2013 Q1 January-March
Health and Wellbeing Policy Update – January-March 2013
31st March 2013
Oasis Healthcare, the largest private dental chain, has been bought by private equity firm Bridgepoint. [I suspect we’ll have to get more used to following commercial transactions as they become more integral to ‘public policy’.]
29th March 2013
CCGs’ payments to hospitals are to include a element which will only be paid if specific quality standards are met, according to Sir Bruce Keogh, the Medical Director of NHS England.
28th March 2013
A report published by JRF on ‘The Impact of Localising Council Tax Benefit‘ finds that 2.4m low income families will pay an average of £138 more in council tax in the year 2013-14.
Guidance from Monitor on how it will exercise its enforcement powers.
Smoking is a major cause of the 10+ years premature mortality of people with mental health conditions but tends to be neglected by the NHS according to a report from the Royal College of Physicians.
Consultation on implementing an EU directive on patients’ rights to cross-border healthcare in other member states of the European Economic Area.
Bulletin for CCGs, Issue 31.
27th March 2013
ACEVO report ‘The Prevention Revolution‘ calls for a shift from reactive, hospital based care to preventative services to keep people healthy.
Information from LINks annual reports 2011-12 on data quality, finances, levels of participation, activity and outcomes and benefits.
[Weekly update sent out ————————————————————–]
28th March 2013
Government review and response to Winterbourne View Hospital
‘The Quarter’ – reporting on performance in the period October-December 2012
‘The Week’: Issue 291
Programme Budgeting Tool provides data on spending by PCTs on different health conditions
Publication: ‘Changing of the guard: lessons for the new NHS from departing health leaders‘.
27th March 2013
The welfare cuts could collectively cost 3.7m disabled people £28bn by 2017-18, according to research by Demos and Scope for the Guardian.
The NHS CB / NHS England has reviewed progress being made by CCGs and has discharged 63 from the conditions that had been placed on them, meaning that 106 (half of the 211) are now fully authorised.
GPs feel no more involved in Commissioning than before CCGs according to a poll of 303 GPs
The Communities and Local Government Committee has said it would not be clear who would be in charge in the event of a health emergency
The NHS CB / NHS England has started the application process for patient and carer members of the 74 Clinical Reference Groups for 2013/14
Ongoing support for health and wellbeing boards transfers from DH to the LGA from 1st April
LGA receives notice to quit from eight core cities
26th March 2013
Government publishes its response to the Francis report: ‘Putting Patients First’.
The changes at a glance: http://www.bbc.co.uk/news/health-21936926
Failing hospitals to be named and shamed and managers responsible for failures to be barred from working in the NHS: http://www.guardian.co.uk/society/2013/mar/26/failing-hospitals-nhs-jeremy-hunt
Trainee nurses to be required to spend a year on hands-on help to patients, helping them eat, wash and get dressed: http://www.guardian.co.uk/society/2013/mar/26/nurses-basic-care-training
Assessment of the proposals: http://www.guardian.co.uk/society/2013/mar/26/nhs-care-overhaul-jeremy-hunt
Reactions to the proposals: http://www.guardian.co.uk/society/2013/mar/26/nhs-care-overhaul-measures
King’s Fund response
An updated version of the NHS Constitution has been published
Monitor’s ‘A Fair Playing Field for the Benefit of NHS Patients’ is published, on how all potential providers of NHS care can have a fair opportunity to offer their services to patients.
The NHS Commissioning Board is now to be called ‘NHS England’ [just when you thought you were getting to grips with the new system!]
A Guardian survey of 81 local government leaders hears that the cuts will bring local government ‘to its knees’. Total spending in the four areas of adult social care, children’s services, planning and culture and leisure is falling in under half the authorities.
The roll-out of the 111 service is being delayed in more than half the country
(28th March) http://www.bbc.co.uk/news/health-21963297
Social isolation is associated with a higher risk of death, regardless of whether people consider themselves lonely, according to new research:
Britain is the worst in Europe for child deaths
Consultation response from the fundamental review of data returns
The four community budget pilots are to go live from April
The Public Accounts Committee warns that the bedroom tax could have a severe impact on the incomes of the poorest people
Publication: ‘Whole Person Care’ from the Royal College of Psychiatrists, on how mental health can be put on a par with physical health.
25th March 2013
Changes to the Quality and Outcomes Framework for 2013-14
Children with parents who have mental health problems are poorly provided for and are sometimes left at risk of harm according to a report from Ofsted and the CQC
There seems to be a big north-south divide in the preparedness of CCGs, with those in the north having fewer conditions from the authorisation process
More needs to be done to involve children in decision making according to research published by the Children’s Commissioner
22nd March 2013
Statutory guidance on JSNAs and JHWSs.
The Government is to end the need for hospitals to report on 76 out of 305 types of indicator.
The government is setting up a national network to spread the lessons from community budgets
[Weekly update sent out ————————————————————–]
22nd March 2013
Public Accounts Committee report on NHS efficiency savings. It suggests savings are being made by freezing wages and rationing access to services [rather than by improving efficiency].
A review on whether the Government should introduce Ofsted style performance reporting for health and social care providers has been published by the Nuffield Trust. It suggests performance cannot be shown in a single score, which could obscure failings.
GP leaders are warning of problems introducing the new 111 service, with examples of shambles in the soft launches in some areas
(25th March) http://www.bbc.co.uk/news/health-21922711
A report by the Patients Association found that nearly 80% of people lack confidence in out of hours services
A study has found that 14% of chronic childhood asthma was due to pollution near busy roads. The study was based on 10 European cities.
See also: (19 March) http://www.guardian.co.uk/environment/2013/mar/19/uk-air-pollution-health-crisis
Three local government navigators have been appointed by ESRC to help get academic research out to local government and help local government influence future research. The three, Clive Grace, Tim Allen and Steve Martin have considerable experience in this field.
21st March 2013
Government response to Health Select Committee report on the future role of NICE. The Government has confirmed that NICE will “have a crucial role in the future value-based pricing arrangements for branded medicines” and have a “broader scope to assess a medicine’s benefits and costs.”
How NICE can help CCGs deliver high quality care: http://www.guardian.co.uk/healthcare-network/2013/mar/20/nice-help-clinical-commissioning-groups-care-guidance
Revised safeguarding guidance for professionals working with children
NHS workforce annual census. Small fall in the headcount in the last year.
‘The Week’: Issue 290. Includes mention of regulations which will apply equality duties to the NHSCB, NICE, the Heath and Social Care Information Centre and all CCGs.
‘The Month’: Issue 64. (pdf, 20pp). Provides a summary of progress towards moving to the new health system across the range of new health institutions.
Publication: ‘Making Integrated Care Happen at Scale and Pace’ – the 16 steps needed. King’s Fund. 8pp.
20th March 2013
The Budget supports drinking (with duty reduced on beer) and driving (no additional duty), help for video games and t.v.. And to really help the earth move for you, they’re supporting fracking.
The latest patient safety statistics are published by the NHSCB
OECD publishes the first comprehensive guidelines on measuring subjective wellbeing
19th March 2013
Health Select Committee report on expenditure on health and social care
Funding future care needs: a collection of essays published by Localis
The government hasn’t fully thought through the implications of its social care reforms, leaving local authorities open to disputes and legal challenges, according to a cross-party committee of MPs and Peers.
Social care funding reform: briefing note from the House of Commons Library
CQC review of privacy, dignity and nutrition in hospitals and care homes. Between 83-88% of establishments were meeting needs but there were also examples of “people not being given help to eat or drink or given personal care in a way that respected their privacy.”
People with learning disabilities are dying an average of 16 years earlier than others largely because of delays in investigating, diagnosing and treating their illnesses according to a study by the University of Bristol based on 247 people in the south west, compared to 58 people without learning disabilities. It found that families and carers had more problems getting their views heard and listened to.
