5.23pm The Financial Times is reporting that Capita and Circle have formed a partnership and plan to bid for NHS contracts. The paper said this would cover everything from “hospitals to adult and social care as well as back office functions such as managing payrolls and handling legal claims”. It said Capita is understood to have proposed the tie-up.
4.38pm As part of HSJ’s celebration on inspiring women leaders in healthcare, HSJ has been pinning onto our social media site Pinterest, the profiles of women in history who paved the way for female leaders working in healthcare today. Pinterest is an open network that allows you to share images. You can see some of the women included here. You can suggest historical women to include by tweeting us using #HSJWomen.
4.03pm Cure the NHS founder Julie Bailey, whose campaigning led to the Mid Staffordshire public inquiry, has commented on the special adminstrator’s proposals.
Ms Bailey, who has moved away from Stafford after being villified by some members of the community, said: “I understand the administrators have been very well informed and very thorough in their involvement of clinicians - the only people who are qualified to advise on this matter. I have every faith that the administrators are making the right proposals.
“Many of today’s proposals will be of concern for people in Stafford. Everyone deserves the best possible care from their local hospital and other care services. Cure The NHS still firmly believes that patient safety has to be the number one priority.”
She said moving some services to Univeristy Hospital of North Staffordshire would be a “be a good thing for Stafford Hospital and everyone who relies on it.”
“Evidence shows that specialist centres, such as the University Hospital of North Staffordshire, have the safest outcomes for patients,” she added.
3.35pm Mike Farrar, chief executive of the NHS Confederation, has commented on both the Mid Staffordshire and Lewisham announcements.
On Mid Staffordshire, he said: “It is in no one’s interest to keep pushing the trust towards the cliff edge - we need to have safe, sustainable and affordable services for the local community.
“Instead of simply focusing on the administrator’s proposals for dissolving the trust, we need to look at how services will be delivered. We must make sure the administrator’s proposals leave the people of Stafford and surrounding areas with services that are not only high quality, but accessible and adequately staffed.”
He described the case of Lewisham as showing “the difficulty and tensions that local changes to services create”.
3.06pm Royal College of Midwives chief Cathy Warwick has welcomed the quashing of the Lewisham hospital downgrade and said she hopes the issue is finally settled.
“The RCM has always been concerned that the proposed closure of the obstetric unit of Lewisham Hospital will increase pressure on neighbouring units, at a time when the demand for maternity services is increasing,” she said.
“We have already witnessed the temporary suspension of services at maternity units in the area on repeated occasions and the closure of the maternity unit at Lewisham would only compound this situation, as well as reducing choice and access of services for local women and their families.”
2.49pm Shaun Lintern’s story on the developments in the negotiations on the consultant contract has been updated.
2.41pm Chief officer of Cannock and Stafford and Surrounds CCGs Andrew Donald has commented on the special adminstrator’s recommendations. He said: “Throughout the TSA process the CCGs Clinical Leads have been working hard with the administrators to ensure they fully understand what we want to achieve for our local populations. It has always been our desire to retain as many services as locally as possible. We understand that any draft recommendations made must ensure that services are clinically and financially sustainable in the long term.
He added: “We have only just seen the draft recommendations and now need time to review the contents of the report, working with our GP member practices to agree our formal response to the draft report as part of the consultation process”
2.28pm NHS England chief executive David Nicholson has written a blog on his visit to the Royal Wolverhampton Hospital Trust.
2.24pm Ben Clover’s report on the Lewisham decision is now online. Read it here.
2.16pm HSJ’s Shaun Lintern tweets: BREAKING: Overall trust administrators say 91% of patient interactions at #MidStaffs will continue. So hardly a closure or downgrade?
2.07pm Breaking news on Mid Staffs: the trust special adminstator has recommended the trust be “dissolved”. The plans drawn up by the Monitor-appointed administrators also calls for the closure of maternity services and backs the retention of accident and emergency services between 8am and 10pm, the hours they currently operate.
2.05pm The union Unite has described the Lewisham decision as a “slap in the face for Jeremy Hunt”. Executive directort of policy Steve Turner said: “If there are concerns in the south London cluster of hospitals, then these need to be addressed by tackling the appalling PFI debts crippling these services. Downgrading Lewisham hospital is not the answer. The answer is to address the handcuff contracts choking the life out of the NHS.”
