The deputy prime minister launches a new national mental health action plan, plus the rest of today’s news and comment.
7:50pm Some people in Scotland are being wrongly charged care home costs, an investigation by BBC Scotland has found.
BBC Scotland learned of three people in a minimally conscious or in a vegetative state who have been refused NHS funding, despite being eligible for having their costs paid under an arrangement called “continuing healthcare”. The arrangement is aimed towards patients with complex or severe medical conditions.
5:31pm Dr Charles Alessi, chair of the National Association of Primary Care, writes in the NHS Voices blog that primary care is “likely to emerge” as “the salvation and, in many respects, our talisman” of the NHS.
Dr Alessi says the NHS is “in transition, as it starts to accept that it must represent the end user rather than the institutions that deliver care,” moving “away from large biomedically focused institutions to a more local and community-based approach”.
He argues primary care “will enable us to emerge from this transition transformed, but with our values intact. Don Berwick called general practice “the jewel in the crown of the NHS” and we have remained one of the most admired aspects of the British health service internationally, always scoring highly in international comparisons.
“As health systems everywhere start to gravitate towards capitated population-based systems and also evolve towards accountable and integrated care systems sharing the same metrics and the same values, these strengths are likely to be the ones which will carry through the uniquely British NHS.”
5:15pm In response to plans to build the first “secure college” for young offenders in England and Wales, Dr Gillian Baird of the Royal College of Paediatrics and Child Health said: “We cannot afford to ignore the health of children and young people in secure settings.
“Over a quarter of young people in secure settings have a long standing physical health medical condition, an estimated 50% have learning difficulties and a high proportion have a history of substance misuse. Many have a history of limited academic attainments and poor school attendance.
“In addition to this, they are three times more likely to suffer from a mental health disorder, with anxiety and depression being the most common. If not addressed these conditions can lead to even greater long-term health complications and severely hinder the rehabilitation process.
“Both health and education must be seen as priorities if we want to see reoffending rates fall. So we call on all new secure colleges, and existing settings, to utilise the ‘Secure Settings’ standards, produced by a group of Royal Colleges, and led by the RCPCH, to make a real difference to the health and wellbeing of these young people.
“We strongly support this increased focus on education, but emphasise that we must also address these health conditions so young people are able to truly benefit from the proposals highlighted today.”
5:03pm Professor Sue Bailey, president of the Royal College of Psychiatrists has discussed the government’s new action plan on mental health at BBC Radio 4’s World at One. Her discussion begins roughly 42 minutes into the programme.
4:37pm Following NHS England’s reponse to The Guardian’s story on patient care data being made available to drug and insurance firms, HSJ reporter James Illman has tweeted:
”@NHSEngland response on care.data: a private firm can get data for research but not insurance. How will NHS know how firms r using the data?”
“Worth a read if you’re worried abt your patient records after news today: @GeraintLewis on reasons for care.data http://www.england.nhs.uk/2014/01/15/geraint-lewis/ …”
4:14pm In response to The Guardian’s story ‘NHS patient data to be made available for sale to drug and insurance firms’, NHS England’s chief data officer Dr Geraint Lewis said: “NHS England and the Health and Social Care Information Centre (HSCIC) welcome the increase in public awareness and debate about NHS data usage following the nationwide distribution of the leaflet ‘Better Information Means Better Care’.
“It is vital, however, that this debate is based on facts, and that the complexities of how we handle different types of data are properly understood. Patients and their carers should know that no data will be made available for the purposes of selling or administering any kind of insurance and that the NHS and the HSCIC never profit from providing data to outside organisations.”
4:09pm Following Nick Clegg’s speech on mental health, Dr Peter Carter, chief executive and general secretary of the Royal College Nursing, said: “It’s good news that mental health is moving up the policy agenda, and needs to be taken as seriously as physical health. Mental health services have been coming under increasing pressure in recent months, with higher bed occupancy rates and bigger workloads for a shrinking workforce.
“Acute mental health beds have fallen by nine per cent since April 2011, and we’ve seen services such as crisis intervention, a major part of the 1999 mental health national service framework, cut or reduced after they have done so much to stabilise mental health services over the past decade.
“It’s vital that we see continued investment in mental health so that health professionals are able to deliver quality, specialist care and that improvements made to services over the last ten years aren’t lost.”
Here are some excerpts:
“It’s true that over the last few decades huge progress has been made – not least because of campaigning by people and groups in this room. But, all too often, attitudes to mental health are outdated; stuck in the dark ages; full of stigma and stereotypes.”