Work is the biggest source of stress in people’s lives (34%) (with knock on effects for mental and physical health), closely followed by money issues (30%) and health (17%) according to a survey of over 2,000 people by Mind
Child health profiles by local authority area
Publication: Health Improvement in Local Government: Challenges and Opportunities, from the Royal Society for Public Health
Note from the NHSCB on a forthcoming website on choice and competition in commissioning clinical services in the NHS in England.
The Patient Opinion health rating website is being endorsed by the Scottish Government which is providing funding to health boards to engage with the service.
18th March 2013
Jeremy Hunt has backed a report from the Institute of Health Equity calling for more to be done to reduce health inequality and address the social and economic causes of ill health.
The NHS Confed says there are financial ‘tough choices’ to “guarantee the delivery of safe, effective and sustainable health services in the years to come.” The Daily Mail says they are proposing charges for calling out of hours doctors and for hospital meals, but the NHS Confed says they are not proposing GP call out fees.
Article by Mike Farrar: http://www.guardian.co.uk/commentisfree/2013/mar/18/four-options-reviving-nhs
Survival rates from cardiothoracic surgery and other key data are to be publicly available on the web, updated every three months, for the first time. Previously they have been paper published every three years and only available to professionals.
Changes to GP contracts
Government response to consultation on GP contracts: http://www.dh.gov.uk/health/2013/03/gp-contracts-response/
DH is forcing GPs to choose between money and patient safety: http://www.pulsetoday.co.uk/home/gp-contract-2013/14/dh-is-forcing-gps-to-choose-between-money-and-patient-safety-gp-leaders-warn/20002312.article#.UUrO9hkeGpQ
LGA briefing on new statutory duty to provide education for some two year olds. [Giving children a better start in life can have a substantial impact on health and other outcomes. This duty is focussed on more disadvantaged children]
Data visualisation of how people died in the 20th Century – [a bit morbid, I know, but absolutely fascinating!]
16th March 2013
The Government is to make manipulation of NHS figures a criminal offence.
15th March 2013
Mindfulness at school reduces likelihood of depression related symptoms in adolescents. This was a randomised control trial involving 400 students aged 13-20, in Belgium.
The Health Select Committee is to investigate how prepared the NHS is for the new system and is seeking views
The Government is introducing emergency legislation to retrospectively change the law so it does not have to abide by a court of appeal decision which would mean they had to pay claimants who had been required to work for nothing, or else lose their benefits. (Labour is abstaining on the vote; the Greens, i.e. Caroline Lucas, is opposing it).
The birth day, 200 years ago of John Snow, one of the founders of epidemiology who identified contaminated water as the source of a cholera outbreak in London. (Article 17 March): http://www.guardian.co.uk/commentisfree/2013/mar/17/john-snow-glass-clean-water-mckie
[Weekly update sent out ————————————————————–]
15th March 2013
Two GP practices in Essex have been forced to join CCGs against their will. It is suggested this means CCGs are not truly ‘membership organisations’
Ann Clwyd is to head a review of how the NHS handles complaints
DH has published a sexual health improvement framework, designed to be used by local organisations when providing services
14th March 2013
Britain is not properly prepared for the rapid increase in the number of older people according to a House of Lords report which recommends raising the retirement age and reviewing pensioner benefits
The final 48 CCGs have been authorised, meaning all 211 are ready to take up their statutory responsibilities on 1st April. In total, 43 of the 211 CCGs have been fully authorised, with the remaining 168 subject to conditions.
A third of GPs in CCGs have interests in private healthcare firms, such as having shares or helping to run them, according to a study by the BMJ.
Health Secretary Jeremy Hunt has said gagging clauses will be ended with immediate effect. Departing NHS staff will have a legal right to speak out on issues of public interest such as death rates or poor care.
There has been a sharp rise in the number of hospitals failing to meet the 4 hour A&E target. The number of Foundation Trusts failing to meet the target doubled in a year, to 32 out of 88 trusts.
King’s Fund report on Volunteering in Health and Care
Older people are more likely to feel they belong to their communities and are more likely to be happier as a result
Pickles criticises councils for using external contractors to increase council income in their bid to reduce antisocial behaviour (on-the-spot fines).
‘The Week’: Issue 289. Includes, England to host an international initiative for mental health leadership in 2014 (see second link).
13th March 2013
Five disabled people attended court to take the Government to judicial review against the scrapping of the £320m independent living fund. The fund allows around 19,000 severely disabled people to live independently. As Zoe Williams notes, those with the greatest needs comprise 2% of the population but are taking 15% of the cuts.
The Community Budget pilots show that combining all public spending in a local area could lead to cheaper and better services, according to the National Audit Office. Four pilot areas produced business plans which were submitted to the Government last October and ministers are currently considering whether to approve them.
The NHSCB is to help up to 100,000 people to use the internet so as to improve their health, working in partnership with the Online Centres Foundation
The NHSCB announced the appointment of 21 National Clinical Directors, who will work there part-time, bringing their existing, working experience to provide advice on specific areas such as obesity, diabetes, emergency preparedness and critical care.
Unequal improvements in health across Europe revealed in the WHO European Health Report 2012
British girls can expect shorter lives: http://www.telegraph.co.uk/health/healthnews/9925895/British-girls-can-expect-shorter-lives-than-continental-cousins.html
A third of patients at high risk of diabetes are being missed by the NHS Health Checks scheme according to a study based on 34,022 patients in Birmingham. The NHS Health Check scheme was set up in 2009 but has had low uptake.
Who’s who on the National Commissioning Board (background rather than news, but interesting)
12th March 2013
People with dementia are not being adequately cared for by many care homes according to the CQC, meaning that they end up in hospital more often, stay longer and ofter die there
An assessment of the quality of NHS hospitals in England has been published by the MHP Health Mandate consultancy. It includes a brief history of rating systems in the NHS. It weights publicly available quality data according to what people think is most important. It includes a general assessment and one for a specific condition (lung cancer) and finds no link between the two.
Two commissioning support units are to merge making a total of 19 CSUs across England. The two are West Yorkshire CSU and South Yorkshire and Bassetlaw CSU.
Two explanations of the Healthwatch regulations have been published, one from the LGA and DH, the other from Healthwatch England. The regulations relate to involvement of volunteers and restrictions on campaigning and political activity
Exercise helps cognitive skills: people who had exercised 2 to 3 times a month from the age of 11, scored higher in tests of memory, attention and learning at 50, according to research based on 9,000 people, by King’s College, London.
The NHSCB launches a library of 70 phone apps which will help people manage their health and which have been reviewed by the NHS to ensure they are clinically safe
The Government is trying to cut people’s daily salt intake from 8g to 6g, through voluntary targets for food and catering companies
GPs are likely to have to tender to provide certain public health services because of new rules, resulting in time spent on tendering and reduced provision of those services.
11th March 2013
Anti-biotic resistant bacteria are a ‘catastrophic threat’, says the Chief Medical Officer, Dame Sally Davies
Antibiotic resistance happens in the ground, so we need to look to agriculture and industry to help solve the problem: http://www.guardian.co.uk/commentisfree/2013/mar/12/antibiotic-apocalypse-ground-resistance
How do we compare with other countries: http://www.guardian.co.uk/news/datablog/2013/mar/11/antibiotic-drug-resistance
She previously raised the issue on 23 January: http://www.guardian.co.uk/society/2013/jan/23/antibiotic-resistant-diseases-apocalyptic-threat
Revised competition rules, the redrawn regulations on procurement, patient choice and competition, are laid. Commissioners will still have to put services out to tender unless they are certain no other provider could offer the service, or if it is in the interests of service users such as by enabling services to be provided in an integrated way:
(19th March) – commentary on the new regulations: http://www.guardian.co.uk/commentisfree/2013/mar/19/new-nhs-lawyers-not-gps-driving-seat
EU report on unequal access to healthcare because of combinations of traits such as ethnic origin, gender, age etc.
