Architect of foundation trust model calls for an all-foundation trust sector within three years, plus the rest of today’s news and comment

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The North West acute trust received the rating because of failings at its Blackpool Victoria Hospital site, where maternity and family services were judged to be “inadequate”.

A CQC inspection team visited the trust’s three main sites in January. The care regulator gave Clifton Hospital and Fleetwood Hospital overall ratings of “good”, and praised the trust as a whole on the caring nature of its services.

The Professional Standards Authority, which is responsible for overseeing health and social care’s professional regulators, claims the Law Commission-drafted bill would take regulation in the opposite direction to that advocated by the Francis Inquiry.

The Law Commission was tasked by the government in 2010 with reviewing the statutory framework governing the nine separate regulators of health and social care professionals, including the General Medical Council and Nursing and Midwifery Council.

3.26pm The Foundation Trust Network has produced an infographic about the better care fund. It sets out where the money is coming from, why integrated care is a good idea, and how provider trust leaders feel about the initiative.

It sets out three solutions: more transitional funding, as argued recently by Sir David Nicholson; “full, meaningful and transparent” engagement between commissioners and providers, and “extended deadlines for the BCF planning process”.

2.44pm Funding for general practice is due to fall by 17 per cent in real terms by 2017/18, while patient consultations are set to rise by 69 million, according to new research published today by the Royal College of General Practitioners.

The study, conducted by Deloitte, shows that if current trends continue funding for general practice across the UK will fall to a record low of just 7.29 per cent of the NHS budget by 2017/18 – down from 8.39 per cent in 2012/13.

Meanwhile, the number of patient consultations in England is estimated to rise to a high of 409 million – up from 340 milliion in 2012/13. In 2008/09 the number of consultations stood at nearly 304 million.

The report finds that the number of consultations in general practice has increased as the population has increased in size, grown older, and more and more people have multiple-conditions. However, the share of funding spent on general practice has been falling since 2005/6, according to the report.

The new Deloitte report into the future funding gap is due to be unveiled officially at an event in the House of Commons tomorrow.

According to the Deloitte projections, general practice in England could receive just 7.28 per cent of the NHS budget by 2017/18, down from 8.5 per cent. General practice in Scotland could receive just 7.4 per cent, down from 7.78 per cent. Meanwhile, general practice in Wales could receive just 7.52 per cent, down from 7.77 per cent.

The RCGP warns that the combined forces of rising demand and diminishing funding will have disastrous consequences for safe patient care.

Dr Maureen Baker, Chair of the RCGP, said: “These projections show just how grim the future looks for the care of our patients in general practice, across the UK.

“The current approach to the way we fund general practice makes no economic sense at all - as investment is being cut at the very point that demand is soaring.

“These projections show that funding for general practice is on a simply unsustainable trajectory.”

2.17pm In our Resource section Shibley Rahman and Anna Gaughan write that innovations to improve wellbeing can have a positive impact on the future of dementia care.

1.26pm The Chartered Institute of Public Relations has spoken out in defence of NHS investment in public relations and communications staff, branded “unnecessary” and “wasteful” by the TaxPayers’ Alliance.

In a report published yesterday, the Alliance claimed that in 2013 £34m was invested in 826 public relations staff across the health service. The CIPR said this equates to 0.03 per cent in proportion to the £95.6bn budget set aside for the NHS in England alone over the same period.

Sarah Pinch FCIPR, CIPR President Elect and former NHS Communications Director said: “Publicly funded authorities, including the NHS, have a responsibility to engage the public and to tackle health care issues - this cannot be effectively achieved without professional public relations support.

“The reintroduction of the modern matron more than 10 years ago was a very clear sign that nurses and doctors needed to spend more time with patients and less time dealing with administrative tasks and other areas where they can call on professional support.

“The day-to-day management of media enquiries, Freedom of Information requests and facilitating open and transparent communications with the public supports the vital role of the NHS.

“Blood and organ donor drives, flu vaccinations, stop smoking campaigns and many other examples of NHS public relations activity both promote and support the successful tackling of public health issues. This is not ‘spin’ - this is life changing and lifesaving work, which actively reduces the burden of healthcare on the public purse.”

Managing the reputation of the NHS, to build trust in healthcare services such as cancer care and paediatrics, should be led by public relations professionals with the full support and involvement of clinical teams, but their priority has got to be the delivery of care to patients.”

1.24pm Patients in intensive care have a better chance of survival if there are more doctors and nurses working on the unit, new research from the University of Greenwich suggests.
The study also shows that the survival of the most severely ill patients is most affected when there are insufficient nurses.
Researchers say they have separated out staffing levels from other factors, such as workload and how ill patients are, after examining nearly 40,000 patient records and data from 65 ICUs in the UK.

The organisation’s chief executive, Dean Royles, said further talks with NHS trade unions could be “an opportunity” to develop a sensible approach to staff pay, terms and conditions.

But he highlighted the need to secure a deal with the British Medical Association in current negotiations on changes to doctors contracts, saying: “The issue around doctors contracts is now pressing, we have to move forward with that.

12.35pm Mandating GPs in NHS 111 call centres as part of the revised specification for the service would be a “big mistake”, potential providers have told HSJ.

The idea is being considered in discussions NHS England is conducting on the future service model for the non-emergency telephone number.

The commissioning body needs to develop a revised specification for NHS 111 in time to allow CCGs to re-procure the service before the first of the existing contracts expire in a year’s time.

