NEWS - MARCH / APRIL / MAY 2018
WHERE ARE YOUR PRIMARY CARE CONTRACTS?
Most CCGs are now “delegated”, which means they have inherited responsibility for primary medical care contracts from NHS England.
Unfortunately, they haven’t all inherited an up-to-date schedule of contracts or complete paperwork for every provider. Your CCG may be paying for enhanced services that are not underpinned by a valid contract.
In extreme cases, services may be out of contract before the commissioner is aware of a problem!
It may be necessary to undertake a comprehensive review to establish a schedule of core and supplementary contracts, ensure that all the right documentation is in place, and create a pipeline for procurement for contracts that are due to expire.
For more information contact [email protected]
https://www.pcc-cic.org.uk/article/do-you-know-where-your-primary-care-contracts-are
Most CCGs are now “delegated”, which means they have inherited responsibility for primary medical care contracts from NHS England.
Unfortunately, they haven’t all inherited an up-to-date schedule of contracts or complete paperwork for every provider. Your CCG may be paying for enhanced services that are not underpinned by a valid contract.
In extreme cases, services may be out of contract before the commissioner is aware of a problem!
It may be necessary to undertake a comprehensive review to establish a schedule of core and supplementary contracts, ensure that all the right documentation is in place, and create a pipeline for procurement for contracts that are due to expire.
For more information contact [email protected]
https://www.pcc-cic.org.uk/article/do-you-know-where-your-primary-care-contracts-are
VOLUNTARY, COMMUNITY AND SOCIAL ENTERPRISE ORGANISATIONS
There has never been more awareness of how vital voluntary, community and social enterprise organisations are to an effective and sustainable health and social care system. And yet a recent survey found that less than half of charities expect to survive more than five years, with many reporting falls in funding from cash-strapped local government and NHS partners. |
Even if they weather the immediate financial crisis, the big long term challenge facing our public services is how they can help people to live well for increasing lifespans, avoiding or delaying the onset of long term conditions wherever possible, and effectively self-managing those conditions they do develop. That will require a different kind of relationship with people and families, with support that reaches them earlier and in their own homes and communities wherever possible.
Even well-funded statutory organisations cannot do that alone: they need community-rooted VCSE partners to build trust and reach communities and groups who face additional inequalities and are at the wrong end of the inverse care law.
But there are Commissioners who recognise that VCSE organisations are also potential design partners, helping them to co-design systems and services, which fit better with people’s changing and very individual lives. These Commissioners invest time in building effective local partnerships and increasing their reach into the communities they serve. Embedding co-design, including through resourcing user led and grassroots groups and challenging those groups to “do what they say on the tin”: reaching people who might otherwise not have their voices heard.
Social Value Act – update
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/690780/Commissioner_Guidance_V3.8.pdf
Even well-funded statutory organisations cannot do that alone: they need community-rooted VCSE partners to build trust and reach communities and groups who face additional inequalities and are at the wrong end of the inverse care law.
But there are Commissioners who recognise that VCSE organisations are also potential design partners, helping them to co-design systems and services, which fit better with people’s changing and very individual lives. These Commissioners invest time in building effective local partnerships and increasing their reach into the communities they serve. Embedding co-design, including through resourcing user led and grassroots groups and challenging those groups to “do what they say on the tin”: reaching people who might otherwise not have their voices heard.
Social Value Act – update
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/690780/Commissioner_Guidance_V3.8.pdf
NHS TO USE PATIENT 'VIDEO SELFIES' FOR NATIONAL DIGITAL ID SCHEME
Adam Lewis, who leads the Citizen ID project at NHS Digital, said the plan was for patients to register through their smartphones by providing their NHS number, showing a form of photo ID on camera and record a short video. In the video, patients would have to read out a randomly generated number, to ensure it was not pre-recorded.
For patients who did not want, or were unable, to register this way, there would be physical locations where they could register, he said.
NHS Digital was also looking at how the biometric function on smartphones could be used to sign in to their NHS identity, once it had been set up, though this was still at an early stage, Mr Lewis said.
Not all health information would request this level of security to access, and NHS Digital was also looking at using the government tool Verify in some instances and potentially other third party software.
Mr Lewis said: “It should be flexible enough to deliver the appropriate level of security for the service. For some things it will be easy to get in the front door, for others it will be much harder.”
Creating a national online identity for NHS patients is regarded as crucial to the success of a new generation of national NHS online services.
These services, such as NHS Online and NHS 111 Online, are meant to give patients better access to their medical records and digital tools for remote or self-care.
Without the ability to securely verify a patient’s identity remotely, the amount of sensitive health information that can be shared over these services will be limited.
Citizen ID has been an NHS ambition since at least 2014, as part of the Personalised Health and Care strategy, but its development has been fraught with delays as NHS Digital has grappled with the level of identity assurances needed to share highly sensitive patient records.
According to NHS Digital papers released under the Freedom of Information Act, developing and rolling out Citizen ID is expected to cost £85m through to March 2019.
Mr Lewis said NHS Digital was expecting to start public testing on the system in late 2018-19, but there was no fixed date for when it will be rolled out widely. NHS Digital has yet to procure the software to run or store videos collected when registering patients online, but said any processing of patient information would be based on consent and comply with new EU-wide data protection regulations that come into force on 25 May.
For patients who did not want, or were unable, to register this way, there would be physical locations where they could register, he said.
NHS Digital was also looking at how the biometric function on smartphones could be used to sign in to their NHS identity, once it had been set up, though this was still at an early stage, Mr Lewis said.
Not all health information would request this level of security to access, and NHS Digital was also looking at using the government tool Verify in some instances and potentially other third party software.
Mr Lewis said: “It should be flexible enough to deliver the appropriate level of security for the service. For some things it will be easy to get in the front door, for others it will be much harder.”
Creating a national online identity for NHS patients is regarded as crucial to the success of a new generation of national NHS online services.
These services, such as NHS Online and NHS 111 Online, are meant to give patients better access to their medical records and digital tools for remote or self-care.
Without the ability to securely verify a patient’s identity remotely, the amount of sensitive health information that can be shared over these services will be limited.
Citizen ID has been an NHS ambition since at least 2014, as part of the Personalised Health and Care strategy, but its development has been fraught with delays as NHS Digital has grappled with the level of identity assurances needed to share highly sensitive patient records.
