qianshanwanshui blog
GP Commissioning « PRImage

Archive for the ‘GP Commissioning’ Category

Government response to Francis Inquiry – PRimage comment

Tuesday, March 26th, 2013

The government’s response to the Mid-Staffordshire NHS scandal has been dribbled out gradually but today we heard the extent of what will follow. It appears that we will see peer-reviewed regulation Ofsted-style ratings for hospitals, a “duty of candour” for NHS providers to their patients and a new training regime for nurses to ensure they practise the basics of caring for patients for at least a year before they nurse anyone.

As a specialist healthcare communications consultancy, PRimage has been reviewing the Government’s initial response to the Francis inquiry.  The response to the inquiry starts by setting out a five-point plan to “revolutionise” the care people receive from NHS and putting an end to failure.  Judy Viitanen believes that the Government has made a positive start to ensure that from now on compassion, dignity and respect will now be at the forefront of patient care.

Of course there is the growing groundswell of public opinion that says that the only thing that will prevent more such horrors as Mid Staffs is stripping power from producers and giving it to patients …. What’s your view?

The response focuses on these key issues: Preventing problems; Detecting problems quickly; Taking action promptly; Ensuring robust accountability, and Ensuring staff are trained and motivated.

Here are the key recommendations from the executive summary:

Preventing problems

At local level, commissioners will work with hospitals to identify and tackle poor care.

  • A chief inspector of hospitals will look into the culture of hospitals, driving change through fundamental standards and national ratings.
  • To ensure that paperwork, box ticking and duplicatory regulation and information burdens are reduced by at least one third.
  • A single national hub − the Health and Social Care Information Centre − will be collecting information; with a duty to seek to reduce information burden on the service year on year.
  • Professor Don Berwick is to work with NHS Commissioning Board (to be known in future as NHS England) to ensure a robust safety culture and zero tolerance of avoidable harm is embedded in the DNA of the NHS.

Detecting problems quickly

  • Chief inspector of hospitals to make assessments based on judgements as well as data.
  • They will become the nation’s whistle-blower.
  • The chief inspector will make an assessment of every NHS hospital’s performance, drawing on the views of inspectors, commissioners, local patients and the public.
  • The inspectors will be specialists not generalists.
  • They will oversee “comply or explain” approach. Good or best established practices that benefit the patients are expected to be used across the hospitals; otherwise a valid explanation needs to be given.
  • The Care Quality Commission will have the power to conduct ratings. It will work with Nuffield Trust to develop these proposals further.
  • Chief inspector to ensure there is “single version of the truth” − single assessment that fully reflects how hospitals are performing, not just targets but also things that matter to patients.
  • “Friends and family” test will be vital component of the ratings.
  • There will be new chief inspector of social care. They will be charged with rating care homes and local care services.
  • Information about hospitals will not be limited to aggregated ratings but it will be possible to drill down to information at a department, specialty care group and condition-specific level.
  • As a starting point, NHS England will extend transparency on surgical outcomes from heart surgery to cardiology, vascular surgery, upper-gastro intestinal surgery, colorectal surgery, orthopaedic surgery, bariatric surgery, urological surgery, head and neck surgery and thyroid and endocrine surgery.
  • Tough penalties and perhaps additional legal action for organisations that are found to be massaging truths or concealing truths about their performance.
  • A statutory duty of candour on providers.
  • A ban on clauses intended to prevent public interest disclosures.
  • A review of best practice on complaints.

Taking action promptly

  • The CQC (with NICE commissioners, professionals, patients and the public) will draw up a new set of simpler fundamental standards which make explicit the basic standards beneath which care should never fall.
  • A new time-limited three-stage failure regime. At the first stage, commissioners will work with the hospital board.
  • In the second stage, if commissioners fail, the CQC will call Monitor or the NHS Trust Development Authority to take action.
  • In the final stage, the chief inspector will initiate a failure regime, if problems still not resolved.

Ensuring robust accountability

  • The CQC will refer criminally negligent practices, identified by the chief inspector, to the Health and Safety Executive for them to consider criminal prosecution.
  • Barring failed NHS managers, with a system based on the barring scheme for teachers.

