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GP commissioners face unsustainable deficits, warns NAO

admin — Tue, 24 Jul 2012 02:58:53 +0000

GP commissioners risk inheriting ‘unsustainable’ deficits in NHS finances, warns a major report revealing that the DH was forced to spend £253m bailing out struggling hospitals last year.

The National Audit Office (NAO) report found that repeated DH bailouts for hospitals in deficit had totalled £1bn over the past five years. It said ‘urgent action’ is needed by many providers to avoid financial collapse and create a sustainable NHS.

Margaret Hyde, chairwoman of the House of Commons public accounts committee, described the finding that there had been a three-fold increase in bailouts as ‘shocking’.

‘It is shocking that over the past year alone the amount the DH has had to spend on bailing out trusts in financial difficulty rose by 333%; up from £76m in 2010/11 to £253m in 2011/12.’

Half of PCTs say they are worried about the financial sustainability of their healthcare providers and the NAO report said it was unclear whether clinical commissioning groups would provide financial support in the way that SHAs and PCTs have done.

The report reveals that despite the financial distress of some trusts there is a surplus of £2.1bn across the NHS as a whole. However, surplus funding held by foundation trusts cannot be reclaimed by the DH to transfer to other providers.

Commenting on this, the NAO said that if trusts are allowed to go bust, ‘it would be unacceptable for people in poorer communities to suffer from poorer health services as a result, exacerbating the postcode lottery that already exists’.

In the past year, 10 NHS trusts, 21 NHS foundation trusts and three PCTs reported a combined deficit of £356m and a PCT census shows that a further 15 NHS trusts and seven PCTs may have reported deficits had they not received direct financial support.

Support and bailouts
South London Healthcare NHS Trust has received significant support with bailouts reaching £79m while Barking and Havering and Redbridge University Hospitals NHS Trust received £55m.

The DH anticipates that NHS trusts and NHS foundation trusts are likely to need up to £300m more by the end of 2012/13.

Amyas Morse, head of the NAO, said that although the NHS is maintaining strong finances in a period of austerity it ‘is clear, however, that parts of the service are under strain’.

Mr Morse added: ‘For value for money to be delivered in future, two things are required: firstly, careful management of the risks created by transition to a new commissioning model; and, secondly a coherent and transparent financial support mechanism which outlines when trusts should be supported, or allowed to fail.’

Millions of hospital data errors ‘threaten GP commissioning’

admin — Tue, 24 Jul 2012 02:50:54 +0000

Hospitals in England are consistently failing to supply correct patient data to the wider NHS, which may undermine GP commissioning, according to a landmark report.

The NHS Information Centre (NHSIC) heavily criticised NHS trusts in England for the ‘poor quality’ of national data in health and social care. It also uncovered problems with certain local authorities.

Its report, the first of its kind, found that up to a fifth of data returns by some hospitals and councils contained errors in patient records.

The NHSIC said poor quality data can undermine efforts to plan commissioning and judge the performance of services.

It suggested the current NHS reforms had undermined data quality in the NHS, citing the ‘reorganisation and reconfiguration of services’ as a factor leading to poor data returns.

The centre reminded GP practices and hospitals that it is their duty to provide good quality data.

The Quality of Nationally Submitted Health and Social Care Data for England report examined the quality of a wide variety of datasets from across the NHS and social care.

Some hospitals made errors in up to 20% of returns when claiming fees under payment by results. On average, hospital trusts made errors in 7% of all data submissions, likely affecting millions of patients’ data.

Hospitals failed to record valid NHS numbers for 7% of patients admitted to A&E and one in 50 inpatients and outpatients.

NHSIC was forced to correct 5,000 patient records that had been accidentally duplicated by hospital trusts.

GP practices also submitted data of ‘variable quality’ when recording disease diagnosis.

Although overall data quality was high for adult social care, some councils performed poorly. Seven local authorities handed over returns with 15-20% of required data missing, while two had failed to fill in more than 20%.

The NHSIC found significant data concerns in the National Child Measurement Programme. Almost one in five (19%) height and weight measurements were found to have been rounded up to the nearest whole number. One in six (17%) children had no ethnicity code recorded. The NHSIC said this ‘may hinder use of the information both locally and nationally’.

‘National action required’

NHSIC found a lack of standards and guidance around data returns, as well as poor training and a failure to recognise the impact of poor quality data.

The centre urged GP commissioners, practices, hospitals and councils to review the findings and improve data quality, adding that ‘local and national action is required’ to create a ‘more consistent and coherent approach’.

NHSIC chief executive Tim Straughan said: ‘High quality information is essential for effective planning and commissioning and we want to see providers across the NHS give their fullest attention to ensuring accurate and comprehensive medical and managerial data.

‘We see these initial findings as a starting point from which we will track improvements in data quality year on year. Each trust has its own summary data quality report which will help them focus on any areas that they need to prioritise.’

Health minister Lord Howe said: ‘Access to good quality information is essential for NHS organisations to plan and improve services for patients and to drive up standards.

He said the report was the ‘first step’ in providing a more comprehensive picture of the quality of information being shared across health and social care. ‘We are shifting power to local healthcare organisations, doctors, nurses and other health professionals and it is essential that the data and information they collect is recorded accurately to help drive up standards for patients.’

He added: ‘These findings will help NHS providers improve their quality of data by allowing them to compare results and identify where to make improvements in how they capture and share information.’

