Pledges have nearly doubled since last year, plus the rest of today’s news and comment.



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5.07pm NHS England has apologised for delays in paying psychiatrists who carry out assessments to detain people forcibly under the Mental Health Act, reports the BBC.

One senior psychiatrist said he had not been paid for almost a year.

NHS England said there had been “some issues in the first financial year of the new NHS commissioning system”, and that it was “unacceptable that any service provider should have to wait for payment”.

4.52pm Public Health minister Jane Ellison has apologised for giving an “incorrect impression of events” to the Commons after she said that NHS medical records released to insurance actuaries were “non-identifiable”.

A report on the use of the data obtained by insurance actuaries said that the patient data released was “at individual episode level” which allowed the analysis “to identify patients across all their hospital admissions” and to build “medical histories” of individual patients”. The report said that the hospital data obtained had included many identifiers including diagnosis; age; gender; area where the patient lives; dates of hospital admission and discharge.

Barbara Keeley MP raised the issue that it was now being reported that the patient data released may also have been put online. The Health and Social Care Information Centre admitted that the NHS Information Centre was aware that a company to which it had given the patient data had uploaded the information to Google servers. HSCIC said that a data mapping tool had been taken down at its request and an investigation had been launched..

4.15pm Sir David Nicholson had a blunt message to deliver at the Health and Care Innovation Expo today - the NHS must change if it is to survive and remain sustainable.

“We need to put systems in place that make change happen,” he told the audience. “This is a matter of survival for the NHS.

“We are at a fork in the road. Those who say we can muddle through for two or three more years as we are and sustain the NHS are wrong. The old ways will not sustain it and we will only see a managed decline.”

Sir David was joined on the Community Stage at Manchester Central by MP Stephen Dorrell, the chairman of the Health Select Committee, and Dame Ruth Carnall, the former chief executive of NHS London and healthcare consultant, to debate ‘Is reconfiguration a luxury or a necessity?’

Sir David said several major changes had to be put in place including empowering people to take charge and make decisions about their own health and care.

“Changes are about organising services around individuals and we need to make sure we have primary care services that can support 7-day working. We need to integrate services, we need to be efficient in elective services and urgent and emergency care services need to be fixed.

“All this is a significant challenge and involves a change in the way we deliver services. It is difficult and it is tough.

“We need to nationally make the case for the change. We need to be shoulder to shoulder in these changes and tackle the politics.”

Stephen Dorrell said he regarded the subject of the debate as “a rhetorical question”, adding: “Reconfiguration is NHS jargon for ‘change’, and we should embrace change.

“The NHS needs to change because the demands we are being asked to meet are changing. The needs of the citizens we now provide services for are different from the needs of the citizens that the system grew up with.

“Reconfiguration must be at the core of the management’s objectives as it moves forward.”

Dame Ruth added: “How did we come up with a word like ‘reconfiguration’? I suspect to most of the public it means cuts and closures.

“We have unacceptable variations in the standards of care. And the financial gap is getting wider. Put those two things together and it tells me the NHS is unsustainable in its current format.”

3.39pm As his Change Day pledge Dr Damian Roland, a paediatrician specialising in emergency care and one of the founders of Change Day, spent an hour ‘collared and blocked’ on a spinal board in a pledge designed to help him understand what it feels like to be a patient with suspected spinal injuries.

3.17pm Amidst the positive pledges mounting up for Change Day there is a note of caution from Partha Kar in our Comment section.

3.00pm Sarah Wollaston MP has queried how the NHS hospital patient database was handed over to management consultants who uploaded it to Google servers based outside the UK, The Guardian reports.

2.50pm More news from Expo where NHS England’s Tim Kelsey toldthe audience at ‘Can We Be Sure our Health and Care System is Safe?’ that was part of a revolution sweeping the NHS, allowing for transparency that will deliver a better service and greater participation by patients.

He said: “I think that we are at the beginning of something that in five years’ time we will reap the rewards of and we will be asking how on earth we could have run the health service so blind for so long.”

2.46pm NHS England’s medical director has challenged patients, NHS staff, industry leaders and politicians to radically change the way they deal with healthcare services.

Making the first key speech of the NHS Health and Care Innovation Expo, Professor Sir Bruce Keogh said everyone involved in the NHS had to play their part in making sure the service can deal with the “quadruple pincer” of difficult increasing demand, escalating costs, a tightened fiscal environment and increasing patient expectations.

