The Care Quality Commission is working on a “special measures” regime for GP practices, plus the rest of today’s news and comment

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3.59pm In the Nuffield Trust blog, policy officer Mark Dayan writes that the “deeper problem” with the better care fund is that “there is little actual evidence that shifting responsibility for care out of hospitals can be a quick money-saver”.

3.30pm The Foundation Trust Network has welcomed today’s announcement that two further Keogh trusts have been taken out of special measures.

Head of policy Miriam Deakin said: “The announcement today shows that a number of the trusts put in to special measures have been able to make lasting improvements to patient care and safety through renewed focus, team working and extra support.  It is good news for patients and should be a source of pride to staff and trust boards that these achievements have been made. 

“The special measures regime has evolved considerably over the last year, and the focus on organisational buddying, support, sharing and learning is very welcome, and can be used more widely across the NHS.”

“No one in the NHS is complacent though. All trust boards continue to place patient care and safety at the heart of their agenda. We know there are still some improvements to be made, and those trusts leaving special measures today will see this as an important step on a journey of continual improvement and not the end of the road.”

2.24pm Care England, the representative body for independent care providers, has given a “cautious welcome” to the announcement today of a special measures regime for care homes.

Chief executive Martin Green said: “It is important that this special measures regime is developed in partnership with the care sector and the time and public resources that are allocated to it, mirror those that were allocated to the health regime that inspired its creation”.

He added: “It is our hope that this regime will give new clarity and consistency in how failing services will be challenged to improve, and clearly define the process and timescales on when they will be removed from the market.”

2.02pm The Times reports that taking health supplements to prevent Alzheimer’s and keep the brain sharp is a waste of money, according to scientists from Oxford University.

B vitamins fail to slow mental decline and do not prevent dementia, an analysis of evidence has found.

Middle-aged people are better off taking a walk or eating more fruit and vegetables, experts say.

1.40pm Researchers are arguing that labelling millions of people as pre-diabetic is needlessly “turning healthy people into patients”, The Times reports (paper only).  

Doctors would be better off telling everyone to eat better and exercise more rather than putting some into a spurious medical category on the basis of high blood sugar, said John Yudkin, emeritus professor of medicine at University College London.

1.26pm Flicking through the day’s papers, The Daily Mail reports that women who have suffered from depression or anxiety face being asked by GPs about whether they plan to have babies.

NICE says women need to be warned they may suffer from a relapse during pregnancy or after the birth, which may affect their ability to care for the newborn.

There is also strong evidence that antidepressants raise the risk of miscarriage, premature births and foetal abnormalities.

1.11pm The health union Unison has warned that proposals to let staff run hospitals under a mutuals model “may sound attractive in theory”, but are “fraught with pitfalls” in practice, and “all too frequently… used as a mask for a top-level management buy-out, with little actual staff buy-in”.

HSJ yesterday exclusively reported that John Adler, chief executive of University Hospitals of Leicester Trust, is “very interested” in exploring the option of it becoming a staff owned social enterprise.
Unison’s head of health Christina McAnea said: “There is a very real danger that bringing the mutual model into hospitals will be a Trojan horse for privatisation.  Even in the early stages mutuals frequently mask top-level buy-outs without any real input or buy-in from staff.
“While there is a welcome and much needed focus on staff engagement in the report, real engagement and involvement of staff in decisions about how healthcare is organised should be the norm, but it’s clear that much needs to be done to make this a reality.”

12.44pm A company which runs a major patient transport service in Kent and Medway is likely to face “further actions” from commissioners after failing to meet targets in its first year.

A report to a meeting of Kent County Council’s health overview and scrutiny committee this week shows the firm has been struggling on six key targets for taking patients to and from the county’s hospitals.

The latest confirmed performance figures, which cover until the end of May, show it was falling significantly short on targets including for the proportion of patients arriving at hospital within an hour of their appointment time; the proportion collected to return home within an hour; for timely collection of renal patients; and for discharges and transfer booked on the day.

12.35pm New guidelines from a host of medical Royal Colleges call for all emergency departments to have co-located out of hours GP services, to help prevent rising demand from overwhelming the urgent care system.

Patients should not be expected to be able to determine whether or not they are suffering a serious problem or minor illness and should have access to both levels of care, the group of senior doctors said.

But at the same time it is not appropriate for A&E departments to be responsible for “anything and everything”, they said.

11.00am A statutory duty of candour in the NHS will cover a wider set of incidents than previously expected, and will force NHS trusts to apologise to affected patients, it has emerged.

The government has laid regulations in Parliament introducing measures including a legal duty of candour, a “fit and proper person test” for NHS directors and “fundamental standards”  to be enforced by the Care Quality Commission. The changes are part of the government’s response to last year’s Francis inquiry final report.

10.28am The Care Quality Commission is working on a “special measures” regime for GP practices, the body has confirmed.

Health secretary Jeremy Hunt introduced the regulation policy for provider trusts a year ago, and is today announcing details of a regime for social care providers. It has been reported he will announce one for GPs.

However, work is still under way on designing the regime for GPs, and it will not be detailed today.

