HSJ Live 23.04.2013: Hunt appears in front of health select committee

5.57pm: NHS England has released the NHS England Review of Children’s Congenital Cardiac Surgery Service at Leeds Teaching Hospitals NHS Trust report.

This report is the output of the independent review team that formed part of the first stage of the review into children’s heart surgery at Leeds. It looked at systems within the unit and found that there were no immediate issues that would prevent a resumption of surgery.

5.20pm: The Spectator has tweeted that Anna Soubry thought she got the public health portfolio beacause she’s a woman.

@Spectator_CH: “Anna Soubry: PM thought only a woman could do ‘soft bloody girly’ public health job http://blogs.spectator.co.uk/coffeehouse/2013/04/anna-soubry-pm-thought-only-a-woman-could-do-my-job/ …”

4.59pm: Back to Jeremy Hunt. According to the health secretary, integrated care of frail elderly with long term conditions is the next big bullet the NHS has to bite; though he pins the blame on EU law for causing obstructions in the way of integration.

4.48pm: Exclusive: New guidelines from the NHS’s competition watchdog may lead commissioners to “perceive the scope for regulatory action as being so wide that it inhibits service redesign”, an influential think tank has warned.

The Nuffield Trust also said recent papers from the NHS Co-operation and Competition Panel seemed to reveal an “automatic assumption” that competitive pressure was beneficial, while placing a challenging “burden of proof” on those wishing to reorganise NHS services.

The warnings were issued in a parliamentary briefing – seen exclusively by HSJ – produced by the think tank ahead of a crucial Lords vote tomorrow on whether to annul controversial NHS competition regulations brought in under the 2012 Health Act. The briefing says there is an urgent need for “balanced guidance” on how NHS commissioners should interpret competition and procurement rules.

4.41pm Experienced teams of doctors, nurses and patient representatives are set to make their first visits to hospitals as part of the Keogh Review.

Led by regional medical and nursing directors of NHS England, review teams will visit the 14 trusts whose mortality ratios have shown higher-than-expected rates for the past two years. Site visits for the first four hospital trusts will commence between May 7-9.

A further six hospitals will receive visits over the following four weeks, while the final four will be visited in mid-June. During the visits, each expected to last 2-3 days, teams will carry out “rapid responsive reviews”, observing the hospital in action, as well as taking part in meetings with patients, members of the public, and staff. These visits will be followed up with unannounced visits.

The review, led by former heart surgeon and now medical director of NHS England, Professor Sir Bruce Keogh, seeks to find out whether there are any sustained failings in the quality of care and treatment being provided to patients at these trusts. It will identify:

· Whether existing action by these Trusts to improve quality is adequate and whether any additional steps should be taken

· Any additional external support that should be made available to these Trusts to help them improve

· Any areas that may require regulatory action in order to protect patients.

Prof Keogh said: “I am determined that these reviews should be about identifying solutions to any problems that may exist. I am interested in not just providing a diagnosis, but helping to write the prescription and provide support to these hospitals to help them improve.

“A higher than expected mortality rate does not in itself tell us that a hospital is unsafe. For example, units delivering highly complex and specialist care could legitimately have higher mortality rates.  It is, however, a warning light that suggests further investigation is necessary.

“It is important that the mortality data warning light – which went unheeded at Mid-Staffordshire Hospitals – is checked in future. That is what this review is all about, and the lessons of Mid-Staffordshire will inform all of the NHS’s new ways of monitoring hospitals.”

4.11pm: More from David Williams: “Hunt: CQC will get as much cash as they need to run the new inspection regime.”

“Una O’Brien: We’ve closed the loophole that meant Gary Walker’s gag didnt need treasury sign off. Issued new guidance since that came to light.”

4.05pm: “On Leeds, Percy argued he didn’t want to see Leeds row repeated. Hunt said Keogh did the best with the info he had.” (2/2)

4.02pm: He further tweets: “Most colourful exchanges have been between Hunt and cttee member Andrew Percy over Leeds childrens heart surgery.” (1/2)

4.00pm: ‏@dwilliamsHSJ tweets from the parliament: “Hunt reveals he had an operation on the NHS last year. Would recommend the care he received warmly.”

