Showing posts with label Jeremy Hunt. Show all posts
Showing posts with label Jeremy Hunt. Show all posts

Friday 15 November 2013

GPs take on extra role for frailest patients

GPs take on extra role for frailest patients

By Nick TriggleHealth correspondent, BBC News
Jeremy Hunt said he hoped this would be part of a "much bigger change"

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The 100,000 most frail patients in England will be identified and given a named GP to co-ordinate their care.
The move has been agreed by the British Medical Association and NHS England in talks over next year's GP contract.
Ministers had been pushing for doctors to take greater responsibility for the most vulnerable patients in society to relieve pressure on hospitals.
An analysis by NHS England showed many of the winter pressures on A&E came from frail elderly patients.
Contrary to common perception, it found that summer was the busiest time for A&E units in terms of numbers, but winter was when the difficulties arose because of the rise in the numbers of elderly patients needing care.
A third of emergency admissions are among the over-75s - many of which could be avoided if they received earlier and better care in the community.
This is where the agreement with GPs - which will kick in next April - will help, ministers say.
'Old-fashioned' approach
Under the terms of the deal, doctors have agreed to carry out a trawl of their registers to identify the frailest 2% of patients.
Dr Richard Vautrey from the BMA: "This will mean GPs will spend less time focusing on box ticking... and more time on the needs of their patients"
This is likely to include people at the end of life, in care homes and those who are frequently in and out of hospital.
They will then take responsibility for overseeing their care across the NHS and social care sectors.

“Start Quote

This will free up GPs to spend more time focusing on treating patients”
Dr Chaand NagpaulBritish Medical Associaton
The aim is to create a much more proactive services whereby their needs - from home adaptations to intensive nursing support - are met much more quickly.
They will also need to offer these patients same-day telephone consultations as well as checking up on them after discharge from hospital.
This contrasts with what the government and doctors' leaders agree is the more reactive service many patients are currently getting.
A further four million people over the age of 75 will be given a named GP - at the moment patients are registered to a practice rather than individual doctor. It is hoped this will lead to greater continuity of care for those patients who visit GPs the most.
'Phone frustration'
Health Secretary Jeremy Hunt hailed as the return of the "old-fashioned family doctor" and an end to the current "box-ticking" culture.
"We are bringing back the named GPs for the vulnerable elderly. This means proper family doctors able to focus on giving elderly people the care they need and prevent unnecessary trips to hospital."

GP FUNDING

GP practices are small businesses - and contracts are held by the practice, rather than individual GPs.
Funding comes from a number of different sources and is weighted so a practice with, say, lots of elderly people on its books will receive more than one which looks after a relatively young and healthy population.
The main source of income, accounting for around half the funding a practice receives, is the 'global sum'. This is a payment based on the estimated workload from the patients registered.
Next comes QOF - the Quality and Outcomes Framework which is at the centre of these latest contract changes.
This is in effect a points system where practices accumulate a score from meeting requirements such as monitoring how many of their patients have a certain condition or ensuring checks such as blood pressure readings are carried out on a regular basis.
These contract changes would cut QOF - and move funding of around £290m into the global pot.
Other funding streams include extras services such as flu and childhood jabs, which are not part of the contract but which most offer, are funded separately.
Seniority payments for long-serving GPs, and funding for premises make up the rest of a practice's income.
Out of this pot, a practice has to pay staff costs and other bills - as well as GPs' pay.
Those GPs who have responsibilities for practice management earned on average across the UK £103,000 in 2011/12.
Salaried GPs, who do not, could this year earn a maximum of £81,969.
In return, doctors have been freed from what they considered some of the most burdensome aspects of the form-filling they had to do for their performance-related pay.
This means requirements such as having to annually ask men with diabetes if they experienced erectile dysfunction at their check-ups will be removed, as will the need to ask those with high blood pressure in detail about their activity levels, with what doctors say were often irrelevant questions.
But Labour's Shadow Health Secretary Andy Burnham told BBC Radio 4's Today programme: "The bottom line is under this government, it has got harder to get a GP appointment. And nothing in today's announcement will correct that.
"People will still face the frustration of phoning the surgery at nine o'clock in the morning, being told there's nothing available for days and then some having to turn to A & E."
He added: "David Cameron cut Labour's scheme of evening and weekend opening and the guarantee of seeing a doctor within 48 hours," Mr Burnham added.
"This announcement will not put an end to patients phoning the surgery at 9am and finding it impossible to get an appointment - many of whom, not happy with a phone consultation, will still turn to A&E.
"People will fail to see how this package delivers the public commitment David Cameron gave last month to keep GP surgeries open from 8am to 8pm."
Dr Richard Vautrey of the British Medical Association's GPs committee, told the BBC: "It will help to a degree. It certainly won't be a panacea but it will start to focus on the needs of the most vulnerable and those patients who do go into hospital more frequently.
"And it will give GPs that bit more time to be able to spend with their patients to try and meet their needs."