Looking back to the establishment of the NHS in the aftermath of the Second World War, Sir Bruce said the current difficult times, if handled in the right way, could herald a new era of innovation and development.

Sir Bruce said: “To patients, I say be more confident and more assertive – do your research, don’t be shy to ask questions and, crucially, don’t be shy to take charge.

“To front-line clinical and managerial staff, I say please, do not aspire to mediocrity. I hear people talk about meeting the European average. I have no interest in meeting the European average and I hope you don’t either. We need to always aspire to excellence and must not be constrained to the normal, the usual, the middle of the pack.

“Push the boundaries. Do not ignore cost, but seek value because it is through value that we will acquire the best possible treatment for everyone. Show courage, and give each other permission to try new things. Take risks with processes, but not with clinical outcomes. And through all of this, help turn taxpayers’ money into good clinical outcomes.

Sir Bruce called on industry leaders to do business in the UK, hailing low corporation tax that reduces further for profits earned on UK international patents and gives significant tax rebate for research expenditure as a “remarkable incentive” for innovation.

He challenged politicians to develop policies that “unleash rather than constrain” the intellectual capital of the NHS’s 1.4 million staff.

2.22pm What do you think could be done to improve the NHS? Share your thoughts through our poll, as part of NHS Change Day.

2.02pm Physiotherapy treatment for patients with complex needs ranging from learning disabilities to long-term conditions like MS could be threatened by cuts to expert posts, the Chartered Society of Physiotherapy warns.

The CSP is concerned that a reduction in the number of senior grade roles means the experience and knowledge of those clinicians will be lost to patients.

There was an almost nine per cent reduction in band 7 and 8 posts between 2008 and 2013, and new statistics expected this month could show further cuts, say the CSP.

Physiotherapists in these roles have developed their skills in specific fields to deliver specialist treatment for patients and provide clinical leadership to colleagues.

Speaking as hundreds of physiotherapy staff meet in Cardiff for the CSP’s Annual Representatives’ Conference, the society’s chief executive, Professor Karen Middleton said: “The evidence shows that clinical leadership improves patient care and safety so these posts are critically important.

“We understand the NHS is facing enormous financial pressures, but specialist services save money by preventing conditions from worsening and requiring more expensive treatment.

“The leadership and expertise of these physiotherapists has a positive impact on the quality of life for many patients and we strongly urge trusts to recognise the value of this by retaining senior posts.”

The overall number of physiotherapists working in the NHS continues to rise, however, with more than 18,000 now providing treatment.

1.35pm The doctor who blew the whistle on care failings in the Baby P scandal has demanded an independent investigation into claims of bullying, intimidation and dismissal of whistleblowers at a prestigious cancer specialist trust.

Kim Holt, who is now chair of the patient safety campaign group Patients First, made the call relating to “very serious claims” involving The Christie Foundation Trust, in a letter to health secretary Jeremy Hunt last night.

She also called for Mr Hunt to appoint an interim chair and an interim chief executive at the Manchester based trust.

1.30pm The chief executive of Birmingham Community Healthcare Trust Tracy Taylor has been appointed as chair of the Aspirant Community Foundation Trust Network (ACFTN), following the departure of Leeds Community Healthcare Trust chief executive Rob Webster.

The ACFTN represents England’s leading providers of dedicated NHS community services. Its 18 members collectively serve a population of over 12.3 million people with a turnover of over £2.3bn.

Ms Taylor said: “I am delighted to be taking on the role of chair of the Aspirant Community Foundation Trust Network and look forward to working with colleagues from all member organisations to build on the group’s achievements and continue to raise the profile and status of community healthcare.

“Working together, this group can fulfil a key role in establishing community healthcare in the public consciousness as a specialist field, delivered by dedicated experts able to fulfil a real leadership role in the modern NHS.

“We have the expertise and experience - and growing evidence - to show that high quality services delivered flexibly in the community hold the key to easing the pressure on the acute sector and enabling many more patients to receive personalised care closer to home.”

1.25pm The Department of Health and Monitor have written to foundation trusts encouraging them to take a tough stance towards suppliers who attempt to impose “blanket inflationary price increases”.

