Tuesday 13 March 2012
New NGH team supports stroke patients at home
New NGH team supports stroke patients at home: A new community stroke team has been established at NGH to provide a countywide rehabilitation service to support stroke patients in their own homes. The team works with the patients as well as their carers and families to develop a rehabilitation programme that fits their needs, with the aim of helping patients to achieve their goals and regain as much independence as possible.
Nurses are guilty of racist abuse
Nurses are guilty of racist abuse:
Two mental health nurses face being struck off after they were found guilty of a campaign of racist, homophobic and physical abuse. Evening Telegraph
Two mental health nurses face being struck off after they were found guilty of a campaign of racist, homophobic and physical abuse. Evening Telegraph
Lifeline thrown in fight to save the Baby Cafe in Northampton - Northampton Chronicle & Echo
Lifeline thrown in fight to save the Baby Cafe in Northampton - Northampton Chronicle & Echo:
 Northampton Chronicle & Echo | Lifeline thrown in fight to save the Baby Cafe in Northampton Northampton Chronicle & Echo The Northampton Baby Cafe, in Wellington Street, in the town centre, as well as the Mum to Mum breastfeeding support service are under threat from NHS Northamptonshire bosses, who are set to remove funding. At next week's full council meeting, ... |
Report on future for public health improvement, education and learning
Report on future for public health improvement, education and learning:
The findings highlight the complexity of developing effective education and learning to support health improvement and the changes that will be needed to ensure that the workforce can operate effectively in the new environment. NHS Networks
The findings highlight the complexity of developing effective education and learning to support health improvement and the changes that will be needed to ensure that the workforce can operate effectively in the new environment. NHS Networks
Metal hips 'should not be fitted'
Metal hips 'should not be fitted': Metal-on-metal hip replacements have a much higher failure rate than other options and "should not be implanted", say researchers. BBC News
GMC guidance protects whistleblowing GPs from 'gagging clauses'
GMC guidance protects whistleblowing GPs from 'gagging clauses': GMC guidance stopping GPs and other doctors from signing contracts containing 'gagging clauses' has come into effect. GP Online
DH refuses to publish NHS Health Bill risk register until it has 'full decision'
DH refuses to publish NHS Health Bill risk register until it has 'full decision': Health minister Lord Howe said the DH cannot release the NHS Health Bill risk register a court told it to until it sees the tribunal's full decision. GP Online
NPfIT to be cut by £1.8 billion
NPfIT to be cut by £1.8 billion: Health secretary Andrew Lansley has confirmed that around £1 billion savings will be delivered to the NHS from CSC's contract for the North, Midlands and East of England. E-Health Insider
Getting it right for children, young people and families
Getting it right for children, young people and families:
This document sets out an ambition that the service vision and model for school nursing services developed through the School Nursing Development Programme will be a framework for local services that meet both current and future needs. It states that services should be visible, accessible and confidential, which deliver universal public health and ensure that there is early help and extra support available to children and young people at the times when they need it. They should also include services to help children and young people with illness or disability within the school and beyond.
This document sets out an ambition that the service vision and model for school nursing services developed through the School Nursing Development Programme will be a framework for local services that meet both current and future needs. It states that services should be visible, accessible and confidential, which deliver universal public health and ensure that there is early help and extra support available to children and young people at the times when they need it. They should also include services to help children and young people with illness or disability within the school and beyond.
NHS mobile working knowledge centre
NHS mobile working knowledge centre:
This knowledge centre brings together good practice, tools and experience to provide support and guidance for those initiating and implementing mobile working programmes and projects.
This knowledge centre brings together good practice, tools and experience to provide support and guidance for those initiating and implementing mobile working programmes and projects.
Reforming the NHS pension scheme for England and Wales: proposed final agreement
Reforming the NHS pension scheme for England and Wales: proposed final agreement:
This document sets out the proposed Final Agreement on the scheme design for the reformed NHS Pension Scheme for England and Wales to be introduced in 2015.
This document sets out the proposed Final Agreement on the scheme design for the reformed NHS Pension Scheme for England and Wales to be introduced in 2015.
