HSJ Live 14.10.14: Wye Valley put in special measures

4.15pm In Michael White’s latest column he argues that Jeremy Hunt was right to focus on the threat of ebola instead of the four hour strike when he addressed Parliament yesterday.

3.10pm In our Comment section two economists and a lawyer give a step-by-step approach to how to navigate a competition review to get trust merger approval.

2.40pm NHS Confederation chief executive Rob Webster has called for patient complaints to be treated as learning opportunities.

He said: “It is vital that patients, their families and carers feel safe and able to feed back on their NHS care and treatment.

“While both positive and negative feedback should be equally valued and encouraged, it is essential that we make every effort to learn from when things go wrong, and that NHS organisations deal with patients’ concerns promptly, effectively and appropriately.

“There is a ‘golden thread’ to handling complaints well - apologising, explaining what happened, and describing why it won’t happen again. Healthcare is personal, and hearing “sorry” from someone who means it can be a major part of finding a successful resolution for patients and their families.

“In the 2015 Challenge Manifesto, we lead a call for an open culture to be delivered in the NHS and in the care system, one that encourages complaints as learning opportunities.
“The NHS performs hundreds of millions of procedures each year, and only a small number of these give cause for a complaint. We need to ensure every one is addressed. We also need to  keep in mind that the volume of complaints does not necessarily indicate an organisation’s quality. A high number of complaints can reflect an organisation’s willingness to listen to negative feedback, and to learn how to make things better.”

2.00pm Council investigations into alleged abuse of adults with care and support needs were most often about incidents reported to have happened in the victim’s own home, statistics released today by the Health and Social Care Information Centre show.

Among investigations that concluded in 2013-14, 42 per cent of allegations were about incidents reported to have occurred in the victim’s own home. The next most common location for alleged abuse was care homes (36 per cent).

The report shows:

• Councils opened investigations for 104,050 individuals with care and support needs in 2013-14. Of these individuals 60 per cent were women, 63 per cent were aged  65 or over and 51 per cent had a physical disability, frailty or sensory impairment
• 49 per cent of allegations were about perpetrators who were known to the victim but not in a social care capacity, 36 per cent were about social care and support employees and the remaining 15 per cent were about someone unknown to the victim.
• The most common type of abuse reported was neglect and acts of omission (30 per cent), followed by physical abuse (27 per cent), financial abuse (18 per cent) and psychological/emotional abuse (15 per cent).

HSCIC chair Kingsley Manning, said: “This report sheds light on the extent and type of abuse reported to have been perpetrated on some of our most vulnerable citizens.

“Councils and policy makers are encouraged to use it in their work to protect adults who have care and support needs.”

1.50pm In the latest HSJ editor column the CQC is given its own rating.

Alastair McLellan argues that the inspection process is getting better but it continues to struggle with consistency, determination to improve the process and unwillingness to join the siren calls for ‘heads to roll’.

1.45pm The Care Quality Commission has proposed to increase its fees for register providers for 2015-16.

It claims that because the new inspection approach is larger, more specialist and includes expert inspection teams led by chief inspectors, it requires more funding.

Its budget is a combination of grant-in-aid from the government and from fees paid by providers. To meet government policy of recovering all chargeable costs from fees, it says it must increase the proportion of cost recovery from fees and reduce the amount of funding from the taxpayer.

The consultation on the fees increase includes:

• Increase annual fees for all registered providers except for the dental sector.
• Amend the fee scheme for independent healthcare providers whose fees increased due only to structural changes made in the 2013-14 fees scheme

With these increases included, health and care providers will still typically pay 1 per cent or less of their income in fees to CQC, the regulator says.

The impact of the proposed fee increase on a typical NHS GP, care home and NHS trust would be:

• NHS GP - £69 
• Care home - £238
• NHS trust - £6458

Paul Husselbee, clinical chief officer of Southend CCG, and Sunil Gupta, clinical accountable officer of Castle Point and Rochford CCG, both stepped down from their positions this month.

A statement issued by Southend CCG said Dr Husselbee “found it increasingly hard to balance his responsibilities at the CCG with the needs of his own patients”.

The care regulator recommended the Herefordshire trust be put in special measures following an inspection in June, the report of which was published today.

The NHS Trust Development Authority confirmed this morning that it had accepted the recommendation.

Wye Valley’s County Hospital was rated “inadequate” and its community services as “requires improvement” by the CQC.

12.30pm In an interview with The Times, Jeremy Hunt has said that ebola is a “global health emergency” that could “get to the scale of the Aids epidemic”.

Mr Hunt has also told the paper that this winter will be more difficult than previous years, but that it is important to “bust the myth that the NHS has failed”.

He refused to blame previous health secretary Andrew Lansley for the current financial difficulties the NHS faces, despite reports yesterday that senior Tories regret the reforms. He said: “Andrew’s structural changes are now saving the NHS more than £1bn. Because of that we can employ 7,000 more doctors and 3,500 more nurses.”

