Leaders of six clinical commissioning groups have written to NHS England criticising “apparent confusion and lack of clarity” in its proposals for primary care co-commissioning, plus the rest of today’s news and comment.

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5.25pm The Royal College of Psychiatrists has commented on Theresa May’s announcement thatthe use of police cells as ‘places of safety’ for children will be banned.

Professor Sir Simon Wessely, president of the Royal College of Psychiatrists said: “Banning the use of police cells as ‘places of safety’ for children experiencing a mental health crisis was a key ‘ask’ in the College’s manifesto ‘Making Parity a Reality’. We therefore welcome the Government’s decision, but call for adequate provision of health based places of safety to be in place before this ban is implemented. 

“While current guidance states that police cells must only be used in exceptional circumstances, children experiencing a mental health crisis are currently being held in police cells as a matter of routine. In 2012-13 45 per cnt of all children and young people detained under Section 136 of the Mental Health Act- 263 children in total- were detained in police cells. 
“The government’s announcement sends a clear message that this is not acceptable.
“However, given that children and young people detained under Section 136 often present with complex social, medical and mental health needs, it is essential that resources are immediately put in place to ensure health based places of safety are available to meet this breadth of need.
“Crisis care services for children and young people are currently poorly developed in comparison to adults and a recent study found that only 40% of child and adolescent mental health services have crisis care pathways in place.
“In the absence of available health based places of safety for children, there is a real danger that the threshold for accessing these services will increase, leaving children experiencing a mental health crisis and in urgent need of support unable to access appropriate care.
“We therefore call on government to prioritise investment in crisis care services for children and young people and for NHS England, Clinical Commissioning Groups and Social Services to ensure that adequate emergency care pathways are in place as a matter of urgency.”

4.45pm The British Society of Rheumatology has responded to our story on Great Western Hospitals Foundation Trust turning away rheumatology patients.

A spokesman said: “The fact that the Great Western Hospitals Foundation Trust has felt that it could no longer cope with the pressures on its rheumatology services and has had to turn away new routine patients is something that the British Society for Rheumatology has been concerned could happen. This needs to be addressed urgently.”

Professor Simon Bowman, president of BSR noted: “Rheumatology services already work in a very integrated way, although there is always more that can be achieved with delegating aspects of care, most of the gains from new ways of working have already been made. Patients from across the spectrum of disease acuity will always need some form of consultation with a specialist and these are below recommended numbers nationally whilst activity is increasing”.

4.35pm The Department of Health has announced that £12m will be invested in helping people with mental health conditions return to work.

Nearly half (46 per cent) of people claiming employment and support allowance have mental health conditions while mental ill-health is estimated to cost taxpayers and businesses £105bn a year in health and police services, welfare benefits and sickness absence, the department says.

Four pilot areas will use the funding to test whether better coordination of mental health and employment services could help people find and stay in employment as well as improve their mental health.

Each of the pilots will test a number of different approaches, including:

  • key workers and individual support packages to help claimants create bespoke action plans and coordinate existing local support services
  • support for new employees to make sure they can stay in work and cope with anxiety and other ongoing problems
  • training employment advisers to identify mental health problems and for GPs to recognise the importance of work in improving mental health

Deputy prime minister Nick Clegg said: “It is shocking to think that mental health is now the leading cause of illness in the workplace. It’s even more shocking that many of the people suffering are simply not getting the support they need.

“That’s why I’m working hard in government to bring mental health out of the shadows. I’m heading up a dedicated mental health taskforce and pushing for investment in pilots like this to help create a fairer society where people get the right support and treatment they need, when they need it.”

4.05pm A gynaecologist who defrauded NHS Wales of over £47,000 by working while sick was today sentenced at Newport Crown Court, following an investigation by the NHS Counter Fraud Service (Wales).

Dr Anthony Madu, 45, of The Oaks, Woolwich, London, was found guilty of six counts of Failing to Disclose Information, contrary to Section 3 of the Fraud Act 2006. He was sentenced to two years’ imprisonment - suspended for two years - and was ordered to complete 150 hours’ community service. Dr Madu is subject to a three month curfew between the hours of 8.00 pm and 7.00 am, to reside at his home address in Woolwich, London and will be electronically tagged.

