HSJ Live 24.02.2015: NHS technology fund cut from £240m to £43m

5.18pm Checking into HSJ Live for the first time today? Here’s some of the day’s biggest stories:

Exclusive: Raid on DH’s capital budget rises to £640m

NHS technology fund cut from £240m to £43m

Third of staff do not feel secure whistleblowing on poor care

NHS staff survey reveals the huge scale of the ‘culture change’ challenge

4.58pm Barts Health Trust has appointed Janice Stevens as interim chief nurse on a six month secondment from Midlands & East Health Education England, where she is currently national director.

Peter Morris, Barts’ chief executive said:

“Jan brings a wealth of experience and knowledge gained through over 35 years of nursing across the NHS in both a national and local capacity, with a track record for improving patient safety. Her leadership will maintain momentum and confidence as we begin the process to recruit to a new chief nurse”.

Jan Stevens said: “Throughout my career three things have driven me: an absolute belief in the core principles and values of the NHS, a passion and pride for my profession, and a real desire to make a positive difference to patients and their families. 

“I am delighted to have been asked to step in as interim chief nurse, and look forward sharing my passion and commitment for patient care with the nursing teams across Barts Health”.

4.33pm Peter Carter, chief executive and general secretary of the Royal College of Nursing has commented on the NHS staff survey:

“Without the commitment, drive and hard work of its staff, the NHS would grind to a halt. And yet there is clearly a crisis of morale among staff, who feel underpaid, undervalued and under pressure.It is disappointing that we are still talking about greater openness in the NHS, after years of commitments, but the reality for staff and patients is that the culture change just has not been delivered.

“If 39 per cent of staff have been made unwell by work related stress during the last twelve months, it is no surprise that many have real concerns about the care their workplace can provide to patients.

“71 per cent work extra hours to try to deal with demand – and yet less than two thirds (64%) would be happy with the standard of care if a friend or relative needed treatment. Staff are overwhelmed by demand, and the frustrations of patients means we are still seeing an unacceptably high number of assaults against staff.

“These are clear signals that the hard work of staff is papering over deep cracks in our NHS. The level of demand on health services has been clear to anyone who has had the misfortune of waiting for hours in A&E or being unable to access services in the community. To meet this huge level of demand we need a real culture change in the NHS, and that does not seem to be happening.

“Worryingly, despite the warm words of encouragement in the years since the Francis inquiry, some staff still feel that reporting errors would lead to punishment or blaming for those involved. It’s important that we now become much more open and honest about the problems in the NHS, which still delivers excellent care under huge pressure.

“We are asking whoever wins the next election to listen to staff, act on what they say and deliver real change. The experiences of staff are a vital pressure gauge, which is why these surveys are so important. These findings need to be taken seriously by everyone in the NHS.”

4.14pm Here’s NHS Providers view on the NHS staff survey. Miriam Deakin, head of policy, said:

“Today’s staff survey results are a testament to the commitment of hard working, motivated NHS staff who provide high quality care for millions of patients and service users day to day. 

“We know that staff empowerment and staff satisfaction are integral to high quality care because patient experience is significantly influenced by frontline staff’s own experiences in the workplace. Staff engagement has to be locally led and all NHS provider boards will therefore wish to consider the findings for their workforce to make the most of the collective skills, ideas and talents of their staff to continually drive quality of care and establish enabling and caring cultures within their organisations.

“This is also an opportunity to acknowledge the resilience of frontline staff, given the growing pressures they and providers are facing, as demand for services rises, resources tighten and the NHS tackles staff shortages in a number of key areas. The future of the service depends on NHS providers being able to deploy a suitably skilled, motivated workforce in the right numbers, to the right places, at the right times. We look forward to continuing to work with the national bodies, and our members to ensure NHS staff are fully supported both in the short term, and as we move to deliver new and more integrated models of care”.

4.01pm Monitor has appointed an improvement director to help turnaround Norfolk and Suffolk Foundation Trust.

