How to develop the role of healthcare assistants, and the rest of today’s news and comment
5pm: Peter Carter, chief executive of the Royal College of Nursing, commented on the announcement of the £50 million pilot scheme for GP seven day working saying: “Increasing patient access to GP services, through more flexible hours and increased technology, is to be greatly welcomed. Nurses working in general practice will play a vital role in the multi-disciplinary delivery of these services, providing greater face to face support to patients.
“Urgent investment has long been needed in general practice and treating more patients in primary care settings can decrease burden on other struggling services. However any extension of services needs to be effectively resourced to equip GPs and nurses working in general practice with adequate tools to cope with demand. The use of new technology must also guarantee patient confidentiality.”
3.45pm: BREAKING NEWS: Monitor has used its powers to require Dorset Healthcare University Foundation Trust to appoint Sir David Henshaw as interim chair after resignation of chair Jonathan Walsh.
Monitor first took action in April this year to agree a series of legally binding undertakings to improve how the trust was run and ensure quality care.
In September Monitor concluded the trust was taking too long to make the necessary changes including addressing quality of care issues raised by the Care Quality Commission.
As a result of these and other issues, Monitor imposed a new condition on the trust’s licence which requires it to ensure its board and committees function effectively and is able to tackle the issues causing the trust to be in breach of its licence.
Paul Streat, regional director at Monitor, said: “We are using our powers to make sure that the Trust brings in the necessary skills and experience at a senior level to enable it to meet the challenges it faces and to make the improvements that are needed.
“Sir David Henshaw brings a wealth of experience and will joint the Trust on an interim basis to help accelerate the process of improving its performance for local patients.”
3.30pm: In an interview with HSJ’s Sarah Calkin the new chief inspector of GPs said he will use his role to reform primary care and develop integrated services, and to call for additional funding where it is needed
Steve Field, speaking on his first day in post at the Care Quality Commission, said he was taking on a far-reaching role which stretches beyond checking basic quality standards.
3pm: Health secretary Jeremy Hunt is speaking at the Conservative Party Conference in Manchester.
Below is a selection of tweets from Nick Golding, HSJ news editor who is covering the speech live.
“Hunt reveals he had head operation on nhs last year. Nurse said what do you do for a living?”
“Hunt talks about value he’s got from visits to frontline. In all places I’ve worked never seen anyone work harder than on NHS frontline.”
“Under Labour the system did everything it could to cover up mistakes.”
“Hunt berates burnham for not mentioning mid staffs in conf speech but mentioning privatisation 13 times”
“Hunt says care bill will include provision to give cqc statutory independence like the bank of england.”
“Ministers can never again lean on it.”
“Conservatives are party for docs, nurses and patients says Hunt.”
2pm: Francis Maude has announced the extension of the friends and family test across the NHS and other public services, including further education, Jobcentre Plus and the National Citizen Service (NCS).
1.45pm: The General Medical Council is to investigate the number of cases where a doctor has committed suicide while under investigation.
The watchdog will review a number of cases after a freedom of information act request revealed 92 doctors had died whilst under investigation since 2004.
Niall Dickson, chief executive of the GMC confirmed the review would take place after the regulator’s latest council meeting this week.
In a statement he told HSJ: “While we must never lose our focus on protecting patients, we also have a duty of care to doctors in our procedures and we have commissioned this review because we want to do everything we can to help and support those with health problems.
“GMC staff already work hard with psychiatrists and others supporting these doctors but we hope this review will consider whether there is any more we can do.”
He said some doctors referred to the GMC with mental health problems have a supervising doctor in their place of work and are regularly examined by two practising psychiatrists.
Mr Dickson added: “Our priority though must always be to protect the public whilst at the same time being fair to the doctor - sometimes that does mean having to take immediate action when we believe patients may be at risk.”
The GMC is planning to speed up its fitness to practise process and has commissioned the BMA’s Doctors for Doctors service to provide confidential emotional support to any doctor involved in a fitness to practise case.
12.45pm: Chris Ham, Chief Executive of The King’s Fund has reacted to the seven day working for GPs saying: “Although most people report good access to their GP, this varies significantly between practices and patients with busy working lives often find it difficult to make appointments at a convenient time. While some practices have made good progress in harnessing the benefits of technology - which evidence shows is delivering benefits to patients - others have been slow to adapt.
