NHS England has has delayed plans to begin collecting patient data from GP surgeries to later this year following mouting criticism, plus the rest of today’s news and comment.
6.10pm In response to the delay of the care.data programme, a Department of Health spokesperson said: “This is an NHS England decision which we support. This is a vital programme which will bring real benefits to patients.
“But concerns over how this has been explained to patients have been raised which must be addressed.”
5.32pm The British Medical Association has welcomed the decision by NHS England to postpone its care.data programme by six months.
The BMA had called for the programme to be halted until patients were better informed about it.
Chaand Nagpaul, chair of the BMA’s GP committee, said: “We are pleased that NHS England has listened to the concerns of the BMA and that the decision has been taken to delay the roll out of extractions to care.data until the autumn.
“With just weeks to go until the uploading of patient data was scheduled to begin, it was clear from GPs on the ground that patients remain inadequately informed about the implications of care.data.
“While the BMA is supportive of using anonymised data to plan and improve the quality of NHS care for patients, this must only be done with the support and consent of the public, and it is only right that they fully understand what the proposals mean to them and what their rights are if they do not wish their data to be extracted.
“This is all in the best interests of patients and GPs, and the BMA looks forward to working with NHS England to ensure that the public is properly informed and that safeguards are in place before uploads begin.”
5.27pm NHS England has delayed plans to begin collecting patient data from GP surgeries by six months, following mounting criticisms of its care.data programme.
The British Medical Assocation previously called from the programme to be halted until patients were better informed about it.
The Royal College of GPs also wrote to NHS England requesting a six-point plan of action to reassure patients before it went live with the scheme.
Tim Kelsey, NHS England’s director for patients and information, said: “NHS England exists for patients and we are determined to listen to what they tell us.
“We have been told very clearly that patients need more time to learn about the benefits of sharing information and their right to object to their information being shared. That is why we are extending the public awareness campaign by an extra six months.”
Anna Bradley, chair of Healthwatch England, said: “This is a really positive move by NHS England. They have shown a willingness to listen to what the public have to say about the way their health and care services are run.
“Crucially they have agreed to Healthwatch England’s request to see the roll-out of care.data delayed to allow more time to ensure the public are fully informed.”
Nigel Mathers, honorary secretary of the RCGP, said: “We would like to thank NHS England for listening to the concerns of RCGP members and for acting so quickly to announce this pause.
“The extra time will provide it with the chance to redouble its efforts to inform every patient of their right to opt out, every GP of how the programme will work, and the nation of what robust safeguards will be in place to protect the security of people’s data.”
5.13pm In The Guardian, Colin Leys argues that there is a “policy vacuum” in health.
He writes: “Jeremy Hunt is momentarily protected by the legal fiction that he is no longer responsible for “providing” the NHS”, but “the government will eventually be held responsible for what happens to our healthcare”.
He adds: “Flooding affecting many thousands of people has finally produced an irresistible demand for a policy response. A major crisis in health care will affect everyone in the country except the very rich. Is it acceptable for the secretary of state for health to have a sign on his desk saying, “the buck stops somewhere else”?”
4.47pm The Evening Standard reports on Royal Surrey Country Hospital Trust admitting liability for the severe brain damage of boy, now three, who was starved of oxygen at birth.
Julian Leyster has cerebral palsy, reduced mobility, hearing and sight problems and a sensory processing disorder.
In a letter to Julian and his parents, the trust apologised “for the errors made and for the very severe disability this caused”.
The trust today said: “We are very sad that in this tragic case the outcome of care has been so devastating for the child and his parents.”
4.20pm The BBC has obtained figures that suggest a “significant variance” in performance between the 12 ambulance services in England.
Professor Jonathan Benger, national clinical director of NHS England, told the BBC: “There has been variation between ambulance trusts since collection of ambulance clinical quality indicators started in April 2011.
“The reasons for variation are multifactorial and carefully analysed by ambulance trusts, as well as in published research. Variation may arise from differences in the interpretation of the definitions and methods used for assessment, the quality of data collection, verification and returns.
“Local demographics and individual patient factors will also lead to variation in outcomes, as will the treatments provided in hospital. It would be entirely wrong to suggest that all variation can be attributed to one single factor.”
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2.38pm More from Nursing Times, trusts placed in “special measures” for poor performance have appointed 600 plus more nursing staff over a period of just three months, according to a progress report.
2.12pm From HSJ’s sister title Nursing Times, community nurses in parts of the country hit by flooding have been faced with a new set of challenges in recent weeks, with many working longer hours and volunteering for extra shifts in order ensure vulnerable patients receive the care they need.
It is understood that Coventry and Warwickshire was advised last week by the NHS Trust Development Authority that its bid had failed to meet criteria relating to liquidity set by Monitor.
NCT chief executive Belinda Phipps told the BBC: “Mothers who contact our helpline about this are desperate and usually in tears.