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Friday 8 March 2013

Jeremy Hunt attacks 'complacent' hospitals


Jeremy Hunt attacks 'complacent' hospitals

By Nick Triggle

Health correspondent,
Mr Hunt said his words were aimed at the bulk of hospitals that were not excellent and not poor

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nursesToo many hospitals are coasting along, settling for meeting minimum standards, according to the health secretary.
In a speech on Friday, Jeremy Hunt will attack a culture of "complacency" and "low aspirations", which he believes is holding the NHS in England back.
He is expected to say while there is a concerted effort to tackle failing hospitals, there should also be a focus on "mediocrity".
Labour's Andy Burnham blamed ministers for the failings in front line care.
Mr Hunt's comments come a month after the problems at Stafford Hospital were laid bare.
The final report of the public inquiry into the scandal, published at the start of February, attacked the way the system protected corporate self-interest rather than putting patients first.
The warnings have already led to investigations into 14 hospital trusts with high death rates.
But Mr Hunt, in a speech to the Nuffield Trust think-tank in Dorking, Surrey, will say part of the challenge is tackling "mediocrity and low expectations before they turn into failure and tragedy".

So how many hospitals are mediocre?

The health secretary will make it clear in his speech that he is not saying the vast majority are mediocre, but according to sources his words are aimed at a significant bulk of those plodding along in the middle.
It is commonly said about a 10th of hospital trusts are failing, although double that are actually not meeting all the essential standards set out by the Care Quality Commission.
That leaves about 80% of trusts that are doing what they should. Some of these will be excellent - perhaps about 10-15% - and some will be striving to become excellent - perhaps a similar number. That leaves close to half that could be said to be stuck in the middle, coasting along.
'Complacency'
"Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then suddenly something gives," he will say.
"I would never describe the majority of hospitals or wards in the NHS as mediocre - but I do believe our system fails to challenge low aspirations in too many parts of the system.
"Imagine for a moment that the main objective for our Olympic athletes was not to win but to 'not come last'. How many gold medals would we have won then?
"It sounds ridiculous doesn't it? But today I want to suggest that too much of the NHS is focused on doing just that.
"Not on achieving world class levels of excellence - the gold medals of healthcare - but meeting minimum standards, the equivalent of 'not coming last'."
Sources said Mr Hunt's words were aimed not at those that are failing minimum standards or waiting time targets, but the bulk in the middle that were not excellent and not poor.
Family test
He is expected to single out Walsall Manor, a hospital in the West Midlands, which has turned itself around after faring badly in the national patients' survey two years ago. The hospital decided to carry out one-to-one interviews with 100 patients to find out what they thought of their care and the staff that looked after them.
On the Today programme, Richard Kirby, chief executive of Walsall NHS Healthcare Trust, said this led to investment in specific areas flagged up by patients and a better understanding of what patients want. The Trust has also introduced a friends and family test.
"Every patient who is admitted to our hospital is asked when leaving if they would recommend us to friends and family and scores are shared with all of our teams week in, week out.
Jo Webber from the NHS Confederation: ''People come to do the best they possibly can for patients''
"We get critical and positive responses. It gives us a simple, clear way of understanding how we are doing."
Katherine Murphy, of the Patients Association, said the health secretary was right to draw attention to the issue.
"There is a malaise in the NHS which has allowed mediocrity to become commonplace," she said.
"We hear from patients every day who are not happy with their care. I am not talking about the really bad, just those that are not putting patients first."
Investment
But shadow health secretary Mr Burnham said it was "no good for ministers to blame hospitals and staff when it is they who have thrown the whole system into chaos with a huge re-organisation, which has siphoned £3bn out of front line care.
Shadow Health Secretary Andy Burnham: "Coasting is the last thing hospitals are doing - they are working flat out."
"Hospitals across England are on a knife-edge and they need a government that provides support rather than points the finger," he said.
Royal College of Nursing director general Peter Carter said: "From one perspective I absolutely agree with him, of course we don't want mediocrity.
"But to make sure that does not happen we need to invest in staff. When we won one gold medal in the 1996 Olympics we started investing in our athletes, rowers and cyclists.
"To achieve gold medal standards in the NHS we need to do the same. It requires proper leadership, time to train and appropriate pay."
Mike Farrar, chief executive of the NHS Confederation, said there was room for improvement, adding hospitals needed to be more open and transparent.
"I believe that there is a crucial opportunity to make this culture change happen. We cannot miss this chance to deliver better care."
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Wednesday 20 February 2013