According to NHS Digital papers released under the Freedom of Information Act, developing and rolling out Citizen ID is expected to cost £85m through to March 2019.
Mr Lewis said NHS Digital was expecting to start public testing on the system in late 2018-19, but there was no fixed date for when it will be rolled out widely. NHS Digital has yet to procure the software to run or store videos collected when registering patients online, but said any processing of patient information would be based on consent and comply with new EU-wide data protection regulations that come into force on 25 May.
BOOK YOUR OWN HOSPITAL APPOINTMENT ONLINE
NHS Digital will be sending information packs out this month to general practices explaining how patients can book their hospital appointments online.
The packs are designed to encourage patients to use the NHS e-referral service website. As well as booking, patients can also check, change and cancel appointments online without help from their practice. Each pack contains leaflets and posters for practice staff and patients. The national telephone appointment line will still be available for patients who prefer it.
The e-RS Manage Your Referral website is easy for patients to use. It allows them to book, check, change and cancel their appointments online without help from the practice.
Patients can take control and book their own appointment on a convenient date and time and at their preferred hospital or clinic if there is a choice. This means no more worried patients contacting the practice to find out what is happening with their appointment.
NHS Digital will be sending information packs out this month to general practices explaining how patients can book their hospital appointments online.
The packs are designed to encourage patients to use the NHS e-referral service website. As well as booking, patients can also check, change and cancel appointments online without help from their practice. Each pack contains leaflets and posters for practice staff and patients. The national telephone appointment line will still be available for patients who prefer it.
The e-RS Manage Your Referral website is easy for patients to use. It allows them to book, check, change and cancel their appointments online without help from the practice.
Patients can take control and book their own appointment on a convenient date and time and at their preferred hospital or clinic if there is a choice. This means no more worried patients contacting the practice to find out what is happening with their appointment.
Better for Practices and the NHS. Encouraging patients to book their own appointments online can also save time and money for the practice and the wider NHS.
Over 40% of e-RS appointments are booked by practice staff. Most of these patients could book their own appointments online. Encouraging patients to book their own appointments online could save practice time and the NHS money.
Did Not Attend rates halved when patients book their own appointments. This means patients are treated in a timely way and Practices do not need to refer these patients again.
Over 40% of e-RS appointments are booked by practice staff. Most of these patients could book their own appointments online. Encouraging patients to book their own appointments online could save practice time and the NHS money.
Did Not Attend rates halved when patients book their own appointments. This means patients are treated in a timely way and Practices do not need to refer these patients again.
Patients can manage their appointments 24/7. When patients book their own appointments they can check, change or cancel their appointment online any time of day, without contacting the Practice.
Only 27% of patients are aware they can book appointments online. Use the posters, leaflets and downloadable content for your waiting room TV to encourage patients to book their own appointments online.
Information packs
In May 2018, GP Practices which have a referral process which allows patients to book their own appointments online, will receive information packs to help them to encourage patients to use the online service.
The pack will include:
You can also download a video to play in your waiting room.
A PowerPoint version is also available.
Only 27% of patients are aware they can book appointments online. Use the posters, leaflets and downloadable content for your waiting room TV to encourage patients to book their own appointments online.
Information packs
In May 2018, GP Practices which have a referral process which allows patients to book their own appointments online, will receive information packs to help them to encourage patients to use the online service.
The pack will include:
- A GP practice staff leaflet - : ‘NHS e-Referral Service: Putting patients in control of their outpatient appointments’
- A4 posters to display prominently in your waiting room.
You can also download a video to play in your waiting room.
A PowerPoint version is also available.
PATIENT INVOLVEMENT IN HEALTH RESEARCH
Patient Involvement in health research can be enhanced by regular feedback
By: Dr. Elspeth Mathie ... 03 May 2018 ... 2 pages
Patient Involvement in health research can be enhanced by regular feedback
By: Dr. Elspeth Mathie ... 03 May 2018 ... 2 pages
NEW CEO - CARE QUALITY COMMISSION
The new Chief Executive of the Care Quality Commission will be Ian Trenholm, the current Chief Executive of the NHS Blood and Transplant Authority.
Mr Trenholm will take up the role in July and replace Sir David Behan who is stepping down after six years at the Regulator.
Mr Trenholm has worked at the NHS Blood and Transplant Authority since 2014, but started his career as an Inspector with the Royal Hong Kong Police [!] before moving to Surrey Police as a uniformed Custody and Patrol Sergeant.
He has previously worked as Chief Operating Officer at the Department for Environment, Farming and Rural Affairs and was Chief Executive of the Royal Borough of Windsor and Maidenhead.
The new Chief Executive of the Care Quality Commission will be Ian Trenholm, the current Chief Executive of the NHS Blood and Transplant Authority.
Mr Trenholm will take up the role in July and replace Sir David Behan who is stepping down after six years at the Regulator.
Mr Trenholm has worked at the NHS Blood and Transplant Authority since 2014, but started his career as an Inspector with the Royal Hong Kong Police [!] before moving to Surrey Police as a uniformed Custody and Patrol Sergeant.
He has previously worked as Chief Operating Officer at the Department for Environment, Farming and Rural Affairs and was Chief Executive of the Royal Borough of Windsor and Maidenhead.
PARLIAMENTARY AND HEALTH SERVICES OMBUDSMAN - ANNUAL SCRUTINY 2016/2017 This report argues that the government needs to take action to improve the NHS complaints system, properly investigate cases of past injustice and modernise the legislation for England's Ombudsman's services. It calls on the PHSO to improve how it supports often very distressed complainants, and to get better at showing how its investigations help improve NHS services for future patients. |
CAPACITY ALERT SYSTEM
Patients get the green light for smarter choices after latest GP pilot
New trial results from the Behavioural Insights Team show improved service access.
A pilot system is now making it easier for GPs to understand the waiting times at hospitals for their patients.
The e-traffic light system could help reduce hospital waiting times while offering patients a clearer choice of treatment and is set to be rolled out across the country after a successful NHS trial.
A tweak to the GP referral system sees a red light appear against a hospital with longer waiting times while a green light shows those with spare capacity, meaning doctors can offer patients potentially quicker routes to treatment and help them make more informed choices.