“It’s the old-fashioned view that mental health problems should be kept hidden: something to be ashamed of and somehow less deserving of our sympathy or attention than physical illness.”
“It’s time for us to bring mental health out of the shadows and to give people with mental health conditions the support they need and deserve.”
“We recognise that we’ve got a mountain to climb. Physical health has been the priority in our health service for years. That’s what’s generated headlines. It’s where the targets have been set. It’s where the bulk of the money has been spent. And it’s going to take a huge effort to turn that around and give mental health the focus it deserves, especially when financial pressures are so tough.”
3:30pm NHS data chiefs have raised “concerns in respect to the governance arrangements” of the pioneering care.data project, according to papers published last week, writes HSJ’s Nick Renaud-Komiya.
The news comes at a critical time for NHS England as it attempts to finalise the business plan for the project, which involves the extraction and linking of patient identifiable data from patients’ records, which it estimates will cost “over £50m”.
3:20pm You can now read part two of waiting time guru Rob Findlay’s analysis of November waiting times data.
Part one is also available to read.
2:47pm Dr Karen Castille, the NHS Confederation’s associate director and chair of the urgent and emergency care forum, writes in The Guardian: “Talking up the NHS is important. Not because it makes us feel good, but because it gives the NHS a chance to meet the challenges it faces. It creates trust, confidence and discretionary effort, just at the point when it is needed.”
She adds: “We can all play our part by making sure that for every negative story we hear about the NHS, we tell two positive ones. We must stop shying away from the leadership challenge, and resist the temptation to hide behind heroes and villains.”
2:31pm In light of the government’s action plan on mental, launched today, the BBC has interviewed Melanie Denyer, who suffers from borderline personality disorder. Ms Dwyer said she waited for more than six months to get treatment following a suicide attempt.
1:47pm What have the controversial section 75 procurement regulations meant for the NHS and its providers? HSJ is holding a free webinar on 5 February to explore the answer to this question.
The webinar will consider whether commissioners’ behaviours have changed since the regulations came into force in April, and how providers from both the NHS and independent sector can respond. It will also look at other aspects of competition within the NHS and the changing landscape these developments present for providers and also for commissioners.
Can’t watch it live? Not to worry, you can catch up on demand at www.hsj.co.uk/hsj-tv
1:20pm Also in Nursing Times, staff shortages and the pressures being faced by nurses in London were highlighted in parliament this month.
12:52pm In our sister publication Nursing Times, the first ever national workforce plan for the NHS was approved at the end of last year by Health Education England. Shaun Lintern analyses what it means for nursing.
12:31pm Sleep could help protect men from prostate cancer according to scientists and reported by The Times.
High levels of the “sleep hormone” melatonin were linked to a 75 per cent reduced risk of the advanced from of the disease, a study has found.
Melatonin triggers feelings of drowsiness and low levels of the hormone are associated with disrupted sleep patterns.
12:25pm More from today’s papers, The Times reports that hospitals are failing to report cases of female genital mutilation despite treating thousands of victims of the practice.
A new report claims that complacency in recording FGM incidents is resulting in a lack of prosecutions.
Out of 161 hospitals that responded to a freedom of information request, 83 said that they did not record FGM cases.
11:51am More from The Guardian: Women are risking their lives by not going for cervical screenings, campaigners have warned, after new research shows many women are too scared or embarrassed to have the test.
A fall in the number of women attending GP’s surgeries for cervical screening has raised fears that more will develop the disease and be diagnosed late. Women aged 25-29 and 60-64 are least likely to attend an appointment, with one in three younger women and more than one in four of the older group not turning up, according to research commissioned by Jo’s Cervical Cancer Trust.
11:42am Back to today’s papers, in the The Guardian, a deaf couple have criticised a hospital for not providing them with a sign language interpreter during the traumatic birth of their son.
Hulusi Bati and Nadia Hassan, say the lack of communication during the birth and Hassan’s subsequent 10-day stay at University College hospital, London, amounted to discrimination, and are now taking legal advice.
The British Deaf Association said the case reflected the experience of many deaf people using the NHS, two out of three of whom have asked for an interpreter at a hospital appointment but have not been give one, according to a 2012 survey.
11:32am Also in response to Nick Clegg’s speech on mental health care, Paul Jenkins, chief executive of the charity Rethink Mental Illness said: “I welcome the fact that the deputy prime minister is bringing attention to these important issues and he clearly has a personal commitment to improving the lives of people with mental illness. However, warm words will only get us so far.
