Major review of nurse training and education in the East of England launched, and the rest of today’s news and comment.

Live logo

4.21pm In Michael White’s latest column he argues that the Welsh NHS is being used as a political tool in the run-up to the election in 2015.

3.46pm Our story on the possible tax implications for autonomous Commissioning Support Units has attracted some interesting reader comments:

“Welcome to the real world of business CSUs - the addition of VAT to a contract value prices most VAT registered small to medium enterprises out of the market, so if the CCG are going to reclaim VAT for the CSU contract then that should level the playing field - shouldn’t it? OK I won’t hold my breath….”

“This was so gosh-darned obvious to anyone with private sector services experience. The fact that we’re here now signifies a huge waste of taxpayer’s money thus far.”

“If this is a new income stream to the Treasury, surely the simple thing to do is to raise the outflow back into the NHS funding stream by the same amount and for this to be allocated to CCGs to meet the anticipated cost pressure. This would have the added benefits of allowing the Government to claim they have funded the health service above inflation and would also allow real competion between and with commercial CSU service providers.”

“Even if the VAT issue hadn’t been clear before, HSJ ran a story in February 2013 about hospitals and VAT that should have raised alarms. I operate a VAT-registered business and spent some time with my local VAT inspector querying the way the local acute Trust was applying VAT when tendering for contracts, which led to the conclusion that the Trust had it wrong. It was always clear to me that CSUs would have to charge VAT and I’m surprised anyone hadn’t realised it.”

Phil Morley said in a statement his departure was a “personal decision” which he “took several weeks ago” and shared with his senior team “in order that we could put transitional arrangements in place”.

“It was an extremely difficult decision for me to take and I will miss my colleagues and all the incredible staff at Hull and East Yorkshire Hospitals Trust,” he said.

2.25pm Between 100 and 500 GP practices are to pilot the extraction of patient data as part of the controversial Care.data programme, NHS England has announced.

A letter from the national agency sent to all CCGs and local area teams lays out the plan for the practices to test and refine the process ahead of a national roll-out this autumn.

Tim Kelsey, NHS England’s director of patients and information, also uses the letter to update commissioners on the work done since the data-sharing scheme was postponed for six months at the end of February. This pause came as a result of concerns from patients, clinicians and privacy campaigners that patient data could be accessed inappropriately.

Mr Kelsey said: “Over the coming months, the Health and Social Care Information Centre will work to provide assurances over the safety of data collected, stored and shared, including the option of accessing data from a controlled environment, sometimes referred to as a ‘data-lab’ or ‘fume-cupboard’, for use by organisations requesting data.”

1.50pm Here are some interesting articles from our Leadership section, including Dame Julie Moore’s wise words to her younger self.

1.26pm Over in our Comment section the chief executive and chair of the Foundation Trust Network outline why they disagree with HSJ editor Alastair McLellan’s piece last week that called for the foundation trust pipeline to be shut off.

The Manchester-based cancer centre, one of the UK’s most prestigious specialist trusts, has entered into a joint venture with Synlab UK. The firm will now provide services at the centre.

The Christie Pathology Partnership will last for 10 years, with an option to extend the agreement for another five years after that, according to a trust spokeswoman.

12.22pm The Times has obtained figures have found the most critically ill patients in Wales are 33 times more likely to face an extremely long wait for an ambulance than patients in England.

11.55am The NHS Atlas of Variation in Diagnostic Services is the latest in the atlas series produced by NHS Right Care, looking at variation in specific areas of healthcare.

The atlas is the first to cover the role of diagnosis, providing 69 maps of diagnostics use across England, including imaging, endoscopy, physiological diagnostics, pathology and genetics. Also for the first time, some data is available at clinical commissioning group level.

11.28am The Easter weekend provided an opportunity to look at some highlights from our innovation and efficiency section. Among them Aseem Malhotra argues that to break the cycle of obesity and diabetes a sugar tax must be introduced, while Edward Peck reflects on the radical transformation that mental health services have gone through over the past 30 years.

The review follows mounting evidence that particular groups experience poorer quality care at the end of life, and that the care they receive does not always meet their needs.

The review will examine the experience of patients with dementia, mental health needs, learning disabilities, non-cancer diagnoses, people from black and minority ethnic backgrounds and people from lesbian, gay, bisexual and transgender communities. It will also examine geographic variations in the quality of care.

10.56am Here is a data video looking at A&E performance in 2013/14. Emergency admissions at major A&E units were at their highest level in nearly a decade.