10.25am The public do not act on mortality rates to work out how best to access care, write Roger Taylor and Paul Aylin of Dr Foster. Solving this remains a challenge, and one that will require all the information we can gather and more, they argue.

10.23am A health minister has accused NHS organisations of “shunting” mentally ill children into specialist inpatient care for financial reasons.

In an exclusive interview with HSJ, care minister Norman Lamb indicated the problem was due to the division of commissioning responsibilities under the 2012 Health Act.

10.16am In his weekly HSJ column, the Guardian’s Michael White asks, when three quarters of clinical commissioning groups fail to follow national guidelines, where does this leave the “N” in NHS?

10.15am Two further trusts placed in regulatory “special measures” last summer have been removed from the regime, the health secretary announced today.

Jeremy Hunt was due to speak to Parliament today to give an update on progress made by the 11 trusts placed in special measures after being investigated under the Keogh review of organisations with persistently high mortality ratios.

Meanwhile, Mr Hunt was expected to detail a new special measures regime for social care providers. A regime for GPs is expected to be announced later in the summer.

10.08amWelcoming the ‘progress report’ on hospitals which were placed in special measures one year ago, NHS Confederation chief executive Rob Webster said: “The staff and the leadership teams at each of these organisations should be proud of the progress they have made over the past 12 months in improving patient care.

“When these trusts were placed in special measures one year ago, we said that their boards could not bury their heads in the sand. With today’s announcement it is clear that the staff and leaders at each of these organisations have faced up to the need to change what they did and how they did it. It is a tribute to their hard work that we can see the fruits of their labour just 12 months later.

“Changing the culture in an organisation – and the outcomes it delivers – is never easy. What is noticeable is a common theme across the trusts which have come out of special measures in that they are all strong performers on staff engagement. We know that engaged staff deliver better health outcomes for patients; this is something reflected in the values of the NHS Constitution, is backed by research, and we can clearly see is paying dividends in trusts which a year ago were in a very difficult place.

“These organisations and their teams now need the support of the wider system to sustain progress and continue to deliver improvements in patient care.”

10.05am A year ago, eleven trusts were placed into special measures following reviews by Professor Sir Bruce Keogh. All eleven have now been subject to new-style Care Quality Commission inspections by the chief inspector of hospitals, Professor Sir Mike Richards.

That announcement coincided with Sir Mike taking up his post as Chief Inspector of Hospitals and the start of CQC’s new approach to inspecting hospitals.

Speaking on the anniversary of the trusts being placed in special measures, Professor Sir Mike Richards said: “We have achieved a great deal in the last twelve months. Using our new way of inspecting hospitals, with significantly larger inspection teams than before, headed up by clinical and other experts including trained members of the public, we have inspected 65 hospitals, 12 mental health trusts and eight stand-alone community health trusts.

“While we know we have more work to do to refine the way we carry out these inspections and report on them, some key themes are emerging. For example, we have found too much variation – not just between hospitals, but even between different services in the same hospital. Across our inspections we have found staff committed to providing compassionate care.

“Whenever CQC inspects we always ask the following five questions of every service: Is it safe? Is it effective? Is it caring? Is it responsive to people’s needs? Is it well-led? The inspections have also underlined to me the importance of good leadership, which is a hallmark of a good or outstanding trust.

“We have also started to award ratings that express our clear judgment on hospital services. These ratings inform my view as to whether I recommend that a trust be put in special measures.

“Recently, we have completed our inspections of the trusts that Sir Bruce Keogh put in special measures following his review of them.

“We have seen significant improvements in almost all of the 11 trusts that were put into special measures, with exceptional progress in two trusts and very good progress in a further three. The hard work by trust staff that has underpinned this progress should be recognised. Special measures bring a new focus on quality improvement in trusts which have previously struggled to provide high quality care.

“Through CQC’s new inspection process we were able to identify good and in some instances outstanding practice, but also areas which require improvement. In some cases we still observed inadequate practice. These areas now need the most urgent attention.

“Two trusts, Basildon NHSFT and George Eliot NHS trust have already reached a rating of ‘good’ overall and are to be congratulated. This is a remarkable turnaround in under one year. I am confident that at least three further trusts can also reach ‘good’ status within a reasonable time-frame and should therefore come out of special measures, but with ongoing support. In other cases I am recommending a further period of six months in special measures, but I am hopeful that they will then be ready to exit.

“Next week, I will publish a report that brings together my findings from my re-inspections of all the trusts put into special measures following Professor Sir Bruce Keogh’s reviews.”

10.00am In his leader column this week, HSJ editor Alastair McLellan writes that recruiting more hospital nurses could ease pressure on acute trusts in the short term, but what the NHS really needs is balanced investment in staff across all settings.

Earlier this week, HSJ analysis revealed that more than three quarters of acute NHS providers have missed their own targets for the number of hours worked at their hospitals by registered nurses.

7.00am Welcome to HSJ Live. To start the day, take a look at the winners of the Patient Safety and Care Awards 2014, who were announced at a ceremony in London last night.