The health secretary said £240m technology fund has not been ‘cut’ but will instead subject to ‘a staged rollout’, plus the rest of today’s news and comment

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5.00pm: A flagship NHS technology fund widely feared to have been raided to finance support for struggling accident and emergency departments has not been “cut” but will instead subject to “a staged rollout”, according to health secretary Jeremy Hunt.

Mr Hunt’s comments at the UK E-health Week conference followed NHS England announcing last month that just £43m of the original £240m in the integrated digital care fund was being allocated.

The fund is designed to help assist trusts and local authorties with projects largely related to integrating electronic patient records.   

1.46pm Delayed discharges from hospitals into social care are 43 per cent higher than average in county areas, leaving them financially stretched but without devolved control over health, MPs have warned.

A new report from the county all party parliamentary group voiced alarm at a “devolution divide” opening up between counties and urban areas after the Greater Manchester Combined Authority was last week promised control of the area’s £6bn NHS budget

1.30pm David Flory will step down as the chief executive of the NHS Trust Development Authority in May, HSJ can reveal.

Mr Flory will retire on 7 May after running the organisation responsible for managing NHS trusts since it was founded in June 2012.

Finance director Bob Alexander will be interim chief executive until a new appointment is made. Elizabeth O’Mahony will be interim finance director in Mr Alexander’s absence.

The TDA is responsible for 90 organisations and is charged with making sure they are in a fit state to be licensed as foundation trusts by Monitor.

12.45pm The entry deadline for the Patient Safety Awards is closing on 6 March. Enter now for a chance to showcase your project infront of NHS leaders.

The Patient Safety Awards recognise and reward outstanding practice within the NHS and independent healthcare organisations.

Now in their 7th year, the awards have joined forces with the Patient Safety Congress.

The awards will be announced at the Patient Safety Congress in Birmingham on 6-7 July.

Patient safety is at the forefront of new policies in the health service. It is the business of every individual involved in healthcare, whether they are on the board or on the ward, making this the only event where you will be able to acknowledge your organisation’s achievements with your entire team.

For more information, click here.

11.01am A new health and social care chief executive will be accountable for Greater Manchester’s £6bn devolved health and care budget, Manchester City Council chief executive Sir Howard Bernstein has said.

In an interview with HSJ’s sister title Local Government Chronicle, he said the region’s elected mayor will not be responsible for the budget.

Last week the region’s 10 council leaders, 12 clinical commissioning groups, 15 NHS providers, NHS England, chancellor George Osborne and health secretary Jeremy Hunt signed a memorandum of understanding for the full devolution of the region’s health and care services from April 2016.

While it falls short of the total devolution of health budgets in Scotland and Wales, the Greater Manchester agreement combines NHS England’s powers to delegate specialised commissioning and primary care funds to CCGs with the freedoms of NHS bodies to pool budgets and powers with each other and local authorities.

Mr Osborne indicated other areas would need to have an elected mayor if they wanted to win similar responsibilities.

10.22am The drive to reduce NHS spending led to a drop in some treatments considered ‘low-value’, according to researchers at Imperial College London.

However, in the absence of clear national guidance about which procedures to perform less, the cuts were applied inconsistently by commissioning groups, they added.

From April 2011, England’s NHS was challenged to find £20 bn of efficiency savings over four years, in part by reducing the use of ineffective, overused or inappropriate procedures.

Researchers at Imperial College London found that the first year of savings coincided with a significant drop in three procedures considered potentially ‘low value’: removal of cataracts, hysterectomy for heavy menstrual bleeding, and myringotomy to relieve eardrum pressure.

There was no significant change in three other ‘low-value’ procedures: spinal surgery for lower back pain, inguinal hernia repair, and primary hip replacement, or in two ‘benchmark’ procedures.

The findings are reported in the March issue of the journal Health Affairs.

Sophie Coronini-Cronberg, from the School of Public Health at Imperial College London, said: “During this period of austerity, each pound spent needs to be squeezed to deliver the maximum health value.

“The data suggests the NHS may indeed be managing costs in a rational way by reducing some procedures that have limited or low clinical value.

“However, we cannot be sure that it is those patients who would not benefit from surgery that are being excluded.

“Our research revealed a lack of consistency between commissioning organisations regarding which procedures were cut.

