The most senior nurse implicated in the Mid Staffs scandal has been struck off the NMC register after a legal agreement was reached, plus the rest of the day’s news and comment

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5.27pm Also by the BBC, health correspondent Nick Triggle examines whether patients’ medical records are in danger once comes into force in the summer.

NHS England’s chief data officer Dr Geriant Lewis said: “If you believed everything you read about this, you would think the NHS was either about to give away everyone’s confidential data free of charge or flog it to the highest bidder.

“Needless to say, we are doing no such thing: to do so would be unethical, illegal and unconstitutional.”

5.00pm The BBC’s Melissa Hogenboom analyses whether there could be another mass outbreak of bubonic plague. This follows a study published in the The Lancet Infectious Diseases, into why the Justinian Plague strain became extinct, while the pathogen that caused the Black Death has mutated and is still in existance.

Helen Donoghue of University College London told the BBC it would be very unlikely for the plague to re-emerge as a mass killer.

She said: “Humans are only accidental hosts for this organism, it’s rodents and the animals that eat them (like fleas).

“It’s only when the fleas are starving or when they run out of rats or other rodents - because of heavy rains or when the harvest fails - that fleas will go on to any alternative hosts. Humans were just unlucky.”

4.27pm The Daily Mail reports on James Wishart, 11, who was diagnosed with a serious heart condition while being treated for a broken wrist at Bristol Royal Hospital for Children.

Dcotors became aware that James’ heart was not functioning properly while he was in surgery to repair his wrist.

4.09pm In his leader column, HSJ editor Alastair McLellan argues Jeremy Hunt cannot stick solely to the political mantra of “keep it simple, stupid”, he has to engage directly with the scale of the change needed at system level being identified by NHS England.

He writes: “Mr Hunt’s agenda is not the only game in town. Work by NHS England is identifying the radical level of change needed to keep the NHS afloat on current levels of spending growth.”

Last week HSJ exclusively interviewed the health secretary, in which he revealed CQC inspectors will check whether hospitals have the name of each patient’s “whole-stay doctor” clearly marked above their bed.

3.56pm The interim chair of the East of England Ambulance Service Trust Geoffrey Harris has resigned, the trust has announced.

Dr Harris joined the trust last May following the NHS Trust Development Authority appointing a new chief executive, Anthony Marsh, to sort out the trust’s poor performance.

3.53pm The NHS Trust Development Authority has appointed Nick Williams as a non-executive director of Mersey Care Trust.

Mersey Care chairman Beatrice Fraenkel said: “Nick will bring a strong combination of customer care and customer service, together with financial expertise to the board. He has a personal commitment to improving lives through the services delivered by Mersey Care and he is supported by his employers, Lloyds Banking Group, whose charity of the year is the Alzheimer’s Society.”

Mr Williams said: “I’m delighted with the opportunity at Mersey Care to support the local community through direct support to such a vital NHS organisation providing mental health services.  I’ve seen people suffer from the pressures of mental distress and I’m committed to helping people with mental health problems and tackling the stigma associated with it.”

Mr Williams is a financial services and banking expert and is currently consumer digital director for Lloyds Banking Group.

He added: “My skills and experiences at Lloyds Banking Group are very transferable to Mersey Care.  Putting your customers at the heart of what you do, public trust and sentiment and cost efficiency are common challenges.  Providing digital services with the rapid growth in everyday use of the internet and mobile devices is having a profound change in the way we source information and research; I am keen to learn how Mersey Care is facing up to the needs of helping people in the digital age.”

3.45pm The BBC reports that charities and educational groups are writing their own guidelines for sex and relationships education in schools, arguing the existing guidance is outdated.

The government said it had no plans to update its official current guidance, which is nearly 14 years old and makes no reference to the internet.

A spokesman for the Department for Education said: “Sex and relationship education is already compulsory in all maintained secondary schools and primary schools are able to teach it as well.

“Our statutory guidance, which all schools teaching sex and relationship education have to follow, explicitly states children must learn ‘how to recognise and avoid exploitation and abuse’.

“Teachers must also cover sexual consent and the importance of stable relationships.

“From the age of five children are taught how to stay safe online and schools are already able to talk about the dangers of pornography in an age-appropriate way.”

