Primary care trusts have been issued with guidance on how to make the necessary adjustments regarding the 2010/11 Quality and Outcomes Framework (QOF) achievement payments. The guidance includes an action to make the necessary adjustments by the end of June 2012.

Quality Management and Analysis System (QMAS) underpayments – action for primary care trusts (PCTs) is to correct payments made in respect of 2010/11 financial year. The guidance highlights an error within the Quality Management and Analysis System.

The Department of Health wrote to PCTs in February 2011 (Gateway Reference 15473) to advise of an error found in QMAS, which calculates payments to GP contractors under the Quality and Outcomes Framework (QOF). The error meant that GP contractors may have been underpaid for achievements under the QOF additional services indicators since 2004/05.

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Article source: http://www.dh.gov.uk/health/2012/05/qof-payment-adjustments/

Content :

April 25, 2012

A new report published in the journal Diabetic Medicine has projected that the NHS’s annual spending on diabetes in the UK will increase from £9.8 billion to £16.9 billion over the next 25 years, a rise that means the NHS would be spending 17% of its entire budget on the condition.

Article source: http://www.sanofi.co.uk/l/gb/en/layout.jsp?cnt=DED9CEF3-26EA-41D0-9FA8-5A49BC2CD024

The recently launched NHS Patient Feedback Challenge, run by the NHS Institute for Innovation and Improvement, is using new ways of working to share, spread and implement the measurement and improvement of patient experience across the NHS.

The Patient Feedback Challenge is about getting the NHS to use feedback from patients to improve services, by spreading the best approaches already out there. NHS organisations will be able to bid for funding, which will be used to help them spread their approaches to improving patient experience to new settings.

A web channel will be used to collect ideas and support the development of strong bids and projects. This ‘crowdsourcing’ of ideas is a fundamental part of the bidding process, giving organisations the chance to share their ideas, convince others of their value, get feedback to improve them and build links that will help ideas spread further. Once projects are chosen, the web channel will become the place to find out what is happening with each successful project.

The successful projects will receive dedicated support, which will have been identified through the selection process. New relationships will be developed with collaborators to raise the profile of the programme and make the most of exceptional practice in other sectors. We hope that these ways of working will prevent the challenge from being ‘the next initiative’ so that it can really work for patients and their families.

The challenge’s expert panel is currently on the lookout for NHS-based projects that use feedback from patients to systematically improve experience. The challenge is backed by a £1 million challenge fund, which will be used to support ambitious projects chosen by the panel that:

• set out to develop a fully integrated patient experience measurement system that leads to continuous improvement cycles
• create wholly patient focused organisations
• encourage spread and adoption of positive patient experience practice within and across organisations
• develop sustainable approaches that live beyond the initial programme

If you want to take part in the NHS Patient Feedback Challenge, register your ideas now on the Patient Feedback Challenge website.

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Article source: http://www.dh.gov.uk/health/2012/05/patientfeedbackchallenge/

The Royal College of Nursing said community nurses were among those facing cuts, which meant that government plans to move care from acute hospitals to community sites were a “facade”.

The RCN said 61,000 posts were at risk of being slashed across the health service, including nursing and other jobs, with 26,000 already lost in the two years to April. The loss of so many jobs showed the “weakness” of government pledges to protect the front line, said the RCN ahead of its annual conference in Harrogate this week.

Community services, covering district and mental health nurses and those who visit patients in their own homes, were being “overburdened”, said the RCN. Cuts and underinvestment risked a “revolving door” for patients, who are discharged from hospital, only to find there is no support in the community, so have to be readmitted to hospital, it was warned.

Fewer than one in 10 of 2,600 community nurses polled by the RCN said they had enough time to meet the needs of their patients, while nine out of 10 revealed that their caseload had increased in the past year.

Dr Peter Carter, general secretary of the RCN, said: “Yet again, and despite numerous warnings, NHS organisations are making short-sighted cuts across the UK. Nurses are being stretched too thin, and many are approaching breaking point. Inevitably, patient care is going to suffer.

