Review looking into CQC findings on mismanagement of cancer patients’ records
4.57pm Our editor-in-chief imagines how the accident and emergency performance conversation might have gone between Jeremy Hunt and various trust chief executives.
4.52pm If you’d like to read a summary of all the action so far at the Chief Nursing Officer for England’s Summit then head to our sister title Nursing Times’ live blog
4.25pm The Daily Mail reports that taxis and police cars are being used to ferry patients to hospital based on FOI figures requested by Labour.
Shadow health secretary Andy Burnham put these figures to Secretary of State for Health Jeremy Hunt in the Commons this morning, asking “Do you think it’s ever acceptable that when a patient dials 999 a taxi turns up instead?”
Hunt replied: ‘I’m afraid this is utterly irresponsible. We are hitting our A&E target, we are hitting our ambulance standard. When you were health secretary you missed the ambulance standard for October, November, December and January. What you are doing is trying to talk up a crisis that isn’t happening and you should think about people on the front line and just for once put patients before politics.”
3.55pm Here’s the Department of Health’s response to the rise in winter deaths. “This rise in deaths is concerning, but we know from a report published by Public Health England this August that increased excess deaths in 2012-13 were occurring across Europe and coincided with an unusually prolonged influenza season and late cold period.
“The NHS is well prepared for winter health issues, and this includes ensuring that people who are vulnerable to the cold are getting the help they need in the community.
“The annual flu vaccination campaign is underway and has been extended to 2-3 year olds to help prevent the spread of the virus to those who are more vulnerable. Public Health England has put in place the Cold Weather Plan, which includes simple and effective measures to help people stay healthy at home.
“In addition, we are supporting A&E departments to prepare for the expected increase in demand over winter – firstly with £250 million funding, and now an extra £150 million from NHS England.”
3.53pm Public Health England’s medical director Dr Paul Cosford has responded to the ONS statistics on an increase on excess winter deaths. He said: “We normally see death rates peak during winter months and last winter we saw an unusually prolonged influenza season and an extended cold period lasting until April this year.
“Many of these deaths are preventable and the Cold Weather Plan sets out a series of actions which can be taken by the NHS, social care and other agencies throughout the year, in response to forecast or actual severe winter weather to minimise any harm to health.
“It’s difficult to identify a single cause when we see an increase in the number of excess winter deaths. There are a variety of contributory factors, such as poorly insulated housing and health inequalities, as well as increased influenza activity. This emphasises the importance of taking up the offer of a flu jab, to protect yourself and others from flu, if you are in an eligible group.”
3.22pm Twenty northern acute trusts will be publishing quality and safety data today as part of a pilot that will be extended to the rest of the country.
The data will cover pressure ulcers developed in hospital; falls in hospital; the results of the NHS safety thermometer; and MRSA infections and will be on each trust’s website and NHS Choices.
Chief nursing officer Jane Cummings made the announcement today at the chief nursing officer’s summit in Birmingham.
3.11pm Consultant old age psychiatrist Dr Tony Rao writes about how alcohol misuse is soaring among older people and is presenting new challenges for service provision and commissioning.
2.47pm A special review of Colchester Hospital University Foundation Trust’s cancer services, being carried out in the wake of serious misconduct allegations, will be published in mid December.
NHS England has announced the review, being carried out by an incident management team led by its local area team and examining all 14 cancer pathways at the trust, would complete on 27 November and publish a report a few weeks later.
Monitor, the Care Quality Commission, Essex Police, the North East Essex Clinical Commissioning Group, Essex County Council, Healthwatch Essex and the trust itself are all represented on the team.
2.27pm Here’s some more detail on the ONS statistics that show an increase in excess winter deaths:
There was a steep increase in excess winter deaths last year, the Office of National Statistics has said in a release today.
Excess winter deaths are a measure of deaths between December and March over and above the level during the rest of the year.
The ONS said there were an estimated 31,100 excess winter deaths in England and Wales in 2012-13 – 29 per cent more than during the previous winter.
The majority were among those aged 75 and over – there were 25,600 excess deaths in this age group, compared with just 5,500 in people aged under 75.
Today’s report echoes revelations in HSJ in July this year that experts had observed an unexpected increase in death rates, particularly among older females, since the beginning of 2012.
A leaked Public Health England report leaked to HSJ said: “When we focus on mortality over 75, we observe rapidly increasing mortality for both males and females, presenting throughout 2012, and continuing into 2013.”
Following the reports, some public health experts expressed concern about the increase and said the cause was unclear. PHE later said it believed the deaths were linked to winter infections and reflected a pattern also seen elsewhere in Europe.
ONS figures published last month showed that 2012 saw the first year-on-year increase in overall death rate in England and Wales since 1995.