“With little national guidance about which procedures to remove or restrict funding for and under which circumstances, commissioners may be turning to locally developed, unofficial lists and criteria of low value treatments.

“This urgently needs to be addressed to avoid local variations. Arbitrary decision-making needs to be replaced with objective, consistent, evidence-based policies.”

The Imperial researchers looked at hospital statistics for six procedures that appear on such lists to see which had been affected and whether cuts were applied consistently across primary care trusts in the first year of the savings programme.

Myringotomy, a procedure to relieve pressure in the ear which is considered relatively ineffective, declined by 11.4 per cent overall. The number of procedures fell in 25 per cent of trusts, but increased in six per cent.

Two procedures considered only effective in certain circumstances also fell overall. Hysterectomy for heavy menstrual bleeding declined by 10.7 per cent overall, but while 13 per cent of trusts recorded a fall, four per cent saw an increase. Cataract removal declined by 4.8 per cent, with procedures falling in 31 per cent of trusts and rising in 13 per cent.

The study was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) North West London.

10.16am Lung cancer survival rates in England should “match the best in Europe” in order to save lives, a group of senior clinicians from the UK Lung Cancer Coalition has said.

The call comes in response to a request from NHS England’s new independent cancer taskforce for expert input into its forthcoming five-year plan. 

“Despite improvements in care over the last ten years, lung cancer survival rates in England still lag significantly behind other European countries,” says Dr Mick Peake, chair of the UKLCC’s clinical advisory group and clinical lead for the National Cancer Intelligence Network and National Lung Cancer Audit.

Dr Peake added: “Lung cancer remains England’s biggest cancer killer – accounting for over 28,000 deaths.”

Currently, England ranks 26 out of 29 European countries in terms of lung cancer survival data – one of the worst in Europe – with only 8.8 per cent of people still alive five years after diagnosis, compared to a European average of 13 percent.

“This is primarily a result of late diagnosis and wide variation in patient experience and access to treatment across the country,”

Dr Peake. “Tackling these challenges has been made harder by the recent NHS reorganisation, which removed advice and support to NHS lung cancer services, such as changes to the role and funding of cancer networks.”

As well as welcoming a commitment by the cancer taskforce to improving lung cancer survival rates in England, the UKLCC is also urging investment in cancer support functions and improved staffing levels across the lung cancer pathway, most specifically in lung cancer nurse specialists.

It also wants sustained funding for national lung cancer awareness programmes and promoting greater support for clinical research. 

“We know over 3500 lives could be saved in the UK if survival rates for lung cancer were to match the best in Europe,” says Mr Richard Steyn, UKLCC chair and associate medical director, surgery, at the Heart of England Foundation Trust.

The UKLCC was founded in 2005 and is a multi-interest group in lung cancer.  Its membership includes lung cancer experts, senior NHS professionals, charities and healthcare companies.

Its members include the British Lung Foundation, Cancer Research UK, Marie Curie Cancer Care and the Roy Castle Lung Cancer Foundation.

10.08am NHS England has yesterday announced details of a review of the commissioning of NHS maternity services.

The review will assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies.  

Simon Stevens, chief executive of NHS England, said: “Most mums say they get great NHS maternity care, but equally we know we can do better in many places, and [yesterday’s] Morecambe Bay report is truly shocking.

“So the time is right to take stock, and consider how we can best deliver maternity care safely in every part of the country, while better meeting the high expectations women and their families rightly have.”

Recent advances in maternity care, changes in the demographics of women having babies, and preferences of where they want to give birth will form a key focus. Terms of reference for the review, released today, state that it will:

  • First, review the UK and international evidence and make recommendations on safe and efficient models of maternity services, including midwife-led units;
  • Second, ensure that the NHS supports and enables women to make safe and appropriate choices of maternity care for them and their babies; and 
  • Third, support NHS staff including midwives to provide responsive care.

This review, which is expected to report in by the end of the year, will be led by an external chair, supported by a diverse panel. The appointment of the chair and other review panel members will be announced shortly.

9.47am A number of important stories broke yesterday afternoon. In case you missed them, here’s a round-up:

7.00am Good morning and welcome to HSJ Live.

Secure online sessions give greater access to therapy for people with mental health problems – an intervention that may stop suicidal thoughts progressing, says Sarah Bateup, clinical lead at Ieso Digital Health.