The Royal College of GPs has called for an ‘immediate pause’ on GP practice inspections, plus the rest of today’s news and comment

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5.10pm Catch up on all today’s key health policy stories and talking points in HSJ’s Executive Summary.

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4.32pm The Palliative Care Bill addresses many of the issues that need to be tackled if end of life care is to be improved to benefit patients and families, says John Hughes, medical director at Sue Ryder.

He writes on “Helping patients recognise and accept the inevitability of approaching death, as reflected in the bill, is a skill that all palliative clinicians have. However, this is not always something that those on the NHS’s frontline care are comfortable with or have enough experience and expertise in.

“It requires a culture change and a rethinking of the management of patients needing end of life care, particularly those in acute services who are predominantly focused on ‘cure’.”

4.18pm What would happen if you took 48 of the brightest brains from Europe’s top business schools, locked them up in a tower for a day and asked them to solve the “wicked” problem of the NHS’s overstretched emergency departments?

This was the scenario played out at Warwick Business School’s London base at the Shard in April.

Eight teams of six from business schools in the UK, Spain, Italy and the Netherlands were tasked with designing the emergency department of the future in the WBS case challenge 2015. Daloni Carlisle reports on what the young leaders came up with.

3.52pm In an article for, Chartered Institute of Public Finance and Accountancy chief executive Rob Whiteman criticises the government’s decision to cut the public health budget by £200m.

He says: The NHS Five Year Forward View is predicated on the aim that the sustainability of the NHS depends on a genuine commitment to prevention. 

“Delivering this will fundamentally require support from local government, given their statutory responsibility to improve public health.  

“Cutting the grant, which already only accounted for less than 3 per cent of overall health spending, sends the symbolic message that there is a lack of belief or commitment to the prevention agenda.”

3.27pm The Royal College of Nursing has passed an “emergency resolution” at its annual congress “deploring” the decision to halt the work by the National Institute of Health and Care Excellence on safe staffing.

HSJ revealed earlier this month that NICE was told to suspend its work to determine safe staffing levels by NHS England.

It has called for the reversal of this decision, which it said “puts patients’ lives at risk”. Over 99 per cent of delegates voted in favour of the resolution.

RCN chief executive Peter Carter said: “Nursing staff were shocked by the decision to stop NICE’s work on safe staffing, which came out of the blue.

“There was a consensus that the number of registered nurses was linked to patient safety – not just among nurses… but by experts including Sir Robert Francis, Sir Bruce Keogh and Don Berwick, not to mention the Department of Health.

“This was a consensus backed up by reams of research and evidence and our concern is that the decision has been made for financial reasons.

“Make no mistake – taking NICE out of the equation is a backwards step. After years of fighting for patients, nursing staff finally had an assurance that staffing levels would be taken seriously, and set by an independent organisation, using thorough, transparent research. This meant a great deal to health care staff, whose biggest concern is patient safety.

“It is utterly demoralising to find we may be returning to the dark days of putting affordability before patient safety. We know how that ends. The government must not repeat the mistakes of the past. Patients will not forgive them, and nurses have shown today that they will not give up on safe staffing for their patients.”

3.00pm The Royal College of GPs has called for an “immediate pause” on GP practice inspections.

The move comes after delegates at the British Medical Association’s annual conference yesterday voted for the abolition of the Care Quality Commission, albeit as a ‘reference’ so it will not become official BMA policy.

The RCGP’s governing council over the weekend voted “overwhelmingly” in favour of an emergency motion calling for on health secretary Jeremy Hunt to introduce an “immediate pause” in routine inspections of GP practices by the Care Quality Commission so that they can “better manage their workloads”, and for an “urgent review of CQC inspections and regulatory processes”.

The motion states: “In response to the Secretary of State’s announcement that GPs are the ‘jewel in the crown’ of the NHS, Council asks the Chair of Council to write [to him] asking for an immediate pause in the CQC’s programme of routine inspections in order for practices to better manage their workloads. Council calls for an urgent review of CQC inspections and regulatory processes.” 

