Joint venture pulls out of MSK procurement following trust impact assessment, plus the rest of today’s news and comment

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4.18pm Here’s what HSJ’s Shaun Lintern has taken this away from the CQC’s deprivation of liberty safeguards report.

3.16pm NHS Clinical Commissioners has welcomed The Kings Fund and Nuffield Trust report on CCGs (see 12.43pm today).

Dr Steve Kell, co-chair of NHSCC and chair of NHS Bassetlaw CCG said: “The research backs up much of what we already know, that CCGs are harnessing their clinical expertise and leadership and delivering real and effective integrated change to the health of their patients and local populations. What we must now do is build on those successes, and not disrupt or delay patient care with any structural reorganisation of the commissioning system.”

“CCG engagement with their GP membership is key, as strong general practice is vital to the future of the NHS but general practice has suffered for too long from a lack of active commissioning and support. CCGs co-commissioning primary care will offer that essential support and be able to target resources where they are needed and ensure the vital clinical voice is not lost to the commissioning process.”

Dr Amanda Doyle, co-chair of NHSCC and chief clinical officer for NHS Blackpool CCG said: “Our members recognise that potential conflicts of interest will occur when CCGs commission primary care, but they are manageable. Conflicts of interest in the NHS are not new and they are not always avoidable but they also shouldn’t be seen as a barrier to commissioning high quality care.”

“The report is right in its final recommendation that it is essential that CCGs have adequate resources and capacity to be able to do the job well, NHSCC and its members have expressed concerns for some time now about the reduction in running costs and increase in responsibilities. At a time when strong commissioning and clinical leadership has never been more important, NHS England and the government must urgently address these issues to ensure CCGs are given the capacity and capability they need to succeed for the NHS.”

 2.18pm You can read the full CQC report here.

2.17pm The Care Quality Commission has published its annual monitoring report on the implementation of the deprivation of liberty safeguards (DoLS). These are part of the Mental Capacity Act, and they protect the rights of adults in care homes and hospitals who lack mental capacity, in situations where they need to be deprived of their liberty to be given necessary care or treatment.

Following clarification by the Supreme Court last year on what constitutes a deprivation of liberty, the numbers of applications for use of the safeguards has soared, from around 13,000 a year to around 55,000 in the first two quarters of 2014-15.

The report points out that this rise in applications is a good thing, since it shows willingness among providers to protect the rights of individuals, and encourage external scrutiny of their care when a vulnerable person might be deprived of their liberty.

David Behan, chief executive of CQC, said:

“Both the House of Lords and the Supreme Court criticised the Deprivation of Liberty Safeguards for their bewilderingly bureaucratic complexity.  I have considerable sympathy with this view, and welcome the decision by government to ask the Law Commission to look for a framework that is simpler, while still protecting peoples’ rights.

“It is essential that all professionals looking after people who are unable to give consent deliver best practice in order to protect their rights.”

2.04pm HSJ, in association with BDO, is offering readers the chance to win £200 of Marks & Spencer vouchers by completing this short survey about quality governance.

Find out more and take the survey here.

12.55pm NHS England has settled a dispute with clinical commissioning groups in the south of England over its proposal to transfer £50m from their budgets to its own specialised commissioners.

The national body had asked for £49.6m to be transferred from CCGs in the region in 2014-15, but the sum was reduced to £32.4m following arbitration.

12.45pm You can see the King’s Fund/Nuffield Trust research in full here.

12.43pm GPs involved in clinical commissioning groups have doubts about whether they will be capable of taking on additional responsibility for primary care, health think tanks have warned.

Nearly half of all the GPs surveyed for a joint report by the King’s Fund and Nuffield Trust, shared exclusively with HSJ, also said they did not feel they had sufficient time to carry out their existing duties. The report includes a survey of 279 GPs and interviews with 72 GP CCG leaders.

The report warned of declining engagement from GPs with formal roles within CCGs and cuts to CCG management funding.

12.32pm Over a third of trusts are not displaying a named clinician above patient beds despite health secretary Jeremy Hunt introducing the policy 18 months ago.

Freedom of information requests were sent to every NHS acute trust by consultancy and technology firm Hotboard, which shared the responses with HSJ. Out of 108 respondents 39 (36 per cent) were not displaying the name of the clinician and nurse responsible for each patient’s care above their bed

12.29pm Our story on Bupa and CSH Surrey pulling out from the £235m Coastal West Sussex MSK contract is now online.

12.19pm Health and IT professionals remain deeply sceptical that the NHS can be paperless by 2018, two years after health secretary Jeremy Hunt unveiled the ambitious target, exclusive HSJ research has found.

Nearly three-quarters (71 per cent) of respondents to HSJ’s second annual technology survey, carried out in association with CCube Solutions, agreed with a statement that the paperless by 2018 goal was “a great ambition but unrealistic”.

The 573 healthcare leaders, clinicians and IT professionals polled also expressed widespread concern that lack of technological expertise and resources would undermine the NHS’s drive to integrate health and social care.

12.00pm The Times reports that cosmetic surgery fell by 9 per cent last year, according to official figures, with breast enlargement procedures dropping by a quarter.

11.43am In case you missed it on Friday, two commissioning support units have not made it onto NHS England’s procurement framework – placing their long term future in doubt, HSJ has learned.

North West CSU, which serves clinical commissioning groups in Cheshire, Merseyside and Greater Manchester, and Yorkshire and Humber CSU, were unsuccessful in their bids for accreditation to provide the full range of “end to end” support services.