In November 2010, the National Audit Office found data collection on cancer – in particular the stage of cancer with which the patient presented – was so poor many PCTs had little idea whether their commissioning benefited patients or offered value for money.

Brighton and Hove Transitional Consortium

admin — Wed, 06 Jun 2012 16:45:22 +0000

Brighton and Hove Transitional Consortium

For more information please see the pdf document below:

Brighton and Hove Transitional CCG update May 2011 pdf

Brighton and Hove CCG Clinical Leads

admin — Wed, 06 Jun 2012 16:38:13 +0000

Brighton and Hove CCG Clinical Leads

Chair - Dr Xavier Nalletamby

Clinical Programme Lead, End of Life Care, Mental Health and Dementia – Dr Christa Beesley

Clinical Programme Lead, Planned Care and Medicines Management - Dr Tim McMinn

Clinical Programme Lead, Elderly Care - Dr Anne Miners

Clinical Programme Lead, Urgent Care – Dr Simon Hincks

Clinical Programme Lead, Planned Care and Medicines Management – Dr Nick Patton

Clinical Programme Lead, Long Term Conditions – Deirdre Prower

City wide IM&T Lead – Dr Darren Emilianus

Clinical Lead, Short Term Services - Dr Nazeer Khan

Clinical Lead, Demential and Mental Health - Dr Becky Jarvis

Clinical Lead, Maternity and Childcare - Dr Liz McCulloch

West

Locality Chair – Nicola Watts

Clinical Commissioning Champion - Steve Cribb

East

Locality Chair – Dr Christa Beesley

Clinical Commissioning Champion – Nina Graham

Central

Locality Chair – Dr Jim Graham

Clinical Commissioning Champions – Lindsay Coleman & Heather Dilks

News from the Clinical Commissioning Group

link reference with thanks:

http://www.brightonandhove.nhs.uk/ClinicalCommissioningGroupclinicalleads.asp

Preparation for commissioning picks up pace – Barbara Hakin

admin — Mon, 28 May 2012 02:13:40 +0000

16 May, 2012

The pace is picking up now in terms of establishing CCGs, with less than ten months left until the new system goes live in April 2013.

Across the country, groups of practices have been coming together and identifying the shape and configuration of their CCG. It is a fantastic achievement that these geographies are now sorted and we have emerging CCGs covering the whole of England coming forward for authorisation.

The reforms are based very firmly on three key principles; that patients in their communities should be at the heart of everything we do; that clinicians should be in the driving seat in shaping services; and that we should focus on outcomes based on sound evidence. CCGs are the cornerstone of delivering these aspirations. GP practices know their patients and largely serve specific communities with whom the practice has had a relationship for many years. They already act as the hub of care for their patients; linking patients with other clinicians and ensuring that, through the registered list and the single lifelong record, all the care patients receive is coordinated in one place. This model is envied around the world and is key to delivering better care, better experience, better outcomes and improved safety. So it is only logical that these practices should be at the heart of determining how the range of local services can best meet their patients’ needs.

But good commissioning is mainly about bringing together all those with expertise and an interest in care in order to arrange the services which can deliver these quality outcomes. So the responsibility on the CCG to involve patients and the public, and the full range of health and social care colleagues, is huge.

There is also lots going on to shape the rest of the commissioning system. This means putting in place all the elements of the NHS CB’s own architecture, the national support office, regional teams and local area teams. The NHS CB will be responsible for ensuring the whole commissioning system works well together and that the £80bn of taxpayers’ money is turned into the best possible outcomes for patients. It will support and oversee CCGs who will have the majority of this resource, as well as commissioning specialised services, primary care, prison and military health services, as well as many public health services on behalf of Public Health England.

Another key plank of the systems will be dedicated commissioning support units. While CCGs will be able to buy their support services from whoever they choose, we need to ensure they have the full range available to them from day one. Many independent and third sector organisations can offer fantastic niche commissioning support or highly sophisticated tools and products to aid commissioners. But the capacity and capability to deliver the full range of commissioning support sits with high experienced individuals currently in PCTs, and we must ensure this expertise is supported to deliver the best range of services from which CCGs can choose.

In the final analysis, our success will be predicated on whether healthcare services deliver better outcomes which meet local needs, whether these services deliver integrated care, and whether local communities feel they have a real voice in shaping services which suite them. The key vehicle in ensuring this happens will be the local health and wellbeing board. These vital structures are still in their early development but need to be the focal point for communities, bringing together patient and public representatives, alongside all the players who commission or provide care in the locality, in one place in order to ascertain the needs of the population and outline the overarching strategic plan on which individual components will be based.

There is still much to do in a relatively short space of time. But much is already in place, and we should be optimistic that this greater clinical and patient engagement will bring about the changes we need to see in order to keep improving the quality of care in this difficult economic environment.

GPs and their practices have been placed centre stage in this arena in a way we have never seen previously. CCGs will only be successful if the majority of practices seize this opportunity and make the CCG their own. Their leaders are already emerging, trusted to oversee much of the day to day aspects of clinical commissioning. But without the support of the majority of their practice colleagues their task will be too great. It is the action of all GPs and their practice teams through their connection with their patients, and all others who care for them, which will create a wealth of collective experience which will make the difference.

With thanks – link to original article below:

http://www.commissioningboard.nhs.uk/2012/05/16/preppicksup-bh/