Roger Taylor to advise CQC on data, and the rest of today’s news and comment
4.34pm More news involving Roger Taylor: the Care Quality Commission has appointed him to advise on how the regulator uses data to monitor health and social care providers.
Mr Taylor will be the regulator’s first national professional advisor on data and intelligence. He will work for the CQC two days a week in a personal capacity while continuing his work at Dr Foster.
His role will involve helping to shape the CQC’s future strategy on data and liaising with the CQC’s recently formed Intelligence Expert Advisory Group whose members include representatives from rival informatics firm CHKS as well as the King’s Fund and Nuffield Trust.
A key priority will be looking at how data can be used to support the development of CQC’s new ratings.
4.12pm The NHS might be underestimating the number of people being admitted to hospital because of alcohol or drug misuse, an NHS data expert has warned.
Recent data from Dr Foster Intelligence, outlined in their report ‘My Hospital Guide 2013’, showed that there were 415,000 drug and alcohol related emergency admissions in 2012/13 and that 9% of emergency hospital admissions overall are due to an adult with a drug or alcohol problem. Additionally, 22% of emergency drug and alcohol admissions in 2012/13 had no GP practice recorded.
Speaking on Wednesday to the All Party Parliamentary Group on Complex Needs, Roger Taylor, director of research & public affairs at Dr Foster Intelligence said: “Worryingly we expect alcohol and drug misuse figures to slightly underestimate the actual amount of patients admitted to hospitals with such problems. This is because we only looked at cases [for the report] in instances where drugs or alcohol can be 100 per cent attributable to a hospital admission - we know many admissions are for instances where alcohol is a strong causal factor. This is why we need integrated care as hospitals don’t have the resources to deal with these issues alone.”
Rob writes: “The NHS ramped up admissions in November to hold the line on 18 week waits, but it wasn’t enough to shrink the waiting list and there were even signs of a slight deterioration against the main 18 week standard (though the slippage was too small and too early to call a trend).”
2.21pm Andy Burnham has tweeted about our story on Norman Lamb saying the role of the OFT in NHS competition should be scrapped.
@andyburnhammp tweeted: “Health Minister finally admits Labour was right all along about NHS & competition law. Another Clegg apology coming?>”
1.37pm Also in The Daily Mail, Professor Sally Davies, the Government’s chief medical officer, said women having children later in life is “a worrying issue”.
She said the chance of conception for women in their late 30s and early 40s is reduced and the medical risks are increased.
Professor Davies added: “The steady shift to have children later, there are issues with that. We all assume we can have children later but actually we may not be able to.”
1.24pm The Daily Mail reports on the inquest into the death of retired gardener Fred Pring, 74, who died of heart failure while waiting for an ambulance for almost an hour.
The inquest head that his wife Joyce called 999 after her husband complained of chest pains and later had difficulty breathing. In her final call, she told the operator: “It’s too late now, he’s gone.”
The inquest also heard that paramedics refused to attend to Mr Pring at first, as they were due a break.
12.21pm More than a million people in the UK now live with atrial fibrillation, including 80,852 in London. AF is a dangerous heart rhythm disorder that increases the risk of stroke five-fold, according to new figures from the British Heart Foundation.
The data, released as part of the BHF’s Ramp up the Red fundraising campaign for heart research, shows the UK has for the first time topped the million mark for the number of people living with the heart rhythm disorder.
Atrial fibrillation causes an irregular, sometimes fast pulse because electrical impulses controlling the heart’s natural rhythm lose coordination. The condition is responsible for over 1,800 strokes a year in London.
Over the past five years, the number of people with atrial fibrillation has risen by nearly 20 per cent with over one million now diagnosed with the condition.
High blood pressure, heart valve disease and binge drinking are among the causes, which can leave sufferers experiencing palpitations, and feeling faint and breathless. However, some people with the condition have no symptoms at all. If left untreated, atrial fibrillation can significantly increase the risk of a blood clot forming inside the chambers of the heart, which increase the risk of stroke five-fold.
Chief executive of the BHF Simon Gillespie said: “The real danger with atrial fibrillation is that some people don’t realise they have it. You can be going about your daily routine oblivious to the fact you’re five times more likely to have a devastating stroke.
“Checking that your pulse is regular is a simple way of seeing if you’re at risk. But only through research can we tackle this dangerous disorder and prevent its devastating consequences. That’s why we’re encouraging people in London to take part in our Ramp up the Red campaign to raise money for life-saving research.”