“Everyone who comes into contact with a new mum needs to be aware of tongue tie as a possibility if there are feeding problems.
“And we would like to see a service for tongue-tie treatment available at every maternity unit in the country.”
12.35pm In a column for The Daily Mail, Melissa Kite argues against the Department of Health’s plans to take into account the “wider societal benefit” of giving particular drugs to a patient.
She writes: “But by formalising the decision to put the young before the elderly, by making it official policy, and thereby casting it in stone, we would be entering very dangerous waters.
“It is not just that the elderly have worked all their lives, paid their taxes and should expect, in any civilised society, to be cared for once they are no longer ‘productive’.
“It is simply, to me, morally unacceptable to quantify a sick person’s suitability for treatment based on their possible use to society.”
12.22pm Under proposed health reforms, patients who have had a ‘fair innings’ in life could be denied access to life-saving treatment, The Daily Mail reports.
The proposals would mean the “wider societal benefit” of giving a medicines to a patient would be considered.
The National Institute for Health and Care Excellence has expressed concerns that this could lead to older people being denied drugs, with young people being given greater priority as they have more years of life ahead and contribute more to the economy.
Ciarán Devane, chief executive of Macmillan Cancer Support, said: “The UK has some of the worst cancer survival rates in Europe and they are especially bad for older people.
“Macmillan strongly recommends against any action which could make this worse. The Nice board is right to reject the Department of Health’s proposal.”
12.10pm The Times also reports that schools could one day screen pupils for depression using a spit test after scientists found the first biological marker for the condition.
Teenage boys who have high levels of the stress hormone cortisol alongside other symptoms were 14 times as likely to go on the develop serious depression, a study found.
12.00pm Back to today’s papers this lunchtime,The Times reports that physical exercise is as important in preventing dementia as keeping your mind active, according to scientists.
A brisk walk three or four times a week can effectively “grow back your brain”, helping to reverse early signs of neurodegeneration and improve performance on memory tests, research has found.
11.49am On the subject of care.data, the Royal College of GPs has written to NHS England requesting a six-point plan of action to reassure patients before it goes live with the scheme.
In the letter, RCGP honorary secretary Nigel Mathers says: “The RCGP believes that care.data has the potential to deliver enormous benefits for patients by helping the NHS to improve the quality of care it delivers.
“While we recognise the substantial programme of activity and materials that has already been developed to communicate care.data, we believe that there is a deficit of awareness and understanding regarding the scheme amongst many members of the public and professionals.
“If the roll out of care.data is to go ahead according to the current schedule, action is urgently needed to tackle this, and to ensure that there is absolute clarity about how the scheme will work.”
He adds: “Crucially, where a scheme is based on an opt out approach, such as in the case of care.data, we believe that it is vital that the NHS is able to show that it is beyond reproach in having done everything practically possible to ensure that patients and the public know about their right to opt out prior to it going ahead.
“At present, we are concerned that levels of awareness concerning care.data are very low, and believe that there is a strong case for substantial additional activity over and above that already in place to tackle this.”
11.36am In The Times, a leading doctor has condemned “paranoia” over the care.data scheme, saying patient records are more vulnerable in GP surgeries than they will be in the central database proposed.
Sir Simon Wesley, professor of psychological medicine at King’s College London and president-elect of the Royal College of Psychiatrists, said fear that insurance companies would be able to identify individual patients was a “red herring” and that the benefits far outweighed theoretical risks.
11.28am However, George Freeman, MP for Mid Norfolk and founder of the Patients4Data campaign, writes in The Daily Telegraph that the care.data scheme is safe and “the benefits for patients are too good to lose”.
“Data collection [in medical research] allows researchers to look at large-scale patterns of disease and drug performance over 30 years,” he writes.
“This enables them to change prescription patterns, to pick the right recruits for specific drug trials and to collect a lot more “lifestyle” information (on diet, exercise etc) which is invaluable in trying to understand patterns of cause and effect.”
He adds: “With the proper precautions in place, this data revolution is a force for good. We should embrace it.”
11.20am The Daily Telegraph also reports on crisis talks between NHS officials over the introduction of NHS’s cara.data scheme, amid continued criticism of the government for not better informing patients about it.
11.10am Turning to this morning’s papers, The Daily Telegraph reports on the development of the first biological test for clinical depression by scientists at Cambridge University.
Professor Ian Goodyer, who led the study, said: “Depression is a terrible illness that will affect as many as 10 million people in the UK at some point in their lives.
“Through our research, we now have a very real way of identifying those teenage boys most likely to develop clinical depression.
“This will help us strategically target preventions and interventions at these individuals and hopefully help reduce their risk of serious episodes of depression and their consequences in adult life.”
10.53am A mental health trust boss has called on staff to suggest changes after the damning results of a survey showed more than two-thirds of its workers thought there was a culture of bullying, fear and blame.