1.52pm The British Medical Council has commented on the Lewisham decision. Chair of the BMA Council Dr Mark Porter said: “It is deeply worrying in the case of Lewisham hospital that the High Court has found that the Health Secretary breached his statutory powers when making the decision to downgrade the emergency care department and maternity units at the hospital.
“Doctors, healthcare staff and patients were concerned that the consultation period was too short and that local people needed more time to put their views across. It is vital that changes to services have the confidence of the local community and the NHS staff who work there.
“There must be an urgent review into the events that led to this situation to ensure that lessons are learned for the future.”
1.48pm NHS England has shelved proposals to change how it commissions gender reassignment surgery following clinicians’ concerns, HSJ’s Ben Clover reports. NHS England took responsibility for commissioning gender reassignment services in April among the £12bn in specialist services it directly commissions. It had consulted on reducing the period indivduals must spend living as their preferred gender. However, following concerns from clinicians this could lead to an increase in the number of people regretting having the irreversible surgery NHS England has had a rethink.
1.36pm An announcement on the trust special administrator’s recommendations for Mid Staffordshire Foundation Trust is expected after 2pm.
1.33pm The Royal College of Midwives has branded the Treasury’s decision to change the way the value of the pensions scheme is calculated, revealed by HSJ this morning, as “peverse”.
Director of policy, employment relations and communications Jon Skewes said: “The Government announced the changes to the NHS Pension Scheme to much fanfare guaranteeing that there would be no need to change the pension scheme for 25 years as their changes were sustainable for the future. Now, just one year later they have taken the perverse decision to change the way the scheme is calculated to result in the scheme appearing to be in debt.
“We ask Ministers to stop tinkering with the calculations and rethink their proposal. Attempts to undermine the pension scheme will result in more and more hard working NHS staff loosing confidence in their pension and will opt out of the scheme. At a time when the Government is strongly encouraging people to sensibly save for their future and pay into a pension it is ludicrous to create confusion and undermine confidence in pensions.”
1.29pm The NHS Confederation has commented on the Lewisham decision. Chief executive Mike Farrar said: “There is no doubt the administrator’s proposals for South London and Lewisham have caused controversy, but we should remember that the original intention shared by all organisations was to find a way to create sustainable high quality care that was affordable. This remains the underlying issue that has to be solved and one which cannot be ignored.
“The Secretary of State was right to appoint a special administrator to address the spiralling problems facing South London, but clearly the process underpinning this work has not been robust and all parties will now have to work on a new solution. This must have a lawful basis.
1.25pm Following the news that NHS Direct plans to withdraw from all its 111 contracts, we have updated our timeline of the troubled rollout of the non-emergency number, including an HSJ Podcast, Briefing and commentary from Michael White.
1.21pm Today’s Telegraph leader column focuses on reform of the NHS, highlighting the roll out of NHS 111 as a “case study in how good intentions can go awry”. Leaving the running of the NHS to “managers and producers” in exchange for “ever-greater amounts of public money” will not work anymore. The NHS should not abandon attempts at reform but “think of ways to do it better”.
The paper also reports on the results of the friends and family test, published yesterday, under the headline “Four in 10 unhappy with their local A&E ward”.
12.44pm A quick reminder that the deadline to enter the Compassionate Patient Care category at the HSJ Awards is this Friday. The new award, which recognises “those who demonstrate real excellence in care”, joins 21 other categories that have already attracted hundreds of entries.
For more information visit the HSJ Awards website.
12.31pm The Foundation Trust Network is calling for a “much quicker and more effective way of delivering changes” to the NHS on the day of South London Judicial Review and Mid Staffs consultation launch, including primary legislation if necessary.
Chief executive Chris Hopson said: “The NHS is in danger of becoming impossibly stuck. It’s just taking far too long to make the changes to NHS services that are needed in many local areas.
“It’s easy to understand local objections. But, in both Stafford and South London, local doctors and the trusts themselves have said that, in future, they will no longer be able to provide safe and affordable services. Sensible and well run processes have created new plans - the only clinically and financially sustainable ones on offer. But these are now being challenged and time is dragging on.
