HSJ Live 22.07.2014: MPs debate Manchester reconfiguration

4.53pm NHS Employers has responded to the news today that health unions are going to ballot their members over strike action. Chief executive Dean Royles said:

“I know trade unions don’t intend to distress patients when talking about strikes, but it does distress them. It’s not fair on them yet they will bear the brunt of any industrial action.

“I completely understand the frustration and anger staff and trade unions feel after a prolonged period of pay restraint and the decision not to fully implement the pay review body recommendations. They are clearly annoyed at the government and I understand they will want to protest. But timing ballots and industrial action for the busy winter period is bound to impact on care. This is a critical time when a union campaign risks a prolonged period of real distress for patients this winter. Employers will do all they can to maximise patent safety and emergency care.

“I urge and plead with the unions to take patients out of the dispute and instead focus on meaningful discussions to find a sustainable way out of pay restraint. Let’s explore longer term deals, protect those on lower pay and the living wage. The NHS has enjoyed good relations between trade unions and employers and I want that to continue. We need more discussion not more disruption.”

4.01pm The Healthier Together debate has now ended.

4.00pm Norman Lamb: “These proposals are not a top down reorganisation, they are led by local clinicians.”

3.56pm The care minister adds that politicians “have to be careful about ramping up anxieties” when discussing service reconfiguration.

3.52pm Mr Lamb says “hundreds of lives have been saved under specialisation” and raises the example of the centralisation of stroke services in London.

3.49pm Mr Lamb says the Healthier Together proposals have their “origin among local clinicians”.

3.41pm Care minister Norman Lamb is now speaking. He said that MPs who have so far contributed to the debate have shown that the “nature of consultation are what concerns [are] centred around”.

3.34pm Jonathan Reynolds MP says the geography and configuration of transport in Greater Manchester makes travel across the conurbation difficult, and that this creates problems with the centralisation of services in the region.

3.25pm Mike Kane MP says that starting the consultation nine months out from a general election that will “pit MP against MP” is “not the best idea”.

3.16pm Conservative MP David Nuttall has also criticised the language in the document, which he described as “unintelligible gobbledegook”. He added that he did not understand “half of it”.

3.09pm Mr Stringer and Kate Green MP both criticised the process underpinning the consultation, highlighting the fact that the consultation events occured during working hours.

3.06pm Mr Stringer said the consultation document varied between “NHS jargon and Janet and John talk”.

3.05pm You can watch the Healthier Together debate on Parliament Live here.

3.00pm MPs are currently debating the Healthier Together reconfiguration of acute services in Greater Manchester. Graham Stringer branded the consultation on the proposals a “shambles and a charade”.

2.27pm The health secretary has been urged to rethink legal reforms that would ease the creation of allegedly unaccountable “super clinical commissioning groups”.

In a letter dispatched to Jeremy Hunt last week, Healthwatch England chair Anna Bradley said local Healthwatch organisations had become concerned about CCGs “clubbing together” in closed groups to discuss reshaping health services across wide areas.

Such set ups circumvented local scrutiny and accountability measures, undermining Healthwatch’s statutory role, the letter stated.

12.59pm The Academy of Medical Royal Colleges has commented on the government’s response to the working time directive taskforce report.

Chairman Professor Terence Stephenson said:

“We look forward to continuing work on handling the implementation of the working time directive.

“Over the period of the implementation of the regulations the academy has consistently engaged with government to seek to ensure that services and training are not compromised.Where there were specific concerns or problems these were always reflected to government.

“It has been clear, however, that difficulties and concerns are not uniform across specialties. Hence colleges have taken differing views about the regulations themselves and the most appropriate solutions.

“Colleges agree that greater flexibility is needed particularly over SiMap/Jaeger and that a single system is not necessarily appropriate across all specialties. In some specialties it is felt that it is possible to provide appropriate training within the 48 hours whilst other feel it was not possible. On that basis there may be differing perspectives on the value and feasibility of separating training and working time but we look forward to exploring these issues with Health Education England and will continue to monitor developments.”

12.14pm The Labour Party has voiced concern about a sharp drop in the numbers of people being barred from working with vulnerable adults in care homes and hospitals.

The party said figures from the Disclosure and Barring Service showed the number of discretionary bans – issued where there has been suspicious conduct but no criminal offence or where an offence did not warrant an automatic ban – have fallen from 2,121 in 2009 to 441 last year.

11.46am The Department of Health has pledged to find ways to help more doctors opt out of the European working time directive, which the authority admits has led to rigid shift patterns and had a detrimental effect on training.

The pledge is one of a number of proposals to tackle concerns about the directive, highlighted by a taskforce led by Norman Williams, former president of the Royal College of Surgeons.

The DH said it accepted the taskforce’s recommendations in full.

11.36am Burton Hospitals Foundation Trust will remain in special measures, the CQC has announced.

Following an inspection by the care regulator, the trust received an overall rating of “requires Improvement”. The trust was rated as “good” with regard to whether services were caring and effective but as requires improvement on whether the trust as a whole was well led, safe and responsive.

CQC’s chief inspector of hospitals Sir Mike Richards, said: “We saw that staff at Burton Hospitals NHS Foundation Trust had been working over the last year to make improvements but clearly the trust still has some way to go before it reaches the required standard. 
 