HSJ has discovered that King’s College Hospital Foundation Trust has written a legal letter to Dartford, Swanley and Gravesham Clinical Commissioning Group in the past few weeks stating that a procurement process should take place to determine the provision of ophthalmology services for Dartford and Gravesham Trust.
10.29am EXCLUSIVE: A mental health trust has told HSJ it is considering a legal challenge against the decision by NHS England and Monitor to impose 20 per cent higher cuts for mental health and community providers than for their acute counterparts.
10.20am Commenting on the Crisis Care Concordat between police, mental health trusts and paramedics to improve standards for people experiencing a mental health crisis, Stephen Dalton, chief executive of the NHS Confederation’s Mental Health Network,said: “There is already a great deal of work underway in organisations right across the health sector to prevent mental health crises occurring and escalating, with clear plans for even closer working between partners to improve access to services and to meet local, individual needs.
“But the very nature of a mental health crisis means that a very vulnerable person needs a fast, individual, joined-up response.
“This is where the Mental Health Crisis Care Concordat can really make a difference, as it sets out the clear commitment of all those involved in the mental health sector to improve support for people before, during and after a crisis.
“It is not just a piece of paper, it’s a pledge to make things better in practice, and the NHS Confederation’s Mental Health Network is proud to have signed it on behalf of all our members.
“We are particularly pleased that the police and the Royal College of GP’s are reviewing their training programmes to improve understanding of mental health problems and to develop and deliver improved services.
“But all the will, awareness and training in the world won’t translate into real improvements in crisis care unless mental health is finally and genuinely put on a par with physical health.
“It is critical that the Government’s and NHS’s commitment to address long-term under-funding of mental health services is delivered on, before the sector experiences an irreversible crisis itself.”
10.11am In Resource Centre today, as NHS England begins to allocate its £260m technology fund, there are many game changing benefits of electronic prescribing for acute trusts, argues Shaun O’Hanlon, chief medical officer of theEMIS Group.
9.56am The average distances between patients’ homes and the hospitals in which they receive emergency care have barely changed for a decade, according to research by the Nuffield Trust and the Health Foundation, as part of its QualityWatch research programme.
The research finds that despite the rise in total number of emergency admissions by over a third in ten years, the average distance from home to hospital only rose by 0.2 miles in the same period.
Nuffield Trust senior research analyst Adam Roberts, who wrote the report, said: “There is understandably a high level of attention on the provision of emergency care and our research provides us with the first picture of the distances from home to emergency care against which we can assess change.
“However, despite concerns around major A&E departments being closed or downgraded, our analysis shows that the average home-to-hospital distance for patients who receive emergency care has remained remarkably stable over the past decade.
“In the future, designating 40-70 major A&E departments, as recommended in Sir Bruce Keogh’s review, would likely result in an increase in home to hospital distances for some patients.
“If this resulted in a better standard of care upon arrival this could lead to better outcomes, as the recent reconfiguration of stroke services in London shows.
“But careful planning will be needed to ensure that this does not adversely impact patients in rural areas where the distances involved are much greater.”
Jennifer Dixon, chief executive of the Health Foundation, Dr Jennifer Dixon, said: “Our QualityWatch report indicates marginal increases in the distances travelled by patients to access emergency services over the last decade.
“However this may change following NHS England’s review of urgent care: service planners will need to balance any extra travel times and distances that may result with potential benefits from having better staffed services with a larger range of experts available.”
9.44am Prescribing continues to be one of the top five risks in general practice, according to on clinical risk self-assessments conducted by the Medical Protection Society across 150 practices in the UK and Ireland in 2013.
Data from assessments found that 95.4 of practices had had risks relating to prescribing.
These include uncollected scripts (which accounted for 53 per cent of prescribing risks), repeat prescribing systems, and administrative staff changing medications on the computer.
Julie Price, clinical risk manager at the Medical Protection Society, said: “To avoid errors, ideally the responsible doctor should add the medication to the prescription list. If administrative staff need to change or add medications, it must be closely checked by the doctor afterwards.
“Considerable care needs to be taken to ensure that all the details are correct and that it has been added to the correct patient record.
“Ultimately the doctor has responsibility for the prescriptions they sign.”
7.00am Good morning and welcome to HSJ Live. We begin with news that the police, mental health trusts and paramedics have made a new agreement to improve mental health crisis care.
The crisis care concordat has been signed by 22 national organisations to try to drive up standards of care for people experiencing crisis such as suicidal thoughts or significant anxiety.
The concordat, which is announced today by care minister Norman Lamb, is aimed at cutting the number of people inappropriately detained in police cells. It sets out the standards of care people should expect if they suffer a mental health crisis and details how the emergency services should respond.
In an interview last month, NHS England national clinical director for mental health, Geraldine Strathdee told HSJ that mental health providers will be expected to implement a single point of access for patients suffering crises in the next year.