The deputy prime minister has announced a £150m investment into the treatment for eating disorders, plus the rest of the day’s news and comment

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5.25pm Speaking earlier at the Commons health committee, David Bennett said Monitor had commissioned a piece of work looking at providers taking failing trusts, and the lessons that can be learnt from them.

He said it would look at the performance of organisations taking over their neighbours have been dragged down.

He gave the example of Heart of England Foundation Trust, which never recovered after taking over Goodhope Hospital, and King’s College Hospital Hospital Trust, which took over Princess Royal Hospital.

3.49pm Back at the Commons health commitee, David Bennett says providers should only enter into a merger if there is a strong benefit to patients from it.

If there is a strong case, when the Competiton and Markets Authority looks it at, it should see that the direct benefit to patients exceed the loss of patient choice.

3.46pm HSJ reporter James Illman has noticed some areas of consensus between Jeremy Hunt and Andy Burnham at the Reform conference:

3.41pm At the Reform conference, Jeremy Hunt advocated a shift to multi-year tariff for hospitals to help drive innovation.

HSJ’s James Illman tweets:

3.39pm Mr Bennett saysa proposed marginal rate for specialised services, which would see providers paid only half the price of a service if they go above this year’s activity levels, is intended to make providers think very carefully about whether or not those specialised services are needed.

3.36pm Earlier in the hearing, David Bennett said the system was “too fond” of criticising managers.

3.18pm Back to the Commons health committee, David Bennett says Monitor will either this month or next publish a guide to how to pull together better linked data for individuals.

He adds that that they are working with eight health economnies about they can do it with them.

Where there are trusts with serious structural difficulties, Monitor needs to work with the whole health economy, he says.

He gives the example of Tameside Hospital Foundation Trust in South Manchester, where he Monitor is helping it to finalise how it can turn into an integrated care organisation.

3.11pm HSJ’s James Illman tweets:

3.09pm Jeremy Hunt has begun this address to the Reform conference into the future of healthcare.

HSJ correspondent James Illman will be tweeting throughout, follow @Jamesillman for full updates.

3.06pm Bennett says only three health systems have taken up capitation based payments this year.

He says this is clearly not enough and they are developing a toolkit to offer advice to encourage more to take up the payments.

2.55pm David Bennett says Monitor is “actively recruiting” a senior nurse and a deputy medical director.

He adds that Monitor has 16 staff with a clinical background and 126 with NHS background.

2.51pm Labour MP Valarie Vaz asks about the possibility of the NHS leasing land rather than selling it off.

2.48pm Earlier in the meeting Mr Bennett noted that foundation trusts are concerned that if they sell surplus land, money will be taken off them.

2.46pm Mr Bennett says it is “completely wrong” to assume that a trust that is in deficit has bad management, and a trust in not in deficit has good management.

He gives the example of a site with severe structural problems. No matter how well run it is, it will never be able to survive in today’s climate.

2.44pm Back to the Commons health committee, David Bennett has assured Monitor has set an efficiency target (3.8 per cent) based on what is achieveable.

2.41pm Royal Cornwall Hospitals Trust has appointed Bill Shields as its interim chief executive.

Mr Shields, currently chief financial officer at Imperial College Healthcare Trust, is a high profile figure within the provider sector.

2.40pm EXCLUSIVE: NHS England has cancelled key meetings at which it was due to decide whether to fund a series of treatments for serious conditions following a threat of judicial review, HSJ has learned.

2.38pm David Bennett says at the Department of Health is looking at introducing incentives to encourage trusts to sell surplus buildings

“I know the department is looking at whether we can create some incentives,” he says.

“[Some trusts] see their spare estate as a sort of fund for a rainy day. I think perhaps it’s raining, I think we need to spend this money.”

2.36pm Mr Benett says he supports the point in the NHS five year forward’s view suggestion that foundation trusts should invest their accumulated surpluses and sell off unuse property to release funds to help the health service move rapidly to new models of care.

