Patient safety is likely to become a key focus of the commons health committee’s work, its newly appointed chair has told HSJ, plus the rest of the day’s news and comment

5.40pm Sir Andrew Cash, chief executive of Sheffield Teaching Hospitals NHS Foundation Trust, has assumed chairmanship of the Shelford Group, succeeding University College London Hospitals chief executive Sir Robert Naylor.

Sir Andrew, who is also deputy chair of the NHS Confederation, said of his appointment: “I am delighted to be taking over as chair of the Shelford Group, and would like to extend my congratulations and thanks to Sir Robert for his excellent leadership over the past year. We have seen significant reform of the NHS in recent times, and with the General Election around the corner, the sector will continue to be in the political spotlight. It is a challenging time for the health system as a whole, and I look forward to working with my colleagues to ensure that, through our shared expertise and collective years of experience, the Shelford Group continues to play an active role in shaping the future of our NHS.”

On stepping down as chair, Sir Robert said: “The past year has seen the Shelford Group cement its position as a leading voice in the continued development of healthcare policy, a highlight being our March conference, in conjunction with Reform. I am proud to have led the Group during this time and I look forward to continuing to work with my esteemed colleagues under Andrew’s leadership. I am confident that he will take the Group from strength to strength.”

4.50pm Thirty years ago, the Griffiths report introduced general management to the health service.

For the first report of HSJ’s Future of NHS Leadership inquiry, being published this summer, the panel will be exploring the legacy of the report and we are interested in your opinions.

You can share your thoughts by completing a short version of our call for evidence questionnaire – it only contains five questions.

More details here.

4.28pm An independent inquiry has been set up by the Royal College of General Practitioners to look at how the NHS can best provide care for patients at a time of constrained resources, to meet the needs of the rapidly increasing number of patients with multiple long term conditions.

The inquiry is to be chaired by Mike Farrar, the former NHS Confederation Chief Executive and former Head of Primary Care at the Department of Health, and will explore how to find cost effective solutions to the medical, social and financial challenges posed by rising levels of multi-morbidity within society.

The inquiry, hosted by the Royal College of General Practitioners, will be entitled the Inquiry into Patient-Centred Care in the Twenty-First Century.

Farrar will lead a panel of twelve experts in NHS care, from organisations including the National Association for Patient Participation, Royal College of Physicians, NHS Confederation, Lloyds Pharmacy, and the RCGP. It will look at the role of general practice within the context of primary, community and social care services.

In order to do this, it will assess three key questions:

  • How do models of NHS care need to change to deliver better patient outcomes, as cost effectively as possible, for the growing number of people living with multiple long-term conditions?
  • What does this mean for the way in which NHS resources are deployed across health economies in a financially constrained environment?
  • How can the role of general practice best be developed to support the new models of care required and what policy levers and financial mechanisms should be put in place to deliver these at the scale and pace needed?

The inquiry is calling for written evidence from interested organisations and individuals, to help inform the proceedings, to be submitted by 16 July.

The inquiry will hold three seminars, during July and August, at which patients, health professionals and other relevant experts will be consulted. It is hoped that the initial findings of the inquiry will be released in September.

RCGP chair Dr Maureen Baker said: “The inquiry provides us with an fantastic opportunity to look at the efficacy of general practice at a time of increasing demand and constrained resources, and to make recommendations about what needs to change for us to continue to deliver high standards of patient care.

“This is an independent inquiry, but we hope that the findings will help inform the College’s landmark Put patients first: Back general practice campaign, which is calling for general practice to receive 11% of the overall NHS budget by 2017.”

Inquiry chair Mike Farrar said: “It is a real privilege to head up this critically important inquiry, which I hope, through working with such a knowledgeable team, will produce ground-breaking findings – which will inform the future development of models of NHS care.

“General practice is key to a fully-functioning, cost-effective NHS and it is important that we look into and promote ways that it can be sustainable in the future whilst working in the best interests of the patients and population it serves.”

3.30pm The BBC reports that University Hospitals of Morecambe Bay NHS Foundation Trust, a failing health trust, will be put into special measures “in the next few days,” its local MP has said.

