Reaction to Jeremy Hunt’s Birmingham speech, plus the rest of today’s news and comment.
5.38pm The Health Foundation has also commented on the speech.
Chief executive Jennifer Dixon said: “Person-centred care is something that we at the Foundation are serious about, particularly shared decision making and self management support. We know that supporting people to take an active role in their care can increase their wellbeing by supporting them to make decisions and feel more in control.
“This week we are launching a new report that will show that many people want to play an active role in their health care. It also shows how person-centred care can improve patient experience, health care quality and health outcomes.
“For person centred-care to be realised across the NHS fundamental changes are needed in the education and training given to both patients and clinicians. Politicians and policy makers need to create a supportive, long-term environment to realise this vision.”
5.36pm National Voices, the health and social care charity coalition, has responded to Jeremy Hunt’s speech.
National Voices’ chief cxecutive, Jeremy Taylor, said:
“We welcome Jeremy Hunt’s emphasis on the importance of personalised care and people being in control. The steps that he mentioned, including greater continuity of care and access to records, should help. It is really important that they are not implemented in a top down, one size fits all way. They also need to be part of a broader package of measures, especially for those with long term conditions and disabilities, including education and support for self management, training for professionals in person centred care and better engagement of communities and voluntary organisations.
“This was a narrowly focussed speech and we will need to hear more from the Conservatives, including how they will tackle major public health problems such as obesity, wide health inequalities and the alarming and growing funding problem in the NHS and especially social care.
“The Conservative party, as well as the other parties, now has an important opportunity to work with the voluntary sector to improve their policies and get them right.”
5.31pm The Royal College of General Practitioners has welcomed David Cameron’s to invest £400m in support for practices to offer patients more flexible access.
However it has warned that the plans will not mean 12 hour opening hours for all surgeries.
Maureen Baker, chair of the RCGP, said: “It is important to realise that this plan will not mean every surgery opening 8-8, seven days a week.
“In order to realise Mr Cameron’s ambitions, the government would also need to ensure the recruitment of thousands of additional GPs.
“The prime minister has pledged that there are 5,000 more GPs in the pipeline. That is a good start, but we estimate that we will need at least 8,000 by 2020 just to continue to deliver services on the basis of the existing hours GPs are contracted to provide.
“To meet this new aspiration practices will need to collaborate in federations. Whilst we feel this allows greater flexibility of workforce and premises, it will mean that patients cannot expect access to their own practice or their own GP for these extended hours.
“At the moment there is not enough evidence that patients want seven day opening, and the challenge fund pilots announced by the prime minister this time last year have not yet been evaluated – indeed some have not started yet.
“Practices in each community need to tailor their opening hours to meet the needs of local people, rather than pursuing seven day opening for the sake of it.
“Newspaper headlines implying that all patients will be able to walk into their local surgery in the evenings or at weekends merely raise expectations that general practice cannot live up to with the resources we are currently being given.
“The college supports the prime minister’s aspiration to extend access for patients, but this has to be matched by a properly-costed investment plan for general practice and an action plan to rapidly increase the number of GPs.”
4.37pm No real “rabbits out of the hat” from Mr Hunt in his conference speech this afternoon. He confirmed the Conservative’s pledges around extending GP access to weekends by 2020, and giving patients access to their GP records by April. As HSJ reported earlier today, the health secretary made no commitments about additional funding for the NHS, but rather stuck to the line that a strong NHS is reliant on a “strong economy” which he said extra borrowing would put in doubt. As soon as a copy of Mr Hunt’s speech is available we will provide a link to it.
4.11pm The health secretary has now finished his speech.
4.04pm Mr Hunt says the Conservatives will train and retain an additional 5,000 GPs.
4.02pm Mr Hunt says the NHS should be open to innovation from the third sector and “yes, the independent sector”, and accuses Labour of “scaremongering about privatisation”. He says he will not let these claims “poison” debate.
4.01pm The health secretary says that a strong NHS is reliant on a “strong economy” and that a Labour government would put this at risk.
3.59pm Mr Hunt says Labour is more concerned about good news stories about the NHS rather than good care for NHS patients.
3.57pm He mentions Frimley Park Hospital Foundation Trust getting the first outstanding rating from the CQC in the country, which draws a round of applause from the conference hall.
