CQC reveals job specification for new chief inspector of hospitals

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4pm: The job advert and role description for the new Chief Inspector of Hospitals has been revealed by the Care Quality Commission.

The advert, available to view here, says the Chief Inspector of Hospitals “will champion the interests of patients and make critical judgements about the quality of care provided.”

It adds: “The new Chief Inspector of Hospitals will be a senior figure who will inspire the trust and confidence of the public, and who will have immediate credibility across the clinical professions.

“This is a public-facing role and the Chief Inspector must have the professional standing to be persuasive to the Secretary of State, clinical professions, and the public.

“Most of all, the Chief Inspector must have a reputation for putting the interests of patients first, and provide an honest and independent assessment of how well or badly hospitals serve their patients.”

A job specification from Russells Reynolds Associates is availanle to download (see right).

3.10pm: A survey by the Medical Protection Society has found 84 per cent of doctors think that online records will add to their workload and will mean spending more time explaining the contents to patients. 

Dr Nick Clements, head of medical services at MPS said: “Online medical records have the potential to transform patient care and making these available electronically will undoubtedly increase patient access. It’s good to see that 68% of doctors and 63% of the public agree that the most important purpose of medical records is to give the doctor an overview of all medical treatments a patient has received and to help the doctor manage their healthcare.

“However our survey also showed differing expectations on how records should be written. If this issue isn’t reconciled before online records are introduced, this could lead to tension and confusion between doctors and patients.”

The findings from a survey of the public showed that three in four (75 per cent) agree that medical records should be written in simple language so that patients can understand them without assistance or explanation, but only one in five doctors (21 per cent) think that medical records should be written this way.

A research report by MPS on ‘Online medical records and the doctor-patient partnership’ will be launched in Parliament on 30 April 2013.

You can see the results of the survey here.

2.45pm: NHS England has published a three year business plan setting out how it intends to put patients at the heart of improving care both now and in future generations.

Called Putting Patients First, the business plan can be downloaded here.

The plan describes an 11 point scorecard which NHS England will introduce for measuring performance of key priorities, focused on receiving direct feedback from patients, their families and NHS staff.

NHS England saus the plan supports the cultural change needed to put people at the centre of the NHS, a key theme in the report by Robert Francis QC following the scandal at Mid Staffordshire Foundation Trust.

Professor Malcolm Grant, Chair of NHS England, said: “Recent events have demonstrated the need for constant vigilance to ensure consistently high standards of care across the NHS and to pick up possible failures at an early stage. This is why we have placed quality care at the heart of everything we do.

“The key test is whether patients would recommend their local NHS care and if NHS staff feel positive about what they are doing.”

The 11 key priorities on the scorecard are:

  • Satisfied patients
  • Motivated, positive NHS staff
  • Preventing people from dying prematurely
  • Enhancing quality of life for people with long term conditions
  • Helping people to recover from episodes of ill health or following injury
  • Ensuring people have a positive experience of care
  • Treating and caring for people in a safe environment; and protecting them from avoidable harm
  • Promoting equality and reducing inequalities in health outcomes
  • NHS Constitution rights and pledges
  • Becoming an excellent organisation
  • High quality financial management

The business plan outlines eight areas that will be used to ensure NHS England delivers on the 11 priorities: supporting, ensuring and developing the commissioning system; direct commissioning; emergency preparedness; partnership for quality; strategy, research and innovation for outcomes and growth; clinical and professional leadership; world class customer service; and developing commissioning support.

The eight activities span the commissioning system (the planning and buying of services), from national to local level, and make it the responsibility of everyone in the NHS to ensure the best care and outcomes for patients.

2.15pm: HSJ journalist Shaun Lintern tweets about the death of Margaret Thatcher: @ShaunLintern: “One thing #Thatcher did for the NHS was the introduction of general management in the #NHS following the Roy Griffiths inquiry in 1983.”

In a second tweet he says: “The Griffiths report began the erosion of clinician control over #NHS putting it in the hands of a new class of lay managers.”

1.15pm: @dwilliamsHSJ tweets:

@zemba if we handed it back to patients, would they run it in the best interests of the taxpayer, who after all pays fo it? #hsjnewsystem

12.49pm: @AdinaMay tweets:

#Hsjnewsystem it’s a partnership b/t patients-CCG. But if it goes wrong the real postcode lottery will begin and the lawyers will join!

12.39pm: @ShaunLintern tweets:

“You could argue the same people are in charge now as were prior to April 1. @NHSEngland top table seems very familiar. #hsjnewsystem

12.36pm: @RoyLilley tweets:

“No one is in charge it is designed with checks and balances to keep the SoS out of the firing line. #hsjnewsystem

12.32pm: Our Twitter chat on who’s really in charge of the new commissioning system is starting now. Follow @HSJnews and use hashtag #HSJnewsystem to take part

12.30pm: The paper also reports that more than a quarter of elderly people in care homes have to ask family and friends for help with fees, even though they are entitled to local authority support. Figures from Age UK show 56,000 people are paying top up fees because the amount their local council contributes falls short of what the home says it needs to charge. The number of people paying top up fees has risen by 4 per cent in the last year alone, the paper says.

12.28pm: The Telegraph carries a story about a grandmother who was handcuffed and escorted from her GP’s surgery by police after receptionists refused to provide her medical notes. The paper reports Mary Kerswell had agreed with her GP she could see her notes after a mix up in which she was mistaken for another patient. However, when she arrived at Biggleswade Health Centre in Bedfordshire the receptionists refused to print out the otes. Mrs Kerswell, 67 refused to leave and the police were called.

