Sepsis treatment could soon be given the same emphasis as reducing pressure ulcers or hospital acquired infections, campaigners understand, plus the rest of the day’s news and comment

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4.30pm HSJ is looking to explore how pathology services can be improved and as a thankyou are offering the chance to win one of 10 £50 Amazon vouchers to all survey participants.

What do you want from your pathology service?

Pathology plays a vital role in many patient pathways – but how is it regarded by others in the NHS and is it delivering what you want from it?

HSJ wants to know how pathology services can be improved and what our readers see as the most important factors in provision.

We want your views whether you are working in a clinical commissioning group which buys pathology services, or a manager or clinician in a hospital service which has pathology embedded in its patient pathways.

To have a chance of winning one of 10 £50 Amazon vouchers take our short survey

3.52pm 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.

On Wednesday 8 October, HSJ will bring together leading figures including 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 and free on HSJ TV. You are invited to ask questions that will be put to the panel.

Register for the webinar, which is supported by Ridouts Solicitors, for free. It will take place from 12.30pm-1.15pm on 8 October.

The panel will also include Paul Ridout and Neil Grant, partners at Ridouts Solicitors.

We very much hope you will be able to join us.

2.54pm Professor Terence Stephenson has been appointed by the Privy Council as the new Chair of the General Medical Council.

Professor Stephenson studied medicine at Oxford Medical School and has spent most of his career specialising in paediatric medicine and paediatric emergencies.

He was also president of the Royal College of Paediatrics and Child Health and a member of the GMC Council between 2009 and 2012.

He is currently Nuffield Professor of Child Health at the Institute of Child Health at University College London, honorary consultant paediatrician at UCL Hospitals Foundation Trust and Great Ormond Street Hospital for Children Foundation Trust, and current chair of the Academy of Medical Royal Colleges.

Professor Stephenson will take up his appointment on 1 January 2015.

Responding to the announcement the GMC’s current Chair, Professor Sir Peter Rubin said: “I am delighted that Professor Terence Stephenson has been appointed. Terence brings a wealth of experience from his previous roles, which will benefit the GMC in our work to protect patients by maintaining and improving standards in medical practice. I look forward to working with him to ensure a smooth transition.”

Professor Stephenson said: “I am honoured and privileged to become Chair of the General Medical Council and greatly look forward to taking up this important role in 2015.

“I am committed to working with doctors, patients, employers and educators to build on the achievements of the GMC over recent years and to make sure we continue to use our expertise and leadership to help ensure safe, high quality care for patients and high standards of professionalism.”

Professor Terence Stephenson was appointed following a robust competitive recruitment process overseen by a four-strong selection panel independent of the GMC and of the government.

The panel, who between them had significant experience of healthcare, regulation and corporate governance, was chaired by Dame Janet Gaymer, a former commissioner for public appointments.

2.20pm HSJ, working with NHS Employers, the NHS Leadership Academy and the British Medical Association, is seeking to celebrate the outstanding contributions professionals from black and minority ethnic backgrounds make to healthcare – and nominations are now open.

This November we will be celebrating individuals working within healthcare who can be considered to be BME pioneers – people from BME backgrounds who, through exceptional leadership abilities or their day to day example, are inspiring others and helping to shape and deliver excellent care for all.

Nominees can be working across health and social care, and at all levels, and can be from a clinical or non-clinical background – we want to identify and celebrate people you are proud to work with and who inspire you.

For nomination details, click here.

The closing date for nominations is Friday 26 September.

2.10pm Child exploitation in Rotherham has been on an unimaginable scale and the response has been unbearably slow. We must listen to young people and the staff voicing their concerns, writes Kim Holt.

Ms Holt, a consultant paediatrician and the founder of Patients First, which campaigns for whistleblowers, says that health and social care professionals were writing reports and attending meetings with senior leaders of the child protection services to raise their concerns about what was happening, but remained ignored, heard and at times threatened. 

2.00pm Michael White’s HSJ column this week argues that Kate Barker’s report on a new deal health and social care contained a number of very good ideas. He welcomes Barker’s sober assessment of the challenges ahead, including the financial ones.

He writes that the report “envisages NHS England gradually move to an integrated system (ticking Andy Burnham’s box) by 2025 with a ringfenced national budget and a single local commissioner. Social care would be free to the neediest, means tested elsewhere.”

1.55pm Identifying and treating sepsis could soon be given the same attention as reducing pressure ulcers or hospital acquired infections, with campaigners claiming Sir Bruce Keogh is “supportive in principle” of increased national focus on the condition.