“We are now seeing a clear and worrying picture of a health service which is struggling. It is struggling to keep people out of hospital because of pressures on the community, and it is struggling to discharge them with support when they leave. Very soon, patients will be left with nowhere to turn.”

Health Minister Simon Burns said: “We do not recognise these figures. Official statistics show that there are only 450 fewer qualified nursing staff in England than in September 2009 while the number of managers has been slashed by 15%.

“We are giving nurses in hospitals and in the community more time to care. We want to remove excessive paperwork and bureaucracy and have asked the Nursing and Care Quality Forum to find ways to free up nurses to spend as much time as possible with patients.

“The Health and Social Care Act will make shifting care out of hospitals and closer to people’s homes simpler. No one should stay in hospital longer than they need to and we are already investing £300 million to help people return to their homes with the support that they need more quickly after a spell in hospital.”

Article source: http://www.dailyexpress.co.uk/posts/view/320020/RCN-warns-over-frontline-NHS-jobs/

District nurses and health visitors are facing job cuts, rising workloads and less time to care for patients, despite pledges by ministers that NHS community services would be boosted to relieve the pressure on overstretched hospitals.

A dossier of evidence assembled by the Royal College of Nursing (RCN), which represents the UK’s 400,000 nurses, reveals that NHS services outside of hospitals are struggling to cope with growing demand brought on by the ageing population, hospital bed shortages and staff cutbacks.

The union also claims that a total of 61,113 posts in the NHS across the UK have been lost or placed at risk since April 2010, as the service undergoes a financial squeeze, including a £20bn efficiency savings drive in England by 2015.

The findings come as the health secretary, Andrew Lansley, prepares to address RCN members at the opening of its annual congress in Harrogateon Monday. Lansley’s appearance comes a year after 98% of delegates backed a vote of no confidence in him at their last congress in Liverpool, amid widespread hostility to his controversial health and social care bill.

According to the UK-wide RCN survey, almost nine out of 10 NHS community nurses (89%) have seen their caseload rise over the last year, while 59% said they were spending less time with their patients than this time last year.

Some 68% said staffing levels had fallen where they worked, while 86% reported that patients were being discharged from hospital more quickly than before.

“These results raise major concerns about the capacity of community services to deal with an increasing number of acutely ill patients,” the RCN document says. “Despite the stated intentions of politicians across the UK and all the advice from health experts, the RCN found very little clear evidence of this shift actually happening on the ground.

“The acute sector may be getting smaller but the community sector is not expanding to ‘take up the slack’ and is vulnerable to short-term cuts.”

Dr Peter Carter, the RCN’s general secretary and chief executive, said NHS community services were “overburdened, under-invested and at risk from cutbacks”. In England, the NHS community nursing workforce fell in 2011, with 1,995 fewer nurses, midwives and health visitors employed, official NHS statistics show.

Cuts to district nursing were “a false economy”, said Carter, because these services saved the NHS money by keeping elderly or patients with long-term conditions out of hospital. Social care budget cuts also put pressure on them and other NHS community personnel, he added.

“This worrying survey shows that the NHS is coming under attack from every possible angle. Services are clearly being cut at both ends – in hospitals and in the community – and that is a very dangerous path for the NHS to take,” said Andy Burnham, the shadow health secretary. “If hospital beds and wards are closing, it is essential that community services are protected. The government’s failure to ensure that suggests there is no clear plan for the efficiency challenge and haphazard cuts are being made across the system.”

But Simon Burns, the NHS minister, said ministers did not recognise the RCN’s job loss figures – reiterating the response he has given each time the union has produced an updated estimate of the total number of posts set to disappear. The RCN insisted its statistics had been strictly certified and were based on official NHS information.

There are only 450 fewer qualified nurses working in the NHS now than in September 2009, while 2,300 community nurses and health visitors are being trained this year, double the number of the year before, Burns said.

