4.47pm In another exclsuive, HSJ’s technology reporter James Illman has revealed details of the ongoing row between Capita and NHS England over the future of the NHS Choices website.
4.44pm HSJ finance reporter Crispin Dowler’s report into plans for an overhaul of the payment system is now live. Monitor and NHS England want to encourage more local experimentation with price setting but plan to set rules to prevent a negative impact on safety or quality of services.
4.41pm In other NHS 111 news, a report by the NHS Alliance has blamed a badly run procurement process and pressure from the DH for the failures surrounding the launch of the service. HSJ’s Sarah Calkin reports here.
4.22pm Leicestershire’s clinical commissioning groups have announced a further delay to the launch of NHS 111 in their area to ensure the service is “fully fit for purpose”, HSJ’s Shaun Lintern reports.
15.29pm Mr Burnham says if he had been in government he would have bought forward a bill to repeal the Health and Social Care Act, including restoring the health secretary’s powers over the NHS, and legislate for the full integration of health and social care.
3.25pm Burnham criticises Mr Hunt for dropping plans to introduce plain cigarette packaging in the Care Bill. He highlights former Conservative health secretary Andrew Lansley’s support for the measure and claims the change is due to the new Downing Street advisor Lynton Crosby. Mr Hunt says he has never discussed the issue with Mr Crosby.
3.21pm Mr Burnham is questioning the health secretary about another HSJ exclusive from last week - the plans to announce a £300-£400m fund to deal with problems in A&E.
3.12pm Mr Hunt claims real-time spending on the NHS has gone up since Labour were in power. A Labour MP highlights the UK statistics authority last December that the claim did not stand up.
3.11pm Mr Burnham claims the £72,000 cap on social care costs will feel like a mirage as costs of care will increase. He claims the crisis in social care is the main driver for recent poor A&E performance.
3.07pm Accusations now flying from both sides about the parties’ proposals on NHS spending.
3.03pm Mr Burnham says Labout will in all likelihood support the bill: “Our objection is not to the modest measures the government is proposing… but what is not in the Queen’s speech.” He accusses the government of trying to suggest pressure on the system is due to immigration.
2.58pm Hunt concludes his speech. He says the government has made more progress in improving care for older people in three years than the previous Labour government in 13 years.
2.53pm Mr Hunt announces the development of a plan for vulnerable older people by the autumn ready for implementation by April 2014. More integration will be key, Mr Hunt says. The plan will look at the barriers to integrated commissioning.
2.50pm Labour shadow health secretary Andy Burnham claims there is a “gap” between the health secretary’s rhetoric and relaity. Mr Burnham highlights the “beacon of integration” Torbay Care Trust which is concerned it may have to put its services out to tender. This was revealed exclusively by HSJ last week.
2.48pm Hunt says it is “shocking” that out of hours GPs, ambulance staff and accident and emergency departments do not have access to patient records.
2.44pm Question on NHS 111 from Conservative MP. Hunt says it highlights problems with out of hours care which must be addresed.
2.43pm Asked whether he is disappointed about the number of trusts that have missed the four hour target this year, Mr Hunt highlights the worse failures in Labour-run Wales.
2.42pm Hunt highlights successes of NHS in recent years and sets out some of the challenges for the future in an aging population with more co-morbidities.
2.38pm Health secretary Jeremy Hunt gets up to make his speech in the House of Commons.
1.53pm Clinical psychologist Reg Morris argues for the importance of considering the emtional and psychological impact of stroke alongside the physical symptoms in an article published on hsj.co.uk today.
1.51pm HSJ’s @sjcalkin tweets: More than 100 nominations in for HSJ’s Inspirational Women in Healthcare. with just two days to go. Nominate here:
1.23pm The director general for social care Jon Rouse has warned NHS cash transferred to local authorities to fund social care is being diverted to other services. In an interview with HSJ’s sister title Local Government Chronicle, available on hsj.co.uk here, Mr Rouse said it called into question whether it could “continue to be acceptable for [the DH] to put money through the NHS into social care”.
12.40pm HSJ has seen a note of what health secretary Jeremy Hunt is expected to say in the House of Commons this afternoon. Describing the Care Bill, published last Friday, as “historic” Mr Hunt will say that nevertheless many of the changes proposed by the Francis report can be introduced without legislation. Mr Hunt will announce the development of a plan for the care of vulnerable older people which is likely to focus on improving integration between health and social care.
11.29am HSJ’s @BenClover comments on Twitter:
“In the light of the PBR news intriguing that the new system intends to be less open about the purchase/provider stuff than the old system. By which I mean, SHAs wd say if providers/commissioners were in arbitration, the confused new system believe that’s not appropriate. Which indicates the weakness of the hold the PbR system has in some places, it needs to be sorted out in secret. Pretty arcane rant, I know.”
10.57am In the longer interview which ran in the Independent on Sunday Mr Hunt reveals he has “answered the phone to patients at a GP’s surgery in Kennington, made the beds on a busy A&E ward and joined the porters as they move patients around hospitals” in order to understand how the NHS works on the frontline.
