HSJ Live 21.03.2014: CQC trialling appeals process for quality ratings

Andy Weir is leaving his post as director of specialist and forensic services at West London Mental Health Trust despite an investigation begun by the trust finding “no evidence” to support the allegations, according to an internal trust document seen by HSJ.

The trust provides mental health services across three London boroughs and also runs Broadmoor Hospital in Berkshire.

The organisations “communications handling plan” on Mr Weir’s departure, obtained by HSJ, states: “A settlement has been reached [in the week commencing] 17 March with Andy Weir regarding the terms of his leaving the trust. Andy has been offered and accepted employment with another NHS trust.”

3.58pm What are the most pressing issues facing commissioners? Download our commissioning supplement to find out.

3.39pm Malnutrition is an issue that has been ignored for too long, according to the findings of an HSJ survey.

3.00pm Medical secretaries, who are UNISON members, will be protesting against Surrey and Sussex Healthcare Trust’s outsourcing of the typing of patient letters.

The protestors will demonstrate outside Crawley Hospital on Monday and East Surrey Hospital on Tuesday.

2.43pm Fellow at the King’s Fund Joanna Goodrich and Eleanor Stanley - a writer specialising in health and social issues - put forward the benefits of organisations working in partnership with patients when working on improving quality.

The Newquay Pathfinder, which was central to Cornwall’s successful bid to be a Department of Health integration pioneer, also led to a reduction in social care costs of almost 6 per cent.

Under the pathfinder the 100 Newquay residents most at risk of hospital admission and with at least two long term conditions received targeted support aimed at improving their overall wellbeing.

Martin Gower, the current chair of Coventry and Warwickshire Partnership Trust, has been announced at the new chair at South Staffordshire and Shropshire Healthcare Foundation Trust.

The appointment follows the retirement of the current chair, Steve Jones, who has been at South Staffordshire and Shropshire for the past 12 years.

A personal injury claim filed in the High Court by Tracy Boylin, the trust’s former associate director of HR, alleges that she was subjected to sustained harassment by an external consultant brought in by the Christie to review its executive team.

It further alleges that the specialist cancer trust failed to pay proper attention to signs that this treatment was making her ill, or to discipline the consultant when Ms Boylin first raised concerns that she was being harassed.

1.17pm In our Comment section Tim Benson argues that patients should be the ones who decide who can see and share their health records.

Kingsley Manning was discussing Care.data, the ambitious and controversial patient record sharing initiative, at the HC2014 healthcare IT conference in Manchester. He said: “There is not necessarily any contradiction between the aims of private companies and the strengthening of health and social care.”

He said HSCIC’s “innocent lack of transparency” has fuelled suspicion that arrangements for organisations use of data were “unfairly tipped in favour of profit making”.

12.55pm Most NHS staff know how to raise concerns and feel safe doing so but ‘most’ is not enough, says chief executive of NHS Employers Dean Royles in our Comment section.

12.27pm The BBC reports that the number of 100 year olds living in the UK increased by 73 per cent in the decade to 2012, according to the Office for National Statistics.

In 2012 there were 13,350 centenarians living in Britain, up from 7,740 in 2002.

The ONS also said life expectancy in Britain had “reached its highest level on record for both males and females”.

11.47am The Guardian has more detail on the two men who will be the first to be charged in the UK under the Female Genital Mutilations Act.

Dr Dhanoun Dharmasena and Hasan Mohamed will be charged when they appear before magistrates at Westminister magistrates court next month. The case relates to a medical procedure performed on a patient at the Whittington hospital, in north London, in 2012.

11.37am In The Times, experts have warned that survivors of female genital mutilation are being forced to have emergency caesarean sections because of midwives lacking training.

11.35am Chief economist at the Nuffield Trust, Anita Charlesworth, has warned that in light of the latest Budget there is a strong chance that the NHS will hit the financial buffers before, not after, the general election.

Providers will be able to formally challenge Care Quality Commission ratings in some circumstances, under an appeals process which it is to begin trialling.

The CQC’s board agreed this week to pilot the process despite some of its non-executive directors warning it could “open the floodgates” to a wave of costly speculative appeals.