“That is why I have recommended to Monitor that the trust remains in special measures for a further six months. I hope that, in six-month’s time, the trust will be able to demonstrate enough improvement to review this again.”

11.27am The Department of Health has published the NHS procurement atlas of variation which shows differences in the amount hospitals pay for everyday items including catheters, gloves and needles.

A DH statement said the new online NHS procurement atlas of variation “will help hospitals to compare prices and identify where they need to drive down costs so they can invest in more doctors and nurses to care for patients, as well as in frontline care”.

The membership body which represents NHS procurement professionals, the Health Care Supply Association, said the atlas identified the need for NHS “to improve pricing and better manage category choice along with the challenge to trusts to support a more managed approach to core common lines”.

But it added it was disappointed about the lack of consultation with the sector and accused the DH of putting “short term headlines [before] long term gain”.

A HCSA statement said: “The HCSA received no advance notification of publication unlike all previous national initiatives/publications.

“The ‘atlas’ illustrates the range of brand/product/price available from NHS Supply Chain along with the local decision making process that exists as opposed to the accusation that trusts are acting profligately.

“Sadly, the above will be lost in the discussion as an approach has been taken that gains short term headlines but not long term gain.

“I am immensely disappointed on behalf of all NHS procurement staff especially those who will read headlines this morning suggesting they will be ‘shamed’ into action.

“The vital work we are all doing to effect real improvement in NHS procurement will continue both at individual trust level and in partnership with the DH.”

11.21am The Foundation Trust Network has commented on the changes to the friends and family test announced by NHS England yesterday.

FTN head of policy Miriam Deakin said:

“The new guidance shows NHS England’s welcome commitment to keeping the friends and family test under review. In particular, NHS England’s decision to move away from using a ‘net promoter score’ to generate the results, responds to direct feedback from FTN members and will offer the public and providers a clearer methodology on which to base the test.

“The friends and family test provides one important source of information among many indicators of quality of care - we want to ensure it is robust enough to deliver meaningful, accessible data to inform patient choice and drive up quality standards.

“The information the friends and family test provides is most useful in driving improvement at local and ward levels, and in providing recognition of NHS staff’s hard work and commitment at the frontline. Our members remain keen to analyse the results to address any issues, drive improvement, and celebrate and share good practice. We look forward to working with members and the NHS England team to ensure not only that the guidance is implemented practically on the ground but also that it allows trusts the freedom to develop the most effective measures of patient experience locally.”

10.32am The Royal College of Midwives will also ballot its members on industrial action over pay.

Last night the RCM Board made the unanimous decision to formally ballot its 26,000 members in England for the first time in the organisation’s history.

Commenting on the decision, Cathy Warwick, chief executive of the RCM said: “This is a step that our board has not taken lightly, hard working midwives are deeply concerned that  the independent pay review body is being ignored and the NHS pay structure threatened.

“Midwives are at the end of their tether. They have already accepted long-term pay restraint and changes to their pension and terms and conditions. Meanwhile they are working harder and harder to deliver high quality care with continuing shortages of midwives and daily pressures on services.

“NHS staff have to be valued and fairly rewarded for the work they do. Staff that are demoralised cannot deliver the quality of care that NHS users, including mothers and babies, deserve. Investing in staff is an investment in better care. I hope the Government joins the RCM and other unions at the negotiating table, reconsiders their position and seeks a solution.”

10.19am The UK’s largest health union is to ballot its 300,000 NHS members in England for strike action.

Unison said the decision was in response to the government’s decision to reject the NHS pay review body’s recommendations and instead give a 1 per cent non-consolidated increase only to staff at the top of their incremental scale.

The ballot will cover health workers including nurses, therapists, porters, paramedics, medical secretaries, cooks, cleaners and healthcare assistants. A yes vote will lead to stoppages in early October, followed by further strikes and action short of a strike over the autumn and winter.

Christina McAnea, Unison head of health, said: “Balloting for strike action is not an easy decision – especially in the NHS.  But this Government is showing complete contempt for NHS workers.  It has swept aside the Pay Review Body’s recommendations and ignored the union’s call for a fair deal. Our members are angry at the way they are being treated and we are left with little choice but to ballot for action.

“We hope to work closely with the other health unions to plan and coordinate action. It is not too late however for Jeremy Hunt to agree to further talks, without pre-conditions, to settle the dispute.”

10.07am To coincide with the release of the sickness absence rates, NHS Employers has launched a new online tool to improve the management of staff sick leave in the NHS.

The online tool provides step-by-step information about what to do when staff call in sick, plus practical advice on some of the common reasons for sickness absence and information on what to do if staff are frequently off sick.

The tool can be accessed here.

10.02am Annual NHS national sickness absence rates in England are at their lowest point since 2009-10, when they first started being recorded.

The latest figures from the Health and Social Care Information Centre show that NHS workers on average had one day off sick out of every 25 in 2013-14. This is a decrease in the number of days off sick from 2012-13, when the sickness absence rate stood at one day off out of every 24.

The sickness absence rates for staff groups in 2013-14 showed that ambulance staff had the highest sickness absence rate and hospital doctor the lowest.

You can read the full HSCIC report here.

9.30am Good morning and welcome to HSJ Live. We begin the day with a second article from Rachel Davis and colleagues looking at why most doctors and nurses disagree with the friends and family test’s scoring method.