Monitor recommends that foundation trusts are externally reviewed every three years, along with the rest of the day’s news and comment.
5.46pm The Evening Standard reports that in London, hospitals have doubled spending on locum doctors in accident and emergency units in the last three years.
At North West London Hospitals Trust, spending rose by £2.2 m during this period. At Guy’s and St Thomas’ Foundation Trust, spending trebled to more than £1 million.
North West London NHS Trust said the the lack of experience emergency department doctors had “pushed up the rates of pay that locum agencies are able to charge” in some.
A spokesman for Guy and St Thomas’ said: “We work hard to minimise spend on agency staff, whilst ensuring we have the right staff to deliver a safe service at all times.”
5.30pm Jennifer Dixon, chief executive of the Health Foundation, writes in The Guardian, about how the NHS can live within its means in the long term.
She says: “Making savings is a tall order for any service-based organisation; let alone one based on as complex an area as healing and care.
“The chancellor may have little option than to get out his chequebook at some stage in the near future. However, the price that might be extracted from the NHS for that cheque is well worth pondering.”
4.27pm Dr Jeremy Farrar, director of the Wellcome Trust, argues in The Daily Telegraph that the EU’s new data protection regulation could cripple research into new medicines.
He writes: “Concerns about patient privacy are legitimate, and are already taken seriously in the UK: medical databases are rightly governed by strong confidentiality rules, and we can opt out.
“I believe that most of us will be comfortable sharing our medical records in these circumstances, for research that stands to benefit our own and other people’s health. But when safeguards become disproportionate, they benefit no one.
“Sharing data saves lives. Unnecessarily obstructive regulations do not.”
4.07pm Following the French Embassy’s criticism of the NHS as “ailing”, health secretary Jeremy Hunt tweeted: “We may face stiff competition from the French on cheese & wine, but there’s a reason the NHS makes us more proud to be British than any other institution.”
He also told The Daily Telegraph: “The authoritative Commonwealth Fund recently found the NHS was the top rated system by its own citizens in a survey of 11 countries - including France which came in tenth.
“Whilst we can always learn from other countries, the NHS should not be attacked for being open and transparent about the challenges it faces, not least from a country that does not publish anything like as much data in areas such as patient safety.”
3.58pm BBC News has compiled accounts of doctors working in accident and emergency units either as locums or permanent staff.
Amir Ali Thakur from Shrewsbury, told the BBC: ” I have been working as an A&E doctor for the last four years.
“I do feel the frustration when locum doctors who are less experienced get paid four times what I am without taking on as much responsibility.”
However, William Davis from Bridgnorth, Shropshire said: “Doing locum work is not “easy money”. One is not guaranteed regular work, and one is only employed when it is going to be busy.
“The sessions may seem very lucrative when paid hourly, but I would always be starting early and working well after the allotted time.
“We are under close scrutiny and would not be asked to return if we did not perform well. We are also not paid superannuation, sick leave or study leave.”
3.43pm Andy Burnham has reiterated criticisms of the government’s reorganisation of the NHS, which he described as a “monumental mistake” in light of the rise in spending on locum doctors in accident and emergency units.
He told BBC News: “The problem has really spiralled out of control in the last three years. I would argue that it goes back to that reorganisation that the government brought through.
“Just at the moment that the College of Emergency Medicine were warning that this was a looming problem, ministers were dismantling the workforce planning structures in the NHS.
“The key people in the NHS who could have done something about were being made redundant, and that explains why we have this problem now that is out of control.”
3.27pm Shadow health minister Andy Burnham and under secretary of state for health, Dan Poulter, discussed the increased spending on temporary doctors in accident and emergency units in the last three years on the Today programme this morning.
Mr Burham said the NHS is stuck in a “vicious cycle”. He claimed the government had “simply not listened” to warnings because it was “obsessed” restructuring the NHS.
3.18pm Bristol-based GP partner Zara Aziz writes in The Guardian that abolishing practice boundaries, as outlined in the latest GP contract, could threaten face-to-fact contact and local access.
She says: “The government feels that abolishing boundaries will add to patient choice and raise standards in general practice through competition.
“But there seems to be little demand for abolishing boundaries. In our practice no patient feedback has highlighted unmet need in this area.
“Certainly, it would be useful for some patients to register away from home, for instance near their place of work, and allowances should be made for that. But this should not be at the cost of the local population, especially those with serious healthcare needs.”
On it’s official website, the French Embassy wrote: “Years of under-investment forced the Blair government to allocate large sums of money to the NHS, and the current government has had to ring-fence funding for this ailing institution.
“Despite all of this, difficulties remain; the Mid-Staffordshire, Morecambe Bay and Colchester scandals illustrate just how widespread problems in the NHS are. The French system, by comparison, which is also almost entirely free of charge, came top of 191 countries in the World Health Organization’s rankings for overall healthcare (source: World Health Organization); France also provides twice as many hospital beds per citizen as the UK. Similar success exists in infrastructure, from high-speed rail to energy.”
