A plan by NHS England to clamp down on growth in spending on specialised services during 2015-16 will shift financial risk onto providers, according to senior health chiefs, plus the rest of today’s news and comment.

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4.10pm Some ambulance staff in the North West will not respond to “potentially life threatening” calls during strike action next week, according to an official briefing.

NHS staff across England are planning to take strike action on Monday between 7am and 11am, followed by an overtime ban throughout the rest of the week, over pay.

North West Ambulance Service Trust said representatives of the Unison union had confirmed that, during the action, its members at the trust would not respond to calls categorised as “Red 2”.

4.05pm National Voices, the health and social care charity coalition, has responded to announcements by Nick Clegg and Norman Lamb as follows.

National Voices’ Chief Executive, Jeremy Taylor, said: “We welcome the statements from Nick Clegg today and Norman Lamb yesterday on health and social care. 

“The announcements on mental health are a significant step in narrowing the gap between the rhetoric of “parity of esteem” and the reality. 

“We also welcome the new pledges for carers. The commitments to shifting more towards prevention, integration and people power continue the emphasis that the Liberal Democrats have placed on these themes in government, and they align strongly with the calls set out in National Voices’ recent position statement.

“We have now heard all three main parties set out their stall on health and care. It is clear that there is a good deal of agreement, partially obscured by party politics.

“But we feel all the parties have underplayed the scale of the challenges we face, especially on funding, health inequalities and the radical implications of genuinely putting people’s priorities above those of the “system”.

“They are being cautious: telling their core voters what they want to hear, and giving general messages of reassurance to the public. They need to talk more openly with the public about the transformations needed.

“We urge all three parties to continue talking to National Voices and our friends and partners in the voluntary sector to help them get their policies right and to build a stronger consensus about the changes needed to create better health and care.”  

Read more in Person centred care 2020: Calls and contributions from health and social care charities.

3.10pm The Health and Social Care Information Centre has published its latest statistics on waiting times to psychological therapies and access to adult mental health services.

Talking therapies

Experimental analysis looking at the proportion of referrals that entered treatment in fewer than 42 and 126 days by quarter and also for the year, by provider - April 2013 to March 2014 - can be found here.

Early Intervention Services

Experimental analysis on the number of days between the start of a person’s spell of care and their first attended face to face contact, by team type - April 2011 to March 2014 can be found here.

Experimental analysis on the number of days between the start of a person’s spell of care and their first attended face to face contact, by team type and provider - April 2011 to March 2014 can be found here.

2.50pm Professor Chris Hollis, director of MindTech, Institute of Mental Health, responds to Nick Clegg’s pledge on waiting times for mental health announced today.

“We welcome Nick Clegg’s pledge on waiting times for mental health. Promising parity of funding and waiting time targets is an important first step in closing the gap between physical and mental healthcare delivery.

“With only one in four people with serious mental health problems currently accessing treatment, the challenge is huge and requires a bold response.

“At the Institute of Mental Health we are supporting a wider transformation of mental health services through new digital technology to make help more accessible, flexible and timely for people with mental health problems.

“Based at the Institute and funded by the National Institute of Health Research, MindTech www.mindtech.org.uk is a new national clinical and research network that aims to accelerate the development and adoption of new digital technologies.

“Examples include apps for self-management and monitoring, on-line therapy and consultations and on-line support through secure social media.

“These technologies can revolutionise mental healthcare by providing support and evidenced based interventions ‘anytime, anywhere’ in a way that people already access banking, retail services and social media.

“NIHR funded CLAHRC East Midlands and AHSN East Midlands also based at the Institute have developed and are now implementing evidence based interventions that would improve the reach, efficiency and cost effectiveness of interventions for mental health to meet the need highlighted by Nick Clegg.

“Key to all of these is a user designed and recovery based focus that enables service users and clinicians to develop interventions that they would be prepared to use.”

2.42pm A plan by NHS England to clamp down on growth in spending on specialised services during 2015-16 will shift financial risk onto providers, potentially pushing even more acute trusts into deficit.

This is the warning from senior health chiefs after the commissioning body unveiled how it expects to keep its £14bn specialised services budget under control after ending last year £377m in the red.

According to a paper outlining NHS England’s commissioning intentions for specialised services, providers will see payments squeezed and even refused if found to be treating patients who do not meet strict access criteria.