3.55pm Mr Hunt mentions the new CQC inspection regime and the four trusts which have been placed in special measures and emerged from the regime.
3.53pm Mr Hunt praises NHS workers, including GPs, A&E staff, nurses, porters, cleaners and caterers.
3.50pm Mr Hunt says to the Labour Party: “Don’t turn NHS into a national political football”. He says the NHS should not be used to “divide” people because it is part of our “social fabric”.
3.49pm Jeremy Hunt is now speaking at the Conservative Party conference in Birmingham.
3.42pm Clare Panniker, chief executive of Basildon and Thurrock University Hospitals Foundation Trust, is speaking at the Conservative Party conference. She was introduced as one of the 50 most inspirational women in healthcare (HSJ’s list of inspirational female leaders published in June).
3.08pm Nigel Edwards, the chief executive of the Nuffield Trust, has commented on David Cameron’s announcement on the expansion of the prime minister’s challenge fund for GP access. Mr Edwards said:
“Today’s announcement rightly recognizes that local leadership is the best way to improve out of hours care and make use of new technology for access to clinicians.
“But there is a danger that easier access to GPs will actually lead to greater pressures on the system, leaving fewer resources for the most vulnerable groups like frail older people. Although the government hopes this initiative will reduce emergency admissions, evidence suggests longer hours may result in people with minor problems, who might not have gone to the NHS at all, using the service.
“Evidence that more care outside hospital can reduce pressure on hospital admissions is very thin. It is a shame, therefore, that the government hasn’t waited for evaluation of the first pilots from this initiative before rolling it out nationwide.
“Another concern is the top-down requirement that GPs, not other parts of the NHS like pharmacists or walk in centres, need to provide these longer hours. The UK has already failed to fill GP training places, and missed GP training targets.”
2.59pm Jeremy Hunt will be addressing the Conservative party conference between now and 4pm. Follow HSJ Live for blow by blow coverage of the health secretary’s speech.
2.06pm Followed by…
Exp of person doing consultation (47%), length of consultation (43%) and weekend opening (42%),
— Alastair McLellan (@HSJEditor) September 30, 2014
2.03pm Alastair on what came ahead of weekend access in our poll:
Most important factors in GPs access were (in order) Convenience of location (64%), eve opening (56%), seeing the same GP (54%), followed by
— Alastair McLellan (@HSJEditor) September 30, 2014
1.57pm Alastair McLellan tweets about some of the findings of the HSJ/FTI Consulting poll:
Weekend access to GP came 6th in the order of priorities the public ascribed to improving primary care.
— Alastair McLellan (@HSJEditor) September 30, 2014
1.41pm Ahead of Jeremy Hunt’s speech this afternoon, and following the Conservative’s pledge to extend access to GPs on weekends, HSJ has published the results of our September HSJ/FTI Consulting poll in full. The article is free to access and the poll has some interesting findings about the public’s priorities for primary care.
1.23pm The Hospital Consultants and Specialists Association union has voted for industrial action short of a strike over pay.
In a ballot 84 per cent of those returning the ballot voted for the action.
The actions the members agreed include:
- Take all the breaks to which they are entitled and scheduled
- Work to their job plan
- Decline any extra duties outside their job plan hours
- Decline any new activities, which are not already in their job plan
- Decline to do any extra clinics/theatre lists for waiting list initiatives
Commenting on the result, HCSA president, Professor John Schofield said: “This result underlines two things we already know about our members, the first is that their priority is always to put their patients first, and the second is that they are not prepared to tolerate the government’s decision on pay, and are prepared to take action short of strike. It’s true that consultants and specialists feel undervalued and undermined, but they are also angry at the treatment of other NHS colleagues.”
The union decided to take the action in protest to the government’s decision to reject the NHS pay review body’s recommendation to increase staff pay by 1 per cent.
1.07pm Every general practice will be required to publish the average earnings of their GPs as part of the new contract announced today.
Practices must publish the average net earnings of their partners and salaried GPs for 2014-15, in addition to the number of full time and part time GPs. The measure is due to be implemented by 31 March 2016.
The government’s “named GP” policy will be extended to all patients, including children, under the new contract. David Cameron is expected to discuss the policy in his speech to the Conservative Party conference in Birmingham later today.
12.19pm The health secretary Jeremy Hunt has commented on the government’s plans to roll out “named GPs” to all patients: “GPs are the bedrock of the NHS and by bringing back a named accountable GP for everyone we will strengthen the relationship between GPs and their patients.