UK Sepsis Trust chief executive Ron Daniels is due to make the case for action to an influential committee of MPs this week, and to discuss the trust’s proposals with NHS England next month.

1.33pm England’s chief inspector of hospitals, Professor Sir Mike Richards, has published his first report on the quality of care provided by Birmingham and Solihull Mental Health NHS Trust.

The Care Quality Commission inspection, which took place between 12 and 15 May, found staff were caring and the trust provided responsive and effective care and was well led.

Birmingham and Solihull Mental Health NHS  Trust was inspected as part of CQC’s pilot of the new inspection approach of mental health services. The trust volunteered to be rated as part of the pilot and agreed to have this shadow rating published with the report. The overall shadow rating for the trust was ‘Good’.

Inspectors found patients received good care and treatment, but CQC highlighted some areas where the trust must improve. Reports relating to the services inspected are published on CQC’s web site and are available via the following link:

This was one of CQC’s new-style inspections which include larger teams made up of specialist nurses and therapists, people who use services as well as CQC’s own inspectors.

Inspectors looked at a range of mental health and community health services provided by Birmingham and Solihull Mental Health NHS Trust including its specialist services, services for older people, long stay forensic and secure services, neuropsychiatry, specialist eating disorder services, perinatal services, psychiatric intensive care and health based places of safety and community health services for adults.

CQC found many areas of good practice, including:

  • The neuropsychiatry core service which had a strong research focus.
  • High standards of person-centred and innovative care practices on Rosemary ward and Ashcroft unit in services provided for older people.
  • Good practice in community mental health services for older people.
  • The trust provided specialist wards in the acute admission service, for example a service for deaf people and a service for young women under 18 years old.
  • The trust’s specialised resettlement team, at Dan Mooney House, supported people transferring from rehabilitation services to their new home.
  • The perinatal services established excellent links with local acute hospitals quickly identify the needs of women in maternity units.

CQC also found some areas for improvement at the trust, including that:

  • The trust needs to ensure people using acute admission services are protected against risks associated with the monitoring of safe temperatures for storing medicines and people receive physical health care medication in a timely manner.
  • The trust needed to assess and address risks identified at Mary Seacole House with regard to ligature points.
  • Records for people using the acute admission service on the Northcroft site needed to be accurate and fit for purpose.
  • The trust must ensure there are sufficient numbers of suitably qualified, skilled and experienced staff to meet the needs of people at Mary Seacole House and Newbridge House.
  • The trust needs to make sure people using specialist rehabilitation services at Ross House are protected from the potential risk of abuse and are treated with dignity and respect.

Professor Sir Mike Richards, chief inspector of hospitals, said: “On all of our inspections, inspectors ask whether a service is safe, effective, caring, responsive to people’s needs, and well-led.

“We found Birmingham and Solihull Mental Health NHS Trust was responsive and well led and, throughout the services we visited, we met and observed staff who treated people with kindness, dignity and compassion.

“Throughout the inspection we saw evidence that the trust organised services to meet people’s needs and found examples of innovative and collaborative working across the service.

“Over all this is a good trust and, while areas for improvement have been highlighted to the trust, the trust knows what action it now needs to take.”


11.55am Commenting on the publication of the Chief Medical Officer annual report on public mental health, Saffron Cordery, director of policy and strategy at the Foundation Trust Network said: “This report is timely and welcome. It presents a bold analysis of both the cost to the economy of mental illness and highlights the personal cost to those individuals who are unable to access treatment.

“Dame Sally’s report chimes with views from everyone across the mental health sector, and provides hard evidence, that there needs to be full parity between the provision of and financial investment mental and physical health services. Targets to access mental health care are a step towards achieving this; but they must be fully costed and increased funding must be available to NHS trusts and foundation trusts delivering these vital mental health services.”

11.30am The Times reports that public health chiefs have accused e-cigarette users of a campaign of online abuse. John Ashton, president of the Faculty of Public, is facing an official complaint after he retaliated and used explicit language on Twitter.

The spat illustrates how high passions run over e-cigarettes, both among users and public health experts, who are divided on the issue.

Also in The Times, children whose fathers smoked before their conception are up to three times more vulnerable to the risk of developing asthma, scientists have found.

The paper reports that children given sips of alcohol by their parents are three times more likely to drink adult-sized measures in their mid-teens than those denied it, research has found.

11.25am Proposals by NHS England and Monitor for reform of the urgent and emergency care payment system would be a “disaster” for emergency departments, the president of the College of Emergency Medicine has said.

