Nicholas Timmins

NCS. Get used to it. If Labour wins the next election, there will, inevitably it appears be a National Care Service to sit alongside the NHS.

And amid all the sound and fury, the all heat and no light controversy that Labour and the Tories are generating between them over the future of social care funding, this is one of the worst bits.

For what does a National Care Service, particularly when put along side the NHS, imply? Well, a largely free at the point of use tax-funded service, of course. Which is what it will not be, whatever solution, if any, finally emerges. So the very definition of this new service contains an implied lie.

Nicholas Timmins

The private sector has established a small but significant bridgehead in general practice in England, but any “corporate takeover” of family doctor surgeries remains a long way off.Primary care trusts have been commissioning some 260 “GP-led health centres”, or “polyclinics”, open 8am to 8pm, seven days a week – one in each primary care trust and a further 110 or so in areas short of doctors.

Continue reading ‘Private companies beef up UK GP presence’

Nicholas Timmins

Sometimes you really do wonder whether the Conservatives are remotely ready for government. The travails of the NHS’s £12.7bn project to create an electronic medical record for all are well known. The health department has just come up with its latest plan to rescue it.

Your guess is as good as mine about whether it will work. But it at least applies to the real world. At the Conservative spring conference at the weekend, David Cameron, the Tory leader, was talking about what he quaintly calls the “NHS supercomputer” as though this was some mighty black box sat in a field somewhere in the middle of England.

Not needed, he said, because “in this age of austerity, a web-based version of the government’s bureaucratic services like Google Health or Microsoft Health Vault cost virtually nothing to run”.

The Conservatives have clearly been listening to snake oil salesmen. Applications like these may well play an important part of patient controlled, and patient accessed, records. But the idea that either of these remotely amount to the patient administration system, appointment booking, test ordering and recording, digital imaging equipment, clinical coding, the decision support systems and the myriad other items needed in a hospital or GP practice to create a full electronic record in the first place is laughable. It really is not a choice between £12.7bn and “virtually nothing”.

Nicholas Timmins

“Whenever we introduce this,” says Clare Dollery, a consultant cardiologist at the Heart Hospital in London, “lots of clinicians come up to me and say, ‘This is the sort of information we have been asking for for years.’ “The information is a set of data showing the clinician team’s activity, its broad costs, whether or not it is making a profit against the tariff – the price the National Health Service pays hospitals per procedure or treatment – plus, crucially, a lot of data on quality.

These are as diverse as infection and readmission rates, length of hospital stay, survival data and, for example, the time elapsed between a heart attack patient arriving and the coronary arteries being opened again, and how that compares with other hospitals both domestically and internationally.

Nicholas Timmins

The NHS and the Department of Health took the biggest hit yesterday as the government allocated its £5bn cut in public spending for next year, which it claims will be made up by efficiency savings.The NHS has to make virtually half the savings – £2.3bn – on top of the 3 per cent-a-year savings with which it was already charged. Next year’s budget has been cut from a planned £104.6bn to £102.3bn, but that will still represent £4bn in growth over this year.

Nicholas Timmins

Poor infection control saw a score of NHS organisations threatened on Thursday with potential fines as the new health regulator bared its teeth on its first day.

Insufficient attention to infection control saw the Care Quality Commission (CQC) impose conditions on the licences of 21 NHS trusts – six of them flagship foundation trusts.

Nicholas Timmins

A wake-up call to business to act to avoid big losses of productivity and profitability as its workforce ages was issued on Sunday by the Work Foundation and by Bupa, the health insurer.The warning came as the think-tank Reform said in a separate report that successful businesses were already investing to improve their employees’ health in what is becoming a Darwinian “survival of the fittest”.

Bupa’s study, undertaken with the Rand Corporation and Oxford Health Alliance, says the average age of the workforce will rise over the next 20 years as the population ages. As a result, millions of employees will be working while suffering long-term health conditions such as diabetes, heart disease, musculoskeletal complaints and mental illness as the average age of those at work rises from 39 to 43.

Nicholas Timmins

Raising the quality of health care is a growing obsession around the world, not least in the US and UK.

In England, the health minister Lord Darzi has declared that quality is to be “the organising principle” for the country’s National Health Service in future.

It certainly has not been in recent years, according to the Healthcare Commission, the health watchdog which this week comes to the end of its four year life to be replaced by a new Care Quality Commission that will cover both health and social care.

Nicholas Timmins

In Sellers and Yeatman’s phrase from 1066 And All That, the Healthcare Commission has on the whole been “a good thing”.

It is a pity therefore that its demise coincides with the worst regulatory failure of its history – the failure to spot, far, far, earlier what the commission itself called “appalling” standards of emergency care at the Mid-Staffordshire NHS Foundation Trust that led to an unknown, but possibly large number, of deaths.

Nicholas Timmins

A Staffordshire hospital was granted flagship status despite providing such “appalling” emergency care that “there is no doubt that patients will have suffered and some of them will have died”, the health service’s quality watchdog said on Tuesday.

Alan Johnson, the health secretary, apparently failed to pass on patients’ concerns at a time when Monitor, the foundation trust regulator, was considering Mid-Staffordshire NHS Trust’s application to become a foundation trust.

The remainder of the article can be read here. Please post comments below.

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Margaret McCartney is a Glasgow-based GP and FT Weekend columnist. She started writing for the Life and Arts section in 2005 and moved to the magazine in 2008. She also has her own blog: www.margaretmccartney.com/blog

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