‘Historians will not be kind in their assessment’ of its record on NHS reform, says the King’s Fund, plus the rest of today’s news and comment
5.30pm In case you missed them, here are today’s top stories:
3.20pm Monitor has issued a statement explaining the work its new ‘provider sustainability directorate’ will be doing, as described in HSJ last week.
2.37pm Shaun Lintern Tweets:
Baroness Pitkeathley tells Lords she is dismayed about how zero harm bill is being handled with Gov officials saying it cant be ammended.
— Shaun Lintern (@ShaunLintern) February 6, 2015
2.35pm North Cumbria University Hospitals Trust has been forced to cancel all non-urgent operations at one of its hospitals following an outbreak of norovirus.
The trust took the decision to postpone the procedures at Cumberland Infirmary in Carlisle on 26 January to try to minimise the impact of the winter vomiting bug outbreak.
It has also asked children and non-essential visitors not to visit any of the wards until further notice.
The trust has introduced strict limitations of two visitors per bed and next of kin only.
1.57pm HSJ’s Shaun Lintern is watching the second reading of the Health and Social Care (Safety and Quality) Bill in the House of Lords. Follow him on Twitter for the latest developments.
— Shaun Lintern (@ShaunLintern) February 6, 2015
1.54pm Tusts will be given an extra £1.2m to fund 700 volunteers to help ease pressures on accident and emergency departments.
The Cabinet Office has supplied the funding, which will be given to 29 trusts to fund three-month volunteer schemes.
Charities Age UK, the Royal Voluntary Service and British Red Cross will work with trusts to supply volunteers and set out their roles.
The volunteers’ roles will differ according to the particular needs of an area but examples the help they could provide include making sure patients are comfortable at home after leaving hospital and regularly visiting vulnerable people.
1.46pm The Daily Mail splashes with a story claiming the flu jab will protect just three per cent of patients this winter. According to Public Health England the mutation of the flu virus means that it no longer “matches” the current vaccine.
12.34pm In response to the King’s Fund report this morning, Paul Briddock, director of policy, Healthcare Financial Management Association, said: “Today’s report released by the King’s Fund reinforces the sheer scale of the challenge of implementing change to the NHS.
“This change can only happen through the transformation of services and tackling the status quo in the delivery of healthcare. This is a complex task. It is happening, but not fast enough – as today’s report highlights.
“The overhaul to how services are commissioned has taken time to settle, and has distracted time and effort away from changing the way services are provided to improve them for patients. The most important thing is the quality of the services provided and the care patients receive.
“Therefore, never before has there been such a need for commissioners and providers to work effectively together. It is only through this collaboration and alignment that much needed changes will be realised in frontline healthcare. The sector needs to pick up pace on the transformation of services to provide quality care, serve the needs of the general public better and guarantee a fit-for-future NHS.”
12.22pm The NHS has been in the eye of the media storm as never before in the winter of 2014/15, but new research from YouGov, commissioned by NHS Alliance, the leading voice for provider organisations across primary care, reveals that public trust in our national health service remains stable
Recent polls show that the public view the NHS as the most important issue to be covered in the news ahead of the election – while the British Social Attitudes research shows that before the winter crisis, public satisfaction with the NHS was stable.
Meanwhile the NHS Alliance’s annual Temperature Check shows that the public has faith in the NHS to look after them when ill is even higher - despite the winter A&E crisis and continued negative media coverage of missed targets throughout December and January.
Even with the barrage of negative media coverage the NHS has received this winter, this year’s statistics show that 73 per cent of people trust the NHS to look after them when they are ill. And, when asked if they trust the NHS the same or more than this time last year, 60 per cent of respondents responded positively. This has shown little change since January 2014.
While 74 per cent of people, according to the BBC poll, believe that it is very important that the NHS receives media coverage in the run up to the general election, NHS Alliance’s Temperature Check poll also reveals that the public’s confidence in the media and politicians to convey an accurate portrayal of the NHS is exceptionally low. The results show that only 7 per cent of the public believe politicians portray a balanced picture of the NHS, regardless of political party, and only 13 per cent of the population believe that the media portray a balanced picture of the NHS.
Dr Michael Dixon, chair, NHS Alliance said: “While it is reassuring that the public still trusts the NHS to look after them, and that this hasn’t wavered despite the tsunami of negative media coverage around the NHS and its failure to meet targets, it is important that we act on the challenges the NHS currently faces and do all we can to change the perception of the one in four who lack confidence in the service.
“We believe it is the system, not the service, which requires treatment. It has become unnecessarily complicated, fragmented and bureaucratic. To address this, NHS Alliance has identified three key aims for 2015:
24/7 responsibility for patients is returned to general practice operating within the Multi-speciality Community Providers model, suggested in NHS England’s Five Year Forward View. NHS Alliance described this model as a ‘Community of Care’ in its 2014 paper, Think Big, Act Now and is leading the way in helping make communities of care a reality through a new, dedicated support unit. We are convening an expert seminar in June to bring together analysis and case studies from our membership, and wider practitioners and policy makers from across the NHS to support their implementation. We welcome expressions of interest – simply email us at email@example.com.
