Ring-fenced NHS spending attacked by former shadow health secretary and the rest of today’s news

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Salisbury will be joining Dorset County Hospital Foundation Trust and the Royal Bournemouth and Christchurch Hospitals Foundation Trust in a ‘hub and spoke’ model agreed by commissioners.

Major arterial surgery moved to Bournemouth at the start of December.

Emergency treatment for abdominal aortic aneurysms has transferred to Bournemouth as of 1 December and planned treatment for abdominal aortic aneurysms will move from 1 April 2014.

4.00pm In reply to those who say that Jeremy Hunt has been intervening too much in NHS management, Steve Richards writes in The Guardian that he is simply doing his job as a minister accountable to the public who fund the NHS.

3.24pm Healthcare leaders have written an open letter, published in The Guardian, that calls for an end to relentless criticism of the health service.

The leaders of 10 organisations have signed the letter which asks for a more measured view of NHS performance.

2.17pm The BBC reports that researchers have developed a degradable implant that could improve surgical success rates.

The protective patch was developed by researchers at the Nuffield Orthopaedic Hospital in Oxford. It wraps around the surgical repair and forms a type of splint. Research suggests that the implant can help to “wake up” tired cells and increase the recovery time following surgery.

1.57pm There are some interesting comments on our story about former shadow health secretary Liam Fox calling for an end to a ring-fenced NHS budget. Here are a few:

“A lot of folk won’t like me for saying this, but I think Fox is right. More of my career has been spent in engineering than in health, so I can say from experience that industry is forced day by day to innovate and improve at a rate unheard of in the NHS. A ‘ringfenced budget’ may sound superficially caring, but it has the perverse effect of protecting waste which in the long term is harmful to patients.”

“Despite the increased funding during the noughties NHS spend still lags well behind healthcare expenditure in other equivalent nations and yet the likes of Liam Fox think it’s reasonable to compare outcomes, and now to actually make the funding gap greater still and the politicians and public continue to expect scandinavian level public services for US level taxes.

In the end we get what we deserve - no party will dare to offer raising taxes to fund the NHS as a manifesto commitment, political suicide, and the likes of Liam Fox continue to come out with drivel about waste and “over-funding” because they see it as politically advantageous - i.e. vote-winning - and sad to say he’s probably right.”

“Although some of Fox’s reported comments make sense, such as outcomes should matter more than throughput, there is an absence of reasoning apparent in many of his ideas. In particular, he fails to say anything about the Nicholson challenge, or the fact that neither ring-fencing nor protecting NHS expenditure will help to make the savings needed. Identifying ‘waste’ is not the real issue, of course. Demands arising from demography and from medical advances are far more important and difficult.”

“Fox is right but does not go far enough. We need to break down the barriers of budgets. We are in the 21st Century now so we do not need the 1940’s insurance policy of separating primary and secondary care budgets. We need one budget for a defined Health Economy based on a sensible geographical area. We need to do away with all Trusts and Boards and replace with one local Management Team. One organisation covering all aspects of care in that location and ALL employed directly by that organisation - and end to contracting. Now that should scare the horses!”

1.18pm Dr James Munro has been appointed as the new chief executive of Patient Opinion, an online feedback platform for health and social care.

Dr Munro, director of research and informatics at Patient Opinion, took over as chief executive on 1 January, replacing Dr Paul Hodgkin, who founded the service.

Dr Munro is a doctor and public health physician by background, and headed the University of Sheffield’s health services research group before joining Patient Opinion in 2006 to lead the technical development of its online feedback platform.

Dr Munro said: “Listening to patients and carers has never been more important in contributing to quality, safety and public trust in our health and social care services. Under Paul’s remarkable leadership, Patient Opinion has helped improve both local services and national policy. I’m excited, and a little awe-struck, to have the opportunity to lead Patient Opinion into its next phase.”

“Our vision remains unchanged: to enable citizens to safely offer honest feedback, in public, to the services they rely on, and allow everyone to see where that feedback leads to learning and improvement. In 2014 our focus will be on achieving greater transparency, greater staff involvement, and greater impact from the feedback people give.”

Dr Hodgkin will remain as chair of the board, and will continue to provide a national voice on issues of innovation, social media, and the power of narrative feedback in health and social care. He will also lead on London-based government and media relations.

Dr Hodgkin said: “Patient Opinion has established itself as a significant part of the UK’s health and social care landscape. Our work and impact is always the result of a team effort, and already owes an immense amount to James’ talent and energy.”