Results from two London trials have been promising – red lights reduced referrals to overbooked hospitals by nearly 40 per cent, while green lights increased referrals to hospitals with available capacity by 14 per cent this winter.
The Capacity Alert system was developed after NHS England commissioned the Behavioural Insights Team (BIT) to come up with ways of helping hospital trusts ease pressure on services.
Following the success of the trials in North East and South West London, BIT is now supporting the roll-out of the Capacity Alert system across the NHS in England.
Patients get the green light for smarter choices after latest GP pilot
New trial results from the Behavioural Insights Team show improved service access.
A pilot system is now making it easier for GPs to understand the waiting times at hospitals for their patients.
The e-traffic light system could help reduce hospital waiting times while offering patients a clearer choice of treatment and is set to be rolled out across the country after a successful NHS trial.
A tweak to the GP referral system sees a red light appear against a hospital with longer waiting times while a green light shows those with spare capacity, meaning doctors can offer patients potentially quicker routes to treatment and help them make more informed choices.
Results from two London trials have been promising – red lights reduced referrals to overbooked hospitals by nearly 40 per cent, while green lights increased referrals to hospitals with available capacity by 14 per cent this winter.
The Capacity Alert system was developed after NHS England commissioned the Behavioural Insights Team (BIT) to come up with ways of helping hospital trusts ease pressure on services.
Following the success of the trials in North East and South West London, BIT is now supporting the roll-out of the Capacity Alert system across the NHS in England.
NHS NATIONAL DEAL WITH MICROSOFT IMMINENT
The NHS is close to signing a new national contract with Microsoft to provide Windows 10 nationally.
The contract could cover upgrades to hundreds of thousands of NHS devices.
The deal will provide national funding for Windows 10 for all NHS organisations, likely in the form of free licenses . [The last national licensing contract between Microsoft and the NHS, which was dropped by the Department of Health and Social Care in 2010, was worth £500m over 12 years.] The new deal is likely to be less generous and cover fewer products.
An Executive update to Dorset Clinical Commissioning Group’s Board last month, raised concerns about insufficient financial support to upgrade IT hardware to support Windows 10. The update said the deal would not cover Office 365.
The news comes after the Commons public accounts committee released its review on Wednesday of the impact on the NHS of last May’s global WannaCry ransom-ware attack. More than 80 NHS trusts and hundreds of GP practices were disrupted by the virus, leading to ambulance diversions and thousands of appointments being cancelled.
Following an NHS England review in February, the DHSC announced that over the next three years at least £175m would be shifted from other national IT projects to boost cyber security.
The deal is not the first between Microsoft and NHS Digital since WannaCry. In January, NHS Digital agreed to pay the company £5m a year to boost its cyberthreat detection capabilities.
The national deal to supply Windows 10 would be a much broader agreement, potentially covering upgrades to hundreds of thousands devices in the NHS.
The NHS is close to signing a new national contract with Microsoft to provide Windows 10 nationally.
The contract could cover upgrades to hundreds of thousands of NHS devices.
The deal will provide national funding for Windows 10 for all NHS organisations, likely in the form of free licenses . [The last national licensing contract between Microsoft and the NHS, which was dropped by the Department of Health and Social Care in 2010, was worth £500m over 12 years.] The new deal is likely to be less generous and cover fewer products.
An Executive update to Dorset Clinical Commissioning Group’s Board last month, raised concerns about insufficient financial support to upgrade IT hardware to support Windows 10. The update said the deal would not cover Office 365.
The news comes after the Commons public accounts committee released its review on Wednesday of the impact on the NHS of last May’s global WannaCry ransom-ware attack. More than 80 NHS trusts and hundreds of GP practices were disrupted by the virus, leading to ambulance diversions and thousands of appointments being cancelled.
Following an NHS England review in February, the DHSC announced that over the next three years at least £175m would be shifted from other national IT projects to boost cyber security.
The deal is not the first between Microsoft and NHS Digital since WannaCry. In January, NHS Digital agreed to pay the company £5m a year to boost its cyberthreat detection capabilities.
The national deal to supply Windows 10 would be a much broader agreement, potentially covering upgrades to hundreds of thousands devices in the NHS.
SIX NON-EXECUTIVE DIRECTORS WANTED FOR NHS IMPROVEMENT
Six new Non-Executive Directors are to be appointed to NHS Improvement in a major shake-up of its Board.
Four of the vacancies are because current Non-Executives are reaching the end of their term and two positions have been vacant for some time.
The Non-Executives whose terms expire this year are: Lord Carter; Lord Darzi; Sigurd Reinton; and Sarah Harkness.
Their departures combined with the two vacant posts – last occupied by Caroline Thomson and Laura Carstensen – will leave Richard Douglas and Dame Glynis Breakwell as Non-Executives and David Roberts as an Associate Non-Executive.
With so many appointments to be made at the same time, new NHSI Chair, Baroness Harding, will have a rare opportunity to help shape her own Board. She is on the three-person Assessment Panel for the roles, alongside Lee McDonough, a Director from the Department of Health and Social Care, and NHS Digital Non-Executive Professor Sudhesh Kumar.
In a message for applicants, Baroness Harding said NHSI is looking for people “with considerable experience of leading transformational change in large organisations, who are collaborative and open minded and keen to be part of a diverse team of Executives and Non-Executives.”
Among the skills, it is looking for are experience of “property transformation”.
NHSI Non-Executives cannot be appointed for more than four years, but they can be reappointed for additional terms.
Odgers Berndtson has been appointed to help with recruitment.
The closing date is TUESDAY, 08 MAY
Six new Non-Executive Directors are to be appointed to NHS Improvement in a major shake-up of its Board.
Four of the vacancies are because current Non-Executives are reaching the end of their term and two positions have been vacant for some time.
The Non-Executives whose terms expire this year are: Lord Carter; Lord Darzi; Sigurd Reinton; and Sarah Harkness.
Their departures combined with the two vacant posts – last occupied by Caroline Thomson and Laura Carstensen – will leave Richard Douglas and Dame Glynis Breakwell as Non-Executives and David Roberts as an Associate Non-Executive.
With so many appointments to be made at the same time, new NHSI Chair, Baroness Harding, will have a rare opportunity to help shape her own Board. She is on the three-person Assessment Panel for the roles, alongside Lee McDonough, a Director from the Department of Health and Social Care, and NHS Digital Non-Executive Professor Sudhesh Kumar.