Dame Barbara Hakin, is to be the interim Chief Operating Officer and Deputy Chief Exec of the NHSCB, with the permanent replacement to be advertised later in the year. Her current position of National Director for Commissioning Development is to be taken by Rosamond Roughton, the Director of Commissioning Systems and Strategy.
7th March 2013
Allotment holders to be surveyed on their mental health.
[Weekly update sent out ————————————————————–]
Changes over the last forty years in how we live our lives are revealed in the General Household Survey, published by ONS. The Guardian headline: ‘smoking, drinking and living alone’ illustrates the significance in terms of social determinants of health.
The proportion of people saying they are heavy or frequent drinkers falls. (But as last week’s research pointed out, self-reporting could underestimate actual consumption)
Briefing for HWBs on working with the voluntary sector, from Regional Voices
More than million people give up work to care for relatives, according to a representative survey by Carers UK / YouGov
Eating processed meat is to blame for 1 in 30 premature deaths, with those eating it 44% more likely to die prematurely. The results are in line with previous studies.
Inpatient care at major hospitals should be reserved for people with life-threatening conditions or those needing complex surgery, according to a report from the NHS Confederation
Cutbacks at NHS Direct, as its contract finishes at the end of March, and since it has won 111 contracts covering only a third of the population
‘The Week’: issue 288
Bulletin from proposed CCGs, Issue 30
6th March 2013
The regulator for nurses and midwives, the Nursing and Midwifery Council, is not doing enough to protect patients, according to the Health Select Committee
The challenges of adult social care can only be met through joint action between local leaders, communities and providers, according to a report from ‘Think Local Act Personal’
5th March 2013
Government withdraws NHS competition regulations (SI 257 made under the provisions of S75 of the Health and Social Care Act 2012)
Welcomed by the Royal College of Physicians: http://www.rcplondon.ac.uk/update/government-withdraws-statutory-instrument-no-257
The UK is 12th out of 19 countries of similar affluence in years of healthy life, in a study of health trends from 1990-2010 published in the Lancet. It is in the same position in the league table as in 1990. It is suggested that 30,000 lives a year could be saved if England performed as well as its European neighbours. Average life expectancy has increased by 4.2 years to 79.9 years, but premature death for ages 20-54 has hardly changed, often from causes where there are avoidable risk factors, like smoking.
Jeremy Hunt’s ambition to cut deaths from the five major causes: cancer, heart, stroke, respiratory and liver disease: http://www.dh.gov.uk/health/2013/03/mortality/
Healthy life years across the EU:
Productivity in the NHS is ‘stubbornly stagnant’ and a number of NHS organisations are getting into financial difficulties according to a new study from the Nuffield Trust
DH publishes the Cardiovascular Disease Outcomes Strategy
CCGs are to have a legal duty to secure health, education and care support for children and young adults with special needs, DfE announces. Councils currently have a duty to ensure support for those with the most complex needs, but health services ‘can fall between the gaps’. The duty will be introduced as an amendment to the Children and Families Bill. The change is part of a package of changes to SEN.
DH have been vetting special severance payments to NHS staff since 2005, it has now emerged
Medical registrars are overworked, according to a survey by the Royal College of Physicians which found that 37% of those surveyed thought their workload was ‘unmanageable’ and 59% said it was heavy. This contrasts with 5% of trainee GPs using either word to describe their workload:
House of Commons Health Committee annual accountability hearing with Monitor
4th March 2013
The troubled families scheme for England is succeeding, according to the Government.
Delivery agreement for putting troubled families on the path to work: https://www.gov.uk/government/publications/delivery-agreement-putting-troubled-families-on-the-path-to-work
“The practical support [from employment advisers] will include CV writing, job interview skills and highlight training opportunities and job vacancies in the area.” [Hmm, that sounds as though it’ll get to the heart of the sort of barriers faced by troubled families …]
There is likely to be slippage in a number of areas in implementation of the new non-emergency 111 service, due to be rolled out starting in April:
Four new ‘what works’ evidence centres to help inform public policy and spending are to be established alongside NICE and the Educational Endowment Foundation. The new centres will focus on: active and independent ageing; tackling crime; early intervention; and local economic growth.
Hospitals with the fewest consultants have the highest death rates, according to a report from the Royal College of Physicians
3rd March 2013
Many nurses feel that the NHS has a culture that discourages speaking out, according to a survey from the Nursing Times. Nearly 30% said being seen as a troublemaker was the biggest barrier to speaking out. Of the 84% who had raised concerns, 52% said there had been no appropriate outcome and a similar percentage said they faced negative consequences.
2nd March 2013
The Academy of Medical Royal Colleges has expressed concern that the Government is privatising the NHS by stealth, in a letter leaked to the Observer:
1st March 2013
Baseline report published on how health behaviours change through the life course:
[Weekly update sent out ————————————————————–]
1st March 2013
More than 1,000 doctors and nurses have written to the Daily Telegraph demanding that the Government withdraws the competition regulations
DH launches a consultation on changes to regulations for direct payments for health care
A coalition of medical organisations are urging government to introduce measures to reduce the £55bn annual cost from alcohol misuse
The Non-executive Directors’ Guide to Hospital Data
Pension arrangements for public health staff transferring to local authorities http://healthandcare.dh.gov.uk/pct-staff-pensions/
28th February 2013
Labour has taken the unusual step of introducing a ‘fatal’ motion in the House of Lords on the proposed competition regulations
CCGs do not need to follow the Any Qualified Provider (AQP) route to comply with EU procurement rules, according to legal advice. Two CCGs have adopted constitutions requiring them to consider the ethical behaviour of providers before commissioning
A briefing on the competition regulations: http://touchstoneblog.org.uk/2013/02/jeremy-hunts-plans-for-nhs-competition-by-stealth/
A detailed briefing on the regulations from ‘Keep our NHS Public’: http://www.sochealth.co.uk/wp-content/uploads/2013/02/konp-section-75-parliamentary-briefing-february-2013-si257.pdf
The latest NHS Staff Survey results have been published. They show that 63% of NHS staff would be happy with the standard of care in their organisation for family or friends. Only 40% were satisfied with how their trust values their work. Only 35% said communication between senior managers and staff is effective. Of indicators comparable with the previous year’s survey, 11 improved and 9 deteriorated.
Guidance for local authorities on which public health improvement activity can be charged for and what must be free at the point of use
The NHSCB discusses with Sir Robert Francis, responses to his report, at their Board meeting
The NHSCB is inviting a wide range of views, through a short survey, to help inform a national strategy to promote equality and reduce health inequalities.
The NHS CB is developing an iPad app to provide a dashboard of patient experience data.
‘The Month’: issue 63. (16pp, pdf). Summary of NHS news from the last month including people transition, NHSCB response to the Francis report, competition, regulation, training, informatics and close down of SHAs and PCTs
‘The Week’: issue 287. (Health news from DH).
27th February 2013
GPs ‘will walk’ from CCGs if the proposed competition rules are not changed, according to Dr Michael Dixon, interim president of NHS Clinical Commissioners: http://www.pulsetoday.co.uk/news/commissioning-news/gps-will-walk-if-ministers-do-not-reword-competition-rules-say-ccg-leaders/20002076.article#.US9LIhlzWpQ
(1st March, from the BBC): http://www.bbc.co.uk/news/health-21625758
A blog spelling out the implications of the competition regulations in more detail: http://abetternhs.wordpress.com/2013/02/27/the-irreversible-process-of-privatisation-of-the-nhs/
Alcohol consumption is higher than previously thought according to a study from University College London. The two main existing surveys rely on people’s self-assessment of how much they drink, but this accounts for only 60% of the amount actually sold.