“The health and social care act will make shifting care out of hospitals and closer to people’s homes simpler. No one should stay in hospital longer than they need to and we are already investing £300m to help people return to their homes with the support that they need more quickly after a spell in hospital,” he added.

Article source: http://www.guardian.co.uk/society/2012/may/14/nhs-community-care-struggling-survey

A sharp rise in the use of sleeping pills led to NHS spending on the drugs reaching nearly £50m last year, figures reveal.

Some 15.3m prescriptions were handed out in 2010/11, compared with 14.5m in 2007/08, according to NHS figures obtained by the Co-operative Pharmacy.

A freedom of information request revealed health trusts spent £49.2m on the drugs in 2010/11, up from £42m three years previously – an increase of more than 17%.

The highest number of prescriptions for sleeping pills were dispensed in the north-west, which spent more than £8.5m on almost 2.5m sleeping medication items.

Zoplicone was given to more than 5.2m patients nationally, making it the most popular sleeping tablet.

Around a third of people in the UK are thought to have bouts of insomnia, which can become a debilitating problem for some.

Health chiefs have voiced concerns that frequent use of sleeping pills can lead to “psychological dependency”.

Mandeep Mudhar, NHS business director at the Co-operative Pharmacy, said: “Our research shows that millions of people suffer from a lack of sleep each year and are seeking medical help for the problem.

“While usage has risen steadily, the costs to the NHS have risen disproportionately, with costs going up at a greater rate.

“However, some sleeping drugs are only recommended for short-term use because they can lead to psychological dependency and lose their effectiveness over time.

“We would urge people who are suffering with insomnia or their use of sleeping pills to discuss their concerns with a pharmacist or their doctor.”

Research published in February found sleeping pills commonly prescribed in the UK may increase the risk of death more than fourfold.

A wide range of drugs was analysed for the study of more than 10,500 people.

They included drugs used in the UK, such as temazepam and zolpidem.

The research, from experts at the Jackson Hole Centre for Preventive Medicine in Wyoming and the Scripps Clinic Viterbi Family Sleep Centre in California, found that people prescribed sleeping pills were 4.6 times more likely to die during a two-and-a-half-year period compared with those not on the drugs.

Article source: http://www.guardian.co.uk/society/2012/may/11/nhs-spending-sleeping-pills-50m

The official assessment of the risks involved in the government’s NHS shakeup will never be published after the cabinet exercised its rare right of veto to keep it secret.

The move ends a 19-month campaign by the Labour MP John Healey for publication of the Department of Health’s own analysis of the damage its radical NHS overhaul may cause.

Healey, a former shadow health secretary, and an array of medical leaders argued during the stormy passage of the health and social care bill that MPs and peers needed to see the details in the transition risk register before they could consider the coalition’s NHS plans properly.

Andrew Lansley, the health secretary, said ministers had taken the “exceptional” step of opting against disclosure – a tactic used only three times before in the previous decade – because releasing it would undermine the process of policy-making by reducing the quality of advice civil servants gave governments in future.

“This is not a step I have taken lightly. I am a firm believer in greater transparency and this government and this department have done far more than our predecessors in publishing information about the performance and results of our policies. But there also needs to be safe space where officials are able to give ministers full and frank advice in developing policies and programmes,” Lansley said in a statement.

“The Freedom of Information Act always contemplated such a ‘safe space’ and I believe effective government requires it. That is why cabinet has today decided to veto the release of the department’s transition risk register. Had we not taken this decision, it is highly likely that future sensitive risk registers would turn into anodyne documents, and be worded quite differently with civil servants worrying about how they sound to the public rather than giving ministers frank policy advice.”

A spokesperson for the information commissioner, Christopher Graham, said he would need to be certain that the cabinet had followed rules that say the veto should be used only in cases meeting “exceptional” criteria for non-disclosure.