“The reality is that NHS spending on mental health has been cut by 2% over the last two years, while demand is increasing. If Mr Clegg really wants to bring mental health care into line with physical health, as the government has already committed, it’s never going to happen while budgets are being cut.
“The ‘mental health action plan’ is a positive step forward, and identifies a lot of areas that need to be improved. The problem is that it’s too vague and does not make any solid commitments or give time-frames for action.
“For example, everyone agrees that we need to introduce maximum waiting times for mental health but we still haven’t been given any commitments on when this will come into force. In the mean time our supporters are having to wait months or even years for life-saving treatment. This would never been seen as acceptable for cancer patients.”
11:24am Responding to Nick Clegg’s speech on bringing mental health “out of the shadows” at the launch of the government’s mental health action plan, Sean Duggan, chief executive of Centre for Mental Health, said: “Today the deputy prime minister called for every person to commit to achieving better mental health in Britain. This is an important message and goes some way to address the challenges that we face and the disparity that we currently see in our society, between the way we see, talk about and treat mental health problems.
“He is right to say that we are talking about people’s everyday lives. One in four of us has a mental health problem every year. Three quarters never get any treatment or support. And life with a mental health problem is harder, shorter and poorer than it should be.
“We agree that mental health problems reach beyond the health service into education, employment, justice, housing and many other areas. We echo the deputy prime minister’s call to close the gap between mental and physical health care. A commitment to clear standards on access and waiting times as an important step to parity for children and adults who currently wait too long to get the help they need.
“We are concerned, however, that recent evidence shows the NHS is cutting mental health support in many areas and that mental health services are being told to make bigger savings than hospitals. Cutting back on parenting programmes and community services is a false economy that will cost us all in future.
“Centre for Mental Health calculated that mental ill health costs £105 billion in England every year. Better mental health is good for everyone: for our families, our workplaces and our society. We need to see today’s Action Plan spur on the NHS, schools, councils and all government departments to take concerted action to improve mental health, reduce inequalities and enhance life chances.”
11:16am Deputy prime minister Nick Clegg has urged NHS commissioners to “step up to the plate” on helping the government, HSJ’s Shaun Lintern reports.
In a speech today Mr Clegg launched a new national mental health action plan setting out key aims the government wants to see mental health prioritised to the same extent as physical health.
He said variability in standards of mental healthcare across the country were worse than the “well documented variability in physical health”.
11:10am On the launch of the government’s new mental health stategy, Dr Geraldine Strathdee, NHS England’s national clinical director for mental health, said: “We are keenly aware of the issues patients with severe mental illness have in terms of their physical health, and the need for extra help to tackle their physical health problems.
“Patients with schizophrenia will on average die 14.6 years earlier, bipolar 10.1 and patients with schizoaffective disorder eight years earlier than the general population. They are dying of the same conditions as the general population but have the life expectancy as people had living in the 1950s.
“In all inpatient units and three community intensive teams, we want to make sure health professionals across the board are making checks which pick up lifestyle issues such as smoking and lack of physical exercise which is markedly higher in the SMI population than the general population, as well as tackling the higher levels of diabetes, cancer and other long term illnesses. We know that medication can be a factor, so people also need to be offered regular education, choice and monitoring of the impacts of medication.
“This needs a co-ordinated effort so that some organisations which traditionally solely address the patient’s psychological problem, also now arrange treatment of the physical health aspects. We urge those leading organizations which have made major progress in recent years in tackling the neglect of physical morbidity to share learning with others
“People with serious mental illness (SMI) often do not respond to health messaging campaigns, such as ‘be clear on cancer’ , in the same way as the general population and therefore there needs to be a real focus to increase awareness, educate and implement forms of outreach to this vulnerable group. Everyone has a part they can play, and we are working with partner organizations representing service users, families and carers, committed mental health clinicians, Royal Colleges, commissioners and GPs to drive improvement.”
Jo Powell, NHS England’s programme lead for the Parity of Esteem programme, added: “The programme aims to prevent and detect long-term physical and mental health conditions earlier, and ensure timely access to high quality services for people with mental health needs, among many other things.”
11:03am HSJ’s Shaun Lintern has tweeted from the government’s mental health strategy launch:
“Clegg said commissioners need to “step up to the plate” on mental health. But you’ve just cut MH trust budgets 20% more than acute trusts.”
“Channel 4 and ITV journos were booed and shouted down by audience for asking questions about Lord Rennard and not mental health.”
“All in all I suspect that was a frustrating speech for anyone on the ground in the mental health sector.”
