HSJ clinical commissioning barometer survey finds CCG leaders concerned about public health services, plus the rest of today’s news and comment.

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4.30pm Take part in HSJ’s latest Twitter chat on commissioning end of life care and keeping terminally ill people out of hospital.

With an ageing population and death rates set to rise by 17 per cent from 2012 to 2030, the pressure on the healthcare system to provide end of life care will only increase. Hospitals will struggle to meet this additional demand and, in any case, research shows that most people do not want to die in a hospital setting.

On Friday 11 April at 12pm, HSJ – in association with Marie Curie Cancer Care – will be running a Twitter chat to discuss how we can commission care to keep terminally ill people out of hospital if there is no medical reason to be there.

  •  How can we move more resources to a community-based model of care?
  •  How can we ensure all end of life care is centred on the needs and preferences of the patient and his or her family?
  •  What needs to change to make this sort of care a reality?

Michael Cooke, Marie Curie’s head of analytics, and Phil McCarvill, Marie Curie’s head of policy for England, will be online taking questions and offering thoughts.

Follow the @HSJnews and @MarieCurieEOLC Twitter accounts from Friday 11 April at 12pm to take part. We will be using #HSJEOLC – you can use this now to pose questions for the debate.

4.00pm In HSJ’s Insights and Influences channel, the Supreme Court decides on what constitutes a deprivation of liberty in a care context – many patients in hospitals will now fall within the definition, write Neil Grant and Samantha Cox of Ridouts LPP.

3.35pm The BBC also reports that half of people with lung cancer die within six months of being diagnosed, according a report by Macmillan Cancer Support looking at variations in cancer survival rates.

Its chief executive Ciaran Devane said: “Cancer is not just one disease, and therefore there is no one-size-fits-all approach to treatment and aftercare.

“The NHS needs to get much better at using robust data to understand the complex needs of people with different cancers so that services can be planned accordingly. It’s no good papering over the cracks any longer, we need a complete system overhaul.”

3.00pm The BBC reports on the 883 new cases of scarlet fever across England in the past week according to figures from Public Health England, the highest weekly total for more than 30 years.

Theresa Lamagni, Public Health England’s head of streptococcal infection surveillance, said: “We are working closely with healthcare professionals to try and understand the reasons behind these increases and do our best to reduce the impact of this infection.”

2.43pm In a BBC Radio 4 interview to mark his first year in the role, Care Quality Commission chair David Prior said there has been a “huge variation” between hospitals.

“We have postcode lotteries in the NHS because the quality of care in one hospital can be very different from the quality of care in another hospital. And I think by exposing those variances, we can address them,” he said.

“In those hospitals where you would not wish to go, you have a very poor damaged culture where employees feel they can’t raise concerns, where patients are not listened to.”

2.30pm HSJ and our sister title Nursing Times, working with NHS Employers, are seeking to celebrate healthcare’s social media pioneers – those whose blogs, posts and tweets influence and provoke debate, and who are using social media to effect and drive change within the service.

Have you submitted your nominations yet? The closing date is 14 April.

2.00pm Forget about pay restraint, referral management and primary care prescribing, there’s a new show in QIPP town apparently – bath salts.

Reports have reached End Game, via fashion and beauty bible Cosmopolitan, that these “age old health boosters” could also save the NHS £14.5 billion annually.

1.30pm We want your views as to whether any qualified provider can be the vehicle for change for commissioning services within the NHS.

Over the past few years the NHS has seen an increasing number of services commissioned through any qualified provider. It will soon be up to commissioners to decide if they want to extend any qualified provider to new areas.

But what benefits are patients and NHS organisations getting from any qualified provider and is there scope to commission more services from high street providers? Do you feel any qualified provider has been a success? Are your local commissioners likely to open up more services to new providers? Which ones? How will they be commissioned?

HSJ, in association with Specsavers, is running a short survey which explores whether any qualified provider can be the vehicle for change within commissioning services for the NHS. The findings will be used to inform a forthcoming HSJ article.

Complete the survey here. As a thank you, Specsavers is offering participants the chance to win £100 of Amazon vouchers in a prize draw.

1.00pm North Cumbria University Hospitals Trust is launching a recruitment campaign to address a staff shortage which has affected its ability to train junior doctors.

At its board meeting last week the troubled trust revealed three junior doctors at its West Cumberland Hospital had been removed by Health Education North East because of concerns of a “lack of available clinical supervision”.

12.45pm Rules aimed at ensuring doctors do not work long hours are leading to cancelled operations and clinics for patients, a government-ordered review has found.

The report into the impact of the European Working Time Directive (EWTD) found that mandatory rest periods for doctors providing out-of-hours emergency hospital care were impacting on the following day’s work.

12.30pm In case you missed the story when it broke yesterday, the largest healthcare union has warned of a “winter of unrest for the NHS” as it revealed plans to ballot members for industrial action.

A meeting of the union’s healthcare executive agreed on Wednesday to seek an emergency vote at its annual healthcare conference on 15 April to obtain permission to ballot its 450,000 NHS members over potential industrial action. The move is a response to the government’s imposed pay deal.

12.00pm The Evening Standard reports on London councils banning supermarkets and off-licences being banned from selling alcohol in areas where ambulances are frequently called to drink-related emergencies.

Janet Burgess, Islington Council’s executive member for health and wellbeing, said: “The night-time economy is important to Islington but excessive alcohol consumption can have repercussions for the wellbeing of the wider community and we have to strike a balance.