“We will need to study the secretary of state’s statement of reasons for imposing the ministerial veto in this case. These must, under the criteria established by the government, be ‘exceptional’. We will present the commissioner’s formal report on the matter to parliament next week”, the spokesperson said.

Healey condemned the veto as “a desperate act which will backfire badly. It is an admission of defeat on the legal arguments for public release. It is totally over the top to place NHS changes on the same footing as preparations for the Iraq war.

“There must be some very big risks in the government’s NHS reorganisation for ministers to override the law with their political veto. “

The health department has lost two separate legal battles, both of which ended with it being ordered – first by the information commissioner and more recently by the first tier tribunal – to publish the register. It has decided not to pursue a further appeal, to the upper tier tribunal.

“The government has lost twice in law, yet still won’t accept that patients and NHS staff have the right to know the risks ministers are running with the biggest ever NHS reorganisation”, said Healey.

The British Medical Association, which represents the UK’s doctors, expressed disappointment at the veto and said it remained vital for the risks inherent in the NHS reorganisation to be known. “There is still a huge amount of complex and very controversial secondary legislation to go through parliament in relation to the Health and Social Care Act, some of which will need to be voted through by MPs,” it said.

“We are therefore disappointed that the government has decided not to publish the risk register in full. As we said well before the bill became an act, it’s vital that everyone involved knows what the potential risks might be so decisions can be made based on a full understanding of what the impact might be.”

The Department of Health said: “The … transition risk register from November 2010, which was a statement of potential risks of NHS changes, will not be published, following cabinet agreement and a final decision made by the secretary of state for health.

“The secretary of state sought the cabinet’s views on the exercise of the ministerial veto in relation to the information tribunal’s ruling that the transition risk register should be released. He did so as part of a full commitment to act in accordance with the provisions of the Freedom of Information Act, which makes specific provision for the exercise of such a veto.”

Lansley added: “The choice to use the veto rather than appeal the decision to publish the risk register was made because the secretary of state and the cabinet views this as an exceptional case where there is a fundamental disagreement on where the public interest lies in relation to the disclosure of the risk register.

“The upper tier tribunal would focus on points of law arising out of the first tier tribunal decision rather than the balance of the public interest on the evidence.”

The shadow health secretary, Andy Burnham, said: “This disgraceful decision is a cover-up of epic proportions.” He accused the cabinet of showing “flagrant disregard for the law of the land. David Cameron is desperate to keep the NHS risk register secret because he knows that, if people could see the scale of the risks he is taking with the NHS, they would not forgive him.”

Dr Peter Carter, chief executive of the Royal College of Nursing, said the public interest meant the document should be published. “We believe it is wrong that yet again the government is refusing to publish, in full, the risks associated with these reforms. Today’s decision is astonishing and means that the public are only being presented with a partial picture of the NHS reforms.”

The only potential challenge to the veto would be if Healey or Graham sought a judicial review of the veto. But Healey said he thought the grounds for seeking such a review were “narrow to negligible”. Department of Health sources said the veto marked “pretty much the endgame, the end of the line” of the long-running saga.

Article source: http://www.guardian.co.uk/society/2012/may/08/nhs-risk-register-publication-vetoed

The Department of Health is seeking views on the proposed abolition of the NHS Commissioning Board Authority and the transfer of employees to the NHS Commissioning Board.

A letter from Richard Douglas, Director General of Policy, Strategy and Finance, to Karen Didovich Joint Chair, HR Transition Partnership Forum, seeks views on:

• the abolition of the Authority and the transfer of employees to the Board
• whether the appropriate staff groups to transfer have been identified
• the potential implications for those staff and others who may be affected by the transfer.

Read the consultation letter and annex on the proposed transfer of employees from NHS Commissioning Board Authority to the NHS Commissioning Board.

