Secretary of state speaks to GPs’ annual conference in Harrogate.

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3.34pm Following his appearance at the RCGP, Jeremy Hunt has indicated that he agrees that resources have to be shifted from the acute sector to primary care.

He tweets: “Great to be @rcgp conf. Proud NHS budget’s protected, but agree we need more GPs & to shift resources from hospital sector to primary care.”

3.16pm The NHS Confederation has responded to today’s announcement about changes to the tariff (see 1.29pm, below).

Director of policy Johnny Marshall said: “NHS providers have done tremendous work over the past couple of years in delivering major efficiency savings alongside quality improvements, and should get credit for this. It has not been easy, and the writing on the wall says it is not going to get easier.

“The nature of the challenge now facing the health service means that only a joined-up approach between providers and commissioners can possibly deliver the changes and improvements which the service needs and which patients deserve.

“Our members tell us that the ‘simpler’ - and it’s all relative, as none of the changes have really been simple or straightforward - savings have already been delivered, leaving only the most challenging changes still to be realised. The new NHS payment system must respond to this, and reward a genuine focus on the interests of local people and patients.”

On proposed changes to the emergency admissions tariff, he said: “We have long been calling for changes to the marginal tariff, so that the NHS payment system incentivises delivery of the best care for patients. Today’s announcement from Monitor and NHS England recognises that the marginal tariff isn’t yet right, and is a major step in the right direction. In particular, the opportunity to agree a revised baseline is an important acknowledgement that changes in activity levels may result from planned changes in service delivery and are not necessarily a sign of inefficiency.”

2.59pm Here’s Clare Gerada’s speech to the RCGP. It’s her final address after three years as chair.

“When I became chair I was advised to keep a low profile for six months, until I got the hang of the job,” she said. “But things didn’t quite go to plan…”

2.51pm It looks as if Jeremy Hunt is taking questions from the audience at the RCGP conference.

The BBC’s Branwen Jeffreys again: “Cheers, whistles and clapping for GP telling Hunt @rcgp that to deliver hours offered this week means 80+ hour week …

“Delegate @rcgp tells Hunt he can have continuity or access but not both from existing GPs - he needs to choose - applause from audience”.

2.49pm Since we’re talking about Jeremy Hunt this afternoon, here’s news editor Nick Golding’s leader, inspired by events at this week’s Conservative party conference.

Policy rabbits were pulled out of hats, he writes, but “Jeremy Hunt is perceived by many as an ambitious man who sees health as a stepping stone to one of the four great offices of state. To prove the doubters wrong, he can show he is in it for the long haul, taking decisions that will sustain the NHS beyond 2015.”

2.42pm Various tweeters have reported that Jeremy Hunt’s speech is over. He wraps up by saying we should aim to make Britain the best country to grow old in.

2.40pm Some official lines from the RCGP twitter feed: “3 changes to start next yr.

“1- move to proactive primary care, free up GPs from QOF which deprofessionalises gen pract @Jeremy_Hunt

“2- integration of primary and secondary and social care services. @jeremy_hunt #RCGPAC. Break down barriers w pooled resources

“3- crack the business of data sharing. We have the basis of a universal electronic health record thanks to GP & rcgp @Jeremy_Hunt #rcgpac

2.39pm One more from Branwen Jeffreys: “Hunt @rcgp we need to crack data sharing. We owe a debt to GPs who stuck with own systems not national IT programme”

2.38pm DH spinner Kirsty Gelsthorpe tweets that Mr Hunt has been telling GPs about some of his frontline experiencesconference. And, she tweets this picture of Mr Hunt speaking, as RCGP chair Clare Gerada looks on.

2.36pm It’s a good job Branwen Jeffreys is in the room for Hunt’s speech, otherwise we wouldn’t have a clue what he’s saying.

“Hunt @rcgp we need to fully integrate health and social care - that’s why £3.8bn from Nhs budget to social care - we want plans by 2014”

2.34pm It appears Jeremy Hunt is gunning for the quality outcomes framework. Branwen Jeffreys tweets: “Hunt @rcgp we need to really move to proactive preventative care - most gps want to do that but managed to death by qof etc”

2.33pm Branwen Jeffreys of the BBC tweets: “Hunt @rcgp says you are the most cost effective way of keeping costs down treating people outside hospital”

2.32pm Tom Moberly of BMJ Careers tweets: “@Jeremy_Hunt tells #rcgpac he hopes to be seen as one of the most pro-GP health secretaries in a generation”

2.31pm Mr Hunt is speaking without notes, the twitterati has noticed…

2.30pm Jeremy Hunt is addressing the RCGP conference in Harrogate now. Stand by for updates from Twitter…

1.31pm Health secretary Jeremy Hunt has dressed his first wound. Mr Hunt, who has been doing frontline shifts in the NHS for some months now tweets: “Just dressed my first wound in a Leeds care home. Thanks Anam for showing me how and Brenda for gamely being the guinea pig.”

However not all of Twitter is impressed. One Don Buxton, who has a picture of Stalin where his own face should be, replies: “What about pt confidentiality Mr Hunt, u shud NEVER identify pt, that’s breach of pt confidentiality!”