The news comes a week after HSJ reported that the Care Quality Commission is planning for a 50 per cent increase in government funding next year, to pay for its intensive new inspections regime.

The TDA’s latest finance report states: “The indicative resource allocation to the NHS TDA for 2014-15 is £55,524,000, which is an increase of £22,024,000 since 2013-14, to fund the wider scope and breadth of oversight required following changes to the regulation of NHS Trusts and other in-year policy developments.”

Alan Milburn, who as a Labour health secretary introduced the legislation that created the first foundation trusts 10 years ago, made the call at a speech delivered to members of the Foundation Trust Network last night.

Mr Millburn, who is now a consultant and chair of private equity group Bridgepoint’s European Advisory Board, called for the current “glacial” authorisation process to be scrapped and for all trusts to be made foundations within three years.

10.51am NHS England’s new chief executive today used his first speech in the role to promise rapid progress on integrating care, to offer hope to small hospitals, and to dub past pay reforms a “missed opportunity”.

Simon Stevens, who joins from international health insurance giant UnitedHealth and was previously health adviser to Tony Blair, told an audience in Newcastle that he would spend several months talking to people before setting out detailed plans.

However, Mr Stevens added that there was a “consensus on many of the big things that need to change” and pointed to several priorities.

Indicating a possible focus on changing staff pay and conditions, he identified some past “pay reforms” as a “missed opportunity” and suggested “redesigned jobs, and pay systems that work” should not be seen as an unattainable goal.

10.35am Our reporter James Illman will be live-tweeting from the Health and Social Care Information Centre board meeting today at 11am. Follow @jamesillman for updates.

10.32am The Competition and Markets Authority has published the final report on measures to increase competition in the private healthcare market, following a two-year investigation.

The CMA will now introduce measures to ensure that arrangements between NHS trusts and private hospital operators to operate or manage a Private Patient Unit will be capable of review.

The Authority will now be able to prohibit arrangements which it decides substantially lessen competition in the relevant local area.

The regulator found that many private hospitals face little competition in local areas across the UK and that there are high barriers to entry into the market. This leads to higher prices for self-pay patients in many local areas - and for both self-pay and insured patients in central London, where HCA, which owns over half of the available overnight bed capacity, charges significantly higher prices to insured patients than its closest competitor.

Other measures include a crackdown on benefits and incentive schemes provided to referring clinicians by private hospital operators and measures to increase the availability of information to patients on both consultant fees and the performance of consultants and private hospitals.

The CMA will also require the private hospital operator HCA to sell the London Bridge and Princess Grace hospitals or alternatively the Wellington hospital including the Wellington Hospital Platinum Medical Centre (PMC). The CMA is not requiring any hospital sales outside central London.

10.27am In a speech last night at the Foundation Trust Network’s annual lecture former health secretary Alan Milburn said that the “NHS supertanker is drifting with little clarity about its direction”.

He called for the NHS Trust Development Authority and the foundation trust pipeline to be scrapped and for all trusts to be made foundation trusts. He said: “I would like to see the current approval Foundation process being scrapped and, within the next three years, every NHS Trust being made a Foundation. The TDA should be abolished and its resources made available to Monitor to help turn round those organisations that are in trouble.”

He added that the current pace of conversion from trust to foundation trust was “glacial”.

He argued that regulation is distracting care providers from their citizens. He said: “the army of regulators being unleashed on the NHS forces care providers to look upwards to those who regulate them instead of facing outwards to the citizens who use them. The balance has swung too far towards top-down regulation as the primary instrument for improving standards”.

A story with more detail on Mr Milburn’s speech is shortly to follow.

10.10am In The Daily Telegraph, Jeremy Hunt has suggested that Chinese medicine could be available on the NHS if there is sufficient evidence that it would benefit patients.

Responding to a question in the Commons on yesterday about what his travels to China have taught him about the integration of Western medicines with traditional Chinese medicine, the health secretary said:  “What I’ve learnt is that the most important thing is to follow the scientific evidence and where there is good evidence for the impact of Chinese medicine then we should look at that but where there isn’t we shouldn’t spend NHS money on it.”

10.08am Charities and breast cancer campaigns that call for women to check themselves regularly for signs of the disease could be doing more harm than good, an editorial in the British Medical Journal has claimed.

The Times reports that GP Margaret McCartney writes that such calls are at best pointless and at worst put women’s health at risk.

She argues that teaching women to examine their breasts regularly has been shown not to reduce deaths from breast cancer and actually increases the chances of a benign biopsy result.

10.04am The Times reports that Simon Stevens has criticised “misplaced consensus” within the health service, urging it to accept a bigger role for charities and businesses.

Mr Stevens said the NHS must accept more failed experiments if it was to find ways to stop the “wheels coming off”.

9.56am The Times reports that ten senior NHS maangers shared £300,000 in pay rises when they switched to identical or similar job titles under a reorganisation of the health service.

One manager saw her salary rise by at least £70,000 when she moved from the Department of Health to Public Health England.

9.49am The Independent reports that NHS staff who perform poorly in their job could face being struck off, under plans drawn up by the Law Commission.

A draft Bill would give the Government powers to create a list of “bad eggs” who should not be allowed to work in the health or social care professions.

It would allow regulatory bodies to stop doctors, nurses or other staff who cannot communicate clearly in English from practising.

7.00am Good morning and welcome to HSJ Live. We begin with an article from Sue James, chief executive of Derby Hospitals Foundation Trust, predicting the big developments for hospitals and leadership in the next five years.