In an open letter to the Mr Hunt, RCGP chair Maureen Baker called for routine practice inspections to be “halted on a temporary basis” while an “urgent review” of the CQC’s inspection regime takes place. However she stressed that this should “not… prelude the CQC from conducting inspections of practices where specific reasons existed for doing so”.

The letter states: “In the view of RCGP Council, the current inspection process tends to focus on those things that can be most easily documented and generates considerable additional clinical and administrative activity for practices. We believe that the time has come to conduct an urgent review of the CQC’s regulatory regime, to eliminate unnecessary bureaucracy and to ensure that it reflects the distinctive nature of general practice and focusses on what matters most to patients. 

“Whilst this takes place, we call for the CQC’s programme of routine inspections to be halted on a temporary basis, as a means of alleviating the pressures on general practice which have now reached such an extent that they are giving rise to serious patient safety concerns. 

“This would not, of course, preclude the CQC from conducting inspections of practices where specific reasons existed for doing so, for instance were a practice to be subject to a significant level of complaints.”

According to research by the RCGP, each GP could gain 120 additional hours per year to spend on direct patient care if the government were to reduce by their general administrative burden by half.

Dr Baker’s letter adds that members are “extremely concerned” about the government’s aspiration to rollout out routine seven day appointments across practices in England, which could set “unrealistic expectations on general practice and have a negative impact on efforts to recruit and retain more GPs”.

“Our members are extremely concerned about the impact such a move would have on their ability to keep vital services up and running for patients. In the current climate – with huge concerns about current and future workforce capacity, and experienced GPs retiring due to high stress levels – we believe it is unrealistic to talk about achieving seven day access for routine GP care,” the letter states.

“As the College has been highlighting… and as you noted in your speech, successive governments have under-resourced and undervalued general practice, with the result that GPs are in no position to take on extra work.

“Attempting to force through seven day working without a significant boost in resources and workforce would cause general practice to go into meltdown and would irreparably damage patient care.

“We are concerned that there is a real risk that the emphasis being placed on expanding seven day working will place unrealistic expectations on general practice and have a negative impact on efforts to recruit and retain more GPs.

“With morale already at an extremely low ebb within the profession, telling GPs they must work longer hours – when workloads are already so high – will make it harder for us to attract young doctors into general practice, and lead to more of our current workforce retiring early.

“We urge the government to give assurances to concerned GPs across the country that plans to move to seven day working will not be forced through whilst our concerns remain unresolved.”

Independent research commissioned by the RCGP found that extending GP hours beyond the current contract so that one in four surgeries open late and at weekends would cost at least £749m per year. This figure would rise to £1.2bn if one in two practices were to take part, which would exceed the funding offered in the GP Challenge Fund.  

The letter concludes: “The RCGP wishes to work with the government to deliver change for general practice, and there is much that we have welcomed in your speech.

“We have been calling for a ‘new deal’ for general practice for some time, and have set out in our Blueprint the specific measures that we believe now need to be taken to translate this into reality.

“However, we have always been clear that measures to increase resources, boost GP workforce capacity and reduce bureaucracy in general practice are needed to shore up current services and make them sustainable for the future – not as a trade-off for expanding practice opening hours.”

1.55pm Chief executive of Public Health England Duncan Selbie on the recent public health budget cut announcement.

12.15pm The rollout of summary care records to community pharmacists has been welcomed by leading pharmaceutical bodies.

A joint statement from the Royal Pharmaceutical Society, Pharmacy Voice and the Pharmaceutical Services Negotiating Committee said: “We welcome and fully support the deployment of access to the summary care record to all community pharmacies in England. There has long been a consensus across the profession that widening access to health information to community pharmacy will enable safer, better and more accessible care.