“I understand the pressures that general practice is facing with an ageing population, but we want make sure that all patients get personalised care tailored to their physical and mental health needs, supporting people to live healthier lives.”
11.49am NHS England has commented on the new GP contract. Barbara Hakin, national director for commissioning operations at NHS England, said:
“Having been a GP, I know how central primary care is to the health and wellbeing of patients and their carers. This continues to grow as more patients with complex health needs receive care in the community.
“Our vision is to see general practice play an even stronger role at the heart of local communities, offering more joined up and proactive care for patients. This is vital in addressing the rising demands on NHS services.
“Today’s contract changes recognise that and most importantly are aimed at improving care for patients.”
11.26am NHS Employers has reached agreement with the British Medical Association’s GP Committee on changes to the national general medical services (GMS) contract for 2015-16.
The changes will mean that all patients will have a named accountable GP who is responsible for coordinating their care. Patients will also have online access to more detailed information from their patient records and a larger proportion of available appointments will be bookable online.
Other changes, all of which will come into force on 1 April 2015, are:
- Practices will publish the average earnings of the GPs in their practice for 2014-15 on their practice website by 31 March 2016.
- The value of a quality and outcomes framwork (QOF) point will be adjusted to take account of relative changes in practice list size and planned changes in thresholds will be deferred for a year. Discussions around any clinical changes to QOF within the current QOF envelope will continue.
- A commitment for NHS Employers, NHS England and the GPC to work together to address workforce issues currently being experienced by GP practices.
- Some armed forces personnel who are at home for long periods of time will be allowed to register with a GP for up to two years (currently up to three months).
- The patient participation and alcohol enhanced services will cease with the money being transferred into core funding. This means that all practices must have a patient participation group and must screen new patients for alcohol misuse.
- The unplanned admissions enhanced service will continue with some minor changes.
Decisions on the 2015-16 uplift to the GMS contract will be made following recommendations from the doctors and dentists pay review body in early 2015.
Stephen Golledge, lead negotiator for NHS Employers, said: “I am pleased that we have been able to achieve a negotiated agreement before the end of September. This will give GPs and their staff time to prepare for the changes which commence in April 2015. The agreed changes will deliver improved care for patients and should further strengthen their relationship with GPs. We believe that the agreement also represents value for money for the taxpayer recognising the current economic climate.”
11.08am West London Mental Health Trust has accused a whistleblower of constructing “conspiracy theories” during an employment tribunal in which it faces bullying claims.
The former employee, psychologist Dr Hayley Dare, has alleged she was targeted with a threatening poison pen letter just weeks after raising concerns about a culture of poor practice within the forensic clinical unit at the trust.
The letter, as described in Dr Dare’s witness statement, urged her to withdraw her claims, warning her “you cannot beat us” and “how hard it will be on your children if you are unemployed”.
11.00am A story from HSJ’s senior bureau chief Dave West at the Conservative Party conference in Birmingham: the Conservatives have declined to commit to increasing NHS spending growth.
Health secretary Jeremy Hunt, pressed on the issue on Monday, said: “I’d like to invest more in the NHS but we have also got a deficit. It’s not just what [money] you need; it’s also what we’ve got.”
Labour last week said it would invest £2.5bn annually from 2015-16 from new taxes if elected, and several health experts called for other parties to respond with funding growth commitments.
10.32am The Daily Mail reports that strong painkillers may be doing more harm than good in the US.
According to the American Academy of Neurology, addiction to codeine, morphine and oxycodone is reaching dangerous levels. Frequent overdoses and a boom in serious side effects in the US means doctors should curb their use of the prescription drugs, the society said.
10.12am Leafing through this morning’s papers, The Times reports that midwives in England have voted to go on strike in protest at the government’s decision not to pay all NHS staff the 1 per cent rise recommended by a pay review body.
The RCM insists it will not put the safety of mothers and babies at risk, but all options are on the table after a consultation of 30,000 members found 94 per cent in favour of industrial action of some kind. Two thirds said they would be prepared to go out on strike over what the union said was a “derisory” offer. The 133-year-old college has threatened action on pensions in the past but never on pay.
It will be the first time in the Royal College of Midwives’ 133-year history that its members will walk out.
