporter Ben Clover is live tweeting from the Reform and Shelford Group conference. Follow @benclover.
Here’s one of his updates:
“Dan Poulter up now #ReformShelford NHS on track to save £4bn in 13-14. Procurement waste now being tackled, he says”
GP education programmes that meet the requirements of this guidance – an update of guidance first published in 2008 and based on the GMC’s The Trainee Doctor standards - will be assumed to meet General Medical Council standards.
Significant developments in this version include:
- Reference to the requirements of appraisal and revalidation for educational supervisors.
- An updated section on making GP recruitment more generic and future proof.
- Further reference to sharing information on trainees; the need to support and report on trainees in difficulty; and the role of regulators (including the GMC and CQC) in GP specialty training.
- Specific reference to the need for trainees to be released to attend 70% of the formal GP teaching programme.
- An extension to the maximum period between re-approvals for GP trainers and GP training practices from three to five years.
1.15pm The BBC reports that nearly 100 GP surgeries could be forced to close because of cuts to funding.
The British Medical Association told the BBC that rural practices are particularly at risk from the changes which are due to come into force next month.
1.11pm There are some interesting comments on our story about a possible lead on specialised commissioning to join the NHS England board:
“Seems sensible but there might be some interesting knock on effects for NHSE senior people.”
“Until Commissioners across England learn how to drive and sustain tough contracts with full and well informed awareness of the patient outcomes, NHSE will continue to lose out.”
“As a past PCT CEO who chaired a regional specialised commissioning consortium of PCTs over a number of years, dealing with both regional specialties and also dealing with other London contracts, I can confidently say that if NHSEng does not have a real grip on this, they will shortly have a very large hole in their financial forecasts…This is after all c. 30% of the total NHS budget, and being (often) tertiary the pathways are much less amenable to more normal demand management approaches…”
12.51pm Here are some of the Social Pioneers’ nominations we’ve had through Twitter:
“I nominate the @revdavesouthall and his good news blog for the #socialpioneers”
”#SocialPioneers for me are @AgencyNurse @DGFoord & @VictoriaBetton …who are yours?”
“Another of my #socialpioneers who was doing social when I was still writing letters is the fabulous @thus_spake_z”
“I nominate @AgencyNurse for #SocialPioneers. What she’s done for the nurse community with @WeNurses is peerless!”
Jim Gee, former director of NHS Counter Fraud Services, said cutting the cost of fraud should be made a priority in the health service.
His remarks, in a Panorama programme broadcast on BBC One, come ahead of the publication of a study co-authored by Mr Gee claiming fraud is costing the NHS £5bn a year, with a further £2bn lost to errors.
12.07pm Shadow health secretary Andy Burnham will deliver a speech to the Association of Chief Executives of Voluntary Organisations today to outline a new role for charities and social enterprises if Labour were to run the NHS.
Mr Burnham will say that the Government has neglected the voluntary sector and citizens’ needs. He will say “the time has come to re-set the NHS for the 21st Century as a service for the whole person.” At the centre of “whole-person care”, Mr Burnham will say, lies the voluntary sector. “For too long, informal carers have been taken for granted and invisible to the system. The voluntary sector has been left to work in isolation from the NHS, filling in the gaps.”
Mr Burnham will articulate a Labour vision for public service reform, which departs from large, block contracts to outsourced providers. “The NHS must move away from its approach of offering one-off, short-term contracts to forming long-term trusted partnerships, with the voluntary sector’s role clearly set out.”
He will argue that the NHS must not be shy of radical reform and working with the voluntary sector.
In a speech at the same conference, ACEVO Chief Executive Sir Stephen Bubb, who in 2011 led the Coalition Government’s review of Competition in the NHS, will argue that strong political leadership is necessary to ensure that NHS reform works for citizens rather than large private sector contractors:
“Citizens should always have the opportunity to choose community-based approaches over hospital-based provision. ‘Citizens’ rights’ and their ‘right to challenge’ public sector monopolies must be enshrined in legislation. Such rights are already part of the Government’s rhetoric, but after a promising start they have fallen by the wayside.”
HSJ has also learnt that the CCG has readvertised for a permanent chief executive, after failing to recruit during the winter.
A paper to the county’s health and wellbeing board this month shows the CCG is forecasting it will record a £6.1m unplanned deficit in 2013-14 and planning for a £7.6m deficit in 2014-15. For 2015-16, it is expecting to break-even, but will not meet the NHS England national requirements to record a 1 per cent surplus and spend 3 per cent of its budget non-recurrently. The CCG is only expecting to meet these requirements in 2016-17.
11.44am Incoming NHS England chief Simon Stevens is considering appointing a senior NHS management figure to lead on specialised commissioning, HSJ has learned.
HSJ understands Mr Stevens has had discussions with a number of leading trust chief executives about taking on the role, which could be a board level position.
Overall responsibility for specialised commissioning currently sits with director of operations Barbara Hakin. However, individuals working on it are dispersed throughout the operations, finance and the medical directorates.
11.21am HSJ is looking for nominations for our social media pioneers - those who are communicating in new and interesting ways to try and reach a wide audience.
You can nominate someone using the form on this article or through Twitter using #socialpioneers.
11.00am Over on our LinkedIn page there is a debate underway over David Nicholson’s exit interview with HSJ. Join in here.
10.55am Competition could work better in the purchase and supply of Information and Communications Technology products and services to the public sector, according to an Office of Fair Trading market study.
The OFT is recommending that the public sector address these concerns by improving the way it procures and manages contracts with suppliers, and that suppliers be more transparent with their public sector customers.
It is estimated that £13.8bn was spent on ICT in the public sector in 2011-12.