The comments were part of a riposte to City AM journalist Allister Heath, who described France as a “failed social experiment”.
2.29pm Also in Audiology Today, Mark Greener says the NHS must act now to deal with the rising burden of age-related conditions such as hearing loss.
“Early screening for hearing loss in people aged 55 to 74 is cost-effective compared to other common interventions,” he argues.
2.10pm To kick off Audiology Today, Colin Campbell, director of professional services for Specsavers Hearing Centres, says the Health and Social Care Act has provided a unique opportunity to reimagine community hearing care services.
He argues hearing care “will soon establish itself as the fifth primary care service in the UK, delivering quality care within communities and providing huge health benefits to a large number of people.
“We might even start to wonder what took us so long.”
1.50pm HSJ has launched Audiology Today, a new channel dedicated to audiology, in association with Specsavers Hearing Services.
1.18pm National Voices, the umbrella group for patient groups and charities, has responded to the government’s final plans for migrant charging. It highlighted that because the plans were published between Christmas and new year, many organisations – including itself – were not able to respond quickly.
The group is pleased that plans to charge for GP consultations have been dropped, but are concerned that the principle of the NHS being free at the point of service risk being undermined
The charity is also concerned over the way the changes are being implemented and the lack of clear evidence of cost effectiveness and viability of the plans.
Jacqui Stevenson, Acting Chief Executive of the African Health Policy Network, a National Voices member, said: “The big question of whether the proposals are workable or valuable is still not answered. Any big policy change should be based on three things: what, why and how.
“The proposed changes to the charging regulations raise concerns on all those fronts. These changes will affect everyone accessing NHS healthcare who will be faced with new identity checks administered through a new system sharing their details held by different government departments.
“We are especially concerned at the impact on migrants who will be re-defined as not ordinarily resident, despite living long term in the UK. The case for change on this scale has not been made, and we are concerned at the impact in terms of access, service flow and cost as well as on patients.”
Laura Robinson, policy advisor at National Voices, said:“Although we welcome the decision not to charge for GP consultations, we still have serious concerns about the Government’s intention to charge for A&E care.
“This could result in serious issues in terms of access and potential delays in treatment for the general public and especially for vulnerable people.
“The changes will also create a complex picture of access and charging entitlements and there is still little clarity about how these will be enforced in practice.”
12.52pm In HSJ’s Hospital Transformation microsite, Richard Vize writes that transforming hospital care is the only hope for securing a high-quality, sustainable NHS in a time of austerity.
“The overwhelming priority for 2014 is to reform care to avoid financial crisis, without undermining quality,” he argues.
“Improvements are edging forward everywhere and transformational plans are emerging. But an outmoded funding regime, a lack of strategic leadership and threadbare political support for tough choices mean change is not happening at the speed and scale to match growing demand and financial risk.
“If these flaws are not urgently addressed, 2014 will be a year of unrealised ambitions and missed opportunities.”
12.35pm Mark Davies has been appointed at improvement director at Colchester Hospital University Foundation Trust.
He will check progress at the trust, which was put on special measures by Monitor in November following allegations staff were pressured into changing cancer waiting times date. He will report directly to Monitor.
Mr Davies was previously the chief executive at seven NHS trusts, most recently at Imperial College Healthcare.
Adam Cayley, regional director at Monitor said: “Mark Davies brings extensive NHS experience to this role, in particular a track record of successfully leading some of the most challenged organisations in England.”
During a Commons debate on the Care Bill, the Conservative MP Anne-Marie Morris suggested splitting the commissioning and provision of social care services, in the same way that the functions are split in the NHS.
In response, Mr Lamb said: “In many respects I think that [Ms Morris’ suggestion of separating provision and commissioning] is a good thing, because the commissioner can then, without fear or favour, hold those providers to account to ensure a high standard of provision.”
He said that in most areas about 80 per cent of care was already run by outside providers, so direct local authority provision of adult care services was “becoming a minority pursuit”.
The CQC has today released the third tranche of its first wave of new-style inspection reports, covering four trusts, which were all visited by inspectors in November.
11.56am In the House of Commons, MPs are now debating the 60 per cent rise in how much hospitals are paying for temporary doctors to work at accident and emergency units in England in the last three years, as hospitals struggle to find permanent staff. Watch the debate live.
11.51am Also in The Daily Telegraph, Paul Burstow, the Liberal Democrat former care minister, and a cross-party group of MPs have tabled an amendment to the Government’s Care Bill to put into law a minimum level of frailty below which people should qualify for care.
11.48am More from The Daily Telegraph, elderly people should have a legal right to care in their homes if they struggle with basic tasks like cleaning or cooking, such as cleaning or cooking, according to plans being put forward by a former minister.
11.41am Back to today’s papers, in The Daily Telegraph: the NHS could reduce its clinical negligence bill by apologising to patients and mounting a “vigorous defence” against bogus claims, according to Jeremy Hunt.
Yesterday the health secretary cited the approach taken by the health service run by the University of Michigan in America, which has seen the number of claims halve in a decade, as an “interesting example of how being open and saying sorry could slash [the] litigation bill”.
