HSJ Live: 04.12.13 A&E attendance highest in spring, not winter

5:00pm Breaking news from HSJ reporter Shaun Lintern: a High Court judge has granted a last minute injunction to stop former Mid Staffordshire Foundation Trust chief nurse Jan Harry from leaving the Nursing and Midwifery Council register.

Ms Harry’s registration with the NMC was due to lapse on Thursday after she decided not to pay the annual registration fee, meaning she would be removed from the register and further disciplinary action could not be taken.

To prevent her from removing herself from the register the Professional Standards Authority today asked the High Court to impose an interim suspension order against her as an emergency injunction.

4:40pm HSJ’s sister publication, Nursing Times, reports that the Nursing and Midwifery Council’s handling of alleged misconduct cases relating to Mid Staffordshire Foundation Trust is going to be reviewed by the Professional Standards Authority.

The PSA does not have the power to appeal early decisions taken by the regulator but has confirmed it will audit actions they have taken and publish a report on its findings in the new year.

4:20pm Our exclusive on the delay to Oxfordshire’s outcomes based commissioning plan has also attracted interesting comments, particularly around the potential complexity of implementation:

“Yes commissioners should be clear what outcomes they are expecting providers to deliver. If a provider is not achieving these outcomes then contract reviews or terminations might be appropriate. However linking actual payments to outcomes is going to be complex. The NHS and government’s track record of successfully implementing complex new systems is not great.”

“Outcomes are definitely the way we should all be going, but they are not simple; is it the patient assessed outcome or the clinician’s? Do you use a basket of value based outcomes? A very narrowly defined outcome set will skew priorities. All of which need to be agreed, and collected on a large scale. This is not a small task.”

3:49pm Our story on the NHS Trust Development Authority applying for more funding from the Department of Health has provoked some interesting reader comments:

“I thought the TDA was supposed to be a time-limited organisation that would shrink in size as trusts became FTs (or are merged with FTs) so shouldn’t their budget be going down not up? We don’t need another organisation trying to invent a role for itself to survive when there isn’t one.”

“‘No [arm’s length organisation] is going to leave themselves open to criticism that they didn’t know what was going on, or that they sat back and didn’t act.’ This is the nub of the problem we have so many arms length bodies protecting themselves from crticism. Trusts - FT and non FT - are bombarded with ‘help’ and requests for information. The net result is organisations spend a significant element of time providing information and evidencing assurance.”

“No doubt even less to go to CCGs after all the rest have taken what they want? So we end up with contracts under pressure leading to cuts and the merry go round of insufficient funds to cope with demand continues.”

3:17pm HSJ is holding a free webinar next week exploring how clinical decision support technology can improve patient safety. Smarter decisions, better care, in association with Wolters Kluwer UpToDate, will take place on 10 December, and you can find out more about the webinar here.

2:57pm A launch event was held yesterday for health and social care leaders from the areas selected as national “integration pioneers”. You can catch up with tweeted coverage of the event, with health minister Norman Lamb, here.

Among Mr Lamb’s comments were that the Integration Transformation Fund – the description given to the CCG and local authority pooled budget – is being renamed the Better Care Fund.

2:40pm Also in the comment section, Alex Khaldi argues that structural change to integrate health and social care will fail unless it is accompanied by “real behaviour change”.

2:25pm Ian Kershaw, managing director of Northern Education, writes in our comment section about what the NHS can learn about ‘special measures’ from the education sector.

Ian argues that just because an organisation is placed in special measures does not mean it is “doomed to have the label forever”. Many schools in such circumstances achieve “rapid improvements in the key performance indicators”, he says.

2:11pm The scale of hunger in the UK represents a “public health emergency” according to medical experts. A group of doctors and academics made the claim in a letter to the British Medical Journal, and said that the impacts of “austere welfare reforms” on the nutritional status of vulnerable people “urgently need to be monitored”.

1:36pm The Telegraph covers another story related to the Health and Social Care Information Centre data. Almost half of patients who attended A&E departments in the past year only needed advice or did not receive treatment, the paper reports.

1:27pm David Cameron has defended GlaxoSmithKline on his trade visit to China, the Financial Times reports. The UK drug company is facing prosecution by Chinese authorities over allegations of bribery, and dozens of its local employees and one UK man who has worked for the company remain in detention.

1:07pm Staffordshire Police are investigating the death of a 90-year old woman at Stafford Hospital five years ago. Ivy Bunn died in November 2008 after being admitted to the hospital following a fall a week earlier.

The Mid Staffordshire Foundation Trust is currently awaiting sentencing at Stafford Crown Court after admitting safety breaches relating to the death of Gillian Astbury, a diabetic patient who was not given insulin.

1:02pm The first national plan for the NHS workforce has been delayed as budget discussions between Health Education England and the Department of Health continue.

When it is released the workforce plan is expected to propose an increase in the number of registered nurses.

12:35pm John Woodcock, MP for Barrow and Furness, has announced on his blog that he is receiving treatment for depression.

Mr Woodcock follows a number of other politicians who have spoken in recent months about their personal experience of mental illness. He said he wanted to help to reduce the stigma surrounding mental health by “not just getting treatment for depression but being prepared to talk about it”.

12:26pm A new report by the Health and Social Care Information Centre has found that A&E admissions are highest between April and June, despite the national focus on winter admissions. In April-June this year, 5.6 million people attended A&E compared to 5.3 million between January and March.

HSCIC’s medical director, Mark Davies, said the idea that activity was highest in winter was a “myth”.

12:19pm CCGs in Warwickshire and Worcestershire have said they need to find 10 per cent cost savings in their support services. The commissioners also want to have core CSU teams permanently based with them.

12:12pm HSJ has today asked for submissions from our readers to help inform our commision on hospital care for frail elderly people. You can find more about the commission here.

11:15am The Times has a story on the national variation in health outcomes for people with lung cancer. According to research by the National Lung Cancer Audit, people diagnosed with lung cancer living in Dorset are likely to live 128 days longer than those in Luton or Hertfordshire.

11:03am HSJ’s editor, Alastair McLellan, has written an editorial about the struggle in Oxfordshire over the outcomes based commissioning plan. Alastair argues that what is unfolding in Oxfordshire will have ramifications for the role of CCG’s across the country.

10:57am The Guardian also reports that exercise may reduce the effects of dementia. According to research published in the Cochrane Library, exercise might help “through improvements in the ability to carry out everyday tasks and positive effects on mental processes such as memory and attention”.

10:49am In today’s papers, 600,000 more people are attending accident and emergency departments than under the previous government, The Guardian reports. The data from the Health and Social Care Information Centre prompted concerns from elderly charity Age UK  that numbers could increase because “the social care system is being stripped to the bone”.

10:43am The NHS Trust Development Authority has applied to the Department of Health for a greater funding allocation. The TDA said that under capacity and an increased workload in the wake of the Francis Inquiry is threatening its ability to “maintain effective oversight and support of trusts”.

10:29am Providers in Oxfordshire have forced the local CCG to delay an ambitious outcomes based commissioning plan, HSJ can exclusively reveal. The chief executives of Oxford University Hospitals Trust and Oxford Health Foundation Trust wrote a lengthy letter to Oxfordshire CCG raising their concerns with the plan.

10:24am HSJ has invited readers to help shape our Commission on Hospital Care for Frail Older People. Read more about it here.

10:17am In the resource centre, Tony Sumner discusses how involving service users in the recruitment process at Manchester Mental Health and Social Care Trust has developed a better understanding of how compassionate a candidate is.

10:07am Good morning. In comment today Ian Kershaw explains some of the lessons which the NHS can learn about special measures. Read his article in full here.