Westmoreland and Lonsdale MP Tim Farron said NHS England confirmed the decision at a meeting about the future of University Hospitals of Morecambe Bay NHS Foundation Trust.

A leaked CQC document revealed services and patient safety were “inadequate”.

The trust runs four hospitals in Cumbria and Lancashire.

Mr Farron, a Liberal Democrat, said: “I’ve had conversations with a few people in the last day or two who have indicated that [will be the case].”

Speaking to BBC Radio Cumbria earlier, he said the move should not lead to the removal of the trust’s chief executive, Jackie Daniel.

“In other hospital trusts across the country when you get special measures it means you sack the chief executive and there’s a complete decapitation at the top and there’s all sorts of chaos.

“Jackie Daniel is relatively new to the post and the problems we have are not her fault.”

In its draft report, the CQC raised issues within acute services, safety and leadership at the trust.

It also reported concerns over staff vacancies levels.

3.10pm Sky News reports that three nurses have been charged with wilful neglect of patients at the Princess of Wales Hospital in Bridgend.

The broadcaster reports that: The charges follow an investigation by South Wales Police into claims of neglect involving the falsification of patients’ notes.

They were brought under Section 44 of the Mental Capacity Act 2005. 

The three accused work at the Princess of Wales Hospital and have been suspended since last year.

They have been named as Lauro Bertulano, 44, Clare Cahill, 41 and Rebecca Jones, 29. All come from the Bridgend area.

They are due to appear before Bridgend Magistrates Court on Monday 28 July.

1.30pm Efforts to develop more sophisticated approaches to commissioning, funding and comparing mental health services could be helped by a new online database.

The National Mental Health Dementia and Neurology Intelligence Network, launched yesterday by Public Health England, brings together mental health data from 13 separate organisations into one single online resource for the first time.

1.20pm The struggle of England’s smallest acute trust to recruit consultants played a major role in the decision to ditch its search for an independent sector management franchise to take it over, HSJ has been told.

Weston Area Health Trust could instead be taken over by one of three foundation trusts that have been shortlisted after an NHS only tender ran earlier this month, it announced yesterday.

1.00pm The Financial Times reports that much-vaunted changes to the private finance initiative have failed to tackle problems with the scheme, according to a critical report from the cross-party Commons Treasury committee.

Chancellor George Osborne announced two years ago that there would be an overhaul to the system, used to finance big projects by successive governments since the John Major administration.

Hardly any schemes have yet been signed off under the so-called PF2 model, with only one hospital built under the new system.

12.50pm The recently departed strategy director of NHS England has been appointed as a partner at a large GP and urgent care provider, which is seeking to sell its model elsewhere.

Robert Harris’ departure from the national commissioning body was announced in April. He had led it’s Call to Action work on a five-year NHS strategy.

He has now been appointed a full-time equity partner at Lakeside Primary Care Centre in Corby, and its linked group practices, it has been announced.

12.45pm The NHS needs a staff support commission to deal with issues such as whistleblowing, staff wellbeing and redeployment of staff who are well skilled but who find themselves out of favour with their employer, writes Narinder Kapur, who was in the whistleblowers meeting with Jeremy Hunt and Simon Stevens yesterday.

He writes that some trusts suspend or dismiss whistleblowers for a “breakdown in relationships”, which will inevitably arise if staff keep raising concerns, or for “bringing their employer into disrepute”, which again is inevitable if they go public with their concerns. Whistleblowers in the NHS need to be praised and rewarded for the courage they have shown in risking their livelihood for the sake of patient safety.

Narinder Kapur is a consultant neuropsychologist at Imperial College Healthcare Trust and visiting professor of neuropsychology at University College London

11.41am Allowing GPs in a single clinical commissioning group to break away from the nationally agreed quality and outcomes framework will test whether the approach could help drive integration and support co-commissioning, HSJ has been told.

Last week HSJ revealed that NHS England had approved a local alternative to the framework for practices in Somerset.

Details of the Somerset Practice Quality Scheme agreement - seen by HSJ - stated that practices that choose to take part will only have to formally report against five of the indicators in the 2014-15 QOF.

11.36am New figures from the Health and Social Care Information Centre show the prevalence of women giving birth who classed themselves as smokers at the time was 12 per cent, the lowest it has been in eight years of data collection.

