4.57pm There is an interesting HSJ reader comment thread building up on David Williams’s story about acute providers lawfully avoiding VAT on drugs.
Readers appear split on whether the trusts are doing anything wrong, whether they’re actually saving any money, and whether there are any winners beyond the legal profession.
Have your say, if you haven’t already.
4.20pm: The Royal College of Midwives has published a comment on the government’s recently-published competition regulations. It declares: “Plans for tendering of NHS services could lead to fragmented NHS maternity services and poorer care.
“The NHS (Procurement, Patient Choice and Competition) Regulations 2013… - as they stand - could effectively open up all NHS services to competitive tendering. This appears to completely contradict assurances give by government ministers during the passage of the Act. The RCM is calling for the regulations to be subjected to scrutiny and full debates in both houses of Parliament.
“This is a particular concern for maternity services. In most parts of England it is only NHS services that are able to deliver the full range of maternity services, antenatal, through birth and postnatal. This ensures women have continuity of care and integrated care across community and hospital settings.”
Jon Skewes, the college’s director for policy, employment relations and communications, says: “I am deeply disappointed with the Government because they seem to have promised one thing and delivered the opposite. We were repeatedly assured by ministers that compulsory competitive tendering would not be imposed on organisations commissioning maternity services. The regulations as they stand will mean that this is exactly what will happen.”
4.15pm “New threat to NHS”, announces an email from the large Left-ish pressure group 38 Degrees.
The organisation has messaged its mailing list over concerns that secondary legislation could make it harder for CCG to not put service contracts out to tender (see 11.16am, below).
“A new fight over NHS privatisation has just begun,” the email says. “Jeremy Hunt is trying to use new powers, hidden within last year’s controversial NHS laws, to force local GPs to privatise more health services. This is one of the things we were afraid might happen - and now our worst fears are being confirmed. We need to do all we can to stop it.
“Jeremy Hunt’s new privatisation plot is contained within “NHS competition regulations”. Usually these kinds of rules get quickly rubber-stamped by Parliament. This time, we need to get MPs and Lords to stand up to Hunt and block his plans.
“It’s a long shot, but we have a chance of stopping these changes because Hunt is breaking promises made to MPs when NHS laws were voted through last year. If we generate a huge, public outcry to put pressure on the politicians who clung on to those promises last time the government attacked our NHS, we can convince them to stop these new laws.”
38 Degrees has launched a petition over the plans.
3.20pm: HSJ has published an opinion piece by a senior figure with experience of the NHS and political communication, who has written anonymously about the government’s dilemmas in considering Sir David Nicholson’s position.
It comes amid persistent media speculation about whether the NHS chief executive should be sacked in light of the Francis report, and other allegations. The author writes: “In number 10 and Richmond House now they will be reading the entrails of politics, media and public opinion. If Sir David was a minister he might have fallen on his sword by now. But he isn’t and it matters to many people that he remains in his post.
“Spare a thought, though, for the man at the centre of this. He has dedicated his professional life to the NHS. He won’t want anyone’s pity, but he doesn’t deserve the vilification he is getting from the Daily Mail. A real concern at Number 10 will be that if the glare of the spotlight continues, this proud man might just walk.”
12.09pm Minister Dan Poulter has announced new checks are being introduced, “to make sure all doctors who work for the NHS can speak English well enough to treat patients.”
Checks are detailed in the government response, published today, to the House of Commons Health Committee Report, 2012 Accountability Hearing with the General Medical Council.
Click the link above to download them one paper at a time. Top of the agenda is Mid Staffordshire - Robert Francis QC, who ran the public inquiry into the scandal - will be in attendance at the meeting.
There is also a recruitment update, two papers on engagement at “public voice”, and a paper on implementing electronic patient records across the NHS.
11.37am Interesting (if minor) news from Monitor.
In the action log from the last board meeting, the board records: “Board members proposed that Monitor should also encourage more honours nominations from the foundation trust sector and asked for further work to be undertaken on how best to achieve this.”
A paper on how this might be achieved is being brought to the April board meeting.
“Don’t say Monitor never does anything for you FT-sector”, tweets HSJ’s acute sector reporter Ben Clover.
11.20am Did we mention that our End Game column is now a blog? There were are a couple of entries late on Friday on about minister Anna Soubry’s recent appearance on the Department of Health’s video channel, and another about a song produced by a foundation trust congratulating themselves on the great care they give.
11.16am HSJ’s pre-weekend story about new secondary legislation which could make it easier for independent sector providers to get contract decisions overturned if they feel they should have been open to tender has been picked up by campaigners.
Keep the NHS Public are urging members to write to the clerk of the House of Lords secondary legislation scrutiny committee to protest the changes.
11.02am There was some highly positive coverage from the Right-leaning press over the weekend of Circle’s running of Hinchingbrooke Health Care Trust.
