Confed Live 5.6.13: Full conference coverage

18.24pm Patient safety cannot be assured though a “one size fits all” approach but must be monitored through measures customised to local circumstances, a report by a leading member of the government’s post-Francis safety review group has concluded.

18.22pm Malcolm Grant confirms NHS England has embarked on a global search for David Nicholson’s successor: full story here.

17.48pm @sjcalkin tweets: Johnny Marshall: CCGs and LAs may find themselves competing for democratic legitimacy #nhsconfed13

17.47pm @ShaunLintern tweets: Health Education England will develop a national strategy for developing staff in bands 1 to 4. #nhsconfed13

17.22pm @BenClover tweets: Nuffield Trust’s Anita Charlesworth: The transition to PbR saw some organisations gifted windfalls by an accident of history #NHSConfed2013

17.19pm @jamesillman tweets: 60% odd ppl in England obese. Wow #nhsconfed13 . Cost of treating it is rocketing. .

17.16pm @ShaunLintern tweets: The taxpayer is spending £10,000 a minute on education and training with majority going to trainee doctor salaries - @hee_ian #nhsconfed13

16.44pm: @NickGolding adds: “I think Grant asks Nicholson, on front row, for details of discussions with Hunt on A+E funding. #nhsconfed13”

16.36pm: Some tweets from @NickGolding on the Grant Q+A, which will be coming to an end shortly.

“Grant insists era in which NHS resisted criticism is over #nhsconfed13” and “Grant ‘pretty critical report’ on 111 to be presented at next NHS England board.”

16.29pm: Andy Burnham tweets: “A&E debate just about to start. I will present new evidence to the House showing the Govt was explicitly warned this crisis might happen.”

15.49pm: Peter Walsh from Action against Medical Accidents is unimpressed with the regulators after their session “Sector regulation: early lessons and future implications”.

He tweets “#nhsconfed13 Monitor and NHSTDA session: Gave me no confidence they should be the enforcers following probs found by CQC. Keep it simple!”

15.32pm: A few more tweets from the conference.

HSJ news editor @nickgolding tweets: “John Wilderspin on Lab plan to make Health and Wellbeing Boards main commissioning org: I’m hwbs’ biggest fan bt even I felt that’s pushing the boat out #nhsconfed13”

Nursing Times editor Jenni Middleton tweets: looking forward to joining the panel discussion about staffing numbers and ratios. V interesting. #NHSConfed2013

15.30pm: NHS England chair Malcolm Grant is speaking in quarter of an hour, sure to be an interesting talk.

15.27pm: A tweet from Richard Humphries at the King’s Fund: “Question time at Health and Wellbeing Board session #nhsconfed2013 first Q points out we’ve had partnership boards before, what’s different now ? #hwblearn

14.33pm: The DH has issued a clarification of Anna Soubry’s remarks in Parliament.This refers to the “‘tremendous burden’ women doctors place on the NHS” story that has now been widely covered.

Her full statement reads: “I fully support women GPs, my comments were not intended to be derogatory and I was responding to a point made by another MP during the debate.

“As the head of the RCGP also recently pointed out - some female GPs work part time due to families. The solution is that we need to increase the number of GPs and we are doing that.

“This government supports good working practices such as flexible working, job sharing and part-time working which help retain female doctors.”

14.26pm: Dave West tweets: @deanroyles kicking off session Sustaining great leadership. Is it year of greatest challenge for NHS leadership.

14.08pm: Non-Confed news as Monitor announces the first case it will investigate under the new (old) rules will be a complaint about NHS England.

The sector regulator this afternoon announced it would examine purchasing decisions made by NHS England and NHS North of England Specialised Commissioning Group in Yorkshire and Humber.

The complaint has been made by Thornbury Radiosurgery Centre, a division of BMI Healthcare, which provides Gamma Knife surgery on the brain from its base in Sheffield.

The company alleges a breach of the Principles and Rules of Co-operation and Competition, which was put on a statutory basis as of April

14.06pm: Mike Farrar told the conference that the recent forure around A&E  should be “the wake-up call of all wake-up calls” for the NHS and policy makers. 

He said calls by NHS managers for a substantial change in the way services aredelivered had been ignored by “successive governments” but this time, that was not an option.

Mr Farrar said: “This is really the wake-up call of all wake-up calls in terms of action.

“My view is that we were not listened to [by successive governments]. My view now is that we simply cant be ignored”   

He set out a four-point strategy which he said should underpin a 10-year strategy for the NHS.