11.58am The Guardian has published a poll which finds that four in five family doctors believe that Jeremy Hunt is deliberately seeking to undermine trust in them through a series of attacks. Some have complained that they are being used as “political scapegoats”.
Denis Campbell writes that 88 percent of survey respondents rejected the health secretary’s claim that the contract between Labour and GPs was a key contributor to greater overcrowding in hospital A&E units.
The paper polled 1,008 GPs in what they write is a representative sample of the 40,000 UK family doctors.
Tiny medical equipment can painlessly penetrate the outer layer of the skin and may be used to deliver medication or monitor the level of drugs in a patient’s body without drawing blood.
Ryan Donnelly from Queen’s University Belfast in Northern Ireland said the work of his team of researchers has been well-recognised.
“We have received a lot of industrial interest in our microneedle technology and are currently working on industrial scale-up of the manufacturing methods described in this paper,” he said.
11.51am Care services minister Norman Lamb has said he wants the Office of Fair Trading’s role in competition in the NHS to be “scrapped”, and expressed concern over the costs and delays caused by the regulator’s intervention in an attempted foundation trust merger.
Mr Lamb made his initial remarks on the subject this week while discussing the Better Care Fund initiative at an event hosted by the King’s Fund.
Speaking exclusively to HSJ later, he clarified that his remarks did not represent a change in government policy, but were instead “relevant to the manifesto process” ahead of next year’s general election.
11.45am Nick Clegg is next week expected to launch a national mental health action plan, advocating a further push towards “parity of esteem” between the sector and the rest of healthcare, HSJ has discovered.
The deputy prime minister is due to publish the document - thought to contain 25 actions and aspirations - on Monday.
It is the second major attempt by ministers to push for parity of esteem, bringing the standard of mental health services to the same level as that of physical health, following the publication of the mental health strategy in February 2011.
11.43am Here’s an interesting letter we received from a reader recently, which takes a wider look at the issue around spending on staff, beyond just A&E locums who have hit the headlines recently:
“Following recent coverage to expose the rise in spending on A&E locum doctors, this is just the tip of the iceberg when it comes to the cost of temporary staffing in the NHS.
While the figures obtained by the opposition government should be placed in some context − given that not every locum will work a 12-hour shift on the same rate every single time − these figures are far from uncommon.
In fact, the annual agency spend across the NHS is widely billed at £2.5bn. What’s more, this statistic only accounts for agency staff and doesn’t factor in bank labour who are managed internally by individual trusts. If you combine the two together then the figure could easily top £5bn each year.
The procurement and management of the NHS temporary workforce is not just confined to A&E − it stretches across the entire health service, covering every grade and individual specialism, including nursing, allied health, admin and clerical and both acute and mental health medical staff.
In any situation where demand increases for a particular category of worker, staffing agencies will attempt to take advantage of the situation. The two main issues associated with this are: where charge rates are allowed to escalate; and where quality and compliance standards are compromised. The NHS should be in a position to exert greater control over these areas, as it is the health service that owns demand.
However, with trusts are under pressure to fill vacant posts and ensure staffing levels maintain government targets (eg: four hour waiting times), the desire to fill shifts often outweighs other considerations.
When you take into account that it takes six years to train as a doctor, then we have to accept that there is no overnight fix where we simply magic doctors up to soften the figures.
Attracting, retaining and ensuring the appropriate number of people are being trained in key roles, is a long term issue and the healthcare sector is a marketplace that is unlikely to change its spots any time soon. The key to addressing the concerns of agency spend is by introducing more efficient and transparent ways of procuring agency staff, standardising pay rates, implementing streamlined and robust policing methods, and introducing visible and controlled assessment measures to ensure processes are compliant and flexible enough to meet everyone’s objectives.
The issue of cost and quality control regarding temporary staff is not limited to the public sector. But those that have taken greater control over temporary staffing spend have seen a reduction in overall cost and an increase in candidate quality.
It is only when trusts and other key stakeholders hold their hands up to wasteful practices, stop paying lip service to the government’s ‘Better Procurement, Better Value, Better Care’ agenda, and admit that they cannot do everything ‘in-house’, will we see true and increased efficiencies across the NHS.”
