5.21pm: The College of Emergency Medicine has raised concerns over proposals for changes to Lewisham Hospital’s accident and emergency unit, and indicated they do not fit its definition of an emergency department.
Last month health secretary Jeremy Hunt announced he would accept the proposals of the trust special administrator to downgrade services at Lewisham, but that a smaller A&E would be retained, with “24/7 senior medical cover”.
“Sir David’s job is a tough one, but a simple question − is there anyone out there who could do it better? If yes, then get them in, if not then we know we could only get worse.”
“Fresh eyes need to look at the Francis Inquiry, ask the right questions, listen to the right people and make the right decisions. Anyone remotely involved in or tainted by Mid Staffs and other similar issues cannot be trusted to be objective and do the right things… Britai’n’s got plenty of talent, so bring in some new people at the top of the NHS.”
“I suggest separating the job from the man in this discussion. Surely the chief executive of the NHS/NHSCB ‘leads’ the organisation and therefore must be able to have an impact on the strategy and operations of the organisation?”
4.08pm: The Office of Fair Trading has cleared the acquisition by University College London Hospitals Foundation Trust of Royal Free London Foundation Trust’s neurosurgery services. The full text of the decision will be available soon.
Yesterday HSJ broke the story about the shake-up in specialist cardiac and cancer services taking place at UCLH, the Royal Free and Barts Health Trust.
3.32pm: There’s an interesting discussion developing in the comments on today’s HSJ story about HMRC looking into trusts’ tax arrangements in relation to outpatient drugs. Join the debate at the bottom of the article.
One reader says: “We often hear that the private sector can do things at a lower cost than the NHS, often this is due to tax advantages rather than productivity. So well done to the FTs who have set up their own schemes and kept the entire benefit within the NHS.”
Another adds: “We need more of this innovation and it is to be hoped HMRC will not clamp down on this sort of activity.”
3.17pm: Following the positive feedback for HSJ’s “gagging clauses in numbers” graphic, let’s draw your attention to the interactive infographic of interviews with pioneering patient leaders on our leadership channel.
2.33pm: Care UK has announced the acquisition of UK Specialist Hospitals, a provider of elective surgery centres for NHS funded patients, for an undisclosed sum. The deal nearly doubles the amount of elective surgery centres Care UK operates, taking its total number of centres to 11.
2.17pm: Sir David Nicholson isn’t in the only topic of discussion on HSJ’s opinion pages today.
David Kerr is encouraging all healthcare leaders to join in Andy Burnham’s health policy debate, while this week’s finance column looks at the influence the competition authorities could have on trust mergers and service swaps as they become increasingly involved in the sector.
1.08pm: Brace yourselves End Game fans, HSJ has some exciting news. The magazine’s ever popular, rib-tickling round-up of the NHS’s most weird and wonderful behaviour has gone digital with its own blog. End Game has been online for less than 48 hours and already there’s a post about NHS-endorsed ninjas.
Meanwhile, the Duke of Edinburgh has been joshing with nurses while visiting Luton and Dunstable Hospital to open a new cardiac centre.
1.00pm: The British Medical Association has said the government’s proposed changes to the GP contract in England risk putting targets before patients and could seriously destabilise local patient services, in its response to the consultation on proposals to make changes to the English GP contract from April.
The BMA’s submission contains interim findings from a survey of GPs with nearly 8,000 responses. The full response is on the BMA website.
12.55pm: Monitor has issued guidance to NHS providers about how best to allocate the cost of their services to individual patients. The full document is available on its website.
12.52pm: Anna Dixon, currently director of policy at the King’s Fund and a regular contributor to HSJ, will join the Department of Health in early May as director of quality and strategy and chief analyst. She has been with the King’s Fund for more than six years and has previously worked for the DH at the strategy unit.
Ms Dixon said: “I am delighted to be taking up this new role at the Department of Health at such a critical point when many organisations are taking on new responsibilities in the NHS and public health system.
“I look forward to working closely with colleagues in the Department as well as partners across the health and social care system to address the key strategic issues facing us, not least among which is the challenge of securing high quality care for patients and users.”
12.48pm: The NHS Commissioning Board has released its latest bulletin for clincial commissioning groups, with an update on the third wave of CCG authorisations.
12.44pm: The Department of Health has published data showing providers of NHS-funded healthcare reported 398 breaches of the mixed-sex accommodation guidance in relation to NHS patients in England in January, compared to 308 in December 2012.
Of the 161 acute trusts that submitted data for January 2012, 131 (81%) reported no sleeping breaches. All 398 of the breaches occurred in acute trusts.
12.13pm: A government-commissioned report has revealed the NHS could be crippled by a shortage of nearly 200,000 nurses in just three years’ time.
The major study makes predictions on changes in healthcare demand and the supply of registered nursing staff in the NHS in England between 2011 and 2016.
The report, compiled by the Centre for Workforce Intelligence, is not yet in the public domain but has been submitted to the Department of Health and is understood to have been read by ministers.
