Andy Cowper debunks NHS management myths as part of our Respect for Managers campaign, plus the rest of today’s news and comment

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3.21pm Fewer than half of people with long term conditions agree they would have enough information to make decisions on how money should be spent on managing their long term condition, if they had more direct control over how a limited amount of money is spent, a survey has found.

Ensuring that people have access to the right kind of information in order to make decisions about their own care, and are also supported to be able to use it, will be crucial to empower patients in line with current ambitions and the future visions for the NHS. In order to delve deeper into whether current information is able to deliver this, Patient Information Forum and consultancy MHP Health commissioned a poll with ComRes.

To see the full survey results and report, click here.

2.12pm NHS England plans to cut jobs and close offices in its primary care support services just weeks before it plans to announce the winning bidder of a £1bn contract to take over the function.

The rationalisation process could lead to over 300 voluntary and compulsory redundancies, from a total workforce of around 1,800. Nine offices running the services are to be closed under the proposals.

NHS England’s PCS function is to be outsourced via a competitive tender. The contract will be worth up to £1bn over 10 years. Capgemini, Equiniti and Capita are leading the three shortlisted bids for the contract, which is due to be awarded after the general election in May.

The final bids were due to be submitted last week.

1.58pm HSJ’s Crispin Dowler tweets:


11.41am Commissioners in north east London have calculated that the financial challenge the area faces comes to almost £950m over five years.

The commissioners predict the local health economy faces a collective deficit of £943m if nothing is done to address its financial situation.

Barts Health Trust, the largest trust in the country, was placed in special measures earlier this month because of a deficit approaching £100m and performance concerns identified by the Care Quality Commission.

11.37am As part of their mental health funding pledge this morning, the Liberal Democrats have said in a statement that they would:

  • Put mental health on the curriculum and build better links with schools. Our investment will help ensure children are able to access high quality care nearer to home, enabling them to keep in contact with family and friends.
  • Ensure that no one in crisis will be turned away, with new waiting time standards and better crisis care in hospital A&E departments, in the community and with crisis phone lines. This will enable us to end the use of police cells for people suffering from a mental health crisis.
  • Establish a world-leading mental health research fund, investing £50m in cutting edge research to further our understanding of mental illness and the most effective treatments.
  • Continue to support the Time to Change programme to tackle stigma against mental health.
  • Introduce care navigators so that people get help finding their way around the system.
  • Set stretching targets to improve the physical health of people with mental health problems and join up care so there is more mental health support in your GP surgery and more physical health advice and support within mental health services.
  • Ensure all front line public service professionals, including in schools and universities, get better training in mental health – helping them to develop their own mental resilience as well as learning to identify people with mental health problems.
  • Radically transform mental health services, extending the use of personal budgets, integrating care more fully with the rest of the NHS, introducing rigorous inspection and high quality standards, comprehensive collection of data to monitor outcomes and waiting times and changing the way services are funded so that they do not lose out in funding decisions in future.
  • Publish a national wellbeing strategy which puts better health and wellbeing for all at the heart of government policy. This includes promoting better public health policy to benefit mental as well as physical health, such as access to the natural environment.
  • As part of this strategy, we will develop a clear approach on preventing mental ill health,  with a public health campaign promoting the steps people can take to improve their own mental health - the wellbeing equivalent of the “five a day” campaign for healthy eating.
  • Support the development of good practice among employers in promoting wellbeing and ensure people with mental health problems get the help they need to stay in their jobs or to find work.

11.32am England’s chief inspector of hospitals, Professor Sir Mike Richards, has published his first report on the quality of care provided by Derby Hospitals NHS Foundation Trust.

Under its new inspection model, the Care Quality Commission has given individual ratings to each of the core services at the trust’s hospitals; urgent and emergency services, medical care (including older people’s care), surgery, critical care, services for children and young people, end of life care and outpatients and diagnostic imaging. 

The CQC inspection, which took place between 8 and 11 December, found the trust was ‘good’ with regard to whether services were effective, caring, well-led and responsive and ‘requires improvement’ with regard to whether services were safe.

Reports relating to the services inspected are published on CQC’s website today and are available via the following link: 

CQC found many areas of outstanding practice, including:

  • Ward 205 is to be commended for helping to improve the mental wellbeing of elderly patients and patients with dementia through the use of a reminiscence room, pictorial information and advanced service planning.
  • The maternity department bereavement service has been recognised by the Royal College of Midwives. The lead midwife has been nominated for the Royal College of Midwives Award 2015 National Maternity Support Foundation Award (NMSF) for Bereavement Care.
  • The KITE (Kids In Their own Environment) team provides an innovative outreach support service to children in their own homes.
  • The trust has a 24 hour mental health liaison support with a one hour target response time for patients experiencing a mental health crisis.=
  • Staff are passionate and committed to providing a good standard of care for end of life patients. Staff are positive about their role despite the resource difficulties they were experiencing.
  • Respiratory medicine has introduced the use of patient colour-coded wristbands to identify how much oxygen each patient needs. Excessive amounts of oxygen can be dangerous for some patients and it is important the correct amount is administered.

