NHS managers will be urged to reject the government’s latest pay offer in a ballot of union members

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5.18pm: A government pilot requiring GP receptionists to check potential new patients possess European Health Insurance cards risks deterring “vulnerable” migrants from accessing healthcare, a charity has warned.

Doctors of the World says the measure could further deter the pregnant women and victims of modern day slavery and parents with children from attending their GPs.

Lucy Jones, who manages the Doctors of the World clinic in Bethnal Green said: “The EHIC system should be made to work, but not at the expense of migrants who are entitled to care but can’t get it because of confusion over proof of identity questions.”

4.57pm: Building work costing more than £580,000 has begun on Lincoln County Hospital’s outpatient department following investment from United Lincolnshire Hospitals Trust

The first phase of the district general hospital’s facelift will see the construction of a central reception area for many of the clinics near the main outpatient entrance.

This is to be followed by improvements to clinical areas, including upgrades of treatment rooms to improve access for disabled patients, particularly wheelchair user.

4.24pm: Nearly 50 clinical commissioning groups will have to decide over the next month how they will access essential support services after NHS England decided their existing providers had no future, HSJ can reveal.

NHS England has chosen not to admit two commissioning support units on to a key procurement framework, casting doubt over their future and the fate of their 2,200 staff.

All bidders were briefed on the outcome on 23 January, and the decisions were due to be published yesterday to allow for a mandatory “standstill” period.

It is now highly likely that the 47 customer CCGs of the two unsuccessful CSUs will have to stop using them and will plan alternative arrangements.

3.53pm HSJ’s editor has picked up on a “very significant” u-turn by Stephen Bubb, chief executive of the Association of Chief Executives of Voluntary Organisations, a charity umbrella group.

Sir Stephen has apparently flip-flopped from his opposition position on Labour’s preferred provider policy to one of championship.

As Alastair McLellan points out, Sir Stephen was once cast as a defender of the coalition’s health reforms.



Perhaps Sir Stephen was convinced by Labour’s tweaks to his preferred provide policy? You know, the ones making it more amenable to ACEVO’s membership?



In one final tweet, our editor considers that the coalition may now find it as difficult to find champions of its health reforms as Labour finds it recalling its business sector supporters.


3.26pm: Worrying news from the Care Quality Commission for the mental health sector.

One in five records of mental health patients lack evidence that their rights have been explained to them after being detained, analysis by the CQC has found.

The finding comes in its fifth report on the use of the Mental Health Act, which was released today.

It found that has found that 16 per cent of the records it examined on its monitoring visits did not state that staff had given patients information about their legal rights.

Almost 20 did not state that staff had discussed these with them.

3.07pm: A community service for homeless people in Leicester has become the first non-NHS organisation to be awarded an outstanding rating by the Care Quality Commission.

Inspectors found the quality of care provided by the Inclusion Healthcare Social Enterprise CIC as “innovative, caring, effective, responsive and well-led”.

The service caters for patients in the area who are “vulnerably housed”, squatting or homeless and is run from a city centre primary health care service.

2.59pm: More than 1,500 people got involved in the first phase of the Challenge Top-Down Change campaign, which aims to help the NHS achieve transformational change.

Among the responses to the first phase of the Change Challenge, many called for the end of reliance on external management consultants, and for the expertise of frontline staff to be used more widely.

The campaign launched last month - by HSJ, together with its sister title Nursing Times and NHS Improving Quality - aims to identify how the NHS could achieve transformational change in order to challenge top-down leadership.

Using a crowdsourcing methodology created by our partner Clever Together, we asked readers what the barriers to bottom-up change are, and what could help support this change.

2.56pm: Following this morning’s Telegraph story about volunteers helping to ease A&E pressures, the Association of Chief Executives of Voluntary Organisations has announced an event to discuss how charities could further aid NHS and social care providers.

The billing for ACEVO’s Health and Social Care Conference includes some prominent figures, including health secretary Jeremy Hunt, Labour shadow health minister Andy Burnham and NHS England chief executive Simon Stevens.

The conference is to be held on 3 March.

