Norman Lamb and communities minister Brandon Lewis have jointly written to health and wellbeing board chairs calling for more involvement of providers in plans for the better care fund, and the rest of today’s news and comment

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5.30pm The BBC reports that almost two thirds of major accident and emergency units in England missed their waiting time target this winter.

Only 52 out of 144 type one trusts met their targets of seeing 95 per cent of patients within four hours over the 20-week period to 23 March, according the BBC.

5.00pm Writing in The Spectator, former political secretary to Tony Blair John McTernan argues that incoming NHS England chief executive Simon Stevens may be more radical and make more difference than anyone has yet realised.

“Stevens’s passion is transparency. He wants patients to have access to the same knowledge as their doctors,” he writes.

“As Health Secretary, Jeremy Hunt has positioned himself as an NHS reformer, a champion of patients who is unafraid to challenge the system.

“It’s a worthy endeavour, but one for which he’ll need serious support. If he is serious about saving the NHS, then he will find the perfect partner in Simon Stevens.”

4.44pm The BBC reports that a nurse has been arrested in connection with the poisoning of patients at Stepping Hill Hospital, run by Stockport Foundation Trust.

Victorino Chua, 48, has been arrested on suspicion of three counts of murder, 18 counts of causing grievous bodily harm and poisoning offences.

4.30pm Providers will need to invest “significant” time in ensuring frontline staff can deliver the plans to improve patient safety which were announced by the health secretary last week, HSJ has been told.

Jeremy Hunt said the NHS should halve rates of avoidable harm and confirmed the government plans to extend an organisational duty of candour to cover moderate harm as well as severe harm and death.

The duty of candour, requiring staff to tell patients where errors take place, is being introduced in the Care Bill, and will apply to all organisations regulated by the Care Quality Commission.

Secondary legislation on the rules, published for consultation last week, defines moderate harm as an incident leading to a “moderate increase in treatment; significant but not permanent harm and prolonged psychological harm”.

4.18pm The Department of Health has confirmed to the College of Emergency Medicine that proposals to remove police stations from section 136 of the Mental Health Act 1983 will not be taken forward.

Jeremy Hunt yesterday announced the details of a joint review between the Department of Health and the Home Office of the operation of sections 135 and 136 of the act.  

Section 136 allows the police to remove an individual from a public place who appears to have a mental illness to a designated place of safety.

In a statement earlier today, the College of Emergency Medicine said it was “extremely concerned” by the proposals.

The College said it “recognises that a police station is a poor place for a patient suffering a mental health crisis and supports the well-meaning intent of this proposal.

“However, there are some patients whose risk of violence to staff and other patients is so extreme that a police cell is the only safe option.

We are also concerned that the provision of s136 suites run by mental health trusts is simply inadequate.”

The College argued that a change in the act would mean “our crowded emergency departments will receive more agitated and disruptive patients.

“We will then suffer lengthy delays in obtaining mental health assessments from psychiatrists.

The optimal designated place of safety is a dedicated s136 suite, run by the Mental Health Trust and adjacent to an Emergency Department. There are very few of these in England or Wales.”

Further discussions are expected to take place under the Mental Health Concordat.

4.00pm Actress Juliet Stephenson argues in The Guardian that all pregnant women, including those in the asylum system, should be exempt from NHS charging.

“As a mother myself, I find it abhorrent that our system puts women and their babies at greater risk,” she writes.  

“The government must ensure that every woman in the UK is supported to have a safe pregnancy and childbirth.

“We must not create additional barriers to healthcare for women who are already so vulnerable and marginalised.”

3.45pm Selected care homes which are accessing patient records via TPP’s SystmOne are discovering the power of easier, joined up communications, writes Jennifer Taylor for the HSJ’s supplement on integrating care.

3.30pm As part of the latest HSJ supplement, Daloni Carlisle explains the thorny issue of how personal health budgets will work in practice is being tackled by an e-commerce platform that promises an easier way for the public to spend.

