Health Service Journal
October 2006
View all stories from this issue.
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'A win-win for both patient and budget'
Finance - Claremont Medical Practice in Exmouth, East Devon -
Andrew Castle on measuring performance
'If we are interested in productivity, quality of output and whether services are being delivered on time and at the right cost, theatre use is not the right measure.' -
Andrew Jones on financial influence
'Providers under fire are likely to react to fill up their capacity and treat more invasively. This will mean more operations and more investigations.' -
Audit Commission report criticises Ipswich trust as deficit reaches £24m
An NHS trust has been strongly criticised for its financial management during a year in which it had four different deputy directors of finance. -
Blazing a trail for cliniical audit
Two clinical auditors left a run-down clinical service and set up a firm to inject their profession with some much-needed rigour. Stuart Shepherd reports -
Bolton Hospitals trust - lean thinking
Download powerpoint presentations from the event -
Boosting nursing numbers could save lives, says RCN
Patients on wards with fewer nurses are more likely to experience complications, according to research launched by the Royal College of Nursing. The research also found that nurses working on wards with lower numbers of nurses are more likely to experience burn out.Read the press release here -
Call to scrap funding formula
The NHS funding formula is based on an untested scientific premise and should be scrapped, the chief economic advisor to the Department of Health was told last week. -
Cancer waiting targets: a guide (version 4)
The latest version of the document outlining cancer waiting targets, providing answers to frequently asked questions about the 2001, 2002 & 2005 Cancer Plan targets. Published in July 2005. -
Choice: NPSA attacks 'meaningless glossy menus'
The National Patient Safety Agency is to push for better information to inform choice after branding the sort of information available to patients as 'meaningless'. -
Conservative conference: charities push for changes to GP incentive framework
Two charities are planning to launch a campaign to push for GPs' incentive payments to be based much more on their success in improving public health. -
Cross-party politicians unite for rival London blueprint
A council, two MPs and a London Assembly member have drawn up their own plans for a reconfiguration of health services in their part of north London. -
Deborah O'Dea on good employers
I recently had lunch with a friend employed at a strategic health authority. Asked by an outplacement consultant what sort of job she wanted, she replied: 'Well I'd really like to keep the one I've got. Yes, that's exactly the job I'd like.' -
Dignity nurse plan scrapped
Plans for hospitals to appoint a 'dignity nurse' have been dropped after the proposal was 'misinterpreted'. -
DoH calls for new definition of urgent care centres
The NHS needs a new definition of an urgent care centre and the minimum range of services patients can expect to find there, the Department of Health has said. -
DoH pledges support teams
The Department of Health is to create a national support team to help primary care trusts and local authorities tackle public health. -
DoH publishes new smoking cessation figures
The Department of Health has published the latest quarterly statistics on access to smoking cessation services. It shows Bedfordshire and Hertfordshire strategic health authority had the highest proportion of successful quitters (63 per cent) while Cheshire and Merseyside SHA reported the lowest (41 per cent). http://www.ic.nhs.uk/pubs/stopsmoking042006to062006/easyfind/file -
Dr Natalie-Jane Macdonald on GPs and commissioning
'Strategic health authorities and GPs must represent the best interests of the citizen and patient... However, they face some pretty daunting challenges' -
Edna Robinson on effective networks
'As we move into an era of reconfiguration, effective networking will be crucial to enable patients to receive the best care' -
Fall in Scottish winter deaths
Winter deaths in Scotland have reached a record low. Nearly 1,000 fewer deaths were recorded between December 2005 and March 2006 than in the same period the year before.The winter had been relatively mild with no serious flu outbreak.For more on the figures click here -
Fall in Welsh waiting times
The number of people waiting for over eight months for inpatient or day-case treatment in Wales has fallen by 737 over the last quarter - a 10.5 per cent reduction. In outpatients, the number of people waiting over eight months for a first appointment has fallen by 5,870 over the quarter - a 34.4 per cent fall. Health minister Dr Brian Gibbons said: 'Health trusts in Wales have some tough targets to meet by March 2007 but the -
First findings from clinical measurement scheme show where more work is needed
The Health Foundation used this year's party political conferences to explore what impact national clinical measurement schemes are having on the NHS. -
Flint urges shops to weigh in on public health effort
Businesses, shops and employers must be drawn into efforts to improve public health, the government said this week. -
Food still leaves bad taste in patients' mouths
Almost half of hospital patients supplement their hospital food with offerings brought in by visitors, the biggest survey of its kind has revealed. -
