Norfolk and Suffolk Foundation Trust the first mental health provider to be recommended for special measures, plus the rest of today’s news and comment
4.34pm Sir Stephen Bubb, the chief executive of the Association of Chief Executives of Voluntary Organisations, has written a comment piece for the New Statesman in support of the integration plans outlined by shadow health secretary Andy Burnham last week.
Sir Stephen writes: “When Burnham talks about integrating the work of public, private and third sector providers, he is indicating a situation in which new services are created by new kinds of collaboration.”
3.06pm The chief executive of NHS Property Services has stood down.
Simon Holden said it has been a “very difficult decision” but after three years in the job, it was time to “move on and look for new challenges”.
“I remain very proud of the organisation we have created, and all our collective achievements, and believe that there is now a robust platform on which to build for the future,” he added.
Elaine Hewitt has been announced as the new chief executive.
She joins the organisation from BT, where she served as the group’s property director.
Ms Hewitt said: “I am delighted to be joining NHS Property Services at such an exciting time in the company’s development.
“Despite the change of sector, I expect some continuity from a role that involves me driving change in both estates strategy and facilities, working with delivery partners and leading a team that actively managesthousands of buildings in communities across the country.”
Company chairman Robin Williams said: “I would like to thank Simon Holden for all his hard work in bringing the Company to where it is now. I would also like to welcome Elaine Hewitt into the company as its new chief executive. I look forward to working with Elaine on the next phase of the Company’s development.”
2.10pm The Chartered Institute of Public Finance and Accountancy’s chief executive, Rob Whiteman has commented on the PAC report:
“This report demonstrates that some parts of the NHS are heading towards a financial cliff unless action is taken. If we are to achieve long term financial sustainability for the NHS, while maintaining quality of care, we need to look at new more effective ways of working such as the integration of services like health and social care.
“Rather than focusing on pre-election top ups for troubled trusts, we need to radically reshape the way we deliver health care. By adopting a whole systems approach to the future funding of the NHS, taking into account the entirety of spend on health and wellbeing in an area, we could better provide for communities without further undermining other public service budgets.”
“This work will, however, take significant time and investment and it’s naïve to think we’d see the benefits of this approach immediately and we can’t settle for stop gap measures until May. It is unrealistic to expect the necessary changes to take effect quickly; we need a sustained and agreed way forward, ideally a cross party answer, but not yet another reorganisation.
“CIPFA sees a range of challenges however. We need to see increased trust between different sectors in the delivery of health care, rather than the current model of caution and competition. And, we also need real work to be undertaken to ensure that the systems and policies, as well as the nature of services, are aligned. All of this must be underpinned by a coherent long-term strategy for the NHS, based around joined up objectives and founded upon sound data and realistic analysis of that data shared across all parts of the system.”
1.34pm NHS Providers has also commented on the PAC report. Here’s what chief executive Chris Hopson had to say:
“The NHS feels like it is on the brink because its funding just doesn’t match the demands it is facing. Today’s public accounts committee report is the latest evidence which shows the current funding for the NHS is unsustainable and that significant funding increases are needed to pay for realistic levels of patient care. Without the funds patient care will suffer as demand outstrips resources. After five years of unprecedented price cuts, with NHS providers making more than £20bn of savings over this parliament, they can no longer guarantee safe and effective care unless they are properly and fully paid for the patients they treat. We have now reached the point where patient care is at risk.
“The demands being placed on the NHS today may be unprecedented but they were not unpredictable. We need to fund all the NHS sectors - community services, mental health, primary care, ambulance and hospitals – to be able to play their full and best role in providing patients and service users with the right care at the right time. Instead we have a system which increasingly lets patients become emergencies which only hospitals can treat. We need to fund the demand our hospitals are actually facing, not that which we would like them to face. We need to properly fund community services, mental health, ambulance and primary care sectors to deliver their real potential. Only then will we have the space and confidence to make the step changes needed to create the new models of care which will provide long-term sustainability for the NHS and better care for patients.
“Either we fit the money to the care provided – NHS providers being paid fully for the patients they treat; or we fit the care to meet the money available – ensuring that providers are commissioned for realistic levels of care to reflect the static overall NHS budget. What we can’t carry on doing is pretending that NHS trusts can achieve the impossible and then berate and criticise them when they inevitably fall short. The PAC report clearly accepts our members’ view that demand has not been controlled and providers are being penalised for treating more patients under the punitive marginal rate rules.
“As this welcome report highlights, we can’t get a different outcome by using the same approach. Last week our members vetoed the proposed tariff for funding next year because it continues a path of continued cuts and unachievable efficiency savings which will inevitably and seriously affect future patient care. All political parties need to explain how they will fund today’s demands and fund the changes needed to make the NHS sustainable. Both are essential”.
12.18pm The NHS Confederation has responded to the Commons public accounts committee’s report on the financial sustainability of the NHS. Chief executive Rob Webster said
“The public accounts committee report reflects what we already know - the finances of the NHS need to support a radical change in service to make the NHS sustainable. The alternative is that the NHS will reach a point at which finances could collapse quickly. Given very high satisfaction with the NHS reported in the most recent British social attitudes survey, this is not something the public or the NHS would be prepared to see.
“All political parties need to make clear how they will ensure both the NHS and social care are sufficiently funded. By 2020 we will need to see at least £8bn of extra funding each year and £22bn of efficiencies delivered. Alongside this, social care services will need funding. An honest debate is required to give the public a better understanding of the choices we face.
“The report calls for a ‘radical change’ to make the NHS financially sustainable. This is in line with the NHS Confederation’s thinking, set out in the 2015 Challenge Manifesto, which calls for a longer term approach to health spending. The NHS Confederation wants to see a ten year settlement. Such a ‘decade deal’ would benefit an NHS that needs financial certainty to plan health services and taxpayers who would like clarity on how the NHS will be funded.