3.17pm In the latest HSJ supplement, we analyse how personal budgets and electronic patient records can help to integrate health and social care.

You can download the integrating care supplement as a PDF.

2.47pm Progress towards Jeremy Hunt’s target for a paperless NHS by 2018 needs to be “accelerated”, according to a report by IT trade body TechUK.

While it supports work already done to develop infrastructure, the report makes some recommendations to ensure the target is met:

  • Public and private investment must be maintained to move towards the paperless goal. 
  • Invest more time and resource into raising awareness of the benefits that technology projects deliver
  • Move towards a more mixed digital system economy.
  • Learn from other industries that have embraced the digital agenda.
  • Improve the way health and social care professionals and patients are engaged on the design of digital products and services

2.33pm In our latest data video, HSJ senior correspondent Ben Clover talks about the deterioration of hospital trust finances.

With more than a third of hospital trusts predicting a year-end deficit, according to an HSJ analysis, what are the reasons for the deterioration of hospital trust finances and why are so many trusts running into difficulties?

2.14pm The National Institute of Health and Care Excellence has been accused of planning a “stealth cut” for cancer treatments by campaigners, after unveiling its proposed new criteria for drugs approval, according to The Financial Times.

Andrew Wilson, chief executive of the Rarer Cancers Foundation, described the plans as “a stealth cut for cancer”, which “could have a devastating impact on access to life-extending drugs”.

2.05pm The Times also reports that countries that have banned smoking in public places have seen a 10 per cent fall in pre-term births and children visiting hospital for asthma, according to a study published in The Lancet.

The study drew together research across Europe and the United States and looked at 2.5 million births and 250,000 incidences of asthma that came after the introduction of smoke-free legislation. In the same period it also found a 5 per cent fall in children born below weight.

1.43pm The Times reports that eating organic does not cut the risk of cancer, a study by Oxford University scientists of hundreds of thousands of women has concluded. (paper only)

Women who always ate organic were no less likely to get a range of 16 cancers than those who never ate organic.

1.30pm A group of consultant obstetricians and gynaecologists have criticised the decision by the Crown Prosecution Service prosecute a doctor for female genital mutilation, The Guardian reports.

Dhanusun Dharmasena is expected to be charged for performing the procedure on a woman at Whittington Hospital, North London.

In a letter to The Guardian, the clinicians, who have all treated women who suffered FGM, state there is “a world of difference between FGM and repairing cuts necessary to allow a baby’s delivery”.

1.15pm The Guardian also examines the contrast the health secretary’s approach to overseeing NHS and his predecessor Andrew Lansley’s attempts to reduce political interference.

1.00pm Flicking through today’s papers this lunchtime, The Guardian has a front page story on senior NHS figures privately telling the paper of their concerns about Jeremy Hunt “micro managing” the health service, which they say is contradicting the coalition’s pledge to “liberate” the NHS from political control.

12.25am North East London Commissioning Support Unit is to provide services to five clinical commissioning groups in Norfolk and Waveney from 1 April.

The CSU was selected to take responsibility of commissioning support services across Norfolk and Waveney in December last year.

Mark Taylor, North Norfolk CCG’s accountable officer, said: “We have been impressed with the excellent service offer, the positive attitude that NEL CSU staff have and their willingness to deliver a service that CCGs really value. 

“Dealing with a bigger organisation will mean that we can look forward to greater capacity, capability, efficiencies and resilience.  

The CSU’s managing director Andrew Ridley said: “The combined knowledge and expertise of Anglia CSU and NEL CSU staff means that we are increasingly attracting high quality organisations keen to work with us to develop better, more efficient services for patients.

“Developing our services in Anglia puts NEL CSU in a stronger position to deliver excellent, flexible services to our customers with more opportunities to develop new, innovative products.”

12.13am Norman Lamb and communities minister Brandon Lewis have jointly written to health and wellbeing board chairs calling for more involvement of providers in plans for the better care fund.