In a message for applicants, Baroness Harding said NHSI is looking for people “with considerable experience of leading transformational change in large organisations, who are collaborative and open minded and keen to be part of a diverse team of Executives and Non-Executives.”
Among the skills, it is looking for are experience of “property transformation”.
NHSI Non-Executives cannot be appointed for more than four years, but they can be reappointed for additional terms.
Odgers Berndtson has been appointed to help with recruitment.
The closing date is TUESDAY, 08 MAY
NEW DATA PROTECTION REGULATIONS (GDPR)
These frequently asked questions aim to help HR departments in the NHS ensure they are compliant with GDPR. From 25 May 2018, all health organisations and arm's-length bodies will need to demonstrate compliance with new General Data Protection Requirements (GDPR). This document is produced in conjunction with Capsticks, national specialists in healthcare employment law, and includes:
|
'DELIVEROO TYPE' PHARMACY APP
Clinicians have raised concerns over the safety of a “Deliveroo type” Pharmacy App that has been ‘supported’ by NHS England and NHS Digital.
The South West Yorkshire Area Prescribing Committee has raised concerns over the “safety and governance” of a prescription delivery App called Echo, after a patient ordered the wrong strength of medication.
Echo is an online delivery service that allows patients to order repeat prescriptions from their GP and have them delivered by post by Echo, after being supplied by two other pharmacy firms which the company is working with.
The App’s founders described the model as a “Deliveroo type” service, which has “support from NHS Digital and NHS England”. It is on NHS Digital’s App library.
Co-founder Stephen Bourke argued it may “have better insight into whether or not there is a prescribing error, and whether or not a patient understands what they’ve asked for” than traditional Pharmacy, due to the data the company has access to.
Echo Clinical Director, Alistair Murray, said that when a patient orders their prescription through the App, it is assessed and sent to their GP. The GP will issue a prescription that is “sense checked” against the original order to flag any differences. The partner Pharmacy can also access the patient’s summary care record.
The RCGP Chair added, “We also hear about patients obtaining potentially harmful medications, such as antibiotics, sleeping tablets or opioid painkillers - on the basis of their answers to vague online questionnaires - and often from people who are unaware of their full medical or medication history. This can have serious consequences on their health and wellbeing.”
Because Echo is neither a Pharmacy nor Dispensary, it is not regulated by the CQC or the General Pharmaceutical Council.
An NHSE spokesman said: “NHS England is working with a range of services to improve digital access to care as the NHS turns 70, including Pharmacies and GPs, in order to develop new solutions to improve clinical communication as part of digital primary care.”
The CQC declined to comment.
Clinicians have raised concerns over the safety of a “Deliveroo type” Pharmacy App that has been ‘supported’ by NHS England and NHS Digital.
The South West Yorkshire Area Prescribing Committee has raised concerns over the “safety and governance” of a prescription delivery App called Echo, after a patient ordered the wrong strength of medication.
Echo is an online delivery service that allows patients to order repeat prescriptions from their GP and have them delivered by post by Echo, after being supplied by two other pharmacy firms which the company is working with.
The App’s founders described the model as a “Deliveroo type” service, which has “support from NHS Digital and NHS England”. It is on NHS Digital’s App library.
Co-founder Stephen Bourke argued it may “have better insight into whether or not there is a prescribing error, and whether or not a patient understands what they’ve asked for” than traditional Pharmacy, due to the data the company has access to.
Echo Clinical Director, Alistair Murray, said that when a patient orders their prescription through the App, it is assessed and sent to their GP. The GP will issue a prescription that is “sense checked” against the original order to flag any differences. The partner Pharmacy can also access the patient’s summary care record.
The RCGP Chair added, “We also hear about patients obtaining potentially harmful medications, such as antibiotics, sleeping tablets or opioid painkillers - on the basis of their answers to vague online questionnaires - and often from people who are unaware of their full medical or medication history. This can have serious consequences on their health and wellbeing.”
Because Echo is neither a Pharmacy nor Dispensary, it is not regulated by the CQC or the General Pharmaceutical Council.
An NHSE spokesman said: “NHS England is working with a range of services to improve digital access to care as the NHS turns 70, including Pharmacies and GPs, in order to develop new solutions to improve clinical communication as part of digital primary care.”
The CQC declined to comment.
'ENTIRELY INAPPROPRIATE' SHARING OF PATIENT DATE WITH HOME OFFICE - 15 April 2018
Letter from Chair of Commons Health and Social Care Committee, attached
MPs have warned the government is leaving the door open to widespread sharing of patients’ confidential details beyond the NHS without their consent or knowledge.
The Commons health and social care committee has published its first report on NHS Digital and the Department of Health and Social Care’s agreement to share NHS patients’ confidential information with the Home Office, to help track suspected illegal immigrants.
Sarah Wilkinson said ‘it is in the public interest to share limited demographic data’
Since the agreement came into effect in January 2017, NHS Digital – the designated “safe haven” for NHS patient data – has passed thousands of people’s non-clinical confidential information, such as their address and registered GP, to the Home Office
The report, published today, [https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/677/67702.htm] follows tense committee hearings earlier this year when NHS Digital executives refused to suspend data sharing. The report said MPs had “serious concerns” about government policy on the sharing of confidential patient information and “NHS Digital’s role as a steward of health and social care data”.
The Committee said the arrangement with the Home Office could lead to “more widespread” sharing with other government departments.
“The Committee continues to have serious concerns about government policy on the confidentiality of address data collected for the purposes of health and social care and in particular the risk that data sharing without patients’ knowledge or consent could become more widespread,” the MPs said.
The agreement also contradicted the NHS and General Medical Council codes of confidentiality and NHS Digital’s own guidance, which only allows for the sharing of this information when a “serious crime” has occurred – a standard immigration offences failed to meet, the report said.
The report continued: “As demonstrated by the Care.data experience, the success of such data sharing depends crucially on public consent and confidence in NHS Digital’s commitment to respecting confidentiality. Its actions in this case risk undermining that confidence.”
Committee Chair, Sarah Wollaston said: “NHS Digital’s decision to routinely share information with the Home Office with a lower threshold is entirely inappropriate. This behaviour calls into question NHS Digital’s ability to robustly act on behalf of patients in the event of other data sharing requests including from other government departments in the future.”