He said changes to financial incentives, culture and leadership would all be required to support the action required to deliver a “bright, sustainable NHS”.

12.40pm: #nhsconfed13 @nhsconfed CEO Mike Farrar up next. I’ll live tweet his comments, says HSJ reporter James Illman from the Confed conference in Liverpool. Follow him at @Jamesillman

11.10am:“Maybe when we look back in a year’s time we will see this year’s [Confed] annual conference as the start of transforming our services. But I’m not sure if we are up for the challenge,” says David Dalton, chief exec of Salford Royal FT, in his blog. “We are in huge danger of missing a crucial point that hospital care is not as safe, reliable and (cost) effective as it could be. Yes, some DGHs have problems today with their surgical rotas – but just doing more of the same, like ‘twinning departments’ across just 2 hospitals only solves yesterday’s problem - it does not address how you create and sustain the best surgical service at the lowest cost.” He notes: “I’m not a lone voice - look at what the NHS Confederation, the Academy of Royal Colleges and National Voices are saying today.”

10.40am: Monitor has opened its first investigation to take place under new NHS purchasing rules. Thornbury Radiosurgery Centre has complained about purchasing decisions taken by NHS England and the North of England Specialised Commissioning Group in Yorkshire and Humber. Monitor will consider if decisions made before 1 April breach the Principles and Rules for Cooperation and Competition, and if those made after 1 April breach the regulations that replaced them. Thornbury is owned by BMI Healthcare and Medical Equipment Solutions. It provides radiosurgery services such as Gamma Knife surgery.

10:35am: Public Health England is planning to publish national rankings of public health outcomes in different local authority areas, in a bid to encourage journalists and members of the public to “challenge those in positions of responsibility”. The organisation will publish data online – focused on premature mortality rate – in a format which allows councils’ public health outcomes to be compared to those of other authorities.

10.30am: Five new commissioners have been appointed to the board of the Care Quality Commission. They are former mental health tsar and now “offender health” tsar Louis Appleby, Sunday Times journalist and chair of the government’s HCA training review Camilla Cavendish, former Labour policy advisor Paul Corrigan, Nuffield Trust chief exec Jennifer Dixon and McKinsey partner Michael Mire. 

10am: The chair of the General Pharmaceutical Council, Bob Nicholls CBE, has decided not to seek re-appointment for a second four-year term. He will complete his current term in early 2014.

9.52am: Quite a lot of debate this morning over new guidance published by the Royal College of Obs and Gynae. The RCOG’s Science Impact Paper No. 37 advises pregnant women to avoid chemicals in household products such as food packaging, cosmetics and family medicines - and new cars. Several scientists and Public Health England have questioned the evidence behind the guidance.

9.40am: Not to be outdone, primary care leader have also highlighted the pressure they are under.GPs are fully booked for same-day appointments as soon as they open because of rising demand, according to Dr Clare Gerada, chair of the Royal College of General Practitioners. She told MPs that the workload for family doctors had risen by around “100%” over the last decade. “I am getting emails from colleagues across the country to say their surgeries are now fully booked by 8.30 in the morning which is disgraceful,” she told the Commons health select committee yesterday.

9.15am: Continuing the theme of gloom for acute services, the Foundation Trust Network has carried out a survey noting that pressures facing A&E units across the country look set to continue, with the majority of trusts fearing next winter will be even worse. Its survey shows that 62% of trusts expect the coming winter to be more severe than 2012-13, while 72% believe the accident and emergency system is at a tipping point. The survey is contained within the FTN’s new report, Emergency Care and Emergency Services 2013 - View from the frontline.

9am: NHS Confed coverage kicks off with a warning from a collective of medical, patient and management organisations that the NHS faces financial ruin and is no longer sustainable in its current form. The Academy of Royal Colleges, NHS Confederation and National Voices have urged politicians to “show more courage” in dealing with the NHS’s multi-billion pound deficit, key to which is a major transfer of services away from hospitals and into the community. Confed chief exec Mike Farrar noted that the required revolution would be “like changing the engine while the car is still running”.

8.45am: Good morning, mental health problems are the largest single cause of illness in in the UK. Current contractual models for mental health do not optimally serve the needs of patients, providers or commissioners, and too often care is poorly coordinated and delivered via a fragmented system of multiple providers and touch points. 

Today on HSJ’s Commissioning channel, Jenny Plamer and colleagues say given the financial and social costs of mental health problems, choosing the right contractual model for commissioning providers is key.