“We can’t go on like this. Pouring a million pounds of NHS money a week into South London Healthcare indefinitely simply can’t make sense. The same applies to keeping services unchanged in Mid Staffs when local clinicians are telling us this will risk future patient safety.
“The recent indication from the Competition Commission that they will prevent Bournemouth and Poole merging - the only way that those trusts believe they can ensure safe and affordable services - is a third example of the same problem.
“We believe that there are well over 50 similar instances where the current pattern of delivery is no longer sustainable and major changes will be needed.
“Jeremy Hunt showed strong positive leadership in his initial decision on South London - he knows the NHS has to make these vital changes. He now needs to quickly bring all the NHS together to create a much quicker and more effective way of delivering this type of change. And if that requires changes in primary legislation, we need those quickly too”.
12.20pm Commenting on the progress on the renegotiation of the consultants’ contract chief executive of NHS Employers Dean Royles said: “This is an important step towards ensuring we have a consultants’ contract that continues to deliver for patients. Recent reports into the quality of NHS services like the Francis report and the Keogh review starkly highlight the importance of safe staffing throughout the week. We are hopeful that we can work in partnership to negotiate changes which will be better for doctors, employers and crucially our patients.
“Our discussions with the BMA over the development of these heads of terms have been extremely useful and we very much hope to continue with a constructive dialogue and achieve a mandate to enter into formal negotiations.”
12.18pm In relation to HSJ’s exclusive story that the Treasury’s pension reform plans that could drain billions of pounds from the NHS budget (see 10.39am), HSJ editor Alastair McLellan says in his leader: “The direct consequence of the changes would be twofold: the increased use of staff not eligible for an NHS pension and an attempt to cut the workforce through reductions in the range of services offered.”
12.13pm Bill Morgan, adviser to Andrew Lasnley when he was health secretary, has responded to Ben Clover’s question about whether the Lewisham decision means the failure regime is worthless. He tweets:
“v difficult Qs. Obv need to read judgement, but seems TSA can only be used at individual trust level, not for ‘system management’”
12.07pm The British Medical Association has revealed details of the Heads of Terms agreed with NHS Employersfor the renegotiation ofthe consultants’ contract.
The draft heads of terms focuses mainly on three key areas:
· Exploration of contractual changes to facilitate seven-day services
· The reform of local and national Clinical Excellence Awards schemes
· A review of pay progression to seek to enhance the provision of safe, high quality care, to reflect the professional development of the consultant and to reward a well-motivated, stable workforce while ensuring it is affordable.
Dr Paul Flynn, chair of the BMA’s UK Consultants’ Committee, said “Never has it been more important that consultants are empowered to drive forward quality in the NHS. We will be considering whether changes to the consultant contract can help this while ensuring that a consultant career is an attractive and rewarding choice.”
12.04pm Royal College of Nursing’s London regional director Bernell Bussue has welcomed the High Court’s decision. He said: “The High Court’s decision to save Lewisham A&E is welcome news for patients in South East London. This is a popular local unit and there has been a passionate campaign by local residents.
“There has never been a clinical justification for shutting Lewisham’s A&E. This ruling sets a precedent that successful hospitals cannot be pulled under by the financial failings of their neighbours.”
11.54am Mr Justice Silver also highlighted prime minister David Cameron’s commitment ot Lewisham MP Dame Joan Ruddock that reconfiguration would not be pushed through without the support of local GPs. The Lewisham downgrade decision did not have the support of GPs.
11.52am Leigh Day have highlighted the key points of the ruling: The High Court today found that “The TSA did not have vires [the power] to make his recommendations relating to LH [Lewisham Hospital]; The Secretary of State did not have vires to make his Decision relating to LH.” (Para 208) ‘Therefore the Decision of the Secretary of State insofar as it relates to LH must be quashed as must the recommendations of the TSA also insofar as they relate to LH.’ (Para 210)
11.46am Ben confirms the DH has asked for leave to appeal and it has been granted. He highlights some of the questions that the ruling poses:
“Decision quashed. Some difficult questions for the DH and TSA legal advisors. Failure regime legislation effectively worthless for the NHS?”