In the letter signed by health minister Daniel Poulter and Monitor chief executive David Bennett the two organisations also advise trusts to avoid signing confidentiality agreements with suppliers, in line with transparency guidance which they say will be due to be introduced in April.

The letter reads: “We would encourage foundation trusts to take a robust approach to resisting blanket inflationary price increases from their suppliers. We are currently developing guidance and tools to support you do this.

1.07pm The director of nursing at Dorset Healthcare University Foundation Trust has resigned after less than three months in the post, HSJ has learned.

Paul Lumsden took up the post at the troubled mental health and community provider in November. He replaced Tim Archer who left last year after Monitor intervened at the trust in response to governance concerns.

The chair and chief executive also resigned and have been replaced on an interim basis by Sir David Henshaw and Ron Shields respectively. Former parliamentary health service ombudsman Ann Abraham has recently been appointed as permanent chair and will take up post from 7 April.

12.27pm Royal Liverpool and Broadgreen University Hospitals Trust’s application for foundation status has been reactivated.

The application has been restarted after the trust reached financial close in December on a £429m private finance initiative deal to demolish and rebuild its main hospital site.

Royal Liverpool has also been inspected by the Care Quality Commission as part of the latter’s new inspection regime – a prerequisite to move forward in the application process.

12.22pm Technology is being used to cut the numbers of missed GP and outpatient appointments, NHS England will announce today.

Figures have suggested that more than 12 million GP appointments are missed each year in the UK, costing in excess of £162m per year. A further 6.9 million outpatient hospital appointments are missed each year in the UK, costing an average of £108 per appointment in 2012/13.

By making the appointment system fit into patient’s lives more easily, the NHS hopes to cut the numbers of missed appointments.

Missed appointments, known as Did Not Attends (DNAs) can cause serious delays in treatment for other patients.

Beverley Bryant, NHS England, said: “It’s important that people realise that not turning up to appointments can have a big impact on the care and treatment we are able to give other patients. It wastes Doctors’ and Nurses’ time too, which costs taxpayers money.

“Patient care is always at the top of our agenda.  That‘s why we are doing everything we can to make our service match with people’s lifestyles and the technology they use, to give more people easy access to the services they need.  We hope the public will do their bit too by making sure they attend or cancel appointments in good time.That way, everybody benefits.”

In an effort to get the message across to the wider public of the cost of missed appointments, the NHS is using Change Day 2014 to appeal to patients. Change Day asks patients, staff and providers commit to one action that will improve care within the NHS. This year, NHS England is encouraging patients to pledge to turn up to their appointments and help push DNA numbers as low as possible. The scheme, in its second year, has already seen 225,000 people make a personal pledge to improve the NHS, which prior to launch is already up on last year’s  total of 189,000 pledges.

12.11pm The NHS Working Longer Review has submitted a number of recommendations on behalf of the NHS Staff Council. The review concludes that meeting the challenge of on older workforce could see major changes to the policies, culture and management of the NHS.

The recommendations aim to ensure that the NHS is on the front foot in addressing the emerging issue of its ageing workforce, whose average age is 43.7 years. Around 910,000 (70 per cent) of the existing workforce will also see an increase in their retirement age, up to 68 years old.

Preliminary findings and recommendations report for the Health Departments contains11 recommendations which concentrate on four main themes - data gaps, pension options, working arrangements and good practice in health, safety and wellbeing.

Christina McAnea, staff side chair of the NHS Staff Council, said: “The reality is many staff are particularly concerned about the impact of having to working beyond 60. Their biggest fear is not being able to continue to do their jobs well and will not be able to keep pace with the demands of the job. Trade unions have never accepted the Governments policy that links retirement age with state pension age. Through this review we have aimed to mitigate the impact of working longer on both NHS staff and service users.

“The clock is ticking to meet the working longer challenge. We cannot afford to ignore the changes and difficulties that need to be overcome. We need to be prepared and work together to allay fears and not be afraid of making changes to work patterns and job design to enable working longer to be a realistic and more desirable possibility.”

11.37am An NHS whistleblower could be sacked for raising concerns that a hospital was fiddling its death rates - bringing into question promises made by ministers to protect those who speak out in the public interest.

Sandra Haynes-Kirkbright last year told the Daily Mail that she was “headhunted” by her employer, Royal Wolverhampton Trust, to “fix” its mortality figures.