2:53pm Monitor has secured binding agreement to make improvements to the leadership and governance of a mental health foundation trust where vulnerable patients were put at risk because of poor care.

Dorset HealthCare University Foundation Trust has given legally binding undertakings that it will put right potential breaches of the licence issued by the health sector regulator.

This regulatory action is part of a suite of new powers for Monitor, in force from April 1, to further its statutory duty to protect and promote the interests of patients. Monitor stepped in after the Care Quality Commission inspected Forston Clinic at Charminster and identified concerns about the quality of care for patients with mental health issues, resulting in the closure of Minterne Ward.

Stephen Hay, managing director for Provider Regulation at Monitor, said: “The Trust has failed to tackle long-standing quality issues and we are concerned that this indicates that the Board is not performing effectively.

Monitor has acted in the best interests of patients to ensure that the Trust takes urgent action and will hold it to account if it fails to make the necessary improvements.”

2.45pm: After live tweeting Jeremy Hunt’s speech at at the NHS Clinical Commissioners’ conference, HSJ reporter David Williams is also covering the health secretary’s appearance in front of the House of Commons health select committee over the findings of the Francis report.

He tweets: “Hunt and the mysterious DH permanent secretary Una O’Brien in front of health cttee now.”

1.54pm: ‏@dwilliamsHSJ: “Hunt says the govt is going to have to look at PbR. Johnny Marshall says its encouraging the wrong behaviour.”

1.10pm: Lord Warner has written an opinion piece for HSJ where he explains how the Health Act’s new draft regulations will benefit patients and improve quality by opening up the NHS provider market, and why he will be voting for NHS competition regulations.

Labour’s former minister of state writes: “The new regulations will help the commissioning groups tackle some of their problems with clearer rules. They should be passed by Parliament forthwith.”

Read the entire article here.

1.05pm: More tweets from @dwilliamsHSJ: “Hunt: “utterly shocking” ppl are admitted to A+E without staff able to see what conditions the patient has. He saw this in Watford first hand.”

..”procurement bureaucracy is imposed.” Hunt goes on to stress the importance of CCG self determination.”

12:55pm: HSJ’s reporter David Williams tweets: “Hunt also says tougher inspections will lead to dramatic increase in quality, and therefore to cost savings.”

12:47pm: More tweets on Jeremy Hunt’s speech at #NHSCC2013. @nhsalliance: “JH: CCGs are not about replacing PCTs / SHAs - this is about autonomy. NHS England is not a new DH. #NHSCC2013”

12:40pm: Jeremy Hunt’s has begun his speech at the NHS Clinical Commissioners conference in London. @DrNickJenkins tweets: “@Jeremy_Hunt tells #NHSCC2013 says clinical leadership & local decision making is a positive change. But best is yet to come.”

12:13pm: There is an interesting debate on Twitter about the prospects for “hospital hotels” to be used in the NHS. King’s Fund fellow Nigel Edwards is cautious: “@SteveKellGP @elinlowri @clarercgp But enough to fill a hotel and self caring enough to use it?”

11.56am: The Telegraph also reported that health secretary Jeremy Hunt has accused the Royal College of Nursing of “missing” the Mid Staffordshire care scandal as their public disagreement escalates.

11.52am: The Telegraph is running a front page story on the likelihood of elderly patients being sent to “hospital hotels” to recover from illnesses or falls under government plans to ease so-called bed blocking on NHS wards.

New mothers and stroke patients could also use such services, which would be run by private hotel chains and provide en-suite facilities, television and room service.

Visiting hours for family members would be far more flexible than in a hospital, relations would be able to stay in a nearby room, and the system would save the health service tens of millions of pounds. The model is based on a system widely used in Scandinavia, with large hotel chains running the service on hospital sites.

The proposal is to be formally reviewed by NHS England, the new body responsible for recommending how local doctors’ groups should provide for their patients.

Earl Howe, the health minister, said he was studying the proposals because the care of older people in the community was an “issue of vital importance to our society.”