11.44am Rosa Curling of the law firm Leigh Day, who represented the Save Lewisham Hospital Group which challenged the special adminstrators decision, has commented on the ruling.
“When the Secretary of State appointed the Trust Special Administrator to investigate and develop recommendations on the future of South London Healthcare NHS Trust, he promised that there would be no “back-door approach to reconfiguration”; there would be no reconfiguration of neighbouring NHS services delivered by other NHS bodies beyond the South London Trust.
“He broke this promise - in fact, his decision regarding South London included a substantial reconfiguration of services delivered by other NHS bodies beyond South London and in particular in relation to Lewisham Hospital. The court has today agreed that the TSA and the Secretary of State has no legal power to do this and has emphatically made clear that this decision should be quashed.”
11.41am The government has lost the judicial review over the Lewisham A&E downgrade. Ben Clover tweets: Judge concludes the claimants were correct, TSA and Hunt did not have authority to make that decision under the act. Applause in court 76
11.40am From Ben Clover at the High Court: Justice Silver says he was not looking at whether services should be reduced at Lewisham but whether TSA had the legal authority to do so
11.33am The decision on Lewisham is moments away. Ben Clover tweets: “Judge Silber has just sat down and is reading summary”
11.23am Back to the CQC’s board meeting. Chief inspector of hospitals Sir Mike Richards tells the board he will be co-producing a methodology for inspecting mental health trusts with the sector. This will be consulted on later this year with the hope of piloting it in early 2014. Sir Mike said he hoped to “catch up” so that there was parity between mental health and acute trusts.
“A lot of principles will be the same but the application will be different because mental health trusts are on a number of different sites,” he said.
11.15am The Foundation Trust Network has welcomed the Heads of Terms agreement between the British Medical Association and NHS Employers about the negotiations for the new consultant contract, warning a lack of progress would mean trusts would look to make their own local arrangements.
FTN Chief Executive Chris Hopson said: “The consultant contract is a cornerstone of the NHS workforce and must become a foundation upon which high quality affordable healthcare can be delivered and not a deadweight holding it back.”
He added: “The new contract will need to be one that recognises the immense contribution of NHS consultants and provides value for money for taxpayers. The public will expect it to be fair at a time of huge pressure on public and personal spending. Without progress on the consultant contract, it is inevitable that trusts will look to make their own local arrangements.
“The primary aim of the negotiations should be a consultant contract which enables providers to design services around the patient in a sustainable way. It is crucial that a reformed contract also helps to incentivise doctors to move into those specialities, such as A&E, where there are more vacancies than applicants at a time when we know a new generation of consultants will be qualifying.
11.12am HSJ understands an agreement has been reached between NHS Employers and the British Medical Association on terms to renegotiate the consultant contract, Shaun Lintern reports.
It is believed an announcement will be made later today revealing heads of terms have been agreed, setting the scope of any future talks.
11.11am CQC director of strategy Paul Bate tells the board they will be using the results of the friends and family test in their surveillance model. He acknowledges concerns about the test but says there is a moderate correlation with mortality rates and a lot of value from the free text box where patients can make comments about their care. Chief inspector of hospitals Mike Richards said looking to see whether trusts were displaying their results during inspections would also be important.
11.06am The CQC’s board is now discussing the report into bullying at the CQC published last week. Chief executive David Behan says some people were moved to tears when reading the report after feeling they had been complicit in a culture that allowed that behaviour to take place.
10.48am Robert Francis is one of a number of appointments to the board of a new charity which aims to “transform the culture” of health and care organisations. The Point of Care Foundation was previously a programme within the King’s Fund but set up as an independent charity in April this year. It offers practical tools to improve staff engagement and patient experience, including Schwartz Center Rounds® which give staff an opportunity to reflect on the challenges of providing care.
The other trustees alongside Mr Francis are: Sean Elyan, medical director at Gloucestershire Hospitals Foundation Trust, Ceinwen Giles, Clore Social Leadership fellow and patient advocate, Rebecca Gray, director of communications and information at The King’s Fund and Jill Maben, chair in Nursing Research, King’s College London and Director of the National Nursing Research Unit.