Ensuring staff are trained and motivated

  • Healthcare assistant training before nursing and other degrees.
  • Every student who seeks funding for nursing degrees should first serve up to a year as a healthcare assistant (this scheme will be piloted first).
  • Camilla Cavendish is reviewing how to best ensure healthcare assistants can provide safe and compassionate care.
  • Chief inspector will ensure that employers meet their registration requirements that all health and care support workers are properly trained and inducted before they start caring for people.
  • A programme will be initiated by NHS Leadership Academy to encourage new talent form clinical professionals and from outside of the NHS into top leadership.
  • An elite fast-track programme and an MBA-style programme to ensure clinicians with a talent for leadership are supported.
  • Frontline experience for Department of Health staff

HAPPY 2012! Love and best wishes from Judy Viitanen and PRimage

Saturday, December 31st, 2011

☆¸.•°*”˜˜”*°•.¸☆ ★ ☆¸.•☆☆¸.•°*”˜˜”*°•.¸☆

In 2012….I hope the kindness you’ve given to others returns many times to you.
May you have the hindsight to know where you’ve been,
The foresight to know where you’re going,
And the insight to know when you’re going too far.
May hope, love, and warmth be in your heart’s possessing,
And may the New Year bring you and yours many blessings.
Happy New Year!

Judy Viitanen

Health Bill – PRimage comment

Thursday, July 21st, 2011

PRimage has heard that on the day that the British Medical Association votes to launch a public campaign which calls for the withdrawal of the Government’s controversial Health Bill, a survey of 500 GPs shows 85% said they had not been reassured by the government’s response to the listening exercise, with a further 62% saying their support for the reforms has not been altered by the changes to the Health Bill.

We were interested to see that many of the GPs concerns centered on the areas that as a healthcare lobbyist, Judy Viitanen believes are the very real and inherent issues around the Bill – such as increased bureaucracy in the NHS, the impact on patient care and the cost of the re-organisation.  What are your views?  We’d love to hear them.

Pharmacy’s place in the new NHS

Wednesday, February 2nd, 2011

For anyone involved in the UK community pharmacy and pharma industry sectors, Judy Viitanen recommends checking out the useful and directional guide on the NHS reforms by the trade journal, C&D.  PRimage found it very helpful in understanding the bodies that will influence community pharmacy in the new NHS.  You can find the guide on the C&D website.

www.chemistanddruggist.co.uk

Health Bill passes first stage in Parliament – PRimage comment

Tuesday, February 1st, 2011

As a specialist healthcare communications consultant, PRimage MD Judy Viitanen, has been following the progress and debate on the Government’s comprehensive reforms of the NHS. The Health and Social Care Bill is a complex and far reaching piece of legislation, reflecting the wide ranging nature of the Government’s programme of reform for the NHS in England.


PRimage is largely supportive of the potentially positive elements of the reforms – we believe giving clinicians greater responsibility for commissioning and shaping local health services, increasing public and patient involvement, and putting a greater focus on improving public health are to be applauded. And it must not be forgotten that the NHS needs to find efficiency savings of £20 billion by 2014-15!  In our view it is important that the Government ensures that the new GP consortia are not forced to promote competition between providers – and instead are able to work collaboratively across primary and secondary care boundaries in order to improve services for patients.

As a former District Councillor, Judy Viitanen welcomes the Government’s aim of increasing local democracy in health and that it recognises the importance of health services and local authorities working more closely together for the benefit of patients and the public. That can only be a win:win scenario.

In recent weeks there has been mounting criticism of the reforms from health professionals. For example, the BMA has warned that patients will become ‘internal medical tourists’, with the wealthy shopping round for consortia that offer expensive or rare treatments.

Despite a raft of warnings and concerns, the government’s controversial Health Bill has passed the first stage of its journey through Parliament – with MPs voting 321 to 235 in favour at its second reading. PRimage was interested to see that no coalition MPs voted against the Bill.

The influential cross-party Health Select Committee has already voiced concern and warnings, saying that the ‘surprise’ decision to abolish PCTs had already led to poor decision-making and additional costs in the NHS. But yesterday the Health Secretary Andrew Lansley dismissed their concerns.  And last month David Cameron revealed that GP frustration with the NHS, the profession’s desire to do more and be more involved is the core motivation behind the Health Bill.

If that is the case, PRimage MD, Judy Viitanen, wonders why Doctor’s union, the BMA is stepping up its opposition to the reforms, and has voted for a special representatives’ crisis meeting to discuss the Health Bill.

NHS Bill: Sound bites round-up

Wednesday, January 19th, 2011

PRimage has been busy assessing reactions from various healthcare bodies to the NHS Bill, announced this afternoon … Lansley has had to contend with a huge amount of criticism of his NHS reforms, much of it dramatically expressed, by many of they key organisations representing doctors and other NHS organisations. Public supporters have been hard to find amongst the host of warnings and reservations! Judy Viitanen especially enjoyed the Titanic analogy used by Unison, who said that the Health Bill is a ‘disaster’ of Titanic proportions’ and which threatens to sink our NHS”

Here’s a listing of top line sound bites …
RCGP
‘makes sense’ for health professionals to be involved in the planning of services, but the proposals risk ‘destabilising the NHS and causing long-term harm to patient outcomes’

‘we must guard against fragmentation and unnecessary duplication within a health service that is run by a wide array of competing public, private and voluntary sector providers, that delivers less choice and fewer services, reduces integration between primary and secondary care and increases bureaucratic costs’.

