The Royal College of Physicians responds to the Francis report, health unions speak out against the lobbying bill and the rest of the days news and comments

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4.12pm The Healthcare Financial Management Association (HFMA) has produced an introduction to mental health services guide in a bid to encourage its members to understand more about the services they support.

The guide includes eight case studies, showcasing examples of how mental health services are provided in England.

HFMA president Tony Whitfield said: “Our recent research has revealed that NHS accountants have a key role in contributing to the delivery of high-quality, value for money services. They can only do this properly if they understand the services which they support. Frontline doctors and nurses have also identified significant benefits to be gained from finance staff developing greater clinical awareness. So this is why we have created our series of guides – Medicine for Managers.”

The first Medicine For Managers briefing on paediatrics was published at the end of last year and briefings on further key specialties will follow. They can be accessed by members at

3.46pm What are the risks of doctors using Google Glass? Following pioneering use of the technology during surgery in the US, head of medical services at the Medical Protection Society Dr Nick Clements discusses the potential impacts on patient safety in HSJ’s latest podcast.

2.51pm The National Institute for Health and Care Excellence is highlighting a letter from its chief executive, Sir Andrew Dillon, which appeared in the Times at the end of last week. In it Sir Andrew questions the pharmaceutical industry’s argument that the prices it charges for drugs are fair as it costs £1.2 billion to develop a new product and bring it to market.

Sir Andrew was responding to a comment piece by the business editor at The Times, Ian King, who argued that unless NICE stopped restricting access to new drugs, pharmaceutical companies would stop developing drugs in the UK.

Sir Andrew writes: “I suspect that the research and clinical environment here holds too many advantages for companies to do that… If it really does cost £1.2bn to develop a new drug, the question the pharmaceutical industry must be able to answer is this: are you absolutely confident that it needs to?”

The public spat come against the backdrop of negotiations between the department of health and industry on a new pricing scheme for drugs which is due to come in by January 2014.

2.31pm Thinktank Localis has published a report on the role of local government in integrating health and social care services. In Sickness and in Health: Assessing the transition to a more localist health system – the first step towards marriage between the NHS and local government? highlights confusion over data sharing arrangements as one of the major barriers to integration. It calls on the government to consider a presumption in favour of data sharing between local partners and the establishment of a joint department of health and cabinet office minister for public health.

The report has the backing of care minister Norman Lamb. He said: “This report is a welcome addition to the ongoing discussion and work on integration. It shows how the health reforms, introduced in April, were designed to put integration at the heart of the health and care system.”

1.51pm Former health secretary Andrew Lansley is the minister responsible for leading the lobbyingbill through parliament in his current role as leader of the house of commons. Commentators on twitter have been quick to draw droll comparisons with the troubled passage of the Health and Social Care Act.

Conservative blogger and Times comment editor Tim Montgomerie tweets: After the huge success of the NHS Bill it’s really surprising that Andrew Lansley’s lobbying bill hasn’t been well received.

@YasMot tweets: This #lobbyingbill debate isn’t going well for Andrew Lansley. What are the odds on him introducing another “listening exercise”?

While journalist Iain Martin speculates: This lobbying bill is a belter. Really quite bonkers. Does the coalition have a special unit or room where they produce these things?

1.37pm The royal colleges of nursing and midwives are among the unions speaking out against the Transparency of Lobbying, Non-party Campaigning and Trade Union Administration Bill currently being debated in the House of Commons.

The RCN and the Chartered Society of Physiotherapy have written a joint letter to MPs calling for part two of the bill covering non-party campaigning to be dropped.

RCN chief executive and general secretary Peter Carter said: “We support making election campaign financing as fair and as transparent as possible, however, this Bill slashes the financial cap on third party campaigning and vastly extends what is considered ‘election material’ in the run up to the general election. These measures will render some campaigning untenable, which is completely disproportionate and undemocratic.

“Campaigning on behalf of our members on key health care issues such as maintaining investment in services, improving care for older people and public health is vital to raise standards of care in the NHS which won’t be possible if this Bill is passed.”

RCM director of policy, employment relations and communications Jon Skewes described the bill as “confused”.

He said: “Low expenditure limits on election-time campaigning by organisations such as the RCM may mean we are unable to ensure that candidates and parties hear the views and opinions of midwives and, women and their families on maternity services and the NHS at just the time when they need to listen most intently.”

12.55pm Your Humble Servant’s latest column is now live on In the mystery contributor’s latest musings the End Game favourite ponders culture – the new religion of the NHS.

12.28pm The chief executive of Kettering General Hospital Foundation Trust has resigned following problems with emergency department performance. HSJ’s Ben Clover reports former nurse Lorene Read stood down after deciding she should take “ultimate responsibility” for continued failure to meet the four hour A&E target and financial difficulties at the East Midlands Trust.

12.15pm A contract to treat NHS patients with brain tumours has been awarded to a controversial American healthcare firm that is a donor to the Tory party, the Daily Mirror reports. The paper claims “a multi-million pound deal with Hospital Corporation of America was pushed through quietly just days before the Government handed responsibility for cancer care to NHS England”. As a result, the paper reports, University College London Hospital Foundation Trust has been told to stop treating brain cancer patients and send them to HCA. An investigation by the Mirror has uncovered HCA has given the Tories at least £17,000 since they came to power. HSJ is looking into the detail of the claims being made by the story. We’ll let you know when we know more.