Madu worked in a number of hospitals while on paid sick leave from Cardiff and Vale University Health Board, which employed him between August 2009 and June 2010. By October 2009 he had been suspended due to concerns over his professional conduct and integrity. In March 2010, Dr Madu informed the Health Board that he was receiving counselling and medical help, and was not able to work, supplying a medical certificate covering 23rd January - 2nd June 2010.

The Health Board terminated Madu’s employment on 10th June 2010. A tip-off was later received that Dr Madu had been working as a locum at Scarborough District Hospital, Yorkshire while on sick leave. Investigators established that Dr Madu had also worked at Sandwell General Hospital, West Midlands and The Royal Oldham Hospital, Greater Manchester, throughout this sick period. He was arrested in November 2011.

Dr Madu earned an extra £69,000 at these other hospitals in addition to his Cardiff & Vale University Health Board salary. This secondary employment was never declared to his employer, as was legally required.

Cheryl Hill, Counter Fraud Specialist, NHS Counter Fraud Service (Wales) said today: “Anthony Madu deceived his employers and was paid thousands of pounds that he should not have been. Being a gynaecologist, he abused a position of particular trust and responsibility. We always press for the prosecution of offenders and seek the strongest possible sanctions, so public money is not diverted from patient care”.

3.10pm South London and Maudsley Foundation Trust has appointed a new chair.

Roger Paffard will take up the role in January 2015.

Julie Hollyman and June Mulroy have also been appointed as new non-executive directors on the trust board.

Roger Paffard has worked in the private sector as a managing director and chief executive before moving into the public and charity sector.

He has held non-executive roles in three major national charities and is currently chair of Sue Ryder. He is also vice chair of Newark and Sherwood Clinical Commissioning Group.

Julie Hollyman is currently chair of the Hyde Group housing association. A psychiatrist by profession, her career in the NHS includes leading West London Mental Health Trust as chief executive. 

June Mulroy has been appointed as non-executive director and will act as chair of SLaM’s audit committee. A chartered accountant she has worked in several financial services roles and in the NHS as finance director.

Commenting on his appointment Roger Paffard said: “I feel honoured to take on the role of chair at SLaM - a unique organisation that is not only steeped in history, but one that is forward thinking and progressive. SLaM tackles stigma and drives pioneering care and treatment, research and training in mental health, as a trust and as part of King’s Health Partners Academic Health Sciences Centre.”

2.55pm A report from the Centre for Health Service Economics and Organisation has found that emergency admissions for older people are unlikely to decrease, though they may remain “fairly flat”.

This supports the findings of the HSJ Commission on Hospital Care for Frail Older People, which concluded the commonly made assertion that better community and social care will lead to less need for acute hospital beds is “probably wrong”.

The report adds: “This suggests that the current policy to reduce emergency admissions by 15 per cent over this period could well face considerable challenges … it seems entirely possible that the uptake of new technology will, unless put on hold for some years, exert continuing upward pressure on cost per day bed of emergency inpatient care such that the cost of a spell will continue to rise. This suggests that, if the numbers of admissions continue to rise, even slightly, total expenditure would also need to continue to rise in real terms.”

“Unless robust new measures can be introduced that prove highly cost-effective in constraining the rise in emergency admissions of older people, the number of such admissions is likely to continue to rise or at best remain constant”, the report adds.

2.45pm The Times reports that charities have claimed “crude” reassessments of funding for 42 cancer treatments could cost patients’ lives.

The medicines could be removed from the Cancer Drugs Fund, after it introduced price restrictions for the first time.

Eric Low, chief executive of Myelmo UK, said it was a “crude assessment of drugs which could mean some important drugs come off the fund at a time where there are no alternatives”.

2.00pm The leaders of six clinical commissioning groups have written to NHS England criticising “apparent confusion and lack of clarity” in its proposals for primary care co-commissioning, HSJ can reveal.

