Stay tuned as HSJ Live takes you through today’s budget announcements, plus the rest of today’s news and comment.

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The 2014 Budget Book, published by the Treasury this afternoon, confirmed plans to raise employer contributions to the scheme from April 2015.

5.15pm In her second posting in the #Transformation2019 series over in our Hospital Transformation channel, Sue James, chief executive of Derby Hospitals Foundation Trust, discusses three of the key issues to tackle for transformation.

5.05pm In the Nuffield Trust blog, senior research analyst Adam Roberts examines whether the NHS pay deal, announced last week by the government, is fair.

4.50pm Basildon and Thurrock University Hospitals Foundation Trust and Southend University Hospital Foundation Trust have appointed private firm Integrated Pathology Partnerships to help reconfigure and run pathology services across south Essex.

IPP will invest £10m to build a major “hub” laboratory equidistant to both trusts. It is due for completion in 2015, though the land has not yet been secured.

3.30pm Foundation Trust Network chief executive Chris Hopson (‏@ChrisCEOHopson) has responded on Twitter to our interview with outgoing NHS England chief executive Sir David Nicholson. Sir David identified several problems with the current NHS system and rules, which he said were inhibiting service change.

He also said the service was wasting energy pursuing foundation trust status when the model is “not going to work in the future”.

Chris Hopson said in a series of tweets:


3.20pm Five independent healthcare organisations have today launched a new eighteen-month project aiming to capture older people’s experiences of care co-ordination. 

The project comes amid intense policy interest in better joining up health and social care in England. It will be delivered by the Nuffield Trust, Picker Institute Europe, The King’s Fund, International Foundation for Integrated Care and National Voices.

The project, which is funded by the Aetna Foundation, is designed to help health and care providers to improve the coordination of care.  To do this, a survey tool will be developed to measure how older people and service users experience care when it is delivered by multiple organisations. This work will allow health and social care services in the UK and internationally to measure the quality of integrated care from the perspective of their users.

As joined up care is critical for older people with long-term conditions such as dementia and diabetes, and for those with multi-morbidities, the tool will be designed to understand the perspectives of people aged 65 and over with at least one long-term condition.

This tool will be an instrument suitable for use by different kinds of local services, not restricted to one type of provider. The survey tool will be developed and tested amongst older patients and service users in England.  It is hoped that the work will support improvements in the commissioning and delivery of well-coordinated, integrated care locally in the UK, and be of relevance to other user groups and for quality improvement efforts internationally.

The work, which gets underway this month, will be based on a literature review combined with input from patients/service users and their representative groups.  This will be followed by the development of a tailored questionnaire that will be fully piloted and tested. The final tool set will be available for use in the summer of 2015.

Don Redding, Director of Policy at National Voices said: “When care is fragmented it affects patients and carers and can have a detrimental impact on their quality of life. But we currently have no way to assess the experience of service users with regard to care coordination. This is a major gap both here and in other countries, which this tool will help to fill.”

Ruth Thorlby, Senior Policy Fellow at the Nuffield Trust said:“Better joined up health and social care services is a priority for most modern healthcare systems and the English NHS is no exception. With a series of Government and locally-led initiatives currently underway to encourage more co-ordinated care, this work will provide us with a robust way of establishing baselines and measuring progress from the perspective of patients and service users themselves.”

2.55pm The Guardian examines why the death of Connor Sparrowhawk, 18, at a residential unit was avoidable, and how it has reignited criticism of care for people with learning disabilities. Connor was found drowned in a bathtub at Slade House, at a seven-bed unit run by Southern Health Foundation Trust

The Guardian has also taken excerpts from the blog of Connor Sparrowhawk’s mother, on her fight to expose the truth about son’s death.

More from The Guardian, the cholesterol-reducing drug statin could help people with advanced multiple sclerosis, according to researchers.

2.52pm Illman adds:

2.48pm Switching back to HSJ reporter James Illman for a moment, he is tweeting from the Healthcare IT conference and exhibition, organised by the British Computer Society, in Manchester. NHS England chief technology officer Geraint Lewis is giving an address on, the ambitious and controversial patient data sharing project:

2.05pm The Treasury’s 2014 Budget document confirms departmental spending limits for the coming years. The NHS budget for the financial year 2014/15 is £108.3bn. The financial year 2015/16 will see a budget of £110.4bn.

1.50pm Dr Maureen Baker, Chair of the Royal College of GPs, has released a statement giving the college’s response to the budget. Dr Baker said: “The Chancellor’s budget today is yet another blow for patients and for general practice. We are really disappointed that another opportunity to address the massive funding gap in general practice has come and gone.

“Unfortunately, it is our patients who will bear the brunt of another year without additional funding and the consequences could be catastrophic for patient safety.

