A “lack of openness and honesty” at trust caused further distress for a family which had lost a child, watchdog concludes, plus the rest of the day’s news and comment

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4.25pm HSJ is hosting a Twitter chat on 28 February, in association with Marie Curie Cancer Care, to discuss how best to tackle the issues of access and inequality when commissioning end of life care.

Recently Phil McCarvill, head of policy and public affairs at Marie Curie Cancer Care, wrote about the World Health Organization finding that only one in 10 dying people have access to palliative care.

He explained that while the UK is a world leader in palliative care, there is still significant unmet need here, especially among black, Asian and minority ethnic communities.

“The time to act is now,” Phil says. “Health and social care services need to listen to people who experience barriers to accessing care and tear these down.”

What are the solutions to breaking down these barriers? How do we reach more people with palliative care need each year and how can commissioners deliver services to meet actual need regardless of disease, ethnicity or any factor other than need?

Phil will be on Twitter on Friday 28 February from 12pm to discuss the importance of tackling access and inquality in end of life care.

Join in using the hashtag #HSJEOLC, as well as follwing @hsjnews and @mariecurieeolc, to ask questions and participate in the discussion.

4:20pm An NHS England moratorium on commissioning new specialist mental health services hasexacerbated the sector’s bed shortage and led to a newly constructed hospital unit standing empty for six months, HSJ can reveal.

To read the rest of Shaun Lintern’s exclusive story, click here.

3:37pm Families who have lost a loved one to pancreatic cancer are joining forces with the national charity, Pancreatic Cancer UK, to spearhead a new campaign calling for key decision makers to add the recently licensed chemotherapy drug Abraxane® to the updated Cancer Drugs Fund list.
Earlier this month, Abraxane (in combination with standard chemotherapy, gemcitabine) was licensed for use in patients, in the UK and Ireland, with metastatic pancreatic cancer (i.e. where the disease has spread from the original site to other organs).
However, the drug – being hailed as the biggest advance in almost 20 years in the fight against the disease – has not yet been approved by the NHS watchdog NICE, depriving many patients from the potential life-extending benefits of the drug. The only hope for patients wanting to access Abraxane® is for the drug to be included in the Government’s Cancer Drugs Fund (worth £200 million per year) list which is due to be updated following a panel meeting next Thursday (6 March).  To date, Abraxane® has been found to extend a patients’ life for on average 2 months, however in some instances it has given people significantly more time.
In response to feedback from patients, families and carers - who have told the charity they would have “done anything” to have had “just two more months” - Pancreatic Cancer UK is today launching a campaign highlighting what precious time with loved ones would have meant to families.
Alex Ford, CEO of Pancreatic Cancer UK, comments; “As a charity which offers a specialist support service, we take many calls from devastated families following the loss of a loved one – and all too often they tell us that it all happened so quickly and that any amount of extra time, however small would have made a huge difference.  This might be time that would have enabled them to complete a degree, walk down the aisle or live long enough to witness the birth of their first grandchild.”
Pancreatic cancer has the lowest survival rate of all of the 21 most common cancers in the UK with only about 4% of people diagnosed surviving five years or more. This figure has hardly changed in 40 years. It is predicted that by 2030 pancreatic cancer will overtake breast cancer as the 4th most common cancer killer. 
With so few treatment options for patients, Pancreatic Cancer UK believes Abraxane® should be made available for free as a matter of urgency, at the point of access.
Alex Ford adds; “We urge the panel meeting next week to consider the very real benefits of Abraxane® - not in terms of statistics and cost efficiencies but in terms of time. Something none of us can put a price on.”

3:00pm The Health Foundation has appointed Anita Charlesworth to the new post of chief economist. Anita will lead the Foundation’s work in economics and will be responsible for recruiting a new team at the organisation.

The creation of the new team at the Health Foundation, an independent healthcare charity, comes at a time when the organisation expands into new areas of work in support of its core focus on improving the quality of healthcare in the UK. As well as creating a new team in economics, the Foundation is creating another two in-house teams in policy analysis and data analytics.