Video:

A&E performance 13/14

Video:

A&E performance 13/14

The scrutiny will examine pre-registration training for nurses at six universities across the region, covering 23 courses and an estimated 4,500 students.

It will be run by the East of England local education and training board branch of Health Education England. The national body last week launched its own nationwide review, which will examine both pre and post registration standards of nurse education.

10.35am The Times reports that thousands of diabetics have had their feet amputated needlessly, the charity Diabetes UK has claimed.

The charity has said that “appalling” regional variations in NHS care have meant that in the worst parts of the country, people are seven times more likely to have amputations than in the best performing areas.

The Scottish Patient Safety Programme Primary Care, run by Healthcare Improvement Scotland has been awarded £450,000 over two years to test the scheme.

HIS said that the majority of patient consultations are safe but that some hospital admissions are due to the adverse effects of medication.

10.25amThe Daily Telegraph reports that small GP practices are facing extinction as the NHS favours so-called “super-surgeries”, with 10 or more GPs based on the same premises.

Figures from the House of Commons library show the total number of GP practices fell from 8,830 in 2003 to 7,960 in 2013. Small practices in rural areas bore the brunt of this decrease.

10.21am The chief executive of Hull and East Yorkshire Hospitals Trust, Phil Morley, has resigned reports the Hull Daily Mail.

Interim chairman Dr Keith Hopkins, who takes over from Rob Deri, said that John Saxby, former chief executive of Pennine Acute Hospitals Trust, will take up the post of interim chief executive.



10.13am Heart of England Foundation Trust has appointed a new chairman.

Les Lawrence was previously a non-executive director on the trust’s board and will start his new role in June.

Mr Lawrence was previously the cabinet member for children, young people and families at Birmingham City Council, and has also chaired both the Royal Orthopaedic Hospital Foundation Trust and the Alexandra Hospital in Redditch.

Mr Lawrence said: “It is an honour and a privilege to be named the new chairman of the Heart of England Foundation Trust. Everything we do must be focused on the patient experience and the quality of their treatment. I am committed to working with patients, staff, governors and the local community to ensure the care provided at Heartlands Hospital, Birmingham Chest Clinic, Good Hope Hospital, Solihull Hospital and Community Services is of the highest standard. It is also important to work with other partners in the local health system and the Local Authorities, including the elected members.  Through this approach, we will be able to seize new opportunities that help shape the future of the healthcare provided at the Trust.”

Richard Hughes, lead governor at the Trust, said: “Les’ experience and expertise in healthcare management means we were able to vote for Les with complete confidence. His passion for local engagement and patient care shines through, and we are committed to working with him and the board of directors to deliver outstanding patient care and health services at the Trust that we can all be proud of.”

Mr Lawrence succeeds Lord Philip Hunt as chairman, who held the position from April 2011 and will retire in May 2014.

10.09am The Daily Mail reports that 67 doctors who were found to have signed off blank abortion forms will not face disciplinary action.

The CQC investigated the practice and referred all 67 to the General Medical Council but an FOI request has established that none of them will be brought before a fitness to practice hearing.

Researchers found that acute kidney injury causes between 15,000 and 40,000 excess deaths every year.

The condition refers to a loss of kidney function and can develop very quickly. It can occur in people who are already ill with conditions such as heart failure or diabetes, and those admitted to hospital with infections.

10.00am Over the Easter break we took a look at some commissioning highlights. Julie Jordan explains what impact the better care fund will have on the NHS, and south Somerset demonstrates what data can achieve as it pieces together care costs across both health and social care.

9.35am Waiting times expert Rob Findlay takes a look at the February waiting times data. He argues that it is a good thing that the NHS breached the 90 per cent admitted target.

The agency has already launched a review to investigate the financial impact of making CSUs independent.

This will examine whether establishing autonomous CSUs would generate new tax charges for the NHS commissioning system.

Senior CSU sources are concerned that they may have to charge value added tax when they become autonomous in 2016 as currently planned.

7.00am Good morning and welcome to HSJ Live. We start the day with a comment piece from Rachael Addicott, senior research fellow at the King’s Fund, who argues that GPs should be put at the centre of a radical approach to integration.

Rachael writes: “General practice is well placed to lead the changes needed in primary care. The registered patient list puts GP surgeries in a unique position to intelligently monitor the overall health of their population and deliver interventions to keep this population healthy and cared for in the community for as long as possible.”