The Committee repeated its demand to suspend sharing of patient information with the Home Office until a review of the NHS code of confidentiality was completed.
Responding to the report, NHS Digital Chief Executive, Sarah Wilkinson, reiterated that the sharing of patient data with the Home Office was lawful. She said: “We will consider the health select committee’s report carefully and will take into account any new evidence as it becomes available, but we have been through a rigorous process to assess the release of demographic data to the Home Office. This has established that there is a legal basis for the release and has assured us that it is in the public interest to share limited demographic data in very specific circumstances.”
During the hearings, the Committee heard evidence that the agreement had undermined public trust in the NHS, could discourage migrants from seeking NHS care, undermine public health and set a precedent for further data sharing.
The national data guardian, Public Health England, the British Medical Association medical ethics committee and several migrant support groups have all raised concerns about the agreement.
John Chisholm, Chair of the BMA Medical Ethics Committee, said the report showed the data sharing “risks undermining the very foundation of the doctor-patient relationship”. He added: “Most immigration offences clearly do not meet the high public interest threshold for releasing confidential data, which according to NHS England, the GMC and even NHS Digital’s own guidance, should be reserved for cases that involve ‘serious’ crime.
“We must, therefore, question NHS Digital’s ability to act as a trusted custodian for the data it holds and its assertion that it prioritises patients’ best interests when handling their data.”
Royal College of GPs Chair, Professor Helen Stokes-Lampard, said: “The Home Office is displaying a blatant disregard for the trusted and vital GP-patient relationship. Its casual approach to confidential patient data risks alienating highly vulnerable patients. “It is treating GP patient data like the Yellow Pages. We are calling on NHS Digital to take urgent measures to suspend the agreement that is allowing them to do so.”
Letter from Chair of Commons Health and Social Care Committee, attached
MPs have warned the government is leaving the door open to widespread sharing of patients’ confidential details beyond the NHS without their consent or knowledge.
The Commons health and social care committee has published its first report on NHS Digital and the Department of Health and Social Care’s agreement to share NHS patients’ confidential information with the Home Office, to help track suspected illegal immigrants.
Sarah Wilkinson said ‘it is in the public interest to share limited demographic data’
Since the agreement came into effect in January 2017, NHS Digital – the designated “safe haven” for NHS patient data – has passed thousands of people’s non-clinical confidential information, such as their address and registered GP, to the Home Office
The report, published today, [https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/677/67702.htm] follows tense committee hearings earlier this year when NHS Digital executives refused to suspend data sharing. The report said MPs had “serious concerns” about government policy on the sharing of confidential patient information and “NHS Digital’s role as a steward of health and social care data”.
The Committee said the arrangement with the Home Office could lead to “more widespread” sharing with other government departments.
“The Committee continues to have serious concerns about government policy on the confidentiality of address data collected for the purposes of health and social care and in particular the risk that data sharing without patients’ knowledge or consent could become more widespread,” the MPs said.
The agreement also contradicted the NHS and General Medical Council codes of confidentiality and NHS Digital’s own guidance, which only allows for the sharing of this information when a “serious crime” has occurred – a standard immigration offences failed to meet, the report said.
The report continued: “As demonstrated by the Care.data experience, the success of such data sharing depends crucially on public consent and confidence in NHS Digital’s commitment to respecting confidentiality. Its actions in this case risk undermining that confidence.”
Committee Chair, Sarah Wollaston said: “NHS Digital’s decision to routinely share information with the Home Office with a lower threshold is entirely inappropriate. This behaviour calls into question NHS Digital’s ability to robustly act on behalf of patients in the event of other data sharing requests including from other government departments in the future.”
The Committee repeated its demand to suspend sharing of patient information with the Home Office until a review of the NHS code of confidentiality was completed.
Responding to the report, NHS Digital Chief Executive, Sarah Wilkinson, reiterated that the sharing of patient data with the Home Office was lawful. She said: “We will consider the health select committee’s report carefully and will take into account any new evidence as it becomes available, but we have been through a rigorous process to assess the release of demographic data to the Home Office. This has established that there is a legal basis for the release and has assured us that it is in the public interest to share limited demographic data in very specific circumstances.”
During the hearings, the Committee heard evidence that the agreement had undermined public trust in the NHS, could discourage migrants from seeking NHS care, undermine public health and set a precedent for further data sharing.
The national data guardian, Public Health England, the British Medical Association medical ethics committee and several migrant support groups have all raised concerns about the agreement.
John Chisholm, Chair of the BMA Medical Ethics Committee, said the report showed the data sharing “risks undermining the very foundation of the doctor-patient relationship”. He added: “Most immigration offences clearly do not meet the high public interest threshold for releasing confidential data, which according to NHS England, the GMC and even NHS Digital’s own guidance, should be reserved for cases that involve ‘serious’ crime.
“We must, therefore, question NHS Digital’s ability to act as a trusted custodian for the data it holds and its assertion that it prioritises patients’ best interests when handling their data.”
Royal College of GPs Chair, Professor Helen Stokes-Lampard, said: “The Home Office is displaying a blatant disregard for the trusted and vital GP-patient relationship. Its casual approach to confidential patient data risks alienating highly vulnerable patients. “It is treating GP patient data like the Yellow Pages. We are calling on NHS Digital to take urgent measures to suspend the agreement that is allowing them to do so.”
CQC - NATIONAL ENQUIRY INTO ABUSE OF MENTAL HEALTH PATIENTS
An investigation into how mental health patients are protected from sexual abuse has been launched by the Care Quality Commission, after it identified 900 incidents on wards across the NHS in just three months.
The regulator’s action comes after it found a trust breaching guidance on eliminating mixed sex accommodation. Paul Lelliot: ‘Our priority continues to be ensuring people using healthcare services are kept safe’
Today, the CQC has written (see below) to every mental health trust nursing director about improving sexual safety on mental health wards.
An investigation into how mental health patients are protected from sexual abuse has been launched by the Care Quality Commission, after it identified 900 incidents on wards across the NHS in just three months.
The regulator’s action comes after it found a trust breaching guidance on eliminating mixed sex accommodation. Paul Lelliot: ‘Our priority continues to be ensuring people using healthcare services are kept safe’
Today, the CQC has written (see below) to every mental health trust nursing director about improving sexual safety on mental health wards.