“We also believe that in order to reduce emergency admissions and better integrate health and social care, a one-off transition fund of at least £4 billion over two years is required to assist local NHS organisations in transforming how they provide care. As part of this transformation we urgently need to see progress on a stategy for our workforce that reflects the scale of change in where, and how, staff will need to work in the future.”
The CQC said it had “identified several areas of concern where the trust must make improvements”. These included low staff morale, lack of senior leadership support towards staff, and a lack of availability of beds.
A statement from regulator added: “Areas of concern included unsafe environments that did not promote patient dignity; insufficient staffing levels to safely meet patient’s needs; inadequate arrangements for medication management; and concerns regarding seclusion and restraint practice.”
11.54am Labour’s health spokesman in the House of Lords, Philip Hunt, has tweeted that he will ask a question about Mr Alexander’s comments in Parliament tomorrow:
— Philip Hunt (@LordPhilofBrum) February 3, 2015
11.41am A big exclusive from Ben Clover: one of the most senior national NHS finance officials attacked the 2015-16 pricing proposals which have been put forward by his counterparts at other arm’s length bodies,HSJ can reveal.
The objections are revealed in letters sent by NHS Trust Development Authority finance director Bob Alexander to NHS England chief finance director Paul Baumann and Monitor’s managing director of sector development Adrian Masters.
Mr Alexander said the proposed efficiency requirement could not be met without risking care quality, and that plans to cap payments for specialised services could lead to hospitals refusing to prescribe certain drugs.
11.13am The row between the Care Quality Commission and Hinchingbrooke Health Care Trust and Circle, the private company which runs the NHS hospital, has been laid bare during a heated evidence session held by MPs.
The Commons public accounts committee yesterday also heard from a senior Department of Health official who suggested there would not be any more franchise deals for NHS hospitals until the health service’s finances were more stable.
10.55am Some breaking news:the Care Quality Commission has recommended Norfolk and Suffolk NHS Foundation Trust should be placed into special measures after an inspection resulted in it receiving an overall rating of “inadequate”.
The CQC found the trust, which provides mental health and learning disability services to a large population across Norfolk and Suffolk, needed to make a number of improvements to ensure it was consistently delivering care which was safe, effective, responsive to people’s needs, in services which were well led. The inspection was carried out in October 2014.
The trust was rated as “inadequate” with regard to whether services were safe and well-led, “requires improvement” with regard to whether services were effective and responsive and “good” with regards to whether services were caring. Its overall rating was inadequate.
A full report on the trust, and on all the individual services inspected, can be found here.
Paul Lelliott, CQC’s deputy chief inspector of hospitals and its lead for mental health, said:
“We found a number of serious problems when we inspected the services run by Norfolk and Suffolk Foundation Trust and we have made a recommendation to Monitor that the trust is placed into special measures. We have informed Monitor of the breaches and it will make sure these are appropriately addressed and that progress is monitored through the special measures action plan
“We were concerned about the safety and quality of care provided by some of the trust’s services. We were also struck by the low morale of many of the staff that we interviewed who told us that their voices were not heard by those managing the trust
“Some of the management team at Norfolk and Suffolk Foundation Trust are quite new in post. They must provide the leadership to bring about the urgent improvements needed to ensure care and treatment consistently meets the required standard.
“The trust managers have told us they have listened to our inspectors’ findings and have begun to take action where it is required. We have maintained close contact with the trust since the inspection and will undertake further inspections, including unannounced visits to check that the improvements needed have been made.”
More to follow
10.23am Also in the FT, the UK risks squandering the potential of “big data” to improve healthcare and advance medical research unless more is done to win support for the sharing of patient information, ministers have been warned.
A report by the Nuffield Council on Bioethics has called for greater transparency over how medical data are used and the introduction of criminal penalties for its misuse in order to increase public trust.
The recommendations follow controversy over the care.data scheme to pool patient data from general practices and hospitals in a single national database.
10.15am The Financial Times reports that the government’s plans to cut NHS waiting lists by shifting routing operations to the private sector has stalled.
In December, private hospitals agreed to provide up to 50,000 operations in the three months to the end of March. But almost two months after that pledge, a large majority of - 80 per cent by one estimate - remains unused.
10.08am The Times reports that spending on stand-in NHS staff jumped by a quarter last year, according to a committee of MPs which says some doctors are leaving permanent jobs because they can earn £1,760 a day as locums.
Ministers must make sure hospitals stick to national pay rates and consider banning consultants trained at the taxpayer’s expense from working as “professional temporary staff” to earn more, the public accounts committee urges.
Margaret Hodge, its chairwoman, said she was more worried about the financial health of the NHS than any other part of government, warning that it could not make the necessary savings by carrying on with current methods, such as pay freezes.
10.01am There’s coverage in this morning’s papers of yesterday’s Commons public accounts committee session on Hinchingbrooke Health Care Trust (see yesterday’s HSJ Live). The Daily Telegraph and The Times both pick up on the admission by the Care Quality Commission that Hinchingbrooke challenged 300 factual inaccuracies in the draft inspection report, of which two thirds were conceded by the CQC.
9.45am Maidstone and Tunbridge Wells Trust has been told it must improve following an inspection by the Care Quality Commission, which found that the trust’s governance was ‘inadequate’.
After visiting the trust in October, the regulator rated it as “requires improvement” overall after it found that patient flow through the hospital was poor and some patients experienced “excessively long” fasting periods before operations.
The inspectors found that “high quality care was not assured by the governance processes or the culture in place in some areas of the trust”.
7.00am Good morning and welcome to HSJ Live.
To kick off the day, HSJ examines how crowdsourcing can provide the NHS with a powerful means of driving change from the ground up.