He added that “we are not moving to a world of fewer hospitals, but the type of caring will change. We need to see a big drop in emergency admissions by looking after people more effectively in their homes.”

12.20pm Senior managers’ pay rise has risen by almost three times as much as nurses’ salaries since the last general election, The Times reports.

Nurses and midwives’ salaries have increased by a total of 5.05 per cent since May 2010, while the average cumulative rise for chief executives and other top administrators has been 13.8 per cent.

Consultants have had pay rises of 2.05 per cent and registrars 2.12 per cent while more junior managers’ wages have increased by 10.23 per cent, according to an analysis of data from the Health and Social Care Information Centre.

12.15pmThe Times reports that care on some NHS wards is as bad as it was at the height of the Mid Staffordshire scandal, the chief inspector of hospitals says today.

Professor Sir Mike Richards says that his inspectors have seen patients languishing in soiled sheets without food or water on grimy wards where staff fail to wash their hands.

He tells bosses that there is no excuse for such failures when care in nearby hospitals is excellent, insisting that NHS quality must be as consistent as “Sainsbury’s, Tesco or M&S”.

12.10pm In our Comment section waiting times expert Rob Findlay argues that the new mental health waiting times targets, while welcome, could end up making some patients wait longer for treatment.

The party hopes an elected health commissioner would “usher in a new era of openness and transparency”.

The health commissioner would replace local health boards, and would be directly accountable to the public.

The London Health Commission will also call for a five year investment plan to invest £1bn in the capital’s GP practices, a large number of which require rebuilding or refurbishment,HSJ understands.

Lord Darzi is expected to recommend that the health commissioner be appointed by mayor Boris Johnson, to whom the postholder will directly report.

Anthony Madu is on trial at Cardiff Crown Court. He denies six counts of fraud.

The 45-year-old specialist registrar was suspended two months into his post with Cardiff and Vale University Health Board before going on sick leave.

However, a jury heard Madu went on to do lucrative locum work with three NHS trusts in England while still earning more than £29,000 from his employers in Wales.

CCGs in Hampshire are on track to spend up to £10m more than expected on the claims, according to Andrew Wood, chief finance officer at Fareham and Gosport CCG.

He said commissioners across the county were facing a “perfect storm” of an ageing population with complex health needs and increasingly expensive care packages.

10.50amThe Guardian reports that passengers will have their temperatures taken in a check for suspected Ebola at Heathrow Terminal 1 from today, but it will be impossible to check all the 1,000 people a month arriving from the worst-affected countries, Jeremy Hunt has admitted.

Hunt said it was likely that Ebola would be diagnosed in the UK by the end of the year but the best estimates suggested there would probably be fewer than 10 cases over the next three months.

10.45am A poll published in the Guardian finds that the NHS has emerged as the most important issue to voters, potentially boosting the chances of the Labour party, which is making the health service one of its main campaign themes ahead of next year’s general election.

10.40am The Guardian reports that hospital clinics had to be postponed, antenatal classes were cancelled and operating theatres were left empty yesterday as thousands of NHS staff staged their first strike in 32 years over pay.

Patients with broken bones and breathing difficulties were told to visit their GP or make their own way to hospital as ambulance services struggled to cope because many paramedics had joined the four-hour stoppage between 7am and 11am.

Unions representing more than 400,000 NHS staff in England have warned of further industrial action next month, potentially involving an all-day walkout, unless the government rethinks its decision to deny the workforce a 1 per cent pay rise the NHS pay review body recommended.

10.05am The Telegraph reports that industrial action by midwives and nurses was “irresponsible” and would have been illegal under a Conservative government because of the low turnout, Francis Maude has said.

The Cabinet Office Minister said that such strikes based on “weak and outdated mandates” added to the pressure to ban walk-outs unless unions could persuade 50 per cent of all their members to vote for strike action.

9.58am The Financial Times reports that Danny Alexander wants to use the Autumn Statement to inject emergency funding into the NHS to avoid a winter crisis just months before the next election.

The Liberal Democrat Treasury chief secretary, who is charged with controlling public spending, spoke this month of the need to address “short-term pressures” in the health service, as the issue rises quickly up the political agenda.

One Treasury official said Mr Alexander wanted George Osborne to release “several hundred million pounds” for the NHS in what is otherwise expected to be a fiscally tight Autumn Statement in December.

9.55am The Care Quality Commission has recommended Wye Valley Trust is placed in special measures after a inspection resulted in it receiving an overall rating of ‘Inadequate’.

Story to follow. 

7.00am Good morning and welcome to HSJ Live. As the NHS moves towards greater use of outcome based commissioning models, Axel Heitmueller and colleagues reflect on what we can learn from other public services that have already tackled many of the challenges the service is likely to face in the future.