Senior leaders in several of the NHS’s “challenged health economies” are not confident their area will be in financial balance in five years’ time, plus the rest of today’s news and comment
3.12pm Cambridge and Peterborough Clinical Commissioning Group has officially appointed an NHS led consortium as the provider for an its £800m older people’s contract.
The Uniting Care Partnership, a Limited Liability Company established by Cambridgeshire and Peterborough Foundation Trust and Cambridge University Hospital Foundation Trust, will take on the contract from April 2015.
The consortium was named preferred provider on 1 October. See here for more information.
3. 04pm Basildon and Thurrock University Hospitals Foundation Trust’s chairman has announced he is standing down.
Ian Luder announced his decision not to stand for a second term in an open letter to staff, explaining that his term expires in March 2015 and that as he feels it is time for a new chairman.
Mr Luder, a former Lord Mayor of London, joined the trust as chairman in April 2012 and oversaw the appointment of Clare Panniker as chief executive.
A trust statement said: “He has overseen numerous changes within the Trust which led to it becoming the first to be taken out of special measures following a “good‟ rating from the Care Quality Commission.
The process to appoint a new chair will begin shortly.
1.10pm The Department of Health has responded to The People’s NHS Campaign’s concerns over the Transatlantic Trade and Investment Partnership.
They are worried that TTIP could lead to the privatisation of the NHS by making it harder to end contracts with private companies.
Here is the DH statement: “The government believes that the inclusion of health in the TTIP does not threaten the public nature of the NHS, but provides an opportunity for European businesses, including improving access to the US market for the UK’s world-class pharmaceutical and medical devices sectors.
“Decisions about the commissioning of NHS care will remain with local GP-led commissioners, who will continue to act solely in the best interests of patients.
“The European Commission has explicitly ruled out public services from the scope of any market liberalisation in the TTIP. The agreement will not require participating EU members to open up their national health systems to private providers. Following the most recent round of negotiations, both EU and US negotiators have confirmed this position.
“The rules on investment protection for the TTIP will be negotiated carefully to preserve the right of the government to regulate in the public interest, whilst offering international investors access to justice if they feel they have been discriminated against unfairly. This agreement is not new, and the UK has over 90 similar agreements in place.
“The European Commission carried out a public consultation on the investor protection provisions earlier this year. The consultation sought stakeholder views on what modern investment provisions should look like in the TTIP.”
12.15pm The permanent secretaries of the Department for Communities and Local Government and the Department of Health have strongly objected to a National Audit Office report that prompted the better care fund planning process to be branded a “shambles”.
Sir Bob Kerslake and Una O’Brien have written to the spending watchdog to complain about its report, Planning for the Better Care Fund, which was published this week.
They have also refused to follow a civil service procedure in which permanent secretaries approve the NAO’s use of information, HSJ’s sister title Local Government Chronicle understands. This is believed to be the first time in his career as a permanent secretary that Sir Bob has ever refused to sign off an NAO report.
11.50am The creation of new integrated provider models and capitated budgets are fundamental to the visions of the national “challenged health economies”, as well as the centralisation and closure of acute services, HSJ has been told.
New models of integrated care were part of the proposals of all seven of the areas HSJ spoke to. Northern, Eastern and Western Devon Clinical Commissioning Group chief officer Rebecca Harriott said the most significant thing to come out of Devon’s challenged health economy work “was an agreement… to look at outcome based commissioning and capitation funding”.
“In drawing together a capitation budget with a set of outcomes you would expect to be able to align the resources of the CCG to the needs of the population more coherently than the current payment systems,” she added.
11.30am The medical profession is losing over 500 doctors a year due to the “bureaucracy of revalidation”, according to Fitness to Practice.
Over 1000 highly experienced doctors have left the medical profession as a result of revalidation in the last two years. With all doctors having to go through the process by 2016 the organisation claims these numbers will continue to rise.
Fitness to Practice claims doctors are concerned that the time spent going through the revalidation process is forcing them to spend time away from patients.
Fitness to Practise CEO Beverley Boon warns that the same revalidation process that is forcing doctors out of practise will, in 2015, come into regulation for nurses and midwives.
During an unannounced visit to Dr Mujib ul Haq Khan at Granville Road, Southfields in August, inspectors found he was failing to meet five of the six national standards inspected. Four of the standards had previously been inspected in June and were still found not to be met at the August inspection.
10.46am Senior leaders in several of the NHS’s “challenged health economies” are not confident their area will be in financial balance in five years’ time, even after months of intensive support from national organisations, they have revealed.
HSJ interviewed bosses of organisations in seven of 11 areas which were earmarked for extra help by Monitor, NHS England and the NHS Trust Development Authority in February. The programme aimed to bring together commissioners and providers across each area to draw up five year plans to overhaul their unsustainable and sometimes poor quality services. They were given substantial nationally funded management consultancy support.
HSJ can reveal that, for some, while the “challenged health economies” process has accelerated proposals for new forms of integrated services, it has also confirmed the need for centralisation and closure of some hospital services. Meanwhile, three areas told HSJ they had not been able to confidently resolve how to close their funding gap.
10.34am The committee concluded that NHS England has not provided effective oversight of whether out-of-hours GP services are serving patients well and providing value for money.
It said there was an inherent risk of conflicts of interest in the current system of commissioning out-of-hours GP services, where GPs who are members of CCGs are able to commission services from organisations in which they have a financial interest.
According to the committee, in Barnet, Enfield and Haringey, a number of GPs who work for the CCGs also have shareholdings in the organisation that provides out-of-hours care.
10.29am The Public Accounts committee also found that about a third of adults in England have either not heard of NHS 111 or have heard of it but do not know what it is for. In addition, a quarter of adults have not heard of out-of-hours GP services. Awareness was lower still among certain groups including younger people and people from black and minority ethnic communities.
The committee has recommended NHS England should set targets to increase public awareness of out-of-hours GP services and NHS 111.
10.21am The Commons public accounts committee has published a report on out of hours GP services. Committee chair Margaret Hodge said: “Too many people are unaware of the different urgent care options – such as out-of-hours GP services, walk-in centres, urgent care centres and A&E departments – and of how to contact them.
“This means people may not receive care in the most appropriate setting. As a result of the confusion, too many go to A&E when they do not need to.”
10.01am Patients are being denied access to life changing treatments because parts of NHS England’s “Kafkaesque” commissioning regime appear to have ground to a halt, clinicians and charities have warned.
HSJ has discovered at least two groups of patients unable to access drugs their doctors want to prescribe as NHS England is yet to finalise commissioning policies for the treatments.
7.00am Good morning and welcome to HSJ Live. We begin the day with a comment piece from James Wilson, who argues the NHS has moved on from the foundation trust model and we need to revisit the structure of our health system.