“We would strongly encourage them to do that,” he says.

He adds that the NHS is “property-heavy” compared to other health system

2.30pm Monitor chief executive is now speaking at the Commons health committee annual accountability meeting.

He is appearing alongside the regulator’s chair Baroness Joan Hanham.

2.28pm Here’s another tweet from HSJ correspondent James Illman at the Reform conference:

1.39pm David Dalton has said his review into future provider models should be published next week.

HSJ’s James Illman has tweeted this from the Reform conference:

1.30pm The most advanced academic health science networks should play a greater strategic role in service reconfigurations, leading AHSN figures have said.

The call comes as NHS England considers a restructure of its innovation and improvement bodies, a move which could impact profoundly the extent of influence AHSNs have on shaping NHS services.

1.22pm At least half of the additional £80m investment pledged to mental health providers to help them deliver new access targets will come from existing budgets, HSJ can reveal.

In a reverse of last year’s decision to cut mental health trust budgets by more than acute trusts NHS England and Monitor have imposed a 0.35 per cent uplift to the national tariff for mental health.

This will result in an estimated £40m less having to be saved through efficiencies by mental health trusts.

1.15pm Here are some comments from the shadow health secretary regarding NHS funding:

1.05pm A few more tweets from HSJ’s James Illman covering Andy Burnham’s speech to the Reform conference:

12.58pm HSJ’s James Illman tweets:

12.46pm HSJ correspondent James Illman is at ‘The future of healthcare’ conference run by the think-tank Reform, which Jeremey Hunt and Any Burnham are both due to speak.

Follow @Jamesillman on Twitter for updates throughout the afternoon.

12.02pm The BBC reports that the mother of a woman who died in hospital three years ago is has launched a High Court challenge against the Parliamentary and Health Services Ombudsman.

11.39am In response to the deputy prime minister’s announcement of extra funding for eating disorder treatment, Professor Sir Simon Wessely, president of the Royal College of Psychiatrists, said: “We are delighted that the government has acknowledged the mounting evidence for effective early intervention for eating disorders.

“We hope this funding will enable more immediate access to the expert care that can prevent eating disorders becoming severe and disabling, and support joined up paediatric and mental health services, outpatient and inpatient care, and services that allow continuity of care through to recovery.”  

11.35am In case you missed it, Jeremy Hunt yesterday indicated that £1.5bn of additional funding to be allocated to the NHS in 2015-16 will be contingent on hospitals providing plans to become more “efficient and sustainable” and to deliver “a commitment to a paperless NHS by 2018”.

Chancellor George Osborne announced additional funding totalling around £2bn for the next financial year for the NHS yesterday, in the run-up to Wednesday’s autumn statement.

The health secretary set out how the funds would be used to the Commons yesterday afternoon, saying they would help implementation of the NHS Five Year Forward View.

11.30am The Times reports that a hospital consultant who was sentenced to 22 years in jail yesterday for sexually abusing young cancer patients in his care could face further charges.

Detectives are investigating further claims from two possible victims of Myles Bradbury.

The case remains open and police say that the full scale of Bradbury’s offending might never be known.

11.22am Middle-aged people with diabetes will decline mentally about five years earlier than their healthy counterparts, The Times reports (newspaper only).

US researchers looked at 15,792 adults aged 48 to 67 and found that patients with diabetes had a 19 per cent greater cognitive decline than those without.

Their fundings were originally published in the the Annals of Internal Medicine.

11.08am The deputy prime minister has announced a £150m investment into the treatment for eating disorders. It will come as part of the autumn statement.

The investment, which will be rolled out over five years, will include:

  • supporting schemes to get young people with eating disorders and self-harm early access to services in their communities with properly trained teams, making hospital admission a last resort
  • extending access to talking therapies so that children and young people have a choice of evidence-based therapies, a treatment plan agreed with their therapist and monitored and recorded outcomes

The aim is to divert fudning institutional care to local provision, and “acts as a base” for the development of waiting time and access standards for eating disorders for 2016.