“We have been planning this change internally for the past year and it will be a pleasure to support James and the team as they continue to develop and grow Patient Opinion’s innovative services in the turbulent mix of change and opportunity that is today’s NHS.”

Circle Holdings, the publicly-traded company that owns a majority stake in the hospital operator, has announced it is to acquire the rest of the company on behalf of employees. This is currently in the hands of Circle Partnership, which is owned by employees and holds a 49.9 per cent stake in the operator.

As part of the process, Circle employees and NHS staff are both being offered shares in the company for free, providing they meet certain performance criteria.

12.39pm The chief executive of Salford Royal Foundation Trust has been awarded a knighthood in the new year’s honours list.

Sir David Dalton is among a group of senior NHS figures and campaigners to be recognised in this year’s cohort.

Sir David said: “To be honoured in this way is not something that I could ever have imagined when I joined the NHS as an administrative trainee almost 35 years ago.

“However, without a shadow of a doubt, it is not just about my contribution to the NHS; it reflects the hard work of all those who strive with me to provide the safest care for our patients today and to plan for the best outcomes in the future.”

11.42am Over in our Comment section chief executive of Heart of England Trust Mark Newbold argues that an overhaul of emergency services is required with less of a focus on blaming management for poor performance.

11.37am Derby Hospitals Foundation Trust has paid compensation to a couple following the death of their baby after care failings at Royal Derby Hospital, reports the Derby Telegraph.

Mrs Roper says she was told by the hospital to take painkillers when she was nine months pregnant and began experiencing intense pains.

Five hours later she was rushed to hospital and her son, Shay, was stillborn.

Chief executive Sue James apologised to the couple and said that following an investigation into the incident failings had been identified and procedures had been put in place to avoid a similar tragedy occurring again.

10.59am The retendering of the NHS 111 service contracts could cost millions an investigation by the BMJ has found, reports The Guardian.

In the West Midlands alone the retendering process could cost £500,000.

10.40am The Telegraph reports that a cosmetic surgeon who left a woman with a dent in her breast has been struck off.

Dr Olufemi Adeyinka Adeogba was employed at the Birkdale Clinic in Crosby until 2011. Dr Malcolm Philips, chairman of the Medical Practitioners Tribunal Service panel which removed Dr Adeogba from the medical register, said his standards “fell below or seriously below those to be expected of a competent cosmetic surgeon”.

10.38am Brighton and Sussex University Hospitals Trust will change its stationary after a patient complained that sensitive medical information could be read through the thin envelopes, The Argus reports.

The trust has bought new envelopes with a hatched pattern inside to prevent them being see-through.

10.30am Revellers in the Midlands called an ambulance every 15 seconds in the first hours after midnight on New Year’s Day, mostly to treat drunks reports The Times.

More than 200 ambulance crews and 100 paramedics were working on one of the busiest evenings of the year for West Midlands Ambulance Service.

10.24am A woman who helped to expose the Mid Staffordshire Foundation Trust failings has faced abuse from some Stafford residents after she was appointed CBE in the New Year’s Honours list, The Times reports.

Julie Bailey began campaigning against poor standards at the hospital after her mother died there in 2007. She has already told how she was forced to leave Stafford because of a local campaign against her.

Critics of Ms Bailey took to Twitter to abuse her, claiming the honour was an insult.

10.23am Patients could be given fast-track access to GPs through the 111 service under a proposal that has angered doctors, The Times reports.

Senior civil servants have drawn up the plan but doctors say that the move could see people using the service to queue-jump.

10.18am Also in the Guardian, hundreds of thousands of young people are experiencing mental health problems because of their unemployment, a survey by the Prince’s Trust has found.

The charity reports that 40 per cent of jobless young people have experienced suicidal thoughts, feelings of self-loathing and panic attacks. Paul Brown, Prince’s Trust director, said the government, private sector and charities had a responsibility to make sure vulnerable young people were not left behind as the economy recovered.

10.17am Foundation Trusts should radically transform the way they operate over the next five years in order to provide quality care for patients on a sustainable basis, says Monitor.

New five year planning guidance from the health sector regulator estimates that all providers will need to make real efficiency savings of at least two per cent every year as part of their contribution to the wider financial challenge facing the NHS. This compares with an estimated real saving of only one and half percent or less in recent years.

In addition to providers improving their efficiency, commissioners will need to work with them to redesign care pathways across local health economies to deliver further efficiency savings whilst also improving quality.

Monitor is introducing a new strategic planning regime to support FTs in developing new ways of working and delivering quality services more effectively.

