Jeremy Hunt releases written statement announcing trust’s fate, plus the rest of today’s news and comment.
4.47pm A joint statement has been released by the trust special administrator of Mid Staffs and the chief executives of Mid Staffordshire Foundation Trust, University Hospital of North Staffordshire Trust and Royal Wolverhampton Trust.
It reads: “We welcome the Secretary of State’s decision to approve the TSAs’ principal recommendation, to dissolve Mid Staffordshire NHS Foundation Trust.
“We are pleased to receive the endorsement of the TSAs’ recommendations by the Secretary of State andconfirmation that we have discharged our duty under the terms of the TSA process.
“We are therefore moving forward with plans for the dissolution of the trust and implementation of our plans to transfer management for the trust to UHNS and RWT as soon as possible, to stabilise local health services.
“We note that the Secretary of State has requested further work from the NHS commissioning body (NHS England) to identify if consultant-led obstetrics could be sustained in a safe way at Stafford in the future as part of a wider review of the local health economy.
“In developing our recommendations, the NHS commissioning body and the local commissioners were fully consulted along with local people and we received input from the National Clinical Advisory Group and other local providers in the local heath economy. Based on this extensive consultation process, the TSAs developed a robust clinical and financial model.
“In respect of maternity this was predicated on the commissioners’ stated intention that they did not wish to commission births at Stafford and concerns from the National Clinical Advisory Group as to clinical sustainability and safety.
“However with their support and following the extensive consultation, our proposals do include a recommendation for a Midwife-Led Unit to allow for births in up to half of circumstances.”
Commenting on next steps, Mr Bloom said: “We have been working closely together with MSFT, UHNS and RWT over recent weeks to ensure that we would be prepared to implement the dissolution of the trust as quickly as possible, should the Secretary of State approve the final report. Today’s decision means that our joint working will intensify over the coming months as the TSA process moves into the next phase.”
Mark Hackett, Chief Executive of University Hospital in Stoke-on-Trent, said: “We acknowledge the Secretary of State’s decision on the principal recommendation of the TSAs. However, we now need to work closely with the TSAs and our wider partners fully to understand the detail underpinning that decision.”
David Loughton CBE, Chief Executive of The Royal Wolverhampton Trust, said: “The Royal Wolverhampton Trust is very positive about the opportunity to ensure good patient experience is delivered in a safe environment for the patients we serve.”
4.30pm The National Health Action Party has issued a statement in response to the break-up of Mid Staffs.
Co-leader Dr Clive Peedell said: “The announcement by Health Secretary Jeremy Hunt that the Mid Staffs NHS Trust is to be dissolved was unfortunately predictable but his statement was very short on detail and begs more questions than it answers. It looks like a politically-motivated fudge, with local services partially reprieved to save the skin of local Tory MPs with a general election looming. But the long term future is very uncertain.
“The Trust Special Administrator’s solution (which has been accepted by Mr Hunt), to downgrade some services will not be good for patient care. This will inevitably lead to further service closures over time because medical and surgical specialties are often interdependent on one another. In particular, a downgrade of the A+E service is very worrying and the concerns of local people over 24 hour care and children’s services have been ignored.
“There were clearly many management failures at the Trust which put business principles before patient care. This was driven by the desire to become a Foundation Trust, as part of national policy to increasingly marketise our healthcare system. This had knock-on effects for many aspects of clinical care which fell well short of acceptable standards.”
4.20pm Monitor has closed its investigation into the commissioning of radiosurgery services.
The regulator said the best way to address the issues raised by the case would be through guidance for commissioners rather than making formal findings.
Thornbury Radiosurgery Centre had complained that the process adopted by NHS England to decide which providers should deliver this specialised service, did not operate in the best interest of patients.
Thornbury, which is owned by BMI Healthcare Ltd and Medical Equipment Solutions and based in Sheffield, provides radiosurgery services such as gamma knife surgery which treats lesions of the brain.
NHS England has confirmed that it has now entered into a contract with Thornbury for gamma knife surgery.
Catherine Davies Executive Director, Co-operation and Competition said “In the circumstances we think the best way forward to ensure patients benefit from what we have learned in this case is to close the investigation and develop some best practice advice for commissioners.”
4.00pm Monitor has made a podcast exploring the peformance and financial health of trusts.