“It is important to recognise that general practice is under increasing pressure, with some practices in need of investment and forecasts suggesting a significant shortfall of GPs will develop over the next decade. However, there are opportunities to work more efficiently, particularly if practices work together in federations, networks and partnerships. Today’s announcement will therefore provide welcome impetus towards ensuring that extended opening hours and better use of technology become the norm, rather than the exception.
“However, the biggest challenges facing general practice are to tackle variations in the quality of care and meet the needs of the growing number of people with long-term conditions. For many of these patients, improving continuity of care is more important than extending access. Meeting their needs will also require sustained reform to ensure that general practice provides a wider range of services, closer to people’s homes.”
12pm: The Daily Telegraph finds space on its front page to report that GPs will be asked to open seven days a week for up to 12 hours and consult patients via email and internet video link.
It says the plans will make it easier for patients to see their doctor.
The paper’s front page also carries a report on a study published in the British Medical Journal which says people who suffer excess stress in middle age are more likely to suffer dementia in later life.
The Daily Telegraph also followed up HSJ’s exclusive revelations, reported by David Williams, that Heatherwood and Wexham Park Foundation Trust is under investigation after an audit uncovered a 14-year feud between doctors and 48 cases of possible harm to patients that were never checked. Details here.
11.45am: HSJ is hosting a Twitter chat on 4 October, to ask if the NHS learns from its mistakes.
Last week Craig Barratt, executive director of transformation and innovation at Lancashire Care Foundation Trust, imagined a possible NHS Museum of Failure, in which the national IT programme, and hundreds of other policies, projects and acronyms were displayed for our edification.
Craig will be on Twitter on Friday 4 October from 1pm to discuss his argument and consider to what extent the NHS already learns from its failures. Join in using the hashtag #HSJChat.
11.40am: Senior figures in healthcare have questioned moves by clinical commissioning groups to introduce “integrated” care pathways for single clinical specialisms, such as cancer or cardiology.
The King’s Fund think tank has led calls for a focus on integrated care in recent years. However, several of its leaders told HSJ they were now concerned that redesigned services focused on a single issue – described as “carve-outs” – could cause fragmentation, and create new “silos”.
11.40am: Health minister Daniel Poulter has said the government is listening to criticism of competition rules which have been blamed for thwarting much needed hospital reconfiguration projects.
He spoke to HSJ after a Foundation Trust Network/New Statesman fringe meeting at the Conservative party conference in Manchester, amid concerns that Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts are being prevented from making their services more sustainable through a merger. The merger proposals are currently being scrutinised by the Competition Commission, and may be blocked.
11.20am: HSJ’s columnist Michael White says government spin is leaving the NHS “dizzy”.
11.10am The Unite union has highlighted 11 marginal Conservative MP seats which it claims are vulnerable due to local NHS problems.
The document, NHS Critical in Tory Marginals, says the 11 seats could be strongly influenced by the rising tide of public concern about the state of the NHS in those areas.
It includes the Broxtowe seat in Nottinghamshire, held by public health minister Anna Soubry, by just 389 votes.
The 11 tight marginal seats highlighted by Unite commissioned research from the NHS Support Federation are: Amber Valley, Brighton Kempton, Broxtowe, Cambourne & Redruth, Lancaster & Fleetwood, Lincoln, Morecambe & Lunesdale, North Warwickshire, Sherwood, Thurrock, and Truro & Falmouth.
“In all eleven of the seats, local hospitals or trusts have serious staffing shortages, which is having a clear impact on patient care.
“Six of the constituencies are close to one of the eleven high profile hospitals that have been put under special measures for poor performance and high mortality rates: North Warwickshire, Sherwood, Broxtowe, Amber Valley, Thurrock and Lincoln.
“Five of the constituencies are linked to hospitals that Monitor - regulator for health services in England - regard as having a high risk of financial failure: Sherwood, Broxtowe, Lancaster and Fleetwood, Morecombe and Lunesdale, and Amber Valley.
“Six are also close to hospitals that have Monitor’s highest warning for poor governance: Thurrock, Sherwood, Broxtowe, Lancaster and Fleetwood, and Morecambe and Lunesdale and Amber Valley.”
