All the latest news on the last working day of primary care trusts and strategic health authorities, before they are abolished under the commissioning transition
6.20pm: And finally. Over the bank holiday weekend we are bringing you a round-up of vital resources from our Leadership and Innovation and Efficiency channels. A selection of HSJ’s best technology articles over the last six weeks is already online.
In a joint HSJ/Capsticks survey of the most senior people in England’s hospital sector, 73 per cent said they did not believe the the introduction of a chief inspector of hospitals would be effective.
The plan for the new senior role at the Care Quality Commission was announced by the government in response to the Francis report.
5.16pm: NHS England has published its latest bulletin for CCGs. It says: “A joint approach to risk sharing for all aspects of direct commissioning, including specialised services, is being discussed between CCGs and area teams on a local basis.”
4.35pm: Health Foundation chief executive Stephen Thornton tweets: “Many of my contemporaries bow out today after years of service to NHS. I fear the loss of corporate memory and as a tax payer resent the cost.”
4.13pm: Chris Hopson, chief executive of the Foundation Trust Network, has blogged about Jeremy Hunt’s recent comparison of the NHS an airline, and the health secretary’s desire for a “zero harm” health service.
Mr Hopson writes: “It is time for a much more sophisticated debate about the levels of risk that we as a society are ready to tolerate in relation to healthcare – a debate that moves beyond simple comparisons between healthcare and airlines
3.38pm: HSJ reporter Sarah Calkin is just about to appear on Sky News to talk about the NHS 111 rollout.
3.26pm: Monitor has deferred foundation trust applications by Dudley and Walsall Mental Health Partnership and Royal United Hospital Bath trusts for up to six and 12 months respectively.
The regulator said it is concerned that the trusts have not yet demonstrated that they meet specific thresholds for authorisation.
The Care Quality Commission identified several areas of concern potentially impacting on the quality and safety of the services provided at Royal United Hospital Bath Trust. These were highlighted by the four outstanding CQC compliance actions and means the CQC will be re-inspecting the hospital.
Dudley and Walsall has been deferred for a short period to enable it to continue the important work it is already doing on strengthen their quality governance capabilities
3.01pm: Royal College of GPs chair Dr Clare Gerada has said of NHS 111:
“The RCGP is becoming increasingly concerned by reports of serious issues with the delivery of NHS 111 services in Manchester, south London and the Midlands. Patients and health professionals need to have confidence in the new system and how it works, and be assured that the health service will be there for them should they need it. We need urgent reassurance that patients and GPs will be able to rely on a fully functioning service from Monday, wherever they live and work.
“Many GPs in affected areas are stepping into the breach to protect vulnerable and worried patients and the RCGP will continue to monitor the situation.”
2.32pm, HSJ EXCLUSIVE: NHS England will not have a fully functioning IT system for up to six months after it takes on its full responsibilities next week, HSJ has learned.
The body, formerly known as the NHS Commissioning Board, will be in charge of more than £90bn of NHS funding from Monday.
Internal emails leaked to HSJ, sent in the past two months, reveal that private contractor firm Atos has been asked to set up an integrated computer system for all of NHS England.
2.28pm: The latest official report on finance and performance across the NHS − covering the third quarter of 2012-13 − has been published by the Department of Health. HSJ analysis to follow.
2.17pm: HSJ editor Alastair McLellan writes in his leader about the departing NHS leaders and the lack of successors. He says: “At dangerous time of change and there appear to be few volunteers to step into the breach. This is not surprising − the job of an NHS chief executive is a punishing one.”
2.01pm: Monitor has set out how it proposes to enforce the rules it will be responsible from 1 April. the regulator said its priority in exercising its functions is to ensure that patients’ interests are protected and promoted.
Powers in the Health and Social Care Act 2012 enable the regulator to take enforcement action against NHS foundation trusts, and other providers and organisations that breach relevant requirements of Monitor’s new regime.