10.00am A large mental health trust has ended its contract with Capita for human resources services after significant recruitment backlogs left wards understaffed.
West London Mental Health Trust, which provides services across three London boroughs as well as national specialist treatment, this month ended its recruitment contract with the outsourcing firm.
The news comes as two further trusts in Merseyside confirmed they were ending payroll and HR contracts with Capita.
9.55am The Royal College of General Practitioners has issued a response to Sky News’ story that up to 200 GP practices across England face threat of closure.
Maureen Baker, chair of the RCGP, said:
“Patients should expect high quality and consistent care from every GP practice and the vast majority of practices do an excellent job of delivering care to the highest possible quality standards.
“But there is no excuse for poor care and action must be taken if practices are failing to provide decent standards of care to their patients.
“What the Care Quality Commission inspections are highlighting, however, are the growing pressures that GPs and their teams are currently facing in trying to deliver safe patient care with diminishing resources.
“If practices are struggling to meet quality standards due to factors beyond their control - such as lack of funding, significant increases in patient consultations and difficulties in trying to recruit sufficient GPs - we should not be ‘labelling’ them but looking at what support they need to bring them up to scratch.
“Also, if practices close, there could be a knock-on effect to neighbouring practices so any decisions about closures will need to be cognisant of that.
“As the UK’s largest medical royal college representing 50,000 family doctors, the RCGP will be working with the CQC to assist practices in drawing up and implementing plans so that all practices are appropriately supported to deliver the highest possible care to their patients.
“General practice is in an extremely fragile state and we urgently need more funding so that GPs everywhere are given the resources and support they need to do their jobs properly and deliver safe and high quality care for all their patients.”
9.48am Sky News reports that up to 200 GP practices face possible closure over unsafe care.
Steve Field, the Care Quality Commission’s chief inspector of general practice said in an interview that 160 to 200 surgeries found to be failing would be given extra support by NHS England.
Under the CQC’s plans if a surgery is deemed to be “inadequate” and does not improve within six months it will be placed in special measures.
If it does not turn itself around within a further six months it could be closed down.
7.42am: HSJ Live will today cover the reaction to Mr Cameron’s speech, as well as the Conservative party conference speech by health secretary Jeremy Hunt, expected at around 3pm.
00:01: Prime minister David Cameron will today announce he would ensure everyone would have access to a GP seven days a week by 2020, and the extension of “named GPs” to all patients from next year.
Mr Cameron will make the announcements at the Conservative party conference in Birmingham, the party said last night.
A Conservative statement said: “The next Conservative government will ensure everyone will have access to a GP seven days a week by 2020.”
It said in April 2015 £100m would be invested in improving access to GPs, between 8am and 8pm and at weekends, under the next phase of the “Prime Minister’s challenge fund”, initially announced at the party’s conference last year.
It added that in addition: “The prime minister will today commit to delivering seven day a week access for everyone in the country by 2020. This is expected to cost £400m in set up costs – spread over the next five years.” This would be funded “from existing budgets”, the Conservatives said.
The party also revealed that the 2015-16 GP contract - details of which will be announced today - would include the extension of the government’s “named GP” policy. In the current financial year GP practices are required to identify a named “accountable GP” for older patients.
The statement said: “The government will also be bringing back named GPs for everyone – which were abolished by the last Labour Government. This will mean every person in the country having a named GP who is responsible for their care outside hospital. It will form part of the new GP contract that the NHS Employers are expected to announce later today.”
Mr Cameron was expected to say: “People need to be able to see their GP at a time that suits them and their family. That’s why we will make sure everyone can see a GP seven days a week by 2020.”
In May Labour leader Ed Miliband announced that Labour would commit to patients getting GP appointments within 48 hours.
Today’s announcement will be seen as a response to that commitment and to last week’s high profile announcement by Labour leader Ed Miliband of £2.5bn investment in the NHS, to pay for thousands of additional nurses, GPs, midwives and careworkers.
An HSJ news story will follow.
00.01: Good morning. A large mental health trust has ended its contract with Capita for human resources services after significant recruitment backlogs left wards understaffed.
West London Mental Health Trust, which provides services across three London boroughs as well as national specialist treatment, this month ended its recruitment contract with the outsourcing firm.
The news comes as two further trusts in Merseyside confirmed they were ending payroll and HR contracts with Capita.
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