Huge, previously unreported waiting list of more than 90,000 patients revealed at Barking, Havering and Redbridge University Hospitals Trust, plus the rest of the day’s news and comment

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4.10pm NHS England is “committed” to pushing up dementia diagnosis rates, chief executive Simon Stevens has told the Alzheimer’s Society Conference today.

The pledge comes as NHS England publishes a new Dementia Toolkit aimed at helping GPs make more timely diagnosis of the crippling condition and, importantly, what they can do in terms of vital post-diagnostic support.

The support covers many areas and is mainly directed at the person with the diagnosis or their carer. It relates to both emotional support and practical task-based help including specific interventions such as cognitive stimulation therapy.

Mr Stevens said: “The biggest test of the NHS is going to be how it treats older citizens and, in particular, how we treat people with dementia. If we get it right for people with dementia, we will get it right for everybody.

“This challenge is going to increase and it is a challenge in economic terms as well.

“We are looking at making a step change in improving the proportion of people who get a diagnosis. We are looking at going from under half of people currently to two thirds of people with dementia getting a diagnosis by 2015.

“Today we have published a dementia guide for GPs in which we say that there are compelling arguments against delaying diagnosis. It is increasingly important the we diagnose people with dementia.

“We have got to find ways of harnessing expertise and insight about dementia and I believe we are on the cusp of a revolution to the way we help people with long term conditions.”

Current rates of diagnosis, which show how many people have been diagnosed with dementia across the country, are relatively low, at just over 50 per cent suggesting there may be around 400,000 people living with dementia without the benefits of a formal  diagnosis. NHS England’s aim is that by next year two-thirds of the estimated number of people with dementia should have a diagnosis and post diagnostic support.

Professor Alistair Burns, NHS England’s national clinical director for dementia at NHS England, is also taking part in a debate at today’s conference in London.

He said: “Being diagnosed with dementia is the start of a life changing journey, and that’s why it’s so important that we reach our ambition of increasing correctly diagnosing dementia in more people, and putting in place the support they need and deserve.

“We firmly believe every person with dementia, who wishes it, deserves a timely diagnosis to allow them to access post diagnostic support with all the benefits that can bring for them, their families and carers.

“We are working hard to support CCGs in providing services to make high quality diagnoses. We know there is significant variation across the country and we are encouraging those with the higher rates to support those with lower rates.”

3.55pm The installation of cameras in care homes to monitor patient care is a hotly debated topic.

Until the issues of leadership, pay and training are tackled, this potential abuse prevention strategy will remain so, writes Paul Ridout, a partner at Ridouts LLP and an experienced adviser for the health and social care sector.

3.40pm There is almost universal agreement that the NHS needs to spend more time focusing on developments in community and primary care, but as HSJ editor Alastair McLellan argues in his leader this week, with a growing focus on hospital performance it will be harder than ever to do this.

Alastair writes that high level Whitehall briefings are stressing that NHS performance poses the greatest threat to the government’s standing as the election nears.

Specifically, the concerns fall into two areas: the impact of the better care fund on NHS providers; and the hospital sector’s waiting times performance.

3.00pm Monitor is to examine governors’ experiences as representatives of patients, staff and other members, and find out whether they feel well-equipped to do their role.

Governors are elected to the Council of Governors from foundation trust members, and represent the views of patients, service users, carers, staff, other members and the public. As part of the Council they can hold the trust board to account.

Part of a governor’s role is to be involved in hospital activities like approving the appointment of a new chief executive, or engaging with the local community about hospital plans. To help them do this confidently, governors should get relevant training and support from their trusts.

The health sector regulator has today sent an online survey to trusts so that governors can share their views on their role and their training. Governors are encouraged to use this to give us feedback on any extra support they feel would be useful.

Monitor plans to publish the results, which will help trusts and training bodies to identify any gaps in the training courses or support they offer governors. Findings will also be compared with previous years to see if the way governors carry out their roles has changed.

