HSJ to publish special supplement in September exploring attitudes to, and experiences of, people who are lesbian, gay, bisexual and transgender in the NHS, plus the rest of today’s news and comment
Shaun Lintern has been shortlisted in the staff journalist (professional media) category.
Sarah Calkin has been shortlisted in the young journalist category.
Winners will be announced at the Awards ceremony on July 9 at BMA House.
4.21pm Basildon and Thurrock University Hospital Foundation Trust have commented on the fact that they have been given a red rating for “open and honest reporting” under the new indicator announced earlier today. Here’s what they had to say:
“The news of Basildon Hospital’s emergence from special measures and receiving a ‘good’ rating from the CQC as announced on June 9 was a result of the significant improvements in quality, safety and culture within the organisation. We are pleased to say that having been an historic low reporter of incidents we are now in the top quartile of medium acute hospitals for incident reporting nationally.
“We are disappointed to note that the red rating for ‘open and honest reporting information’ relates to data which is out of date, highlighting an increased number of patient safety incidents resulting in harm. This is due to incidents being reported and graded in relation to potential harm instead of actual harm (as recognised by the National Reporting and Learning System). We are confident that current data will show we are in line with the national average.”
It is also disappointing to note that the NHS Choices performance data gives us a CQC rating of red just weeks after the commission scored us ‘good’.
We recognise the importance of publishing data relating to performance in key areas such as infection and cleanliness, staffing, safety and openness and honesty. These are measures which allow patients to better understand the quality of services they can expect across the NHS.
It is precisely for this reason that we have made great strides to improve standards in all of these areas over the past year
4.01pm Chris Hopson, the chief executive of the Foundation Trust Network, has commented on the health secretary’s announcements from earlier today:
“Today’s announcements demonstrate that the NHS is the most transparent and honest health system in the world. The NHS already provides its patients and staff with a greater level of information about the quality of local health services than any other system in the world and this will be enhanced further.
“NHS trusts and foundation trusts have responded quickly and effectively to last year’s Francis report, by investing substantial resources in increased staff levels and implementing additional quality and safety reporting. Every NHS provider and member of staff wants to ensure avoidable mistakes and harm to patients don’t happen. Sir Robert Francis’ new review and the ‘sign up to safety’ patient safety campaign, led by Sir David Dalton, one of the NHS most respected chief executives will both bring valuable additional focus to these efforts.
“This will all help add to the existing high levels of patient satisfaction with the NHS. It will also reinforce the world-leading position of the NHS for safety and quality, confirmed just last week by the internationally renowned Commonwealth Fund. We must however ensure that there is minimal additional bureaucratic burden so that trusts can maintain momentum and staff can focus their effort where it’s most needed - on frontline care. For example we will want to review how well the new staff level reporting is working once it has bedded in.”
3.52pm HSJ, working with the NHS Leadership Academy, will be publishing a special supplement in September exploring attitudes to, and experiences of, people who are lesbian, gay, bisexual and transgender in the NHS.
Through a reader survey, HSJ will be examining whether the NHS is as inclusive, accessible and welcoming to the LGBT community – patients, employees, service users and customers – as it could be.
We will examine whether and how attitudes are changing, how stigma and prejudice is being addressed and whether the health needs of the LGBT community are being fully understood and met.
3.35pm Alastair has also written about the “ambitious” plans being pursued by integration pioneers across the country.
3.30pm Alastair McLellan’s latest editorial is now online, discussing the appointment of Sarah Wollaston as the new chair of the Commons health committee.
In his piece the HSJ editor argues that Dr Wollaston should follow former chair Stephen Dorrell’s example of “always taking the long view and avoiding the distraction of fashionable ‘issues of the day’” to shape the health policy debate.
3.03pm Judith Smith, director of policy at the Nuffield Trust has commented on the health secretary’s announcements:
“It is vital that people in the NHS see concerns about patient care as something they can talk about and address in an open and honest manner. One of the most promising signs emerging from recent work we conducted on the impact of the Francis inquiry was that hospitals are working hard to create a more open and supportive culture.
“What was less promising, however, were signs that some central bodies were not necessarily echoing this behaviour, with some hospitals reporting that they felt over-burdened by external regulation and performance management which was often focused on financial and other targets that were not directly concerned with patient safety. So it’s good news that the government has appointed Sir Robert Francis QC to head up a review into openness in the NHS.
“In addition, the government’s moves to publish actual and planned staffing levels are to be welcomed. These recognise that safe and dignified care cannot be provided unless there are enough doctors and nurses, but without falling back on a one-size-fits-all model of blanket minimum staffing levels.
“But the real question for hospitals considering increases in staffing is the issue of where additional funds will come from. We know that the need to meet extremely ambitious financial targets has been the key issue for NHS trusts thinking of employing more staff. It is very important that the health service continues to become more productive, but there will ultimately be a limit to how fast this can done while still improving the quality of care.”