Andrew Preston, managing director of de Poel Clarity, a Cheshire based independent and vendor neutral expert in managing temporary workforces in the NHS and private health and care sectors.
11.35am The Telegraph also reports that mistakes are made in a fifth of GMC disciplinary cases against doctors which means they are dropped without investigation, a review has found.
The audit by the Professional Standards Authority examined 100 cases that the GMC closed between October 2012 and March last year. It found that 22 cases were mishandled.
11.31am The Telegraph reports that the number of women delaying motherhood is a “worrying issue” according to Professor Dame Sally Davies, the chief medical officer for England.
She said that the “steady shift” towards women choosing to have children in their late 30s and early 40s could cause issues.
11.25am The Times reports that the decision to tell parents the sex of their baby at 12-week or 20-week scans should be reviewed to prevent the selective abortion of girls, a Conservative MP said.
Sarah Wollaston MP challenged the Department of Health’s view that there is no evidence of women from ethnic-minority groups selectively aborting girls.
An analysis of the 2011 census by Imperial College researchers found an anomaly in the male-female balance of babies in some immigrant groups.
Dr Wollaston said she did not want a ban on revealing the sex of a baby but that the timing for passing on the information should be postponed.
11.11am What is the digital future for the NHS? In our Comment section four digital natives give their take on what might lie in store.
10.48am A junior doctor was laughed at by a senior colleague when she suggested a consultant should examine a four-year-old girl who died hours later after suffering a severe infection, an inquest has heard.
Freya Wells, from Wallington, Surrey, died at Kingston Hospital after being admitted for breathing difficulties, vomiting and diarrhoea.
Hilary Towse, who was a paediatric senior house officer at the hospital, told West London Coroner’s Court that she tried to convince paediatrics registrar Rosita Ibrahim to call for a consultant in the early hours of November 22, 2012.
10.42am This week’s magazine is available to read on your iPad. Just follow this link to download the latest issue.
10.31am A Harvard Business School professor has convinced influential figures across the world he has the ‘strategy that will fix healthcare’. Ahead of a trip to 10 Downing Street, he tells HSJ what this means for the NHS and why inspection is not the answer.
Anyone skim reading Michael Porter’s work on healthcare could be forgiven for assuming his ideas have already been consumed and digested by the English health service. It is peppered with language that will echo with followers of NHS wonk speak. Integration, outcomes and value all feature, as do bundled payments and service specialisation.
As NHS leaders wrestle with relating these concepts to reality, it is Professor Porter’s trick of stitching them together into a coherent and persuasive whole that has made his work so appealing.
10.11am The first trust to accept a sweetener payment to switch to the Lorenzo electronic patient record system has admitted it continues to face a series of risks to patient safety and performance arising from its implementation.
Tameside Hospital Foundation Trust was the first trust to implement and deploy the system under an interim agreement drawn up between the Department of Health and supplier CSC, following the unravelling of the IT giant’s contract to exclusively provide patient record systems to the North, Midlands and East regions.
Trust board papers published this month suggest measures to minimise disruption caused by problems with Lorenzo are unlikely to significantly lower the likelihood of serious incidents occurring.
9.58am The King’s Fund chief executive Chris Ham discusses the role of acute hospitals in moving toward integrated care.
He writes that the Royal Free Hospital in London offers a good example of the actions the acute sector can take now to prepare themselves for the upcoming changes.
9.45am Two private hospital operators have been told by the Competition Commission that they must sell off nine hospitals between them in order to improve competition in the private healthcare market.
The regulator told HCA that it will be forced to sell two of its hospitals in central London, while BMI Healthcare has been given instructions to divest from seven of its hospitals, spread across Greater London, the Home Counties and the North West.
Further proposals announced by the commission yesterday include a ban on private hospitals using incentive schemes to encourage consultants to refer patients to their facilities.
9.38am Barnet, Enfield and Haringey Mental Health Trust has been issued with a warning notice by the Care Quality Commission after an inspection team found seclusion rooms were being used as bedrooms.
Inspectors visited St Ann’s Hospital in June and identified that seclusion rooms were being used inappropriately to admit patients when bedrooms were unavailable.
Upon a return visit in November the inspectors found that this practice was still going on. Two seclusion rooms and the section 136 suite - a designated area for people detained for up to 72 hours under section 136 of the Mental Health Act while awaiting a formal assessment - were being used as bedrooms.