3.36pm The former director of nursing at the Mid Staffordshire, Janice Harry, has been struck off the Nursing and Midwifery Council register.

Jackie Smith, chief executive and registrar of the Nursing and Midwifery Council said: “We are pleased to confirm a legal agreement has been reached between the NMC, Professional Standards Authority (PSA) and Janice Harry, which will lead to her being struck off the nursing register.” 

 “We had previously raised concerns about the sanction imposed by an independent panel in November 2013, and took immediate steps to refer it to the PSA for review.

“The case raised important issues about the responsibility of nurses who hold senior management positions and their duty to ensure the protection of the public.”

3.30pm Nearly a year since the Francis report into failures at Mid Staffordshire Foundation Trust, Jennifer Trueland examines how much progress hospitals have made implementing his recommendations in HSJ’s Hospital Transformation microsite.

She spoke to chief inspector of hospitals Mike Richards, who said: “Variation is unacceptable – we shouldn’t accept it. It might sound a flippant example but you wouldn’t go into one branch of a supermarket and expect it to have different standards to another branch. I’m not saying that we will have completely identikit hospitals, but we have to be able to expect the same high standards wherever we go.”

3.18pm In The Guardian, Andrew Clegg, clinical specialist at the e-health company Orion Health, argues that for integration to be achieved, there needs to be a change in how healthcare staff work with colleagues in different organisations.

3.08pm Our other sister publication Local Government Chronicle reports that Norfolk County Council is to take its social care mental health service for adults of working age back under direct control.

3.04pm In our sister publication Nursing Times, there was a dramatic rise in the number of nursing staff employed by hospitals in England in the immediate wake of the report into care failings into Mid Staffordshire Foundation Trust, latest official figures reveal.

Hospitals were employing around 2,400 more acute, elderly and general nurses in October 2013 than they were when the Francis report was published in February.

The period was marked by a widespread focus on safe staffing in hospitals culminating in the government telling hospital trusts to begin publishing daily details on ward staffing levels from April, as part of its response to the Francis report.

2.46pm Talks over plans to impose 20 per cent higher efficiency targets on mental health and community trusts have ended without agreement, HSJ has learned.

In a meeting on Tuesday Monitor and NHS England rebuffed appeals from the Mental Health Network, NHS Confederation and the Foundation Trust Network over their proposal to impose a tariff deflator a fifth higher for non-acute organisations than for their acute counterparts in 2014-15.

2.26pm In The Guardian, columnist Michele Hanson writes that NHS hospitals have too many rules and regulations. She reflects on her friend Rosemary’s recent stay in hosptial, where she was “treated almost too perfectly”.

She writes: “The nurses were so attentive, she had to beg them to leave her alone. But it wasn’t allowed. They had strict instructions, on a plastic card hanging from their waists, which must be obeyed.”

2.14pm In a letter to the The Times, a coalition of 23 children’s groups including the Royal College of Paediatrics and Child Health, has called for politians to invest more in children.

The groups warn that children in Britain will “suffer” as a result of politicians not affording them the attention they give the elderly.

The letter states: “The UK has the one of the worst child mortality rates in Western Europe with up to 2,000 excess deaths a year; the number of children who are obese or who have mental health porblems is growing; and the economic; and the economic challenges faced by country are particularly impacting younger people.

“For the first period since the Victorian age it is predicted that living standards for children will be worse than their parents.”

1.59pm The Times reports on Maisha Najeeb winning a multimillion-pound payout from Great Ormond Street Hospital Trust after her brain was accidentally injected with glue during treatment.

The High Court yesterday approved a settlement for Maisha to receive a £2.8m lump sum and £383,000 every year from the trust until she is 19.

1.51pm In today’s papers this afternoon, The Daily Telegraph reports that a u-turn by the National Institute for Health and Clinical Excellence (NICE) could lead to “thousands” of men with prostate cancer being denied treatments that could extend their lives.

12.52pm In response to the CQC’s Mental Health Act Monitoring report, Paul Farmer, chief executive of the mental health charity Mind, said: “As the number of detentions under the Mental Health Act tops 50,000 for the first time, national and local commissioners need to urgently look at the services they provide and ensure they are adequately resourced and able to cope with demand. That more people are becoming so unwell they need to be formally admitted to hospital suggests failings in services that are supposed to help people manage their mental health problems at an earlier stage.

