Friday 17 February 2012

Q&A: The NHS shake-up

Q&A: The NHS shake-up: How will England's health service change? BBC News

Patients give views on standards of care at Northampton General Hospital - Northampton Chronicle & Echo

Patients give views on standards of care at Northampton General Hospital - Northampton Chronicle & Echo:

Northampton Chronicle & Echo
Patients give views on standards of care at Northampton General Hospital
Northampton Chronicle & Echo
A WEBSITE which allows patients to review their experience of Northampton General Hospital has revealed that less than half of visitors would recommend its services. But the feedback has been welcomed by the hospital who said it helped them to improve ...

Who gets what gets tricky: allocating public health resources to local authorities

Who gets what gets tricky: allocating public health resources to local authorities Kings Fund

Can doing the right thing give the wrong impression?

Can doing the right thing give the wrong impression?: Darshan Patel asks: Could it be that hospitals that work harder to keep frail patients alive are being penalised for their higher readmission rates, whereas others providing lower standards of care, look better on paper? Health Foundation

The week, issue 235

The week, issue 235:

This week’s edition is full of news! Read about new calculators available for the NHS Pension Scheme proposal, NIHR professorships awarded to eight medical health research leaders and find out about a number of new publications. Department of Health

Download ‘the week’: issue 235, 10 – 16 February 201


SHAs fear Health Bill threatens patient care and commissioner support

SHAs fear Health Bill threatens patient care and commissioner support: Patients receiving worse care, lack of support for GP commissioners and not meeting targets are just some of the risks identified by SHAs with the implementation of the Health Bill. GP Online

BMA calls for NHS 111 slow-down

BMA calls for NHS 111 slow-down: The British Medical Association has written to health secretary Andrew Lansley urging him to adopt a "flexible deadline" for the roll-out of NHS 111 amid concerns about its procurement and progress. E-Health Insider

Management of SHA and PCT administration estate

Management of SHA and PCT administration estate:

This letter sets out the framework for the management of the SHAs and PCTs administrative estates. It explains how future decisions will need to be made in respect of future office requirements for the NHS Commissioning Board and other Arm’s Length Bodies at sub-national and local level.

Quality accounts reporting requirements for 2011-12 and planned changes for 2012-13

Quality accounts reporting requirements for 2011-12 and planned changes for 2012-13:
The Department of Health and Monitor have jointly written to provide advance notice of likely changes to quality account reporting requirements for the 2012/13 round of quality accounts, following consideration by the National Quality Board about strengthening quality accounts by introducing mandatory reporting against a small, core set of quality indicators. The letter also flags up that NHS acute and mental health trusts will be formally required to have their quality accounts externally audited from this year, 2011/12

People with learning disabilities are still not being included in decisions about their care

People with learning disabilities are still not being included in decisions about their care: Despite policy and legislation, people with learning disabilities are still not being including in decisions about their care. It's time to make services more accountable. Foundation for People with Learning Disablities

Disabled people face unlimited unpaid work or cuts in benefit - The Guardian

Disabled people face unlimited unpaid work or cuts in benefit - The Guardian:

The Guardian
Disabled people face unlimited unpaid work or cuts in benefit
The Guardian
The Royal College of Psychiatrists (RCP) fears that managers in jobcentres and private companies who specialise in getting people back to work have inadequate health expertise and will push those with mental health issues into inappropriate placements.

and more »

Schwartz scheme boosting staff morale in NHS

Schwartz scheme boosting staff morale in NHS:

Schwartz Rounds allows healthcare professionals to explore and discuss difficult emotions and could help boost morale and patient care in the NHS, writes Carol Davis

A groundbreaking workforce scheme that allows NHS staff to use real cases to explore difficult feelings and stressful situations can help tackle low morale in the NHS and promote better patient care.

US lawyer Kenneth B. Schwartz developed the Schwartz Center Rounds® following a lung cancer diagnosis as a means of bringing health professionals together to discuss their dilemmas in a mutually supportive way, with a focus on compassionate care.

Using the concept of a consultant's rounds, the scheme encourages interdisciplinary dialogue – across an entire hospital rather than just a clinical team – using real patient cases to enable participants to explore their own responses and feelings. The hour-long confidential sessions, which are open to staff across an entire hospital and have board level support, focus on an anonymised patient case which staff discuss to explore their feelings.

In one session, a senior nurse talked about how she had felt about a case early in her career, which one participant said "was good for junior staff to see that senior staff have the same dilemmas and difficulties, and don't always have the answer."

Having a multidisciplinary session which included staff from across the hospital also brought surprising insights and anomalies: an aggressive patient might have been extremely courteous to a consultant; or a porter might say they had to explain to a patient what a doctor had said because the patient only pretended to have taken in what their doctor had said.

Researchers at the King's Fund say the model has successfully transferred to the UK, say researchers at the King's Fund. Originally piloted at the Royal Free and Cheltenham hospitals, the rounds are now running in six UK hospitals and another has just been added, with plans for more through the year. The scheme is also now being extended to hospices to improve nursing and medical care.

"There are high levels of stress in the NHS compared to some other occupations," says Joanna Goodrich, programme manager for the point of care programme at the King's Fund, which has also just evaluated the UK rounds.

"Although staff want to provide the sort of kind, compassionate care that they would want for themselves or their own families, it's difficult for all sorts of reasons to do this consistently. Rounds help staff to reflect on the nature of the emotional and social challenges involved, and to support each other."