Telehealth may not be as effective as previously thought according to the latest results from DH’s ‘whole system demonstrator’. The research found that telehealth did not improve the general quality of life for people with long term conditions. However there may be benefits from techniques developed since the research ended and also specific condition related benefits not covered by the research.
Improvement in housing can boost health, particularly when targeted at those in poorest health, according to a systematic review from the Cochrane Library
GP vacancy rates quadruple in four years
Sugar is an significant cause of diabetes according to US medical researchers
[Not news, but a fascinating blog] – what it means to be a good doctor and the importance of kindness. [A lecture to final year medical students, with some important messages and lots of links to further sources.]
26th February 2013
Norman Lamb MP says the NHS competition rules should be reviewed
Jeremy Hunt is to rewrite the competition rules as a result of pressure from the Lib Dems: http://www.guardian.co.uk/society/2013/feb/26/jeremy-hunt-nhs-regulations-rewrite
25th February 2013
The CQC is to work with the Patients Association who will provide information from the 8,000 calls it receives each year to its helpline to help the CQC target inspections, focussing initially on elderly people.
Volunteering for 10 weeks led to healthier cardiovascular systems according to US research on 106 teenagers in Vancouver, split into a control and an intervention group.
24th February 2013
Government is not properly planning for a growing elderly population, according to a House of Lords committee which is due to report next month. The number of people over 85 is expected to double between 2010-2030. It is being suggested that the system is not coping with existing pressures and there is no adequate strategy for the future.
22nd February 2013
DH Impact Assessment of the Procurement, Patient Choice and Competition Regulations
GP leaders have urged the DH to scrap plans to pay a ‘quality premium‘ to successful commissioners.
[Weekly update sent out ————————————————————–]
22nd February 2013
Consultation on proposed legislation requiring all healthcare professionals to hold indemnity or insurance to practice
21st February 2013
Asking staff if they would recommend their hospital to family and friends could be as good a predictor of performance as the hospital standardised mortality ratio (HSMR) with which it is closely correlated, according to an Imperial College study published in the British Medical Journal Quality and Safety
Anna Dixon, Director of Policy at the King’s Fund is to join DH as Director of Quality and Strategy and Chief Analyst in early May
Prescriptions for psychotropic drugs for elderly people increase when they go into care homes according to research from the Queen’s University Belfast.
43% of GPs have not yet started addressing how they will allow patient access to their medical records according to a survey for eHealth Insider
‘The Week’: Issue 286
Bulletin for Proposed CCGs, Issue 29
20th February 2013
The NHSCB has authorised the 62 CCGs in the 3rd wave, bringing the total authorised to 163. Of the 62, 56 were only authorised with conditions.
Statistics for obesity, physical activity and diet in England are published by the NHS Information Centre for Health and Social Care. 65% of men are now overweight or obese. Only 36% of adults took part in moderate intensity sporting activity for at least 30 minutes at least once a week. The number of people hospitalised because of obesity increased 11 times in the decade to 2011-12.
[See also report by the Academy of Medical Royal Colleges on obesity, 18/2/13]
A series of individual stories suggesting the need for individualised solutions which support people to help themselves with obesity: http://www.guardian.co.uk/commentisfree/2013/feb/21/diet-weight-loss-readers-respond
There is a correlation between sitting for long periods (e.g. 6-8 hours a day) and chronic illnesses such as cancer, diabetes and heart disease, even after allowing for weight and other activity, according to research by Kansas State University based on 220,000 people in Australia.
Researchers at Cornell University have demonstrated the creation of a replacement ear by using a 3-D printer and the injection of living cells.
A new smartphone app making feedback from patients and family easier has been developed by Birmingham Children’s Hospital
19th February 2013
Virtually all health services will be opened up to competition either through competitive tendering or ‘any qualified provider’, as a result of the regulations laid last week on procurement, patient choice and competition. This is in spite of assurances by Andrew Lansley that CCGs would not be forced to “fragment services, or to put services out to tender”. The regulations are subject to ‘negative resolution’ which means they will pass in 40 days unless an MP objects and can win a vote. Which hasn’t happened in the House of Commons for over 30 years.
(22nd Feb) Polly Toynbee’s take on it. She says Labour are to ‘pray against the regulations next week: http://www.guardian.co.uk/commentisfree/2013/feb/22/lib-dems-not-stand-lies-nhs
Mortality was 3.6 times higher for mental health service users compared to the general population, for those aged 19 and over in England, in 2010/11 according to new figures from the Health and Social Care Information Centre.
The Government is signing a pledge to reduce child deaths, with the UK now amongst the worst in Europe for child mortality.
Pollution could be responsible for 4,800 early deaths a year from heart attacks according to research by the London School of Hygiene and Tropical Medicine
The NHS Leadership Academy has announced which institutions it will work with to develop the largest ever leadership programme for up to 25,000 NHS staff starting this September.
Information about PLACE – Patient Led Assessment of the Care Environment which replaces PEAT from April 2013. This is an annual assessment of the quality of the hospital environment, with patients and their representatives making up at least 50% of the teams.
39% of people say they delay seeing a doctor because of the difficulty in getting an appointment, with 32% because of what they might find and 24% wasting the doctor’s time, according to a survey from Cancer Research UK.
24% of councils (86/354) are rejecting the government’s offer of funding to freeze council tax, so far. Last year only 10% (35 authorities) rejected a similar offer. [Article free for a limited period]
18th February 2013
Recommendations for attacking the obesity epidemic have been made by the Academy of Medical Royal Colleges. They say that doctors are “united in seeing the epidemic of obesity as the greatest public health crisis facing the UK.” Obesity is estimated to cost the NHS £5.1bn a year. Their 10 point plan includes: an experimental 20% tax on sugary drinks; councils to limit the number of fast food outlets near schools and places where children gather; NHS staff to use every contact to talk to obese people about their eating and exercise habits; and health visitors to advise new parents on how to feed their children properly.
[See also obesity statistics: 20/2/13]
Fizzy drinks manufacturers reject the idea of a fat tax, saying fizzy drinks make up only 2% of the calories in the average diet: http://www.telegraph.co.uk/health/healthnews/9877083/Fizzy-drink-manufacturers-hit-back-over-plans-for-new-fat-tax.html
One in three patients do not take their medication properly putting their health at risk and costing the NHS £500k per year according to a study by Aston University’s Pharmacy School
17th February 2013
90% (55/64) of contracts with departing hospital doctors had gagging clauses according to information from foi requests.
Atos has sub-contracted elements of the medical assessments for people claiming benefits to a number of NHS trusts.
15th February 2013
Overview of responses to consultation on NHS constitution published
The Government could mandate GPs to ‘make every contact count’, to encourage healthy lifestyles, through changes to the NHS constitution.
Whistleblowing legislation is to be revised, with public consultation on possible changes to the Public Interest Disclosure Act (Pida) 1998, a government minister has said in a private letter to MPs and peers.
Serco has had another warning from the CQC about its out of hours service for NHS Cornwall and the Isles of Scilly, following a surprise inspection which found a number of improvements but a shortage of health care assistants
[Weekly update sent out ————————————————————–]
15th February 2013
There are now 5.8m unpaid carers in England and Wales, a rise of 0.6m since 2001, according to an ONS study
Public Health England’s organisational structure and appointments to its National Executive have now been finalised and can be found here:
14th February 2013
A&E waiting times are at their highest for a decade according to the King’s Fund quarterly update on NHS performance. However, infection rates are falling. A third of finance directors surveyed (16/48) said the quality of patient care in their area had worsened in the last year.