“There are over 340 million consultations in general practice per year - around 90 per cent of all patient contacts in the NHS. GPs are wilting under the pressure of trying to meet the demands of a growing and ageing population whilst the share of government funding that general practice receives is at an all-time low of 8.39 per cent.

“With greater investment in general practice we could provide more appointments, a wider range of services and improved continuity of care, as well as providing even greater value for money to the NHS.

“If the Government is serious about alleviating pressures on hospitals and providing more care in the community, it must act now and urgently put plans in place to increase investment in general practice to 11 per cent of the NHS budget by 2017.”

1.45pm During the Chancellor’s budget speech he pledged to continue protecting spending in the NHS, schools and the overseas aid budget.

1.08pm Alan Turing Institute will be created to drive big data research, Osborne says.

12.58pm The Chancellor has just pledged to fund a new Air ambulance service for London, with tax relief on fuel for air ambulances. Also waiving inheritance tax on those who work in public services.

12.50pm Osborne: There will be cuts in public service pensions in accordance with the work done by John Hutton. We will ensure schemes are properley valued. We are continuing with pay restraint in the public sector. In order to lock in underspends we will find £1bn of efficiencies in departmental budgets.

12.40pm Country can afford increase in national minimum wage, says Osborne.

12.33pm Chancellor George Osborne stands up to set out the budget.

12.25pm Sky’s Anushka Asthana tweets: Closing the gap could only happen with a massive investment in services - w disproportionate increases for mental health. Unlikely.

12.22pm Guardian journalist and HSJ columnist Michael White tweets during PMQs:

12.10pm The Times reports that Jeremy Hunt has promised to cut the number of patients needlessly moved around hospitals in the middle of the night.

Sir Bruce Keogh is to tell trusts that they must stop transfers that are not carried out to improve patient care.

The Times also reports that women who become mothers through surrogacy cannot claim maternity leave the European Court of Justice ruled yesterday.

The case concerned a woman from Newcastle who was employed by an NHS foundation trust and was refused paid maternity leave after the birth of her baby through a surrogacy arrangement.

A mother was barred from breastfeeding her newborn baby in a hospital waiting room in case it offended other patients, The Times reports.

The woman was sat in the waiting room of the Hospital of St Cross in Rugby University while she waited for a blood test.

The National Childbirth Trust and the Royal College of Midwives criticised the decision.

A spokesman for University Hospitals Coventry and Warwickshire Trust said that he would contact the woman concerned and that patients should not bring children to blood tests.

The Times reports that one patient in ten will die during their hospital stay and almost one in three will be dead within a year a study by researchers at the University of Glasgow suggests.

The researchers say that palliative care ought to be higher on the NHS agenda. A team at the University of Glasgow looked at data on more than 10,000 inpatients in 25 Scottish hospitals on one day in 2010. Three per cent died within a week, 9 per cent within 30 days and 21 per cent within six months, 29 per cent within a year.

11.25am Exclusive: Councils and NHS commissioners are set to share pooled budgets of more than £5bn in 2015-16 under the better care fund, HSJ has learned. They have agreed to pool more than a third over and above the £3.8bn they are required to do under the policy, according to early indications in their plans.

10.54am Sir David Nicholson on the lack of BME leaders in the NHS: “You need to nurture and support people in the middle of organisations and help them with their careers, and take them forward in an organised and planned way. People have been very reluctant to cooperate across the NHS in terms of getting talent management and talent planning going. People too often think all they should be interested in is their own organisation.” Read more here.

10.45am More from Tim Kelsey at #hc2014:

10.41am Health workers will stage Budget day protests today against the government’s “insulting” pay offer.

Demonstrations are expected in Westminster and Bristol, amid continuing anger over the coalition’s decision not to accept pay review body recommendations.

10.33am Sir David Nicholson’s departure from NHS England leaves space for a new kind of leader to step up to the challenges facing the service, argues HSJ deputy editor Emma Maier in this week’s leader.

10.30am James Illman tweets on Tim Kelsey discussing


10.25am NHS providers are wasting energy pursuing foundation trust status when the model is “not going to work in the future”, Sir David Nicholson has said.

In his final HSJ interview before retirement at the end of this month, the outgoing NHS England chief executive also gave a damning account of how current NHS rules and structures were obstructing vital changes. He also warned the NHS could tip into overall deficit in the next financial year for the first time since 2005-06.

9.50am HSJ reporter James Illman is tweeting from the Healthcare IT conference and exhibition in Manchester this morning (#hc2014).

Listening to Tim Kelsey, NHS England’s director for patients and information he tweets:


7.00am Good morning and welcome to HSJ Live. We kick things off with a piece bu Alison Williams, arguing that transferring outpatient pharmacy to a subsidiary company can provide financial gains for foundation trusts, while improving the patient experience.