2.30pm Jennifer Dixon, chief executive of the Health Foundation, has commented on the health secretary’s “sign up to safety campaign”. Here’s what she had to say:
“The focus on patient safety in the campaign is very welcome. The campaign should be underpinned by a clear strategy for how to improve care across England for the next five years, based on tried and tested quality improvement techniques. A strategy produced through the combined efforts of national, regional and local organisations, and with input from patients and the public, would fill a current gap. It would be a much needed route map for how the NHS can speed up improvements to both safety and the quality of care.”
In an exclusive interview Dr Robert Harwood, lead negotiator for the British Medical Association, said consultants were willing to consider losing the veto on weekend working and were committed to seeking a deal through the current negotiations with NHS Employers.
Under their current contract, medical consultants have the ability to refuse non-emergency work before 7am or after 7pm on weekdays and on weekends.
1.49pm Northumbria Healthcare Foundation Trust is set to take over the “full ownership” of two GP practices, it has said, and is offering to run others.
The organisation already provides acute, community and social care services, and some minor primary care services in a joint venture with GPs.
Chief executive Jim Mackey told HSJ it had agreed with two practices, which it is not yet naming, that it would begin running them through a subsidiary company called Northumbria Primary Care.
12.58pm Here’s the paragraph from Jeremy Hunt’s written ministerial statement on the new Francis review:
“I am announcing an independent review into creating an open and honest reporting culture in the NHS chaired by Sir Robert Francis QC, who chaired the landmark inquiry into the poor standards of care in Mid Staffordshire NHS Foundation Trust. The review is being established to provide independent advice and recommendations on measures to ensure that NHS workers can raise concerns with confidence that they will be acted upon, that they will not suffer detriment as a result and to ensure that where NHS whistleblowers are mistreated there are appropriate remedies for staff and accountability for those mistreating them. The review will consider the merits and practicalities of independent mediation and appeal mechanisms to resolve disputes on whistleblowing fairly. It will do this by listening to and learning the lessons from historic cases where NHS whistleblowers say they have been mistreated after raising their concerns and by seeking out best practice.”
12.50pm Sir Robert Francis QC is to head up a review of whistle blowing in the NHS, it has been announced. The former chair of the Mid Staffordshire Foundation Trust Public Inquiry was asked to lead the review by the government and will consider what further action is necessary to protect NHS workers who speak out and create an open culture. More coming soon
12.19pm Rob Webster, chief executive of the NHS Confederation, has commented on Mr Hunt’s plans for a new poor reporting indicator. Here’s what he had to say:
“We welcome the decision by the secretary of state to publish ratings of patient safety performance about hospitals in a drive towards greater patient confidence in the NHS. We want to make NHS providers of care as safe as possible for patients. Driving up patient safety and making it top of the agenda is what we support and fully endorse a ‘safety culture’ of hospitals.
“The new campaign ‘sign up for safety’ provides a further opportunity for staff to think about how they can do things differently to improve patient safety. This has to be a good thing. The NHS need to constantly change, develop and improve. Engaging everyone in taking forward this work has the potential to drive the open and inclusive culture many organisations are already working towards.”
“In implementing these arrangements, we need two things to happen, the first is we communicate well with the public so that they can interpret patient safety information, the second is that we need a culture that supports NHS leaders and clinicians and is engaged on improvement. Too often we see a blame culture applied rather than a learning culture.”
11.55am The University Hospital of South Manchester Foundation Trust has secured a £25m government loan to keep on top of its private finance initiative repayments, Department of Health papers have revealed.
The financially troubled trust has however been denied the further financial lifeline of a £32m working capital facility which the DH’s independent trust financing facility agreed that it needed.
According to papers from a ITFF meeting in May, DH officials had been unable to agree the terms of the 30-day facility with the Treasury.
11.49am Six trusts that have been in special measures over the past year are among the 30 set to be named as having a poor culture of reporting patient safety incidents by the health secretary later today,HSJ understands.
HSJ has analysed the Care Quality Commission data on patient safety reporting, which is being used to compile the new “open and honest reporting” indicator.
According to guidance shared with trusts and seen by HSJ, the indicator has five components. Poor performance against any of these will lead to trusts being rated as a cause for concern
11.26am Rachel Sylvester, political columnist for The Times, writes that the NHS has so far been “the dog that did not bite for David Cameron”, but with the health service missing its cancer treatment target for the first time in May, growing waiting lists and rising A&E attendances, “a low growl is coming from the kennel”.
She argues: “The problem is that the NHS has wasted more than £3 billion on a structural reorganisation that was a distraction from the real problems in the NHS”.
She says what is “more shocking” is that the abolition of primary care trusts and strategic health authorities “for the sake of streamlining” has been replaced with “440 organisations employing a whole new layer of bureaucrats”, who “have been rehired from the old NHS bodies, having also received lucrative redundancy payments for leaving their old jobs”.