Today’s report shows the prevalence of women who classed themselves as smokers whilst pregnant fell to 12.0 per cent, 75,910 out of 632,960 maternities, from 12.7 per cent, 83,490 out of 658,110 maternities, in the previous year, and this continues the steady decline from 2006-07 when this was 15.1 per cent.

Since 2006-07 the number of women who smoked whilst pregnant fell by 16 per cent, from 90,890, but overall maternities increased by five per cent, from 601,260.

Despite a continuous decline in the prevalence of pregnant smokers, the published national ambition to reduce rates of smoking throughout pregnancy to 11 per cent or less by the end of 2015 has not yet been reached, however over one third of clinical commissioning groups are currently achieving this (39 per cent or 82 out of 211).

Statistics on Women’s Smoking Status at Time of Delivery is a quarterly report for the period January 2014 to March 2014 which also gives an annual picture that can be compared with data going back to 2006-07.(7)

In the 12 months to March 2014 in England:

  • There was wide regional variation in women who smoked during pregnancy, with the highest prevalence in the Durham, Darlington and Tees Area Team (20.6 per cent) and the lowest prevalence in the London Area Team (5.1 per cent).
  • At CCG level NHS Blackpool had the highest prevalence where more than one in four mothers smoked during pregnancy (27.5 per cent) and both NHS Central London (Westminster) and NHS Richmond had the lowest prevalence (1.9 per cent).
  • Almost one in 12 CCGs (18 of the 211 CCGs) recorded a prevalence of at least one fifth of women smoking during pregnancy.
  • Of the four commissioning regions, London had the highest proportion of CCGs that are meeting the national ambition (97 per cent of 32 CCGs), followed by CCGs in the South of England (52 per cent out of 50 CCGs) and those in the Midlands and East of England (26 per cent of 61 CCGs). The North of England had the lowest proportion of CCGs that are meeting the national ambition (13 per cent of 68 CCGs).

Information centre chair Kingsley Manning said:“It is encouraging to see that since 2006-07 the number of pregnant women who smoked during pregnancy has declined. However, there is still a little way to go to achieve the national ambition.

“Today’s figures highlight there is a still work to be done and it is fundamental that mothers-to-be are aware of the damaging effects smoking can have on their baby.”

You can read the full report at

11.15am The new chair of the Commons health committee has named whistleblowing, patient safety and the safeguarding of patient records as key areas of attention for the committee under her stewardship, she told HSJ.

Sarah Wollaston, the Conservative MP for Totnes and a former GP, was elected to the role yesterday.

Speaking exclusively to HSJ, Dr Wollaston outlined some of the issues on which she would like the committee to focus on in coming months.

Full story here

10.45am In the Letters section of The Times a number of leading health figures have written to the paper to reject the idea of charging patients to see their GP. Previous Department of Health permanent secretary Lord Crisp writes that charges would dissuade people with real problems from seeing their doctor, while raising “very little” money if exemptions are given to the chronically ill, poor or older people.

In a joint letter from the Foundation Trust Network’s Gill Morgan and Chris Hopson they lament that the paper did not report on the Commonwealth Fund’s finding that the NHS is the best healthcare system out of 11 nations and they add that all other funding mechanism increase administrative costs.

10.42am Six whistleblowers met Jeremy Hunt and Simon Stevens yesterday morning from the Patients First campaign group. They want a public inquiry into whistleblowing.

Also attending the meeting was Helene Donnelly, Raj Mattu and Roger Kline.

They told HSJ that Hunt said he was considering an independent body to tackle whistleblowing, something similar to an Ombudsman-type organisation.

He gave no details as to what or how this might work.

Whistleblower nurse Jennie Fecitt, from Patients First told HSJ: “He did recognise I think that what he has done so far is not enough.

“He didn’t give us any major pledge but he wanted to hear what we had to say. We all want a public inquiry into these issues.

“He said he was looking into some sort of independent body for whistleblowing similar to the ombudsman, but he didn’t give us any details. Both him and Simon Stevens said they were looking into this.”

10.41am The Daily Mail reports that health secretary Jeremy Hunt is in talks with NHS bosses regarding an apparent £2bn funding gap that the health service faces in the next financial year.  