Anita will join the Health Foundation from the Nuffield Trust where, since 2010, she has led on analysis of financing and market reforms in healthcare. Prior to this Anita had been chief analyst and chief scientific advisor at the Department of Culture, Media and Sport since 2007.

Previously, Anita was director of public spending at the Treasury, where she led the team working with Sir Derek Wanless on his reform of NHS funding in 2002. Anita has a Masters in health economics from York University and has worked as an economic advisor in the Department of Health and for SmithKline Beecham pharmaceuticals in the UK and USA.

Dr Jennifer Dixon, chief executive of the Health Foundation said: ‘Anita will be a terrific asset to the Foundation. At a time when the NHS across the UK faces unprecedented pressures, she will bring analytical clarity to some of the big issues of the day relating to financing health care and related reforms.

“Helping the Foundation to understand the big picture in this way will help us to target our efforts and investments to improve the quality of care for patients in future.”

Anita Charlesworth said: “I am delighted to joining the Health Foundation at such an exciting time and look forward to working with colleagues to develop the Foundation’s work on economics and health service funding.”

2.20pm Ensuring commissioners have the necessary skills to manage service change is an investment we cannot delay, argues Ciarán Devane, chief executive of Macmillan Cancer Support.

Read his full comment piece in HSJ here.

1:45pm The Times has a lot of health coverage today, including one study which found that older fathers are more likely to have children with psychiatric problems and learning disabilities.

The paper reports on the health secretary’s decision to dissolve the “scandal ridden” Mid Staffordshire Foundation Trust yesterday.

Further allegations of neglect by nurses have emerged at a Welsh hospital trust that has been compared to Mid Staffs, the The Times reports.

Also in The Times, the head of Unite has said the union is to launch a campaign against politcians, private health compnaies and pension funds that it believes are contributing to the growing privatisation of the NHS.

Speaking at Cambridge University event last night, Len McLusky said:  “This is about defending the NHS from the predators it is the predators we will target.”

More from The Times, the healthwatdog NICE has recommended that all children with cancer should be allowed take part in clinical trials to help others survive the disease.

There has been a rise in the number of people admitted to hospital because of obesity, The Times reports.

On the subject of obesity, The Times also reports on babies born by Caesarean section being more likely to be obese as adults, according to research by Imperial College London.

11:47am The Daily Telegraph reports that thousands of family doctors are being paid automatic bonuses of up to £14,000 a year simply for staying in their jobs, according to new figures.

Official statistics reveal that more than 13,000 GPs are being awarded annual payments for time served, under a system which was quietly introduced as part of Labour’s GP contract.

11:40am Looking to this morning’s newspapers, The Guardian reports that the parents of the 78,000 babies a year who spend months in neonatal care are spending hundreds of pounds a week to visit them, according to a survey by the neonatal care charity Bliss.

Travel, food and drink and parking charges mean that parents of children born prematurely or who are very sick face an average bill of £282 a week.

The average eight week stay for such babies costs £2,256 the survey of 1,300 patients and 178 hospitals found.

11:20am The parents of premature and sick babies face “crippling costs” such as hospital parking charges and needing to buy food on-site, a charity has said.

A report from Bliss found parents spend £2,256 during their baby’s stay in hospital - an average of £282 per week. Food and drink cost around £53 a week, while travel costs including petrol and parking averaged more than £100 per week.

11:10am A “lack of openness and honesty” at University Hospitals of Morecambe Bay Trust caused further distress for a family which had lost a child, a watchdog has concluded.

Dame Julie Mellor, the parliamentary and health service ombudsman, investigated five complaints against Morecambe Bay relating to the way in which the trust handled the Titcombe family’s complaints about the death of their 9-day-old baby Joshua in 2008.

10.35am NICE has prepared a briefing for local government on the NHS Health Check programme, which assesses people aged 40-74 for their risk of developing diabetes, heart disease, kidney disease and strokes.