Clifford Mann described the plans, which the pricing authorities believe could encourage closer working between urgent and emergency care providers, as a “thinly veiled attempt to introduce a block contract” for accident and emergency services.

The proposed reforms have been broadly welcomed by other players in the urgent care sector, although the Foundation Trust Network warned that without increased funding they could encourage unwanted “compromises” by commissioners and providers.

11.20am Responding the to government’s public health funding announcement, Councillor Teresa O’Neill, London Councils’ sxecutive member for health, said: “London faces a unique scale of public health challenges, including a high prevalence of sexually transmitted infections and HIV, high levels of childhood obesity, teenage pregnancies, and a high number of problematic drug users. 

“Since the transition of public health responsibilities to local government in April 2013, boroughs have been working with partners to improve the health and wellbeing of residents, and reduce health inequalities. 

“Public health funding and resources play a vital role in the delivery of a range of preventative measures that help reduce pressures on health and social care services and improve outcomes for all.

“We will be looking closely at what the latest settlement means for London. In addition, we are keen to ensure that any future method of allocation appropriately reflects the public health needs of Londoners.” 

11.17am David Buck, senior fellow in public health and inequalities at the King’s Fund suggests the government’s 2015-16 funding settlement for public health in fact represents a real terms cut:

#publichealth #allocations for #localgov, cash standstill, real cut 2015-16— David Buck (@davidjbuck) September 9, 2014 

11.12am The Department of Health has announced that local authorities’ public health funding is to be set at £2.79 billion, similar to last year. The funding will remain ring-fenced to ensure it is used solely for improving public health.

A further £5m of funding has also been announced as part of the Health Premium Incentive Scheme (HPIS). The scheme is designed to reward local authorities that make improvements to their localities public health by providing cash incentives.

Under the scheme, which will be piloted during 2015 and 2016, local authorities will be rewarded for meeting one mandatory national public health target, related to improving drug and alcohol services, and one local target of their choice.

Minister for Public Health, Jane Ellison, said: “We have made a huge investment in improving public health across the country in the last two years. With this major investment staying in place for the next year, we want to see local areas continue their excellent work to help people lead healthier lives. The money has again been ring-fenced so the focus will remain firmly on improving the health of local communities. This will be further boosted by an extra £5 million to target priority areas.

The CEO Designate of Public Health England, Duncan Selbie, said: Local authorities are best placed to achieve improvements in the public’s health. The announcement of the public health allocations will allow them to get on with planning the services their communities need most.

A consultation on the technical design aspects of HPIS and distribution of public health allocations for 2015 to 2016 is now open for comment. The consultation closes on 23 October 2014.

11.06am The College of Emergency Medicine, the body that speaks for doctors and consultants working in A&E departments in the UK, is today calling for urgent action to address blocked A&E departments.

A new condition called ‘exit block’ is harming patients: they are put at risk when ‘exit block’ occurs. This happens where you can’t get patients from A&E into a hospital inpatient bed. This is explained in more detail in this video:

Over 500,000 patients a year are affected. The College of Emergency Medicine says that this is unacceptable.

The College is calling on hospital Chief Executives and their Boards to make sure that this issue is on their agenda. To help with tackling this issue the College has issued guidance: Crowding In Emergency Departments. NHS England and

Monitor, the Trust Development Association have endorsed this in their own winter planning guidance for this coming winter.

President of the College of Emergency Medicine Dr Clifford Mann said: “We are concerned with patient safety. When the A&E becomes crowded because of Exit Block we know that patients do less well. We know thatcrowding kills. This is such an important issue. It is about the flow of patients from ambulances, through A&Es and into hospital wards. The simple fact is that crowding kills. It is simply not acceptable to let this situation continue which is why we are speaking out to urge hospital Chief Executives and their Boards to make sure they have plans to deal with this issue.”

10.57am Health services are buckling under the pressure caused by new legal highs and the increasing use of club drugs, leading doctors have suggested. Every week a new legal high, also known as a novel psychoactive substance (NPS), is introduced in Europe, experts said.

Health services are “not equipped” to deal with the rise, according to a report by the Royal College of Psychiatrists.

10.39am Patients suffering from the “silent killer” of pancreatic cancer are treated like tennis balls as they are passed between their GP and doctors, MPs were told yesterday.

No progress has been made in boosting the chances of survival in the last 40 years, and politicians should consider making it easier for GPs to send patients for CT scans to help diagnose cancer, Labour’s Nic Dakin added.

The Scunthorpe MP told a Westminster Hall debate the number of deaths from pancreatic cancer had been increasing as deaths from other cancers declined.