A point of care workshop found that barriers to compassionate care included staff stress and burnout; conflict between perceptions of professionalism and compassion; a lack of systematic role modelling or mentoring; and training that emphasises professional detachment, as well as natural defences staff develop to cope with continuous exposure to patients in pain and distress.

Despite some initial scepticism, the scheme has worked well in England, says Barbara Wren, consultant lead psychologist in health and work at the Royal Free Hampstead NHS trust. "The rounds help staff to reconnect with the most valuable aspect of their work – their clinical role – and allows them to witness compassion, care and the humanity that drives healthcare staff to go the extra mile, which is motivating and rewarding in these tough times."

There were some initial concerns that an approach from America would not work in a UK context, but these have proved to be unfounded: "We know from our evaluation that staff who attended really welcomed the opportunity to talk openly about the challenges and difficult emotions associated with caring for patients," says Goodrich.

At the Royal Brompton and Harefield NHS foundation trust, Dr Caroline Shuldham, director of nursing and clinical governance, says "the sessions put everyone on an equal footing." "If you are a leader, it helps you learn more about the experiences of colleagues dealing with difficult situations, and the long lasting impact patients can have."

Carol Davis is a Liverpool-based freelance health and travel writer

Guardian Professional.

NHS bill will damage children's health, say paediatricians

NHS bill will damage children's health, say paediatricians:

More than 150 paediatricians have signed a damning letter calling on the government to scrap its health and social care bill

More than 150 paediatricians are calling on the government to scrap its controversial health bill, saying it will have an extremely damaging effect on the health of children.

In a damning letter to The Lancet medical journal, members of the UK's Royal College of Paediatrics and Child Health said there was "no prospect" of improving the health and social care bill, which is going through parliament.

They accused the government of "misrepresenting" the bill as being something that was necessary for the NHS.

The signatories join several royal medical colleges, including the Royal College of General Practitioners and the Royal College of Radiologists, in calling for the bill to be scrapped.

The move will put increasing pressure on the government over the reforms, which have come under repeated fire from healthcare professionals.

Unions, including the British Medical Association, the Royal College of Nursing, and the Royal College of Midwives, are among those calling for the bill to be withdrawn.

Friday's letter said that "if passed, we believe that the bill will have an extremely damaging effect on the healthcare of children and their families, and their access to high quality, effective services".

It added: "We see no prospect for improvement to the bill sufficient to safeguard the rights of access to healthcare by children and their families.

"In our view, no adequate justification for the bill has been made.

"The costs of dismantling existing National Health Service structures are enormous and, at a time of financial austerity for all public services, have resulted in precious resources being diverted to private management firms and away from frontline patient care.

"We believe that the bill will undermine choice, quality, safety, equity, and integration of care for children and their families."

The signatories said the NHS already outperforms most other health systems internationally and is highly efficient, and expressed fears over the potential role of private companies in managing groups of GPs, who will control most of the NHS budget, under the new system.

They added: "Competition-based systems are not only more expensive and less efficient but are associated with gross inequality in perinatal and child health outcomes, including child safeguarding.

"Far from enabling clinicians to control and determine local services, the new commissioning proposals are more likely to lead to increased power for private management organisations attracted to this lucrative opportunity to manage small clinical commissioning groups."

The letter said using multiple private companies "will make it difficult to innovate, co-operate, plan, and improve the quality in children's services".

They warn that care will become more fragmented and families and clinicians will struggle to organise services for children.

"Children with chronic disease and disability will particularly suffer, since most have more than one condition and need a range of different clinicians."

Safeguarding of children will become even more difficult when services are put out to competitive tender and organisations compete instead of co-operate, the letter said.

"Children who are vulnerable, neglected, or abused will inevitably slip through the net."

More than 130,000 people, including footballer Rio Ferdinand and TV star and author Stephen Fry, have signed an e-petition calling for the bill to go.

A spokeswoman for the Department of Health said: "We have listened and substantially strengthened the bill following the listening exercise.

"It's not true to say that the health and social care bill will fragment children's healthcare.

"In fact, the bill will help address the very concerns about fragmentation that the experts raise.

"It will help the NHS and other public services work together better for children, young people and their families.

"These 150 individuals represent just over 1% of the total members of the Royal College of Paediatricians and Children's Health and cannot be taken as an accurate representation of the college, who we continue to work with." The Guardian

Clinics 'palming off breast implant clients on NHS'

Clinics 'palming off breast implant clients on NHS': Beauty clinics faced with women returning with ruptured breast implants are palming them off on the NHS by claiming they do not have the skills to treat them, plastic surgeons have claimed. The Daily Telegraph

Rushed NHS helpline roll-out 'risks endangering patients' warns BMA

Rushed NHS helpline roll-out 'risks endangering patients' warns BMA: A rushed roll-out of the new 111 number to replace NHS Direct could put patients at risk, the British Medical Association (BMA) has warned in letter to the Government. The Daily Telegraph

Dawn of the age of wireless medicine

Dawn of the age of wireless medicine:
Medical treatment is about to go wireless. New advances in microelectronics have enabled doctors to contemplate the day when they will be able to monitor and treat their patients with medical implants that use wi-fi, Bluetooth and other kinds of wireless technology. The Independent

Wide regional variation in percentage of women who smoke at the time of delivery

Wide regional variation in percentage of women who smoke at the time of delivery: Women in the North-East are around three times more likely to be smokers at the time of giving birth than women in London, new figures out today from ... NHS Information Centre