The foundation trust regulator has appointed former NHS chief executive Alan Yates as improvement director at the trust. He has over 27 years NHS experience, over half which he has spent working for mental health trusts.

Mr Yates is employed by Monitor, but will be based at the trust in a part time capacity. He will work alongside the trust’s leadership, providing expertise and support while also holding it to account to ensure it makes progress against an improvement plan.

His appointment comes after Monitor put the trust into special measures last week as a result of concerns about the safety of services, staffing levels and leadership at the trust.

Alexandra Coull, deputy regional director at Monitor, said:

“This extra support will help Norfolk and Suffolk make the improvements to its services that patients need.

“Alan has extensive experience of leading NHS organisations and therefore will be able to provide invaluable help and expertise.

“We will continue to monitor the trust’s progress in making improvements and will take further action if necessary.”

3.51pm The Parliamentary and Health Service Ombudsman has also commented on the NHS staff survey. A spokesman for the ombudsman said: 

“Although 73 per cent of NHS staff believe their organisation acts on concerns and complaints made by patients, NHS organisations need to do more to create a culture that listens and learns when things go wrong. We expect health and social care providers in England to implement ‘My expectations’ which sets out what good complaint handling looks like from patients and service users’ perspectives and has already been adopted by the Care Quality Commission. 

“Implementing these measures will put patients and whistleblowers at the heart of the way safety concerns are dealt with, which is critical in driving improvements in the health service.”

3.31pm Here’s Unison head of health Christina McAnea’s reaction to the NHS staff survey:

“It is clear that nothing has been done in the last 12 months to ease the pain of health workers. The NHS staff survey is a key tool for reviewing and improving the staff experience and so providing better care. But this is at risk as more and more private companies are getting hold of NHS contracts and denying staff a voice.

“More workers are dissatisfied with their level of pay this year than the previous year. And with so many feeling undervalued, not listened to, and provided with so little support, it is no surprise that fewer would recommend the NHS as a place to work.

“It is also worrying that more than a third of staff questioned this year would be unhappy with the standard of care provided by their organisation should a friend or relative need treatment.

“And there are still way too many staff experiencing bullying, harassment and violence at work – particularly in the ambulance service and mental health trusts.

“It is unacceptable for any member of staff to be attacked when all they are trying to do is help people. We want to see better protection for staff from violence as well as tough penalties and more prosecutions to deter future assaults.”

2.59pm Leaders from 120 clinical commissioning groups, representing almost 60 per cent of all CCGs, have called on the General Medical Council, the Department of Health and NHS England to remove the current barriers preventing CCGs from commissioning eye care services using the drug Avastin ‘off licence’ to treat the debilitating condition of wet age related macular degeneration (AMD).

The CCG’s, coordinated by NHS Clinical Commissioners, argue that using Avastin to treat AMD could release millions of pounds that the NHS could re-invest into other front line patient services.

Dr Amanda Doyle, chief clinical officer at Blackpool CCG and co-chair of NHSCC said:

“As clinicians we are seeing an increase in the incidence of this chronic eye condition due to an ageing population, and as commissioners we have a responsibility to ensure that every pound spent is done so to the best effect, and that is even more important with the current financial pressures the NHS is facing.

“The recent Cochrane review shows that Avastin has been proven to be comparable in terms of its effectiveness and it’s safety, and is a significantly more cost effective treatment for wet AMD than anything which is currently available for us to use. Members of the public would be baffled if they knew the sums of money being spent on expensive drugs when there is an alternative available that is cheaper and as effective.”

2.09pm Speaking at health questions in the Commons earlier today, shadow health secretary Andy Burnham claimed that new regulations passed on the Friday before recess mean that all NHS contracts over €750,000 will have to be put out to tender.

Mr Burnham said the NHS contracts would now have to adhere to the “Public Contract Regulations” and would be “opened up for to full EU procurement”.

He said he would not let the coalition “sneak this under the radar”.