Former health secretary urges halt to Tory manager bashing
The Conservatives will not win elections by continuing to vilify managers, the man drawing up the party's health policy said last week. -
Gail Richards on community cohesion
What do you think about when you hear the phrase 'community cohesion'? Is it only important in inner cities? And do we have a role to play? -
Gender-specific services: equal, but not the same
From next April, trusts will have a legal duty to demonstrate gender equity across all areas of service provision. But as the deadline approaches, the national picture is looking decidedly patchy. Gabriel Fleming looks at how it will work -
Get a buzz from Wasp: how to get ahead in workforce planning
A long-term conditions workforce planning modelling tool could have benefits across the service, reports Emma Dent -
GMC: patients should rate GPs
GPs should be rated by the public in the same way as users of auction website eBay, according to the president of the General Medical Council. -
Guidance for displaced staff
New advice to help trusts manage staff affected by redundancy or service change has been launched by the Department of Health and NHS Employers. It advises trusts to ring-fence vacancies for staff at risk of job losses. To read the press release click here -
Health professional training cuts average at 10pc
Training budgets for nurses and other healthcare professionals are being cut by up to a third in some parts of the country as strategic health authorities make savings to deal with deficits. -
Health secretary quashes local objections to back maternity plans
Health secretary Patricia Hewitt has quashed the objections of an overview and scrutiny committee and upheld local NHS proposals on maternity services on the advice of the independent reconfiguration panel. -
Healthcheck ratings: Audit Commission focuses on 37 trusts that failed in key areas
The Audit Commission has voiced concern about 37 organisations deemed to be failing in three key financial areas. It compiled findings from local auditors for 2005-06 and scored all non-foundation organisations in the category of 'use of resources', which makes up half of the healthcheck ratings. -
Healthcheck: just 11 have self-declared ratings reduced after inspection
The Healthcare Commission reviewed more trusts' self declarations than originally intended, chief executive Anna Walker has revealed.In total, 11 trusts had their overall rating reduced as a result of inspection of their self-declared standards. -
Hewitt warns: patients will vote with feet
Patients will 'vote with their feet' and refuse to be treated at poorly performing hospitals, health secretary Patricia Hewitt has said. -
Homeless people lack health support
Eight out of 10 homeless people do not know where to get health support to help with drug, alcohol or mental health problems, according to a homeless charity. Research carried out by Broadway on the impact its healthy living centre has on homeless and vulnerably housed people found service users were unlikely to access statutory health services and had limited knowledge of them. -
Identifying 'ghost' patients in residential and nursing homes
There are plenty of methodologies for systematically validating list of patients registered with primary care trusts to identify 'ghost' patients - those who no longer live at their recorded address or do not exist. -
In practice: reducing length of stay
Reducing hospital length of stay is an effective way to address the challenges of productivity and NHS financial efficiency. -
Inappropriate admissions: guidance to urge 12.5pc cut
The prime minister's delivery unit is taking a key role in shaping 'crisp' new guidance for primary care trusts to reduce inappropriate hospital admissions and save over £1.4bn a year. -
IT programme Accenture loss sparks fresh debate
The loss of another major contractor to the national IT programme has triggered a fresh round of debate about its future. -
'It's not about Americans in 10-gallon hats'
While North Eastern Derbyshire primary care trust's decision to award an APMS contract to UnitedHealth Europe ended in the High Court, at neighbouring Central and Greater Derby PCTs managers are confident that UHE will meet local people's needs. Lynne Greenwood reports -
Ivan Lewis accused of 'throwing his toys out of the pram' at Labour fringe meeting
Health minister Ivan Lewis was accused of 'throwing his toys out of the pram' after an angry performance at a Labour Party conference fringe meeting last week. -
Lansley: at-risk hospitals 'better off as charities'
Many community hospitals at risk of closure 'would be better off with charitable status' than remaining in the NHS, shadow health secretary Andrew Lansley has said. -
Lansley: PBC is not enough
GPs would be handed direct responsibility to manage demand under a Conservative government because the party does not believe primary care trusts are up to the task. -
Legal briefing: commissioning change after North Eastern Derbyshire PCT
PCTs need to be aware that commissioning of health services has to meet basic standards of transparency and fairness under European Union law -
Legal Briefing: resolving payment disputes between PCTs and foundation trusts
As the NHS becomes accustomed to the legally-binding contracts between primary care trusts and foundation trusts, the main pressure points are beginning to emerge. -
Lord Warner welcomes millionth choose and book referral