Monitor can require providers who breach their licence conditions to put things right, or risk having their licence revoked in certain circumstances. In future it will also be able to impose financial penalties. More details are in Monitor’s enforcement guidance, published today.
12.46pm: Peter Smith has looked at the challenges facing new CCG chairs. He says: “It is not an easy job chairing a clinical commissioning group. Many volunteered (or were perhaps persuaded by their colleagues) and they are already discovering that leading the creation of a new organisation is hugely demanding. They are about to find out, from April, what it takes to make their CCG effective and high performing.”
12.41pm: On HSJ’s Commissioning channel, Candace Imison, deputy director of policy at the King’s Fund, has set out what the top 10 priorities for new commissioners from should be from 1 April.
She writes: “High-quality commissioning requires extensive collaboration and the ability to work with partners across the health and social care system to deliver change. [Commissioners] will need to make progress in all areas if they are to rise to the challenge of transforming the healthcare system.”
12.32pm: On Twitter, people are expressing reservations about the transition next week:
@MBirty: “Have heard some brilliant/depressing stories about NHS people with jobs in new system who are not sure where desk will be on Tues.”
@helen_whiteside: “We’ve no idea who to contact to collaborate even in own new organisations and only weeks ago got new T&Cs for posts.”
The former writes that the that NHS is in “a dangerous place… when all around are other government departments, eyeing the NHS’s ‘ringfence’”, while the latter says the NHS spending system needs a serious review.
11.39am: NHS England, previously known as the NHS Commissioning Board, has said it will will need to have “presentational consistency” with government policy as it adopts its new name.
Chair Malcolm Grant wrote in a letter that the name change “brings additional responsibility to work with other members of the health and social care system”.
11.19am: The Centre for Public Scrutiny has called on government not to ignore support for council health scrutiny in its plans to implement recommendations from the Francis report. HSJ’s full coverage of the Francis report and the goverment’s response is available here.
The centre says: “The government’s response to the Francis recommendations contains some important headline ideas. CfPS welcomes the principles behind appointing a chief inspector of hospitals, a duty of candour, banning contractual non-disclosure and a new approach to rating health services. We think that these initiatives can add value to a system that needs to refocus on the most important aspect of healthcare − the experiences of people who come through the doors of the NHS expecting compassionate care and treatment.
“The evidence in Robert Francis’ report leaves no doubt about the scale of what can go wrong when patients and the public struggle to get their voices heard. The important roles of the local Healthwatch network and Healthwatch England, connecting to health and wellbeing boards locally and the Care Quality Commission and secretary of state nationally, are rightly promoted in the response − but we think the government has missed an opportunity to set out their commitment to another of Mr Francis’ important recommendations − about support and guidance for council scrutiny.”
11.15am: George Eliot Hospital Trust chief executive Kevin McGee tweets: “Good bye to many old friends and colleagues from PCTs and SHAs leaving the service today. Best wishes for the future.”
11.12am: Surinder Sharma has beome chair of the HSC Network’s governing council. On taking up the appointment he said: “I am delighted to take on this role and continue to build on the very necessary work that needs to be done to ensure the healthcare sector embraces diversity and delivers fairness for all. The governing council provides an opportunity for professionals at the top of their game to put their heads together and come up with pragmatic solutions to some of the intractable challenges we have faced over the years”
11.09am: Dr Phil Hammond, a vocal critic of the Lansley reforms and contributor to HSJ, has tweeted: “How not to reorganise the NHS. In a mad rush on Easter Monday by sacking some of its best managers & not being able to replace them. Chaos++.” He has also invited Ruth Carnall to join NHS England. She didn’t take up the offer.
11.01am: Half of clinical commissioning groups have no conditions at all on their authorisation, NHS England has said, days before they take control. NHS England, previously called the NHS Commissioning Board, said 106 of the 211 groups were now “fully authorised”, following planned reviews of CCGs’ conditions. The other 105 still have conditions attached to their authorisation.