1.29pm Ben Clover also has this story about changes to the tariff. He reports that Monitor and NHS England will increase the proportion to be withheld from providers from 1.5 per cent to 1.9 per cent. The measure is intended to encourage efficiency.

However, the Foundation Trust Network is unimpressed. Click here to read their response.

1.24pm Acute sector reporter Ben Clover has a couple of interesting new stories today.

First, new research suggests that delayed transfers of care could be behind this years dip in A&E performance, rather than NHS 111 troubles, increasing demand or a lack of doctors. More acute sector news to follow….

1.12pm New on HSJ today: Our commissioning support unit reporter David Williams says NHS England may outsource more of its own back office functions to CSUs.

The central body is conducting a fundamental review of its use of CSUs, in part to subject itself to the same discipline that it asks of clinical commissioning groups. Read more here.

11.31am Our reporter Sarah Calkin tweets that the CQC’s verdict on Anna Jefferson “must surely raise questions about the validity of the other findings of the report by Grant Thornton which made the allegation”.

11.27am Here’s a story by Sarah Calkin detailing what Anna Jefferson was alleged to have said. To reiterate - the CQC has found she has no case to answer and will not be disciplined.

And here’s the statement she released in response back in June.

11.23am The Care Quality Commission has published a statement about Anna Jefferson, its head of media, who was alleged to have taken part in a cover up over regulatory failings around Morecambe Bay.

Here’s the full statement:

On 19 June 2013, CQC published an independent report into its own regulation of the University Hospitals of Morecambe Bay NHS Foundation Trust.

This report, conducted for CQC by Grant Thornton LLP, contained statements regarding the professional conduct of Anna Jefferson, amongst others. Anna is currently CQC’s Head of Media but at the time relevant to the report was a media manager.

The statements relating to Anna Jefferson have now been investigated by CQC in line with its disciplinary procedure and the conclusion of the investigation is that there is “no case for Anna Jefferson to answer” and consequently no disciplinary action will be taken.

The internal investigation was not a review of Grant Thornton’s report, although it was one source of information. In summary, the investigation concluded, based upon the information reviewed, that:

  • Anna Jefferson had not used “any inappropriate phrases” as attributed to her by one witness quoted in the Grant Thornton report; and
  • Anna Jefferson had not supported any instruction to delete an internal report prepared by a colleague – Louise Dineley.

The CQC regrets any distress Anna Jefferson has suffered as a consequence of this matter and is pleased to welcome Anna back to the organisation following a period of maternity leave. She is currently undertaking a course of postgraduate study with CQC’s support.

10.46am Ministers are waging war on an NHS pay system which allowed thousands of doctors to enjoy pay rises of up to nine per cent last year, the Daily Telegraph reports. The story is based on the Department of Health’s submission to the Review Body on Doctors and Dentists remuneration and reports that health secretary Jeremy Hunt is determined to renegotiate doctors pay deals.

10.43am Health secretary Jeremy Hunt will address the Royal College of GPs conference this afternoon.

Ahead of that, the RCGP has got some good coverage in the nationals today about how NHS funding is flowing away from primary care and into the acute sector - our chief reporter Dave West did this story a few weeks ago.

The Guardian reports the coalition put £400m less into GP services last year than Labour’s final year in office, despite family doctors struggling to meet growing patient demand for appointments, according to research by the Royal College of General Practitioners (RCGP).

The study says general practice received £943m less across the coalition’s first three years because an increase in spending under Labour was not sustained.

Dr Clare Gerada, chair of the RCGP, warned that surgeries’ declining income was a key reason why patients’ waiting times to see their GP were increasing and practices were having to reduce services. “The cumulative effects of year-on-year decreases in funding are now having a disastrous effect on patient care,” she said. GPs need an emergency funding package, like the £500m given to help A&E cope, she added.

“GPs are heaving under the pressure of ever increasing workloads and diminishing resources, including a chronic shortage of GPs,” she said. GPs’ inability to offer patients timely appointments could mean that some patients’ illness may be missed, she added. “If we can’t see you, how do we know you’re not ill?”. 

The story was picked up on BBC Radio 4’s flagship Today programme this morning, too.

10.27am One more new opinion piece on HSJ this morning - Andrew Taylor warns that there is a danger that NHS trusts which have received bailouts from the Department of Health could find themselves the subject of a complaint to the European Union.

He explains that trusts receiving cash from the DH, such as from the government’s A&E fund, or tax relief or “soft loans”, could all be complained about.

Mr Taylor was the founding director of the Competition Commission. Read his analysis here.

10.13am Here’s another piece tackling the issue of information in the NHS from another perspective. Toby Knightley-Day, the managing director of Fr3dom Health argues that, although the friends and family test has been subject to a barrage of criticism, it could be one of the most useful tools for providing an accurate and dynamic view of service quality.

10.07am Good morning. New on HSJ this morning: Chris Alderson, a partner at legal firm Hempsons, reviews the imrpovements to patient data being sought in the wake of the Francis report into Mid Staffordshire. Read his analysis on how better data saves lives here.