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4.45pm: The Journal of Hospital Infection has just released the awaited epic3 guidelines on infection prevention and control for a range of healthcare professionals. They are freely available online on ScienceDirect and on the journal’s website

The guidelines were commissioned by the Department of Health and have been developed after a systematic and expert review of all the available scientific evidence. They update and supersede the previous guidelines on this topic published in 2007.

Microbiologist Dr Jenny Child, Editor in Chief of The Journal of Hospital Infection, said “It is difficult to stop the rise of increasingly resistant organisms. What we can do however is prevent them spreading between patients and becoming established among the resident microbial flora- the bacterial population in our hospitals. Infection prevention and control has never been more important than it is now.” 

4.15pm: In response to today’s reports that the overall spending in mental health services has seen a 2 per cent cut in real terms, the chair of a body representing nine independent mental health providers has expressed her worry about the effects this is likely to have.

Alison Rose-Quirie, chair of the Independent Mental Health Services Alliance, said: “We are deeply concerned by today’s findings, which are especially worrying in light of Monitor’s recommendation of a further 1.9% reduction in rates for 2014/15. This can’t be good for mental health patients.

“This disinvestment is completely at odds with the stated government priority to achieve parity of esteem for mental health and physical health and certainly will not address the significant historic disinvestment in mental health services. Once again, mental health services are to lose out when it is recognised that people need more from us, not less.”

“IMHSA is fully aware of the severity of the pressures on the NHS and providers have worked hard to realise efficiencies in the services they offer. A standard 1.9% reduction fails to recognise the efficiencies that different mental health providers have already generated nor the differential cost base from which they start.

“IMHSA remains committed to working in partnership with the NHS during this challenging time to create long term efficiencies to the benefit of patients and taxpayers. It is proven that investment in mental health services leads to cost savings elsewhere in public services, so it cannot be right to be cutting funding in mental health at this sensitive time.”

4.07pm: In this week’s issue of HSJ: With people taking more drugs than ever before, Duncan Hockey asks who is responsible for ensuring each patient’s prescriptions are appropriate. Read his comment piece here.

3.25pm: Health sector regulator Monitor has today closed its investigation into South Warwickshire NHS Foundation Trust after the trust took action to reduce waiting times in Accident and Emergency and to reduce the length of time patients have to wait for planned treatment.

Monitor launched its investigation in June 2013 after the trust failed to meet the four-hour A&E target in five out of eight financial quarters.  It is now meeting its target to see 95 per cent of patients in A&E within four hours.

The regulator also had concerns over the length of time patients had to wait for planned treatment. Monitor has concluded that the trust has addressed the issues that caused it to breach the national target to see patients waiting for planned treatment within 18 weeks.

Laura Mills, Senior Regional Manager for Monitor said today: “We welcome the news that patients in South Warwickshire no longer have lengthy waits to be seen when they go to A&E, or for planned treatment.

“We have now closed our investigation and the trust will return to being regulated using our normal regime.”

2.40pm: Does your healthcare organisation have a wireless network? Do you use it? If so, how reliable is it?

HSJ, in association with Mey Networks, is running a survey to find out more about wireless access in healthcare provider organisations and we would like to hear your views. Our questionnaire only takes 10 minutes to complete and all answers are anonymous. The results will be used to inform a forthcoming article in HSJ. To take part, click here.

1.38pm: In this week’s issue of HSJ, Crispin Dowler argues that contracts linking general practice and community services, with GPs commissioning secondary care, would challenge the underlying logic of the NHS reforms. Find out more here.

1.35pm: The company which owns Quantum Pharmaceutical Limited (Quantum) and Total Medication Management Services Limited (trading as Tomms Pharmacy – ‘Tomms’), has agreed to pay over £380,000 for breaching competition law in relation to the supply of prescription medicines to care homes throughout England.

The settlement announced today relates to an OFT investigation into a market sharing agreement between Quantum and Lloyds Pharmacy Limited (Lloyds), a subsidiary of Celesio AG, over the supply of prescription medicines to care homes between May 2011 and November 2011.

12.35pm: NHS England have responded to the CQC survey into women’s experiences of maternity care.

A spokesman said: “NHS England welcomes this survey as it gives a voice to women. The improvements to care are very encouraging but there is more to do.

“This survey emphasises that the role of staff during childbirth is key to ensuring women have a positive experience and this feedback will help those 137 Trusts inform their service delivery.

“Providing maternity care is very complex and care is part of a pathway that spans from contraception services, preconceptual care through pregnancy and birth to early years. NHS England will support and guide local commissioners to understand these findings and translate them into the excellent service women should expect.”              

12.00pm: This week HSJ is inviting readers to help shape our Commission on Hospital Care for Frail Older People by answering this question: What policies, techniques and approaches have you seen improve the care of frail older people in hospitals?

The commission, in association with Serco, is tackling the most pressing issue facing the NHS today: hospital care of an ageing population against a backdrop of flat funding.

The conversation is happening here. Registered users of will have had an email with login details last Friday. If you didn’t get it and want to take part you can email

11.08am: Health chiefs are being urged to publish the results of an inquiry which caused a top flight liver surgeon to be banned from carrying out operations.

Surgeon David Paul Berry was “fully suspended” from duty in January after the discovery that eight of his patients suffered “avoidable” deaths. Read the full story here

11.05am: The Daily Mail has put the CQC GP inspection story on its front page this morning. “Danger in the GP’s surgery”, runs the headline.