“The summary care record provides up to date clinical patient information, available 24 hours a day, however this information is only accessible with patient consent. It contains highly relevant information for pharmacists about patients’ medicines and associated information such as allergies and adverse reactions.

“We strongly believe by extending summary care record access to community pharmacists people will receive better, safer and more accessible care.

“Patients can be assured their records are safe, as they can only be accessed by a registered pharmacist or pharmacy technician using an NHS smartcard and PIN, and then only after the patient has given consent.”

11.50am Community pharmacists across England will be given the opportunity to access the Summary Care Record, in new plans announced today.

More than 96 per cent of the population have an SCR and it is already being used in many settings across the NHS, such as A&E departments, hospital pharmacies, NHS 111 and GP out of hours services and walk in centres.

Following a pilot across 140 sites, NHS England has commissioned the Health and Social Care Information Centre to support all community pharmacies in England to implement access to the SCR.

A report assessing the effectiveness of the pilot found that SCR access in community pharmacies delivered benefits to patients, pharmacy and general practice, including:

  • In 92 per cent of encounters where SCR was accessed, the pharmacist avoided the need to signpost the patient to other NHS care settings.
  • 85 per cent of pharmacists surveyed agreed or strongly agreed that SCR reduced the need for them to contact the patient’s GP.
  • In 18 per cent of encounters, the risk of a prescribing error was avoided.

Implementation is expected to begin in autumn 2015.

Capita’s IT enterprise services division, along with IT firm Clinisys Group, were awarded the £1.6m contract by Empath, a joint venture created by Nottingham University Hospitals Trust and University Hospitals of Leicester Trust to deliver shared pathology services.

The companies will build, design and install a laboratory information service for blood transfusion across University Hospitals of Leicester’s three main sites to make them compatible with Nottingham University Hospital’s existing systems. 

11.20am The Times reports that a large majority (80 per cent) of delegates at the Royal College of Nursing annual conference voted to oppose the use of secret surveillance cameras in nursing homes.

Relatives are able to install hidden cameras in nursing homes when they suspect ill treatment or abuse of their loved ones, under official guidance.

However, the RCN warned that covert filming made health workers feel they were “under the microscope”.

10.55am Plans to give allied health professionals the ability to prescribe medicines without the input of a doctor will help the NHS develop new models of care, an NHS England official has said.

Suzanne Rastrick, chief allied health professions officer for NHS England, said the health service needed to look beyond the stereotype of a workforce predominantly made up of doctors and nurses and instead embrace what AHPs can offer.

AHPs cover 12 qualified roles including occupational therapists, paramedics, physiotherapists, radiographers and arts therapists. They usually train for 3-4 years and work in acute, community and primary care settings.




10.05am HSJ reporter Nick Renaud-Komiya is at a King’s Fund today which discusses private healthcare.

He is tweeting from the event and you can follow him @nickrenkom.

9.55am The Independent reports that people who go to their GP with tell-tale cancer symptoms will be sent for fast-track tests in an attempt to prevent thousands of deaths a year caused by late diagnosis, health experts have announced.

Doctors should order cancer tests for patients displaying certain symptoms immediately instead of referring them to a specialist first, according to new guidelines published by NICE.

7.00am Good morning and welcome to HSJ Live. We begin the day with the news that outsourcing company Capita has been awarded a contract to deliver a blood transfusion system as part of plans to create a centralised pathology service across Nottinghamshire and Leicestershire.

Capita’s IT enterprise services division, along with IT firm Clinisys Group, were awarded the £1.6m contract by Empath, a joint venture created by Nottingham University Hospitals Trust and University Hospitals of Leicester Trust to deliver shared pathology services.

The companies will build, design and install a laboratory information service for blood transfusion across University Hospitals of Leicester’s three main sites to make them compatible with Nottingham University Hospital’s existing systems.  

The contract award is part of the trusts’ broader strategy to consolidate pathology services into a “hub and spoke” model, with one central laboratory doing routine work alongside five specialist analysis sites.