The letter from six of the seven CCGs in Sussex says the situation means none of them will apply to share responsibility for primary care from April next year, as NHS England has encouraged.

The groups say they are “unable to recommend to the members of our organisations any change to the current commissioning model”.

The trust has also submitted a revised deficit plan to the regulator after it exceeded its forecast deficit at the end of October.

It reported a £10.6m deficit at the end of October, according to board papers. It had forecast a year end deficit of £6.5m and its “run rate continues to move adversely”, the papers state. It has submitted a revised year end deficit plan of £14.2m to Monitor.

12.35pm The Patients Association has announced that Esther Rantzen, who founded the child protection charity ChildLine in 1986 and the Silver Line charity designed to combat loneliness in 2012, has joined the Patients Association as a vice president.

She will assume her position straight away.

Katherine Murphy, Patients Association chief executive said: “The Patients Association continue to speak out and campaign for a safe, dignified, compassionate and caring NHS. We are the only organisation that has been consistent in our arguments that the NHS and social care sector needs to treat patients honestly and with respect. We ask all those who work within the service to never lose sight of the desperate need to reform the system and aspire for a truly patient–centred NHS and care system. The Patients Association are honoured that Esther Rantzen, CBE, has accepted the role.”

Esther Rantzen said: “I have admired the work of the Patients Association for a very long time, their campaigning and tireless work on patient safety and honesty. They bring the voice of patients to the forefront and speak out on their behalf so often. I am passionate about giving people control and choice – we must look after our most vulnerable. It is inevitable that we will all get old, but we must treat and respect people in their time of need. I have the utmost admiration for the work that the Patients Association does on behalf of the public on a daily basis.”

Tony Halsall, who was chief executive at the North West trust between 2007 and 2012, will appear at the independent inquiry being chaired in private by Bill Kirkup to answer questions about his role at the trust and events surrounding failures in the maternity unity at Furness General Hospital.

Mr Halsall stepped down from the trust in 2012 following the launch of a police investigation into deaths at the trust. He continued to receive his salary until October 2013 as well as a lease car entitlement and career management advice to the value of £5,000 plus VAT.

11.55am The government will pledge to end the scandal of holding mentally ill teenagers in police cells, The Times reports.

On Thursday the home secretary Theresa May will publish a review of the Mental Health Act, under which police can section someone in mental distress and take them to a hospital or police station.

The move follows a complaint by Devon & Cornwall police on Twitter last month that they were forced to hold a 16 year old girl with mental health problems in a cell for two days because there was no hospital bed.

11.35am The Times reports that elderly people are becoming healthier, according to research suggesting an ageing population is putting less pressure on accident and emergency departments than commonly thought.

Researchers at the University of Oxford found that people born in each year from 1912 were increasingly less likely  to need emergency treatment, and spent less time in hospital once they were admitted.

Experts said the changes were because of reductions in smoking and healthier diets, as well as vaccination programmes earlier in life and preventive drugs such as statins.

10.30am The Daily Telegraph reports that hospitals and fire services will be run “outside of the public sector” as the Conservatives dramatically shrink the state and cut costs, a senior minister has disclosed.

Francis Maude, the Cabinet Office minister told the paper that services could be handed over to mutual companies owned by employers and other non-state bodies.

He also warned that public sector jobs and wages would have to fall sharply to ensure the Government lives within its means.

Mr Maude said there would be more such changes to come in the health service, adding that he did not “see a line” limiting the number of transfers out of the public sector.

Sir Mike Richards, who will help oversee application of the controversial test for the Care Quality Commission, has also warned the test could deter good leaders from rescuing struggling trusts if its introduction is not handled properly.

In an exclusive interview withHSJ, Sir Mike stressed that the CQC’s role was not to rule on whether individuals were fit and proper.

7.00am Good morning and welcome to HSJ Live.

Dudley Clinical Commissioning Group restructured services to ensure the patient was at the centre of networks of healthcare professionals, social workers and the voluntary sector. Paul Maubach and Simon Western explain how.