Peter Carter to leave RCN after eight years as chief executive, plus the rest of today’s news and comment

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5.15pm Peter Carter has announced that he is leaving the Royal College of Nursing after eight years as chief executive. He will stay in post while a successor is appointed.

Dr Carter said: “I have thoroughly enjoyed my time at the RCN. It is just over eight years since I joined the college and it has been a wonderful time in my career.  The challenges when I joined the RCN were significant and with the support of the RCN council and my colleagues we have taken forward the work of the RCN on behalf of our members.  This has involved change in the way that the College works and has resulted in financial stability and a huge increase in the membership of the College.  The RCN credibility with stakeholders is very high and the college brings huge added value to the health agenda throughout the United Kingdom and internationally”. 

“There are countless experiences and people that I have met that have given me memories that I will cherish.  Every week I meet nurses and other healthcare workers in clinical settings and I am nothing other than hugely impressed by them.  As a nation we should be proud of those who work in health care as the vast majority give over and above what is expected of them”.

“I would like to particularly place on record my appreciation for the support I have received from Michael Brown,  current Chair of Council, and his predecessors”.

Michael Brown, RCN chair of council said: “It is with great regret that today I have accepted Dr Peter Carter’s resignation as Chief Executive of the Royal College of Nursing.  In the eight years Peter has been with the RCN, the College has moved forward significantly and has improved under his management in difficult times within healthcare.  Personally it has been a pleasure to work alongside Peter in helping him to achieve the goals of our members and on the behalf of RCN Council I offer him our warmest thanks and wish him well in the future.

“Peter has been a champion, not only for our members but the whole nursing family and health services during his time with the College. He has really raised the profile of both nursing and the RCN and has consistently championed the very best in patient care.  We thank him for all he has done for members and the College over the years”.

5.15pm The report into infant deaths at University Hospitals Morecambe Bay Foundation Trustwill be published in the week commencing 23 February.

The enquiry’s report has been delayed several times because of the volume of evidence and organisations the panel had to examine.

4.00pm A charity providing specialist mental health care, St Andrew’s Healthcare, has been given a rating of ‘requires improvement’ by the Care Quality Commission.

The charity also provides private therapy services for GP referred patients. It has eight registered locations serving mental health and learning disability needs, including four hospital sites in Northampton, Birmingham, Nottingham and Essex.

The service was rated as Good with regard to whether services were effective, caring and responsive and Requires Improvement with regard to whether services were safe and well-led.     

The service has been told that it must take action to improve in the following areas: 

•           The provider must ensure that care in the adolescent service is planned in accordance with children’s rights.

•           All care and treatment options must be discussed and explained in a way the patient understands, particularly in the learning disability and children and adolescent mental health services.

•           The provider must ensure that all accommodation is in line with best practice guidance for same sex accommodation.

•           The provider must ensure that patients who are deaf or have hearing loss are cared for by staff able to communicate with them effectively.

Paul Lelliott, CQC’s deputy chief inspector of hospitals (lead for mental health), said: “Overall we rated St Andrew’s Healthcare as Requires Improvement.

“Many of the children and young people admitted to St Andrew’s Healthcare have severe mental health problems and have a history of behaviour that has put themselves or others at risk. Despite that, we were surprised at the number of occasions when staff had resorted to physical restraint. The staff at St Andrew’s Healthcare must ensure that when restraint is used it is by the safest means to minimise the possibility of harm to the patient. 

“St Andrew’s Healthcare has had difficulty recruiting nursing staff and many posts were vacant. It has been relying heavily on the on the use of agency and bank nurses

“The service has given us assurances that it is making the necessary improvements and we have already witnessed some of these in action.

“People deserve to be treated in services which are safe, caring, effective, well-led, and responsive to their needs and this is what we look at when we carry out our inspections. We will continue to monitor this service closely and this will include further inspections.”

3.30pm The Guardian reports that the NHS is to shut many of the 58 hospital units in England where people with learning disabilities are still being sent to live despite ministers’ demands that the practice should end in the wake of the Winterbourne View abuse scandal.

Health chiefs intend also to force closure or reform of up to 49 private hospitals that provide long-term accommodation for people with learning disabilities or autism whose behaviour is considered challenging. One company has already been refused a licence to operate.

The moves were announced by Simon Stevens as he was questioned by MPs about the failure of previous attempts to stop people being placed in hospitals rather than supported to live in the community.

