HSJ Live 27.03.2014: Competition to run district general hospital is abandoned

University Hospitals Bristol Foundation Trust said it had written off over £668,000 from treating patients registered with Aneurin Bevan University Health Board and its neighbour Abertawe Bro Morgannwg Health Board in the last four years.

From next month the trust will stop carrying out non-specialist elective procedures on patients registered with either of them. It said the reason was “ongoing payment issues”.

4.37pm Secretary of State for Health Jeremy Hunt today announced that he has asked Helene Donnelly, Ambassador for Cultural Change at the Staffordshire and Stoke on Trent Partnership Trust, to work as a senior advisor to develop mandatory raising concerns training for all NHS staff.

Mr Hunt announced Helene Donnelly’s new additional role at his key note speech at Virginia Mason Hospital in Seattle.

Ms Donnelly will work with Health Education England to introduce greater support for health and care staff to ensure they are fully aware of how to raise the alarm about concerns over patient safety, neglect and high death rates.

She said: “I know from experience how frightening and daunting a task it can feel to raise concerns in the workplace. There are many reasons why people feel that it is just easier to turn a blind eye and not raise your head above the parapet!”

She added: “There has been much talk, but now is the time for action. We must truly empower and support all NHS staff to raise concerns, and part of this is about ensuring they know how to do so and what to do if their concerns are ignored.”

“That’s why I’m delighted to be working on new mandatory training about whistleblowing, so that all staff will know what to do if they see care slip below the high standards we would all expect.”

Ms Donnelly previously worked in the A&E department at Stafford Hospital and following her experience and difficulties in trying to raise concerns there, she was a key witness at the Public Inquiry held by Robert Francis QC into the Mid Staffordshire NHS Foundation Trust.

3.40pm The BBC reports that the World Health Organization has announced that the world is now 80 per cent polio-free.

It comes after India officially recorded three years without a new case of polio.

3.10pm A report published today by children’s charity the National Children’s Bureau says that projects by primary and first access health care teams around England have risen to the challenge of improving children’s access to and experience of health services.

‘Opening the door to better healthcare: A snapshot of innovations in primary and first access care for children and young people’ highlights how projects have sought to improve child health by, for example: improving health advice and enabling self-care for less serious illness, making health care more accessible, and reconfiguring services to ensure child health expertise is available in the community thereby preventing inappropriate visits to A&E.

The report builds on earlier research by NCB that concluded that improvements to general practice for children is needed, including better training for GPs on how to work with children and taking into account the views of children and young people when evaluating and commissioning services.

Dr Hilary Emery, Chief Executive of the National Children’s Bureau said: “We know that getting effective and appropriate access to primary healthcare depends on a wide range of factors so it is essential that we share and learn from the innovative solutions being developed across the country.   This snapshot, of just some of the work going on, demonstrates how listening to children and families, and putting their needs at the heart of planning, can stimulate tangible improvements to local health services.”

2.55pm The BBC reports that hospitals in the UK have a fraction of the number of doctors on site at weekends as they do during the week.

On average, doctor staffing levels at weekends were 16 per cent of those in the week, according to figures obtained by the BBC.

2.42pm HSJ’s deputy editor Emma Maier writes in her latest Leader column that Andrew Lansley’s ‘no legacy debt’ pledge to CCGs has not been honoured.

The list is to be established under plans to introduce a “fit and proper person test” for boards of all providers registered with the CQC, details of which were published by the Department of Health today.

The regulator will record concerns about individual directors, specifically including where directors resign ahead of the CQC taking intervention action at their organisation.

2.25pm The chair of Wye Valley Trust has announced he is standing down to pursue his “business interests”.

2.17pm UNISON has hailed the announcement that the George Eliot tender process has been abandoned as “a victory for common sense”.

The three remaining bidders in the process, run by the NHS Trust Development Authority, were South Warwickshire Foundation Trust, which wanted to take the trust over, and Circle and Care UK, which had both submitted bids to run it as a franchise.