The programme also provides support to help prevent the conditions concerned, including advice on beneficial lifestyle changes. Full story here.

10:25am The health secretary yesterday announced that Mid Staffordshire Foundation Trust would be dissolved in line with the recommendation of the trust’s special administrators.

However, in a written statement, Jeremy Hunt asked NHS England to identify whether consultant-led maternity services could continue at Stafford Hospital. The TSAs recommended that the trust’s maternity unit should be downgraded to be midwife-led.

Mr Hunt said: “I am asking NHS England to identify whether consultant-led obstetrics could be sustained at Mid Staffs in a safe way in the future. In doing this, NHS England will work with local commissioners as part of their wider review of the local health economy.”

10:10am A report published today by the Surgical Never Events Taskforce has made a series of recommendations for new standards and systems to further improve the safety of surgery in English hospitals.

In response, NHS England has committed to identifying practical ways to take forward the report’s recommendations to eradicate never events from surgical procedures.

The Surgical Never Events Taskforce was commissioned by NHS England last year to examine why currently available preventative tools and guidance are not succeeding in completely eliminating surgical never events - a number of identified types of serious errors that should never occur, such as surgery on the wrong part of the body.

In its report, the taskforce has recommended much greater consistency between different hospitals in all areas of the country, focussing on three themes:

  • Standardise - The development of high-level national standards of operating department practice that will support all providers of NHS-funded care to develop and maintain their own more detailed standardised local procedures. The report also recommends the establishment of an Independent Surgical Investigation Panel to externally review selected serious incidents;
  • Educate - Consistency in training and education of all staff in the operating theatres, development of a range of multimedia tools to support implementation of standards and support for surgical safety training including human factors; and
  • Harmonise – Consistency in reporting and publishing of data on serious incidents, dissemination of learning from serious incidents and concordance with local and national standards taken into account through regulation.

Never events are events that should never happen because there is sufficient guidance to prevent them. The taskforce found that the 255 incidences of wrong-site surgery, wrong implant or prosthesis used, or objects being mistakenly left inside patients that were reported in 2012/13, were caused by a combination of factors. In the context of the 4.6 million hospital admissions that lead to surgical care each year in England, these incidents are rare. However, each and every never event is one too many.

Key to the taskforce’s recommendations will be the development and implementation of national standards on the prevention of surgical never events.

These national standards will be overarching frameworks and high level descriptions of what should constitute standard practice for various aspects of peri-operative procedures. The standards will be further developed locally to create standardised practices within organisations on an organisation by organisation basis. 

Dr Suzanne Shale, Chair of the Surgical Never Events Taskforce, said:

“Surgery is an inherently risky process, and surgical systems are highly complex. This risk and complexity means that despite a genuine commitment to safe practice and a high degree of technical competence, error occurs in surgery in health systems across the world.

“But while surgery is a risky business, it is also possible to make it safer. What we found when we looked at NHS data and international research, is that surgical never events almost always occur as a result of systems that are not safe enough, combining with behaviours that are not safe enough. So as well as making underlying systems safer, we want to make sure that everyone understands how safety is built into systems, and we want to enable everyone - from the front line to the boardroom, including patients - to play their part in upholding safety. And when harm does happen – as, sadly, it will – we want those affected by it to be better supported. 

“The NHS became the first and only healthcare system in the world to mandate the use of the World Health Organisation’s Surgical Safety Checklist in 2009. This is already helping to build a safer culture. But to promote deep-seated and systematic change the checklist has to be embedded into wider practices and protocols. This is exactly what some NHS trusts have done, and many of our recommendations build on their good practice.

“Our recommendations are designed to reduce unwarranted variation, better share learning from mistakes and successful improvements, and to support provider and professional responsibility. We now look forward to a wider conversation between NHS England, patient organisations, professional organisations, regulators, service leaders and others about how our recommendations for safer surgery can be implemented.”

Clare Marx, Council Member and Patient Safety Lead at the Royal College of Surgeons, said:

“We welcome the Never Events Taskforce Report and the proposal to develop national standard operating procedures to avoid variation in surgical practice and reduce the risk of never events occurring.