The funding is intended to deliver:

  • faster access to evidence based community treatment
  • fewer transfers to adult services – reducing up to 70 per cent of those who need to be treated as adults
  • an end to the current “cliff edge of transition” for young people with eating disorders  when they turn 18
  • a more standardised level of provision for children, young people and their families

Deputy prime minister Nick Clegg said: “Too often children with mental health problems are being completely let down, with many suffering from eating disorders that go unreported and untreated.

“We know that if an eating disorder goes untreated for more than 3 to 5 years the chances of recovery are greatly reduced, while incidents of self-harm increase.

“That’s why we need to act now to transform the current system, intervening earlier with dedicated and targeted community-based services to ensure that we don’t fail this generation or the next.

Care services minister Norman Lamb, said: “I want to build a fairer society and that’s why I’m determined to make sure children and young people get the best possible mental health care.

“That’s why I convened a taskforce of experts to focus on improving services.

“Better care for eating disorders is a top priority and this investment will help drive up standards so that no child is left without support.”

Sarah Brennan, chief executive of the mental health charity Young Minds said: “It is great news indeed to hear that areas of support for children and young people’s mental health will receive additional, desperately needed, resources.

“Too often children and young people’s services are overlooked in preference for adult services. Young people make up 20 per cent of the population, yet receive a fraction of the resources available with the terrible consequences we hear about daily in the news.

“We wish to congratulate the government on championing the change, in recognising there is a huge gap to address and in taking the first steps to focus funds where they are so badly needed – for children and young people.

“We trust this is the beginning of a new approach by government and commissioners nationally, and that the Mental Health Taskforce recommendations will receive equal support in March and with future governments.”

10.53am The Times reports that a shortage of stroke doctors and nurses could be costing hundreds of lives, according to a new report on stroke services at NHS  hospitals.

One in four hospitals in England, Wales and Northern Ireland has an unfilled post for a consultant stroke physician and there are not enough doctors being trained to fill them, experts warned.

The audit, run by the Royal College of Physicians, also found that only 50 out of 183 hospitals had three qualified nurses on duty per 10 stroke patient beds – the recommended level – at 10am on weekends.

10.46am Out of hours providers are struggling to find GPs to cover shifts because of spiralling insurance premiums.

One quote seen by HSJ put the cost of indemnifying a GP to work eight out of hours and two working day sessions at £30,000. Annual premiums for some GPs are as little as £3,000.

10.33am Commons health committee chair Dr Sarah Wollaston tweets:


10.31am The Telegraph also reports that people suffering from depression are being told to phone a helpline rather than trouble their GP, because of a national shortage of family doctors.

A Devon practice has emailed all patients warning that demand for appointments is outstripping capacity, and urging many to go elsewhere if they need help.

Last night mental health charities raised concerns that the message could risk lives, deterring those who had plucked up the courage to talk to their family doctor from seeking help at all.

They said those who were feeling suicidal or suffering from anxiety attacks should not be made to feel unwelcome, and called for better funding of GP services for mental health.

10.28am The Daily Telegraph reports that three quarters of hospitals do not have enough nurses to care for those admitted to hospitals at weekends after suffering a stroke, a national report has found.

“Major shortages” of nurses could be endangering thousands of lives, the audit by the Royal College of Physicians found. It follows research that showed a clear link between the number of nurses and death rates among those who suffer a stroke.

In August a study by King’s College London found that units with three nurses per 10 beds for stroke patients saved an extra life for every 25 admissions, compared with those with half as many nurses.

Elsewhere, the paper reports that a new multi-million pound fund to tackle dementia will be announced in this week’s Autumn Statement, David Cameron has said, as he warned that the disease is “one of the greatest enemies of humanity”.

The Prime Minister said that George Osborne, the Chancellor, will use Wednesday’s statement to announce a £15million fund to help find innovative new cures for the disease.

