Labour leader appears to indicate that party would retain clinical commissioning groups as key decision making bodies in the NHS, and the rest of today’s news and comment

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5.44pm The Royal College of GPs has expressed concerns about

RCGP’s honorary secretary Professor Nigel Mathers said: “We are very concerned that, with just seven weeks to go before the national roll out, the public have not been properly informed about the benefits of and the safeguards surrounding the programme.

“The inevitable result of the failure to make the case for the scheme is the crisis of public confidence that we are now seeing.

“We urgently need a renewed national push by the authorities to ensure that patients are fully informed, in clear terms, about the benefits of the scheme, what their rights are, and what their rights to opt out are.

“Many GPs remain uncertain about the safeguards that will apply.

“The College remains supportive of the initiative in principle, as we believe that it will help the NHS improve the quality of care for patients and to better prepare for outbreaks of infectious disease, such as flu, through for example, the use of shared suitably anonymised data to build up a picture of which treatments work best.

“However we urgently need reassurance about what plans are being made to address current GP and public concerns to restore public confidence in the scheme.

“The Government and NHS England need to act immediately, otherwise further questions will inevitably be asked about the wisdom of rushing the scheme through before the current gaps in information and awareness have been addressed.

“It would be a tragedy if something that could have enormous benefits for patient care falls at the first hurdle because of a failure of communication.

“It is vital that patients and doctors are as informed and as confident as they can be in the scheme, and in the safeguards in place to ensure patient confidentiality, before it is introduced across England.

“We have been informed by NHS England that the Health and Social Care Information Centre does not make a profit from providing data to other organisations; that data will not be sold to insurance companies for the purposes of insurance and that confidential data can only be disclosed where allowed by the law.”

4.15pm The High Court has dismissed an appeal by two former Mid Staffordshire Foundation Trust nurses struck-off by the Nursing and Midwifery Council for misconduct and altering A&E waiting times.

Sharon Turner and Tracy White launched a bid at the High Court on Tuesday, appealing the decision of the Nursing and Midwifery Council fitness to practise panel which banned them both from practising in July.

The pair were found guilty of a string of offences including bullying of colleagues, poor care and dishonesty.  The fitness to practise panel concluded both had brought the profession into disrepute.

The High Court has confirmed they lost their bid and the appeal was dismissed on Tuesday although the formal judgement has not yet been released by the court.

Reacting to the court decision a spokeswoman for the Nursing and Midwifery Council said: “The NMC exists to protect the public. We contested this appeal because the case raised serious issues of public protection.
“We are pleased that the judge has upheld the panel’s original decision to strike Ms White and Ms Turner from the register.”

She added: “We will consider the judge’s comments in detail, and any lessons learnt from this case will be shared across the NMC and with fitness to practise panel members.”

Both Ms Turner and Ms White were working as sisters in Stafford hospital’s A&E department during the time “hundreds” of patients suffered appalling care and were the subject of a complaint by whistleblowing nurse Helene Donnelly who was bullied and threatened as a result.

4.00pm Michael White argues in his HSJ column this week that Ed Miliband’s recent lacklustre pronouncements on public service reform need to rise beyond what amounted to ‘Blair without the flair’ and a promise to decentralise power - something many government’s have talked about.

3.05pm Updated guidelines that emphasise the need for people with osteoarthritis to exercise regularly and take action if overweight have been welcomed by the Chartered Society of Physiotherapy (CSP).

The latest recommendations from NICE recognise activity and exercise as a ‘core treatment’ for the condition to help reduce pain and improve mobility.

Physiotherapists are experts in assessing patients’ symptoms and developing tailored exercise plans that allow them to manage their condition independently.

Professor Karen Middleton, chief executive of the CSP, said: “These guidelines should help challenge the perception that many people often have about osteoarthritis being a normal part of ageing and that ‘nothing can be done’.

“Physiotherapists provide effective treatment for the symptoms of osteoarthritis and deliver expert advice on physical activity and weight-management strategies to reduce pain and improve mobility.

“NICE has recognised how important this is for the day-to-day management of the condition and the positive impact it has on patients’ quality of life.

“We can do better for people with this condition it is now important that NHS commissioners provide access to the right services to make that happen.”

Prof Middleton added that the decision to recommend that acupuncture not be offered as a treatment was “disappointing” but said the CSP would continue to work with NICE to understand how research studies into the practice can be better designed.

Professor Krysia Dziedzic, Arthritis Research UK professor of musculoskeletal therapies at the University of Keele and physiotherapist on the NICE working party said: “Physiotherapists provide expert advice on the core treatments for all people with osteoarthritis recommended by NICE: accurate information, support with physical activity and the right forms of exercise, and interventions to lose weight if the person is overweight or obese.”

1.45pm Tracey Batten has been announced as the new chief executive of Imperial College Healthcare Trust. She is currently head of St Vincent’s Health, Australia’s largest hospital group, and will take up her new post in April.

1.30pm NHS England has reneged on its plan to give a designated “integration pioneer” area special status as a centre of best practice in the use of its £260m technology fund. Full details here.

1.00pm The Guardian has also covered the statins story, which can be read here. The paper also highlights the findings of the Commons health select committee, which states that some hospitals must stop providing certain services or even shut altogether if the health service is to remain viable.

Denis Campbell, the paper’s health correspondent writes that the massive shakeup of the national health service has left many staff unhappy, and chiefs will need to lift morale.

The committee acknowledged that such changes are “notoriously controversial”.