2.45pm Monitor has appointed a new non-executive director.

Timothy Heymann is a senior consultant physician and gastroenterologist at Kingston Hospital, is a reader in health management at Imperial College London and a host examiner of the Royal College of Physicians of London.

Dr Heymann has been a member of the Government’s Better Regulation Committee, and the Risk and Regulation Advisory Council. He has also been a non-executive director for NHS Direct.

He will take up his position on 16 February and the appointment lasts for three years.

Baroness Joan Hanham CBE, chair of Monitor said: “I would like to warmly welcome Timothy Heymann to Monitor. His mix of extensive clinical experience and knowledge on regulation will be of real value to the decisions we take as we concentrate on making the health sector work for patients.”        

2.25pm Our story on Simon Stevens’ suggestion to introduce a voluntary tariff has attracted heated reader debate:

“‘Mr Stevens said his proposed arrangement would be voluntary for providers, but not for commissioners’ Another piece of clear & concise guidance for us all to follow….”

“Just sort it out. Senior leaders rapidly becoming a laughing stock as we are supposed to locally agree contracts and plans by end of Feb and haven’t got a clue as to their bases. Utterly ridiculous, Monitor must have known at end of Dec they had a problem and should have sat in a room then with Nhse and tda and thrashed it out. Instead, a wall of silence.”

“So apologies for being sceptical but if it is voluntary then if I was a provider (NHS or Independent/Private) I would ask ‘which makes me more money - 14/15 + wait for a mandatory 15/16 tariff vs a voluntary tariff?’ Yes there are some politics at play as well which need to be taken into account but how would this lead to anything but a significant cost pressure for commissioners?”

“Wouldn’t take long to agree a block contract,with a six month review based on either revised new prices or old prices. But when exactly did choice and competition fly out the window?”

1.55pm Monitor chief executive, David Bennett, has responded to Simon Stevens’ idea for a voluntary tariff.

He said: “Simon Stevens and I have discussed our options over the national tariff extensively in recent days, and we will continue to do so. We both think it is desirable to find some arrangement that would give the sector a degree of certainty from 1 April, while we sort out whether we should go out to consultation on revised proposals or refer the issue to the Competition and Markets Authority. Of course we will share our thinking more widely with the sector once we have finalised the details.”

1.30pm The NHS could save £2bn by 2020 if patients were more involved in their own healthcare, claims a report by the think tank Reform.

The analysis claims that greater engagement by patients will help the NHS with its immediate and its long term problems. Unnecessary visits to A&E units fall when patients better understand their conditions, the report states.

New technology can allow patients to do jobs previously carried out by clinicians, such as diabetics measuring their own blood sugar levels.

The study advocates a much greater use of private sector expertise to improve patient engagement. 
Private and third sector organisations are going direct to the citizen to offer services not typically offered by the NHS. Social networking sites such as iWantGreatCare and PatientsLikeMe give patients a forum to offer feedback on services, learn from other patients and track their own conditions. Apps such as Babylon are giving patients access to “virtual” primary care.  The NHS can learn from these disruptive innovations, the report claims
1.20pm In The Guardian, Jackie Ashley has written a piece on how some clinical commissioning groups are considering restricting access to hearing aids to cut costs.

She argues that if North Staffordshire CCG and others reviewing their hearing aid services do introduce rationing this will only increase long terms costs.

She writes: “What is happening with hearing loss – an apparently mundane and certainly very common problem facing so many of us – is that a short term panic about budgets is producing ludicrous medium and longer term judgments.”

1.10pm The Argus reports that Coastal West Sussex CCG’s aborted Bupa contract to run MSK services cost £348,000.

Bupa pulled out of the contract after an impact assessment said the contract change could put Western Sussex Hospitals Foundation Trust into deficit.

1.05pm Shane Gordon has been appointed chief operating officer of Colchester Hospital University Foundation Trust.

He will leave his current role as clinical chief officer of North East Essex Clinical Commissioning Group “within the next few weeks” to take on take on his new permanent, full-time position, the trust today announced.

He succeeds Sandy Spencer, who has been serving in an interim capacity since December.

1.00pm UNISON is calling on nurses across the country to record nurse-to-patient ratios today as the union launches its fourth annual survey into safe staffing levels.

The survey findings - which shed light on staffing levels over a 24-hour period on a regular day in the NHS - will be released at UNISON’s annual healthcare conference in April.