2.38pm: MPs debated the following motion during a parliamentary debate this morning on sustainable GP services (#GPcommonsdebate):

Here’s the motion again that MPs will be voting on in today’s #GPdebate: “That this House notes the … pic.twitter.com/LCgyeAN0n6

The debate was attended by some prominent MPs include the Green Party’s Caroline Lucas, former shadow health minister Derek Twigg, Paul Burstow and Walthamstow’s campaigning MP Stella Creasey.

Ms Creasey claims on twitter to have successfully convinced the government to probe problems with GP access in her north London constituency.

2.16pm: Signs that the NHS Five Year Forward View is exerting its influence on health providers is seen in this story, just posted on HSJ.

Liverpool Community Health Trust has abandoned its bid for foundation trust status after concluding it no longer represented a sustainable future for the trust.

The trust said it had withdrawn from the FT pipeline to explore “alternative organisational models”, including the option of becoming a multispecialty community provider as outlined in the NHS Five Year Forward View.

The last few years have been troubled for the trust.

2:12 pm: Some legal news now. A south London clinical commissioning group’s bid to contract a new integrated GP out of hours and urgent care service has been left in limbo after a losing bidder initiated judicial review proceedings against the decision, HSJ can reveal.

Alongside the judicial review, Grabadoc Healthcare Society has also begun separate proceedings against Greenwich CCG under Public Contracts Regulations 2006 legislation.

A report to the CCG’s latest governing body meeting warns that the legal challenges have “significantly prejudiced” plans to have the new service in place by 1 April, creating a “significant risk to the delivery of safe, responsive and effective urgent care services”.

12.34pm: The Guardian has reported on a new effort by the Health and Social Care Information Centre to keep tabs on the number of adults with mental health problems forced to seek treatment in hospitals far from homes.

Data collected by the HSCIC at the end of last October and crunched by the paper reveal more than 400 adult mental health patients travelled more than 30 miles for treatment.

They show that in some cases patients from Derbyshire are being treated in south Devon and others from south Devon are being treated in Birmingham.

The paper provides this handy link to the spreadsheet.

The Lib Dem care minister who requested the figures, has ordered three NHS bodies – Monitor, NHS England and the Trust Development Authority – to analyse the data as quickly as possible.

Norman Lamb wants the triumvirate to establish the cause of the problem and look into an apparent shortage of readily available beds for patients in crisis and lack of support for those discharged into their local communities.

12.11pm: Labour frontbench peer Lord Hunt has raised the tariff debacle in the Lords.

He refers to the news, revealed by HSJ, that “the finance director of the NHS Trust Development Authority warned Monitor he did not consider the tariff’s proposed efficiency requirement for next year can be met without risking quality of care”.  

Conservative minister Lord Howe said the government recognised “the frustration and uncertainty” the delay in the tariff would cause.

The Department of Health was working closely with Monitor and NHS England “to consider which option to pursue that provides the fairest settlement for different NHS organisations while ensuring that patients continue to receive the best possible care”, he said.

HSJ reporter Ben Clover points out on twitter that this line appears to contradict an earlier statement by the DH that it was “staying out of this one”.

12.02pm: NHS managers will be urged to reject the government’s latest pay offer in a ballot of union members, HSJ can reveal.

The Managers in Partnership union warned it would work with individual employers to restore pay for senior managers outside of the Agenda for Change framework if other trade unions accepted the deal.

The union represents around 6,000 senior staff including 200 chief executives,

Its council voted to ballot its members following a meeting on Tuesday over what the union called a “divisive” offer from the government to end the NHS pay dispute.

11.50am: NHS England will today unveil the final full list of organisations that have won places on its lead provider framework for commissioning support.

A year in the making, the framework will be the main mechanism the body will use to offer clinical commissioning groups a choice of supplier, stimulating and assuring a market in support services.

Aside from a small number of CCGs that do everything in-house, commissioning support provide a vital range of services.

These include “transactional” services such as finance, human resources and communications, as well as contract management, business intelligence and service redesign.