“There are obvious pressures on the system, which are having a significant impact on the care of people who are at their most unwell. Increasing bed shortages and staffing difficulties resulting from cuts to mental health services over two consecutive years mean people aren’t getting the help they need. We are concerned at the evident lack of therapeutic activities available on some wards – it is essential that services focus on recovery rather than simply containing people who are in crisis.

“We welcome and echo the CQC’s call for trusts to reduce their use of seclusion and restraint to a minimum, and to involve people in planning their own care as a means to achieving this. In difficult financial times more than ever people must be placed at the absolute heart of their care and treatment and have as much control as possible over what happens to them. It is good news that access to advocacy is now commonplace, as this helps ensure that people can understand and exercise their rights while under section.

“The government has this month reinforced its commitment to bringing mental health out of the shadows and putting mental and physical health services on an equal footing. Excellent crisis care does exist, but today’s report is a stark reminder of just how much needs to be done to make sure that all people with mental health problems get the help they need.”

12.45pm The number of people detained or treated under the Mental Health Act has risen by 12 per cent in the last five years, the Care Quality Commission says in its fourth annual Mental Health Act report, published today. 

The Act was used 50,000 times to detain or treat people under compulsion last year and there were 45,000 uses of the Act in 2008-9.

Examples of outstanding care were also found over the year, with inspectors seeing people with mental health problems benefiting from high quality and safe psychiatric care that respects their dignity.

However, access to crisis care remains inadequate and assessment suites for people experiencing a mental health crisis - or health-based places of safety - are often not staffed at all times, the report finds. 

Some of these health-based places of safety have been found to be empty while patients are taken to police custody, and this contradicts the fundamental principles of the Act that urge the least restrictive care.

CQC chief executive David Behan said: “We have seen great advances in treatment and care for people with mental health needs in recent years. We have also met staff committed to reducing the restrictions placed on patients as far as possible.

“However, we are concerned that access to crisis care is still a problem and that police custody is used when people should be in health-based places of safety. This needs to improve.

“We’re also asking hospitals, other providers and commissioners to act on these findings and make sure that people receive high quality, safe care.”

People with mental health problems in a crisis should have an emergency service that equals in speed and quality to that provided to people with a physical health emergency.

The MHA report does not include findings from inspections carried out under the Health and Social Care Act, although these two inspection programmes are merging.

CQC chief inspector of hospitals Professor Sir Mike Richards said: “We’re committed to making sure people detained or treated under the Act get the least restrictive care possible and that this care is the highest possible quality and designed around the individual needs of the patient.

“These people have the right to safe and respectful care. This is why we are changing the way we inspect, to make sure patients have positive experiences as far as possible during what can be very challenging and distressing periods in their lives.’

Other findings in the MHA report include:

  • One or more blanket rule was in place in more than three quarters of the wards the CQC visited. These rules most commonly apply to internet or mobile phone use, smoking, access to outdoor space or communal rooms, withholding post or phone calls.
  • Some patients’ physical health needs were not met, of 550 records examined, the regulator found 14 percent were on a ward with no access to a GP service
  • Staffing levels were linked to the quality of care in some places, with inadequate staffing preventing patients from taking leave and also exacerbating problem behaviour
  • Examples of patients in seclusion with inadequate regard for their privacy and dignity
  • More than a quarter of care plans showed no evidence in patients being involved in creating them
  • Around a third of care plans do not show evidence of discharge planning – this means detention periods could be inappropriately long

12.10pm Commissioners have prepared a set of compromises to one of the most ambitious integrated contracting plans after a Department of Health review recommended much closer collaboration with local providers.

The governing body of a clinical commissioning group will vote this week on a set of concessions, which reflect the DH’s recommendations and demands made late last year by local trusts. For more details and to read David Williams’s story in full - click here.

11.40am Francine Bennett, chief executive and co-founder of big data specialist Mastodon C, today argues thatm freely available, raw, open data provides a different way to get under the bonnet of what’s happening in the NHS.

11.10am A report published by the Information Commissioner’s Office today has highlighted the positive approaches GP practices are adopting to look after people’s data.