He added around 1 per cent of research funding - £5.2m - was spent on pancreatic cancer despite it having the worst survival rate and being the fifth-leading cause of cancer death in the UK.

10.35am Writing in the Guardian today, columnist Polly Toynbee argues that Labour has no choice but to advocate for a tax increases in order to save a health service “on the verge of cardiac arrest”.

She says that Labour cannot afford not to make a commitment to increase spending on the NHS. Lagging on credibility, writes Toynbee, a promise to raise tax for the NHS would show it can take tough and unpopular decisions.

10.33am The Care Quality Commission has today announced that private hospitals will begin to be inspected under its new inspection approach.

The chief inspector of hospitals Sir Mike Richards has identified eight independent hospitals to be inspected. These vary in size and in the number and type of services they provide, including both NHS-funded care and solely private care.

In a statement the regulator said: “The first new style inspections will allow us to test out our new model in different independent hospital settings. CQC will expect to receive equivalent information about performance to that it receives from NHS hospitals.

“CQC’s new regulatory approach for the independent healthcare sector signals the first time that these providers will be awarded ratings (from April 2015). There will also be a significant increase in access to information that will help people who use the services to make decisions about their care.

“The first inspections will take place from October to December 2014. They will include announced and unannounced elements and may include inspections in the evenings and weekends when we know people can experience poor care.

“These first inspections will help us refine the way we inspect this sector and help us develop a rating system. We will begin to issue ratings for private hospitals in 2015.

“The core services being inspected will follow the same approach as in the NHS to include: surgery; including cosmetic surgery, urgent care services, medical care, children and young people’s care and outpatients.

“Our inspection teams include clinicians from the NHS and the independent sector, CQC inspectors and members of the public who are “experts by experience”.

The eight providers are:

  • The Lister Hospital, London
  • The London Welbeck Hospital, London
  • Baddow Hospital, Essex
  • Spire Southampton Hospital, Hampshire
  • BMI Mount Alvernia, Surrey
  • Peninsula NHS Treatment Centre, Devon
  • Oaklands Hospital, Salford
  • Nuffield Health Tees hospital, County Durham

Professor Sir Mike Richards, chief inspector of hospitals, said: “We need to hold the independent sector to the same standard as the NHS.

 “As we have seen in the NHS, these new-style inspections will allow us to get under the skin of the organisation to give us a much more detailed picture of independent hospital care in England than ever before.

“We are significantly increasing public access to information on independent healthcare, which is good news for people who use services, as it will help people to make informed decisions about their care.”

Each inspection seeks to answer five questions about services: are they safe, caring, effective, well-led and responsive to people’s needs? All independent healthcare providers will receive full ratings from April 2015. The ratings are: outstanding, good, requires improvement and inadequate.

Where there are failures in care, Sir Mike will highlight what needs to be addressed and will ask the hospitals to make sure a clear programme is put in place to deal with any problems.

10.30am The Mental Health Foundation has said it welcomes many of the recommendations in the chief medical officer’s report; Employment is Good for Mental Health. 

In a statement it said: “We are pleased to see a call for parity in funding for mental health and waiting time targets – this is something that the Mental Health Foundation have been strongly advocating for.  

“We also welcome the case for investment in mental health services for children, young and older people - these are just two of the groups that often ‘lose out’ in the system;  with completely unacceptable waiting times for help and complete lack of services in some areas .  

Jenny Edwards Chief Executive of the Mental Health Foundation commented;  “Whilst we recognise the benefit of good quality work to mental health we are concerned about the suggestion to focus the fast tracking of care on people of working age who are at risk of falling out of work. 

“A health service that is free at the point of delivery should ‘fast track’ all and not discriminate in favour of those who are economically active. We consider that there must be an investment in establishing a suite of evidence based solutions to mental ill health and support mental well being, particularly targeted where there are the greatest inequaliites.”   

10.29am Sally Davies’ report has recommended that the quality of data collection in mental health needs to be improved to bring it on a par with that for physical health. She has also called for a specific period of mental health training within GP training.

10.23am England’s chief medical officer Sally Davies has called for funding to be protected for mental health treatment amid signs that funding had fallen at a time when the cost to the economy was rising.

In her annual report on public mental health, Dame Sally has also said that more needs to be done to help people with mental illness stay in work.

Since 2009, the number of working days lost to “stress, depression and anxiety” has increased by 24 per cent and the number lost to serious mental illness has doubled, costing the UK economy between £70-100bn per year.

9.46am Good morning and welcome to HSJ Live. First up, Foundation Trust Network chief executive Chris Hospson argues that despite tight finances, mental health needs a better settlement.