THE CGC's LETTER RE. SEXUAL ABUSE - from Dr. Paul Lelliott, Deputy Chief Inspector of Hospitals (Lead for Mental Health) . 11 April 2018 ... 2 pages
Sexual safety on Mental Health Wards . What alerted us to this issue? . What work have we done to explore this issue further?
Sexual safety on Mental Health Wards . What alerted us to this issue? . What work have we done to explore this issue further?
ONLINE CONSULTATIONS IN GENERAL PRACTICE: THE QUESTIONS TO ASK
7 pages
Introduction - If you are a patient using online services to get care . - If you are a GP considering working for an online provider . If you are a practice considering purchasing an online system . If you are an SPT, Health Board, CCG or Practice Network considering commissioning an online system for your locality
7 pages
Introduction - If you are a patient using online services to get care . - If you are a GP considering working for an online provider . If you are a practice considering purchasing an online system . If you are an SPT, Health Board, CCG or Practice Network considering commissioning an online system for your locality
It also recommends that patients ensure the service has been inspected by the Care Quality Commission, or equivalent bodies outside of England; look into how their personal information will be kept safe; and consider whether it is providing a free NHS service, or if a fee will be required.
The guidance comes as a growing number of services offering consultations online, most commonly via a smartphone apps, are hitting the market. Whilst many of these are private, some have developed partnerships with GP practices in order to deliver NHS care.
The new document, which is available to download, also outlines considerations for GPs and GP practices considering using or implementing online consultation services.
It also includes advice for commissioning bodies such as Clinical Commissioning Groups in England that might be considering a system for their local population – one question being whether the system is likely to address current demand or generate new demand, and if the latter, what resources are available to meet it.
Professor Martin Marshall, Vice Chair of the RCGP and author of the guidance, said: "Technology is being used more and more in every aspect of our lives and general practice has always been a trailblazer in this respect.
"Online consultations can seem like a very convenient option for accessing general practice services, particularly for young, generally healthy people who want to see a GP quickly. "But the ways some online services are provided raise patient safety concerns - people need to be aware of these, and properly understand what they are signing up to. Often, for example, patients will have consultations with unfamiliar GPs who don't have access to their full patient records.
"The College recognises that online consultations can be beneficial for patients, and indeed many practices across the country are already implementing in some form. However, we want to ensure that they are being implemented in a way that is safe for patients, and alleviates pressures in general practice and across the NHS. We also think that online consultations should be provided in addition to traditional services, not instead of them.
"We hope this guidance will help everyone – patients, GPs, practice team members and commissioners - gain a better insight into online consultations, and, most importantly, help equip them with the information they need, so that patients are receiving high-quality, safe care, whichever way they choose to receive it."
Further Information ... RCGP Press office: 020 3188 7574/7575/7633/7410
Out of hours: 0203 188 7659
[email protected]
The guidance comes as a growing number of services offering consultations online, most commonly via a smartphone apps, are hitting the market. Whilst many of these are private, some have developed partnerships with GP practices in order to deliver NHS care.
The new document, which is available to download, also outlines considerations for GPs and GP practices considering using or implementing online consultation services.
It also includes advice for commissioning bodies such as Clinical Commissioning Groups in England that might be considering a system for their local population – one question being whether the system is likely to address current demand or generate new demand, and if the latter, what resources are available to meet it.
Professor Martin Marshall, Vice Chair of the RCGP and author of the guidance, said: "Technology is being used more and more in every aspect of our lives and general practice has always been a trailblazer in this respect.
"Online consultations can seem like a very convenient option for accessing general practice services, particularly for young, generally healthy people who want to see a GP quickly. "But the ways some online services are provided raise patient safety concerns - people need to be aware of these, and properly understand what they are signing up to. Often, for example, patients will have consultations with unfamiliar GPs who don't have access to their full patient records.
"The College recognises that online consultations can be beneficial for patients, and indeed many practices across the country are already implementing in some form. However, we want to ensure that they are being implemented in a way that is safe for patients, and alleviates pressures in general practice and across the NHS. We also think that online consultations should be provided in addition to traditional services, not instead of them.
"We hope this guidance will help everyone – patients, GPs, practice team members and commissioners - gain a better insight into online consultations, and, most importantly, help equip them with the information they need, so that patients are receiving high-quality, safe care, whichever way they choose to receive it."
Further Information ... RCGP Press office: 020 3188 7574/7575/7633/7410
Out of hours: 0203 188 7659
[email protected]
COMPLAINTS - 2017/18 NHS complaints data return
The NHS has a statutory responsibility to collect service-wide information on patient complaints so trends can be identified and the service is shown to be responsive to patient feedback.
For queries relating to the categorisation of complaints received during the year, contact NHS Digital at
[email protected]
The NHS has a statutory responsibility to collect service-wide information on patient complaints so trends can be identified and the service is shown to be responsive to patient feedback.
For queries relating to the categorisation of complaints received during the year, contact NHS Digital at
[email protected]
LIBRARY OF ENTER AND VIEW - LHW
https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.patientlibrary.net%2Fcgi-bin%2Flibrary.cgi%3Fpage%3DEVMAP%3Bprevref%3D&data=02%7C01%7C%7Ce8ad63d190044a7bb0ba08d5a049d1c4%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636591161260432337&sdata=SCDdstPapcTbes9c7yt%2Bxv02Dx8UfKWj4UpSbkP2HxY%3D&reserved=0
Scroll down to the end and browse the "All reports" map, or visit the "Enter and View" map to see how Local Healthwatch are reporting on visits to local health and care providers.
The Enter and View map also shows all nearby CQC inspection reports.
https://eur02.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.patientlibrary.net%2Fcgi-bin%2Flibrary.cgi%3Fpage%3DEVMAP%3Bprevref%3D&data=02%7C01%7C%7Ce8ad63d190044a7bb0ba08d5a049d1c4%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C636591161260432337&sdata=SCDdstPapcTbes9c7yt%2Bxv02Dx8UfKWj4UpSbkP2HxY%3D&reserved=0
Scroll down to the end and browse the "All reports" map, or visit the "Enter and View" map to see how Local Healthwatch are reporting on visits to local health and care providers.
