HSJ’s daily digest of the must read stories and debate in health policy

Digital watching

This is proving to be an especially interesting week for the NHS’s digital agenda. On Monday, HSJ revealed that the Department of Health’s bid to the government spending review said the NHS will need up to £5.6bn to deliver its technology plans.

This is a huge sum of money in the context of the government’s spending review, in which some departments are already facing eye-watering cuts. Pressure on departmental bids has only intensified following the House of Lords forcing the government to delay plans for £4.4bn of cuts to tax credits last month.   

On Tuesday, we reported that a new index will rate NHS providers’ technological capabilities and eventually be part of the statutory regulatory regime.

NHS England said its existing index was too supplier focused and does not provide enough information on meaningful use or interoperability, so it needs a new one.

The new digital maturity index has been launched just as NHS organisations are formalising in which groups they will come together to draw up new local “digital roadmaps”.

These gangs, led by clinical commissioning groups but with provider involvement, need to set out how they plan to achieve a paperless at the point of care NHS by 2020 – not an easy task.

NHS England national director for patients and information Tim Kelsey told the EHI Live conference on Tuesday that the majority of NHS organisations hit the October deadline for telling NHS England about their groups.

More details will follow about them is expected in the coming weeks, but it would be fair to say that, regardless of the spending review outcome, this is where the hard work starts rather than finishes.

CCGs stand firm

Mutterings about the need for changes to the current 209 clinical commissioning group configuration keep getting louder. One thing driving this is increasing complaints from providers experimenting with new models of care about a lack of wholehearted support from their local commissioners. There’s also an inherent tension between the emergence of new provider models, which want to take on delegated budgets and functions from CCGs - it threatens CCG viability and suggests groups probably need to merge to cover larger patches.

These factors seem to have come to a head in the East Midlands, where vanguard and GP “super partnership” Lakeside Healthcare applied to move from tiny Corby CCG (for which it provides services) to large neighbour Nene CCG. It was refused, with Corby admitting its viability was a factor in that decision, along with, apparently, some Nene GPs objecting.

We fear this is just the beginning: you can expect turbulence in the commissioning system to increase, rather than reduce.

Falling short

A study for NHS England, seen by HSJ, has exposed three quarters of hospital emergency departments as being below the minimum standards for liaison psychiatry.

The work, commissioned by NHS England, found 133 out of 179 A&E departments were below the minimum core standard for 24/7 liaison psychiatry. This service has been identified as necessary for trusts to improve outcomes and increase savings for the NHS.

In total, 169 A&E departments had a shortage of 1,270 trained nurses to support the delivery of liaison psychiatry, while 153 departments had a shortage of 230 trained consultants. Eleven hospitals had no liaison psychiatry service, with only 35 departments delivering at or above the minimum standards.

The results have emerged as NHS England has released a one-off £30m fund to invest in liaison psychiatry. But experts have told HSJ the cash doesn’t go far enough, putting services at risk of collapse in future if they are not properly funded by CCGs.