Suzie Bailey, development director at Monitor, said: “Governors offer trusts vital insight into the opinions of patients, service users, carers, staff, other members and the public. It’s an important role working with FT boards to understand the needs of patients and the local community when planning for the future.

“We want to make sure that governors have the right level of support to do their role well. I encourage all governors to give us their feedback, as it will help to identify where they could use extra support to make sure their trust is well-led for its patients.”

The survey is now open for six weeks. Results will be published early next year.

2.26pm The NHS shouldn’t be content with mere survival – the 2015 Challenge manifesto urges politicians to helps us turn the service from ‘good’ to ‘great’, writes Johnny Marshall, director of policy at the NHS Confederation.

2.05pm A broad coalition of health and social care leaders will tomorrow call on all political parties to make a manifesto commitment of at least £4bn to fund NHS service changes over the next parliament, HSJ has been told.

The demand is one of 15 set to be issued by the group of leading national organisations as they urge politicians to set out and debate their plans before the general election in May 2015 to ensure the next government has a clear mandate for service change.

The 21 groups expected to back the “2015 Challenge Manifesto” include the NHS Confederation, the Foundation Trust Network, the Royal College of Nursing, the Association of Directors of Adult Social Services, National Voices and Age UK.

1.35pm The Daily Telegraph reports today that common sleeping tablets and anxiety drugs taken by millions have been linked to a 50 per cent increased risk of Alzheimer’s, researchers found.

Taking the drugs known as benzodiazepines, which include diazepam and lorazepam, for three months or more was linked with a greater chance of being diagnosed with Alzheimer’s five years later.

Gordon Brown professed his “love” for the National Health Service last night and said the Scottish National Party were not “telling people the truth” on the future of the health service in Scotland, The Telegraph also reports.

Speaking to Labour activists in Glasgow Gordon Brown dismissed the idea that Scotland’s health service is slipping towards privatisation under Westminster rule.

Seperately in the paper, a growing number of GP practices are demanding to close their doors to new patients as doctors warn that services are “teetering on the brink of collapse”.

Last year 104 practices applied for permission to stop accepting patients – more than twice as many as two years before.

A further 45 surgeries asked to “shrink” their practice boundaries, throwing existing patients off their lists, while 100 more practices are threatened with closure.

1.25pm HSJ is looking to explore how pathology services can be improved and as a thank you 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.

For more information and terms and conditions, click here.

1.15pm 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.

12.00pm 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. We are particularly looking for people who you believe meet one or more of the following criteria:

  • Benefit: how has this individual’s work benefited patients? To what extent have his or her efforts helped enhance access to and/or the quality of care?
  • Influence: to what extent has the individual been a game changer in his or her organisation, or more widely?
  • Leadership: to what extent has this individual created a platform for others? Has he or she enabled greater numbers of BME staff to take up roles at all levels of the health sector?
  • Inclusivity: to what extent is the individual having a long term impact on the debate around inclusivity within the health sector?

A panel of expert judges will decide on the final list, which will appear online and in print in HSJ during November.

To nominate somebody, click here.

11.00am The National Council for Palliative Care and Public Health England have today announced an opportunity to apply to be one of six Pathfinder Communities to pioneer a public health approach to end of life care in England.

Applications are being sought from organisations or collaborations of organisations including local authorities, clinical commissioning groups, health and wellbeing boards and NHS or voluntary sector providers of health and social care.

Implementing the new Dying Well Community Charter which is launched today, the pathfinders will receive support to help their local community to work together to improve their response to people who are dying and those who have been bereaved.

The new charter has been updated from “What makes a good death? A North East Charter” - produced by the NHS North East Strategic Health Authority in 2010.

It incorporates the five Priorities for Care that came from the Leadership Alliance for the Care of Dying People (LACDP) recommendations, as well as the Royal College of Nursing and Royal College of General Practitioners’ 2011 End of Life Care Patient Charter.