Former health trust CE, Gary Walker, speaks out about gagging agreement and speaks of a culture of fear and oppression in the NHS. The East Midlands SHA refutes the charges.
AUDIO: the Today Programme interview: http://www.bbc.co.uk/news/health-21455553#sa-ns_mchannel=rss&ns_source=PublicRSS20-sa
Gary Walker faces financial ruin if he is sued by the NHS. Stephen Dorrell chairman of the House of Commons Health Committee is supporting his case.
Monitor publishes its licence for foundation trusts and other NHS funded providers
‘The Week’: Issue 285
13th February 2013
Camden Council is to move 761 poor families (2,816 adults and children) out of London, because the Government’s welfare cap of £500 per week means they won’t be able to afford their current accommodation. Other London boroughs are looking at similar action.
Regulations on procurement, patient choice and competition have been published. The Guardian’s daily healthcare blog quotes a reader as suggesting that it will be hard for for any NHS contract to be awarded without competition,
The regulations are here: http://www.legislation.gov.uk/uksi/2013/257/contents/made
Draft guidance stating that homeopathy does not work was watered down [yes, please feel free to insert your own joke here] following lobbying by a charity set up by the Prince of Wales, which has since been closed [the charity, that is]. [Actually, despite the jokes, this is a bit worrying. The NHS Choices website is a good source of evidence based guidance, and interference in its ability to offer that would be serious]
An online database of care providers, ‘Care Choices’, is to be launched to the public in April. This will build on the basic profiles currently available on the NHS Choices website.
International private patients make up 6% of patient numbers but 35% of private income according to a survey of 28 hospitals published in the BMJ.
New Chief Social Worker post is advertised
Sainsbury’s is continuing its programme of hosting GP surgeries in its stores, with seven more due to open this year. However some doctors have questioned whether this free offer is too good to be true and what the risks are.
The NHSCB has published ‘Securing Excellence in Commissioning NHS Dental Services‘. They take over from PCTs commissioning all dental services (primary, secondary and community) from April 2013.
12th February 2013
Most home care is good but a quarter of homecare services for the elderly are substandard, with a lack of continuity and late and missed calls by some providers, says the CQC:
The fiscal case for working with ‘troubled families’ is published suggesting that the Government will spend about £9bn on those families between 2010-15, with £1bn spent proactively addressing problems and £8bn reacting to them.
There are more obese children in middle class, than poorer or richer areas, according to a study by Leeds Metropolitan University which looked at 13,333 school children across the city over three years. The study is published in the International Journal of Obesity.
Trends in wages and income. From the Resolution Foundation. ‘Squeezed middle’ must wait another decade for rise in living standards.
More people are volunteering (an increase of nine percentage points), 84% of people are satisfied with their local area and nearly half of people want to be involved in local decision making, according to a new Cabinet Office survey. The survey, ‘Community Life’ “is designed to be comparable with key measures on the previous Citizenship Survey.” Which was ‘cancelled’ by DCLG in March 2011 (see the web archive link).
Detailed information on the survey: http://communitylife.cabinetoffice.gov.uk/
UK Public Sector Internal Audit Standards are published (relevant for Board and Audit Committee members)
Hunt wants to cut nurses’ paperwork by a third, and asks NHS Confederation to look into it
Food, drink and alcohol companies are using similar strategies to tobacco companies and have too much vested interest to be involved in formulating policy or through measure such as the ‘responsibility deal’ according to public health experts writing in The Lancet.
Interactive map showing smoking related deaths and costs by local authority area using new data from the London Health Observatory
11th February 2013
Funding reforms for care and support. Cost of personal care for the elderly to be capped at £75k from 2017. Means test threshold for residential care to be raised to £123,000.
Graph and flowchart explaining the reforms
A simple explanation of the proposals [but I still had to read it twice – and still got a bit lost]: http://www.guardian.co.uk/money/2013/feb/11/qanda-social-care-costs-elderly
Dilnot regrets decision to set the cap at £75k but recognises the tricky state of public finances: http://www.guardian.co.uk/uk/2013/feb/11/dilnot-regrets-social-care-cap
Announcement disappoints campaigners: http://www.guardian.co.uk/society/2013/feb/11/cap-bills-long-term-care
Still a high level of concern: http://www.guardian.co.uk/society/2013/feb/11/social-care-costs-cap-analysis
What the cap on care costs doesn’t do: http://www.bbc.co.uk/news/health-21411148
King’s Fund – a step in the right direction but still a mountain to climb: http://www.kingsfund.org.uk/blog/2013/02/reforming-social-care-funding-step-right-direction
Commentators from both right and left ask whether it is such a scandal, as the Government claims, to require people to use their assets, including home, to pay for their care rather than having the taxpayer cover the costs so that assets can be inherited:
Nine more hospitals with higher than average mortality rates are being added to the five already being investigated by Sir Bruce Keogh, NHS Medical Director. The hospitals are already working with regulators and the purpose of this investigation “is to assure patients, public and parliament that these hospitals understand why they have a high mortality [sic] and have all the support they need to improve.”
Readmission rates for over 75s have doubled in the last decade and 16% need emergency readmission within 28 days.
A quarter of people diagnosed with cancer in the UK has no support available from family or friends according to a survey of 1800 patients by Macmillan Cancer Support.
Government’s response to consultation on proposals for ensuring commissioners deliver best value
10th February 2013
Hunt says he will reduce inspections to reduce the chance of another Stafford hospital scandal
Wealth inequality is growing. (Resolution report due later this week)
8th February 2013
HWB and health scrutiny regulations are published. The LGA and the Association of Democratic Services Officers are to jointly publish practical guidance shortly. The regulations allow for non-councillors to vote in the HWB and remove the normal committee requirements for political proportionality.
Guidance on Friends and Family test scoring and presentation
An IBM super-computer system (Watson) is being used commercially to improve decisions on cancer treatment. It is estimated that while doctors are accurate about 50% of the time, the computer is accurate about 90% of the time.
[Weekly update sent out ————————————————————–]
8th February 2013
Two thirds of English councils have reduced funding for older people’s home care, with 20,000 fewer people receiving LA funded domiciliary care, according to government figures analysed by Age UK
The Public Accounts Committee says the DWP is to blame for problems with fitness-to-work which have led to a 38% overturn rate on decisions, with considerable cost to the taxpayer.
2.3m children are deprived but not in the current poverty figures according to a Policy Exchange report. It says other factors should be included such as whether a person has been in care, whether a parent has a criminal conviction and the quality of housing. This would also help focus action on causes rather than simply income.
7th February 2013
The number of babies born in England and Wales increased by 22% in the last decade (with consequent implications for service provision in future):
Stress at work is unlikely to trigger the four most common types of cancers – colorectal, lung, breast and prostate – according to a meta-analysis published in the BMJ. However it can affect physical and psychological health, including an increased risk of coronary heart disease.
There is some evidence that legalising gay marriage may improve mental health of lesbian, gay and bisexual people
‘Bedroom tax’: informative blog from Claudia Wood of Demos:
Slides on arrangements for the transfer of public health staff to local authorities (designed for PCT and LA senior managers)
Bulletin for proposed CCGs, issue 28
‘The Week’: Issue 284
6th February 2013
The Francis report on the Mid-Staffordshire NHS Foundation Trust. 290 recommendations. The Government is to respond next month.