We commend the RCGP campaign to attract young doctors to general practice and look forward to building on it when we launch our inspiration campaign to attract dynamic, young health professionals across primary care in its entirety next month. The campaign will be driven by our Tomorrow’s Leaders Network, which brings together some of the brightest minds from primary care. These individuals are passionate about their careers in the community as pharmacists, optometrists, dentists and GPs, and are motivated to play a part in sustaining a national health service, free at the point of need.
However, none of the above is possible without a model of equitable funding between primary and secondary care providers. It is time to properly review the way healthcare is funded, as the disparity in funding between primary and secondary care is making it almost impossible to treat people where they want to be treated, and where they are most efficiently and safely treated; in the community. Over the coming months, NHS Alliance will be looking at how we change historical imbalances between primary and secondary care, whether it be funding, training, support or profile.
“Finally, as patients, we need to think carefully about our expectations and challenge the ethos that everyone is entitled to everything. To do that we must involve patients more in the management of the NHS, and move their care into the community where possible. Together we can help sustain a healthcare system that remains free at the point of need. We need to help people understand that A & E is not the front door to the NHS – it should be used only as its name suggests, that is, in case of an accident or emergency.
“My hope is that in a year’s time, when we undertake our 2015/16 NHS Temperature Check, we are looking at a service in considerably better health, where patients are increasingly cared for in the community, by the community, wherever possible.”
10.57am Emergency patients at Nottingham University Hospitals Trust who are in need of specialist dermatology treatment could be forced to wait more than a day to be seen, HSJ has learned.
An internal memo from trust chief executive Peter Homa, which has been seen by HSJ, revealed the extent of the “scaled back” dermatology service at the trust. The service collapsed after five consultants left rather than transfer to the nearby Circle run treatment centre.
In 2013 Rushcliffe Clinical Commissioning Group decided to transfer elective dermatology services to Circle despite concerns from the trust, its 11 consultants and the British Association of Dermatologists.
The internal memo, which was sent to all consultants, ward managers, site matrons and emergency department staff on 30 January, informed them that from 2 February the trust was “no longer able to provide a comprehensive adult acute dermatology service”.
10.54am Senior figures from the three main political parties have backed health and wellbeing boards as the main commissioners of integrated health and social care, HSJ’s Judith Welikala reports.
Speaking at a King’s Fund event on integrated commissioning this week, Conservative MP Stephen Dorrell said the boards are “one of the innovations of the [Health Act 2012] that will stand the test of time”.
Mr Dorrell, a former health secretary who chaired the Commons health committee for much of this Parliament, was responding to a question by King’s Fund chief executive Chris Ham on who should be in charge of a single integrated budget for health and social care.
10.52am Responding to the report by the Home Affairs Committee on policing and mental health, for which a nurse gave evidence on behalf of the Royal College of Nursing, Dr Peter Carter, general secretary said: “Many of us can only imagine the additional distress caused when a person experiencing a mental health crisis is placed in a police cell as a so-called ‘place of safety’.
“Many police officers are well informed and compassionate when it comes to mental health issues, but they are right to recognise that a police cell is not the right place to be when experiencing distressing symptoms.
“The Committee are right to call for an end to the detention of vulnerable patients in police cells. They are also right to listen to the experience of nurses like RCN member Karla, who advocated for street triage for those at risk as a key component of the better care which could be delivered with proper funding across the board.
“This report is a vital reminder of the importance of providing enough beds, treatment programmes and community services where they are needed. It is an abject scandal that in one of the richest countries in the world, mental health patients are waiting for help in police cells and that many are having to travel hundreds of miles for urgent care.
“The only way these scandals will be stopped in the long term is by ensuring that services are available wherever they are needed, and for that there must be a step change in the importance placed on mental health.”
10.46am The Times reports on its front page that the country’s chief prosecutor is to appear in front of the Commons home affairs committee to “explain lessons that can be learnt” after a jury took less than half an hour to acquit an NHS junior doctor of female genital mutilation.
Dhanuson Dharmasena, was accused with performing the procedure on a patient after she gave birth at the Whittington Hospital in 2012. It had been alleged that he effectively re-did an earlier FGM procedure carried out on her as a child.
Public Health England has said the NHS flu jab has only been three per cent effective this year because experts misjudged the dominant strain, The Times reports.
Also in The Times, agency staff and bad management are largely to blame for poor care in nursing homes, according to a senior inspector at the Care Quality Commission.
10.39am The Department of Health has hit back at the King’s Fund’s analysis of the government’s performance on the NHS. DH director of communications Sam Lister tweets:
— Sam Lister (@samjlister) February 6, 2015
10.35am The Labour Party today released the following statement, responding to the King’s Fund report The NHS under the coalition government:
Andy Burnham MP, Labour’s shadow health secretary said: “Labour warned David Cameron that his reorganisation would damage the NHS and we now have independent authoritative evidence that that is what has happened.