2.35pm Dr Phil Moore, chair of NHS Clinical Commissioners Mental Health Commissioners Network responded to Nick Clegg’s mental health announcement in his party conference speech today.

Dr Moore said: “Additional investment for mental health is an important step in the right direction for our patients and their carers.  

“Setting new target waiting times would help ensure that mental health services start to be seen in the same light as physical health services. We welcome commitments from all political parties to ensure parity of esteem for all of us who may suffer from a mental health condition.

“We hope that Nick Clegg’s party conference speech will raise the awareness of this issue across the nation. The key now is to make sure those good words translate into real action on the ground for patients.

“All of us working in mental health know that more work is needed to ensure we get it right for our patients - CCGs are key to that process and although they are still relatively new organisations we know they are working hard to improve and deliver new models of mental health care for our patients and local populations.”

2.05pm Society of Radiographers’ members who work in the NHS will take part in a UK-wide strike for the first time in more than 30 years, they have announced in a statement.

Following a ballot in which 53.7 per cent of members who work in the NHS voted in favour of strike action, the Society’s UK Council has called on radiographers to stop work for four hours on Monday 20 October.

In addition, SoR members will work-to-rule for the remainder of that week. Emergency care will continue to be provided but pre-booked appointments and procedures may be affected

“Radiographers who work in the NHS in the four countries of the UK will participate,” said Richard Evans, the Society’s Chief Executive Officer.

“There is the possibility of more action by radiographers in the future. The anger that they and other health professionals feel is very strong,” he continued.

The action is being taken by members of the Society and many other NHS trade unions because of an ongoing pay freeze.

The government rejected a recommended one per cent pay rise for the current year and Jeremy Hunt, the health secretary for England, has said that there will be no increase in 2015. The pay freeze will have been imposed for four out of five years.

“Radiographers will try and keep the effect on patients to a minimum but radiographers and other healthcare workers have got to the stage that they feel there is no alternative,” Richard Evans commented.

“Because of inflation, staff in the NHS have been taking a year-on-year pay cut. Unless we show the government that we are serious about our claim that NHS staff should be treated fairly, they will continue to take advantage of our goodwill,” he continued.

“There is a shortage of radiographers, which already has an effect on the timely delivery of diagnostic examinations and the treatment of cancer, which has direct negative consequences on patients.

“Without reasonable and proper recognition of the work that they do, it is increasingly likely that qualified professionals will leave radiography and it will become even more difficult to recruit the additional people which are needed.”

2.00pm Speaking this week at the Liberal Democrats conference in Glasgow, Nick Clegg announced waiting time targets for some groups of people with mental health problems in England to be introduced by April next year.

Dr Jennifer Dixon, chief executive at the Health Foundation, comments: “We welcome the focus of this announcement being on the need to address waiting time targets for people with mental health problems.

“The imbalance of how long people wait for mental and physical health services is highlighted in our QualityWatch report, which is launched this Friday with the Nuffield Trust.  It is important to continue this scrutiny, especially for some of the most vulnerable people in our society.

“Our own mental health projects have demonstrated how you can effectively transform care by changing the relationships between health services and those with mental health problems. 

“The peer support project at Nottingham Healthcare NHS Trust, which we have funded, involved people drawing on their own experiences of severe mental health problems to support others.

“This resulted in a 14 percent reduction in inpatient stays with a saving of around £260,000. The project increased the confidence and hope of both service users and the peer support workers themselves, changing the culture of teams and placing people with experience of mental health at the centre of services.”

“This project is just one example of how making small changes to services can have a significant impact on the lives of those who have mental health problems.”

1.45pm Clinical commissioning groups should be handed responsibility for commissioning specialised services worth more than £600m, NHS England has recommended.

The national body’s commissioning intentions for specialised services in 2015-16 reveal it is seeking to hand over responsibility for renal dialysis and surgery for morbid obesity to CCGs.

NHS England has recommended to the government’s Prescribed Specialised Services Advisory Group that the services should be transferred.

1.33pm Mr Clegg will add: “If you are a young person experiencing psychosis for the first time, you will be seen within 2 weeks, something we are going to roll out across the country – just as if you suspect you have cancer.