This May we will be analysing the way in which social media is changing how the NHS interacts, both internally and externally, its role in helping to shape and influence debate and how social media is even being used as a tool for changing or improving policy and best practice.

Within this, we will be identifying those who are breaking new ground when it comes to using social media, and we want your nominations. We are looking for the people or organisations you feel are using social media tools in new, thoughtful or innovative ways to improve healthcare and shape its future.

11.14am NHS England has announced that three new drugs have been added to the Cancer Drugs Fund.

The drugs Albumin Bound Paclitaxel, Bevacizumab and Cabozantinib are to be used to treat pancreatic cancer, brain tumours in children and thryroid cancer.

Albumin Bound Paclitaxel will be used to treat advanced pancreatic cancer in combination with the drug gemcitabine. Up to 800 patients a year may be eligible and may have their life expectancy increased by an average of around two months. The average cost for a 28 day cycle of treatment is £2,656.80 with an average of four cycles of treatment being given.

Bevacizumab will be used to treat low grade glioma in children to try and delay the need for radiotherapy until the patient is older and less likely to develop side effects to radiotherapy. Up to 75 patients per year may be eligible. The average cost for one 14 day cycle of treatment is £582.38 with a year of treatment being given.

Cabozantinib will be used to treat medullary thyroid cancer and may be used in up to 30 patients every year as an alternative, in certain patients, to another drug already approved by the CDF. It may extend their progression free survival - the length of time during and after the treatment that a patient lives with the disease but it does not get worse - by around seven months. This decision is pending the drug being licensed and price being confirmed.

The Chemotherapy CRG is working closely with clinicians and representatives of the pharmaceutical industry to ensure a rapid review process for new drugs that may be appropriate for inclusion on the Cancer Drugs Fund list. The review process looks at the available evidence regarding a drug’s efficacy, plus data relating to its safety.

Professor Peter Clark, chair of the Chemotherapy CRG, said: “These new additions to the list demonstrate NHS England’s commitment to achieving maximum benefit to patients from the £200 million Cancer Drugs Fund. The process of updating the list is led by cancer specialists, and should ensure that patients benefit quickly when new drugs become available that are backed by good evidence from trial data.”

Professor Sir John Savill insisted only “consent fetishists” could object to the Care.data scheme.

The controversial project was pushed back until the autumn after patients, doctors and other professional organisations raised concerns that they had not been given enough time to learn about the project.

11.00am The Times reports that scientists have developed a test that could predict a person’s risk of developing Alzheimer’s disease through spotting abnormalities in spinal fluid.

10.58am This week’s issue of HSJ is available to read on the app.

To find the latest issue, simply navigate to “This week’s issue” on the app, or tap on the cover image on the homepage.

HSJ’s tablet app is free to download for both iPad and Android devices. iPad users can download it directly here, Android users will need to download it from the Google Play store.

10.53amThe Telegraph reports that breast cancer survival rates are improving more quickly in Britain than in any other country, according to an international study presented at the European Breast Cancer Conference yesterday.

The research shows that death rates in England and Wales from breast cancer have fallen by 40 per cent in just over two decades.

10.45am Six out of ten GPs are considering early retirement as general practice struggles to cope with rising workload according to a new BMA tracker of GP opinion. The poll also finds that despite the pressures they are under, GPs are changing the way they work to provide more emergency appointments.

Key findings from the poll include:

• Almost all GPs reported that their workload was too heavy some of the time, with more than half saying their workload was unmanageable or unsustainable at all times.
• Nine out of ten GPs said that they regularly worked beyond their regular hours.
• Over half of all GPs reported their morale as being “low” or “very low”.
• Almost six out of ten GPs said they had considered early retirement and over a third are actively planning for this decision.
• Over a quarter of GPs had said they were considering leaving the profession, while almost three out of ten had thought about leaving the profession altogether.
• Despite these pressures, eight out of ten GPs said they were changing the way they worked to meet demand for more emergency appointments, while half said they were responding to demand for more evening appointments.

Dr Chaand Nagpaul, Chair of the BMA’s GP committee, said: “This survey demonstrates that GPs are working harder than ever before to meet the demands of their patients, as well as working innovatively to provide the service their local community want, including providing more emergency care appointments and evening consultations.