The £2bn figure was originally reported by the BBC yesterday.

Elsewhere in The Daily Mail, consultant surgeon Nick Boyle criticises the influence of managers on the health service and thinks clinicians should have greater freedom in decision making.

He notes that trusts usually only include one doctor and nurse on their board  of directors.

“Even at the level of clinical teams, consultants no longer run what they do day-to-day but are given instruction by professional managers,” he writes.

“In surgery, for example, this means most consultants are no longer trusted to manage their own waiting lists.

“Instead, patients are added to lists by administrators who decide who takes priority, often according to national targets.”

He argues: “The fatal mistake that hospital managers and many policy makers have made is in trying to remedy the problem through fiddling with existing systems of management or through structural reform.

Dr Boyle is head of business development at Circle, which runs Hinchingbrooke Hospital in Cambridgeshire.

In its leader column, The Daily Mail argues there needs to be a debate on the “radical reform” of structure and financing of the health service:

“The time has surely come to stop treating the 1940s model as a sacred cow, and to launch a mature debate on radical reform of the way the NHS is structured and financed.

“This paper believes the debate should include an examination of successful healthcare systems overseas, which mix private insurance with public funding.

“What is certain is that the political class simply mustn’t keep running away from this issue, for we can’t go on as we are.”

10.20am Patient safety is likely to become a key focus of the commons health committee’s work, its newly appointed chair has told HSJ.

Sarah Wollaston, Conservative MP for Totnes and a former GP, was elected to the role yesterday.

Speaking exclusively to HSJ, Dr Wollaston outlined some of the issues the committee is likely to prioritise in the coming months.

She said holding the NHS to account as it undergoes a “culture shift” in attitudes to patient safety, and looking at “how staff can feel confident that if they raise a concern that somebody will listen” would be key areas of focus.

Full interview soon…

10.12am The Daily Telegraph reports that NHS England is facing a £2bn funding shortfall in the next financial year, health bosses have warned.

The health service’s outgoings will outstrip the £100bn budget it has been allocated from April 2015, the BBC was told.

The Department for Health said it was “confident” the NHS could make the savings needed.

Elsewhere, the paper reports that medical language is so complicated that half of patients do not understand it, leaving them at risk of serious conditions, the Royal College of General Practitioners has warned.

10.10am Looking toward this morning’s newspapers, The Times reports that four times as many young people are being treated in hospital for Crohn’s disease than a decade ago, with junk food blamed as one of the main causes.

The condition, which attacks the intestines and is thought to be triggered by problems with the immune system, appears to be becoming more common.

Jeremy Hunt is understood to be considering the creation of a “beefed-up” ombudsman to handle whistleblowing cases in the NHS, reports The Times.

The health secretary has also said that he is open to holding a Leveson–style public inquiry after hearing stinging criticism of NHS trusts and unions.

Mr Hunt and Simon Stevens met with six whistleblowers yesterday.

David Cameron will today announce a global fight against “one of the greatest enemies of humanity”, as charities pledge a £100m fund to find a treatment for dementia, The Times reports.

A “brain in a dish” will be used to fast track promising dementia drugs to trials, while tissue from two million British patients will be used to search for causes of the disease.

Four out of 10 trusts with published financial figures for April have experienced increased cost pressures in that month because of unplanned demand on emergency departments or because they kept beds open, which were previously paid for by the national winter pressure fund.

This funding - distributed to trusts to help them cope with increased pressures on accident and emergency departments during winter - finished at the end of March.

7.00am Good morning and welcome to HSJ Live. Allowing GPs in a single clinical commissioning group to break away from the nationally agreed quality and outcomes framework will test whether the approach could help drive integration and support co-commissioning, HSJ has been told.

Last week HSJ revealed that NHS England had approved a local alternative to the framework for practices in Somerset.

Details of the Somerset Practice Quality Scheme agreement - seen by HSJ - stated that practices that choose to take part will only have to formally report against five of the indicators in the 2014-15 QOF.

Payment of the additional QOF funding will be based on quarterly reports from practices on their progress developing integrated care for people with long term conditions, reducing avoidable hospital admissions and improving general practice sustainability.