“If you are having a breakdown, if you are thinking of harming yourself, for any emergency which takes you to A&E, you’ll get the help you need – just as if you had gone to hospital with chest pains or following an accident.

“These are big, big changes. And in Government again the Liberal Democrats will commit to completing this overhaul of our mental health services – ending the discrimination against mental health for good.

“And while I know not everyone in the party is going to agree, I can tell you now: I want this smack bang on the front page of our next manifesto.”

1.30pm A copy of Nick Clegg’s speech prior to delivery has been published by the Spectator.

Here is an extract from that speech dealing with the Lib Dem leader’s pledges on mental health and the NHS:

“And then there’s one more policy. One I care about passionately. Mental health. The second class status given to mental health in the NHS was the subject of the first question I ever asked at Prime Ministers Questions.

“I have campaigned to end the Cinderella treatment of mental health services ever since – because it threatens the opportunities available to hundreds and thousands of our fellow citizens.

“Anxiety, panic attacks, depression, anorexia, bulimia, self-harm, bi-polar disorder – these and many other mental health conditions are one of the last remaining taboos in our society, and yet they will affect one in four people.

“Much progress has been made – people now speak out in the way they never did before…We have put mental health on the same legal footing in the NHS as physical health…We’re massively expanding talking therapies and transforming the help children can get as they move into adulthood – but there’s still a long, long way to go.”

1.25pm All three major parties have committed to above inflation NHS spending growth, but the amountsare not enough to protect the system from the realities of a continued financial squeeze, writes Crispin Dowler.

12.47pm A plan by NHS England to clamp down on growth in spending on specialised services during 2015-16 will shift financial risk onto providers, potentially pushing even more acute trusts into deficit.

This is the warning from senior health chiefs after the commissioning body unveiled how it expects to keep its £14bn specialised services budget under control after ending last year £377m in the red.

According to a paper outlining NHS England’s commissioning intentions for specialised services, providers will see payments squeezed and even refused if found to be treating patients who do not meet strict access criteria.

12.42pm The Liberal Democrats have proposed to set up a ‘Dilnot style’ cross-party commission on how the NHS can meet the needs of an ageing society.

The plan is contained in a policy paper Age Ready Britain – Realising the Potential of an Ageing Society, which was published to coincide with the party’s annual conference this week.

12.35pm More doctors are coming from Europe to work in the UK than ever, according to a report by the General Medical Council.

The largest source of overseas-trained doctors had previously been south Asia, but recently there has been a sharp rise in doctors from southern Europe.

12.15pm With the health service already a major general election issue, Nick Clegg will have to make it a personal campaigning priority, says Sarah Winstone, founding partner at Incisive Health.

The polls make for dismal, but not unsurprising, reading for the Liberal Democrat leader, Ms Winsonte writes.

Nick Clegg trails not only David Cameron and Ed Miliband, but also Nigel Farage, with just 5 per cent of respondents to our poll choosing him as the party leader most trusted to manage the NHS. Clegg and Farage were level on 8 per cent in HSJ’s most recent survey.

This is consistent with wider national polling on the party leaders voters feel most positive – or rather, least negative – about. It is also symptomatic of the Liberal Democrats broadly, and their leader specifically, lacking a compelling narrative on the NHS.

11.33am HSJ’s Webinar, in association with Riddouts LLP, on the challenges facing the Care Quality Commission inspection regime is on at 12.30pm today. Watch as an expert panel including Adam Cayley, regional director of Monitor, Sir Mike Richards, the chief inspector for hospitals and HSJ editor, Alastair McLellan, discuss the new regime and answer questions about it.

Register to watch our Webinar here at 12.30pm

10.59am The Guardian reports that a drug derived from cannabis, which many with multiple sclerosis say helps ease their symptoms, has been ruled too expensive to be used by the NHS in England even though it is approved for Wales.

In new guidelines NICE says the price set by the manufacturer of Sativex is too high for the benefit it gives patients.

The Multiple Sclerosis Society’s chief executive, Michelle Mitchell, said the rejection of the drug was disappointing.

Confidential patient information is to be housed in a network of regional centres across the country, in a proposal that critics say amounts to an attempt to reintroduce the national database of medical records that was abandoned earlier this year, The Guardian reports.