A review conducted by Monitor found widespread weaknesses in short-term operational planning by FTs, with over three-quarters unable to forecast their financial performance accurately within a reasonable range.

A Monitor report – Meeting the needs of patients – says that robust planning by trusts is an essential first step in meeting the challenges facing the sector, enabling them to make decisions about service provision and resource allocation, and to govern effectively in the interests of patients. 

Under the new planning guidelines, FTs will be required to:

·        Adopt a five year strategic planning regime from 2014 instead of three years as at present;

·        Provide Monitor with a detailed a two year operational plan, followed by a further three year strategic plan outlining transformational plans for the organisation;

·        Submit plans earlier in the financial year to allow for quicker visibility of upcoming risks.

Monitor is aligning its planning processes with NHS England and the NHS Trust Development Authority to ensure FTs, local commissioners and NHS Trusts work together to meet local patients’ needs now and in the longer term.

David Bennett, Chief Executive of Monitor, said: “Robust strategic planning is essential if trusts are to provide patients with high quality care now and in the future.

“We know that foundation trusts are facing major clinical and financial challenges, but we also believe they have the capacity to rise to them. For example, the introduction of the Better Care Fund, which potentially takes £2 billion from the budget of providers in 2015-16, offers an unprecedented opportunity to make the transformational changes we have been urging for some time, to enable patients to be treated out of hospital and closer to home.

“Our guidance contains advice as to how providers can improve their current offer to patients and work with commissioners to take other steps to improve productivity, such as redesigning care pathways.”

10.12am NHS England has today announced the appointment of Celia Ingham Clark as the National Director for Reducing Premature Deaths.

Mrs Ingham Clark was previously a consultant general and colorectal surgeon and then Medical Director at Whittington Hospital NHS Trust. In 2010, Mrs Ingham Clark was appointed Associate Medical Director for Secondary Care for NHS London and later Medical Director for Revalidation and Quality for the London region of NHS England. Most recently she was also the National Clinical Director for Enhanced Recovery and Acute Surgery for NHS England.

Mrs Ingham Clark, said: “I am delighted to accept this appointment which enables me to broaden the scope of my focus on quality improvement. I look forward to working with colleagues across the country to drive a reduction in early deaths.”

Professor Sir Bruce Keogh, Medical Director for NHS England, said: “I am delighted by Celia’s appointment. Her work on the review into seven day services, leading the clinical standards work stream, was outstanding and I look forward to continuing to work with her in future.”

With her interest in using service development to improve quality of care, Mrs Ingham Clark was previously National Clinical Lead for Transforming Inpatient Care with NHS Improvement from 2007 to 2013, and also chaired the clinical expert panel for the emergency general surgery work stream of London’s acute care Quality and Safety review from 2011 to 2013.

Mrs Ingham Clark is currently a member of the Association of Surgeons of Great Britain and Ireland Emergency Surgery special interest group and this year she was awarded an MBE for services to the NHS. Mrs Ingham Clark takes up her new appointment as of 1 January 2014.

10.08am The Guardian also reports that many people with diabetes who smoke are not being supported to quit the habit even though it can be particularly harmful to those with the condition.

Diabetes UK found in a survey that 45 per cent of smokers were offered assistance and advice on giving up over the previous 12 months.

10.07am The Guardian reports that Public Health England is urging people to cut down on sugary drinks and saturated fat in its latest advertising drive.

The advertising campaign, Smart Swaps, seeks to build on health-conscious new year resolutions, and focuses on healthier alternatives which can be substituted in to people’s diets. For example, Public Health England says swapping whole milk for semi-skimmed could result in the average family cutting down their fat intake by a third of a pint over four weeks.

They include patient notes being found in public places within NHS buildings, documents left in car parks and public transport, and personal information being sent to the wrong address.

Figures obtained by the Scottish Liberal Democrats through Freedom of Information requests show that there have been 806 incidents of data loss, leaks or Data Protection Act breaches in Scotland’s health boards between 2009 and 2013.

Britain is lagging behind other countries in key areas such as cancer outcomes and the idea that ploughing money into the NHS improves standards had been “tested to destruction”, according to Liam Fox.

The former defence secretary backed the prime minister’s decision to keep his promise to increase funding in real terms, but urged him not to include such a pledge in the next Conservative manifesto.

Dr Fox told The Times: “I think we’ve tested to destruction the idea that simply throwing lots more money at the health service will make it better.

9.47am Have a look at the 25 people who made the cut in our debut Rising Stars list. Judges went through the longlist and considered how much influence and impact each nomination currently wields.