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Article source: http://www.dh.gov.uk/health/2012/05/employees-transfer/

Details of potentially surplus land for housing, currently owned by NHS organisations, which is no longer required nor likely to be needed for health service purposes in the future have been published. The information was provided by each of the 399 NHS trusts in England to the Department of Health through a central data collection.

The main findings from the 2012 data collection from NHS trusts, which related to parcels over 0.25 hectares, include:

• of the total 399 NHS trusts, 188 (47 per cent) declared at least one parcel of surplus or potentially surplus land and 211 (53 per cent) gave a nil response
• a total of 414 separate parcels of land were identified by the 188 NHS trusts who declared surplus or potentially surplus land.

See the main findings and the details of the surplus land data collection.

The results provide an update to the information published in October 2011 by the NHS and the Department of Health on the Disposal strategy – Land For housing. The information will assist in quantifying the contribution of the NHS to the on going government initiative of accelerating the release of public sector land for development.  The data collection used to compile these statistics was undertaken during January and February 2012 and the statistics relate to information available as at 1 January 2012.

A report published by the Department of Communities and Local Government sets out the progress of Accelerating the release of surplus public sector land: Progress report one year on to support housing.

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Article source: http://www.dh.gov.uk/health/2012/05/public-sector-land/

Editor’s Choice
Main Category: Public Health
Article Date: 04 May 2012 – 11:00 PDT

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According to an investigation conducted by Pulse, hospitals are owed as much as £40m in outstanding fees for treating foreign nationals.

The results will most likely fuel the debate over health tourism again and expose incidents in which GPs were under pressure to register foreign nationals who are not eligible to receive secondary care. In instances where individuals are not entitled to NHS care, their insurer or their country of origin will be approached for payment.

Pulse approached acute trusts across the UK under the Freedom of Information Act to obtain information on outstanding payments owed for the treatment of foreign nationals who were not eligible to free NHS care.

They received a response from a total of 35 acute trusts that were able to provide figures. The average unpaid debt for the provision of care to foreign nationals amounted to £230,000, extrapolated across all 168 trusts in England, the total figure owed to the NHS by foreign nationals would be £40m.

The largest outstanding debt was at St George’s Healthcare Trust. Their total outstanding from a total of £3.55m invoices to foreign nationals for health treatments from April 2009 was £2m. Barnet and Chase Farm came second with having written invoices worth £934,000 of which £488,000 were still outstanding.

The two most inefficient trusts in recuperating outstanding monies was the Royal Wolverhampton, with only 24% collected from the £419,000 the trust was owed and Newcastle-upon-Tyne which managed to collect just 36%.

Some hospitals admitted that they wrote off fees, with Northampton General stating that they wrote off £140,000 regardless of having only been reimbursed with £87,300 to date. Other hospitals included St George’s, which wrote off over £95,000, whilst University Hospitals Coventry and Warwick and the Royal Wolverhampton wrote off £79,000 and £41,000.

According to a St George’s spokesperson:

“A high percentage of our patients require life-saving trauma, neuroscience, cardiovascular or pediatric care. We’re working hard to improve the way we record overseas patients and the debt recovery rate.”

The deputy chair of the BMA’s GP committee, Dr Richard Vautrey, declared:

“Hospital trusts must put in place arrangements that ensure people cannot exploit the system. However, we need to be careful that we are not putting barriers in place that prevent people from getting access to healthcare. It can be quite challenging. It is too simplistic to call it health tourism. The reality is a lot more complex.”

The editor of Pulse, Richard Hoey, concluded:

“The amount of unpaid debt is likely to at least in part reflect the degree of confusion across the NHS about which foreign nationals are eligible to free NHS care, and which are not. GPs are in theory allowed to exercise discretion about whether to register foreign nationals who are not eligible for hospital care, but in practice they are sometimes put under pressure to take them on. Where NHS hospitals give care to patients they know are not entitled to it for free, they have a responsibility to taxpayers in the UK to chase payment promptly after treatment.”

Written By Petra Rattue

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