With Labour planning a “state of the NHS” study next month to coincide with the fourth anniversary of Andrew Lansley’s health reforms, and the election of Sarah Wollaston as chair of the health select committee who has “shown herself to be more than willing to cause trouble for the prime minister”, she warns that “the government cannot bank on another mild winter to help to avoid patients on trolleys between now and May 2015”.
11.24am The Times reports on Mark Porter’s speech to the BMA’s annual representative meeting yesterday, in which he said the body would fight back against the government’s “assault” on the health service every day until the next general election, unless it relented on NHS pay, cuts and “market lunacy”.
“With the general just 10 months away, we could be fighting like this every day,” he said.
However, the paper reports that sources close to health secretary Jeremy Hunt have dismissed the threats as “typical trade union behaviour”.
11.19am The part of the hearing involving the three health witnesses has now ended.
11.15am Mr Stevens says he was not personally asked by the prime minister to apply for or accept the role of NHS England chief executive.
11.09am Mr Stevens agrees with Ms O’Brien, saying “there are many possible arrangements to lead the NHS and they’ve been tried in various permutations”.
“There’s no right answer, but there’s a wrong answer, and that’s to keep changing your mind.”
11.07am Ms O’Brien says to improve accountability in the NHS we should “leave structure alone” and “not get waylaid into more reorganisations”. “Any set of structures can be made to work” she adds.
11.01am Professor Ham says idea that ministers no longer have levers to control health service would come as a surprise to hospitals chief executives who are being subject to increased regulation and performance management.
10.53am Sheila Gilmore MP puts it to the witnesses that the NHS reorganisation increased the number of arms length bodies when it was supposed to reduce complexity. Professor Chris Ham agreed there is a “complex and confusing set of arrangements” but said bodies are doing more to clarify their roles.
10.44am Greg Mulholland MP criticises NHS England for its decision to suspend children’s heart surgery at Leeds General Hospital last year. He also claims NHS England refused to share information with a local health overview and scrutiny committee. Mr Stevens said he was not familiar with this latter case.
10.35am Ms O’Brien says that in an industry as large and complex as health and social care, it is “inevitable” that accountability for patient safety sits at different levels.
10.30am Simon Stevens is asked whether he was brought into the NHS to oversee the “salami slicing” and privatisation of the health service. He says he was not.
10.25am Ms O’Brien says that so long as the NHS is funded by taxpayers, ministers will remain accountable for it.
10.23am Una O’Brien, permanent secretary of the Department of Health, tells the committee that the DH did not envisage NHS England to be “as large” as it has become when it was first developed.
10.17am Simon Stevens, Una O’Brien and Chris Ham have started giving evidence to the public administration committee.
10.13am On the front page of the Daily Mail, the paper reports that thousands of patients are being arbitrarily struck off by GPs who say they can no longer cope with spiralling numbers.
9.59am Leafing through this morning’s papers, The Daily Telegraph reports that doctors have said that providing routing NHS appointments seven days a week is a “utopia” that the health service cannot afford.
During a debate at the British Medical Association conference yesterday, Bruce Hughes, from the BMA’s GP committee, attacked the idea of a “seven-day-a-week utopia which is just for the sake of a political gimmick”.
9.36am It appears that Simon Stevens will be appearing in the second tranche of witnesses at the public administration committee’s hearing on the accountability of public bodies and quangos this morning.
We’ll let you know when he’s in the hot seat here on HSJ Live.
Mr Stevens will also be appearing with Department of Health permanent secretary Una O’Brien and King’s Fund chief executive Chris Ham.
9.33am Hospitals with low numbers of the most serious patient safety incidents are among those set to be highlighted as having a poor reporting culture on a website being launched by the health secretary later today.
Jeremy Hunt is expected to say concerns have been found with the reporting culture at one in five NHS hospitals under a new indicator developed by NHS England.
The new indicator, which the Department of Health claims is the first of its kind in the world, combines performance against a number of data points including reporting of patient safety incidents to the National Reporting and Learning System and staff views on the effectiveness of their organisation’s incident reporting procedures.
9.28am As we wait for the public administration committee to kick off, here’s a few new stories which have gone live on HSJ this morning.
The head of the Care Quality Commission has acknowledged that the heavy workloads of his new inspection regime have had a “negative impact” on the morale of some staff.
In a report presented to the CQC board last week, chief executive David Behan admitted that vacancies within inspection teams were “adding to the workloads of existing staff, at a time when staff are beginning to adapt to new methodologies”.
Earlier this month HSJ exclusively revealed that a number of CQC inspectors had told management they felt “exhausted” and “drained” by the hours they had worked to roll out the CQC’s new inspection approach.
7.00am Welcome to HSJ Live. Simon Stevens, chief exective of NHS England, is due to appear in front of the public administration committee today at 9.15am.
Follow HSJ Live throughout the morning for full coverage and analysis.