The framework seeks to quality-assure and accredit organisations deemed able to supply the full “end-to-end” range of support services for CCGs.

We already know that two commissioning support unit bids have not made it onto the framework – making it highly likely that North West CSU and Yorkshire and Humber CSU will not have a viable future.

The move also raises serious doubts over the futures of 2,200 staff, and makes it like that there will need to be significant movement in the market across a swathe of northern England soon.

But the fates of non-NHS bids have not yet been revealed.

Here is the full list of organisations, including some big private sector names, which were invited to tender last summer.

We’ll have the final list around 4pm today.

11.26am: The British Medical Association has welcomed healthcare regulators’ intervention at Norfolk and Suffolk NHS Foundation Trust.

As reported in HSJ, the The Care Quality Commission has rated Norfolk and Suffolk Foundation Trust ‘inadequate’ and recommended the trust be placed into special measures.

Dr Rob Harwood, chair of the BMA Eastern regional consultants committee said the association had warned it was “very unlikely patient care and access to services could be maintained in the face of considerable cuts and poor management at Norfolk and Suffolk,” he said in a statement just released.

“Rather than listening to staff about their concerns and working with them to improve patient care, those managing the trust ignored these voices, as highlighted in the CQC report which raised concerns over a lack of senior leadership while praising the work of staff,” it adds.

The trust has accepted the CQC’s findings, made “extensive changes” to its leadership and is working to address problems, it has said in a statement.

10.59am: Ambulance services struggled to meet response targets in December after receiving the largest volume of emergency calls since records began, according to figures released today.

Only 66 per cent of callers with the most serious conditions known as Red 1 received an emergency response within eight minutes. The target is 75 per cent.

In total, there were 883,741 calls to switchboards in December- 29,000 per day on average. The previous largest figure was 828,194, recorded in December 2012.

Only 61.1 per cent of calls in the less serious category known as Red 2 received a response vehicle within eight minutes.

Across England the ambulance service has failed to meet the Red 1 target since April last year.

The only ambulance service that met the targets in December was the Isle of Wight.

10.53am: Here’s another slice of the Telegraph: a report that hundreds of charity volunteers are being drafted into hospitals to help older patients leave over-stretched accident and emergency departments.

The charities, backed by £1.2m in funding from the Cabinet Office, will deploy volunteers at 29 hospitals across the UK for the next three months.

The volunteers from the charities– the British Red Cross, Age UK and the Royal Voluntary Service – will help up to 10,000 mainly elderly patients be discharged or stay out hospital.

10.34am: Several papers are reporting on death rate figures, released by the Office for National Statistics. The Times (£) says they show deaths in England and Wales are about a third higher than normal for the time of year.

Some 28,000 deaths were registered in the fortnight ending January 23, according the ONS stats show, 32 per cent higher than the average over the previous five years of 21,859.

The ONS suggests that the flu virus and cold snap could be to blame for the increased death rate.

10.27am: A notable snippet here from the organisation formerly known as the College of Emergency Medicine. The CEM has been granted the title “Royal”, so shall from now on be known as the Royal College of Emergency Medicine. “This is such great news for the specialty and a real encouragement to the hard working doctors and consultants in UK emergency departments,”its president Dr Clifford Mann.

10.20am: The Daily Telegraph reports today that patients will have to prove their nationality when registering with GPs under a government crack down on migrants attempting to access free healthcare.

Under pilot initiatives in ten parts of the country, patients will be required to produce a valid European Health Insurance Card showing whether they are resident in the UK or another country in the European Union.

The Department of Health said the scheme will help the NHS to claim back the costs of treating EU visitors from their home countries.

Latest annual figures show that the NHS recoups just £50m for treating EU visitors – and nothing for the costs of providing GP care – yet pays out £750m to European countries who claim back the costs of treating Britons.


7.00am: Good morning and welcome to HSJ Live. We begin the day with Lime solicitors partner Robert Rose raising a pertinent question about the health and social care regulator in this comment piece.

With its additional responsibilities for social care, and the ‘fit and proper persons’ and ‘duty of candour’ remits, is the Care Quality Commission spreading itself too thin?