More than one million referrals to specialist care have been made through choose and book by GPs across England, health minister Lord Warner has announced.He said 85 per cent of all practices were using the IT system to make referrals, and more than 6,000 practices made referrals last week.Read the press release here -
Mayor calls for action on Muslim health in London
London mayor Ken Livingstone has called on NHS organisations to act on the recommendations of the first ever large-scale report on the lives of Muslims in the capital One in twelve Londoners is Muslim and the report finds that their health is disproportionately affected by low levels of employment, poor educational achievement and high crime rates. http://www.london.gov.uk/view -
McKinsey accused of unfair advantage on commissioning
Companies bidding to win a place on the government's list of approved commissioning support suppliers are questioning whether rival bidder McKinsey has been given an unfair advantage. -
More long-term contraceptives being used
One in five women are using long acting reversible contraception such as implants and the contraceptive jab, according to research by The Information Centre for health and social care. There has been a massive increase in the numbers of women using the intrauterine system and prescriptions for the female contraceptive injection have more than doubled in a decade. http://www.ic.nhs.u -
New chief for scandal trust
A new chief executive has been parachuted into a trust at the centre of a waiting-list scandal. -
New efficiency indicators launched
The National Institute for Innovation and Improvement has launched a set of efficiency indicators, a number of which have a people management dimension. -
New pay-off packages to reflect length of service
New redundancy and retirement packages based on length of service rather than age have been agreed by the Department of Health. -
News analysis: Five years and billions of pounds later, what has changed since Wanless?
Sir Derek Wanless's 2002 report prompted the chancellor to pump billions into the health service - but called for reform too. Now he is back to pack another punch by examining how wisely the money was spent and set out lessons for the future. Daniel Martin reports -
News analysis: 'Hot and cold' hospitals plan gets a chilly public reception
Momentum is growing for radical reconfiguration of acute services in England, which could mean closing dozens of 'excess' hospitals. But could a combination of celebrity campaigns and the fear of Kidderminster win out? Mark Gould reports -
News analysis: Jostling parties reignite debate on limiting Whitehall meddling
At their recent conferences all three major parties made proposals to devolve more power from the centre. Would this help bring structure and consistency to policy, or are they solutions without a problem? Daloni Carlisle takes a closer look -
News analysis: time to give PECs the muscle to make a real difference
Professional executive committees have been weighed down by corporate affairs and unable to influence strategy and clinical design, so the DoH's decision to review them has been widely welcomed. But what will the new PECs look like? Daloni Carlisle finds out -
NHS Appointments Commission: Wells to exit after six years
The chair of the NHS Appointments Commission is to step down at the end of his second term. -
NHS campaigners to hold mass demonstration outside Parliament
Protesters are to march on Westminster tomorrow to demonstrate against NHS 'cuts'. Health unions and community groups including the Trades Union Congress and Keep Our NHS Public plan to lobby MPs at the end of the protest. To download the announcement, click here -
NHS chief sets out surplus expectations
The NHS is aiming for a surplus of 0.5 per cent by 2008-09, David Nicholson told the Commons public accounts committee on Monday. -
NHS could save £2.2bn by tackling inefficiency
The NHS could save up to £2.2bn if trusts take steps to address wide variations in productivity and efficiency.The Department of Health has published its Better care, better valueindicators, which show trust-by-trust performance against a range of measures.Reducing unnecessary admissions could unlock £348m, and reducing wasted bed days a further £510m.Find out more here -
NHS Employers: far fewer job cuts than first claimed
The threat hanging over 20,000 NHS posts has amounted to fewer than 800 redundancies so far, NHS Employers has claimed. -
NHS Immunisation Statistics, England: 2004-05
Office of National Statistics report, published in September 2005, on vaccines uptake among children: MMR vaccine uptake rose slightly year-on-year, uptake of vaccines for dipththeria, tetanus, etc remained stable at 93 per cent. -
NHS London chiefs to face London assembly
The chair and interim chief executive of NHS London Dr George Greener and Ruth Carnall are to be questioned by the London Assembly's health and public services committee this week.Questions on finances, service provision and immunisation are expected at the Wednesday meeting.Foe more information go to www.london.gov.uk -
NHS Maternity Statistics, England 2004-5
A summary of information from the hospital episodes statistics relating to NHS maternities in the year 2004-05. Among the findings: 20 per cent of deliveries were induced, and the caesarean rate remained at just under 23 per cent. -
NHS Networks latest round-up
The best new material posted on the NHS Networks website -
NHS pay rises 'eaten up by inflation'