The Enter and View map also shows all nearby CQC inspection reports.
WHAT YOUR GP WILL NO LONGER PRESCRIBE
36 pages NHS England has published guidance on conditions for which over-the-counter items available at the chemist/pharmacist] should not routinely be prescribed in primary care. NHS England is asking CCGs to take the guidance into account in formulating local policies as well as in prescribing practice. https://www.pcc-cic.org.uk/article/guidance-prescribing-over-counter-medicines-primary-care |
WHO WILL REGULATE WHAT?
Not only will STPs and ICSs be a vehicle for leading transformation and supporting the long term sustainability of local health economies, they will also be involved in the oversight of the performance of organisations within their footprint.
But there have been no legal changes to the accountabilities and statutory duties of Trusts or the Regulators, and STPs and ICSs have no legal status and derive their decision-making powers from the statutory bodies which comprise them. This means that NHS Improvement is still required to hold individual Trusts to account for their performance, and if performance is at risk, it is still NHS Improvement that will be required to intervene.
A model is emerging in which trusts are held to account by their Clinical Commissioning Groups, NHS Improvement, Care Quality Commission and also their STP or ICS.
Trusts already feel that the regulatory system is hugely burdensome.
https://www.hsj.co.uk/policy-and-regulation/the-importance-of-a-proportionate-regulatory-system/7022120.article?mkt_tok=eyJpIjoiWVRNeU1HSTVZbVUzTkRSaiIsInQiOiJiV3Rzdmk2N1ZyQm15UDUxWEZ4aUt3ZHlseWd2QVV2ZUhreVBXNHpxamNoSHRQNldOVndOOTZzd3EwYk5uR2xQWE1WYmJqdzgrNTUraVdUZGVKdXVYUzEycmc2a1ZNeElHZHF0UndHV05veGNsZ0U1UlVnZ2tsd1d5dVwvcW5jSXMifQ%3D%3D
Not only will STPs and ICSs be a vehicle for leading transformation and supporting the long term sustainability of local health economies, they will also be involved in the oversight of the performance of organisations within their footprint.
But there have been no legal changes to the accountabilities and statutory duties of Trusts or the Regulators, and STPs and ICSs have no legal status and derive their decision-making powers from the statutory bodies which comprise them. This means that NHS Improvement is still required to hold individual Trusts to account for their performance, and if performance is at risk, it is still NHS Improvement that will be required to intervene.
A model is emerging in which trusts are held to account by their Clinical Commissioning Groups, NHS Improvement, Care Quality Commission and also their STP or ICS.
Trusts already feel that the regulatory system is hugely burdensome.
https://www.hsj.co.uk/policy-and-regulation/the-importance-of-a-proportionate-regulatory-system/7022120.article?mkt_tok=eyJpIjoiWVRNeU1HSTVZbVUzTkRSaiIsInQiOiJiV3Rzdmk2N1ZyQm15UDUxWEZ4aUt3ZHlseWd2QVV2ZUhreVBXNHpxamNoSHRQNldOVndOOTZzd3EwYk5uR2xQWE1WYmJqdzgrNTUraVdUZGVKdXVYUzEycmc2a1ZNeElHZHF0UndHV05veGNsZ0U1UlVnZ2tsd1d5dVwvcW5jSXMifQ%3D%3D
ANOTHER CARTER RECOMMENDATION ABANDONED
NHS Improvement has dropped a target in the Carter efficiency review for Trusts to cut their back office costs.
The regulator confirmed last week it did not know which Trusts had reduced these costs to 7 per cent or less of turnover, as Lord Carter suggested they should in February 2016.
Lord Carter’s report said Hospital Trusts attributed £4.3bn of workforce spending to corporate back office and operational administration costs, with an “inexplicable” variation in costs of between six and 11 per cent of turnover.
Trusts were supposed to have produced a plan by October 2016, for reducing these costs to no more than seven per cent and to have achieved those savings by the end of 2017-18.
NHSI accepted the recommendation at the time, but last week said it would instead track delivery only through general savings plans produced by Trusts.
The regulator, however, is not holding Trusts to the 7 per cent target, and is not measuring the proportion of turnover spent on back office functions.
NHS Improvement has dropped a target in the Carter efficiency review for Trusts to cut their back office costs.
The regulator confirmed last week it did not know which Trusts had reduced these costs to 7 per cent or less of turnover, as Lord Carter suggested they should in February 2016.
Lord Carter’s report said Hospital Trusts attributed £4.3bn of workforce spending to corporate back office and operational administration costs, with an “inexplicable” variation in costs of between six and 11 per cent of turnover.
Trusts were supposed to have produced a plan by October 2016, for reducing these costs to no more than seven per cent and to have achieved those savings by the end of 2017-18.
NHSI accepted the recommendation at the time, but last week said it would instead track delivery only through general savings plans produced by Trusts.
The regulator, however, is not holding Trusts to the 7 per cent target, and is not measuring the proportion of turnover spent on back office functions.
'ACTIVATED' PATIENTS ARE CHEAPER TO TREAT
7 pages
'Patient activation' is the process of making people more knowledgeable and confident about their own care.
Research suggested that 'activated' patients are cheaper to treat and benefit from improved health outcomes.
7 pages
'Patient activation' is the process of making people more knowledgeable and confident about their own care.
Research suggested that 'activated' patients are cheaper to treat and benefit from improved health outcomes.
WHO MUST CONSULT WHOM AND WHEN - Update ... Planning, assuring and delivering service change for patients.
NHS England has published guidance for those considering or making substantial service change.https://www.england.nhs.uk/wp-content/uploads/2018/03/planning-assuring-and-delivering-service-change-v6-2018.pdf Content Executive Summary . Overview of Roles and Responsibilities . Assurance of Service Change . Service Change . The Assurance Process . Planning Service Change . Decision Annexes |
STP in the NHS
A Parliamentary Report concludes that the Department of Health and Social Care’s system for funding and financially supporting the NHS, focuses too much on short-term survival and limits the NHS’s ability to transform services to achieve sustainability in the long term. https://publications.parliament.uk/pa/cm201719/cmselect/cmpubacc/793/793.pdf Content Summary . Introduction . Conclusions and Recommendations . Formal Minutes Witnesses . Published Written Evidence . Published Correspondence . List of Reports from the Committee during the current Session |
EXCLUSIVE: GOVERNMENT TO WATER DOWN MEDICAL EXAMINER PLANS
Post-Shipman 'medical examiner' plans watered down ... 2 pages
Post-Shipman 'medical examiner' plans watered down ... 2 pages
NEW MONIES TO NHS - 70th BIRTHDAY ... 2 pages
Forty NHS hospitals and community services will get £760 million to modernise and transform their buildings and services in the year of the NHS’s 70th birthday.