Mental health sickness rise
Mental health sickness rise: Official data from the Department for Work and Pensions has revealed a sharp rise in people claiming the new style of incapacity benefit for mental health problems.
The difficult economic situation is pinpointed as behind the rise of more than a quarter in a year.
DWP statistics show the number claiming Employment and Support Allowance (ESA) for mental and behavioural disorders rose 29% between May 2010... Healthcare Today
The difficult economic situation is pinpointed as behind the rise of more than a quarter in a year.
DWP statistics show the number claiming Employment and Support Allowance (ESA) for mental and behavioural disorders rose 29% between May 2010... Healthcare Today
Busting the myths about 'saintly' GPs - Public Finance
Busting the myths about 'saintly' GPs - Public Finance:
Busting the myths about 'saintly' GPs Public Finance But it is based on many myths about GPs being closer to patients than other healthcare professionals The whole NHS reform is based on an assertion – that GPs are somehow better placed to decide what NHS services need to be provided because they are in ... and more » |
If GPs wouldn't use their local hospital, why should we?
If GPs wouldn't use their local hospital, why should we?:
A quarter of GPs wouldn't use their local hospital themselves, according to a survey. But are they prepared to demand improvements, asks Dick Vinegar
Some readers see me as the Great Satan, because I dare to criticise certain luddite practices and attitudes in the NHS. But my criticisms are as nothing compared to what doctors say about each other. Pulse Magazine recently published a survey on what 500 GPs thought about their local hospitals. It was not a pretty picture.
Only 74% of GPs would use their local hospital for themselves and their families. You could interpret this as a ringing endorsement of the local hospitals; or you could be shocked that 26% of the GPs found their local hospitals sub-standard. I lean to the latter view.
Worse still, only 64% of the GPs whose family members had been in hospital during the past year received a high standard of treatment. Again, 36% didn't. Personally, I would rate the treatment I have received in hospital over the past 10 years to be of high standard. But, I am just a simple patient. I have to defer to the more professional but adverse judgment from GPs.
Some 34% of the GPs considered that the care their patients had received at the local hospital was dangerously sub-standard. 74% said their patients had complained of poor quality care, and 10% claimed that patients had died because of this sub-standard care. These are awful figures. I am a patient and do not want to die. One would expect GPs to support me in taking the battle to the hospitals.
But I find that only 32% of GPs have raised concerns with the hospitals. Why not 100%? Perhaps it is because, in an answer to another question, only 42% "have confidence that the concerns would be fully investigated and acted upon". This is a dreadful admission, that doctors, bound by the hippocratic oath, do not believe it is worth their while to blow the whistle on patient abuse carried out by another part of the medical profession and its managers.
There are too many vested interests stacked up against the poor patient, even those related to GPs, who one might expect to be able to make the hospitals sit up.
To me, these attitudes explain Mid Staffs, and could result in a multiplication of Mid Staffs across the country. The editor of Pulse makes the same point in his editorial about the survey.
The survey is very important. It shows that, in the view of those who should know best – the GPs – that the hospital sector is imperfect, to put it mildly. So, what happens next? Does the hospital sector admit its failings and draw up a plan to improve? I doubt it, because the consultants and managers do not really understand the criticisms.
Do the GPs mobilise to insist on better performance from the hospitals? In my view, there is a chance that they could do that with the Lansley "GP commissioning" model. But they have probably blown that by opposing the bill. I was looking forward to GP commissioners getting tough with hospitals, for instance, refusing to do business with them unless they provided discharge summaries in under two days. According to the Pulse survey, 77% of discharge summaries are sent after two days, which to me as a patient, and to most GPs, is totally inacceptable. But hospital doctors carry on blithely providing their discharge summaries when they see fit, three years after a DoH published a directive that discharge summaries should be sent to GPs within 48 hours.
I am alarmed that GPs may not be prepared to confront the abuses in the hospital sector. I have a nasty feeling that they want to huddle together for warmth with their hospital colleagues, and not rock the boat. I can see them trying to rubbish the survey; it is too small, with only 500 GPs responding; the survey is academically flawed; and, worst of all it was produced by a branch – albeit a tame one - of the media, and therefore not worth serious study.