The article, by the paper’s political correspondent Oliver Wright, states: “At the heart of Hunt’s diagnosis – from his visits and meetings – is that the NHS has lost track of what it should be doing. GPs have been incentivised to fulfil tick-box exercises proving they have assessed their patients for certain conditions – rather than looking at their care in the round. Hospitals have been paid “by results” for operations rather than thinking what happens when the elderly lady who has had a hip operation leaves the ward. And most importantly there is no obvious connection between the NHS, which is responsible for health, and local councils, which are responsible for social care.”
10.46am This morning’s Independent carries a story based on an interview with health secretary Jeremy Hunt which ran over the weekend in which he reveals the plans to reform the payment system as part of a package of measures to improve care for the elderly. Mr Hunt tells the paper elderly patients will have a single named individual to manage all of their care while a “shake-up” of out of hours care will see GPs take on more responsibility and access to detailed patient notes for all doctors “out of hours”.
The paper said Mr Hunt was due to announce a review of all aspects of later-life care today.
10.33am Staff at a “superhospital” have complained that they are suffering from sore feet because it is too big, the Daily Telegraph reports. The Queen Elizabeth in Birmingham is 135,703 square metres An anonymous post on NHS Choices website said: “The size [of the hospital] is ridiculous; much too big to be efficient.”
10.29am NHS England and Monitor have announced plans to reform the payment by results system by 2015-16. The organisations were given joint responsibility for the design and oversight of the payment system following the Health Act. They have published a discussion paper and are seeking views on how the system could be reformed as well as calling for evidence on the system of payments for emergency admissions. Currently trusts are only paid 30 per cent of the costs for emergency admissions above 2008-09 levels.
NHS England’s chief financial officer Paul Baumann said: “We are keen to use this opportunity to develop and design a new payment system that does more for patients. We are asking people to contribute by answering the four questions set out in the document.
“Changes to this system will not happen overnight, and it is important we get this right. As part of this engagement we are gathering evidence to support short and longer term improvements to the payment system.”
10.24am Jeremy Hunt will today tell the House of Commons “The fundamental problem with A&E is that the NHS is not geared up to preventing people having to come to A&E in the first place”, The Times reports.
The paper said the Department of Health was considering plans to get “GPs to manage older people’s health much more actively, rather than wait for them to become ill, and giving them a single point of contact to oversee their rehabilitation as they are treated by different NHS bodies”.
But it admitted: “The details of the plans have yet to be worked out and are likely to [be] (sic) greeted with scepticism by some health experts.”
10.21am The front page of the Daily Mail today reports out-of-hours provider Harmoni is using senior nurses to cover counties with populations of 250,000 people when they can’t recruit GPs. Advanced nurse practitioners are working eight hour shifts covering districts as large as 150 square miles, the paper says. The company admitted using ANPs “on very rare occasions” adding: “There are some occasions when filling all the planned GP rota slots is a challenge.” A whistleblowing GP from Somerset has claimed during busy times there has been just one nurse covering the whole of North Somerset. The GP also claims locum doctors have been flying into the UK on EasyJet to work back to back shifts without sleep.
They also allege terminal cancer patients have been made to wait eight hours for a doctor to visit them at home and staff have been altering waiting times. The whistleblower told the paper working for Harmoni was like: “taking a loaded gun and sitting with it because at some point it’s going to become so unsafe it’s going to go off.
10.18am Today’s Times carries a short story on page four headlined “brain disease increase”.It reports research from Bournemouth University and theUniversity of Southampton that found “neurological diseases are more prevalent in Britain than ever and are affecting sufferers earlier”. It said the rise of conditions including dementia and motor neurone disease could not be attributed to greater longevity as more young people were being affected. The research was published in Public Health journal.
10.09am The Observer reported that the number of ambulances waiting outside accident and emergency departments for more than half an hour has gone up 58 per cent “under the coalition”. The paper said “nearly 99,000 ambulances were delayed for 30 minutes last year – 37,000 more than in 2010-11”. North Middlesex Univeristy Hospital Trust and Lewisham Healthcare Trust were among the trusts with the biggest increase.
9.58am The BBC was among many media outlets to report on warnings from the Safe Staffing Alliance about low nurse staffing levels. The alliance, which includes the Royal College of Nursing and Unison as well as some hospital nursing directors, claims nurses on many wards are the only registered member of staff responsible for eight or more patients. The alliance says more than eight patients per nurse is unsafe.
The BBC quoted Salford Royal Foundation Trust director of nursing, Elaine Inglesby-Burke, who is also a member of the government’s patient safety advisory group led by international patient safety expert Don Berwick. She said heavy workloads meant that at times “it comes across that nurses have lost their compassion and their care, when in actual fact they’re too stressed and too laboured to be able to deliver compassionate care”.
9.52am Health secretary Jeremy Hunt has agreed to look in “more detail” at the findings of what the Mail on Sunday claims to be the “first authoritative study on what can happen when an A&E shuts”. The paper analysed the percentage of deaths among patients from Newark admitted as an emergency before and after the town’s accident and emergency department closed in 2011. It concluded the death rate increased from 3.5 per cent to 4.9 per cent.
It said: “Of 5,441 Newark patients admitted for emergency treatment last year, 264 died – 4.85 per cent. Yet in 2009, when there were 5,431 emergency cases, just 192 patients died – 3.53 per cent. That was the year before NHS chiefs decided to close Newark A&E, promising ‘more lives being saved’. If the percentage rate had stayed the same after the closure, that would have meant 72 fewer deaths last year – in just one area, and in just one year.”
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