The regulatory body has noted that “problems with the way trusts are led are on the increase”. Since 2008, one in four foundation trusts have been subject to regulatory action as result of governance failings.
Its evidence suggests governance problems, should they arise, tend to be several years after a trust has achieved foundation trust status.
Monitor’s new guidance, released today for consultation, proposes:
- Board reviews be to be conducted every three years
- Reviews “should be robust, in-depth and tailored to cover the specific circumstances of a board”
- Reviews should be carried out by independent reviewers should “to ensure objectivity and provide maximum assurance”
Toby Lambert, Director Strategy and Policy at Monitor, said: “Good governance enables trusts to meet the challenges they face, while providing patients with the high quality care they deserve.
“We believe regular effective governance reviews are a vital tool in showing that a trust is well-led, and whether any of their practices or capabilities need to improve.
“Our guidance will help trust boards successfully conduct these reviews, so that they can gain the maximum benefit from the process and support the provision of sustainable high quality services for patients.”
11.11am The Guardian also reports on the inquest into Sean Turner’s death. At the inquest, his mother said that he was forced to suck liquid from moisturised tissues because he was desperate for water. S
She also claimed that one of the doctors stopped her and her husband from seeking further advice from a retired Great Ormond Street Surgeon because “he would never go to London for a second opinion”.
10.58am The BBC reports on the inquest into the death of four year old Sean Turner, following heart surgery last year at Bristol Children’s Hospital.
His parents have blamed staff shortages and lack of training for his death. His mother Yolande told the inquest her she begged doctors and nurses to help her son.
The inquest continues.
10.45am Also in The Times, tens of thousands of potential blood donors are being turned away for non-medical reasons such as staff shortages and growing delays. One in every 80 people who tries to donate blood is sent home as a result of inefficiencies, which represents a 40 per cent increase compared with two years ago.
Jon Latham, assistant director at NHS Blood and Transplant, told the paper that people would always face the frustration of being sent home without donating blood, when donors walk through the door “on the spur of the moment”.
10.41am In this morning’s papers, The Times reports that Dr Paula Vasco-Knight, CBE, NHS England’s national lead on equality and diversity and a trust chief executive, has been accused of nepotism after employing her daughter’s boyfriend.
Dr Vasco-Knight, was criticised after giving the equality and diversity manager job at South Devon NHS Foudnation Trust to Nick Schenk, a family friend, an employment tribunal has heard.
Penny Gates, director of education and development at the trust and her deputy, Clare Sadari, are claiming constructive dismissal. They have said that they were removed from their posts after making a formal complaint about Mr Schenk’s appointment.
Miss Sadari told the tribunal she suspected that Mr Schenk had been coached for his job interview. “He did give a good interview…His performance was so good that it did cross my mind that it was as if he had advance knowledge of the questions,” she said.
Miss Sadari and Ms Gates were told they could not remain in their jobs after making a formal complaint due to a “breakdown in trust”.
Laywers for the trust are reported to have said that Dr Vasco-Knight had not met Mr Schenk before the job interview and her daughter was not at that time going out with him.
10.23am Almost a third of a million people in the UK are diagnosed with cancer every year, figures show.
In 2011, more than 330,000 people were diagnosed with some form of the disease, Cancer Research UK said.
10.12am Integrated care and pooling budgets really are the only paths forward at this critical time for the NHS and social care, argues Sandie Keene, president at the Association of Directors of Adult Social Services.
“Wholesale transfers of budgets would mean investing in one half of a joint system that has so far failed to keep up with burgeoning demographic and economic realities,” she says.
“Despite the squeals of pain from people unaccustomed to this sort of change, throwing money at the solution − integration − will prove far more successful in the long run.”
10.03am In response to figures out today showing a sharp rise in spending on temporary doctors on accident and emergency units, Dr Mark Porter, chair of BMA Council, said:
“Doctors in the NHS face increasingly challenging, high pressured and stressful work environments, often with limited resources and gruelling workloads across both weekdays and weekends. In some specialties, such as emergency medicine, this has contributed to a recruitment crisis and means that because existing doctors are working flat out to meet rising demand an increasing number of locums are being used.
“Whilst locums have always been an integral part of the NHS workforce when there are periods of high demand or staff absences, they should not be used as a long term solution to gaps in the NHS workforce. As these figures suggest, they can be more expensive to employ than permanent staff, resulting in additional costs for an NHS that is already struggling with declining budgets.
“To stem this problem the government urgently needs to address issues around workload pressures, resourcing and work-life balance. Only by making working practices and environments safe and sustainable will the NHS be able attract and retain the required number and mix of doctors.”
Data obtained by the Labour party shows that spending on locums was £83.3m last year, a rise from £52m in 2009-10, the BBC said.
7.00am Good morning and welcome to HSJ Live. We start the day with a piece from Georgina Craig, director at Experience Led Care, on how the NHS can unlock the potential of outcomes based commissioning.