The charity will be chaired by Sir Adrian Montague, chairman of the private equity firm 3i plc and Anglian Water.
The Government is investing £650,000 to expand a pilot of Schwartz Center Rounds to an extra 40 hospitals over the next two years, as reported by Nursing Times earlier this year.
10.42am Shaun Lintern tweets about his exclusive pensions story: ‘NHS Employers and unions say the unexpected raid on pensions will mean service cuts and job losses will be “inevitable.”’
10.40am In an exclusive interview with HSJ’s James Illman, former NHS England chief operating officer Ian Dalton revelas he will not be applying for the top job when chief executive David Nicholson leaves next year.
10.39am An exclusive from HSJ’s Shaun Lintern is bad news for NHS finances.
Exclusive: Treasury raid on pensions could drain billions from NHS
10.35am Breaking news on Lewisham. Ben Clover tweets:
“I understand the judge has ruled the special administrator acted outside his powers making a decision abt Lewisham when appointed to SLHT [South London Healthcare Trust]”
He adds: “The fact tht GP opposition meant it also fails the 4 tests was an own goal, given ithat they’re not legislation. Understand DH is appealing”
10.33am The Royal Society of Medicine is warning of a likely reduction in the quality of patient care in August due to the cohort of new junior doctors taking up their posts. The warning is based on new research which suggests that junior doctors in their annual changeover period fail to identify deteriorating patients and have poor prioritisation skills.
Researchers writing in JRSM Short Reports, the open-access offshoot to the Journal of the Royal Society of Medicine, found that there was a significant increase in the number of urgent medical tasks after changeover, but that new junior doctors completed routine tasks quicker than their more experienced predecessors. The researchers analysed data from the wireless system for the management of out-of-hours workflow at City Hospital and the Queen’s Medical Centre, Nottingham.
Lead researcher Dr John Blakey of the Liverpool School of Tropical Medicine, said: “The abrupt change to the provision of care by junior doctors who are inexperienced, or who are less experienced for their level of seniority, presents clear potential for a reduction in the quality and safety of patient care.”
10.24am And background to the Lewisham decision is here.
10.21am A quick summary of the background to the special adminstrators’ decision on Mid Staffordshire Foundation Trust’sfuture is here.
10.15am In another hugely important legal decision the BBC reports Right to Die Campaigners have lost their court battle.
10.13am HSJ’s Shaun Lintern has been watching the CQC’s board meeting at which they are discussing their response to the Francis report with the man himself:
”#Francis warns about the #NHS system which he says can “crush the compassion” out of people and put them into their own “indvidual silos”
10.10am HSJ’s reporter Ben Clover is covering the judicial review of the decision to downgrade Lewisham Hospital’s accident and emergency department, due this morning. He tweets:
“Multiple sources now indicate the government might have lost the Lewisham Hospital downgrade judicial review”
10.05am Robert Francis is appearing at the meeting. New non-exec Camilla Cavendish, the Sunday Times journalist, asks what happens to people who are well intentioned and want to do a good job but end up being involved in cover-ups. He says he understands the risk of defensiveness through the introduction of criminal sanctions for a lack of openness but sometimes it is necessary to have accountability. He says his recommendations seek to deter people from preventing others from doing the right thing.
9.54am The CQC’s board meeting is taking place this morning. Non-executive director Kay Sheldon, who blew the whistle to appear at the Mid Staffordshire Foundation Trust public inquiry and has recently had her term on the board renewed, tells the board she is seeing the early signs of a positive culture. She says she wouldn’t have agreed to stay on if she hadn’t been confident of that.
8.48am: Good morning, a review conducted by Beacon UK has demonstrated that only 3.2 per cent of child and adolescent mental health services’ patients in a London borough successfully transitioned to adult ones.
Even when an appropriate adult service did exist, the clinical threshold for acceptance into the service tended to be significantly higher than in child ones. This meant that only 17 per cent of referrals were actually accepted. On HSJ’s innovation and efficiency channel Emma Stanton writes on the need to establish new ways to reach young people and improve transitions from adolescent to adult mental healthcare.
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