“Almost every NHS contract will be advertised across Europe,” he added.   

1.39pm Chris Graham of the Picker Institute Europe, which conducted the NHS staff survey on behalf of NHS England, has written for HSJ on the survey’s whistleblowing findings.

Chris writes: “Scaled up, they suggest that more than 100,000 NHS employees would not feel secure raising concerns about unsafe clinical practice.

“This is astonishing, and conclusively demonstrates that there is a very widespread fear – justified or not – about the personal consequences of whistleblowing.”

1.38pm Our story on the 2014 NHS staff survey is now live.

Nearly one third of NHS employees do not agree that they would feel secure raising concerns about unsafe clinical practice, according to the 2014 NHS staff survey.

The survey, published today, paints a picture of increasing pressure on those who work within the health service.

Of the survey’s 29 “key findings”, 15 have deteriorated since last year, 11 have improved, one has remained the same, and two cannot be compared due to changes in the questions.

1.00pm A flagship NHS technology fund has been slashed from £240m to just £43m after ministers raided it to bolster a separate fund to help hospitals struggling with winter pressures.

NHS England has announced the £43m of funding from the integrated digital care fund will now be allocated as £20m in 2014-15 and £23m in 2015-16.

12.31pm Nearly one third of NHS employees do not agree that they feel secure blowing the whistle on unsafe clinical practice, according to the 2014 NHS staff survey.

The survey, published today, can be accessed here.

We’ll update you throughout the afternoon on HSJ Live on the survey’s key findings.

11.23am An HSJ exclusive: the Treasury agreed a further £150m transfer from the Department of Health’s capital budget in the early months of 2015 to help the health service cope with ongoing revenue spending pressures.

The latest raid brings the sum taken out of the health capital budget to £640m this financial year. It covers day to day costs such as drugs and staffing.

The DH this week confirmed to HSJ that officials agreed between late January and early February to transfer a further £100m from the DH capital budget to revenue, alongside a £50m transfer from NHS England’s capital budget

11.08am Monitor has extended the deadline for foundation trusts to submit their planning submissions for 2015-16, in light of providers’ rejection of the proposed tariff for the coming year.

FTs will now be given until early to mid April to submit their draft plans, with a final plan due in May.

However, providers will still need to submit the draft activity elements of their annual plans by the original deadline this Friday, the regulator said.

10.48am NHS Blood and Transplant has launched its first ever five year blood strategy, shaping the direction of travel for blood services in England and North Wales through to 2020.

The document outlines NHS Blood and Transplant’s aim to provide extended services to the NHS and to increase integration with hospitals. This includes working to improve patient outcomes by providing extended blood group testing for patients with sickle cell and thalassaemia, allowing blood to be better matched. 

Ian Trenholm, chief executive at NHS Blood and Transplant said: “We are excited to launch the strategy which sets out our ambitions for the next five years. We have come a long way since the inception of NHS Blood and Transplant nearly ten years ago, and this strategy builds on what we have learned along the way and paves the way for our future. 

“We will of course continue to focus on donors – without them being prepared to give their time to donate we wouldn’t be able to provide hospitals and patients with the transfusions they need.  We hope that 80% of donors will be using our digital services by 2020, enabling them to register, book and amend their appointments online. We will keep working to offer donors a safe, positive and modern experience, including moving towards paperless appointments and health checks.”

10.42am An NHS England regional director has been announced as the permanent accountable officer for a North West clinical commissioning group rocked by leadership turmoil last year.

Jon Develing, who is currently NHS England’s regional director of operations and delivery in the North, will join Wirral CCG in May.

Mr Develing was Wirral’s interim accountable officer until December. He took over the management of the CCG in May when its accountable officer and chair “stepped away” from their duties while a probe into the group’s leadership was carried out.

7.00am Good morning and welcome to HSJ Live. We start with a piece by the NHS Confederation’s chief executive, offering his views on the current tariff proposals.