The two ministers’ letter, sent yesterday, emphasised the “importance of sustained involvement and engagement of the leadership of the acute sector and primary care”.

It follows concern from some providers they are being excluded from discussions about use of the fund, which will include money pooled by the NHS and local authorities.

In 2015-16 it will be worth £3.8bn nationally, with around £2bn funded by the NHS, and is designed to be ring-fenced for out of hospital services. Officials have warned it could mean a “cliff edge” funding cut for hospitals.

11.59am You now download the full HSJ Top Chief Executives supplement.

11.44am Times are tough for NHS trusts so there is no better time to celebrate the best NHS trust chief executives, writes HSJ editor Alastair McLellan.

11.32am See the full list of HSJ’s top 50 provider chief executives.

Dame Julie Moore and Sir Robert Naylor are among the 50 chief executives doing an exceptional job of steering provider trusts, according to a panel of expert judges assembled by HSJ.

11.15am In our comment section, greater centralisation is not the answer to all the NHS’s problems – smaller hospitals still have a vital role to play in the future of acute care, argues Nigel Edwards, senior fellow at the King’s Fund who will become chief executive of the Nuffield Trust in April.

11.03am The way hospitals record deaths could be covering up poor treatment and costing lives, according to a new report.

Figures show a dramatic rise in the number of people recorded as needing “palliative care” at the end of their lives, with some hospitals saying more than 35 per cent of their patients die this way.

10.43am This week’s issue of HSJ magazine is now available to read on our tablet app.

In this week’s issue we reveal the top 50 chief executives of NHS provider organisations, as nominated by their peers.


  • NHS England has admitted that £650m of provisions made by PCTs to pay for continuing care claims will not be available to CCGs
  • Trusts are hoping for bailouts totalling £376m this financial year
  • Paul Corrigan and Andrew Taylor propose changes to NHS competition rules that cannot “be seen from space” but could improve the merger process
  • Peter Homa gives his advice on how to turn around a struggling acute trust
  • Dame Julie Moore writes an open letter to a younger self on what her NHS career has taught her

To find the latest issue, simply navigate to “This week’s issue” on the app, or tap on the cover image on the homepage.

HSJ’s tablet app is free to download for both iPad and Android devices. iPad users can download it directly here, Android users will need to download it from the Google Play store.

10.29am The NHS’s biggest pathology reorganisation will take place in May, after the Office of Fair Trading ruled it would not be investigating the plan further.

The competition watchdog announced this week that the consolidation, which involves six trusts and will be hosted by Cambridge University Hospitals Foundation Trust, does not “qualify” for OFT scrutiny.

10.15am Royal Cornwall Hospitals Trust’s bid for foundation status has been further delayed, following a Care Quality Commission inspection which found the trust “required improvement”.

Following an inspection of acute services at the trust’s Treliske Hospital in Truro, the CQC said that the trust’s safety, quality of its surgical treatment and organisational responsiveness needed improvement.

10.00am The chief executives of some of England’s most powerful hospital trusts have warned that the organisational independence of other providers should not be a barrier to them being taken over.

A conference organised by Reform, the right-wing think tank, and the Shelford Group, which represents England’s 10 most influential hospital providers, saw Central Manchester University Hospitals Foundation Trust chief executive Mike Deegan tell delegates: “Organisational sovereignty is a barrier to change.”

9.44am EXCLUSIVE: The government has failed to issue guidance on the operation of a new legal right of choice for mental health patients, ahead of it coming into force next week.

This has sparked confusion among mental health providers about how widely patients will in reality be given choice, how it will be offered in practice, and how providers will be paid.

6.00am Good morning. The chief executive of the Royal National Orthopaedic Hospital Trust, Rob Hurd, says the NHS is in a period of major change and the job of trust leaders has never been more complex.

Specialist hospitals play a vital role in the delivery of excellence in healthcare and must support the clinical and financial viability challenges of the wider NHS, he says.