“Our database tool links public health with licensing objectives, helping us to protect our communities from harm.”

11.45am The Times reports that smog levels that topped the government’s official air pollution scale in parts of the country led to soaring ambulance calls for people with breathing difficulties yesterday.

There was a 14 per cent increase in 999 calls in London while East of England Ambulance Service said that calls were up by 6 per cent.

The Daily Mail also leads on the story.

11.30am In today’s papers, people with severe drink-related liver disease are to be considered for transplant for the first time, The Guardian reports.

The pilot scheme outlined by the NHS Blood and Transplant is for patients with severe alcohol associated hepatitis.

James Neuberger, associate medical director of the NHSBT, acknowledged the sensitivities surrounding the decision but told the paper, “we transplant humans, not angels”.

11.15am Today marks the deadline for NHS foundation trusts and trusts to submit their two year operational plans. Trusts will then need to move to working on the five year strategic plans, due to be submitted in June.

Commenting on the planning process, Miriam Deakin, head of policy at Foundation Trust Network, said: “This is the first time trusts have been required to submit two and five year operational and strategic plans, and marks a welcome shift in NHS planning towards a longer term view of ensuring clinically and financially sustainable local health and care systems.

“However, we must not expect the planning round to resolve all of the pressures facing the NHS. Providers need to safeguard and improve patient care in the context of unprecedented financial pressure, rising demand and growing expectations. In this context of uncertainty, we also need a sustained national focus on immediate pressures as well as a mid term view.

“Our members have expressed concern about their ability to plan given uncertainties in the system and the fact they cannot commit to service changes which rightly require public consultation. In this context, the statutory bodies, NHSE, Monitor and TDA, will wish to ensure that commissioner and provider plans are fully aligned to ensure clarity of direction in a local health economy”.

Today is also the deadline for the submission of better care fund plans.

11.00am A trial scheme fund mental health professionals in police stations and courts has launched this week in ten locations across England. 

These areas are:

  • London
  • Wakefield
  • Coventry
  • Merseyside
  • South Essex
  • Sussex
  • Leicestershire
  • Dorset
  • Sunderland/Middlesborough
  • Bristol

The ten pilots, commissioned by NHS England, will run for 12 months. If successful the model will be extended, with aim to cover the population of England by 2017. 

£25m has so far been invested into the scheme.

Kate Davies, head of health and justice, armed forces and public dealth direct commissioning at NHS England, saidthe services “mark an achievement in providing better healthcare and support for those who need it the most.

“Whether it is a son, daughter, friend or neighbour, all vulnerable people in contact with police or courts will in future receive the same support and service despite where they are in England.

“The 10 schemes trialling the new model have started to make this change and improvement of these services a reality so that vulnerable people can receive the treatment and support that they desperately need. “

Care services Norman Lamb, said: “I am committed to improving mental health care for everyone. I want to build a fairer society and that’s why we’ve invested £25 million in this valuable scheme to make sure people with mental health problems who come in to contact with the criminal justice system get the support they need at the right time.

“It is encouraging to see progress being made with the 10 local area pilot schemes and I look forward to personally visiting one of these services at some point in the near future.”

Policing minister Damian Green said: “The Home Secretary and I have made it a priority to improve hugely the way people with mental health issues are dealt with when they come into contact with the police.

“Where people with mental health problems are arrested by the police it is vital they receive appropriate care while in custody and this is best provided by health professionals.”

10.50am The Competition and Markets Authority has begun a review of the proposed merger between Frimley Park Hospital Foundation Trust and its troubled neighbour Heatherwood and Wexham Park.

The review, to examine the potential effect of the merger on patient choice and care quality, will be only the second such probe since the 2012 Health Act gave the UK’s general competition authorities oversight of mergers between NHS foundation trusts.

10.40am In rural and remote areas, partnership working is essential to provide people with high quality end of life care, writes Diana Hekerem, divisional business and service development manager for Scotland at Marie Curie Cancer Care.

10.25am Two of London’s most famous teaching hospitals are locked in dispute over the sale of land in central London.

HSJ understands the governors of one of the trusts have written to planning officers at the other, urging them to refuse change of use permission for land a neighbouring foundation trust aims to sell. Click here to find out who the trusts are.

10.10am One year on from their statutory formation, the CCG barometer shows that clinical commissioning groups remain full of ambition, argue Kalee Talvitie-Brown and Rob Yearsley of PwC’s health practice.

10.00am More than a quarter of clinical commissioning leaders say they have opened NHS services up to competition – or are currently doing so – only because they fear they would fall foul of competition rules if they did not, HSJ’s CCG barometer survey has found.

And a fifth of respondents said their groups’ decisions had been formally challenged under controversial NHS competition regulations.

9.45am Also in HSJ’s latest barometer survey, the ability of the NHS to control costs and curb hospital activity has not improved with the government’s reorganisation of the NHS, according to many leaders of the clinical commissioning groups created by the reforms.

The survey asked CCGs’ most senior leaders to rate whether the NHS’s situation in various important areas was now better or worse than it was before the reforms.

7.00am Good morning and welcome to HSJ Live. We begin the day with the news that clinical commissioning leaders have expressed serious concerns about the current state of public health services.

In the latest HSJ clinical commissioning barometer survey, carried out with PwC, 40.6 per cent of respondents said it was worse and 39.6 per cent said the same.