I disagree. The Pulse survey shows that a quarter of 500 doctors consider that their local hospitals are not fit for purpose. It would be rash to extrapolate that a quarter of the country's hospitals are not fit for purpose, but it sets the alarm bells ringing. (I have to say that I have been in and out of hospitals a lot in the last month, and have never found any of the problems that the GPs are complaining about. Maybe I am just lucky.) How the royal colleges and the BMA react to this survey will show their mettle and their often-expressed commitment to patient-safety. My guess is that some "motherhood statements" will be made about how the "safety of patients is paramount, and it will then be brushed under the carpet with all the other "inconvenient truths" expressed in recent Care Quality Commission, ombudsman and National Audit Office reports. The Guardian Professional
Some readers see me as the Great Satan, because I dare to criticise certain luddite practices and attitudes in the NHS. But my criticisms are as nothing compared to what doctors say about each other. Pulse Magazine recently published a survey on what 500 GPs thought about their local hospitals. It was not a pretty picture.
Only 74% of GPs would use their local hospital for themselves and their families. You could interpret this as a ringing endorsement of the local hospitals; or you could be shocked that 26% of the GPs found their local hospitals sub-standard. I lean to the latter view.
Worse still, only 64% of the GPs whose family members had been in hospital during the past year received a high standard of treatment. Again, 36% didn't. Personally, I would rate the treatment I have received in hospital over the past 10 years to be of high standard. But, I am just a simple patient. I have to defer to the more professional but adverse judgment from GPs.
Some 34% of the GPs considered that the care their patients had received at the local hospital was dangerously sub-standard. 74% said their patients had complained of poor quality care, and 10% claimed that patients had died because of this sub-standard care. These are awful figures. I am a patient and do not want to die. One would expect GPs to support me in taking the battle to the hospitals.
But I find that only 32% of GPs have raised concerns with the hospitals. Why not 100%? Perhaps it is because, in an answer to another question, only 42% "have confidence that the concerns would be fully investigated and acted upon". This is a dreadful admission, that doctors, bound by the hippocratic oath, do not believe it is worth their while to blow the whistle on patient abuse carried out by another part of the medical profession and its managers.
There are too many vested interests stacked up against the poor patient, even those related to GPs, who one might expect to be able to make the hospitals sit up.
To me, these attitudes explain Mid Staffs, and could result in a multiplication of Mid Staffs across the country. The editor of Pulse makes the same point in his editorial about the survey.
The survey is very important. It shows that, in the view of those who should know best – the GPs – that the hospital sector is imperfect, to put it mildly. So, what happens next? Does the hospital sector admit its failings and draw up a plan to improve? I doubt it, because the consultants and managers do not really understand the criticisms.
Do the GPs mobilise to insist on better performance from the hospitals? In my view, there is a chance that they could do that with the Lansley "GP commissioning" model. But they have probably blown that by opposing the bill. I was looking forward to GP commissioners getting tough with hospitals, for instance, refusing to do business with them unless they provided discharge summaries in under two days. According to the Pulse survey, 77% of discharge summaries are sent after two days, which to me as a patient, and to most GPs, is totally inacceptable. But hospital doctors carry on blithely providing their discharge summaries when they see fit, three years after a DoH published a directive that discharge summaries should be sent to GPs within 48 hours.
I am alarmed that GPs may not be prepared to confront the abuses in the hospital sector. I have a nasty feeling that they want to huddle together for warmth with their hospital colleagues, and not rock the boat. I can see them trying to rubbish the survey; it is too small, with only 500 GPs responding; the survey is academically flawed; and, worst of all it was produced by a branch – albeit a tame one - of the media, and therefore not worth serious study.