11.36am: Mr Hunt will also appear in front of the House of Commons health select committee this afternoon, in a session to address the findings of the Francis report.Expect the committee to grill Mr Hunt on ministers’ response to Francis, including how the Care Quality Commission’s new inspection regime will work and whether barring “failing” managers is a good idea. There could also be discussion on legal sanctions for trust boards, and maybe even an update on the government’s ongoing row with the RCN over nurse training.If you’re on Twitter follow @dwilliamsHSJ for live updates, though we’ll also be posting highlights on this page.

11.35am: Health secretary Jeremy Hunt will be speaking at the NHS Clinical Commissioners conference in London at 12.30 today. Although most of the event is taking place behind closed doors, HSJ reporter David Williams will be there for his speech.

The majority of clinical commissioning groups are now fully signed up members of NHS CC, and today will be the first time Mr Hunt has addressed them since they took over NHS commissioning at the beginning of April.

11.22am: Follow HSJ reporter Shaun Lintern for exclusive live coverage of senior speakers - including Sir David Nicholson - at an NHS Employers event on staff wellbeing. @ShaunLintern: “The context in which we are working is unprecedented” says NHS England chief exec Sir David Nicholson. #hwbsummit”

10.48am: Patrick Leahy, healthcare public affairs professional, tweets: @paraic84: “BBC: Labour rules out ‘massive’ NHS spending increases but says will protect NHS budget http://t.co/MglxYI7Hmq”

10.13am: In this week’s HSJ Local Briefing, reporter Shaun Lintern examines the changes being made to the health economy in Leicester and the ambitious £200m development plans for acute services at the University Hospitals of Leicester Trust.

Read the full briefing and the analysis here.

10.04am: The Times carries a page lead about the row between the government and the Royal College of Nursing this morning.

Prime Minister David Cameron has backed health secretary Jeremy Hunt over proposals for trainee nurses to complete a year of work as a healthcare assistant before beginning their training.

The proposals form part of the government’s response to the Francis inquiry, but the RCN has called the scheme “stupid”.

10.01am: Exclusive: A majority of the public believe some hospitals have a “tolerance of poor standards”, according to respondents to a national survey shared exclusively with HSJ. 

Polling firm Ipsos Mori said its survey on public attitudes towards the NHS following publication of the Francis public inquiry report revealed a public perception of a “listening deficit” in the NHS.

Jonathan Nicholls, head of health research at Ipsos Mori, said the findings were “a concern for the NHS”.

9.32am: In the build up to the debate on competition regulations tomorrow - King’s Fund chief executive Chris Ham tweets: “Why is OFT is investigating the proposed integration of hospital and community services there [in Torbay]. #regulationonspeed”

9.16am: Numerous NHS staff - and authors Philip Pullman and Mark Haddon - have signed an open letter co-ordinated by the NHS Action Party calling for the dropping of the controversial section NHS privatisation regulations. It comes ahead of a crucial Lords vote tomorrow, called by the Labour party, which could see the regulations overturned. The HSJ Live blog will cover the debate tomorrow.

9.13am: The NHS Confederation this morning published a report looking at lessons from the pre-April commissioning system, drawing on knowledge from experienced figures in the system.

The Confederation says: “This report has been produced to mark the end of a significant period of transition for NHS commissioning. It explores the achievements and challenges experienced over more than a decade of commissioning through the voices of those who lived it on the ground.

“Through interviews with twenty leading figures, this report captures critical lessons from the past, and translates these into messages that are relevant to new commissioners. It is intended to be a practical and supportive product for colleagues in the new system, with resonance for commissioners in CCGs, local authorities and NHS England.”

8.27am: There’s also a podcast discussion with Dr Charles Alessi, chair of NHS Clinical Commissioners and Mr Malcolm Qualie, pharmacy lead specialised services at NHS England, on how to get the most out of the drugs budget across the new NHS.

8.25am: Good morning, a new 360-degree based research is identifying which specific board behaviours and activities creates the kind of culture that Robert Francis urged. On HSJ’s leadership channel Beverly Alimo-Metcalfe and Juliette Alban-Metcalfe outline how boards can measure their performance and effectiveness.