Big rises in the basics of daily living eat up 'cost of living' increases for NHS staff covered by the nurses and other health professions pay review body, according to research by Unison.In its evidence to the review body, the union says that last year's 2.5 per cent pay rise ended up as a pay cut due to increases in rent, council tax, electricity, gas, transport and food.Read the press release -
NHS redundancy figures revealed
NHS chief executive David Nicholson has published figures showing that 900 compulsory redundancies were made in the NHS in the first half of this financial year.The vast majority of those were in managerial and administrative roles and under a quarter in clinical posts.To see the figures click here -
NHS staff views on violent patients
Poll suggests NHS staff believe withholding treatment from violent patients is sometimes justifiable -
NICE chief calls for QOF recognition
The chief executive of the National Institute for Health and Clinical Excellence has criticised the government for not taking account of its guidance when drawing up the quality and outcomes framework. -
NICE insiders criticise Alzheimer's drug decision
The National Institute for Health and Clinical Excellence has been criticised by its own senior advisers for not listening to experts when deciding to limit the use of the only drugs available in the UK for Alzheimer's disease. -
Nicholson calls for 'headroom'
Creating 'financial headroom' this fiscal year is essential in coping with the risk of increased costs as healthcare shifts from hospitals to primary care, NHS chief executive David Nicholson told a Downing Street press conference on Tuesday. -
Out of harm's way: developing the PICU
Psychiatric intensive care units are meant to serve patients who are too ill for general inpatient treatment. Emma Dent investigates how they are developing their role in the absence of mandatory standards -
Payment by results tariff launched
The Department of Health has published the test version of the 2007-08 national tariff. The overall uplift in prices is 2.5 per cent, net of 2.5 per cent efficiency savings.NHS chief executive David Nicholson says trusts should use the latest version to model the impact of the increased tariff.To read his letter to strategic health authority chief executives, click -
PbR 'fundamentally flawed' says coding chief
The current system of payment by results is 'fundamentally flawed and unacceptable' the head of the Professional Association of Clinical Coders warned last week. -
PCT chief questions value of competency assessments
A primary care trust chief executive has given a 'warts and all' account of the fitness for purpose programme now about to launch into its third wave, demanding to know whether it is value for money. -
PCT to lose 90 posts in £29m cuts plan
A primary care trust has announced plans to cut up to 90 jobs in response to the Department of Health requirement to balance its books within one financial year. -
PCTs may face £1bn QOF bill
Primary care trusts will be required to pay out up to £1bn if all GP surgeries attain maximum points under the quality and outcomes framework this year. -
Plus signs in all the right places: a winning formula for HR
Ali Mohammed found himself hooked on human resources after a stint in a hospital personnel department. He tells Alexis Nolan that simplicity is the key to success -
Primary care trusts told to save money for 2006-07 GP payments
Primary care trust directors of finance should accrue funds during the financial year 2006-07 to enable them to pay GPs in the first quarter of 2007-08.The guidance is published in a series of letters to trusts and GPs about this year's GP Patient Survey.Read the letters here -
Private finance guidance for trusts published
New draft guidance which will help NHS trusts select, evaluate and appoint private sector bidders in private finance schemes has been published by the Department of Health.The guidance has been developed in conjunction with the Treasury, private sector contractors and managers of NHS organisations that have been through private finance initiative deals.Download the guidance here -
Productive ward: stand by your bed
Inpatient care swallows funds and staff time. Jennifer Taylor reports on a pilot scheme that aims to break the cycle -
Raj persaud on gender
'The female is often enduring several sacrifices to make the relationship work and the male isn't' -
Research shows how patient involvement can improve healthcare quality
Involve the patient for better health outcomes and efficiency. That's the strategy suggested by new research from the Health Foundation. -
Right to rehab reconsidered
The government is considering introducing a 'right to rehabilitation leave', health minister Andy Burnham has announced. -
Rise in NHS sight tests
Two out of three sight tests are paid for by the NHS, compared to a decade ago when almost half of all sight tests were carried out privately. The total number of sight tests has increased by 5 per cent since 2003-04 with a small increase in NHS eye tests, according to research carried out by The Information Centre for health and social care. -
Royal College of Nursing names new chief
Peter Carter has been appointed general secretary of the Royal College of Nursing. -
Sharing management between hospital and community
Glaucoma treatment: Peterborough and Stamford Hospitals foundation trust -
Social marketing in practice