I disagree. The Pulse survey shows that a quarter of 500 doctors consider that their local hospitals are not fit for purpose. It would be rash to extrapolate that a quarter of the country's hospitals are not fit for purpose, but it sets the alarm bells ringing. (I have to say that I have been in and out of hospitals a lot in the last month, and have never found any of the problems that the GPs are complaining about. Maybe I am just lucky.) How the royal colleges and the BMA react to this survey will show their mettle and their often-expressed commitment to patient-safety. My guess is that some "motherhood statements" will be made about how the "safety of patients is paramount, and it will then be brushed under the carpet with all the other "inconvenient truths" expressed in recent Care Quality Commission, ombudsman and National Audit Office reports. The Guardian Professional
NHS costs soar as GPs focus on health reforms
NHS costs soar as GPs focus on health reforms:
Family doctors 'too busy' setting up clinical commissioning groups, while locum surgeons costing almost £1m a year
GP commissioning: the full data from False Economy
Senior GPs are spending as little as one day a week seeing patients because they are too busy setting up new organisations as part of the coalition's health reforms, official NHS records reveal.
Family doctors are devoting as many as four days a week to setting up clinical commissioning groups (CCGs), the groups of family doctors that will become key NHS bodies from April 2013.
But it costs the NHS up to £123,900 a year to replace a GP with a locum. In one CCG area alone, 15 local doctors are each spending up to two days a week away from surgery, at a cost of almost £1m a year.
Doctors' leaders claim GPs' skills are going unused and that the costs involved show how vital NHS funds are being wasted on health secretary Andrew Lansley's radical restructuring of the NHS in England.
"It cannot make sense for experienced doctors to stop providing clinical expertise when the NHS is under such pressure. It's also incredibly bad timing as the NHS shouldn't be wasting precious resources on reorganising itself yet again," said Dr Laurence Buckman, chairman of the British Medical Association's GPs committee.
Freedom of information requests submitted to NHS primary care trusts (PCTs) by False Economy, the TUC-backed research group, show how many GPs are involved in setting up CCGs; how much time each is spending preparing the new set-up rather than treating patients; and the cost to the NHS of their being redirected into managerial tasks.
From April next year, CCGs will gradually gain control of £60bn of NHS funds as they replace PCTs in commissioning and paying for treatments on behalf of patients.
In Shropshire, Swindon and Camden, north London, doctors are spending four days a week organising the new CCG system. In 16 other CCG areas, at least one doctor spends at least three and a half days a week away from patients.
East and North Hertfordshire CCG is being created by one GP acting as its chair, working two days a week, and 14 GPas each spending an average of one and a half days on it. Each half-day session worked by each of the 15 GPs costs NHS Hertfordshire, the local PCT, £460. That means it is spending £973,360 a year on temporary replacements and "responsibility" payments to the 15 GPs – extra payments on top of their salaries to reflect their extra duties in relation to the CCGs.
The same PCT is also footing a £211,600 bill for the equivalent costs in the neighbouring, much smaller Herts Valley CCG, leaving NHS Hertfordshire spending a total of £1,184,960 on these start-up costs.
It is costing £654,500 to set up Oxfordshire CCG, covering for eight local doctors, including one acting as the CCG's chief executive, who is doing either seven or eight sessions a week with the new body, each lasting four hours and 10 minutes, at a cost of £15,400 per session per year.
Leicester City PCT is spending £545,564 a year covering for 10 doctors and three laypeople who are setting up the City CCG. Similarly, Brighton and Hove CCG is costing £455,450 a year to set up (with 15 doctors), while East Leicestershire and Rutland CCG is costing the local PCT some £434,182 (seven doctors and one layperson).
That CCG also contains the doctor who is costing the most to replace. The group's chair works seven sessions of three and three-quarter hours a week, with each of those sessions costing £17,700 a year, giving a total cost to the PCT for that GP's diversion into CCG duties of £123,900.
Five other individual doctors are each costing £100,000 to replace, including two in Bath and North East Somerset CCG – the accountable GP and the chair – who cost the NHS £100,100 each.
Labour warned that the disclosures underline the danger that patients could lose out in the new set-up because some GPs will spend part, much or all of their week helping to run the new CCGs. Andy Burnham, the shadow health secretary, said: "One of our major concerns about this bill is the damage it will do to the doctor-patient relationship.
It creates conflicts of interest and could undermine trust as GPs are forced to mix medicine and the money motive. It might also mean patients seeing less of the GPs they know and trust as they are taken away from the frontline.
