4th September 2015
- NHS England reveals plans for a paperless health service
- Almost one in three CCGs consider rationing services, finds HSJ
- HSCIC data shows large variances in head and neck cancer survival rates
- A&E delays last winter caused by poor patient flow
- City regions agree to principle of devolution
NHS England reveals plans for a paperless health service
Tim Kelsey, National Director for Patients and Information at NHS England, has declared that “every patient needs a barcode” in an announcement this week at the NHS Innovation Expo of plans to develop a paper-free NHS. He has also written an HSJ article (subscription required) on why the NHS must go digital.
NHS England aims for the NHS to be paper-free at the point of care by 2020, and have announced that by April 2016 Clinical Commissioning Groups (CCGs) , working with local authorities and providers, must submit delivery plans for eradicating the use of paper across services.
Guidance has been produced for CCGs with a set of digital standards that providers must implement, including:
- From October 2015 all discharge summaries for acute or day care patients transferring from hospital to general practice care must be completed electronically, and will be expanded to include discharge to social care
- From 1 November 2015 CCGs and providers will be asked to complete self-assessments to benchmark their digital services, in order to build a digital maturity index, which will in future form part of the CQC inspection regime
NHS England highlights that evidence shows electronic prescribing systems halve the number of medication errors made by clinicians.
Pilots trialling health apps will also begin this month to promote self-management of health conditions. The initial focus will be on diabetes, before expanding into areas such as obesity prevention, maternity and early years health, smoking cessation, and chronic obstructive pulmonary disease (COPD).
NHS England will also investigate the potential to turn the whole NHS estate into a free Wi-Fi zone to enable patients to access their data in hospital and at the GP surgery.
Almost one in three CCGs consider rationing services, finds HSJ
According to research by the Health Service Journal (HSJ), around one in six CCGs report introducing or approving restrictions to certain services, and another one in six are considering doing so. Further details are available on their website but require a subscription.
Restrictions tend to focus on procedures considered to be of low clinical value.
Amanda Doyle of NHS Clinical Commissioners said that “The NHS does not have unlimited resources and it is right that clinical commissioners review their services to ensure they are providing the best possible care, balancing demand with supply for the benefit of their patients and local populations.”
The RCS released a report in 2014 illustrating the wide variation in surgical commissioning policies across the country, called ‘Is access to surgery a postcode lottery?’. This week Mr David Sanders and Mr Martin Kurzer from the British Hernia Society published a blog on our website entitled ‘Hernia surgery – limiting service provision puts patients at risk’.
HSCIC data shows large variances in head and neck cancer survival rates
New statistics released by the Health and Social Care Information Centre (HSCIC) National Head and Neck Cancer Audit reveal significant variation in the survival rates between the different types of head and neck cancers.
The four-year survival rate for patients with cancer of the larynx (voice box) was 60 per cent, whereas for those diagnosed with cancer of the hypopharynx (between the larynx and oesophagus) the survival rate was 33 per cent. The Audit emphasises the impact of early diagnosis, as for example, of patients diagnosed with larynx cancer at an early stage, 75 per cent survived at four years, as opposed to fewer than 50 per cent for those diagnosed at a later stage.
The rate of Human Papilloma Virus (HPV) testing across England and Wales is recorded for the first time in the Audit, and the figures find that of patients diagnosed with oropharynx cancer who had an HPV status test, 79 per cent had tested positive for HPV.
Audit lead clinician Mr Richard Wight said: “Referral to radiotherapy services is still highlighted as a problem with one in four patients waiting over a month and a half from diagnosis to start their treatment. We believe that audit provides an important tool in promoting standards of care for patients with head and neck cancer and has now become an excepted part of the routine workload of a head and neck multidisciplinary team.”
A&E delays last winter caused by poor patient flow
Following the increase in A&E delays last winter, to the highest levels in over 10 years, health regulator Monitor has conducted research to examine the reasons behind it.
From October to December 2014, only 88.8 per cent of A&E patients were seen within the four hour target, a drop from 93.5 per cent the previous year. Monitor contacted trusts with a major A&E department, and received responses from 96 per cent of them (123 trusts). They also conducted interviews with experts and visited trusts.
Based on these responses, Monitor concluded that the main reason behind the increase in A&E delays was high bed occupancy rates, preventing hospitals from admitting more patients. The report therefore recommends that efforts to improve patient flow are likely to be an effective way to prevent a similar A&E performance from taking place this winter.
City regions agree to principle of devolution
Following the agreement of regional devolution in Greater Manchester, and extended talks between the government and local authorities, major city areas including Liverpool, Leeds, Newcastle, Birmingham and Sheffield have responded positively to proposals from the Chancellor, George Osborne, for bids for new powers.
The arrangements include powers to install directly-elected mayors, and local authorities will now enter a period of negotiation over new funding agreements in advance of the government’s spending review due on 25th November.