The OFT study looked at competition between companies in two key areas that account for around half of UK public sector ICT expenditure – commercial off-the-shelf software and outsourced IT.
The OFT found that there are barriers preventing companies from entering the market or expanding their share of supply, and also deterring buyers from switching between suppliers.
These include:
- Overly complex procurement practices that mean responding to tenders can be time consuming and expensive
- Prohibitively costly and time consuming processes for gaining security clearances to carry out public sector ICT work
- The inherent advantage held by some incumbent suppliers can lead to significant switching costs. For example, the incumbent may provide bespoke products that large numbers of staff are trained to use – leading to significant costs and disruption from changing supplier.
The OFT also found that the public sector lacks sufficient in-house commercial and technical expertise that could help it understand and manage large and complex ICT contracts more effectively. In addition, ICT suppliers tend to know more than public sector buyers about the quality and suitability of ICT goods and services. This imbalance of information can be compounded by the practices of suppliers such as complex pricing and a lack of transparency.
The OFT has made some recommendations:
- The public sector should continue to seek improvements in the way it procures and manages contracts with suppliers.
- ICT suppliers should also do more to improve understanding for public sector buyers.
10.38am A new website with information on mental health problems in children and young people has been launced today.
The launch of MindEd was accompanied by a survey which shows over a third of adults are unsure of the signs of depression in children, and more than half of adults lack the confidence to approach a child, or a parent of a child, that they suspect to have a mental health problem, in case they are mistaken.
The MindEd website is funded by the Department of Health, and has been developed by a Consortium of seven organisations, including the Royal College of Psychiatrists.
Professor Sue Bailey, President of the Royal College of Psychiatrists, said: “We are delighted that our members have been involved in the fantastic new MindEd website. There has been a large increase in young people’s mental health problems in the last 25 years. One in 10 children and young people have a diagnosable mental disorder, which is equivalent to three children in every classroom. And half of all diagnosable mental health problems start before the age of 14.
“Identifying these problems and providing the right support at an early stage should be a priority. I believe the MindEd website will be an invaluable resource for everyone who works with children and young people, and will truly support the development of young healthy minds.”
10.34am The Financial Times reports that the Department of Health does not know exactly how much money the NHS loses to fraud each year.
This has emerged following a BBC investigation that found up to £7bn may be disappearing through criminal schemes or mistakes.
10.26am The Times this morning reports that nine out of ten businesses say the rise of dementia cases and the pressure on staff to look after relatives who need care is an increasingly pressing concern for their company.
A study by the group Employers for Carers, a business forum, found that employees are increasingly under stress due to caring responsibilities, causing physical and mental health problems, declining productivity and a loss of valuable staff.
10.24am The Daily Mail reports that doctors are needlessly prescribing antibiotics according to Professor Dame Sally Davies.
Professor Davies said GPs are prescribing antibiotics to patients who are reluctant to take time off work with minor illnesses.
10.20am The Telegraph reports that unbranded cigarette packs could cause people to smoke more, according to data from Australia pulled together by Philip Morris International, the Marlboro maker.
They claim that putting cigarettes in plain packets could lead to a rise in sales because smokers will no longer care about buying expensive brands.
Director of Action on Smoking Deborah Arnott said: “We are repeatedly seeing attempts to undermine the case for standardised packaging. The number one reason for standardised packaging is to protect children. It is about dissuading them from taking up smoking - and one year’s data from Australia about delivery levels of tobacco tells us nothing about that.”
9.56am The number of people working for the NHS has increased slightly according to the latest workforce figures from the Health and Social Care Information Centre.
Over 1.36 million people were working for the NHS in England at 30 September 2013 an increase of 0.4 per cent (5,870) on 2012. This makes up an increase of 12.5 per cent (151,580) since 2003.
The figures show that GPs number 40,240, a decrease of 0.1 per cent since 2012 and an increase of 19.9 per cent since 2003.
There are 20,440 females within the GP workforce, an increase of 2.9 per cent since 2012. This is the first year the number of female GPs has been greater than their male counterparts. Male GP headcount is 19,800, a decrease of 2.9 per cent since 2012.
There has been an increase of 50.9 per cent female GPs since 2003, whereas male GP numbers have decreased by 1.1 per cent.
There has also been a 2.4 per cent increase in the number of doctors in training since 2012 and a 46.2 per cent increase since 2003.
Consultants have increase by 2 per cent on 2012 and 43.4 per cent on 2003.
Qualified nurse numbers have not risen as much with a 0.4 per cent increase on 2012 and a 6.5 per cent increase on 2003.
HSCIC chair Kingsley Manning said: “Today’s figures show an overall rise in staff numbers across the whole NHS, with increases for doctors, nurses and a slight decline in management figures.”
9.47am Providing compassionate care is not only a concern for nurses, it is relevant throughout the health service, writes Paul Crawford in our Comment section.
He argues that compassion and cost-effectiveness can work togther.
9.35am The NHS could face an increased tax bill of at least £500m from 1 April when HM Revenue and Customs attempts to standardise across all government departments the rules for reclaiming VAT on outsourced services, experts have warned.
Tax advisors have told HSJ that changes introduced to VAT recovery rules for certain contracted out services – including administrative agency staff, estates maintenance, and professional services including consultancy – could mean NHS organisations face substantial increased costs.
An analysis by auditors Ernst & Young found that the loss of this recoverable VAT could cost the NHS upwards of £500m.
7.00am Good morning and welcome to HSJ Live. To start the day, the chief executive of University Hospitals Birmingham Foundation Trust turns back the clock to tell her younger self about the received wisdom she will encounter throughout her NHS career.
All this week HSJ celebrates the launch of its list of the top 50 chief executives of NHS provider organisations.
No comments yet