1.52pm The Faculty of Public Health has given its response to the ONS figures that show an increase in elderly winter deaths.
President of the faculty Professor John Ashton, said: “We have to ask ourselves why it is that older people, particularly women, are more likely to die in winter. Yes, we had a particularly cold winter in 2012 and 2013, but the problem here is one of poverty, not just a lack of heat.
“Poorer people end up paying more for their fuel because they don’t benefit from the economies of scale that people who use more fuel enjoy. If you are paying for your gas and electric on a key meter, it costs you more, even if you have less income. So those with the least end up paying more for their heat. We need a different approach to fuel pricing that is not regressive, so that people who live sustainably and use less fuel benefit.”
1.37pm Here’s a reader comment on our story revealing that the friends and family test is to be reviewed by NHS England:
“A whole NHS economy approach to prevention is the key. Far too many NHS bodies only interested in what works for them. This is a role for NHS England to take on and make a difference to the inequalities many groups feel and suffer from because it is in no single Trust’s interest to reduce the built in inequalities in the system.”
1.18pm The Guardian reports that Boots has recalled some of its cough and cold medicines after concerns were raised that plastic may have got into the liquid.
The pharmacy firm said that a manufacturing fault with the tamper seal may have caused bits of plastic to enter the bottles. Boots is asking for medicines to be returned that were purchased from September onwards.
1.13pm A survey looking into sexual attitudes and lifestyle in the UK has found that men and women are having sex less regularly, down to five times a month from six times a month ten years ago.
Other findings included an increase in women reporting sexual activity with another woman. The findings were gathered by the National Surveys of Sexual Attitudes and Lifestyles who interviewed over 15,000 adults aged 16-74.
Independent provider of sexual health services, Marie Stopes International, welcomed the focus on sexual behaviours. Genevieve Edwards, UK Communications Director, said: “We are very British about these things and it’s still easier to have sex than talk about it. What would be great is if this survey prompted a more open conversation about sex and as a result, people had the support they needed to not only be in control of their fertility, and avoid sexually transmitted infections, but to have the confidence to enjoy healthy relationships throughout their lives.”
12.09pm The Times reports that a potential cure for HIV will be tested on British patients next year that aims to put sufferers into a cancer-style remission.
The treatment aims to “wake-up” hidden HIV cells which can then be targeted by a combination of drugs.
11.49am The Telegraph reports that almost four in 10 older people are obese according to a new study. A team from the University of Glasgow found that up to 38 per cent of people aged 60 to 70 have a body mass index which is considered obese. The researchers also found that the proportion of obese Britons has risen by 5 per cent to 15 per cent across all age groups since the mid-Nineties.
11.35am Exercise in later life can significantly increase the chance of healthy ageing according to public health academics from UCL and reported by The Telegraph.
They followed 3500 people with an average age of 64 over eight years and found that those who had already been doing moderate exercise before the study started were three to four more times likely to be a healthy ager.
11.30am HSJ and Nursing Times’ reporter Sarah Calkin is tweeting from the chief nursing officer’s summit today. Follow her for all the latest updates @sjcalkin
11.26am NHS England is reviewing the future use of the controversial “friends and family test”, while alternative patient experience measures have been adopted for two important performance frameworks.
The national commissioning body’s head of insight and feedback Dan Wellings, who joined from Ipsos MORI in the spring, has been asked to carry out the review over the next few months.
It follows widespread debate about the value of the test, particularly whether it can be used to compare providers.
11.24am The Telegraph reports that winter deaths have risen by 29 per cent last year, the highest since 2009.
The Office for National Statistics blamed the cold weather and flu and said most of the deaths over the 2012-2013 winter involved over 75-year-olds. The highest proportion of winter deaths were in the north west of England and the lowest in London.
11.19am Today Professors Simon Dyson and Karl Atkin discuss the resource and funding accorded to services mainly accessed by minority groups such as sickle cell and thalassaemia.
11.11am Only half of people who would like to be organ donors have expressed their wishes to the families, a poll suggests.
While 82 per cent of the English public would like to be an organ donor in the event of their death, just 50 per cent of these have told their families their wishes, NHS Blood and Transplant said.
Meanwhile, seven out of 10 of the 1,000 people surveyed said if they did not know a member of their family wanted to be an organ donor they would not agree to donation if asked.
11.06am The Royal College of Surgeons has called for an urgent review of all hospitals in Wales amid “public anxiety” over standards of NHS care.
It said “urgent assurance” on safety is needed and expressed fears about poor levels of performance, the BBC reports.
A more robust hospital inspection programme including greater input from professional medical bodies is needed, according to the RCS, although it stopped short of calling for a wholesale review of the Welsh NHS.