UNISON head of nursing, Gail Adams said: “For years, our surveys have shown how increasingly difficult it is for nurses to deliver safe, dignified and compassionate care to all patients in the way they’d like. This is unfair for patients and for staff.

“UNISON has long campaigned for the introduction of legally enforceable staffing levels. This year, we want to see what impact if any the NICE guidance has had, and how over-reliant on agency staff the health service has become.”

In last year’s survey, two thirds (65 per cent) of nurses said they did not have enough time with patients and more than half (55 per cent) said care was left undone as a result.

Nurses must submit their data via the online survey by 9am on Monday (16 February) for their data to be included in the results.

12.45pm In HSJ’s leader column Alastair McLellan argues that Simon Stevens has “set about dismantling the recent past to make way for the future”.  

12.10pm The BBC reports that chief executive of Norwich CCG, Jonathan Fagge, has been cleared of assaulting his estranged wife.

12.00pm Members of the House of Lords have accused civil servants of trying to ‘short circuit’ the parliamentary process to pass a law on avoidable harm.

During a debate on the Health and Social Care (Safety and Quality) Bill, which places a duty on the health secretary to ensure no avoidable harm is caused by healthcare providers, peers expressed “dismay” over the way the private members bill was being driven by government whips.

Speaking in the debate last week Baroness Pitkeathley, chair of the Professional Standards Authority, told the chamber she felt “dismay” at the way it was being “handled”.

11.50am The Guardian reports that an inquiry by leading doctors has rejected controversial claims that death rates in NHS hospitals are far higher than in the United States.

A report by the Academy of Medical Royal Colleges has dismissed high profile claims made in 2013 by Sir Brian Jarman that 45 per cent more patients die in England because of NHS care weaknesses.

The inquiry was commissioned by Sir Bruce Keogh, NHS England’s medical director, and found that the hospital standardised mortality ratio indicator was an unreliable and flawed way of comparing the quality of hospital care in England and the US.

The report identified four reasons for this, including patients being less likely to be classified as high risk on arrival in hospital in England, NHS doctors recording far fewer secondary diagnoses, patients being sicker on admission in England and a greater proportion dying in hospital in England than in the US.

“This can skew the HSMR data, making the results appear worse in England,” the academy noted.

11.45am Plans outlined by Jeremy Hunt to calculate the number of avoidable deaths for individual hospitals ‘wouldn’t have any meaning’, according to the expert whose research the idea is based on.

Nick Black, professor of health services research at the London School of Hygiene and Tropical Medicine, said he did not think the health secretary’s proposal to produce a tailored percentage of avoidable deaths for each hospital in England based on a national estimate could work.

Mr Hunt on Sunday announced an annual review of roughly 2,000 patient case notes to establish “a national rate of avoidable deaths every year”.

11.35am This year will see a ‘generational shift’ in senior NHS management with the rise of a ‘new cadre’ of leaders able to see beyond the interests of single institutions, the NHS England chief executive has said.

In a wide ranging interview with HSJ, Simon Stevens said that meeting operational and financial challenges would sometimes require “action beyond the individual institution”.

Mr Stevens said: “I think 2015-16 is going to be a year when across the health service we see in many places a new cadre of leaders step up… so I think this is going to be year of generational shift, and passing of the batons to a new group of leaders.”

11.10am The Telegraph reports that hospitals will be fined £10,000 if they are found to have lied over negligence claims, under new government plans to tackle a “cover-up culture” in the NHS.

New financial penalties to encourage openness, and jail sentences of up to two years for those who “consent or connive” to provide false information, will be introduced as an inquiry into the treatment of NHS whistleblowers reports tomorrow.

11.00am The Financial Times reports that the soaring bill from medical negligence damages has become a threat to the NHS and there is a question as to whether patients should lose their right to sue, a senior business figure in Whitehall has said.

The NHS Litigation Authority, which provides indemnity cover for leal claims against the health service, has set aside £26.1bn to cover otustanding liabilities, equivalent to almost a quater of the £113bn annual health budget, and £1.6bn was paid out last year.

The number of claims rose almost 13 per cent in the year from March 2013.

10.55am Simon Stevens believes the NHS Trust Development Authority and Monitor should be merged.

The NHS England chief executive also warned politicians that taking out management costs will not be an effective way of making the NHS more efficient.

His comments come after Monitor chief executive David Bennett told HSJ last week that he could “see a lot of sense” in merging the two regulators.