12.04pm Wide variations in the quality of services for patients with rare blood disorders are at least partly a result of their prevalence among ethnic minority communities, HSJ has been told. A major peer review of services for patients with sickle cell disease and thalassaemia in England found just a fifth had adequate numbers of staff with the right skills while many patients reported feeling “second class”, HSJ’s Sarah Calkin reports.

11.53am The Health and Social Information Centre has released figures showing that one in six hospital admissions for dog bites are in the North West. The data shows there were 1,099 admissions for dog bites or strikes in the region during 2012-13. This compares to 925 in Yorkshire and Humber, the region with second highest number of admissions, and 229 in the South East Coast, the lowest region. The report also covers hospital admissions for bites, strikes and stings from other mammals and insects.

10.56am The Pharmacy Schools Council has welcomed Health Education England’s consultation on managing the number of students on the pharmacy degree (Mpharm) in England. HEE is consulting as a result of the Centre for Workforce Intelligence report which warned the profession is at risk of oversupply in the near future with not enough training posts for graduates. It proposes three options: allowing the market to determine supply, introduce an intake control at each university, or to create a “break-point” during study which enables some students to graduate with a Bachelor of Science degree and others to progress through further study to qualify as registered pharmacists.

Professor John Smart, Chair of the PhSC, said: ‘The increase in numbers of students applying to do a pharmacy degree each year since 1999 is testimony to both the popularity of the subject and reputation of pharmacy education in the UK. The management of student numbers is something that the PhSC has spoken in support of previously and we will continue to work with members to understand the effects of the proposed models of student number management.

10.42am Patients with rare diseases could be denied access to cutting-edge therapies because of changes to the way drugs are funded, MPs have warned. The all party parliamentary group for muscular dystrophy raised concerns that money previously earmarked for rare disease medication has been merged into the overall budget for NHS services in England.

10.38am Foundation Trust Network chief executive Chris Hopson has told the BBC NHS England and the Department of Health are like “warring parents”.  Mr Hopson said: “There’s a joke that relationships start off by forming. Then they go through a storming stage, and once that’s finished they norm.

“There’s a definite sense at the moment that there’s quite a lot of storming going on. One would hope the relationship will develop and norm - because at the moment they’re finding their feet.”

10.32am The Times reports on warnings from the surgeon leading government efforts to publish data on doctors’ performance that “doctors risk becoming as mistrusted as bankers”.

Professor Ben Bridgewater tells the paper medics must do more to prove they are listening to their patients in order to avoid “repeats of the Mid Staffs scandal”.

10.29am Most of the national newspapers focus on the RCP’s call for an elder care  “kitemark” for wards in their reports on the college’s Francis response.

The Telegraph reports hospitals should compete to demonstrate that they can safely care for the elderly in order to earn the “elder-friendly” quality mark. The Mail says the RCP will begin assessing wards from next spring and will consider surveys of patients and their relatives as well as visiting wards to monitor how nursing staff and doctors behave. The paper also highlights the college’s concern that elderly patients recovery in hospital is impaired by numerous moves during their hospital stay.

10.18am The Royal College of Physicians has backed the Francis report’s recommendations for a duty of candour on individuals and criminal sanctions for the most serious breaches of fundamental standards. The RCP’s registrar and most senior clinician Patrick Cadigan has spoken to HSJ’s Shaun Lintern about the college’s response to the Francis report and where he feels it let patients down in Mid Staffordshire.

10.10am The Daily Mail reports on the inquest of a teenager who died at United Lincolnshire Hospitals Trust’s Pilgrim Hospital. The inquest heard evidence from the paramedic who bought the teenager to the hospital’s emergency department, describing it as chaotic. He said staff seemed “overwhelmed” by the seriousness of the situation and tried to use a bone gun, which administers fluids via bone marrow, upside down. However, South Lincolnshire Coroner returned a verdict of death by natural causes and said the treatment did not contribute to the 14-year-old’s death.

9.55am The Daily Telegraph, drawing in part of HSJ’s exclusive about the upcoming publication of “never events” data, suggests that “potentially fatal ‘never’ errors double in year on NHS”, based on previous figures.

The piece says: “The number of patients to suffer blunders so serious that they should never occur has doubled in just one year, new figures reveal.

“The number of reported “never” events – which include operations on the wrong side of the body and medical instruments left inside the body after surgery, rose from 163 to 299 in just twelve months, the official statistics show.

“From next month, NHS trusts will be ordered to publish quarterly lists detailing the number and type of all such errors, so that performance of different hospitals can be compared.

“Doctors are instructed to record 25 types of incident which are so serious and avoidable that they should never occur.”


8:49am: Good morning, for medical care, responsibility for decision making at a local level has been transferred to clinical commissioning groups and local area teams. For the remaining “independent contractor” groups, namely dentistry, optical and pharmacy services, local professional networks (LPNs) are seen as providing the link to NHS England, albeit working through the local area teams.

Today on HSJ’s commissioning channel, Paul Batchelor and Catherine Needham say that balancing local flexibility against a single national framework for service delivery is a challenge for the NHS, but it can be overcome.