“However, it is clear general practice is facing a workload disaster that is threatening its long term future. We are seeing morale dip to a level that I cannot remember in my twenty five years as a GP.

“The root cause of this crisis is that GP practices are facing an unprecedented combination of rising patient demand, especially from an ageing population, and declining resources. The government is also asking GP practices to provide more services, including many involving the transfer of hospital care into the community, without the resources required to successfully deliver them.

“We need politicians to realise that in order to meet the challenges facing general practice, we need to value the hard work GPs are undertaking by supporting them properly. This includes expanding the number of GPs so that patients are given the time and care that they deserve. Most importantly, the government needs to work with all healthcare professionals and patients to find practical solutions to a crisis that is threatening to overwhelm general practice.”

There were 2.9 million patients on the waiting list in January, according to the NHS England data for that month, published this week.

This does not include the waiting lists of three trusts – Barking, Havering and Redbridge University Hospitals, Whittington Health and Barnet and Chase Farm Hospitals – which have not reported for several months due to IT problems.

10.37am The BBC reports that the first female genital mutilation prosecutions have been announced by the Crown Prosecution Service.

10.30am Responding to the Department of Health’s announcement that the meningococcal B (MenB) vaccine will be introduced into the childhood vaccination programme RCGP chair Dr Maureen Baker said: “Worried parents and doctors will breathe a huge sigh of relief at today’s announcement. Meningitis and meningococcal infection is a dreadful disease and its consequences can be devastating.

“This vaccine has the potential to save thousands of lives, primarily children, and GPs will play a major role in promoting the new immunisation programme to parents and in ensuring a successful rollout.

“The College has been very vocal in the campaign to introduce the vaccine and we are pleased that our advice, together with other expert input, has been heeded.”

10.11am Local protestors who are against a private provider taking over the George Eliot Hospital travelled to the Trust Development Authority headquarters yesterday to make their voice heard, reports The Nuneaton News.

10.05am And here is the comment piece from Maria Von Hildebrand that the news story refers to below:

Valentine’s Day this year was a poignant day.

I attended a meeting of parents whose children had died following heart surgery at Bristol Children’s Hospital or had survived but left parents concerned about the safety of care at the unit.

Maria Von Hildebrand, whose nine-week-old daughter died following heart surgery in Bristol in 1987, acknowledged surgical outcomes had much improved since the late 1980s and early 1990s.

However, writing for HSJ she said University Hospitals Bristol Foundation Trust appeared “inured”, or hardened, to the impact care failings had on “children, their families and staff”.

The findings from 23 paediatric units indicate there are increasing numbers of such admissions for longer periods of time because of poor prevention and a lack of child and adult mental health services to take patients on after admission.

Nik Johnson, a consultant paediatrician at Hinchingbrooke Hospital in Cambridgeshire, carried out the survey of acute paediatric units after seeing a sustained rise in admissions at his trust in summer last year.

9.47am The Department of Health has announced it will introduce the meningococcal B (MenB) vaccine into the childhood vaccination programme.

The JCVI, the Government’s vaccine experts, says evidence shows that the Bexsero vaccine is effective in preventing MenB in infants and should be rolled out, subject to it being made available by the manufacturer at a cost-effective price.

The Department of Health will start negotiations with Novartis, which produces the only licensed vaccine, as soon as possible. The JCVI has recommended adding the vaccination to the primary childhood programme meaning that, if plans progress, infants will be immunised starting at two months of age.

Deputy chief Medical Officer, Professor John Watson said: “Infants under one year of age are most at risk of MenB and the number of cases peak at around five or six months of age. With early diagnosis and antibiotic treatment, most make a full recovery. But it is fatal in about one in ten cases and can lead to long-term health problems such as amputation, deafness, epilepsy and learning difficulties.

“We will now be working closely with Novartis in the coming months and if negotiations are successful, we hope to work with the other UK health departments to introduce a vaccine to prevent MenB as quickly as possible. This would make the UK the first country in the world to implement a nationwide vaccination programme.”

The JCVI has also advised that the vaccine is further extended to three and four month-olds as a one-off catch-up programme when it is introduced.

7.00am Good morning and welcome to HSJ Live.