“People will remember patients, nurses, doctors and midwives lining up in their thousands and pleading with the Government to call it off. But they ploughed on and plunged the NHS into the chaos we see today.
“The vast majority of NHS staff now say that David Cameron’s reorganisation has harmed patient care. The sad truth is that by turning the NHS upside down and causing a crisis in A&E, David Cameron has made care problems more likely, not less.
“The government should accept Labour’s five point plan to bring A&Es back up to acceptable standards. We will rescue the NHS with a £2.5 billion a year Time to Care fund - on top of Tory spending plans - to fund new staff, including 20,000 more nurses and 8,000 more GPs.”
10.30am EXCLUSIVE: The decision to award a 10 year contract covering more than half of England’s PET-CT imaging service to a single company has created a ‘monopoly’ that could damage NHS interests, HSJ has been told.
NHS England awarded the £350m contract that covers an estimated 53-58 per cent of the country to Alliance Medical last month. It came less than a year after one of the national body’s own experts said the domination of the market by one company “could potentially have negative effects for patients”.
Last year Alliance Medical completed the acquisition of two of the three companies in England that produce the radioactive isotope FDG, which is injected into patients as part of the imaging process. The Competition and Markets Authority approved the acquisition of IBA Molecular UK in August, and Alliance Medical took over Erigal in July 2013.
10.20am The NHS endured “three wasted years” due to the coalition government’s health service reforms, according to the Financial Times’ coverage of this morning’s critical King’s Fund assessment of the coalition’s health record.
The paper reports that the minimum £1.5bn spent on the Andrew Lansley reforms would have been better devoted to patient care, according to the think tank.
The report also suggests that the Labour Party claims that the health service was being privatised were “exaggerated”.
However, the think tank’s chief executive Professor Chris Ham warned that those responsible for commissioning healthcare were under increasing pressure to put contracts out to tender to other NHS or private sector providers.
10.11am The Guardian also covers the publication of the King’s Fund report this morning.
The paper writes that the coalition’s shake-up of the NHS was misguided, deepened the growing problems facing A&E units and left it weaker, structurally “incomprehensible” and less able to improve care, according to the think tank.
The paper also reports on the news that volunteers are stepping in to help 29 accident and emergency departments, as NHS England struggles to cope with the demand for care and a squeeze on its budget.
Elsewhere, The Guardian reports on comments by MPs who say that the detention of more than 6,000 mentally ill people in police cells last year is a continuing scandal that urgently needs to be stopped.
A report from the Commons home affairs select committee today says detention of children, in particular, must cease immediately.
In all, the paper reports, 236 children under the age of 18 with mental health issues were detained in police custody in England and Wales from 2013 and 2014.
Separately, the paper contains a story from the Press Association detailing a warning from health experts that the flu vaccine issued this winter only provides “low protection” against the main strain of the virus spreading around the UK.
The vaccine was estimated to work in just 3 per cent of cases in lab tests, compared with a more typical past effectiveness of 50 per cent, Public Health England said.
10.09am The Daily Telegraph reports that the flu vaccine given to millions of people in Britain has proved almost useless, health officials have admitted, amid warnings that the number of deaths this winter will be the highest for 15 years.
The dominant strain of influenza in circulation, which is particularly lethal among the elderly, is a different mutation from the type used in the jab, Public Health England warned.
As a result, the vaccine is working in only three per cent of those given it, when it is normally effective in around half.
GPs are being urged to prescribe anti-viral drugs to prevent flu among the most vulnerable and in care homes where viruses are spreading.
The alert follows research on more than 1,3000 patients admitted to hospitals with the virus. Questions were being asked last night about why health officials had not raised the alarm earlier.
Doctors’ surgeries are losing the equivalent of one GP per week because patients do not show up for appointments, an MP has warned, The Telegraph reports.
About 12m slots are missed each year, costing the NHS £160m.
Yesterday in the Commons, John Howell, MP for Henley in Oxfordshire, criticised patients who fail to attend appointments which could be re-allocated to others.
He called for surgeries to move over to remote care that would allow people to be monitored from home.
7am: Good morning and welcome to HSJ Live. We begin the day with the King’s Fund’s report on the coalition government’s flagship legislation on health which it describes as ‘damaging and distracting’.
‘Historians will not be kind in their assessment’ of its record on NHS reform, the report adds.
The King’s Fund argues the decision to re-organise the NHS with the Health and Social Care Act in 2012 distracted the service from the much more urgent tasks of responding to growth in demand and squeezed finances.
According to the authors, the “massive organisational change” resulting from the act contributed to the current “widespread financial distress and failure to hit key targets for patient care”.
Speaking to HSJ, King’s Fund chief executive Chris Ham said there had been a welcome shift away from technocratic change to a focus on safety and care quality since Jeremy Hunt succeeded Andrew Lansley as health secretary in 2012.
The appointment of Norman Lamb as care minister at the same time also had the positive effect of pushing integration further up the agenda, he added.