"These plans are flawed on every level and represent a poor use of scarce NHS resources. It makes no sense to take GPs away from frontline patient care and pay [for] them twice in the process," he added.
Dr Clare Gerada, chair of the Royal College of GPs, said the disclosures underlined the case for expanding the number of GPs and the need to get CCGs to work together in federations to minimise the total amount of doctor time spent away from patients.
GPs helping set up CCGs was becoming "unsustainable" because most family doctors have "heaving workloads", Gerada said. Some were doing work in relation to CCGs in their lunch breaks and evening in order not to disrupt the service they provide to their patients, she added.
False Economy said the annual cost to the NHS of setting up CCGs was at least £20m, based on the replies it had from 106 of the estimated 230 CCGs that have emerged. But the true cost is probably nearer £40m when groups that had not replied or were not yet established are factored in, it believes.
Clifford Singer, False Economy's campaign director, said: "This isn't about greedy GPs – after all, GPs are overwhelmingly opposed to the bill that has created this situation. Instead, this is about chaotic reforms that are dragging GPs away from patients, and the inevitable financial costs of doing so.
"It is perfectly possible to increase doctors' involvement in NHS decision-making without creating these rigid, expensive and bureaucratic structures. The government's obsession with pursuing this bill has nothing to do with patient care or saving money and everything to do with privatisation and politics."
On Tuesday, both houses of parliament will discuss the health and social care bill, which is expected to finally become law next Tuesday.
Simon Burns, the NHS minister, defended GPs' involvement in the CCGs. "Putting GPs in leadership positions in the NHS will mean they can improve services for their entire local population. Patients want doctors to make decisions about their care, not managers, and that is what our reforms will deliver.between now and 2015 because we are removing large swaths of bureaucracy. This money will be reinvested in the NHS," he said. The Guardian
GP commissioning: the full data from False Economy
Senior GPs are spending as little as one day a week seeing patients because they are too busy setting up new organisations as part of the coalition's health reforms, official NHS records reveal.
Family doctors are devoting as many as four days a week to setting up clinical commissioning groups (CCGs), the groups of family doctors that will become key NHS bodies from April 2013.
But it costs the NHS up to £123,900 a year to replace a GP with a locum. In one CCG area alone, 15 local doctors are each spending up to two days a week away from surgery, at a cost of almost £1m a year.
Doctors' leaders claim GPs' skills are going unused and that the costs involved show how vital NHS funds are being wasted on health secretary Andrew Lansley's radical restructuring of the NHS in England.
"It cannot make sense for experienced doctors to stop providing clinical expertise when the NHS is under such pressure. It's also incredibly bad timing as the NHS shouldn't be wasting precious resources on reorganising itself yet again," said Dr Laurence Buckman, chairman of the British Medical Association's GPs committee.
Freedom of information requests submitted to NHS primary care trusts (PCTs) by False Economy, the TUC-backed research group, show how many GPs are involved in setting up CCGs; how much time each is spending preparing the new set-up rather than treating patients; and the cost to the NHS of their being redirected into managerial tasks.
From April next year, CCGs will gradually gain control of £60bn of NHS funds as they replace PCTs in commissioning and paying for treatments on behalf of patients.
In Shropshire, Swindon and Camden, north London, doctors are spending four days a week organising the new CCG system. In 16 other CCG areas, at least one doctor spends at least three and a half days a week away from patients.
East and North Hertfordshire CCG is being created by one GP acting as its chair, working two days a week, and 14 GPas each spending an average of one and a half days on it. Each half-day session worked by each of the 15 GPs costs NHS Hertfordshire, the local PCT, £460. That means it is spending £973,360 a year on temporary replacements and "responsibility" payments to the 15 GPs – extra payments on top of their salaries to reflect their extra duties in relation to the CCGs.
The same PCT is also footing a £211,600 bill for the equivalent costs in the neighbouring, much smaller Herts Valley CCG, leaving NHS Hertfordshire spending a total of £1,184,960 on these start-up costs.