Mr Cameron said that the Government must “play our part in defeating” dementia in the coming years.

The World Health Organisation predicts that more than 115 million people in the world will have dementia by 2050.

10.20am A national Accident and Emergency survey shows some encouraging results with almost eight out of 10 respondents saying their overall experience was good rating it seven or more out of ten and only 3 per cent of patients saying the doctor or nurse did not listen to what they had to say.

The Care Quality Commission today publishes results from the fifth accident and emergency (A&E) survey which almost 40,000 people took part in.

A&E is one of the eight core services that CQC inspects and rates in acute hospitals, and patients’ experiences of care are a key aspect in determining these ratings. The national findings are presented under the questions inspectors ask about A&E departments: are they safe, caring, effective and responsive to people’s needs.

The findings demonstrate that departments are largely caring, however, more work needs to be done so that services are safer, are more effective and are more responsive to people’s needs.

Caring: Most of the questions (22 out of 35) relate to ‘caring’. The results are encouraging as 79 per cent of patients reported that they were treated with respect and dignity all of the time and 75 per cent ‘definitely’ had confidence and trust in the doctors and nurses examining them. 

Eighty six per cent of patients said staff explained the purpose of the medication in a way they were able to understand, Just over four in 10 (41 per cent) said the side effects of their medicine were not explained to them or they were not told when they could resume normal activities (42 per cent).

Safe: Forty per cent of patients waited less than 15 minutes to speak to a doctor or nurse when they first arrived, with almost three quarters (73 per cent) waiting less than one hour to be examined by a doctor or nurse. Around four in 10 patients (41 per cent) arrived at A&E in an ambulance. Of these, around one in 10 patients (11 per cent) said they waited over 30 minutes for their care to be handed over to the A&E staff; 5 per cent experienced waiting times of over an hour. The large majority (94 per cent) of patients did not feel threatened by other patients or visitors, but 2 per cent did.

Effective: Almost eight out of ten patients (79 per cent) said they got their pain relief medication within 30 minutes, however 13 per cent of people who requested pain relief medication waited for more than 30 minutes. While 63 per cent of patients thought that staff did everything to control their pain, 13 per said that staff did not do enough.

Responsive:  Two thirds (66 per cent) of patients said that their visit to the A&E department lasted less than four hours.  Most patients (82 per cent) reported having enough privacy when being examined or treated.  However, the figure was much lower (53 per cent) when asked about discussing their condition with the receptionist.

Commenting on the findings, Professor Sir Mike Richards, Chief Inspector of Hospitals, said: “Overall the results of this survey are encouraging, with better results in 2014 than in 2012 despite the known increase in pressures on A&E departments. 

“However, we do see significant variations between trusts.  This highlights the need for all trusts to review their own results and to take action where necessary.  The findings are set out in the report according to the same key questions as we use for our inspections.  This will assist us in making judgments about the quality of individual A&E services.”

Further results reveal over half (51 per cent) of patients between the ages of 76-85 said that their home and family circumstances were not always taken into account as part of discharge planning.

Nationally, 22 per cent of patients did not feel staff helped to reassure them if they were feeling distressed while in A&E. Almost one third of people (33 per cent) with a mental health condition and 31 per cent who had a learning disability, said that A&E staff did not help to reassure them.

Twelve trusts achieved ‘better than expected’ results for 7 or more (20 per cent) of the 35 questions in the survey with a score. For the 2014 A&E survey, Dorset County Hospital NHS Foundation Trust, Salisbury NHS Foundation Trust and Taunton and Somerset NHS Foundation Trust have the highest numbers of ‘better than expected’ results of all trusts.

7.00am Good morning and welcome to HSJ Live. An evaluation of emergency admissions at Barnsley Hospital revealed that people often wrongly view hospital as the ‘best place’ for treatment. Joanna Blackburn and colleagues discuss how the findings influenced the department’s redesign