Medical data taken from GP and hospital records would be uploaded to the new “accredited safe havens” scheme.

In August the Department of Health said Ash was only intended to provide access to records that have been stripped of personal details.

However, patient watchdogs have raised the alarm over fears that the new system replicates all the worst aspects of the “care.data” scheme

Meanwhile, the World Health Organisation said yesterday it was ready to provide support for Spain as authorities in the country scrambled to contain the first case of Ebola infection within Europe, The Guardian reports.

WHO’s European director, Zsuzsanna Jakab, said it was “quite unavoidable…that such incidents will happen in the future because of the extensive travel from Europe to the affected counties and the other way around”.

10.51am Healthcare focussed smartphone interfaces launched by Samsung and Apple will be instrumental in propelling the global healthcare accessory hardware market to $3bn by 2019, according to a report from analysts Juniper Research.

The report – Digital Health: Remote Monitoring, Smart Accessories & EHR Cost Savings 2014-2019 – argues that greater visibility and availability of healthcare smartphone platforms will encourage independent device manufacturers to launch a wider array of increasingly sophisticated so-called ‘mHealth’ products.

Such devices include blood pressure cuffs, oximeters for diabetes and sleep monitors for sleep apnoea.

10.45am The Foundation Trust Network responds to deputy prime minister’s announcement of first ever waiting time standards for mental health. Saffron Cordery, director of policy and strategy at the FTN, said: “Today’s launch marks a major milestone in parity between mental and physical health.

“It is a clear advance in the prioritisation, respect and treatment for people who need mental health care. This is a turning point in ensuring the highest quality treatment for those with mental health conditions and it is imperative that this remains a priority both now and in the next Parliament. 

“While we welcome the focus on maximum waiting times for mental healthcare, real improvement comes from parity of esteem in funding, payment systems and profile. This is a big ask in the current harsh financial climate but a commitment to mental health and other non acute services must translate into real investment if we are to make meaningful progress. This includes support for locally-led change, integrated services and preventative care.

“This is just a first iteration. After years of chronic underfunding and structural discrimination, we are on a journey to ensure increasing investment so that we truly place mental health on the same footing as physical health.

“We look forward to working with the Department of Health, NHS England and the whole of the mental health community to explore how further progress can be made across every part of the mental heath system.”

10.43am Professor Sir Simon Wessely, president of the Royal College of Psychiatrists said: “The College warmly welcomes these new waiting time standards for Improving Access to Psycholoicgal Therapies and Early Intervention Psychosis services - and increased provision of liaison psychiatry - as an important first step to providing timely and responsive treatment for patients in all areas of mental health care.
“This five-year plan sets out a bold and compelling vision for bringing mental healthcare on a par with physical healthcare, and we call on the 2015-20 government to either do the right thing and see it through, or explain to those with mental health problems why they didn’t.”

10.37am The Independent Mental Health Services Alliance has today welcomed the publication of the government’s five-year plan for mental health, Achieving Better Access to Mental Health Services by 2020.

IMHSA chair Joy Chamberlain said: “IMHSA welcomes the publication of the five-year plan for mental health as a positive step in improving mental health services.

“In particular we welcome the focus on ensuring that parity of esteem between mental and physical health is achieved as this is crucial to improving patient care and attaining the outcomes we need.

“IMHSA has called for increased funding for mental health and as such we welcome the commitment to invest in mental health care alongside the focus on prevention and early intervention.

“It is essential that this plan is fully implemented and that the Government works in partnership with providers to ensure that health professionals and patients are aware of the full range of services available and to improve data collection, reporting and assurance.”

“While the plan is laudable it is equally important that ongoing issues such as the moratorium on the commissioning of specialised mental health services and the continued existence of block contracts are addressed. IMHSA is committed to working in partnership with the health and social care sector to meet these challenges and to ensure that everyone with a mental health need is able to receive the best quality of care possible at the best value.”

10.35am There has already been reaction to Nick Clegg’s policy announcements on mental health. Rebecca Cotton, director of mental health policy at the Mental Health Network, which is part of the NHS Confederation, said: “This manifesto commitment from the Liberal Democrats today will be very warmly welcomed by our members, who provide mental health services around the country.