3.47pm The chief executive of Mid Staffordshire Foundation Trust, Maggie Oldham, has responded to the health secretary’s decision to dissolve the trust.
She said: “I hope that today’s announcement by the Secretary of State will give staff assurance that they have a part to play in the future of health services for patients in Staffordshire.
“I would like to pay tribute to all the staff at our hospitals who continue to focus on delivering safe and compassionate care for our patients, despite the difficulties and uncertainty they have faced.
“Mid Staffs has come a long way over the past few years and I am very proud of all of our staff and what they have achieved.
“I would also like to remind patients that we are still working as usual and that they should please keep their appointments and keep using the services provided at Stafford and Cannock Chase Hospitals”
3.37pm NHS England has launched a three month public consultation on changes made to its specialised services specifications.
The specifications set out what is expected of providers in terms of the standards required, and define access to a service.
3.31pm Public services law firm Bevan Britten has some thoughts on the Mid Staffs break-up announcement.
David Owens, a partner in the firm, said: “The statement does flag up some of the uncertainties which flow from the Trust Special Administrator regime.
“It is significant in the light of what happened subsequent to the TSA process in South London where the CCGs have started to unpick the allocation of services through their commissioning responsibilities that the focus of the secretary of state’s response is on what properly lies within his powers.
“Monitor can dissolve a foundation trust in these circumstances and make an order transferring assets and liabilities – including current healthcare contracts. However the Secretary of State recognised in his statement to Parliament that the CCGs and NHS England as commissioners will be responsible in the longer term for decisions about where services will be provided.
“Given the concerns expressed locally about the loss of services it is not surprising that in addition to emphasising that 90 per cent of the activity will continue to be provided where currently, the Secretary of State has held out the prospect of a continued Consultant led maternity unit at Stafford, notwithstanding the service recommendation of merely a midwife led unit. This may be intended to reduce the risk of challenge by those who seek to preserve services in Stafford. It will be interesting to see how the pattern of services in fact develops, and indeed whether the effective takeover of Stafford hospital succeeds in maintaining services and continuing the improvements in quality.”
2.55pm The Chairs of Stafford and Surrounds and Cannock Chase Clinical Commissioning Groups have welcomed the Secretary of State’s decision to approve the Trust Special Administrators recommendation to dissolve Mid Staffordshire Foundation Trust.
Chair of Stafford and Surrounds CCG Dr Anne-Marie Houlder said: “We recognise what a hugely difficult time this has been for patients and the public in Stafford and Cannock as well as the staff at both hospital sites. The Secretary of State’s announcement now marks a step forward in the process.
She added: “We are relieved that the Secretary of State has agreed with the TSA’s proposals to dissolve the trust. We look forward to continue to work with the TSA, new providers and the communities of Cannock and Stafford to get the best possible healthcare for the populations in which we serve.”
Cannock Chase CCG Chair Dr Johnny McMahon said: “We have been working closely with the TSA and providers over the last few weeks and we will build on this work going forward to help support with the transition. We want to continue to work together as a health economy to create stability for patients, public and the Trust’s staff to ensure safe, quality, effective healthcare services, both now and in the future.”
However, in a written statement, Jeremy Hunt asked NHS England to identify whether consultant-led maternity services could continue at Stafford Hospital. The TSAs recommended that the trust’s maternity unit should be downgraded to be midwife-led.
Mr Hunt said: “I am asking NHS England to identify whether consultant-led obstetrics could be sustained at Mid Staffs in a safe way in the future. In doing this, NHS England will work with local commissioners as part of their wider review of the local health economy.”
2.33pm In a written statement Jeremy Hunt said that Mid Staffordshire Foundation Trust will be dissolved. However, he has asked NHS England to look at whether a consultant-led maternity unit could continue at Stafford Hospital.
A longer story will follow shortly.
2.31pm HSJ is hosting a Twitter chat on 28 February to discuss how best to tackle the issues of access and inequality when commissioning end of life care.
If you would like to join the discussion then you can do so by using the hashtag #HSJEOLC, as well as following @hsjnews and @mariecurieeolc, to ask questions and participate in the discussion.
1.40pm In the first in a series of articles from senior NHS leaders’ who went on a research trip to India, Ros Roughton reports on providers that have found innovative, low cost ways to care for a huge population.