Patient choices as outlined in the Bill ‘run a risk of destabilising the NHS and causing long-term harm to patient outcomes’. The RCGP has also yet to receive sufficient evidence to be reassured the plans would prevent this from happening.

BMA
The BMA said ploughing ahead with the reforms at the speed proposed was a ‘massive gamble’.

Dr Hamish Meldrum, chairman of council at the BMA, said: ‘The BMA supports greater involvement of clinicians in planning and shaping NHS services, but the benefits that clinician-led commissioning can bring are threatened by other parts of the Bill.’

‘Forcing commissioners of care to tender contracts to any willing provider, including NHS providers, voluntary sector organisations and commercial companies, could destabilise local health economies and fragment care for patients.

‘Adding price competition into the mix could also allow large commercial companies to enter the NHS market and chase the most profitable contracts, using their size to undercut on price, which could ultimately damage local services.’

Royal College of Physicians
Supports the shift towards putting clinicians and patients in the driving seat but is concerned the Bill doesn’t require specialists to be at the heart of commissioning.
‘The scale and pace of change – and the challenge of unprecedented efficiency savings – should not be underestimated. Neither should the risks if we get this wrong.’

Unison
The public sector union, called the Health Bill a ‘disaster’ of Titanic proportions’. Karen Jennings, head of health at Unison, said: ‘This Titanic health bill threatens to sink our NHS. The only survivors will be the private health companies that are circling like sharks, waiting to move in and make a killing.

‘Lansley has turned his back on the warnings from across the medical establishment that these changes are unnecessary, undemocratic and unlikely to deliver improvements in patient care. We need a U-turn from the Government.’

Unite
Bill is ‘a charter for private profit at the expense of patients care’.
‘It is clear that one of the biggest influences on Tory ideology regarding health policy has been the massive and insidious lobbying by the  private healthcare companies, which have opened their cheque books for David Cameron big-time.’
‘The GP consortia, the supposed vanguard of this so-called reform programme, will be juggling financial decisions with the help of the private healthcare companies they will buy-in, versus the needs of their patients – this is a stark conflict of interest. Patients should always come first.’

The Nuffield Trust
Reforms are ‘broadly in the right direction’ but they will have to be judged on the extent to which they deliver – with minimum disruption – sustained improvements to patient care during a period of major financial challenge for the NHS.

‘The NHS is at a fork in the road. It embarks on this period of reform with much strength but the pressures it faces over the next four years will continue to rise. ‘Given the reforms over the past 20 years the Government’s decision to devolve more responsibility to the front line is logical. However, this approach carries significant risks in today’s financial climate and needs to be managed very carefully.’

General Healthcare Group
The UK’s largest private hospital group, welcomed the proposed reforms and said it was ‘only right’ the NHS, private and third sector providers worked together in austere times.
‘In our view, the challenge for instituting these reforms will be about maintaining the pace of change and how instability during the period of transition is minimised.’

The King’s Fund
The Bill signals the biggest shake-up of the NHS since its inception
‘But, while the government’s reforms have the potential to improve the NHS, they will be implemented against the backdrop of the biggest financial challenge in its history. ‘Finding the £20bn in efficiency savings needed to maintain services must be the overriding priority, so the very real risk that the speed and scale of the reforms could destabilise the NHS and undermine care must be actively managed.’

NHS Confederation
Urged MPs to ‘forensically analyse’ the Health Bill.

‘We support the objectives behind this legislation but there are huge risks and major uncertainties associated with it. ‘The system is already geared up for change and we can not afford for these reforms to fail – the public will not forgive us. The focus in parliament has to be on making this work on behalf of patients.’

CBI
‘We support the Government’s plans to modernise the NHS, because this will lead to better services for patients, and ensure taxpayers’ money is spent wisely. ‘Allowing the best provider to deliver healthcare services, whether they are a private company or a charity, will spur innovation and choice. But bidders must be able to compete for contracts on a level playing field.’

Can GP-consortia learn from US experience?

Wednesday, January 19th, 2011

The UK influential and independent health think-tank, The Nuffield Trust, certainly thinks so – and PRimage finds their new report on the US experience and insights from American medical organisations makes for fascinating reading: http://www.nuffieldtrust.org.uk/publications/

The report sets out the lessons that the nascent GP consortia in England will need to learn from the experience of groups of doctors in some parts of America, which have been commissioning healthcare for patients, with a budget to match, for up to 20 years. It suggests that these new groupings of family doctors will need excellent leadership, management and IT support if they are to work well, and that there are ‘clear risks of introducing GP commissioning in England when the Government has placed such a strong emphasis on reducing management costs.’