10.49am, HSJ EXCLUSIVE: A team of specialist lawyers is likely to take on an attempt to bring a private prosecution against NHS chief executive Sir David Nicholson, HSJ has been told.
Senior lawyers for the firm Edmonds Marshall McMahon have confirmed they are examining evidence to potentially bring charges against Sir David.
Charges could include corporate manslaughter, gross negligence manslaughter, misconduct in public office, perverting the course of justice and conspiracy to pervert the course of justice
10.42am: A couple more tweets reflecting on the last day before the commissioning transition:
@andrewridley112: “Last day in old NHS - many great leaders leaving today. What a waste.” Read Nick Timmins’ interviews with some of those leaders here.
@JanetAth: “Mixed emotions as leave NHS and move to local govt. Optimistic for future, glad to see back of transition, sad not to be part of NHS.”
10.37am: Richard Vautrey, deputy Chair of BMA’s GP committee, says on Twitter: “Received concerns about #NHS111 from Buckinghamshire, Shropshire, Staffs, Birmingham/Solihull, Kent, Medway, Brighton & East Sussex.”
10.30am: The British Medical Association has written to Sir David Nicholson to highlight its concerns about the NHS 111 service, which is due to go live in England on 1 April. The BMA said there should be a delay in the launch of a new non-emergency helpline, saying it is putting patient safety at risk.
Last week, HSJ broke the story that NHS Direct has been asked to provide a contingency service in almost a third of England due to delays in rolling out the urgent care phone number.
10.26am: Monitor has published further guidance about its new licensing regime and “commissioner requested services” − those which will receive particular protection if a provider is put into an administration regime. Earlier this month William Sprigge and Laura McIntyre wrote for HSJ, examining the issues facing providers as they prepare for the second wave of licensing.
10.20am: @HSJEditor tweets: “In advice to CCGs @clarercgp mentions @ruthcarnall ‘s request for HSJ to write an ‘idiot’s guide’ to NHS Competition.” The guide in question was written by HSJ’s Crispin Dowler.
10.12am: In an interview with the BBC, Dame Ruth Carnall has said she has neither spoken to, nor met, health secretary Jeremy Hunt, and says the reforms risk fragmenting NHS services in London. She also says the intervention in south-east London (covered in-depth in a HSJ Local Briefing earlier in the year) will happen again in other places in the capital.
On Twitter, @ruthcarnall says: “Yesterday was spent in tears with many friends and colleagues today airplane to Canada Used last days leave.” Read her advice for her successors, and lessons from other NHS leaders leaving the service, in HSJ’s cover story.
10.08am: The Department of Health has published its response to legal advice about the controversial competition regulations recently published by campaign group 38 Degrees.
9.50am: The Care Quality Commission has published details about the fees to be paid by NHS providers from 1 April. The new fee structures have been approved by the health secretary and reflect government guidance that the CQC must recover the costs of regulation from providers. The full fees scheme, guidance and impact assessment can be downloaded from the CQC website.
The main changes to the fees scheme include:
- Updated descriptions of the fee categories to better reflect how the health and social care sectors are organised.
- Extending the scheme to include the fees primary medical services, including NHS general practice providers, will pay when they come under CQC regulation on 1 April. Practices operating from a single location will be charged on a scale from £550 to £850 based on the number of registered patients on their lists. Practices with more than one location will be charged based on the number of locations, irrespective of the number of patients on their list
- Changes to the fee structure for primary dental services to make charges fairer, for example, smaller dental providers with less than six locations whose fees are now £800 per location.
- A decrease in the fees for individuals who provide diagnostic services from a single location.
- A change to the category and fee levels for NHS out-of-hours providers.
- Extending the scheme from 1 October, to include independent midwives who will pay £800 for each location they operate from.
9.43am: Good morning. On the last day before the transition, what lessons do a departing generation of NHS leaders they have for their successors? Nick Timmins spoke to Dame Ruth Carnall, Andy McKeon, Robert Creighton, Sophia Christie and others for the Nuffield Trust. HSJ presents the edited highlights.