1.28pm Here is an extract from HSJ editor Alastair McLellan’s leader piece this week on the NHS waiting list:
The news the NHS waiting list for planned care is hovering under 3 million is cause for both celebration and caution.
Celebration because the NHS is shouldering the burden of higher demand in a period of financial constraint and still broadly achieving quality and access standards.
Caution is necessary because HSJ’s analysis shows that since the turn of the decade the NHS’s success in dealing with waiting lists backlogs has reduced and if the trend continues that ability could vanish within a year or two.
12.56pm David Cameron has indicated that a consultant-led maternity unit may remain at Stafford Hospital.
During Prime Minister’s Questions in the Commons Mr Cameron said: “What’s being proposed are good steps to make sure that A&E continues at Stafford Hospital and hard work to be put in to see if it is possible in the future to make sure we continue with the consultant-led maternity services so people can go on having their babies delivered in Stafford Hospital.”
A consultant-led maternity unit at Stafford Hospital would require paediatricians to look after the most seriously ill babies which could mean demand for paediatric in-patient facilities, a service the Trust Special Administrators rejected.
This will increase costs for the trust and also present staffing and recruitment issues. The Royal College of Paediatrics and Child Health has highlighted a current national shortage of paediatricians and “too many” units.
A written statement from Jeremy Hunt is expected later on today.
12.38pm In response to NICE’s guidance on training for clinicians to deal with domestic violence victims the Royal College of GPs has said that GPs and health professionals need to be on the alert for signs of domestic violence against people in same sex and transgender relationships.
The College is calling for more support to help GPs and other health professionals improve the ways in which they respond to patients in non traditional relationships who they suspect are living under threat of violence.
This should extend to men in heterosexual relationships who are experiencing or are at risk of abuse from their female partners, says the RCGP.
RCGP Chair Dr Maureen Baker said: “GPs are at the frontline in recognising and helping those experiencing domestic violence and abuse. But domestic violence is still a taboo subject, with a lot of societal stigma attached.
“The difficulty for GPs in identifying patients and their children exposed to violence is that they rarely present with physical signs of abuse or disclose spontaneously during the consultation. This can be even more complex for patients who are in same sex relationships or men experiencing abuse in heterosexual relationships and they can often be overlooked.
“We welcome the NICE guidance, particularly as it highlights the need for greater awareness of the whole range of people in our society who can experience domestic violence.
“We would welcome more research into the extent of the problem and how GPs can respond appropriately and safely to these patients we suspect are in violent relationships but who are worried about speaking out and seeking help.”
12.33pm The Medical Protection Society has expressed concern over how candid patients will feel they can be with their GP under the new care.data programme.
Director of Policy and Communications at the Medical Protection Society Dr Stephanie Bown said: “Historically, patients have had confidence in their GP to look after their sensitive information. We worry that patients’ concerns about care.data could prevent them from speaking openly to their doctor about significant health issues for fear of it being shared outside the practice.
“An MPS survey of over 600 GP members found 32 per cent believed care.data will aid local decision makers on how best to meet the needs of local communities; however over half of GPs were concerned, with 80 per cent believing the system could undermine public confidence in the principle of medical confidentiality.
“The potential benefits of the care.data database are clear to see, but we do not want this to be at the cost of the trust between the patient and their family doctor.”
12.15pm Nurses, social workers, health services and the organisations they work with must be better trained to understand domestic violence and help those experiencing it, the National Institute of Health and Care Excellence has said.
The institute has published new guidance aimed at helping to identify, prevent and reduce domestic violence, as well as outlining the most effective responses to it.
Recommendations from the new guidance include specific training for health and social care professionals in how to respond, training frontline staff in all services to recognise the indicators of domestic violence and ask relevant questions to help people disclose their past or current experience.
12.10pm Also in The Telegraph, a study has found that hospital patients have a greater chance of dying after surgery if they are treated by nurses who do not have a bachelor’s degree.
“All the hoo-ha about nurses being overeducated in our view is a gross exaggeration,” said Anne Marie Rafferty of King’s College London, who co-wrote the report.
“What we’ve found is that the higher you raise the bar and the more competitive it becomes, the talent pool expands.