Hinchingbrooke Hospital: private firm “transforms” failing NHS trust, said the Telegraph. A near-identical story in the Daily Mail is headlined: Transformed: The failing NHS trust taken over by private firm has one of the highest levels of patient satisfaction.
Both pieces focus on patient satisfaction ratings, based on the controversial friends and family test. Both cite unnamed “experts”, who say: “The system in place at Hinchingbrooke, which empowers doctors and nurses, could be used in dozens of other struggling NHS trusts.”
HSJ reporter James Illman might beg to differ, as he reported last week that interest in the franchise model “has waned dramatically”.
In the most recent friends and family survey for the East of England region, Hinchingbrooke came seventh out of 46.
The Mail story also said Circle: “Made up [the trust’s] deficit from its own coffers, rather than taxpayer funds, and is expected to break even in the current year.”
Of course HSJ readers will know that the franchisee taking the hit for a deficit isn’t quite the same as “breaking even”. Circle currently predicts it will break even in 2013-14, although this time last year they thought they were going to break even in 2012-13. See James’s HSJ Local Briefing on the subject here for all you need to know about Hinchingbrooke.
10.52pm More NHS coverage from the Daily Mail. Columnist Melanie Phillips links the Mid Staffordshire scandal to both the BBC’s journalistic and organisational shortcomings over Sir Jimmy Savile, and the current crisis engulfing the Liberal Democrats over allegations of misconduct by a senior figure. It’s all part of a “cover up culture”, she says.
10.39am The Care Quality Commission has published the results of an inspection of Hampshire Hospitals Foundation Trust.
The regulator found that at the trust:
- Patients experienced care, treatment and support that met their needs and protected their rights
- Patients were protected from the risk of infection because appropriate guidance had been followed; patients were cared for in a clean hygienic environment
- Patients were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.
However, it identified a “minor concern” on staffing levels. The CQC found that the trust “was aware of the situation and was taking action”.
10.28am New comment on HSJ this morning. Jules Acton of National Voices says that since everyone agrees they want integrated care, now is the time to have your say about what integrated care should be like.
10.20am A modest showing for health stories in The Daily Telegraph.
A very short story on page nine reports the finding of a survey that said “eight out of ten people said nurses should be encouraged to speak out” and “69 per cent felt nurses were unable to voice concerns”.
The survey was released by Britain’s Nurses, “an independent organisation set up to give nurses a platform to express their opinions”, the paper said.
In the comment section, the paper’s resident medic Max Pemberton’s column asserts “we only know about [‘gagging’ clauses] because of campaigning by Conservative MP Steve Barclay”.
10.17am Mid Staffordshire campaigners are to hold a silent protest at this week’s NHS Commissioning Board meeting in public. Cure the NHS, who formed to raise concerns about failures of care at the trust, say the move will mark the beginning of a campaign to hold Sir David Nicholson to account.
They will stand in silence outside the board’s Manchester base, where the meeting is being held, on Thursday between 10am and 1pm. Campaigner Julie Bailey said: “Sir David Nicholson isn’t a scapegoat, he is ultimately responsible as the leader of the NHS, but he also played a direct role in the disaster at Mid Staffs.
“In recent days we have heard that the public don’t want him and neither do the staff within the NHS.
We heard he played an important role in pushing through the Government recent health reforms and that is why he is being defended by this Government. In the last few days David Cameron said he had saved the NHS money - but it is hardly a glowing endorsement while patients are dying of neglect in our NHS.
“We are urging people to support our call for his resignation. We are not scapegoating but holding someone to account who has failed.”
10.07am The Conservative Home website does have a piece on Mid Staffordshire Foundation Trust by Chris Skidmore MP, however which attacks Labour over the scandal.
No mention of Sir David Nicholson though, which might explain why it wasn’t picked up in the Daily Mail. There’s not even a single mention of Sir David in the 97 reader comments posted underneath the blog.
10.00am Another day, another Daily Mail story attacking NHS Commissioning Board chief executive Sir David Nicholson. This time it’s Conservative MP Andrew Bridgen calling for him to resign over the Stafford Hospital scandal. In the story Mr Bridgen is quoted as saying: “It think it is very difficult to lead an organisation where 90 per cent of the3 staff do not have confidence in you, so he should consider his position.”
The Mail says Mr Bridgen’s comments come from a blog on the Conservative Home website, but a quick search of the site reveals no such article.
8.05am: Good morning, multiple factors will influence the setting of pay for clinicians on CCGs but a basic formula is available, Peter Smith writes on HSJ today. Following the third wave of authorisation, clinical commissioning groups are in the final stages of preparation for their formal start in April. One of the outstanding issues is the terms on which clinicians will be involved and how much they should be paid.