CQC found some areas where the trust must make improvements, including:

  • Suitable arrangements must be implemented for acting in accordance with the best interests of patients without the capacity to give consent to care and treatment, in line with the requirements of the Mental Capacity Act 2005.
  • The trust must ensure that all district nursing staff are able to attend mandatory training and other essential training as required by the needs of the service.
  • The trust must take appropriate steps to ensure that there are sufficient numbers of suitably qualified, skilled, and experienced district nursing staff available at all times.
  • The trust must ensure that electronic patient records can be located promptly by staff visiting patients at home, before providing care and treatment.

Professor Sir Mike Richards, Chief Inspector of Hospitals, said: “On all of our inspections, inspectors ask whether a service is safe, effective, caring, responsive to people’s needs, and well-led.

Derby Hospitals Foundation Trust was found to be providing a good service overall. Patient feedback during our inspection was positive and staff were praised for their caring and compassionate nature. All departments were clearly working very hard to achieve positive patient outcomes.

“While some areas for improvement have been highlighted to the leadership at the trust, particularly regarding safety, overall this is a good trust providing caring, effective and responsive services that are well led. The trust knows what action it now needs to take to make any improvements.”

The CQC has asked the trust to send us a report that says what action they are going to take to make improvements.

Derby Hospitals Foundation Trust provides both acute hospital and community-based health services, serving a population of over 600,000 people in and around southern Derbyshire.

11.27am The Liberal Democrats have said they intend to spend £3.5bn more on mental health care in England over the next parliament, if they form part of a new government.

In a statement on their website, the party said the money would be spent on “revolutionising children’s and mental health care” including:

  • £250m over five years for pregnant women and mums dealing with depression. This would include eight new mother and baby units providing inpatient care for pregnant women and new mums and 40 new community services helping new mums adjust to life at home with a new born. 
  • New waiting time standards for people in crisis and for conditions like bipolar disorder so that those who are ill know how long they have to wait.
  • Hundreds of thousands more people will get access to talking therapies for anxiety and depression.

The Guardian reports that today’s Liberal Democrat manifesto commitment includes an additional £250m a year in 2016-17 and 201718, rising to £500m a year after that.

Added to the existing money for mental health announced in the budget, that would make a total of £3.5bn over the parliament. The party says it will pay for the funding commitment with the £250m for NHS England announced in the budget.

The remaining funding will be raised through increasing the required shareholdings to qualify for entrepreneurs’ relief from capital gains tax from 5 per cent to 10 per cent and reducing the annual exemption to £2,500, something the Liberal Democrats estimate would raise about £700m.

Funds would also be raised by abolishing the shares-for-rights scheme, which the party says would raise about £200m. The rest of the money would come from the increased NHS budget already announced by the party.

10.52am Circle has given share options to Hinchingbrooke Health Care Trust’s charitable fund on the eve of its departure from the hospital.

The company said awarding the options was a “gesture of our support” to the Cambridgeshire district general hospital’s staff.

In January Circle announced it was pulling out of its 10 year contract to manage Hinchingbrooke, the first NHS trust in the country to be operated by a private company.

The announcement came shortly before the release of a highly critical Care Quality Commission, which rated the hospital “inadequate” and resulted in it being placed in special measures.

10.32am Smaller hospitals must ask ‘searching questions’ about the services they can realistically provide in order to guarantee their sustainability, a district general hospital chief executive has said.

Gavin Boyle, chief executive of Chesterfield Royal Hospital Foundation Trust, told HSJ that DGHs would need to be “really sure” that the services they provide are appropriate for their size and location.

Mr Boyle’s comments came as he outlined the trust’s five year clinical services strategy - an ambitious plan that includes a new £8.7m cancer facility, service reconfigurations and recruitment.

10.21am NHS England will accelerate planned changes to urgent and emergency care services because of poor performance across the sector.

A new payment system for urgent and emergency care will be trialled “later this year”, in partnership with Monitor, as part of its business plan for 2015-16.

HSJ understands this trial was originally scheduled to start next month. However, a spokeswoman for NHS England said the trial was on track.

7.00am Good morning and welcome to HSJ Live. We start with a piece written by HSJ’s comment editor, Andy Cowper, debunking NHS “management myths” as part of our Respect for Managers campaign.

Andy writes: “[Managers] are charged with keeping the public safe, supporting clinicians in their life-saving and life-improving work, and making scarce resources go further than ever.

“Negative political rhetoric not only damages morale and retention, it also gets translated into policies that undermine good management: look no further than endless, often pointless restructuring and pay freezes targeted at managers.”

You can support our campaign on Twitter using #respect4managers.