10.58am The Guardian reports on Department of Health figures which show that cases of hypothermia have increased by a quarter on last year. In 2012/13, 28,354 cases of hypothermia were treated by the NHS, 25 per cent higher on the year before and 40 per cent on the year before that.
10.56am The Department of Health has revealed where the majority of the £250m accident and emergency winter pressures fund will be allocated. The money is mostly being spent on extra beds and staff.
There will be “up to 320 extra doctors and 1,400 nurses (full time equivalent positions), including temporary staff, extended hours and new positions” as well as “up to 1,200 other NHS staff, including physiotherapists, social workers and occupational therapists (FTE positions).”
There will also be “up to 140 additional acute specialist beds and 980 additional acute general beds in hospitals and up to 1,200 other beds, including in the community and in care homes.”
10.51am Our exclusive story on Hunt phoning trusts with poor accident and emergency performance has been updated with more detail on who got the call.
10.35am Heatherwood and Wexham Park bosses have carried out a review of clinical quality in their maternity services following a cluster of serious incidents.
October board papers reveal that the trust had commissioned external reviews of 10 “serious incidents requiring investigation”. Seven of these occurred in July, and three in June.
The trust would not give further detail on the nature of the incidents, but HSJ understands all relate to the quality of clinical care given.
10.27am QualitySolicitors Burroughs Day claim that care providers may soon face a care cost crisis because of a new legal ruling.
The recent decision made by the Employment Appeal Tribunal on the rights of a care worker to receive the National Minimum Wage whilst travelling between care visits, and for time spent asleep during ‘sleepover’ shifts, will add to mounting pressure on cash strapped care providers, according to legal experts at QualitySolicitors Burroughs Day.
In Whittlestone v BJP Home Support Limited  the Employment Appeal Tribunal confirmed that the time a care worker spent travelling between care visits, and time spent asleep during a ‘sleepover’ shift, was subject to minimum wage regulations. The solicitors claim that whilst the ruling is a stark reminder to care providers of their duty to pay staff the National Minimum Wage for travel time and sleepover shifts, these additional cost pressures come at a time when the sector is facing funding difficulties.
10.20am The Chief Nursing Officer for England today called for further improvements in care standards and transparency, saying: “Absolute transparency is the key to driving improvements in standards of care. We need to ensure that every single patient receives great care, every time.”
Jane Cummings also called for a culture of empowerment in the nursing and midwifery profession.
She said: “Failings such as those at Mid Staffordshire and Winterbourne View threatened patient confidence and challenged us all as professionals.
“The response to these failings has been the focus of the health system over the last year with the overriding question being - what do we need to do to ensure this is never repeated?
“This was central to the development of the Compassion in Practice strategy, which was developed last year and published in December 2012. The aim was to get back to the very essence of what great care means for patients and how we can put far reaching changes in place that translate into real improvements for our patients and the staff who care for them.
“We have listened to patients and staff in developing the 6Cs (Care, Compassion, Competence, Communication, Courage, and Commitment). Over the last year I have witnessed a widescale, positive embrace of the 6Cs as a set of values; the likes of which I have never seen before. It has re-instilled a common purpose and recharged pride in the profession.
“Never before has change been more important. Absolute transparency is the key to driving improvements in standards of care and we need to ensure that every single patient receives great care, every time. Today trusts in the North of England will publish safety, effectiveness and experience data; with the overall aim of driving improvements in practice and culture.
“I have travelled the length and breadth of the country this year and heard heart-warming stories of truly exceptional patient care where staff have gone above and beyond the call of duty and made a real difference. I’m proud to be a nurse and I know that the vast majority of my fellow nurses, midwives and care staff have, and always will, deliver great care.”
10.13am The largest single patient safety improvement programme in the world will be created by NHS England in response to the Francis report, the director overseeing it has explained.
The organisation’s patient safety director Mike Durkin explained the plans to HSJ and said he believed they would bring “the greatest” benefit of all the developments taking place in response to the Mid Staffordshire Foundation Trust public inquiry.
10am Just over half of adult self-harm cases dealt with by hospitals last year involved existing specialist mental health service users according to new figures released by the Health and Social Care Information Centre today.
These service users accounted for 56 per cent (54,700 of 96,900) of self-harm inpatient care episodes in 2012-13.
Of the remaining care episodes, 11 per cent (10,500) resulted in a mental health assessment on the same day as admission, while a further 11 per cent (11,000) were assessed later in the year.
Today’s report also shows a third of self-harm episodes involving these services users related to intentional self-poisoning by prescription drugs generally used for treating conditions such as depression, epilepsy and schizophrenia.
HSCIC chair Kingsley Manning said: “Today’s report gives several important areas of insight – including the extent to which those already in contact with specialist mental health services self-harm so seriously they require hospital inpatient care. Our data also shows that many of these self-harm incidents involve everyday drugs that can be bought over the counter.”