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NHS

Kailash Chand: Statins

18 Feb, 14 | by jaislabie

Kailash ChandNew draft guidance issued by the National Institute for Health and Care Excellence (NICE) for public consultation recommends that the threshold for starting treatment to prevent cardiovascular disease should be halved from a 20% risk of developing cardiovascular disease over 10 years to a 10% risk. The guideline is being updated to allow for a consideration of new evidence on cardiovascular disease risk assessment tools, and to reflect changes in the price and availability of generic statins. more…

Martin Carroll: Thinking of working in the NHS?

17 Feb, 14 | by BMJ

martin_carrollIn 2013, the National Health Service (NHS) celebrated 65 years of providing comprehensive healthcare, free at the point of delivery to UK citizens. There are a number of factors contributing to the success and longevity of the NHS, including the dedication of its workforce. The role of doctors and nurses from overseas should not be underestimated. In a recent poll by the think tank British Future 75% of respondents believed that the NHS would not have survived without the work of doctors and nurses coming from abroad. more…

Anna Allan on applying to core training

14 Feb, 14 | by BMJ

Alongside thousands of other trainees, over the past months I have been partaking in the core training application rigmarole. And it is exhausting. For example the process of compiling a portfolio of academic self worth for a 10 minute flick through, is simultaneously self assuring and depressing. The need for a quick and effective selection method nationally results in a nameless, faceless application process that may as well do away with the candidates entirely. Meeting face-to-face is a mere formality, and the questions asked seemingly as indiscriminate as the black folders clutched by hopeful applicants. more…

Martin Caldwell: My concerns about care.data

13 Feb, 14 | by BMJ

Over 212,000 people have signed a SumOfUs.org petition calling on the government and NHS England to think again about selling access to our personal medical information to private companies.

Our members are very worried about the government’s proposed collection and sale of patient data held by GPs. They are deeply concerned about who will have access to the data, about others seeking to make money from their medical histories, and about protecting their privacy. more…

John Appleby: Care.data—your bits in their hands

13 Feb, 14 | by BMJ

Over the past few months there has been considerable debate and argument about plans by the NHS to collect and centrally collate details of individual patient records from general practice for the first time. Many have expressed worries about the care.data initiative and how potentially sensitive patient information will be used, who will have access to it (and for what reasons), and not least its security. Such fears are perhaps not just hypothetical given past examples of lost patient notes and what appear to be the misuse of sensitive patient information (even for the best of intentions). more…

Clare Gerada: Why care.data will be transformational to the NHS

12 Feb, 14 | by BMJ

clare_geradaIf I learnt anything about myself while being chair of Royal College of General Practitioners, it’s that I am not one to shy away from giving opinions that are out with the views of “establishment.” But even for me, it’s strange to find myself arguing against many of those whom I admire in the health field. But on balance, I believe that those who are arguing so vocally against care.data either have not declared their conflicts of interest, or have not read the guidance, or do not understand what is being proposed (conflating the summery record with care.data)—or quite simply (and I can understand this) mistrust any reassurances offered from on high (after all, were we not offered “no top down reorganisation?” But that’s another story). more…

David Lock: Do CCGs have the power to pay out for past PCT NHS continuing care errors?

11 Feb, 14 | by BMJ

The NHS has paid out vast amounts—probably hundreds of millions of pounds—in recent years as a result of decisions that patients were not entitled to NHS Continuing Care (where the NHS meets the costs of a package of social care and accommodation outside a hospital).  Mostly these are claims by relatives of deceased patients who objected to paying nursing home fees for elderly patients who were classified as “social care” rather than being eligible for NHS Continuing Care.

Several attempts have been made by the NHS to stop new claims, but these have not been too successful because the claims, based on alleged maladministration, continue. The “liabilities” associated with NHS Continuing Care claims were supposedly transferred from primary care trusts (PCTs) to clinical commissioning groups (CCGs) in the “transfer orders,” which transferred assets and liabilities from PCTs to CCGs. The intention was that CCGs should pay out for past NHS Continuing Care errors made by the PCTs. more…

Richard Smith: Will digitisation transform the NHS as it has much else?

10 Feb, 14 | by BMJ

Richard SmithDigitisation of the NHS will both save and improve it believe Jeremy Hunt, secretary of state for health, and Tim Kelsey, national director for patients and information at NHS England. Both were youthful, bubbly, and even charming as they did a double act last week at the Cambridge Health Network, although Kelsey had to perform alone for an hour while Hunt was stuck in traffic courtesy of the tube strike.

When he finally arrived Hunt began by saying, “This has been a tough year for the NHS.” Increasing transparency is surfacing problems in the NHS. What he found most disturbing about the patient abuse at Mid Staffs was that “people in the system” had known that something was wrong for about five years before action was finally taken.

Fresh from university in 1991 Hunt started a business exporting marmalade to Japan. It was not a success: he managed to export only half a container load. If it had been a success, he joked, I wouldn’t be here now. He evoked 1991 because it was just the beginning of the internet revolution, and we had no idea how it would change our lives—how, for example, we would be able to email anybody, anywhere, at any time, and how we could do free video calls to anywhere in the world. He and Kelsey believe that the NHS still has to experience the same revolution, but that it will come. more…

Elin Jones: Recruiting an additional 1000 doctors for Wales

10 Feb, 14 | by BMJ

In recent years the problems of appropriately staffing the NHS throughout all four nations have become more widely known, whether it is the impending timebomb of GP retirement, the problems highlighted by the Francis report in relation to safe staffing, or the challenges posed by the European Working Time Directive and stricter immigration controls. In Wales, the Longley report of 2012 [1] highlights the future recruitment challenges we face, particularly with regards to GPs in rural areas and the South Wales Valleys. Against this backdrop, demands being placed upon the NHS are increasing due to demographic changes and higher prevalence of chronic conditions. If we are not careful, this combination of ever fewer staff facing ever increasing demands will threaten the sustainability of the NHS. more…

Catherine Foot: Can the Care Quality Commission live up to expectations?

7 Feb, 14 | by BMJ

catherine_footThis week marks one year since Robert Francis published his second report into failures of care at Mid Staffordshire Foundation Trust.

Mid Staffs director of quality and patient experience, Julie Hendry, gave a moving presentation at a conference at the King’s Fund in November summarising the journey that the trust have been on since 2009, and the progress they have made and continue to make.

But what developments have there been more broadly across the system? more…

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