Pathfinder applicants will be required to provide evidence or confirmation of working in collaboration with a broad range of other organisations across sectors in their locality, as well as be able to confirm they have the resources to hold an event to launch the Charter locally, with advice and non-financial support from the NCPC and PHE.

Speaking today, Claire Henry, chief executive of the National Council for Palliative Care said: “Despite being one of life’s few certainties, the needs of many people who are dying or who have been bereaved continue to be overlooked. That’s why we need a public health approach to end of life care, with a much greater focus on compassionate care and support. Together, the Charter and Toolkit have the potential to improve end of life care for everyone through the commitment of pathfinder Charter communities”

Professor Julia Verne, Clinical Lead for the National End of Life Care Intelligence Network at Public Health England said:

“Every 70 seconds someone in England dies. It is a societal responsibility to ensure that people who are dying are cared for with dignity and that their family and loved ones are supported through their caring roles and during bereavement.

One of the greatest sadness of our modern society is that many older adults spend their last days and hours alone with no close family or friends to care for them or give human comfort. They are totally dependent on the input of professional carers.

The Dying Well Charter is a rallying call to society to improve the care of the dying and the ‘Public Health Approaches End of Life Care Toolkit’ will support Pathfinder Communities in mobilising local action.”

10.52am The concept of independent contractors in general practice will become “anachronistic” and “probably will have gone” within ten years, according to one of NHS England’s most senior GP leaders.

Deputy medical director Mike Bewick also called for primary care providers to grow to cover populations of around 300,000 and merge with organisations in other sectors.

He said today: “In ten years’ time the term independent contractor will be anachronistic, and probably will have gone.”

Dr Bewick pointed out that a growing number of doctors in primary care at present were salaried, rather than being partners, who own a stake in their practice.

10.38am A huge, previously unreported waiting list of more than 90,000 patients has been revealed by one of England’s most troubled trusts. It comes amid an intense national drive to tackle politically sensitive waiting targets.

An investigation into waiting times performance at Barking, Havering and Redbridge University Hospitals Trust found that 92,236 patients had not started treatment at the end of August, 61,143 of which had been waiting past the national 18 week limit.

10.37am The Guardian also reports that at least 150 and possibly several thousand patients a year are conscious while they are undergoing surgery in the operating theatre, according to the Royal College of Anaesthetists.

A report warns that some people suffer long-term psychological damage as a result.

In the vast majority of cases, patients have been given muscle-relaxing drugs that temporarily paralyse them, preventing them from warning theatre staff that they are awake.

10.29am Looking to this morning’s newspapers, The Times reports that Gordon Brown has made a personal plea that the NHS in Scotland is not under risk of privatisation. The former prime minister spoke of the death of his daughter and his partial blindness to highlight his admiration for the health service.

He said: “Do you think I or anybody else who cares about the NHS would stand by and do nothing if we thought the NHS was about to be privatised in Scotland and its funds going to be cut? Of course not.”

His intervention followed repeated claims by Alex Salmond that the Conservatives intend to privatise the health service, ahead of Scotland’s referendum on independence next week.

The Times also reports that at least 150 patients a year wake up during surgery, according to the Royal College of Anaesthetists says.

10.25am Up to half a million patients could be put at risk every year as hospitals struggle to admit patients to hospital wards from bursting A&E departments, the College of Emergency Medicine has warned.

As many as 500,000 patients across the UK could see their situation deteriorate as a consequence of “exit blocking”, the college said. Exit blocking occurs when emergency doctors recommend that a patient should be allocated a hospital bed but they are unable to be admitted in a reasonable time frame.

7.00am Good morning and welcome to HSJ Live six-point plan to help organisations adopt the Patient and Family Centred Care methodology – which focuses on shadowing patients through a care experience – is now available online, write Lisa Byrne and Beverley Fitzsimons.

The King’s Fund and the Health Foundation have launched a toolkit of resources based on the patient and family centred care methodology, which includes a step by step guide to implementing this simple, clinically led approach to service improvement.