It is costing £654,500 to set up Oxfordshire CCG, covering for eight local doctors, including one acting as the CCG's chief executive, who is doing either seven or eight sessions a week with the new body, each lasting four hours and 10 minutes, at a cost of £15,400 per session per year.
Leicester City PCT is spending £545,564 a year covering for 10 doctors and three laypeople who are setting up the City CCG. Similarly, Brighton and Hove CCG is costing £455,450 a year to set up (with 15 doctors), while East Leicestershire and Rutland CCG is costing the local PCT some £434,182 (seven doctors and one layperson).
That CCG also contains the doctor who is costing the most to replace. The group's chair works seven sessions of three and three-quarter hours a week, with each of those sessions costing £17,700 a year, giving a total cost to the PCT for that GP's diversion into CCG duties of £123,900.
Five other individual doctors are each costing £100,000 to replace, including two in Bath and North East Somerset CCG – the accountable GP and the chair – who cost the NHS £100,100 each.
Labour warned that the disclosures underline the danger that patients could lose out in the new set-up because some GPs will spend part, much or all of their week helping to run the new CCGs. Andy Burnham, the shadow health secretary, said: "One of our major concerns about this bill is the damage it will do to the doctor-patient relationship.
It creates conflicts of interest and could undermine trust as GPs are forced to mix medicine and the money motive. It might also mean patients seeing less of the GPs they know and trust as they are taken away from the frontline.
"These plans are flawed on every level and represent a poor use of scarce NHS resources. It makes no sense to take GPs away from frontline patient care and pay [for] them twice in the process," he added.
Dr Clare Gerada, chair of the Royal College of GPs, said the disclosures underlined the case for expanding the number of GPs and the need to get CCGs to work together in federations to minimise the total amount of doctor time spent away from patients.
GPs helping set up CCGs was becoming "unsustainable" because most family doctors have "heaving workloads", Gerada said. Some were doing work in relation to CCGs in their lunch breaks and evening in order not to disrupt the service they provide to their patients, she added.
False Economy said the annual cost to the NHS of setting up CCGs was at least £20m, based on the replies it had from 106 of the estimated 230 CCGs that have emerged. But the true cost is probably nearer £40m when groups that had not replied or were not yet established are factored in, it believes.
Clifford Singer, False Economy's campaign director, said: "This isn't about greedy GPs – after all, GPs are overwhelmingly opposed to the bill that has created this situation. Instead, this is about chaotic reforms that are dragging GPs away from patients, and the inevitable financial costs of doing so.
"It is perfectly possible to increase doctors' involvement in NHS decision-making without creating these rigid, expensive and bureaucratic structures. The government's obsession with pursuing this bill has nothing to do with patient care or saving money and everything to do with privatisation and politics."
On Tuesday, both houses of parliament will discuss the health and social care bill, which is expected to finally become law next Tuesday.
Simon Burns, the NHS minister, defended GPs' involvement in the CCGs. "Putting GPs in leadership positions in the NHS will mean they can improve services for their entire local population. Patients want doctors to make decisions about their care, not managers, and that is what our reforms will deliver.between now and 2015 because we are removing large swaths of bureaucracy. This money will be reinvested in the NHS," he said. The Guardian
The PM, his pro-smoking aide, and a dirty war over cigarette packaging
The PM, his pro-smoking aide, and a dirty war over cigarette packaging:
The independence of a Government adviser on red tape appointed by David Cameron has been called into question as details emerge of a possible covert attempt by the tobacco industry to undermine the proposed introduction of plain cigarette packets with no branding or company logos. The Independent
The independence of a Government adviser on red tape appointed by David Cameron has been called into question as details emerge of a possible covert attempt by the tobacco industry to undermine the proposed introduction of plain cigarette packets with no branding or company logos. The Independent
Doctors give up fight with Government over NHS reforms
Doctors give up fight with Government over NHS reforms:
Doctors' leaders have issued an extraordinary appeal to David Cameron for a truce in their vitriolic battle over the Government's health reforms. The Independent
Doctors' leaders have issued an extraordinary appeal to David Cameron for a truce in their vitriolic battle over the Government's health reforms. The Independent
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