HSJ understands the decision does not mean the NHS is abandoning management franchising as an option for NHS trusts altogether. It remains an option for Weston Area Health Trust, in the south west.

1.40pm As the NHS struggles with growing demands on its limited resources, involving the voluntary sector could help stop the NHS grinding to a halt, writes director of services at Age UK Pam Creaven.

1.18pm The Institute of Cancer Research has responded to proposed changes from NICE to the way it makes recommendations on new medicines and other treatments for use in the NHS.

Professor Paul Workman, deputy chief executive of The Institute of Cancer Research, London, said: “The suggestion from NICE that it could remove its end of life criteria is extremely worrying and could deny thousands of patients with diseases such as cancer access to life-extending drugs.

“Approval of cancer drugs via end of life criteria is often the gateway to their use in the NHS earlier in the course of disease, with even greater benefit to patients, and is also a critical step in building up portfolios of new drugs that can be used in combination.

“It is disappointing that NICE has included nothing in its guidance to place greater stress on innovation when evaluating new drugs, and indeed removing end of life criteria could stifle innovation by erecting a major barrier to the approval of many innovative new cancer drugs. We encourage NICE to think again to find ways of improving access for cancer patients to new drugs and to stimulate innovation, which is essential to improve patient outcomes.”

12.33pm The American accountable care organisation model has achieved success, but the NHS can improve on it if it acts quickly, write The King’s Fund’s Chris Ham and Nicola Walsh.

11.53am Moorfields Eye Hospital has announced it will be providing all eye care services at Croydon University Hospital and Purley War Memorial Hospital from 1 April.

The change will mean that patients in Croydon will be seen by Moorfields staff and will have access to all of its specialist services. Patients with very complex needs will be treated at the specialist Moorfields Eye Centre based at St George’s Hospital in Tooting.

Declan Flanagan, medical director for Moorfields Eye Hospital, said: “The Moorfields team are delighted to be working in and with the local community in Croydon, providing patients with a comprehensive range of services to treat a wide variety of eye conditions, and bringing high-quality eye care closer to their homes.

“We have more than 20 years’ experience in providing care in community locations and other hospitals through our networked satellite model and are looking forward to extending our services to patients in Croydon.”

Stephen Hall, associate director of operations for the Critical Care and Surgery Directorate which has been running the ophthalmology service at Croydon University Hospital, said: “Moorfields Eye Hospital is known as a centre of excellence for ophthalmology around the world. I am really pleased that our patients will be receiving high quality specialist care from an organisation of this calibre.”

11.45am Over in our Comment section the chief executive of University Hospitals Bristol Foundation Trust, Robert Woolley, responds to Maria Von Hildebrand’s piece last week where she raised concerns over the quality of care at Bristol Children’s Hospital.

Data from the Health and Social Care Information Centre showed there were 20,440 women working as GPs in England as of last September, a 51 per cent rise since 2003.

Overall, the number of female GPs has risen 2.9 per cent (570) since 2012.

Meanwhile, the number of men working in general practice stood at 19,800 as of last September, a 2.9 per cent drop (599) since 2012.

10.51am Overweight adults are becoming the norm as the majority of our adult population is overweight or obese, chief medical officer Professor Dame Sally Davies will say today as she publishes her latest annual report on the state of the public’s health. 

Her concern is based on data showing that – when taking into account average height and weight – the average man and woman in England is overweight. This brings with it an increased risk of diabetes, strokes and other health problems. The report highlights studies that show some people who are overweight believe they are “about the right weight”.