Their take is that “thousands of patients are being put at risk” by GP surgeries that fail to meet the basic standards of care and hygiene.

The Mail emphasises the maggots story that has been widely picked up elsewhere, out of date medicines, and nurses not trained in basic first aid.

11.00am: There are some interesting Twitter responses to professor Steve Field’s comments in the press and on the radio this morning about the CQC’s inspections of GP surgeries.

Dr Robert Morley, Birmingham LMC secretary and a BMA Council member this morning tweeted: “What does NHS England do to support general practice Steve, and how will morning’s headlines help patients?”

10.55am: The Guardian takes a similar line on its front page, noting “evidence of medical records left lying around, vaccines not kept in the right temperature, and dangerously dirty rooms with maggots in one practice” that have been uncovered by the CQC inspections.

10.48am: The Daily Telegraph front page leads on the story about the Care Quality Commission’s inspections of GP surgeries, with the headline “Dangerous GP surgeries are named and shamed”. Chief inspector of general practice professor Steve Field claimed many family doctors were “dismayed” by poor standards among their peers, the paper reports. “There are doctors practicing we all know are not up to it,” he said.

10.45am: More details emerged of how the lead GPs of poorly performing practices have been replaced following Care Quality Commission inspections.

Steve Field, the chief inspector of general practice, told HSJ that in “at least in two practices” the GPs in charge “are no longer running the practice.”

Read Judith Welikala’s full story here

10.30am: NHS England should not “become an agency that begs for more money for business as usual”, NHS England chair Sir Malcolm Grant has said.

Several commentators have suggested the NHS would soon need more funding to pay for increasing demand and the maintenance of care quality, while efforts continue to make services more efficient.

To read the rest of Dave West’s exclusive interview with Sir Malcolm, click here.

10.15am: NHS England have today published detailed data about “never events” – serious errors in care that put patients at risk of harm and that should not happen if full preventative procedures are in place.

Provisional quarterly data on the number of never events happening at each hospital trust in England will be published for the first time, for patients, healthcare professionals, managers, stakeholders and the public to see and understand.

The data can be found on the NHS England website, and will be updated in three months’ time. The body has said that from April 2014 the data will be updated every month.

Never events include such incidents as wrong-site surgery, items like swabs and other medical equipment being accidentally left inside a patient, and strong drugs like chemotherapy being administered in the wrong way.

The provisional data shows that102 NHS trusts had at least one never event between April and September this year. Eight independent hospitals had at least one never event between April and September this year. In the same period there were 37 instances of wrong-site surgery and 70 incidents of foreign objects being mistakenly left inside patients.

10.00am: Hospital outpatient attendances totalled 75.5 million during 2012/13, an increase of 3.9 per cent on the previous year, figures from the Health and Social Care Information Centre show.

A total of 94 million appointments were made during the year (3.4 per cent up on 2011/12, 91 million).

Aside from the 75.5 million attendances, patients missed 6.9 million or 7.3 per cent of appointments (an increase of 1.1 per cent or 75,200 on last year) and cancelled 5.8 million or 6.1 per cent (an increase of 3.5 per cent or 196,400).

Meanwhile, hospitals cancelled 5.8 million or 6.1 per cent (an increase of 0.5 per cent or 26,100)

The figures are published today in Hospital Outpatient Activity 2012/13. The report also shows:

• At their first attendance, 32.0 per cent of patients (7.3 million) were discharged, 33.2 per cent (7.5 million) had a follow-up appointment booked and 33.6 per cent (7.6 million) were marked down to be sent a follow-up appointment at a later date.

• The treatment specialties with the highest number of attendances included Trauma and Orthopaedics (7.4 million or 9.8 per cent), Ophthalmology (6.6 million or 8.8 per cent) and Physiotherapy (3.7 million or 4.8 per cent).

• Overall, patients aged 65 to 69 had the highest number of attendances (6.3 million or 8.5 per cent of all attendances), a rise of 9.4 per cent on last year.

• For women, the highest number of attendances was recorded for those aged 30-34 (3.7 million or 8.4 per cent of all attendances for women) largely due to maternity-related appointments.

The full report can be viewed at:

9.45am: Women’s experiences of maternity care have improved over the last three years, but progress is needed in some critical areas, the findings of a survey published by the Care Quality Commission show.

The 2013 survey of women’s experiences of maternity care in England shows some improvements since the 2010 survey but highlights concerns around continuity of care, support during labour and birth, cleanliness and other issues.

The findings include:

  • More women than in the 2010 survey felt they were always involved in decisions about their care, both antenatally (77 percent) and during labour and birth (74 percent)
  • More women than in the 2010 survey said that most of the time they were able to move around and find a position that made them most comfortable during labour and birth (71 percent)
  • More women said they definitely had confidence and trust in the staff caring for them during labour and birth, up from 73 percent in 2010 to 78 percent
  • More women than the 2010 survey reported that they were left alone at a time that worried them during labour and birth, up from 22 percent to 25 percent
  • Almost one in five women said their concerns during labour and birth were not taken seriously (19 percent)

The survey received responses from more than 23,000 women who had a baby in February this year and it covers all aspects of maternity provision; antenatal care, care during labour and birth, and postnatal care. One hundred and thirty-seven acute NHS trusts took part.

7.00am: Two trusts in the south west have changed the way they deliver pathology services in order to make financial and quality improvements. Jennifer Nemeth explains the changes made and the improvements seen.