Five key points from the report (from Guardian on the day blog):
1. Clearly understood fundamental standards (should be a criminal offence to cause death by non-compliance)
2. Openness, transparency and candour (a statutory duty of candour)
3. No hands on care without proper training and registration (new registered status for those working with older patients)
4. Strong patient centred healthcare leadership (disqualify those breaching the code of conduct)
5. Accurate, useful and relevant information (to which patients also have access)
The report: http://www.midstaffspublicinquiry.com/report
Prime Minister’s statement. There is to be a new post of Chief Inspector of Hosptials: http://www.number10.gov.uk/news/prime-ministers-statement-on-mid-staffs/
Key recommendations: http://www.guardian.co.uk/society/2013/feb/06/mid-staffs-hospital-francis-report
Response from families of the victims: http://www.guardian.co.uk/society/2013/feb/06/stafford-hospital-victims-families-report
NHSCB initial steps it is taking in response to the report, including five hospitals which are outliers in mortality indicators: http://www.commissioningboard.nhs.uk/2013/02/06/response-to-francis/
National Voices response – yes to a duty of candour, but more needed to bring patients to the decision making table: http://www.nationalvoices.org.uk/francis-report-strong-candour-weak-patient-voice-experience
King’s Fund blog commentary on the report. The report is thorough, but there is a risk that even if implemented in full it wouldn’t change the culture as needed: http://www.kingsfund.org.uk/blog/2013/02/building-culture-compassionate-care-nhs
Nuffield Trust: failure of arrangements to hear the public’s voice: http://www.nuffieldtrust.org.uk/blog/mid-staffordshire-public-inquiry-will-public-and-patient-voice-be-heard
Richard Vize; changing the culture will take years, and there are lots of contradictory factors: http://www.guardian.co.uk/healthcare-network/2013/feb/07/francis-report-culture-change-nhs
King’s Fund brings together responses to the enquiry: http://storify.com/TheKingsFund/the-francis-enquiry
Summary of reactions to the report from the Health Foundation: http://www.health.org.uk/blog/reaction-to-the-francis-report-a-summary/
Summary of commentators reactions to the report, from twitter: @flipchartrick: “The Francis report proves [insert whatever view of the NHS you’ve been banging on about for years]”
Anne Clwyd has been asked by the Prime Minister to advise on how NHS hospitals handle complaints
Statistics for rough sleeping in England
A cross party group says the inability to cope with failure is a major bar to social mobility for disadvantaged students
5th February 2013
Government sticks to the ban, in regulations, that prevent local Healthwatch organisations opposing any policy of a public authority (unless it is incidental to other functions.
House of Lords Debate (via NALM): http://www.nalm2010.org.uk/uploads/6/6/0/6/6606397/lords_debate_on_no_campaigning_regs_for_lhw.pdf
Healthwatch England response to regulations on Healthwatch. Suggests guidance to show how LHWOs can campaign. Suggests that the amount of allowable profit making should be lower than the current 50%. Suggests it is not enough to rely on FOI to get information.
Evaluation of Family Nurse Partnerships. (Family Nurse Partnerships are preventative programmes for vulnerable first time young mothers, offering intensive, structured home visiting by specially trained nurses from early pregnancy until a child is two.)
Research into young disabled people’s participation in decisions about services
3-d printer technique used to build up layers of embryonic stem cells. Experts believe the first organs using this technique could be available in 10 years.
4th February 2013
There are 2,300 fewer nurses working in acute care according to Labour using figures from foi requests.
DH says there are, ‘more clinical staff working in NHS than two years ago’: http://www.itv.com/news/update/2013-02-03/department-of-health-more-clinical-staff-working-in-nhs-now-than-two-years-ago/
NHS Trusts should be more open about the governance performance of their Board according to Grant Thornton, following a study of publicly available annual reports from more than 100 trusts. Also includes the claim that only 20% of respondents thought that CCGs were ‘fit to launch’.
Their report (published 31 Jan) is here: http://www.grant-thornton.co.uk/Global/Publication_pdf/NHS-Governance-Review-2013.pdf
Four charities are together encouraging people and communities to get involved with Healthwatch. They are: CSV, Regional Voices, NACVA and National Voices.
Their website is at: http://healthwatch-ci.co.uk/
Local Government finance settlement
2nd February 2013
Privacy and confidentiality could be at risk from a new centralised database, warn the BMA and privacy campaigners. The records, which will have detailed medical information, will not contain names, but will have NHS number, date of birth and postcode. GPs will have to provide the information to the NHS Health and Social Care Information Centre.
[Weekly update sent out ————————————————————–]
1st February 2013
A 12 week consultation to establish a set of NICE quality standards and guidance for social care has been launched by Care and Support Minister, Norman Lamb
NICE opens consultation on 32 indicators to form the CCG Outcomes Indicator set. The consultation is open until 1 March.
A briefing to support the voluntary sector in influencing HWBs has been published by Regional Voices
31st January 2013
David Nicholson apologises for the Mid-Staffordshire scandal
South London Healthcare Trust to be dissolved by 1 October 2013. Specialist emergency care is to be centralised on 4 sites. Lewisham to retain its A&E department but downgraded to provide for patients with less serious conditions. Maternity services are also to be downgraded. This partial reprieve for Lewisham follows vigorous local protests. [The national significance is the use of the failure regime to affect services in one area because of problems in another, and also at the extent of consultation.]
King’s Fund response: the failure regime should be a last resort and not “a back-door route for reconfiguring hospital services”: http://www.kingsfund.org.uk/press/press-releases/our-response-secretary-states-announcement-future-south-london-healthcare-nhs
Labour response: Jeremy Hunt has “crossed a line and set a dangerous precedent”: http://labourlist.org/2013/01/burnham-jeremy-hunt-has-just-crossed-a-line-and-set-a-dangerous-precedent/
The wonderful Lucy Mangan’s take on it from 16 November: http://www.guardian.co.uk/lifeandstyle/2012/nov/16/nhs-hospital-closures-lucy-mangan
Three quarters of councils to increase council tax for the poorest. Councils have been handed responsibility for the scheme and a 10% cut at the same time.
Health spending could double by 2061 with health and social care spending accounting for half of government spending. [Just my view, but those sort of predictions that far ahead are almost meaningless. Besides anything else we could have had the singularity by then, so we’ll have been taken over by artificial intelligence. But the point of the report isn’t, I think, that specific prediction: it’s to highlight the trend and suggest that difficult choices may be needed at some point.]
Hospitals are not sharing data with the police in around two thirds of the country, contrary to the coalition’s programme for government
A vegetarian diet can reduce the risk of heart disease by up to a third
Social Value Act comes into force, requiring commissioners to consider how services can benefit local people.
Template public health services contract published by DH for use by local authorities
Government response to consultation on front of pack nutrition labelling
Self-help books to be prescribed by GPs for people with mild mental health problems, with £20k funding from the Arts Council
‘The Week’: Issue 283. Includes confirmation that the Francis report on Mid-Staffordshire is to be published on 6th February.
30th January 2013
NHSCB is providing £50k to each of 12 pilot areas for the development and sharing of best practice in partnerships and relationships between CCGs and voluntary, community and social enterprise bodies. The 12 areas are:
Bristol; Croydon; City & Hackney; Dudley; Durham; Hampshire; Bradford & Airedale; Manchester; Shropshire; Staffordshire; Swindon; and Wakefield.
The NAO says cuts to council budgets are having a direct impact on frontline services
No. 10 says that benefits are set at a level that means no one should have to use food banks (although around 128,000 used them in 2011-12, with the number expected to increase to 230,000 this year).
29% of responding councils could not confirm whether they would have a fully functioning Healthwatch by 1st April, according to a Labour foi survey with 121 councils responding, an 81% response rate
Increased maternal and infant deaths as asylum seekers are pushed into severe poverty according to a Parliamentary enquiry
More people are dying of cancer in this country than many other places because of not wanting to waste doctors’ time
Mental Health Act Annual Report from the CQC. Finds that 15% of people receiving care under the Act are not being involved in decisions about their care.