The government is also releasing £150 million to support the NHS’s work to become more efficient. This additional money will be used to:
Forty NHS hospitals and community services will get £760 million to modernise and transform their buildings and services in the year of the NHS’s 70th birthday.
The government is also releasing £150 million to support the NHS’s work to become more efficient. This additional money will be used to:
- Improve the use of a digital programme that helps the NHS use its workforce better
- Enable more efficient use of energy in hospitals, which could save the NHS £12 million a year in the first 3 years
- Improve pharmacy IT and administration systems to reduce medication errors and improve patient safety
MUST TRY HARDER
The commitment in NHS England’s ‘General Practice Forward View’ (April 2016) is to reduce duplication and administrative workload for health professionals as a result of regulation.
Yet there remain 11 national organisations responsible for the regulation and oversight of general practice in England.
These are:
The commitment in NHS England’s ‘General Practice Forward View’ (April 2016) is to reduce duplication and administrative workload for health professionals as a result of regulation.
Yet there remain 11 national organisations responsible for the regulation and oversight of general practice in England.
These are:
CQC SEEKS MORE INSPECTORS AS WORKLOAD MOUNTS
The Care Quality Commission is to recruit an extra 100 inspectors this year amid concerns from staff over unmanageable workloads.
The regulator has moved to an “always on” approach to recruitment after underspending on pay costs by £10.2m in the nine months to December due to a failure to recruit sufficient staff.
A survey of CQC staff found the size of the workload was a key source of disquiet. The worst affected directorate was adult social care where only 22 per cent of staff agreed their workload was manageable. The next lowest score was the hospital directorate at 54 per cent.
Following the survey, the regulator has said it would work to bring both directorates up to their full staffing establishment. The primary medical services directorate is already at full establishment. The recruitment is scheduled to be completed by the end of this month.
In addition, 100 inspectors will be recruited after March to boost staffing levels and address “skill mix issues”.
The CQC said it hoped to reduce the time between a member of staff leaving their job and a replacement arriving by launching the “always on” recruitment policy.
Finance director Kate Harrison told the CQC board: “The pay underspend is very much due to recruitment not having gone as well as it could do.
“At the end of Q3 we were underspent having a net surplus of £8.1m, which is made up of an underspend on £10.2m offset by an under recovery on income of £1.6m.
“We are still forecasting a surplus of around £10.2m, that is largely on pay although some still on non-pay due to the continued drive for efficiency on the non-pay area and linked to that is colleagues in the people directorate are moving to an always on recruitment model, so next year we are hoping that will enable us to have a steady stream of people coming in and we are not underspending on pay. Any underspend that we do have will be taken into a reserve held by the CQC and used for the benefit of fee payers.”
She added that the CQC will face increasing financial pressures during the next two years: “We still have a need to reduce expenditure next year. We will have a budget of £223m next year, the following year we will have a budget of £217m so we still need to take money out of the system and we need to achieve quite a lot of change during that period.
The Care Quality Commission is to recruit an extra 100 inspectors this year amid concerns from staff over unmanageable workloads.
The regulator has moved to an “always on” approach to recruitment after underspending on pay costs by £10.2m in the nine months to December due to a failure to recruit sufficient staff.
A survey of CQC staff found the size of the workload was a key source of disquiet. The worst affected directorate was adult social care where only 22 per cent of staff agreed their workload was manageable. The next lowest score was the hospital directorate at 54 per cent.
Following the survey, the regulator has said it would work to bring both directorates up to their full staffing establishment. The primary medical services directorate is already at full establishment. The recruitment is scheduled to be completed by the end of this month.
In addition, 100 inspectors will be recruited after March to boost staffing levels and address “skill mix issues”.
The CQC said it hoped to reduce the time between a member of staff leaving their job and a replacement arriving by launching the “always on” recruitment policy.
Finance director Kate Harrison told the CQC board: “The pay underspend is very much due to recruitment not having gone as well as it could do.
“At the end of Q3 we were underspent having a net surplus of £8.1m, which is made up of an underspend on £10.2m offset by an under recovery on income of £1.6m.
“We are still forecasting a surplus of around £10.2m, that is largely on pay although some still on non-pay due to the continued drive for efficiency on the non-pay area and linked to that is colleagues in the people directorate are moving to an always on recruitment model, so next year we are hoping that will enable us to have a steady stream of people coming in and we are not underspending on pay. Any underspend that we do have will be taken into a reserve held by the CQC and used for the benefit of fee payers.”
She added that the CQC will face increasing financial pressures during the next two years: “We still have a need to reduce expenditure next year. We will have a budget of £223m next year, the following year we will have a budget of £217m so we still need to take money out of the system and we need to achieve quite a lot of change during that period.
FAILURE TO CONSULT
CCG loses judicial review for failure to consult Overview and Scrutiny
A High Court judgment* this week against the NHS in Hertfordshire is a timely reminder to all CCGs in England that a failure to consult Overview & Scrutiny Committees have serious consequences.
The full story is described in a press release from the Claimants’ lawyers and concerns the withdrawal of funding for a respite centre for disabled children in Watford, called Nascot Lawn. The case is probably the first time that part of the NHS has tried to justify by-passing a local authority and sought to defend a failure to observe the 2013 Regulations on Health Scrutiny.
CCG loses judicial review for failure to consult Overview and Scrutiny
A High Court judgment* this week against the NHS in Hertfordshire is a timely reminder to all CCGs in England that a failure to consult Overview & Scrutiny Committees have serious consequences.
The full story is described in a press release from the Claimants’ lawyers and concerns the withdrawal of funding for a respite centre for disabled children in Watford, called Nascot Lawn. The case is probably the first time that part of the NHS has tried to justify by-passing a local authority and sought to defend a failure to observe the 2013 Regulations on Health Scrutiny.