10:59am The Guardian reports that drug and insurance companies will be able to purchase patient information from later this year, through the care.data database.
Once the care.data is live, organisations such as university research departments, insurers and drugs companies will be able to apply to the Health and Social Care Information Centre to access the database, which will contain NHS numbers, data of birth, postcode ethnicity and gender information.
Mark Davies, the centre’s public assurance director, said there was a “small risk” that patients could be “re-identified” if organisations had their own medical data which could be matched against the records.
10:48am In today’s papers, The Daily Telegraph reports on figures which suggest care homes have been allowed to remain open despite never having passed inspections set by the Care Quality Commission. Some homes have failed as many as nine consecutive times.
Andrea Sutcliffe, chief inspector of adult social care, told The Telegraph: “The decision to cancel a provider’s registration is never one we take lightly as it can be very distressing and disruptive for the residents involved.
“However, when a service persistently fails to meet the standards of care and safety required by law, we will act to use our powers, which can lead to the closure of a home. The people who use care services are always our number one priority.”
“There are a range of actions that we consider depending on the level of concern and the risk to those who use the services. These can range from telling a provider it has to improve by a certain date, to issuing fixed penalty notices, to taking enforcement action that, ultimately can lead to the closure of a service.”
She added the CQC plans to introduce a new ratings system across the adult social care services that “will make our judgements clearer than ever before.”
10:44am Every GP practice in Liverpool is to have access to dedicated Citizens Advice advisors to whom patients with non-medical problems can be referred, HSJ’s Judith Welikala writes.
Liverpool Clinical Commissioning Group plans to invest over £1m in the Advice on Prescription Programme over the next three years as part of its mental health strategy.
New guidance issued by Scottish health secretary Alex Neil makes it clear that the vast majority of patients should be treated within NHS Scotland, the Scottish government said.
10:34am Debate has reignited about the sale of patient records containing information on mental health conditions, diseases like cancer and habits such as drinking or smoking being sold to organisations such as drug and insurance companies.
Information on the nation’s medical history will be held on a giant database called care.data, which will be controlled by the Health and Social Care Information Centre, starting in March.
The issue was highlighted by HSJ last year.
10:25am The Department of Health has published Closing the Gap: priorities for essential change in mental health, which sets out its 25 priorities for change in how children and adults with mental health problems are supported and cared for.
10:17am Ahead of the government’s mental health strategy launch this morning deputy prime minister Nick Clegg said it was “just plain wrong” to treat the illness as the “poor cousin” of physical health in the NHS, in an interview with the BBC.
10:09am The controversy about zero hours contracts is obscuring the real issues about workforce planning and staffing levels, says Emlyn Williams, who heads the commercial healthcare sector and is partner in the employment team at Weightmans law firm.
She asks: “While using zero hours contracts is instinctively always likely to seem wrong within the NHS, we risk missing the key question, which is why do so many organisations currently feel the need to use significant numbers of temporary staff at all?”
10:04am The NHS reforms have distracted the people responsible for protecting the population against the threat of a pandemic, argues Richard Coker, professor of public health at the London School of Hygiene and Tropical Medicine.
“The public health community’s efforts to protect the population are often hampered by the perpetual reorganisation of the state’s apparatus,” he says.
“None of the agencies that coordinated or delivered the response to the last pandemic now exist.”
9.58am HSJ reporter Shaun Lintern is tweeting from the Department of Health’s mental health strategy launch this morning. Follow him @ShaunLintern for any updates.
9:48am A clinical commissioning group leading one of the most high profile procurements in the NHS has agreed to publish commercially sensitive documents following a threat of legal action, HSJ’s Sarah Calkin reports.
A law firm acting for campaign group Stop the NHS Sell Off in Cambridgeshire accused Cambridgeshire and Peterborough CCG of acting unlawfully by failing to allow opportunities for meaningful public engagement in the tender of a multi-million pound contract for older people’s services.
7:00am Morning and welcome to HSJ Live. Terry Young, professor of healthcare systems at Brunel University, has written for HSJ on how ” [computer] modelling provides a safe, inexpensive way to try new methods” in urgent care.
Professor Young refers to a number of examples where NHS organisations are already using modelling, including the Royal Free, which used simulation to see whether a planned emergency department could cope with extra demand created by a local reconfiguration in London.
He observes: “Nobody would design a smartphone or an airport without modelling capacity. It looks increasingly strange that so many people believe that we can roll out health measures on the basis of intuition and past experience”.