29th January 2013
English local authorities should be given more freedom, including raising their own revenue, to end their ‘subservience’ to Whitehall, according to the House of Commons Political and Constitutional Reform Committee. Rejected by Eric Pickles.
28th January 2013
New publication: ‘Stronger Together: how health and wellbeing boards can work effectively with local providers”
More men than women are diagnosed with and die from cancer
Funding for Sure Start Centres has been cut by a third according to Labour, using figures obtained through Parliamentary Questions. [‘Give every child the best start in life’ was one of the six Marmot policy recommendations]
Overview of the NAO’s work with the Department of Health, 2011-12
Study on the use of contractual mechanisms in commissioning
Pickles accuses councils of ‘dodging democracy’ over council tax rises. He accuses them of using ‘loopholes’ if they increase council tax by less than the 2% figure he has imposed, to avoid a costly referendum. He also warns that ‘anybody using loop holes will lose out next year’. In an article in the Daily Telegraph, he says:
“Across the country a quiet revolution is under way. We’ve devolved powers and devolved finances to local government, so people have more flexibility than ever before to transform their services.” He then goes on to say:
“What residents really want is cuts to taxes not bin collections; potholes filled not pockets. … The days of the knee jerk tax and spend hike are over. … We want to freeze council tax and save on average families 72 pounds a year on a band d property.”
He also rather chillingly says:
“You would think listening to the BBC that sensible savings and improved services were a bad thing. To them every saving is a cut. It’s high time the BBC curbed some of her wasteful ways and became more transparent with our cash.”
Councils will have had to make a real terms cut of 40% of their budgets between 2010-15, with disabled people facing the biggest cuts.
27th January 2013
Hospitals are not doing enough to learn from complaints, according to a report from the Patients Association
[Weekly update sent out ————————————————————–]
25th January 2013
The Way Forward: Clinical Senates has been published by NHSCB. The 12 clinical senates will provide strategic clinical advice and leadership to CCGs, HWBs and the NHSCB
A public health surveillance strategy overview has been published
24th January 2013
Labour proposal to combine health and social care. HWBs would commission and CCGs would become advisory. The proposals are for consultation.
Commentary on the proposals from Richard Vize: http://www.guardian.co.uk/local-government-network/2013/jan/25/health-social-care-council-funding
Labour says a merger of health and social care funding could be paid for by a compulsory levy on people’s estates, which risks reopening the criticisms of a ‘death tax’.
The LGA have published a series of resources for Healthwatch. The topics include: carrying forward the LINks organisational memory; knowledge, skills and competencies required for Healthwatch; and Healthwatch working with district councils.
Researchers in a European Commission funded study have criticised the formula used by NICE to recommend which drugs should be funded. NICE base judgements on quality-adjusted life years (QALYs), but the researchers say this doesn’t adequately reflect people’s views about the impact of different levels of illness and disability.
People in the UK want a more caring and compassionate society with greater accountability and honesty and more effective governance but that is not how they see society currently operating, according to a survey of 4,000 people by the Barrett Values Centre in consultation with ONS and support from Action for Happiness.
NHSCB has published Supporting Planning for 2013/14 for Direct Commissioning which follows on from Everyone Counts
The National Quality Board (NQB) has published its final report on how quality will be maintained and improved in the new health system
NHS Confederation calls for a reduction in ‘unnecessary bureaucratic burdens’ on the NHS, such as data collections
Interactive atlases of health inequalities published by WHO
‘The Week’: issue 282
23rd January 2013
A report from DCLG says “billions of pounds” can be saved by intervening more effectively in ‘troubled families’. This is based on early calculations from a number of local authorities. No overall total of savings is given. [The figure of 120,000 troubled families is still being used, despite having been widely criticised.]
(18 January) A guide to evidence and practice
Dame Sally Davies, the chief medical officer, has said that the possibility of drug resistant diseases should be added to the national risk register of civil emergencies.
Francis report to be published 6 Feb, according to twitter.
Bulletin for proposed CCGs, issue 27
22nd January 2013
Second wave of CCGs authorised, three with stringent conditions
The number of people committing suicide increased by 7% between 2010 and 2011, with increases particularly for men and in Wales. The rate has generally been on a long term downward trend.
Ribena, Lucozade and J2O have signed up to the ‘responsibility deal’ to reduce the calories of their drinks
However campaigners were unimpressed and noted that the changes would still leave the drinks with a red flag under the Food Standards Agency guidance
Transforming Public Health Bulletin, issue 15 (web and pdf, 7 pages)
Payment by results updated eleven, published by DH
21st January 2013
The NHSCB could impose individuals or teams to support CCGs if the authorisation process puts them at ‘level 4’ or above.
Organisation chart for DCLG
Asthma hospital admissions reduced sharply after the ban on smoking in enclosed public places was introduced, with a fall of 12% in the first year, according to research from Imperial College examining figures going back to 2002.
From the ESRC: “A group of social scientists has … [developed] software which enables other researchers to easily create interactive internet-based intervention programmes to support behavioural change. The software, known as LifeGuide, is being used in intervention programmes, for example to quit smoking or manage weight loss.”
The All Party Parliamentary Group on Cycling is to hold 6 evidence sessions on cycling. Apart from racing and tourism, Britons are near the bottom of most European rankings.
19th January 2013
Oxfam says that the $240bn made by the world’s 100 richest billionaires last year would be enough to end extreme poverty 4 times over. The short (4pp) briefing outlines how inequality has been increasing globally and notes the harmful economic, political, social and environmental effects. Inequality has been linked to health impacts, for the rich as well as the rest.
Prescribing self-help books for depression was found to be more effective than usual GP care according to research by the University of Glasgow. However the study may have excluded those with more severe depression.
[Weekly update sent out ————————————————————–]
18th January 2013
The National Quality Board, which brings together the major organisations in the health system responsible for quality (including the CQC, Monitor, NHSCB and DH), has published a report setting out how quality will be maintained and improved in the new system.
The National Quality Board has published guidance on establishing Quality Surveillance Groups. QSGs will “bring together different parts of health and care economies” locally and regionally to share information and intelligence “to protect the quality of care patients receive”. They will monitor the quality of health and care providers so that early action can be taken if there are problems.
Paul Corrigan blog from 16 Jan, on how patients and carers can be the eyes and ears to spot failings [not about the NQB, but addressing the same issue]
A review of urgent and emergency services is to be led by Sir Bruce Keogh, Medical Director, the NHSCB has announced. It will look at the respective roles of A&E and other specialist treatment centres which go by ’11 or 14 names’.
17th January 2013
The strengthening of the NHS Constitution is to be overseen by an expert group, chaired by Minister Norman Lamb. This web page includes a list of the 25 members:
A new assessment and advisory service is to be set up by 2014 to help british business tackle long term sickness in the workplace
Research for a coalition of leading charities has found that fewer disabled people are receiving help, despite an increase in their numbers, and 40% (in a survey of 600) were failing to get basic needs (e.g. eating, washing, dressing) met. It estimates a £1.2bn funding gap for younger, disabled adults
‘The Week’: Issue 281
‘The Month’: Issue 61. (19pp, pdf). Includes items on: people transition into the new system; developments in commissioning arrangements; ‘developing a robust and diverse provider sector; Public Health England appointments; education and training; health research; informatics; property; and closedown arrangements for SHAs and PCTs.
16th January 2013
Nearly 90% of councils are due to receive reduced funding for ‘early prevention’ services such as nursery places and Sure Start centres.
The benefits of mobile technology for health staff and patients are described in the final report of a project covering 11 NHS sites.
A potential £4.4bn could be reinvested in improving care by making better use of information and digital technology in the NHS and social care, according to a DH commissioned study by PwC.