11.55am: A campaign to encourage NHS Wales staff to lead healthier lives resulted in fewer than half of those who signed up sticking to the full programme BBC News Wales reports. More than 1,300 signed up to Champions for Health, with 456 “actively engaged” throughout the six-month pilot project.

The project, inspired by the London 2012 Olympics, aimed to improve the health of NHS staff and their patients. It said half of the 120 people who signed up to eat healthily ate five portions of fruit and vegetables a day for 52 days or more.

11.09am: More from the survey - 54 per cent feel patient care in the NHS is worse today than it was ten years ago. Only 18 per cent feel the Government’s healthcare changes will help improve standards in the NHS.

On whether NHS nursing has become less compassionate in recent years - 65 per cent agree and 19 per cent disagree. Only 25% feel the NHS is well managed as an organisation.

11.03am: The ITV News Index survey also shows 55 per cent of people feel the NHS provides a high standard of care to patients, but 76 per cent agree the NHS is more focused on meeting Government targets than on ensuring high standards of patient care.

10.58am: Only 7 per cent feel the quality of care provided by the NHS has gotten better under the coalition an ITV News Index survey by ComRes reveals. A total of 2,038 British adults were interviewed online from 22nd to 24th March 2013. Of these, 42 per cent felt it was worse, 39 per cent felt it was neither worse or better and 12 per cent did not know.

10.35am: A report in this morning’s Financial Times about the increasing use of “zero hours” contracts for white collar employees states that the number of such contracts in the health service has increased by 24 per cent over the past two years, to almost 100,000.

“While many of these are nurses and healthcare assistants,” the paper adds, “the number of consultants on the flexible contracts has also increased.”

10.33am: Lincolnshire Echo reports that Lincolnshire NHS 111 non-emergency hotline pilot has cut A & E visits by 20 per cent.

The amount of people attending Lincolnshire hospitals’ A & E departments has fallen by a fifth since the NHS 111 non-emergency phoneline was launched two years ago.

10.27am: Yesterday’s Sunday Express caried a story that GPs will be led by cost in new NHS reforms. The radical changes to how our GPs work, introduced last Monday, may not affect the public for months but many experts warn of financial chaos and the potential fracturing of the patient-doctor relationship.

“If a GP’s budget is under pressure then a patient who may have been referred quickly for a hip operation might have painkillers while the op is delayed,” said Roy Lilley, a health policy expert and former NHS manager. “Another with cataracts may be told to struggle on and the whole relationship between patient and GP will come under pressure.”

10.13am: Families and clinicians at Leeds General Infirmary face a tense wait to see whether surgery will resume at the centre as expected this week. Child heart surgery was suspended at the LGI more than a week ago after concerns were raised about death rates and other issues - a decision greeted with anger and

On Friday, after a week of arguments and high-level meetings, an announcement was made that operations could be resumed early this week “subject to independent validation of the clinical data and an external review of clinical governance processes”.

10.11am: We are holding a Twitter chat at 12.30 today to discuss who is really in charge of the new commissioning system. 

We would love to hear your views on some of these questions and more: Are CCGs really running the show or is the centre still the boss? Do the new organisation have the power to question and influence providers or are they just too small? Is it the same people in charge of the new bodies or have clinicians stepped up?

Let us know from 12.30 using the hashtag #HSJnewsystem

10.04am: The Daily Mail reports that the NHS is paying trainee doctors more than £2,000 for a day’s work. Hospitals are squandering millions of pounds on agency workers to cover shifts at understaffed hospitals it reports.

Desperate trusts are being forced to hire temporary doctors to plug holes during busy times and fill in shortages created by illness, maternity leave and reduced working hours for junior doctors.

10.00am: The Guardian carries a front-page story headlined “Hospitals must shrink or shut, doctors warn”.

Dr Mike Dixon, the interim president of NHS Clinical Commissioners, told the paper: “A very large amount of what’s currently  done in hospitals could or should be done elsewhere. I think 50 per cent.”

Approximately half of the NHS’s £105bn budget is spent on the acute sector.

He said hospitals would have to slim down and some close and told the paper “CCGs are up for it, but [doing] this isn’t everyone’s cup of tea… because it’s at a high level and is politically difficult. We are used to being loved by our patients and having 90 per cent trust and all the rest of it”.

The BMA said an arbitrary shift of resource would leave the NHS unable to offer comprehensive specialist care but the NHS Confederation;s chief executive Mike Farrar agreed with Dr Dixon, adding “The public’s attitude to hospitals needs to change.”

On an inside page the paper has breif interviews with five CCGs leads, Steve Kell, chair of Bassetlaw CCG, Sarah Baker, chief clinical officer of Warrington CCG, Amanda Doyle chair of Blackpool CCG, Sam Everington, chair of Tower Hamlets CCG and Adam Morris, clinical lead for South Devon and Torbay CCG.

9.30am: The Times has run a story on rising levels of measles in Wales.

“Measles clinics inundated as clamour grows for MMR”, runs the headline. “Emergency clinics in south Wales were overwhelmed at the weekend as almost twice the expected number went to be vaccinated.”

Measles is infecting 20 people a day in the outbreak – which is due to low levels of take up of the MMR vaccination because of a scare in the late 1990s.

8.21am In the first in a series on international healthcare innovators, Pedro Yrigoyen, co-founder of MedicallHome in Mexico, talks to Claire Read about the impact of technology on primary care.

He says: “For people who have literally nothing, no type of access to any medical services, to have a £3 a month hotline plus medical discount makes sense.”