Key areas of concern in the report include:

• Obesity – According to estimates, almost two thirds of adults and one third of children under 18 are overweight or obese.
• Deafness and blindness and dementia – The GP patient survey shows a greater prevalence of dementia, including Alzheimer’s disease, in those with severe vision loss or severe hearing impairment. The report highlights the lack of robust data which hampers our understanding of this possible association.
• Alcohol – The report concludes that in popular culture, drinking alcohol to excess is sometimes portrayed as normal behaviour. An analysis of six weeks of soap operas in the UK in 2010 found 162 instances of characters drinking to excess, with negative consequences rarely shown. According to the report, 75 per cent of the population does not consume excessive quantities of alcohol, and the proportion of the population which abstains from alcohol is increasing.
• Walking and cycling – Safety for pedestrians and cyclists must be improved if we are to encourage people to walk and cycle more and reap the associated health benefits, says Dame Sally. The risk of serious injury for each kilometre travelled on a bike is 21 times higher than by car, according to the report.

Professor Dame Sally Davies says: “I have long been concerned that being underweight is often portrayed as the ideal weight, particularly in the fashion industry.

“Yet I am increasingly concerned that society may be normalising being overweight.

“Larger mannequins are being introduced into clothes shops, “size inflation” means that clothes with the same size label have become larger in recent decades, and news stories about weight often feature pictures of severely obese people, which are unrepresentative of the majority of overweight people.”

10.44am The Times reports on Sir Andrew Dillion, chief executive of the National Institute for Health and Care Excellence, saying that age would “inevitably” be a factor under plans to take benefits to society into account when assessing new drugs.

However, Sir Andrew said elderly people would not be denied new drugs because the plans would increasing the number of treatments approved.

10.31am Karen Lynas, deputy managing director at the NHS Leadership Academy, identifies what traits and skills we should be looking for in the NHS’s top influencers to help steer us to a more successful and secure future for the service.

Sir Andrew Dillon told HSJ that he didn’t think the proposals, published today for consultation, would make a “substantial difference” to the amount the government will pay for drugs in future.

NICE currently considers a drug to be a good use of health service resources if it costs between £20,000 - £30,000 per quality adjusted life year, an internationally recognised way of measuring a drug’s price against its potential to extend or improve the quality of life.

9.58am Men aged under 20 and over 64 are at greater risk of developing skin cancer than women because they are more likely to ignore warnings to protect themselves against sunshine, The Guardian reports.

According to research published in the British Journal of Dermatology based on 2,215 French people men in those two age groups are the least likely to heed advice about the need to minimise the harmful effects of UV radiation from sunlight.

9.54am The Guardian reports that an inquest has found there were “shortcomings” in the NHS care given to a teenager who died in a psychiatric unit after alledgedly being presused by a male celebrty into sexual activity.

The family of Ben Cowburn said that he had been let down by staff because they had not responded to his allegation’s effectively.

Commissioners are now asking why their predecessor organisations were required to set aside the huge sum – which was intended to ensure CCGs did not come into being with inherited “legacy debts” – if it was not going to be available in future years.

Department of Health accounts show the provisions made by PCTs contributed to a large revenue surplus for the department in 2012-13, which was returned to the Treasury and used to reduce the national budget deficit.

7.00am Good morning. Dame Julie Moore and Sir Robert Naylor are among the 50 chief executives doing an exceptional job of steering provider trusts, according to a panel of expert judges assembled by HSJ.

Read the full list with profiles of all 50 Top Chief Executives on the HSJ app. Download the app here.

HSJ’s Top Chief Executives 2014 recognises for the first time the outstanding leaders of English NHS provider organisations. Other names on the list include Stuart Bell of Oxford Health Foundation Trust; Mike Cooke of Nottinghamshire Healthcare Trust; and Peter Homa of Nottingham University Hospitals Trust.

A heavyweight judging panel selected the 50 names on the list, and highlighted the 10 most exceptional leaders.

Editor Alastair McLellan said: “Leading a provider trust is a mission which surely at times appears thankless – political sensitivities abound, as does the pressing target to deliver outstanding care at reduced cost.

“What judges focused on in their deliberations was not moratality rates or financial bottom lines; instead their litmus test was one particular question in the staff survey: the percentage of staff who would be happy for a friend or family member to be treated at the organisation at which they work.”