Mr Stevens agreed that the two should merge. He said: “Increasingly the provider oversight role, as between those two organisations, is founded on a distinction without a difference,” although they have “distinctive capabilities”.

10.40am The involvement of GPs is the most important and most challenging factor facing any area wanting to trial one of the new models of care detailed in the NHS Five Year Forward View, Simon Stevens has said.

The NHS England chief executive told HSJ that more than 100 areas had expressed an interest in becoming part of the“vanguard” implementing new integrated ways of working. The deadline for submissions was yesterday.

The forward view detailed four new models of care that national bodies would support local leaders to implement over the coming years. Two of these – multispecialty community providers, and primary and acute care systems – involve integrating primary care and hospital care in a single provider organisation.

10.35am The Daily Mail reports that hundreds of nurses recruited to NHS hospitals from abroad are leaving after a few months.

This is according to figures obtained by HSJ’s sister title Nursing Times under the Freedom of Information Act, which found that found that 13 organisations saw at least half of the overseas nurses they actively recruited leave within two years of being hired. In some cases, none of the nurses now work at the trusts that originally recruited them.

Nursing Times collected workforce data from 95 per cent of the 158 acute trusts in England, asking trusts how many overseas nurses they had actively recruited and how many remained in post.

10.20am NHS Providers chief executive, Chris Hopson, has some questions on Simon Stevens idea to introduce a voluntary tariff.

He said: “The idea of a voluntary tariff is worth examining but it begs a whole range of different questions that must be answered before it can be seriously considered. These include:

•             What would be in the tariff?

•             Is it legal?

•             What does Monitor think of it?

•             How will all providers, particularly those who objected to the original proposals, be able to express their views on any new proposals?

“The whole point of the 2012 Act in this area was to give all affected providers a legitimate and justified say in the prices they are paid for the care they deliver. That must be preserved.

“To solve this difficult situation, two things are vital.

“First, NHS England and Monitor must march completely in step. Monitor has a range of statutory obligations here and there is no point pursuing solutions that do not meet those obligations. The law is the law.

“Second, the provider sector and, by extension, those who represent them need to be fully and intimately involved in any solution. There’s little point in flying kites that haven’t been fully and properly tested with those affected. As the Five Year Forward View sets out, it’s important we take a system wide approach to addressing our challenges, with national system leaders committed to co-designing solutions with those who have to deliver them on the ground”.

10.15am Official advice to cut the amount of saturated fats in people’s diets “should not have been introduced” because of a lack of evidence that it would reduce heart disease, according to a new study published in the journal Open Heart.

The Times reports that researchers said gold-standard evidence available to experts drawing up dietary guidelines, which were announced in 1983, did not support their conclusions.

10.00am The Times reports that the number of patients who have to return to accident and emergency departments within a week has exceeded a million, with the figure rising as people struggle to get the care they need.

Rushed care and a lack of GP appointments were blamed by doctors and patients’ leaders, who said many commuters and immigrants had given up on family doctors in favour of hospitals where “the lights are always on”.

9.55am More than 1,500 people got involved in the first phase of the Challenge Top-Down Change campaign, which aims to help the NHS achieve transformational change. Today we launch the second phase.

The NHS should stop using external management consultants to solve its problems and instead rely on the expertise of frontline staff.

This was the resounding cry from contributors who took part in the first phase of our NHS Change Challenge, a free online ideas exchange.

9.35am Trusts will be asked to accept a new ‘voluntary’ tariff for 2015-16 after the formal price setting process was thrown into uncertainty and delay by a provider revolt, Simon Stevens has proposed.

The NHS England chief executive suggested the move, of making a new offer to providers that would be agreed outside formal price setting rules, as a means to avoid the damage threatened by further delay. He warned it could take “many months” to follow the formal steps available to break the impasse on NHS pricing.

His intervention comes after NHS England and Monitor revealed in late January that their proposed 2015-16 tariff had received objections from providers accounting for three-quarters of all tariff funded services.

7.00am Good morning and welcome to HSJ Live.

Today HSJ, in association with NHS Improving Quality, launches the second phase of its campaign to achieve better transformational change within the NHS.

The Challenge Top-Down Change initiative uses a crowdsourcing methodology, created by our partner Clever Together, to enable users to exchange and rate ideas. Launched last month by HSJ, together with its sister title Nursing Times and NHS Improving Quality, the aim is to identify the best ways to help the NHS drive real and sustainable change.

Learn more about the second phase of the campaign and how to get involved here.