Jeremy Hunt


Jeremy Hunt warns NHS trusts over 'defensive culture'

Gary WalkerGary Walker broke an NHS gagging clause when he spoke to the BBC

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Health Secretary Jeremy Hunt has warned NHS bosses against allowing a culture that is "legalistic and defensive" in dealing with staff who raise concerns over patient care.
In a letter to all English NHS trusts, Mr Hunt highlighted fears that "gagging" clauses were being used to "frustrate" such whistleblowing.
A climate of "openness and transparency" is essential, he said.
It comes after one former NHS trust boss broke a gag to talk to the BBC.
Gary Walker, former chief executive of United Lincolnshire Hospitals Trust (ULHT), said he had been forced out of his job and gagged from speaking out about his concerns over patient safety.
'Positive move'

Analysis

Andrew HoskenBBC Today programme
The row over secret gagging clauses has focused attention on the man at the top of the English NHS, Sir David Nicholson.
His position was already being questioned in the wake of a highly critical report on the Mid Staffordshire Hospitals scandal, where hundreds of patients may have died from neglect and abuse.
However Sir David escaped personal censure from inquiry chairman, Robert Francis QC.
Following the report, another 14 NHS trusts have been placed under investigation.
What makes the gagging row potentially so toxic for Sir David is one of those trusts, the United Lincolnshire Hospitals Trust, has been trying to enforce Gary Walker's gagging clauses with the threat of legal action.
Since Mr Walker broke cover, more people are asking whether Sir David and other senior NHS civil servants can bring about the cultural change and openness Jeremy Hunt and many others consider essential.
In his letter, Mr Hunt called for the NHS to "recognise and celebrate" staff who had "the courage and professional integrity to raise concerns over care".
The health secretary insisted that "fostering a culture of openness and transparency" was essential in creating a climate "where it is easy for staff, present and former, to come forward with any concerns they have relating to patient safety".
Mr Hunt also warned NHS bosses against the "institutional self-defence that prevents honest acknowledgement of failure".
"I would ask you to pay very serious heed to the warning from Mid Staffordshire that a culture which is legalistic and defensive in responding to reasonable challenges and concerns can all too easily permit the persistence of poor and unacceptable care," he said.
Mr Walker, who was sacked in 2010 for gross professional misconduct for allegedly swearing in a meeting, told the BBC he had no choice but to sign an agreement linked to a confidentiality clause in April 2011.
He said he was gagged by the NHS from speaking out about his dismissal and his concerns over the quality of care at the trust.
After breaking the order, lawyers for the trust then warned him he would have to repay £500,000.
Speaking to BBC Radio 4's Today programme on Saturday, Mr Walker applauded Mr Hunt for "clearly taking a personal interest" in his case and the issue of gagging orders.
"I think that's a very positive move."
"I don't think it's simply about the Lincolnshire Trust," he added, calling for Mr Hunt to investigate the "chain of command" that led to the gagging, which he said included the Department of Health, the East Midlands Strategic Health Authority (SHA) and the Lincolnshire Trust.
"I don't think Mr Hunt can investigate his own department so I think he should be looking for someone exceptionally independent from all of this."
'Suppressed and bullied'
BBC Radio 4 Today programme reporter Andy Hosken said Mr Hunt's letter could spell the end of the National Health Service gag if the NHS trusts' chairmen to whom he wrote actually followed the advice and guidance contained within the letter.
Our correspondent said the letter was certainly a warning shot across the bows of the trusts. It appeared the use of these gagging clauses was widespread in the NHS, he added.
Meanwhile, Dr Phil Hammond, chief medical correspondent at Private Eye magazine joined calls for NHS chief executive Sir David Nicholson to stand down.
He told BBC News: "We need to change the culture, we have to change the people at the top. David Nicholson has to go and that's the one constructive thing that Jeremy Hunt could do.
"Unless you have accountability at the top, you won't get it at the bottom."
Health Minister Lord Howe: "It is the right and the duty of any NHS employee to raise concerns"
A spokesman for the East Midlands SHA said it had always acted "appropriately and properly" in the "interest of patients".
And ULHT has said the allegations that they had tried to stifle debate about patient safety issues were "incorrect".
ULHT is one of 14 trusts in England currently being investigated for high death rates, in the wake of the Stafford hospital scandal, where hundreds are believed to have died after receiving poor care.
It emerged on Friday that police and prosecutors are now studying a damning report into failures at Stafford to see whether any criminal charges should be brought against staff.

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