The report summarises 24 advisory visits undertaken by the ICO at GP surgeries across England in the past year.

The visits found surgeries tended to have good data protection policies and awareness of issues, including the need for adequate security and patient confidentiality. Practices also tended to have procedures in place around the practical aspects of data handling, including disposal of confidential papers.
But there are also areas highlighted in the report where improvements can be made. The advisory visits found some surgeries didn’t fully appreciate the need to report data breaches, and could make improvements to the way they inform patients about how their information will be used. Improvements were also suggested around faxing and the risks posed by unrestricted internet access.

Almost all of the surgeries had significant volumes of paper records that take up considerable space, highlighting the need for careful management of patient records on an ongoing basis.
Announcing the publication of the report Lee Taylor, ICO Team Manager in the Good Practice team, said:
“The NHS processes some of the most sensitive personal information available and data breaches at GP surgeries can have significant repercussions for the individuals affected. But we were broadly pleased with what we saw during the advisory visits. Having the right policies and procedures in place is the backbone to good data protection and the GP practices we visited tended to have these.
“The findings are particularly important as the NHS has been undergoing a period of considerable change. We hope GP surgeries use this report to review their procedures for handling personal information at their own practice; this can only be good news for patients.”
The advisory visits were carried out between April and November 2013. The visits are a free service provided by the ICO for volunteers, and involve data protection experts visiting practices for around half a day. The visits to GPs were promoted with the support of the British Medical Association.

10.35am The government has been accused of scrapping an annual survey of mental health spending because it highlighted funding cuts.

Shadow health minister Lord Hunt of Kings Heath said the survey showed the proportion of the NHS budget spent on mental health had fallen for two years.

The issue was brought up in parliament following a story by HSJ revealing that the survey had been dropped last month.

10.28am More than a tenth of clinical commissioning groups have lost at least £10m of the funds originally earmarked for them for this year, HSJ has discovered

HSJ reporter Will Hazell illustrates the swings in the funding allocations of CCGs during the current financial year and their possible impact in this great data video.

10.25am This week, Public Health England announced plans to develop a national framework for HIV, sexual and reproductive health service commissioning in England.

Working together with the Local Government Association and NHS England, the initiative underpins PHE’s commitment to improving sexual and reproductive health, reducing sexually transmitted infections and securing best outcomes for people with HIV.

Commissioning responsibilities for HIV, sexual and reproductive health have undergone major changes over the last year, now shared between NHS England, local authorities and clinical commissioning groups.  These changes bring both new opportunities and new challenges.

Announcing plans for the national framework, Professor Jane Anderson, HIV, sexual & reproductive health lead at Public Health England, said: “In this new landscape, meticulous partnership working will be required to develop and maintain high quality services, delivered via seamless, integrated care pathways.

“This framework will help bring together all those involved in commissioning HIV, sexual and reproductive health services to deliver a whole system approach, which is flexible and adaptable, and meets the needs of local populations.

“The framework will also identify innovative practices that improve sexual and reproductive health outcomes in a holistic way. We are delighted to be working with our national partners on this project.”

The final framework, scheduled to be available in early summer 2014, will:

  • Describe working relationships between local government, NHS England and CCGs
  • Provide the evidence base for a whole system approach
  • Illustrate models of existing and emerging practice to deliver best outcomes
  • Demonstrate new ways of working to support continued modernisation and integration
  • Produce relevant and practical tools.

The work is being supported by NHS England, Local Government Association, Association of Directors of Public Health and Department of Health, and MEDFASH has been appointed by PHE as project delivery agent.

10.10am Roughly one in eight doctors’ surgeries are now “research ready” after signing up to an initiative encouraging GPs and their patients to get involved in primary care research.

There are now 1,006 GP practices signed up to the Royal College of General Practitioners scheme.

For full details on this story - click here.

10.00am NHS England is looking to develop accident and emergency standards that are “far more meaningful” than the current target of treating, admitting or discharging 95 per cent of patients within four hours, it has been disclosed.

9.50am Senior NHS Staff are being warned that they could be hit by changes to taxation on pensions which come into force in April

For more details and to read Sophie Barnes’s story in full - click here.

6.00am The NHS is awash with information about hospital performance but it is not always translating into a safer acute care system for patients, says Alex Kafetz.