Staff at the CSUs were briefed on the issue on Friday, HSJ understands.

The CSUs collectively serve 47 CCGs. In 2013-14 their combined turnover was £183m.

More to follow

11.39am Bupa CSH, a joint venture between the healthcare firm Bupa and the social enterprise CSH Surrey, has announced it will not be continuing in the procurement process to provide musculoskeletal services in Coastal West Sussex. Here’s their press statement:

Bupa CSH had been looking forward to working with the Coastal West Sussex Clinical Commissioning Group and current providers to develop a more coordinated and higher quality service for local patients. Both patients and clinicians have said this is needed.

We have taken this decision in agreement with the CCG because the recent Impact Assessment, requested by Western Sussex Hospitals NHS Foundation Trust in November (after Bupa CSH was selected as the preferred bidder) and jointly commissioned by the Trust and the CCG, has shown that the financial position of the Trust would be worsened by implementation of the contract.

This has changed our ability to implement the integrated care service – which we modelled on information available to us during the commissioning process in early 2014 – and means we cannot deliver the model without either compromising on the quality of care or destabilising other local services – neither of which we are prepared to do.

Peter Lock and Jo Pritchard from Bupa CSH said:  

“Our priority was to provide high quality and better coordinated care for local patients, and we have worked hard with the CCG to try and find a solution.

“However, the recent impact assessment means we cannot deliver the model we proposed without either compromising on the quality of care or destabilising other services.

“This is disappointing, but we fully support the CCG’s vision to improve MSK care in Coastal West Sussex. We acknowledge that transforming local health systems in these challenging times is extremely difficult for commissioners who want to introduce new care models.

“We remain committed to working in partnership with the NHS and the public sector to deliver high quality health and care services.”

11.12am As part of an investigation into immigration and population growth in London, The Times reports that patients could face longer waits and more disjointed care in general practice because rates of training doctors has fallen behind the city’s exploding population. This is according to former Royal College of GPs chair Clare Gerada, who is leading a work into modernising GP care in London.

11.10am The Times reports that nine in ten GPs are concerned that spartphone health apps are resulting in greater numbers the “worried well” taking up time in surgeries, according to a poll carried out by the market research company Research Now.

Three quarters of GPs surveyed also said they thought more patients were seeking appointments after looking up their symptoms online.

10.47am NHS Providers has said “immediate action” will be needed after the general election to “stabilise the financial position of the health and care system”.

Chris Hopson, chief executive of NHS Providers, made the comment on the day that marks 100 days before the general election. He said:

Chris Hopson, chief executive, NHS Providers, said:

“The NHS consistently ranks as one of the top three issues concerning voters and as the public service that people want to protect. What is new is the exceptional pace of change required if we are to protect standards and quality of care for all patients. Immediate action will be needed to stabilise the financial position of the health and care system.

“The main political parties have largely accepted that they could work with a system that has the Five Year Forward View at its core. There was also welcome cross party recognition that the challenges the NHS is facing must be confronted, with an emphasis on more funding and a whole system approach to building capacity and changing the way services are delivered. We are building on this consensus to work with all parties on what’s required from day one after the election to enable the NHS to transform to meet 21st century patient needs. A key point in our narrative has been for NHS providers themselves to be a catalyst for change by creating conditions for the sector to lead its own development.

“Our direction for change is set out in Providing for the Future, our programme for the next Parliament, which focuses on four priority areas - funding, workforce, regulation and NHS providers. This is particularly significant as major reconfiguration has a window of opportunity, usually within the first two years following an election – the new government must be poised to support the NHS to be autonomous and accountable as it adapts to deliver the more integrated models of care set out in the Five Year Forward View.

“We have an unprecedented opportunity to tackle one of the pressing public policy challenges of our time. As the countdown begins, tough choices need to be enshrined from now, so that we have the right funding, the right support and the right freedoms to effect meaningful change in every single local health economy in the country”.

10.09am Elsewhere, the Telegraph reports (newspaper only) that GPs will be encouraged to delay or come back from retirement under a £10m scheme to increase the number of family doctors.

NHS officials said doctors would be offered more flexible ways of working to encourage them to stay in or return to general practice.

In the past three years, the number of unfilled GP posts has quadrupled to almost 8 per cent.

10.03am The Daily Telegraph reports that half of people over 50 are ignoring potential symptoms of cancer due to a “stiff upper lip” and a fear of wasting their GP’s time, a study by Cancer Research UK has found.

The research came as a new NHS campaign warns the public to visit their doctor about health complaints – such as persistent heartburn – which seem trivial, but could in fact indicate cancer.

10.01am UKIP made a health announcement over the weekend. Party leader Nigel Farage pledged an extra £3bn per year to the NHS, which he said would be directed at frontline services.

The party said it would cut £2bn “wasted on health tourism” by ensuring migrants and tourists have health insurance as a condition of entry.

Speaking on the BBC’s Andrew Marr Show, Mr Farage said: “We would promise an extra £3bn a year for the NHS, funded out of the fact that we will not be paying daily membership fees as members of the European Union.”

9.49am In case you missed it, The Sunday Telegraph yesterday picked up our story on ambulance services being forced by labour shortages to recruit paramedics from abroad.

7.00am Welcome to HSJ Live.

Public Health England’s Health X competition was won by three innovative technology apps that have huge potential to change behaviour for the better, as Kevin Fenton, director of health and wellbeing at Public Health England, explains.