12.55pm Looking to the healthcare stories in today’s newspapers:

The Times reports that millions more middle-aged people will be offered cholesterol-lowering drugs in a major revision of NICE guidance.

NICE said that fresh evidence shows that statins are safe and cut the risk of heart disease. Most men over 50 and most women over 60 are likely to be offered statins after a decision to halve the heart disease risk thresholds at which the NHS will pay for the drugs.

Currently statins are offered to anyone with a 20 per cent risk of developing heart disease in the next ten years.   

12.50pm The outgoing head of NHS England has said hospitals will have to close and services centralised to improve patient care.

Sir David Nicholson called for a radical reorganisation of health services so a smaller number of larger hospitals offer most major surgery while smaller hospitals scale back the care they provide.

12.45pm Responding to the Health Select Committee’s report on public expenditure on health and social care, Nuffield Trust Chief Executive Andy McKeon said:

“This report is an important summary of where the NHS stands three years into an unprecedented period of financial challenges. Overall, our research and analysis support the Committee’s conclusions. The NHS has met its headline targets, but it has relied on relatively straightforward ways to do so, cutting the prices paid to hospitals and freezing wages. These policies will not be sustainable over the next few years, and won’t provide enough savings to bridge the £30 billion funding gap which NHS England expects to see by 2021.

“The report perhaps puts too much emphasis on the importance of ‘transformative change’ involving shifting funds and patients out of hospitals and towards social and community care. Better joined-up care may well improve the experience and quality of life of patients, but it probably won’t create savings, certainly not in the short term. It has been suggested that changes like these will save money by keeping people out of hospitals. But our research on many ‘integrated care’ initiatives designed to achieve this has found no evidence of lower costs.

“The report’s argument for ring-fencing social care funding must be seriously addressed – deep cuts to local authority budgets mean financial pressure here is intense. Surveys suggest councils are responding by changing their eligibility policies, so that adults facing significant but not overwhelming problems with everyday tasks increasingly cannot get help to pay for care. Our researchers are looking at demonstrating the impact of these cuts in social care, which are set to continue.

“Looking ahead, a major challenge for the NHS, closely linked to social care cuts, will be finding the money to transfer into the ‘Better Care Fund’ to create more integrated services. Coming on top of existing savings requirements, this will make 2015/16 a very difficult year for the health service. Even if the NHS succeeds in doing this, the major risk is that the money will be needed mainly to prop up existing services, rather than create new ones’’.

12.45pm The Commons health committee has called for health and wellbeing boards to be given a greater role in spearheading integration between health and social care to ensure the sectors make urgently required savings.

In a report released today the committee warned the NHS was at risk of failing the “Nicholson challenge” of year-on-year efficiency savings to meet rising care demand and said there had not so far been the “transformative change” needed to make services financially sustainable.

10.40am The managing director of healthcare at independent provider Care UK has used an HSJ interview to express optimism that the company can increase its share of NHS provision, including through taking over the running of hospitals.

Former NHS England director of transformation Jim Easton disclosed that his new employer was in discussions with a number of NHS trusts about expanding its provision of elective services. Read Nick Renaud-Komiya’s full story here.

10.30am HSJ Editor Alastair McLellan argues in this week’s leader that the hospital sector is at an intriguing fork in the road, with policymakers from across the board offering their visions for the future. But first, he says, they need to get the incentives right.

There are not enough NHS − or private sector − organisations prepared to throw their hats in the ring and create the capacity needed to have a significant impact on service redesign plans across the country, he writes.

10.15am Ed Miliband has suggested that under a future Labour government CCGs would draw up plans to reconfigure services. He added that consultation on such changes should be led by other bodies such health and wellbeing boards.

This appears to contradict a proposal put forward by shadow health secretary Andy Burnham last year.

9.52am The King’s Fund responds to the Health Select Committee report on public expenditure, released today.

Commenting on the Health Select Committee’s report on public expenditure, John Appleby, Chief Economist at The King’s Fund said:

‘The Health Select Committee is right to stress the severe financial pressures now facing health and social care - the reality for many NHS organisations is that they are already facing a difficult choice between meeting financial imperatives and maintaining quality of services.

‘In the short term, finances are tightening significantly, with a growing number of hospitals now in deficit. This raises real questions about whether the NHS will be able to maintain its recent record of balancing its books at the end of the financial year. Beyond 2015, the prospects look even more challenging, with further cuts in public spending likely whoever wins the general election. It is now almost inevitable that the next government will have to find more resources for health and social care if services are to be maintained.

‘In the meantime, a combination of unremitting financial and demographic pressures is having a significant impact on social care services – although  welcome, implementing the Dilnot reforms is only part of the solution. And while the establishment of the Better Care Fund provides an important opportunity to promote integrated care, it will not offset inadequate funding for social care and will increase financial pressures on hospitals.

‘As the committee points out, a more ambitious approach is needed to align health and social care resources around the needs of patients and service-users. This raises fundamental questions about whether to maintain the current separation between the NHS as a universal service, free at the point of use, and social  are as a separately funded, means-tested service.  This is why we have established an independent commission, chaired by the economist Kate Barker, to explore how the NHS and social care system can be brought closer together.’

6.00am Integrated care is making inroads into the NHS and new models are springing up across the country.

The better care fund is a further indication that the government is serious about promoting integrated care.

However, while we often hear that integrated care produces benefits for patients a close look at the data highlights a dearth of evidence on the impact of integrated care, writes Veronika Thiel.