24th July 2015
- NHS England recommends new standards for heart surgery
- Cancer Taskforce publishes strategy that could save 30,000 more lives per year
- Healthwatch highlights the importance of patients’ experience leaving hospital
- Government responds to petition calling for vote of no confidence in Jeremy Hunt
- Health Committee questions Simon Stevens and Sir Bruce Keogh on the future of the NHS
- NHS England announces eight new vanguard sites
NHS England recommends new standards for heart surgery
Details of the two-year review into standards for congenital heart surgery have been released, and proposals were considered by the NHS England Board this week.
The report states that not all heart units across England currently work in the way NHS England recommends, and hospitals undertaking low-volume practice should be stopped. Therefore the review recommends that surgeons work in teams of at least four, and there should be a minimum requirement of each team member performing at least 125 such operations per year.
The Royal College of Surgeons released a joint statement with the Society for Cardiothoracic Surgery in support of the standards for fetal, paediatric and adult congenital heart disease care. The organisations stated that “units must be large enough to ensure that the teams are exposed to all conditions in sufficient volume to maintain experience and expertise”, and agreed that the new standards will help to ensure consistent and high quality levels of care.
Cancer Taskforce publishes strategy that could save 30,000 more lives per year
The Independent Cancer Taskforce report, A Strategy for England 2015-20 was published this week, and set out a plan to ‘radically’ improve outcomes for cancer patients.
NHS England established the Taskforce in January to develop a five-year strategy for cancer services. Dr Harpal Kumar, Chief Executive of Cancer Research UK chaired the group and the Royal College of Surgeons was represented by Council member Mr Shafi Ahmed.
The report makes a number of recommendations for improving cancer care , including changes to cancer surgery commissioning, public health prevention, building better relationships between patients and healthcare professionals, clinical trials and research, and transforming the workforce.
Particular recommendations of surgical interest include:
- The Royal College of Surgeons of England and of Edinburgh should work with CRGs, NCIN, CQC and CRUK to define key quality metrics for each cancer surgery sub-speciality by 2016.
- CRGs should regularly evaluate emerging evidence to determine whether service reconfiguration for surgery merits further centralisation
- All commissioners should commission to NICE guidelines and CRG-approved service specifications
- Cancer surgery where national volumes are between 2,500 and 7,500 per year should be commissioned by a lead CCG commissioner for populations of 1-2 million or more.
- Breast and colorectal cancer surgery should be commissioned at CCG level.
- NCIN should evaluate the impact on cancer outcomes of patients living long distances from a cancer centre.
The Taskforce predicts that an additional 30,000 patients per year will survive cancer for 10 years or more by 2020 if the recommendations are implemented.
The report was welcomed by Simon Stevens, who called the strategy a “groundbreaking route map for prevention, earlier diagnosis, modern treatments, and compassionate care”.
Healthwatch highlights the importance of patients’ experience leaving hospital
A Healthwatch report focusing on what happens when patients return home from hospital has found that many patients feel let down by the health service at the point of leaving hospital.- Delays in hospital discharge and a lack of effective coordination between different services
- Inconsistencies in access to required services and support after discharge
- Stigma, discrimination, and a lack of respect in the way people were treated due to their conditions
- Lack of patient involvement in decisions about their care
- Full range of people’s needs is not considered
Healthwatch emphasise that a failure in properly caring for people as they transition from hospital to home contributes to high costs associated with readmissions. This chimes with findings from a Royal College of Surgeons survey conducted in 2014.
Government responds to petition calling for vote of no confidence in Jeremy Hunt
Over 185,000 people have signed a petition calling for a vote of no confidence in Parliament for the Health Secretary following last week’s announcement of consultant contracts reform to provide seven-day NHS services. Jeremy Hunt’s ultimatum to the BMA to negotiate over seven-day NHS care prompted significant media coverage and a social media campaign by NHS doctors over the weekend.
Dr Ash Sadighi launched the petition on Tuesday, which reads; “Jeremy Hunt has alienated the entire workforce of the NHS by threatening to impose a harsh contract and conditions on first consultants and soon the rest of the NHS staff”.
The Government responded that the aim of the contract reform is to reduce excess weekend mortality rates in hospitals. The response also said that the new contracts will have limits on the number of weekends consultants can work per year, and there will be arrangements for pay incentives for the highest performing individuals.
As the petition has surpassed 100,000 signatures, it will be debated in the House of Commons.
Health Committee questions Simon Stevens and Sir Bruce Keogh on the future of the NHS
This week the Commons Health Select Committee met for the first time since the election, giving new members a chance to seek answers from NHS leaders on the future of services.
Simon Stevens, Chief Executive of NHS England, Sir Bruce Keogh, National Medical Director, and Jane Cummings, Chief Nursing Officer, gave evidence on a wide range of issues including future funding of NHS services and efficiency savings, the case for seven-day care, staffing, patient safety, and health and social care integration.
When discussing efficiencies, Sir Bruce noted the Royal College of Surgeons’ findings on the use of value-seeking clinical treatments, as well as the need to create leaner specialist units, and to tackle overuse of treatment. He also stressed that in order to reduce costs, seven-day care should first focus on emergency care, instead of looking initially at the whole system He announced that new research containing evidence that confirms higher mortality rates at weekends will be published soon.
New Committee member and SNP Health Spokesperson, Dr Philippa Whitford MP, a consultant breast surgeon, highlighted her experience in Scotland of reviewing patient safety in surgery. She said that by creating a culture of candour and encouraging open communication among staff and patients within surgical teams, patient safety and experience had improved. In response, Sir Bruce noted an upcoming summit of healthcare regulators in September which will aim to make speaking up advantageous for staff.
NHS England announces eight new vanguard sites
NHS England has announced the eight new emergency and urgent care vanguard sites that aim to deliver a more joined-up approach to tackling emergency and urgent care capacity.
Emergency and urgent care will be provided by hospitals, GPs, pharmacists, community teams, ambulance services, NHS 111, social care and others, along with a drive for patient education to enable individuals to manage their own conditions.
Each new vanguard will work around a unique local service focus, and will vary in the size and demographic of the populations they are serving.
Vanguards with secondary care focuses of interest include:
- Cambridgeshire and Peterborough CCG will form a ‘super SRG’ with a focus on reducing variability and providing seven-day care
- North East Urgent Care Network will cover the whole North East region, and will focus on reducing fragmentation and improving consistency in clinical standards
- West Yorkshire Urgent Emergency Care Network will include in their priorities the creation of an Integrated West Yorkshire Care Record with a real-time patient information dashboard
- Leicester, Leicestershire and Rutland SRG will re-launch the University of Leicester Hospital NHS Trust urgent and emergency care front door service with a designated assessment team
- Solihull Together for Better Lives will focus on rapid access to specialist care
NHS England Director of Acute Care Professor Keith Willett commented on Radio 4’s Today programme that the overall aim of the vanguards is to find effective ways of stopping hospitals from being inappropriately used.