Concerns over variations in surgery survival and use of the ‘friends and family’ test in A&E, plus the rest of today’s news and comment
Board papers for May found that the trust delivered £400,000 of savings in April, which was less than half of the £1m planned.
4.54pm: Dr Karen Castille, chief nurse and director of organisational development at Cambridge University Hospitals, will be joining the NHS Confederation on secondment as associate director. She will be leading the NHS Confederation’s work on supporting the service in its response to the Francis report.
4.42pm: Two updates from waiting times analyst Rob Findlay on his hsj.co.uk blog. The first corrects an error he made previously after adjusting the size of the English waiting list for trust mergers. The waiting list has grown more significantly than originally thought, and is now noticeably higher than in recent years.
The second blog says outpatient waits are rising in Scotland as health boards struggle with their new inpatient target.
4.25pm: A mental health worker savagely stabbed to death by a paranoid schizophrenic who was living in the community should not have been visiting him alone, a report has concluded. An investigation into the circumstances surrounding her death has criticised health chiefs from Northumberland, Tyne and Wear Trust and said that Dixon should not have been managed in the community
Ronald Dixon stabbed Ashleigh Ewing 39 times, breaking three knives in the process, when she went to his home to deliver a letter from her employers.
4.07pm: A woman with complex mental health problems committed suicide after funding decision errors by a primary care trust and local authority saw her prematurely removed from a care home, HSJ has reported.
A narrative verdict from a north London coroners court into the death of Sheila McInulty found “failures at every level of the process” between NHS Barnet and Harrow Council. Read the full verdict here.
3.51pm: Here are some more details on NHS England’s data guidance for GPs and commissioners (see 2.28pm). It has outlined plans to merge the main data set used to monitor hospital activity with general practice data in the first step of its long-term programme to better link patient data across care settings.
A joint statement by NHS England and leading GP groups said a new data set, “care episode statistics (CES)”, would link hospital episode statistics (HES) with primary care data.
While HES data will continue as an independent data set, NHS England said this was “the first step” of its ambitious care.data programme designed fully lintegrate primary and secondary care data.
NHS England, in partnership with the British Medical Association and the Royal College of GPs, has produced fresh guidelines on what GP data will be extracted and how it will be used.
An NHS England statement said: “The initiative is designed to link information from general practice, with information from hospitals and community health care services.
“This will help the NHS evaluate and improve the quality and safety of the NHS, and enables patients to make more informed choices about the treatments and services they use.”
3.32pm: HSJ has just published a wide-ranging supplement looking at different ways NHS trusts have been improving efficiencies and reducing costs, in areas including pathology, service design, diagnostics and the workforce. Download the PDF version for free here.
3.23pm: HSJ has published more on the story that NHS officials have been criticised for letting sales people have access to new mothers just hours after they have given birth (see 10.29am).
The chief executive of parenting charity NCT, Belinda Phipps, said it was angry about the way some NHS organisations let the company Bounty access new mothers. “Within hours of giving birth, they are being asked questions - their name and address, details of life insurance - and they give them in good faith, thinking they’re speaking to a hospital person,” she said.
2.28pm: NHS England has released guidance for GPs explaining how using anonymised patient data in general practice will help commissioners improve services. The GP Technical Specification and its associated guidance was developed in partnership with the British Medical Association and Royal College of GPs.
GP practices will be contacted directly with more details and materials in June
2.00pm: In an HSJ podcast recorded at NICE’s annual conference, Dr Kevin Fenton, director for health and wellbeing at Public Health England, discusses its role in health improvement and how the new organisation will tackle health inequalities.
12.01pm: In her column, Sally Gainsbury warns of a lack of forsight in some area’s of the government’s Health Education England “mandate”, which HSJ reported on yesterday. She says:
“The document is almost completely silent, however, on the other source of significant instability in medical education: the 20,000 oversupply of hospital doctors that will hit the NHS workforce in the next seven years without radical change in either employment patterns or training pathways.”
11.35am: This week’s HSJ Local Briefing provides in-depth analysis of community engagement in Mid Devon and examines the future of Tiverton and District Hospital after a meeting between commissioners and the public.
11.21am: King’s Fund assistant director Nicola Walsh has looked at the practical and cultural challeneges facing healthcare leaders trying to pioneer models of integrated care. She says:
“Integration of care in itself is not a technical or a policy challenge, it is much more of a leadership challenge. If pioneers are to successfully implement integrated care at scale and pace, we will need to see changes in behaviour and, in some instances, a significant shift in organisational culture.”
11.18am: Following the magnificent cake based on the Bristol stool chart, End Game has been alerted to more medically inspired cakes in time for elevenses. Tuck in.
11.09am: Michael White has commented on a difficuly week for GPs and MPs, with the newspapers revelling in playing the two sides off against each other. He also writes on the shortage of doctors in general practice and A&E:
“You could add (as some MPs privately do) that another explanation for the shortage of GPs and A&E specialists which the BMA and royal colleges rarely mention is that both are good career training grounds, but offer little by way of private practice in the longer run. It’s another reminder of the cultural split in medicine that’s always been there.”
11.02am: Trusts have consistently raised concerns about using the controversial “friends and family” test in A&E departments, according to research commissioned by the NHS and obtained by HSJ .
The audit of 162 trusts by consultancy Fr3dom Health was carried out in February and March, as they were preparing to use the patient satisfaction survey. It found all were ready to roll it out in April but said trusts highlighted concerns about the viability of its use in A&E
10.40am: John Carvel has written an article for The Guardian on the lack of clear guidance available to NHS trusts on brain donation.
He writes: “When [my mother] Florence Carvel died, aged 92, we called the brain bank at King’s College London to activate the donation procedure. However, none of the nearby NHS or local authority mortuaries were willing to carry out the brain donation post-mortem.”
10.29am: The variation in surgery survival rates story (see 9.42am) makes the front page of the Daily Mail and The Daily Telegraph.
The former emphasises that patients who have operations at the weekend are 82 per cent more likely to die, while the latter calls the situation a “death risk lottery”. The Telegraph says patients are 44 per cent more likely to die after an operation Friday than on Monday. The research also features in The Guardian.
Inside the Telegraph, a report says new mothers are being “duped” into talking to sales staff from a promotion company called Bounty while it hands out application forms for child benefits on wards. On the opinion pages, Mary Riddell asks whether Labour will be bold enough to put Andy Burnham’s plans for the NHS at the heart of its 2015 election campaign.
10.12am: In The Times, Dr Phil Hammond, who is also a contributor to HSJ and Private Eye, writes that doctors are right to keep telling overweight patients to lose weight, but it’s ultimately up to the individual to do something about it, otherwise “the NHS will simply collapse under our collective weight”.
9.42am: BBC News has given plenty of prominence to research published by the BMJ that found people who have surgery at the end of the week are more likely to die than those who have operations earlier on. The researchers found “unacceptable” variation in survival rates through the week, a leading body of UK surgeons says.
However, the research into non-emergency operations in England suggests the overall risk of death from such planned procedures remains low.
8.32am: While the data may not be conclusive, there is evidence to suggest that closing small accident and emergency departments is not necessarily the solution to the problems facing the sector. The top-10 trusts by A&E volume shows a disproportionately large number of non-foundation trusts and some record extremely large deficits.
8.29am: Good morning, the structure of German company boards offer many lessons for the role of foundation trust governors and should be introduced here, say Naomi Chambers and Bill Gregory.
Many European countries operate systems of corporate governance that have two boards. The system developed in post-war Germany has allowed many businesses to flourish while protecting public and social interests.