The announcement last month by health minister Caroline Flint of the launch of a social marketing strategy for obesity next year highlights the importance of social marketing in delivering results that more traditional approaches fail to achieve. -
South West chief execs move in
As senior appointments for the newly reconfigured PCTs continue to take shape, HSJbrings you the latest recruits in the South West -
State of healthcare report published
The Healthcare Commission today published its State of Healthcare 2006report. The report includes the first assessment of the independent sector against minimum standards.The figures are available here -
Statistics on Alcohol: England, 2006
Document from the National Office of Statistics, published in July 2006, on alcohol use and misuse, examining drinking among school pupils, adults, and a survey of drinking-related ill-health, and country-wide economic costs. Among the report?s findings: 74 per cent of men and 59 per cent of women reported drinking an alcoholic drink on at least one day in the week prior to interview, and in 2004/5 there were around 35,600 NHS hospital admissions with a primary diagnosis of mental and behavioura -
Stephen Thornton on global patient safety challenges
'I was struck by how hospitals in Malawi and the UK face similar challenges in making healthcare safer for patients' The chief executive of the Health Foundation and our new regular columnist discusses the global challen -
The Health of Minority Ethnic Groups
Document from the Office of National Statistics, based on the 2004 Health Survey for England, and published in April 2006. It examines a range of health indicators among ethnic minority populations, including blood pressure, exercise levels, smoking and alcohol use, and obesity. Among the findings: diabetes was almost four times as prevalent in Bangladeshi men than among the general population, and black African boys were nearly twice as likely to be obese as compared to the general population. -
Tips for achieving the 18-week target
There is no magic solution to achieving the 18-week target from GP referral to hospital treatment; but the secret is to tighten up all aspects of every element of the patient's journey. -
Tobacco control: Fresh air for the North East
There are encouraging reports from an independent tobacco control agency set up in an area with the highest adult smoking prevalence in the country -
Tories call on government to work with them on NHS Independence Bill
David Cameron has challenged Labour to help his party draw up legislation to give 'independence' to the NHS. -
Tories will not rule out increased NHS spend
Shadow health secretary Andrew Lansley has hinted that a Conservative government could spend more on the NHS than a Labour government under Gordon Brown. -
Tory pledge for more nurses
Every school would have a school nurse under the Conservatives, Andrew Lansley told the party conference. -
'Unbundling' options promised soon
Ministers are to review financial incentives to encourage the NHS to rehabilitate older people in the community, rather than acute settings. -
Unions demand 'decent' pay increase
The 14 unions that make up the NHS Staff Council staff side have blasted a 1.5 per cent pay rise the Department of Health is predicted to propose. In a joint press conference the unions outlined their case for a 'decent' pay rise based on their evidence to the independent pay review body, which makes recommendations to the government on the level of pay awards for NHS workers. Amicus Health said attempts to -
Unison claims Labour conference victory on market
Unison has claimed a 'decisive' victory after Labour's attempts to agree a compromise statement on the future of the NHS failed - just a day after the union's motion criticising current health policy was carried. -
Wales exceeds forecast debt
The Welsh health service went over its forecast debt of £20m last year, ending £24m in the red. -
Wanless warning: future of NHS hangs on obesity action
The government has failed to tackle obesity - and unless it does so, the future of the NHS hangs in the balance, says the man who persuaded ministers to pump record sums into the service. -
Warner congratulates PCTs on practice-based commissioning progress
Primary care trusts and practices should be congratulated for 'keeping their eye on the ball', in spite of reorganisation, according to health minister Lord Warner. He was speaking after figures published today showed that at the end of September 82 per cent of PCTs had plans in place to achieve universal coverage of practice-based commissioning by the end of 2006. NHS North East and South West have now joined London in achieving 100 per cent coverage.The proportion of practices taking -
Warner: PCT consultations 'pretty inept'
Primary care trusts have been criticised by government ministers and opposition MPs for sparking public protests by their handling of reconfigurations. -
Website promises easier comparisons to promote public understanding
The Healthcare Commission today launched a new web service designed to allow the public to make easy national and local comparisons about the state of NHS services. -
West Midlands chiefs named
HSJ introduces eight new primary care trust chief executives appointed by NHS West Midlands -
Winterton: BME service discrimination 'unethical and unlawful'
Black and minority ethnic mental health service users are being discriminated against in ways that are unethical and unlawful, a health minister has admitted. -
Your Humble Servant: deliberative consultation