Jeremy Hunt says the NHS should become paperless by 2018. (But there’s no new money to support it)
‘Paperless NHS’ plan to enable patients to see their medical details online to save time and money. Rather than create a new, single system the aim is to enable different IT systems to talk to each other. Concerns have been raised about privacy.
Joyce Redfearn, former CE of Wigan, has been appointed Director for Health and Wellbeing Board Implementation, taking over from John Wilderspin
Jon Rouse, CE of Croydon is moving to DH to be Direct General of Social Care, Local Government and Care Partnerships
14m people at risk of poverty according to new figures from ONS
Nice report [sorry]. The House of Commons Health Select Committee publishes a report on NICE, saying that decisions are urgently needed on the new drug pricing regime.
GPs expect to cut services and reduce pay as a result of changes to contracts, according to a survey of 229 GPs.
Personal budgets cut social workers’ productivity by adding new processes, says a report in a peer reviewed journal.
15th January 2013
The review of the Liverpool Pathway on end of life care is to be chaired by Baroness Julia Neuberger, former Chief Executive of the King’s Fund. The review is due to report by summer 2013.
A ‘proactive care programme’, led by a Kent GP, could save £2,000 per patient per year, according to an evaluation based on 17 patients. The programme provides selected high risk patients and people with long term conditions, twelve weeks of intensive support.
14th January 2013
A revised government impact assessment of changes to mobility allowance (published on 8th Jan) will mean 428,000 people will lose out. The previous estimate was 280,000. Under the rules, those unable to work more than 20m would qualify, rather than the previous 50m.
Data from 500,000 children in 50 countries suggests that eating fast food more than three times a week could lead to asthma and eczema in children
Council staff lack the skills to commission public services according to a Guardian survey to which 300 members of its local government network responded.
CCGs will not be able to pay quality premiums to GP practices as a ‘bonus’, the NHSCB has said. This is to be made clear in regulations to be laid before April. Instead they should be used improve outcomes for patients:
13th January 2013
Seventeen NHS hospitals are amongst 26 health providers in England operating with unsafe staffing levels, according to the CQC
A dozen hospitals are failing to properly feed patients:
CQC inspector resigns, warning that it would not be able to spot another scandal like the one at Stafford Hospital.
The Department of Health is attempting to measure the extent of ‘social isolation’ in the UK, which could a series knock effect on health
Monitor’s ‘Fair Playing Field Review’, due to report later this month, could recommend that private companies providing NHS services be exempt from corporation tax
… but, next day
Monitor rules out tax exemptions for private health firms, so sorry, no story.
Comment, 16th Jan, suggesting that nevertheless some sort of subsidy is likely: http://www.guardian.co.uk/commentisfree/2013/jan/16/competition-healthcare-state-subsidies-private-firms
[Weekly update sent out ————————————————————–]
11th January 2013
LGC reports that Joyce Redfearn, former CE of Wigan is to be the lead for DH’s work on health and wellbeing boards (subscription required).
Consultation on 7 more service specifications and a further clinical policy for specialised commissioning from the NHSCB
There is a big variation in the prescription of cancer drugs by hospitals in different parts of the country according to a DH commissioned report by the Health and Social Care Information Centre.
10th January 2013
Public health grants to local authorities for the next two years are published. At £2.6bn for next year, they are 18% higher than originally proposed last February. There is to be an average 5% increase in the second year (in cash terms) with a minimum of 2.8%. The grants are ring-fenced.
LGA’s ‘on the day briefing’ (links to pdf, 2 pp)
(19th March) Analysis by Labour MP John Healey suggests an imbalance of funding towards richer rather than poorer areas: http://www.guardian.co.uk/society/2013/mar/19/jeremy-hunt-unfair-health-funding
LGA says that community budgets could save the public sector £4m a year
Monitor is consulting on a risk framework for assessing whether NHS funded providers are in danger of failing to deliver key services. It builds on the existing framework but covers a wider range of matters and providers.
Over 90% of NHS Trusts are not providing sufficient information for patients to initiate involvement in clinical research (as opposed to being invited by clinicians) according to a mystery shopping exercise in 82 hospitals in 40 trusts, commissioned by the National Institute for Health Research.
The NHSCB has started recruiting for the 65 Clinical Reference Groups which will support directly commissioned specialised services. The initial recruitment is for chairs and clinical members with that for non-clinical members to follow shortly.
‘The Week’: Issue 280
From Twitter, Ruth Keeling (LGC): Council tax benefit funding to be cut by a further 8.5% in 2014-15 – significant cut emerged when #localgov leaders met DCLG ministers y’day”
DCLG response: “.@ruthkeeling @dandrillsma claims about council tax support wrong – overall pot constant £3.3bn in 13/14 and £3.3bn in 14/15 #CTB #localgov”
Sharon Taylor, Stevenage: “DCLG now denying further cuts in council tax support. Good. But officials told us (twice) it would be cut again next year #righthandlefthand”
9th January 2013
Report on CQC from the Commons Health Select Committee:
CQC response: we consulted on our role and are now taking action: http://www.cqc.org.uk/media/cqc-statement-health-select-committee-report
Hospital inspectors criticised in damning report: http://www.telegraph.co.uk/health/healthnews/9789740/CQC-Governments-hospital-inspectors-criticised-in-damning-report.html
Government invests £120m in health research involving partnerships between universities and surrounding health organisations.
8th January 2013
Personal health budgets newsletter (5pp. Not very up to date, though only just published, but a useful resume).
An informative blog on the NHSCB’s ‘Everyone Counts’ document by Anna Dixon, King’s Fund. Suggests that the document indicates a lack of clarity by the NHSCB in its role, e.g. mixed messages in the level of support and challenge to CCGs
Guidance on commissioning palliative care is published by the National Council for Palliative Care
‘End of Life Care: Shortfall in NHS Services’: http://www.bbc.co.uk/news/health-20948340
7th January 2013
New Government advertising campaign on harms in foods
6th January 2013
105 private healthcare firms have been given ‘any qualified provider’ (AQP) status, allowing them to provide NHS services including physiotherapy, dermatology, hearing aids, MRI scanning and psychological therapy. Doctors leaders have argued that it is atomising the NHS.
7th January 2013
Response to Dilnot doesn’t appear in the mid-term review afterall
Research report on how Scotland, Wales and Northern Ireland are doing more than England to reduce sickness absence
[Weekly update sent out ————————————————————–]
4th January 2013
A new vision and service model for district nursing has been published
David Cameron says that the ‘friends and family’ test of satisfaction being introduced in hospitals in April, should be extended to GPs, district nursing and community hospitals.
NHS Confed response: don’t just rely on the friends and family test.
3rd January 2013
Westminster City Council and LGIU have published a report which considers whether benefits could be cut if claimants don’t take measures to reduce obesity
A House of Lords committee looking at ageing will question ministers at its final meeting on 9th January.
GP funding is to include an average of £7,500 per practice for reducing ‘avoidable’ admissions to A&E, which could mean not referring those with pneumonia, severe flu and heart failure.
‘The Week’: issue 279.
2nd January 2013
(Blog) The Health policy issues likely to be big in 2013 (nursing standards, ‘independence day’, public health, reconfiguration, access to drugs, social care – [a thoughtful and informed analysis]
And a slightly shorter view of the year ahead from the King’s Fund
Five things to look out for in 2013 from the BBC’s Nick Triggle (27 December): the Francis report on Stafford hospital; funding for elderly care; action to discourage unhealthy habits (tobacco and alcohol); NHS finance; and the ‘big bang’ of the new health system coming into effect on 1st April.
Worcestershire County Council faces judicial review over maximum expenditure policy for adult social care. It is being argued that they failed to undertake a lawful consultation when deciding the policy.
A report from the Royal College of Physicians says the NHS needs to do more to manage the large number of patients with severe complex obesity