“NHS leaders, professionals, researchers and service users have been speaking with one voice on this issue - we need to see a real step change in investment in mental health if we’re going to tackle unmet need and keep up with rising demand.

“That’s why we’re delighted to see this vital commitment being made. We look forward to working with all political parties over the coming months to explore how further investment can be made in mental health services over the next Parliament.”  

10.30am The Daily Telegraph reports that major NHS hospitals across the country have been put on standby, as health officials warn of a “real risk” that the deadly Ebola virus could spread to Britain.

The Prime Minister will convene a meeting of the Government’s Cobra emergency committee this morning to discuss the growing threat to the UK from the spread of Ebola.

Separately, the paper writes that people suffering from anxiety and depression will be treated with the same urgency as those with physical illnesses under the first ever NHS waiting targets for mental health.

Nick Clegg will today announce the plans to offer patients counselling within weeks of seeing their GP in a pledge to “end the injustice” of long waits for those with mental illness.

Under the targets, to be introduced in April, most of those referred by doctors for “talking therapies” should start treatment within six weeks, ministers will say.

Elsewhere, the paper reports that health officials are to go ahead with a widely-criticised plan to gather the personal data of millions of NHS patients despite widespread privacy concerns.

A pilot scheme involving 265 GP surgeries and 1.7 million patients will involve confidential medical information being put on a giant database, it was disclosed.

The data, which includes details of childhood illnesses as well as recent medical conditions, will be uploaded unless a patient specifically opts out. Those behind the £50  million data-sharing plan say it will improve healthcare and help medical research.

10.26am Looking to this morning’s newspapers,The Times reports that the NHS will not repeat the mistakes made by the US and Spain in the fight against ebola, public health chiefs promised yesterday.

Brian McCloskey, director of global health at Public Health England, said Britons should not worry about the virus unless they have been in contact with patients or dead bodies in west Africa. The risk to people in this county was very low and NHS systems had been “tried and tested,” he said.

10.25am This afternoon HSJ, in association with Ridouts LLP, is hosting a webinar to discuss the new Care Quality Commission inspection regime.

As the CQC prepares to publish its definitive methodology for its new inspections this autumn, debate about the regime and its sustainability continue to rage.

At 12.30pm HSJ will bring together leading figures including Adam Cayley, regional director of Monitor, and Sir Mike Richards, the chief inspector for hospitals, for a webinar debate about the challenges and successes of the new regime.

The discussion will be chaired by HSJ editor Alastair McLellan, and broadcast live by workcast

For more details, and for your last chance to register for the webinar, click here.

10.18am Deputy prime minister Nick Clegg will also today announce £120m investment in mental health services and the introduction of waiting time targets for the sector.

The Liberal Democrat leader will announce a five year strategy, which will include the introduction of two waiting standards from April next year, at the Liberal Democrat Party conference in Glasgow

10.15am Responding to Nick Clegg’s announcement on mental health services, Nuffield Trust chief executive Nigel Edwards said: “The deteriorating quality of mental health services is a real concern and the Liberal Democrats are absolutely right to focus their attention on this in the next parliament. 

“Nick Clegg has highlighted the current imbalance between how long people wait for mental and physical health services. This is backed up by new research to be published on Friday through our QualityWatch programme with the Health Foundation. 

“We will show that there is cause for serious concern around the state of mental health services - often accessed by some of the most isolated and vulnerable people.

“The real test for the Liberal Democrats’ policy will be how far it can go in meeting the growing demand for services at a time when the whole of health and social care is creaking in response to austerity.” 

10.13am The Liberal Democrats would seek to invest an additional £500m a year in mental health services if they formed part of another government, HSJ can reveal.

Deputy prime minister Nick Clegg has said in an exclusive piece for HSJ today that he wants “at least half” of his promised £1bn real terms NHS funding increases between 2016 and 2018 to be spent on mental health.

The money would help in “completing the journey” to make “parity of esteem” for mental health services a reality, he said.

10.08am The Liberal Democrats in government in the next parliament would invest to achieve equal standards in mental health services, writes deputy prime minister Nick Clegg.

7.00am Good morning and welcome to HSJ Live. We begin the day with a comment piece from Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine.

He argues that the radical changes needed to improve the NHS will be much more attainable if we find the right people with a vision to lead, inspire staff and facilitate rigorous progress.