“Educating the entire surgical team is fundamental to learning about and preventing never events. The way we deal with the aftermath of these events is also very important – both for the patient and the staff involved.  We must be able to speak to patients in a compassionate, caring and honest way and create a culture where all staff feel they are able to learn from incidents that lead to failures in care.”

Dr Mike Durkin, Director of Patient Safety at NHS England, said:

“Patient safety has come a very long way in the past few years, and there has been a real revolution in how we monitor, manage and learn from incidents and build systems to minimise the risks of surgery. But every single never event is one too many. Many cause severe, life-changing harm and all of them damage confidence and trust in healthcare services.

“We are determined to make the NHS the safest healthcare system in the world, and we have made even further strides towards that in the last year, with a new National Patient Safety Alerting System to make sure lessons and warnings can be shared much more quickly, and a new programme of monthly publication of data about never events.”

The full Surgical Never Events Taskforce report and summary report can be found on the NHS England website www.england.nhs.uk/ourwork/patientsafety/never-events/surgical/.

10:05am David Nicholson has tweeted this brilliant Downfall-style video:

9.55am The proportion of women screened for breast cancer in England has fallen slightly, latest figures from the Health and Social Care Information Centre show.

At 31 March 2013, 76.4 per cent of eligible women aged 53 to 70 (about 4.25 million women in total) had been screened within the last three years – a figure known as coverage. This compares to 77.0 per cent at the same point in 2012 and to 77.2 per cent in 2011.

This is the second year running that coverage has fallen, although the figure is still above the NHS Cancer Screening Programme’s minimum standard of 70 per cent.

Today’s report about the Breast Screening Programme in England also shows a fall for the second year running in annual uptake – the proportion of women invited for screening who are screened adequately within six months.

In 2012-13, 72.2 per cent of women aged 50 to 70 (about 1.68 million women in total) took up their invitation compared to 73.1 per cent in 2011-12 and 73.4 per cent in 2010-11.

Today’s report includes data on those invited for breast screening, coverage, uptake of invitations, outcomes of screening and cancers detected. Considering coverage and uptake it also shows

Coverage at March 31 2013:

  • Coverage fell across all the 53-70 age groups compared to the previous year, with the exception of women aged 70, for whom coverage increased from 73.8 per cent to 74.2 per cent.
  • Coverage among women aged 53 to 70 was 70 per cent or above in all of England’s reporting regions apart from London, which reported coverage of 68.7 per cent.

Uptake in 2012-13:

  • Uptake was highest among women in the 60 to 70 age groups at just over 73 per cent and lowest among women aged 71 to 74 (which includes the programme’s age extension trial to women aged 71-73 years) at 66.7 per cent.
  • Uptake rates (considering the 50 to 70 age group) varied considerably according to the type of invitation. Uptake was lowest among those women who received a routine invitation having failed to respond to a previous invitation(s) – at 17.7 per cent.
  • Uptake (considering the 50 to 70 age group) fell in seven of eight reporting regions in 2012-13 compared with the previous year, with only London seeing an increase. However all regions but London (at 63.3 per cent) remained on or above the 70 per cent minimum standard.

HSCIC Chief Executive Alan Perkins said: “It goes without saying that the impact of breast cancer on people and their families can be severe and life-changing – this is why data included in today’s report is so enormously important in trying to monitor, evaluate and understand the use and outcomes of the NHS Breast Screening programme in England.

“Today’s figures point to a fall in the proportion of women who are taking up their screening invitation for the second year running – and while this is a relatively small fall in percentage terms – it is nevertheless a vital piece of information for health professionals and the public.”

9.00am Good morning, Here is an interesting comment piece - There is paucity of training and development programmes tailored for practice managers to help them meet the needs of patients in the context of a changing and challenging NHS. With clinical commissioning groups leading decisions about healthcare in the new commissioning system, this has put practices very much in the foreground of service development, write Thoreya Swage and Maggie.