11am: The Guardian reports on calls from more than 100 scientists, doctors and other healthcare professionals of the Breast Cancer Campaign group for action to close what they described as the “ten critical gaps in breast cancer research”. The paper says some of the gaps concern the need for new treatments – particularly for secondary or metastatic cancer – and warns more patients will die without more research.
10.10am: Responding to the Prime Minister’s announcement on seven day working in GP practices Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee said: “GPs are always open to new ways of working that can benefit patients.
“Many GP practices already offer extended opening hours and provide out of hours care to meet the needs of their local populations and provide the best quality care for patients.
“Crucially, for this to work the government needs to address issues around GP numbers and support services. Without extra GPs the existing workforce will have to be stretched over seven days, meaning potentially reduced services during the week.
“It will also require additional resources and investment in support and diagnostic staff such as district nurses and access to community care so GPs can meaningfully provide a full service across the week, and it remains to be seen if the money set aside will be enough to deliver this.
“The BMA will be interested in the results of this pilot and are committed to working with the government to improve access to care for patients, but the GPs will need more detail on how it will work in reality, particularly when it comes to staffing and resources.”
10.05am: The Prime Minister has announced a first wave of GP practices who will operate seven days a week and out of office hours under a £50m pilot project.
David Cameron said the plan would make it easier for people see their family doctor from 8am to 8pm, seven days a week.
Innovative practices will be able to apply to a new £50m Challenge Fund to set up a pioneer programme. Pioneers will be established in every region of the country – 9 in total – which together are expected to cover up to half a million patients.
Ministers want to use the pilots as the first step to rolling the scheme out across the country and encouraging hundreds more GP practices to sign up.
New pioneer GP groups will also test new technology such as greater use of Skype, email and phone consultations for those who would find it easier.
This first wave of pioneers will form part of a wider plan to strengthen out-of-hospital NHS care, and make it easier for practices to join up with each other, as well as other services provided in the community.
The pilots will also consider using electronic prescriptions and online booking of appointments, easier, on-line registration and choice of practice, joined-up urgent care and out-of-hours care.
Patients will also be able to visit a number of surgeries in their area and access better telecare for those with long term conditions.
The Prime Minister said: “Millions of people find it hard to get an appointment to see their GP at a time that fits in with their work and family life.
“We want to support GPs to modernise their services so they can see patients from 8am to 8pm, seven days a week.”
Health Secretary, Jeremy Hunt, said: “We live in a 24/7 society, and we need GPs to find new ways of working so they can offer appointments at times that suit hard-working people.”
Professor Steve Field, the new chief inspector for General Practice, said: “This move towards seven day services is great news for patients, and should be embraced by GPs. I want to see brilliant access to GP services for patients across the country, and will be assessing this in each practice I inspect.”
9.45am: Mark Davies, chief executive of Imperial College Healthcare Trust is to leave at the end of the year.
Mr Davies, who has been at the trust for two and a half years, said he will continue working in a new role with the NHS TDA to support NHS trusts who need strategic or leadership support.
Mr Davies said his decision had been prompted in part by the need for continuity of leadership as the Imperial College Healthcare NHS Trust moves towards Foundation Trust status.
Mr Davies said: “Monitor is always keen to ensure a proper degree of continuity in the leadership of NHS trusts as they move towards and then become foundation trusts.
“I have now been the chief executive here at Imperial College Healthcare for two and a half years and this important need for on-going continuity has led me to ask myself whether I really want to remain at the helm for what might be another two and a half years or even longer. I have determined that the time is right to move on.
“I have been discussing with David Flory CBE, the chief executive of the NHS Trust Development Authority, the need for experienced leaders within the NHS to share their expertise across the health system and with his encouragement I will be exploring how myexperience at Imperial College Healthcare can be put to best effect across the wider NHS.”
8:37am: Good morning, Camilla Cavendish’s review into healthcare assistants and support workers in the NHS and social care made a number of recommendations to ensure they are providing care to the highest standard. The review has propelled this somewhat forgotten group of healthcare workers into the spotlight and has highlighted the importance of their role.
Care support workers are a vital part of the healthcare team and provide essential nursing care for patients’ personal needs.Today on HSJ’s leadership channel, Christine Wilkinson highlights one development programme already making a difference to 17 trusts after only a year.