“We see that the move towards graduate training is a very good move and has had a positive effect on the link between nurse education and mortality rates.”
12.08pm The Daily Telegraph reports on the private firm Atos being given the contract to extract patient records from GP surgeries as part of NHS England’s care.data scheme.
Members of the Commons health committee criticised the NHS’s handling of the care.data project, in a heated evidence session yesterday.
Implementation of the programme, which plans to join up data from GPs, hospitals and other care settings in order to improve care, is to be paused for six months, following concerns about public awareness and confidence in the project.
In response to questioning by Conservative committee member Charlotte Leslie, the Health and Social Care Information Centre’s director of information and data services Max Jones admitted that no code of conduct had been drawn up for the implementation of care.data. Under the terms of the 2012 Health Act, this should have taken place.
11.47am A third of hospital trusts in England are failing to comply with safety regulations designed to reduce the risk of needlestick injuries to nurses and other frontline staff, according to latest research.
Analysts found 33 per cent of trusts did not instruct staff to use safety devices “wherever possible” in their sharps policies, despite it being an explicit requirement of health and safety regulations introduced last year on the back of a European Union directive.
A report from business analysts MindMetre investigated the implementation of directive 2010/32/EU, which came into force in May 2010, and was followed by UK guidance from the Health and Safety Executive.
11.43am The Guardian reports that Stephen Dorrell, Conservative chairman of the health select committee is to writeto the health secretary, Jeremy Hunt, to ask for details about which organisations have acquired medical records since 2010.
10.39am Nursing cutbacks are directly linked to higher patient death rates in hospitals, a major study has found.
Every extra patient added to a nurse’s workload increases the risk of death within a month of surgery by 7 per cent, according to data from 300 European hospitals in nine countries.
The situation is made worse by employing poorly qualified nurses, the research showed.
10.32am The Financial Times reports that the NHS has asked the private sector to help in buying billions of pounds worth of services for hospitals and GPs.
NHS England advertised for companies to compete for work worth at least £5bn advising CCGs. They will advise on patient care reforms, fiannces and drug purchasing among other areas.
The latest NHS England data shows the waiting list decreased only slightly between August and December, bucking the trend in recent years for it to fall sharply at this time of year. However, the list – which shows 2.88 million people waiting for treatment in December – may have been artificially deflated because three trusts in London did not report their statistics due to IT problems.
HSJ’s projected figure for the real waiting list in December is 2.94 million – the same as the officially recorded high point for 2013 in August. To obtain this we took the official figure and added on the last recorded positions of the three missing trusts – Whittington Health; Barking, Havering and Redbridge University Hospitals; and Barnet and Chase Farm Hospitals – which had been amended in line with national trends. A spokeswoman for NHS England cautioned against projections when no data was available.
Jeremy Hunt has the final say on plans to dissolve the trust and move key services to neighbouring hospitals.
In January, the health watchdog, Monitor, approved plans drawn up by administrators to downgrade some services at Stafford Hospital, despite opposition from local campaigners.
Mid Staffordshire was the focus of one of the biggest scandals in the history of the NHS when hundreds more people died than would normally be expected.
9.36am Figures released by the Health and Social Care Information Centre today show that for the tenth year running obesity admissions were much higher for women in 2012-13 than men.
There were 8,010 obesity admissions for women compared with just 2,950 for men.
In 2002-03 there were 850 women and 430 men admitted for obesity. The 2012-13 obesity admissions are more than eight times the 2002-03 figure for admissions with a primary diagnosis of obesity.
9.20am Members of the Commons health committee have criticised the NHS’s handling of the care.data project.
In a heated evidence session one MP said that while she backed the patient database she believed NHS officials could not be trusted to deliver it.
In response to questioning by Conservative committee member Charlotte Leslie, the Health and Social Care Information Centre’s director of information and data services Max Jones admitted that no code of conduct had been drawn up for the implementation of care.data. Under the terms of the 2012 Health Act, this should have taken place.
7.00am Good morning and welcome to HSJ Live. We begin the day with the news that the National Audit Office has found that Monitor delivers value for money and has been effective in helping underperforming foundation trusts to improve.
However, in a report published today the NAO also said Monitor’s capacity to regulate foundation trusts in difficulty may come under “unsustainable pressure” due to the growth in risk across the sector.
No comments yet