Ms Haynes-Kirkbright claimed that “every rule in the book” was broken to try to improve mortality rates, and alleged that she was suspended from her post as a senior “health coder” after refusing to take part in a cover-up.

11.22am Here’s a selection of interesting pledges made for NHS Change Day:

Professor Tricia Hart: “My additional pledge on NHS Change Day to get another 100 staff using social media to share learning and encourage new networks.”

Occupy London: “On NHS Change Day let’s change the way NHS hospitals are funded. That means scrapping usurious PFI schemes!”

Mid Yorkshire Trust: “Sisters at male and female wards in Dewsbury pledge to ‘consider their colleagues’.”

10.55am Our reporter Nick Renaud-Komiya is at NHS Expo in Manchester today where he’ll be tweeting updates throughout proceedings. Follow @nickrenkom for the latest news from the conference.

10.52am Here’s a round-up of all our content for NHS Change Day.

10.36am The Daily Mail dedicates its front page to reporting that an NHS whistleblower has been threatened with the sack.

Sandra Haynes Kirkbright publically claimed she was headhunted by the Royal Wolverhampton Hospitals Trust to “fix” mortality figures to cover up failings.

Mrs Haynes Kirkbright was suspended by the trust, and last week received a letter via email ordering her to attend a disciplinary hearing, which could result in her dismissal.

10.29am The manufacturers of Gaviscon, Reckitt Benckiser, have agreed to pay a settlement to the Department of Health. This was in connection with the supply of Gaviscon to the NHS in England.

10.17am The NHS in Scotland is coping “much better” with winter pressures than it did last year, Scottish health secretary Alex Neil said.

Mr Neil spoke out after recent figures revealed a large drop in the number of patients spending 12 hours or more in hospital accident and emergency departments.

In December 2012 there were 323 patients who had to wait this long in A&E, compared to just 42 in the same month in 2013 - a drop of 87 per cent.

10.12am The Independent writes that a terminally ill man was refused repeated requests to return to his home to die beside his brother because of multiple failings by doctors and social workers, according to a report by the Parliamentary and Health Service Ombudsman and the Local Government Ombudsman.

The man, who had diabetes, Alzheimer’s and breathing problems and unable to walk, had been admitted to hospital, then transferred to a care home, where he died in December 2009.

The report criticised five organisations - Derbyshire County Primary Care Trust, Moss Valley Medical Practice, Chesterfield Royal Hospital Foundation Trust, Derbyshire County Council and Sheffield City Council – for  failing to take account of laws regarding depriving people of their liberty.

10.02am Former health secretary Alan Milburn writes in the Financial Times that the financial squeeze on the NHS “create the circumstances for change”. He argues that new models of care are already emerging but what is needed is a long-term plan.

He says that incoming chief executive of NHS England, Simon Stevens, needs to be “empowered” to bring about “clarity instead of uncertainty”.

10.00am The Financial Times also reports that official data used to improve public health in the UK are at risk of being lost because of budget cuts at the Office for National Statistics.

The ONS says it can no longer afford to produce statistics that track trends in inequality in life expectancy at birth alongside 14 other sets of figures unless an outside funder steps in by the end of March.

9.57am The Financial Times reports that the prime minister’s drive to open up public services is threatening to replace “public sector monopolies with private sector oligopolies” the chief executive of the Association of Chief Executives of Voluntary Organisations has said.

Sir Stephen Bubb stood alongside David Cameron when he launched this initiative in 2011 as he declared the old approach to delivering public services as “broken”.

However, in a letter to Mr Cameron Sir Stephen said that public service reform had too ofen “emphasised narrow cost savings” over “engagement, collaboration and social value”.

9.49am The Guardian reports that cigarette breaks cost British employers £8.4bn a yearin lost productivityas smokers take 10 minute breaks four times a day according to a study for the British Heart Foundation.

Smoking breaks cost employers £1,815 a year for each full-time staff member who smokes at work, according to the study by the Centre for Economics and Business Research.

9.43am As part of NHS Change Day Martin Land and colleagues look at the “energy for change” index which they argue is providing practical tools to develop greater capacity and commitment for change.

7.00am Good morning and welcome to HSJ Live.

The successful example of people power NHS Change Day represents has the potential to change the face of healthcare reform as we know it, writes Damian Roland, a senior paediatric registrar at University Hospitals of Leicester Trust and one of the early co-founders of NHS Change Day.