11.59am: HSJ’s exclusive graphic showing the extent of the use of compromise agreeements and confidentiality clauses (or “gagging orders”) in the NHS has gone down well with the twitterati. Let us know what think at @HSJnews.
Our investigation has found at least 30 trusts have brought in private firms to run their outpatient dispensaries and identified two foundation trusts which have set up wholly owned subsidiary companies to run the service.
11.23am: David Cameron has extended his support to Sir David Nicholson, saying campaigners and MPs shouldn’t “seek scapegoats” for the care failures at Mid Staffordshire Foundation Trust. The Daily Telegraph reports that the prime minister said: “I am impressed with the grip and grasp [Sir David] has over the NHS, and his love for it.”
The Telegraph also runs a short story about how the “friends and family” test may have helped identify the problems at Mid Staffordshire earlier. While Sir David features on its opinion pages, where Sue Cameron asks “should one man take the rap over Mid Staffs?”
11.12am: Sir John Oldham’s article published yesterday in defence of Sir David Nicholson has attracted a lot of comments − agreeing and disagreeing with his argument. Today, Roger Kline considers both sides of the “should he stay or should he go” debate. Mr Kline writes:
“Let’s ask two questions. The first one is whether Sir David was sufficiently aware, or could reasonably have been expected to have been sufficiently aware, of the carnage in Mid Staffordshire, and have intervened earlier?
“The second question is whether Sir David is the right person to take forward the Francis report’s recommendations?”
10.32am: Away from the nhsmanagers.net survey, a poll by Ipsos Mori, shared exclusively with HSJ, has found 52 per cent of the public blame NHS managers for the disaster of poor care at the Mid Staffordshire Foundation Trust.
Ipsos Mori head of health research Jonathan Nicholls told HSJ: “It’s clear where the public places the blame for Mid Staffs.
“While the Francis report talks about failings throughout the system, over half of the public point to NHS managers as most at fault.”
10.25am: With the government’s deadline to give all patients online access to their healthcare records only two years away, just 4 per cent of GPs surveyed by Doctors.net.uk say their practice currently provides this functionality to patients.
The survey, conducted among more than 1,000 GPs nationwide for eHealth Insider, found that 43 per cent of GPs said their practices had yet to address the issue, raising concern over one of the government’s flagship NHS IT pledges. Fifteen per cent of respondents said they had a long way to go before their IT system would be ready; while 24 per cent said they did not know whether their system allowed patients to access their records online. A further 5 per cent of respondents said their IT system was ready but not live yet, and 9 per cent said it was nearly ready.
10.19am: Gary Walker tweets about the survey and the headlines around it: “More like ‘90% of managers and “a lot” of Drs say Nicholson must go’?”
10.17am: Ben Page, the chief executive of Ipsos Mori, and BBC health correspondent Branwen Jeffreys have tweeted some comments about the poll on the front page of the Daily Mail this morning:
“Our motto is that if its interesting its usually wrong. Self selecting zombie poll by the sound of it.”
“Need to look at methodology - self selected panel - so weighting applied to correct for bias?”
“It’s what we call a zombie poll. Also the sample is only 75 per cent NHS staff - rest in private sector.”
“Looks like 2 small self selecting survey samples from workforce of a million? Not best statistical backup?”
10.05am: In The Times, Matthew Parris has noted how at the Labour conference last October Ed Miliband spoke about “the magic of the NHS” but says just a few months later no party leader would use such a phrase: “The Francis report has let light in on the magic”.
9.56am: The Daily Mail has covered the results of an online poll of 1,723 NHS staff by nhsmanagers.net, in which 91 per cent of those who responded said Sir David Nicholson should resign as NHS chief executive.
The paper also reports prime minister David Cameron continuing to give strong support to Sir David. Mr Cameron said: “I’ve been impressed with the grip and grasp he has over the NHS and his knowledge and understanding and love for it and what he helps to deliver in terms of results.
“It seemed to me that he had properly apologised and acknowledged the mistakes that the regional health authority had made [in relation to Mid Staffordshire Foundation Trust] when he ran it for that short period of time as these events unfolded.”
9.21am: The NHS Commissioning Board has published results of the third wave of clinical commissioning group authorisation decisions. Five groups were found to have sufficient problems that they were have been given legal directions by the board, limiting their working. They are: Eastbourne, Hailsham and Seaford CCG, Newham CCG, Herefordshire CCG, Scarborough and Ryedale CCG, and Vale of York CCG.
The groups will receive “intensive support” from the commissioning board. Details have been published on the board’s website.
In total decisions were made on 62 CCGs. In total 163 CCGs have been authorised.
Dame Barbara Hakin, the commissioning board’s national director for commissioning development, said: “The majority of CCGs are now authorised and up-and-running and we are moving at pace towards a clinically-led NHS that is focused on delivering improved health outcomes, quality, patient safety, innovation and public participation.”
8.03am: Good morning, prospective academic health science networks have now submitted their prospectuses and business plans for evaluation and it is anticipated that by March between 12 and 18 will have been designated and will hold a five-year licence. On the HSJ site today Robert McGough and Sue Rubenstein look at the seven main challenges facing the new organisations.