News / News review October 2015

It may have been a gift story for the tabloids, but NHS England chief executive Simon Stevens’ announcement that NHS staff would be offered Zumba classes did not provoke an avalanche of antipathy or mirth. Perhaps the cost of sickness absence to the NHS, estimated at £2.4bn a year by Public Health England, made them view the story in a more serious light. Mr Stevens’ initiative, announced at the beginning of September, will see a £5m programme that will encourage physical activity, promote initiatives to reduce stress and urge hospital food outlets to serve healthier fare. There will also be checks for the two biggest causes of sickness absence – mental health and musculoskeletal problems.

Sickness absences have to be covered, often using agency staff, and new rules to reduce nursing agency spending were introduced last month. However, trusts believe the government could help further. NHS Employers said current immigration rules are compromising patient safety and cost controls, leaving a shortage of doctors and nurses at a critical time. It said many non-EU nurses were waiting for immigration certificates to take up nursing posts in UK hospitals. The body wrote to home secretary Theresa May to raise the concerns of its members and to call for nursing to be added to the shortage occupation list. This would make it easier for hospitals to recruit overseas staff.

An analysis of 2013/14 hospital data pointed to a ‘weekend effect’ leading to 11,000 deaths a year. Health secretary Jeremy Hunt (left)had put the figure at 6,000 deaths, based on a 2012 study. The latest study, in the British Medical Journal, suggested patients were 10% more likely to die if admitted to hospital on Saturday compared with Wednesday. The authors included NHS England national medical director Bruce Keogh, who said the case for reorganising services around seven-day operation was ‘unassailable’.

To move to seven-day operation, employers think clinicians’ contracts must be renegotiated. The government has committed to introducing new contracts for new consultants from April 2016, with existing consultants moving to the new contract by 2017. The new junior doctors’ contract will start from the August 2016 intake. But British Medical Association junior doctor representatives have decided not to re-enter negotiations with employers and the government now faces the prospect of imposing the new contract on juniors. Meanwhile, consultant colleagues in England and Northern Ireland did re-enter talks after pulling out over concerns about safeguards on long hours and a lack of reliable data on which to base changes to consultants’ contracts. They said the government had addressed the issues. Consultants in Wales were to decide on whether to re-join the talks. The Welsh government has indicated it will retain the existing junior doctors’ contract.

Monitor took regulatory action in September, most notably placing Cambridge University Hospitals NHS Foundation Trust into special measures. The move followed an investigation into the trust’s finances and governance. The trust is predicting a deficit of at least £64m this year due to an average overspend of £1.2m a week. It also underestimated the scale and challenge of implementing its new electronic patient record system. Chief executive Keith McNeil and chief finance officer Paul James stepped down before the regulator made the move. The trust pointed to its good record on patient safety and clinical outcomes, and would take rapid action to tackle the concerns.

Monitor deferred the Royal Liverpool and Broadgreen University Hospitals NHS Trust application for foundation status for 12 months. While it had shown improvements in the way it manages care, its financial planning needed further work. Monitor also opened an investigation into the finances of the Black Country Partnership NHS Foundation Trust. The regulator said the trust has recorded a larger than planned deficit and is predicting a continued deterioration in its finances.

There was more positive news for Bolton NHS Foundation Trust, where Monitor ended its formal action after the trust improved its financial management and planning. The regulator said the financial improvements built on the trust’s progress in how it is run, board effectiveness and management of the quality of patient care. It also removed Tameside Hospital NHS Foundation Trust from special measures after it agreed to work with partners to ensure it becomes clinically and financially sustainable. Monitor’s contingency planning team recommended a model for integrating health and social care in the area to improve quality for patients and the trust’s financial position.

Though Barnsley Hospital NHS FT remains subject to regulatory action on financial grounds, Monitor removed a condition on the trust’s licence introduced following concerns over the effectiveness of its board and senior management team. The regulator added the trust had developed a credible recovery plan and now needed to deliver its financial plans for 2015/16.

Following Jeremy Corbyn’s election as the new Labour leader, Heidi Alexander (left) became shadow health secretary, with Luciana Berger shadow minister for mental health. Other shadow ministers include Barbara Keeley (older people, social care and carers), Andrew Gwynne (public health) and Philip Hunt (Lords spokesperson).

The third NHS Atlas of variation in healthcare was published, highlighting opportunities to address ‘unwarranted’ variation. Public Health England said there could be variations in quality, safety, equity, outcomes, money spent and types of service used. It hoped the new atlas would help commissioners, service providers and health professionals deliver the best healthcare.

Welsh GP practices in danger of closing in the next 12 months can apply to their local health board for support, the Welsh government said. The support will include financial and other back office functions, as well as additional management and workload help.

NHS Scotland is to pilot a reform of the role of general practice. First minister Nicola Sturgeon said over the next two years 10 health centres would form community health teams to test different ways of delivering healthcare. These include surgeries working together for faster appointments; GPs and other health professionals working in multidisciplinary teams; and health centres offering treatments currently provided in hospital.

Clinical commissioning groups must be transparent about the decisions they make to give the public confidence that potential conflicts of interest are well managed, the National Audit Office said. A report, Managing conflicts of interest in NHS clinical commissioning groups, said NHS England must be satisfied it has sufficient and timely information to assure itself that CCGs are managing conflicts promptly and effectively.